When a tooth has suffered wear or tooth decay the options to restore the tooth are many, which makes for complex decision making.

The first and most affordable option is direct white composite fillings. As technology has improved since their invention, they are now a hard wearing and aesthetic choice. We have trained with Dr Didier Dietchi from Geneva. His method of placement results in a long lasting hand sculpted aesthetic restoration that can now out last the old amalgams. When a restoration is small this is the most conservative recommended option. However, direct resin can also be used in larger restorations with great success due to the now superior properties of the material.

The second choice is indirect resin restorations. The tooth is prepared, and an impression taken of the preparation, a resin filling is hand sculpted on a model and then cemented back into the tooth. This method is ideal if you have trouble keeping your mouth open and there is not suitable access to ensure an excellent fit.

The third choice is indirect porcelain or gold onlays or inlays. If the restoration extends into a flossing area between the teeth and includes some or complete coverage of a cusp, this is an excellent choice. The tooth is prepared, an impression taken and the inlay/onlay is made outside of the mouth by a laboratory technician and then re-cemented back into the tooth. Whilst the cost is more, the benefit is a harder wearing and longer lasting restoration. A favourable indication for onlays/inlays is where moving to a crown would be far too destructive to the tooth, but the size of the restoration is too large for a direct composite resin restoration.

Sometimes tooth structure needs to be sacrificed to protect a cracked tooth and sometimes teeth break or decay in a manner that makes them perfect for porcelain inlays and onlays. So every tooth needs to be evaluated individually and there is no one size fits all.


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