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DENTAL EXAMINATIONS. [+] [-]
A dental examination is the process where your dentist will examine your teeth and gums to check how healthy they are and also assess if there are any problem areas within your mouth. If any problems are identified, your dentist will advise the most suitable course of treatment available to you.
What does the examination involve?
During the dental examination your dentist will:

• Check your jaw and face to see that all appear healthy
• Look at other places in and around the mouth i.e. not just the teeth and gums to ensure that they are in a healthy condition. He will typically check the back of your throat, roof of the mouth and your tongue for amongst other conditions oral cancer.
• Check your teeth and gums for signs of decay, disease, wear, damage and correct alignment.
• Compare the condition of your teeth and gums to the last visit by examining patient notes and possibly x-rays. This is to assess if any additional treatment is necessary and to check progress of any treatment programme you may be undergoing.

WHITE FILLINGS. [+] [-]
What are white fillings?

A filling replaces part of a tooth that has been lost because of decay or accidental 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 in back teeth.
What will the 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 onto it (the dentist will be folding something which looks like a water pistol);
• Put the filling material into or onto the tooth and shape it. This is done in small increments.
• Harden the filling by pointing a bright light at it, inside your mouth (you will see the dentist and dental nurse protecting their eyes)
• Trim and polish the filling.

• White fillings are the same colour as teeth. They come in a range of shades so they can be matched to the colour of your own 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 cannot be removed by cleaning.
• At Newnham Dental Practice we believe that providing mercury containing silver amalgam fillings is detrimental to general health and consequently do not offer them to our patients. Not only are composite (white) fillings more aesthetically acceptable, they are equally durable and do not release toxic mercury that is emitted from silver fillings.

ROOT CANAL TREATMENT. [+] [-]
What are root canal fillings?

Teeth are held in the jaw by their roots. Front teeth normally have one root but teeth further back have more.
Inside the tooth the 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 a root.
Root filling means removing damaged or dead pulp and filling the space left.
The remaining tooth can then be repaired.

What does my dentist do?

• An X-ray can show the shape of the root canals, and also signs of infection in the surrounding bone. Some tooth roots are easier to fill than others, because of their shape. The dentist will discuss the X-ray with you if it suggests that a root filling isn't going to be successful;
• To keep root 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 an is called a "rubber dam".
• The dentist uses narrow files to find a root canal and remove the dead pulp;
• Roots are filled with rubbery materials and with pastes which set hard.

• 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.

APICECTOMY. [+] [-]
This is also known as surgical endodontics. Occasionally a tooth does not settle after having had root canal treatment and a small surgical operation is done to achieve a successful outcome. This is done under local anaesthesia in the practice or may be referred out to a surgical specialist, normally in the hospital.

INLAYS AND ONLAYS. [+] [-]
What are inlays and onlays ?

You can have inlays and onlays instead of fillings. Inlays and onlays are made on a model made from an impression and constructed in advance in a dental laboratory. They are then glued to the tooth in the surgery.
An inlay sits in a hole in the tooth. An onlay sits on the tooth and builds up its shape. Inlays and onlays can be made in tooth-coloured 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 a 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 made; 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).

• 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.

EXTRACTION. [+] [-]
What is an extraction?

A tooth which is very decayed, damaged or loose because of gum disease may have to be extracted (taken out of your mouth).
Children's teeth are sometimes taken out for 'orthodontic' reasons to help the new or remaining teeth grow regularly or without being crowded.

What will my dentist do?

Some teeth are easier to take out than others because of the size, shape, position in the mouth or the shape of their roots. After working out the best way to take the tooth out, your dentist will discuss with:

• How long it will probably take;
• How to make sure you don't feel the extraction while it is happening;
• For certain types of pain control, whether you should bring someone with you;
• When it would be convenient for you to have the tooth removed, if not immediately; and
• How your mouth should recover afterwards.

• You will be able to move your jaw as normal; and
• You may feel some pressure as the tooth is eased out, but not any 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 advise on:
  • How to look after the hole where the tooth was while it is healing;
  • How to control any pain when the anaesthetic wears off;
  • How to contact the practice if there are any problems.

TOOTH WHITENING. [+] [-]
Cosmetic surgery is becoming increasingly popular in today's image conscious age, with tooth whitening being one of the most widely used treatments in the quest to improve our appearance. It is also one of the easiest ways to enhance one's looks and above all it is simple and safe. Many people say that they feel years younger after the treatment, having erased the effects of ageing, coffee, red wine and cigarettes.
There are a few different methods to whiten teeth. At Newnham Dental Practice we use the highly successful system called Kor. The difference with Kor bleaching is the result. Follow your dentist's guidelines and teeth will whiten more predictably than any other system.
Kor bleaching works by increasing the tooth's permeability to oxygen which breaks down stain molecules. It is a combination treatment meaning that there is a 2 week home treatment followed by a 1 hour visit at the dentist.

How white will my teeth get?

Evolution bleaching can whiten teeth up to 16 shades. Results vary but if used correctly all teeth will whiten dramatically.

Will they look too white?

No natural teeth rarely look too white. Sometimes very white crowns can look wrong because they are made of porcelain not tooth enamel.

Will my crowns, veneers or fillings change colour?

No sometimes you may need to change some of these after bleaching.

Is there pain or discomfort?

You may get some transient sensitivity, however your dentist will give you easy to use desensitizing swabs to take home, which work immediately.

How long does it take?

Two weeks after your dentist delivers your Evolution bleaching trays. These are thin and comfortable and must be worn at night for 14 nights, then on the 15th day you need to see your dentist for the second treatment which takes only 40 minutes.

How long does it last?

Results can last indefinitely with some very simple maintenance, wearing the trays for 1 night once every 2-3 months.

CROWNS. [+] [-]
What are crowns? A crown completely covers a weak tooth above the gum line and protects it. Crowns are made of metal or porcelain, or porcelain with metal inside for strength.

What will my dentist do?
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• We will normally give you a local anaesthetic to numb the area
• The tooth will be shaped 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 moldable 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 the impression is accurate round the edges.
• A temporary crown made of plastic or metal 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 cemented into place.

• 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.
• Advances in porcelain development mean we can produce stronger more aesthetic crowns than previously. Zirconia is now used as a metal free material for crowns on back teeth.

FIXED BRIDGES. [+] [-]
What is a bridge?

A bridge replaces a missing tooth (or teeth) by fixing the replacement to the natural teeth at each side of the gap. Some bridges have crowns at each end. Others are fixed to the surface of the teeth next to the gap. Sometimes a bridge is only fixed to the tooth on one side of the gap. Bridges are made of metal and porcelain or sometimes just porcelain.

What will my dentist do?

There are several stages in making a bridge.

• The dentist uses soft, mouldable material to take impressions of your mouth. A dental technician makes exact plaster models of your upper and lower teeth and gums, which show how your teeth bite together.
• The teeth which will support the bridge are prepared so that the bridge is not too bulky.
• Another impression is taken of the teeth and any gaps. The dental technician uses this to make the bridge. A plastic temporary bridge or temporary crown may be fitted in the meantime.
• At your final visit, the dentist will check that the bridge fits, make any minor adjustments and then fix it permanently in place.
• Your dentist or hygienist will show you the best way of keeping your new bridge clean.

• It can improve the way you look, bite, chew and speak.
• The teeth can be matched to the colour of your own teeth.
• A bridge can last many years if you keep it clean and if there is no accidental
• Natural teeth are protected from wear and tear and from moving or tilting out of line, which could cause your teeth to bite together incorrectly. If you do not want a bridge, you can have a removable partial denture or dental implant. The dentist will explain how successful a bridge will be and if the supporting teeth are not strong enough, a denture might be better. If you have just had some teeth taken out, a denture might be made first, with a bridge fitted later when the gum has healed.

VENEERS. [+] [-]
What is a veneer?

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

What will mv dentist do?

Some veneers are built up on the tooth directly using white filling material, while you are with your dentist. Others are made out of porcelain by a dental technician, from an impression of the tooth. You will have to visit the dentist more than once for this type of veneer.

• Your dentist will check any fillings in the teeth first.
• Very little tooth preparation is needed, just enough to prevent the veneer making the tooth feel bulky, so it may not be necessary to numb the tooth.
• For veneers made in the surgery, the surface of the tooth is roughened with a mild acid. Then white filling is applied in layers until the teeth look right.
• For a veneer made by a dental technician, the dentist will take an impression first. This shows how the teeth bite together as well as telling the technician the shape and size of veneer that is needed.
• Your dentist will cement the veneer made by a technician to the tooth when you next visit.

• Veneers can greatly improve your appearance. They hide imperfections and you lose very little natural tooth. Gaps between teeth can be closed using veneers.
• Veneers also protect teeth from any more damage. For example acid n foods and drinks or from the stomach can cause your teeth to wear away. The teeth become thin and week but veneers can protect them.
• If the tooth is strong a veneer is often a better option than a crown for improving a tooth's appearance.

DENTAL IMPLANTS. [+] [-]
A dental implant is essentially a substitute for a natural tooth root, commonly screw or cylinder shaped. This 'foundation' forms the support for an oral prosthetic e.g. a dental crown. The implant is carefully placed into a socket drilled in the jaw bone at the exact location of the intended tooth replacement. The initial stability is further enhanced as the bone grows over time to fill the micro roughness on the implant surface. The result is a stable foundation for the placement of various oral prosthetics e.g. crowns, bridges or dentures. Use of implants Implants can be used to support single teeth or form a foundation for the support of dentures or bridge work. Large spaces left by two or three teeth may not require implants for each missing tooth but this will depend on the quality and depth of bone at each implant site. Suitability for dental implants If you are in good general health, implants will almost certainly work for you. However, heavy drinking and smoking can compromise the initial healing process, so your dentist may insist on you reducing or ceasing drinking/smoking before treatment begins. Length of treatment Implant treatment times can very considerably from patient to patient and is typically between 6 weeks and 6 months. This is often dependent on the bone structure of the patient. How long will they last? As implants are a relatively new form of treatment there is no long term data for durability, however, it is reasonable to project short term data which shows that 90% of implants will be in place and functional after 20 years. A high proportion of failures occur in patients who persist in smoking.

WISDOM TEETH. [+] [-]
What are wisdom teeth?

Wisdom teeth are the last to appear, at the back of the mouth, from the late teens onwards. Commonly people have four wisdom teeth but it is not unusual to have fewer - even none.
Because they are the last teeth to form, there sometimes isn't room for them. They 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 think there may be a problem.

• X-rays can show where the wisdom teeth are in the jaw and how much room there is for them to come through, as well as showing if they are causing any damage to the teeth in front.
• 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 removed. As wisdom teeth are coming through, the surrounding gum becomes inflamed and sore. This is called 'pericoronitis'. It may settle down or come and go over a period. It is usually better to remove a wisdom tooth after you have had pericoronitis because they often continue to cause trouble.
  If you need to have a wisdom tooth removed, you should be able to fit it in with work or other commitments. Sometimes, all wisdom teeth are removed in hospital under general anaesthetic. 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

DENTURES. [+] [-]
A removable denture replaces missing teeth. 'Partial' dentures replace a few missing teeth and 'full' dentures are needed if all the natural teeth are missing. Dentures are made of plastic and sometimes metal was well to make them strong and less bulky.

What will mv dentist do?

• The dentist uses 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, which fit the plaster models. The dentist trims them to show the technician how your 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 trial denture then goes back to the technician who permanently fixes the teeth. The denture is then ready to use.

• They are custom-made to match your mouth and can be made to look as natural as possible.
• You will be able to chew more efficiently.
• The teeth that are left are protected from wear and tear. Without dentures, the natural teeth may move or tilt, stopping your teeth biting together properly.
• Dentures can be fitted straight after teeth have been taken out so that nobody will know that you have had a tooth out. 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 haven't had a denture before, the dentist will want to explain the difficulties of wearing dentures, as well as the benefits and how you should look after your new dentures and the teeth you have left.

SCALING AND POLISHING. [+] [-]
What is scaling and polishing?

A 'scale and polish' cleans your teeth very thoroughly.
Scaling removes the hard tartar which forms on your teeth like scale inside a kettle. You can't remove it just 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 dental hygienist will scale your teeth. If you clean your teeth very 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. This is why you will see the dentist or hygienist changing instruments quite often.
• Ultrasonic 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.

• Regular scaling and polishing by a dentist or hygienist helps keep your teeth and gums healthy by making it easier for you to keep your teeth clean at home. You should see and feel the difference.
• If your gums bleed when you brush, you may have early gum disease. Regular scaling helps to stop the disease getting worse.
• Gum disease can cause bad breath, which you can prevent by regular scaling and cleaning your teeth thoroughly at home.

FISSURE SEALANTS. [+] [-]
What are fissure sealants?

Fissures are grooves in the chewing surface of back teeth. They are difficult to keep clean so there is more risk of decay. Fissures can be sealed with tough plastic to protect them. The plastic is runny at first but sets hard, like paint. Sealants may be see-through or tooth coloured. They are commonly only used for children and only on permanent teeth, not on milk teeth.
Your dentist will discuss whether you need sealants. If you do you will also have to agree which teeth need to be sealed. The need for sealants 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 (because there can be family patterns in tooth decay); and
• A child's general health (because general health problems can make it especially important to avoid dental problems).

• 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 at it (you will see the dentist and dental nurse protecting their eyes);
• Check that the tooth is comfortable to bit on; and
• Trim and polish the sealant.

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