Dental crowns, also referred to as “dental or tooth caps,” envelop the visible section of the tooth that lies above the gum line, and may even be extended slightly below the gum line, depending on the extent of the dental decay and/or support required by the affected tooth. A London-based dentist might recommend inserting a dental crown using numerous rationale, however the majority of these typically include the following; restoration of a tooth to its unique form and function, and for aesthetic reasons.
Dental crowns become the new external tooth shell, and are made-up of many types of materials including; all porcelain (a type of ceramic), metal (gold or other metal alloy), or a combination of both (i.e., porcelain fused to gold/metal, with the gold/metal being the undersurface of the crown and the porcelain being baked onto the gold/metal and shaped to replicate the tooth).
A broken-down, extremely worn, or extremely decayed tooth, generally require a full crown to properly restore the tooth. Local anesthesia is used when the dentist prepares a tooth for a crown. The remaining tooth enamel and some of the dentin layer (i.e., second layer) of the tooth is prepared using a variety of diamond drills, with the walls of the tooth kept in a parallel orientation to help with the crown retention. When an adequate amount of tooth structure is removed and the dentist is pleased with the preparation, gingival cord is packed around the tooth so that an impression can be made of what is left of the tooth. The dentist then sends this impression, an opposing impression, and bite registration to the lab, so that they can fabricate a dental crown. The dentist writes the instructions on a laboratory prescription so that the laboratory knows exactly what the dentist needs and also the proper shade of the tooth. The finished product is sent back to the dentist, and the dentist then cements the crown in place, and adjusts your bite properly. There are many other methods to improve your dental aesthetics, and these should be presented to you by your dentist before you decide that you want your front teeth prepared into peg-like structures for cosmetic reasons.

In London, your dentist will properly care for your dental needs to prevent calculus from forming on your teeth. Some dental plaques mature into dental calculus. Some people do not form calculus, others form only moderate amounts, and still others form heavy amounts. Before supragingival plaque (above the gums) mineralizes to form dental calculus, you can remove it with proper oral hygiene. As the plaque matures, it becomes more resistant to removal with a toothbrush, and significantly more pressure is required for its removal. Once dental calculus is formed, your London dentist, using professional instrumentation needs to remove it; you can no longer remove it.Calculus itself is not harmful; however calculus needs to be removed because its presence makes routine oral hygiene more difficult or even impossible and it may contribute to greater plaque accumulation and stagnation. Calculus formation is related to the fact that saliva is saturated with calcium and phosphate ions as well as other ions, such as magnesium, zinc, fluoride, and carbonate. Supragingival calculus that forms on the tooth crown frequently developing opposite the duct orifices (openings) of the major salivary glands and is often found where saliva pools on the lingual surfaces of the mandibular incisors. It can also form in the grooves of the tooth (called fissures). Subgingival calculus forms from calcium phosphate and organic materials derived from blood serum which contributes to its mineralization, and may be darker in appearance.

Local factors, behavioral and systemic conditions affect calculus formation. Conversely, medications such as beta-blockers, diuretics, and anticholinergics can result in significant reduced levels of calculus. The medications are either excreted directly into the saliva affecting the rate of crystallization, or they alter the composition of the saliva, and as a result indirectly affected calculus formation.

Teeth problems have been associated with TMJ dysfunction. These problems can be treated in the London Dental Clinic. Loose and mobile teeth are usually due to resorption or damage of the surrounding oral bone by excessive lateral influences on the teeth. Tooth movement may cause the jaw to close down or bite in a misaligned position, thus changing the configuration of the mouth, teeth, temporomandibular joints, and jaw and facial muscles. Dental pulp inflammation can also occur if the forces are too great.
Outside causes put excessive stress on the TMJ. Some of the causes are: (1) Opening the mouth and jaw further than it normally should open, and habitual and recurring lateral and forward movements of the lower jaw; (2) alteration of the biting surfaces of the teeth due to excessive wear, neglecting oral hygiene (i.e., dental cavity formation), or tooth damage; (3) inadvertent speaking patterns; (4) too much gum chewing or chewing of finger nails; (5) too much lower jaw activities when exercising and/or teeth grinding; and (6) over-stretching of the mouth when eating. Also, several investigations have shown an association between TMJ disorder and people with a diagnosis of bipolar disorder.
Proper occlusion must be restored if the teeth are decayed or damaged. Some medications may relieve the primary pain; however these medications may not work in all cases. Several tricyclic antidepressants have been shown to work better than pain medication in some cases. Prior to using drugs or surgery to help alleviate the pain associated with TMJ dysfunction and correct the problem, you and your London dentist should try every other conservative approach to resolve the problem.

If you are experiencing temporomandibular joint dysfunction syndrome (TMJD), you can get help at the London Dental Clinic. The temporomandibular joint (TMJ) is associated with a number of conditions known as TMJD(s), and refers to a complicated and misunderstood group of conditions that involve pain in the TMJ area, its related muscles, and ear. One or both TMJ(s) may be involved in this problem. TMJDs interfere with someone’s capability to eat, chew, swallow, make facial expressions, speak and even breathe easily. Patients that have been told that they have TMJD(s) can possibly have additional medical symptoms and muscle, back, and postural problems that can go unnoticed. TMJDs are usually diagnosed by your general dentist, and in several cases, a periodontist or oral surgeon.
When you visit your London dentist, you will be given a complete dental examination. If you seem to be having a TMJD problem, your dentist will continue to collect additional data, such as performing a cranio-mandibular and postural examination. The dentist may press on certain muscle groups and determine if trigger points and so-called “hot spots” are present. These are signs of spasms and the muscles being over-contracted or overstretched. Impressions will also be taken of your mouth and stone study models will be poured and mounted on a dental articulator. The models, which are a representation of your mouth, will be thoroughly examined. You will also be asked numerous questions about your frequency of headache, or ringing in your ears, etc. After all of the data is collected, your dentist will recommend a course of treatment. Your dentist most likely will suggest a type of orthopaedic appliance to be worn at all times. This clear acrylic appliance is custom-designed for your specific needs, and will act as both a diagnostic aid and a conservative treatment appliance. The appliance should be fabricated as to allow your lower jaw to function in a relaxed, non-stressed position in relation to your upper teeth and the base of your skull. It will also give your TMJ(s) the ability to relax. For further information about TMJ and TMJDs, contact your London dentist!

Tooth sensitivity is tooth pain that can be caused by the following sensations on your tooth or teeth, these are; excessive heat, cold, sweets or sour foods and drinks. Even breathing cold air or touching your tooth or teeth in the wrong area, may produce this sensitivity. The ache felt in the tooth may be sharp and abrupt, and penetrate deep into your tooth’s nerve endings. The causes of tooth sensitivity and its treatment can both be explained to you, and treated, in our  London Clinic.
The causes of tooth sensitivity happens when the tooth’s dentin layer is exposed due to receding gum tissues, or when the tooth is not properly covered all the way around by enamel on the crown portion of the tooth, and cementum on the root portion of the tooth. When this occurs, exposed minute dentinal tubules, which make up the dentin layer of the tooth, are exposed to the environment. These dentinal tubules communicate with the pulp of the tooth. The pulp contains nerves, a blood supply, and other tissues. When exposed, these dentinal tubules (or channels) allow the external stimulus to create a situation where the nerve cells endings are triggered, leading to pain.
There are many reasons why people have tooth sensitivity. These include, but are not limited to: using a hard bristle brush and being overzealous with your brushing, thus wearing down enamel over time; gum recession; gum disease; cracked, chipped, or decayed teeth; teeth grinding; overuse of whitening products, abrasive toothpastes, plaque accumulation (as end-products of bacteria are acidic), several over-the-counter mouthwashes that are acidic, and acidic drinks and foods. Also, individuals between the ages of 25-30 years olds are at increased risk of tooth sensitivity. Regular dental therapies may also leave your tooth or teeth sensitivity however this is usually a temporary situation.
There are several things that you can do to reduce or eliminate tooth sensitivity. These include but are not limited to: maintaining good oral hygiene; using a soft- bristled toothbrush; using fluoride-based toothpastes for sensitive teeth (e.g., smear it on your tooth with your finger and let it penetrate for a few minutes and then brush); pay attention to what you eat and drink; try to avoid grinding your teeth, use fluoridated dental products, and visit your dentist regularly. If you cannot manage tooth sensitivity by yourself using the above methods, speak with your dentist. Your dentist may recommend the placement of tooth bonding materials, fluoride based polishes or dentin sealers.

Porcelain veneers are being widely used by London-based dentists and have been available for many years throughout the world. Teeth that are uneven, discoloured, worn and/or damaged may be corrected with the use of porcelain veneers. Porcelain veneers, also referred to as dental veneers and laminates, are thin porcelain coverings fabricated distinctively for each individual patient and tooth. They provide an excellent cosmetic result in the properly chosen situation. Porcelain veneer technique(s) involve minimal preparation of the tooth enamel (the outer shell of the tooth), and at times the dentin (substructure of the tooth that can be sensitive to tooth preparation). This depends on the misalignment of the teeth, and the result sought by both you and your dentist.
The porcelain veneer procedure usually takes two dental visits. During your first visit, a smile analysis is performed either by using a camera or a cast of your mouth, or both. The result that can be obtained is usually shown to you via computer or by wax being placed on the stone model of your teeth. Any changes to colour, form and function of your teeth should be discussed with your dentist at this time. Once you and your dentist have agreed on the result that can be obtained, your anterior (i.e., front) dentition (i.e., teeth) are prepared using a diamond bur with local anaesthesia or no anaesthesia. This will depend on the amount of tooth structure that needs to be removed for the desired result.
Temporary acrylic or composite shells are fabricated by your dentist or his in-house laboratory to prevent tooth sensitively and the inadvertent shift of your teeth until the delivery visit. Impressions are taken of your mouth, and the stone models are sent to a laboratory that specializes in porcelain veneer fabrication. Upon return for your insertion visit, the porcelain veneers are bonded in place on your teeth utilizing the special materials to firmly affix the thin porcelain shell to each tooth. Porcelain veneers are inherently delicate; however, when securely bonded to the well-built tooth substructure they become both physically strong and long-lasting.
The greatest advantage of veneers above other aesthetic former brands are that porcelain veneers created to copy and achieve an extremely realistic look, and depending upon the artistic nature of the laboratory that fabricates the porcelain veneers and the artistry of the dentist placing the veneers, stunning results can be achieved. The best results are to both imitate the natural translucency of the tooth enamel and to also achieve the colour changes that are expected by the patient using opaque bonding materials and additional intrinsic colouring if required. Since Londoner’s generally have darker teeth, this intrinsic staining and use of opaque bonding materials should be carefully evaluated. After being placed and bonded, the porcelain veneers should very closely resemble the outer look of tooth enamel. A great advantage of porcelain veneers over composite bonding materials are their resistance to staining and discolouration.

London dentists advise that several herbal remedies help with oral care. Tea Tree Oil (melaleuca alternifolia), bloodroot, and propolis extract will be discussed. Tea tree oil (melaleuca alternifolia) has been found to have antiseptic, fungicide and bactericide effects. Its efficiency against oral bacteria has been reported, and it has also been found to be effective in treating thrush and herpes in the oral cavity. Mouth rinses containing essential oils have been shown to significantly reduce both gingival inflammation and gingival bleeding when compared to fluoride containing toothpastes. Sanquinaria extract is a mixture of benzophenanthridine alkaloids derived from Sanguinaria Canadensis L. (bloodroot). When Mexican Sanguinaria extract (1 mg/ml) was used twice daily as an oral rinse for 2 weeks, without allowing any toothbrushing, the results demonstrated that Mexican Sanguinaria extract significantly reduced gingivitis, and concluded that Mexican Sanquinaria extract in oral rinse can be used as an adjunct in gum disease therapy. Other extensive clinical trials using oral rinses and toothpaste products containing Sanguinaria extract have shown its effectiveness in reducing plaque build-up and gingivitis. Other studies using a combination of sanquinaria extract and zinc chloride also showed excellent results. It has been suggested that the zinc ion may provide a mild enhancement of sanguinaria effectiveness against gingivitis. A 20% ethanol Propolis extract was compared to antifungal agents such as nystatin, clotrimazole, econazole, and fluconazole in a study designed to assess the susceptibility of Candida albicans (which causes thrush). Propolis extract was as effective as nystatin in reducing C. albicans, and was significantly more effective than the other antifungal agents used in this study. Full denture patients that used a propolis extract also showed a decrease in C. albicans. These three herbal remedies have been shown to be effective in helping several oral diseases.

In London, the standard of care for the treatment of gingivitis and periodontal disease includes: 1) removal of bacteria (i.e., the source of inflammation) by mechanical cleaning; 2) providing and training patients to maintain optimal oral hygiene; 3) dietary evaluation and nutritional counseling and/or supplementation; 4) maintenance and optimization of host immune defenses; and 5) the use of the best available oral health care products.
Although patients with advanced periodontal disease can be effectively treated in London, it is certainly more desirable to take precautions early on, before the damage is done. Patient motivation and compliance are major obstacles to an effective preventive program, which can be dramatically improved when high risk patients are informed about their condition. Likewise, the dental professional needs to know when to proceed more aggressively with therapy, and which patients can benefit from considering future risk or benefits in making or not making this recommendation.
Significant periodontal research has provided evidence that chronic periodontitis is treatable. However, once periodontal tissue is lost, complete restoration of these tissues are limited, and are dependent upon the specific circumstances. The majority of periodontal treatments are aimed at arresting the progression of the disease in an attempt to prevent tooth loss; it has also been shown that the majority of individuals that have sought periodontal treatment significantly reduce their risk of tooth loss. However, there are those cases of periodontitis, even if adequately treated, still continue to progress and have poor prognoses. Why do some patients have excellent outcomes, while others do not? This answer may be found in the host response to the disease, as well as the individual’s nutritional status.

London dentists say that “dental caries can be prevented by good oral hygiene and regular professional care, and can be effectively treated by adequate brushing and flossing of the teeth and by the use of fluoride based oral care products.” Mouth rinses, gels, and toothpastes, when used in conjunction with toothbrushing and flossing, are probably adequate to deliver the needed preventive measures. If the carious lesion reaches the underlying dentin layer of the tooth the dentist in London will treat it. The dentist will place a filling (amalgam or composite) to restore proper functioning of the tooth.
The role of fluoride in caries prevention has been extensively documented. The decrease in dental caries that occurs after adding fluoride to the water supply is by and large accredited to the fluoride molecule being substituted for hydroxyl molecules in the tooth enamel, forming fluorapatite in the place of hydroxyapatite. Fluorapatite is less acid soluble than hydroxyapatite, causing enamel to demineralise more slowly when under attack by plaque. Fluoride containing enamel also remineralises more quickly between the times it is being bombarded with sugar. This does not explain all of the mechanisms of action of fluoride.
More recently the spotlight has shifted to deleterious effect on fluoride on tooth development. The prevalence of fluorosis in infants and young children is increasing. The increase in fluorosis among infants and children in both fluoridated and non-fluoridate communities has led to the following recommendations: 1) the use of low-fluoride water in infant formulas; 2) adult supervision of children during brushing; and 3) rigid fluoride application standards when administering fluoride supplements to children. Nonetheless, community water supply fluoridation is the most effective way to prevent dental caries.
When neutral 1.0% sodium fluoride was used on a daily basis by high risk adults (i.e., those with mouth dryness after jaw carcinoma radiation), the finding was minimal to zero dental caries. Children, aged five to six years were treated with 1.2% F- fluoride gel versus a placebo gel twice daily, and the children receiving fluoride showed approximately 40% caries reduction when compared to the placebo group after a 2 year period; S mutans (the bacteria that causes decay) were also lower. Thorough cleaning with the fluoride paste significantly reduced the streptococci (sanguis, mitis, and mutans), preventing colonization of these bacteria. Higher fluoride paste doses (i.e., 5%) instantly stop these bacteria. Also interesting, is that fluoride levels of 1-5 ppm stopped oral streptococci at low pH levels. These doses are commonly found in people using fluoridated oral care products and/or fluoridated water. For more in depth prevention measures, visit your London dentist!

Dental implants are among the most successful procedures used to replace missing teeth. Studies have shown a greater than 90% five-year success rate. Even though there are a number of other restorative options available for the treatment of missing teeth, dental implants in London have proven to be functionally effective and durable. In countless cases, dental implants may be the choice for the restoration of all required functioning of the teeth and their supporting structures. Dental implants are more natural looking, and stronger and more durable than their restorative counterparts (bridges, removable partial and full dentures) and offer a more permanent solution to tooth loss. Implants can be used for single tooth or multiple teeth replacement(s), and can also be used to stabilize partial or full dentures. Your dentist will decide which type and how many dental implants are required to obtain the optimal result.Any dentist trained in the placement of implants can perform this procedure; however the patient may be referred to a dental specialist. A dental team approach usually provides the patient with the best results. Successful implants require that all parties involved; the patient, and the dental team, outline and follow a careful plan of treatment and stay in close contact with each other to make sure the patient’s expectations are met.
Dental implants are mostly composed of a titanium material screw and a crown. A small-diameter hole (pilot hole) is drilled where the implant is to be placed to effectively guide the titanium screw that holds a dental implant in place. To avoid damaging vital jaw and face structures, the dentist must use great skill and expertise when boring the pilot hole and sizing the jaw bone. For best results the dentist usually performs a comprehensive oral examination, X-rays and even a CT-Scan (a three-dimensional jaw scan), to ensure ideal dental implant placement.
Implants are typically placed in a single sitting but require a period of osteointegration; a process by which the jaw bone attached to the implant. Osteointegrated implants are the most universally used and successful dental implants. These implants take anywhere from three to six months to anchor and heal. Once significant osteointegration occurs, the restorative procedure can be completed. In contrast, if osteointegration does not occur, the implant will fail. Dental implants must also be cleaned regularly, as peri-implantitis (oral bone loss) can occur around them causing them to fail. On the plus side, dental implants are not susceptible to the formation of cavities.