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We
want to make sure your teeth look good, feel good, and last the rest of
your life.
In this
section you should find everything you need to know about teeth: preservation
and repair, replacement of lost or missing teeth and treatment for common
problems. |
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Bruxism
Bridges
Cad-Cam Dentistry
Crowns
CEREC®
Clenching
Computer Teeth
Cracked Tooth Syndrome
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Enameloplasty
Endodontics
Extraction
Fissure seals and 'Preventive Resin' Restorations
Grinding
Laser Decay Diagnosis
Microdentistry
Porcelain Veneers
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Reconstruction
Replacement Dentistry
Root Canal Therapy
Sensitivity
Tooth Replacement
Tooth Whitening
Excessive Wear
Wisdom Teeth |
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| The
word bruxism
is
used to describe what happens when you clench or grind your
teeth together-usually when you're asleep, but you can also do it
while awake. Another dental term that means the same thing is 'parafunction'.
Parafunction is loosly defined as doing things with your teeth other
than eating, talking, or smiling.There
is no widely-accepted reason to explain why you might do this, but
recent reserach suggests a link with disturbances in patterns of
sleep, and may be related to the casues of sleep apnoea. In some
people, parafunction is a habit, like using worry-beads or chewing
pens and pencils or biting nails.
Others do it when the're awake but are completely unaware they they
do. A partner might tell you they can hear you grinding your teeth
while you sleep; someone might notice a repetitive movement of your
jaw as you grind while awake. Dentists can tell if you do it when
they see excessive wear, chipping and fracturing of your teeth.
In the past, dentists believed you could 'cure' bruxism by adjustments
to patient's bite. Other groups of dentists supported the diea that
complex dental interventions to completely 'reconstruct' a whole
mouth would prevent problems. While this might be a good idea for
some people with extensive wear, it doesn't stop people bruxing.
The truth is still unclear about exactly what might work to prevent
us from doing this. What is true is that trying to stop the habit
when you're awake and attempting to protect your teeth when you
sleep does work to prevent damage.
It's important
to know if you brux or not: apart from excessive wear, fillings
can fracture, as so can your teeth. You can chip porcelain crowns
and veneers, and you can develop acute pain as a result of clenching
too much. That's why, during your initial assessment and examination,
we'll look for signs that you might be 'parafunction' with your
teeth. |
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| Bridges are
used if you have lost a tooth; they are a way to replace a missing
tooth or teeth. |
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| Cad-Cam
Dentistry is a way to use computers to make crowns, bridges,
inlays, onlays, and veneers-in fact, you can make a wide range of
replacement parts for a host of diferent applications.
CAD stands for 'computer-aided-design' and CAM stands for computer-aided-manufacture'.
There are some things humans do really well, and other things machines
do so much better. Computers make dental ceramic restorations quicker,
with more accuracy and precision than is possible using old-fashioned
methods. Dental technicians can also use Cad-Cam to make their lives
easier. It's now possible to manufacture all-porcelain bridges using
Cad-Cam. A range of other procedures that either took longer or
were difficult or impossible to complete by hand can also now be
undertaken using computers and dental milling instruments.
For more information, see CEREC®.
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| A Crown is
a specialised filling that covers a tooth. Called 'caps' in the
USA, crowns have been used for more than a hundred years to restore
teeth. Today there are more than 20 different types of crowns dentists
can use. Gold was a common material used in crown manufacture and
it's still used today, where it is usually covered by a layer of
porcelain. Most crowns can be made from high-strength dental ceramics,
so they look and feel just like your own tooth.
You will need a crown if you have a root canal therapy, or your
own tooth has fractured, or if you have a really big cavity.
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| CEREC®
is the acronym for one Cad-Cam dental system sold by Sirona Dental
Systems. The letters represent Chairside Economical
Restoration in aEsthetic Ceramic.
Cerec restorations are made using a 'millable' dental porcelain
to manufacture crowns, onlays and veneers in a single appointment.
Here's how:
Step 1
Old fillings and decay are removed; your tooth is gently shaped
and smoothed
Step 2
An image of the tooth is captured by a specialised camera
Step 3
Your new filling is designed with the aid of a 'library' of images
and designs available within the Cerec software
Step 4
The Cerec computer sends instructions to a milling unit which manufactures
the finished restoration (crown, onlay, inlay or veneer). This only
takes the computerised miller about 10 minutes.
Step 5
The polished ceramic is bonded to your tooth, making it strong and
comfortable once more.
But what's in it for you?
Here's a comparison of old and new:
| New |
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Old |
| Same |
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Smooth and prepare tooth |
| Get a video image of your tooth |
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Impressions of both jaws and
tooth with rubbery stuff |
| Read a newspaper, have a snooze,
go for a walk for 10-15 minutes |
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Wait while the dentist makes
you a temporary plastic crown |
| Design and mill the crown |
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Impression sent to a dental technician |
| Bond the crown, dental treatment
complete |
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Wait 1-2 weeks |
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Second appointment, second injection,
cement the crown |
| Summary: Single appointment, no yucky dental
impressions |
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Two appointments with impressions and temporary
crowns |
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| Cracked
Tooth Syndrome is a collection of symptoms caused by a fracture
in a tooth. 99.999% of the time, the culprit is an existing filling,
although if you brux you can crack your own
unfilled tooth. The most common filling material in fractured teeth
is silver alloy or amalgam. An 'amalgam' is a mixture of
mercury and a silver/tin alloy (with other trace metals). Although
these alloys were improved in the 1970s, silver used in earlier
decades was susceptible to a number of problems that only show up
after years in use. One of these is a fracture pattern that starts
internally and can take months to progress to a broken tooth.
As the fracture
progresses microscopically, you might experience sensitivity to
cold, particularly with cold drinks, or cold air in winter. With
further development, your tooth might become sensitive when you
eat, typically when you try to chew something tough (meat, nuts,
hard candy, ice).
Cracked tooth syndrome is a very distinctive pain on chewing: it
can be exquistely painfulbut the pain has an extremely short
duration, and doesn't last.
It can be very
difficult to diagnose exactly which of your teeth tooth are fractured.
Occasionally there can be multiple teeth that have the same problem,
and it's very common to have more than one fracture in a single
tooth. Some fractures are 'favourable'and others can cause
you to lose your tooth.
Treatment varies
from onlays to crowns and root canal therapy, depending on where
the crack ends.
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| Enameloplasty
is a method of making tiny changes to your teeth by altering
your tooth enamel. Tooth enamel is 'insensitive', so these changes
don't hurt and don't take long.
Most of
the time the changes make your teeth look betterlike eliminating
points, irregularitities or smoothing small fractures on front teeth.
Enameloplasty can also relieve the discomfort of rough teeth and
can be used to affect minor alterations in occlusion. |
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| Endodontics
is the art and science of treating that have infected or damaged pulps.
The pulp is a tiny organ comprised of soft tissue, deep within your
tooth; this tissue was originally responsible for forming your tooth.
If bacteria infect the soft tissue, or it becomes exposed because
of trauma, rathern than have the tooth removed, endodontics ('treatwent
inside the tooth') is used to disinect a tooth and allow you to keep
it ehalthy. This treatment is also known as root canal therapy. |
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| Extractions
are the last thing we normally provide for our patients. But sometimes
it's the best treatment. Crowded teeth, wisdom teeth and extra teeth
need to be removed. Trauma, or extensive decay can mean an extraction
is the idea treatment. Occasionally a tooth with severe periodontal
disease cannot be kept or helped with periodontal therapy and requires
extraction. If you need to have a tooth removed, I'll provide instructions
and help to plan for before and after. For some people, specialist
referral to an oral/maxillofacial surgeon is a desirable choice. if
you would like to download a copy of our istructions for surgical
procedures including extractions, please click here. |
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Fissure
seals and Preventive Resin Restoration ('PRR') therapy are used
when fissures in back teeth develop so they trap plaque and bacteria,
causing decay and cavities. These cavities are so small, we need to use
extremely tiny diamond-coated instruments to remove a thin layer of enamal
to ensure all decay is exposed and removed. Once we are sure the surface
of the tooth is healthy, tooth-coloured resin is securely bonded to repair
the defect. These restorations can be expected to last many years, and
are a wodnerful way to protect the grooves in back teeth from biscuits,
sticky foods and attack from sugary drinks.
These images show an upper molar before preparation, with
the cavity prepared, and with the bonded resin restoration in place. 

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