Crowns
A crown also known as a cap fits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth. It protects and restores a broken, weakened or heavily filled tooth. They are also used to improve the appearance of discoloured or crooked teeth.
Crowns are made of many different materials including metals and ceramics. We prepare the tooth so it is the ideal shape for the crown. This will involve removing the outer surface, and leaving a strong inner core. The amount of the tooth removed will be the same as the thickness of the crown. Once the tooth is shaped, we can take an impression (mould) of the prepared tooth, one of the other jaw, and possibly another to mark the way you bite together.
The impressions are then sent to the Dental Technician, along with details of the shade, to match corresponding teeth .The patient is fitted with a temporary crown and waits 1-2 weeks for the crown to be made.
The crown will be “tried in your mouth “so you are happy with the crown before it is permanently fitted into place.
Bridges
Bridges are ideal for people who do not like dentures and only have one or two teeth missing.
The dental bridge is permanent and will be matched in colour to your other teeth so the appearance of the new tooth is natural.
Bridges are usually made by crowning the teeth on either side of the gap then attaching a false tooth in the middle. They are fixed in the same way as crowns. These bridges are usually made of precious metal bonded to porcelain.
There are also new bridges made entirely of a special type of strong porcelain.
Metal bridges are stronger than porcelain bonded bridges, and stronger than porcelain only bridges.
Veneers
Veneers make teeth look natural and healthy, while at the same time improve the colour, shape and position of your teeth.
A veneer is a thin layer of porcelain that will bond to your tooth to give it a whole new appearance. They will improve the appearance of the teeth that you have chipped, is misaligned or discoloured. A veneer can change the size and the shape of teeth and their colour.
You may have teeth that are badly stained and cannot be whitened; the perfect solution here would be dental veneers.
Additionally, Veneers can also be used to close small gaps, when orthodontics (braces) are not suitable or if a tooth is slightly out of position, a veneer can be fitted to bring it into line with the others.
Dentures
Dentures are removable false teeth made of acrylic (plastic) or metal. They fit snugly over the gums to replace missing teeth and eliminate potential problems caused by gaps.
Gaps left by missing teeth can cause problems with eating and speech, and teeth either side of the gap may grow into the space at an angle.
Sometimes all the teeth need to be removed and replaced. You many need a complete set of dentures.
Partial dentures, replace one or a few teeth.
If your dentures are well looked after, they should last several years. However, your dentures will need to be relined or re-made because of normal wear or a change in the shape of your mouth. Bone and gum ridges can shrink, causing your jaws to meet differently. Loose dentures can cause health problems, including sores and infections, and discomfort.
A loose or badly fitting denture can also make eating and talking more difficult, so worn or badly fitting dentures should be replaced before they cause problems.
Tooth Extraction
Unfortunately, even today we still have to extract teeth. Contrary to popular belief it is usually a quick and painless procedure.
At Princes Street Dental Practice we carry out tooth extraction under local anaesthetic.
We will first make the tooth completely numb by administering an injection. It is exactly the same injection we would do for a filling except that all sides of the tooth are numbed. When the tooth has had sufficient time to go completely numb us check to make sure it is. Only when we are both agreed that the tooth is frozen will we proceed to take the tooth out.
We do not pull teeth out we actually push them out! So you will experience pushing or pressure. There should be no pain, only pressure.
Occasionally you may hear some tooth movement sounds; this is perfectly normal and it is due to the forces being applied to the tooth.
After the tooth has been delivered we will ask you to bite down on a piece of gauze. This is to form a plug or clot in the extraction site, Which starts the healing process
We will then go through your post-operative instructions with you.-for mouth and home care following the extraction.
On occasions you may be informed by the Dentist that you need a Surgical Extraction
A surgical extraction is a more complex procedure and you will be given a longer treatment session. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. A small incision is made into your gum. Sometimes it’s necessary to remove some of the supporting tissue around the tooth or to section the tooth, in order to extract it.
White Fillings (Mercury Free)
A filling replaces a part of the tooth that has been lost due to decay, erosion or accidental damage. For over 150 years fillings have been made out of a silver material called amalgam containing mercury. Although it is a strong material, it is certainly not the most attractive!
The alternative is what are called ‘white fillings’, using materials that match the colour of your tooth.
Sometimes white fillings can be used to cover unsightly marks on teeth.
The technology behind white fillings has improved considerably in the last few years, and their strength will now match that of amalgam fillings.
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 will advise you.
White fillings have not eliminated the usefulness of more traditional dental materials, such as gold and amalgam. That’s because the strength and durability of these materials makes them useful for some situations, such as fillings in teeth that could be under the gum margins or where chewing forces are excessive.
Can you replace older amalgam (silver) fillings with white fillings?
Absolutely. White fillings are, in a majority of cases, almost impossible to notice. That’s because they can be matched and shaped to the existing colour and contours of your tooth.
Treatment pathway
Fillings are usually a very simple and straightforward procedure
The area around your tooth will be numbed with local anaesthetic (Only if you wish). The decay together with possible old fillings will be cleared out. Weak parts of the tooth may be removed to lessen the risk it will break off later.
Unlike silver fillings, white filling materials stick to the tooth surface. This means that less tooth is drilled away.
Once the cavity has been cleaned out, conditioned and lined, a filling material is matched to the colour of your tooth and then placed. It is set (hardened) with a specially designed bright light.
At the final stage, the filling is trimmed and polished so it fits in more naturally with the contours of the rest of your tooth.
Root Canal Treatment
Root canal treatment (also called endodontics) is needed when the nerve of your tooth or its blood supply (the pulp) has been infected through decay, fracture lines or injury.
An infection in the pulp can cause an abscess. An abscess is an inflamed area in which pus collects, and its symptoms range from a dull ache to a severe pain.
What is involved?
The aim of the treatment is to remove all infection from the root canal and stop the infection from spreading to the jaw bone.
The tooth is “Opened Up”-allowing the Dentist access to the pulp chamber and root canals of the tooth- the infected pulp is removed and any abscesses are drained.
The root canals are cleaned out with differing instruments and Medicaments
A temporary filling is put in and the tooth and left to settle.
The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.
Root canal treament sometimes requires several appointments
Once the treatment is complete, the dentist will discuss additional recommendations (e.g. a crown) to strengthen the whole tooth
What if I don’t have treatment?
The alternative is to take the tooth out. The reason is that once the nerve is destroyed, it can’t heal and we would never recommend leaving an infected tooth in the mouth.
Although some people might prefer an extraction, we would recommend keeping as many of your natural teeth as possible.
Wisdom Teeth
A wisdom tooth is one of the large chewing teeth all the way at the back of your mouth. Not everyone develops wisdom teeth, but if they do develop, it’s usually during your late teens or early twenties.
What are “impacted” wisdom teeth?
An “impacted” wisdom tooth is one that has failed to emerge fully into its ideal position. That failure may be because there isn’t enough room in your jaw or because the tooth is emerging at an angle and is pushing against your other healthy teeth.
An impacted tooth that is still buried underneath your gums can be left alone as long as it’s not causing you any pain or discomfort.
What problems can an impacted wisdom tooth cause?
The term “pericoronitis” refers to an infection that is common with impacted wisdom teeth. It is most common when only part of the wisdom tooth has emerged from underneath your gums, a condition known as “partial eruption”.
When your wisdom tooth is only partially erupted, dental plaque can accumulate in the space between your gums and your wisdom tooth and unfortunately there is no way for you to effectively clean it out. The plaque can cause an infection to spread to the tissues surrounding your wisdom tooth, which in turn makes the area feel tender and start to swell. It can also be quite painful and can cause unpleasant mouth odours and taste. In some cases, it can make it difficult for you to open your mouth.
Pericoronitis is usually a temporary problem that can treated and preventative advice offered . If pericoronitis is occurring repeatedly, then your dentist may recommend having the wisdom tooth extracted, most likely by a Specialist Oral Surgeon
What is Gum Disease?
Gum disease is the swelling, soreness and infection of the gum and tissues supporting your teeth. The first stage is called gingivitis – it is when the gums around your teeth become red and swollen. The swollen gums may bleed when you brush your teeth .Gingivitis is reversible with advice and you taking action.
However, it may indicate a deep-seated problem called Periodontitis. The bone anchoring your teeth in your jaw is lost and your teeth become loose affecting 10% of the Population. . If untreated, your teeth can drift and could eventually fall out.
The major implications are Family History of Perio disease, Stress, Smoking and a link with Diabetes. Stopping smoking is an important part of reducing the risk of further disease.70 % of smokers can lose teeth through smoking links. If untreated, your teeth can drift and could eventually fall out.
What causes it?
Gingivitis and Periodontitis is caused by plaque. Plaque is a thin film of bacteria which builds up on your teeth every half an hour. When Plaque is a couple of days old, it’s seen on your teeth as the white/ yellow deposit – “Furring”.
You can remove plaque by thorough brushing and cleaning between your teeth every day.
How is it treated?
Your dentist will start with a thorough check up of your teeth and gums. Your dentist will measure the ‘cuff’ of the gum around each tooth to detect bleeding or whether periodontal disease has started.
X-rays may be needed to see the amount of bone that has been lost.
Gingivitis Treatments a session with the hygienist Or Dentist will be needed to thoroughly clean all surfaces of your teeth.
You will be offered advice on specific oral hygiene methods to help control the bacteria that collect on your teeth. We recommended regular Dental Check-ups.
Periodontal Treatments
To help with your periodontal disease we will offer further more intensive cleaning of the roots of your teeth ,with the Hygienist or Dentist .This is known as Root Surface Instrumentation (RSI) or Root Planing.
RSI thoroughly debrides the root surface, to remove hard and soft deposits from under the gum line, thus bacteria from within the gum pocket.
We will monitor your plaque levels, any sites of bleeding gum and re-evaluate the original pocket depths from your first visit.
Research has proven that regular 3monthly Perio maintenance appointments are extremely beneficial.