Dental Treatments

We provide quality preventative dental care and treatment in a comfortable and friendly environment. What’s more, we have a complete range of dental services open to everyone – whatever your needs we have the dentists and specialists for you.

For general dentistry treatments just select the appropriate button below to find out more.

Preventing oral disease starts with your dental examination where we screen for disease in the oral tissues by carefully examining the whole mouth looking for early changes what might lead to cancer, gum disease, tooth decay – either new or around existing restorations, the wear of your teeth – caused by grinding or acids and assess the longevity of existing restorations taking your bite into account.

 

We will ask you questions about your diet, as that affects the development of caries as well as potentially contributing to tooth wear. We will also ask about your oral hygiene routine (brushing, flossing using inter-dental brushes, mouthwash etc) as that plays a very big role in the development of gum disease.

 

Gum disease is unfortunately very common but also largely preventable. It rarely causes pain and may lead to reduction of the bone support of teeth without any symptoms. Gum disease starts as inflammation of the gums (gingivitis), with evidence of bleeding and if present for some time may lead to recession of the gums and loss of bone support for the teeth (periodontitis). Both your dentist and hygienist are trained in treating gum disease.

 

Gum disease assessment:

This involves measuring:

  • The plaque score – a measure of how well your teeth are cleaned.
  • The bleeding score – a measure of how inflamed your gums are.
  • The probing depth – how deep the pocket between the gums and teeth are, pockets over 4mm cannot be kept clean
  • Recession – how much the gums have receded, making the teeth look longer. This together with the probing depth can indicate the amount of bone loss
  • We also take different types of x-rays that show the type and amount of bone loss. We use the x-rays to both diagnose and monitor gum disease.

 

Our qualified hygienists will clean and polish your teeth removing plaque, calculus and stains from your teeth, both over and under the gums and advise you on how to care for your teeth and gums on a routine day to day basis, paying particular attention at problem areas. For deeper cleaning anaesthetic might be required.

 

Timing:

During treatment of gum disease we might book several appointments close together in order achieve a clean mouth, not giving the bacteria time to re-colonise areas already cleaned. Additional treatment might involve use of antimicrobials of in some cases surgery performed by your dentist for areas of disease resistant to deep cleaning.

 

During periodontal maintenance we would usually ask you to attend every 6 months, although some patients need appointment more frequently if some areas in the mouth are very difficult to keep clean at home.

 

Many of our patients, especially those who like tea, coffee red wine or other foods that stain teeth, request more frequent appointments for the staining to be removed, revealing the white enamel under the stains. Our gentle cleaning methods ensure that this procedure is safe.

 

Caries prevention:

Caries, or tooth decay, is caused by bacteria that convert sugars from our diet to acids that eat away at the tooth enamel and dentine. Caries can be prevented by a diet that has low frequency of sugar intake and brushing with a fluoride tooth paste that both strengthens the tooth mineral and removed the bacterial plaque of the mouth. Some of the early changes, such as those on the biting surfaces of teeth can be seen by the visual examination we perform. Caries between teeth cannot be spotted by visual examination, to look for decay in these areas we take x-rays we take during your examination.

 

We may ask you to fill in a diet sheet, prior to offering advice aimed at a less cariogenic diet.

 

For some of our patients, especially younger children, we may advice for fissure sealing. This is the use of a resin to fill the pits and fissures in our teeth, where food may get stuck of plaque stagnate without being cleaned, thus helping prevent decay.

Once teeth have had advanced decay they become weaker and may form cavities. Teeth may also chip of break with time. These teeth need to be restored to their original form for function and aesthetics.

The technique and material used to restore teeth depend on the size of the decay or break and the biting forces placed on the teeth.

Examples of the restorations for single teeth are fillings, inlays, onlays and crowns. If whole teeth are missing they can be replaced with implants, bridges or dentures.

Modern, tooth-coloured fillings are made of durable resins and tooth coloured fillers, resulting in a natural-looking effect.

We use different filling materials for different applications, harder wearing fillings for back teeth, subjected to greater biting forces and ones that polish better and reflect the light in a more natural way for the anterior teeth within the smile line.

All are placed using special adhesives that minimise the loss of strength of the heavily filled toot. Fillings are used for smaller defects where the remaining tooth structure is substantial.

An inlay is a lab made restoration that is cemented in a tooth that has been suitably prepared after the decay is removed. Inlays have superior strength compared to fillings.

An onlay is very similar to an inlay except in that onlays also replace parts of or the whole biting surface of teeth. This “hugging” effect protects the tooth from biting forces which can cause flexing and eventually breaking of a filled tooth. Onlays require less tooth filing compared to crowns.

Both inlay and onlays can be made from precious metal or more frequently out of high strength tooth coloured ceramic materials.

Crowns, also called caps, are natural tooth-like covers that may be all-ceramic,  porcelain fused to metal or metal and are designed to restore teeth that are very broken down. Porcelain fused to metal and all-ceramic crowns are matched to your natural tooth colour, making them blend in with your other teeth.

A conventional bridge is a false tooth, natural in appearance, that replaces one or more missing teeth thus bridging the space between two teeth, called abutment teeth. Fixed bridges are usually fused between two porcelain crowns to fill in the area left by a missing tooth and cannot be taken out of your mouth, unlike dentures. Compared to dentures, they may reduce your risk of gum disease, help correct various bite issues and can even improve your speech.

When the teeth next to the missing tooth are already crowned or heavily restored a bridge is a very effective solution. In situations where the adjacent teeth are healthy we usually suggest treatment plans that do involve cutting back a healthy tooth. Another type of bridge known as an adhesive bridge can be constructed in these situations, or an implant retained crown may be suggested. An adhesive bridge is glued to the backs of the teeth instead of putting a crown over the entire tooth. Although adhesive bridges are used as permanent solutions we frequently also use them as temporary replacements for teeth undergoing implant treatment.

Our teeth contain a network of nerves and blood vessels which form the pulp. This is contained within the pulp chamber and root canal system. If the nerve dies, usually due to tooth decay, the pulp and root canal space can get infected resulting in abscesses and a great deal of pain and discomfort. A tooth may cause a great deal of pain while the pulp and nerves are dying, called pulpitis, or it may die with complete absence of symptoms only to be discovered during an x-ray examination. The presence of a sinus – gum-boil- is another indication of infection of the root canal.

 

Although our immune system is very effective at fighting infection through our white blood cells and other responses, the space within the root canal system where the pulp was contains not blood vessels and thus is an area where bacteria are protected from the immune system. Root canal therapy is aimed at disinfecting this space and filling it, thus preventing re-infection. To do this we use a drill to access the tooth’s crown and pulp chamber and flexible files to clean out and shape the infected root canals. We then use a strong liquid disinfectant to further clean the root canal system, prior to filling it.

 

During root canal treatment we will use an isolator, called rubber-dam to exclude the bacterial from the saliva from the clean root canal. We also use different state of the art machines which help us locate the length of the root canals and help us shape and fill the canals. Those techniques, together with good local anaesthesia ensure that root canal therapy of your teeth is a comfortable experience.

Dentures are removable replacements for missing teeth. They may be made of pink acrylic (plastic) or metal and both carry natural looking teeth. When many teeth are missing dentures are a relatively quick and cost effective way of replacing the missing teeth. When all the teeth in a jaw are missing we may use implants to prevent excessive movement of the denture. Although for some patients the provision of dentures is the aim of treatment, we may also construct a denture as part of your bigger dental treatment plan if that involves implant placement.

Tooth whitening is also known as dental bleaching and is a process during which a gel is applied on teeth in a custom made tray, resulting in brighter teeth. The gel active ingredient, carbamide peroxide, is used to remove stains that have penetrated into the structure of the tooth, resulting in the tooth appearing brighter. Surface stains on teeth have to be removed by our hygienist prior to whitening. Tooth whitening is safe on healthy tooth structure, but it is very important that it is carried out under our supervision to ensure excellent dental health prior to staring treatment and good fit of the custom tray over the teeth to ensure delivery of the gel. Most treatment last 14 days, however longer treatment might be required for bigger changes in colour.

 

Tooth whitening may result in tooth sensitivity, our preferred whitening system ensures this is minimal and provides you with a desensitising swabs to counter any experienced sensitivity.

 

Although we can help you achieve very bright teeth, it is worth remembering that the greater the difference from your natural brightness, the more frequent the top-up applications that are required to maintain that result. If your have any fillings, veneers, crowns inlays or onlays, their shade will not change with whitening but can be matched by changing them. For this reason if you are having any restorations placed in your smile line we will ask you if you are considering whitening, so we can match the restorations to the shade you want your teeth to be.

We may use veneers to improve the shape, shade or position of your teeth. Veneers are very thin laminates of tooth-coloured porcelain, ceramic cemented to your teeth or a special composite resin bonding material. Although on some occasions veneers require not tooth preparation, in most cases we would shave back some of your tooth in preparation. Prior to the construction of veneers we consult with you in designing your smile and agree on the smile you aim for, prior to treatment by showing you the result on models or, if possible, as a mock-up in your mouth. If the changes you want us to achieve in your mouth are significant, we may work together with Dr Heike Börnert, our orthodontist to align your teeth prior to the construction of veneers. We do this to ensure we shave back the minimum amount of tooth, thus increasing the longevity and structural strength of your teeth.