Broken Down, Worn & Misshapen Teeth

The first stage in assessing teeth with these problems is to assess whether they harbour an underlying infection and whether there is enough tooth structure left for the teeth to be restored. (If there is not enough tooth structure available for restoration the tooth usually requires removal and then replacement options can be considered.) Following management of any infections and establishing that the tooth is restorable, we often consider the following options.
Crowns
This involves drilling down the remaining tooth structure to make room to fit a ‘cap’ over the tooth.   A mould of your mouth is taken and sent to a laboratory to fabricate the crown. At the end of the appointment to shape the tooth you will be left with a temporary crown to protect it. At a subsequent appointment, which needs to be at least two weeks later, once the crown has been finished it is definitively fit onto the tooth. Crowns can be made out of metals like gold, porcelain or a combination of the two. The main risk of removing tooth tissue to fit a crown is that the nerve inside the tooth dies necessitating root canal treatment or tooth extraction.

Veneers
Veneers are similar to crowns however they are invariably made of porcelain, usually only applied to front teeth and involve less removal of tooth tissue. They rely on the use of specific methods to bond them to the teeth. 

Composite Build-Ups
This technique involves the use of commonly used tooth coloured filling material (composite) to rebuild the lost structure of teeth. The main benefit of this approach is that little to no tooth tissue requires removal and hence the risk of the nerve inside the tooth dying is significantly reduced. The build-ups require regular repair and polishing and hence they require intervention earlier than a crown would but the actual tooth underneath the restoration may well last for longer than it would have had it been crowned. This is a common approach for worn teeth. Sometimes composite can be used as an alternative to a veneer.