Patients present regularly stating they are unhappy with their dental appearance. This can be caused by mis-shapened teeth, broken or decayed teeth, discoloured teeth, and crowded teeth, jaw shape discrepancies, missing or damaged teeth from accidents or developmental problems.
These causes have a profound effect on people's confidence, self esteem, communication and wellbeing. For many patients possible treatment options to improve their appearance have never been explained in a simple uncomplicated way.
Discoloured teeth can be from intrinsic staining, extrinsic staining, or old stained fillings. Extrinsic staining is from deposits that develop on the surface of our teeth such as food colouring, medication staining and calculus build-up. These discolourations can be removed by a dentist or hygienist.
Intrinsic staining is discolouration of the inside layers of the teeth. It can be caused by food stuff, accidents naturally darkened teeth or medication induced. These colourations can only be removed by using tooth whitening processes and in the case of accidents possible internal bleaching.
If whitening or bleaching teeth doesn't achieve the desired result we move onto some form of coverage of the discolouration. This can be achieved by using veneers both composite or porcelain or crowns.
Composite veneers are a very effective way of masking discolouration by minimal or no drilling of the tooth surfaces, have good appearance, are quick to make, are repairable if fractured or damaged and are very cost effective. The lifespan is 5-7 years.
Porcelain veneers and crowns require removal of tooth structure to achieve an acceptable result. Veneers usually take a layer of the front surface of a tooth and a crown requires removal from all surface of the tooth to then replace with porcelain. This treatment is more expensive but with a lifespan of 15-20 years before re-treatment may be necessary.
Usually damaged crowns and veneers cannot be repaired and have to be replaced.
Missing teeth can be replaced in two major ways, with a removable appliance or treatment that is fixed in place either to the existing teeth or to the jaw bones,
Removable appliances are dentures of which there are a range of types. If all teeth are missing then a full denture is made which relies on suction to the gum tissues. These are made from acrylic. The acrylic partial denture is made of the same materials.
There are also metal framed dentures which clip around teeth and are supported by the gums. All of these dentures have varying benefits and price ranges.
Fixed treatment for teeth are either bridgework or dental implants. Bridgework can either be bonded to teeth supporting a false tooth or by full coverage of teeth by crowns joined together to support false teeth. These are usually made from porcelain fused to metal or all ceramic.
Implants are screws that attaches the jaw bone to hold crowns, bridges and over dentures. They are hugely successful with the right patients and are the most sophisticated end result.
For more information visit www.dentalonraffles.co.nz.
Presented by Dr. Gary Winter BDS