What will my dentist do?

• They will normally give you a local anaesthetic to numb the area.

• They will shape the tooth so that, with the crown, it will be the same size as a normal tooth.

• Preparation time will depend on how damaged the tooth is
and whether it needs to be built up with a filling first.

• The tooth might have to be root-filled first – this is sometimes called ‘removing the nerve’.
The crown is sometimes held in place by a peg in the root canal if a lot of the tooth is missing.

• Your dentist will use a soft mouldable material to make an exact ‘impression’ of the tooth
that is to be crowned and the nearby teeth. A dental technician uses an impression
to make the crown the exact height and size needed.

• A thin cord may be used to hold the gum away from the tooth
so that the impression is accurate round the edges.

• A temporary crown made of plastic is 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 finished one.

• When the crown is fitted, your dentist will make small adjustments to make sure
you can bite comfortably. The crown is tried on first, and then glued into place.

What are the benefits?

• A crown is strong and can look and feel 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 you look after your mouth and teeth and the crown is not accidentally damaged.

• Crowns can also improve the appearance of misshapen or discoloured 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 has two stages. First, the implant is placed in the jaw. Then, when the jaw has healed, replacement teeth are attached to the implant.

What will my dentist do?

First you should decide whether implants could be right for you. Ask your dentist about the stages of treatment, about who would be carrying out each stage and the timetable for completing treatment. Your own dentist might do the implant surgery or you might be referred to a specialist.

If you decide to go ahead, this is what will happen:

• Implants are out into holes in the jaw with a local or general anaesthetic.

• 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 tables several months.

Implants usually have two sections – the post in the jaw and an extension that is added later when the post is secure. Attaching the extension needs a small cut in the gum above the implant. You might have more than one implant. The replacement teeth might be fixed permanently (like a crown or bridge) or attached in a way which lets you remove them for cleaning (like denture).

What are the benefits?

• Some people can’t use removable dentures however hard they try
and however hard the dentist to make the dentures a good fit.

• Implants can be a last chance for eating and speaking properly
and for improving appearance.

• Implants keep a denture very stable.

• People will not be able to see that your teeth are supported by implants.

Implants are not suitable for all patients.

• Like hair and skin, teeth vary in colour. Some are yellow or darker than others, even when they are quite healthy

• Teeth sometimes darken if their roots have been diseased. A change in colour is caused by blood from the root canal

Tooth bleaching is completely safe as long as the bleach does not touch your gums and burn them. Dentists use special jelly bleach.

What will my dentist do?

For a tooth which is dark inside, the bleach is put in the root canal temporarily, before or after the tooth is root-filled.

There are two ways of bleaching the outside of teeth.

• The dentist may give you weak bleach jelly at use at home in a tray
which fits closely round your teeth. The tray makes sure that the jelly does not
burn gums. You will need to use the tray for an hour or two a day, for up to six weeks.

• A dental technician will make the tray you use for bleaching your teeth at home
from an impression of your teeth that your dentist has made. Your dentist will check
the tray fits and show you how to put the jelly in the tray at home.

• Your dentist can use a stronger bleach jelly. Dentists use this method
to bleach all the teeth at the same time in either your upper or lower jaw.
The strong bleach will touch the teeth for less time than with home bleaching.

If your dentist uses stronger bleach, they will protect your gums. They will paint the bleach onto the teeth and heat it with a light for a few minutes. They then wash it off with water.

• Your dentist will make a note of your tooth colour using model teeth in different
shades before they treat you. Look at the colour match yourself
before the treatment so you can compare it with the colour after bleaching.

• Your teeth may be sensitive to hot and cold food and drink for a few days after bleaching.

What are the benefits?

• Bleaching improves the appearance of your teeth without removing
any of the natural tooth surface. Bleaching is a better option than a crown
or veneer if you want to lighten the colour of healthy teeth.

Many of the newer tooth coloured dental materials are adhesive which means that they stick or 'bond' to teeth, unlike amalgam (black fillings).

The surface of the tooth needs to be made slightly rough so that the restoration can grip correctly. this is called 'etching' and for this the dentist will use a mild acid which is completely harmless.

'Etch-retained restorations' are repairs which are attached to the tooth in the above highlighted way, such as fillings, crowns, veneers, inlays or onlays. They are very life-like in appearance.

*Information courtesy of the British Dental Association