Dental treatments

What are bridges made of?

Bridges are usually made of a precious metal. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base for strength.

Are bridges expensive?

Although a bridge may seem costly they can be a wise investment that will give many years of good service. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it's similar to ordering a piece of hand-made jewellery.

How do I look after my bridge?

You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.

What are dentures?

A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.

How long does it take to make dentures?

Depending on the complexity of each case, the duration of the treatment will vary. After the initial visit of examination and diagnosis, the subsequent visits will include taking impressions of the mouth, bite registration, try-in of the denture, fitting and review.

What to expect?

New dentures always feel strange when first placed in your mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies with different persons and often time and experience are essential before dentures can be worn comfortably and function effectively.

Useful suggestions to help you to adapt to the new dentures:

Eating - Eating will take a little practice. Start with soft foods and foods cut into small pieces will help. Chew slowly using both sides of your mouth at the same time to prevent dentures from tipping. Once you become accustomed to chewing, include other foods until you return to your normal diet.

Increased salivary flow - You may experience an increase in salivary flow when the dentures are first inserted. This is a natural response of the salivary glands that will return to normal after a few weeks. You can improve the situation by swallowing more often.

Speech - New dentures may alter your speech initially. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will speed up the adaptation process. This problem rarely persists beyond two weeks.

Sore spots - Minor irritation caused by surface irregularities or pressure spots on the denture-bearing areas are quite common. Your dentist will relieve the discomfort by adjusting the denture surface. Stop wearing the denture if the irritation is very painful. Consult your dentist immediately.

Care of your dentures

Like natural teeth, dentures can accumulate plaque and food debris, particularly in areas where the denture is in contact with the remaining teeth and gum. In addition to the usual oral hygiene measures like tooth brushing, dentures should be cleaned regularly. Poor denture hygiene can result in stains on the denture and a bad odour.

If possible, dentures should be removed and cleaned after every meal. When cleaning, remember the following:

• Use a soft hand brush or a special denture brush. 
• Avoid very hot water as it may distort the denture.
• Use mild detergent to clean dentures. Avoid using abrasive cleaners that can roughen the polished surface of the denture. Do not use bleach as this may whiten the pink acrylic.
• Hold the denture firmly while cleaning. Accidentally dropping the denture may result in chipped or broken dentures.  Always wash your denture over a basin of water.

Soak the dentures in denture cleanser once a week to remove stains and always rinse them thoroughly before using the dentures again.

When you are not wearing the dentures, store them in water. Dentures may lose their shape if left to dry out.

How long should you wear your dentures?

During the first few days you are advised to wear them most of the time except when sleeping. Always remove the dentures before going to bed. This will allow your gum tissues to rest and promote oral health. Gentle massaging of the gums with a soft toothbrush is encouraged. Remember to soak the dentures in water to prevent them from drying out.

The next denture review

Your jawbones and gums naturally shrink over time and this can cause the dentures to fit less securely. Ill-fitting dentures can give rise to chewing difficulties, soreness, infections and changes in facial support. It is important that you visit your dentist to have your dentures and oral tissues evaluated yearly. Your dentures may need to be adjusted, relieved or even relined from time to time to ensure an optimal fit. Do not attempt to adjust the denture yourself - seek professional help.

With time and practice you will soon learn to eat, talk and smile with your dentures as you would with your natural teeth.

When Is Root Canal Treatment Needed?

The crown of the tooth is made up of the hard, white, enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves within and extends from the crown to the tips of the root or roots.

Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. The pulp can be infected or inflamed due to either deep decay or an extensive restoration that involves the pulp, cracked or fractured tooth due to trauma, excessive wear of enamel and dentine exposing the pulp, and sometimes as a result of severe gum disease.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth. On the other hand, there may be no symptoms at all. If pulp inflammation or infection is left untreated, it can eventually cause pain, swelling and loss of the supporting bone.

What Are The Advantages Of Root Canal Treatment?

Root canal treatment saves teeth that would otherwise have been extracted.

After root canal treatment the tooth is pulp-less i.e. it has no vital tissues within. However, there are vital tissues surrounding the root e.g. the gum, periodontal membrane and supporting bone. A root canal treated tooth can function normally and can be maintained with routine dental care and oral hygiene measures.

Is Root Canal Treatment Painful?

Root canal treatment procedures are relatively comfortable and often painless as the tooth is anaesthetised during treatment. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking mild analgesics or painkillers available over the counter at the pharmacy. However, if the pain persists and is severe, or a swelling occurs, you should contact your dentist.

How Is Root Canal Treatment Carried Out?

• Removal of the infected or inflamed pulp is the first step in saving the tooth. Under local anaesthetic an opening is made in the crown of the tooth to get access to the infected or inflamed pulp within.
• Using small, specially designed hand or rotary files, the root canals are cleaned and shaped to a form that can be sealed. Debris within the canals is removed by flushing with an anti-bacterial solution.
• The canals are finally filled or sealed with an inert material called gutta-percha. The tooth should be restored to full shape and function by either a permanent filling or a crown, depending on how much of the tooth is left. This should be done as soon as possible as there could be a risk of tooth fracture due to biting forces.

All root canal treatment procedures are performed by isolating the tooth with a rubber dam to provide a clean and saliva-free environment. Root canal treatment may be done in single or multiple visits depending on the complexity of the tooth. In between treatment appointments, medicaments may be placed within the canals and the tooth is covered with a temporary filling.

Often, X-rays are taken to determine the length of the root and to monitor the various treatment stages.

Care Of The Root-Treated Tooth

As far as possible, avoid chewing or biting on the tooth being treated until you have it permanently restored with either a filling or a crown. Excessive pressure at this stage may crack or fracture the tooth. Therefore, it is very important to restore the tooth properly as soon as possible. Most endodontically treated teeth last as long as natural teeth following permanent restoration.

Practise good oral hygiene, including brushing and flossing at all times, as root-filled teeth are as prone to decay as natural teeth. It is also important to have your treated tooth reviewed regularly by your dentist.

Most people have fillings of one sort or another but today, because we are much more conscious of our smile, we can choose a natural looking alternative - the composite or tooth-coloured filling.

A composite resin is a tooth-coloured plastic mixture filled with glass (silicon dioxide) first introduced in the 1960s. Originally only used for front teeth because of their softer nature, modern improvements to their composition make them generically suitable today.

Composite fillings are more difficult to place than silver fillings so may take your dentist 15-20 minutes longer to complete and because they are considered to be a cosmetic treatment, they are not available on the NHS and must be paid for.

The main advantage of composite fillings is their aesthetic appeal. The main disadvantage is their life expectancy. 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 your composite filling can depend on the depth of cavity and its position in the mouth; your dentist is best positioned to advise you.

What is a crown?

A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.

Crowns are used for several reasons:

At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.

At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.

How long do crowns last and how do I care for them?

Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.

Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.

Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.

What are implants?

Implants are one way of replacing missing teeth. A post is planted in the jaw bone to support a replacement tooth. This acts like the root of a natural tooth. Implants can also be used to support fixed bridges or dentures.

Implant treatment normally has two stages. First, the implant is placed in the jaw. Then, when the jaw has healed, replacement teeth are attached to the implant. In some situations it is possible for temporary teeth to be attached to an implant at the time of fitting.

Would implants be right for me?

First, you should decide whether implants could be right for you. Contact us to arrange an implant consultation and discussion and we will let you know the possibilities. Our team will be only too happy to help you with any questions you may have.

If you decide to go ahead, this is what will happen.

• Implants are put into holes in the jaw with a local anaesthetic. You can opt to have sedation for this procedure also.
• The implant is screwed or pushed in and the gum is stitched so that it heals over the implant
• Under the gum. the bone then grows round the implant to hold it firm. This takes several months.

Implants usually have two sections - the post in the jaw and an extension that is added later when the post is secure. Attaching the extension needs a small cut in the gum above the implant. You might have more than one implant. The replacement teeth might be fixed permanently (like a crown or bridge) or attached in a way which lets you remove them for cleaning (like a denture).

Porcelain (tooth coloured) inlays and onlays are restorations placed usually on the chewing surfaces of the back teeth.

An inlay fits within the confines of the teeth. An onlay covers the entire chewing surface of the tooth. These can be made of either plastic resin or porcelain.

The procedure involves removing decayed tooth structure or old fillings, preparing the tooth cavity, taking an impression of the cavity to fabricate a custom-fit inlay or onlay. Two visits are required to complete the treatment.

You may have heard about the new ‘invisible brace’ and wondered what it is all about. If you have teeth that are crowded, too far apart or have shifted since wearing conventional braces, invisalign® at STM may give you a new reason to smile!

Because it is nearly invisible almost no one can tell you are wearing invisalign®, so you can smile more during as well as after your treatment. You can remove invisalign® so you can eat and drink what you like, and studies have shown that it can be better for your dental hygiene during treatment. With no metal or sharp edges, invisalign® is comfortable to wear and does not cause allergies.

The convenience and ease of use have made it the choice of over half a million people, giving hundreds of thousands of people amazing new smiles.

How does it work ?

Using the latest advances in 3-D computer technology, invisalign® uses your dentist’s instructions to create a series of custom made removable mouth trays (aligners). These aligners apply a controlled amount of force to your teeth, causing them to move. Each aligner is slightly different, moving your teeth gradually into the desired position.

How long will invisalign® take ?

Invisalign® only works while you wear the aligners. We recommend they are worn full time day and night (min 22–24 hours).

Each aligner is worn for 2 weeks, (before moving onto the next in the series), moving your teeth millimetre by millimetre, week by week, until you reach your desired result.

Treatment length will vary depending on your case, but the average invisalign® treatment is nine to eighteen months.

During treatment you should visit us periodically at STM, until it is determined that your treatment is complete.

Once active treatment is complete, there may be some fine tuning to create that perfect smile.

Veneers are thin, custom-made shells crafted of tooth-coloured materials designed to cover the front side of teeth to improve the overall appearance of teeth. They are made of either thin plastic resin or porcelain and can be placed to:

Tooth preparation is minimal and confined to the enamel structure. The veneer is bonded to the tooth structure with  tooth-coloured resin cement. Several visits are necessary to complete treatment.

Patients should be aware that this is usually an irreversible process because it's necessary to remove a small amount of enamel from your teeth to accommodate the shell.

Whitening is a process where the tooth discolouration is 'whitened' to a lighter shade. It removes the staining agent through chemical means. It is a safe procedure when carried out under professional supervision. Treatment results usually depend on the severity of the discolouration. Both vital (i.e. live) and non-vital teeth (e.g. tooth with root removed) can be bleached and may take several visits to complete. It is not effective on dental restorations such as amalgam fillings, metal or porcelain crowns, etc.

Teeth can discolour for various reasons. The dentist will recommend the most ideal method based on your oral condition after an in-office examination to establish the cause and nature of your tooth discolouration, as well as provide you with more information on the various types of whitening procedures available, duration & frequency of treatment.

Deep pits and grooves can be found on the chewing surfaces of the back teeth. Such pits and grooves are termed ‘fissures’ and are usually so narrow that toothbrush bristles and streams of water are not able to clean them effectively. These form a favourable environment for bacteria to flourish, often resulting in tooth decay.

What can be done?

Fissure sealants can be applied to the teeth. Fissure sealants are special materials used by dentists to seal off pits and fissures from the oral environment. Sealing the tooth surface protects fissures from bacteria and fermentable foods like sugar and starches to prevent decay from starting deep within the fissures. Any tooth with pits and fissures can be treated, provided the surface to be filled is sound and has not been previously filled. The most commonly treated teeth are the molars and premolars.

How are sealants applied?

Sealants are applied easily and painlessly. No drilling is required. The tooth is properly cleaned, treated, dried, and the sealant applied. It then hardens to form a protective coating over the tooth.

How effective are sealants and how long can they last?

Many studies show sealants to be very effective in preventing decay in fissures. They do, however, require regular maintenance by your dentist. This can be performed with your six- monthly check-up. Recent studies show that a properly placed sealant will last as long as a typical amalgam filling. Even if a sealant is damaged or lost, it is easily repaired and replaced. Regular maintenance by your dentist will help them last. This can be done with your six-monthly check-up.

When should sealants be put on the teeth?

Sealants are most effective when applied after the eruption of the tooth. Early application ensures pits and fissures are sealed before the decay process begins.