Dental FAQs
CROWNS
Q: What is a crown?
A: A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem. If a tooth is cracked a crown holds the tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
Q: How does the dentist make a crown?
A: The tooth is shaped so the crown can fit over it. An impression of the teeth and gums are made and sent off to the laboratory to be custom made. A temporary crown is fitted over the tooth until the permanent crown in made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.
Q: I have seen people with crowns that look “fake” or that have a dark line at the gum line of the crowns. What causes that?
A: This is usually caused by the metal margin of a porcelain fused to metal (or PFM) crown. In the “old days,” many dentists used PFM crown, but now in most cases, cosmetic dentists use all porcelain crowns, which provide virtually the same strength but are highly superior in their aesthetic result.
Q: Why would someone want an all-porcelain crown?
A: Some restorations are designed with a metal lining, covered with porcelain (porcelain- fused-to-metal or PFM). At one point in time, most restorations were made this way. When placed, they usually look opaque or “flat” because they do not let light pass through like a natural tooth. There is often a tell-tail dark line next to the gum-line that is undesirable (often the darkness invades the adjacent gum tissue as an adverse reaction). All-porcelain restorations are what we chose to use unless there is a compelling reason otherwise. Again, when properly seated, they are as strong or stronger than their metal predecessor. And the appearance can be identical to a natural tooth, allowing light to pass through (referred to as translucency).
Q: Why would the dentist recommend crowns instead of veneers?
A: Crowns require more tooth structure removal; hence, they cover more of the tooth than veneers. They are usually indicated for teeth that have sustained significant loss of tooth structure. Crowns may be placed on natural teeth or dental implants.
Q: What can be done to replace a missing tooth?
A: Cosmetic dentistry now offers options beyond having a denture. One option is to have an implant and crown placed. An implant is a titanium cylinder that is placed in the bone (under the tissue) and functions to replace what was once the root of the tooth. After a period of 5-6 months the crown is placed over the abutment. This tooth is now cared for like all the other teeth in your mouth. Another option is a bridge. A bridge is like a crown that is bonded to the teeth on either side of the missing tooth. Some people prefer to not go through the surgical procedure of having the implant placed. Others prefer to have a quick fix and to not go through the waiting period of 5-6 months before a crown can be placed on the implant.
Q: What can I expect on my first visit for the crown procedure?
A: As soon as you are seated, we will numb the area to be worked on using a local anesthetic. Depending upon the type of local anesthetic used, you can expect to feel numb for one to four hours. If your anesthesia should last longer, do not be concerned. Individuals react differently to anesthesia. While the area is numb, please be careful not to bite your lip or tongue. You may want to consider a soft diet or no meal at all while until your sensation returns in the affected area. Once the appropriate area is numb, the dentist will prepare the tooth to maximize the function, retention and aesthetics of your new crown. After the tooth is fully prepared, we proceed to the impression stage where we create a model of your prepared tooth for our technician to custom-fabricate your crown.
Q: How should I care for my crowns?
A: To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects – just like you should avoid for your natural teeth. You also want to avoid teeth grinding. Brushing twice a day, cleaning between your teeth is vital with crowns. Floss and interdental cleaners (specially shaped brushes) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease. Of course regularly visiting your dentist and hygienist to maintain your mouth.
COSMETIC DENTISTRY
Q: Do you perform general dentistry or only cosmetic dentistry?
A: Our primary focus is on comprehensive oral health care, so we look after all aspects of your dental care. We carry out cosmetic dental procedures such as porcelain veneers, crowns, bridges, inlays, onlays, and whitening. We also perform general dental procedures including hygienic cleanings, fillings, etc. The difference is that we practice dentistry with the aesthetics of the final result in mind, so we place a special emphasis on making you look great.
Q: I would like my smile improved, but I am simply fearful of going to the dentist. Can you do anything to make me feel better?
A: Our principal dentist Dr. Uchenna Okoye is terrified of dentists! This means we work hard to cater for guests like her and make sure it is a great experience every time! Our practice uses new, more effective types of anesthetic to numb the teeth than in earlier years, we even use a gel to numb the gum first before injecting so it is painless. We have many amenities designed to distract you from the dental procedure and to help you with the psychological discomfort you may associate with visiting a dentist. From the selection of DVD movies, music CDs, anti-anxiety medication (when appropriate), and our in-house massage therapist, you will feel very relaxed with u
Q: What are porcelain veneers?
A: These are also called “porcelain laminates,” “porcelain laminate veneers,” and just “veneers, “Veneers are thin sculpted pieces of toothshaped porcelain that fit over the front of the teeth and are the premier standard of care in cosmetic dentistry. Permanently bonded to the front surface of a tooth, they can improve the position, shape tooth colour and they can make a dramatic, immediate difference to one’s smile and overall facial appearance.
Veneers are wonderful for fixing common problems such as midline spaces (the gap-toothed look of the two front upper teeth) or chipped, crooked, missing, discolored, pitted, malformed or improperly positioned teeth. Once only accessible to the wealthy and top Hollywood stars and models, veneers are now a popular way for many people to obtain the smile of their dreams.
Q: What is a crown?
A: A crown is a restoration that covers, or “caps,” a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won’t solve the problem. If a tooth is cracked a crown holds the tooth together to seal the cracks so the damage doesn’t get worse. Crowns are also used to support a large filling when there isn’t enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
Q: How Do I Choose a Cosmetic Dentist
A: For the best results, it is important to know the qualifications and experience of the treating cosmetic dentist. The term “cosmetic dentistry” has become trendy and many dentists are promoting themselves as cosmetic dentists. At this time, cosmetic dentistry is not a recognised specialty (like orthodontics, for example).
However, it is a discipline of dentistry that requires a thorough knowledge of science and an artistic eye. Ask your cosmetic dentist about his or her training, credentials, and experience in this area. A very effective way to understand your dentist’s skills is asking to see their portfolio of photographs. Dentists who are dedicated to the art of cosmetic dentistry always take photographs of their cases.
Ask which organisations the dentist belongs to. Dentists that are members of AACD (American Academy of Cosmetic Dentist) and BACD (British Academy of Cosmetic Dentists) have to fulfil certain criteria and hours of continuing education to become a member.
Q: Is there a standard beautiful smile for all people?
A: No. Each person is different and each case is different, and has to be planned very carefully. There are many differences between male and female teeth and between all people. The design of the teeth has to be in proportion with the gum line, the lips, and the construction of the face of each individual to achieve a beautiful and natural smile.
At London Smiling each smile we create is unique to that individual, that is the artistic excellence of a great cosmetic dentist.
Q: How white should I get my teeth?
A: In adolescence we generally have a white, bright smile but over the years our teeth pick up stains and become discolored. When undergoing cosmetic dental procedures the question then is how pearly white do we want to make your teeth? Many people are choosing shades that are whiter than in years past. We like a natural look and use the colour of the whites of your eyes as the starting point.
Q: Are you more expensive than other cosmetic dentists?
A: Our fees are comparable to those at premier dental practices nationally. If you are price shopping for dental care, bear this in mind – just like all restaurants, cars, or hotel rooms are not the same and you would never purchase one because it was the cheapest one you could find, all dental practices are not alike.
Q: Will my dental insurance cover cosmetic dental treatment?
A: Like plastic surgery, insurance does not usually cover treatment done for purely cosmetic reasons. However, treatment that is needed to repair broken or decayed teeth, or to replace existing restorations that are
defective will usually qualify for dental insurance
Q: Will my dental insurance cover cosmetic dental treatment?
A: Like plastic surgery, insurance does not usually cover treatment done for purely cosmetic reasons. However, treatment that is needed to repair broken or decayed teeth, or to replace existing restorations that are defective will usually qualify for dental insurance.
DENTAL FILLERS
Q: What is a ‘filler’ made from and is it safe?
A: Dermal fillers are a clear gel containing a concentrated component of collagen called Hyaluronic Acid. The gel is injected into the correct layer of the skin to act as a collagen-replacement, giving lift & support. The modern dermal fillers are not animal-derived, rarely cause any allergic reactions and have been used for over 10 years.
Q: Is the treatment painful?
A: There is some mild discomfort. A topical (cream) anesthetic is recommended for most facial line treatments. A local anesthetic injection (like a dental injection) is used for treatment of the lips.
Q: How long will the treatment take?
A: Once you are properly anesthetized, your treatment should only take about 30 minutes. There will be a thorough consultation and medical history check to ensure it is safe to proceed with treatment.
Q: Will I see the results immediately and are there any side effects?
A: Yes – you will see the improvement immediately. You should expect some redness, swelling and mild bruising in the hours and days after your treatment. For some people, this inflammation can take a couple of weeks to resolve completely. By the review visit at 2 weeks, the full effects of your treatment can be assessed.Lips – because of the highly complex nature of the lip tissue, you should allow at least 2-3 weeks for all of the swelling to subside.
Q: How long will my treatment last?
A: Dermal fillers are not only an instant way to replace the lost collagen in your skin. They also have some effect in boosting the production of your own collagen in that area. The treatments are highly effective and will last 4-6 months depending on your age and skin type.
HALITOSIS
Q: What is halitosis?
A: More than 90 million people suffer from chronic halitosis or bad breath. In most cases it originates from the gums and tongue.
Q: What causes bad breath?
A: Although there may be a number of causes, most of the time, halitosis originates in the mouth. It is caused by oral bacteria breaking down food debris. This process creates byproducts called volatile sulfur compounds, which emit a smell similar to rotten eggs. The type of bacteria that initiates this process needs an environment that is free of oxygen, so they usually inhabit areas that are difficult to reach, such as the pockets around teeth and the fissures of the tongue. In some circumstances, the odor may be caused by a systemic condition such as diabetes or a problem in the sinuses, pharynx, lungs, or stomach. Other debris in your mouth and poor oral hygiene can also cause odor. Therefore, the first step in solving bad breath problems is to undergo a medical examination to ensure that there are not any systemic problems contributing to the condition. Other factors can also cause halitosis: tobacco, alcohol, mouth rinses containing alcohol, garlic, onions, spicy food, hunger and dry mouth. These are all secondary to the main culprit – oral bacteria. If you have concerns about bad breath, please discuss this with us.
Q: Can bad breath also come from other causes?
A: Bad breath also may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath.
Q: What can be done to combat bad breath?
A: If it is clear that bacteria are the culprits, methods to reduce them are the first line of defense. That’s why if you have bad breath, you should make sure to obtain a complete dental examination that includes a periodontal examination. Keeping your mouth as clean as possible helps eliminate bacteria. This ‘disinfection’ includes thorough brushing, proper use of dental floss, recommended mouth rinses and cleaning the tongue. Our hygienists are skilled at removing all the bacteria and most importantly showing you the skills needed to maintain things at home.
Q: Do certain food cause bad breath?
A: Very spicy foods, such as onions and garlic, and coffee may be detected on a person’s breath for up to 72 hours after
DENTAL IMPLANTS
Q: What is an implant?
A: A dental implant is a small man-made titanium screw that serves as the replacement for the root portion of a missing natural tooth. The implant is placed in the bone of the upper or lower jaw and allowed to bond with the bone and serve as an anchor for the replacement tooth. Dental implants can be used to replace a single lost tooth or many missing teeth. Implant supported replacement teeth look, feel and function like natural teeth.
Q: Who is a candidate for dental implants?
A: Anyone who is missing one or more of their teeth due to injury, disease, or decay may be a candidate for dental implants. If one, a few or all teeth are missing, dental implants in conjunction with a crown or bridge can replace those teeth. Occasionally, older patients express concern that their age may prevent them from enjoying the benefits that dental implants offer. However, health is more of a determining factor than age. If you’re healthy enough to have a tooth extracted, you’re probably healthy enough to receive dental implants. Your dentist will determine if you are a candidate for dental implants after a careful evaluation of your dental and medical health history.
Q: Is there pain or discomfort involved?
A: Most of our guests report that there is very little discomfort and that they were much more comfortable following the procedure then they anticipated. Modern implants are placed in a very gentle fashion and care is taken to the various tissues involved. We will often introduce you to another guest who has had the procedure so you can have first hand advice!
Q: How will I benefit from dental implants?
A: Dental implants offer many benefits never before available for the treatment of missing teeth. They look, feel and function like your real teeth. You will have the ability to chew and enjoy your food, avoiding the embarrassment of loose dentures.
Q: How long will the treatment take?
A: Treatment time will vary depending on your unique situation. Nowadays it is often possible to get well functioning and esthetic looking teeth within a few days. In some cases it may be necessary to wait a longer time period before finishing the restoration in order to obtain an optimal result.
Q: How much will it cost?
A: The fee for tooth replacement with dental implants will depend on several factors, including the number of teeth being replaced and the number of implants required to support your replacement teeth. It is important for you to know that you do not necessarily need an implant for each missing root. Some additional procedures may be required prior to the placement of your dental implants to ensure the long-term health of your dental implants. To obtain a specific fee estimate, it is necessary to have the dentist examine your mouth. After a thorough diagnostic examination, your dentist will recommend the treatment that is best for you and what your investment would be for the procedure.
Q: Is it important to take care of the implants after the treatment is completed?
A: Yes! Maintaining care of the implants will help to assure the long-term success of your treatment. You will be responsible for daily plaque removal, which can be accomplished through brushing and flossing around your restoration. Your dentist or hygienist will show you how to properly care for your implants. You must visit your dentist at least once a year for maintenance appointments.
Q: Are implants a new invention?
A: Implants are not new to the dental field. Prof. Brånemark started his research in the early 50’s and has revolutionised implants as we know them today. There are over fifty years of clinical studies supporting the success and longevity of dental implants.