Cosmetic dentistry forms part of a series of treatments called Prosthodontics.

What is Prosthodontics?

This speciality is concerned with treatment to restore damaged teeth, replace missing teeth and generally improve the cosmetic appearance of a patient’s smile. It encompasses treatments with fillings, veneers, crowns (‘caps’), bridges, dentures, tooth whitening and Implants. There are often many options for treatment in any given situation. The following information is designed to give an overview of the most common treatments, though it is not comprehensive – your dentist will be able to give a more detailed assessment of the best options available in your own particular case.

What treatments are available to restore a damaged tooth?

A tooth can be damaged by decay or by fracture. Both may weaken the remaining tooth. If there is still enough solid tooth structure remaining, the damage can be repaired with a filling, either with amalgam or alternatively with a tooth-coloured material to improve the appearance.

If the damage has been significant, added protection of the remaining tooth may be needed in the form of a crown. A crown is a thin but strong shell which fits over the tooth being treated and has the same shape as a natural tooth. It can be made entirely of metal, metal with a porcelain coating, or entirely of porcelain. Many different shades of porcelain are available to give a very close colour match to adjacent teeth. Developments are being made all the time in the process of making crowns and advanced porcelains can have a very natural, life-like appearance.

What is involved in having a crown?

The damaged tooth needs to be altered to a certain shape, if necessary by removing approximately 1-2mm from the tooth surface. An accurate mould is then taken of the tooth and a dental technician will construct a crown to fit precisely against the prepared tooth and to the colour determined by the dentist. The crown is cemented in place and is regarded as a permanent fixture.

What treatments are available to replace a missing tooth?

A missing tooth does not always have to be replaced, though if desirable from a cosmetic or functional viewpoint, the available options are usually a bridge, a removable denture or an implant.

A bridge is a false tooth which fills a gap where a tooth is missing and which is attached to adjacent teeth to hold it in place. Different designs of bridges have different means of attachment – a ‘conventional bridge’ uses crowns on adjacent teeth connected to the false tooth; an ‘adhesive bridge’ has thin metal wings which bond to the surface of the adjacent teeth. The choice of design depends upon the site of the gap, the condition of the adjacent teeth and the biting forces on the bridge.

A removable denture has the tooth or teeth to be replaced held on a connector made either of metal or acrylic resin (plastic). Being stronger, a metal connector can be made much smaller than one made from acrylic. This reduced bulk usually makes the denture more comfortable to have in the mouth. Removable dentures may be removed easily from the mouth by the patient for cleaning. To assist with retention of the denture in the mouth, small attachments can be incorporated which clip around any remaining teeth.

Implants – see Patient Information – Implantology

What treatments are available to improve the appearance of my teeth?

Making improvements to the appearance of teeth can be a simple matter of stain removal or replacement of discoloured fillings. For teeth that show a generally darkened appearance, tooth bleaching can sometimes be used. This involves treating the surface of teeth with a bleaching gel placed in a custom-made tray which fits closely around the teeth to be treated. Significant lightening of teeth can often be obtained. Another option for improving the look of one or more teeth is to use porcelain veneers. These are thin coverings of porcelain made in a dental laboratory to match the colour and shape of adjacent teeth and which are bonded to the front surface of anterior teeth. They can also be used to close small gaps between front teeth or to mask irregularities of tooth alignment.

What are the benefits of seeing a Specialist?

A Prosthodontic Specialist will have undertaken significant postgraduate training in the speciality and will have a great deal of experience in dealing not only with routine Prosthodontic treatments but also with patients whose treatment presents special difficulties.

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