Details of Dental Treatments

Dental Treatment Liverpool Dental

The primary objectives of treatment are to help you achieve great dental health, an attractive smile, a comfortable mouth with smooth teeth, restore function (eating and speaking) and prevent future dental disease.

Dr Smyth’s day to day clinical is primarily concerned with:

1. Treating patients referred to the clinic by local dental colleagues for root fillings and restorative dentistry

2. The restoration of adult dentitions that have gum, tooth or dental nerve problems, broken, worn or missing teeth

3. The maintenance of children’s and adult dentitions after dental trauma

Dental Implants Liverpool
Implants are titanium screws that can be placed into the jaw bone and used to support replacement teeth. Nobel Biocare dental implants have been used in dentistry for over 30 years and have a proven track record. They are very successful and often the best way to replace missing teeth.

One tooth can be replaced using a single implant, a gold attachment and a crown. The cost of a dental implant is a commonly asked question. At this clinic a guide of £1,000 for the dental implant first stage of surgery and £1,500 for second stage surgery, gold attachment and crown is a good estimate. However dental patients must bear in mind that each individual is different, some cases are simple, some are complex e.g. require bone grafting. Fees will vary depending on the complexity of the treatment.

Several teeth can be replaced with multiple dental implants that support a bridge (linked crowns).

All the upper and lower teeth can be replaced with 8 to 10 implants in the upper jaw, and 5 to 6 implants in the lower jaw. These are used to support two large bridges.
Very large bridges, that replace all the teeth in either the upper or lower jaw would cost from £15,000 per jaw.

Alternatively conventional dentures can be constructed and implants placed beneath this to help stabilise the denture during eating and speaking.

Implant surgery is very comfortable. It is a relatively painlessly procedure with local anesthetic. A simple sedation procedure is recommended for dental implant surgery.

It is a fact that dental implants may be used to support teeth immediately after they are placed into the jaw bone. However, more often than not it is advisable to wait 4 to 6 months to enable full healing to take place before using the implants to support replacement teeth.

Amalgam Fillings / Silver Fillings / Alloy Fillings
Amalgam is a silver or light grey filling material which is very strong and long lasting. This material remains a good option for medium to large fillings in back teeth. Amalgam is often placed inside root filled molar teeth in order to build them up ready for a crown.

Tooth Coloured Fillings Liverpool
Tooth coloured fillings or composites are best for repairing small/medium sized repairs in front teeth, and small repairs in back teeth. They can be used to provide imperceptible repairs. However, they are much more time consuming and require much more frequent maintenance and replacement than their amalgam counterparts.

Rubber Dam
Rubber dam is used routinely to prevent saliva and the bacteria that it contains from contaminating teeth whilst they are being repaired or root filled. Rubber dam enables teeth to be repaired under optimal conditions (clean and dry). This helps make sure the materials adhere to the enamel and dentine this avoid post-operative pain too. In addition the dam helps protect your lips and tongue whilst work takes place on your tooth. The dam prevents the risk of a patient swallowing a piece of equipment and it improves the dentists’ visibility of your tooth.

Tooth-coloured Porcelain Onlays and Inlays
When substantial amounts of tooth tissue have been lost and their restoration will be too big for tooth coloured filling materials, laboratory made porcelain onlays or inlays can provide aesthetic restorations. Occasionally due to a very heavy bite a gold restoration rather than porcelain would be the material of choice.

Crowns & bridges, Veneers Liverpool
When a large amount of tooth has been lost, or when teeth are severely discoloured or misshapen, porcelain crowns are frequently the restoration of choice.

Two types of crown are used:

(1) All porcelain crown
These are vital looking crowns and very natural.

(2) Metal ceramic crowns
Porcelain is fired onto a precious gold sub-structure. These are the most common crowns used to restore broken down teeth and they have excellent longevity.

Bridges Liverpool
When teeth are missing, they can frequently be replaced by fabrication of a bridge supported on the teeth either side of the gap. These bridges are often made from metal ceramic restorations, they are first fabricated in small sections. Each section is tried in the mouth to check and ensure quality of fit and appearance before joining them together in the dental laboratory – to form the bridge.

Veneers Liverpool
When only the outer surface of a tooth needs to be restored, this can frequently be accomplished by fabrication of a veneer which is glued to the tooth. Dr Wise uses porcelain veneers, fabricated by the laboratory technician, rather than plastic or composite veneers. These restorations are not as strong as metal ceramic crowns. But they are often the restoration of choice because they require much less tooth preparation.

Tooth Wear
Treatment often includes fabricating a plastic bite-guard to be worn at night and if necessary during the day to reduce the damaging effect of tooth-grinding habit (bruxism). Or all teeth can be restored back to their original shape using metal ceramic restorations.

Gum Disease / Adult Gum Disease / Periodontal Disease Liverpool
This is the most common human disease. It is the main reason people loose teeth in adulthood. In susceptible patients the body overreacts to the natural bacteria in their mouths and the inflammation around the teeth damages the gums.

Over time the supporting gums and bone are lost. This process is largely painful and patients can be unaware of the problem until the disease has progressed to the stage were teeth become loose, painful gum and tooth abscesses develop and teeth are lost.

This disease is frequently amenable to treatment to either decelerate the progression of the disease or regenerate lost tissue. Unfortunately, the disease often occurs with little sign to the patient, other than bleeding gums, bad breath and eventually loose teeth. Early detection and treatment is therefore desirable.

Stages of treatment would frequently be:

    * Examination
    * Diagnosis
    * Multiple visits with the hygienist
    * Sometimes surgery to the gums
    * Long term maintenance programme with the hygienist in conjunction with Dr Smyth

Tooth extraction
Some teeth cannot be repaired or fail and require removal. Dr Smyth attempts to remove teeth painlessly, with a local anaesthetic and a simple sedation procedure for nervous patients.

It is important to carefully remove teeth from the jaw bone to minimise post-operative discomfort, enable you to heal fast and to preserve as much bone as possible for future implant placement, should this become necessary.

Wisdom tooth removal is often carried out with a simple sedation procedure.

Preventative Care
Dr Smyth’s philosophy is that it is better to prevent dental disease than treat it. Also that once treatments are complete the recurrence of dental disease such as tooth decay and gum disease is undesirable. After treatment a maintenance program is recommended with regular hygienist appointments, dietary advice, application of topical fluorides and a regular recall appointments.

Root Canal / Root fillings / Endodontic therapy / Endodontics Liverpool
Teeth with problem dental nerves no longer need to be removed. Modern root filings are successful. The procedure is time consuming however it means the tooth can remain healthy for many more years.

The procedure is very comfortable with a local anaesthetic. This is often contrary to what friends and family will tell you. X-rays are taken to investigate the shape of the roots, dental pulp space and the canals inside the tooth.

The space inside the tooth where the dental nerve resided is cleaned, shaped and dressed with medicine that carrys on cleaning the inside of the tooth between appointments and helps healing as inflammation resolves.

At a second visit 2 weeks later the tooth is cleaned once again and then sterile gutta percha (the natural rubber used inside golf balls) is used to ‘root fill’ the space inside the tooth.

The tooth is then sealed up. This seal is very important because it prevents the ingress of saliva and bacteria which re-infect the root canals and cause the root filling to fail.

Often teeth that require a root filling are heavily repaired and broken down. After a root filling a tooth is like an empty cardboard box that if you stood on it – it would collapse. A foundation restoration is necessary, this is like putting stuffing inside the empty card board box.

Root filled back teeth are routinely crown to protect them from the risk of tooth fracture.

Root filled teeth are fragile. However, they can be repaired with a high degree of predictability and the procedure is very successful. To put this in perspective over the last 3 years root fillings for recently infected teeth have been 100% successful. Teeth that have had long term infections (e.g. 12 to 18 months) have been successfully treated in 95% of cases. Moderate post-operative pain has been experienced by approximately 5 patients in the last 3 years.

A clinical microscope is used to illuminate and magnify the tiny canals within the teeth.

For safety and reliability the sets of small files that are used to shape and clean the canals inside your tooth are brand new and they are carefully disposed of after use. They are not used within another persons tooth.

Orthodontics (tooth movement)
Occasionally orthodontics is employed to realign teeth into more favourable positions as part of a restorative dental plan. In most situations, patients are referred to a specialist orthodontist. Adults can benefit from orthodontics and it is often best to have teeth realigned rather that rely of expensive cosmetic treatments that involve irreversible tooth preparation.

Dentures Liverpool
Partial dentures are one possible solution to replace some missing teeth. The denture will usually be fabricated from a metal frame that supports tooth and gum coloured plastics. These are often the most cosmetic solution when replacing several missing teeth.

Complete dentures are fabricated when all the natural teeth are extracted. Sometimes they are used as a stepping stone when the ultimate goal is to plan for dental implants to support large bridges and eventually replace the dentures.

Rather than delegate the setting up of the denture teeth in wax to the dental technician who is remote from the clinic, Dr Smyth sets the teeth up at the chair-side. This enables the teeth to be tried in the patients mouth as the trial denture is fabricated to help recreate a natural and attractive smile. Several tooth shade and moulds are often used and our technician completes the denture by hand carving the gum work so it is anatomically correct and staining it shades of red and pink to recreate realistic prosthetic teeth and gums.

Sedation Liverpool
A simple sedation procedure is often recommended for nervous patients. This involves taking a tablet the night before your dental treatment. And then taking a second tablet 1 hour before your appointment.

Sedation is helpful in the following situations:

    * Anxious and nervous patients
    * Long and tiring restorative and surgical appointments