There are different functional (biting)  and cosmetic demands from front and back teeth. Some poeple have very strong bites and a standard silver amalgam or tooth coloured composite fillings are simply inadequate. Gold and porclain (ceramic) may be a reasonable alternative in these situations or when the cavity is paticularly large.

A silver amalgam can cost as little as ￡45:00... A tooth coloured composite up to ￡200:00. When it is impossible for your dentist to rebuild your tooth directly in the mouth they may have to take an impression and get a porcelain or gold filling made in the laboratory. These restorations can cost from ￡450:00 to ￡700:00

In the right situation .. Yes !
Some fillings however are very technique sensitive and your dentist may have a prefered option that works particularly well for them.

Of all the fillings white or tooth coloured fillings placed directly (and not made by a laboratory and glued in) are the most technique sensitive. Isolating the tooth from moisture is one of the keys to success and may prove difficult at the very back of the mouth. The skill and experience of your dentist can determine  the filling materials that are offered to you.

No they are not. The NHS guidelines do change but silver amalgams are the most common and readily accepted as the restoration of choice within the NHS.

Not at all. All dentists are taught the skills required to provide tooth coloured fillings. The technique is however much more complex than a silver amalgam and most dentists will undergo extra training to ensure they are providing their patients the highest level of dental care.

A cap, sometimes called a crown, demands more tooth removal on top of that of the original filling. Only when your dentist advises you that there is not enough tooth to successfully rebuild your tooth or they are worried about tooth fracture, should you consider a laboratory made crown.

On occasions, when an old filling is replaced or after removing tooth decay, the resulting cavity is so large that restoring the tooth directly in the mouth is impossible. This maybe because the direct filling materials are not strong enough or it is impossible to create the right contours and shapes for function and health.

Yes, in EU countries they should use, as we do here in the UK, only accredited products. Like all medical proceedures you must reassure yourself that the highest standards are met, as the costs of replacement could prove counterproductive. In reality even the very best dentists have failures and for this reason you may feel more comfortable having treatment closer to home.

No but it is not unusual. The proccess of removing an old filling or decay is a traumatic one. The nerve inside the tooth can take time to recover. Severe toothache however would need urgent attention as on rare occasions the nerve is unable to recover and can become infected or abscesses.

Well constructed fillings should last for many years. You should expect between 7 and 15 years for a direct restoration. Reports would suggest that gold fillings, called inlays, made in the laboratory are the most successful of all.

As with any tramatic procedure there is always a risk. More drilling may cause the nerve inside the tooth to become irreversibley dammaged and need further attention. It is worth remembering that, with further intervention the cavity can only get bigger.

When a filling breaks, the tooth fractures around a filling or decay gets under a filling, it must be replaced. You will not always experience pain or feel a hole in your tooth. Your dentist will take X-rays and may use a tiny camera in your mouth to monitor the integrity of your old fillings.

Dental occlusion is the way in which your teeth contact when you bite together, swallow, chew or clench. Your dentist will routinely make an assessment of your occlusion based on whether it is a comfortable and stable relationship that works well for you. A poor occlusion might lead to more serious problems later in life, so your dentist may suggest ways in which it might be improved as a preventative measure.

When you bite together your teeth should, ideally, meet evenly on the back teeth and allow you to chew efficiently and comfortably. However, teeth may grow or drift into the wrong place, they may be lost due to decay, trauma or gum disease or they may just wear away over time; all of which could result in occlusal problems.

If your teeth don’t meet evenly, such as when you have a new filling or crown that is slightly “high”, this could cause pain on biting or with extremes of temperature. In the long term you could develop mobile teeth, receding gums, fractures, abnormal wear, tension headaches and even jaw joint problems such as stiffness, clicking and locking.

Clenching or grinding your teeth, which many people do due to stress, will put much more strain on the teeth, muscles and joints, particularly if it’s done during sleep when you don’t have conscious control over your actions. Other factors like a whiplash injury, holding your mouth open wide during root canal therapy, or even just yawning and shouting can also bring on problems.

If the problem is just related to the way the teeth meet then treatment may be as simple as polishing the tooth that is too high or as complicated as rebuilding the teeth with crowns, bridges or implants, or even moving them with orthodontics or surgery in more extreme cases. However, in most cases, if clenching or grinding habits are suspected, it would be more usual for some sort of hard plastic splint to be made which will prevent further damage and allow healing to take place.

TMJ stands for TemporoMandibular Joint - in other words, the joint between your Temple and Mandible (lower jaw). This is the joint that allows your mouth to open and close, and to move from side to side or forwards and backwards during chewing.

TMD usually refers to a “disorder” of the temporomandibular joints (TMJs) and the muscles and nerves that control the movement of the jaws. If the joints are affected this could cause pain just in front of the ears, particularly on wide opening or chewing hard foods, or some limitation of movement and reduced function. Headaches, migraines, sinus pain, dizziness and joint noises are also common symptoms in TMD.

It does seem strange, but studies show that about 80% of the population have this habit from time to time. It tends to be worse at more stressful times, such as before exams and holidays, and it’s often worse in more intelligent people who normally appear to cope well with stress. There’s also some evidence that clenching and grinding takes place more during REM (dreaming) sleep.

If you stand in front of a mirror in a good light you can check a few things. Firstly, open your mouth and, without moving it around, look at your tongue - does it have indentations? And your cheeks, are there lines along the inside that match where your teeth meet? Finally your teeth, rub them together and have a look if they fit together in particular positions - that may be where you are habitually holding them and you could have worn them away so much that they now fit like a key in a lock.

Most dentists will be able to make an initial diagnosis of a problem with your occlusion or TMD. Depending upon the dentist’s training and the severity of your problem you may then need to be referred to a dentist with a special interest who can carry out tests and x-rays as required. This could be an Oral and Maxillofacial Surgery Department at your local hospital, or a specially trained dentist in private practice. The first phase of treatment will usually be some form of appliance (splint) that will help to establish a proper diagnosis.

An Implant- retained bridge is like a regular dental bridge, but instead of held in place by natural teeth it is supported by implants. When an implant-retained bridge is used, one or more implants are placed according to the patients needs and then crowns which are linked to each other to form a bridge are placed on top of the implants. Unlike traditional bridgework, implant retained bridges are more conservative as there is no need for destruction of tooth tissue

They are often used when there is one or more teeth missing or in some cases they are used when teeth are extracted. They are ideal for patients who cannot tolerate a partial denture or when the natural teeth are not suitable. They are used to improve function and/or aesthetics.

The first stage of the process is placing the titanium screws directly in the jawbone. This is done under Local Anaesthesia. The implants are then left to integrate for about 3-6months. After healing the dentist then uncovers the screws and healing abutments are fitted. An impression is then taken which is sent to the laboratory for the fabrication of the bridge. The final bridge is then cemented or screwed in place.

IRBs have a higher success rate than conventional bridges. Since there is no need to prepare any neighbouring teeth there is no risk of needing root canal treatments in the future. Since the implants take up all the forces on the bridge, there is no risk of tooth movement. There is also no risk of recurrent caries to the prepared teeth as the bridge is supported by the implants which are made of titanium

Implant retained Bridges are more expensive than conventional bridges. The procedure involves minor oral surgery and it is done under Local Anaesthetic but some patients who have dentist phobia might not wish to have it done. The process involves multiple visits to the dentist and takes longer to be completed as the implants need to heal first. If there is not enough bone present, the patient might need a bone graft which involves more surgery.

The IRB must be treated like your natural teeth. It must also be cleaned with a special type of floss or a little brush that your dentist will give you. That way the space between the gum and the implants is kept healthy. You might need to see your dentist more regularly for the first year or two and have regular hygiene visits.

There are a small number of clinically qualified technicians who do supply dentures directly to the public, but they cannot provide restorations such as crowns, bridges, implants or more complex restorations. These must be prescribed by dentists, who work in close cooperation with specialist dental laboratories.

Dentists and dental technicians will work together as a team to provide correctly designed and constructed crowns, bridges and dentures. This involves careful examination, diagnosis, and treatment planning to ensure that the best possible treatment options are made available to all patients.”

About twice as long, at least, as a porcelain restoration

In most cases it can be well hidden, so when talking to people , they will not notice that you have a gold restoration

For a crown, only 1mm, which is 50% less than for porcelain.

Most dentists usually charge the same, if not less, than for a porcelain filling

There is a small risk of this happening but this risk is far smaller compared to other preparations as less tooth needs to be taken away

Yes, but this can be an advantage as it acts as a shock-absorber when chewing and means the restoration will last longer

No. Gold is mixed with other metals to make the resultant alloy harder and therfore more resistant to wearing away. Pure gold would be too soft.

Yes. The gold needs to be 'tin-plated' by the laboratory technician and then it can be bonded to the tooth with the modern-day resin.

Yes. In fact a porcelain and metal crown will look more tooth-coloured if a high gold content metal is used underneath the porcelain

Yes. Probably the best material for making a post for root-treated teeth is a high gold content metal. It has the most scientific research to back up its use compared to any of the modern materials. And it requires less tooth to be taken away