Balbriggan Dental Care

Our Dental Treatments

TYPES OF FILLINGS

Tooth-Coloured Composite Fillings:

• Bond to tooth structure, thus can also be used to repair chipped, broken or worn teeth.
• Wear out sooner than amalgams (lasts on average 5 to 8 years,compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgams under the pressure of chewing and particularly if used as the filling material for large cavities.
• More expensive.

Amalgam Fillings:

• Silver coloured fillings don’t match the colour of you natural teeth.
• Last on average 10 to 15 years and usually outlast white fillings.
• Strength – can withstand chewing forces. This kind of filling is normally used on the back ‘chewing’ teeth.

Are there any risks from amalgam fillings?
Mercury in dental amalgam is harmless as it is combined with silver and tin in the amalgam filling. Research into the safety of dental amalgam has been carried out for over 100 years. No reputable controlled studies have found a connection between amalgam fillings and any medical problem.

Crowns: If a tooth is broken, weakened by decay, or has a large filling, a crown covering the whole tooth would be a stronger alternative. They can be made of porcelain so they can look just as good as a natural tooth.

WHY REPLACE A FILLING?
Fillings don’t last forever. When you chew, your teeth and any fillings in them are subjected to tremendous pressures. Even if no other problems develop, some fillings will wear out over time and will need to be replaced. Fillings that are cracked or leaking can decay underneath them. Decay under a filling can become extensive before you notice it or it causes you pain. This can be prevented by having your fillings checked regularly and getting them replaced when problems are found.

 

GUM DISEASE

• Infection that affects the gums and bone supporting the teeth.
• It begins when the bacteria in plaque builds up on your teeth causing the gums to become inflamed.
• With time, plaque can spread and grow below the gum line. The tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.
• Eventually, teeth can become loose and may have to be removed.
  

SYMPTOMS OF GUM DISEASE

• You may not know as it is often not painful & no symptoms.
• Bleeding from the gums when you brush your teeth.
• Red and swollen gums
• Bad breath/ metallic taste.
• Sensitivity to hot and cold and when getting cleaned by the dentist (due to gums receding leaving the sensitive roots exposed
• Eventually your teeth can become wobbl
• You may get gum abscesses (pus collecting under the gum).
  

HOW IS GUM DISEASE TREATED?

• Deep Cleaning: If you have gum disease, you need more extensive scaling to remove plaque and tartar from the pockets that have formed. Usually takes 4 visits, doesn’t hurt as one corner of your mouth is numbed and cleaned at a time.
• It’s Your Choice: if you want to treat your gum disease, make an appointment for deep cleaning.

Costs €90 per ¼ of your mouth
(usually €150 per visit in most other dental surgeries).

Up to 20% of the cost can be claimed back from the taxman. We will even complete the necessary forms for you!

If you chose to, or not to get deep cleaning done, either way please follow the following advice:

 

PREVENTING GUM DISEASE

Gum disease is totally preventable. Preventing gum disease (from starting or returning after deep cleaning) involves controlling the amount of plaque and tartar that builds up on your teeth.

• Twice yearly Scale and Polish with the dentist or hygienist (free with Medical card or PRSI, we will send you a reminder). Proper cleaning prevents the gums receding. We try to be as gentle as possible but it can sometimes be sensitive getting your teeth cleaned thoroughly (especially if the gums have started to recede leaving sensitive roots exposed). You can ask to be ‘numbed’ with local anaesthetic if they are very sensitive.
• Daily Flossing
• Brushing and Listerine mouthwash.
• Give up smoking

 

FRESH BREATH TREATMENT

What causes badbreadth (Hallitosis)?

• 96% both cases of Hallitosis are caused by a build up of bad bactera on your teeth, gums and tongue
• 3% have a gastrointestinal cause
• 1% have a respiratory cause

Diagnosing the cause

• X-rays
• Oral examination
• Diet analysis: if necessary liaison with our medical colleagues to investigate potential other causes
  

Treatments
Essentially involvse the removal of the bad bacteria from your mouth through a series of cleanings. The prevention of their return by using a special brushes/mouthwashes etc. The main thing to remember is that bad breath is a common problem. It is easily treated andt easily prevented from coming back. So don't be embarrassed, it is never to make to go to the dentist.

 

CROWN TREATMENT

What is a Crown/Cap?
A crown is an artificial restoration that fits over the remaining part of the prepared tooth, making it strong and giving it the shape and colour of a natural tooth.

Why would I need to crown a tooth?

• To improve the appearance: e.g. of discoloured or crooked teeth.
• To increase strength and prolong life of tooth: The tooth may be broken or weakened by decay and a large filling would not stay in.
• To help hold a bridge in: (a bridge replaces missing teeth, and is fixed in place by being attached to one or more crowned teeth beside it)

How is the crown prepared?
Local anaesthetic is given making the procedure painless.

• Stage 1: The dentist will gently remove most of the outer surface of the tooth, leaving a strong inner core (20 mins. approx). This outer surface will be replaced by a new stronger outer surface, i.e. the crown.
• Stage 2: The dentist will take impressions (moulds) of the prepared tooth and of the opposing jaw (takes 20 mins).
• Stage 3: A temporary crown will be made while you wait 2-3 weeks for the crown to be made. We only temporarily glue it in. Sometimes they can come off, so just drop in and we’ll glue it back in.
• Stage 4: 2-3 weeks later you will have a shorter appointment where the crown is permanently cemented.

Up to 20% of the cost can be claimed back from the taxman. We will even complete the necessary forms for you!

VENEERS

What is a Veneer?
It is a thin layer of porcelain made to fit over the front surface of a tooth, like a false fingernail fits over a nail.

What are the advantages of dental veneers?

• Veneers can improve the colour, shape and position of your teeth.
• The colour of a porcelain veneer can be selected such that it makes dark teeth appear whiter.
• A veneer can make a chipped tooth look intact again
• Veneers can also be used to close gaps. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others
• Porcelain veneers are stain resistant. Gum tissue tolerates porcelain well.
• Very thin and are held in place by a special strong bond (rather like super-glue), thus very little tooth removal is needed.

How are teeth prepared for a veneer?
Local anaesthetic often is given making the procedure painless.

• Stage 1: Some of the shiny outer enamel surface of the tooth may be removed. The amount of enamel removed is tiny and will be the same as the thickness of the veneer to be fitted, so that the tooth stays the same size.
• Stage 2: The dentist will take impressions (moulds) of the prepared tooth and of the opposing jaw.
• Stage 3: Although it is not necessary to protect the tooth, for cosmetic reasons a temporary veneer can be made while you wait about a week for the permanent veneers to be made.
  

How is the veneer fitted?

• Stage 4: Bonding a veneer in place is done with a special adhesive, which holds it firmly on the tooth.

Will the veneer match my other teeth?
Yes, the shade of the neighbouring teeth is picked from a range of shades by the patient (helped by the dentist and the nurse) to make sure the colour looks natural and matches the surrounding teeth (or a whiter shade can be selected). We will try the veneer in for you to see before permanently cementing. We will get you to sign off that you are 100% happy for us to permanently cement it in (bring a friend if you like). Adjustments can be made to the veneer after it is fitted. It is usually best to wait a little while to get used to it before any changes are made.

How long will a veneer last?
Veneers should last for many years; but they can chip or break, just as your own teeth can. Small chips can be repaired, or a new veneer fitted if necessary. We will repair/replace a veneer free of charge in the unlikely event it fractures within 3 years of being made. Though not likely, veneers can dislodge and fall off. To minimize the chance of this occurring, do not bite your nails; chew on pencils, ice, or other hard objects; or otherwise put pressure on your teeth. You should also avoid sugary snacks, floss daily, and brush with a soft toothbrush. You must also agree to attend for six-monthly check-ups.

What are the other treatment options to porcelain veneers?

• White Fillings: Covering part, or, all of the visible surface of the tooth. Unfortunately they don’t look as well, plaque and stains build up easily, and are not as strong.
• Crowns: If a tooth is broken, weakened by decay, or has a large filling, a crown covering the whole tooth would be a stronger alternative. They can be made of porcelain so they can look just as good as a veneer.
• Whitening: Usually very effective for discoloured teeth. Often, whole smile is whitened before placing veneers on a few front teeth. (only 250 euro, normally 500 euro)
• Orthodontics to close gaps: Very good results, but typically takes 2 years and is expensive.
• Do nothing.

Up to 20% of the cost can be claimed back from the taxman. We will even complete the necessary forms for you!

 

REPLACING TEETH

WHAT ARE THE OPTIONS FOR REPLACING MISSING TEETH?

1. An implant

An artificial root onto which crown is attached. A titanium implant is placed in the jawbone by a specialist implant dentist. It is used to support one or more false teeth placed by your local dentist. Ideal option.

• No need to trim down adjacent teeth.
• Typically lasts a lifetime. Implants are a well-established, tried-and-tested treatment. 95 per cent of modern implants should last for many years with the right care.
• You can have any number of teeth replaced with implants – from one single tooth to a complete set.
• Five or six implants can replace all the teeth in one jaw, as each implant can usually support two teeth.
• Placing the implants can be done using a simple local anaesthetic, and sometimes with sedation if you are very nervous. You will not feel any pain at the time, but you may feel some discomfort during the week after the surgery. This is usually due to having stitches, and the normal healing process.
• If you have dentures, then these can be worn throughout the healing period.
• Have to wait 3-6 months for implant to knit in with bone before crown is attached.
• Most artificial teeth attached to implants can only be placed and removed by the dentist.
• Loose full dentures can be held in tightly by 2 to 4 implants in the jaw, and you’ll be able to take them out for cleaning
• We are the best value in Ireland (less than Belfast), €2000 for 1 implant including crown (usually over €4,000). Also, up to 20% of the cost can be claimed back from the taxman. We will fill out the tax form for you.

2. Removable Partial Denture

2a.Valplast Flexible Denture (Highly Recommended)

• Non-metal, thus gum coloured clasps much less noticeable than metal clasps/ frameworks on other dentures.
  
• More comfortable, thinner, smaller. lighter to wear and much stronger than the all-plastic variety.
• They are more expensive than the plastic dentures (normally €1,000)

2b. Metal Partial Dentures
(Chrome-Cobalt/Palate-free dentures)

• Much stronger, less likely to break, thinner, smaller and lighter to wear than the all-plastic variety.
• Although the base is metal, they have gum-coloured plastic and natural-looking teeth fixed to them.
• Since they sit on the teeth, as well as being attached to them, they are extremely stable and hold in tighter.
• They are more expensive than the plastic dentures (up to €800).

2c. Acrylic Partial Dentures (plastic dentures)

• Breaks easily, thus the acrylic is usually built fairly thick which can take some “getting used to”.
• Less stable and usually don’t hold in as tight as metal dentures.
  
• Intended only as a temporary denture which is placed straight after an extraction. However, bone and gums shrink over time, especially during the first six months after your teeth have been taken out. Thus, your dentures become progressively more lose, thus may need relining (to tighten), adjusting or even replacing. The longer you wait after an extraction, before making the denture the better the fit, but
  healing may take several months.
• If some of the existing natural teeth are extracted for any reason, new false teeth can be added quickly to the denture.
• Less expensive (approx. €120 on PRSI)

3. A Bridge

An artificial tooth (crown) is fixed in place by being attached to one or more teeth beside it.

• Can last many years if taken care of.
• In many people it can take up to 6 months for the gums to heal properly after an extraction. This means that you may need to have a temporary denture (or less commonly a temporary bridge) for a few months before the bridge is fitted.

A.Traditional Bridge - An artificial tooth (crown) is fixed in place by being attached to one or more crowned teeth beside it. Need to trim down at least one adjacent tooth. Sometimes, the crowned adjacent tooth can become infected. Root canal treatment is very successful and removes the infection over 90% of the time.

B. Resin Bonded Bridge (also known as a “Maryland” bridge) - this type of bridge involves the artificial tooth being fused to metal bands, and glued to the back of the adjacent teeth with a resin cement.

• Commonly used when the teeth missing are in the front of the mouth.
• Conservative: involves only minor reshaping of the enamel of the adjacent teeth.
• Sometimes less stable than a traditional bridge and can fall out occasionally .

 

ROOT CANAL TREATMENT

What is a root canal?
It is the blood and nerve supply, which runs along the centre of the tooth down to the tip of the root (also known as pulp).

What is root canal treatment?
Decay or a blow to a tooth can lead to infection of the root canal of a tooth. The cleaning and filling of an infected root canal is root canal treatment.

What happens if I don’t root canal treat a tooth?
If the tooth is infected the infection usually spreads resulting in a potentially dangerous swelling and loss of the tooth.

Does it hurt?
No. A local anaesthetic is used and it should feel no different to having an ordinary filling done. Sometimes it can be sore afterwards because of infection but antibiotics usually resolve this problem.

Can I claim for any of the cost?
Yes, up to 20% of the cost can be claimed back from the taxman. We will fill out the tax form for you at the end of treatment.

Will I need a crown afterwards?
It depends on how weak the tooth is. We generally advise that back teeth be crowned after root canal treatment. If you don’t crown a root canal treated back tooth, it has a 50% chance of breaking within 3 years.

What will my tooth look like after treatment?
In the past, a root filled tooth would often darken after treatment. However, with modern techniques, this does not usually happen. If there is any discolouration the tooth can be whitened, or crowned.

How successful is root canal treatment?
Very successful, the infection subsides 9 times out of 10. In 1 in 10 cases the root canal treatment has to be repeated or the tooth extracted.

WHAT DOES THE PROCEDURE INVOLVE?
Root canal treatment is a skilled and time-consuming procedure that take place over two visits.

First Visit: Small hole drilled into tooth and root cleaned out with tiny instruments called files. Temporary filling placed (don’t worry if this chips/falls out).

Second Visit: Tooth filled to tip of root with a rubber stopper (like plugging a sink) Rarely one of the thin files can break in the canal and be left to plug the root along with the rubber filling.