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General

Veneers

What is a veneer?

A veneer is a thin layer of porcelain made to fit over the front surface of a tooth, like a false fingernail fits over a nail. Sometimes a natural-colour ‘composite’ material is used instead of porcelain.

When would I need a veneer?

Veneers can improve the colour, shape and position of your teeth. A precise shade of porcelain can be chosen to give the right colour to improve a single discoloured tooth or to lighten your front teeth. A veneer can make a chipped tooth look whole again.

The porcelain covers the whole of the front of the tooth, with a thicker section replacing the broken part. Veneers can also be used to close small gaps, when orthodontics (braces) are not suitable. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others.

What are the advantages of veneers?

Veneers make teeth look natural and healthy. Because they are very thin and are held in place by a special, strong adhesive, very little preparation of the tooth is needed. Some types of veneers don’t need any preparation at all.

How are teeth prepared for a veneer?

Some of the shiny, outer enamel surface of the tooth may be removed, to make sure that the veneer can be bonded permanently in place later. The amount of enamel removed is tiny and will be the same as the thickness of the veneer to be fitted, so that the tooth stays the same size.

A local anaesthetic (injection) may be used to make sure that there is no discomfort, but often this is not needed. Once the tooth has been prepared, the dental team will take an ‘impression’ (mould). This will be given to the dental technician, along with any other information needed to make the veneer.

The colour of the surrounding teeth is matched on a shade guide to make sure that the veneer will look entirely natural.

How long will it take?

A veneer takes at least two visits. The first is to prepare the tooth and match the shade, and the second is to fit it. Before bonding it in place, your dentist will show you the veneer on your tooth to make sure you are happy with it. Bonding a veneer in place is done with a special adhesive, which holds it firmly on the tooth.

Will I need a temporary veneer between visits?

Because the preparation of the tooth is so slight you will probably not need a temporary veneer. The tooth will look very much the same after […]

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Root canal treatment

What is root canal treatment?

Root canal treatment (also called ‘endodontics’) is needed when the blood or nerve supply of the tooth (called the ‘pulp’) is infected through decay or injury. You may not feel any pain in the early stages of the infection. In some cases your tooth could darken in colour, which may mean that the nerve of the tooth has died (or is dying). This would need root canal treatment.

Why is root canal treatment needed?

If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess. An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth. The symptoms of an abscess can range from a dull ache to severe pain, and the tooth may be tender when you bite. If root canal treatment is not done, the infection will spread and the tooth may need to be taken out.

Does root canal treatment hurt?

No. Usually, a local anaesthetic is used and it should feel no different to having an ordinary filling done. There may be some tenderness afterwards but this should gradually get less over time.

What does it involve?

The aim of the treatment is to remove all the infection from the root canal. The root is then cleaned and filled to prevent any further infection.

Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist.

At the first appointment, the infected pulp is removed and any abscesses can be drained. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle.

The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.

What will my tooth look like after treatment?

In the past, a root-filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments that will restore the natural appearance.

What if it happens again?

Root canal treatment is usually very successful. However, if the infection comes back, the treatment can sometimes be repeated.

What if I don’t have the treatment?

The alternative is to have the tooth out. Once the pulp is destroyed it can’t heal, and it is not recommended to leave an infected tooth in the mouth.

Although some people would prefer to have the tooth out, it is usually best […]

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Mouth Ulcers

What are mouth ulcers?

Ulcers are painful sores that appear inside the mouth. They are usually red or yellow. They are different from cold sores, which appear on the outer lips and are caused by a virus.

What are the common causes of mouth ulcers?

Usually a single mouth ulcer is due to damage caused by biting the cheek or tongue, or by sharp teeth, brushing or poorly fitting dentures. These ulcers are called ‘traumatic’ ulcers. If you have a number of mouth ulcers, and they keep coming back, this is called ‘recurrent aphthous stomatitis’.

How do I know if I have a traumatic ulcer?

Traumatic ulcers are usually on their own, are next to the cause of the damage and go away once the source of the problem is removed.

What are the signs of recurrent aphthous stomatitis?

Recurrent aphthous stomatitis is a common problem, and is the repeated appearance of mouth ulcers in otherwise healthy children and young people. The cause is not known, but it is not infectious and is unlikely to be inherited.

Are there different types of recurrent mouth ulcers?

Yes.

Minor ulcers are the most common. They can appear inside the cheeks, and on the lips, tongue and gums and, more rarely, on the roof of the mouth. Most of these ulcers are the size of the top of a pencil and can sometimes come in clusters. You can get four to six at any one time.

Large ulcers are more severe and can take longer to heal. Any ulcer that lasts longer than 3 weeks should be checked by your dentist. Large ulcers may appear near the tonsils and can be very painful, especially when you swallow. You usually only get one at a time.

It is also possible to have up to 100 very small, painful ulcers which last for one to two weeks. However, these last two varieties are very rare.

You may get ulcers in other parts of the body such as your eyes or genital area. It is important to tell your dental team about this.

What are the less common causes of mouth ulcers?

Infections can cause mouth ulcers. Herpes simplex often causes mouth ulcers in children and some adults. Other less common viral and bacterial infections may cause mouth ulcers, but this is rare. Mouth ulcers can be caused by anaemia and occasionally by other blood disorders, and some skin or gastrointestinal diseases. Sometimes the mouth ulcers are the only sign of an underlying disease.

Can cancer cause mouth ulcers?

Cancer of the mouth can first appear as a mouth […]

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Implants

What are dental implants?

A dental implant is used to support one or more false teeth. It is a titanium screw that can replace the root of a tooth when it fails. Just like a tooth root, it is placed into the jawbone.

Are implants safe and how long will they last?

Implants are a safe, well-established treatment. It’s probably true to say that implants, much like natural teeth, will last for as long as you care for them.

How well you look after your implants – and whether you go for your regular maintenance appointments – will have the biggest impact on how long they will last.

If you don’t look after your implants they will develop a coating similar to what you get on neglected natural teeth. Left untreated, this can lead to gum infection, bleeding, soreness and general discomfort. You could get all these problems with natural teeth.

If your implants are well looked after, and if the bone they are fitted to is strong and healthy, you can expect them to last for many years. However, just as with other surgical implants (such as a hip replacement) there is no lifetime guarantee.

I have some of my own teeth. Can I still have implants?

Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.

Can implants always be used to replace missing teeth?

It depends on the condition of the bone in your jaw. Your dentist will arrange for a number of special tests to find out the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.

Do implants hurt?

Placing an implant is often easier than taking a tooth out and is usually done using a simple local anaesthetic. You will not feel any pain at the time but, just like after an extraction, you may feel some discomfort during the week after the surgery.

Sometimes your dentist might give you a sedative if you are very nervous or if the case is a complicated one. General anaesthetics are rarely used for implants and are generally only used for very complicated cases.

How long does the treatment take?

Your dental team will be able to give you a rough timetable before the treatment starts.

Some false teeth can now even be fitted at the same time as the implants (these are called ‘immediate implants’). Check with your dental team to see whether these are suitable for you. Usually the false teeth […]

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Dentures

What is a denture?

People wear dentures to replace lost or missing teeth so they can enjoy a healthy diet and smile with confidence. Dentures are made of either acrylic (plastic) or metal.

A ‘complete’ or ‘full’ denture is one which replaces all the natural teeth in either the upper or lower jaw.

A ‘partial’ denture fills in the spaces left by lost or missing teeth. It may be fastened to your natural teeth with metal clasps or ‘precision attachments’.

Why should I wear dentures?

Full dentures, to replace all your own teeth, fit snugly over your gums. They will help you to eat comfortably and speak clearly, and will improve your confidence and self-esteem.

Partial dentures replace teeth that are missing, and can sometimes be supported by the teeth you have left. If you have gaps between your teeth, then your other teeth may move to take up some of the space, so you could end up with crooked or tilted teeth. This could affect the way you bite and could damage your other teeth.

How soon can I have a denture after my teeth are taken out?

Usually dentures can be fitted straight after your teeth have been removed. These are called ‘immediate dentures’. You will need to visit the dental team beforehand for them to take measurements and impressions of your mouth.

With immediate dentures you don’t have to be without teeth while your gums are healing. However, bone and gums can shrink over time, especially during the first six months after your teeth have been taken out. If your gums shrink, your immediate dentures may need relining, adjusting or even replacing. Your dental team will be able to talk to you about this.

Sometimes your dental team may advise you to wait until your gums are healed before having your dentures, as this can sometimes mean a better fit. Healing may take several months.

Who will make and fit my denture?

Your dentist will take measurements and impressions of your mouth, then order your dentures from a dental technician.

Will dentures make me look different?

Replacing lost or missing teeth is very good for your health and appearance. A complete or full denture replaces your natural teeth and gives support to your cheeks and lips. Without this support, sagging facial muscles can make a person look older and they will find it harder to eat and speak properly.

Dentures can be made to closely match your natural teeth so that your appearance hardly changes. Modern dentures may even improve the look of your smile and help to fill out the appearance of your face.

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Crowns

What is a crown?

A crown is an artificial restoration that fits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth. A crown is sometimes known as a ‘cap’.

Why would I need a crown?

Crowns are an ideal way to repair teeth that have been broken, or have been weakened by tooth decay or a very large filling. A crown could be used for a number of other reasons, for example:

  • You may have a discoloured filling and would like to improve the appearance of the tooth.
  • You may have had a root filling and need a crown to protect what is left of the tooth.
  • It may help to hold a bridge or denture firmly in place.

What is a crown made of?

Crowns can be made of a variety of different materials and new materials are continually being introduced. Some of the most popular options are listed below.

Porcelain bonded to precious metal:

This is what most crowns are made from. A precious metal base is made and then porcelain is applied in layers over it.

Porcelain

These crowns are made entirely out of porcelain and are not as strong as bonded crowns. But they can look very natural and are most often used for front teeth.

All-ceramic

This modern technique offers a metal-free alternative, which can give the strength of a bonded crown and the appearance of a porcelain crown. Therefore it is suitable for use in all areas of the mouth.

Glass

These crowns look very natural and can be used anywhere in the mouth.

Gold-alloy crowns

Gold is one of the oldest filling materials. Today it is used with other metal alloys to increase its strength, which makes it very hardwearing. These crowns are silver or gold in colour.

How is a crown prepared?

The dentist will prepare the tooth to the ideal shape for the crown. This will involve removing a layer of the outer surface, leaving a strong inner core. The amount of the tooth removed will be the same as the thickness of the crown.

Once the tooth is shaped, the dental team will take an impression (mould) of the prepared tooth, one of the opposite jaw and possibly another to show the way you bite together.

The impressions will then be given to a dental technician, along with information about the shade to use and any other information they need.

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Children’s Teeth

When should I take my child to the dentist?

It is recommended that children should go to the dentist with their parents as soon as possible. You should then take them regularly, as often as your dental team recommend. This will let them get used to the noises, smells and surroundings and prepare them for future visits. The earlier these visits start, the more relaxed the children will be.

When will my child’s teeth appear?

First (or ‘baby’ or ‘milk’) teeth usually start to appear when your child is around 6 months old. All 20 baby teeth should appear by the age of 30 months. For more information, visit ‘Dental care for mother and baby‘.

The first permanent ‘adult’ molars (back teeth) will appear at about 6 years, before the first baby teeth start to fall out at about 6 to 7. The permanent ‘adult’ teeth will then replace the ‘baby’ teeth. It is usually the lower front teeth that are lost first, followed by the upper front teeth shortly after. All permanent teeth should be in place by the age of 14, except the ‘wisdom’ teeth. These may appear any time between 18 and 25 years of age.

All children are different and develop at different rates.

How should I clean my child’s teeth?

Cleaning your child’s teeth should be part of their daily hygiene routine. You may find it easier to stand or sit behind your child, cradling their chin in your hand so you can reach their top and bottom teeth more easily.

  • When the first teeth start to appear, try using a toothbrush designed for children, with a small smear of fluoride toothpaste.
  • It is important to supervise your child’s brushing until they are at least seven.
  • Once all the teeth have appeared, use a toothbrush with a small head and soft bristles in small, circular movements and try to concentrate on one section at a time.
  • Don’t forget to brush gently behind the teeth and onto the gums.
  • Spit out after brushing and do not rinse, so that the fluoride stays on your teeth longer.
  • If possible, make brushing a routine – just before your child goes to bed and at least one other time during the day.
  • Remember to encourage your child, as praise will often get results!

Should I use fluoride toothpaste?

Your teeth can get fluoride in a number of different ways, including from toothpaste, specific fluoride applications and perhaps the drinking water in your area. These can all help to prevent tooth decay.

If you are unsure about how much fluoride you […]

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Caring for my teeth

Why are my teeth so important?

Your teeth vary in shape and size depending on where they are in your mouth. These differences allow the teeth to do many different jobs. Teeth help us to chew and digest food. They help us to talk, and to pronounce different sounds clearly. Finally, teeth help to give our face its shape. A healthy smile can be a great asset; and because this is so important, it makes sense to give your teeth the best care possible.

What can go wrong?

Tooth decay can be painful and lead to fillings, crowns or inlays. If tooth decay is not treated, the nerve of the tooth can become infected and die, causing an abscess. This may then need  root canal treatment or even for the tooth to be removed. It is very important that you keep up a good routine at home to keep your teeth and gums healthy. Gum disease is common and, if left untreated, may lead to bone loss around the teeth. In some cases, it may lead to loose teeth and teeth being lost. Gum disease is preventable. It can be treated and kept under control with regular cleaning sessions and check-ups, preventing further problems. If teeth are lost, it may be necessary to fill the gaps with bridgesdentures or implants.

How do I keep my teeth and gums healthy?

It is easy to get your mouth clean and healthy, and keep it that way. A simple routine can help prevent most dental problems:

  • brushing your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste
  • spit out after brushing and do not rinse, so that the fluoride stays on your teeth longer
  • cleaning between the teeth with ‘interdental’ brushes or floss at least once a day
  • good eating habits – having sugary foods and drinks less often, and
  • regular dental check-ups.

Although most people brush regularly, many don’t clean between their teeth and some people don’t have regular dental check-ups. A few small changes in your daily routine can make a big difference in the long term. Your dental team can remove any build-up on your teeth and treat any gum disease that has already appeared. But daily dental care is up to you, and the main weapons are the toothbrush, toothpaste and interdental cleaning (cleaning between your teeth).

What is plaque?

Plaque is a thin, sticky film of bacteria that constantly forms on your teeth.

How can plaque cause decay?

When you eat foods containing sugars and starches, the bacteria in plaque produce acids, which attack tooth enamel. The stickiness of the […]

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Bad Breath

How can I tell if I have bad breath?

Lots of small signs can show that you have bad breath. Have you noticed people stepping away from you when you start to talk? Do people turn their cheek when you kiss them goodbye?

If you think you might have bad breath, there is a simple test that you can do. Just lick the inside of your wrist and sniff – if the smell is bad, you can be fairly sure that your breath is too.

Or, ask a very good friend to be absolutely honest with you; but do make sure they are a true friend.

What causes bad breath?

Bad breath is a very common problem and there are many different causes. Persistent bad breath is usually caused by the smelly gases released by the bacteria that coat your teeth, gums and tongue. Also, bits of food that get caught between the teeth and on the tongue, will rot and can sometimes cause an unpleasant smell. Strong foods like garlic, coffee and onions can add to the problem. So, it is very important to brush your teeth correctly and regularly. This will help keep your breath smelling fresh.

The bacteria on our teeth and gums (called ‘plaque’) also cause gum disease and tooth decay. One of the warning signs of gum disease is that you always have bad breath or a bad taste in your mouth. Again, your dental team will be able to see and treat the problem during your regular check-ups. The earlier the problems are found, the more effective the treatment will be.

What else causes bad breath?

Bad breath can also be caused by some medical problems. ‘Dry mouth‘ (xerostomia) is a condition that means your mouth produces less saliva. This causes bacteria to build up in your mouth and this leads to bad breath. Dry mouth may be caused by some medicines, by salivary gland problems or by continually breathing through your mouth instead of your nose. Older people may produce less saliva, causing further problems.

If you suffer from dry mouth, your dental team may be able to recommend or prescribe an artificial saliva product. Or they may be able to suggest other ways of dealing with the problem.

Can other medical conditions cause bad breath?

Other medical conditions that cause bad breath include infections in the throat, nose or lungs; sinusitis; bronchitis; diabetes; or liver or kidney problems. If your dentist finds that your mouth is healthy, you may be referred to your family GP or a specialist to find out the cause of your bad breath.

Can smoking cause bad breath?

Yes. Tobacco causes its own type of bad breath. […]

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