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Tooth conservation, cosmetic dentistry & orthodontics

If any of your teeth have become weakened, loose, broken or infected – and you are in danger of losing them – there are several sophisticated modern techniques which your dentist can offer you to save the tooth or replace it with a carefully matched false tooth. 

Many can be offered on the NHS, although due to the skill and materials required, many dentists prefer to carry them out on a private basis. Always ask for an estimate of the cost and discuss this in detail with your dentist before starting treatment.

Root canal treatment is needed when the blood or nerve supply of a tooth becomes infected through decay or injury. The infection may spread through the root canal system of the tooth, leading to an abscess.

Root canal treatment is a skilled procedure which aims to save the affected tooth by removing the infected material and cleaning, shaping and filling the root canal. Most courses of treatment involve two or more visits to the dentist.

   

For broken teeth – or those that have been weakened by decay or very large fillings – crowns (also known as ‘caps’) are an ideal solution. A crown can be made of many different materials, sometimes bonded to gold or another precious metal to strengthen it. It fits right over the remaining part of the tooth, giving it the shape and contour of a natural tooth. If the original tooth has been broken, the dentist may fit a crown to a post which fits into the root of the tooth.

If you have already lost a tooth through decay or injury you can have a single false tooth permanently fitted to replace it. Replacing a missing tooth is done not only for cosmetic reasons but also because the teeth on either side of the gap are placed under greater strain. They may ‘lean’ into the gap, altering the bite, and food may become trapped in the gap, causing decay or gum disease.

A false tooth can be fitted either with a fixed bridge (in which the teeth either side of the space are crowned and the false tooth is bonded to these) or through an implant (a titanium metal rod placed into the jawbone, to which the false tooth is attached). Fitting an implant is very costly and requires an operation with local or general anaesthesia.

Fissure sealants are a safe and painless way of protecting your children’s teeth from dental decay. A sealant is a protective plastic coating which is applied to the biting surfaces of the back teeth (molars and pre-molars), forming a hard shield that stops bacteria getting into the tiny grooves (‘fissures’) on the surface of the tooth.  The procedure is often done at about the age or six or seven (as soon as the permanent teeth appear). It is quick and straightforward and the sealant should last for several years.

Cosmetic dentistry

If any of your teeth are stained, discoloured, irregular, misshapen, chipped or missing, this can have a significant effect on your appearance and your confidence. Fortunately, much can be done by your dentist to improve matters.

 

  • Front teeth that are visibly chipped can be ‘repaired’ by gluing on a piece of carefully shaped porcelain or using a special white substance (called ‘composite’ filling material) which can be moulded and set into the correct shape.

  • Similar techniques can be used to cover the entire visible surface of front teeth which have become discoloured. In these cases, a very thin layer of porcelain or filling material (called a ‘veneer’) is bonded to the tooth surface, rather like a false fingernail.

  • For broken teeth – or those that have been weakened by decay or very large fillings – crowns (also known as ‘caps’) are an ideal solution. A crown can be made of a number of different materials bonded to gold or another precious metal to strengthen it. It fits right over the remaining part of the tooth, giving it the shape and contour of a natural tooth.

  • For teeth that are missing, individual false teeth can be permanently fitted using a fixed bridge (in which the teeth either side of the space are crowned and the false tooth is bonded to these), or through an implant (a titanium metal rod placed into the jawbone, to which the false tooth is attached). Fitting an implant is very costly and requires an operation with local or general anaesthesia.

Dentistry done for purely cosmetic reasons is usually only carried out on a private basis and you will need to discuss the costs in advance.

Orthodontics

Orthodontic treatment involves straightening and adjusting the position of teeth which are crooked or overcrowded. The aim is to improve appearance and, in some cases, to reduce strain on the jaw muscles, make teeth easier to clean or create a more even bite. Orthodontic treatment is usually carried out in children but nowadays adults are treated too.

The first step is generally a full examination, including taking x-rays and making plaster models of your teeth. Next, your dentist or orthodontist (a specialist with extra qualifications) will then decide whether you need to have any teeth removed to create more space in your mouth and what sort of brace is needed to correct the position of your teeth. Depending on the type and severity of the problem, braces may be removable or fixed, and there are many varieties, sometimes involving the use of elastic bands or headgear worn at night. You usually need to see your dentist or orthodontist every four to six weeks to check and adjust the braces.

Finally, when the treatment is complete (which usually takes one to two years), the newly-straightened teeth are held in position with a device called a ‘retainer’ for a while longer. This allows the surrounding gum and bone to settle.

Orthodontic treatment is free if carried out in hospital. If the work is done in the dentist’s or orthodontist’s practice, NHS charges are payable, except for children under the age of 18, students under the age of 19, pregnant / nursing mothers and patients in low income groups. If you opt for private treatment, always discuss the costs fully with your dentist or orthodontist first and ideally confirm your discussions in writing to avoid any misunderstandings later on.