Dental implants* are a fixed solution to missing teeth. The finished result is natural and long-lasting, and feels just like a normal tooth. While there are other procedures to replace missing teeth, dental implants can create a smile that is very natural and extremely durable. It’s almost impossible to distinguish the implant from your existing teeth.

What’s an implant?
An implant is a manufactured replacement for the root of a tooth. Usually made of titanium and looking a little like a screw, the implant is surgically positioned in the jaw bone. A crown is then attached to the top of the implant to fill the gap of the missing tooth.

How is an implant fitted?
A series of scans are taken by your dentist to aid in positioning the implant and to ensure you have plenty of healthy bone structure. If the bone is diseased or missing, there is still a possibility of a bone graft in order to make an implant viable.

The titanium implant is surgically placed in the bone of your jaw where a tooth once was. It is then left for between two and six months so the bone can grow around the implant. During this time you may wear a temporary crown.

Once the implant is securely fused to the bone, the temporary crown is removed and a permanent crown is either cemented or screwed into place.

If you are missing all of your teeth and wear a full denture, it is still possible to use dental implants to restore your smile. A full arch of natural-looking teeth can be held in place on as little as four implants. These fit snugly to help make it feel comfortable and eliminate the need for daily removal and cleaning.

Crowns and bridges are a fixed solution to missing or damaged teeth. This restorative procedure uses prosthetic devices to return your smile to its natural state. A crown is used when the tooth structure is damaged or fractured. A bridge is used when one or more teeth are missing.

What is a crown?
A crown is basically a manufactured tooth. It’s generally made of porcelain or ceramic that can be colour and texture-matched to your existing teeth. A crown can also be made of gold alloys for improved strength when replacing a back tooth. Often a metal crown will have porcelain bonded to the exterior to give it strength and a natural look.

How is a crown fitted?
Crowns are used when an existing tooth is damaged, fractured or weakened. The tooth is filed down and reshaped into a smaller size. Any decay is removed and the tooth structure is restored to support the crown. The crown fits like a cap over the newly shaped tooth and is cemented into position.

What is a bridge?
A bridge is a prosthetic appliance that replaces missing teeth. Bridges are usually made of porcelain fused to metal in order to achieve both strength and a natural look.

How is a bridge fitted?
A bridge consists of false teeth rigidly attached between two crowns. The teeth on either side of the gap are prepared for these crowns and the bridge is cemented into place. In some cases, it’s possible to use implants to replace the missing teeth rather than using the existing teeth. Once a bridge is cemented into position, it looks and works just like natural teeth.

Teeth whitening can be a simple, safe and quick way to refresh your smile. It’s one of the most popular cosmetic dental procedures and the results can be quite dramatic. An hour in a dental chair can transform stained or discoloured teeth into a whiter smile.

Likewise, a whitening kit recommended by your dentist may allow you to lighten your teeth in the comfort of your own home.

Causes of discoloured teeth
There are various reasons why teeth become discoloured. Some people are simply born with yellowish teeth while, for others, their teeth yellow as they age.

The biggest cause of stained teeth is due to what is put in the mouth. Smoking, coffee, tea and red wine can all colour the teeth. And, of course, the more you partake, the worse the staining will be. Dark foods such as beetroot, cherries and mulberries can also stain the teeth.

Finally, various medications may also make the teeth look yellow and stained. Fortunately, teeth whitening treatments work effectively on the vast majority of people.

Is whitening right for you?
A thorough dental examination is the best way to determine whether you’re an appropriate candidate for whitening, or if there’s a reason to your teeth discolouration that needs to be addressed first. After all, you may have an underlying dental problem that needs treatment rather than a course of teeth whitening.

Teeth or gum sensitivity and fillings may prevent the use of some products. A short discussion with your dentist will reveal if there is an alternative solution for you.

Some brands of teeth whitening kits are unsuitable if you have any crowns or veneers because the peroxide in the product simply can’t penetrate the surface. Once again, your dentist can advise you about the best method to brighten your teeth.

Endodontics is the arm of dentistry concerned with the pulp – the soft tissue at the centre of each tooth. When people talk about endodontics, they are generally referring to the procedure known as root canal treatment.

What is endondontics?
The pulp consists of blood vessels, nerves and various other tissues. While the pulp is vital in a tooth’s development during childhood, by the time we reach adulthood, the tooth has finished growing and the pulp starts to decrease in size.

If the pulp becomes infected or contaminated by decay, the tooth becomes painful and root canal treatment is usually indicated.

Signs you may need a root canal treatment
The most obvious sign is that the tooth really hurts. It is not uncommon for the pain to be throbbing in nature. The gum nearby may also be swollen while cold or hot drinks cause severe pain for an extended period. Often the pain is bad enough to wake a person from their sleep. A discoloured tooth or an obvious cavity are also signs of possible pulp damage.

Don’t ignore the symptoms
If you are experiencing any of the symptoms of pulp infection, it is vital that you see your dentist. If you ignore the pain, it may go away by itself but that only means the pulp of the tooth is dead and the nerves there can no longer send pain signals. But the bacteria causing the infection will still be present and if left untreated, it can migrate to the jaw and gums and even lead to an abscess.

What is the procedure for root canal treatment?
The infected or diseased pulp is removed, along with any decayed sections of the tooth. A very fine spinning file is used to clean and shape the empty root canal where the pulp once was. The root canal is then treated with disinfectant to destroy any remaining bacteria. The final step is to fill the root canal with a special material called gutta percha and then restore the tooth. In some cases, if the decay has been particularly extensive, a crown will need to be fitted.

Does it hurt?
In the past, root canal treatments were painful and became the punchline of many jokes. (‘I would rather have a root canal than…!’). These days, with modern anaesthesia and the latest endodontic technology, a root canal procedure is virtually painless. The fear of the treatment is often much worse than the treatment itself.

Are there alternatives to root canal treatment?
An alternative to root canal treatment is extraction and replacement of the tooth with either a bridge, an implant, or dentures. However, it is always preferable to keep your natural tooth rather than replace it with a false tooth. The other advantage of root canal treatment is that it is usually cheaper than the other options.

How long does a root canal treatment last?
After your treatment, the tooth will feel just like normal. It may seem strange that a tooth without a pulp can be functional and look normal but, happily, that is the case. A treated tooth can last a lifetime but that is dependent on an effective and frequent oral hygiene regimen, and regular visits to the dentist – at least twice a year.

A toothache is pain that you feel in or around your tooth. Most often, toothache pain is a sign that there’s something wrong with your tooth or gums.

Sometimes, however, toothache pain is referred pain. That means the pain is caused by a problem elsewhere in your body.

You should never ignore toothaches. Toothaches caused by tooth decay can get worse if left untreated.

Toothaches are usually not life-threatening, but in some cases, they can be signs of serious conditions that require immediate medical treatment.

You may feel:

• throbbing pain or swelling in or around your tooth or gum
• fever
• sharp pain when you touch your tooth or bite down
• tenderness and achiness in or around your tooth
• painful sensitivity in your tooth in response to hot or cold foods and drinks
• burning or shock-like pain, which is uncommon

Common causes of toothaches
Tooth decay is the most common reason for toothaches. If tooth decay goes untreated, an abscess can develop. This is an infection near your tooth or in the pulp inside your tooth.

See your dentist right away if you think you have a dental abscess. In rare cases, the infection can spread to your brain, which can be life-threatening.

A toothache can also be caused by an impacted tooth. This happens when one of your teeth, usually a wisdom tooth, is stuck in your gum tissue or bone. As a result, it can’t erupt, or grow in.

Toothaches usually require medical treatment. Home treatment may temporarily relieve your pain while you wait for your dentist or doctor’s appointment.

Dental treatment
Most people go to a dentist for a toothache, since most toothaches are caused by problems with your teeth.

Your dentist will use X-rays and a physical exam of your teeth to detect tooth decay or other dental problems. And they may give you pain medication and antibiotics to treat an infection.

If your toothache is due to tooth decay, your dentist will remove the decay with a drill and fill the space with dental materials. An impacted tooth may require surgical removal.

If your dentist can’t find the cause of your toothache, they may refer you to a doctor for further diagnosis and treatment.

Dental emergencies can happen at any time day or night and range from an agonising toothache to a knocked-out tooth. A calm, rational response can help prevent tooth loss or any permanent damage, so here are some handy tips in case a dental emergency occurs.

How soon should I see a dentist?
Most injuries to the mouth should be treated by a dentist as soon as possible. Getting there within 30 minutes can make the difference between saving or losing a tooth. Most dentists reserve time in their daily schedules for possible emergencies, so explain the full condition to staff so they can fit you in immediately.

How do you respond if you have a…

• Knocked-out tooth: 
  The first step is to stay calm and find the actual tooth. Handle it by the crown (the top), not the root, without scraping or rubbing away any tissue fragments. If possible, rinse the tooth quickly in milk or some saliva to remove any dirt or debris. Then try to gently hold it in place in the socket. If you’re not able to replant the tooth, keep it moist by immersing it in milk or saliva (not water), sealing it in plastic wrap, or placing it in the person’s mouth next to the cheek. Time is critical in saving the tooth so contact the dentist immediately for an emergency appointment.
• Chipped, fractured or cracked tooth:
  Clean the area by rinsing the mouth with warm water. Use an ice pack wrapped in a clean towel or a cold compress on the face if needed to reduce swelling. The urgency depends on the severity but only a dentist can discern how serious the condition is. It’s better to be safe than sorry – head to the surgery as soon as possible.
• Toothache
  Rinse the mouth with warm water to clean it out. If swelling is present, place a cold compress to the outside of your mouth or cheek. Gently use dental floss to remove any food caught between your teeth. Do not put aspirin directly on your aching tooth or gums as it may burn the gum tissue. For quick relief, ask your dentist or pharmacist about any over-the-counter pain medication. If the pain persists, see your dentist as soon as possible.
• Bitten lip, tongue or cheek
  This often occurs during eating or as a result of a fall. Clean the area gently with warm, salty water. Then apply pressure to the area with an ice pack in a clean cloth or a cold compress to the area outside to reduce bleeding and limit any swelling. If bleeding continues after about 15 minutes, see your dentist or go to the emergency room.
• Abscess
  This is a localised infection that usually forms at the root of the tooth or in the space between the teeth and gums. This painful condition can actually damage tissue and surrounding teeth and if left untreated, it can cause more widespread infection and may be life threatening. So it’s important to see your dentist as soon as possible. Regular warm salt water rinsing can also help alleviate discomfort until you’re able to see your dentist.
• Lost filling or crown
  If a cavity develops underneath a filling or crown, it can become loose and eventually fall out. It can be rather painful because the exposed middle layer (dentine) of tooth will be sensitive to any hot or cold foods. A new filling or crown will be needed so visit your dentist as soon as you can for a solution.

How can you prevent a dental emergency?
There are simple precautions to help prevent certain injuries to the teeth. When participating in sport or recreational activities, always wear a custom-made mouthguard that is designed and fitted by a dentist.

When opening a pack of chips, a bag of peanuts or other plastic containers of food products, always use scissors rather that your teeth. Also, try not to chew on hard objects such as ice, pens, nuts or even a brutal baguette!