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Treatments » Restorative Dentistry
Crowns
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A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement. Crowns can be made from a variety of materials. They can be made from plastic, ceramic or metal alloys. A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.
What is a crown?
A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.
Crowns are used for several reasons:
- As a protective cover for badly decayed teeth or fractured teeth
- As a permanent restoration for teeth with large fillings
- To correct minor problems in natural teeth like spacing and irregular shape or severe discolouration
What are crowns made from?
Crowns can be made from a variety of materials. They can be made from plastic, ceramic or metal alloys. A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.
How are crowns made?
Firstly, a thorough clinical examination is conducted with radiographs, by the dentist. The suitability for crowns is assessed and any preparatory work is carried out. Your dentist will also be able to advise on material choices, treatment sequence and any other concerns you may have.
At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.
At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.
How long do crowns last and how do I care for them?
Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.
Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.
Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.
Bridges
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What is a bridge?
A bridge is a means of replacing missing teeth using the neighbouring teeth as supporting structures. Bridges are usually performed by trimming teeth on either side of a missing tooth as is done with crowns. The crowns made are joined together by adding a tooth in between. The resulting structure is called a bridge. Like crowns, they are also fabricated in a laboratory utilising the same materials and then fitted in the mouth. Maintenance care for bridges is similar to that for crowns. The focus is on regular flossing, brushing, as well as regular check-ups.
Can all missing teeth be replaced with bridges?
Bridges can be used to replace a small number of missing teeth if the neighbouring teeth are sufficiently strong. The number of missing teeth, condition of the neighbouring teeth, condition of the supporting gums and bone are all important factors which need to be assessed by your dentist prior to making a bridge. Your dentist will also be able to advise on alternative methods of replacing missing teeth after a clinical examination.
Dentures
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A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.
What is a denture?
A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.
Partial denture Complete dentures
How long does it take to make dentures?
Depending on the complexity of each case, the duration of the treatment will vary. After the initial visit of examination and diagnosis, the subsequent visits will include taking impressions of the mouth, bite registration, try-in of the denture, issue and review.
What to expect?
New dentures always feel strange when first placed in your mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies with different persons and often time and experience are essential before dentures can be worn comfortably and function effectively.
Useful suggestions to help you to adapt to the new dentures:
Eating - Eating will take a little practice. Start with soft foods and foods cut into small pieces will help. Chew slowly using both sides of your mouth at the same time to prevent dentures from tipping. Once you become accustomed to chewing, include other foods until you return to your normal diet.
Increased salivary flow - You may experience an increase in salivary flow when the dentures are first inserted. This is a natural response of the salivary glands that will return to normal after a few weeks. You can improve the situation by swallowing more often.
Speech - New dentures may alter your speech initially. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will speed up the adaptation process. This problem rarely persists beyond two weeks.
Sore spots - Minor irritation caused by surface irregularities or pressure spots on the denture-bearing areas are quite common. Your dentist will relieve the discomfort by adjusting the denture surface. Stop wearing the denture if the irritation is very painful. Consult your dentist immediately.
Care of your dentures
Like natural teeth, dentures can accumulate plaque and food debris, particularly in areas where the denture is in contact with the remaining teeth and gum. In addition to the usual oral hygiene measures like tooth brushing, dentures should be cleaned regularly. Poor denture hygiene can result in stains on the denture and a bad odour.
If possible, dentures should be removed and cleaned after every meal. When cleaning, remember the following:
- Use a soft hand brush or a special denture brush.
- Avoid very hot water as it may distort the denture.
- Use mild detergent to clean dentures. Avoid using abrasive cleaners that can roughen the polished surface of the denture. Do not use bleach as this may whiten the pink acrylic.
- Hold the denture firmly while cleaning. Accidentally dropping the denture may result in chipped or broken dentures. Always wash your denture over a basin of water.
Soak the dentures in denture cleanser once a week to remove stains and always rinse them thoroughly before using the dentures again.
When you are not wearing the dentures, store them in water. Dentures may lose their shape if left to dry out.
How long should you wear your dentures?
During the first few days you are advised to wear them most of the time except when sleeping. Always remove the dentures before going to bed. This will allow your gum tissues to rest and promote oral health. Gentle massaging of the gums with a soft toothbrush is encouraged. Remember to soak the dentures in water to prevent them from drying out.
The next denture review
Your jawbones and gums naturally shrink over time and this can cause the dentures to fit less securely. Ill-fitting dentures can give rise to chewing difficulties, soreness, infections and changes in facial support. It is important that you visit your dentist to have your dentures and oral tissues evaluated yearly. Your dentures may need to be adjusted, relieved or even relined from time to time to ensure an optimal fit. Do not attempt to adjust the denture yourself - seek professional help.
With time and practice you will soon learn to eat, talk and smile with your dentures as you would with your natural teeth.
Dental Implants
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Implants are one way of replacing missing teeth. A post is planted in the jaw bone to support a replacement tooth. This acts like the root of a natural tooth. Implants can also be used to support fixed bridges or dentures. Implant treatment normally has two stages. First, the implant is placed in the jaw. Then, when the jaw has healed, replacement teeth are attached to the implant. In some situations it is possible for temporary teeth to be attached to an implant at the time of fitting.
Dental implants
Dental implant therapy has been around for many years with a proven track record. Improvements in materials and surgical techniques have made dental implants the gold -standard treatment in many instances for the replacement of missing teeth.
What are dental implants?
A dental implant essentially substitutes for a missing tooth root. It is commonly cylindrical or screw-shaped. Each implant is carefully and precisely drilled into the location of the intended tooth and provides a foundation for long-term support of replacement teeth.
Almost all dental implants in use today are made from titanium or titanium alloy. These materials have been shown to be well tolerated by bone. The terms ‘osseointegrated implants’ and ‘endosseous implants’ are widely used to describe dental implants that can develop and maintain a close union with bone in order to support replacement teeth.
Who is a suitable candidate for dental implants?
Implants can be used to replace a single tooth, multiple missing teeth or to replace teeth in cases with complete tooth loss. Therefore, almost any situation can potentially be treated with this modality. However, various factors need to be taken into consideration such as bone volume and quality, tooth and jaw relationships, oral habits and general medical health. Your dental surgeon will assess your suitability for treatment with these implants.
How is treatment carried out?
Phase 1: Treatment Planning - Thorough assessment of your medical health, oral health, the way your teeth fit together and bone volume will be performed to produce an individualised treatment plan.
Phase 2: Surgical Treatment - A minor surgical procedure is carried out to place titanium fixtures into bone. If bone and/or soft tissue are insufficient, there may also be a need for additional bone or soft tissue grafting procedures.
Phase 3: Restorative Treatment - After integration of the implant fixtures to the bone, ‘new permanent teeth’ will be designed and fabricated to fit over the dental implants.
How long does the treatment take to complete?
It normally takes about four months to a year to complete the entire treatment. This would depend on case complexity as well as the need for additional procedures like bone grafting. ‘Immediate loading’ implant, where the entire implant treatment is completed within the same day, is possible for a few selected cases.
How do I maintain these implants?
These ‘new teeth’ are maintained in much the same way as normal teeth. Specific brushing and flossing techniques will be taught, as well as regular dental checks on the implants. Good oral hygiene is required to ensure the long-term success of your implants.
How long will the implant fixtures stay in the bone?
If the titanium fixtures have successfully integrated to the bone and are properly maintained, they should last for many years. However, just as you would expect conventional crowns, bridges and fillings to need occasional repairs or replacements during the course of their lifetime, your implant-supported teeth may also need similar maintenance.
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