Aesthetic tooth restoration
There are many ways to restore a tooth which needs attention. A tooth may sustain a carious lesion (tooth decay), have broken, or have worn or eroded (this is now very common). The aim is to remove as little tooth at all, often none at all. We will always give you two guarantees-we will always try our best, and, if you live long enough, the treatment will always need to be done again. It is thus important to work as carefully as possible to avoid removing any precious tooth structure.
Fillings
Dental amalgam is the age-old dark material which contains an alloy of metals and is held together by Mercury. Although this is a recognised material for use in the UK we do not offer it, and will refer you to somewhere else should you request this material.
There are two main types of filling material in use which are tooth coloured and do not contain Mercury. These are Glass Ionomer Cement and Composite Resin ("white fillings"). Composite resin (also known as resin bonding in some situations) is more hard wearing, generally longer lasting, much more aesthetically pleasing and has wider application. We need to keep the tooth dry for optimum performance of the material and so a rubber dam is often used to isolate the area. Japanese materials are thought to be the premium brands and we have tried to use these for many years.
American bonding agents work very well to link the resin to the tooth and sandblasting using Australian aluminium oxide prepares the tooth very well prior to the bonding process. An international effort is required to get the best results!
Glass ionomer cement is used where it is difficult to keep the tooth dry or as a medium-term provisional restoration. It can last for a number of years but is unlikely to outperform composite resin.
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Resin Bonding
Worn teeth are very common today and we carry out a number of resin bonding cases. Often we restore a case every day of the week as tooth wear grows and grows. The beauty of resin bonding is that we do not prepare or reduce the tooth at all. To repeat, no tooth is removed during this process. Often we will open the bite by a millimetre or more to allow restoration of wear and to stabilise the bite for the future.
The Dahl technique is priceless in allowing us to work in a way where the bite is opened and the teeth move to accommodate the new improved tooth shapes. Protecting exposed dentine improves the lifespan of teeth effectively.
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Inlays and Onlays
Although filling materials as described above can work very well, they do not last as long as another class of materials/techniques, known as indirect restorations. Fillings are known as direct materials as the dentist and nurse take unset or soft material, place it into the cavity or onto the tooth and set it often using a light. Unfortunately, during the setting reaction, the materials shrink, water can get in and air bubbles can be incorporated. This affects the success of the restorations markedly.
Inlays are made outside the mouth in the dental laboratory and the dentist and nurse cement them into the tooth. There are no air bubbles, less risk of any issues with water, the aesthetics can be incredible, and the lifespan is recognised as being superior. This is a two-visit process with a temporary restoration being cemented into place to maintain the tooth while the lab makes the inlay or onlay.
An inlay resembles a filling, whereas an onlay covers any thin parts of the walls or cusps of the teeth to try and prevent fracture in use over the years. Both are more conservative of tooth structure than a crown. We have predominantly placed ceramic restorations for many years. Lab-made composites, gold, and other materials are available but ceramics seem the closest to the natural tooth and perform very well.
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Scanning
You no longer require a mouth full of impression material in a tray to record the shape of your teeth. Sophisticated intraoral scanners are used to acquire a 3D image which is sent to the lab within a couple of minutes. We use laboratories in the UK and various countries including Italy where the level of artistry seems superb.
The 3D scan is also valuable in monitoring the teeth for movement or wear. When someone experiences trauma to the teeth, we can refer back to it to allow a rebuild copying the original shape. We have seen this occur multiple times over the years and it is nice to be able to help people in this situation.
What our PATIENTS say
I was so impressed with my consultation with Andrew so went ahead with my treatment. I am absolutely blown away with the result. Andrew achieved everything he said he would and more. I could not be happier and will certainly be going back. Thank you so much Andrew.