A tooth broke
A cusp sheared off, or a chunk came away around an old filling. Usually an onlay or a crown, sometimes a direct composite rebuild.
Crowns, bridges & rebuildsCrowns, bridges and rebuilding
Crowns, bridges and rebuilding
broken or worn teeth
Careful, layered work on teeth that are damaged, worn or missing — planned and done by one dentist.
Who does the treatmentThe last five per cent
The last five per cent
is the whole job
I’m Jack Dowling. BDS Bristol 2019, two years of Dental Core Training at Newcastle Dental Hospital — which is where you learn to rebuild teeth other people have given up on — and private practice in Newcastle since 2021. I’ve completed a diploma in advanced restorative dentistry.
There’s a molar I still think about. It had rejected four filling attempts at other practices. We rebuilt it slowly, in layers, over a few visits rather than trying to do it in one. It’s still going. That last five per cent most people would never notice is basically the whole job for me.
Right for me?
Which of these is you?
A filling keeps failing
Same tooth, same filling, third or fourth time. Usually means the remaining tooth can’t support a filling any more and needs something that holds it together rather than fills a hole.
Teeth are getting shorter, thinner or see-through
That’s wear, from grinding or acid or both. Treating the damage without addressing the cause just buys you time.
A tooth is missing
Bridge, denture or implant, and which one depends on where the gap is, what’s either side of it, and how much you want to spend.
An old crown looks wrong
Dark line at the gum, wrong shade, wrong shape. Replaceable.
In plain English
Materials, in plain English
- Composite
- Tooth-coloured resin, built up in layers directly in the mouth. Nothing is sent to a lab. Best for smaller repairs and front-tooth work where matching matters more than strength.
- e.max
- A pressed ceramic. Strong, and it handles light the way enamel does, which is why it’s my usual choice for front teeth and for onlays where appearance matters.
- Zirconia
- Tougher and less translucent. It’s what I’d use on a back tooth taking heavy load, or where there isn’t much room.
- Gold
- Still, objectively, the best material for some back-tooth restorations. Almost nobody wants it. I’ll mention it once and then let it go.
The lab matters as much as the material. I use the same technicians for the work that shows, because consistency in shade and shape is most of the result.
A fair question
NHS or private?
A fair question, and the honest answer is that it depends what you need.
NHS Band 3 covers crowns, bridges and dentures at a fixed charge, and for a lot of people that’s the sensible option. What it doesn’t cover is choice — of material, of appointment length, or of how much time gets spent on the shade and the shape. NHS dentistry is designed to restore function reliably at scale, and it does that.
Private work buys time and materials. Longer appointments, a choice of ceramic, a better lab, and the ability to spend three visits on something rather than one because that’s what it takes to get right.
If what you need is a back tooth restored so it works, and you can get it on the NHS, take it. If it’s a front tooth, or you’ve had the same thing fail repeatedly, or you want it to look like nothing happened, that’s when it’s worth paying.
How it works
From first call to review
Free 15-minute call
Describe what’s happened. I’ll tell you what it’s likely to need.
Examination
X-rays where needed, and a proper assessment of what’s left of the tooth.
Options and a written quote
Including the option of doing nothing, where that’s reasonable.
Preparation and impressions or a scan
Temporary fitted if it’s lab work.
Fit
Checked for bite, shade and margin before it’s cemented. If it isn’t right, it goes back.
Review
A check that everything has settled.
Aftercare
How long it lasts
A well-made crown on a healthy root typically lasts ten to fifteen years, often longer. Composite fillings, five to ten. Bridges, similar to crowns, but they depend on the teeth holding them.
Things that shorten all of those: grinding, gum disease, decay at the margin, and not coming back. Things that lengthen them: a nightguard if you grind, hygiene appointments, and catching problems while they’re small.
Nothing I place is permanent. Anything that’s told you otherwise was selling something.
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