Tooth-colored Filings
Dental Fillings

Fillings are used to fill cavities or defects in teeth as the result of tooth decay or damage by excessive force. Different types of materials including metals, composite resins, porcelain, and zirconia have been used. As the strength, durability, biocompatibility and aesthetic properties are vastly different, the choice of filling material depends on clinical and patient factors such as cost.

Types of Tooth-Coloured Fillings
  1. Conventional Tooth-Coloured Filling Materials – Composite Resins Composite resins are mouldable materials placed to repair cavities in teeth. It is currently the mainstay for most fillings as it closely matches the colour of teeth. However, composite resins are not as strong and are less suitable for larger cavities. In general, they last around 5-7 years.
  1. Adhesive Filling Material – Glass Ionomer Cement Another tooth-coloured filling material, glass ionomer cement (GIC), is commonly used in children’s fillings and for adults who have high cavity risks. GIC has the advantage of containing fluoride, which is released to the tooth slowly over time, thereby strengthening the enamel more than composite resins. These fillings are simple to use and are effective but seldom last more than 2-3 years.
  1. Porcelain and Zirconia Fillings


Porcelain fillings are popular due to its strength and superior cosmetic appearance. Zirconia fillings are better for patients with strong bite force because of its relative durability. However, these fillings are more costly. These fillings last longer than composites and is the preferred material of choice for larger cavities. The average lifespan is 7-10 years.

How are computer-designed fillings manufactured?

The tooth is scanned and a filling is custom-designed using digital technology. Pre-fabricated blocks of filling materials such as porcelain, zirconia, or resins are trimmed to the exact specification in a laboratory using precision tooling in a highly automated process. The end-product is then heat-treated to harden it and produce a smooth or glazed surface. The dentist then attach the fillings using a special biocompatible cement. Porcelain and plastic fillings can be made within hours while zirconia fillings need an extra day to process.

Root Canal Treatment
Who needs Root Canal Treatments?

If you have been experiencing toothache, extreme sensitivity to cold/hot, or pain upon chewing, your tooth may have a damaged nerve. This is often irreversible and would require treatment of the nerve to remove the injured tissue.


Root Canal Treatment

Root canal treatment is the procedure which removes the injured or infected tissues from within the central core of the tooth, known as the pulp chamber and root canals. This is then followed by disinfecting and reshaping the canals before sealing them off from the rest of the body using an inert material and cement.


The Procedure

A local anaesthetic injection is required and the dentist will place a rubber sheet around the tooth. This is to reduce the risk of the disinfectant entering the rest of the mouth or irritating the surrounding gums. There is no pain after the anaesthesia, though there may be slight discomfort as the mouth must be kept open throughout the procedure. If the tooth affected is a back tooth, the procedure is usually longer as premolars have 2 root canals and most molars have 3 root canals, whereas front teeth only have 1. Root canal treatment usually requires two visits to complete. On the first visit, the contents of the pulp chamber and root canals are removed and the remnants disinfected. If there is an infection, a medication is placed and the cavity is sealed for 1-2 weeks to allow the infection to clear. At the second visit, the canals are cleaned once again and shaped to receive the sealant. The dentist will discuss the appropriate long-term restoration plan with you – a large filling, or a crown.


How will I feel after the procedure?

There may be some discomfort when biting on the affected tooth for the first 2-3 days after the procedure, but with far less pain than before the treatment. If necessary, take the painkillers prescribed. Root canal treated teeth are weaker and may eventually darken in colour over time even when the treatment is successful, as the tooth no longer has a healthy pink nerve. It is recommended that a crown be used to protect the treated tooth from cracking. This will also help restore the aesthetic appearance of the tooth, though it should be noted that the tooth inside the crown may still get darker with time.


Success Rates of Root Canal Treatment

The success rate of root canal treatments exceeds 90%. However, if the infection is extensive, or in back teeth where the canals are much narrower and curved, the success rate decreases. It is also more difficult to redo a previously root canal treated tooth and the success rate decreases to around 70% regardless of whether a conventional or surgical approach is used. It should be noted that the lifespan of a root canal treated tooth is usually shortened as it is compromised structurally by previous decay, cracks, or by the need to remove the internal core of the tooth in the process of saving it.

Gum Treatment
Gum Treatment / Deep cleaning (Root Planing)

The routine cleaning for patients with normal or slightly diseased gums is known as scaling and polishing. Scaling is the process of removing the hardened deposits that form on your teeth. These deposits, known as calculus or tartar, form when the natural calcium in our saliva mixes with the bacteria in our mouth and food debris. Starting off initially as a soft mix called plaque, it hardens over time and becomes difficult to remove. Polishing is usually done after scaling, to remove plaque and stains on the teeth’s surface, whilst smoothening the teeth’s surface so that it is more difficult for dirt to get attached onto the teeth. If the calculus / tartar remains on teeth for a prolong period of time, gums begin to bleed and recede, and the supporting bone underneath the gums also start to disappear, causing teeth to become shaky. This severely diseased state of the gums is known as periodontitis. At this stage, normal scaling is insufficient, hence a deep cleaning, or root planing, is recommended to remove the hardened deposits on the root surfaces of teeth. By reducing the bacteria load found in these calculus / tartar, the progression of periodontitis can be reduced.


The Procedure

In order to remove the buildup of hardened deposits, a more thorough effort is required. As most adults have 28 teeth, the procedure is usually performed on one quadrant of the mouth at a time (e.g. upper left teeth only, or lower right teeth only), to enable the dentist to carefully clean each tooth. For the patient’s comfort, a local anaesthetic injection is given to numb the teeth and the surrounding gums before proceeding. While this will completely stop the pain during the procedure, patients may still feel the pressure as well and hear the ultrasonic scaler sound. It is possible for thorough cleaning of our teeth (and gums) to be carried out painlessly through the use of intravenous sedation. The sedation can be done at our clinic by appointment with a certified anesthesiologist. This is an increasingly popular option as many patients prefer to have the treatment done in a single seating and without feeling the multiple injections required.


What happens if my gums get worse?

Some patients seek treatment late, some are genetically predisposed, some have inherent risks such as diabetes, HIV, chronic smoking, and some face an aggressive form of gum disease. While dentists will still try to help you keep your teeth through more aggressive cleaning, sometimes gum surgery is required to clean the roots or the teeth may need to be stabilised through a procedure termed splinting. Note that in some cases, extraction may be the only choice. With modern scientific knowledge and technology, the dentist may recommend to regenerate the bone which have been lost as a result of severe gum disease, and restore your eating function and aesthetics with dental implants.

Dental Crowns
Dental Crowns

Dental crowns are customised shells made from various dental materials to fit over cracked or broken teeth in order to rebuild them to their proper forms. They are also known as caps, and besides protecting teeth that are weak, can also be used to change the shape, size and colour of teeth for cosmetic dental purposes. In the past, metal or gold was often used; but in modern times, tooth-coloured materials such as porcelain or zirconia which are strong, yet aesthetic, are the popular choice. Dental crowns are used for both functional and aesthetic reasons, for example:

  • to build-up a chipped, cracked, or worn tooth
  • to protect weak teeth (teeth with large fillings or after root canal treatment)
  • as support for a dental bridge to replace missing teeth
  • for cosmetic dental purposes, such as covering misshapen or discoloured teeth


Post and Core Buildup Prior to Crowns

In a badly fractured / decayed tooth, there may be insufficient natural tooth structure left to carry a crown. In order to strengthen the foundation of the crown and reduce the risks of the tooth fracturing, post and core buildups are used. A post made of carbon fibre, a strong lightweight material, can be inserted into the root canal of a treated tooth to provide a scaffold for a resin core to be built around it, so that a crown can be attach onto it. Alternatively, a mould of the canal can be made and a specially-cast metal post made to fit into the canal. In either case, the tooth is then rebuilt sufficiently to receive the final crown.


Crown Lengthening Surgery

Teeth may sometimes be too short or too damaged for a crown to stick on it. A surgical procedure will be required to expose more tooth structure beneath the gumline. After numbing with local anaesthesia, the gums are pushed back to expose more tooth structure. In some cases, the dentist may need to gently remove some bone before suturing. This procedure is known as crown lengthening and is required to enable the new crown to achieve a proper fit with more long-lasting results.

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