Parkview Dental
Practice
will undertake a variety of dental procedures... Please click on the
keyword to take you directly to the subject matter:
Braces
Bridges
Crowns
Dental Examination
Dentures
Extractions
Fillings
Implants
Root Fillings
Scaling & Polishing
Veneers
Dental
Examination
What is it? Before treatment, your dentist needs to understand your
needs and the treatment options. A dental examination (or 'check-up')
enables you and the dentist to discuss any problems and what to do about
them.
What does the dentist do? The dentist will start by asking questions...
for example, about:
Any problems you've noticed in your mouth (such as pain or sensitivity)
Your medical history and any medicines that you might be taking (because
general health problems can be relevant to your dental care)
Your diet (because decay can be worse if you use a lot of sugary snacks
and drinks)
How you brush your teeth (because this can sometimes damage your teeth
and gums)
Smoking and drinking (because both can affect the health of your mouth)
The questions will depend partly on what the dentist sees in your mouth.
Expect the dentist to:
Look at your face and neck for signs of ill-health
Look inside your mouth, especially inaccessible places where there might
be something you cannot see or feel which could still need treatment or
investigation
Look at your teeth and gums, for signs of tooth decay, damage and gum
disease
For children, the dentist will look at tooth and jaw growth in case
orthodontic treatment (such as a brace) might be needed
Compare how your mouth is now with how it was when you were last seen
Decide whether any more information is needed... for example, from
X-rays, or using plaster models of your teeth to study the way your
teeth bite together
Tell you whether any treatment might be needed, explaining the choices
including what it will probably cost
What happens at an examination will depend on whether you are seeing a
particular dentist for the first time or at a check-up appointment.
What are the benefits? Regular
dental examinations help you keep your
mouth healthy by preventing problems. A thorough examination enables you
and the dentist to look after your mouth in the way that is best for
you. The dentist explains and then you decide. At Parkview Dental
Practice, we place a great deal of store in preventive dentistry.
Back to the top
Fillings:
Fillings replace parts of the tooth removed because of decay or lost
through accidental damage and need to be tough so that they last. Both
'amalgam' and 'cosmetic' white fillings can be provided, in many cases
without the need to drill the tooth to clean the cavity, thanks to
modern technology.
Amalgam Fillings... What are they? Amalgam is a mixture of mercury with
silver, tin and sometimes copper, which is soft and mouldable at first
but quickly becomes very hard. Amalgam is used especially for the
chewing surfaces of back teeth where there is heavy wear.
What does the dentist do? There are several steps:
Any decay is removed, together with any of the old filling needing to be
replaced
The hole or cavity is shaped so that the tooth holds the filling in
place. Any weak part of the tooth which might break later is also
removed
For a large filling, tiny pins and screws can strengthen the tooth's
hold on the filling
Unfortunately, amalgam conducts heat well, so the tooth can be sensitive
to hot and cold if the filling is deep. An insulating lining might be
put in the hole first
The hole is filled with amalgam which is pressed in tightly. You might
hear it squeak as this happens
The filling is carved into a tooth shape. The dentist might put a thin
metal band round the tooth while doing this, to keep the amalgam in
place whilst it is still soft
You will be asked to bite on the filling to check that you can chew
comfortably
The filling might be polished... this would be done at the next visit
when the filling is completely hard.
What are the benefits? If tooth
decay is caught very early, a filling
may not be needed... the tooth can mend itself using minerals in saliva
and fluoride. But once decay has gone beyond the outer layer of the
tooth (the enamel) the hole will probably become bigger unless the decay
is removed. A filling stops the decay and rebuilds the tooth for
chewing.
White Fillings...
What are they? White fillings will normally be used where the filling
can be seen. They come in a range of shades to match your own teeth.
Unlike an amalgam (silver) filling, which is held in place by the shape
of the tooth, a white filling can stick to the tooth. You will probably
hear the dentist talk about 'composite' or 'glass ionomer'... these are
just different types of white filling.
What does the dentist do? As with amalgam fillings, there are several
steps:
Any decay is removed
Some or all of any old filling might also be removed
The hole is washed and dried by blowing water and then air into it. You
will see the dentist holding an instrument at the end of a pipe which
sends air, water or a both into your mouth
The new filling material is packed into the cavity
The filling is shaped while still soft
The filling will then be hardened or 'cured' very quickly using a very
strong light in the blue spectrum
The filling with then be trimmed and polished
It might be polished again at your next visit.
What are the benefits? White
fillings are not ideal for chewing on but
they have the advantage of being tooth-coloured and other advantages as
well, because of their ability to adhere to the tooth:
Less shaping of the hole is needed to keep a filling in place, once any
decay has been removed
White fillings can be used to reshape and rebuild teeth... broken edges
or worn teeth, for example
They can be used to cover discolouration, if it can't be removed by
cleaning.
Back to the top
Crowns:
What are they? Crowns are made of metal, or porcelain, or porcelain with
metal inside for strength. If a tooth has been weakened a lot by decay
or other damage, a crown can protect it. It completely covers the tooth
above the gum line. A crown can also improve appearance if a tooth is
misshapen or discoloured.
What does the dentist do?
The tooth is shaped first. The crown needs to fit over the tooth easily
without making it bulky
Preparation time will depend on how damaged the tooth is. If not much
natural tooth is left, the tooth might be root-filled (see below)
first... this is sometimes called 'removing the nerve'
The tooth is built up with a filling, which might be held in place by a
peg in the root canal (preparation would then take more than one visit)
Soft material like putty is used to record exactly the shape of the
tooth to be crowned and the nearby teeth. A dental technician uses this
'impression' to make the crown the right size and height. The edge of
the crown will normally be very close to the gum. A thin cord is used to
hold the gum away from the neck of the tooth so that the impression is
accurate round the edges
A temporary crown will be put over the tooth until the crown is made.
You can chew on a temporary crown but it won't be as strong as the
permanent crown. Temporary crowns are made of plastic or metal
When the permanent crown is fitted, small adjustments will be made to
ensure that you can bite comfortably. The crown is tried on, first, and
then fixed permanently into position.
What are the benefits? A crown is
strong and can look and feel almost
exactly like a natural tooth. The colour and shape can be matched to
your own teeth. Depending on the strength of the tooth underneath, a
crown can last for many years if your oral hygiene is good and the crown
is not accidentally damaged.
Back to the top
Fixed Bridges:
What are they? A bridge replaces missing teeth by fixing a replacement
tooth (or teeth) to the natural teeth at each end of the gap. Some
bridges have crowns at each end, whilst with others, the replacement
teeth are stuck just to the sides of the teeth beside the gap. Bridges
are made of metal and porcelain. A bridge is fixed and therefore cannot
be removed for cleaning so food can get trapped underneath. To avoid gum
disease or decay around the supporting teeth, you will need to use
special floss or little brushes as well as a normal toothbrush and
toothpaste to keep a bridge clean. Your dentist will show you how this
is done.
What does the dentist do? Firstly, your dentist will discuss whether a
bridge is for you. For success, a bridge needs strong supporting teeth
and thorough regular cleaning. What are the prospects for success in
your case? The alternative will probably be a removable partial denture.
If a bridge doesn't have a good chance of success should you choose a
denture from the start? If teeth have just been lost, fitting a bridge
will need to wait until the gums have healed... up to six months. If a
gap is visible, would you want a denture first? There are several stages
in making a bridge:
The dentist will first use soft material like putty to make impressions
of your mouth. A dental technician then turns these into exact plaster
models of your upper and lower teeth and gums, which help the dentist
understand how your teeth bite together
The natural teeth which will support the bridge are made the right shape
(either to be covered by a crown or to stick to the bridge at their
sides)
Another mould is made to record the shape of the prepared supporting
teeth and the gap between them. A dental technician uses this to make
the bridge
Whilst you wait for the final bridge to be made by the technician, a
plastic temporary bridge or temporary crowns will be fitted
At your last visit, the dentist will put the final bridge in place
without fixing it permanently, so you can check that the fit is right.
Your dentist can make final small adjustments before permanently fixing
it into position.
What are the benefits? A bridge
almost lets you forget that you have
missing teeth at all. It can Improve the way you look, bite, chew and
speak; It won't take so long to get used to as a denture; It can last
many years provided you clean your teeth well and there isn't accidental
damage; It can help protect other teeth from wear and tear. If a gap
isn't filled the natural teeth may move or tilt, stopping your teeth
biting together properly; replacement teeth can be matched to your other
teeth and made to look very natural.
Back to the top
Veneers:
What are they? A veneer is a thin layer of tooth-coloured material put
onto the front of a tooth to make it look better. To be secure, a veneer
might be made to fit round the biting edge of the tooth. Veneers can
also be used to protect worn teeth from further damage. For example,acid
in foods and drinks or from the stomach can
cause erosion... the teeth become thin and weak but veneers can protect
them. Veneers can improve the shape of teeth as well as their colour.
What does the dentist do? There are two kinds of veneer. Some can be
made in the surgery at one visit, from 'composite' (white filling
material) whilst others can be made out of porcelain by a dental
technician, using a mould which the dentist makes with soft material
like putty. This type of veneer needs two visits.
Any fillings in the teeth will be checked first
Very little tooth preparation is needed... just enough to prevent the
tooth being bulky
For veneers made in the surgery, the surface of the tooth is roughened
with a mild acid, then composite is applied in layers until the look and
shape are right
For a veneer to be made by a dental technician, an impression is taken
first. This shows how the teeth bite together as well as telling the
technician the shape and size of veneer needed
The technician-made veneer is glued to the tooth by the dentist.
A veneer can sometimes come away from the tooth, in which case it might
be refixed or a new veneer might be made. The dentist will discuss with
you what the prospects are for a veneer on a particular tooth.
What are the benefits? Veneers can
transform the patient's appearance.
They hide imperfections while destroying very little of the natural
tooth. If the tooth is sound and strong a veneer is a better option than
a crown for improving a tooth's appearance. A crown is more likely for a
tooth weakened by decay or other damage.
Back to the top
Scaling &
Polishing:
What is it? 'Scaling' means cleaning your teeth thoroughly, especially
to remove bits of 'tartar' that can form on your teeth like the 'scale'
inside a kettle. Tartar can't be removed by brushing and may help cause
gum disease. You can't remove it just with a toothbrush or floss.
Scaling cleans above and slightly below the gums. Hard tartar is removed
as well as trapped food and sticky 'plaque'. Stains from coffee,
cigarettes or red wine are also cleaned away. Your teeth will be scaled
by a dentist or by a dental hygienist.
What happens? There are two ways to scale teeth:
Hand scalers come in different sizes and shapes, to reach different
parts of the teeth. This is why you will see the dentist or hygienist
changing instruments quite often
Electric scalers are very efficient and are the type of scaler we use at
this surgery. They use very fast 'ultra sonic' vibration with water. The
water is removed from your mouth using suction.
A hand scaler can be used to check whether the teeth are completely
clean.
For polishing, a rotating brush or rubber polisher is used, with
toothpaste. You may be given advice on how to clean your teeth if there
are signs that you are not doing this properly.
Sometimes teeth are scaled for two or three visits in a row. How
effectively you clean you teeth between visits can then be checked.
What are the benefits? Regular
scaling by a dentist or hygienist helps
you keep your gums healthy by making it easier for you to keep your
teeth clean at home. You will feel and see the difference. Some people
are worried about bad breath. Good oral hygiene is usually the answer.
Early gum disease can get better without any permanent damage to your
gums. But if your teeth are not kept clean some of the bone around your
teeth can dissolve away, so that eventually the teeth become loose in
their sockets and possibly have to be extracted. Bone cannot re-grow but
red and swollen gums can get better after deep scaling and other
treatment. If you have this problem, talk to a dentist. If your gums
bleed when you clean your teeth, this is usually a sign of gum disease
and you should go to the dentist for advice.
Back to the top
Root Fillings:
What are they? Teeth are held in the jaw by their roots. Inside the
tooth, the 'pulp' is normally alive, with nerves and a blood supply, but
decay or injury can destroy this living part and might also cause an
abscess at the end of the root. 'Root filling' means removing damaged or
dead root pulp and filling the space left behind. The tooth above the
root can then be repaired.
What does the dentist do? The inside of the root has to be completely
clean before it is filled:
An X-ray can show bone loss caused by pulp infection as well as the
shape of the roots. Some tooth roots are easier to fill than others,
because of their shape. The dentist will discuss the X-ray with you if
it suggests that a root treatment isn't going to be successful
The dead pulp is removed with narrow files;
Another X-ray can show how long the root is, to help the dentist in
filling it
Roots are filled with rubbery materials and pastes which set hard
A root filling could need more than one visit. The time needed will
depend on whether there is infection and the number of roots to be
filled (back teeth have more roots than front teeth)
You might not need a local anaesthetic for a root filling if the pulp is
dead, but the tooth could still be tender for a day or two afterwards
(you may need to take a mild pain killer... your dentist will give you
advice about this)
What are the benefits? Pulp damage
can cause painful toothache but the
pain will usually end very quickly when the root is cleaned out. Without
a root filling the tooth would probably have to be taken out. First-time
root-fillings are usually successful and can last many years. If a root
filling fails and there is infection again, the root can sometimes be
re-filled, but the success rate will be lower and the tooth might have
to be taken out if it can't be saved by surgery.
Back to the top
Implants:
What are they? Missing teeth are usually replaced with
removable dentures or fixed bridges. Implants are another option.
They're usually made of metal and set surgically in the jawbone. They
support replacement teeth, a little like the roots of natural teeth. As
with all surgery, there will be some discomfort to start with. The
treatment also takes a long time because the jaw needs to heal fully
before the implants can have teeth attached. Implants need a lot of
co-operation from the patient. Oral hygiene must be excellent for
implants to stay healthy.
What does the dentist do? Implant surgery is usually done by
specialists, but more family dentists have experience of the next
stage... fitting replacement teeth to the implants once the jaw has
healed. In deciding whether implants might be for you, ask your dentist
about all the stages of treatment and about who would be carrying it
out. Think about aftercare too... if you have implants it is more
important than ever that you have regular dental checkups. If you
finally decide to go ahead here are the usual stages:
Implants are put into the jawbone under a 'local' or 'general'
anaesthetic. Each implant needs a hole in the bone
The implant is screwed or pushed in and the gum is stitched so that it
heals over the implant
Under the gum, the bone then grows round the implant to hold it firm.
This takes several months
Implants usually have two sections, the implant in the jaw and an
extension added later when the lower part is secure
Attaching the extension needs just a small cut in the gum above the
implant. The implant extension then remains visible
You might have just one or two implants in a jaw, or several. The
replacement teeth might be fixed permanently or attached in a way which
allows you to remove them for cleaning.
Implants can support single teeth, fixed bridges or removable dentures.
Making replacement teeth to go onto implants is much like making a
crown, bridge or denture for someone without implants. Sometimes there
will be a gap below the tooth, so that the implant can be kept clean,
but people won't see it.
What are the benefits? Some people
are never able to use removable
dentures, however hard they try and however hard the dentist tries to
make the dentures a good fit. Implants can then be a last chance for
restoring eating function, speech and appearance. Implants keep a
denture very stable. People will not be able to see that your teeth are
supported by implants. With very good oral hygiene implants can last for
many years provided they aren't accidentally damaged.
Back to the top
Dentures:
What are they? A removable denture replaces missing teeth. Dentures are
made of plastic or with metal as well, which makes them less bulky and
stronger. Sometimes, when a denture sits beside natural teeth, metal
clasps can be used to help keep the denture in place. Normally, people
won't notice the 'metalwork' when they look at you.
What does the dentist do? Dentures won't feel like natural teeth and it
can take time to get used to a new denture. If you haven't had a denture
before, the dentist will want to explain the difficulties of
denture-wearing as well as the benefits. There are then several stages
in making a denture:
At the first visit the dentist uses putty-like material to make moulds
of your mouth, called 'impressions'. A dental technician turns these
into exact plaster models of your upper and lower teeth and gums for the
new dentures to be made on
More visits are then usually needed to decide how to place the false
teeth so that they look and feel as natural as possible. The technician
will have made wax blocks which roughly fit the models of your mouth.
The dentist trims them to fit exactly
The trimmed wax blocks show the technician how to make the denture. A
trial denture is made first, which fits your mouth but has the teeth set
in wax so adjustments can be made. The dentist will ask you how the
denture fits, feels and looks and make final changes
The denture then goes back to the technician who permanently fixes the
teeth into place. The denture is then ready for you to use
Your dentist may want to see you again fairly soon after the initial
fitting, to see how you are getting on with your new denture. If there
are problems, small adjustments can be made. Dentists call this 'easing'
your dentures
Your dentist will probably want to see you at least once a year after
dentures are fitted, to make sure that your mouth and any remaining
natural teeth are keeping healthy
What are the benefits? Dentures
can improve the way you look, bite, chew
and speak; they are custom-made products which can be matched to your
own mouth and made to look very natural; they put the jaw back into its
natural biting position after back teeth have been lost, restoring the
shape of the face and making chewing more comfortable and efficient;
they help protect any natural teeth from wear and tear. Without dentures
to fill the gaps, the natural teeth may move or tilt, stopping your
teeth biting together properly. Dentures can be fitted straight away
after teeth have been taken out, so a new gap doesn't have to be seen...
however, dentures like this will probably need to be replaced a few
months after your gum has healed.
Talk to your dentist about wearing
dentures at night. If you do, you
need to be especially careful about cleaning your mouth and denture and
any remaining natural teeth.
Back to the top
Extractions:
What are they? Extractions are the removal of teeth from the upper and
lower jaw. Although we prefer to save a tooth if at all possible, there
is sometimes no alternative to an extraction.
What does the dentist do? Extractions are done quickly and carefully,
with the patient under 'local' anaesthetic, using either 'tooth keys' or
extraction pliers, or a combination of both:
A 'local' anaesthetic is first administered
Often, your dentist will scale or polish your teeth whilst the
anaesthetic takes effect, making good use of the time required for this
to happen
The tooth to be extracted is loosened in its socket until it can be
extracted
On rare occasions, it is necessary for the patient to be operated upon
under a 'general' anaesthetic, and where this is necessary, the patient
will be referred outside the practice (for reasons of patient safety, no
'general' anaesthetics are administered at our surgery)
What are the benefits? An
extraction is sometimes the only way to treat
acute dental pain, particularly when a root-filling would be
ineffective.
Back to the top
Orthodontics:
What is it? Orthodontics is the science of adjusting the position of
mis-aligned teeth by the use of 'braces'.
What does the dentist do? Braces are used over a period of several
months to re-align the teeth to form a better bite or cosmetically to
remove a 'goofy' appearance:
At the first visit the dentist uses putty-like material to make moulds
of your mouth, called 'impressions'. A dental technician turns these
into exact plaster models of your upper and lower teeth and gums for the
brace to be modelled on to a fine tollerance
It may be necessary to extract teeth on either side of the affected jaw,
to provide enough room for the mis-aligned teeth to move back into, to
fill the gaps
The new brace is fitted and adjusted to provide the pressure needed to
move the teeth. The teeth will cut their way through the jaw bone over a
period of time and the bone grows back behind them as they move
As the re-alignment process is a slow one, your orthodonist will want to
see you from time to time to inspect the re-alignment is going well and
to re-adjust tension on the brace to keep the teeth moving
Sometimes, an appliance called a 'whisker' is used at night-time. This
clips onto the brace and provides more tension and hence greater
pressure on the teeth, causing them to re-align quicker
What are the benefits? Dramatic
improvements to the bite can be made,
making it easier to bite, chew and speak; cosmetically, appearance can
be greatly improved.
Back to the top