Fillings and Crowns

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Tooth fillings and dental crowns are two of the most common ways of helping with the wear and tear of teeth over time, as well as the effects of tooth decay. There are a number of options, including composite and amalgam fillings, and gold or porcelain crowns. You can also have an inlay or an onlay, when neither a filling nor a crown is suitable. Your dentist will advise which particular solution will be best for you. The procedures are normally carried out using local anaesthetic and are generally not painful. Both NHS and private dentists offer the treatments.

Tooth fillings and dental crowns are two of the most common ways of helping with the wear and tear of teeth over time, as well as the effects of tooth decay.

There are a number of options, so you will need to consult with your dentist in order to determine which particular solution will be best for you.

Dental fillings or restorations are used to fill in the cavities caused by tooth decay. The process of having a filling carried out will take place whilst you are awake, however, a local anaesthetic will be used to make sure you cannot feel the areas being worked on.

Toothpick filling image

Your dentist will use a small drill to remove the parts of your tooth that are decayed or weakened. If necessary, a 'liner' may be used to cover the tooth to make sure there is no exposed nerve.

The material used for the filling may be amalgam or composite. Amalgam fillings are made of a mix of copper, tin and mercury (which is safe for most adults and children over six years old). They are extremely hard wearing and can last for a couple of decades, if not more, with the right care.

Some people can be allergic to amalgam so you will need to talk this through with your dentist. If you are pregnant, you should alert your dentist to this fact. Although it will not be poisonous for you, it is theoretically possible for mercury to be passed to your baby via the placenta.

Composite filings are tooth coloured and are usually used for more visible, conspicuous teeth due to their more natural appearance. Modern improvements also mean that composite fillings can last as long as amalgam fillings but your dentist will talk through the options.

Another material used is glass ionomer cement. This restorative material can also benefit teeth by slowly releasing fluoride. They are generally used when the surface of the tooth is not used heavily in the bite.

The use of a local anaesthetic will ensure that the area of your mouth being working on is numb throughout. Though you may feel some pressure from the instruments being used, you will not experience any pain.

That said, for the anaesthetic to be administered, you will need an injection in your gums. This is not particularly painful, but for those who are concerned, the dentist may be able to use a numbing gel to take away the feeling from your gum before the injection.

If your filling comes out then you should contact your dentist as soon as possible and make an appointment to have the filling replaced. This will only be possible if there is still enough of your tooth left to support a new filling.

Dental crowns are covers or caps that fit over your natural teeth so as to protect and secure the remaining part of the tooth. They could be needed when a cavity is so large that a filling will not work, or because a tooth has been weakened significantly by tooth decay. The crown wraps around the whole natural tooth to help secure what remains of it.

Crowns vary in colour according to what they are made of. They could be gold or other metals, porcelain, ceramic or a mixture of materials. As crowns are made to fit over your teeth exactly, your dentist will take a mould of your tooth, which he or she can then use to make your own bespoke crown. This can take a couple of weeks and, whilst it is being prepared, you will need to wear a temporary crown. Your teeth may also need to be filed down slightly or otherwise treated before a crown can be fitted.

Once your permanent crown is fitted you can expect it to last for many years, but again, it will require looking after and a proper dental hygiene routine.

Modern cosmetic crowns can be very lifelike and can be used to replace the front teeth. They are however generally more expensive than conventional crowns.

The general anaesthetic used ensures that the procedure is not painful. At most you might feel a bit of discomfort in the gums around the tooth for a short time after the fitting.

Inlays and onlays provide a solution in between fillings and crowns - when a crown fitting is not possible without removing more of the healthy tooth, and a filling is not sufficient. They are more durable and usually last longer than fillings. Dental inlays and onlays are usually made of either gold or porcelain, the latter being used to match the colour of more visible teeth.

An impression of your teeth will be taken to ensure that the inlay or onlay will fit perfectly over the cavity. For this reason, you will need to make two trips to the dentist and you will get a temporary filling to wear whilst the inlay/onlay is being readied. At the second appointment you will have it fitted, usually after a local anaesthetic has been administered.

Fillings fall into Band 2 treatments on the NHS, currently at £50.50 (2014 prices). Inlays, onlays and crowns fall into Band 3 treatments and cost £219.

If you go private, treatment prices will vary but simple fillings start around £40 to £180. Inlays, onlays and crowns cost from £150 to £1000 depending on what material is used.

The bleaching agents used in whitening treatments only work on natural teeth. Any fillings, crowns, veneers, inlays or onlays you have will be immune to the whitening process.

This article was provided by Toothpick, the leading provider of online dentist appointments in the UK.

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