The thoughts, musings, observations and ramblings of a man passionate about dentistry.
This is the most popular topic in cosmetic dentistry – teeth whitening! As time goes on (the polite way of saying as we get older!) teeth get darker and darker, and that’s why whitening teeth makes you look younger. For the right candidates it is a relatively quick, safe, painless, non-invasive way of taking years off the appearance of your smile. But, you may ask, is teeth whitening suitable for me?
We’ll need to check that it is safe to whiten your teeth first, and that means checking for things like cavities, fractures, tooth decay and gum disease first – you don’t want existing minor problems to become painful major ones. Also, tooth whitening works very well on natural teeth but will have no effect on crowns, veneers or fillings, so it is vitally important to get a professional opinion before starting out – it might end up just being a waste of time and money, or worse, it could leave you with a chess board-like collection of some white and some dark teeth. Not a good look! This is why it is illegal for non-dental professionals to carry out whitening. Also, legitimate suppliers are forbidden from providing teeth whitening products to non-dentists, so not only do they not know what they are doing, they don’t know what reagents or concentrations they are using.
You will probably want to see our hygienist first to remove all plaque, tartar and staining from all surfaces of all your teeth so that we can bleach your teeth rather than the just stains. That way you get a more impressive result that lasts longer. People ask, how long does tooth whitening last, and the answer is that your teeth will always be lighter than if you hadn’t had the procedure, however, teeth will continue to darken with time – it’s like winding the clock back, not stopping the clock – so you might want to top up occasionally to maintain the benefits of a bright, white smile for the long term.
Before the law changed, we used to be able to get decent results with one-hour whitening. Now that we are restricted to using lower concentration whitening gels, it takes longer, ideally overnight for a couple of weeks or so. Not the instant result that everyone wants, but it is far more predictable and comfortable, with far fewer instances of sensitivity. We offer a couple of packages for your whitening procedure. They both work well and predictably, but one comes with your own desensitising kit to take home with you and has a guarantee of shade B1 or lighter.
One final thing to mention, whitening toothpastes and off-the-shelf kits don’t work. We’d sell them if they did. Save your time and money and get it done professionally for guaranteed impressive results that last.
I’m continuing my blog on the subject of frequently asked questions I hear week in week out (during “normal times” that is! – this is being written during COVID 19 lockdown.)
Dental crowns or onlays are a good idea where teeth are significantly broken down by decay, cracks, fractures or large old fillings that are failing. It’s like the next step for a tooth that can’t reliably be filled anymore. Done properly and cared for afterwards, crowns are a way of keeping your previously damaged teeth strong and healthy for the long term.
A dental crown is a restoration that covers the top of your tooth and encircles it 360° to help strengthen and reinforce it, whereas an onlay covers the whole of the biting surface, but it involves less drilling of the sides of the tooth, therefore more conservative and less destructive. That’s why I prefer to provide onlays wherever possible.
At Enhance Dental Care, we use the CEREC system to make metal-free ceramic crowns/onlays in the same visit. We scan your tooth with a camera, so no need for moulds or impressions. Then, using CAD/CAM technology we design your new tooth so that it looks great and functions well with the other teeth in your mouth. This is then “milled out” in the neighbouring room, tried in and then fired in a special furnace at 860°C to make it super tough. The beautiful ceramic material is metal free so that you don’t get a black line around the gum margin.
It is possible to get tooth decay underneath a crown, so you still need to brush and floss your teeth and be careful with sugar in your diet. Occasionally a crown might dislodge or fall off. Don’t worry, just keep it safe and bring it with you to have it rebonded back in place.
A heavily broken-down tooth that requires a crown to fix it is also a candidate for needing root canal treatment (RCT). It’s not the case that having the crown caused the tooth to need RCT, rather the tooth that was compromised in this way may need RCT as well. Root filled teeth at the back of your mouth, molars and premolars, need a crown or onlay for strength to prevent them from fracturing.
Having a crown or onlay done is a painless procedure with a high success rate. You can get rid of your large unsightly amalgam fillings in one comfortable visit. For more info, check out our dedicated website page:
Today I’m writing my blog on my favourite branch of dentistry: Endodontics, or root canal treatment (RCT).
I’ve been receiving referrals for root canal treatment from local dentists since 2013, and in this time, I get asked the same handful of questions. Number one, by far, is “Does a root filling hurt?” The short answer is no, almost never! Very occasionally you might need extra local anaesthetic to make it comfortable, and if you want more numbing all you need do is ask. Sometimes you’ll need to take painkillers afterwards, but paracetamol and ibuprofen usually does the trick.
“What is a root filling?” That’s where the dental pulp, or “nerve” as it is sometimes (wrongly) called, is removed from the middle of the tooth, the root canals cleaned and disinfected and sealed with a rubbery filling material called gutta percha. It’s usually best to do this in one visit, but sometimes it can take 2 or even 3, depending.
“How long does a root filling take?” is another FAQ. Depending on complexity, it’s usually done in one to two hours. If you have a favourite kind of music or a preferred radio station, then you can listen to that to keep your mind relaxed and occupied. We can also provide you with a comfortable mouth prop to prevent your jaw from aching.
If the RCT tooth is a molar or premolar, then it will need a crown or onlay afterwards, and the sooner the better. This can be done at the same visit using CEREC same day crown technology, or it may be more financially prudent to wait until symptoms subside.
“Why do root canals at all?” you may ask. Your options are usually (a) attempt to save the tooth with RCT, (b) extract the tooth or (c) do nothing and let the infection spread, so really you need to weigh up if is it better to have RCT or your tooth extracted. If you lose a tooth then it might affect your appearance or ability to chew, and it might cause other changes to your bite. If it’s a useless tooth with poor chance of success, then it’s usually best to extract.
“Do root fillings work?” RCT is highly successful but not 100%, and due to the complex nature of the procedure it cannot be guaranteed. Typically, there’s a 90% to 95% chance that the tooth will be healthy and comfortable for the next 5 years and more.