GENERAL DENTISTRY

Amalgam Fillings

 

Dental amalgam is the traditional silver-coloured filling we are all familiar with. Although there is mercury in dental amalgam, once it is combined with the other materials in the amalgam filling its chemical nature is changed rendering it harmless. Research into the safety of dental amalgam has been carried out for over a century and to date, no trustworthy controlled studies have found a connection between amalgam fillings and any medical problem.
 

Whilst composite (tooth coloured) fillings are becoming more popular, amalgam fillings represent the most durable and long-lasting form of filling available. (Apart from gold fillings which are more expensive.)

Amalgam fillings are the only type of filling provided through the NHS – composite fillings are considered to be ‘cosmetic’ and therefore must be paid for.

Life Benefits

  • Least expensive form of filling

  • Strong and durable

  • Quick to apply

  • Last for many years

 

Bridges

What are bridges made of?

Bridges are usually made of a precious metal. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base for strength.

 

Are bridges expensive?

Although a bridge may seem costly they can be a wise investment that will give many years of good service. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it's similar to ordering a piece of hand-made jewellery.

How do I look after my bridge?

You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.

Here is how they work:

  1. Bridges are usually made of a precious metal base, which gives them a solid structure and makes them hard-wearing. If you need a bridge in your smile line, porcelain is usually added to the base to make it look more like real teeth.

  2. A bridge helps to strengthen the prepared teeth and makes chewing and eating easier because they are fixed and can't come out.

  3. Some bridges can also be fixed to your jaw with dental implants, if you have several teeth next to each other that are missing.

Life Benefits

  • A sturdy way to restore several teeth in a row.

  • Beautiful, natural-looking restoration.

  • Restores the ability to chew and eat as before.

 

Crowns

What is a crown?

A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.

Crowns are used for several reasons:

  • as a protective cover for badly decayed teeth or fractured teeth

  • as a permanent restoration for teeth with large fillings

  • to correct minor problems in natural teeth like spacing and irregular shape or severe discolouration.

What are crowns made from?

Crowns can be made from a variety of materials. They can be made from plastic, ceramic or metal alloys. A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.

How are crowns made?

Firstly, a thorough clinical examination is conducted with radiographs, by the dentist. The suitability for crowns is assessed and any preparatory work is carried out. Your dentist will also be able to advise on material choices, treatment sequence and any other concerns you may have.

At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.

At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.

 

How long do crowns last and how do I care for them?

Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.

Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.

Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.

Here is how it works:

  1. An impression is taken of the tooth that needs restoring.

  2. A crown is made in the dental laboratory to fit the tooth precisely and match the neighbouring teeth.

  3. The tooth is then prepared and the crown fitted securely on top.

Life Benefits

  • Strengthens remaining tooth structure.

  • Natural-looking restoration.

  • Functions like a real tooth, so you can bite and chew as usual.

 

Dentures

What are dentures?

A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.

How long does it take to make dentures?

Depending on the complexity of each case, the duration of the treatment will vary. After the initial visit of examination and diagnosis, the subsequent visits will include taking impressions of the mouth, bite registration, try-in of the denture, fitting and review.

What to expect?

New dentures always feel strange when first placed in your mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies with different persons and often time and experience are essential before dentures can be worn comfortably and function effectively.

Here is how it works:

  1. A denture is made from hard-wearing material that mimics the look of teeth and gums to give your mouth a natural appearance.

  2. After impressions are taken, a denture is designed in a dental laboratory.

  3. Dentures are made to fit snugly on your gums and you will be able to remove them for cleaning.

Life Benefits

  • A solution to replacing several missing teeth.

  • Designed to give you a natural-looking smile.

 

Root Canal Therapy

When Is Root Canal Treatment Needed?


The crown of the tooth is made up of the hard, white, enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves within and extends from the crown to the tips of the root or roots.

Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. The pulp can be infected or inflamed due to either deep decay or an extensive restoration that involves the pulp, cracked or fractured tooth due to trauma, excessive wear of enamel and dentine exposing the pulp, and sometimes as a result of severe gum disease.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth. On the other hand, there may be no symptoms at all. If pulp inflammation or infection is left untreated, it can eventually cause pain, swelling and loss of the supporting bone.




What Are The Advantages Of Root Canal Treatment?


Root canal treatment saves teeth that would otherwise have been extracted.

After root canal treatment the tooth is pulp-less i.e. it has no vital tissues within. However, there are vital tissues surrounding the root e.g. the gum, periodontal membrane and supporting bone. A root canal treated tooth can function normally and can be maintained with routine dental care and oral hygiene measures.




Is Root Canal Treatment Painful?


Root canal treatment procedures are relatively comfortable and often painless as the tooth is anaesthetised during treatment. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking mild analgesics or painkillers available over the counter at the pharmacy. However, if the pain persists and is severe, or a swelling occurs, you should contact your dentist.




How Is Root Canal Treatment Carried Out?


Removal of the infected or inflamed pulp is the first step in saving the tooth. Under local anaesthetic an opening is made in the crown of the tooth to get access to the infected or inflamed pulp within.
Using small, specially designed hand or rotary files, the root canals are cleaned and shaped to a form that can be sealed. Debris within the canals is removed by flushing with an anti-bacterial solution.
The canals are finally filled or sealed with an inert material called gutta-percha. The tooth should be restored to full shape and function by either a permanent filling or a crown, depending on how much of the tooth is left. This should be done as soon as possible as there could be a risk of tooth fracture due to biting forces.

All root canal treatment procedures are performed by isolating the tooth with a rubber dam to provide a clean and saliva-free environment. Root canal treatment may be done in single or multiple visits depending on the complexity of the tooth. In between treatment appointments, medicaments may be placed within the canals and the tooth is covered with a temporary filling.

Often, X-rays are taken to determine the length of the root and to monitor the various treatment stages.




Care Of The Root-Treated Tooth


As far as possible, avoid chewing or biting on the tooth being treated until you have it permanently restored with either a filling or a crown. Excessive pressure at this stage may crack or fracture the tooth. Therefore, it is very important to restore the tooth properly as soon as possible. Most endodontically treated teeth last as long as natural teeth following permanent restoration.

Practise good oral hygiene, including brushing and flossing at all times, as root-filled teeth are as prone to decay as natural teeth. It is also important to have your treated tooth reviewed regularly by your dentist.





Life Benefits

  • Preservation of remaining healthy tooth structure.

  • Prevention of infection spreading any further.

  • Restoration of tooth to its natural look and feel.

 

Dental Implants

What are Dental Implants?

Implants are one way of replacing missing teeth. A post is planted in the jaw bone to support a replacement tooth. This acts like the root of a natural tooth. Implants can also be used to support fixed bridges or dentures.


Implant treatment normally has two stages. First, the implant is placed in the jaw. Then, when the jaw has healed, replacement teeth are attached to the implant. In some situations it is possible for temporary teeth to be attached to an implant at the time of fitting.

 

Would Dental Implants be right for me?

First, you should decide whether implants could be right for you. Contact us to arrange an implant consultation and discussion and we will let you know the possibilities. Our team will be only too happy to help you with any questions you may have.

 

If you decide to go ahead, this is what will happen:

  • Implants are put into holes in the jaw with a local anaesthetic. You can opt to have sedation for this procedure also.

  • The implant is screwed or pushed in and the gum is stitched so that it heals over the implant.

  • Under the gum. the bone then grows round the implant to hold it firm. This takes several months.

 

Implants usually have two sections - the post in the jaw and an extension that is added later when the post is secure. Attaching the extension needs a small cut in the gum above the implant. You might have more than one implant. The replacement teeth might be fixed permanently (like a crown or bridge) or attached in a way which lets you remove them for cleaning (like a denture).

This is how they work:

  1. Dental implants are small metal screws that are placed in the jaw in place of a missing tooth.

  2. Once established, crowns, bridges and dentures can be fixed onto the implants, creating a natural-looking and stable restoration.

Life Benefits

  • When you lose your natural teeth, your jaw bone and surrounding tissues start to resorb or disappear over time. When implants are placed in the jaw, it stimulates the remaining bone to grow and mesh around the metal, along with tiny blood vessels, preventing bone loss.

  • Retained bone structure prevents the face from acquiring a 'sunken' look.

  • Implants help restore function so you can eat, chew and bite as usual.

  • Implants are a natural-looking way to replace missing teeth.

 

Inlays

 

Porcelain (tooth coloured) inlays and onlays are restorations placed usually on the chewing surfaces of the back teeth.

 

An inlay fits within the confines of the teeth. An onlay covers the entire chewing surface of the tooth. These can be made of either plastic resin or porcelain.

 

The procedure involves removing decayed tooth structure or old fillings, preparing the tooth cavity, taking an impression of the cavity to fabricate a custom-fit inlay or onlay. Two visits are required to complete the treatment.

Here is how they work:

  1. After an impression is made of your tooth, the inlay or onlay will be made in a dental laboratory by a technician.

  2. While these are being made, you will wear a temporary filling. When your inlay or onlay is ready we will bond it into place using a special adhesive, after removing the temporary filling. Your restored tooth will not only look like a real tooth but also function like one, allowing you to bite, chew and eat without any discomfort.

Life Benefits

  • Preserves remaining tooth structure.

  • Long-term aesthetic and functional solution.

  • Natural-looking restoration.

 

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