Deep inside the tooth is a soft mass of tissue called the Pulp. If the tooth is damaged - either by injury or decay - it may cause the pulp to get infected. If this happens, your dentist may carry out a root canal treatment, but if the infection spreads to the end of the root and into the bone, the dentist may have to perform an Apicectomy.
During this treatment, which is done under local anaesthetic, the dentist makes a very small cut in the gum, cleans out any infection and then puts a small filling at the end of the root canal to stop any future infection. Once this is done, the dentist stitches the gum - and, because the cut is made as far away from the tooth as possible, there is little chance of visible scarring.
A Bridge is a fixed replacement for a missing tooth or teeth.
Dental bridges are false teeth, which are anchored onto neighbouring teeth in order to replace one or more missing teeth. The false tooth is known as a Pontic and is fused in between two crowns that serve as anchors by attaching to the teeth on each side of the false tooth, thereby bridging them together.
Unlike traditional removable dentures, a dental bridge is permanent as it's anchored to the teeth at one, or both, sides using metal bands held in place by resin or cement.
A bridge is usually created from precious metal and porcelain and will be fixed in your mouth, as opposed to dentures, which can be removed.
There are three main types of dental bridges:
- Traditional fixed bridge - This is the most commonly used type of bridge and consists of a Pontic fused between two porcelain crowns that are anchored on neighbouring teeth or implants. The Pontic is usually made of either porcelain fused to metal or ceramics. These are fixed and cannot be removed.
- Resin-bonded bridges or Maryland-bonded bridges - These are chosen when the gap to be filled is in between the front teeth, or when the teeth on either side of the missing tooth are strong and healthy without large fillings. The false tooth is made of plastic and is fused to metal bands that are bonded to the adjacent teeth using resin that is hidden from view.
- Cantilever bridges - These are opted for in areas such as the front teeth that are susceptible to lower stress. Cantilever bridges are used when there are teeth present on only one side of the space, where the false tooth is anchored to one or more adjacent teeth on one side.
If part of a tooth has been lost through decay or damaged due to an accident, your dentist may put in a Filling. A Filling will plug the hole and stop any future pain or discomfort. A filling can be made out of a variety of materials.
The most common of these are amalgam (silver) or composite (white).
Silver fillings are made of a material called amalgam, which is a mixture of mercury, silver, tin, copper, and other metals.
Some people opt for white fillings which match the colour of the natural tooth better. White fillings are becoming more and more popular as patients prefer the natural look.
Cosmetic Gum Surgery / Gum Contouring
Patients are often concerned that too much gum is showing when they smile or that their teeth look too short.
This problem, commonly referred to as a "gummy smile", can be easily remedied by gum reshaping or contouring.
Excess gum tissue is marked out by the dentist and then trimmed away using a special laser, which also cauterises (seals) blood vessels, and minimises bleeding. After the procedure, the gum is left to heal. Results are immediate.
In some cases where a large amount of gum tissue is removed, the healing process may take longer and it may be necessary to trim bone on the front of the tooth root to prevent regrowth of the gum tissue. The results are usually permanent and relatively inexpensive.
Dental crowns are also commonly known as caps (because a crown sits over your existing tooth, covering the entire outer surface).
Dental crowns are restorations that protect damaged, cracked or broken down teeth. A crown strengthens your existing, damaged tooth so as to preserve its functionality.
Crowns can be fitted where a tooth has broken, decayed or been damaged, or just to make a tooth look better.
Why might I need crowns?
- If your tooth has undergone significant decay and there is not enough tooth structure remaining to support a filling or an inlay and maintain functionaility.
- If a large portion of your tooth has fractured and it cannot be built up using traditional composite bonding techniques .
- If you have a large cavity and opt for the additional protection a crown offers to your tooth over a large composite filling or an inlay.
- If you have had a dental implant to replace a missing tooth, a crown will be fitted to the abutment of the titanium implant.
- Following root canal treatment, a crown is often needed to strengthen the tooth.
- If you grind your teeth and have a poor diet, acid erosion may reduce your teeth to a point where the only option available is to crown them.
- For cosmetic reasons, to improve the aesthetics of your smile, you may opt for all porcelain cosmetic crowns.
A crown is like a special sleeve made of metal or porcelain, or both, that goes over a damaged or weak tooth. Your dentist will match it up to the shape – and, in the case of porcelain crowns, colour - of your other teeth so it will look natural. The crown will probably last for many years, depending on the health of the tooth underneath.
A temporary crown made of plastic or metal is put over the tooth until the permanent crown is made. You can chew on a temporary crown but it won't be as strong as the finished one. When the crown is fitted, the dentist will make small adjustments to make sure you can bite comfortably. The crown is tried on first, and then glued into place.
More commonly known as false teeth, Dentures are fitted in place of natural teeth.
Dentures are removable replacements for your teeth, designed to look and function like your own natural teeth and surrounding gum tissues.
Modern-day dentures can look very realistic and natural and feel comfortable. A full set is used to replace all your teeth, a part set is used to replace one or more missing teeth.
Dentures are custom-made using impressions (mouldings) from your gums.
They're removable, so you can clean them. A full set needs to be removed and soaked in a cleaning solution yet part dentures can be brushed at the same time as your other teeth.
Dentures have been used to replace missing teeth for many years now.
Alternative methods used to replace missing teeth include dental implants and fixed bridges.
Tooth loss can occur for many reasons (periodontal disease, decay or trauma).
Dentures are important because if you lose all your natural teeth, it's hard to chew your food, which will adversely affect your diet and may cause your facial muscles to sag which can have negative effects on your self-confidence and may make you appear older than you are.
Dentures should be held in place by their natural suction to your gums; sometimes a fixative may also be used. However, they tend to come loose and this can cause difficulties when trying to eat certain foods. Dentures can be fixed securely in place by dental implants or mini implants, which can give you the confidence to eat whatever you want without having to worry about your dentures coming loose or falling out.
A Dental Implant is an artificial substitute/replacement for the root portion of your natural tooth and is anchored into a pre-drilled socket in your jaw-bone to support a crown, bridge or secure a denture firmly in place.
Implants are made from titanium, a material that is well tolerated by bone and integrates easily with bone tissue.
During the placement of a dental implant, the goal is to achieve a close contact between the outer surface of the implant and the surrounding bone tissue so they can "fuse" together (osseointegration), creating a stable support for the new teeth.
Before any implants are placed, it is important for the dentist to assess the health of your teeth and gums and also to assess your bone quality.
The procedure is usually carried out under local anaesthesic - IV sedation is sometimes used if it is a long procedure or the patient is very anxious.
The gum where the implant is to be placed is cut and lifted and a small hole is drilled in the jawbone at the precise location of the intended implant.
The titanium implant is tightly fitted into this socket and the gum is stitched back over the implant.
If there is insufficient bone material to accommodate the implant, a bone graft may be required, or the dentist may use smaller-sized mini implants if suitable.
Once the implant has been placed, it is left to heal and integrate with the jawbone for between six weeks to six months. The bone tissue will grow and anchor itself into the microscopic rough surface of the implant.
During this "healing period", patients are given temporary teeth (bridges) or continue to wear dentures.
After the healing period the gum is opened up, a post is fitted to the implant and then the Crown is attached to the post.
Traditionally, an implant placed into your bone supports a single crown and this is know as a "single tooth implant".
However, if you have several missing teeth, you do not necessarily need an implant for every missing tooth: one implant can support several teeth via a bridge or denture. The number of implants required depends on the volume and density of bone tissue available at each implant site.
People lose teeth all the time, either through trauma (when teeth are knocked out) or due to decay, gum disease or old age. Whatever the reason for losing your teeth, they need to be replaced, both for aesthetic and functional reasons.
Implants provide a long term solution, slow down bone loss and preserve nearby healthy tooth tissue.
Root Canal Treatment
Sometimes, damage or decay gets deep into the tooth and can affect the root. If left unchecked, this could mean that the tooth either falls out or has to be removed by your dentist.
Root fillings - also known as root canal work - can ensure that you keep your tooth. Your dentist will take an x-ray of the tooth to check the shape of the root canals and to see whether there is any added infection around the root.
After putting you under local anaesthetic, the dentist will go through the top of your tooth into the pulp - the bit right in the middle of your tooth that holds the nerves and blood supply. He will then remove the dead bits of the pulp and check for any infection.
If the infection has spread beyond the tooth, he may have to give you a temporary filling and some antibiotics until it clears up. After the pulp has been removed, the dentist fills the gap with a rubbery material and puts a normal filling on top.
A sinus-lift procedure is a surgical procedure to augment bone mass in the top jaw (maxilla), which increases the likelihood of successful placement of dental implants.
Bone from another part of the body, such as the iliac crest, or artificial bone grafting material is grafted into the bone below the floor of the maxillary sinus. In the upper jaw the amount of bone is reduced by the presence of the sinus. A number of techniques are used to increase the bone height.
Teeth whitening is the process of removing stains and discolouration from teeth and improving their colour through a bleaching process to make them look "whiter".
Everyday life takes its toll on our teeth. Drinking too much tea or coffee, smoking or even eating strongly coloured foods can stain and discolour them. There are toothpastes available which will help remove these stains, but they can't change the actual colour of the tooth underneath.
The colour of your teeth is determined by your DNA, just like the colour of your hair or your eyes. As we get older, the dentine - the soft, pulpy substance below the enamel that protects the nerves and the blood supply to the tooth - changes colour, becoming more yellow. This is something which a stain-removing toothpaste alone cannot help. Dentists can, though.
By applying a bleaching agent to the teeth, they can whiten the teeth, giving you a sparkly white smile. This procedure is simple, harmless and practically painless. It is important, though, to do it under your dentist's supervision.
Don't be tempted to buy kits over the counter or on the Internet. Not only are they not made to fit your mouth exactly, it may be that bleaching isn't suitable for you, especially if you have gum disease or crowns.
A dental veneer is a thin layer of tooth-coloured material - usually porcelain - which the dentist attaches to the damaged or discoloured tooth.
Veneers are wafer-thin laminates or shells of tooth-coloured material (which can be either porcelain, ceramic or composite bonding material).
They are "cemented" to the front surface of teeth to improve their cosmetic appearance.
Dental veneers have long been used to create the ultimate smile makeover.
With this treatment, it's possible to transform crooked, stained, damaged or badly worn teeth into a brand new, straight, white smile, as seen on many of the Hollywood greats.
Dentists use the analogy that dental veneers are for your teeth what false fingernails are for your hands.
The most popular type of Veneer is porcelain, which offers a stronger and more durable alternative to its composite counterpart. Composite Veneers are also more prone to staining and do not last as long as porcelain Veneers.
Porcelain Veneers also offer a more natural looking, translucent appearance.
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 and in some cases infections can occur causing pain.
The dentist will take an x-ray of your mouth to assess how your wisdom teeth are coming through.
They are then able to make a judgement on whether or not to take them out (extraction). This can be done either with local or general anaesthetic dependant upon the individual circumstances.