White Filling

White Fillings are made from composite resin and provide a more aesthetically pleasing alternative to amalgam (silver) fillings. Unlike amalgams, composite resins bond chemically to tooth structure. By doing this they hold portions of a tooth together, somewhat protecting the tooth against fracture. In some situations, the tooth may be so heavily restored that it may still need further reinforcement with a crown.

Once all decay is removed from the cavity, the correct shade of composite resin material is selected to match the patient’s natural tooth colour. Amalgams, however, must be locked into undercuts within the tooth. This can undermine the strength of the surrounding tooth structure. Over time, amalgams slump or deform into the tooth – a condition known as ‘creep’ – this can have a splitting effect on the surrounding tooth. These days, composite resin is the best material for restoring teeth by direct technique.

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Composite material may be bonded to both front and back teeth. Bonding applies mainly to front teeth to enhance their appearance. No tooth preparation (drilling) is required for direct bonding and no local anaesthetic is necessary for such procedures.

Bonding may provide a less expensive alternative to indirect porcelain veneers. This technique can be to situations where teeth are chipped, poorly-shaped, discoloured or spaced apart.

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Porcelain veneers (facings) are often a suitable alternative for patients with discoloured, poorly-shaped or slightly misaligned teeth. Providing the tooth structure involved is in reasonable condition (preferably not heavily filled), veneers are a more conservative approach to crowns.

A thin layer of the front surface of the tooth is prepared and impressions are taken from which porcelain veneers are manufactured in the lab by a dental ceramist. At the return visit, providing the veneers fit accurately and the colour/shape are correct, they are bonded into place, trimmed and polished by the dentist.

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Teeth Whitening

For teeth that are naturally discoloured, bleaching may provide the most cost effective alternative to achieving a brighter smile. Providing your front teeth are not already heavily filled, this whitening process is very affordable. Impressions of your teeth would be required for the construction of custom made bleaching trays. These act to hold a mild bleaching gel against the tooth surface – the trays are often worn during sleep.

The home bleaching techniques/products are completely safe providing the patient follows the directions of the dentist. After bleaching, some white fillings on front teeth may require replacement. Bleaching trays may be kept and reused if further tooth whitening is required in future.

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Root Canal Therapy

If a tooth has suffered damage within its nerve and blood vessels due to either trauma, deep decay or extreme wear, it may still be possible to save if Root Canal Therapy (RCT) is performed. If the tooth remains untreated, an infection (tooth abscess) may develop resulting in pain and swelling.

RCT involves the careful removal of the dead nerve tissue within the tooth, hence, preventing the development of infection within the root system. The procedure is performed under local anaesthetic over 3-4 visits. At each visit, a rubber dam sheath is placed around the tooth to ensure the open cavity that leads to the roots is not contaminated with saliva.

Once the nerve canals are completely cleaned, they are sealed and a final restoration is placed. Quite often, crowning of root-filled teeth is necessary if parts of the remaining tooth structure are weak.

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Jaw & Bite Problems

If you suffer from tooth wear, jaw muscle/jaw joint fatigue and headaches, it is quite possible you may be grinding your teeth during sleep.

Quite often your partner or another family member may hear this grinding during your sleep. If the problem is habitual and long-term, the best management is Occlusal Splint Therapy. An occlusal splint is a simple bite guard that is custom made to prevent tooth wear and protect the jaw muscles/joint against the forces of nocturnal grinding.

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Crown & Bridgework

Crowns (or caps) are indicated when teeth are heavily filled or severely damaged. If the tooth in question has had Root Canal Therapy (RCT), it will normally be reinforced with a metal post, forming part of the foundation for the overlying crown. Teeth can only be crowned if their supporting tissues (the gums and bone) are in a healthy condition.

Crowning a tooth involves preparing back the outer surface of the tooth, leaving a slightly smaller version of the tooth. This surface removal of tooth structure allows space to accommodate the crown which acts like a protective shell over the tooth. This shell prevents the weak tooth from splitting or the large filling from crumbling away.

Once a tooth is crowned, instead of the heavily restored tooth requiring refilling every 2-3 years, it becomes a very low maintenance tooth.

Bridgework follows the same concept as crowns in protecting heavily filled teeth, however, it also closes spaces between one or more missing teeth. Again, both supporting teeth must have healthy supporting tissues.

Dental implants may also be considered before deciding on any bridgework. Despite being more expensive they have the advantage of the new tooth ‘standing on its own two feet’. This means not involving the other adjacent teeth. However, bridgework may still be preferable to implants if these supporting teeth are heavily restored. Bridging them would improve their strength as well as restore function to the area where teeth were missing.

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