Dental Services

Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (called the pulp) is infected through decay or injury. You may not feel any pain in the early stages of the infection. In some cases, your tooth could darken in colour, which may mean that the nerve of the tooth has died or is dying. This would require treatment, as otherwise the tooth may produce pain and/or an abscess.

If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess. An abscess is an inflamed area in which pus collects and it can cause swelling of the tissues around the tooth. The symptoms of an abscess can range from a dull ache to severe pain, and the tooth may be tender when you bite. If root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.

The aim of the treatment is to remove all the infection or inflammation from the root canal. The root is then cleaned and filled to prevent any further infection. Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve one visit to your dentist but if the tooth is badly infected then two or more visits may also be required.

The treatment process involves the following:

• Drilling a hole inside the tooth through the tooth surface/existing filling or crown and reaching up to the inner core of the tooth.
  Once here, the dentist will locate how many canals the tooth has and this will differ from tooth to tooth.
• At this point, the dentist will apply a rubber sheet on the tooth to protect it from any salivary seepage in the tooth (thus re-contaminating with salivary bacteria). You will need to breathe through your nose as your mouth will be covered with this rubber sheet. If you have problem with mouth breathing or are claustrophobic, then please speak to your dentist at the beginning to find another solution.
• After this, the dentist will remove all infected, inflamed or necrotic (dead) material from your tooth and clean and disinfect it. We will be using a bleach-like chemical to dissolve any such material as well.
• Once the root canal system is nicely cleaned and shaped we will fill these tightly with a plastic material known as Gutta-Percha (a natural plant-based material). Your tooth then will be filled with a suitable material to build it back.

A tooth that has just received root canal treatment may also need a crown to prevent it from collapsing under biting forces. Your dentist will provide you with the necessary information about this so that you can make an informed decision.

At Melksham Dental Practice, we provide root canal treatment routinely and enjoy a good success rate. It is important to remember that root canal treatments are not 100% guaranteed to be successful and may fail even after the proper processes are followed.

If your root canal treatment is difficult to do or the best treatment can be provided by a specialist, then we will advise you accordingly and refer you to a suitable specialist after discussion with you.

White fillings are made of resin and these days have a similar strength to amalgam fillings. The fillings are also known as composite fillings. The main advantage of these fillings is superior appearance and in some cases a tooth after filling with white fillings can look as good as new.

At Melksham Dental Practice we will advise you what kind of fillings are suitable for each individual tooth. We always try to provide the best outcome for you. Nowadays a badly broken tooth can also be built back using resin fibres and resin (composite) filling materials. This is sometimes is a better option than a crown, which can be more intrusive.

Please discuss with your dentist about white fillings and the advantages over other fillings.

We do not normally suggest replacing a sound amalgam filling with a tooth-coloured filling, but if you wish to do so please do speak with your dentist and discuss the pros and cons.

Amalgam fillings are also known as metal or silver fillings. The material is made by mixing a powder of silver, tin and copper with mercury in a safe way and then compacting this material in the prepared tooth. This filling material has been used for more than 100 years and has one of the best long-term results. Amalgam fillings are superior to other fillings in certain conditions, such as when it is not possible to keep the tooth dry, as other filling material won’t stay in wet condition but amalgam will.

There is some concern about amalgam restorations in the general public, but it is considered a safe material by UK Health authorities and is routinely used in general dentistry. No known cases of toxicity because of this material’s dental use has been reported in literature. 

If you have any concerns or known allergies to amalgam, please advise your dentist as soon as possible and have a chat regarding alternatives.

A crown is a type of dental restoration that, when cemented into place, fully cups over that portion of a tooth that lies at and above the gum line. Since it encases the entire visible aspect of a tooth, a dental crown, in effect, becomes the tooth’s new outer surface. In comparison, dental fillings are restorations that fill in or patch just a portion of a tooth. Other terms that are used to refer to crowns are ‘dental caps’ and ‘tooth caps’.

Crowns can be made from porcelain, metal (a gold or other metal alloy), or a combination of both (porcelain-fused-to-metal). A dental crown might be used to restore, or even improve, a tooth’s shape. A dentist might also recommend a crown to strengthening the tooth, for example following a root canal treatment, or to improve the cosmetic appearance of the tooth.

Dental crowns are fabricated in a dental laboratory using the impression your dentist has made of your tooth after having prepared it. Using the impression, a lab technician can visualize and examine all aspects of your bite and jaw movements. The technician then makes a crown that will fit accurately on the tooth and follow the same bite pattern which you already have. During the fit appointment, the dentist will remove the temporary crown and fit the proper crown in place using a dental cement.

Dental onlays are similar to crowns, but cover only part of the tooth, rather than the whole tooth. In this way, the dentist is able to converse more of your natural tooth. Ideal candidates for onlay work typically have too much damage or decay in the tooth structure to be successfully treated using a filling, but have sufficient healthy tooth remaining to avoid the need for a crown.

Dental onlays are used when old fillings need to be removed or replaced, for example due to decay or a fracture. During treatment, the dentist removes the old fillings under local anaesthesia and takes an impression of the tooth, which is sent to the dental laboratory. The new onlay is made from this mould in porcelain, metal or composite resin material. The onlay is then cemented into place at the next appointment.

If you’re missing one or more teeth, you’re not alone. The American Dental Association reports that adults between 20 and 64 years old have, on average, three decayed or missing teeth. Fortunately, you have multiple options for replacing these missing teeth, including dental bridges. Here are four types of dental bridges that your dentist may recommend.

Traditional Dental Bridges

Traditional bridges were the most popular kind of bridges 10-15 years ago. These bridges consists of one or more pontics (fake teeth) and are held in place by dental crowns. These dental crowns are also called abutments, and they are cemented onto the teeth adjacent to your missing tooth.

Traditional bridges can be used when you have natural teeth on both sides of the gap created by your missing tooth. Bridges are even strong enough to replace molars. The downside of traditional bridges is that your dentist will need to prepare the adjacent teeth by removing their enamel to make room for the crowns that will be cemented on top. Since enamel doesn’t grow back, these teeth will always need to be protected with crowns, even if you later choose a different type of bridge. There is about a 10% risk of becoming painful in the future and requiring root canal treatment. These types of bridges are most destructive to natural teeth for support and so at Hounds Road we try to avoid these if possible.

Cantilever Bridges

Cantilever bridges are another option for replacing missing teeth. They are very similar to traditional bridges, but the fake tooth is supported by a crown on only one side, rather than on both sides. So, if there’s only one natural tooth next to the gap, a bridge can still be secured. Like traditional bridges, your dentist will need to prepare the adjacent tooth to support the bridge by removing its enamel. All the complications mentioned above may also occur for that one tooth.

Adhesive Bridges

Adhesive bridges are considered a conservative alternative to traditional bridges. These bridges consist of a fake tooth that is held in place by a metal or porcelain framework. This framework is bonded onto the backs of the teeth adjacent to the missing tooth. Since this type of bridge isn’t held in place by crowns, the adjacent teeth don’t need to be filed. This makes these bridges nearly reversible and very tooth friendly.

These bridges may initially feel high on biting as we do not cut natural teeth to make space for the bridge. In most cases, you will get used to it with in 4 to 6 weeks. These bridges should last a very long time and at Hounds Road Dental Practice, we prefer these type of bridges to replace your teeth.

Implant-Supported Bridges

Implant-supported bridges are another option for replacing missing teeth. They can be used when you have more than one tooth missing. Instead of being supported by crowns or frameworks, these bridges are supported by dental implants. Usually, one implant is placed for every missing tooth, and this series of implants holds the bridge in place. However, the bridge may consist of a fake tooth suspended between two implant-supported crowns if placing one implant for every lost tooth isn’t possible.

Dentures are removable false teeth. They fit snugly over the gums to replace missing teeth and eliminate potential problems caused by gaps. Gaps left by missing teeth can cause problems with eating and speech, and teeth either side of the gap may grow into the space at an angle. A denture replacing one or more tooth is called a partial denture. Sometimes all the teeth need to be removed and replaced. A denture replacing all of the teeth is called a complete denture.

Complete Dentures

A full denture will be fitted if all your upper or lower teeth need to be removed or you’re having an old complete denture replaced. If you are having your teeth removed, your new denture can be fitted as soon as your teeth are removed, which means you won’t be without teeth for long. If you have dentures fitted immediately after the removal of several teeth, the gums and bone will alter in shape fairly quickly and the dentures will probably need remaking after a few months.

Partial Dentures

A partial denture usually clips onto some of your natural teeth with or without metal clasps, which hold it securely in place in your mouth. It can easily be unclipped and removed. Occasionally, the clips can be made of a tooth-coloured or gum-coloured material, although this type of clip isn’t always suitable because it tends to be more brittle than metal.

Dentures can be made from different materials, each have their pros and cons.

Acrylic (plastic)

Acrylic-based dentures are made of a resin material, which is moulded according to the shape of your jaw and gums. It fits snuggly over your gums and should stay there with the help of suction between denture base and your gums, and also with the help of muscle tone. The dentures typically cover a large gum area to provide sufficient suction for retention and support. Metal clasps can be added if necessary to provide additional support.

The main advantage of these dentures is ease of manufacture and repair (including adding additional teeth if required in the future).

Metal fused with acrylic

These dentures involve a cobalt-chrome based metal framework that is fused with acrylic to support artificial teeth. Due to the metal framework, these dentures can be made smaller and less intrusive. These dentures typically take support from one of the natural existing teeth by mean of clasps and rests and can provide very good retention and support. These dentures are not easy to repair or add additional teeth to, and if they lose adaptation they need to be replaced.

Flexible dentures

This type of denture is suitable only for partial dentures. They are made from a flexible resin, so they can be more comfortable than acrylic or metal-based dentures. Teeth can be added onto them, and they are less brittle so less likely to fracture. Due to the material, they are more likely to pick up stain over time.

Implant-supported denture

Millions of people around the world are missing enough teeth to require the use of a denture. Many of them struggle to keep their dentures secure, particularly in the lower jaw. If you have this problem, you already know about the embarrassment of slipping dentures, not being able to eat the foods that you love and the ineffectiveness of denture adhesives.

Fortunately, there is a way to make your denture work the way it was intended: stabilise it with dental implants.

If you are interested in implant-supported dentures, please speak to your dentist who will give you more information about this.

Looking After Your Dentures

Dentures may feel a bit strange to begin with, but you’ll soon get used to wearing them. For the first couple of days, you may need to wear your dentures all the time, including while sleeping. Your dentist will advise you that, thereafter, you should remove your dentures before you go to sleep. Dentures should be cleaned twice a day with warm soapy water and a soft brush – try to avoid using toothpaste as this can take the shine off the denture. We recommend cleaning your denture over a sink of water or a soft towel, as if they are dropped they can break! If using a denture cleaning solution, follow the manufacturers instructions.

Keeping your mouth clean is just as important when you wear dentures.  You should remove your denture and brush your remaining teeth, gums and tongue every morning and evening with fluoride toothpaste to prevent tooth decay, gum disease and other dental problems.

Eating with Dentures

When you first start wearing dentures, you should eat soft foods cut into small pieces and chew slowly, using both sides of your mouth. Avoid chewing gum and any food that’s sticky, hard or has sharp edges. You can gradually start to eat other types of food until you’re back to your old diet.

Denture Adhesive

If your jawbone has shrunk significantly, adhesive may be the only way to help retain your dentures. Your dentist will advise you if this is the case. At first, some people feel more confident with their dentures if they use adhesive. Follow the manufacturer’s instructions and avoid using excessive amounts.

Adhesive can be removed from the denture by brushing with soap and water. Remnants of adhesive left in the mouth may need to be removed with some damp kitchen roll or a clean damp flannel.

A dental implant is used to support one or more false teeth. It is a titanium screw that can replace the root of a tooth when it fails. Just like a tooth root, it is located within the jawbone.

Implants are a safe, well-established treatment. It’s probably true to say that implants, much like natural teeth, will last for as long as you care for them. How well you look after your implants – and whether you go for your regular maintenance appointments – will have the biggest impact on how long they will last. If you don’t look after your implants they will develop a coating similar to what you get on neglected natural teeth. Left untreated, this can lead to gum infection, bleeding, soreness and general discomfort. You could get all these problems with natural teeth. If your implants are well looked after, and if the bone they are fitted to is strong and healthy, you can expect them to last for many years. However, just as with other surgical implants (such as a hip replacement) there is no lifetime guarantee.

Dental implants can be used to replace a single tooth, or the complete set. 

Six reasons why you should consider implants instead of other solutions: 
1. They look, feel and function like your natural teeth.
2. Healthy teeth do not need to be ground down to support the dental implants.
3. Anchoring dental implants in the jawbone stimulates bone tissue and gums, ensuring an attractive, aesthetic result while helping to maintain facial structures. 
4. Dental implants do not require any adhesives to hold the new teeth in place.
5. They eliminate the discomfort and insecurity of loose, ill-fitting dentures.
6. You have a secure, permanent tooth replacement.

There are three parts of a dental implant: implant, abutment and crown

Implant

A small titanium screw is inserted into your jawbone. Titanium is a metal accepted by the body and heals together with the bone tissue to form a new, stable tooth root.

Abutment

An abutment is a ceramic or titanium component that ensures a secure fit between the dental implant and the crown.

Crown

Once the dental implant and the abutment are in place, your dentist fits the crown, the bridge or the denture. 

Examination and discussion

Your dentist will advise you all treatment options for a missing tooth including an implant. If you decide after discussion with your dentist that an implant is the best option for you then an appointment will be made with our dentist who places implants. This appointment is free of charge and no obligation. At this appointment our implant dentist will discuss in detail the process, how suitable an implant is for you and answer all your questions. At the end if you are interested then we will provide you an estimate of cost and some information to read.

Assessment

After receiving the estimate and reading material, if you think implant is the option for you then we will make another appointment with the implant dentist. At this appointment we will take necessary diagnostic records and may refer you for specialised X-rays to another dental practice.

Implant placement

Following your thorough assessment by the implant dentist, we will book a longer appointment for the implant placement. You should have all the information about this appointment in advance provided by our dedicated implant coordinator.

Review appointments and healing phase

The reviews will normally be with your dentist one week and two months after the implant placement. These appointments are for us to monitor the healing process and make sure you are comfortable. We normally recommend leaving the implant in the jaw bone for at least 3 months before placing the replacement tooth to allow proper integration with the bone.

Exposure of implant

After three months we will make a small cut in the gum under local anaesthesia to check  enough bone has grown around the implant. If there is sufficient bone, we will place a specialised cap on top of implant on this appointment and stich the gums back. This specialised cap
heals the gum and give a shape which enhances the final appearance of the crown and make it look like more natural.

Impression

At this appointment , we remove the healing cap and take an impression of implant inside the bone and surrounding structure. This impression is sent to a qualified dental implant technician for fabrication of the abutment and the  crown.

Crown fit

At this appointment, we remove the healing cap and fix the abutment and crown according to specifics of that particular implant system. We make sure it is accurate, comfortable and fits into your bite

Review

This appointment is to make sure you are still happy with your new tooth!

Teeth whitening can be a very effective way of lightening the natural colour of your teeth without removing any of the tooth surface. There are a number of reasons why you might get your teeth whitened. Everyone is different; just as our hair and skin colour vary, so do our teeth. Our teeth can also become more discoloured as we get older. Our teeth can become stained on the surface by food and drinks such as tea, coffee and red wine. Smoking can also stain teeth.

Your dentist will be able to tell you if you are suitable for whitening treatment. Some causes of discolouration are not suitable for whitening treatment.

At Melksham Dental Practice, we recommend an at-home teeth whitening method. We take impressions of your teeth, and sent them to a dental laboratory to make custom fitting whitening trays (like gum shields). It normally takes about ten days to two weeks for the lab to make these trays. Then we show you how to use whitening gels in your new whitening trays.

The active ingredient in whitening product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, free radicals get into the enamel on the teeth and dislodge with the carbon molecules that make teeth look stained, and the tooth colour is made lighter.

It typically takes 4 to 5 weeks to get your teeth 2 or 3 shades lighter. The effects of whitening are thought to last up to three years. However, this will vary from person to person. The effect is less likely to last as long if you smoke, or eat or drink products that can stain your teeth. Your dentist will be able to suggest ways of keeping your teeth whiter for longer after you have your teeth-whitening treatment done.

Some people may find that their teeth become sensitive to cold during the treatment. Others may have discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing. You may benefit from using a toothpaste for sensitivity during the whitening treatment. Contact your dentist if you have any concerns.

In Europe, whitening can only legally be carried out by a dentist. Teeth whitening by beauticians and in whitening kiosks is illegal. In Europe, it is illegal to supply bleaching material containing more than 0.1% peroxide (or the equivalent in carbamide peroxide) to anyone other than a dentist, or direct to the public. These regulations are to protect the public. They make sure that anyone carrying out whitening is properly trained and has the right skills and knowledge to carry out the procedure without risking permanent damage to the teeth or gums.

There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining. Therefore, they may improve the overall appearance of your teeth. Whitening toothpastes may also help the effect to last, once your teeth have been professionally whitened.

Sometimes teeth become discoloured after root canal treatment. These teeth can be whitening by removing the covering filling on the back of the tooth and applying the whitening product inside the tooth.

Tooth whitening can only lighten your existing tooth colour, it only works on natural teeth. It will not work on any types of ‘false’ teeth such as dentures, crowns, veneers or fillings.

You can help to keep your teeth white by cutting down on the amount of food and drinks you have that can stain teeth. Stopping smoking can also help prevent discolouration and staining.

If you’re interested in Invisalign treatment to straighten your teeth, please discuss with your dentist.

More information coming soon.