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Bridges

Why should I replace missing teeth?

Appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain is put on the remaining teeth on either side. A gap can also mean that 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 lead to food getting packed into the gap, which can cause both decay and gum disease.

Why is a bridge used?

A bridge is usually used when there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth. They are only possible if you have enough strong teeth with good bone support.

What are bridges made of?

Bridges are usually made of porcelain bonded to precious metal. Sometimes, there are other non-precious metals used in the base for strength. There are also new bridges made entirely of a special type of strong porcelain.

What will a bridge cost?

Costs will vary according to the size and type of bridge that you need. Although a bridge may seem expensive, it should last many years.

Can I have a bridge fitted straight after having a tooth removed?

In many cases it can take up to 6 months for the gums to heal properly after an extraction. This means that you may need to have a temporary denture for 6 months before the bridge is fitted.

How do I look after my bridge?

You will 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.

Are there other methods for fixing false teeth?

There are other methods, such as using a combination of crowns and partial dentures that can keep the retaining clips out of sight. These are quite specialised dentures, so you should ask your dentist about them.

Crowns

What is a crown?

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’.

Why would I need a crown?

Crowns are an ideal restoration for teeth that have been broken, or have been weakened by decay or a very large filling. A 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 may need a crown to protect what is left of the tooth
  • It may help hold a bridge or denture firmly in place.

How is a crown prepared?

The dentist will prepare the tooth to the ideal shape for the crown. This will involve removing most of the outer surface, and leaving a strong inner core. Once the tooth is shaped, the dentist will take an impression (mould) of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together.

The impressions will then be given to the dental technician, along with an appropriate shade and other information needed for the crown to be made.

What is a post crown?

In root-filled teeth it may be necessary to insert a post before placing a crown. A post provides support and helps the crown stay in place. The weakened crown of the tooth may be shortened to gum level.

A post can be made of prefabricated stainless steel which the dentist can fit directly into the root canal, or a custom-made post can be constructed by the dental technician to accurately fit the shape of the prepared root canal. The post is placed into the root canal and cemented in position, ready for the crown to be attached.

Are there any alternatives to post crowns for root-filled teeth?

If a root filled tooth is not completely broken down, it may be possible to build it up again using filling material. This ‘core’ is then prepared in the same way as a natural tooth and the impressions are taken.


How is the crown fitted?

When you and your dentist are happy with the fit and appearance of the new crown it will be fixed in place with special dental cement or adhesive. The cement forms a seal to hold the crown in place.

How long does the treatment take?

You will need to have at least two visits – the first for the preparation, impression, shade taking and fitting the temporary crown and the second to fit the permanent crown. There will usually be about 1 to 2 weeks in between appointments.

Will the crown be noticeable?

The crown will be made to match your other teeth as closely as possible. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth.

What will it cost?

Costs will vary according to the type of crown and material used. It is advisable to get a written estimate and treatment plan before beginning any dental treatment.

How do I care for my crown?

How long your crown lasts depends on how well you look after it.
The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. Therefore, to prevent decay affecting the crown, it is important to keep this area just as clean as you would your natural teeth.

How long will the crown last?

Properly cared for crowns should last for many years. Your dentist will be able to tell you how long the crown may be expected to last.


Dentures

What are dentures?

Dentures are removable false teeth made of acrylic (plastic), nylon or metal. They fit snugly over the gums to replace missing teeth and eliminate potential problems caused by gaps.

What is the difference between complete and partial dentures?

Complete dentures (full set) are required if all the upper or lower teeth need to be removed and replaced. Partial dentures replace just one or a few missing teeth.

Why should I replace missing teeth?

Improving your appearance and confidence is one reason. Another is that the gap left by a missing tooth can mean greater strain on the teeth at either side. Your bite may also be affected, because the teeth next to the space can lean into the gap, allowing food to get trapped, potentially leading to decay and gum disease. Your speech can also be affected.

How are complete dentures fitted?

The denture will usually be fitted as soon as your teeth are removed, which means you won’t be without teeth. However, they will probably need relining or remaking after a few months, if the gums and bone alter in shape. Dentures can be made and fitted either via a dentist or directly by a clinical dental technician who will take measurements and impressions of your mouth.

How are partial dentures fitted?

A partial denture is a plastic or metal plate with a number of false teeth attached to it. It usually clips securely onto some of your natural teeth via metal clasps and can easily be removed. As with full dentures, you can either go to a dentist or clinical dental technician. An alternative is a fixed bridge where crowns are put on the teeth either side of the gap and joined together by a false tooth that’s put in the gap. Your dentist will advise the best type for you.

What will it all cost?

Costs will vary according to the type of denture required and materials used. It is advisable to get a written estimate and treatment plan before beginning any dental treatment.

Root Canal Treatment

What is root canal treatment?

Root canal treatment (also called endodontic) is used to treat infection in the soft tissue (pulp) at the centre of the tooth, caused by decay, injury or leaky fillings.

How do I know this may have happened?

You may experience pain when eating or drinking hot or cold food or drink, pain when biting or chewing or a loose tooth. Sometimes you may notice your tooth darken in colour.

Why do I need root canal treatment?

If the pulp is infected with bacteria, it will begin to die allowing the bacteria to multiply and spread which may eventually lead to an abscess. An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth. Left untreated, further symptoms eventually occur such as increased pain when biting or chewing, swelling of the gum, pus oozing from the affected tooth, facial swelling or the darkening of the tooth. Antibiotics, used to treat bacterial infections, are not effective in treating root canal infections.

Why is it important not to delay treatment?

Leaving the infected tooth in your mouth may make it worse. There may also be less chance of the root canal treatment working if the infection within your tooth becomes established. If root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.

What does it involve?

After taking x-rays, the dentist will remove all infection from the root canal system. The root is then cleaned and shaped ready for the filling. A temporary filling is put in allowing the tooth to settle and to ensure the infection has cleared. Finally, the tooth is permanently filled. In some cases, it may be necessary to restore the tooth with a crown for extra support and strength.

Will it be painful?

No, a local anaesthetic is used so the procedure shouldn’t be painful and no different to having a filling. Any tenderness will naturally disappear over time.

How long does the treatment take?

Root canal treatment is a time-consuming and skilled procedure and most courses of treatment will require two or more visits to your dentist. There is typically 1-2 weeks between appointments.

What will the tooth look like?

Many people think that a root-filled tooth will darken after treatment but with modern techniques this does not usually happen. If there is any discolouration, there are several, very effective treatments available to restore the natural appearance.

What is a crown?

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’.

What will it all cost?

Costs will vary according to the extent of the root canal treatment and, if required, the type of crown and material used. You will be given a treatment plan outlining treatment costs before beginning any dental treatment.

How long will the treatment last?

In the vast majority of cases, a tooth can survive for up to 10 years after root canal treatment and, properly cared for, crowns should last for many years.

White Fillings

Why should I consider white fillings?

Most people have fillings of one sort or another in their mouths. Nowadays fillings can be natural looking, as well as doing the job they’re meant to do. Many people don’t want silver fillings that show when they laugh or smile because they are more conscious about the way they look.

Are white fillings expensive?

Because many white fillings are classed as a ‘cosmetic’ treatment, you can only have them done privately. Costs usually depend on the size and type of white filling used, and the time it takes to carry out the treatment. Your dentist will be able to give you an idea of the cost before you agree to treatment.

Are they as good as silver amalgam fillings?

White fillings have always been considered less long lasting than silver amalgam fillings. But there are now new materials that are almost as good as silver amalgam, and these are proving to be very successful. With both composite and silver fillings there are pros and cons, composite fillings are considered overall the better option in most circumstances. How long a white filling lasts can depend a lot on where it is in your mouth and how heavily your teeth come together when you bite. Your dentist can tell you how long your fillings should last.

Is it worth replacing my amalgam fillings with white ones?

It is usually best to change fillings only when your dentist decides that an old filling needs replacing, however they can be changed for cosmetic reasons too.

Are there any alternatives to fillings?

There are alternatives such as crowns and inlays although they can cost a lot more or may not be necessary. Veneers can be used on front teeth instead of crowns or fillings.

What are tooth-coloured fillings made of?

It can vary, but they are mainly made of glass particles, synthetic resin and a setting ingredient. Composite fillings are tooth coloured and are made from powdered glass, quartz, silica or other ceramic particles added to a resin base. Your dentist will choose a shade to match your own teeth, although over time the filling can get stained. After the tooth is prepared, the filling is bonded onto the area with an adhesive and a light shone onto it to set it. With this type of filling, your dentist may have to remove less of the tooth, which is obviously better.