Treatments

In an examination, your dentist will check how healthy your teeth, gums and other oral tissues are.

You and your dentist will then discuss the options that are available to you and decide which treatment, if any, is most suitable for you.

 

What will this involve?

During the examination, your dentist will:

Check your face and neck and jaw joints to ensure that they are healthy.

Look at places inside and around your mouth, which you may find hard to see. For example, your tongue, the floor of your mouth and other oral soft tissues need to be checked.

An oral cancer screening is a routine part of all our oral examinations.

Check that your teeth and gums are healthy and identify whether there are any signs of decay, damage or gum disease.

If necessary, take x-rays to gain more information about your teeth and gums.

Check out any areas that you the patient are concerned about.

 

Why are regular dental examinations important?

It is important for you to have regular oral examinations, so that your dentist can help you to maintain a healthy mouth and also to check for any early signs of dental problems, such as decay or gum disease.

It is also important to check for any early tissue changes in the tongue or lining of the mouth, that might need regular monitoring or further checks.

This will enable your dentist to rectify any problem before it gets too complicated and requires extensive treatment.

The chances of somebody suffering from gum disease are greatly reduced with regular visits to the dentist.

In some instances, however, patients will require more intense treatment to halt the process of tissue breakdown.

These may range from cleaning under local anesthetic, through to small surgical procedures to remove infection, which allow patients to clean their teeth properly.

Each individual case will be assessed and treated accordingly by the dentist in conjunction with the hygienist.

Gum disease is the term used to describe the process of tissue breakdown that results in loose teeth, or at worst, lost teeth.

Gum disease is a chronic infection and its presence can have a detrimental effect on the entire body.

There are proven links between gum disease and other serious heart conditions, diabetes, and strokes for example.

Can everybody benefit from preventive dentistry?

Yes. Preventive dentistry will benefit anyone with some of their own teeth. People who don’t have any teeth can also benefit because conditions such as mouth cancer and denture stomatitis can be spotted during regular visits to the dentist and then treated.

It is excellent for children and young people, but it is never too late to start.

 

What is preventive dentistry?

Preventive dentistry is the modern way of reducing the amount of dental treatment necessary to maintain a healthy mouth.

It helps you to keep your teeth. The two major causes of tooth loss are decay and gum disease.

The better we prevent or deal with these two problems, the more chance people have of keeping their teeth for life.

The joint efforts of the dentist, the hygienist and the patient, can help to prevent the need for treatment, and so avoid the traditional pattern of fillings and extractions.

A course of treatment may be recommended to get your mouth into good condition, and a maintenance plan will be worked out to help you keep it that way.

 

Can everybody benefit from preventive dentistry?

Yes. Preventive dentistry will benefit anyone with some of their own teeth.

People who don’t have any teeth can also benefit because conditions such as mouth cancer and denture stomatitis can be spotted during regular visits to the dentist and then treated.

It is excellent for children and young people, but it is never too late to start.

What are pit and fissure sealants?

Tooth showing pits and fissures

Tooth showing fissure sealant in place

The biting surfaces of teeth can be protected by the application of ‘sealants’.

These make the tooth surface smoother and easier to clean, and stop decay starting in the difficult to clean areas.

 

When should fissure sealants be applied?

Sealants are ideally applied as soon as the permanent teeth start to come through. This usually occurs when the child is in Second Class in Primary School, between 6 and 7 years of age.

The rest are usually sealed if required as they appear which can be any time between 11 and 14 years of age.

 

How long do pit and fissure sealants last?

Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact.

They can wear over time, and sometimes the dentist needs to add or replace some sealant to be sure that no decay can start underneath them.

 

How do pit and fissures work?

The sealant forms a smooth, protective barrier, by covering all the little grooves and dips in the surface of the tooth. Dental decay easily starts in these grooves.

What is a mouthguard?

A mouthguard is a specially made, rubber-like cover which fits exactly over your teeth and gums, cushioning them and protecting them from damage.

 

When would I need a mouthguard?

It is important to wear a professionally made mouthguard whenever you play sport that involves physical contact or moving objects.

This includes: cricket, hockey and football – which can cause broken and damaged teeth; and American football, boxing and rugby – which can all cause broken or dislocated jaws.

A mouthguard will help protect against these events.

 

Where can I get a mouthguard made?

Your dentist will be happy to make you a custom-made mouthguard, which will fit your mouth exactly and protect your teeth and gums properly.

Custom-made mouthguards can prevent damage to the jaw, neck and even the brain – helping to prevent the concussion and damage caused by a heavy blow.

 

How much will a mouthguard cost?

You cannot get mouthguards on the NHS, so costs can vary from dentist to dentist. Ask your dentist about mouthguards and always get an estimate before starting treatment.

When you consider the cost of expensive dental work and the risk of missing teeth, it is a small price to pay for peace of mind.

 

How long do custom-made mouthguards last?

Depending on your age, your mouthguard may need replacing fairly regularly. If you are still growing, new teeth will come through and move into position.

So the mouthguard may become too tight or loose, and will need to be remade to fit the new shape of your mouth.

Adults may not need to have their mouthguards replaced quite so often. But they are like any other form of sports equipment and will suffer from wear and tear.

It is recommended that you take your mouthguard along to the dentist when you go for your check-up, so it can be checked.

 

What about home mouthguard kits?

Mouthguards are made by taking an accurate impression of your mouth and making the mouthguard fit your own teeth.

The dentist will register the way your jaws bite together to make sure the mouthguard meets properly with your teeth.

There are cheaper kits available. They involve heating the product in hot water and then putting it in your mouth until it sets.

Unfortunately, these mouthguards can fit badly and be uncomfortable to wear. They can fall out or even cause choking.

Also the material is at its thinnest where it is needed most.

 

Can I get coloured mouthguards?

There are many types of mouthguard including striped, multi-coloured and clear.

Many people now have coloured mouthguards made in their favourite team’s colours or to match their own sports strip.

Your dentist will be able to tell you whether they can provide coloured mouthguards.

Are there any alternatives to fillings?

Adhesive dentistry is another form of this treatment. This involves bonding the filling to the tooth. The dentist has to remove less of the tooth, which is obviously better.

As we have already said, there are alternatives such as crowns and inlays although they can cost a lot more. Veneers can be used on front teeth instead of crowns or fillings.

 

Are white fillings 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 available with properties comparable to silver amalgam, and these are proving to be very successful.

The life expectancy of a white filling can depend greatly on where it is in your mouth and how heavily your teeth come together when you bite.

Your dentist can advise you on the life expectancy of your fillings.

However, any fillings provided on the NHS are automatically guaranteed for one year.

 

Are white fillings expensive?

Because many white fillings are classed as a cosmetic treatment, you can only have them done privately.

So costs can vary quite a lot from dentist to dentist.

Costs usually depend on the size and type of white filling used and the time it takes to complete the treatment.

Costs may also vary from region to region, but your dentist will be able to give you an idea of the cost before you agree to treatment.

 

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.

If so you can ask to have it replaced in a tooth-coloured material.

Some dentists prefer not to put white fillings in back teeth as they are not always successful.

One way around this would be to use crowns or inlays, but this can mean removing more of the tooth and can be more expensive.

 

What are tooth-coloured fillings made of?

This can vary, but they are mainly made of glass particles, synthetic resin and a setting ingredient.

Your dentist should be able to give you more information about the particular material they use.

 

Where can I get white fillings done?

Most dental practices offer white fillings as a normal part of the treatment they give you.

 

Why should I consider white fillings?

Most people have fillings of one sort or another in their mouths.

Nowadays fillings are not only functional, but can be natural looking as well.

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 there any risks from amalgam fillings?

Mercury in dental amalgam is not poisonous once it is combined with the other materials in the amalgam filling. Its chemical nature changes so that it is harmless.

Research into the safety of dental amalgam has been carried out for over 100 years.

So far, no reputable controlled studies have found a connection between amalgam fillings and any medical problem.

 

What are amalgam fillings?

Amalgam fillings are silver coloured. They are made by combining mercury and a silver alloy (50% mercury, 35% silver, 15% tin, copper and other metals).

Amalgam is long lasting and hard wearing and has been used in fillings for at least 150 years.

It is economical to use and it is not unusual for an amalgam filling to last 15 to 20 years.

This kind of filling is normally used on the back ‘chewing’ teeth.

Before the filling can be placed, the area must be prepared by removing all the decay and shaping the cavity to hold the filling in place.

If the tooth is badly broken, your dentist may need to place a small stainless steel pin to help secure the filling.

 

What are composite fillings?

Composite fillings are strong, but may not be as hard wearing as amalgam fillings.

Composite fillings are tooth coloured and are made from powdered glass quartz, silica or other ceramic particles added to a resin base.

After the tooth is prepared, the filling is bonded onto the area and a light shone onto it to set it.

The dentist will choose a shade to match your existing teeth, although over time staining can happen.

 

What are glass ionomer fillings?

Glass ionomer fillings form a chemical link with the tooth.

They may also release fluoride, which helps to prevent further tooth decay.

This type of filling is fairly weak and, because of this, is usually limited to use on baby teeth and non-biting surfaces such as around the necks of the teeth.

Little preparation is needed as the filling bonds directly to the tooth.

A veneer is like a false fingernail.

It’s a thin layer of porcelain that is colour matched to the remaining teeth and covers over the complete front surface of a tooth.

These are often used to disguise teeth that that are discoloured or heavily filled.

They are often the treatment provided that gives what’s known as the Hollywood smile. They would be a good treatment for a class 1 fracture.

Their lifespan would generally be regarded to last five years.

They often last considerably longer if looked after.

A bridge is used to replace missing teeth.

I will concentrate on a single missing front tooth.

Depending on the tooth involved and the strength of the adjoining teeth a replacement plan is put in place.

Typically the tooth on either side of the space is reduced to accept a crown. A bridge in this scenario would involve three units.

A false tooth made up of porcelain spanned on either side by a crown.

This three unit bridge is cemented into position to fill the space.

This is known as a bonded crown .

A different type of bridge is a Maryland bridge where the teeth on either side of the space are not ground down to accept a crown but instead has a false tooth supported by metal wings bonded to the inside aspects of the neighbouring teeth.

This is also a good alternative although its lifespan wouldn’t be as long as a bonded bridge.

Dental implants are devices used to replace any lost teeth.

These devices can be set in place through surgery and are known to efficiently do most of the functions of the lost teeth.

Similar to dental implants, there are other medical implants like artificial knee joints, which are used in people with damaged or worn out knee joints.

Dental implants are made using materials that won’t be rejected by human body.

These implants are used to create a substitute for any lost teeth in the patient’s mouth.

When implants and the natural teeth act in tandem, the patient is going to regain his ability to chew food properly, smile confidently and speak as legibly as he used to do before the teeth loss.

Threaded titanium cylinder, which is set on to the jawbone, is the most commonly used implant.

There are alternative dental implants like non-threaded, non-tapered cylinders and non-threaded, tapered cylinders as well.

Your dental surgeon is going to decide the appropriate implant for you based on different factors like the place of the teeth, the chewing and biting forces applicable on it etc.

Protecting your natural teeth from damage is the best method for having healthy teeth.

Even then, there are thousands of people out there with missing teeth in their jaws.

Some of them avoid the use of dentures for personal reasons or psychological reasons.

Dental implants are a dream come true for these people.

Dental implants act as the tooth roots for people with missing teeth.

These devices are attached to the jawbone or gums so that the artificial teeth can be attached to them.

The benefits of implants are better biting/chewing ability, improved speech, better physical appearance etc.

The major part of the process involves the insertion of the lightweight metal fixture on to the person’s jawbone.

Your dentist can attach the fixed or removable false teeth on to them.

The newly gained teeth are going to serve its owner ably for many years.

These dental implants have a very high efficiency rate of 90%.

As they are made with Titanium and custom fitted for each patient, these implants are a bit on the expensive side.

The people who get these devices must follow a healthy oral cleanup regimen as well as routine dentist appointments with your doctor.

You may set a denture on top of your implant.

You will be able to take it out and clean it easily.

But when they are in the mouth, they are going to stay put.

A partial dental bridge or a dental crown can also be set on top of your dental implants.

Benefits Of Dental Implants

Some of them are:

Bring your old smile back
Improved over all facial appearance
Feeling better
Better speaking ability
Improved ability to chew/bite different types of food items
Easy to manage
Better confidence levels

As dental implants are going to last efficiently for many new years of your life, ht money spent on the devices are totally worth the expense.

Frequently Asked Questions (FAQ) – Dental Implants

Am I Qualified For Dental Implants?

People with any number of missing teeth are potential candidates for dental implants.

The over all health of the person should be at a reasonably good level.

The dentist will go through your medical history before recommending you for the procedure or not.

Under control diabetes won’t be a problem in getting implants.

Be frank and discuss any and all of your queries regarding the procedure and potential problems with your dentist before opting for the implants.

If the implants have to be effective, the bone structure near the teeth should be reasonably intact.

After any teeth loss, nearby bone may start to disintegrate and the process is called resorption.

If resorption is mild in nature, the implants can be set in place safely.

In case the resorption is of a major nature, you may have to opt for dental grafting before, so as to gain sufficient bone to hold the implant in place.

While doing preliminary examination, your dentist is going to check the born structure to see if it is strong enough to support the dental implants.

 

What Proportion Of Dental Implants Is Successful?

The success rate of dental implants can vary depending on the location of them in your mouth as well as the workload imposed on them.

If the implants are for the front teeth on lower jaw, they are almost always successful with a success rate of 98 to 100%.

Front teeth belonging to upper jaw can be successful in 90 to 95% of cases and back teeth in either jaw are successful in 85 to 90% of cases.

 

How Come Dental Implants Are This Popular?

People have been living longer and longer for the past few decades.

Along with this came the need of teeth substitutes so as to help you to live longer and healthier.

As dentures and removable bridges are not reliable, people started to look for dental implants as an effective alternate for them.

As the technology became what it is today, the market for the same became obvious.

 

How Long Do I Have To Wait To Set My False Tooth On To The New Dental Implant?

Originally the agreement between dentists was to set new false teeth only four months after setting dental implants in place.

But those times have changed and dentists are reducing this time lag for people based on their health and other parameters.

Some dentists are even setting false teeth along with the implants, without any delay between the two processes.

 

Is It Painful To Have New Dental Implants?

As the dental implant surgery is performed under local anesthesia, there is no pain during the process.

But there can be pain after the effects of anesthesia wears off. Some people may feel less pain than others and vice versa.

Usually there is not much pain or discomfort associated with this procedure.

There are rare occasions where the people may feel discomfort for a few days.

Swelling andinfection are rarely possible.

 

Am I Going To Stay Teeth Less While The Implants Are Setting On My Jawbone?

The standard procedure among most dentists was to avoid using the false teeth for two weeks after the procedure. But those days are over and the current practice let people leave the dentist office with their false teeth on the same day of the surgery.

But this decision can vary from person to person and the dentist may request some to not use their false teeth for a few days.

 

What Are The Steps Involved In Dental Implant Procedure?

Your dentist is going to examine you thoroughly.

He will go through your medical history. He will also take X-rays so as to understand your dental health.

After discussion between you and your dentist on the pros and cons of your options, you may decide to go ahead with the procedure.

Now the additional steps can include:

– Set the dental implant in place through surgery.

This is done under sedation at your dentist’s office.

For the complete healing after the surgery, it may take up to four months of time.

By this time, the implants will become attached to the bone through osseointegration.

– During the second session, your dentist will connect the post to the implant.

Your false teeth are going to be held in place by the post.

The procedure can be completed in a short interval under local anesthesia.

– In this final session, the dentist will get impressions and make false tooth based on them.

It can be a while before the whole process will be over.

Once done, you will be blessed with the beauty of your original teeth.

A denture is a prosthetic designed to replace missing teeth and may be removable or fixed to existing teeth or implants.

Complete dentures replace all the teeth on one or both arches and retention is obtained either by attachment to dental implants or the remaining soft tissue and bone ridge.

Partial dentures fill in the gaps left by missing teeth and prevent the remaining teeth from moving.

These dentures are retained in place by suction to the soft tissue or attachment to other teeth.

Dentures help in the normal functions of chewing and speaking but also benefit the wearer by supporting facial muscles and enhancing the facial appearance.

Dentures are normally expected to last five to seven years.

The fit of a denture will tend to diminish as gums shrink and bone is resorbed.

In the short-term, a denture can be re-lined to compensate for these factors but eventually normal wear and tear will require replacement of the denture.

There are several options available when considering replacement of a denture.

Implants offer the closest solution to replacing the original missing teeth and also give the most protection against further bone loss.

In the case of complete dentures, implants can be used either to replace all the missing teeth or a denture can be used in conjunction with a number of anchoring implants that hold the denture in place.

The benefit of an implant-anchored denture is that it provides a more stable solution than a denture alone and helps avoid the common problems of dentures not staying in place when eating or speaking.

A replacement denture can be made using the same or different materials.

Dentures and the underlying tissue should be examined at least annually.

Review of the performance of the denture and the supporting anatomy on a regular basis can ensure that any deterioration of either can be detected early and action taken to avoid irreversible changes to oral structure or facial appearance.

Cracked or damaged dentures can often be repaired quickly and perhaps on the same day.

Wearing damaged dentures can adversely affect oral health and should be repaired without delay.

Removable dentures should be removed at least daily to be cleaned.

They are subject to the same destructive effects of plaque as normal teeth and should be cleaned by gently brushing them with a toothbrush and a small amount of toothpaste.

Remove partial dentures when brushing the remaining teeth and clean them on their own.

Clinical research have shown that removal of dentures for at least eight hours (such as overnight) has a beneficial influence by allowing the gums to rest and receive stimulation from the tongue and saliva.

Any dentures removed from the mouth should be kept safe in a jar of water or cleansing solution.

Why do I need a root canal treatment?

Root canal treatment (root canal filling) is needed when the pulp, commonly called “the nerve” is either inflamed, dead or infected, or is at risk of becoming so in the future.

The pulp extends along small channels which are situated in the centre of the root(s) of teeth (“the root canals”).

The reason for the pulp being damaged maybe any of the following:

• Dental or “tooth” decay (fig. A)

• Large or deep filling

• Leakage under an old crown or filling

• Trauma (from a fall, accident or sports injury)

• Cracks or fracture in the teeth

Where a damaged or dead pulp is not removed, it will often become infected and may result in a dental abscess.

Root treatment may not be as successful when there is long standing or severe infection such as a dental abscess.

A successful root canal treatment may extend the functional life of a badly damaged tooth when very often the only real alternative is extraction of the tooth.

The treatment is carried out under local anaesthetic, just like a filling, and is generally painless. The objective is to remove the pulp tissue and any infection from the root canals in the centre of the tooth.

These canals are then filled with a combination of a rubber-like material called ‘gutta-percha’ and a sealer cement to provide a good root filling and prevent bacterial infection.

During the procedure the dentist uses fine metal instruments (files) along with a disinfectant material to clean out the root canals. (fig.B)

Once the root canal is cleaned and the root filling completed, the tooth must then be restored to complete the seal from oral bacteria.

how long will it take?

This depends on a number of factors including, which tooth is being treated and whether or not infection is present.

An upper front tooth has only one canal, whereas a molar or back tooth has three or four canals of more complex shape and size.

An infected tooth will possibly require more than one visit for adequate cleaning and disinfection.

Where the treatment is carried out over several visits, a temporary filling is placed as a seal between visits.

Will it be painful after a visit?

Some discomfort and tenderness is possible for the following few days, especially if there was pain before the treatment commenced.

This can be managed with mild painkillers of your choice such as those you might use for a headache.

Any persistent or severe symptoms should be reported to your dentist.

Extraction of a tooth is in most cases the last resort in treatment options.

If extraction has to be carried out, it is done by first of all ‘numbing’ the area and then removing the tooth.

In cases of extreme difficulty, such as impacted wisdom teeth, we may refer patients to a specialist oral surgeon.

Extraction of a tooth is in most cases the last resort in treatment options.

If extraction has to be carried out, it is done by first of all ‘numbing’ the area and then removing the tooth.

In cases of extreme difficulty, such as impacted wisdom teeth, we may refer patients to a specialist oral surgeon.

Advice for patients after a routine extraction

Eating & Drinking
A soft diet after is advisable after having a tooth removed.

Take care to ensure that food does not become trapped in the socket where the tooth was.

Try to avoid alcohol and hot drinks in the period immediately following the extraction, especially if the local anesthetic effect is still present.

 

Rinsing
Do NOT repeatedly rinse your mouth out after your extraction.

A blood clot forms in the socket where the tooth was; frequent rinsing will tend to dislodge this clot thus causing bleeding to start again.

24 hours following the extraction, you should rinse your mouth with warm salty water (a half teaspoon of salt in a warm glass of water).

Repeat this 3-4 times a day after meals.

 

Cleaning
Please continue to brush your remaining teeth in the normal fashion.

Take care not to disturb the healing socket area.

 

Bleeding
If bleeding occurs after leaving the surgery, please do the following:
Roll a handkerchief / tissue into a small pad (about the thickness of your finger).
Place it over the bleeding socket and bite down on it for 20-25 minutes.

If after this period, bleeding is still occurring, please contact your dentist immediately.
(Bear in mind that minor oozing from the extraction site can occur for up to 24 hours after having the tooth removed.)

 

Swelling
You should expect to have some degree of swelling after the extraction.

This can take up to 10 days to resolve in some cases.

 

Smoking
We strongly recommend that you avoid cigarettes and other tobacco products for the 24 hours following the extraction.

Cigarette smoke can delay or prolong the healing of the extraction site, and in some cases, cause severe pain 1-4 days after the extraction (Dry
Socket).

 

Pain Control
You should expect to have some discomfort following an extraction.

If you think you may require pain killers, please discuss this with your dentist.

 

Stitches
If you have had stitches (sutures) placed after an extraction, please do not touch them or pull at them.

You should return normally one week after the extraction to have these
stitches removed.

 

Local Anaesthetic
The type of anaesthetic used by your dentist can leave your lip and other soft tissues numb for up to 4 hours.

Please be extremely careful not to bite your lip or cheek during
this time period.

This is especially important for parents to take note of if their child has
had local anaesthetic.

In addition, take care not to burn yourself with very hot drinks – you will not realise what has happened until after the anaesthetic effect has worn off.

The chances of somebody suffering from gum disease are greatly reduced with regular visits to the dentist.

In some instances, however, patients will require more intense treatment to halt the process of tissue breakdown.

These may range from cleaning under local anesthetic, through to small surgical procedures to remove infection, which allow patients to clean their teeth properly.

Each individual case will be assessed and treated accordingly by the dentist in conjunction with the hygienist.

Gum disease is the term used to describe the process of tissue breakdown that results in loose teeth, or at worst, lost teeth.

Gum disease is a chronic infection and its presence can have a detrimental effect on the entire body.

There are proven links between gum disease and other serious heart conditions, diabetes, and strokes for example

The chances of somebody suffering from gum disease are greatly reduced with regular visits to the dentist.

In some instances, however, patients will require more intense treatment to halt the process of tissue breakdown.

These may range from cleaning under local anesthetic, through to small surgical procedures to remove infection, which allow patients to clean their teeth properly.

Each individual case will be assessed and treated accordingly by the dentist in conjunction with the hygienist.

Gum disease is the term used to describe the process of tissue breakdown that results in loose teeth, or at worst, lost teeth.

Gum disease is a chronic infection and its presence can have a detrimental effect on the entire body.

There are proven links between gum disease and other serious heart conditions, diabetes, and strokes for example.