Our Treatments

This table is not a diagnostic tool; it shows which headings will come up.

The first row is what we see most often, and all three options deserve discussion; which is right depends on bone volume, the condition of the neighbouring teeth and where the gap is.

The second row is the only one that does not wait: pain arriving on its own and worsening at night indicates an inflamed pulp and should be seen the same day.

There are three options, all of them valid; which is right depends on the person.

An implant leaves the neighbouring teeth untouched and stimulates the jawbone, slowing resorption. Where the neighbours are sound it is clearly the best option; it requires sufficient bone volume and takes three to six months because of integration.

A bridge is quick and predictable, finished in one to two weeks. But it requires cutting down the neighbouring teeth, which is irreversible. Where those teeth already need crowning, it becomes a sensible choice.

Dentures are a genuine solution where many teeth are missing and fixed treatment is not appropriate. For patients struggling with retention in the lower jaw, a denture seated on two to four implants changes comfort markedly.

Leaving the gap has a cost that is usually overlooked: neighbouring teeth tilt into it, the opposing tooth over-erupts and the bone in the area resorbs. Years later the treatment is both longer and more complicated.

This heading comes first in any plan; no aesthetic or preventive work takes precedence over infection.

Root canal treatment is done when the pulp becomes inflamed or loses vitality. The aim is to save the tooth: infected tissue is removed and the canal system sealed. Back teeth then need a covering restoration, because root-treated teeth are prone to fracture.

Gum treatment comes in where there is bleeding, pocketing and bone loss. This is the most common cause of tooth loss in adults and can be stopped completely at an early stage.

Knowing which pain does not wait matters: pain arriving on its own and worsening at night, pain not relieved by painkillers, sharp pain on biting, and swelling. These should be seen the same day.

If swelling comes with fever, or difficulty swallowing or breathing, go to the nearest emergency department; that picture is measured in hours and is not managed by a dental appointment.

With aesthetic work, getting the order right matters as much as the result, because some steps cannot be undone.

1. Whitening. Where colour is the only issue. Nothing is removed from the tooth.
2. Composite bonding. Small chips, gaps and shape corrections. One visit, almost no reduction, reversible.
3. Orthodontics. Where the problem is tooth position, this is the right answer. It moves teeth rather than cutting them.
4. E-max veneers. Thin ceramic surfaces requiring limited reduction of the front face.
5. Zirconia crowns. Where tooth loss is extensive or the tooth is root-treated.

The third step is often skipped, and skipping it is expensive. Recommending crowns straight away for crowded teeth means cutting down sound teeth, whereas orthodontic treatment achieves the same result without losing tissue. It takes longer, but the decision is permanent.

Smile design is not a separate treatment; it is these steps combined into one plan. In a good plan, the options that require cutting teeth were chosen because the less invasive ones fell short — not the other way round.

Overshadowed by restorative work, this is the heading that makes the biggest long-term difference.

• Scaling and gum maintenance. Where there is a history of gum disease the interval is three to four months, not six.
• Fluoride application. Can arrest early decay; the only way to intervene before a cavity forms.
• Fissure sealants. The deep grooves of molars cannot be cleaned by a brush.
• Night guard. If you clench; a restoration made without removing the excess load meets the same end.
• Sports mouthguard. For contact sports.
• Interdental cleaning technique. Decay and gum disease start between the teeth, where a brush does not reach.

The fourth item matters particularly. In a patient who clenches, a crown, bridge or implant superstructure made without planning a night guard carries far more load than intended. If you have noticed morning jaw fatigue or flattened incisal edges, say so at the examination.

What preventive measures have in common: each of them heads off far more extensive treatment later, and none of them removes anything from the tooth.