Practice News

our service

March 2020

I am delighted to announce that our extended contact activity has just been confirmed. Should you wish to make an appointment for yourself or someone else, kindly get in touch with us at your convenience. -Conrad Costa

 

GDPR

May 2018

We have updated our privacy policy in accordance with GDPR legislation. Our website does not track you, nor do we collect any information about you whilst you browse our website. We do not covertly make you mine Bitcoin on our behalf nor do we drop any cookies or sell you adverts. We value our own privacy very much and therefore have a lot of respect for your online privacy.

Patient satisfaction Survey

August 2016

Our patient satisfaction survey, which had been ongoing since April, is now closed. We would like to thank all those who participated. We would nonetheless welcome your feedback (whether written, verbal or by email) at any time. Our Friends and Family Test remains ongoing.

New Practice manager

January 2016

We would like to extend a warm welcome to Ms Angelique van Woerkom, who joins us at Castle and Costa as our new Practice Manager. Angelique has many years of experience as a Dental Care Professional and had worked for us frequently as a locum. She is familiar with our working system and is very eager to learn and help us improve our service.

New Associate Dental Surgeon

August 2015

We are pleased to welcome Dr Gavin Gill to our practice as our new associate dental surgeon, following the retirement of Dr Gillian Fellows. Dr Gill has many years of experience in general practice and in teaching hopsitals and will prove to be an asset to our team.

CQC inspection and report

June 2015

We are delighted to announce that Castle and Costa Dental Surgeons have passed their CQC inspection. Following a visit by two inspectors, we were given a clean bill of health - as well as a few suggestions - which we have taken on board. For more information, visit our Resources page.

Dementia Awareness training

November 2014

We extend our congratulations to our dental care professionals and dentists after they were awarded an NVQ level II in dementia awareness training. This will enable us to engage with our patient base better and to improve our understanding of their condition.

Conrad and audrey Costa

March 2013

We are pleased to announce that following the sad demise of Mr Castle, Conrad and Audrey Costa have recently taken over the running of the practice and will strive to maintain and improve the good standard of care that Castle and Costa have been delivering to the non-ambulatory for the past years.

Firefox 3

Get a free PDF reader

Get DoPDF for free

Crowns, Bridges & Implants

Restoring badly damaged teeth or replacing missing teeth is the job of advanced dental techniques such as crowns, bridges and implants.

Crowns are 'jackets' of metal, porcelain or a mixture of both that are designed to sit onto an adequately prepared tooth to restore function and/or aesthetics as appropriate. Teeth are prepared by being cut into smaller sizes, and a crown is manufactured at a laboratory on a model that is prepared from an impression of the prepared tooth. Being stronger than the original tooth and because it sits over the surface of the tooth, the crown gives added support th the tooth structure which would have been weakened through fracture or extensive filling.

This picture shows a model with the front teeth prepared for crowns. The crown on the left of the picture is a porcelain-fused-to-metal crown (PFM), showing the metallic base structure. This will eventually leach a greyish discolouration around the gums and gum margins, and may look artificial. The one on the right is a full-porcelain crown (PJC), which is highly aesthetic, albeit more brittle.

Bridges are two or more crowns joined together that replace a missing tooth. A tooth adjacent to a space is crowned, with a second crown joined onto it which replaces the missing tooth. A special sort of bridge known as an adhesive bridge does not make use of the first crown, rather it uses a metal wing that sticks to the adjacent tooth using a special cement, and serves the same function as a traditional bridge. Adhesive bridges have the advantage that they are reversible, and one does not have to cut an adjacent tooth to take a crown.

A Conventional Bridge shown from above, with the 'false' tooth lying in between two crowns

 

The same conventional bridge, showing its metallic sub-structure. This has the same disadvantages as the PFM crowns, shown above

 

A Maryland (minimal preparation) bridge shown next to a cast of the tooth it is intended to replace

The Maryland Bridge situated on the study cast. Note the lack of damage to the neighbouring teeth

Both crowns and conventional (non-adhesive) bridges involve cutting a tooth down to a certain extent, to allow room for the supporting crown to be cemented. This implies a risk of possible damage to the said tooth - around 40% of crowned/bridged teeth will develop inflammation (pulpitis) which may manifest as sensitivity or discomfort for a while following cementation of the crown/bridge. In most cases, this sensitivity will eventually resolve, but in some cases, the pulpitis becomes irreversible, and might lead to toothache in the long-term, with the affected tooth/teeth requiring extraction or Root Canal Treatment.

 

Implants are the ultimate in replacing missing single or multiple teeth. Metal or crystalline implants resemble screws, which are placed in a precise manner into the bone under the gums. Following a discrestionary period of healing to allow integration of the implants into the bone, the implants are then restored the conventional way with a crown or a bridge on the surface. In cases of fully edentulous patients, a number of implants (typically 3 or 4 top and bottom), are used to support a fixed bridge (usually screwed into place) or a removable denture, that is more likely to stay securely in place being aided by special connectors.

Since no other adjacent teeth are harmed or relied on in replacing a tooth or a number of teeth when implants are used, these are quickly becoming the method of choice for replacing missing teeth, especially in aesthetically-conscious patients and in difficult cases where other options might not be beneficial in the long term. The only drawback at the moment is cost, since implants may cost around £1,500.