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All you need to know about crowns, implants and veneers

All you need to know about cosmetic dentistry…

Veneers (Porcelain and Composite)

A veneer is like a false fingernail, it is used to cover the tooth surface in order to mask any defects in colour, shape or size. They are not recommended as an alternative to orthodontic treatment because they only serve to mask problems and are considered to be invasive. The longevity of a veneer is around 10 years and you would need to replace them due to deterioration of the material. To place a veneer on a tooth the dentist might have to drill the tooth surface to reduce its overall thickness, however this is not necessary in every case. Special care is taken to match the colour and translucency of your other teeth for the most natural result.

There are two main types of veneers, porcelain and composite. Porcelain veneers are wafer thin pieces of ceramic material that are stuck to the front side of the teeth. Their placement usually involves some amount of tooth reduction.

Composite veneers are made from a resin material that is directly applied in layers to the tooth surface and then hardened with a high intensity light. A common use of a composite veneer is to correct chipping, however persistent tooth chipping may be because of a bad bite, in which case you should have orthodontic treatment.

Stage 1

Consultation and assessment.

Stage 2

Special care is taken so the veneer matches the colour and translucency of your other teeth. Some preparation to the tooth surface may be required.

Stage 3

Your finished smile.

Crowns and Bridges

A crown is also known as a cap, and is used to cover the entire tooth back, front and sides. Crowns are also used to improve the appearance of natural teeth that are broken, damaged or discoloured.

Your dentist will prepare or reduce the tooth on all sides to create a slightly tapered shape and the crown is then glued to this prepared surface.

Bridges are used when one or more teeth are missing or damaged. They are also helpful to balance the bite and prevent movement of adjacent teeth. A bridge is a false tooth or set of teeth, which can be supported by neighbouring teeth. This is achieved by attaching the caps to the teeth on either side of the space, thereby bridging them together. The teeth supporting the bridge might also require some drilling.

Materials used to construct crowns or bridges include porcelain, a metal/ porcelain hybrid or gold. Movement of teeth into correct positions by orthodontic braces is sometimes required for the successful construction of a crown or bridge.

Stage 1

The two adjacent teeth of the gap are prepared, as they will hold the bridge in place.

Stage 2

The ‘wings’ of the bridge are also prepared. A strong composite resin cement is used to bond the wings to the back of the teeth.

Stage 3

The wings of the bridge are not visible from the front.

Implants

Dental implants are titanium screws which can be inserted into the jaw bone under local anaesthetic. Before the tooth replacement can be incorporated the jaw bone has to grow onto the dental implant, so that the implant is firmly anchored permanently. The healing process takes from six to twelve weeks, depending on the situation. The four stages involved in the process are:

Stage 1

Consultation and assessment.

Stage 2

The implant is screwed into the jaw bone and allowed time to fully bond with the bone.

Stage 3

Once the implant has healed and is secure, the implant peg is inserted to hold the crown.

Stage 4

The new crown is secured onto the implant.

Stage 5

Implants require regular checkups and good oral hygiene, just like normal teeth.

Periodontal Treatment

Teeth are attached to the jaw bone by some spring-like tissues called periodontal ligaments. When these ligaments or the bone become damaged by bacteria and inflammatory diseases (periodontitis), the teeth become loose and the gums weaken and drop down (gum recession). The accumulation of plaque and hardened food (calculus) further irritates the supporting structures of the teeth, causing the situation to become worse, eventually resulting in the loss of several teeth. The dentist or periodontist will arrest the progression of the disease and work in conjunction with the orthodontist to stabilise/rearrange the teeth.

Gum disease

Periodontal diseases can cause inflamed, bleeding, sensitive gums. In more severe cases it can lead to gum recession, bone and tooth loss.

Bite Adjustment

Bite adjustment is technically known as ‘occlusal equilibration’. When you bite, speak or put your teeth together, ideally the teeth should not clash, bang or rub against each other because unnatural contacts between teeth can cause accelerated tooth wear, fracture, pain or sensitivity. An analysis of your bite can reveal if these normal contacts exist and adjustments can be made to these contact points, in order to achieve a more harmonious balance.

A limited amount of reshaping of the teeth is sometimes required to improve the overall appearance but it is not advisable to get your teeth filed down as this can lead to irreversible tooth damage.

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