Our range of services
If you want general information on a condition or treatment, go to the British Dental Health Foundation’s web site where they have over 40 online leaflets.
Online Resource: Want to find out about dental treatment? Want to know how to look after your teeth better? Visit the new BDA Smile web site.
3D Education: Learn about dental anatomy, conditions, treatments and good oral health with the BDA’s cutting edge 3D Educational web site.
Screening for gum disease forms an integral part of your routine examination. Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.
What is gum disease?
Gum disease describes swelling, soreness or infection of the tissues supporting the teeth.
What is gingivitis?
Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.
What is periodontal disease?
Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out.
What is the cause of gum disease?
All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.
What happens if gum disease is not treated?
Unfortunately, gum disease progresses painlessly on the whole so that you do not notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.
The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.
The hygienist/therapist has been specially trained to remove plaque and tartar from your teeth. This is achieved with the use of instruments called hand scalers or ultrasonic scalers , after which teeth are polished to a very smooth and shiny finish. The hygienist will give you comprehensive advice on oral hygiene and aids that you may need to maintain healthy mouth.
You may sometimes require special drugs and mouthwashes to help to reduce infection and these will be prescribed where required. Air polishing is also available to get rid of stubborn stains caused by smoking, red wine, tea and coffee.
A fissure sealant is a safe and painless way of protecting teeth from decay. Traditionally used for children, a sealant is a plastic coating applied to the biting surfaces of back teeth to stop decay starting in the tiny grooves. Liquid sealant is applied to the surface of the tooth and set with a special light.
There are several excellent specialists in the area to whom we refer problem cases for root canal, gum disease and implant work. Orthodontics and oral surgery are also areas that sometimes need referral.
Silver Amalgam Fillings
This is a good long term filling material, which can give many years of satisfactory service. The main disadvantage is that they are not cosmetically appealing. They are made from mercury, tin, copper and silver.
Made from composite resin, the benefit of white fillings over amalgam is that they can be matched to the tooth colour and bonded to the tooth structure, making the tooth almost as strong as it was before the decay. Many patients prefer tooth coloured fillings because they look natural and other people can’t see them when you laugh or smile. Composite fillings are often called “white fillings” but we actually use a wide range of different shades to exactly match the natural colour of your teeth. Composites are made from glass particles , resin and setting agents. Sometimes, when the existing fillings are very large, a composite filling may not be an option – a porcelain inlay may be required.
Root Canal Treatments
Root canal treatment (also called endodontic treatment) is the process where a dentist removes the pulp (the blood and nerve supply) from an infected or dying tooth and replaces it with dental filling material. The pulp of the tooth can become infected when decay passes right through the hard parts of the tooth into the root canal system in the middle. It can also happen if the tooth is accidentally damaged for example a blow to the teeth or face.
When an infection starts it can spread throughout the root canal system, eventually leading to an abscess. If you don’t have root canal treatment the infection can spread into the surrounding tissues, causing pain and swelling, and your dentist may have no choice but to extract the tooth. It is always better to avoid an extraction if possible.You won’t necessarily feel any pain in the early stages: but just because a tooth isn’t hurting yet doesn’t necessarily mean that it is healthy.
As with many illnesses, there isn’t any pain or discomfort until the latter stages of the disease and treatment is often more effective and more likely to succeed if started early. The aim of this treatment is to remove all infection, after which the root is cleaned and filled with warmed Gutta Percha to prevent further infection.
Teeth often last for many more years after a root filling has been placed. Nonetheless, root filled teeth are more brittle and prone to fracture than “live” teeth. This often means that it is necessary to place a crown on the tooth after root canal treatment. The crown helps to hold what remains of the tooth together and to protect it.
Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist. It is possible for the infection comes back and the tooth may need to be re-rootfilled or may need to be extracted.
The alternative to root canal treatment is extraction followed by no replacement or replacement with a removable partial denture, bridge (fixed or adhesive) or an implant.
Teeth sometimes need to be extracted, although this is quite rare these days. Some of the main reasons teeth may need to be extracted are:
- To relieve over-crowding
- If a tooth is broken and cannot be repaired
- If a tooth is so badly decayed it cannot be repaired
- If a tooth has an abscess and the patient for whatever reason does not wish to save it
- If a tooth has severe gum disease and is very loose
Extractions are normally carried out under local anesthetic and are usually quick and painless. Occasionally they are more difficult and a small surgical procedure is required to remove the tooth.
There are several excellent specialists in the area to whom we refer problem cases for root canal, gum disease and implants. Orthodontics and oral surgery are also areas that sometimes need referral.
Tooth whitening can be a highly effective, yet very simple way, of lightening the colour of teeth without removing any of the tooth surface. Many people like to whiten their teeth because it gives them a more youthful appearance: dark, discoloured teeth can be very unappealing. It often makes a tremendous difference to how your mouth looks – many patients feel it makes them look five to ten years younger.
It is also essential to consider tooth whitening whenever you are having a new crown, filling, veneer, denture or inlay. This is because teeth can be whitened but crowns, inlays, etc cannot. If you have new crowns and then later decide you’ d like whiter teeth you may need to have the crowns remade (at considerable expense) just to match your new tooth shade.
The degree of colour change varies from person to person. Teeth have natural colour variations – a bit like the natural variations in the shade of people’s skin or hair. If your teeth are naturally darker in colour, they won’t necessarily reach the brightest white shade. There is a limit to just how much you can whiten a tooth. Teeth that are naturally very white but have been stained by smoking, drinking red wine, tea, coffee, etc, are likely to whiten quite easily and to achieve a very bright white. Your dentist can give you a better idea of the likely shade change at your dental examination.
Before tooth whitening starts, your dentist will examine your teeth and mouth to make sure that everything is healthy. Provided there aren’t any problems that need to be addressed first, your dentist will take impressions of your teeth. The dentist sends these to a specialist dental laboratory, who make flexible dental trays with a tiny air gap to allow the whitening gel to spread evenly over your teeth. Your dentist will also record the shade of your teeth using a special calibrated guide so that he/she can measure how much the colour has changed when you are reviewed.
At the next appointment, your dentist will check that the trays are a good fit and will give you instruction in how to use them. The trays are usually worn at night while you are asleep. In the morning, you simply take them out and brush away the remaining gel. The tooth shade will gradually change and you continue to use the kit until the desired shade is achieved – your dentist will review your progress with you. It is quite common for people to experience some sensitivity for a few days during or after tooth whitening. Applying toothpaste for sensitive teeth or special desensitising agents can reduce this.
If a stain is very deep within the tooth then porcelain or composite veneers can be considered. Veneers are thin coverings of porcelain or composite (Componeers) , which are bonded to the tooth with a special resin. They behave much like a false fingernail, which covers the front surface of the tooth. Because they have a glazed surface they feel very smooth and also tend to resist staining. Veneers are often chosen by celebrities to perfect their smile.
To replace lost front teeth we can offer all ceramic bridges for an optimal aesthetic result. If a tooth has been lost, crowns can be prepared on either side of the gap and a bridge manufactured by the laboratory. The bridge consists of two crowns with the replacement tooth attached to them and suspended in the gap. This is cemented into the mouth eliminating the need for a denture.
Other types of bridges such as “sticky” (Adhesive /Maryland) bridges which are minimally invasive can also be a treatment option.
A perfect solution to single or multiple tooth loss, dental implants offer secure predictable results, giving patients complete confidence in their dental restorations. Whether you have lost teeth due to disease or accident, dental implants or an implant borne denture could provide the answer.
Dental implants offer a number of advantages over other treatments. Unlike traditional bridgework, dental implants do not require adjacent, often healthy teeth, to be “ground down”, thus preserving as many of your natural teeth as possible. In addition, implants also have a positive effect on the jaw bone, helping to maintain its natural shape and fighting gum loss so often apparent in the wearers of traditional dentures.
When a tooth is very broken down it is necessary to provide a crown. This involves trimming the tooth down to a cylindrical shape, taking an impression, and asking a laboratory to manufacture a crown, which is subsequently cemented in place with a special adhesive. You could choose to have a gold crown, which is particularly suitable for back teeth, which do not show, as gold is hard wearing and very kind to the mouth.
Well-made dentures will make you look good, allow you to eat almost all foods without embarrassment, and will restore the facial contour around the mouth. Dentures last for many years, but they and the mouth should be checked once a year. Dentures will need to be replaced after about five years. However, if you have an immediate denture following an extraction, then a replacement denture will be necessary much sooner. This is because the jawbone shrinks back quite rapidly following an extraction and the dentures may not be as tight or may appear to have gaps underneath. This replacement denture will incur further charges.
Night Bite Guides
A great many people grind their teeth in their sleep. This is often worse when someone feels tense or stressed. Often tooth-grinding causes no particular problems for the patient; however, it can contribute to aching jaw joints and headaches. If severe it can also cause teeth to become very worn down and even to break. A night bite guard is an appliance that is worn at night and just props the teeth open slightly. This has two main benefits – firstly it prevents the patient from grinding their teeth and can help alleviate symptoms, and secondly it can help to break or reduce the grinding habit.
Mouthguards should be worn when taking part in most sports, but especially perhaps rugby, hockey and horse riding, as the best insurance against accidentally broken teeth. They are custom made for each individual, and fitted by the dentist. Bring your mouthguard to each examination so that its effectiveness can be checked.
Practice Policies and Medical Questionnaire
Changes in Circumstances
Please remember to advise your dentist of any medical problems you may have or any medicines, pills, lotions or creams you are taking or using by completing a Medical Questionnaire available in reception. Advise us if you think you might be pregnant. All information you give us is treated in confidence.
Advise us of any change of address or telephone number.
In carrying out our treatment we use the latest material available to ensure pain free dentistry. Only the highest standards of cleanliness are employed by our dental team. Everything that can be disposable after a single use is favoured and everything else is autoclaved or sterilised by other appropriate methods.
Private treatment is also available and we are happy to explain the options and costs with you.
We take patient confidentiality extremely seriously and all personal information is treated in strictest confidence. Only members of staff have access to patient personal information and we have a strict confidentiality policy. To see a a copy of this policy please Denham Green Confidentiality Policy (PDF), or ask at reception.