At Lee Dental Practice, we enjoy the challenge of restoring your health and smile. Now there is much more that we can do to help repair and restore your teeth. Modern ceramics make beautiful longer lasting fillings. We can also make beautiful crowns, inlays and onlays. If you break a tooth it can be fixed all in one session’ restoring the tooth as close as we can to its original strength and beauty. Take a look below to find about more about the options available.
Spot decay before it gets serious.
When you visit for a check-up, your dentist will use a small inspection mirror to assess the surface of your teeth, looking for signs of decay or little cracks and fissures. We also use an intra oral camera to take pictures of the problem. They will let you know as soon as they see anything that might require treatment, and a small filling is a lasting preventative solution that far outweighs a root canal treatment, which can be the result of extensive decay. By closing up the gap, your dentist is preventing bacteria from getting in and preserving your tooth in the least invasive way.
The process is straightforward and often only requires one or two appointments. Once your dentist has assessed the area that requires treatment, they will clear out any decay before filling the clean cavity with a material of your choice.
What kind of fillings are available?
There are a number of different materials that can be used to fill the cavity in your tooth. Indirect fillings are those that require a couple of visits as the tooth is treated with a tailor made filling that has to be crafted to your needs in a dental laboratory before fitting.
Direct fillings are those that can be applied in one sitting, or chair side. White or tooth coloured fillings ; prove to be the most popular of these options as they remain the quickest and most natural-looking of the options – no one can tell that you’ve had a filling.
- Porcelain fillings: Porcelain fillings are referred to as onlays or inlays, and are custom-made and then fitted to your teeth. They boast a similar durability to that of gold fillings, but look much more natural.
- Gold filling: Gold is known for its low reactivity, meaning it is a safe substance to leave in your mouth for years. Gold fillings are also long-lasting and could stay in place well for over 15-20 years. However, gold fillings are also ‘indirect’, so they require manufacture in a dental laboratory and then applying to your teeth, making this one of the longer processes.
- Composite resin fillings: Composite resin is a kind of plastic that will match your natural tooth colour, making a filling less visible. The resin mixture can be placed straight into the cavity, making it a relatively quick treatment, and as less durable as gold or silver.
- Silver (amalgam) fillings: Silver fillings are also durable, but due to their noticeable colour are mostly used for treating the back teeth. The silver filling is made from an alloy that contain Mercury, which has become an environmental issue in the last few years.
Should you require a filling, your dentist will discuss with you the different options available and best advice on the most suitable for you and your teeth.
Root Canal Treatment
Root canal treatment can make all the difference between losing a tooth and saving it. It is a complex treatment, as it involves removing infected matter from the roots system of your tooth, and then filling it.
Our dentists at Lee Dental Practice have many years of experience, together with an excellent success rate, which means you can relax in a safe environment.
If you have been experiencing severe, throbbing, longer lasting tooth pain, it is possible that you may require root canal treatment. If your tooth has become damaged or cracked, you have tooth decay, large fillings or have recently had a trauma to the tooth, the chance of a root canal procedure increases.
When is a root canal required?
Root canal treatment (or endodontics) is required when there is an infection deep within your tooth. The blood or nerve supply may be infected either due to an injury or a large cavity. You may not experience any pain or discomfort during the early stages of an infection, however if your tooth changes colour and darkens that is a sign that your tooth nerve is in danger of dying. If left untreated, this kind of infection can not only be very painful, but can lead to a tooth abscess or even tooth loss.
Five signs of infection:
- Serious toothache when eating, or when you put pressure on the tooth. Does it hurt when you bite down hard?
- Excessively sensitive teeth. Does the sensitive pain linger after the initial contact with hot or cold foods or drinks?
- Darkening of your tooth. Has your tooth changed colour? This may be a sign of the nerve dying
- A small bump on the gum, close to the painful tooth
- Tender or swollen gums around the tooth
Why is it called a root canal?
The visible part of your tooth, above the gum line is called the ‘crown’. Below the gum, fixing the tooth to the jaw, is the ‘root’ of your tooth. The root canal system is a network that fills a central hollow area inside the tooth and down to the roots. Root canals are filled with loose connective tissue called ‘dental pulp’ and they are responsible for nourishing and hydrating the tooth, as well as reacting to hot and cold.
When an infection takes hold, it is this pulp which becomes inflamed, which is why it may be painful to eat or drink. Eventually a bacterial infection will cause the pulp to die. It is important to see your dentist if you are experiencing toothache, as the infection will not go away of its own accord and antibiotics cannot be used to treat a root canal infection.
If left untreated, a deep infection can spread through the whole root canal system of your tooth. In this case, the pain may subside, as the infection will have removed all of the pulp but the infection then spread into the bone around the tooth and the soft tissues of the face.
What does treatment involve?
Root canal treatment removes the infection from the tooth, before sealing the tooth and restore you back to good oral health. Endodontic treatment is always carried out by an expert clinician and an anaesthetic is used to keep you comfortable through the process.
When you first come into our practice, we will take an x ray to assess the status of the infection. Then a local anaesthesia is administered to the area and a piece of rubber material called a ‘rubber dam’ is placed around the tooth the keep it dry and accessible throughout the procedure. Once you are fully anaesthetised, your dentist will use specially designed tools to remove the infected tissue. Once it is clear, a rubber compound is used to fill the tooth where the root canal tissue previously was. This is usually finished with a temporary filling. This is the completed stage of your first visit. Following this, we create a custom made crown to fit your tooth and this is fitted at your second visit.
How do I avoid a root canal?
Root canal treatment can be avoided by practising good dental care. Regular visits for check-ups mean that your dentist is in a good position to pick up on any problems you may not have noticed. They will check any current fillings or crowns for damage or cracks. By treating issues in the early stages you avoid infections and further complications that would ultimately lead to endodontic treatment.
Tooth decay is one of the common reasons for root canal infections. You can keep tooth decay at bay by brushing and flossing regularly, chewing sugar-free gum between meals and reducing the amount of fizzy drinks and sugar in your diet.
Inlay and Onlay
Perhaps you’ve not visited the dentist recently and since your last check-up you’ve spotted some decay, or part of a tooth is noticeably suffering. Now is the time to call our team to make an appointment. If decay has already set in and caused damage to the tooth, it may be that a filling is not sufficient. The next step to cover the damage and restore your tooth to its natural looking state is an onlay or inlay. Onlays and inlays bridge the gap between a small filling and the need to cover the tooth entirely with a crown, and will stop decay before it develops into something more serious.
The art of preserving your natural teeth
When it comes to dentistry, our dentists work hard to maintain and keep your teeth as healthy as possible for as long as possible. The longer you can keep your natural teeth, the better it is for your overall oral health. Inlays and onlays are a method of preserving teeth which have been attacked by decay. While crowns are an option for damaged teeth, they often require your dentist to file down or remove a little of your existing tooth, in order for the sleeve to fit nicely over the top and stay in line with your existing teeth. Onlays and inlays fit onto your teeth in a way that maintains all or most of your current tooth structure.
What are onlays and inlays made from?
Like fillings, inlays and onlays are usually made from porcelain or composite resin to blend naturally with the rest of your teeth and provide lasting strength and reinforcement to your otherwise damaged tooth. It is possible to get gold and silver inlays and onlays, however composite resin and porcelain choices make for a solution that is hardly noticeable.
Sometimes known as a caps, crowns are carefully fitted sleeves that sit over an existing tooth to protect it from further damage, and to improve your overall smile.
Crowns can hold cracked teeth together and support bridges, and they are often applied as the final step in root canal treatment. They can also cover discoloured teeth to improve the appearance of your teeth.
Why are crowns needed?
A tooth crown may be required if you have a weak or damaged tooth. This ‘sleeve’ fits over the exposed part of the tooth, above the gum line to effectively keep together cracked teeth and prevent further damage. It also protects a worn down tooth from any further wear and tear. A crown may also be fitted where there has been a substantial amount of tooth decay and there is a large filling or a root canal treatment with not enough tooth left to support it. As crowns are shells, they are also used to fit over dental implants or to cover discoloured or misshapen teeth. You may need a crown if you are having a bridge fitted, as they create anchors to hold the bridge in place.
How is a crown fitted?
Fitting your crown will usually involve two visits. The first is an assessment of the tooth and its surrounding area, including the root. This will usually require an x ray. Occasionally a root canal may be required ahead of fitting a crown, if there is any trace of infection or inflamed tissue. The tooth underneath must be as clean and healthy as possible before the crown is fitted. If your tooth is its original size, your dentist may need to file it down to allow the cap to fit snugly in line with the rest of your jaw and not affect your bite.
What are crowns made from?
Dental techniques are highly developed, and in today’s practices crowns can be made from a variety of materials:
- Metal, including gold alloy and other metal-based alloys
- Porcelain fused to metal
- Porcelain fused to zirconia
We recommend the use of porcelain crowns, as they are durable and can be crafted to match the natural shade of your teeth. We are proud to use our local dental laboratory, Borough Crown and Bridge. They are highly skilled and experienced and happy to help with personalising the treatment to your individual needs.
How long will a crown last?
A permanent crown can last up to 15 years, depending on your habits, lifestyle and oral care routine. Teeth grinding can put pressure on a crown, leading to cracks and possible damage. If you know that you suffer from clenching or grinding, speak to us because we will be able to provide you with advice and possible solutions (such as a mouthguard) to help protect your crown and keep it looking its best into the future.
Tooth wear refers to the loss of tooth substance that is not caused by dental caries or trauma. Almost all patients have some minor tooth wear which does not cause any problems. However, some patients show accelerated tooth wear that may result in:
- Poor dental appearance
- Difficulty chewing
- Sharp teeth
- Change in the profile of the face
- Concerns about further tooth wear
There are 3 main causes of tooth wear:
This is the chemical dissolution of tooth substance by acid. Erosion may occur with excessive consumption of acidic foods and drinks such as alcohol, carbonated drinks, fruit juice, citrus fruit and vinegar. Erosion may also occur in medical conditions such as indigestion, eating disorders and pregnancy related sickness; all of which may cause repeated vomiting or reflux of gastric acid. Some patients are however unaware that they suffer with gastric acid reflux.
- Attrition:This results from direct tooth to tooth contact and tends to affect the biting surfaces of the teeth. Attrition is often caused by repeated clenching and grinding of teeth (bruxism). Some people may not be aware that they grind their teeth as it occurs when they are asleep.
This is the loss of tooth substance through mechanical means other than direct tooth to tooth contact. Causative factors include vigorous manual tooth brushing, pipe smoking and nail biting.
Prevention of Tooth Wear
It is important to think about your lifestyle, diet and possible habits to determine the cause of your tooth wear. You should think about both your current and historical situation. If the cause of tooth wear can be identified it can be addressed.
All patients should brush their teeth twice daily with a Fluoride containing toothpaste and use a Fluoride containing mouthwash at a separate time to brushing. This will harden the surface of the teeth and help with any sensitivity.
If you clench or grind your teeth you may benefit from wearing a splint which can be made by your dentist. Splints wear over time prevent further wear of your teeth. We normally recommend a hard acrylic splint as this can be easily adjusted to ensure an even bite.
Try to avoid snacking between meals and limit the amount of acidic food and drink that you consume. Water, milk and tea/coffee (without sugar) are preferable to fizzy drinks and fruit juice.
If you have problems with recurrent vomiting or reflux of stomach acid see your GP. If you vomit regularly, avoid tooth brushing immediately afterwards as this leads to greater tooth wear.
Do I need Treatment
Not all patients with tooth wear require treatment. When tooth wear is mild and not causing any problems it should be monitored. This will be done by your dentist with clinical photographs, study models and putty indices. When tooth wear becomes more advanced, or it causes problems, treatment is often required to prevent further tooth wear, improve dental appearance and relieve symptoms.
We will often recommend that worn teeth are built up with composite restorations (white fillings). These restorations are usually recommended because they do not damage the underlying teeth and allow the teeth to be built back up to their normal size and shape protecting the underlying tooth structure. These composite restorations are usually placed high so that you only bite in a few areas. This will feel strange initially, however, most patients adapt within a couple of weeks. Your other teeth will usually move to meet each other with time although this may take up to 18 months.
With time composite restorations could stain, chip, fracture and debond. This is to be expected and the composite restorations will require repair and replacement in the future. Studies show that composite restorations usually work well over 5-7 years.