So what is a crown?

The crown fits ontop of the prepared tooth structure

A crown covers part of your tooth that has been cut down to form a peg like shape. We usually do this when part of your tooth is diseased or broken away. The crown is designed to look just like a new, healthy tooth. Crown materials are usually porcelain ( but not the type that is made into plates etc) which is shaped and then cooked in a furnace. We are talking 900 degrees centigrade here, not for the faint hearted. This gives the porcelain the appearance of natural teeth.

Crowns help keep adjacent natural teeth stable, provide a strong biting or chewing surface and protect the remainder of the natural tooth underneath.

More coming soon.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

http://grandsmiledesigns.co.uk/

However, it can be misleading to consider cosmetic restorative dentistry as superficial and shallow or for only those who see beauty as appearence. There are very valid functional and health benefits to having a balanced well functioning mouth. It may be that you are quite happy with a front tooth twisted or a little discolouration. For those of you of an age, David Bowie’s famous smile was changed I think in the mid 1990’s and he just did not look the same. There is appeal in being unique. This is fine when the function of your mouth is not effected, but the sliding action function of chewing and talking can be interrupted, painful and detrimental to you health.

In an ideal world the function of your teeth is what we call mutually protected. Different teeth have different functions, front teeth for biting and tearing and your back teeth for grinding and chewing. You may have noticed that these teeth have different designs. If all your teeth were like your front incisors, how easy would it be to chew food?

Do this simple exercise. Let your jaw muscles go slack. Allow a small gap to exist between you upper and lower teeth. Now bring your teeth together gently. You may be aware of one side or one tooth area coming into contact before the others. You may be aware of your jaw sliding slightly as this happens. When your teeth are in contact gently slide the lower teeth over the upper ones. You are now getting an idea of the function of your mouth. As you move your lower jaw forward, your front teeth come into contact bringing the upper and lower teeth out of contact. As you slide from side to side your Canine teeth ( 3rd from the centre on your left and right) have a similar action. When you bite down your back teeth come into contact to stop you biting through your lip. If this highly evolved and effective part of your digestion system is impeded or not as effective as it can be we can help.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

http://grandsmiledesigns.co.uk/

But if the unfortunate happens, you lose a tooth through trauma, gum disease or caries, what can you do?

Your teeth sit in bone sockets in your jaw, supported by little shock abosorbers called periodontal fibres. There is a blood supply that feeds your bone, teeth and gums keeping it healthy and alive. One of the major contributors to teeth loss in smokers is the constriction of the capilliaries and a lack of oxygenated blood feeding the gum and bone.

If you lose a tooth the supporting bone and gum no longer has a function, it therefore resorbs away speeding up teeth drifting either side of the gap. As there is no tooth to support these teeth either side, they start to move effecting your mouth’s function.  Also, as the diagram shows, teeth opposing the lost tooth will over erupt and create further interferences.

An excellent solution to this problem is a dental implant. This can fill the gap left from the lost tooth but also can encourage bone growth as the part of the implant that is drilled into the bone is made of Titanium, a material that bone is attracted to and grows around. So with a secure new titanium implant rooted into your jaw, I can easily construct a crown that not only look natural but prevents your adjacent teeth from moving leaving you to chew and smile in comfort.

I have been working with Oral Surgeon Dr Carl Manhem for nearly 10 years and we are confident of our results. Please visit my home page http://grandsmiledesigns.co.uk/dr_tom_keppel.html for a bit more about me.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

So what can you do?

Changing your diet,quitting smoking and not brushing your teeth too hard will help for more than just the colour of your teeth. You can use some of the teeth whitening systems that are available both in the surgery or at home treatments being available. Finally you can get your teeth covered with porcelain veneers to block out the discolouration.

Veneers are think layers of porcelain designed specifically to be the colour you would like of your teeth. The veneers are so thin that sometimes alot of the colour is derived from the bonding cement I use to fix the veneers in your mouth. Each mouth is different, thankfully we can make your veneers as thick or thin as is needed. These veneers are fragile, but they are strong when bonded to your teeth. Sometimes I do not need to remove much, if any, of your natural tooth. On other occasions to achieve the best result more tooth needs to be cut away. Please look at these cases on the GSD website

http://grandsmiledesigns.co.uk/folio.html

What is important is that you have the time with us before you decide on any treatment and that we provide you with all the information you need.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

I have noticed an increase in tv advertising for sensitive teeth toothpastes. I love the simplicity of the message that is being sold. Do I sound sarcastic enough for you?

Just put this stuff on your teeth and sensitivity just melts away, icecream becomes a delicious sweet treat and cups of tea just flow down with ease. Tooth sensitivity and pain are far more complex than just hot and cold food and drink.

So find out whats causing it. There are lots of reasons,think about tooth wear, jaw pain,teeth cracking, the acidic food we eat, infrequent teeth cleaning, receding gums, night grinding and trauma.

I always advocate my patients understanding their mouths better. The causes of tooth sensitivity are wide and I feel it is important to identify key factors as part of the treatment prognosis.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

Surrey

http://grandsmiledesigns.co.uk/

If your teeth become more loose, so your gums may recede. The damage to your jaw could be clicking, ringing in your ears or difficulty opening or closing your mouth. Plus there is the chance of increased tooth sensitivity.

Get an occlusal exam today, we have the solutions to these problems

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

Surrey

UK

But how do we measure your biting forces and how balanced it is across your mouth? I am lucky to have the T Scan III in my practice. This tool helps me to identify how your mouth is biting in real time projecting the information onto a computer screen.

The T Scan occlusal exam is simple. You simply bite down on a thin sensor, which is comfortably shaped to fit the arch of your mouth. Vivid graphics display tooth contact data immediately and accurately, highlighting each tooth and force level exerted in that tooth during chewing. This allows you and I to immediately visualise any problem areas before you leave the chair.

As you can see this image shows the ‘high spots’ where teeth are coming into contact one at a time rather than in one balanced bite. The likelihood of teeth cracking, chipping and excessive wear is increased when your bit is imbalanced as well as jaw pain and dysfunction.

Grand Smile Designs offers effective treatments that can adjust and rebalance your bite using the latest techniques. Treatments usually take about 6 months   leaving you chewing with comfort, your bite rebalanced.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

In a study of people over 59 years of age in three North American cities, researchers discovered a link between those taking certain medications and an increased risk of caries (or cavities). The at risk group taking these medications experienced  increased cavities over 12 months which may be due to chronic disease and multiple medication use leading to an increased risk of dry mouth. By 2021, the authors conclude, one-third of retired Canadians will develop root caries and need restorative surgery or treatments.

It’s suggested that there is also a growing number of aging people with tooth sensitivity issues.   The wearing of the enamel on teeth, exposing root surfaces leading to sensitivity. Although the problem is showing up more in older adults, it is suggested that it is also caused by diet, over-vigorous brushing and teeth grinding.

Once gums begin to recede, the tooth’s dentine coating is exposed, and eventually, so too is the network of microscopic tubules that lead from the tooth’s surface to the inner nerve, and transmit sensations of hot, cold and sweetness. Once the dentine is worn away and the tubules are left without a covering, the teeth and inner nerve can become painfully sensitive to sensation. As the tooth is longer, the forces of chewing and grinding lose enamel, and teeth are worn down through attrition.

If there is gum recession, the root of the tooth begins to show and so do the tubules. It’s a very gradual process that can be slowed down by regular flossing. The issue can be resolved with bonding and desensitisers placed on teeth, as well as surgical procedures such as root canal treatment to deaden touchy nerves.

I recommend a soft or extra-soft toothbrush to glide over teeth in a motion away from the gums. There are a number of toothpastes on the market containing agents that coat the dentine and protect tubules from hot and cold messages to the nerve bundles.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

Surrey

Thanks to  Julie Beun, Canwest News Service

In just 2 hours we can improve your smile, we can even throw in some tooth whitening if needed as well. You also get a thorough fresh breath session with our hygienist. You can leave us smiling, brightened and breathing on anybody with confidence.

Please visit our website http://www.grandsmiledesigns.co.uk , more on The 2 Hour Smile coming soon.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

London

So if you have not been dentally fit for a while, what can we do to get your teeth into shape and help you to keep them this way?

Its common for people with poorly maintained teeth to feel more than a little embarrassed about it. As dentists we are not here to judge you, we are here to help you and provide the best clinical opinion and treatment for you. Sometimes people are just plain scared and as time goes by a combination of fear and embarrassment become very strong resistance to improved dental health.

I have written many times now about the benefits to your whole body’s health by looking after your mouth. The health of your heart, the joints and muscles in your head and neck. Your ability to be comfortable when eating, talking or sleeping all these effect the quality of your life.

Getting back to a good level of dental health may just be an extensive cleaning session with our hygienists, but it may also require treatments to remove decay and infection from parts of your mouth. But when this is completed, the benefits are clear to you.

If you are frightened, you are more than welcome just to visit us to get an idea of our caring and pretty relaxed approach to dental care.

So consider this when you avoid time at the dentist. Its a bit like going to the gym or playing sport to keep fit. The benefits to your wellbeing are clear, the same applies to your mouth.

Best wishes

Tom

Dr Tom Keppel

Grand Smile Designs

Surrey