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TREATMENTS

GENERAL PROCEDURES

Examination

What is a dental examination?

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.


Fillings

There are two basic types of filling material that are widely used:

1. composite resin, which is a very hard plastic, and is white in colour.

2. dental amalgam, which is a metal alloy

Composite Resin Fillings

Composite resins are tooth-colored, plastic materials (made of glass and resin) that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites have improved dramatically in quality in recent years and are now the filling of choice in our practice for both front and back teeth. In back teeth composite resins are more difficult to place and consequently are more costly than amalgam fillings.

Dental Amalgam

Used for more than 150 years, dental amalgam (a.k.a. silver filling) is a safe, affordable and durable material used to restore the teeth of many hundreds of millions of people worldwide. Its main benefit is its strength and durability. Its downside is its appearance. The use of amalgam is declining mainly because of a reduction in dental decay and also because of the development of better tooth coloured materials.


Fissure Sealants

What are Sealants?

Sealants are a safe and painless way or protecting your children’s teeth from decay. A sealant is a protective plastic coating, which is applied to the biting surfaces of the back teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.

Which teeth should be sealed?

Sealants are only applied to the back teeth – the molars and premolars. These are the teeth that have pits and fissures on their biting surfaces. 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 involved?

The process is usually quick and straightforward taking only a few minutes per tooth. The tooth is thoroughly cleaned, prepared with a special solution, and dried. The liquid sealant is then applied and allowed to set hard – usually by beaming an intense light onto it.

Will my child feel it?

No, it is totally pain free, and the teeth do not feel any different afterwards.

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.

When should this be done?

Sealants are usually applied as soon as the permanent teeth start to come through. This is usually between 6 and 7 years of age. These first molars are the most susceptible to decay. The rest of the back teeth can be sealed later any time between 11 and 14 years of age.

Do my children still have to clean their teeth?

Yes. It is still vital that they do this. The smooth, sealed surface is now much easier to keep clean and healthy with normal toothbrushing. Pit and fissure sealing reduces tooth decay and the number of fillings your child might need.


Hygiene

What does a Hygienist do?

Your dental hygienist will carry out careful removal of all traces of plaque and tartar from the teeth and gum pockets. This restores your gums to a healthy state. She will also demonstrate ways that you can keep good plaque control yourself such as special tooth brushing techniques or use of interdental floss or brushes. If there is a lot of deep cleaning to be done the hygienist will put some local anaesthetic solution into your gums to make the treatment more comfortable. A few visits may be necessary to get your gums back to full health.

It is vital that this is followed by regular recall visits every three to six months. If you are able to maintain good plaque control then in most cases the gums will begin to heal. The inflammation will disappear and the gums will tighten up around the root surfaces. However, it must be stressed that the outcome of treatment will depend in the most part on the plaque control you are able to maintain yourself at home.

Plaque and Gum (periodontal) Disease:

Plaque is the name given to a film of bacteria which is constantly forming on all teeth. Plaque causes tooth decay and gum disease. Good oral hygiene will help prevent this disease. Brushing your teeth regularly helps remove plaque from the surface of the teeth.

  • It is important to brush the teeth twice a day with a soft to medium bristled brush. Be sure to choose a brush of the right size and shape.
  • Clean between the teeth using inter-dental brushes (TePes) or floss. Your hygienist or dentist will advise you. Plaque produces substances that attack and inflame gums making them bleed easily. If the gums are not treated the bone around the teeth can be destroyed.
  • Gum disease is one of the main causes of tooth loss in adults.

Assessing the Health of your gums and the support for the Teeth

A vital part of the management of gum disease is a careful recording of the condition of your gums before active treatment starts. This will involve the measurement of gum pockets and of the amount of plaque and bleeding present. This is important so that we can assess progress and plan future treatment. The time taken to record these measurements is as valuable as time taken in active treatment. Most of your first appointment may be taken up with these recordings.


Extractions

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 wisdom teeth extraction, we refer patients to a specialist.


Root Canal Treatments

Why is it necessary?

It is usually necessary because of severe pain. There may also be swelling. The classic toothache is usually due to damaged or infected pulp tissue (you call it "the nerve").

Root canal therapy removes this damaged or infected tissue, thereby eliminating the pain.

The dental pulp, or "nerve," can be damaged due to the following reasons:

  • deep decay
  • severe tooth fracture
  • repeated fillings over many years
  • associated severe gum disease
  • trauma

How is it done?

Local anaesthetic is administered, and a small hole is made in the top or back of the tooth. A series of thin, flexible "files" are introduced into the roots to remove all remaining tissue and infection. Irrigating liquids are used to sterilize the inside of the tooth. Occasionally antibiotics are used to control infection. The cleaned canals are then filled with an inert, pink, rubbery-like material.

The success rate of root canal treatment, when properly performed, is in the range of 95%.

So why do we sometimes hear stories about the loss of these teeth after treatment?

The greatest cause of tooth loss after root canal therapy is severe tooth fracture due to inadequate reinforcement of the tooth. Proper reconstruction with a core filling and crown will virtually eliminate the potential for fracture.


Orthodontics

What is orthodontics?

Orthodontics is the branch of dentistry that focuses on the diagnosis, prevention and treatment of dental and facial irregularities.

At what age can people have orthodontic treatment?

Children and adults can both benefit from orthodontics, because healthy teeth can be moved at almost any age. However it is a good idea to have a child assessed either by the family dentist or by a specialist shortly after the permanent teeth start to erupt (age 7 -8) to see if there are any problems developing. A decision can then be made as to whether early intervention is appropriate or whether it is better to wait until all the permanent teeth erupt (about age 12).

What causes crooked teeth?

Most malocclusions (poorly aligned teeth)) are inherited, but some are acquired. Inherited problems include crowding of teeth, too much space between teeth, extra or missing teeth, and a wide variety of other irregularities of the jaws, teeth and face.

Acquired malocclusions can be caused by trauma (accidents), thumb, finger or dummy sucking, airway obstruction by tonsils and adenoids, dental disease or premature loss of primary (baby) or permanent teeth. Whether inherited or acquired, many of these problems affect not only alignment of the teeth but also facial development and appearance as well.

What are the most commonly treated orthodontic problems(malocclusions)?

  • Crowding: Teeth may be aligned poorly because the dental arch is small and/or the teeth are large. The bone and gums over the roots of extremely crowded teeth may become thin and recede as a result of severe crowding. Impacted teeth (teeth that should have come in to the mouth, but have not), poor biting relationships and undesirable appearance may all result from crowding.
  • Overjet or protruding upper teeth: Upper front teeth that protrude beyond normal contact with the lower front teeth are prone to injury, often indicate a poor bite of the back teeth (molars), and may indicate an unevenness in jaw growth. Commonly, protruded upper teeth are associated with a lower jaw that is short in proportion to the upper jaw. Thumb and finger sucking habits can also cause a protrusion of the upper incisor teeth.
  • Deep overbite: A deep overbite or deep bite occurs when the lower incisor (front) teeth bite too close or into the gum tissue behind the upper teeth. When the lower front teeth bite into the palate or gum tissue behind the upper front teeth, significant bone damage and discomfort can occur. A deep bite can also contribute to excessive wear of the incisor teeth.
  • Open bite: An open bite results when the upper and lower incisor teeth do not touch when biting down. This open space between the upper and lower front teeth causes all the chewing pressure to be placed on the back teeth. This excessive biting pressure and rubbing together of the back teeth makes chewing less efficient and may contribute to significant tooth wear.
  • Spacing: If teeth are missing or small, or the dental arch is very wide, space between the teeth can occur. The most common complaint from those with excessive space is poor appearance.
  • Crossbite: The most common type of a crossbite is when the upper teeth bite inside the lower teeth (toward the tongue). Crossbites of both back teeth and front teeth are commonly corrected early due to biting and chewing difficulties.
  • Underbite or lower jaw protrusion: About 3 to 5 percent of the population has a lower jaw that is to some degree longer than the upper jaw. This can cause the lower front teeth to protrude ahead of the upper front teeth creating a crossbite. Careful monitoring of jaw growth and tooth development is indicated for these patients.

Why is orthodontic treatment important?

For most children or adults, the main downside of crooked and crowded teeth is that they are perceived as unsightly. Orthodontic treatment therefore can often greatly improve a person's self image and confidence.

Crooked teeth can also be hard to clean and maintain. This may contribute to conditions that cause not only tooth decay but also eventual gum disease and tooth loss. Other orthodontic problems can contribute to abnormal wear of tooth surfaces, inefficient chewing function, excessive stress on gum tissue and the bone that supports the teeth, or misalignment of the jaw joints, which can result in chronic headaches or pain in the face or neck.

The value of an attractive smile should not be underestimated. A pleasing appearance is a vital asset to one's self-confidence. A person's self-esteem often improves as treatment brings teeth, lips and face into proportion.

In general, active treatment time with orthodontic appliances (braces) ranges from 18 months to abaout 30 months. Interceptive, or early treatment procedures, may take only a few months. The actual time depends on the growth of the patient''s mouth and face, the cooperation of the patient and the severity of the problem. Mild problems usually require less time, and some individuals respond faster to treatment than others. Use of rubber bands and/or headgear, if prescribed, contributes to completing treatment as scheduled.

While orthodontic treatment requires a time commitment, patients are rewarded with healthy teeth, proper jaw alignment and a beautiful smile that lasts a lifetime. Teeth and jaws in proper alignment look better, work better, contribute to general physical health and can improve self-confidence.

What records are necessary before orthodontic treatment is started?

Diagnostic records are made to document the patient's orthodontic problem and to help determine the best course of treatment. As orthodontic treatment will create many changes, these records are also helpful in determining progress of treatment. Complete diagnostic records typically include a medical/dental history, clinical examination, plaster study casts of the teeth, photos of the face and teeth, a panoramic or other X-rays of all the teeth, a facial profile X-ray, and other appropriate X-rays. This information is used to plan the best course of treatment, help explain the problem, and propose treatment to the patient and/or parents.

How is treatment accomplished?

Custom-made appliances, or braces, are prescribed and designed by the orthodontist according to the problem being treated. They may be removable or fixed (cemented and/or bonded to the teeth). They may be made of metal, ceramic or plastic. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new desirable position.

How have new "high tech" wires changed orthodontics?

In recent years, many advances in orthodontic materials have taken place. Braces are smaller and more efficient. The wires now being used are no longer just stainless steel. They are made of alloys of nickel, titanium, copper and cobalt, and some of the wires are heat-activated. (The nickel-titanium alloy was originally engineered by NASA to automatically activate antennae or solar panels of spacecraft orbiting into the sun's rays.)

How do braces feel?

Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. Overall, orthodontic discomfort is short-lived and easily managed.

Do teeth with braces need special care?

Keeping the teeth and braces clean requires more precision and time, and must be done every day if the teeth and gums are to be healthy during and after orthodontic treatment. Patients who do not keep their teeth clean may require more frequent visits to the dentist for a professional cleaning.

How important is patient cooperation during orthodontic treatment?

To successfully complete the treatment plan, the patient must carefully clean his or her teeth, wear rubber bands, headgear or other appliances as prescibed, and keep appointments as scheduled. Damaged appliances can lengthen the treatment time and may undesirably affect the outcome of treatment. The teeth and jaws can only move toward their desired positions if the patient consistently wears the forces to the teeth, such as rubber bands, as prescribed.

Please summarise the steps in having orthodontic treatment?

Assessment and Records

  • Data collection
  • X-rays
  • Study casts
  • Photos

Plan of Treatment discussed, costed and agreed

  • Active treatment - usually between 18 and 30 months
  • Retention phase - it is vital to wear retainers after the completion of treatment to ensure that there is no relapse.

FILLING SPACES

Dentures

Complete Denture

If you’ve lost all of your natural teeth, whether from periodontal disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile. Replacing missing teeth will benefit your appearance and your health. Without support from the denture, facial muscles sag, making a person look older. You’ll be able to eat and speak—things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures.

  • A conventional denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed which may take several months.
  • An immediate denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

Partial Dentures

Partial dentures replace some missing teeth. There are two types, plastic and metal based. Plastic partial dentures are less expensive to make. But unless they are designed very carefully they can damage the teeth they fit against. Metal partial dentures are usually from an alloy of cobalt and chromium and they are much stronger. They are lighter to wear and can be supported by the remaining teeth. Although the base is metal, they have gum-coloured plastic and natural-looking teeth fixed to them. They are more expensive than the plastic ones.

How do I look after my denture?

The general rule is: brush, soak, brush. Always clean your dentures over a bowl of water or a folded towel in case you drop them. Brush your dentures before soaking, to help remove any food debris. The use of an effervescent denture cleaner will help remove stubborn stains and leave your denture feeling fresher – always follow the manufacturers’ instructions - then brush the dentures again, as you would your own teeth, being careful not to scrub too hard as this may cause grooves in the surface. Most dentists advice using a small to medium headed toothbrush and toothpaste. Make sure you clean all the surfaces of the dentures, including the surface which comes into contact with your gums. This is especially important if you use any kind of denture fixative.


Bridges

How does a Bridge Work?

Technically they are similar to individual crowns attached together in a series. Similarly, the procedures to fabricate fixed bridges are virtually identical to individual crowns, although somewhat more extensive. The final result will closely mimic the look and feel of natural teeth.

Technically they are similar to individual crowns attached together in a series. Similarly, the procedures to fabricate fixed bridges are virtually identical to individual crowns, although somewhat more extensive. The final result will closely mimic the look and feel of natural teeth.

Construction of Fixed Bridges

  • Diagnosis: Determination of number and health of support teeth, including periodontal (gum) status, mobility (looseness), cosmetic implications, occlusion (“bite”), and other factors. The number of support teeth will vary depending on the diagnosis. Teeth with supporting bone loss due to periodontal disease are less able to accept the added load that fixed bridges create. As a result, more support teeth may be needed if periodontal disease has been a problem.
  • Preparation and impressions: The teeth that will support the bridge are first shaped and refined. Then an impression (mould) is made of the teeth, as well as the adjacent teeth and the teeth of the other jaw. These impressions are used to construct models of the prepared teeth, and are used in the laboratory during fabrication of the bridge.
  • Temporisation: Temporary fixed bridgework is usually fabricated to stabilize support teeth, provide for effective function and give a reasonable appearance.
  • Evaluation: It is common to evaluate bridgework in its various stages of fabrication. This enables detailed verification of correct fit prior to finalising the aesthetic ceramic layer. Additionally, the ceramic layer may be evaluated for correct occlusion (bite) prior to the application of final colour and shading.
  • Cementation: Final evaluation and placement of the non-removable bridge.

Implants

Role of Dental Implants

Dental implants have significantly expanded our capabilities to replace missing teeth, and now allow us to avoid removable tooth replacements in many circumstances. Additionally, dental implants can provide us with the capability of replacing missing teeth without having to involve adjacent sound, natural teeth. You can think of a dental implant as an artificial root. With “roots” now replacing missing teeth, we can build on these implants to construct crowns and fixed bridges.

Unlike fixed bridges, individual missing teeth can be replaced with a single implant while leaving adjacent healthy teeth alone.

Implants can also be used as primary or additional support for non-removable bridges when traditional therapy required a removable partial denture.

Implants can also be used to support a denture and make it very much more secure.

There are too many possible treatment approaches to list, and each reconstruction needs to be individually planned.

Reconstruction with Dental Implants

Planning reconstructive care with dental implants requires careful coordination between the surgical phase and reconstructive phase. It is vital to fastideously plan the entire treatment and prosthesis prior to implant placement surgery. This reduces unexpected surgical and anatomical complications and ensures the best possible outcome.

  • Diagnosis: Dental x-rays, panoramic x-rays, diagnostic models, and CT scans are commonly performed. This enables full planning of both the surgical and reconstructive phases of treatment.
  • Implant placement: The surgical procedure to place the implants in the jaw is generally performed with a conventional local anaesthetic. Sedation can be arranged if you are very nervous. While in the past many types of implant remained completely covered by gum tissue during the healing phase, this is now less usual and the implant is allowed to heal with a 'healing cap' attached to its head. This cap prevents the gum from growing over. The healing phase is now usually less than three months.
  • Implant evaluation: After the appropriate healing time, the implants are checked and evaluated for stability.
  • Reconstruction: It is now time to build the final tooth structure on top of the implant(s). This can be an individual crown or a bridge of some type, thus replacing one or more teeth.

COSMETIC TREATMENTS

Veneers

What are Porcelain Veneers?

Porcelain veneers, often alternatively termed porcelain laminates, are wafer-thin shells of porcelain which are bonded onto the front side of teeth so to make a cosmetic improvement in their appearance. Porcelain veneers are used to restore the ideal appearance to teeth that are discolored, worn, chipped, or misaligned. Different dental materials can be used for this purpose, but porcelain has distinct advantages.

Costs

Single porcelain veneers are notoriously difficult to colour match with the natural teeth. Consequently the more veneers that are done - the easier the matching.

What are the advantages of porcelain veneers over other types of cosmetic dental bonding?

Translucency

Porcelain veneers, because they are glass-like, have a great advantage over other types of cosmetic dental bonding by the fact that they are translucent. When they are bonded onto a tooth's surface they mimic the light handling characteristics of enamel.

Light striking a porcelain veneer will penetrate its thickness, and then subsequently be reflected back out once it has reached the opaque cement and tooth structure lying underneath the veneer. This translucency effect provides a sense of depth, and thus a very life-like appearance.

Porcelain veneers resist staining

Cosmetic dental bonding materials utilised in the past had the shortcoming of being susceptible to staining and discoloring. This was especially a problem for those people whose teeth had excessive exposure to tea, coffee, red wine, or cigarette smoking.

A significant advantage of porcelain veneers over other types of cosmetic dental bonding is related to the fact that a porcelain veneer's surface is just that, porcelain. Since porcelain is a ceramic, and therefore glass-like, its surface is extremely smooth and impervious. This means that the surface of a porcelain veneer will not pick up permanent stains.


Tooth Whitening (Bleaching)

Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours.

The options are as follows:

  • In-surgery bleaching
  • At-home bleaching
  • Whitening toothpastes

What is in-surgery bleaching?

Because of new EU legislation the concentration of hydrogen peroxide used for tooth whitening cannot exceed 6%. Consequently in-surgery bleaching is not likely to be effective – getting a good result simply takes more time.

What is at-home bleaching?

On day one, impressions (moulds) are taken of your teeth. We then construct custom-fitted soft mouthguards (bleaching trays), which you wear ideally in bed overnight. These trays contain the bleaching agent which we supply.

Treatment time is generally about 2 weeks, although even after 1 week there is a noticeable improvement in most cases.

A follow-up appointment is needed to review progress. The treatment continues until the desired shade is achieved. This method is very effective, has a long track record and the results are better than any other method.

What are whitening toothpastes?

All toothpastes help remove surface stain through the action of mild abrasives. "Whitening" toothpastes usually have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these products do not alter the intrinsic color of teeth.

Re-bleaching

Once you have whitened your teeth they stay good for between 1 and 3 years. However, you can ‘touch up’ your bleaching at any time so it is very important to keep your bleaching trays. Re-bleaching takes only a quarter of the time used in original bleaching to achieve a desired degree of whiteness.

Background & Safety Record

Prior to its introduction into the dental literature in 1989, this technique had been used for patient care since 1968. Laboratory studies published have shown no significant detrimental effects on teeth or restorations, and animal/tissue studies have shown no detrimental effects systemically or on oral tissues. However, it is advisable to cease smoking during treatment.

Recent literature indicates that this form of dentist-prescribed, home-applied bleaching using a concentration of no more than 6% hydrogen peroxide, when preceded by a proper examination and correct diagnosis, applied with a properly-fitted prosthesis and monitored as needed by a dentist, is a safe procedure. Human clinical studies have shown 9 out of 10 patients have a successful experience.

Response Variation

Most persons using home bleaching experience some lightening of their teeth, even if it may not be to the extent they desire. However, not all patients are responsive to the treatment, and not all patients respond at the same rate.

  • Some patients’ teeth get very naturally white, while other patients’ teeth (especially those stained by the antibiotic tetracycline) get lighter but retain a grey colour.
  • Tetracycline-stained teeth are the least responsive. Also teeth of a deep grey colour are difficult to whiten.
  • Brown-fluoresced teeth and single dark teeth respond moderately
  • Teeth discoloured by age, genetics, smoking or coffee stains are the most responsive to bleaching.

Teeth in the two "less-responsive" categories often require an extended treatment-time to achieve the maximum benefit.

Possible Side Effects

In approximately 65% of people using this dentist-prescribed, home bleaching treatment, researchers have noted two common side effects:

  • The most common side effect noted is that some teeth may be more sensitive to temperature changes during treatment. However, sensitive teeth return to normal when treatment is terminated, and no long-term effects noted from this sensitivity (7-year recalls).
  • For some patients the peroxide solution may initially cause some tissue irritation on an isolated portion of the gums. Chemical irritations may resolve in 1-4 days without cessation of treatment.

Limiting factors

There are no upper age limitations. Older people's teeth respond well, although some root surfaces do not lighten much. The lower limit of treatment to comply with EU legislation is 18 years of age. Treatment is not recommended on pregnant women or nursing mothers because, in general, it is good practice to postpone all elective dental procedures during pregnancy. Very heavy combined smoking and drinking makes a patient unsuitable for tooth whitening due to the fragility of the lining of the mouth.


Crowns

When are they Necessary?

Crowns, and variations of crowns such as onlays, are designed to strengthen or reconstruct teeth that have extensive fillings or fractures. They may also be used to enhance the appearance of teeth.

  • There are many materials used to construct crowns, from metals such as gold, to resins and ceramics. Each material has its unique advantages and disadvantages. As a result, there is no “perfect” material.
  • Many crowns today are constructed of an all ceramic material, usually either Lithium Disilicate or Zirconia. Ceramic material fused to a metal substructure was used for many years and had an excellent track record. This type of crown is still popular. It have good aesthetics and great strength, being almost indestructible.

How are Crowns Constructed?

The process of restoring a tooth with any type of crown takes a fairly similar course.

  • Diagnosis: The tooth is evaluated to determine extent of decay, periodontal (gum) health, and type of crown restoration.
  • Preparation: Local anaesthesia is administered and the tooth is prepared for the crown restoration.
  • Impression: An impression (mould) is made of the tooth, as well as the adjacent teeth and the teeth of the other jaw. These impressions are used to construct models of the prepared tooth, and are used in the laboratory during fabrication of the crown
  • Temporisation: A temporary crown is fabricated and placed on the prepared tooth for the duration of the laboratory phase. This is usually a number of weeks.

White Fillings

Composite resin is by far the most commonly used white material used to restore both front and back teeth.

Composite resins are tooth-colored, plastic materials (made of glass and resin) that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites are always used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. In back teeth composite resins are more difficult and more time consuming to place and consequently are more costly than amalgam fillings.

Other Treatments

Mouth Guard

A mouth-guard or gum shield is the most important piece of equipment a contact sport's player should own.

The mouth-guard not only protects your teeth and gums, it can reduce damage around the jaw and your chances of getting concussed. As every mouth is different, so every mouth guard should be moulded to fit perfectly around the top half of a player's mouth.

The best way to do this is to see your dentist, who will take moulds of your mouth and make sure the shield is custom made for you.

The other type of mouth-guard is the "boil and bite" type which you mould yourself using hot water. Put the warm shield in your mouth and suck on it for roughly three minutes until it has moulded to the shape of your upper teeth.

Whether you opt for a custom made mouth-guard or a "boil and bite type", the most important thing is to make sure you wear some sort of protection when playing contact sports.


Anti-Snoring Devices

In the treatment of obstructive sleep apnoea or other sleep disturbances or snoring conditions, dentists can have an important role in the screening of patients for signs and symptoms which may predict the presence of obstructive sleep apnoea syndrome.

Obstructive Sleep Apnoea is a condition that can have serious consequences. It is important that all patients who exhibit signs and symptoms of sleep apnoea should have a proper medical assessment and, if necessary, be referred to an appropriate specialist trained in the diagnosis and treatment of OSA.

Where obstructive sleep apnoea is present, any anti-snoring device should only be provided as part of an integrated treatment plan. An anti snoring device can come in different designs but is usually a clear plastic device fitted to your upper teeth. Worn at night, it is comfortable and well secured. The device works by repositioning your lower jaw, keeping your tongue in a forward position, and enables you to maintain an open airway.

Because of the possible medical implications of snoring we take the view that the treatment of snoring should only be carried out by a professional with appropriate expertise in the treatment of sleep apnoea.


Anti-Grinding Devices

Anti-Grinding Devices, or Nightguard Appliances as they are more commonly known, take the punishment that your teeth would normally endure during night-time grinding to minimize the damage from grinding your teeth.

A nightguard appliance is a custom-made thin transparent horseshoe-shaped (retainer like appliance) made of hard plastic that has shallow borders for good tooth alignment and ideal bite relationship.

This appliance is worn between the top and bottom teeth and does not allow the teeth to interlock which absorbs the force of the clenching and grinding to elimate wear on your teeth and also to reduce jaw joint irritation and inflammation.

How is the appliance made?

  • At the first appointment an accurate impression of your upper and lower teeth will be made. These impressions are used to create models of how your teeth fit together. These items are used to form a customized heat-processed hard plastic nightguard appliance.
  • At the second appointment the final fitting and adjustment of the nightguard will be carried out.