1. Implant Dentistry
  2. Hygiene and Maintenance
  3. Tooth Borne Crowns and Bridges
  4. Veneers
  5. Tooth Whitening
  6. Full Mouth Reconstruction
  7. Sinus Grafting
  8. Implant Supported Over Dentures
  9. Facial Aesthetic Treatments
  10. Sedation Dentistry 


1.  Implant Dentistry

All aspects of implant dentistry are undertaken routinely.

Implant Components

There are basically three parts to an implant restoration:

  1. The titanium ‘root’ piece which gets placed in the bone. Over time, bone grows up to and around the implant ‘root’. This process is called ‘osseointegration’ and provides a biologic fixation with the bone.
  2. The abutment is the component which is connected to the implant ‘root’ once the implant root has integrated.
  3. The definitive porcelain implant crown/tooth, which is made in a laboratory and fitted to the implant abutment.

Sometimes it is possible to connect a temporary or transitional crown to the implant ‘root’, at the implant insertion appointment. This can only be done if a number of important ‘clinical checkpoints’ are passed at this insertion appointment. It is not possible to accurately assess these conditions beforehand, only at the time of the implant ‘root’ placement appointment.

The time required for osseointegration can vary from patient to patient, but a guideline of eight to twelve weeks would be reasonably common.

Implants are used to:

  • Replace a single missing tooth.
  • Support a bridge which spans the gap of more than one missing tooth.
  • Help full denture wearers who find the mobility of their dentures intolerable. In this case the placement of a few strategically placed implants in the jaw can act as supports with ‘poppers’ on top which ‘snap’ into corresponding receptors on the underside of the denture. While this may not totally eliminate movement of the denture, it certainly reduces it to an acceptable level, where the denture remains stable under function, allowing greater confidence during chewing and speech and improved patient satisfaction.
  • Replace full dentures with a fixed restoration. This is for patients with no teeth who wear full dentures and who want a totally stable, fixed restoration that is not a denture. It is often possible in the presence of sufficient bone, to have multiple implants placed to retain bridgework, thus avoiding a removable denture.

Success rates of 98% are achievable in the hands of properly trained and skilled dentists. When properly planned and executed, dental implants are a safe and predictable treatment modality and are often the preferred alternative to conventional tooth supported bridgework and dentures.

 When an implant is used to replace a missing tooth rather than a conventional bridge or an adhesive bridge, the teeth either side of the gap are not needed to retain the replacement tooth, i.e. your own teeth remain untouched. Thus it is a minimally invasive means of replacing a missing tooth.

How 'easy' or straight forward an implant case is for a particular patient depends on the quality and quantity of own available into which an implant can be placed.  To this end CAT scan is often necessary to determine baseline height and width of bone levels.  This information can be garnered in house at SEDS, as we have available ont he premises as state of the art Serona, Galileos, digital low dose radiation CAT scan machine.  This enables us to give you very compreshensive treatement proposals early in the consultation process.

 Once integration has sucessfully occurred, the titanium root component of the implant can be considered a longterm root support and has the potential to last a lifetime. The implant retained porcelain crown or ‘tooth’ on top of the implant root is subject to wear and tear and can be expected to need replacement over time. This time interval varies from patient to patient and is influenced by many factors such as:

  • Are the restorations being regularly cleaned and maintained during patient homecare and as part of a regular dental recall ?
  • Are there enough other teeth of suitable quality in the mouth to help share the chewing function load ?
  • Are the restorations under increased load because they are compensating for other missing or weakened tooth units ?

An individual who is a heavy grinder or clencher can expect to have more wear and tear than a non grinder and therefore more replacements over a life time.  


  • In a small percentage of cases there is failure of the implant to integrate. If this is the case, the implant is removed and the area allowed to heal. In due course the implant is placed again possibly in a different site.
  • Swelling, bruising.
  • Infection. - As with failure to integrate, the implant will be removed and replaced once healing has occurred.

Pre Implant treatment

If it is determined that bone is deficient in your particular case, bone grafting may be necessary before implants can be placed.

In the case of the upper jaw, if CAT Scan reveals that the bone under the sinus cavities is sparse and insufficient for implant placement, it may be necessary to ‘lift’ the sinuses with grafting material. This is called a Sinus Lift Procedure.

If implants are required in the front of the mouth in what is called the Aesthetic Zone  and there is insufficient gum in the area to allow a pleasing end result, it may be necessary to have gum generated so that when the implant crowns are fitted, they look natural, as if they have emerged from the gum the way a natural tooth would. We sometimes achieve this ‘gum growth’ by using specially adapted orthodontic techniques.  

Placement Appointment

On the day of your appointment, you will be given antibiotics and anti-inflammatory medication prior to the procedure which will take place under local anaesthetic just like any other dental procedure. Most patients do not find implant placement any more demanding than other forms of dental treatment.

However, if you feel you would like help with anxiety, we can offer either inhalation sedation, intravenous midazalam conscious sedation or oral sedation.  No matter what form of sedation is deemed suitable for you, you will be awake, conscious and responsive at all stages.

Swelling can occur after treatment and therefore it is sensible to take anti-inflammatory medication on a regular basis as indicated even in the absence of pain to help with any swelling. Peak swelling can occur 48 to 72 hours after surgical procedures.

Implant supported crown construction

Once the implant has integrated, an impression of the area is taken in order to make a mould to facilitate construction of the implant supported crown in the laboratory. Once made, the crown is fitted, often with a light based cement so that access to the implant root can readily be obtained by the dentist if so desired. 


2.  Hygiene and Maintenance

Once you have completed your treatment and your restorations are successfully in place, they will need to be maintained. Restorations are only as good as their foundations and the foundations, like your own natural teeth, can become compromised by bacteria. 

We have a dedicated hygiene dentist who will assist you in the correct home maintenance of your restoration(s) and general oral hygiene. We understand and value that you, as a patient, have made considerable investment of both time and expense in the health and function of your mouth.  We will encourage and help you maintain your new oral status.  You will be taught the skills, tools and techniques to maintain in health, every surface of every tooth every day.

At a hygiene appointment:

  1. Your medical status will be reviewed to see if there is any general medical condition which could have an impact on your oral health.
  2. An oral cancer screen will be performed as well as screening for oral symptoms of other serious medical illnesses.
  3. Any necessary digital xrays will be taken.
  4. Hard and soft deposits of calculus and plaque which contain damaging bacteria will be removed.
  5. Your Implants/Restorations will be reviewed.
  6. If surface tooth staining is present, this will be removed by means of prophyjet technology.
  7. Your teeth will be polished.
  8. Instruction on the maintenance of your implants/restorations will be reinforced and demonstrated.
  9. Oral hygiene instruction will be given.
  10. Desensitising medicaments will be applied to any sensitive teeth.

We usually advise that you alternate your hygiene appointments between our hygiene dentist and you own dentist to ensure maximum oral health as it is now known that poor oral health can have serious implications for your general health and well being.

If appropriate, local anaesthetic and/or nitrous oxide relaxation gas can be administered to make your appointment more comfortable.


3.  Tooth Borne Crowns and Bridges

Crowns are used to protect and rebuild broken teeth that are beyond filling. They can also be used to reshape teeth.

Crowns are custom made in a dental laboratory and are normally composed of porcelain reinforced with metal. They are cemented on the natural tooth which must be prepared first to accept the crown. At the preparation appointment, the tooth and surrounding gum is numbed with local anaesthetic and then the tooth is prepared and shaped in such a way that the crown will fit precisely, giving a smooth transition against the gum margins. This is important as if a crown is poorly fitting, it will not lie harmoniously against the gum and the health of the gum will be compromised. Every endeavor is made at SEDS to ensure the fit is excellent, from the attention to detail and particular techniques used at the preparation stage to the construction stages undertaken in the laboratory. The quality of different dental restorations vary widely. Quality depends on attention to detail at all stages of construction and this cannot be emphasised enough. The life span of a restoration depends heavily on these factors.


When the support teeth either side of the gap are heavily filled and would benefit from protection;  a conventional bridge may be suggested.  In this case the support teeth are crowned and joined to the crown replacing the missing tooth.

When the support teeth either side of the gap do not themselves require restoration or protection; an adhesive bridge may be suggested rather than a conventional bridge, as these bridges require less intervention to the abutment support teeth. The missing tooth is replaced by a crown that has metal ‘wings’ on either side that are bonded to the back of the abutment teeth in such a way that the ‘wings’ are not visible from the front of the teeth.


4.  Veneers

In some cases it is advantageous to alter the shape, shade or alignment of a tooth and this is often achieved using a porcelain veneer. Veneers are a very thin porcelain shell of tooth coloured ceramic material that is bonded to the front surface of the tooth. While the natural tooth is prepared to a certain extent to accept the veneer, the preparation is minimal when compared to that needed for a conventional crown. As a general rule, crowns tend to be used to restore more broken down teeth while veneers are used to improve:

  • Discoloured teeth.
  • Cracked or chipped teeth.
  • Unevenly spaced teeth.
  • Misaligned teeth.
  • Worn teeth.


5.  Tooth Whitening

This technique can be used on its own, or is often used at SEDS as an adjunctive therapy to other restorative measures. For example, before crown or veneer preparation it is sometimes advantageous to prelighten the underlying tooth structure so that the finished crown or veneer can reflect more light from it’s surface and therefore look more vibrant.

Tooth Whitening is also used extensively to restore vitality and youthful appearance to natural teeth and in some cases is the only treatment required for a dental cosmetic up grade.

There are different types of bleaching techniques:
•  Home whitening with 10% Carbamide Peroxide.
•  In-office whitening
•  Deep whitening
•  Non-vital tooth whitening (to lighten the colour of a previously root treated tooth)
•  Combination therapies
You will be advised which technique is most suitable for you. Donal Blackwell has lectured and advised dentists for many years on the various techniques for tooth whitening due to his experience and success rates. While there are many over the counter ‘whitening’ products and ‘whitening’ toothpastes, results are mixed at best.

Many unregulated products often contain acidic components in their formulation which can be very damaging to teeth. These types of products, although freely available, are to be avoided. The safest and most predictable results are obtained under the guidance of  dentists familiar and successful with the procedure, using regulated products with proven documented efficacy and safety data.



6.   Full Mouth Reconstruction

In some cases, teeth are so broken down that oral function is at a minimum and reconstruction of the whole mouth is required to establish a functioning bite. This requires a high level of expertise and is accomplished using an extensive variety of dental techniques. 


7.  Sinus Grafting

The maxillary sinus is an air cavity lying over the upper back teeth. There are many air cavities in the skull and their function is to allow air to circulate and humidify.

The maxillary sinus has no major important biologic function and can increase in size and volume over time.  If any of the maxillary teeth are lost, the sinus increases in size to occupy the area of the lost teeth. This means that bone volume is decreased and there may not be enough bone to place implants without intervention.

Bone volume increase in this situation is achieved by grafting which lifts the sinus. Success rate for implants placed in the grafted maxillary sinus area is 92%. Antibiotics and anti-inflammatory medication is prescribed before and after the procedure which is carried out under local anaesthetic.

There are two methods by which the sinus is lifted.
Osteotome Sinus Lift

In this procedure, the area to be lifted is relatively small and the sinus anatomy favourable. The graft material is advanced into the sinus by an instrument called an osteotome through a small opening made in the gum at the site of the missing tooth. The implant is often placed at the same time as the grafting procedure or may be done after a period of healing.

Lateral Window Sinus Lift

This technique is used when larger areas require lift. ’A window’ is made through the bone on the side of the sinus in the area above the missing teeth and graft material is placed directly into the sinus space. After several months of healing, the grafted bone integrates with the surrounding bone so that there is sufficient volume for implant placement.   



8.  Implant Supported Over Dentures

The jaws are composed of two types of bone called basal bone and alveolar bone. Most of the major vessels and nerves are in the basal bone and the teeth are housed in the alveolar bone.  When teeth are lost the alveolar bone no longer has a function and resorbs over time. If all the teeth are lost as is the case in full denture wearers, there is considerable bone loss over time. This is more noticeable on the lower jaw as there is less bone here to start, the upper jaw having the benefit of the palate and no moveable tongue.

This brevity of bone can make wearing dentures, especially lower dentures, very difficult due to movement. It can also be painful as the lower denture will eventually lie on basal bone and therefore on nerves and blood vessels housed in this bone.

If at least two dental implants are placed in the jaw,  they can support an implant assisted over denture. Implants are placed that have snap like anchors which snap into corresponding anchors on the denture giving security and confidence to the patient. The denture remains in place but can be removed by the patient.

This relatively simple technique can truly revolutionise people’s lives as it allows more comfortable nourishment and confidence when speaking.


9.  Facial Aesthetics

After achieving a nice new smile it can be advantageous to frame the result with revitalised lips. With time, the definition and outline of the lips can fade, causing what is known as ‘lipstick bleed’.

Dermal fillers can be used in a subtle way to give renewed definition without unnecessary over plumping.

Other areas can be treated by means of dermal filler to give structure  and foundation to the oral area.

These areas are:

• The area between the nose and the side of the mouth, which is known  as the nasolabial fold.
• The area from the side of the mouth to the chin, which is known as the marionette line.

Botulinum toxin treatments (BTX) are available to soften wrinkles:

• over the nose,
• across the forehead,
• at the side of the eyes (‘crows feet’),
• to disguise or reduce a high lip line which causes unsightly show of the gums over upper teeth.


This simple treatment can avoid the need for surgery.




10.   Sedation