Q. is there anychance in putting a tooth back in as i had it punched out?its the front one

A. The answer is yes if on the same day.  The longer it is left out the more likely it will not take.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. i had a root canal filling a year or so again and it has discoloured my tooth? what do you recommend i do? would tooth whitening help? also i have one crooked tooth i am not prepared to wear a brace what would be the best procedure for it? many thanks

A. root filled teeth can sometimes be successfully whitened internally.  The crooked toth would be better treated with abrace but if not you would probably require multiple veneers to get the correct proportions of the teeth – one veneer may well be a strange shaped tooth ( too narrow) that would look more unsightly than a crooked natural tooth

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I recently had one of my molars crowned and am having problems at the margin. When I brush or poke my finger nail in between my tooth and crown at the gum line, it feels like I’m hitting a nerve. My dentist tried to put a little “filling” over this area but it didn’t bond and fell out after a few days. Will this tooth have to have the crown done again?

A. it sound like the crown will need to be remade to fit your tooth better.  if it is left there is a high chance of infection and potential pain.
I hope this helps
Dr Riten Patel BDS

Dr Riten Patel
The Mulberry
www.mulberrydental.co.uk
Tel: 01932 223 479
18 Ashley Road
Walton on Thames Surrey
KT12 1HS

Q. I lost most of my top teeth due to gum disease my dentist didnt spot years ago.I am now left with 3 teeth in my upper jaw.I wear a denture that I find intolerable and I cant eat with it which is horrendous.What would be the cost of dental implants , I would reckon I might need about 5 or 6.Im desperate !!!

A. It is difficult to give you an accurate figure but it is likely to cost for a bridge retained by implants in excess of £30K.  There is a removable bridge option – removed once a year for cleaning- that only uses 4 implants and costs nearer the £20K mark.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. Hello Rob I am considering vaneers and am confused with which i the best overall i.e porcelain, creamic, lumineers? cost is important. i already have a bridge and two crowns. will this affect the overall result? regards Jasbir

A. Porcelain is another term for ceramic
matching to the existing work is important but you need a clincal assesment to recommend a system

Sorry for the delay during my annual leave

please contact direct if you still require help

Dr Rob Tennet
stjohns.dental@btconnect.com
www.e-dentalpractice.co.uk
0121 643 0610

Dr Rob Tennet
St Johns Dental Practice
www.e-dentalpractice.co.uk
Tel: 0121 643 0610
18 Bennett’s Hill
Birmingham B2 5QJ

Q. 25 years ago I had a large bridge fitted, I have cleaned and flossed every day,this,, and a good job in the first place,as made sure it has lasted.Now it is beginning to give me trouble, e.g.tiny bits have worn away,discolouration and a little pain,I am worried as to what to do now.I live in Portugal. Thankyou

A. Large bridges are great while they are healthy unfortunately if they start to fail the only real options are dental implants ( the best) or dentures.
I hope this helps
Dr Riten Patel BDS

Dr Riten Patel
The Mulberry
www.mulberrydental.co.uk
Tel: 01932 223 479
18 Ashley Road
Walton on Thames Surrey
KT12 1HS

Q. I am a 39 year old female. I have been wearing braces for 14 months trying to correct a crooked tooth in the bottom jaw. I started with a perfect bite that I maintained it throught the duration of the treatment. I did however notice that both my upper and lower teeth are positioned on an angle…I am very concerned about this outcome. Please advise.

A. My best advice is to discuss this with your dentist as I can not tell exactly where your teeth are and I would not want to give you inappropriate advice.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I have had various full top dentures since I was 21 and I am now 58. If I stop wearing dentures and have implants wont my top lip cave in as my gum will probably have receded. Will I need a bone graft and how many implants are used for a full top set. Is this the only solution, as I dislike wearing dentures.

A. There are a few options for you if you are considering having implants.
1) implant retained denture.  3-4 implants are placed in the top jaw and a horse shoe shaped denture is made. This feels better than a normal denture as it does not cover the palate and it is fixed firmly into place. You do however still have to take it out at night. You may not a bone graft for this and you will not loose any facial support.
2) implant retained bridge. 6-8 implants are placed in the top jaw. a full arch bridge is made and this is permanently fixed into position. You don’t have to remove it. You may need bone grafts for this or sinus lifts which are not as invasive. To help the facial support an extra piece of pink porcelain can be added to the bridge to fill out your lip.
3) individual implants. You would need 12 implants to fill out the upper jaw. You would definately need bone grafts for this and it is more difficult to provide extra facial support.

I think option 2 would be best for you. It is very difficult to give exact costs but you are definately looking at above £10,000.
Kind regards

Dr Komal Suri
Smile Design Dental
www.smiledesigndental.co.uk
Tel: 01296 624163
33 High Street
Wendover Buckinghamshire
HP22 6DU

Q. My front top 3 teeth are caps i was wondering if teeth whitening would work on them aswell as the rest of my teeth or would i need to have them replaced. thank you

A. Teeth whitening only affects natural teeth and not restorations such as crowns.  As such you will probably need new crowns following tooth whitening

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I have an overbite and when my teeth are closed together I can get my finger through the gap at the front. However, my jaw looks right. Can anything be done to give me teeth which meet at the fron please?

A. orthodontics could improve this.  it is called an anterior open bite and is common in people who used to suck there thumbs.  An orthodontic consultation would give you all the options available.
I hope this helps
Dr Riten Patel BDS

Dr Riten Patel
The Mulberry
www.mulberrydental.co.uk
Tel: 01932 223 479
18 Ashley Road
Walton on Thames Surrey
KT12 1HS

Q. Dear Dr Suri, I have seen some of the before and after photos on your website, I think the results look great. I wonder if it would be possible for you to give me an estimate for four veneers on the front teeth? My teeth are straight and a good colour, I just wish for the front ones to be improved. Many thanks for your time, A

A. Thank you for your question
Four veneers would cost £4400. We offer financial options at the practice to help spread the cost if neccessary 
If you are interested in coming for a consultation there is no charge for this appointment and we can discuss your treatment options
The practice phone number is 01296 624163
Kind Regards

Dr Komal Suri
Smile Design Dental
www.smiledesigndental.co.uk
Tel: 01296 624163
33 High Street
Wendover Buckinghamshire
HP22 6DU

Q. My dentist recommends pulling 30 teeth due to broken cracked. Then put 10 mini implants to hook to dentures. cost 16,300. Is this the right thing to do and is the cost in line?

A. The cost doesn’t sound too expensive but whether it is the correct treatment for you is impossible for me to say without examining you.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I have recently had a white composite filling and suffering with extreme pain and living off ibuprofen. I visited the dentist and they said I am just sensitive and prescribed me a high fluoride toothpaste, this has made no difference. I returned to the dentist and they said they may have to remove the filling? I chose a white filling so it wasn’t unsightly , I am also scared of the dentist and was never advised when purchasing the filling that it would cause me discomfort. Please can you offer any advise and also if they do remove it will I get my money back? many thanks Bryan.

A. When a tooth is restored with a filling of whatever type the nerve within the tooth can become inflammed.  This usually subsides over time but in some cases the filling may need to be redone or the nerve treted within the tooth.  it is likely that you will need to pay again as these problems are usually caused by the decay within the tooth prior to treatment and as such it is often impossible to predict that this problem will occur -0 not usually the dentists fault but the bacteria that had infected your tooth. Hope this helps.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. My mouth is causing me to feel miserable! My teeth, at the top, used to completely striaght, but now, they are moving. One front tooth has gone slightly behind the other and one incissor is pushing forward and the othe going backwards. I also have gum recession and I’m only in my thirties. My bite is annoying me and my dentist days my jaw is inflamed. I have a mouth guard for night time, which leaves my bottom teeth feeking fragile in the morning -can’t bite on them for a while. How can I stop the gum recssion -is this why my teetj move? What can I do -please bear in mind I’m not loaded and get no benefits. Thanks.

A. It sounds like the two problems you are suffering with are your gums (periodontal disease) and your bite ( the way the teeth bite together).  I would recommend a full consultation to assess both factors.  You probably need some more in depth hygiene treatment and maybe some orthodontics to improve your bite and jaw.  It sounds like you are grinding your teeth at night.
I hope this helps
Dr Riten Patel BDS

Dr Riten Patel
The Mulberry
www.mulberrydental.co.uk
Tel: 01932 223 479
18 Ashley Road
Walton on Thames Surrey
KT12 1HS

Q. Hi, I have white fillings in my front 4 teeth- (top) and they have started to dis-colour and made me really concious about my smile- Its like people always comment and say it looks like i got stuff stuck in my teeth. Is there anything I can do to make them white again. Also- if I was to have my teeth whitened would my fillings go as white as my teeth at the front?

A. You can sometimes have them polished to remove surface stain.  If they are leaking around the margins they usually need complete replacement.  Fillings will not whiten with bleach.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I have tilted molar lower right due to missing adjacent tooth A dentist suggested a bone graft before inserting a crown on tilted tooth. i also have occlusion problems on left side due to heavy filling and am thinking an onlay would improve my bite. What is your opinion? Have had bad experiences in past hence dental problems now and I am very wary of dental tx,

A. Very complex question with unfortunatley not enough information to give you any type of answer.  I am sure your dentist discussed why a bone graft was necessary.  If you can give me these reasons and why you have a bad bite then I should be able to give you some advise.

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I am planning to do invisalign to close the gap between my front teeth, Dr was talking abt doing some slight reshaping to my teeth, is that to be done before taking impression or can it be done after the treatment?Usualy at what time the reshaping is done?

A. Sometimes reshaping has to be done before hand. I am going through invisalign treatment and I have had some enamel stripping in between my teeth to create space to move them. I may have a small amount of reshaping afterwards as well. Every case is different and it depends on what your teeth look like in the first place.
I think your dentist will know best so I would listen to what he /she has to say
Kind regards

Dr Komal Suri
Smile Design Dental
www.smiledesigndental.co.uk
Tel: 01296 624163
33 High Street
Wendover Buckinghamshire
HP22 6DU

Q. Hai Riten, Am 26 years old and I have gaps between my front upper teeth. I have heard about the braces which can be adjusted at the back of the teeth. I want to know the duration it takes to get ma teeth dully filled with no gaps and also the cost for the braces to be donr.

A. Orthodontics is a great way to have treatment my favoured method is invisalign which involves making see through removable mouthguards which move your teeth.  As they are removable you can take them out to eat and clean your teeth they are very comfortable.  Some people do not like having braces on the insides of there teeth thay are called lingual braces.  Pricing varies from dentist to dentist and the severity of your treatment.
I hope this helps
Dr Riten Patel BDS

Dr Riten Patel
The Mulberry
www.mulberrydental.co.uk
Tel: 01932 223 479
18 Ashley Road
Walton on Thames Surrey
KT12 1HS

Q. I had my four top front teeth crowned 20 years ago. Crowns have lasted well but don’t look so good now. Is it possible to have them replaced? Have crowning techniques/materials improved much over the last 20 year or would I just be replacing like with like? Many thanks for your reply.

A. You can have them replaced and the porcelain crowns are much more attractive today than 20 years ago provided an experienced technician makes them .

Dr Julian Caplan
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry
www.avivacosmeticdentistry.co.uk
101 St. Peters Street
St. Albans Hertfordshire
AL1 3EN

Q. I am 69yrs old and in good health. I have had to have two root anals done on my #15 molar. There is still an infection at the root area. My endodontist feel that the root is short and the crown is small since it has been capped. The endodontist thinks I should just remove the tooth and not bother with an implant since the jaw in that area has very little bone to set in an implant. My regular dentist removed the cap before I saw the endodontist, leaving only a small tooth crown. I have had three other implants that have worked very successfully. Two of the implants have been in for fourteen years.

A. The available volume & quality bone will affect the chance of a succesfull outcome for implant treatments. each region of the mouth is different even for a given patient
If you have specific clinical questions relating to your own best course of action I would recommend a second or third opinion which would require a clinical assesment

Regards

Dr Rob Tennet
Dental Surgeon
www.e-dentalpractice.co.uk

Dr Rob Tennet
St Johns Dental Practice
www.e-dentalpractice.co.uk
Tel: 0121 643 0610
18 Bennett’s Hill
Birmingham B2 5QJ