Tooth restoration is the use of an artificial substance or structure that’s used to replace missing teeth or part of a tooth in order to maintain your mouth’s ability to eat, chew, and speak as normal. Restorations include fillings, inlays, crowns, bridges, partial and complete dentures, and dental implants.
There are many types of tooth restoration available, each dependent upon the type of damage that needs to be repaired. For example fillings, inlays and crowns are used to repair damage to individual teeth, and replace tooth structure, which has been lost due to decay or injury. These methods mend and protect the remaining part of the tooth, and restore it to its original shape and function. Alternatively bridges, dentures and implants are used to protect the shape and function of the whole mouth.
Fillings are used to repair damage caused by tooth decay, known in the dental profession as caries. Tooth decay happens when microorganisms convert sugar from food into acid, which attacks the hard outer tooth enamel and causes cavities, this can spread the tooth’s centre, which contains nerves and blood vessels. Tooth decay can cause inflammation and infection, which causes toothache and more serious complications. To halt decay we drill away the decayed part of the tooth using a high-speed drill, sand replace the tooth structure with a choice of two filling materials, either silver amalgam, or white composite resin.
A filling is placed into the prepared cavity as a liquid or soft solid and sets within a few minutes, and continues to harden over the next few hours. Silver amalgam is commonly used to fill cavities on the biting surfaces of the back teeth because it’s strong enough to withstand the tremendous pressures exerted by constant grinding and chewing. Composite resins are used to fill cavities in front teeth and teeth visible when you smile, because its colour can be matched to the tooth surface.
Inlays, similar to fillings, are a halfway solution between fillings and crowns, and fill the cavity that remains after the decayed part of the tooth has been removed. They are used within teeth at the back of your mouth, which have suffered low-levels of decay and can also be used on teeth with moderate fractures. Unlike a filling an inlay is created outside of the mouth and cemented into place after the decay is removed, the cavity walls shaped and a wax mould taken. Porcelain or resin is used because these materials can be naturally coloured. Because of this inlays are a good replacement option for grey / amalgam fillings.
Your tooth’s crown is the exposed part covered by hard enamel. If a tooth becomes cracked or seriously weakened by decay we can apply a restorative crown to replace the protective outer part of the tooth. Like fillings or inlays, we initially remove the decayed part of the tooth, and ready the tooth for a new crown. We may taper the outside tooth edges into a peg and reinforce this with a cast metal core, or rebuild the tooth with both a cast metal core and a post. We prepare a wax impression of the prepared tooth and the teeth next to it, and the new crown is made to fit within the mould.
A crown can be made from gold, stainless steel, or metal with a veneer of tooth-coloured porcelain or resin, from a porcelain, or resin alone. The finished crown is placed over the prepared tooth, adjusted, and cemented into place.
Bridges are non-removable devices made up of one or more artificial teeth, and anchored in place by crowns on the adjacent teeth. Bridge restoration is used when one or multiple teeth are lost or removed, and a gap needs to be filled to stop the surrounding teeth from moving. A bridge helps to maintain the correct bite, which if unchecked can lead to jaw pain. When teeth move they can fall out of alignment and become more difficult to keep clean, and the chance of suffering tooth decay and gum disease becomes more prevalent. This increases the risk that further teeth can be lost. So a bridge is used to prevent this risk.
A partial denture is like a bridge because it fills a gap created by missing teeth. A partial denture uses artificial teeth connected to a metal frame, and is totally removable. The denture attaches to a crown via an adjoining tooth with a metal clasp attachment. Partial dentures are mainly used at the end of a row of natural teeth, where there’s only one adjoining tooth. The pressure that’s exerted by chewing is shared by the adjacent tooth, along with the soft tissues of the gum ridge beneath the denture.
Dentures are complete removable devices that are used to replace missing teeth and to help restore your smile. If you’ve lost all of your natural teeth, or need to have your teeth removed due to severe gum disease, tooth decay or injury then dentures are a good way of recreating your appearance and health. If you are facing the prospect of losing all of your teeth then dentures could be the right solution for you. Dentures make it much easier to eat, speak, maintain the integrity of your facial muscles, and help to fill out the appearance of your face and profile. Dentures can be created to closely resemble your natural teeth so that your appearance doesn’t alter much. If you’ve been suffering with serious gum and tooth issues and losing teeth over time then dentures may even improve your smile.
Complete dentures are recommended if you’ve lost all of your teeth, they consist of artificial teeth mounted within a plastic base moulded to fit your oral anatomy. Dentures can be held with or without a denture adhesive.
Dental implants are a great way of securing crowns, bridges, and dentures in the mouth. A hard plastic or metal fixture is implanted through the soft tissue and into the jawbone. The bone then grows around the implant securing it in place. The exposed part of the implant is covered with a crown, which in turn could also serve as a secure platform for a bridge or denture.
Root canal treatment
Our teeth should last a lifetime but if severe damage occurs through a deep cavity caused by decay, or because of an injury such as a cracked tooth, then the inside of the tooth can become infected. A serious infection can cause damage to the crucial blood vessels and nerves within the tooth. If untreated infection can damage the bone around the tooth and cause swelling and pain. If this occurs then we may need to carry out a Root Canal Therapy to help save the tooth from destruction. This treatment is also known as an endodontic treatment, and involves opening up the tooth to remove the damaged internal pulp. The remaining tooth structure will then be cleaned, re-shaped, prepared, filled and sealed. If an extensive infection is present, then it is possible that we will need prescribe specific drugs to manage this ahead of any root canal treatment.
Preparation of all restorations
Before any restoration is placed in the mouth all decay is removed and the remaining tooth is shaped in readiness for restoration. Apart from fillings all restorations are created in a laboratory and use a model of the tooth structure to make this possible. This means that a filling can usually be carried out in a single dental visit, while other restorations usually take several appointments, depending on their level of complexity, and so temporary crowns and dentures are used after the tooth has been shaped, until the permanent restoration is completed and delivered back from the laboratory.