Patient information

Patient Questions

Clear, balanced answers about preserving natural teeth, replacing missing teeth and planning complex dental treatment. This information cannot determine which treatment is suitable without an individual clinical assessment.

Saving or Replacing Teeth

1. Can my tooth be saved, or does it need replacing?

A damaged or infected tooth should not automatically be removed. The first question is whether it can be restored to a comfortable, functional and maintainable condition.

Assessment may include the remaining tooth structure, the condition of the root and surrounding bone, gum health, cracks, previous root canal treatment, the bite and the likely demands placed on the tooth. A tooth may be preserved with root canal treatment, retreatment, bonding, an onlay or a crown. In other circumstances, extensive structural damage, an unfavourable fracture, advanced periodontal disease or an unpredictable restorative outlook may make removal more appropriate.

The decision should compare the expected benefits, limitations, maintenance and risks of preservation with those of extraction and replacement. Keeping a maintainable natural tooth is often desirable, but treatment should not be continued when the prognosis is unacceptably poor.

2. Does root canal treatment hurt?

Root canal treatment is normally performed using local anaesthetic so that the tooth and surrounding area are numb. Most patients should not experience sharp pain during treatment, although an acutely inflamed tooth can sometimes be more difficult to numb. Additional anaesthetic techniques can be used when necessary.

The purpose of treatment is to remove inflamed or infected tissue from inside the tooth, disinfect the root canal system and seal it. The tooth may feel tender when biting for several days afterwards, particularly when there was infection or inflammation before treatment. This usually settles, but increasing pain, swelling or other unexpected symptoms should be reported promptly.

Complex anatomy, previous treatment and procedural complications can affect the treatment required and its prognosis. No root canal procedure can guarantee that every tooth will heal or remain symptom-free.

3. Why does a root-treated tooth sometimes need a crown or onlay?

Root canal treatment manages disease inside a tooth; it does not replace tooth structure already lost through decay, fracture, previous fillings or access to the root canals.

Back teeth commonly carry substantial biting forces. If their remaining cusps and walls are weakened, a bonded onlay or crown may be recommended to reduce the risk of fracture and restore function. The most conservative suitable restoration depends on how much sound tooth remains, the bite, the presence of cracks and the location of the tooth.

Not every root-treated tooth needs the same restoration. The final restoration and its timing should be planned as part of the root canal assessment.

4. What can be done about worn teeth?

Tooth wear can be caused by several interacting factors, including acidic food or drinks, reflux, tooth grinding, clenching, an unstable bite and abrasive habits. Treatment begins by identifying these factors and determining whether the wear is active.

Early or stable wear may only require prevention, monitoring and protection. More advanced wear may be managed with composite bonding, onlays, crowns or a planned combination of restorations. Trial restorations or provisional changes can sometimes help assess appearance, speech and bite before definitive treatment.

The aim is not simply to make teeth look longer. Treatment must create a maintainable bite, preserve viable tooth structure and allow comfortable function.

Clinical examples illustrate individual treatment. Circumstances and outcomes vary, and a case does not predict another patient’s result.

Clinically reviewed by Dr Firas Daoudi.

Dental Implants

5. Am I suitable for dental implants?

Suitability depends on more than whether a space exists. Assessment considers your general health, medications, smoking, gum health, oral hygiene, available bone, restorative space and the forces created by your bite.

Active gum disease and uncontrolled dental disease normally need to be stabilised first. A clinical examination, photographs, digital scans and radiographs are commonly required. Three-dimensional CBCT imaging may be indicated when conventional radiographs cannot show the necessary anatomy.

Implant position should be planned backwards from the intended crown, bridge or denture so that the restoration can be biologically safe, cleansable and appropriately supported.

Related information: Dental implants · Advanced implant procedures · Arrange an assessment

6. What are the stages of implant treatment, and how long does it take?

Treatment usually begins with diagnosis and restorative planning. Any active decay, gum disease or infection should be addressed before implant placement.

The implant is placed under local anaesthetic. Healing time varies according to the site, bone quality, implant stability, grafting and individual healing. After healing, impressions or digital scans are used to make the crown, bridge or removable overdenture.

A straightforward case may take several months. More complex treatment can take longer. Immediate or early restoration is suitable only in selected circumstances.

7. Implant, bridge or denture: how do I decide?

An implant can support a crown, bridge or removable overdenture. It requires surgery, sufficient healthy tissue, ongoing maintenance and acceptance of implant-specific risks.

A fixed bridge may be appropriate when neighbouring teeth can provide reliable support. A removable denture can replace several teeth and surrounding tissues without implant surgery. Leaving a space can also be reasonable when appearance, function and tooth stability are not adversely affected.

The decision should compare biological cost, predictability, maintenance, treatment time and personal priorities.

8. Will I need a bone graft or sinus lift?

An implant needs sufficient bone in an appropriate position. Bone volume can reduce after tooth loss, infection, trauma or previous surgery. In the back of the upper jaw, the maxillary sinus may limit the available bone height.

A bone graft may rebuild a local defect. A sinus lift raises the sinus lining so graft material can be placed beneath it. Not every patient with reduced bone needs grafting; alternatives may include a different implant design, a bridge, a denture or accepting the space.

Grafting adds surgical complexity, healing time and specific risks, which should be discussed before consent.

9. How long do implants last, and how are they maintained?

Dental implants can function for many years, but they should not be described as permanent or maintenance-free. The implant, surrounding tissues and attached restoration can each develop problems.

Long-term care includes effective daily cleaning, professional maintenance and periodic examination of the gums, bite and restoration. Smoking, a history of periodontal disease, poorly controlled diabetes, ineffective cleaning and excessive biting forces can increase risk.

The restoration may require maintenance even when the implant remains integrated. Inflammation around an implant should be assessed early because progressive bone loss may compromise it.

The linked case is an individual clinical illustration. It does not establish typical implant longevity or predict another patient’s outcome.

10. My implant crown feels loose. What does that mean?

A loose implant crown does not always mean that the implant itself has failed. Possible causes include a loosened prosthetic screw, failure of the cement, damage to the crown, or a problem affecting the implant or the surrounding bone.

Avoid chewing hard foods on that side and contact the dentist who provided your implant treatment as soon as possible. They hold the records and component details needed to assess and repair it. Continuing to use a loose restoration can damage components or make repair more difficult. Do not attempt to tighten or glue it yourself.

If you notice swelling, discharge, significant pain or rapidly increasing movement, seek urgent dental advice from your own dentist or NHS 111.

Treatment depends on the cause. A crown or screw can often be repaired by the clinician who provided it. Problems involving the implant itself or the supporting tissues need a different discussion.

If the dentist who provided your treatment is no longer available, see ‘Can you help with a failing implant placed elsewhere?’ below.

11. Can you help with a failing implant placed elsewhere?

Dr Daoudi can assess an implant placed elsewhere and explain the apparent problem, prognosis and reasonable options. Where appropriate, he may remove a failing implant.

He does not restore implants placed by other clinicians. This includes making a new crown or bridge directly on an implant that another clinician has placed.

If removal is appropriate and the site may subsequently be suitable for a replacement implant, that treatment follows Dr Daoudi’s standard implant pathway. It requires fresh assessment, planning and consent; replacement cannot be confirmed before the condition of the site has been evaluated.

An assessment does not assume that the original treatment was inappropriate, because implant complications can arise for several reasons.

Related information: Implant complications · Advanced implant procedures · Request an assessment

12. What are the fixed options if I’ve lost most of my teeth?

A fixed full-arch bridge can sometimes replace most or all teeth in one jaw using several implants. The appropriate design depends on available bone, implant distribution, gum display, lip support, speech, cleaning access, bite and the materials used.

A fixed full-arch bridge may be supported by four or six implants, sometimes called ‘All-on-4’, ‘All-on-6’ or ‘All-on-X’. These descriptions do not mean that the branded Nobel Biocare All-on-4 treatment concept is being provided. Implant number alone does not determine suitability or outcome. Position, distribution, unsupported bridge length, implant stability and biting forces are important.

A removable implant-supported overdenture may offer good stability while being easier to remove for cleaning. Full-arch treatment requires a clear discussion of surgical and mechanical complications, maintenance, repair and what happens if an implant is lost.

Clinical examples illustrate individual treatments and do not show what is typical or promise comparable results.

Clinically reviewed by Dr Firas Daoudi.

Aesthetic Treatment

13. Composite bonding or veneers: what’s the difference?

Composite bonding uses tooth-coloured resin applied directly to a tooth. It can repair edges, adjust selected shapes and close some spaces, often with limited tooth preparation. Composite can stain, chip or wear and may require maintenance or replacement.

A porcelain veneer is a laboratory-made ceramic restoration bonded to the front of a tooth. It may provide greater colour and surface stability in suitable circumstances, but it is usually less readily repaired and may require removal of some tooth structure.

Neither option is automatically preferable. The decision depends on tooth position, colour, existing restorations, enamel, bite, the number of teeth involved and the changes being requested.

14. How much tooth is removed for veneers?

The amount varies. Some carefully selected teeth can receive very thin veneers with minimal preparation, while others require more reduction to create space, change position or mask colour. ‘No-preparation’ treatment is not appropriate for every tooth.

Planning should account for the desired shape, existing enamel, tooth position, bite, gum line and the thickness required by the ceramic. Preserving enamel is valuable because bonding is generally more predictable when sufficient enamel remains.

Adding ceramic without appropriate space can make teeth appear bulky. Conversely, unnecessary reduction removes sound tooth structure. Digital planning, photographs and a trial smile can support the decision.

These cases are individual illustrations. The preparation required and the outcome depend on the patient’s own teeth, bite and treatment needs.

Related information: Ultra-thin veneers · Aesthetic dentistry planning · Ultra-thin veneer example

Clinically reviewed by Dr Firas Daoudi.

Consultations, Locations and Aftercare

15. What happens at my first appointment?

The first appointment is primarily an assessment, not a commitment to treatment. You will be asked about your concerns, dental history, relevant medical conditions, medicines and what you hope to achieve.

The examination may assess teeth, restorations, gums, bite, jaw function and any implants. Photographs, digital scans or radiographs may be advised. Existing records are helpful when available.

Dr Daoudi will explain the initial findings, uncertainties and reasonable next steps. If you feel worried about treatment, tell the team when arranging your appointment so that sufficient time and support can be considered.

16. Why do treatment fees vary?

Fees reflect the diagnosis and the individual treatment required. Relevant factors can include complexity, appointment time, imaging, laboratory work, materials, implant components, grafting, sedation where applicable and the amount of follow-up or maintenance anticipated.

Dr Daoudi works as a visiting clinician at three independent dental practices. Each practice is responsible for its own appointments, fees, payment arrangements and treatment administration. This means fees can differ between locations.

A meaningful estimate normally requires an assessment. Information on this website is not a quotation. You will receive an explanation of the proposed treatment and its costs before proceeding.

Related information: Contact the selected practice · Treatment overview

17. Which of the three locations should I choose?

Dr Daoudi provides care as a visiting clinician at three independent dental practices: Bespoke Smile in Central London, Park Road Dental in Teddington and Smile Design by Ash in Chigwell.

You may choose according to travel, availability, the type of consultation required or where your existing care is already being provided. Existing patients should normally select the independent practice managing their current treatment.

If you are unsure, select ‘Not sure which location’ on the enquiry form. We’ll help direct your enquiry to the most suitable location. Submitting an enquiry does not book an appointment.

18. I’d like a second opinion. How does that work?

A second opinion is an independent assessment intended to clarify the diagnosis, prognosis and reasonable treatment options. It does not assume that a previous dentist’s advice or treatment was inappropriate.

Bring relevant radiographs, reports, treatment plans and details of any symptoms or previous care. New records may be required if the available information is incomplete or no longer current.

The consultation may confirm the existing recommendation, identify alternatives, suggest further investigation or advise monitoring rather than treatment. With your permission, findings can be communicated to your usual dentist.

Clinically reviewed by Dr Firas Daoudi.

Urgent dental problems: contact your own dentist or NHS 111.