What is restorative dentistry?
Restorative dentistry means repairing damaged teeth and replacing missing ones. It includes fillings, crowns, root canals, gum disease care, bridges, dentures and implants. Your dentist can explain which suit you.
On this page
Your dentist may say a tooth needs restoring, or you may have met the word on a dental website without an explanation.
What does restorative dentistry mean?
NHS England’s clinical standard describes specialist restorative dentistry as replacing missing teeth, repairing damaged teeth and extending to rehabilitation of the whole mouth. It describes routine care in a general dental practice in similar terms: managing tooth decay, replacing missing teeth, repairing damaged teeth, and treating gum disease and root canal infections.
The standard groups restorative procedures into three areas.
- Periodontal care, which is the management of gum disease.
- Endodontic care, which means root canal treatment. The standard says it is designed to keep the root and the remaining tooth tissue.
- Prosthodontic care, which covers crowns, bridges, dentures and restorations held in place by implants.
Specialist restorative dentistry is different from that routine work. The standard says it is for people with complex problems who need care from several specialisms, mostly delivered by NHS consultants in hospitals. It says patients with routine needs in general practice do not routinely need it.
That definition comes from a document written for people who plan NHS services. The NHS website’s patient guide to dental treatments does not use the word restorative, so the list below is our grouping of the treatments it describes.
Why might teeth need restoring?
NHS England says the need comes mainly from diseases of the teeth and soft tissues, and to a lesser extent from injury and conditions a person is born with. Among the main problems it names are:
- tooth decay, whether a new cavity or a recurring one beyond an existing restoration (a filling, crown or other repair)
- tooth surface loss, meaning wear and erosion of the tooth surface
- gum disease
- dental injury
We explain cavities, enamel erosion and gum disease in separate guides.
Which treatments does it include?
| Treatment | What it is | When it may be used |
|---|---|---|
| Filling | Repairs a hole in a tooth, in white (tooth-coloured) material or amalgam | Decay has made a hole, or a tooth is chipped or worn |
| Crown | A cap that completely covers a real tooth | A tooth is broken, decayed or damaged |
| Root canal treatment | Removes infection from inside the tooth, which is then cleaned, filled and sealed | The soft centre of the tooth (the pulp) is infected |
| Bridge | A fixed replacement for missing teeth, supported by the surrounding teeth | One or more teeth are missing |
| Denture | Removable false teeth, either a full set or a partial set | Some or all teeth are missing |
| Implant | A titanium screw in the jawbone that supports a crown, bridge or denture | A tooth or teeth are missing |
| Gum disease care | Management of gum disease, which affects the tissues that support the teeth | Gum disease is affecting the gums |
The NHS describes the first six of these in its dental treatments guide. Gum disease care is in NHS England’s grouping, and our gum disease guide explains the treatment.
The line with cosmetic dentistry is not sharp. The NHS says a crown can be fitted where a tooth is broken, decayed or damaged, or just to make it look better, and it calls teeth whitening cosmetic. See our guides to teeth whitening and veneers.
How does treatment change with the damage?
The NHS says treatment for tooth decay depends on severity:
- For early decay, a dentist can prescribe fluoride treatments, such as a mouthwash or varnish, to reverse it.
- A hole in a tooth will probably need a filling.
- Decay that has reached the pulp may need root canal treatment.
- Sometimes the tooth has to be removed.
A crown goes over the whole tooth. The Oral Health Foundation says one may be recommended in these cases:
- a tooth is badly damaged or broken
- a large filling has weakened the tooth
- the tooth has had root canal treatment
- the tooth is worn down or cracked
The NHS says a crown may be needed after root canal treatment if the tooth was badly infected.
If a tooth is lost, the NHS describes three ways to replace it. A bridge is fixed in place, a denture can be taken out, and an implant is a fixed alternative to a removable denture. Our guides to replacing a missing tooth and dental implants compare the options.
How long do repairs last?
The Oral Health Foundation says how long a filling lasts depends on:
- where it is in the mouth
- how big it is
- your bite and chewing habits
- how well you look after your teeth
It says crowns can last many years if well cared for. Your dentist can give you an idea of how long yours is likely to last.
To look after a crown, it suggests brushing twice a day with fluoride toothpaste and cleaning between your teeth daily. It also suggests avoiding biting hard objects such as ice, and visiting your dental team regularly.
Replacing a filling is not always needed. The Oral Health Foundation says dentists usually recommend it only when a filling is worn, broken or has decay underneath. Removing a working one can mean extra drilling and losing healthy tooth.
When to see a dentist
A dental abscess is a build-up of pus caused by infection. In the NHS’s words, an abscess will not go away on its own, and a dentist needs to treat it urgently. Signs include intense toothache or gum pain, a swollen face or jaw, a bad taste, a high temperature, and difficulty opening your mouth and chewing. If you think you have one, ask for an urgent dentist appointment or get help from NHS 111. The NHS says not to go to a GP surgery, because they cannot give dental treatment.
Call 999 or go to A&E if you:
- find it hard to breathe, speak or swallow
- have a swollen or painful eye, or suddenly start having problems with your eyesight
- have a lot of swelling in your mouth
- find it hard to open your mouth
Do not drive yourself, the NHS says: ask someone to take you or call 999 for an ambulance, and take your medicines with you.
If a tooth is knocked out, the NHS says to ask for an emergency dentist appointment, even if you cannot find the tooth. A knocked-out or badly broken adult tooth should be treated as soon as possible, within 30 minutes to 1 hour if possible. Until you are seen, the NHS says to hold the tooth by the crown (the part that shows), not the root.
If the tooth is whole and dirty, rinse it gently in milk, saline or saliva, then try to put it back in the gap. If it goes back in easily, bite gently on a clean cloth to hold it in place. If it will not go back in, keep it in milk or saliva. A baby tooth should never be put back, because it could damage the tooth growing underneath, but a knocked-out baby tooth still needs a dentist.
Outside opening hours, call your dentist, as the answerphone may say what to do. If you do not have a dentist or cannot get an emergency appointment, the NHS says to call 111.
For problems that are not urgent, the NHS says to see a dentist if:
- you have toothache, or a sharp pain in a tooth when you eat or drink
- you notice a white, brown or black spot on a tooth
- your gums are painful, swollen or bleed when you brush
- a tooth is chipped, which the NHS says a dentist can smooth down and fill, or fit with a crown, at a non-emergency appointment
- you have not had a check-up for 2 years, or 1 year if you are under 18
The Scottish Dental Clinical Effectiveness Programme (SDCEP) writes advice for dental teams on lost, loose or broken fillings, and on loose crowns, bridges and veneers. It says to seek urgent dental care if painkillers do not relieve the pain. If the pain is relieved, or is not a big part of the problem, it says to seek non-urgent care. If a lost filling has left an open cavity, it says an emergency temporary repair kit, which you can buy at a pharmacy, can be used. If a piece of tooth or filling may have been breathed in, it says to go straight to emergency care through NHS 111.
What we would do
We would start with a new patient exam. We examine your teeth, gums and soft tissues, carry out an oral cancer screening, take small X-rays where needed, and explain any treatment in plain language. Depending on what we find, treatment can include:
- Fillings in tooth-coloured composite and, for some, glass ionomer, usually in one visit, with the area numbed first if needed.
- Crowns in porcelain, all-porcelain or gold. A laboratory-made crown takes two visits, with a temporary crown in between.
- CEREC same-day restorations, where a ceramic crown or onlay (a partial crown) is designed and milled in the practice, with no second visit for fitting.
- Root canal treatment under local anaesthetic: we remove the infected pulp, clean the tooth inside, then fill and seal it, and often recommend a crown afterwards.
- Tooth extractions, recommended only once other options are ruled out, with a talk about replacing the tooth.
- Dental bridges, dentures and dental implants to replace missing teeth.
Our dental hygiene appointments remove plaque and tartar and include brushing and flossing advice. If a tooth hurts and cannot wait, our emergency dentist page explains how to reach us.
If your fillings or crowns have not been checked for a while, or a tooth has changed, a check-up is the simplest way to find out what needs doing. You can book an appointment at whichever of our five practices suits you.
Want us to take a look?
Book an appointment at whichever of our five practices suits you. We will check what is going on and talk you through your options.
Questions this guide answers
Is restorative dentistry the same as cosmetic dentistry?
Not exactly, but they overlap. NHS England describes restorative dentistry as replacing missing teeth and repairing damaged teeth. The NHS calls teeth whitening cosmetic, and says a crown can be fitted where a tooth is damaged, or just to make it look better.
Do I need a specialist for restorative dentistry?
Not for routine care, according to NHS England. It says people in general dental practice who need decay managed or teeth repaired or replaced do not routinely need consultant-delivered specialist care. The same goes for people who need gum disease or root canal infections treated. The standard is written for NHS services. In the NHS, it says, more challenging cases are diagnosed and planned with a consultant-led team, and your dentist can tell you if yours is one.
Are fillings, crowns and implants available on the NHS?
The NHS says the treatments on its dental treatments page are usually available on the NHS, except teeth whitening, implants and veneers. It says implants are usually only available privately. TG’s Dental Suite is a private practice and is not currently taking NHS patients. The NHS says to ask your dentist what a treatment will cost before you go ahead. The Oral Health Foundation’s white fillings page says to ask for a written treatment plan with costs before you start.
How long do fillings and crowns last?
It varies. The Oral Health Foundation says a filling’s life depends on where it is, its size, your bite and chewing habits, and how well you look after your teeth. It says crowns can last many years if they are well cared for. Your dentist can give you an idea of how long yours is likely to last.
Does a damaged tooth always have to come out?
No. The NHS describes fillings, crowns and root canal treatment as ways to repair a damaged tooth, and says that sometimes a tooth with decay has to be removed. If a tooth is lost, the NHS describes a bridge, a denture or an implant as ways to replace it.
