Treatment Guide
Which treatment for your situation?
You do not need to know the names of treatments. Find the situation you are in, and read which treatments are considered for it and how they differ.
One of my teeth is missing
With a single missing tooth there are three routes, and the real difference between them is what happens to the neighbouring teeth. An implant puts its own root into the gap and leaves the teeth on either side untouched; the trade-off is surgery and a period of healing. A dental bridge needs no surgery, but the two healthy teeth beside the gap have to be trimmed down, and that cannot be undone. A removable denture is the least invasive of the three, though it is also the least comfortable.
Treatments considered
I am missing several teeth next to each other
The longer the gap, the more load a bridge places on the teeth holding it up. An implant-supported bridge closes the whole gap with fewer implants than there are missing teeth, and the healthy teeth beside it are left alone. Across a short gap a tooth-supported dental bridge is still an option; across a long one it is not advised, because too much load falls on the supporting teeth. If surgery is not suitable for you, a removable partial denture is considered instead.
Treatments considered
I have no teeth left in one jaw
There are two main routes here, fixed and removable. All-on-4 and All-on-6 carry fixed teeth on four or six implants, and in suitable cases they can be planned without a bone graft. A complete denture needs no surgery and can still be made when there is not enough bone, but it holds less firmly than the implant-supported options. Which one suits you depends on how much bone you have.
Treatments considered
My teeth have changed colour
Where the colour comes from decides the treatment. When it is surface staining left by tea, coffee and smoking, whitening is often enough on its own. When the discolouration sits inside the tooth tissue, whitening will not shift it, and composite bonding, veneers or crowns come into the picture. What separates those options is how much tooth tissue has to be removed and how long the result lasts.
Treatments considered
My gums bleed or are receding
Bleeding is usually the first sign of inflammation, and at that earliest stage it is also the simplest thing to treat. Curettage cleans away the tartar sitting under the gum. Once gum recession has started, the tissue you have lost is not expected to grow back on its own and a separate treatment is needed. Only an examination and X-rays can show which stage you are at, and bleeding that stops does not mean the problem has healed.
Treatments considered
I have toothache
The kind of pain tells you where it comes from. A brief sensitivity that arrives with something hot or cold and then passes is one thing; a throbbing that starts on its own and grows worse at night points to something else. The second usually means decay has reached the nerve, and root canal treatment is needed. Pain that fades on its own does not mean the problem has gone; more often it means the nerve has lost its vitality.
Treatments considered
My teeth are crooked
Crowding is not only a question of appearance: the surfaces your brush and floss cannot reach raise the risk of decay and gum problems. Choosing between fixed braces and clear aligners depends on how complex the case is and on what you can carry through your day. With either one, the same thing decides the result: regular check-ups and sticking to the planned timeframe.
Treatments considered
My teeth are worn down or chipped
A restoration placed before the cause of the wear has been found tends to break again in the same spot. The most common causes are clenching at night, reflux and an acidic diet. Where little tooth substance has been lost, composite can be enough; where the loss is greater, a crown is needed. As long as the cause is still there, no treatment lasts, which is why the cause is looked at first.
Treatments considered
What should I be doing about my child's teeth
Baby teeth are not left alone on the grounds that they will fall out anyway: a decayed baby tooth affects the position and the health of the permanent tooth underneath it. Fluoride applications early on, and a protective sealant that closes off the grooves, lower the risk while there is still no decay. Once decay has started a filling is placed, and if it has reached the nerve, root canal treatment is carried out on a baby tooth as well. If a baby tooth is lost before its time, a space maintainer is fitted; without one the neighbouring teeth drift into the gap and the permanent tooth cannot find room to come through.
Treatments considered
I am afraid of the dentist and cannot bring myself to sit in the chair
Putting things off for years out of fear turns work that would have been finished in a single appointment into major treatment. The first step is usually to break the procedure up and to explain in advance what will be done; for most people that is enough. When it is not, or when the treatment is extensive, dental treatment under general anaesthetic comes into the picture: everything is completed in one sleep. A general health assessment is carried out first, so it is not a method that can be used for every patient.
Treatments considered
Far too much gum shows when I smile
This is called a high smile line, and the cause is not always excess gum. If the gum covers too much of the tooth, the gum line is redrawn by reshaping it. If the gums look excessive because the teeth look short, the real work is on the length of the teeth. If the problem comes from the vertical position of the upper jaw, a gum procedure does not change the outcome and orthognathic surgery is discussed. This distinction is made by examination and measurement; there is no way of telling which one it is in the mirror.
Treatments considered
My jaw sits too far back or too far forward and my bite is off
Whether a bite problem comes from the teeth or from the jaw changes the treatment completely. If it stems from the position of the teeth, orthodontic treatment is enough. If there is a skeletal discrepancy, that is, if the length or the position of the jawbones do not match, braces on their own do not deliver the result; orthodontics and orthognathic surgery are planned together. This distinction is made with X-rays and measurements, and no surgical decision is taken before growth is complete.
Treatments considered
I was told I do not have enough bone for an implant
A shortage of bone is not an absolute barrier to an implant; most of the time it means an extra step beforehand. Where width or height is lacking, volume is built up with a bone graft. If the sinus cavity has dropped down at the back of the upper jaw, a sinus lift is carried out. If there is a tooth due to be extracted, that tooth can be ground down and used as graft material. In some cases the graft and the implant are done in the same session, in others only after a wait of several months; which one applies depends on how much bone is missing.
Treatments considered
I clench my teeth at night and my jaw feels tired
Clenching first wears the teeth down, then brings pain in the jaw muscle and headaches in the morning. A filling or a crown placed while the clenching continues breaks again in the same place, so the cause is looked at first. A night guard protects the teeth and reduces the load on the muscle. If the chewing muscle has visibly enlarged, masseter botox lowers the strength of the muscle temporarily. If teeth have been lost, rearranging the bite also becomes part of the plan.
Treatments considered
Tartar has built up and I would like a clean
Plaque that the brush does not remove hardens within twenty-four to seventy-two hours and turns into tartar, which can no longer be cleaned off at home. With the GBT method the tooth surface is first stained so that the plaque becomes visible, then cleaned with a mixture of air and powder; scaling is used only where it is needed. If there is tartar below the gum, the clean does not stop at the surface and curettage is needed. Sensitivity for a few days after the clean is usual; it is not permanent recession.
Treatments considered
I want to change my smile completely
With a change on this scale the real question is how many teeth will be touched and how much tooth tissue will be removed. For differences in colour and small differences in shape alone, veneers may be enough, since they call for less preparation. If a tooth is broken, root-treated or has lost a great deal of substance, a crown is needed. If the bite is off as well, orthodontics first and the cosmetic work afterwards means both less tooth preparation and a longer-lasting result. Planning is done with impressions and a digital design, so you can see the result before treatment begins.
Treatments considered
This page is for information and does not replace an examination. Which treatment suits you is decided after an examination and imaging.