IMPLANTS
Dental Implants are the latest innovation to replace a missing tooth or a number of teeth. An implant consists of an artificial titanium rod which is placed directly into the jaw bone and acts as a replacement for the root portion of the natural tooth. The implant is made using pure titanium which allows new bone cells to grow around it: the implant then integrates with the newly formed bone which firmly locks it into place. This process is called 'Osseointegration'. A Dental Implant can be used to replace:
-
One tooth - One implant will be placed, a crown will then be fixed on top of the implant.
-
Several teeth - Either several implants and crowns will be placed or a dental bridge will be fitted onto the implants.
-
All the teeth - A number of implants are placed, then either a fixed bridge will be fitted onto the implants or the implants will be used to firmly hold a removable denture.
ORTHODONTICS - BRACES
Orthodontics is when the teeth are straightened or moved in order to improve the appearance of your smile by correcting the alignment of your teeth and the way you bite together. An incorrect bite can lead to long term dental problems and even jaw and head pain. By straightening the teeth, you also help to prevent tooth decay and gum diseases as straighter teeth are easier to clean. Orthodontic braces are either fixed or removable
-
Fixed braces consist of brackets and bands which are cemented (glued) to your teeth which hold flexible wires in place. In turn, these wires exert pressure on your teeth gently moving them into their correct position over the course of your treatment.
-
Removable braces can be taken in and out of the mouth. It has delicate wires and springs attached which move the teeth using gentle pressure. These are used for less complex cases or in conjunction with fixed Braces as part of a combined treatment.
Your dentist will refer you to a dentist who specialises in braces 'Orthodontist', or you can refer yourself. At the first appointment, the Orthodontist will discuss with you what you would like to achieve from the orthodontic treatment. You will have an oral assessment, x-rays and moulds taken of your teeth. At the second appointment the orthodontist will outline your treatment plan to discuss all the options available to you. In many cases, permanent teeth need to be taken out to create space in your mouth so that the remaining teeth can be moved. If this is the case, the extractions are carried out by your regular dentist.
It usually takes between 18-24 months but will vary according to how complex the case is. We will provide you with a time frame at the beginning of the treatment; however breakages of the brace will add time to the treatment.
Appointment Three - Small plastic bands 'Separators' will be placed in between your molar teeth. The bands will stay in place for one week to create a space between the teeth for the permanent molar bands. At the next appointment the molar bands, brackets and wires will be put in place. You may find that for the first couple of days your teeth may feel tender to bite and your jaw aches; this is because of the pressure of the brace, taking a headache tablet will help. If the discomfort lasts longer than a few days, make an appointment to see your orthodontist to see if your brace needs adjusting. You may find that your brace may also rub against the inside of your lips or cheeks. If this is the case, use the wax which your orthodontist will have supplied. You will now need to see your Orthodontist every six to eight weeks to have the bands and wires changed, tightened or indeed elastics added. If you have had your brace tightened, you may fell a little discomfort later in the day which is a normal and a headache tablet will help. You still require regular six month check-ups with your dentist to ensure your gums and teeth are healthy.
You will be able to eat most of the foods you were eating before, but more care will need to be taken not to damage your braces. There are some foods that have to be cut out of your diet whilst you are wearing the appliance.
-
Toffees
-
Chewy sweets, like Mars bars or starburst for example
-
Hard foods, like crusty bread and apples
Also think twice before opening bottles with your teeth, biting pen tops or chewing your finger nails as these can also damage your braces. It is very important that your oral hygiene is excellent as cleaning your teeth is much more difficult with a brace in place. Brushing your teeth after every snack and meal throughout the day will reduce the risk of decay and gum disease. In addition, take longer brushing your teeth in the morning and at night. Ask your Orthodontist which is the best type of tooth brush for cleaning braces. If you do not look after your teeth during your treatment they can become permanently stained.
After your treatment is complete Your braces will be removed and your teeth cleaned and polished to remove any remaining cement. Your treatment is not over as the teeth need to be held in position while the surrounding gum and bone settles. This period is called retention and the appliance that holds the teeth are called retainers, which are either fixed or removable. Depending on the type of retainers, Impressions may to be taken in order for the retainers to be made at the dental laboratory. You will then return a week later to collect your retainers.
WISDOM TOOTH
Adults have up to 32 teeth, of which four are wisdom teeth and these are the last to come through the gum. They are the one's right at the back of the mouth and usually appear between the ages of 17 and 25 although sometimes they can appear in later years.
If there is enough room in the mouth the wisdom teeth will come through (erupt) in a useful position and there will only be minor discomfort as they erupt. However, wisdom teeth can cause problems if there is not enough room in the mouth, as the wisdom tooth erupts at an angle and gets stuck against the tooth in front; the dentist will describe this as 'Impacted'.
The dentist will be able to assess whether there is sufficient room for the teeth to come through by taking an x- ray which will show the position of the root. Once the x-rays have been taken, the dentist will be able to tell how easy or difficult it will be to remove the tooth. The dentist will then determine whether the tooth should be taken out at the Dental Practice or by a Specialist Oral Surgeon. The dentist will only recommend taking out wisdom teeth if:
-
The teeth are not able to fully erupt through the gum and are causing an infection in the surrounding tissue; this is known as Pericoronitis.
-
There is decay present - wisdom teeth will often decay as it is very difficult to clean them as thoroughly as your other teeth.
Following the removal of wisdom teeth, there is likely to be some discomfort. However, this will vary depending on how difficult it was to remove the tooth; it is not uncommon to experience some swelling for a few days. The dentist will advise on how best to reduce this discomfort and may recommend pain killers such as Paracetamol or Ibuprofen. A further dental appointment will be necessary for the dentist to check the healing process and remove any stitches.
EXTRACTIONS
Dental Extraction is a removal of a tooth from the mouth. It is performed for a wide variety of reasons.
-
Tooth decay - If the decay is severely advanced and the nerves and blood vessels in the tooth have been infected, and are unsuitable for root canal treatment. Impacted wisdom teeth - Sometimes our mouths are simply not big enough to accommodate these teeth. The teeth become impacted (stuck), this can cause infection and pain.
-
Orthodontics (braces) - Teeth can erupt in many different positions, if this happens you may have to have teeth extracted so your other teeth can be brought into line.
-
Periodontal disease - Bacterial infection under the gum damages the tissue which connects the tooth to the gum; as the disease progresses, the bone anchoring the tooth to the jaw begins to dissolve, resulting in the tooth becoming loose.
-
Teeth that have been damaged by trauma.
-
Certain medical conditions may require teeth to be extracted.
Your dentist will examine your tooth and explain the reasons why your tooth needs to be extracted, an x-ray will be taken to help plan the best way to remove the tooth and to see if an abscess is present. If an abscess is present your dentist will give you a course of antibiotics before your tooth is extracted.
Your dentist will ask you about your medical history. You must list every medication you are taking even if you have purchased it from over the counter, as some medications can complicate an extraction Tell your dentist if you are anxious about the procedure as sedation is available. If your dentist does not carry out sedation he will refer you to a practice that does. There are two types of extraction
1/ A simple extraction is performed when the tooth can easily be seen in the mouth. The dentist will give you a local anaesthetic to numb the area around the tooth. When the anaesthetic has taken affect and the area around the tooth is numb the dentist will grasp the tooth using a pair of forceps, you will feel pressure but NO pain. The dentist will move the forceps back and forth to loosen the tooth in order to extract the tooth.
2/ Surgical Extractions - This is carried out on teeth which -
-
Cannot be seen in the mouth but are present below the gum.
-
Partially showing through the gum
-
Broken off at gum level.
A local anaesthetic will be administered to numb the area before a small incision is made in the gum. The gum is pulled back to expose the whole of the tooth or the root. The dentist then uses the same procedure as a simple extraction to remove the tooth, in some cases the tooth or root may have to be cut into pieces to be removed.
3/ When the tooth has been removed a swab will be placed at the extraction site and you will be asked to bite on this until the bleeding has stopped and a blood clot has formed.
After the extraction a blood clot will form in the socket were the tooth used to be, this is NOT to be disturbed by vigorous rinsing or poking the site with your tongue or finger as it is a very important part of the healing process. If the socket does start to bleed after you have left the dental practice, place a clean tissue or handkerchief over the extraction site and apply pressure by biting down, the bleeding will normally stop within a few minutes. Again do NOT disturb the blood clot. If the bleeding does persist please contact your dentist for further advice.
Your mouth will still be numb for an hour or so after the local anaesthetic, please take care not to bite your cheek or tongue or burn your mouth when drinking hot liquids. Avoid Smoking and Alcohol for 24 hours as these can have an effect on the healing process. You may be in discomfort after the anaesthetic has worn off, take a household painkiller (headache tablet) following the manufacture's instructions. Do NOT take Aspirin as this may cause the socket to bleed.
POST OPERATIVE INSTRUCTIONS
After the extraction a blood clot will form in the socket were the tooth used to be, this is NOT to be disturbed by vigorous rinsing or poking the site with your tongue or finger as it is a very important part of the healing process.
If the socket does start to bleed after you have left the dental practice, place a clean tissue or handkerchief over the extraction site and apply pressure by biting down, the bleeding will normally stop within a few minutes. Again do NOT disturb the blood clot. If the bleeding does persist please contact your dentist for further advice. Your mouth will still be numb for an hour or so after the local anaesthetic, please take care not to bite your cheek or tongue or burn your mouth when drinking hot liquids.
Avoid Smoking and Alcohol for 24 hours as these can have an effect on the healing process You may be in discomfort after the anaesthetic has worn off, taking a household painkiller will help (headache tablet) following the manufactures instructions. Do NOT take Aspirin as this may cause the socket to bleed.
ROOT CANAL TREATMENT
This dental procedure is carried out when the innermost part of the tooth 'the pulp' becomes badly decayed or infected. If left untreated, the tooth will begin to die which could lead to the loss of the tooth. To save the tooth, the infected pulp needs to be removed to prevent the formation of an abscess. In dental terms this procedure is called 'Endodontics' The tooth is made up of
-
Enamel - The hard outer layer of the tooth.
-
Dentine - This forms the core and gives the basic shape to the tooth which supports the enamel, it is softer than enamel but harder than bone.
-
Pulp - Is the central part of the tooth which contains nerves and blood vessels and lies within the root canal
The reason the pulp would die
-
Caries - If caries 'decay' is left it will travel through the enamel and dentine down into the pulp chamber.
-
Trauma - A severe knock that affects the pulp.
-
Severe Gum Disease - The gum detaches itself from the tooth creating a gap between the tooth and the gum, bacteria then gets trapped causing an infection which can infect the pulp.
The symptoms
-
Pain - This can be anything form a constant dull ache to severe pain or pain only when biting
-
A spot sometimes appears on the gum in the area of the infected tooth, this is where the collection of puss from the root tip is draining which will leave a bad taste in your mouth.
-
Swelling in the gum area surrounding your tooth
PERIODONTICS GUM CARE
Periodontal Disease is the later stages of gum disease. This is when the bacteria infection under the gums progresses deeper and affects the bone and tissue supporting the tooth. Your gums will -
-
Bleed when brushing or flossing.
-
Will be red, swollen and tender.
-
Bad Breath.
-
The gum will have pulled away from the tooth, this is called 'Pocketing'
-
Pus may be seen in the pockets around the tooth.
The infection damages the tissue that connects the gum to the roots of the tooth. Once the tissue has been destroyed the gum pulls away from the tooth, this forms a pocket which bacteria thrive in. If not treated, in time the bone anchoring the teeth in the jaw will dissolve, making the teeth loose and eventually the teeth will fall out.
Periodontal disease is irreversible, but you can slow down the progression by regular visits to the Dentist and Hygienist also improving your oral hygiene at home.
DENTURES
Dentures are a removable appliance used to replace missing teeth, They are fabricated using either acrylic or cobalt chrome to which false teeth are added. They help with speech, chewing, add support to your lips and chin as well as improving the appearance of your smile. There are two types of dentures -
-
Partial denture which replaces one tooth or several teeth.
-
Full denture which replaces the whole set of teeth, on the upper or lower.
Dentures are kept in place by either using clasps which anchor around neighbouring teeth or by the dentures' natural suction. On occasions a denture fixative or glue is recommended to aid in keeping the denture in place. All dentures are designed by the dentist or our dental technician to suit each patient's individual needs.
CHECK UP & CLEAN
Our team of qualified dentist offers the highest level in patient care to ensure optimal oral health through maintenance and preventative programs and patient education. The dentist has specialist training in the meticulous cleaning and maintenance of the teeth and gums and will develop a personalized oral hygiene program to suit patient's individual needs. This program aims to maintain healthy teeth and gums and prevent decay and gum disease. Healthy gums are a long term investment for beautiful teeth and the dental hygienist will monitor your oral hygiene helping you to achieve your optimal oral health.
-
Appointments include
-
Evaluation of health and gums
-
Meticulous cleaning and polishing of the teeth including below gum level
-
Identification of oral conditions such as bad breath and dry mouth and aid in treatment of such
-
Advice on oral products to aid specific oral conditions
-
Application of decay preventing agents
-
Taking of dental x-rays for diagnostic purposes
-
Instruction on correct brushing and flossing techniques and advice on appropriate oral hygiene products to suit the individual
-
Outline of a personalized oral hygiene program with recommended 3, 6 or 12 monthly visits, recommended future treatment and referral for specific treatment if required
We stock a wide range of products and the dentist will recommend certain product suitability for individuals.
-
Toothbrushes - manual/electric
-
Interdental cleaning devices and irrigation devices
-
Oral cleaning aids for patients with implants
-
Oral rinses and specialty products for oral conditions such as 'dry mouth'
Use a soft toothbrush at the gum line where the teeth meet the gums. Brush in small circular motions on 1-2 teeth at a time. Angle the brush at a 45 degree angle to allow the bristles to gently clean under gums. Brush top and bottom teeth, cheek-side, lip-side and in close to the tongue. Brush the chewing surfaces of all upper and lower molars. Brush the top of the tongue to remove bacteria. Electric tooth brushes are effective if used systematically, i.e. brushing only a small area at a time. Correctly brushing is important to your dental health. Break off about 40cm in length of dental floss, ribbon or tape. Wind the ends around the longest, middle fingers. This leaves the index fingers and thumbs free to move. Try to keep only 1cm tight enough to slide between teeth. Leave about 5cm each side for "leverage". Slide using a "sawing" motion between teeth. Do not force the floss since it will hit the gums and hurt. Slide up and down each tooth to clean off plaque and food debris. Continue to floss all teeth. To reach your back teeth, it helps to close your mouth enough to soften cheek muscles.
ORAL HYGIENE
In order to keep your gums healthy you need to remove the daily build up of plaque from all the surfaces of your teeth by - Brushing your teeth twice a day, for two minutes each time. Ask your dentist which type of tooth brush is best for you, as many of us use brushes that are too hard or too large. Floss your teeth, as a toothbrush doesn't always reach into the gaps in between the teeth or below the gum line. Do not brush your teeth too hard as this can damage your gums, ask your dentist or hygienist to show you the correct technique Use fluoride toothpaste. Healthy gums are -
-
Pink in colour
-
No areas of redness or inflammation
-
No bleeding when brushing or flossing
-
No tenderness or discomfort
If the daily build up of plaque is not removed this can lead to the first stages of gum disease 'Gingivitis' Gingivitis is caused by sticky bacteria which are known as 'plaque'. Plaque collects in the small gaps between the gums and the teeth and if not removed by regular brushing & flossing will multiply by feeding on sugars found in your food and drink. This can lead to -
-
Bleeding when brushing or flossing
-
Soreness or discomfort
-
Appear red in colour, puffy or swollen
Bleeding when brushing or flossing your teeth is the earliest and most common sign of gingivitis. Gingivitis is reversible if treated by a hygienist or by improved brushing and flossing techniques. However, if left untreated you will develop the later stages of gum disease, which is known as 'Periodontal Disease'. Periodontal Disease is the later stages of gum disease. This is when the bacteria infection under the gums progresses deeper and affects the bone and tissue supporting the tooth. Your gums will -
-
Bleed when brushing or flossing.
-
Will be red, swollen and tender.
-
Bad Breath.
-
The gum will have pulled away from the tooth, this is called 'Pocketing'
-
Pus may be seen in the pockets around the tooth.
The infection damages the tissue that connects the gum to the roots of the tooth. Once the tissue has been destroyed the gum pulls away from the tooth, this forms a pocket which bacteria thrive in. If not treated, in time the bone anchoring the teeth in the jaw will dissolve, making the teeth loose and eventually the teeth will fall out Periodontal disease is irreversible, but you can slow down the progression by regular visits to the Dentist and Hygienist also improving your oral hygiene at home.
BAD BREATH SOLUTIONS
Bad breath (or halitosis) is an unpleasant odour which can occur from time to time or be long lasting. The main cause of bad breath is in the mouth. We have millions of bacteria that live in the mouth, particularly on the back of the tongue and these bacteria feed on the food debris that accumulates in the mouth and between our teeth. The bacteria give off a sulphur compound and it is this that creates the bad odour. Smoking and drinking alcohol contribute to the unpleasant odour. There are other conditions which affect the airways and stomach that can lead to bad breath too. Improving your oral hygiene is the most effective way to eliminate bad breath. Brushing teeth and tongue twice a day using fluoride toothpastes, as well as flossing, will remove the bacteria which generally removes the odour. Other things that help are -
-
Drinking plenty of water
-
Chewing sugar free gum after meals
-
Stopping smoking
-
Eating a well balanced diet
-
Making regular visits to your dentist
The other causes of bad breath (which can be treated by your dentist) are
-
infection of the gums (Periodontal disease)
-
decayed teeth
-
a condition called 'Dry mouth' affecting the flow of saliva
If your dentist finds that your mouth is healthy but you still have bad breath, you may be referred to your family medical practitioner as there are other causes of bad breath -
-
Sinusitis and bronchitis.
-
Problems within the stomach.
-
Diabetes.
-
Liver and kidney problems.
INITIAL CONSULTATION
The first people you will meet will be our friendly reception staff, who will ask you to complete a medical form. Our dentist needs to be aware of your general state of health as this can often impact upon the condition of your teeth and gums and may effect medication such as anaesthetics and antibiotics we may use for you. At your consultation you will have the opportunity to discuss any dental concerns you may have or how you would like your teeth improved. Your dentist will give you a full oral assessment to help accurately plan which treatments would be best for the health of your mouth. During this examination we will be looking at -
-
Teeth and the way you bite
-
Original restorations - Filling, crowns, veneers etc
-
The health of your gums and surrounding bone around each tooth
-
Your tongue, throat, cheeks & lips for signs of oral cancer
-
Jaw joint evaluation
Dental X-rays will also be taken of your teeth to check for -
-
Decay inside the tooth or between the teeth.
-
Abscess or cysts on the roots of your teeth.
-
Root positions
-
Bone loss
Once the examination is complete the dentist will discuss the findings with you. We will then create a treatment plan with alternative options for you, including all the benefits and risks of each procedure and the costings. This will allow you to decide what is best for your long term dental health.
GRINDING APPLIANCES
Teeth grinding is a surprisingly common occurrence and often happens whilst asleep. Most people are therefore unaware that they are grinding and only come to realise it when their partner complains of the noise the following morning. Other noticeable effects of grinding (bruxism) are:
-
Ear ache
-
Jaw pain
-
Facial and neck pain
-
Sleep disorder - both yourself and partner
-
Sensitivity to hot and cold drinks
The most common reason for grinding is when we try and compensate for an imperfect bite. This is when the upper and lower jaw comes together but the teeth don't seem to fit comfortably and you therefore try and force them into a perfect bite. Imagine chewing hard but with no food in your mouth. You may also find that you suffer from jaw clenching, which if combined with grinding, will cause greater discomfort and damage to the teeth. It is also thought that stress can lead to grinding although you may be equally unaware that you are doing so as it often happens during your sleep.
As you try to compensate for the imperfect bite you end up biting harder and thus causing damage to the enamel on your teeth. It becomes a vicious circle as you bite harder to try and make the teeth fit better you end up creating more damage to your teeth by initially wearing down the tooth's enamel to gradually wearing down the tooth itself. As most grinding occurs during your sleep, the most common solution is the use of a mouth guard to prevent such grinding. This helps reduce the pressure of tooth grinding and helps prevent further damage to your teeth. Your dentist may also be able make adjustments to your teeth order to achieve a better bite and thus reduce the subconscious effort you are making
Naturally, if your grinding is a result from stress then you should learn relaxation techniques and stress management.
SPORTS MOUTHGUARDS
Mouthguards are made from a plastic material called Ethylene Vinyl Acetate (EVA). EVA is strong and tough and can be easily moulded to fit precisely over your teeth and gums. Mouthguards are the most effective protective pieces of equipment to help prevent injury to the mouth - protecting the teeth, lips, cheeks and tongue. A mouthguard does not only protect your mouth, it can also cushion blows to the mouth or jaw therefore preventing damage to the jaw, neck or brain.
Having a dentist take special impressions will create a guard to perfectly fit your mouth, teeth and gums, providing ultimate protection. The procedure is very simple; your dentist will take moulds of your teeth both upper and lower. They will be sent to the dental laboratory where our technician will fabricate your custom made guard. Your sports mouth guard will need replacing over time. Just bring it along to your check-ups and your dentist will inspect it for wear and tear.
FLUORIDE TREATMENTS
Fluoride is a natural mineral found in food and water which helps to strengthen teeth and prevent tooth decay, by making the tooth more resistant to acid attacks from plaque and sugars. If fluoride is lacking from the diet, the teeth will be prone to tooth decay and cavities. The hard outer surface of the tooth is called 'enamel', which contains mineral crystals. Everyday plaque bacteria and sugars in the mouth attack the enamel causing it to weaken. This process is called 'demineralisation'. Minerals such as fluoride, calcium and phosphate from the food and water we consume and the toothpaste we use, helps to strengthen the enamel. This process is called 'remineralisation'. Fluoride speeds up the remineralisation process. Fluoride intake is very important when teeth are developing; it can be taken into the body in two ways -
-
The food and drink we consume or supplements.
-
Fluoride toothpaste, mouthwashes or when applied directly to the teeth by the dentist or hygienist.
Fluoride treatments are offered to children who have a number of cavities or are at high risk of developing cavities. Adults can benefit too. Fluoride treatment is a very simple process administered by the dentist or dental hygienist which helps to prevent tooth decay.
-
The teeth will be cleaned to remove any food debris, staining.
-
A high concentrate fluoride foam or gel is placed into an arch shaped dental tray which is inserted over the teeth and left for the required time. Alternatively, a fluoride varnish is painted on to the tooth surface.
-
Nothing should be eaten or drunk for 30 minutes after the treatment to allow the fluoride to penetrate the teeth.
Fluoride supplements are available; please speak to the dentist to see which supplement is best for you or your child.