Prosthodontics and Restorative

List of procedures


Crowns

A crown is a type of dental restoration used to fix teeth that have been broken, weakened by decay or contain a very large filling. Here is how it works:

  1. An impression is taken of the tooth after it has been prepared, that needs restoring.
  2. A crown is made in the dental laboratory to fit the tooth precisely and match the neighbouring teeth.
  3. The crown fitted securely on top.

A crown could be a good solution for you if you have some discoloured fillings and would like to improve their appearance. Crowns can be used to replace these to give you a more appealing smile. Additionally, if you have had root canal treatment you will need a crown to protect or cap the restored tooth, allowing you to eat and bite down on it as if it was a real tooth. Crowns are also used to anchor a bridge or denture firmly in place in the mouth.

Life Benefits


Bridges

If you require a more extensive restoration than a crown or have a missing tooth that needs to be replaced, a good solution is a bridge. Here is how they work:

  1. Bridges are usually made of a metal base, which gives them a solid structure and makes them hard-wearing. If you need a bridge in your smile line, porcelain is usually added to the base to make it look more like real teeth.
  2. A bridge helps to strengthen the prepared teeth and makes chewing and eating easier because they are fixed and can’t come out.
  3. Some bridges can also be fixed to your jaw with dental implants, if you have several teeth next to each other that are missing.

Once you have a bridge fitted, you will have to take extra care during your daily hygiene regime to ensure it stays plaque free and does not cause bad breath.

Life Benefits


Dentures

If you have a few or all of your teeth missing, one solution is to have a denture. Here is how it works:

  1. A denture is made from hard-wearing material that mimics the look of teeth and gums to give your mouth a natural appearance. It can also have a metal frame-work.
  2. After impressions are taken, a denture is designed in a dental laboratory.
  3. Dentures are made to fit snugly on your gums and you will be able to remove them for cleaning.

When you wear a denture for the first time it may take some getting used to when speaking or eating and chewing. It is important that you take extra care when conducting your hygiene regime so that you can avoid bad breath, tooth decay and gum disease. The hygienist will be able to show you how to best take care of your denture and gums and will tell you about specialised brushes you can use to do this.

Life Benefits


Tooth Wear

Dental erosion or “tooth wear” is the loss of enamel and dentine from the tooth as a result of direct acid attack. It can be caused by excessive exposure to acid substances such as fruit juices and fizzy drinks. It is an irreversible condition. Tooth erosion differs from tooth decay. Tooth decay is the progressive loss of tooth enamel by plaque acid attack. Bacteria in the mouth break down sugars into acids which then attack the teeth. The most common teeth affected by dental erosion are the upper front teeth, although all teeth can be affected. Teeth that have been eroded look glassy, can appear short, and have uneven tips that are easily chipped away. Teeth that have been eroded may become sensitive. Research has shown that erosion is very common (50 percent of 4-18-year-olds have some tooth erosion).

The source of acid that causes the erosion is either from an intrinsic source from within the body (eg acid from the stomach) or from an extrinsic source from outside the body (eg acidic foods, drinks or medicines). Intrinsic causes are vomiting and acid reflux (where acid from the stomach escapes up into the mouth) which can be caused by a hiatus hernia, obesity or certain drugs. Fruit juices and soft drinks, together with foods such as rhubarb and citrus fruits, are examples of extrinsic sources of acid.

Regular check-ups at the dentist mean signs of erosion can be detected early. If dental erosion has been diagnosed the first stage is to record accurately how severe and extensive the damage is; this is best done by the dentist taking impressions of your teeth. The impression is cast in plaster and can be used to see if the amount of erosion is getting worse over a period of time.

For those affected by erosion it is important to:

  1. Limit acidic foods and drinks to meal times
  2. Reduce the number of times during the day that acidic foods and drinks are consumed
  3. Choose soft drinks which have no added sugar and have been shown to pose a negligible risk of tooth erosion
  4. Delay brushing teeth immediately after eating especially acidic foods or drinks.

It may be possible to improve the appearance of teeth that have been eroded with the use of adhesive filling materials, veneers or crowns. However, it is important that the cause of tooth erosion is identified first before this kind of dental treatment is undertaken.

Hypodontia

What is hypodontia?

Sometimes teeth do not develop and are missing since birth. This is called hypodontia. It can affect baby and adult teeth and vary in severity from one missing tooth to many missing teeth in very rare cases.

Why does hypodontia occur?

Hypodontia often runs in families but people affected do not always pass it onto their children. Sometimes, hypodontia may occur for no known reason.

Is it common?

Hypodontia is quite common with up to 5% of the population being affected. Most commonly, one or two teeth are missing.

How would I know if I had hypodontia?

You may have noticed gaps between your teeth or your baby teeth may still be present. Some of the teeth that are present may be small in size or appear pointed. An examination and an x-ray investigation are needed to diagnose hypodontia.

How long will my baby teeth last?

This can vary but baby incisor teeth usually do not last beyond the teenage years. Baby canine and molar teeth can sometimes last into your 20’s – 30’s or even longer. It depends on the health of the teeth and the length of the roots.

What are my treatment choices?

There are different options that may be available to you:

  1. Accept the space – this may be appropriate when back teeth are missing and the spaces are not visible.
  2. Close the space – using fixed braces.
  3. Create space – in the right place for a false tooth using fixed braces allowing one of the following to be fitted:
    • Dental bridges (resin bonded bridges) – a false tooth glued onto another tooth.
    • Dental implants – a false tooth on a titanium screw put into the jaw bone. They can only be placed once you have stopped growing and are not suitable for everyone.
    • Dentures – these are removable plates with false teeth attached.

The restorative specialist and orthodontist will talk with you about options for any further treatment needed. You may therefore need a second joint consultation in such cases.

What type of treatment is involved?

Treatment usually involves wearing fixed braces and you may need bridges or implants to replace the missing teeth.

However, the type of treatment needed depends on your age and the number of teeth that are missing. Definite decisions about your treatment often cannot be made until all the adult teeth have grown through the gums. This is normally when you are in your early teens (12-14 years).

Why might I need braces?

Fixed braces can be used to:

  1. Straighten your teeth.
  2. Close the gaps between your teeth.
  3. Create space in the right place for false teeth to be placed.

Your orthodontist will explain how they will be useful in your case.

I have noticed some of my teeth are small or pointed. Can anything be done?

Small adult, as well as baby teeth, can often be made to appear larger with a tooth-coloured filling material, called composite. Composite is the treatment of choice for small or pointed teeth. It may give a very nice appearance but the composite can change colour and chip over time and need replacement. In adults, fitting veneers or crowns may be advised depending on the shape and size of the teeth. Your general dentist or a restorative specialist can talk to you about these options.

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