Restorations

Composite Fillings

A composite (tooth coloured) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages. You and your dentist can discuss the best options for restoring your teeth. Composite fillings, along with silver amalgam fillings, are the most widely used today. Because composite fillings are tooth coloured, they can be closely matched to the colour of existing teeth, and are more aesthetically suited for use for the front teeth or the more visible areas of the teeth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

• Chipped teeth
• Closing space between two teeth
• Cracked or broken teeth
• Decayed teeth
• Worn teeth

How are composite fillings placed?

Composite fillings are usually placed in one appointment. While the tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment. Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

Crowns (Caps)

Dental crown is a tooth shaped cap that is placed over the tooth surface, to improve its appearance. Dental crown can repair extensively decayed or damaged teeth. Dental crowns may be of gold metals, silver metals, porcelain or combination of porcelain and metal. The damage to the teeth should be repaired by using crowns. Crowns restore the size of shortened teeth, restore a patient’s bite, eliminate sensitivity and improve the aesthetics of the teeth.

Crowns are usually bonded to the tooth with the help of dental cement. A dental crown may be needed to:

• Protect broken tooth
• Cover severely discoloured teeth
• Cover an implant
• Hold a dental bridge in place
• Restore severely worn teeth
• Repair broken teeth
• Cover a tooth with large filling
• Cover a root canal treated tooth

Dental Implants

Dental implants are artificial tooth roots usually made of titanium, used to replace the root of the natural tooth. Bridges can be used when a single tooth is lost. For those who have lost more than one tooth, removable partial dentures can be given. In cases where there is a complete absence of teeth, complete dentures with or without implants can be given.

The advantages of dental implants include:

• Improved facial appearance
• Improved speech
• Easier eating
• Improved self-esteem
• Improved oral health
• Long lasting
• Convenient
• Comfortable

Procedure

Dental implants are surgically placed in your jawbone. The procedure is performed under general or local anaesthesia. Your oral surgeon or implantologist then exposes the bone by making incision. The implant is placed inside the jawbone; the incision is then stitched back. The titanium in the implants fuses with your jawbone. It requires a healing period of about 3- 6 months. The crown is then placed over the implant.

Dentures and Partial Dentures

A denture is a removable dental appliance replacement for missing teeth and the surrounding gum tissue. They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures. Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain. A partial denture not only fills in the spaces created by missing teeth, it also prevents other teeth from shifting into the empty space.

A complete denture may be either “conventional” or “immediate.” A conventional type is made after the teeth have been removed and the gum tissue has healed, usually 4 to 6 weeks. During this time the patient will be without any teeth. Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process. Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years but may have to be remade, repaired, or readjusted due to normal wear.

What does getting dentures involve?

The process of getting dentures requires multiple appointments, usually over several weeks. Highly accurate impressions (moulds) and measurements are taken and used to create your custom dentures. Several “try-in” appointments may be necessary to ensure proper shape, colour, and fit. At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulties, however this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures. Proper cleaning of your new dental appliance, maintaining good oral hygiene, and regular dental visits will aid in the life of your new dentures.

Fixed Bridges

A dental bridge is a fixed (non-removable) appliance and is an excellent way to replace missing teeth.

There are several types of bridges. You and your dentist will discuss the best options for your particular case. The “traditional bridge” is the most popular type and is usually made of porcelain fused to metal. This type of bridge consists of two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.

Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.

Reasons for a fixed bridge:

• Fill space of missing teeth
• Maintain facial shape
• Prevent remaining teeth from drifting out of position
• Restore chewing and speaking ability
• Restore your smile
• Upgrade from a removable partial denture to a permanent dental appliance

What does getting a fixed bridge involve?

Getting a bridge usually requires two or more visits. While the teeth are numb, the two anchoring teeth are prepared by removing a portion of enamel to allow for a crown. Next, a highly accurate impression (mould) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment.

At the second visit, you permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit. Occasionally your dentist may only temporarily cement the bridge, allowing your teeth and tissue time to get used to the new bridge. The new bridge will be permanently cemented at a later time.

You will receive care instructions at the conclusion of the procedure. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.

Inlay Restorations

An inlay restoration is a custom made filling made of composite material, gold, or tooth-coloured porcelain. It is made by a professional dental laboratory and is permanently cemented into the tooth by your dentist.

Inlays can be utilised to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Inlays are an ideal alternative to conventional silver and composite fillings. Also, they are more conservative than crowns because less tooth structure is removed in the preparation of inlays.

As with most dental restorations, inlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.

Reasons for inlay restorations:

• Broken or fractured teeth
• Cosmetic enhancement
• Decayed teeth
• Fractured fillings
• Large fillings

What does getting an inlay involve?

An inlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (moulds) that will be used to create your custom inlay and a temporary restoration.

While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an inlay restoration. A temporary filling will be applied to protect the tooth while your inlay is made by a dental laboratory.

At your second appointment your new inlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.

You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new inlay.

Onlay Restorations

An onlay restoration is a custom made filling made of composite material, gold, or tooth-coloured porcelain. An onlay is sometimes also referred to as a partial crown. It is made by a professional dental laboratory and is permanently cemented onto the tooth by your dentist.

Onlays can be utilised to conservatively repair teeth that have large defective fillings or have been damaged by decay or trauma. Onlays are an ideal alternative to crowns (caps) because less tooth structure is removed in the preparation of onlays. Onlays are essentially identical to inlays with the exception that one or more of the chewing cusps have also been affected and need to be included in the restoration.

As with most dental restorations, onlays are not always permanent and may someday require replacement. They are highly durable and will last many years, giving you a beautiful long lasting smile.

Reasons for onlay restorations:

• Broken or fractured teeth
• Cosmetic enhancement
• Decayed teeth
• Fractured fillings
• Large fillings

What does getting an onlay involve?

An onlay procedure usually requires two appointments. Your first appointment will include taking several highly accurate impressions (moulds) that will be used to create your custom onlay and a temporary restoration.

While the tooth is numb, the dentist will remove any decay and/or old filling materials. The space will then be thoroughly cleaned and carefully prepared, shaping the surface to properly fit an onlay restoration. A temporary filling will be applied to protect the tooth while your onlay is made by a dental laboratory.

At your second appointment, your new onlay will be carefully and precisely cemented into place. A few adjustments may be necessary to ensure a proper fit and that your bite is comfortable.

You will receive care instruction at the conclusion of your treatment. Good oral hygiene practices, a proper diet, and regular dental visits will aid in the life of your new onlay.

Root Canal Therapy

Root canal treatment, also known as endodontic treatment is a dental procedure in which the diseased pulp tissue is removed and the inside of the tooth is cleaned and sealed with a special filling material.

To understand about root canal treatment, you need to know the basic structure of the tooth. A tooth has two main parts: a crown portion and a root portion. Crown is the part of the tooth which is seen in the mouth and root is the part of the tooth which is inside the jaw bone. Inside the crown and root there is a soft core of tissue known as pulp that contains blood vessels and nerves. In the crown, the pulp is present within a chamber called the pulp chamber and it travels down the length of the root to the tip (or apex) called the root canal.

When tooth decay has progressed far enough into the pulp you may have severe toothache, sensitivity to heat or cold, pain with biting or pressure, tooth discoloration, and swelling around the affected tooth. These symptoms may indicate the need for a root canal treatment where the pulp of a tooth is treated in an effort to maintain a healthy tooth. The aim of root canal treatment is to save a tooth that is severely damaged due to decay or injury.

Indications

The most common indications for root canal treatment include:

• Trauma to the tooth that exposes the nerve
• Severe tooth decay that extends into the pulp
• Infected pulp that causes an abscess (an accumulation of pus in the teeth or gum tissue).
• Break or crack in the tooth that extends into the nerve of the tooth
• To save the dying tooth due to aging or previous trauma

Procedure

Root canal therapy can be performed in one or more appointments. It is performed in a dental clinic under local anaesthesia. For an infected or abscessed tooth, antibiotics are started before completing the root canal.

The first step in the procedure is to take an X-ray that displays the entire tooth to see the shape of the root canals.

Next, to keep the area dry and free of saliva during treatment, a rubber dam is placed around the tooth. The rubber dam is a sheet of latex or non-latex material. The main function is to isolate the tooth being treated and also to keep the different chemical solutions from falling to the back of the throat.

Using a dental drill, an opening is created in the tooth to reach the infected pulp area.

Then, the infected contents of the pulp chamber are carefully removed using root canal files. A series of root canal files of increasing diameter are subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. It is necessary to remove the entire nerve in order to prevent re-infection and toothache after the procedure.

Frequent irrigation of the root canals is done using sodium hypochlorite to flush away the debris.

Once the entire tooth is completely cleaned, it is dried with tiny absorbent paper points.

After the canals have been dried, they are filled with a rubber like substance called gutta percha. The purpose of this filling material is to seal the canals inside the tooth.

The tooth is then restored with a permanent filling material.

Root canal treated teeth tend to become brittle and can break because the blood supply to the tooth is removed during the procedure. Therefore, after a root canal treatment the tooth should be protected with a crown. The purpose of the crown is to prevent the tooth from breaking in future.

After the Procedure

After the completion of the root canal procedure you may have some discomfort for a few days which can be controlled by over-the-counter pain medications. Brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly. It is advised to minimize chewing on the tooth under treatment until the procedure is completed to avoid recontamination and also to prevent a fragile tooth from breaking.

Complications

As with most dental procedures, complications can occur. After root canal treatment new infections may occur from:

• An undetected crack in the root of the tooth
• Defective dental restorations
• A missed root canal (leaving one of them uncleaned )
• Breakdown of the inner sealing material over a period of time

All these causes can result in failure of root canal treatment.