Please fill out form if you are a patient.

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PATIENT FORM
NAMEyour full name
person
ADRESSyour address
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DATE OF BIRTH
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TELEPHONEHome
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DENTIST’S NAME
person
DENTIST’S ADDRESSdentist's address
business
DENTIST’S TELEPHONEdentist's telephone
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CHIEF COMPLAINT
CURRENT MEDICAL CONDITIONSmore details
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CURRENT MEDICATIONmore details
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Please fill out form to refer a patient.

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REFERRAL FORM
REFERRING PRACTITIONER
NAMEyour full name
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ADDRESSyour address
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PATIENT
NAMEyour full name
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ADDRESSyour address
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CHIEF COMPLAINT
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REASON FOR REFERRAL:more details
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CONSULTATION OR TREATMENT:more details
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POST SPACE REQUIRED:(YES/NO)
RESTORATIVE STATUS OF TOOTH:more details
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RELEVANT MEDICALS DETAILS:more details
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Please fill out form to request a callback.

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CONTACT FORM
NAME
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TELEPHONEMobile
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CHIEF COMPLAINTmore details
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Please fill out form to request an emergency discussion.

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24/7/365 EMERGENCY
NAMEyour full name
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DATE OF BIRTH
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MOBILEyour mobile number
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TELEPHONEMobile
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DETAILSmore details
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Please fill out form to request an appointment cancellation (must be done 48 hours prior to appointment). Full appointment costs may be charged in failing to do this.

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CANCELLATION FORM
NAMEyour full name
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DATE OF APPOINTMENT
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MOBILEMobile
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CANCELLATION REASONmore details
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Construction of Provisional Crown

A temporary dental crown, also known as a provisional crown, is a provisional covering placed over a prepared tooth structure when the original crown or fixed restorative prosthesis has been removed to facilitate therapy, especially in calcified cases or where root canal anatomy has been missed or to simply aid in diagnosis. Occasionally, porcelain crowns can be damaged either in function or when trying to drill through them to undertake an endodontic procedure. Construction of new provisional crown aids functionality maintains aesthetics and protects the underlying tooth structure. They are typically cemented onto the prepared tooth using temporary cement, allowing for easy removal. Temporary crowns are not as durable or long-lasting as permanent crowns and are intended to be in place for a few weeks to a few months at most.

Tooth Extration

Radiological Failure

Postoperative Pain

Complications

£350.