What we do
We offer a wide range of treatments best suited to fit your needs
Examination and Treatment Planning
The dental exam is the cornerstone of any dental treatment planning and should be done before any scheduled treatment is carried out. It is carried out in four stages after a detailed medical and social history have been taken, these are:
- Soft tissue exam of the tissues in the mouth.
- Periodontal exam of the gums
- Hard tissues exam of the teeth
- Extra oral exam of the face, head and neck.
Any findings are duly noted and discussed with the patient giving their treatment options for each noted treatment. A treatment plan is then drawn up and the costs discussed, a written treatment plan is then given.
At the exam, x-rays may be taken to assist with treatment planning. This falls under a Band 1 treatment cost.
A crown is a dental restoration which completely caps or encircles every surface of the tooth. Crowns are often needed when a heavily filled tooth breaks or the aesthetics of a discoloured tooth need to be improved. Crowns fall into Band 3 NHS charge.
Crowns can be made of many materials (porcelain, Porcelain bonded to metal, metal and composite resins) and are indirect dental restorations made on models in laboratory constructed from impressions the dentist has taken in the patient’s mouth after your dentist has prepared the tooth. They are held in place by dental cement.
The practice offers private crowns as well which are more tailored to the variations of the individual patients, whilst the fit is no better, the technicians can match the aesthetics of the crown in a more detailed way by spending much more time fabricating the crown.
Over a period of time, plaque and calculus can build up on the teeth. The saliva in our mouth contains millions of bacteria. These adhere to the tooth surface forming plaque. Calcium within the saliva is then deposited on these bacteria to form calculus (scale). This hard deposit once formed cannot be removed by regular brushing.
It is important that calculus is removed as it is full of bacterial toxins which cause inflammation of the gums. If left in situ, calculus will cause the gums to recede from the teeth leading to eventual tooth loss.
Most of us at some point will need to have our teeth scaled. Scaling is the dental method used to help smooth the surface of the teeth so that bacteria are less able to adhere to the enamel surface.
Your teeth will be scaled by either your dentist or a dental hygienist. They will use hand scalers and/ or an ultrasonic scaler to remove the calculus build up.
Once all the calculus is removed and these teeth are clean, your dentist/ hygienist may use a polishing instrument to further clean and smooth the teeth. This will be with a brush or a rubber cup containing a prophylactic paste.
Scaling is an NHS Band 1 Treatment and the frequency at which this procedure will be prescribed by the dentist will vary according to your level of oral hygiene.
A denture, also known as false teeth, is a prosthesis made to replace missing teeth, it can be worn in the upper or lower jaw or both, and may replace some teeth (a partial denture) or all the teeth (full dentures). They are supported on the soft and hard tissues in the mouth. Dentures are an NHS Band 3 treatment.
This type of denture replaces some of the teeth; they are generally made of acrylic resin on models constructed from impressions taken of the patient’s mouth. If the patient has an unstable dentition (more tooth loss is likely) the denture will be made entirely of acrylic because it can easily be altered if further tooth loss occurs. This type of denture has the advantage that it is easy to alter but sometimes its retention in the mouth can be compromised because it relies on suction alone to hold it in.
Some patients have lost teeth through trauma or dental infection but have a stable dentition (no current dental disease) in these cases an acrylic denture is often made supported on a metal framework which clips to the teeth. This style of denture is considerably firmer than an all acrylic denture and retains using suction and positive clasp pressure so it is always a firmer fit, and because it has a metal framework thinner and stronger than an all acrylic denture. It is technically demanding to construct and very difficult to alter should any further tooth loss occurs so is only made in patients who have a healthy disease free mouth.
These replace all the teeth and are now quite rare; they are made of acrylic resin and rely on suction to retain them. Your dentist will discuss the appearance carefully with you if they are made because generally there is a compromise to be made between the prominence of the teeth and how well they will function.
Fillings are placed to repair cavities in teeth caused by decay or fracture. On the NHS most fillings placed in posterior teeth (molars and premolars) will use dental amalgam, and these are a Band 2 Treatment. Dental amalgam is a silver coloured mixture of metals including mercury, silver, tin and copper. Those materials mixed together from a very hard, durable alloy, ideal for the restoration of posterior teeth. Concerns are frequently expressed about the possible toxicity dental amalgam. However this material has been used for approximately 150 years and to date there is still no evidence of any systemic toxicity resulting from its use. Amalgam is considered to be safe and the ideal filling material for restoring the biting surfaces of the posterior teeth which are subjected to the greatest chewing forces.
These are white adhesive fillings and are made of acrylic resin they are placed and set once the tooth cavity has been repaired and then set and trimmed to shape.
Composite fillings are generally used to repair broken or decayed anterior teeth, once the cavity has been prepared so that it is a fillable shape and decay free the tooth is dried and etched gel is used to prepare the tooth surface so that the filling will bond to the tooth and again washed, then primer and bond are applied before the liquid filling material is introduced to restore the tooth. The material is cured by bright light and large fillings are built up in layers to guarantee a thorough cure once finished the set filling is trimmed to shape. Composite fillings are a plastic material and can break if too large.
An Inlay is an indirect restoration consisting of a solid structure (precious metal, porcelain cured composite resin) which is made in a laboratory on models constructed from impressions taken in the mouth after the tooth has been prepared by your dentist. Once made, they are held in place by dental cement. They are generally stronger than fillings placed in a soft state in the teeth which then set.
An Onlay is very similar to an inlay but is generally a larger filling replacing at least one cusp, the biting surface generally covers more of the tooth to protect it from the pressure of chewing.
Inlays and onlays are not frequently used restorations as modern filling materials placed in a soft state have become much stronger, they are used when patients with a heavy bite continually break standard fillings.
As an NHS restoration they fit into the Band 3 charge structure.
A bridge is a fixed dental restoration used to replace a missing tooth (or several teeth) by joining an artificial tooth (Pontic) to an adjacent tooth (abutment).
Permanent bridges are indirect restorations made by technicians on models made from impressions taken by your dentist after the abutment tooth/ teeth have been prepared. Bridges can be made of porcelain, porcelain bonded to metal or gold coloured metal depending on their type and position. Typically a bridge is made by reducing the teeth on either side of a gap and then in the laboratory crowns or inlays are constructed on these teeth and an extra tooth (Pontic) is fused in the middle to permanently join the two abutment teeth. It is important that the ratio of missing teeth to abutment teeth does not exceed 1:1
Bridges are complicated restorations and make cleaning of teeth more difficult, the more teeth the bridge involves the more difficult the cleaning becomes so they should only be placed when the patient’s oral hygiene is excellent because the risk of decay is high.
Bridges fall in Band 3 of NHS charges; the practice provides both NHS and private bridges, whilst the fit of a private bridge is no better the technicians can spend more time fabricating the appearance to more closely match the aesthetics of the patient’s teeth.
This procedure involves removal of teeth from the mouth; it is done for 2 main reasons:
- To remove a painful diseased tooth.
- To make space to allow teeth to erupt in the correct position or to create space so that crowded teeth can be straightened.
Before this procedure is undertaken local anaesthetic is applied to deaden the area around the tooth and a radiograph will be taken, if one is not available to view the root shape and structure of the tooth. The tooth is then removed using instruments called elevators to prise away the bone around the tooth. The tooth is then lifted out of the socket using dental forceps.
Once the tooth has been removed pads are applied over the socket to staunch any bleeding, then once it is observed that a clot has formed the patient is discharged carrying a set of post-operative instructions so that they know how to look after the socket.
Extraction is an NHS Band 2 Treatment.
This is a Preventative procedure where a plastic resin is placed on the chewing surface of molar teeth in patients who are susceptible to dental decay. It helps to prevent dental decay.
Firstly the tooth is cleaned and dried and then etched with a diluted acid to provide a key to attach the resin.
The tooth is then washed and dried before resin is flowed over its surface and set. This process blocks up the pits and fissures on the tooth where bacteria collect making it less susceptible to decay.
The procedure is carried out in patients who have experienced decay in their primary teeth.
Fluoride applied to teeth helps prevent decay.
Fluoride varnish is temporarily adhesive form of fluoride applied to the tooth surface by a dentist, dental hygienist or other health care professional as a type of topical fluoride therapy. Fluoride varnish is not permanent, but is designed to adhere to the tooth surface and keep fluoride in contact with the tooth for several hours. Fluoride varnish may be applied to the enamel, dentine or cementum of the tooth and can be used to help prevent decay, remineralise the tooth surface and treat dentine sensitivity.
We apply fluoride varnish to all children's teeth between the ages of 4 and 18 years routinely at dental inspections. We also encourage patients to use fluoride toothpaste in the morning and evening and not to rinse out. Additionally if patients are susceptible to decay they will receive dietary advice and may be prescribed a higher fluoride toothpaste which will protect their teeth more thoroughly.
Root Canal Treatment
In the centre of each tooth there is a dental pulp, a collection of blood vessels and nerves. These blood vessels and nerves extend down the roots of the teeth in the root canals.
The pulp in your tooth can become infected by
- Dental decay
- Injury or trauma- such as a blow or fracture
- Cracked teeth
- Placement of deep restorations.
If the pulp becomes infected this can spread down the root canals of the teeth and eventually spread into the surrounding tissues. The aim of root canal treatment is to remove the damaged/ infected tissue from the pulp and root canals. Root canal treatment is usually performed under local anaesthesia. In some cases where the tooth has died this may not be necessary. After anaesthesia the dentist may place a rubber dam over the tooth to isolate it from the rest of the mouth. The pulp chamber will then be accessed through the occlusal surface of the tooth. The root canals once located, are measured. The dentist will then use a series of small files to clean, shape and enlarge the root canals facilitating the placement of an insert rubber-like filling material.
If the treatment is carried out over a number of visits, a small pledget of bactericidal medication may be placed in the pulp chamber secured by a temporary filling. Once completed the root is then sealed and a conventional filling placed. Root filled teeth are more likely to break than healthy unrestored teeth, so your dentist may suggest placing a crown to help prevent this occurrence.
A root filling can sometimes be a complex procedure and is an NHS Band 2 Treatment. If your dentist can foresee problems with carrying out this treatment he may suggest a referral to a specialist.
Are your teeth stained, chipped, or not aligned on top of each other? Veneers are a good treatment option to consider because they look like natural teeth and don't require a major procedure.
A veneer is a very thin, tooth-coloured piece of porcelain (like a false finger nail) that is bonded on top of your own tooth. Based on your needs, we can adjust the shape of your veneers to make your teeth overall look longer and or closer together. You can have just one veneer or a whole set, known as a smile makeover.
For a single stained tooth we can also match the precise shade of porcelain to give it a lighter appearance and fit in with the surrounding teeth. Veneers can also be used to close small gaps, when braces are not suitable. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others.