Tooth Extraction

If it is not broken, do not try to fix it. Your natural teeth are the best when they are functioning properly. We will always try our utmost to keep your natural teeth. This is part of our core values – to be gentle. However, teeth do break, get damaged or infected to a level that they cant be saved. Then we, together with you, will discuss the alternatives to, if needed, replace the missing tooth or teeth. Implants are not the only alternatives, but the most common.

When required, the Snö team are highly experienced in removing a tooth in the most gentle way possible. To give you the latest kind of care we have 3D x-ray (cone beam) for better diagnosis, we Nitrous Oxide for sedation and The Wand, a state of the art digital tool for a kinder local anaesthesia. Today, it is possible to remove teeth without feeling any pain.

The Snö value of being gentle also means that every tooth being treated has the right to be pain free.

Oral surgery:
Implants
Root canal treatments
Tooth removal

Root Canal Treatment

Tooth pain does not necessarily have to be because of a root canal. You can experience pain even if the nerve of the tooth is dead (to learn more, see pulp damage). Quite often, the symptoms are obvious, and a “root canal treatment” (root filling) where we remove inflammation/infection is the best treatment. Simply put, we gently remove the soft tissue inside the tooth (the pulp), clean it and seal it. Today, this can be done without any pain. However, we always try to save the pulp in order to not perform a root filling.

There are four different scenarios depending how extent of the damage:

  • Pulp inflammation with a chance for recovery
  • Pulp inflammation with no chance for recovery
  • Pulp partially or fully infected with bacteria
  • Already root filled teeth with problems

Pulp inflammation with a chance for recovery
If possible we always begin by removing the trauma (eg caries) to the pulp in order to save the pulp.

Above is a schematic example of a healthy tooth (left) and one with a caries lesion (right) filled with bacteria that irritates the pulp. The tooth is very sensitive, especially to cold. This inflammation will create pressure inside the pulp chamber, making the nerve even more sensitive. A quick way to alleviate the pain is to remove the pulp and do a root filling. But this would be very destructive to the tooth and require even more root canal treatments. In many cases, when most of the caries is removed and, more importantly, the cavity is sealed from the mouth with a tight temporary filling, the pulp relaxes and the inflammation disappears. After a while (usually two months) we check the tooth to see if we have managed to save the pulp tissue. This also saves you the cost of a root filling. In some cases, however, the inflammation spreads causing pain, making it necessary for a root canal treatment.

Pulp inflammation with no chance for recovery
When the symptoms are more severe and/or when we can diagnose an irreversibly damaged pulp, the two options are to remove the tooth or try to save it with a root canal treatment. The root canal treatment is similar to the treatment for an infected tooth, but generally has a little bit better prognosis and can sometimes be done a bit faster.

Depending on the case, we always inform you about the prognosis and the alternatives.

Pulp partially or fully infected with bacteria

When bacteria gets into the pulp (eg: above via a caries lesion) the infection spreads down the root canals and even comes in close contact to the bone. Common symptoms at this stage are tenderness to touch and chewing, discolouration of the tooth, and swelling, drainage and tenderness in the lymph nodes, as well as nearby bone and gum tissues. Sometimes, however, there are no symptoms. When treating this, we remove the diseased and dead pulp tissue from the tooth with specially designed instruments used to clean out the root canals and pulp chamber (at Snö we always use new instruments).

This stage is not painful; the area is numb and the tissue being removed is either dead or dying. Once the pulp, along with the nerves contained in it, is removed, the tooth itself can no longer feel pain. If there is an infection outside the root, it can cause some pain, but usually disappears. In difficult cases, we leave a special paste inside the tooth to fight the bacteria. In other cases we do the filling of the tooth in the same session.

Root canal fillings are selected to exactly fit into the freshly prepared canals. Usually, a rubber-like material called gutta-percha is used to fill the canal space. It is a thermoplastic material (“thermo” – heat; “plastic” – to shape), which is heated and then compressed into and against the walls of the root canals to seal them. Together with an adhesive cement called a sealer, the gutta-percha fills the prepared canal space. Sealing the canals is critically important to prevent them from becoming reinfected with bacteria. When the infection is gone, the bone will heal (right) into the cavity it created during the infection.

Your tooth will then need a permanent restoration — a filling or a crown — to replace lost tooth structure, and provide a complete seal to the top of the tooth. This step is particularly important.

Already root filled teeth with problems
The prognosis of a root canal treatment depends on how thoroughly the dentist does the treatment. If it is done very quickly, or without good infection control, it might feel right, but could develop problems later. It might get reinfected due to leakage. This is why we put so much effort in performing the treatment as thoroughly as possible.

Sometimes, even after being thorough, the tooth could become reinfected due to hidden canals or small fractures. It may be possible to redo the cleaning/filling procedure. The last option for a problematic tooth is to remove it. Then the infection always disappears.

At Snö we give you pain-free techniques. You will always get information regarding all available scientifically proven techniques, alternatives, risks and prognosis. You can always ask your Snö team any questions you have regarding your procedures.

Oral surgery:
Implants
Root canal treatments
Tooth removal

Dental Implant Surgery

If teeth are missing, there are different options for restoration. Your Snö dentist will consult you on what the best options are, as well as all the alternatives.

Implants are the most common solution today to replace gaps, but in some cases, a bridge is an alternative. Our dentists are experienced at the surgery required for a strong and reliable foundation for implants. In difficult cases, our specialist surgeon will take part in the treatment.

In the 80s, a Swedish dentist, Per Ingvar Brånemark (Nobel Biocare, is still the world’s leading brand and used by Snö) pioneered the idea of dental implants. He realised that the metal titanium is not rejected by the body, but is easily accepted as a natural part of the body. This means the titanium implant will integrate with the bone it is put in. This is called osseointegration. There are numerous people around the world with ‘new’ teeth using this method.

A close up of a single implant replacing a gap on front teeth. Implants, in many cases, can replace one, several or all teeth.

The bone quality is paramount.
The number of implants the dentist will fit depends on the bone quality and the available bone. In a completely edentulous (lacking teeth) jaw, six implants are sufficient. On these six implants, it is possible to place 12 new porcelain teeth. One implant can also be used to replace one tooth. The possibilities are many.

An example of a 3D cone beam scan before placement of the implant. All implant treatment at Snö includes cone beam 3D x-rays, 3D planning with prefabricated guides to enhance the result and maximise success. 

When you lose a tooth, the bone in that cavity usually resorbs. This is because without teeth there is nothing to stimulate the bone. When you chew, the pressure stimulates the tooth and subsequently the bone. When an implant is placed we can avoid the resorption of bone. But if one waits too long before inserting an implant, there might not be enough bone left.

In cases where a lot of bone has been lost it is possible to transplant bone from another part of the body. This may seem like a lot to overcome, but when the alternative is a denture, it is worth it.

An implant treatment is a well-documented and tested treatment. Furthermore, it has the highest success rate in dentistry. It has to be carefully planned to ensure success and requires, at the minimum, an extensive x-ray examination and consultation with specialists.

An implant treatment consists of two elements. A surgical part, where the dentist places the implant in the bone, and a prosthetic part, where the new teeth are fixed onto the implants. As a new implant in the bone needs some time to heal before you can put any load on it, your dentist must make a temporary solution. This could be a temporary denture or bridge.

When the bone is good, no preparation is needed. However, if loose teeth have to be removed prior to placing implants, it is important to give the bone time to heal. This way, we can be sure there is no infection left in the bone when placing an implant.

Two missing front teeth replaced with implants.

Close up from the biological integration of a single implant (left), and the ceramic crown attached to it (right).

Prognosis
The success rate for implants is very good. A long-term study shows that more than 90 percent of implants placed work very well. Regular visits to your dentist and hygienist will help ensure that your implants continue to work well. With time, the teeth on the implants will wear just like normal teeth and may require replacing. But in most cases, the implant will not need to be changed. If you lose an implant, it is possible to have a new one put in after a healing period.

Does it hurt?
Placing the implant is done under local anaesthetic, hence no pain is experienced during the procedure. Post-op, you can expect some swelling and moderate soreness. It will not be worse than having a wisdom tooth removed. We will advise you on the appropriate use of painkillers, if necessary.

Are complications to be expected?
Serious complications are extremely rare. Occasionally, an implant will not osseointegrate (root in the bone) leading to loss of the implant. In such a case you leave the area alone for a while to heal, before trying again, with a bone transplant. If it is deemed impossible to place an implant, you will need to discuss the alternative options with your dentist.

The quality and lifespan of the implant depends on the technique and time spent on the treatment.

A treatment can look and feel good, but can still have quality concerns. At Snö, we always document everything during treatment in order to ensure our high-quality standard. The crown/bridge carries a two-year warranty. If you follow our protection plan you can get up to 10 years of warranty on the implant and 5 years on the crown/bridge.

Oral surgery:
Implants
Root canal treatments
Tooth removal

Oral surgery

While most dental treatments are surgeries, some of them are more involved and require an experienced general dentist or a specialist with a particular expertise in surgery. Experience comes from practice, so we make sure we give all surgical work to our specialised team members. At Snö we have the scale to afford specialisation, even among the general dentists. This is what guarantees you treatments of the highest quality.

Oral surgery:
Implants
Root canal treatments
Tooth removal

Dental Bridge Treatment

If teeth are missing, there are different options for restoration. Your Snö dentist will consult you on what the best options, are as well as all the alternatives.

Implants are the most common solution today to replace gaps, but in some cases, a bridge is an alternative. The bridge treatment requires the neighbouring teeth to be filed down (prepared) to allow the bridge to fit.

In order for the bridge to be successful, the neighbouring teeth must be strong. If they are loose or extensively filled/repaired, the long-term prognosis is dubious. At the same time, if the neighbouring teeth are untouched, it would be a shame to file them down. If a patient is missing more teeth in a row, it can also be difficult to make an adequate bridge as the span is simply too long.

Before implants were available, the only alternative was to have a removable partial denture made. Dentures take some getting used to as many complain it is loose in the mouth, covers the taste buds, makes chewing difficult and doesn’t look good.

Schematic of an example that involves replacing a gap with a three-unit bridge in the back of the mouth. The two supporting teeth need to be prepared to fit the custom-made bridge. If the supporting teeth are strong and healthy but have had restorations, a bridge might be the best alternative as we do not have to file down the teeth as much.

 

Using strong enamel-like ceramic materials we can most often (depending on the case) fabricate a bridge during the same day or the next. Thanks to our advanced digital scanners, there is no discomfort while we make dental impressions. A two-minute scan gives us all the information we need, in full detail and the highest resolution.  The bridge is cemented to the teeth – aesthetic, durable and strong.

The quality and lifespan of the ceramic bridge depends on the technique and time spent on the treatment.

A treatment can look and feel good, but can still have quality concerns. At Snö, we always document everything during treatment in order to ensure our high-quality standard. This applies to veneers too. The veneer treatment also carries a two-year warranty. If you follow our protection plan you can get up to five years of warranty.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges

Dental Veneers Treatment

Teeth can become discoloured for different reasons. This means that bleaching is not always the best solution. Some teeth cannot be bleached. Old fillings have visible borders that become more pronounced when bleached, making it unsightly. To avoid these problems, your dentist might recommend using a crown made from ceramic. This is particularly helpful if most of the tooth is either filled or damaged, where bleaching would be unsuitable. However, if the tooth is healthy, crowns are not recommended, as much of the healthy tooth would have to be destroyed to make way for the crown.

A modern alternative is a veneer. A veneer is a very thin shell made of porcelain and customised to fit individual patients’ teeth. It will be glued to the outer surface of the tooth, forming a strong bond. The appearance is natural because the veneer mimics the layers of enamel.

This patient was unhappy with the colour of her teeth and the old fillings (yellow). First, all her teeth were bleached. Then, veneers were placed on the front four teeth. Veneers allow you to alter the shape of the teeth. So this patient requested an increase in the length of her front teeth.

 

Enamel is a relatively thin and transparent layer on the surface of the tooth. Under the enamel is the dentine, which is darker and coloured. The veneer is glued to the enamel and masks the darker underlying dentine. The porcelain used for veneers is very similar to enamel, making the appearance natural – almost like a new layer of enamel.

A tooth gets its natural colour from reflections of light through the different layers of the tooth. In order to create a natural appearance, the dentist will try to mimic the natural construction of the tooth. Veneers are highly precise, very thin shells of porcelain. They are customised to fit each individual patient and tooth. The veneer is glued to the outer surface. It mimics the natural appearance of the tooth, almost like a new layer of enamel.

This patient’s front tooth was broken in an accident and repaired with composite (above). Over time, it turned slightly yellow. This was fixed using a porcelain veneer (below).

It is not necessary to remove any tooth substance if you choose to increase the size of a tooth with the veneer treatment. However, your dentist might need to remove a thin layer of enamel – usually 0.5mm – to accommodate the veneer. Next, your dentist will take an impression of your tooth and create a cast. Our dental laboratory will then make your customised veneer and your dentist will schedule a fitting. If the fit and appearance are to your liking, the veneer will be “cemented” (glued) in place, and you can enjoy your new smile.

This patient had veneers made for six front teeth.

 

At Snö, our dental technician works like an artist to craft veneers in-house. During an inlay, onlay or crown procedure, we can usually fabricate it on the same day or the next. To make aesthetic veneers usually takes a few more days due to the customisations.

Thanks to our advanced digital scanners, we also save you from the discomfort of taking tooth impressions. A two-minute scan is all we need to get all the information of your teeth in full detail and the highest resolution. The crown is cemented to the tooth – aesthetic, durable and strong.

The quality and lifespan of the veneer has a direct relation to the technique and time spent on the treatment and oral hygiene going forward.

A treatment can look and feel good, but can still have quality concerns. At Snö, we always document everything during treatment in order to ensure our high-quality standard. This applies to veneers too. The veneer treatment also carries a two-year warranty. If you follow our protection plan you can get up to five years of warranty.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges

Dental Crowns Procedure

When a tooth is damaged to the extent that it is not possible to do a filling, inlay or onlay, a crown is the alternative. Old crown techniques often used a metal base with a porcelain material on top for aesthetics. Today, we use strong ceramic materials instead of metal. The only exception is a golden crown, if requested.

Using strong, enamel-like ceramic materials we can most often (depending on the case) fabricate a crown in a day or two. Thanks to our advanced digital scanners, there is no discomfort while we make dental impressions. A two-minute scan gives us all the information we need, in full detail and the highest resolution. The crown is then crafted and cemented to the tooth – aesthetic, durable and strong.

The quality and lifespan of the ceramic crown depends on technique and time spent on the treatment.

A crown can look and feel right, but still have quality concerns. At Snö, we always document our procedures in order to ensure our high-quality standard. When a crown is suggested, you get a two-year warranty, irrespective of what happens to the filling. This can be extended to five years if you follow our maintenance instructions.

A damaged front tooth that had old composite fillings. Teeth were bleached before making the new ceramic crown.

The old technique to make a crown (at Snö we do not do this) with an inner shell of metal/gold.

The metal blocks out the light (left) and often discolours the tooth towards the gum. To the right, we have replaced it with a modern, biological, ceramic crown.

Front tooth fractured. The tooth (root filled many years ago) could, in this case, be lengthened with a ceramic post in order to place the full ceramic crown on top of the post.

Schematic drawing (cross section) of a healthy tooth (left) with enamel (white) dentine (more yellow) and the pulp anchored in the jaw bone and gums (red).

To the right, the tooth has been root filled and a ceramic post (white) has been cemented to the root and a crown (white with lines) placed on top of the post.

Ceramic crowns can also as this case be made on implants.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges

 

Inlays and Onlays Procedure

Larger restorative work requires inlays or onlays. We have our own high-quality lab at our main facility in Abu Dhabi. Using different ceramic materials, we can manufacture onlays and inlays directly for you to minimise your wait time. We also do not use temporary fillings, as this can sometimes lead to discomfort. Thanks to our advanced digital scanners, there is no discomfort while we make dental impressions. A two-minute scan gives us all the information we need, in full detail and the highest resolution.

We provide the perfect restoration fast – usually the same day – and the entire procedure is quality controlled. The inlay/onlay is bonded to the tooth and becomes almost like a new layer of enamel – aesthetic, durable and strong.

It is important that the tooth is dry during treatment. The quality and lifespan of the ceramic inlay/onlay has a direct relation to the technique and time spent on creating the filling.

An inlay/onlay can look and feel right, but still have quality concerns. At Snö, we always document our fillings during treatment in order to ensure our high-quality standard. When the treatment is suggested, you get a two-year warranty, irrespective of what happens to the filling.

Schematic of a cavity filled with a ceramic inlay.

Close up of back teeth (molar) before and after ceramic inlay.

Schematic of a cavity filled with a ceramic onlay (covers the chewing area).

Three back teeth (molars and premolar) with old amalgam.

Amalgam replaced with bonded ceramic onlays.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges

Composite Dental Fillings

Composite fillings are the most common restoration when we find a caries lesion. Small caries lesions can be treated with fluoride and monitored for any recurrence. We also use a superficial sealant to treat certain caries lesions. With good oral hygiene and healthy eating/drinking habits, small cavities can heal themselves.

Composite fillings are often tooth coloured and are the most common filling material we use (we do not use amalgam at Snö). Composites bond to the tooth, saving your tooth from damage that usually occurs when using amalgam fillings.

A composite filling is usually done in one visit. It is important that the tooth is dry during treatment and that the form (matrix) that shapes the filling is done properly. The quality and lifespan of the filling has a direct relation to the technique and time spent on creating the filling.

A filling can look and feel right, but still have quality concerns. At Snö, we always document our fillings during treatment in order to ensure our high-quality standard. When a composite is suggested, you get a two-year warranty, irrespective of what happens to the filling.

Closure of space (diastema) with composite.

Close up of back teeth (molar). Small caries lesion filled with composite.

Close up of back teeth (premolar). Small caries lesion between teeth filled with composite.

Close up of back teeth (molar). Bigger cavity filled with composite.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges

Tooth Restoration Treatment

In keeping with the Snö philosophy of minimally invasive and pain-free dentistry, we also help restore functionality and health of your teeth. All our restorative work comes with at least a 2-year warranty. If you follow our protection plan you could be entitled to a 5-year, and sometimes, even a 10-year warranty. If any of our work fails in this period for whatever reason, we will redo it. On the house. We believe in the quality of our workmanship and always endeavour to preserve your natural, healthy teeth, which is why we provide this warranty. All our recommendations are built on our thorough Snö exam and additional tests, as needed.

We have our own in-house dental laboratory and are fully digitised in our making of inlays/onlays, veneers, crowns and bridges. Our dental laboratory works with the latest ceramic materials and we invite all our patients to see and experience our high-tech environment.

Teeth restorations:
Composite fillings
Inlays and Onlays
Crowns
Veneers
Bridges