What is it?

Teeth are held in the jaws by their roots.Front teeth normally have one root, but teeth further back have more.
At the core of each tooth is a soft massof tissue called the pulp. In a healthy tooth, the pulp contains living fibres, cells, nerves and a blood supply,extending into the root(s) through theroot canal(s). Decay or injury can destroy the living pulp. Because dead pulp lacks a blood supply, it is more prone to infection, leading to an abscess and toothache.
Root canal treatment (also known as root filling or endodontics) means removing damaged or dead pulp and filling the space left.The remaining tooth can then be repaired.

What will my dentist do?

An X‐ray can show the number and shape of the root canals, and also signs of infection in the surrounding bone. Teeth can have a number of roots and some roots are easier to fill than others,because of their shape.
To keep root canals dry during treatment the dentist may stretch a sheet of thin rubber around the tooth, on a frame outside the mouth; this is called 'rubber dam'. Having this filled makes the treatment more comfortable.
You will be given a local anaesthetic , and then an opening is made through the top of the tooth, down into the pulp.
The dentist then uses narrow files to remove the dead pulp from the core of the tooth and from the root canal(s).
At this point, the dentist may put in a temporary filling and possibly also give you antibiotics if any infection has spread beyond the tooth. If so, you will have to return at a later date,once symptoms have settled, so the dentist can complete the treatment.
In the next stage, the dentist fills the root canal(s). A filling is then placed in the remaining cavity in the top of the tooth. Or, if necessary, a crown can be placed on top of the tooth, supported by a post placed inside of the filled root canal.
Root filled teeth can become darker than other teeth, but bleaching can be used to make them look lighter.

What are the benefits?

Pulp damage can cause toothache but the pain will usually end very quickly when the root canal is cleaned out.
Without a root filling, a tooth with a dead pulp would probably have to be taken out in the end. There is also a possibility of infection spreading beyond the tooth itself.
Root‐fillings are usually successful and can last many years, but re‐treatment is also possible if infection recurs. Occasionally, if inflammation persists at the tip of the root, surgery can be carried out to remove part of the root, clean the area and put in a filling. This is known as n 'apicectomy'.

Orthodontic treatment is a way of straightening or moving teeth, to improve the appearance of the teeth and how they work. It can also help to look after the long-term health of your teeth, gums and jaw joints, by spreading the biting pressure over all your teeth.

Why should I have orthodontic treatment?
Many people have crowded or crooked teeth. Orthodontic treatment will straighten the teeth or move them into a better position. This can improve their appearance and the way the teeth bite together, while also making them easier to clean.
Some people have upper front teeth that stick out and look unsightly. These 'prominent' teeth are more likely to be damaged, but orthodontic treatment can move them back into line. Or the way the upper and lower jaws meet can cause teeth to look unsightly and lead to an incorrect bite. Orthodontic treatment may be able to correct both of these problems.
When the teeth don't meet correctly, this can put strain on the muscles of the jaw, causing jaw and joint problems and sometimes headaches. Orthodontic treatment can help you to bite more evenly and reduce the strain.
At what age should I have orthodontic treatment?
The best time is generally during childhood, but adults can have orthodontic treatment too - and more and more are doing so. Age is less important than having the right number of teeth. In children it may be necessary to wait for enough teeth to come through before starting treatment.
Who carries out orthodontics?
Your dentist may carry out orthodontic treatment. Or they may send you to a specialist who has extra qualifications. The specialist may be in a practice or in a hospital department, and is called an orthodontist.
What does it involve?
The most important thing is to have a full examination. This will usually involve looking at your teeth, taking x-rays and making plaster models of your teeth.
Your dental team or orthodontist will then discuss what treatment is possible. Once you are sure you want to go ahead, the treatment can start as soon as you have enough permanent teeth.
Will I need to have teeth taken out to make room?
You may not have enough room for all your permanent teeth. If so, you may need to have some permanent teeth taken out to make space. Your dental team will tell you whether this is the case. Sometimes space can be made using other forms of treatment.
How is treatment carried out?
Orthodontic treatment can be done by many sorts of appliances, which most people call a 'brace'.
What is a removable appliance?
Simple treatment may be carried out with a removable brace (a plate that can be taken out to be cleaned). It has delicate wires and springs attached, which move the teeth using gentle pressure.
What is a functional appliance?
It is sometimes possible to change the way the jaws grow, using a functional brace. This works by using the power of your jaw muscles and can help with certain types of problem.
What is a fixed appliance?
Often, teeth need to be guided more accurately than they can be using a removable brace. So a fixed brace is used. This has brackets and bands which are temporarily stuck to the teeth. A flexible wire joins all the brackets and allows the teeth to be moved. You can't take the appliance out yourself, so it is called a fixed appliance.
What is headgear?
As well as a brace some people need to wear headgear. You usually only need to wear it in the evening or at night. If you do not wear it in the way you have been told, your front teeth may stick out at the end of treatment.
What are the brackets made of?
Fixed braces are not always made of metal. Plastic and ceramic can be used, especially for adults.
What are elastics?
Sometimes delicate elastic bands are attached to a fixed brace to help move the teeth. Your orthodontist will tell you if you need elastics.
What are 'invisible braces'?
They are tough, clear plastic 'aligners' (moulds) that are used to straighten teeth. Several sets of specially moulded, slightly different aligners are made for each patient. Each set is worn for two weeks before being replaced with the next one. They are made from clear plastic, so they are nearly invisible. This means that no one need know you are straightening your teeth.
The aligners should be worn for 22 to 23 hours a day for the best results. They can be easily removed for eating, drinking, brushing, and for cleaning in between your teeth. You need to have all your adult teeth before you can have this treatment.
How long will it take?
The length of treatment depends on how severe the problem is, and it may take anything from a few months to two-and-a-half years. Most people can be treated in one to two years.
What happens when the teeth are in the right position?
When treatment is finished the teeth need to be held in position for a time. This is called the ‘retention' period, and the appliances that hold the teeth in place are called retainers.
The retainers hold newly straightened teeth in position while the surrounding gum and bone settles. The retainers can be removable or fixed, depending on the original problem.
How many visits will it take?
Orthodontic braces usually need adjusting every 4 to 6 weeks. Your orthodontist will tell you how often your brace will need adjusting.
Will it hurt?
All appliances may feel strange at first, and can cause discomfort. If the problem doesn't go away, the orthodontist may be able to carry out adjustments to help. Teeth are usually uncomfortable immediately after a brace has been adjusted, but this will settle.
How successful will it be?
Success depends on both the skills of the orthodontist, and the enthusiasm and helpfulness of the patient (and parents, if the patient is a child). It is important to follow any instructions given by the orthodontist and to go to any appointments you have with them.
The success of the treatment also depends on the commitment of the patient. For children's orthodontic treatment it is very important that the patient is as keen as the parent.
Can orthodontics damage my teeth?
Your teeth can be damaged if you don't look after them properly during treatment. The braces themselves will not cause damage, but poor cleaning and too many sugary foods and drinks can cause permanent damage to your teeth. Brackets, wires and braces can trap food and cause more plaque than usual to build up. So you need to clean your teeth and appliance very thoroughly.
Is orthodontic work permanent?
Even after retention, it is normal for minor tooth movements to happen throughout life. So no permanent guarantee can be given. However, it is unusual for teeth to alter enough to need more treatment.
How do I go about getting orthodontic treatment?
The first thing to do is to visit your own dental team and get their advice. Your dental team will know whether you need treatment and will make the necessary arrangements.
How do I care for my brace and teeth?
It is important to keep having your teeth checked by your dental team while you are having orthodontic treatment. You also need to take extra care of your teeth and mouth:
1. Clean your teeth carefully every day, including between your teeth where you can. Braces are delicate and you need to make sure you clean them carefully so that they do not break. Your dental team will be able to show you the special techniques to use depending on the appliance you are wearing.
2. Cut down on how often you have sugary foods and drinks. Avoid snacks and drinks containing sugars, and fizzy drinks. Also, sticky and hard foods may damage your brace.
3. Brush your teeth last thing at night and at least one other time during the day. Use a mouthwash if you need to. Your dental team may recommend a stronger fluoride toothpaste, or perhaps a fluoride gel or mouthrinse, for you to use.

What are they?

A filling replaces part of a tooth that has been lost because of decay or through accidental damage. You may hear the dentist talk about ‘composite’ ‘glass ionomer’ and ‘compomer’ – these are different types of white filling.

What will my dentist do?

Your dentist will:
Usually numb the area around the tooth with an injection – but some small fillings may not need an anaesthetic;
Remove any decay, together with any old filling material, using a small, high‐speed drill;
Remove any weak part of the tooth which might break later;
Wash and dry the tooth by blowing water and then air onto it (the dentist will be holding something which looks like a water pistol);
Etch the surface to be restored with a mild acid, to help the filling stick better;
Coat the surface that is to be restored with a bonding agent (which acts like cement) and then place the filling material – this is pushed into the cavity that is to be filled and it is shaped as required;
Harden the filling by pointing a bright at it, inside your mouth (you will see the dentist and dental nurse protecting their eyes)—this is called ‘curing’; and
Trim and polish the filling as necessary.

What are the benefits?

Unlike silver (amalgam) fillings, white filling material sticks to teeth and can form edges, so it may be effectively used to repair front teeth that are chipped, broken, decayed or worn. It can also be used as a ‘veneer’ to cover marks or discolouration that cleaning won’t remove.
White fillings are less noticeable than silver fillings, which turn black in the mouth. White fillings come in a range of shades so they can be matched to the colour of your own teeth.
A tooth needs less preparation for a white filling than for a silver filling.
White fillings can sometimes be used in back teeth if there is not too much decay or damage. But white fillings are less durable than silver fillings under the wear and tear of chewing. White fillings are also difficult to place in back teeth, as they need very dry conditions, which can be hard to achieve right at the back of your mouth.

What is it?

Teeth are held in the jaws by their rLike hair and skin, teeth vary in colour. Some are yellower or darker than others,even when they are quite healthy. Teeth tend to get darker as people get older.
Teeth sometimes become darker if their roots have been damaged or diseased and the ‘nerve’ has ‘died’. Tooth colour can be very effectively lightened with Hydrogen Peroxide (bleach), used on either the outside or the inside of the tooth.
Tooth bleaching is completely safe as long as the bleach does not touch your gums and burn them. Dentists use a special jelly bleach.

What will my dentist do?

Where the ‘nerve; of a tooth has ‘died’ (through damage or disease) and the tooth’s root has been filled, bleach is put inside the tooth,under a temporary dressing. The bleaching agent remains in the tooth for about a week before being cleaned out so that a white filling can be place.
There are to ways of bleaching the outside of teeth. One takes place at home and the other in the dentist’s surgery.
Home bleaching works like this:
The dentist will give you weak bleach jelly to use at home in a tray which fits closely round your teeth. The tray makes sure that the jelly does not burn your gums. You will need to put the tray in your mouth for a few hours on several occasions, as instructed by your dentist (probably over a period of weeks).
The dentist will need to use a putty‐like material to make moulds of your mouth (called ‘impressions’), so a dental technician can make the tray to fit. At your next appointment, your dentist will check that the tray fits and show you how to put the bleach in the tray at home.
Bleaching in the surgery works like this:
Your dentist will use a stronger bleach jelly than is used for home bleaching. Dentists use this method to bleach all the teeth at the same time in either your upper or lower jaw. The strong bleach will touch the teeth for less time than with home bleaching.
The dentist might protect your gums. They will paint the bleach onto the teeth and either shine a special light at them or just leave the bleach on the teeth for some time.
The bleach is then washed off with water.
Your dentist will make a note of your tooth colour using model teeth in different shades before they treat you. Look at the colour match yourself before the treatment, so you can compare it with the colour after bleaching. Your teeth may be sensitive to hot and cold food and drink for a few days after bleaching.

What are the benefits?

Bleaching improves the appearance of your teeth without removing any of the natural tooth surface. Bleaching is a betteroption than a crown or veneer if you want to lighten the colour of healthy teeth, as the placing of crowns and veneers involves changing the shape of the tooth.

What are they?

A veneer is a thin layer of tooth‐coloured material that is put onto the front of the tooth to make it look better. This is done because the tooth might have been damaged by decay or an accident, or might be badly discoloured for some reason.

What will my dentist do?

Veneers are usually made out of porcelain by a dental technician.You will have to visit the dentist more than once for this type of veneer.
Your dentist will check any fillings in the teeth first.
A very small amount of natural tooth material needs to be removed – just enough to prevent the veneer making the tooth look or feel bulky. For this reason, it may not be necessary for the dentist to numb the tooth.
Preparation till will depend on how damaged the tooth is and whether it needs to be built up with a filling first.
The dentist will need to use a putty‐like material to make a mould of your mouth (called an ‘impression), so the dental technician can tell the shape and size of veneer to make for you.
Your dentist will glue the veneer made by the technician to the tooth when you next visit.
Veneers sometimes come away from the tooth or break if the tooth is knocked. They can sometimes be glued back on, but will have to be replaced if they are damaged.
Some veneers are built up on the tooth directly using the same material that is used for white fillings. The surface of the tooth is roughened with a mild acid. Then white filling material is applied in layers until the teeth look right.

What are the benefits?

Veneers can greatly improve your appearance. They hide imperfections, and you lose very little natural tooth material.
Veneers also protect teeth from any more damage. Tooth surface can be dissolved away by acid in the mouth (usually from too frequent consumption of certain kinds of food and drink);this can make teeth very sensitive to hot and cold. In this situation, veneers can protect the teeth.
If the tooth is strong, a veneer is often a better option than a crown for improving a tooth’s appearance.

What are they?

Wisdom teeth are the last teeth to appear, at the back of the mouth,from the late teens onwards. Most people have four wisdom teeth, but it is not unusual to have fewer – or even none.
Because they are the last teeth to form, there sometimes isn’t room for them. They come through at an angle, pressing against the teeth in front or the bone behind.

What will my dentist do?

Watching how your teeth and jaws grow is part of your regular dental care. Do tell your dentist if you think there may be a problem.
X‐ray pictures can show where the wisdom teeth are in the jaw and how much room there is for them to come through, as well as showing if they are causing any damage to the teeth in front.
The X‐rays will also show how simple or difficult it may be to take a wisdom tooth out.
As wisdom teeth are coming through, the surrounding gum sometimes becomes inflamed and sore. This is called ‘pericoronitis’. It may settle down or come and go over a period.It is usually better to remove a wisdom tooth if you have repeated bouts of pericoronitis.
If you need to have a wisdom tooth removed, you should be able to fit it in with work or other commitments.
Sometimes, you may be referred to a specialist to have a problem wisdom tooth removed in hospital.
Most wisdom teeth are removed under a local anaesthetic but depending on how difficult the tooth is to remove, sedation (something to make you drowsy) or general anaesthetic (only given in hospital) may be considered.
Depending on your job you may need to take two or three days off work to recover from your wisdom tooth operation. If you have had a general anaesthetic then you will need time off work to recover from the effects of the anaesthetic.
Sometimes, nerves can be damaged when lower wisdom tooth are removed. This leads to numbness in part of the tongue or in some teeth and part of the lower lip and chin‐but this is usually temporary.
What are the benefits of removing wisdom teeth which are causing problems?
If you have your wisdom teeth removed, there will be no more pain and infection.
It will usually make it easier for you to keep your mouth clean.
Normally there is no need to have wisdom teeth removed unless they are causing you problems.

What is it?

A dental implant is a titanium metal rod which is placed into jawbone. It is used to support one or more false teeth. In practice, both the false teeth and their supporting rod are known as ‘implants’.

Are implants safe and how long will they last?
Implants are a well-established, tried-and-tested treatment. Over 95% of modern implants should last for many years with the right care.
I have some of my own teeth. Can I still have implants?
Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.
Can implants always be used to replace missing teeth?
It depends on the condition of the bone in your jaw. Your dentist will arrange for a number of special test to find out the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.
Do implants hurt?
Placing the implants means a small operation. This can be done using a simple local anaesthetic, and sometimes with sedation if you are very nervous. Sometimes the dentist needs to use a general anaesthetic for complex cases. 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.
How long does treatment take?
our dentist will be able to give you a rough timetable before the treatment starts. Usually the permanent teeth are fitted 6 to 9 month after the implants are put in, but many implant systems now allow the time to be as short as 3 months. Some teeth can now even be fitted at the same time as the implants (known as immediate implants) but you should check with your dentist to see whether these are suitable for you.
What about after care?
Your dentist may give you some pain relief after the surgery, or check whether you have them at home to take over the next few days if you need them. Your dentist may also prescribe antibiotics. Don’t smoke, exercise or drive for the rest of the day. Don’t rinse the area and only eat soft foods. However, it is important that you keep your mouth clean by brushing – but do not poke the implant site. You can use a chlorhexidine mouthwash every day during the first week after surgery (you can get these from supermarkets and chemists).
What happens next?
The implants need to bond with the bone after they have been put in. This usually takes at least 3 months in the lower jaw and 6 months in the upper law. Sometimes the implants may be stable enough when they are fitted for the
artificial teeth to be attached much sooner than this.If you are having one, two or three teeth replaced, you may have a temporary denture in the meantime. If you have complete dentures, then you can keep wearing these throughout the healing period once they have been modified after the surgery. A healing cap will usually be placed onto the implant site to protect the area during healing.
Are the teeth difficult to clean?
No. But after care is important if you are going to have a long-lasting, successful implant. Your dentist should give you detailed advice on how to look after your implants. Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that are difficult to reach and you’ll be shown methods to help you. You may need to visit your hygienist more often but your dentist will be able to talk to you about this.
If I had gum disease when I had my own teeth, will I get it with the teeth attached to the implants?
Yes, if you don’t care for them well enough. If you keep them clean, and don’t smoke, then you should not have any problems.
Can I take the teeth out if they are fixed to implants?
Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by bars, then you’ll be able to take them out for cleaning.
Do the implants show?
Your dentist will make sure that the implants won’t show during all normal movements of the mouth and lips. You will need to be able to see them, so that you can clean them properly.
Do I have an implant for each missing tooth?
No, unless you’re only having a single tooth replaced. Normally, five or six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be used.
What if I have an accident?
Implants and the teeth they support can be damaged by an accident in the same way that natural teeth can. It is therefore important that you wear a professionally made mouthguard if you play sports that involve contact or moving objects. If there is damage, the teeth can be dismantled from the implant and replaced. However, if the titanium rod is damaged beyond repair, this part may be safely left in the jaw if it is too difficult to remove. Another implant may be placed alongside it to replace the damaged implant.
What happens if the implant does not bond with the bone?
This happens very rarely. If the implant become loose during the health period or just after, then it is easily removed and healing takes place in the normal way. Once the jaw has healed, another implant can be placed there. Or, the dentist can make a bridge, using the implanted false teeth that have ‘taken’.
Is the treatment expensive?
Unfortunately, yes. However, in many situations, the cost of the treatment is only a little more than the cost of more conventional treatment with crowns and bridges. Over the longer term, implants are usually a more cost-effective and satisfactory option.There are advantages to it, too. An implant to replace a single tooth avoids the need to cut down the teeth either side for crowns to support a bridge. Normal dentures often mean you can’t eat or speak well, due to the dentures moving about. But teeth attached to an implant don’t cause this problem as they are anchored to the bone more firmly than natural teeth.

What is it?

Dentistry is no longer just a case of filling and extracting teeth, as it was for many years. Nowadays many people turn to cosmetic dentistry, or ‘aesthetic dentistry’, as a way of improving their appearance, much as they would use cosmetic surgery or even a new hairstyle. The treatments can be used to straighten, lighten, reshape and repair teeth. Cosmetic treatments include veneers, crowns, bridges and tooth-coloured fillings. Before cosmetic treatment After cosmetic treatment

What is a veneer?
Veneers are thin slices of porcelain. These are precisely made to fit over the visible surface of front teeth, like a false fingernail fits over a nail.
Why might I have a veneer?
Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.
Before veneer
After veneer
Why might I have a veneer?
Veneers are an ideal way of treating discoloured or unsightly teeth, closing gaps between front teeth, or repairing chips and cracks.
Before veneer
After veneer
How are veneers made?
A small amount of enamel is removed from the tooth, usually the same thickness as the veneer will be. An impression is taken by the dentist and sent to a dental technician for the veneer to be made in the laboratory. The veneer is then bonded to the tooth to form a strong and natural-looking repair.
Can I have white fillings?
For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam’. This is considered one of the strongest and longest-lasting materials available for fillings. However, many people find it unattractive and some are concerned about possible health risks.White fillings are now becoming a popular alternative to amalgam fillings. The new dental materials mean it is much easier to find a perfect match for the shade of a particular tooth. In most cases, it is quite impossible to see that the tooth even has a filling. Sometimes white filling material can be used to cover unsightly marks on teeth, in a similar way to veneers.
Composite filling
My tooth is badly broken – what can I do?
When a tooth is badly broken or heavily filled, the dentist may need to crown or ‘cap’ it to restore its appearance and strength.
How does the dentist make a crown?
The usual procedure for fittings a crown involves shaping the tooth under local anesthetic and then taking an impression using a rubber-like material. The impression is then sent to the laboratory along with the details of the shade to be used, and the technician makes the crown.
What happens to my teeth while the crown is being made?
While your crown is being made, the prepared tooth can be protected with a temporary crown. This is easily removed just before fitting the permanent one. In most cases, the temporary crown is in place for approximately two weeks.
Before Crowns
After Crowns
What is a crown made of?
Crowns can be made of a variety of different materials, such as porcelain or porcelain bonded to gold. New materials are continually being introduced. It is a good idea to talk to your dentist about which crown would be best for you.
How can my dentist fill a gap in my mouth?
If a tooth is missing, or needs extracting, there are several ways to fill the gap that is left. In some cases it is important to try to replace any missing teeth in order to balance the way your jaw bites. If you have several missing teeth, the remaining teeth are under more pressure, which can lead to broken fillings or even jaw problems.A partial denture is the simplest way of replacing missing teeth. However, some people find dentures uncomfortable and eventually decided to look at alternatives.
What is a bridge?
Bridges are ideal for people who don’t like dentures or only have one or two teeth missing. Conventional bridges are made by crowning the teeth on either side of the gap and attaching a false tooth in the middle. They are fixed in the same way as crowns. These bridges are usually made of precious metal bonded to porcelain. Sometimes other non-precious metals are used in the base for strength.
What if I don’t want my remaining teeth drilled?
Adhesive bridges are another way of bridging a gap, and less of the tooth needs removing. These bridges are made up of a false tooth with metal ‘wings’ on either side. These wings are made to bond to the teeth on either side, with very little drilling involved. Instead, the teeth are roughened and the bridge is fitted using a very strong composite resin.
Can implants be used to replace missing teeth?
‘Implants’ are an alternative to dentures or bridgework, but they are more expensive. Implants are titanium rods, which are surgically placed into the jawbone and act as anchors for fastening dentures or crowns onto.A complete or partial denture can be attached to a number of implants.
Can I lighten the colour of my teeth?
Tooth whitening can be a highly effective way of lightening the natural colour of your teeth without removing any of the tooth surfaces. It cannot make a complete colour change, but it should lighten the existing shade.
What does tooth whitening involve?
Professional bleaching is the most common form of tooth whitening. Your dentist will apply the whitening product to your teeth, using a specially made tray which fits into your teeth, using a specially made tray which fits into your mouth like a gum-shield. The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the enamel on the teeth and the tooth colour is made lighter.Once your dentist has started this treatment you may be given the trays to take home and continue the treatment, or you may need further appointments at the dentist’s. This treatment can be done within 3 to 4 weeks, depending on how long you keep the trays in your mouth each time, and how much whiter you want your teeth to be.
What other procedures are there?
There is now laser whitening or ‘power whitening’. During this treatment a light or laser is shone on the teeth to activate the chemical. The light speeds up the chemical reaction of the whitening product and the shade change can be achieved more quickly. Laser whitening can make teeth up to five or six shades lighter.This procedure usually takes about one hour. What is an incorrect bite?
This is when the teeth do not fit in the jaw properly, when the teeth are not in the correct relationship with the rest of the face or it teeth are lost and not replaced.
What can happen if it is not treated?
If an incorrect bit is not treated the face can ‘collapse’. This can cause the face to sag, the chin to stick out or the smile to droop. It can even cause headaches, neck pain and other pains in the body.
How can it be treated?
There are a number of treatments, including crowns, bonding and orthodontics (braces). Ask your dentist which treatment is most suitable for you. Ask for an estimate of the cost and a written treatment plan before you start.
Can my crooked or twisted teeth be straightened?
Teeth can be straightened with orthodontics (braces). This is usually done during the teenage years, when the teeth are going through a period of growth. However, many adults also have treatment to straighten their crooked teeth or to improve their appearance. The procedure can take much longer in adults and is therefore more expensive.For cosmetic reasons, clear or plastic braces can be used, which are hardly noticeable. If you are considering orthodontic treatment, first go along to your dentist and get their advice. Your dentist can discuss your treatment options and if necessary refer you to an orthodontist.
Are there any alternatives to orthodontics?
Cosmetic contouring can be used to improve the appearance of teeth. It is ideal if you have irregular shaped or slightly crowded teeth.However, in contouring the teeth a small amount of enamel would be lost. Contouring can also be used to improve the shape and appearance of your gums. These treatments are not recommended for young children.
What is tooth Jewellery?
Tooth jewellery involves sticking small jewels onto the teeth using dental cement. They should be fitted by a dentist, who can easily remove them if necessary. It is important to keep the area around the jewel clean as plaque can easily build up around it and you will be more likely to get tooth decay.

What is it?

Bad breath is usually caused by bacteria in the mouth and is not usually a sign of general ill health.
Gum disease can cause bad breath. But you could still have bad breath with good oral hygiene, and healthy teeth and gums. The smell then usually comes from the far back of the tongue. It gets stronger when you talk, as your mouth gets drier.
Most adults occasionally suffer from bad breath; perhaps a quarter have it regularly. If you are worried about bad breath, please talk to your dentist. Your dentist will:

Work out whether you really have bad‐breath problem; and
Find out what sort of problem it is and help you deal with it.

What will my dentist do?

Make sure, before you see your dentist, that you have not done anything to hide the normal smell of your breath. Do not smoke, chew gum or use a mouth rinse, and avoid any sort of perfume; do not clean your teeth immediately before your appointment.
Your dentist might use a plastic spoon to gently scrape the back of your tongue and test the smell. There are also instruments that measure sulphur compounds in the mouth or swelling around the gums.
Good oral hygiene will usually be the answer to a bad‐breath problem. A scale and polish from your dentist or hygienist makes it easier for you to keep your mouth clean at home.

What can I do myself?

Brush your teeth thoroughly twice a day with a fluoride toothpaste.
Use floss or other oral hygiene aids if your dentist or hygienist recommends them. You can check bad breath by smelling the floss after you have used it. If there is a smell from a particular part of the mouth, clean that area with special care.
Gently brush your tongue if it is heavily coated. Special plastic tongue scrapers can be bought from chemists.
A mouth will smell less if it is moist. Chewing sugar‐free gum can help with bad breath by increasing the flow of saliva. You might have a dry mouth because you breathe with your mouth open or because you are taking certain medicines.
If you smoke, try to give up. As well as making your breath smell better, giving up smoking will keep your mouth and gums healthy,and benefit your general health.

What are they?

A removable denture replaces missing teeth. ‘Partial’ dentures replace a few missing teeth and ‘full’ or ‘complete’ dentures are needed if all the natural teeth are missing.
Complete dentures are best made of acrylic (plastic). Partial dentures can also be made wholly of acrylic. Alternatively, they can consist of acrylic teeth on a light metal alloy base: this type of partial denture is more secure and less bulky, but also more expensive.

What will my dentist do?

The dentist uses a putty‐like material to make moulds of your mouth‐called ‘impressions’. A dental technician uses them to make models for the denture to be built on. Sometimes, second impressions are taken.
The technician makes wax blocks which fit the models. The dentist puts these in your mouth to record the position of your jaws in relation to each other. The dentist then trims and seals the wax blocks to show the technician how your teeth should bite together, and the shape to make the denture.
A trial denture is made and put in your mouth. The dentist will ask you how it fits, feels and looks before they make any final changes.
The trial denture then goes back to the technician who permanently fixes the teeth. The denture is then ready to use.The dentist may want to see you again fairly soon to see how you are getting on with the denture. If there are problems, he/she can make small adjustments.

What are the benefits?

If you have lost some teeth, dentures can improve the way you look, bite, chew and speak.
They are custom‐made to match your mouth and can be made to look as natural as possible.
The teeth that are left are protected from wear and tear.Without dentures, the natural teeth may move or tilt, stopping your teeth biting together properly.
Dentures can be fitted immediately after teeth have been taken out so that nobody will know that you have had a tooth out.These are called ‘immediate’ dentures.
Dentures will never feel like your own teeth and it can take time to get used to them. If you haven’t had a denture before, the dentist will want to explain the difficulties of wearing dentures,as well as the benefits and how you should look after your new dentures and the teeth you have left.

What is it?

Having sensitive teeth can mean anything from getting a mild twinge to having severe discomfort that can continue for several hours.It can also be an early warning sign of more serious dental problems.

Who suffers from sensitive teeth?
Many people suffer from sensitive teeth and it can start at any time. It is more common in people aged between 20 and 40, although it can affect people in their early teens and when they are over 70. Women are more likely to be affected than men.
What causes sensitive teeth?
The part of the tooth we can see is covered by a layer of enamel that protects the softer dentine underneath.
If the dentine is exposed, a tooth can become sensitive. This usually happens where the tooth and the gum meet and the enamel layer is much thinner.Here are some causes of sensitivity.
Toothbrush abrasion – brushing too hard, and brushing from side to side, can cause enamel to be worn away, particularly where the teeth meet the gums. The freshly exposed dentine may then become sensitive.
Dental erosion – this is loss of tooth enamel caused by attacks of acid from acidic food and drinks. If enamel is worn away the dentine underneath is exposed, which may lead to sensitivity.
Gum recession – gums may naturally recede (shrink back), and the roots will become exposed and can be more sensitive. Root surfaces do not have an enamel layer to protect them.
Gum disease – a build-up of plaque or tartar can cause the gum to recede down the tooth and even destroy the bony support of the tooth. Packets can form in the gums around the tooth, making the area difficult to keep clean and the problem worse.
Tooth grinding – this is a habit which involves clenching and grinding the teeth together. This can cause the enamel of the teeth to be worn away, making the teeth sensitive.
Other causes of pain from sensitivity may be:
A cracked tooth or filling – a cracked tooth is one that has become broken. A crack can run from the biting surface of a tooth down towards the root. Extreme temperatures, especially cold, may cause discomfort.
Tooth bleaching – some patients have sensitivity for a short time during or after having their teeth bleached. Discuss this with your dentist before having treatment.
When are teeth more likely to be sensitive?
You are more likely to feel the sensitivity when drinking or eating something cold, from cold air catching your teeth, and sometimes with hot foods or drinks. Some people have sensitivity when they have sweet or acidic food and drink. The pain can come and go, with some times being worse than others.
Is there anything I can do to treat sensitive teeth at home?
There are many brands of toothpaste on the market made to help ease the pain of sensitive teeth. The toothpaste should be used twice a day to brush your teeth. It can also be rubbed onto the sensitive areas.These toothpastes can take anything from a few days to several weeks to take effect. Your dentist should be able to advise you on which type of toothpaste would be best for you.
Is there anything I should avoid if I have sensitive teeth?
You may find that hot, cold, sweet or acidic drinks, or foods like ice cream can bring on sensitivity, so you may want to avoid these. If you have sensitivity when brushing your teeth with cold water from the tap, you may need to use warm water instead. It is important you do not avoid brushing your teeth regularly as this could make the problem worse.
Do I need to go and see my dentist?
Yes, if you have tried treating your sensitive teeth for a few weeks and have had no improvement.
What treatments can the dentist offer?
During an examination the dentist will talk to you about your symptoms. They will look at your teeth to find out what is causing the sensitivity and to find the best way of treating it.The dentist may treat the affected teeth with special de-sensitising products to help relieve the symptoms.Fluoride gels, rinses or varnishes can be applied to sensitive teeth. These can be painted onto the teeth at regular appointments one or two weeks apart, to build up some protection. Sensitivity can take some time to settle, and you may need to have several appointments.If this still does not help, your dentist may seal or fill around the neck of the tooth, where the tooth and gum meet, to cover exposed dentine.In very serious cases it may be necessary to root-fill the tooth.
How can I prevent sensitive teeth?
Brush your teeth twice a day for two minutes with fluoride toothpaste. Use small circular movements with a soft-to medium-bristled brush. Try to avoid brushing your teeth from side to side.Change your toothbrush every two or three months, or sooner if it becomes worn.Have sugary foods, and fizzy and acidic drinks less often. Try to have them only at mealtimes.If you grind your teeth, talk to your dentist about the possibility of having a mouthguard made to wear at night.If you are thinking about having your teeth bleached, discuss sensitivity with your dentist before starting treatment.Visit your dentist regularly, as often as they recommend.