Many patients want whiter teeth and will always ask about the latest toothpaste/mouthwash/beauticians treatment etc. Unfortunately, the only thing that can actually change the shade of your teeth long term is a properly prescribed and monitored course of tooth whitening
At Railway Dental Surgery we use 2 different types of systems:
Zoom in house bleaching and a home maintenance kit:
This combination is our most popular. It involves the use of trays for a couple of days at home followed by a 1hour session in the surgery, then a couple of days at home. The results tend to be very good and patients like it as they get an immediate result and because they have the maintenance kit there is no need to return for another course of bleaching in a few years unlike the more traditional “laser whitening” which is still offered by many but does not have the longevity of this system.
While this is a more traditional system it is still widely used and provides a good result. The patient uses custom made trays and bleaches at home for approximately 2 weeks every night under our supervision using prescribed bleach. Once the trays are kept safe and minimal maintenance is done once or twice a year, there is no need to ever complete another course of bleaching to keep a great result.
Crowns are a commonly placed restoration. They are usually done because;
There is not enough tooth left to hold in a filling.
There is a very discoloured or misaligned tooth which is too dark or too crooked for a veneer.
We are very concerned about a tooth fracturing more so that it cannot be fixed and will be lost so a crown is put on to protect it.
The procedure is very similar in all cases and usually involves two visits. At the first visit, the tooth preparation is done which involves removal of some of the tooth substance so that the crown can be fitted over what is left. At the second visit, the crown is fitted once the patient and dentist are happy with the fit and appearance. A temporary crown will be in situ for the duration of the treatment.
All crowns are not the same and a range of different options are available with or without metal to fit different situations and budgets. Your dentist will discuss these various options with you.
All porcelain crowns: these give the most natural result and eliminate the black line at the gum that many people associate with crowns.
Porcelain with a metal under layer, these are usually on back teeth as the metal layer provides more strength.
A gold shell crown, not very commonly used but very useful in patients with severe tooth grinding habits.
These are porcelain facings which fit on the front of your teeth which can be used to correct some crooked teeth and mask discoloured teeth. Veneers are suitable in many cases and involve the removal of much less tooth enamel than traditional crowns. Usually two visits are required, one to prepare the tooth in which minimal amounts of tooth enamel may be removed and impressions taken which are sent to the laboratory. The second visit is to fit the veneer once the dentist and patient are both happy.
Bridges are used to replace missing teeth. Teeth may be missing because they did not develop or they were extracted. There are two different types of bridgework commonly used:
Maryland bridges or adhesive bridges: These bridges require very minimal amounts of tooth substance removal (if any) and are often used for younger patients who have teeth which never developed and they are not old enough for dental implants. They are permanently cemented in place with very strong glue.
Fixed Bridges: These are very similar to crowns and use the adjacent tooth or teeth to support an artificial tooth which is cemented in place. Bridges tend to be more suitable for smaller rather than larger gaps but when appropriate, most patients tend to prefer fixed bridgework than removal dentures. To be a suitable candidate for bridgework your remaining teeth need to be healthy and strong. Bridges need to be looked after like your own teeth once cemented in place and need careful brushing, flossing and regular check-ups.
Implants: are used to replace missing teeth or to stabilise dentures. Implants are most successful in non-smokers with healthy mouths. A dental implant is a titanium rod that is placed into the jaw. This implant can then be restored with a crown or can have an attachment put on to it, to hold a denture in place. Implants must be looked after the same as your own teeth with good hygiene and gum care. Regular dental check-ups are also required as part of a proper maintenance programme. If looked after well, an implant can last for many years.
Root Canal Treatments
A root canal treatment is an alternative to extraction of a tooth with an irreparably damaged nerve. This can happen as a result of decay or trauma. There is usually pain and infection associated with the tooth and patients may experience “grumbling” symptoms for weeks as the tooth dies. A root canal treatment works by removing the nerve of the tooth (which is the source of the infection) and filling the nerve canals with specials cones and antibacterial paste. Every tooth is different and may have between one and four canals that need to be treated, your dentist will discuss this with you.
At railway dental surgery we use the latest nickel titanium root canal systems to ensure the best outcome possible. Root canal treatments generally have a very high success rate and allow a well looked after tooth to function for many years.
Removable dentures are made of either an acrylic or Cobalt Chrome base depending on the patients’ needs and wishes. Dentures are more commonly used where there are several teeth missing. They sit in the patients mouth for all normal daily functions i.e. eating, speaking etc. and should be removed at night. While there is definitely a period of adaptation after getting new dentures, many patients function very well with full or partial removable dentures.
Implants are used to replace missing teeth or to stabilise dentures. Implants are most successful in non-smokers with healthy mouths. A dental implant is a titanium rod that is placed into the jaw to hold an artificial tooth or to clip a denture in place. Implants must be looked after the same as your own teeth with good oral hygiene and regular checkups. If well looked after, an implant can last many years.
There are 2 main types of fillings commonly used, white and silver. We offer both types of filling and will provide guidance to our patients as to which type filling will perform better in each individual circumstance.
Silver (amalgam) fillings: while these certainly do not have the aesthetic qualities of white fillings, they still perform well and last many years in function. Safety of all dental materials is being constantly reviewed and accessed. There is no evidence based studies that have proved that amalgam fillings are in any way harmful and in certain situations such as when the decay extends below the gum line they definitely perform better than white fillings.
White fillings: these have the advantage of being discrete and not usually visible in photographs. Over the years white filling materials have been constantly improving so that they now preform as well as silver fillings in many situations and in some cases actually perform better.
Please discuss with your dentist which type of filling you would prefer.
Clenching or grinding teeth at night is an increasingly common problem as life becomes more stressful. While it can be stress related, it can also simply be a habit that runs in families.
It can lead to several problems including jaw joint problems, teeth dying or fracturing and teeth getting smaller due to wear.
Your dentist can identify these problems and prescribe the appropriate type of guard necessary to manage this.
Sports injuries are very commonly see in dental practices and players frequently loose teeth as a result. Many injuries can be avoided by wearing a custom fitted gum shield which provides far superior protection to a “boil and bite” one. We can provide clear or team coloured gum shields as per patient’s wishes.
Gum disease is becoming more and more prevalent in Ireland. This can be due to genetics, medical problems such as epilepsy or diabetes, and habits such as smoking, poor oral hygiene and tarter deposits. Many people are not aware of the need for regular cleanings to treat and prevent gum problems. Even with a good brushing technique, the spaces between your teeth do not get brushed properly and these spaces are where problems occur.
By regular check-ups and cleanings gums will be monitored as will all soft tissues for infections, oral cancer etc. and any necessary treatment will be prescribed. Patients will also be advised on home maintenance and how to keep gum disease at bay. It should be noted that despite advertising to the contrary, mouthwashes do not cure gum disease and can actually just mask the symptoms allowing the disease to progress unknown to the patient.