Restorative Dentistry

Dental Implants

Dental implants are regarded as the most advantageous solution to missing teeth. Implants are recommended in cases where a patient has lost teeth as a result of trauma or injury, decay or the ageing process. They can have positive implications on confidence and self-esteem, improving the function and aesthetics of the smile.

Implants can be used to replace single or multiple teeth, as well as to retain dentures. They are unique in design and can fit into small spaces and also where the bone is limited in both height and width.

Single Tooth Implants

Dental Implants

Single Tooth replacement with Dental Implant and Procera© Crown

If sufficient bone is available replacing a missing tooth with a dental implant has several advantages:

  • Teeth either side do not need to be drilled or undergo extra pressure
  • The surrounding bone is supported and prevented from further resorbtion
  • Implants are usually a longer lasting option
  • Implants usually are stronger and support the bite forces better
  • The don’t move around and interfere with speech like dentures

Multiple Tooth Implants

When several teeth are missing it can become difficult to chew properly. Replacing these teeth with dental implants can give the confidence to choose any type food without worry of a moving denture or un-comfortable sensations.

Dental Implants

Quite often if several teeth are missing in the same area a bridge can be firmly attached to the underlying implants.

Full Mouth Implants

Dental Implants

Full Mouth restoration with Dental implant supported bridgework

Implant Retained Dentures (Denture stabilisation)

Denture stabilisation is a process undertaken to improve the stability, comfort and effectiveness of dentures. There are various methods of stabilising dentures but the most effective is using dental implants to anchor the denture.

Implants are beneficial for denture wearers because they provide unrivalled levels of support and anchorage. Patients with dentures may worry that their dentures will come loose at times – but this won't happen with dental implants and so patients are provided with peace of mind.

Dental Implants FAQs

A. A dental implant is a titanium metal rod which is placed into the jawbone. It is used to support one or more false teeth. In practice, both the false teeth and their supporting rod are known as 'implants'.
A. Implants are a well-established, tried-and-tested treatment. Over 95 per cent of modern implants should last for many years with the right care.
A. Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.
A. It depends on the state 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.
A. Placing the implants needs a small operation. This can be done using a simple local anaesthetic, and sometimes with sedation if you are very nervous. Sometimes the dentist needs to use a general anaesthetic for complex cases. You will not feel any pain at the time, but you may feel some discomfort during the week after the surgery. This is usually due to having stitches, and the normal healing process.
A. Your dentist will be able to give you a rough timetable before the treatment starts. Usually the permanent teeth are fitted 6 to 9 months after the implants are put in, but many implant systems now allow the time to be as short as 3 months. Some teeth can now even be fitted at the same time as the implants (known as immediate implants) but you should check with your dentist to see whether these are suitable for you.
A. Your dentist may give you some pain relief after the surgery, or check whether you have them at home to take over the next few days if you need them. Your dentist may also prescribe antibiotics. Don't smoke, exercise or drive for the rest of the day. Don't rinse the area and only eat soft foods. However, it is important that you keep your mouth clean by brushing, but do not poke the implant site. You can use a chlorhexidine mouthwash every day during the first week after surgery (you can get these from supermarkets and chemists.
A. The implants need to bond (integrate) with the bone after they have been put in. This takes at least 3 months in the lower jaw and 6 months in the upper jaw. Sometimes the implants may be stable enough when they are fitted for the artificial teeth to be attached much sooner than this. If you are having one, two or three teeth replaced, you may have a temporary denture in the meantime. If you have complete dentures, then you can keep wearing these throughout the healing period once they have been modified after the surgery. A healing cap will usually be placed into the implant site to protect the area during healing.
A. No. But after care is important if you are going to have a long-lasting, successful implant. Your dentist should give you detailed advice on how to look after your implants. Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that are difficult to reach and you?ll be shown methods to help you. You may need to visit your hygienist more often but your dentist will be able to talk to you about this.
A. Yes, if you don't care for them well enough. If you keep them clean, and don't smoke, then you should not have any problems.
A. Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by bars, then you'll be able to take them out for cleaning.
A. Your dentist will make sure that the implants won't show during all normal movements of the mouth and lips. You will need to be able to see them, so that you can clean them properly.
A. No, unless you're only having a single tooth replaced. Normally, five or six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be used.
A. Unfortunately, yes it can be. Your Implanologist will be able to provide you with a written estimate of cost. However, over the longer term, implants are usually a more cost-effective and satisfactory option. There are advantages to it, too. An implant to replace a single tooth avoids the need to cut down the teeth either side for crowns to support a bridge. Normal dentures often mean you can't eat or speak well, due to the dentures moving about. But teeth attached to an implant don't cause this problem as they are anchored to the bone more firmly than natural teeth.

Dental Crowns

Crown and bridgework

Crown and bridgework, also described as restorative dentistry, involves the restoration of natural teeth that have been damaged, decayed or lost. Crowns and bridges can correct missing teeth, bite dysfunction, and functional or structural problems. A crown can restore an individual damaged tooth back to its original form and function, while a bridge can replace one or more teeth. These restorations are cemented onto the teeth and are referred to as "fixed" dentistry rather than using a removable appliance or partial denture.

Crowns

A crown is a prosthetic placed over an existing tooth to create a smoother, cleaner look and enhance strength and durability. When a tooth is fractured, has an outdated filling, or is severely damaged by decay, the placement of a crown may be recommended. Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your smile. Types of crowns include the full porcelain crown, the porcelain-fused-to-metal crown and the all-metal crown.

Dental Implants FAQs

A. Crowns are an ideal way to rebuild teeth which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as ‘caps’.
A. There are a number of reasons. For instance:
  • the tooth may have been weakened by having a very large filling
  • you may have discoloured fillings and would like to improve the appearance of the tooth
  • you may have had a root filling which will need a crown to protect it
  • you may have had an accident and damaged the tooth
  • it may help hold a bridge or denture firmly in place.
A. Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:
  • Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and layers of porcelain are then applied over it.
  • Porcelain: these crowns do not have any metal component to them, constructed from very strong porcelain materials. This makes them the most cosmetically acceptable and biocompatible crowns available.
  • Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
  • Precious metal (gold and palladium): these crowns are very strong and hard-wearing, but are usually used at the back of the mouth, where they are not visible.
A. The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a strong inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other information they need to make the crown.
A. The impressions and information about the shade of your teeth will be given to a dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.
A. No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth.

A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about two weeks.
A. You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.
A. No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.
A. Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated stainless steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.
A. If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This 'core' is then prepared in the same way as a natural tooth and the impressions are taken.
A. The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.
A. Once the fit and appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.
A. Because the shape of the crown will be slightly different from the shape of you tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.

Teeth Bridges

When one or more teeth are missing, the remaining teeth can drift out of position, which can lead to a change in the bite, the loss of additional teeth, decay and gum disease.

When tooth loss occurs, we may recommend the placement of a bridge. Designed to replace missing teeth and support surrounding teeth, a bridge is a grouping of interconnected crowns. Held in place by two crowns, a bridge can reduce the risk of gum disease, help correct bite issues and even improve speech.

Bridge FAQs

A. Your appearance is one reason. Another is that the gap left by missing tooth can mean greater strain on the teeth at either side. A gap can also mean your ‘bite’ is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bite together. This can then lead to food getting packed into the gap, which causes both decay and gum disease.
A. This depends on the number of teeth missing and on where they are in the mouth. The condition of the other teeth also affects the decision.There are two main two ways to replace the missing teeth. The first is with a removable false tooth or teeth – a partial denture. The second is with a fixed bridge. A bridge is usually used where there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth.
A. Yes, if you have enough strong teeth with good bone support. Your dentist will help you decide which is the best way of replacing the teeth within your budget.
A. Bridges are usually made of a precious metal base. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base to reduce the cost.
A. Bridges are usually made to have a metal substructure with procelain bonded to this.

Nowadays All Porcelain Bridges can be designed, which allow light to pass through them and hence look more life-like than porcelain bonded to metal bridges.
A. Although a bridge may seem expensive it will last many years. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand-made jewellery. The materials are also expensive so it's fair to say a bridge will not be the cheapest treatment you have ever had.
A. You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.
A. There are other methods, such as using a combination of crowns and partial dentures that can keep the retaining clips out of sight. These are quite specialised dentures, so you should ask your dentist about them. You can also have teeth implanted, ask your dentist for more information. Remember that it’s as important to care for your remaining teeth as it is to replace the missing ones.
A. Yes, there are different types of bridge which use different fixing methods. Your dentist will choose the most effective and conservative bridge for your personal situation.

Dental Dentures

At DentiCentre, our dentures will restore your beautiful smile and confidence. Replacing lost or missing teeth has substantial benefits for your health and appearance. A complete or full denture replaces the natural teeth and provides support for cheeks and lips. Without this support, sagging facial muscles can make a person appear older and reduce their ability to eat and speak.

Dentures FAQs

A. 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 jaws. 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'.
A. Usually dentures can be fitted straight after your teeth have been removed. These are called ?immediate dentures?. You visit the dentist 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 dentist will be able to discuss this with you. Sometimes your dentist may advise you to wait until your gums are healed before having your dentures, as this can sometimes provide a better fit. Healing may take several months.
A. 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 fill out the appearance of your face.
A. Eating will take a little practice. Start with soft foods cut into small pieces. Chew slowly using both sides of your mouth at the same time to prevent the denture from moving. As you become more used to your denture, add other foods until you return to your normal healthy diet.
A. During the first few days, you may be advised to wear them for most of the time, including while you are asleep. After your mouth gets used to your dentures, your dentist may advise that you remove them before going to bed. This allows your gums to rest and helps keep your mouth healthy.
A. Dentures are custom made to fit your mouth and you shouldn't need a denture fixative. However, over time, dentures may become loose and not fit as well. When this happens, some people prefer to use a fixative for a short time before having them replaced. A poorly fitting denture may cause irritation and sores. This can often happen if you have worn immediate dentures for some time.
A. The general rule is: brush, soak, brush. Always clean your dentures over a bowl of water or a folded towel in case you drop them. Brush your dentures before soaking, to help remove any food debris. Using an effervescent (fizzy) denture cleaner will help remove stubborn stains and leave your denture feeling fresher. Always follow the manufacturer?s instructions. Then brush the dentures again, as you would your own teeth, being careful not to scrub too hard as this may cause grooves in the surface. Most dentists advise using toothpaste and a small- to medium-headed toothbrush. Make sure you clean all the surfaces of the dentures, including the surface which touches your gums. This is especially important if you use any kind of denture fixative. If you notice a build up of stains or scale, have your denture cleaned by your dentist or hygienist. For more information on cleaning your dentures, look out for our leaflet ?Tell me about denture cleaning?
A. Over time, your dentures will need to be relined or re-made due to normal wear or a change in the shape of your mouth. Bone and gum ridges can shrink, causing your jaws to meet differently. Loose dentures can cause health problems, including sores and infections, not to mention discomfort. A loose or ill-fitting denture can also make eating and talking more difficult. It is important to replace worn or poorly fitting dentures before they cause problems.
A. Regular dental check-ups and having your teeth professionally cleaned are vital for keeping your teeth and gums healthy. Most dentists recommend a dental check up at least once a year. Regular visits allow your dentist to check the soft parts of your mouth, including the tongue and cheeks. These examinations are important so the dentist can spot any infections, mouth conditions or even mouth cancer at the earliest stages. Full denture wearers should check with their dentist about how often they should visit. With regular professional care, a positive attitude and persistence, you can become one of the millions of people who wear their dentures with a smile.

Inlays & Onlays

A porcelain or resin inlay or onlay is used when the cavity is too big for a filling, but isn't so big that a crown is required. An inlay is a subtle tooth-colored restoration which can fill large cavities and repair damaged teeth and is virtually indistinguishable from natural teeth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth.

The procedure involves removing decayed tooth structure or old fillings, preparing the tooth cavity, taking an impression of the cavity to fabricate a custom-fit inlay or onlay. Two visits are required to complete the treatment.