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Cosmetic dentistry or how to improve your smile and boost your confidence!

In the UK the importance of your smile has historically been low on the priority list. We are in the process of catching up with many other countries now we know how effective a good smile is. Research has shown how a good smile improves confidence, which has a knock on effect socially and professionally. How we are perceived by others has also been proved to be affected by our teeth. Studies show that people with healthy looking smiles are regarded as more successful and more attractive. Again, the benefits professionally, socially and romantically are well documented.

We used to think that improving the look of your teeth or cosmetic dentistry was for film stars and celebrities. But with the advanced cosmetic dental training courses available in the UK in the past few years, these techniques are much more accessible and affordable than ever. If you are searching for appropriately trained dentists, look for those with some form of accredited training in the field. Memberships of a cosmetic dental society are an indication of experience. You should ask the dentist about their experience and memberships before embarking on any form of cosmetic dentistry.

When deciding on the treatments that you want to undertake to improve your smile, you should always try to choose the least invasive method possible. This means the techniques that avoid using a drill on your teeth! It also has the additional benefit of being a cheaper option as well. These techniques include teeth whitening and direct veneers. Teeth whitening is well known, and for the most effective methods you should choose to have it done by a dentist. Although more expensive at first, the results tend to be much better and longer lasting. The best proven method is the take home system where you apply Whitening gel into a custom made thin mouth guard. This is then worn overnight for 14 to 28 nights.

Direct veneers are tooth coloured filling materials that are bonded just onto the surfaces of the teeth. They can be done in one visit, in most cases do not involve trimming the teeth, and are much cheaper than porcelain veneers. The disadvantages are that they are not as smooth as porcelain and may stain over time. They can be repaired but this may incur additional future costs 2 to 5 years later.

Another method of improving your smile without the need for any extensive removal of tooth tissue involves orthodontic treatment. This consists of moving teeth using braces. There are now different forms of braces, not just the ‘train track type’. An increasingly popular choice is the clear braces systems now available. The most well-known one is Invisalign, and at Bridge Dental, being Platinum accredited, we have been at the forefront of this technology for several years.

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Gum Disease Advice

Gum disease or to give it it’s medical term, Periodontitis, is an extremely common condition and we are only just realising the overall impact it has on general health. Research has now revealed links with heart disease, diabetes and Alzeimers to mention a few, and when figures show that up to 85% of the population have some form of Periodontitis, it is important to get the message out that,on the whole, this is a preventable condition.

The process of gum disease starts with a build up around the teeth of plaque this consists of debris in the mouth, precipitations from saliva, and bacteria. The initial inflammation is known as gingivitis. It then progresses to early Periodontitis where there is some destruction of the tip of the bone surrounding the root of the tooth and some of what’s known as the periodontal ligament. This ligament runs between the bone socket in your jaw and the root of your tooth. At this point the margin of gum begins to come away from the tooth forming a ‘pocket’.

If left unchecked, this will then progress to moderate and then advanced gum disease. The bone and ligament around the root of the tooth become more and more eroded, and the pocket becomes deeper. This will eventually lead to the tooth becoming loose and being lost. Periodontitis has been called the ‘silent disease’ in some quarters as there are often no warning signs such as pain, or swelling until the more advanced stages.

People often say to me if they brush twice a day and floss then surely they can’t get gum disease. Every one is different but the vast majority of us will develop Periodontitis if we just rely on our home care. A visit to the dentist or hygienist for a comprehensive check and ‘scale and polish’ can not only prevent problems with the gums, but also prevent cavities and make fillings, crowns, bridgework and dental implants last even longer. An effective scale and polish should effectively provide a full mouth disinfection and should take around 30 minutes. This is usually available under a private basis, and not under the NHS.

If you are about embark on any dental treatments such as implants, teeth whitening or braces such as Invisalign, it is imperative that the gums are healthy. Dental implants can get gum disease just like teeth, and it can be more difficult to treat. In addition unhealthy gums can lead to complications if teeth are moved with any form of brace. This includes the popular clear brace systems, Invisalign being the most well known of these.

How susceptible we are to this condition does vary considerably. Some people will need hygiene visits every 6 weeks and some only annually. Hopefully I have explained how important it is to visit your dentist to check for gum disease, not only for your mouth but also for your overall health as well.

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Root Filling Or Dental Implant?

What is a root filling, why are they so expensive and why do they fail?

Should I have a root filling or dental implant?

Dentistry, as with all forms of medicine continues to evolve with the ever increasing knowledge we gain as the years go by. This especially applies to the procedures known as root canal treatment and also dental implant therapy. To explain what root canal treatment is I will need to describe the structure of a tooth. The outer layer you can see in your mouth is made of enamel. Underneath this is a slightly softer layer called dentine. Then further down you find the part of the tooth that anchors the tooth into your jaw bone. These are the roots and can number one ( usually for the teeth at the front of the mouth) to four,five or even more for the teeth at the back (the molars). These roots are hollow and have canals that run inside them, these are the root canals. 

Then, the centre of the tooth there is a space filled with nerves and blood vessels. This is called the pulp chamber. Finally, hanging down from the base of this pulp chamber are branches of these nerves and blood vessels. Each branch runs down the inside of the root canals. We used to think that there was a single canal inside each root, but now we know it is quite a complex structure with a whole network of offshoots. 

Root canal treatment is required when the nerves and blood vessels inside the tooth have become so irritated that they die off. This can be due to many reasons including bacteria causing decay deep inside a tooth, a large filling, a hard knock to the tooth or even grinding your teeth! The symptoms when the tooth is dying off can range from severe pain to no feeling at all, but if left a dental abscess can ensue. The tooth then requires these dead nerves and blood vessels to be removed, the canals inside the roots then need to be cleaned and widened to allow the removal of infection and sealing.

At best the success rates are around 85%. Reasons they can fail due to no fault of the dentist are that as I mentioned, the canals are a complex network and it is impossible to ensure that every part is sterilised. Another cause is that there may be a hairline fracture of the root of a tooth. These do not show up on Xrays and are not visible to the eye.

I would recommend root canal treatments are carried out by dentists who specialise or have a special interest in this procedure. For the best chance of success these procedures can take up to 2 or 3 hours, and if not done to the highest standards the first time around, the chances of success if they need to be redone comes down to around 60%.

After root canal treatment it is recommended that the tooth is strengthened by placing a crown or onlay over the tooth, as root filled teeth are more prone to breaking. These are metal, metal fused to porcelain, or purely ceramic ‘caps’  placed over a trimmed down tooth.

Generally, to be done to the highest standards, only private care is available in general practices. The costs can be high, around £1500 to £1800 per tooth for the root filling and crown. Then if the root filling fails and the tooth needs to be removed, all that work and money is wasted, but there is no way of knowing if your tooth is one of the approximately 15% that ends up in this way.

The other option is to remove the tooth and fill the resulting space. The space can be left but is generally not recommended. Ways to fill the space includes a denture, bridgework or a dental implant. Your dentist will explain all the pros and cons of these but I will concentrate on dental implants. These are now the recommended treatment in most situations. Ideally they be made from titanium and be placed in the jaw bone where the tooth used to be. They are then left for 6 weeks to 5 months to fuse to the bone. After that a tooth in the form of a crown, made of metal and porcelain or metal free products can be fixed to it. The advantages of dental implants are that they usually last longer than the alternatives, they help strengthen the bone, and they don’t require any trimming of the teeth next to the gap. The disadvantages include the initial costs and that surgery is required (although this is normally relatively minor). 

So which is better a root filling or dental implant? The general consensus in the dental profession is that it’s better to try to save a tooth first and do a root filling. But given that the success rates are roughly 85% and they are approximately 90 to 98% for dental implants there is an argument for removing the tooth and placing an implant. As if the root filling should fail, you may have paid around £1500 for it and a crown, then the tooth needs to be taken out and an implant placed. This may cost an additional £1700 to £3500.

 These are large sums of money, and in other parts of the world where private dentistry is the only option, people tend to be used to the costs. However, if you’re used to the NHS system it seems unthinkable to spend this on a tooth. So why is it so expensive? These procedures do involve complex surgical procedures carried out by usually highly experienced and qualified professionals. The materials used are expensive and if laboratories are used for crowns etc, then you have another highly trained technician spending hours creating a replica tooth that will look and function perfectly in your mouth.

In the end it’s an individual choice once given all the facts, risks and costs. I hope I have provided some of the background information needed to make an informed decision if you ever need this form of treatment. For any further information, please contact us at Bridgedental on 02074072174 or email info@bridgedental.com.

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Wrinkle smoothing injections


By far one of the most popular cosmetic procedures in the UK, wrinkle smoothing injections continue to more popular than ever this year.

Botulinum toxin (which has several trade names e.g. Botox® or Azzalure®) is the agent which is used to relax the muscles that cause the wrinkles that we would rather not have.

With this procedure, dynamic lines are gently softened for up to 4 months at a time and with repeated treatments; the lines may become softer and softer. Unlike surgery, the procedure is quick, minimally uncomfortable and completed in a few minutes.

Results take about 2-7 days to appear and ideally you should visit with your doctor again 2 weeks after the injections so that the effect can be assessed properly and recorded for future treatments. Like any medical procedure, there can be some side effects and limitations – but these will be clearly and carefully explained to you before your doctor even picks up the syringe!

Wrinkle relaxing injections are used often in combination with dermal fillers and other facial aesthetic treatments for a refreshed look – like a non surgical lifting effect that is less invasive and with less downtime than surgery.

Did you also know that Botulinum treatment can be used to diminish underarm sweating for months at a time? Although licensed and most commonly used to soften lines in the upper face; Botulinum injections can even be used to slim the appearance of the lower face with modern techniques to give sharper definition to the jaw line.

Dermal fillers
Another way to soften lines and plump the facial skin is to use filler injections and the agent used now is mainly composed of hyaluronic acid, a sugar based molecule that is naturally present in young skin tissues.

We see it included more and more these days in premium skincare ranges because in its non-linked form it is a wonderful hydrator and attracts up to 1000 times its weight in water! We can use a three visit course of these micro-injections over aged, dull and dry skin areas to restore radiance and hydration to boost the appearance of the skin. This is like an injectable moisturiser that works deeper than any over the counter product you may be using!

The other type of hyaluronic acid is cross linked and can be used to return volume back into areas of the skin that are showing signs of sagging or have lost support.

Depending on the brand of filler, the results can last from a few months to more than a year and nearly all brands stimulate the skin to produce natural collagen around the filler for a longer lasting effect. Commonly treated areas are the nose to mouth lines, the lines from the corner of the lips (marionette lines), cheeks, and of course lips to give fullness and definition.

There are over 100 different brands in the UK alone and we at Bridge Dental only use brands that have been subjected to strict testing and research. At consultation we can describe the different ones available and select the most appropriate one for your treatment together.

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Digital Dentistry

As with many things, over the last 20 years dentistry has been transformed by advances in technology. The rapid development of the micro chip and it’s applications has affected many aspects of life and dentistry is no different. We start before you even visit the dentist! At Bridge Dental we use text messages to remind our patients of their appointments. We also utilise emails, Facebook and Twitter to communicate any information or offers available at the practice. Theres also our online booking system at Bridgedental.com.

Dental procedures themselves have been transformed to provide alternatives to the traditional fillings and crowns. Starting with the check up, if x-rays are needed digital technology allows us to reduce radiation to up to 80% compared to traditional ‘wet film’ x-rays. Images are quickly processed while you are still in the surgery and as the resulting pictures are larger and clearer with tools to zoom in and measure amongst others. This allows us to be able to spot problems and deal with them at an earlier stage.

If you do need treatment at Bridge Dental we are one of the few practices to have the ‘Cerec’ technology. This allows us to create porcelain covers (inlays and onlays) and crowns in one visit. Usually two visits are needed, at the first you would have to be numbed up, have the tooth prepared, have moulds or impressions, a temporary cover is then fitted. At the second you are numbed up again, the temporary cover is removed and the final one fitted. With the Cerec procedure this is all done in one visit. This uses a CadCam system where the tooth is prepared, and then a 3d camera takes images. From these pictures, a final cover or crown can be designed and a milling machine creates this restoration from a block of porcelain. Advantages over the traditional system includes being only numbed once, no temporary covers which can come off, no moulds or impressions and it is all done at one visit.

Another application of advanced technology we use at Bridge Dental are our DVD glasses. We have a library of films, documentaries and sports DVDs for you to choose from in the reception area. You then are able to watch this during the procedure and we find this transforms the experience of longer dental visits and greatly helps reduce any anxiety.

At the forefront of current dentistry are dental implants. These are titanium screws that are placed into the jawbone where a tooth is missing. They then integrate and fuse to the bone allowing crowns, bridges and dentures to be attached to them. Through research and computer aided designing, they have improved over the years to the extent that they are now the recommended replacement for missing teeth. To aid in the

placement of them we now use advanced scanning techniques. This allows us to view the jawbone in 3d which allows us to be far more accurate when implants are inserted. The same imaging is now being utilised to help to make certain types of bridgework that can be made and fitted when the implants are inserted.

There are an ever growing range of uses of digital technology and further applications are not far away. At Bridge Dental we are at the forefront of these where they have been proven and tested to be an ideal solution for our patients. To schedule a visit to us please book online at bridgedental.com, email us at info@bridgedental.com or call us on 0207 4072174.

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