Save Dentine And Put A Lid On It

“The Tooth And Nothing But The Tooth”

 By Chris “Dr Smile Maker” Branfield

Save Dentine And Put A Lid On It

Hello again. I hope that you are well.  As usual it’s been another busy month, working and keeping up to date with the ever-changing world of dentistry.  My colleagues, Andrew, Anna and myself went to a 2-day conference in Leicester all about digital dentistry.  Wow, things are changing really fast with some exciting innovations.  I also went to London to an event called “Stars Of Dentistry”.  It was the second one, I went to the first last year.  They have some big, international names in dentistry coming from, America, Italy and Brazil.  I was not disappointed.  They were inspiring.  So much knowledge and talent, also great educators.  There was even a live video link from Seattle.  It was a long day though, 8-30am until 8-30pm.   I thoroughly enjoyed it and booked for next year.  Such a geek!

Why So Precious About Dentine?

Dentine is the yellow stuff under the hard lighter coloured enamel on the surface of teeth.  It has tubes that lead to the pulp (nerve).  The more that is gone the weaker the tooth and the more chance there is of damage to the pulp (nerve) causing possible inflammation, pulp death and then infection.  Are you with me so far?

Think Of A Shoe Box

These days we have materials that we can bond onto teeth that get damaged by decay or trauma.  This is great because it means less tooth structure removal to get a material to stay in or on the tooth.  Now, with back teeth that are really broken down some sort of filling may not be strong enough.

This where the shoebox analogy comes in.  I was another course some time ago when a guy talked about it.

Imagine a shoebox with no lid. At this point the walls of the box are quite weak and if you stand on them they will cave in.  If you put a lid on it this gives real strength and you can stand on it or at least put a lot more force before it caves in.  Simple, but brilliant, I thought.

So The Solution To A Badly Broken Down Back Tooth?

Put a lid on it! This is called an onlay or overlay. Rather than remove loads more tooth like with a crown, save as much as we can, protect what is left with a lid and bond on to give more strength.

Here is a large filling with decay under it replaced with an onlay. It looks better and gives strength so is longer lasting.

Tying It All Together

In days gone by rebuilding teeth like this would involve impressions, sending to a laboratory, having a temporary restoration that may come off and waiting 2 weeks before fitting the final restoration.  With digital dentistry we can now do these in house, often within a couple of hours.  No impressions but a digital laser scan, then design on a laptop, then Mill in a CAD Cam milling machine and sometimes (depending on the material) fire in a furnace.

Into The Unknown

As I write a lot of players have left Hull City Football Club and not many coming in.  Who knows what the season will hold for us.  Fingers crossed we actually manage to get a defence and do well.  Might be a big ask this year. We’ll see, eh.

Until next time.   Take care and be good.

Chris Branfield is Principal Dentist at Castle Park Dental Care, Castle Villa, 28 Castle Road, Cottingham, telephone 01482 772550.  He has been in dental practice for 24 years and has a special interest in life changing, pain free dentistry with dental implants, rapid teeth straightening and cosmetic dentistry. And, not only that Chris is founder member and trustee of Dental Mavericks charity- ending the daily dental pain of Moroccan kids. For more patient success stories and Chris’s humanitarian work go here now www.castleparkdental.co.uk