Restorative dentistry is repair work. Something has broken, decayed, worn down or been lost, and the job is to rebuild it so the tooth functions properly, lasts a long time, and does not announce itself when you smile. This is the bulk of what a general practice does, and doing it well is mostly a matter of not rushing.

Fillings

We place tooth-coloured composite fillings. Composite bonds to the tooth structure, which means less healthy tooth has to be removed to hold it in place than with the older amalgam approach where the cavity had to be shaped to mechanically lock the filling in.

We do not routinely replace sound amalgam fillings. An old silver filling that is sealed, unfractured and not decaying underneath is doing its job, and drilling it out removes healthy tooth and shortens the tooth's life for cosmetic reasons. If it is failing, we replace it. If it is fine, we photograph it, note it, and watch it.

Crowns

When too much of a tooth is missing for a filling to be reliable, a crown covers the whole visible portion and holds everything together. The usual triggers are a large old filling that has fractured, a cracked cusp, or a tooth that has had root canal treatment and become brittle.

We use mostly all-ceramic crowns, which look considerably better than the older metal-backed type and no longer come with the dark line at the gum that those developed over time. For back teeth taking heavy load, particularly in patients who grind, we sometimes recommend a stronger zirconia material and will explain the trade-off in appearance when we do.

The process is two appointments. At the first, the tooth is prepared, a digital scan is taken, and a temporary crown is fitted so you leave with a normal-looking tooth. The laboratory makes the permanent crown, and at the second appointment it is tried in, checked against your bite, adjusted and cemented.

Inlays and onlays

Between a filling and a crown sits a category most patients have never heard of. An inlay or onlay is a custom-made ceramic piece bonded into a prepared cavity, covering part of the tooth rather than all of it. When a tooth is too damaged for a filling but does not need the full coverage of a crown, this is the conservative option, and it preserves more of your own tooth. We offer it because for the right tooth it is genuinely the better answer.

Bridges

A bridge replaces a missing tooth by joining a false tooth to crowns on the teeth either side. It is fixed, it does not come out, and it is completed in two appointments over about three weeks.

The honest downside is that the teeth either side have to be prepared for crowns, even if they are perfectly healthy. Where those neighbours already need crowns, a bridge is efficient and sensible. Where they are untouched, an implant is usually the better long-term choice because it leaves them alone entirely. We will lay both options out with costs before you decide.

Dentures

We make full and partial dentures, and we take our time over the fitting appointments because that is what separates a denture people wear from a denture that lives in a drawer. Partial dentures replace several missing teeth and clasp onto the remaining ones. Full dentures replace an entire arch.

Where a lower full denture is involved, we will always mention implant retention. Lower dentures are notoriously unstable because there is far less ridge to hold them, and two implants to clip onto transforms how one feels. It costs more, and it is not the right answer for everybody, but people should at least know the option exists before committing.

Making restorations last

Good restorative work fails for two main reasons: new decay at the margins, and mechanical overload from grinding. The first is handled by hygiene visits and keeping the margins clean. The second is handled by a night guard, which is a fraction of the cost of the crowns it protects. If you grind, we will tell you, because we can see the wear facets even when you have no idea you are doing it.