Restorative dentistry

We place both types of filling. Composite, white in colour, bonds to the tooth and is completed in a single visit: it is the usual choice for visible teeth and for small to moderate cavities. Amalgam, grey in colour, stands up very well to heavy chewing loads and remains appropriate for certain posterior restorations.

The choice depends on where the tooth sits, how large the cavity is, how much force the tooth has to take, and what you prefer. We discuss it with you before we start, not afterwards.

An old filling that cracks, comes loose or lets decay through underneath needs replacing. That is not a failure: restorations have a lifespan, and regular follow-up exists precisely to catch the moment when it is time to act.

At the centre of every tooth is the pulp, which holds the nerve and the blood vessels. When deep decay, a fracture or repeated trauma infects it, the pain resolves neither with a filling nor with antibiotics alone. Root canal therapy means removing the affected pulp, cleaning and shaping the canals, then sealing them.

The signs that should bring you in: pain that lingers long after contact with something hot or cold, spontaneous pain, especially at night, a tooth that hurts under pressure, a swollen gum next to a tooth, or a tooth that darkens.

The procedure is done under local anaesthetic, in one or two visits depending on the tooth. A treated tooth becomes more brittle: it almost always needs a crown afterwards so that it does not fracture.

These treatments are provided by a general dentist. In Quebec, the title of specialist is reserved for dentists recognised by the Ordre des dentistes du Québec.

A crown covers a tooth that has become too damaged to be simply filled — a large fracture, heavy wear, or a tooth that has had root canal therapy. It restores the shape and lets the tooth take chewing forces again.

A bridge replaces one or more missing teeth by resting on the neighbouring teeth, which have to be prepared to receive it. It is a fixed solution: it does not come out. Where the neighbouring teeth are intact, an implant is often worth considering, because it leaves them untouched.

In both cases the sequence is the same: preparing the tooth, taking an impression, fitting a temporary piece, then trying in and cementing the final one. We discuss materials — ceramic, ceramic-fused-to-metal — according to where the tooth sits and the forces it must handle.

A bridge needs a particular cleaning routine: floss has to pass underneath the part that replaces the tooth, using a floss threader or an interdental brush. We will show you how.