Your Dentist in Hammersmith, caring for all your needs

AMALGAM FILLINGS

Dental materials have improved drastically in recent years. Gone are the days when a silver amalgam filling was the only option. Although such fillings are strong, durable, comfortable and relatively inexpensive, they do tarnish and blacken over time, leading to dissatisfaction. At Salisbury House, we only use them in three sets of circumstances – when a patient either:

• wants a cost-effective solution to restoring back teeth; or
• needs badly damaged back teeth built up prior to a crown being fitted; or
• has such a large cavity that an amalgam filling is undoubtedly the best option.

Although these fillings have had something of a bad press recently, it’s important to remember that they’re completely safe, as demonstrated by numerous studies. The only exception to this is pregnant women who should not have amalgam fillings because of their developing baby. Our fillings of choice for front teeth and most back teeth are made of composite (see below). For further information, please contact the practice.

COMPOSITE FILLINGS

Composite fillings are the much improved successor to silver amalgams. Composed of resin and a filler – hence the name, they have all the advantages of amalgams (strength, durability, comfort), plus the added advantage of being very natural-looking. They can provide many years’ service and look virtually indistinguishable from your natural teeth.

I recommend composite fillings for small and medium fillings, but not for large ones where an inlay, onlay, or even an unaesthetic amalgam would perform better. For further information, please contact the practice.

Inlays and onlays are, more or less, the same thing – they are large fillings that are made in a dental laboratory by a skilled technician. These are the solution for patients who need an aesthetic solution to an extensively broken down back tooth. Composite fillings are the best option for small and medium-sized cavities, but seldom produce adequate and durable results when used to restore large cavities.

I prepare the tooth by removing all old fillings and any decay, take an impression of the cavity, and then place a temporary filling. A skilled local technician uses the impression to construct the inlay from either a composite resin or porcelain and returns it to the practice about a week later. I then cement it into place. Although inlays and onlays are a very satisfactory – and aesthetically pleasing – solution to extensively broken down back teeth, there are some occasions when a crown will be necessary.

For further information, please contact the practice.

• Gold crowns – although these are still a valid treatment, many patients now opt for a more aesthetic alternative. However, for back teeth with a close bite, gold crowns remain the option of choice.
• Porcelain bonded to metal crowns – these are made of a shell of metal alloy to which porcelain is bonded. The crowns are therefore both natural looking and very strong. At Salisbury House, we use these crowns as standard for those back teeth that need crowning.
• High-strength all-porcelain crowns – these are a relatively recent development and are a great boon to the market being both reliably strong and durable. They are particularly good in those situations where aesthetics are of prime importance because they eliminate that disfiguring ‘black line’ so often associated with porcelain bonded crowns in the past. Several brands are available; Lava, Emax and Procera are the ones I use at Salisbury House.

For further information, please contact the practice.

• Conventional bridges – these involve cutting down the two adjacent teeth as though crowns were to be fitted. After the dentist has taken an impression, a skilled technician uses it to construct the bridge that is then shade matched to produce a lifelike result. Finally, the dentist cements the bridge into position. Bridges of this type can last many years; however, in my view, it’s a shame to cut down healthy teeth unless they would have needed crowns anyway.
• Adhesive bridges – these are literally stuck to the back of the adjacent teeth with a special dental adhesive. Their big advantage over conventional bridges is that they are much less destructive of the adjacent teeth. Their disadvantage is that they are more likely to come out. This can be inconvenient and embarrassing if they are bridging a front tooth. Although some dentists consider them as little more than a temporary solution, they can be a viable alternative to a conventional bridge if, for some reason, an implant is not possible.

For further information, please contact the practice.

Implant dentistry is a special skill, and I have chosen to work with a highly qualified dentist with many years’ experience in this area. Together, we can offer patients with missing teeth a viable alternative to dentures that also leaves the adjacent teeth intact. For further information, please contact the practice. You can find additional information on the Association of Dental Implantology website at www.adi.org.uk/public.

A number of options are available to you. They can be made from

• Plastic, a relatively inexpensive and traditional option
• A combination of a metal framework with plastic, or
• A flexible plastic called Valplast. Please visit www.valplast.com/patient for more information.

If you require a denture for the first time I will take special care to explain the options to you. If you are an experienced denture wearer you will probably know what has suited you well but I will ensure you are aware of any options.

For further information, please contact the practice.

The aim of the treatment is to remove all infection from the root canal. We thoroughly clean the inside of the root and then fill it to prevent any further infection. Although root canal treatment is a demanding and time-consuming procedure, it is almost always painless. It is also usually very successful. However, on those occasions when an infection does return, a specialist dentist can repeat the treatment. In such cases, I refer patients to a highly qualified and experienced colleague.

Root canal treatment weakens the affected tooth to such an extent that a crown is sometimes necessary for additional protection. This is almost always the case with back teeth that have had root canal treatment.

Ignoring an infection – and not having the recommended treatment – is risky. You could suffer an abscess and even lose the tooth. If that happens, you may then require a bridge, implant, or denture.

For further information, please contact the practice.

Bad breath is a surprisingly common problem; the underlying cause is usually dental. The bacteria that coat our teeth and gums can often be the culprit as they release smelly gases. Another cause is odds and ends of food; these get trapped between the teeth and the tongue and emit an unpleasant smell as they rot.

You can help to ensure that your breath remains fresh by:

• Correct and regular brushing; and
• Regular visits to the dentist.

For example, old filings that are no longer smooth will collect plaque and food debris, increasing the likelihood of bad breath. Your dentist will be able to tell you when such fillings need replacing.

For further information, please contact the practice.