General Dentistry

Please view a range of the treatments we provide for General Dentistry:

Crowns	Etch-Retained Restorations
Extractions	Fissure Sealants
Fluoride	Healthy Eating
Inlays and Onlays	Keeping Your Mouth Clean
Keeping A Denture Or Bridge Clean	Periodontal (Gum) Disease
Removable Dentures	Root Fillings
Root Planing And Curettage (Gum Treatment)	Scaling And Polishing
Temporomandibular (Jaw) Joint Problems	Tooth Erosion
Veneers	Bad Breath
Apicectomy	X-rays
White Fillings	Wisdom Teeth
Bridges

Crowns

What are they?

• The crown is the visible part of the tooth. An artificial crown covers a weak tooth above the gum line and protects it. They are made up of metal or porcelain, or just porcelain with metal bits mixed in to increase the strength.

What will my dentist do?

• The dentist will shape and form the artificial tooth to replicate the characteristics of a normal tooth.
• Preparation time will depend on the damage of the tooth and whether or not it will be need a build up of filling.
• 'Removing the nerve' may have to take place if the tooth needs to be root-filled first. Often the crown is held by a peg in the root canal, that is if a lot of tooth is missing.
• The dentist will use soft, mouldable material to make exact 'impressions' of the tooth that has to be crowned and also of the nearby teeth. This is then passed onto a dental technician that uses the impression to make the crown the exact size needed.
• The use of a thin cord would be used to hold the gum away from the tooth for a more accurate impression around the edges.
• A temporary crown would be put over the tooth until the permanent crown has been made. The temporary can cope with chewing but not as strong as the permanent.
• Your dentist will make small adjustments once your crown is fitted to make sure that you can bite comfortably. The crown is tried on first then glued into place.

What are the benefits?

• Crowns are very strong and look exactly like natural teeth in which the colour and shape can be assigned to match current teeth.
• If the tooth is strong underneath the crown, the crown can last for many years if you look after your teeth and mouth.
• Crowns can also improve the appearance of misshapen or discoloured teeth.

 

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Etch-Retained Restorations

What are they?

• Many newer dental materials are adhesive which means they stick or bond to teeth. The surface of the tooth is made slightly rough by using a mild-acid so that the repair (restoration) can grip properly. This process is called etching.
• They can be found on fillings, crowns, veneers or onlays.

What will my dentist do?

• The dentist will sometimes numb the tooth, then dab the etching acid onto the tooth surface and hold it there for a while to roughen it up while keeping your mouth open. Then they will wash the tooth out thoroughly with a jet of water. Finally they will dry the tooth and paint the 'bonding agent' (a sort of glue) onto the roughened area, before filling tooth or applying any more type of restoration.

What are the benefits?

• The bond holding the restoration can be very strong therefore increasing the time it stays in place.
• The restoration can always be glued back into place even if it breaks.
• Less of the natural tooth is lost as the restorations are held in place by the bonding agent and not just by the shape of the tooth.

 

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Extractions

What is it?

• An extraction is the removal of a tooth out of your mouth. This is because the tooth may be damaged, decayed or gum disease.
• Children's teeth are sometimes taken out for 'orthodontic' reasons to help new or remaining teeth grow regularly.

What will my dentist do?

• Depending on the size, shape, position or root shapes of the tooth will equate to the difficulty it is to extract. After evaluating the best way to take your tooth out, the dentist will discuss to you:
  • How long it will take;
  • How to prevent any feeling of the extraction while it's happening;
  • For certain types of pain control, whether to bring someone with you;
  • When it would be convenient to have the removal; and
  • How your mouth should recover afterwards.
• You might also discuss other treatment you need such as replacement denture in the future.
• While your tooth is being taken out: you will be able to move your jaw as normal and you may feel pressure from where the tooth is eased out, but not pain.
• Afterwards: the dentist will give you a pad to bite on, to stop any bleeding; sometimes stitches are used to help the mouth heal and the dentist will give you help on how to look after the gap, how to control any pain and how to contact the practise if there are any problems.

What are the benefits?

• Having a tooth out can end pain and infection and sometimes be the only way to keep your mouth healthy.

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Fissure Sealants

What are fissure sealants?

• Fissures are groves in the chewing surfaces in the back teeth. They are difficult to keep clean and therefore at more risk of decay but they can be sealed with a tough plastic to protect them. The plastic is liquid at first but then it sets hard once dried. They may be see-through or dyed to the colour of the tooth. The sealant is only used on permanent teeth rather than milk teeth.
• Your dentist will discuss with you whether or not you need sealants. If you do, you will have to evaluate which teeth need sealing and agree to it. The need for the sealant will depend on:
  • The shape of each tooth;
  • How much a child's teeth have already decayed;
  • How much decay a brother or sister has had (patters of tooth decay found within a family); and
  • A child's general health (general health problems can make it especially important to avoid dental problems).

What will my dentist do?

• Clean the tooth thoroughly with a rotating brush or rubber polisher;
• Dry the tooth and keep it dry by putting cotton wool round it and using suction;
• Dab a mild acid on the tooth and leave it for a short time to make the tooth surface rough (this will not hurt at all);
• Wash and dry the tooth by blowing water and then air onto it;
• Change the cotton wool rolls around the tooth to keep it dry;
• Paint the plastic onto the fissures;
• Harden the plastic by pointing a bright light on it(you will see the dentist and dental nurse protect their eyes);
• Check the tooth is comfortable to bite on; and
• Trim and polish the sealant.

What are the benefits?

• Fissure sealants protect teeth from decay.
• They can last for years. If they fall or wear out, they can usually be replaced if there is no decay underneath.

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Fluoride

What is Fluoride?

• Fluoride is a mineral that is found all around us in small amounts. It is very effective in protecting teeth against decay.
• Public health experts have known for many years that fluoride protects teeth. Some parts of America had natural fluoride in their water and more than 50 years ago, dentists noticed that people living there had strong healthy teeth.

How does fluoride work?

• We all have bacteria in our mouth all the time. Living off food in the mouth and produce acids as a waste product. These acids attack the teeth by dissolving the minerals in the tooth surface.
• Luckily the minerals in the saliva which can help the tooth decay as it first starts, but the mending process needs fluoride to work properly.
• Some water supplies contain enough fluoride to keep teeth healthy. This can happen naturally and can be adjusted to the concentration that would be correct for teeth. In Britain only 1 in 10 people get enough fluoride from water supply.
• Most people get fluoride from toothpaste. Each pack of toothpaste should tell you the ppm (parts per million) of fluoride the toothpaste contains. Low fluoride being (around 500 ppm) or high dose being (1000 or 1500 ppm). You should use low dosage for children under 7.
• For specific patients, dentists recommend they take extra fluoride in either tablet or drop form, or even as a varnish painted onto the teeth. These specific patients will only be the ones who suffer with very bad decay or an illness that will avoid any dental problems.
• The fluoride concentration in water and toothpaste is completely safe. If there is fluoride in your local water supply, you can still use the toothpaste as well
• There is just one thing to be careful with when using fluoride toothpaste with children. Up to the age of 7 children's are developing permanent teeth and too much fluoride can mark the teeth during this stage. During these times you should supervise the child while brushing, to make sure they are not swallowing the toothpaste and using the correct amount (recommended a pea size).
  • Fluoride helps the teeth stay healthy and strong.
  • Can help early decay.
  • You will need less dental treatment. (not so much time at the dentist!)
  • Healthy teeth look better than repaired teeth.
  • The food left on your teeth forms plaque which in long term will cause gum disease if it is not cleaned off regularly.
  • The bacteria in plaque produce acids which cause decay.
  • The tooth surface can be dissolved away by acids in food surfaces – this is called 'erosion'
  • Dental problems are best prevented by good oral hygiene. But you can also reduce any risks for your mouth by having sticky of acidic food and drink les often.
  • Labels sometimes hide what's in the product. Labels may say 'carbohydrates' rather than 'sugars' for example.
  • Some products may say 'no added sugars' even though they contain a lot of natural fruit sugar.
  • Products containing small amounts of sugars could be harmless if they also contain calcium.
  • There is no testing method to show how erosive food and drink are, so labels cannot answer this question for you.

What are the benefits to fluoride?

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Healthy Eating

Why does healthy eating matter?

Food and drink are the most common problem in the dental world.

How can I tell what's healthy?

You will not always be able to tell whether a product will harm your teeth.

Milk and water are safe drinks. So are tea and coffee if you do not add sugar to them. Fruit, vegetables, dairy products (such as cheese) and starchy products (such as bread, rice and pasta) are all safe foods.

Remember these rules:

• Clean your teeth twice a day
• Don't eat sugary, sticky erosive foods more than five times a day.
• Eat at least five servings of fresh fruit and vegetables a day.

During the day when you cannot clean your teeth, think about chewing sugar-free gum. Chewing gum increases flow of saliva around the mouth, helping remove bits of food. Also saliva contains minerals as well as toothpaste containing fluorides that will help mend teeth after they have been attacked by plaque.

What are the benefits?

• A healthy diet and good oral hygiene should prevent most dental problems.
• Nutritionists give the same advice as dentists about healthy eating. If you aim to improve dental health you will overall improve the whole bodies' health.

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Inlays and Onlays

What are they?

You can have inlays or onlays instead of a filling. Fillings are soft to begin with and are moulded to the shape in the mouth. Inlays and onlays are made outside the mouth, usually in a dental laboratory, and then glued to the tooth in the surgery.

An inlay sits in a hole in the tooth. And onlay sits on the tooth and builds up its shape. They can be made in tooth colouring porcelain, gold or a material called composite. Different materials are suitable for different parts of the mouth and different parts of the teeth.

What will my dentist do?

Your dentist will:

• Normally give you a local anaesthetic to numb the area;
• Remove any old filling material and any decayed or damaged tooth;
• Use soft, mouldable material which sets in the mouth to record the shape of the tooth being repaired and the teeth around it;
• Give the impression to the dental technician to make the inlay or onlay;
• Use a temporary filling to protect the tooth that is being repaired while you wait for the inlay or onlay to be repaired; and
• Glue the inlay or onlay in place on your next visit (they may make small adjustments so that the tooth is comfortable to bite on).

What are the benefits?

• Inlays and onlays are strong and can last longer than fillings
• They are especially suitable for the chewing surfaces of back teeth and for large repairs to front teeth where it can be difficult to make a white filling look natural
• Your dentist can match the colour to your other teeth.

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Keeping Your Mouth Clean

What are the benefits of keeping my mouth clean?

Keeping your mouth clean helps prevent disease.

• Sticky plaque builds up on everyone's teeth every day and this can lead to gum disease. The gum comes away from the teeth, making the plaque more difficult to clean away. This makes gum disease worse. You can stop gum disease starting by cleaning your teeth carefully.
• Just brushing your teeth will not prevent tooth decay. You need to brush with fluoride toothpaste. This helps the tooth mend itself after being attacked by plaque acids. Thorough brushing gets fluoride all around the mouth.
• Teeth also erode. This means they dissolve away when you have acidic food and drink too often. Rinsing acids away with water always helps to prevent erosion.

As well as cleaning your teeth and gums thoroughly, try to have sticky and acidic food and drink less often.

How should I brush my teeth?

• Brush your teeth thoroughly twice a day with a soft-to-medium brush and fluoride toothpaste. Replace the brush when the bristles get out of shape.
• Put the bristles at the join between teeth and gums, pointing towards the gums using short circular motions.
• Brush all around every tooth, carefully making sure you can feel the brush on your gums.
• Don't use too much force – give your teeth and gums a gentle scrub.
• Small children usually cannot brush properly until they are eight or nine so brush their teeth yourself. One way is to stand behind your child and tilt their head back so you can reach around all their teeth.

How should I floss?

Dental floss helps you clean between your teeth. Your dentist or hygienist will tell you whether you need to floss. If you do, they will show you how to do it. You may need to practise in front of a mirror.

• Use about 18 inches of floss. Wrap the ends around the middle fingers of each hand, leaving two of three inches between the first finger and the thumb.
• Gently slide the floss between two teeth and put it round one tooth, next the gum, using your fingers.
• Move the floss up and down the side of the tooth several times.
• Do the same for every tooth

Children do not need to use floss.

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Keeping A Denture Or Bridge Clean

Why is cleaning important?

Dentures and bridges collect bits of food, plaque and tartar, just like natural teeth. By keeping them clean, you help prevent gum disease and stop decay in any natural teeth. The lining of your mouth can become swollen and sore where it is in contact with dirty dentures.

You can take a denture out of your mouth so is quite easy to clean. Cleaning all around and underneath the fixed bridge is harder. Your dentist or hygienist will show you how to do it.

How do I look after a denture?

• Clean the denture over a basin of water so that it does not break if you drop it.
• Brush the denture inside and out with a toothbrush everyday. Use a soft-to-medium brush so that you do not scratch the denture. Use your normal toothpaste, or soap and water. Then rinse the denture.
• Ask your dentist about denture-soaking solution. Soaking a denture will not clean it. You also need to brush it. Rinse the denture before you put it back in your mouth.
• Take a denture out at night to let your mouth rest. If you wore plastic shoes 24 hours a day, your feet will become smelly and swollen even if you washed them well. Dentures do the same.
• Keep a denture in clean water or a denture-soaking solution when you are not using it.

How do I clean a bridge?

How you clean will depend on where the bridge is in the mouth and its design. As well as normal brushing with a fluoride toothpaste and flossing at each end of the bridge, you need to keep the bridge clean underneath.

You might use:

• Special floss with a stiff end which you can poke underneath a bridge and pull through;
• 'bottle brushes' (your dentist will tell you what size and shape to buy); or
• Water jets- sending a stream underneath the bridge.

What are the benefits?

• By keeping a denture or bridge clean, you help keep your gums and teeth healthy and avoid bad breath.
• People who wear dentures sometimes get an infection called oral thrush. Thrush is more likely if you wear the denture all the time. Good denture hygiene is important for preventing oral thrush.

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Periodontal (Gum) Disease

What is it?

Periodontal disease affects the gums and bone supporting your teeth. It is caused by sticky plaque and hard deposits of tartar. It occurs when teeth are not kept clean enough. When you get really bad gum disease it is usually hereditary or an affect of malnutrition. This should be immediately investigated.

Thorough brushing can remove sticky plaque. Scaling and polishing can remove hard tartar. Without regular cleaning, the gum will come away from the tooth, making pockets around the teeth where food and plaque can collect. Pockets are more difficult to keep clean so gum disease will usually get worse if nothing is done.

Gum disease has two stages:

• It starts with inflammation – redness and swelling. Dentists call this gingivitis. It can be cured with good oral hygiene.
• The next stage is called chronic periodontitis. Some of the bone that's supports the teeth are lost and the teeth become loose until they eventually have to be taken out. Periodontitis cannot be reversed once it starts but it doesn't have to get worse if you clean your teeth properly and have regular root planing from your dentist or hygienist.

Who gets gum disease?

Gum disease can start from childhood. Only adults should normally have a problem with chronic periodontitis. You might be worried about bad breath or teeth looking longer due to the gums covering less of them.

Some people are more prone to periodontal disease than others.

• Crooked teeth are more difficult to keep clean so you might have gum disease in just one part of your mouth.
• People have different bacteria in their mouths. This can explain why gum disease can get worse very quickly for some people but not for others.
• Smoking and drinking a lot of alcohol can make gum disease worse. Both are also linked with mouth cancer.
• Drugs and medicines can affect you gums so your dentist will as k you about your general health.
• Diabetes and some other diseases can reduce how resistant gums and bones are to damage.
• Hormonal changes also affect gum health. It could make a difference if you are pregnant or using an oral contraceptive.

Why should I try to avoid periodontal problems?

• Healthy gums and bone are just as important as just your teeth. Periodontal disease can lead to you losing teeth and all the difficulties that this can cause for eating and speaking.
• Scientists are now discovering that periodontal disease is linked to coronary heart disease and stroke, especially for people who are already at risk in other ways (through bad diet, smoking or high blood pressure).

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Removable Dentures

What are they?

A removable denture replaces teeth. 'partial' dentures replace a few missing teeth and 'full' dentures are needed if all the natural teeth are missing. They are made with plastics or sometimes metal to make them strong and less bulky.

What will my dentist do?

• The dentist uses a putty-like material to make moulds of your mouth – called 'impressions'. A dental technician uses them to make plaster models for the denture to be built on.
• The technician will make wax blocks that fit the plaster models. The dentist then trims them to show how teeth should bite together, and the shape to make the denture.
• A trial denture is made and put in your mouth. The dentist will ask you how it fits, feels and looks before they make any final changes.
• The technician will receive the trial denture and will then permanently fix the teeth. It is then ready to use.

The dentist may want to see you again fairly soon to see how you are getting on with the denture. If there is a problem the dentist will make small adjustments. They call making small adjustments 'easing 'your dentures.

What are the benefits?

If you have lost some teeth, dentures can improve the way you look, bite, chew and speak.

• They are custom made to match your mouth and can be made to look as natural as possible.
• Chewing will be made more efficient.
• The lasting teeth will have protection from wear and tear. Without dentures, the natural teeth may move or tilt, stopping your teeth from biting together properly.
• Dentures can be fitted straight after an extraction and therefore people will not know that you've lost a tooth. These are called 'immediate' dentures.

Dentures will never feel like your own teeth and it can take time to get used to them. If you never have had one before the dentist will provide all the precautions about the difficulties of wearing them as well as all the appropriate actions to look after the denture.

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Root Fillings

What are they?

Teeth are held in the jaw by their roots. Front teeth normally have one root but further back have more.

Inside, the tooth pulp should be alive, with nerves and a blood supply in the root canal. Decay or injury can destroy this living part and might also cause an abscess at the end of the root.

Root filling means removing damaged or dead pulp and filling the left space. The remaining tooth can be repaired.

What does my dentist do?

• Any signs of infection in the surrounding bone, and to see the shape of the root canals they use an X-ray image.
• To keep the canals dry during treatment the dentist may stretch a sheet of thin rubber round the tooth. On a metal frame outside the mouth. This shouldn't be uncomfortable.
• The dentist uses narrow files to find a root canal and remove the dead pulp;
• Another X-ray can show whether all the dead pulp has been removed;
• Roots are filled with rubbery materials and with pastes which set hard.

A root filling could need more than one visit. You might not need a local anaesthetic for a root filling if the pulp is dead, but the tooth could still be tender for a day or two afterwards. You might need to take a mild pain killer.

What are the benefits?

• Pulp damage can cause painful toothache but the pain will usually end very quickly when the root canal is cleaned out;
• Without a root filling a tooth with a dead pulp would probably have to be taken out;
• First-time root-fillings are usually successful and can last many years. Re-treatment is also possible.

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Root Planing And Curettage (Gum Treatment)

What is it?

Root planing is 'deep' scaling to clean parts of the teeth behind the gum-line, which cannot be reached with a toothbrush.

Gums can become diseased so that they look red and puffy. They will probably bleed when you brush. Painless gum 'pockets' start to form around the teeth and bone supporting the teeth is slowly lost.

Root planing cleans out these pockets and removes plaque and hard tartar from the tooth roots. It takes longer than a scale and polish and is often done under local anaesthetic. Your mouth might be treated in sections, at more than one visit.

What does the dentist or the dental hygienist do?

Dentists and hygienists use two types of tool for root planing.

• To reach different parts of the teeth there are hard scalers come in different sizes and shapes. This is why you see them changing them quite often.
• Electric scalers vibrate very fast with water. The water is removed from your mouth using suction. A hand scaler is used to check whether the roots are completely clean.

After a tooth has been root planed, the pocket should shrink, making the gum slit closer to the tooth. You then need to be especially careful about cleaning the teeth above the gum-line. Root planing will probably need to be repeated regularly.

What are the benefits?

• Gum disease will get worse and because it's painless, it can become very bad without you noticing. When there is not enough supporting bone left, teeth become loose and eventually have to be taken out. Root planing can prevent gum disease becoming worse and therefore avoid tooth loss.
• Like scaling and polishing, root planing helps you to keep your teeth and gums clean at home. Dentists and dental hygienists cannot keep your mouth healthy by themselves. Your own cleaning is just as important.

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Scaling And Polishing

What is it?

A 'scale and polish' cleans your teeth very thoroughly.

Scaling removes the tartar which forms on your teeth like scale inside a kettle. You cannot remove it by brushing your teeth. Scaling also removes trapped food and plaque containing millions of germs which can cause tooth decay and gum disease. Stains from coffee, tea, cigarettes or red wine are also cleaned away when your dentist polishes your teeth.

A dentist or hygienist will scale your teeth. If you clean your teeth thoroughly anyway, your scale and polish will take less time.

What happens?

There are two ways to scale teeth.

• Hand scalers – these come in different sizes and shapes, to reach different parts of your teeth.
• Electric scalers – these use very fast vibration with water. The water is sucked out of your mouth. A hand scaler is used to check whether the teeth are completely clean.

For polishing, your dentist will use a rotating brush or rubber polish with toothpaste. Scaling cleans above and below the gums. If you have gum disease, scaling needs to be deeper, around the roots of the teeth. This is called 'root planing'. Your dentist may give you a local anaesthetic to make it more comfortable. Your dentist or hygienist will tell you about the best way to clean your teeth and gums thoroughly at home.

What are the benefits?

• Regular scaling and polishing helps to keep your teeth and gums healthy by making it easier for you to clean at home. You should see and feel the difference.
• If your gums bleed when you brush, which you can prevent by regular scaling and cleaning your teeth thoroughly at home.

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Temporomandibular (Jaw) Joint Problems

What are they?

The joint between your upper and lower jaws, just in front of your ears is called the temporomandibular joint ('TMJ' for short). Gristly cartilage separates the bone surfaces and sometimes it becomes worn or moves out of place.

• Example, grinding or clenching your teeth, biting your nails or chewing a pen.
• Some people get arthritis in the joint
• If your back teeth are missing, you might eat mainly with your front teeth and disturb the way your jaw bites together.

You might notice several things.

• Clicking or grating noises when you your jaw.
• Difficulty opening or closing your mouth.
• Swelling or tenderness over the joint.
• Pain in the face, neck and chewing muscles.
• Headaches or back pain.
• Pain in your ear, possibly with ringing noises.

What might the dentist do?

Your dentist will try and make your jaw more comfortable and look for the cause of the problem. You could take painkillers or tablets to relax the muscles or the face-muscles might be massaged. You could use an ice pack at home or stress-relieving techniques. Avoid yawning a lot or biting into very hard foods.

If the problem seems to be caused by a habit, the dentist will explain this so you can try giving up the habit.

Other possible solutions might include:

• Replacing missing teeth with a denture or bridge, or a different denture, to change the way your jaw sits; or
• A 'biteguard' for you to wear at night which will take pressure off the joint.

Will the treatment work?

Like joint problems in other parts of the body, jaw problems can be difficult to deal with completely. Success will depend on how much the joint has been damaged and on how much more damage can be prevented.

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Tooth Erosion

What is it for?

As well as damaged by decay, they can be eroded by acids in the mouth. Acids can come from food, drink or sometimes from your stomach. Acids dissolve minerals out of the hard enamel surface, making teeth thin. The teeth can then become extra sensitive to hot and cold food and drink.

Erosion can also be linked with acidic drinks such as fizzy drinks. Even if they are 'diet' they are just as bad. Dentists will prioritise speaking to teenagers about these specific acidic drinks.

Some people suffer from erosion more than others. People with eating disorders may suffer from erosion because stomach acids attack their teeth. Dentists may inquire about an eating disorder if the teeth are badly eroded.

Can I prevent erosion?

You can protect your teeth from erosion by being careful how you use acidic drinks

• Drink them less often.
• Drink them quickly.
• Drink them cold.
• Use a straw so it misses your teeth.

Some foods are acidic too – for example, pickles.

Because acids temporarily soften the tooth, don't brush your teeth immediately after eating or drinking something acidic. If you can, rinse your mouth with water and brush your teeth 20-30 minutes after have the acidity in your mouth.

Dentists say you should brush your teeth twice a day (twice is enough if you do it thoroughly), and always use fluoride toothpaste. Like teeth which are attacked by decay, eroded teeth can use the minerals in saliva to mend themselves. Fluoride helps this process.

Can my dentist treat erosion?

The erosion attacks a tooth's entire surface; you may not notice it at first. Sometimes the teeth can be weakened so much that they have to be protected with crowns or veneers which replace the lost tooth surface.

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Veneers

What are they?

A veneer is a thin layer of tooth coloured material that is put in front of your tooth to make it look better. The tooth might have been damaged by decay of an accident, or be discoloured.

What will my dentist do?

While you are with your dentist, some veneers are built up on the tooth directly using white filling material. The tooth might have been damaged by decay or by accident, or it might be discoloured.

• The fillings in your teeth will be checked first.
• It may not be necessary to numb the tooth as very little preparation is needed, just enough to prevent the veneer feeling bulky.
• In surgery veneers will be made with a white filling to be applied till the teeth look right. That is after the surface of the tooth has been roughened by a mild acid.
• For a veneer to be made by a dental technician, this will involve the dentist taking an impression to begin with. This show the technician how the teeth bite together as well as the shape and the size of the veneer that's needed.
• On the next visit to the dentist, they will glue the veneer to the tooth.

If the tooth is knocked sometimes the veneer comes away from the tooth or breaks. These can be glued back on or replaced if needed.

What are the benefits?

• Appearance can be greatly improved by veneers. They hide imperfections and you lose very little of the natural tooth.
• Veneers will protect the teeth from any more damage. For example, the acids in foods and drink or the stomach can cause the teeth to wear away. The teeth become thin and weak but veneers can protect them.
• If the tooth is strong, a veneer is often a better option than a crown for improving a tooths appearance.

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Bad Breath

What is it?

Bad breath can be caused by gum disease, but even with good oral hygiene and healthy teeth, you could still have bad breath. It is the bacteria in the mouth which usually causes bad breath and is not a sign of general ill health. As your mouth gets drier, the smell usually gets stronger and comes from the far back of the tongue. Sometimes the smell comes from the nose. Around a quarter of adults suffer from bad breath regularly and almost all adults will occasionally suffer from it.

What can my dentist do?

• Your dentist will be able to tell where any problem is coming from, as long as you have not done anything to hide the normal smell of your breath before you see your dentist. For example, do not smoke, chew gum or use a mouth rinse and avoid any sort of perfume.
• A plastic spoon may be used to gently scrape the back of your tongue and test the smell.
• Instruments can be used to measure sulphur compounds in the mouth or swelling around the gums.
• A scale and polish can be provided by your dentist or hygienist. This makes it easier for you to keep your mouth clean at home and is usually the answer to a bad-breath problem.

What can I do myself?

• Use a fluoride toothpaste and brush your teeth thoroughly twice a day.
• Your dentist may recommend oral hygiene aids such as floss for you to use.
• If your tongue is heavily coated, then gently brush it with your toothbrush.
• Once you have flossed an area of the mouth, if you smell the floss then you can check if your bad breath is coming from a particular part of the mouth. This then enables you to clean that area with special care.
• Chewing sugar-free gum increases the flow of saliva, which can help with bad breath as a mouth will smell less if it is moist. A dry mouth can also be caused by taking certain medicines, or by breathing with your mouth open and also gets drier as you get older.
• If you smoke, try to give up. This protects your general health and will not only make your breath smell better, but also keep your mouth and gums healthy too.

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Apicectomy

What is it?

This is where a painful infection (an abscess) has developed in the surrounding bone at the end of the root of a tooth. The dentist cleans the infected area to save the tooth, and is usually carried out on a tooth which has already been root-filled.

What will my dentist do?

• Numb the mouth around the infected tooth with local anaesthetic, so the procedure is painless.
• Make a small cut in the gum, far away from the tooth so that there won't be a visible scar afterwards.
• Uncover the infected area by moving a small flap of gum to one side.
• Clean out the infection.
• To stop any more infection, a small filling is placed at the end of the root canal.
• Stitch the gum back in place.

You should not feel any pain during an apicectomy but you may feel some pressure and hear instruments being used.

After the treatment you will need to keep the area clean by:

• Rinsing with warm salty water several times a day for the first day, especially after meals. Use half a teaspoon of salt in a glass of water.
• Brushing the teeth normally but being very careful not to disturb the cut.
• Continue rinsing on the next day and begin to gently brush the teeth next to the cut.

For two or three days afterwards, there may be some mild discomfort, bruising and swelling which an ice-pack can help with. Healing usually takes about a week.

What are the benefits?

An apicectomy stops pain and will save a tooth which would otherwise have to be taken out.

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X-rays

What are they?

X-rays show what is happening inside and around the tooth and its roots. They will show any decay or gum disease, bone loss and, in children, how the jaw is growing too.

There are two types of x-rays dentists will use. You grip a 'bitewing' x-ray between your teeth and it shows in the areas in between the tooth but not the roots. A 'periapical' x-ray is placed next to the tooth and shows the whole tooth and its root.

There are also large x-rays that show all of the jaw and teeth. These are called panoramic x-rays and the x-ray machine moves around your head while you stand still.

What happens?

All trained members of staff are entitled to take the x-rays, as well as the dentists. There is a small risk of radiation in x-rays that are taken for health reasons but dental x-ray radiation is very low.

If you are concerned about safety, it may be helpful to know that:

• Your dentist will only take x-rays if they are needed;
• X-ray machines are checked regularly to make sure they are only using the intended radiation dose; and
• You can still have dental x-rays when you are pregnant (your dentist may still ask you whether you are pregnant or whether you might be, and whether you would rather not have an x-ray)

When the x-ray is taken:

• You will need to keep very still for a few seconds to give a clear picture;
• The film is usually developed while you wait and then labelled; and
• Sometimes it is useful for the dentist to compare a new x-ray with one taken some time ago. Your dentist will keep old x-rays in your file.

What are the benefits?

• All forms of dental treatment rely on dental x-rays. Simply looking in your mouth cannot give the dentist that much information.
• They allow dentists to review old treatment as wells as identify new problems.

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White Fillings

What are they?

A filling replaces a part of the tooth that has been lost because of decay or damage.

Unlike silver (amalgam) fillings, white fillings stick to teeth so they can be used to repair teeth (especially front teeth) which have been chipped, broken or decayed. They can also be used for back teeth depending on the damage.

You will probably hear the dentist talk about 'composite' or 'glass ionomer' – these are different types of white filling.

What will my dentist do?

Your dentist will:

• Normally give you a local anaesthetic to numb the area;
• Remove any decay;
• Remove some or all of an old filling;
• Wash and dry the tooth by blowing water and then air into it (the dentist will be holding something which looks like a water pistol);
• Put the filling material into or onto the tooth and shape it;
• Harden the filling by pointing a bright light at it, inside your mouth (you will see the dentist and dental nurse protecting their eyes); and
• Trim and polish the filling.

What are the benefits?

• White fillings are the same colour as teeth. Dental technicians can provide a variety of shades in order to match your current teeth.
• White fillings are sticky so they can be used to reshape and rebuild broken edges or worn teeth. They can also be used to cover marks (discolouration) if they can't be removed by cleaning.
• A tooth needs less preparation for a white filling than for a silver filling.

White fillings are not as strong as silver fillings so they may not be suitable for large fillings in back teeth. They also need very dry conditions, which can be hard to achieve right at the back of the mouth.

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Wisdom Teeth

What are they?

Wisdom teeth are the last to appear, at the back of the mouth from late teens onwards. Most people have four wisdom teeth but some have less or even none.

Sometimes there is not enough room for them to grow as they are the last ones to grow. They usually come through at an angle pressing against the teeth in front or the bone behind.

What will my dentist do?

Watching how your teeth and jaws grow is part of your regular dental care. Do tell your dentist if you are suspicious of any problems.

• X-rays can show can show where the wisdom teeth are in relation to the jaw and how much room there is to come through, as well as showing the damage they might be inflicting.
• The x rays will also show how simple or difficult it may be to take a wisdom tooth out. The dentist might refer you to a specialist to have your wisdom teeth extracted.

Surrounding gums become inflamed and sore whilst the wisdom teeth are coming through. This is called 'pericoronitis'. It may settle down or come and go over a period of time. If you have had this then it would be advised to remove the wisdom tooth as it is likely to continue to cause trouble.

If you need a wisdom tooth removed, you should be able to fit it in between commitments. Sometimes all are done at once under general anaesthetic; however you may need two or three days off work.

What are the benefits of removing wisdom teeth?

• If you have your wisdom teeth removed, there will be no more pain and infection.
• It will stop any damage to the teeth in front.

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