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Restorative Treatments

CROWNS

A crown is an artificial restoration that fits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth. A crown is sometimes known as a ‘cap’. Crowns are an ideal restoration for teeth that have been broken, or have been weakened by decay or a very large filling. They can be made of porcelain, Zirconia or gold or a combination of these materials. Avoiding metal in any restoration will always make it more aesthetic and lifelike. 

A dental crown could be used for a number of other reasons, for instance:

  • you may have discoloured fillings and would like to improve the appearance of the tooth
  • you may have had a root filling which will need a crown to protect it
  • it may help hold a bridge or denture firmly in place.

BRIDGES

Besides having dental implants, there are two main ways to replace missing teeth. The first is with a removable false tooth or teeth – a partial denture. The second is with a fixed bridge.

A dental bridge is usually used where there are fewer teeth to replace, or when the missing teeth have another strong tooth adjacent to them. Bridges traditionally were made of a precious metal base with porcelain overlay. In modern times we have some amazing materials such as Zirconia and porcelain which can look beautiful and natural. 12  You should replace missing teeth for a number of reasons. Your appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain is put on the teeth at either side. Chewing is more efficient and comfortable when you don’t have missing teeth. A gap can also mean your ‘bite’ is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bite together. This can then lead to food getting packed into the gap, which causes both decay and gum disease.


DENTURES

Replacing lost or missing teeth has substantial benefits for your health and appearance. A complete or full denture replaces the natural teeth and provides support for cheeks and lips. Without this support, sagging facial muscles can make a person appear older and reduce their ability to eat and speak.

A denture is an appliance which is worn to replace lost or missing teeth to enable you to enjoy a healthy diet and smile with confidence. 

A complete or full denture is one that replaces all of the natural teeth in either the upper or lower jaws. 

A partial denture fills in the spaces created by lost or missing teeth and is attached to your natural teeth with metal clasps or devices called precision attachments.

The base of a denture is called a plate and can be made of either acrylic (plastic) or metal. The teeth are normally made of acrylic and can be made to match your natural teeth. This is especially important in the case of partial dentures.

INLAYS/ONLAYS PORCELAIN OR GOLD

Dental inlays and onlays are used to restore damaged or decayed tooth's biting surface. They are bigger than fillings and smaller than crowns. Inlays and onlays are usually made from porcelain, composite resin or gold. Due to its natural tooth colour and its strength, porcelain is now becoming the most popular choice for patients who desire a more natural looking smile. Gold is used where strength is paramount. Inlays are custom made in the dental laboratory. Therefore it will require at least two visits to complete the treatment.

Dental inlays are similar to fillings and lie within indented top surfaces of a tooth. They are individually made to match your tooth's specification and are then cemented into place. Dental onlays are a more extensive reconstruction and are used to treat decay/ damage that extends to one or more of cusps. Onlays conserve more tooth structure when compared to a placement of a crown because their use requires minimal removal a tooth's surface.

ROOT CANAL THERAPY

WHAT IS ROOT CANAL TREATMENT? Root canal treatment (also called endodontics) is the process of cleaning and filling the space inside a tooth where the nerves and blood vessels (pulp) would have resided, before being infected through decay or injury 

WHY IS ROOT CANAL TREATMENT NEEDED?If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess. Unl;ike other areas of the body a tooth cannot repair itself once the pulp is damaged. If root canal treatment (RCT) is not carried out, the infection will spread and the tooth may need to be taken out.

DOES IT HURT? No. A local anaesthetic is used and it should feel no different to having an ordinary filling done.  

WHAT DOES IT INVOLVE? The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two visits to your dentist. At the first appointment, the infected pulp is removed. Any abscesses, which may be present, can also be drained at this time. At the second (main) visit the root canal is then cleaned, shaped and the space filled with an inert material. The tooth is then restored for the short term with a resin material. In the medium to long term we will normally recommend an inlay or crown on these teeth to prevent further breakage. 

WHAT WILL MY TOOTH LOOK LIKE AFTER TREATMENT? In the past, a root filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance. 

WHAT IF IT HAPPENS AGAIN? Root canal treatment is usually very successful. However, if the infection comes back the treatment can be repeated. 

WHAT IF I DON'T WANT THE TREATMENT? The alternative is to have the tooth out. Once the pulp is destroyed, it can’t heal and it is not recommended to leave an infected tooth in the mouth. Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible. 

WILL THE TOOTH BE SAFE AFTER TREATMENT? Yes. However, it is better to restore the tooth with a crown to provide extra support and strength to the tooth.

WHERE CAN THIS TREATMENT BE CARRIED OUT? Root canal treatment is a routine dental procedure, which your dentist will be happy to do for you. 

WHAT ABOUT AFTERCARE? Root-treated teeth should be treated just the same as any other tooth.

ORAL SURGERY

WISDOM TEETH Sometimes there may not be room in your mouth for your wisdom teeth and, as they start to come through, they push against the teeth already there or may start to come through at an angle. When this happens, you might feel some pain or discomfort, so the best thing to do is to visit your dentist. The dentist will probably take an x-ray of your mouth to see how - or if - your wisdom teeth are coming through. From this, they will be able to make a judgement on whether or not to take them out, and how easy or difficult it might be. 

EXTRACTION Having a tooth out is the same as having an operation and, because of this, you must look after the area to speed healing and to reduce the risk of infection. 

Here are some pointers: 

  • For the first 24 hours, try to avoid eating hot food, don't smoke, don't drink any alcohol and try not to disturb any blood clot which might have formed.
  • Don't rinse your mouth for 24 hours after extraction. After that, rinse gently with warm salty water - half a teaspoon of salt in a glass of water is enough.
  • Brush your teeth as normal to keep your mouth as clean as possible.
  • You may feel some small pieces of bone work their way out of the socket - don't worry, this is perfectly normal.
  • There may be some swelling and a bit of discomfort in the first two to three days. If you need to, take some ordinary painkillers - aspirin, ibuprofen or paracetomol will be fine.
  • If you feel pain a few days after the tooth has been removed, it might be where the blood clot has broken down leaving an empty hole in the gum. This is called a 'dry socket' and will need to be looked at by your dentist. Simply go back and the dentist will pack the wound to ease your discomfort.

Your dentist may have given you some gauze to place onto the area where the tooth has been removed - if not, a clean cloth handkerchief will do just as well (but not a paper tissue). 

  • Roll it into a small firm pad large enough to fit over the gap (probably around 1cm by 3cm).
  • Sit up and gently clear away any blood clots around the gap using the gauze or hanky.
  • Put a clean pad over the gap (from tongue side to cheek side) and bite down on it firmly for 10 to 15 minutes.
  • Take the pad off and check whether the bleeding has stopped. If not, apply a fresh pad and contact your dentist

BROKEN TEETH

Broken teeth can be repaired by crowns, veneers or Resin bonding depending on the severity of the damage. The concept is to try to make the repaired tooth last as long as possible and look as close to the original as possible. 

A veneer can make a chipped tooth look intact again. The porcelain covers the whole of the front of the tooth with a thicker section replacing the broken part.

Bonding: sometimes instead of a porcelain veneer, a natural colour ‘composite’ material is used instead of porcelain. A natural-coloured filling material can be used for minor repairs to front teeth like chipped or broken tooth corners.

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