Treatments Provided
Aesthetic Dentistry
Modern dentistry can provide amazing aesthetics. A beautiful smile is said to the most important factor when people meet and greet each other. There is a vast range of treatments now available to improve your smile and of varying complexity, from tooth whitening to complete smile makeovers.
Tooth Whitening (Tooth Bleaching)
Everybody wants bright white teeth!
Tooth whitening removes staining and lightens the colour of the teeth. Current evidence suggests that the effect lasts eighteen months and that there is no harmful effect to the teeth and gums. The current evidence confirms that the procedure is successful in 92% of cases.
Tooth whitening can be completed in the dental surgery (power bleaching or laser bleaching) and in the patient’s home (at-home whitening or tray bleaching) or just at home and there is no doubt that lighter teeth impart a pleasing and youthful appearance. With both methods the end result is the same but power whitening achieves 60 to 70% of the final result within 60 to 90 minutes and means there is less for the patient to cope with at home.
At home tooth whitening is completed with close fitting mouth guards which are loaded with 10% hydrogen peroxide and worn for 30 to 60 minutes per day. The normal course lasts ten to fourteen days or five to seven days if power whitening has been completed.
Bonding with composite resin (tooth coloured filling material)
There have been amazing developments over recent years in tooth coloured filling materials (sometimes called white fillings or composite) and the adhesives used with this material. A wide variety of problems can be fixed with this material and the clinicians at SCED are very experienced in the use of this material.
Some people have stained areas on their teeth and because the tooth substance is healthy and it is not desirable to remove healthy tooth, bonding with composite can hide these areas.
Sometimes the teeth don’t form fully and have less than ideal shape and bonding can be used to correct this without progressing to a veneer or crown. Composite can also be used to close spaces between teeth or to build up worn teeth and this is invariably successful with a very natural appearance.
Composite can even be used in some circumstances over the whole front surface of a tooth – this is called a composite veneer and allows the dentist to change the surface of a tooth in just one visit. It is not unusual for this procedure to be performed without the need for a local anaesthetic.
Inlays and onlays
When a lot of tooth has been lost, the dentist wants to restore the lost substance but also protect the remaining vulnerable tooth. In situations like this, it is not unusual to recommend an inlay or an onlay.
These types of restoration are usually indicated when the problem cannot be resolved just by filling the tooth but there is enough tooth left to allow restoration without preparing for a full coverage crown (link to this).
Inlays and onlays used to be routinely made from gold by a dental technician but the remarkable CEREC® technology allows us to make these restorations from tooth coloured ceramic. This really is cutting edge technology and allows a precision, durable and beautiful restoration to be prepared and placed in one visit.
Porcelain Veneers
These are very fine porcelain facings which are made by the dental technician and bonded to the front surfaces of the teeth. Veneers can be used to mask discoloured teeth, to correct misshapen and mis-aligned teeth and close spacing. Treatment with veneers is sometimes known as “instant orthodontics” since it allows correction of crooked teeth over a relatively short period of time.
While a porcelain veneer is very delicate the adhesive used to bond these to the underlying tooth structure is very strong. This means that a superb and very natural aesthetic result can be achieved without sacrificing a lot of healthy tooth structure. The natural colour of the underlying tooth shines through a veneer and this helps to give these restorations a very natural appearance. Sometimes tooth whitening can be completed prior to treatment with veneers and this gives a bright white smile.
What’s involved?
At the first appointment, it is important to plan the treatment and work with the patient to visualise the predicted outcome. Sometimes it is important to complete a simulation of the final outcome on a model. Digital photographs can be extremely useful in communicating the important information to the dental technician.
At the second appointment, the teeth are carefully prepared and impressions are taken. Provisional or temporary veneers are also placed at this visit and these are to the predicted final outcome in complicated cases, which allows the patient to view the predicted final outcome.
At the third appointment, the temporary veneers are removed and the porcelain veneers are placed with try-in cement. This allows the patient to check that they are happy with their new restorations. The veneers are then bonded into place with multiple layers of adhesive. It is not unusual for the dentist to see the patient one more time to check that everything is satisfactory and to hear how much the patient is enjoying their beautiful new smile.
There have been amazing developments over recent years in tooth coloured filling materials (sometimes called white fillings or composite) and the adhesives used with this material. A wide variety of problems can be fixed with this material and the clinicians at SCED are very experienced in the use of this material.
Some people have stained areas on their teeth and because the tooth substance is healthy and it is not desirable to remove healthy tooth, bonding with composite can hide these areas.
Sometimes the teeth don’t form fully and have less than ideal shape and bonding can be used to correct this without progressing to a veneer or crown. Composite can also be used to close spaces between teeth or to build up worn teeth and this is invariably successful with a very natural appearance.
Composite can even be used in some circumstances over the whole front surface of a tooth – this is called a composite veneer and allows the dentist to change the surface of a tooth in just one visit. It is not unusual for this procedure to be performed without the need for a local anaesthetic.
CEREC® and Tooth Coloured Fillings
Many patients ask if it is possible to replace their “silver” or “black” fillings with a material that is tooth coloured. This is nearly always possible, but the solution depends on the size of the filling.
For small to medium fillings, it is possible to remove the silver material and replace this with white (composite) filling material. The photograph shows three back teeth with this type of filling.
With larger fillings other options have to be considered. Ceramic (porcelain) inlays can be manufactured in one visit at SCED with the CEREC 3D system and have the potential for beautiful aesthetics, wear resistance and harmony with the natural tissues. This is state of the art technology.
Think of the advantages with this technique
- fewer visits
- less injections
- no temporary fillings.
Crowns
This type of restoration can be used for front and back teeth and reproduces the anatomy and colour such that it is difficult to tell the difference between a crowned tooth and a natural tooth.
While crowns can be used purely for cosmetic reasons (link to smile makeovers), it is usual for a crowned tooth to be heavily restored with filling material prior to preparation. A crown improves the appearance of a tooth but also protects tooth substance which is at risk from fracture. It is usual to recommend that a root treated tooth (link to this) is protected and a crown is very often the treatment of choice.
Crowns can be made from porcelain (or ceramic), porcelain fused to precious metal or entirely from gold. Great advances have been made in recent times allowing the manufacture of an all porcelain (or all ceramic) crown that is just as strong as porcelain fused to metal and without the grey lines that are sometimes a problem with porcelain fused to metal crowns (link to Procera, Nobelbiocare?).
Making a crown is a highly skilled job completed by a dental technician. Each individual crown is hand crafted and designed for the individual patient’s needs. With an all-ceramic crown, the foundation is sometimes made in Sweden and then shipped back to the United Kingdom and finished to our exacting standards. At SCED, we have our own in-house technicians and we also use some of the best technicians in the United Kingdom. It is amazing that this procedure only takes two to three weeks to complete!
What’s involved?
At the first appointment, any old or defective material is removed and replaced and the tooth prepared. A crown preparation is best described as a reduction of tooth structure – imagine a tooth and then imagine this same tooth shrunk by a precise amount. At the preparation visit any tooth structure is replaced with a provisional or temporary crown which restores the appearance while the crown is being made but allows the patient to get on with their life.
At the second visit, the temporary crown is removed, the final crown placed with try in paste and assessed by the patient and then cemented into place. When multiple crowns are being planned it can be useful to complete a final visualisation of the predicted final outcome on a model of the teeth.
A well planned and well executed crown looks and feels excellent and should last in excess of ten years.
Smile makeovers
Using a combination of the techniques described above and by meticulous planning by the clinicians at SCED, it is possible to provide you with the smile that you desire. A detailed treatment plan will be provided prior to commencement so that you are in full knowledge of the proposals before treatment is started.
