<![CDATA[Online Dentists - Dental A-Z]]>Tue, 25 Jun 2024 21:55:55 +0100Weebly<![CDATA[Sensitive teeth]]>Thu, 11 Feb 2016 23:06:37 GMThttp://www.onlinedentists.co.uk/dental-a-z/sensitive-teeth

Why do we get sensitive teeth?

Sensitive teeth or a sensitive tooth can be caused by many different things. Each of your teeth has a blood and nerve supply which enters the tooth at its apex which is hidden at the end of the tooth root in your jawbone. The nerves feed information back to your brain about eating, chewing, clenching and more. Unfortunately there are lots of pain nerve fibres in your tooth. The nerve tissue is covered by the dentine which is less hard than enamel and is made up of lots of tunnels which are intimately connected to the nerve fibres and so this part of your tooth is sensitive. This is usually covered by the rock solid enamel which the nerve supply cannot penetrate.

As you can see therefore, anything that exposes the dentine of the tooth or otherwise irritates the nerves inside your tooth has the potential to cause tooth sensitivity or sensitive teeth.

Below are all the main causes of Sensitive teeth along with why they cause tooth sensitivity. The second table details how to treat each form of tooth sensitivity:

Cause	Why it causes sensitivity?
Recent deep filling in your tooth	The filling may be very deep and it may take a while for the inflamed nerve beneath it to settle down. This will often be hypersensitive to cold and sweet foods and drinks. Alternatively the nerve may never settle down and may lead to toothache and the need for a root canal treatment or extraction.
Recent high filling or other restoration in/on your tooth	This will often be felt as a high spot on your tooth when biting and will cause pain or sensitivity when biting down or chewing as soon as the numbness (if you had local anaesthetic) has worn off.
Leaking filling	This may be an old filling that has decay around the edges or a new filling that has not bonded or been packed fully into place. This will be sensitive to cold and sweet and often sensitive to sucking cold air in.
Tooth Decay	Tooth decay can often go unnoticed as it generally doesn't cause sensitivity or pain until it has progressed a long way into your tooth. At this point your tooth will become hypersensitive to cold and sweet foods and drinks and eventually sensitive to bite on.
Lost filling, crown or other restoration	If your tooth has not been root treated then often losing a filling or other restoration exposes the dentine which is the sensitive part of the tooth. Unless covered this will by hypersensitive to hot, cold and sweet.
Cracked tooth	This is a specific type of pain where you will get sensitivity to cold and sweet foods depending on the extent of the crack. You will also get pain after biting when you release from biting. i.e. if you clench it will not be sore but once you then unclench your teeth it will start to be sore.
Trauma	Any trauma to teeth that exposes the dentine i.e. on the front incisors usually anything more than a 2mm fracture will cause the tooth or teeth to be sensitive to cold and sweet foods
Gum recession	Gum recession may occur as a result of gum disease, brushing too hard, ageing or a number of other reasons. The dentine of the tooth below gum level is usually covered by bone and gum but as the bone and gum recedes it slowly exposes the sensitive dentine underneath. This will usually be generalised around the whole mouth but can be localised to one or more teeth.
Tooth wear from grinding	Tooth wear from grinding (bruxism) will wear away the protective enamel as well as cause little enamel fractures at the gum level. This will expose sensitive dentine underlying the enamel which can cause generalised tooth sensitivity. You may have associated jaw pain or jaw-ache as a result of clenching and grinding also.
Acid Erosion	This is another form of wear caused by a diet that is too acidic i.e. too much citrus fruit, sugar, fizzy drinks and so on. The acidity will erode away the enamel on teeth hence exposing the sensitive underlying dentine and causing generalised sensitivity. If you have reflux or you vomit regularly it can cause acid erosion also which can lead to tooth sensitivity and tooth decay.
gum disease and periodontal disease	This causes inflamed gums which are held away from the teeth, as a result there is no longer a tight seal around the neck of the teeth and the sensitive underlying dentine is exposed. Chronic periodontitis also leads to accelerated gum recession and often generalised sensitivity of the affected teeth.
Tooth whitening	Tooth whitening, whether done at home or in the surgery has the potential to cause temporary tooth sensitivity. If you are having tooth whitening done then your gums need to be in perfect condition beforehand and you should use desensitising toothpaste before, throughout and afterwards to reduce the potential for tooth sensitivity.

Sensitive Teeth Treatment

Cause	Home Treatment	Dentist Treatment
Recent deep filling in your tooth	May monitor for a few weeks but if not improving or if worsening then need to see the dentist as soon as possible.	If not improving then dentist may need to medicate your tooth and refill it at a later date or carry out a root canal treatment or extraction.
Recent high filling or other restoration in/on your tooth	May monitor for a couple of weeks to see if it settles but if it does not then see the dentist as soon as possible.	Your dentist will adjust the biting surface of the restoration until it feels comfortable to bite and chew on.
Leaking filling	Call your dentist to arrange an appointment and in the meantime, use sensitive toothpaste such as "Sensodyne Pronamel" or any of the other well known branded sensitive toothpastes	Your dentist can replace the filling or sometimes repair the filling where it is leaking. It may be best to have a white filling as these can bond to the tooth to seal the dentine whereas amalgam fillings cannot.
Tooth Decay	Arrange to see dentist and reduce sugar in your diet. Ensure tooth brushing effectively and ensure to be using floss regularly to help prevent decay between your teeth	See your dentist to have the decay removed and the tooth or teeth restored. If your tooth is unrestorable it may require extraction
Lost filling, crown or other restoration	Arrange an appointment with the dentist, In the meantime you may purchase a temporary filling kit from a pharmacy or some supermarkets to help cover over any sensitive cavities.	See dentist at earliest convenience so as they can assess the problem and treat it accordingly.
Cracked tooth	Avoid biting anything hard with the tooth and take ibuprofen painkillers if you are allowed (avoid them if you have any stomach issues) and arrange to see your dentist as soon as possible.	The dentist will investigate the crack and often will numb the tooth and remove the crack and any fillings. Sometimes the crack goes through the entire tooth and it needs extracting. Other times the crack will be small and can be treated with an adhesive white filling.
Trauma	Call dentist (or A&E if severe) and get seen as quickly as possible for the best chance of successful treatment. Take painkillers while you are waiting to be treated.	The dentist will temporarily repair any broken teeth that are sensitive, remove any exposed nerves and often splint (join) teeth with white filling material to help stabilise them.
Gum recession	If generalised and ongoing then sensitivity from gum recession can be treated with regular use of desensitising toothpaste such as "Sensodyne Pronamel" or other branded sensitive toothpastes. Avoid brushing too hard and ensure to be using either a soft manual toothbrush or an electric toothbrush that is simply held on the tooth and not used to scrub.	May be treated with "duraphat" prescription toothpaste which is a lot stronger than those bought over the counter. Your dentist may apply sealant to the tooth or fluoride varnish to help tackle the sensitivity. They may sometimes place small white or pink fillings to seal the sensitive exposed dentine also.
Tooth wear from grinding	See dentist as soon as possible, distraction techniques and sensitive toothpaste can be used. We would advise against wearing a normal mouthguard as it is not close fitting and may affect teeth by allowing some to over-erupt whilst others are in the guard.	Your dentist can make a soft splint (mouthguard) to wear at night or in the day in order to prevent further wear. Again they may give prescription toothpaste to help with generalised sensitivity. If severe they can restore your teeth with adhesive white fillings and crowns.
Acid Erosion	Reduce acidic foods and drink in the diet, use sensitive toothpaste regularly. Don;t brush straight after acidic foods and drinks; ideally rinse with water in between acidic food and drink and tooth brushing. Use a soft manual toothbrush or an electric toothbrush with gentle brushing technique.	Oral hygiene and diet advice at the dentist, prescription toothpaste to help with generalised sensitivity. Restoring worn surfaces with adhesive white composite restorations or adhesive lab made crowns and onlays. Prescription of anti-acids such as Omeprazole to prevent acid reflux.
Gum disease and periodontal disease	Improve oral hygiene, improve tooth brushing and ensure to be using dental floss or other interdental cleaning aids. Stop smoking, use sensitive toothpaste	If gum disease (gingivitis) then improved tooth brushing should reverse it. If periodontitis (your dentist will be able to tell you which you have) then it will need gum treatment with the dentist or hygienist as well as other methods of desensitising such as prescription toothpaste and fluoride varnish.
Tooth whitening	Use of sensitive toothpaste, reduced acidic foods such as citrus fruits, fizzy drinks and sweets; especially during the tooth whitening period. Limit the whitening so as you are not doing home whitening every night for example but every other night instead or less frequently depending on severity of sensitivity.	Your dentist may give you prescription toothpaste to use during whitening. All gum treatment is to be completed to ensure healthy gums prior to commencing whitening. Any leaking fillings, broken teeth and any of the above issues are treated before commencing tooth whitening.

As an additional note, If you have crowded or crooked teeth then your risk of tooth decay, gum disease and trauma may be increased and therefore your risk of tooth sensitivity. It may be wise to seek orthodontic treatment not only to improve the appearance of your teeth but to improve their function and reduce your risk of tooth decay, gum disease, trauma and sensitive teeth.

We hope you found this information useful and remember, any further questions you can always ask our dentists by clicking below or ask your own dentist of course...

Ask A Dentist

]]><![CDATA[Baby Teeth]]>Sun, 31 Jan 2016 12:42:00 GMThttp://www.onlinedentists.co.uk/dental-a-z/baby-teeth

When do baby teeth appear?

The first baby teeth can appear any time between birth and 3 years old. They usually erupt into the mouth in a specific order with the front incisors first followed by the first molars at the back and then the teeth in-between to follow; but this can vary between different children. Sometimes children get little white cysts on their gums which resemble teeth starting to erupt but are not. These are termed Epsteins pearls, they do not require treatment and will disappear after a few weeks.

When are baby teeth lost?

Normally the first baby tooth is lost at age 6 (range of ages 5-8) and will be the very front top teeth. The first adult molar teeth will come into the mouth at around the same time but they erupt behind all the baby teeth. The other baby teeth are lost between the ages of 6 and 12 as the adult teeth come into the mouth. Some baby teeth may remain longer, usually if their adult successor is missing or they are out of their normal position. Also if your child has to have a baby tooth removed early then the succeeding adult tooth may be delayed in erupting into the mouth

How many baby teeth should we get?

we should get 20 baby teeth which dentists assign the letter a-e in each corner. E being at the back and A at the front. Usually we will get all of our baby teeth even if we are missing some adult teeth but some children will be missing baby teeth. Occasionally baby teeth may not separate before erupting and so erupt as one large tooth with a dip in the middle instead of two separate teeth. This can happen in adult teeth also.

Teething

All Babies/Children will experience teething and it will cause varying amounts of discomfort from none to severe. There are a number of ways to help ease the discomfort and these are:

1. Teething Rings and toys - For your baby to chew on and ease discomfort while distracting them from the pain of teething. This can be chilled in the fridge for additional relief but NOT IN THE FREEZER as it can damage their gums.

2. Teething gel - this must be specific to babies and young children (not adult oral gel). You should ask your pharmacist about these as they can vary considerably with some being antiseptic whilst others not.

3. Chewing items - if your baby starts chewing on things e.g fingers, toys; this is a good sign that they are teething. You should give them healthy things to chew such as raw carrots or even crusty bread but keep a very close eye on them, NEVER leave them when they are eating in case they choke.

4. Painkillers - Medicine designed for your age of child should be used only. This will most likely be Calpol for children and will state the ages and doses on the bottle. Always consult your pharmacist if you are at all unsure and they will be able to help you. These medicines will contain small dosages of paracetemol and or ibuprofen to ease your childs pain.

AVOID adult painkillers and ASPIRIN at all costs as it is not indicated and can be dangerous if given to children!

5. Cool sugar free drinks, such as tepid temperature WATER is good for relieving pain and discomfort also. Any drinks need to be sugar free to avoid tooth decay.

6. Distracting your baby/child with playing and comforting can often be a welcome relief from teething pain as they are distracted and if the pain is mild may well forget about it.

7. Wipe your babies/childs face regularly as they will dribble more during teething and are at increased risk of teething rash around their mouth.

Brushing childrens teeth

Ages 0-3: From the first sign of erupting teeth in your child's mouth, children's toothpaste (1000ppm fluoride concentration) and a small headed soft toothbrush should be used

Ages 3-6: A smear of adult toothpaste (1350ppm minimum fluoride concentration) and a soft small headed toothbrush

Ages 6 plus: Use a normal adult toothpaste (pea sized amount, minimum 1350ppm fluoride concentration) and a normal size head soft toothbrush.

Note that if your child is at high risk of tooth decay as pointed out by your dentist then they may use adult toothpaste from age 3. Your dentist may want to supplement this with a fluoride mouthwash. In severe cases for older children a prescription toothpaste containing either 2800ppm or 5000ppm fluoride can be given or fluoride vanish containing higher fluoride concentrations still can be applied to your childrens teeth at their dental visits.

What is bad for baby teeth?

Juice of any kind, Fruit squash, Flavoured water containing sugar, sweets, having a bottle after age 1 and especially having a bottle at night, sweet foods, too much fruit especially dried fruit, formula unless it is completely sugar free, not toothbrushing properly, not toothbrushing at all , sugar containing medicines, eating rusks as all contain sugar.

What is good for baby teeth?

Breast feeding with breast milk provides the best nutrition for babies, Drinking from a free flowing cup rather than a bottle from 6 months is ideal and drinking from a bottle should be discouraged completely after 1 year of age. If not breast milk then milk and water are the best drinks for babies teeth and health. Good brushing technique, brushing twice a day as above with supervised brushing up-to the age of 7 and beyond if deemed necessary. Avoid adding any sugar to weaning foods and drinks. As soon as teeth erupt in the mouth brush them twice daily with a fluoridated toothpaste, reduce any sugary foods and drinks in the diet including flavoured water and ensure any medications given are sugar free - confirm this with your pharmacist or GP if you are unsure.

Can decay, abscess or trauma to baby teeth damage adult teeth?

This Depends:
1. Decay - on its own, unlikely to cause damage but a decayed hole in the back of a baby molar may trap food which then causes decay in the first adult molar tooth behind the baby molar. this can happen anywhere in the mouth also. Your child will then require a filling on their adult tooth.

2. Abscess - yes, infection beneath a baby tooth when the adult tooth is developing can cause damage to the developing tooth underneath and so the baby tooth will need extracting.

3. Trauma - if you take a knock to the baby tooth then the initial knock may hit the baby tooth up into the developing adult tooth, if this happens then the damage is done instantly and only recognised when the adult tooth erupts into the mouth. If the tooth is knocked straight up or knocked to stick out of the mouth more, then damage to the adult tooth is more likely. If knocked back then the root of the baby tooth will deflect away from the developing tooth and so there is less chance of damage to the adult tooth.

When to first take children to the dentist and why?

Children should be taken to the dentist from as early an age as possible, to get them used to the surroundings and used to seeing the dentist and seeing what their siblings and parents have done From around the ages of 1-2, the dentist should be trying to have a look in their mouth and then on a 6 monthly basis from this point onwards. If the child needs any treatment later on then they are accustomed to the environment and less likely to need a general anaesthetic for treatment.

They are also less likely to need treatment with regular attending so it is a win win situation. Do not wait until all their baby teeth are through or worse still until the adult teeth start coming through as any anxiety they may have about the dentist will be increased at this later stage having not become accommodated to the environment when they were very young. Also if you wait too long decay that could have been treated may have progressed and your child may not have a choice but to have a general anaesthetic for extraction of baby teeth.

Should I be in the room during treatment?

If your child is having treatment and is not apparently nervous but you, as the parent, are anxious it may be best not to stay in the room as it may make an otherwise fairly co-operative child less co-operative. So do not be offended if your dentist or dental nurse suggests you wait in the waiting room or outside the door of the surgery.

If you are not nervous or if the child is slightly or somewhat nervous/anxious then it is often best to stay in the room and offer reassurance but please try to avoid using any words that may alert your child such as: needle, injection and pain. Please refrain also from telling any stories about how bad an experince you may have had at the dentist previously.

Summary

We hope you have taken something out of the information above. It is important to remember that the dentists aim is to treat your child safely with as little distress and discomfort as possible. Whilst your aim is to look after your child's teeth as best you can whilst minimising their pain and discomfort also. You can see we have the same aim and we can work together so that everyone is happy and healthy. You can even prepare your child before their first visit to the dentist by watching the Peppa Pig Video above!

If you have any further questions about baby teeth please do not hesitate to ask our dentists by clicking below

Ask a dentist

]]><![CDATA[Periodontitis]]>Fri, 29 Jan 2016 12:45:31 GMThttp://www.onlinedentists.co.uk/dental-a-z/periodontitis

What is Periodontitis?

Your teeth are supported by your jaw bones and by ligaments connecting your teeth to the jaw bones. Your gums then lie on top of the jaw bones.

The area of jaw bone supporting each tooth along with the ligaments are termed the Periodontium . Inflammation and break down of this area is called periodontitis or periodontal disease.

Periodontal disease - signs and symptoms

The inflammation of this Periodontium is reversible but the damage done by the inflammation is not reversible and so can be catastrophic to your teeth and can cause early loss of teeth. Signs and symptoms are:

1. Bleeding gums as often a later stage of gingivitis
2. In smokers, the gums may not bleed which can mask the severity of the condition
3. Sore gums or painful gums
4. Gum recession (receding gums) due to erosion of the underlying supporting tissues
5. Sensitive teeth as a result of the gum recession (receding gums)
6. Possible food trapping
7. Possible abscesses in the gums.
8. Black spaces appearing between your teeth (black triangles)
9. Bad breath/halitosis
10. Loose teeth
11. Drifting and Spreading out of teeth where they have lost their support

Types of Periodontitis?

Chronic

This can be generalised or localised which means: around the whole mouth or around certain teeth in the mouth. Chronic simply means ongoing and over a longer period of time, this may occur over an entire lifetime or a number of decades leading to eventual tooth loss

Aggressive

This again can be generalised or localised as above but is much more rapidly progressive than chronic periodontitis and often does not respond well to normal treatments. This is less common but much more difficult to treat and prevent. This can cause very early tooth loss

Risk factors for Periodontitis

Genetics - some people are at increased risk of periodontitis despite good oral hygiene but it is definitely worsened if combined with poor oral hygiene.
Gingivitis - as is often predisposing to periodontitis
Poor oral health habits - poor oral hygiene leading to chronic periodontitis
Tobacco use
Diabetes - poor blood sugar control linked directly to poor gum condition
Compromised immune system such as in the elderly, infirm or HIV sufferers.
Poor nutrition
A few medications including antidepressants and anti-epileptic drugs.
Hormonal changes
Poor-fitting crowns, bridges and fillings
Unusual bite problems or tooth grinding/clenching problems

Periodontitis Treatment

Oral hygiene advice, scaling and polishing - Your dentist or hygienist can teach you the best way to remove all the plaque off your teeth by brushing. They may need to scale any hardened plaque off your teeth to make them easier for you to clean yourself.
Removal of ledges and replacement of poor fitting crowns and bridges - this again is to enable you to clean your teeth as easily as possible and remove any areas where food may get trapped and the gums may become unnecessarily inflamed.
Deep cleaning (Root surface debridement) - This is where the gum pocketing around your teeth is cleaned out to remove and/or disturb bacteria within the gums that are causing the periodontitis. This is essential to halt the disease process but it is futile/pointless if the teeth are not then kept clean afterwards to prevent return of the periodontal disease. This will often require use of local anaesthetic (numbing) in order to make sure it is not painful
Antibiotics - In the case of periodontal abscesses or gum pockets that consistently do not respond to conventional treatment then antibiotics can be given in various forms to help tackle the periodontal disease.

Periodontal Surgery

If your periodontal disease does not respond to repeated conventional treatment despite good oral hygiene and good root surface debridement then you may need surgical treatment.
This is usually carried out by a specialist periodontist and will involve lifting your gum to clean directly beneath it before suturing it back into place.
A periodontist can also reposition your gums where they have receded, graft bone into areas of lost bone and a number of other procedures to help treat or overcome periodontal disease and early tooth loss.

Periodontitis - Summary

Brush your teeth effectively at least twice a day, if your dentist recommends and electric toothbrush do not delay in buying one
See your dentist regularly and if they suggest seeing the hygienist then make sure you make the appointment and turn up!
Floss daily or use inter-dental brushes/floss sticks to ensure good cleaning between your teeth
Use a mouthwash to supplement brushing your teeth. If you have bleeding gums use Corsodyl mouthwash at a different time to toothbrushing
Limit the risk factors that are within your control; namely: Smoking, Oral hygiene, Nutrition, attending the dentist and hygienist when requested, good blood sugar control in diabetics, not leaving things like deficient crowns and fillings that you are aware of needing replacement.

We Hope you found this information useful and are now informed on Periodontal Disease. If you still have any questions please do not hesitate to ask our dentists below:

Ask a Dentist

]]><![CDATA[Gum disease]]>Wed, 20 Jan 2016 18:38:33 GMThttp://www.onlinedentists.co.uk/dental-a-z/gum-disease

Gingivitis

Gum disease is known as gingivitis in the dental world. This is because gingivae means gums and "itis" means inflammation. So in the same way that Arthritis is inflammation of your joints, gingivitis is inflammation of your gums.

Signs of Gum Disease

The gums become inflamed (red and swollen) when they are irritated. This will usually be due to the bacteria in plaque on your teeth or from trauma or other items becoming lodged in your gums.

The gums have an immune response to the bacteria or foreign items and therefore become red and swollen. They will become increasingly fragile, bleed easily and look and feel sore

There is a specific type of gum disease called Acute necrotising ulcerative gingivitis that is caused by a specific bacteria and will cause very sore gums along with a disgusting taste and smell. This is an extreme case of gingivitis and can be very damaging to your gums unless you see a dentist quickly.

Causes of Gum Disease

You are at increased risk of gum disease if:
1. You don't clean between your teeth or use floss/interdental brushes
2. You have poor oral hygiene and plaque control
3. You have low vitamin C (Scurvy)
4. You have diabetes
5. It runs in your family

Gum disease treatment

Gingivitis is a reversible disease. This means that if it is treated by yourselves or by the dentist then your gums can return to normal again without any long term damage.

If you find your gums bleed easily or on brushing then you have gum disease, your dentist will be able to tell you this also. If this is the case you need to ensure you are brushing all of the visible plaque off your teeth by ensuring you brush every surface of every tooth each time you brush them.

Using floss or interdental brushes to clean between your teeth will help prevent gingivitis between your teeth; in the places the bristles of your toothbrush cannot reach.

1. At home - meticulous toothbrushing and interdental cleaning with floss or interdental brushes
2. At home - use of Corsdyl mouthwash when gums are bleeding but only for a period of 2 weeks at a time to avoid staining.
3. At home - use of an electric toothbrush over a manual if you are still finding your gums bleeding with a manual toothbrush
4. At the Dentist - cleaning with your dentist or hygienist and oral hygiene advice.
5. At the Dentist - Oral hygiene and tooth brushing advice from your dentist or hygienist to teach you the best way to clean your teeth in order to minimise your risk of gingivitis

Receding gums and more

If you do not treat the gingivitis then the disease process progresses in most cases until you have what is called Periodontitis.

This is inflammation of not only the gum but of the structures supporting the tooth (the periodontium). This includes the bone and ligaments supporting the tooth. If these are inflamed then they start to deteriorate. This is irreversible meaning it is permanent.

We will discuss periodontitis in its own article but in short, if left untreated, the supporting structures of the teeth are eaten away causing receding gums. Teeth will become more and more loose until they fall out or need taking out.

Gum Disease Summary

1. Gum disease is inflammation of your gums and is also called Gingivitis
2. If your gums bleed easily you have gingivitis
3. Gingivitis is Reversible and so if treated will reverse completely back to healthy gums
4. Excellent tooth brushing and inter-dental cleaning is the best way to prevent gum disease
5. If left it will usually progress to Periodontitis which is not reversible and causes receding gums and worse to the point of losing your teeth.

We hope you have found this article informative and remember if you have any further questions you can always contact our dentists by clicking below:

Ask A DENTIST

]]><![CDATA[Wisdom Teeth]]>Tue, 19 Jan 2016 13:19:10 GMThttp://www.onlinedentists.co.uk/dental-a-z/wisdom-teeth

Wisdom teeth, lower third molars, lower back molars or number 8 teeth are your very back teeth. They erupt into your mouth usually between the ages of 17 and 25 but can be earlier or later. With regard to having wisdom teeth you will fall into one of the following categories

1. Wisdom teeth don't ever develop
2. Wisdom teeth develop but never erupt (enter) into your mouth (may cause pain or be unaware)
3. Wisdom teeth develop and partially erupt into your mouth (may cause pain or not)
4. wisdom teeth develop and fully erupt into your mouth (may cause pain or not)

Quite often there is not enough room for the wisdom teeth to erupt fully into your mouth, in which case they may only partly erupt into your mouth and stay this way, or not erupt at all and stay hidden beneath the gum level.
The lower wisdom teeth are more likely to cause problems than the upper wisdom teeth. They are also often more difficult to extract/remove when they do cause a problem than the upper wisdom teeth.

Impacted Wisdom Tooth

This is where there is not enough room for your tooth to erupt fully. This is often the case for lower wisdom teeth. The lower wisdom tooth impaction is classified depending on the angle of the erupting wisdom tooth which can be anything from a normal angle (vertical impaction) to sideways (horizontal impaction) or even upside down!
Impacted wisdom teeth may not cause any pain or problems at all and in these cases they can be left alone.
Alternatively the impacted teeth may cause decay in themselves or the back of the teeth in front
Pericoronitis - repeated inflammation of the gum still covering the partially erupted tooth which can cause repeated infections and pain in the area.
Cellulitis - the infection as above that spreads in the tissues surrounding the wisdom tooth causing swelling, pain, limited mouth opening and systemic illness,

Wisdom Tooth Removal

Wisdom tooth extraction: Depending on difficulty and your level of anxiety this progressive scale explains the stages of treatment:

1. Straightforward local option of sedation
2. Raising gum flap and removal then suturing of gum flap with or without sedation
3. Raising gum flap and sectioning of tooth for removal in pieces then suturing gum flap into place
4. Raising gum flap, removing bone and removing tooth with or without sedation
5. Raising gum flap, removing bone and sectioning tooth for removal in pieces

Wisdom Tooth Extraction Procedure

Procedure:
1. If having intravenous (IV) sedation see dental sedation section. This is where a cannula is inserted in the arm or back of the hand and a sedative drug is administered to sedate you.
2. Next whether having sedation or not, local anaesthetic is required. This is injected at the back of the mouth on the side of the extraction and also on the cheek side of the tooth to ensure the area is fully numb before starting
3. Raising gum flap - a cut is made into the gum and the gum is lifted to expose the underlying tooth and bone. You will be numb so will not feel this.
4. Bone removal - this is where special equipment is used to remove the smallest amount of bone possible in order to enable access to the tooth that needs removal.
5. The tooth is then taken out in one piece or sectioned into a number of pieces and then removed depending on its shape and location.
6. the remaining socket is cleaned and then the gum flap is placed back to where it was originally
7. A number of sutures (stitches) are then used to secure the gum back into place neatly and cover over the socket.
8. The sutures may dissolve or be removed 2/3 weeks later by your dentist/oral surgeon.

Pain Relief

1. Hot salty mouthwash (2 teaspoons salt dissolved in warm water) if mild discomfort
2. Corsodyl mouthwash if mild discomfort instead of the salt water mouthwash
3. Antibiotics if causing infection prescribed by your dentist or emergency dentist
4. Wisdom tooth removal if causing repeated infection
5. Removal of lower second molar (tooth in front of the wisdom tooth), if impacted wisdom tooth causing decay or resorption of this tooth.
6. Removal of upper wisdom tooth that is causing pain from biting on gum covering lower wisdom tooth as is a much easier procedure and less chance of complications than removal of the lower wisdom tooth.

X rays required?

An Orthopantogram (OPG) or half OPG is needed to assess type of impaction. This is a large X ray that is taken by standing in a machine and having the x ray film rotate around your head. This is necessary for almost all wisdom tooth extractions unless your dentist is happy with the information from an intra-oral (in mouth) x ray.

The X ray shows
1. Likelihood of difficult extraction and what will be required with regard to planning treatment
2. Location of surrounding nerves and any increased risk of nerve damage
3. Extent of any decay in wisdom tooth or surrounding teeth
4. Extent of any infection and/or bone loss around the wisdom tooth.

Wisdom tooth Removal - Aftercare

Day of treatment: Just ibuprofen, soft diet, avoid alcohol, avoid smoking, avoid very hot food and drink. You can take paracetamol if you are unable to take ibuprofen.
2 to 5 days after - painkillers, Gentle hot salty mouthwash, soft diet and as above
2 weeks - Return for suture removal at 2 weeks or sometimes sutures will dissolve - your dentist will tell you which
After Wisdom tooth extraction:
- Pain, swelling, bleeding, bruising and soreness is to be expected following wisdom tooth extraction.
Nerve pain, numbness or altered sensation may occur and any increased risk of this is discussed with you prior to treatment based on your X rays.

Wisdom tooth pain and Complications

Infection - in socket following extraction. This will be sore underneath the jaw, swollen, painful after extraction and will require antibiotics to treat
Dry socket - loss of blood clot early from socket leading to very painful bone inflammation. will usually occur after 3 days where day 1 and day 2 the pain was relieving and then gets progressively worse.
Nerve damage - Numbness to lower lip and gum on the side of extraction. This is usually temporary but there is a small risk of permanent in the region of 1%. Alternatively or as well you may get numbness of the tongue on the affected side. Again, there is a small risk of permanent damage but it would usually be temporary.

Wisdom tooth Removal - Charges

1. May be removed by your own dentist in UK under a band 2 dental charge which is around £55
2. Referral to oral surgeon in UK, NHS, there is a waiting list and charge will be around £55 and you may or may not have sedation
3. Privately - £100-£500 depending on location, may have sedation also at additional charge
4. Northern Ireland - simple wisdom tooth extraction around £15, medium difficulty extracted by own dentist will cost around £40, referral to an NHS oral surgeon is about £60 with awaiting list or private referral as privately above and without the waiting list.

So charges are dependent on the difficulty of the extraction and whether it requires referral to a specialist or hospital. Whether you are happy to wait on an NHS list to be seen or pay pirvately to be seen much sooner. Whether you would like sedation for the treatment or not and whether you live in Northern Ireland or the rest of UK.

We hope you have learnt from this article and now feel more informed with regard to your wisdom tooth extraction or wisdom tooth pain. Any Further questions please ask our dentists below:

Ask A Dentist

]]><![CDATA[Toothache]]>Thu, 14 Jan 2016 13:17:33 GMThttp://www.onlinedentists.co.uk/dental-a-z/toothache

What is Toothache?

Your tooth has a nerve supply and a blood supply (called the dental pulp), much like any other organ or tissue of the body. If this is irritated by trauma, decay or any other means then an inflammatory response occurs inside your tooth.

If you get an inflammatory response on your skin for example the area will become red and swollen and your skin will stretch. As your tooth cannot stretch, pressure builds up inside the tooth which causes pain.

Dental Abscess

An abscess is essentially a collection of pus (dead tissue and bacteria). If you get toothache due to inflammation inside your tooth, this inflammation eventually forces the blood supply to be cut off to the tooth and the dental pulp dies.

This dead tissue and its by products eventually leave out of the end (apex) of the tooth and form a gathering of pus beneath the tooth. This is why you may get a swelling, the tooth feels high or raised and it is sore to bite on.

Stages of Toothache

1. Something will happen to your tooth: fracture, crack, decay; often this will go unnoticed or be hidden

2. This will irritate the inside of the tooth (the dental pulp), leading to inflammation

3. This inflammation will cause pain that comes and goes and is often made worse with hot, cold or sweet things - this should be when you see the dentist as early as possible as the inflammation may be reversible.

4. If left (or even sometimes if treated) this will progress to pain, more and more often, as the inside of the tooth becomes more inflamed until constant inflammation in the tooth causes constant pain

5. At this point of constant pain, the inflammation is not reversible and therefore the tooth will require a root canal treatment or removing/extracting in order to get rid of the pain

6. This inflammation and pain will spread out of the end of the tooth and cause inflammation directly under the tooth making it even more painful to bite on.

7. If left untreated at this stage or if your dentist has been unable to disinfect the tooth fully during treatment then this will progress to form an abscess beneath the tooth which can lead to swelling and systemic infection.

8 If still left untreated then this can lead to hospitalisation, Intravenous antibiotics and as seen usually in third world countries, death.

Managing toothache at home

1. Toothache as described above is usually progressive and so early treatment is always the best option.

2. The inflammation can be managed with anti-inflammatories in the first instance (ibuprofen, nurofen etc) but the dentist will need to remove any previous fillings, decay or cracks as early as possible to

3. If left too long the inflammation will become irreversible and although it may be relieved somewhat by ibuprofen, the inflammation and therefore pain will persist until it is treated by a dentist.

4. If you have a swelling or pain caused by an abscess (usually in very filled teeth or previously root treated teeth) then antibiotics may be given to help reduce the abscess and pain but this is only temporary and your tooth will need root treating, re-root treating or extracting/removing in order to prevent reoccurence.

How the dentist assesses toothache

1. Most importantly they will take a history of your pain. This will include how long have you had it for? where is it? is is constant? what type of pain is it (e.g. throbbing, shooting etc)? does the pain spread anywhere? does anything make it better or worse? how severe is the pain out of 10?

2. They may tap on the tooth to check for inflammation underneath the tooth

3. They may put something hot or cold onto your tooth to check the extent of the inflammation in your tooth

4. They may take an x-ray for early signs of abscess or inflammation, decay beneath fillings, fractures etc.

5. They will use some or all this information to develop a treatment plan for you.

How the dentist treats toothache?

1. If reversible and in early stages, your dentist will remove any fillings and decay and put a sedative dressing in your tooth to help reduce inflammation before getting you back at a later date to refill the tooth, all being well.

2. If irreversible your dentist will decide with you whether to extract/remove your tooth or to carry out the initial stages of a root canal treatment in order to relieve the pain and save your tooth.

3. NOTE: sometimes no matter how much the area is numbed, the initial root treatment stage will still be painful for a few seconds while the dentist relieves the pressure in your tooth. This may be neccessary and unavoidable in order to save the tooth

4. NOTE: occasionally if you have an abscess your dentist may give you a course of antibiotics before carrying out any treatment. Alternatively your dentist may lance (pop) the abscess in order to relieve the pressure and pus in this area.

What happens next?

1. After dressing: return to dentist few weeks later for permanent filling/restoration

2. After initial root canal treatment: return to dentist few weeks later for completion of root canal treatment

3. After extraction: May return to dentist 3 months later to look at replacing missing tooth

4. After Antibiotics: return to dentist a week or two later to carry out root treatment or extraction depending on what has been decided upon.

We hope you have found this helpful and easy to follow, feel free to comment below and as always click below to ask our dentists any other questions you may have

Ask A Dentist

]]><![CDATA[Dental Implants]]>Sun, 10 Jan 2016 18:08:38 GMThttp://www.onlinedentists.co.uk/dental-a-z/dental-implantsDental Implants are essentially titanium screw threaded components that are placed into your jaw bone to replace a root of a tooth. Occasionally they will be made out of other materials.

The implant, once placed, often requires some additional bone adding (a graft) around it in order to ensure its long term stability and an aesthetic result.

In order to access the bone where the implant is to be placed, once the area is numb (with local anaesthetic) the gum is cut and a flap of it is raised and held out of the way whilst the implant is placed into the bone.

The implant can be placed at the same time as tooth removal or around 3 months afterwards. Obviously if your tooth is already missing then this time scale will change

Once an implant is placed, the gum is either sutured (stitched) to cover over the implant completely or a healing cap is placed and the gum sutured around it.

Very occasionally dentists may place a crown (the part of the implant restoration above the gum level) on the implant immediately (known as immediate loading) but although this may be desired from an aesthetic point of view and reduced number of visits; It may put too much force onto the implant in the early stages when the implant should be integrating with the bone surrounding it and may lead to early failure.

Usually, therefore, an implant is usually left for a minimum of 2-3 months to integrate with the bone surrounding it. Sometimes, in cases where a lot of bone has been grafted onto the implant site it should be left for 6 months or longer before placing the final restoration.

In this interim period, a temporary restoration is usually placed if desired. Back (posterior) teeth may not require a temporary tooth. The temporary will usually be either
1. Conventional denture
2. Conventional Resin bonded bridge (which is a false tooth with one or two metal wings attached to it that bond to the teeth next to the implant
3. Composite resin bridge (which may be made freehand from white filling material and bonded to the teeth next to the implant)

The Next Stage

Your dentist may need to uncover your implants (if they were covered over completely with gum at the surgical implant placement stage) and then healing caps placed on the implants and the gum sutured around this. This needs to be left another month or so to allow accurate impressions of the implant and site to be taken at the next visit.

Sometimes your dentist will place different healing caps at this stage in order for the surrounding tissues to form the correct gum shape to give the most aesthetic final result and so a couple of additional short appointments may be required.

Impressions stage

This will either take place at the first appointment after the 3 or more months of implant integration or after the stage above.

The healing caps are removed and other inserts placed into the implants. Impressions (moulds) of the implant and surrounding tissues are taken and sent to the lab so as they can produce the final or a provisional restoration (crown, bridge or denture)

Your temporary restoration will then be replaced along with the healing caps for as long as it takes to make your crown/bridge (usually around 2 weeks)

After Impressions

In the case of simple crowns and bridges supported by implants these may be made straight away and then fitted at this appointment! about 2 weeks or so after the impressions appointment

If a lot of teeth are being replaced with crowns, bridges or dentures on multiple implants then 2 or 3 additional appointments are required where your dentist will record the positions of your jaws relative to each-other and try in the different restorations before getting them finished and fitted.

The Fit Appointment for Crowns and Bridges

At this appointment any temporary crowns or bridges are removed or the healing caps/covers are unscrewed from the implant. The part that connects the implant to the final restoration (the abutment) is attached to the implant which will then resemble the shape of a prepared tooth.

The final crown or bridge can now be either cemented or screwed onto the implant abutment. If a screw retained restoration is used, the screw hole is filled with filling material so you are not left with a dip in the restoration.

Any excess cement is cleaned, the tooth contacts with adjacent teeth and opposing teeth are checked to ensure everything as fine and appearance is checked

Screw retained vs cemented restorations

Some restorations (crowns and bridges) will be screwed into place rather than cemented. This is being done more and more often nowadays as it removes the need for cement which can degrade over time or remain deep in the gum after fitting the restorations and cause your gums to become inflamed (red and sore). The entry hole for the screw on front teeth is from the back of the tooth so it is hidden and from the biting (occlusal) surface on back teeth. The screw hole is then covered with filling material.

The Fit Appointment for implant supported dentures

As before, any temporary denture or healing caps are removed, implant abutments are attached to the implants and the denture is fitted into place. How your denture looks and how you bite together is then rechecked.

The denture will then be screwed into place if it is screw retained. In some cases rather than screws; ball and socket attachments,bar attachments, magnets or friction grip is used to retain the denture (keep the denture in place). In case of these, the denture is pushed into place and then you will be shown how to take the denture in and out if it is a removable one.

Position of implants for back teeth

Important points to note/expect

You will be sore, bruised and swollen after implant placement as it is a surgical procedure
This procedure cannot be rushed, if your dentist thinks the implant is best left for 6 months or more before restoring it then this is because it is in your best long term interests.
If you need extra appointments before fitting the final restoration in order to shape the gum, this again is to ensure the best final aesthetic result possible
In some cases an ideal result may not be possible due to the extent of bone loss or condition of surrounding teeth. You must understand the limitations in your case before you commence treatment so you fully know what to expect
You may have to wear a temporary removable denture for a number of months before your final restorations are fitted
At the fit appointment the gum may blanch (go white) around the restoration but this is normal and it will go back to normal colour quickly.

Dental Implant cost

We will discuss implant cost further in the next article on dental implants but as a general guide the implant itself will cost you between £1100 and £1600. The Crown and abutment on top will cost between £700 and £1500per tooth and then if you require a bone graft as well it will cost between £250 and £600. Therefore typically all in costs will start from £2200 and £3800

We hope this has been useful for you for what to expect when it comes to your implants. The next articles in this series will discuss different types of implant and implant restorations as well as the fees involved and how the latest research applies to you...the patients!

Ask Our Dentists Your Questions here

]]><![CDATA[Dental Veneers]]>Sat, 02 Jan 2016 13:01:34 GMThttp://www.onlinedentists.co.uk/dental-a-z/dental-veneers

What are veneers - Very thin layers of tooth coloured porcelain or tooth coloured filling material which are used to improve the appearance and/or function of a patients teeth. Dental veneers like veneers of any other kind usually just cover a layer on the visible surface of the tooth although they may overlap the edge of tooth and onto the back of tooth depending on the circumstances.

What materials are veneers made out of - they are made out of feldspathic porcelain usually which has a proven track record for veneers and can give an excellent lifelike appearance when done well. Alternatively they can be made out of high quality direct composite resin material. This is when they are made directly in your mouth as opposed to in a lab but these are very difficult to get looking as good as porcelain veneers unless your dentist is very experienced with this type of material.

Porcelain Veneers

Composite Veneers

These require removal of less tooth structure generally and can be completed in one appointment as well as being less expensive but they will pick up stain more quickly and generally need replacing more frequently than porcelain veneers

How long do they last/should they last - if done properly and in the correct conditions then these should last 10 years or more. Their longevity is reduced in people that grind or clench their teeth (bruxers), people that dont look after their teeth or in cases where there is less tooth or less good quality tooth left to start with. Composite veneers will typically last half to 2/3's as long as porcelain veneers but each situation and patient is different so please ask your dentist about this.

Why are veneers done? - they are done less nowadays than they were 20-50 years ago as new materials and methods have developed. They are generally done to improve the appearance of the teeth(when decayed or chipped) or improve the alignment and appearance of the teeth (when they are crooked, crowded or spaced) either as a result of periodontal disease or naturally.

What to consider

1. Usually to ensure the veneer is not too thick or too thin and does not look false, a certain amount of teeth will need cutting back. This is less of a concern in a tooth which already has a large fracture or moderate decay in it but more of a concern in perfectly sound teeth or teeth with very minimal chips or decay.

2. If the chips are small or decay is minimal then a directly adhered tooth coloured composite material would be more suitable as it saves a lot of tooth from being cut away.

3. If the teeth are crowded or spaced then orthodontic movement is preferred to veneers in almost every situation. More recently dentists are moving towards an initial period of alignment of teeth with orthodontics followed by restoring the teeth with minimal veneers or direct composite restorations in order to improve the final appearance.

4. The decision to have veneers on teeth to improve the appearance should not be taken lightly as the removal of tooth structure is irreversible and once it is gone it is gone for good.

5. As veneers will need replacing then it must be considered that they may stain or look worse over time and more tooth structure will be removed each time they are replaced.

6. There is always a small risk when preparing a tooth (removing tooth structure) that the nerve inside this tooth will become inflamed or die off and need subsequent root canal treatment which greatly reduces the strength of that tooth.

7. The Orthodontic (braces) option prior to veneers may seem a costly treatment or over treatment but if it saves the majority of your tooth from being cut away and therefore gives a result that looks better, lasts longer and has much less potential for early replacement and complications then it must be considered a preferential option to veneers from the outset.

8. A staged approach of aligning your teeth first and whitening them may be enough to give you the result you want and in turn save you money and more importantly save all of the enamel on your teeth.

Veneers cost

Porcelain veneers are rarely available on the National health Service and when they are come under band 3 in England and Wales (dental fees) and cost around £100 per veneer in Northern Ireland but require approval (which takes around 3 months) before they can be done. Even if done on the NHS they will only be available in standard materials and the appearance will not be the best available. Privately they will cost around £400 but this can range from £350-£1000 or so depending on where you go to have them done.

Summary

Veneers can be very destructive, especially if you have no or very minimal fillings in your front teeth to begin with.
Veneers will not last forever and typically will need replacing every 10 years.
Veneers can be done indirectly in porcelain or directly in composite resin material
Veneers can give an excellent result and aesthetic appearance.
Often Orthodontics prior to veneers is required or offered in order to limit the amount of tooth removal required for an acceptable result.
Veneers will not stop your teeth from decaying and in fact require greater looking after than even your natural teeth to avoid staining and tooth decay.
Veneers require a large area of good tooth to bond onto and so if this is not available then a crown will most likely be required in order to make a restoration that lasts.
Veneers may not be possible in people that grind their teeth as they are at high risk of fracture and alternative restoration methods may need to be sought.

As we move further into the 21st Century patients must take responsibility for their own dental decisions and so need to make themselves as fully informed as possible before making any decisions. It is vital that you realise a staged approach may be in your best interest even if it takes longer or costs a little more in the first instance.

It is important to understand also the essential need to maintain as much or your tooth enamel and dentine (tooth substance) as possible and for as long as possible if you are going to keep your teeth into old age

In the same vain however it is important to understand that in some cases a little more tooth removal may be required in order to restore your tooth with something that will look good and last a long time as opposed to something that is doomed to fail, is compromised on appearance and which may put other parts of the tooth at greater risk of fracture in the future.

These are the questions you need to be asking yourself:

What exactly do I not like about my teeth?
1. Is it the shape - they maybe easily corrected with orthodontics and reshaping/addition of tooth coloured composite material
2. Is it the colour - whitening and polishing may be all that is needed
3. Is it old fillings, old veneers, old, crowns appearance - their careful replacement may be required but with possible risk of further tooth removal and subsequent root canal fillings.
4. Is it crowding or spacing of teeth - orthodontics or orthodontics followed by veneers may be suitable or direct closure of spaces with tooth coloured composite material
5. are they very worn/too small - build up directly with tooth coloured composite material or full coverage crowns may be required as if due to grinding/clenching then veneers are likely to just chip and fracture.
6. Do I show too much or too little gum - gum recontouring may bee all that is needed or this along with veneers
7. Is my gum level uneven - again gum recontouring may be required alone or with veneers
8. Anything else? - everything in between, if any further questions please click the button below.

Celebrity Veneers

Compromised Results

Rylan Clark - TV presenter; Veneers here without orthodontics to align the teeth would be very destructive of tooth enamel and so orthodontics would always be recommended first. Some patients will prefer this look but in our opinion the teeth are too white and too uniform in colour and shape causing them to look false.

Chloe Sims - From The Only Way is Essex (TOWIE) has had veneers placed but without correction of her overjet with orthodontics. This may not be possible to fully correct with orthodontics but at least would have given a more natural result.

Natural Looking Results

Tom Cruise - Excellent realistic result with veneers. This would be a case for orthodontics definitely to align the teeth prior to veneers in order to save as much tooth as possible.

Cheryl - Excellent final result, without orthodontics this would require a reasonable amount of tooth removal prior to fitting veneers. Ideal case for orthodontics prior to veneers to improve long term success.

Niall Horan - demonstrably had Orthodontics (braces) followed by minimal veneers to give an excellent final result whilst saving almost all of his tooth structure underneath

Hilary Duff - Very pleasing result but which requires reasonable amount of tooth enamel removal. Alternative of whitening and reshaping teeth only could have given a pleasing result also although would have been a slight compromise on aesthetics.

We hope you enjoyed the article and will continue to take an active interest in your oral health as well as an active role in your dental decisions, any further questions please ask our dentists but clicking the button below:

Ask a dentist

]]><![CDATA[Tooth Fairy]]>Sat, 02 Jan 2016 12:52:58 GMThttp://www.onlinedentists.co.uk/dental-a-z/tooth-fairy

The argument for the existence of the tooth fairy is a lot like the argument for the existence of Santa Claus. Our views change dramatically as we age.

As very young children, we are too young to understand what it is all about. we are learning the intricacies of walking and talking so an age old debate is far from our grasp at this stage.

As we begin to become increasingly aware at the age of 3, we have all of our deciduous (baby/milk) teeth, and may start to hear about the tooth fairy from our parents and older siblings. We now begin to look forward to the day our first tooth falls out. It is a new feeling and a magical emotional time. We get excited about the idea if the tooth fairy however we are too young to appreciate what she he stands for.

Ages 5-7: Here we start to lose our first teeth and our belief in the tooth fairy is at an all time high because it has to be! The promise of the tooth fairy can sometimes even be enough to enable us to sit through removal/extraction of bad teeth at the dentist. The belief is so great that it can encourage us to develop a greater understanding of ourselves in the face of adversity and a greater appreciation for our ability to overcome our anxieties.

If we have good teeth and do not require any to be taken out by the dentist then we have the experience of our teeth becoming loose and falling out (sometimes with a helping hand from a football or a rogue siblings foot) safe in the knowledge that it will be worth the temporary pain when the tooth fairy comes and leaves us a treat or some financial compensation.

Ages 7-10; between these ages, we start to develop our reasoning skills; although many still believe in the tooth fairy, the belief suffers from growing skepticism. This will largely revolve around the same anti-Santa arguments: how can the tooth fairy visit all the children in the world that lose a tooth on the same day? how does she (or he) get into the house? how does the tooth fairy have so much money to give away? and why does the amount of money differ from family to family? (does she have favourites?)

over 10's: Many here have deduced their own conclusion that the tooth fairy simply cannot exist due to all the pitfalls above and they feel that they have outgrown the very idea of the tooth fairy. At this age most children will have lost all of their deciduous teeth as usually the final baby teeth are lost around age 11.

Adults - I would fathom to assume that almost all adults are convinced that the tooth fairy does not exist (and that Santa Claus does not exist either for that matter). THIS IS INCORRECT and it is a shame, the Tooth Fairy does exist and in the same vain so does Santa Claus but we will save that argument for another day. Now let's look at this from an all encompassing business, health and economic perspective.

Reasons for Not Believing:

I haven't seen her
I (the parent/guardian) put the money or gift under the pillow
I (the parent/guradian) keep the teeth in a jar in my memory drawer or dispose of them in the bin myself
The gifts and amounts of money vary between families and even within families
It is not possible to be in multiple countries and multiple places on the same night
It is not possible to be inside peoples house without them or somebody else knowing or hearing something
The Tooth Fairy is a fairy; a mythical creature; and therefore does not exist.

These are all valid points but they are not proof, they are weak evidence based largely on less than expert opinion.

Now why we should believe?

The Tooth Fairy, like Santa Claus, is known worldwide. Therefore the notion of the tooth fairy, without the need for global marketing, is accepted and reinforced by billions or people, it is on a par with Santa Claus himself, Jesus Christ and even Facebook!

Whether Adults believe in the tooth fairy or not, it is very rare that they do not rekindle and revel in the idea of her existence when they have kids of their own. Adults spend precious time convincing their own children about the existence of the tooth fairy which is an odd occurrence when you consider they do not believe in her themselves.

Parents, no matter what their financial situation, will always find a token gift or money to leave under their children's pillow and take their child's tooth in exchange.

Parents do all this on behalf of the Tooth Fairy without ever having direct contact with her and all to maintain their children's belief in her. This is carried out the world over, and has been for centuries so it must be important right?

The Benefits of believing in the Tooth Fairy

1. The Tooth Fairy orchestrates an entire system of parents convincing their children and others children of her existence without having any direct contact or conversations with any of them. This serves to aid the development of imagination, encourage creative thinking, broaden the mind of children and offer practice for improvement of parent-child communication.

2. The Tooth Fairy also orchestrates a tooth-cash exchange system handling millions of pounds every day with absolutely zero staff costs, zero overheads and again without having to directly contact parents herself. This helps to develop children's early financial education and allows them opportunity to begin to comprehend the value of frugality.

3. The Tooth Fairy is such a worldwide brand that everyone knows about her one way or another and her legacy will live on long after she has gone, although no-one will ever know that she has gone such is the effficiency of her business. She is the second greatest delegator that ever lived (after Santa Claus of course). This realisation is an important leadership lesson for children and parents alike and is a style of leadership we should all aspire to.

4. The existence of the tooth fairy enables very young children to overcome fears and anxieties. It encourages a belief system for them (whether that runs parallel to a religious belief system or not) and brings their oral health to the forefront of their minds as well as their parents minds.

5. Oral Health may otherwise be overlooked in the years when it is vitally important if it wasn't for the tooth fairy. Childrens permanent back teeth (molars) are at most risk of tooth decay in their first few years in the mouth (ages 6-12), so utilising the tooth fairy to aid conversations about brushing teeth and maintaining a healthy mouth and smile can be imperative to a caries free child.

6. The Tooth Fairy's existence encourages older children to develop their logic and reasoning skills. It gives them early and ample opportunity to start to question and debate her existence whilst all the while developing their unique personalities. This stands them in excellent stead for getting ahead in life.

7. Finally and possibly most importantly, the tooth fairy is a compassionate being, she takes away something now useless to you, and gives you a tangible, useful gift in return. She has no favourites and treats everyone as equal. If you lose your tooth she still knows and will still pay you a visit in the night. This encourages children to show compassion, treat all people equally and to be selfless by way of giving without expecting something in return. If children and adults can absorb this teaching alone then the Tooth Fairy has served her purpose.

The Tooth Fairy therefore can be seen as a silent dental Dalai Lama offering an insight into the qualities of compassion and selflessness among other things for children and parents. Her values are shared without need for preaching as her existence alone enables self development and oral health promotion in so many ways.

Thank for reading

Dr T F Airy

]]><![CDATA[Dental Insurance and Dental Plans]]>Tue, 29 Dec 2015 10:39:47 GMThttp://www.onlinedentists.co.uk/dental-a-z/dental-insurance

Who are they for?

Those wanting to pay dental fees via a regular monthly amount rather than often unexpected unplanned lump sums
Those looking to move to private dentistry and away from NHS dentistry
Those looking for peace of mind with regard to emergency dental treatment and dental cover when abroad
Those struggling to pay dental bills or potentially struggling to pay dental bills

Here we will look at the different types of dental plans that you can have and the main companies offering them in the UK, we are not affiliated with any companies and so will not recommend one over another but will give you the facts for you to make your own informed decision and hope we can help!

Dental Plans

1. Dental Insurance plan

Monthly plan set up separate to your dental practice where you pay a monthly premium to the insurance company
Here you will pay your dental fees up front and then make a claim by filling out a claim form to be reimbursed
Companies often have a range of these based around the level of dental cover you want/desire and are priced accordingly starting from as little as £5 per month
This works a lot like any other insurance policy
Your dental condition is not assessed prior to being accepted for one of these policies
These are available to National Health Service and Private patients

The most basic dental insurance policies will cover your NHS dental costs (with some restrictions), for more about dental fees in the UK and for who is exempt from fees in the UK please see our article on dental fees.

Clinically unneccessary treatment (treatment wanted but not needed), cosmetic treatment and treatment within the first few months of the policy is usually not covered, some cover a percentage of the costs but not the full amount. Usually age does not affect the cost of the policy and they are renewed annually in most cases.

Bupa - Unique in that they offer insurance policies for everyone as well as capitation plans within their dental centres (find Bupa dental centres here), fees vary from £10-£28 so see their site for more info.
Dental Cover 10

100% reimbursement for all NHS charges.
No annual limit on oral cancer treatment and paid in full

Dental Cover 20

For private patients, will pay upto £150 per year for exams and cleaning;
Pay upto 75% of your private treatment costs upto £700 per year and upto £600 for emergency treatment,
Covers upto £5000 per year for dental injury (external impact e.g. car accident)
No annual limit for oral cancer treatment

NHS LEVEL POLICY

DenCover is underwritten by AXA PPP
They offer a number of different policies but the second tier silver policy at £6.99 per month is our most reasonable starting point for Health Service cover.
They have limits and excesses which is why the premiums are so low.
They will Covers check ups and x rays upto £30
Then Cover 55% of dental work upto £210, £850 for worldwide emergencies, £5000 for accidents and £5000 for oral cancer

NHS LEVEL POLICY

AXA PPP Healthcare - AXA PPP healthcare are another leading provider of health insurance and offer almost equal best value National Health Service policy without any excesses.
£10.26 per month for all ages - It pays out for all NHS routine treatment for those aged over 18 (child treatment is free on the NHS)
Will pay £200 per incident worldwide and upto £12,000 for oral cancer
One month qualifying period which is low and like others does not cover treatment already identified as needed

PRIVATE LEVEL POLICY

£20.55 per month;
This covers all NHS work and 50% private upto £1000 per person per year
They will cover £125 per year for routine private treatment
Good worldwide and emergency cover also

NHS LEVEL POLICY

This is a shared ownership health service level policy from simplyhealth
premium is £8.68 per month and cover is slightly more than Dencover
upto £40 for exams and cleans and 50% the cost of treatment upto £200 is covered.
Otherwise very similar to Dencover.

NHS LEVEL POLICY

WPA - A leading Health and dental insurance provider and currently only £10.25 per month upto age 49 and then £12.93 if over 50 years old.
Cover 75% for dental emergencies and not the full amount
£10,000 towards oral cancer costs included
1 month qualifying for check-ups and cleaning but 3 month qualifying period for actual treatment.
Currently offering 2 months free premiu

PRIVATE LEVEL POLICY

From £15.07 per month, £18.93 for over 50's
This is a shared ownership policy which covers upto £125 for NHS work and £1000 for restorative health service work but will also cover 75% of private costs upto £250 and 75% private emergency costs.

1. NHS cover

£9.75 per month and covers NHS treatments only
The reimbursement is for cost in England and Wales even if treated in Northern Ireland or Scotland.
Upto £500 for routine dental treatment and emergency dental treatment.

£100 per night benefit for hospital cash benefit.

2. Private level 1

£14.25 per month, upto £750 per year treatment costs
£1000 worldwide accidental dental injury and hospital cash benefit,

£5000 oral cancer treatment limit.

3. Private level 2

£20.25 per month, upto £1000 for private treatment costs
£1500 worldwide cover, hospital cash benefit
£10,000 oral cancer benefit but has a 6 month qualifying period for oral cancer cover.

2. Capitation Plan

Monthly payment plan set up through your dental practice
You have a clinical assessment of your mouth first and then a plan is discussed with your dentist based on your clinical need
The fee per month will be higher if you are more likely to require lots of treatment in the future and lower if not
Depending on which plan you choose, the costs or part of the costs are covered by the premiums and so you do not have to pay up front for treatment and then claim the fee back from a company
This will only be possible for private patients most likely.
Companies include: Denplan, Bupa, Quality plan (Northern Ireland), Practice plan (England) and any other in house plans your individual practice may host.
Quite often these plans will cover your check ups, hygiene visits, x-rays, emergency treatments and worldwide cover and then offer a discount on all other treatments typically 10-20%.

Here are some of the more established companies offering capitation plans and what you should expect:

As Discussed above Bupa have their own dental centres so have the scope to offer you a tailored dental plan which they call the Bupa Dental Health Plan

This includes 2 check ups and 2 hygienist visits per year and all X-rays, 20% discount on all treatment
Upto £400 per dental emergency upto £1000 per year again
Oral cancer unlimited and paid in full. visit a bupa dental centre or call them to find out more
Cost varies from £10-£28 so call on 0800 606 570 or email them here

Denplan is a household name in dental cover and offer their private basis services through dental practices or sometimes through your occupation. Their plans range from £13-£38 and are set up with your dental practitioner depending on your dental health/risk. In summary they offer:

Denplan essentials - monthly fee is set with patient to cover check ups, hygiene visits, x rays and preventative advice and therapy
Denplan care - a plan which covers all necessary treatment except lab fees and covers check ups and hygiene visits but like all of the others, it doesn't cover sedation fees or cosmetic treatment fees.
Plans for children - for those who cannot access an NHS dentist or would prefer private care for their whole family.
Membership plans - discounts on treatments decided by your dentist and worldwide cover arranged by denplan.

QUALITY PLAN is based in Northern Ireland and will be arranged through your dentist. Cost again will range from around £10-£38 and their levels of private cover include the following:

dental membership plan - standard plan with discounted treatments
full care plan - fee set depending on clinical need
children's dental plan
student dental plan
dental hygiene plan,
these vary considerably but tend to include exams, X-rays, hygiene visits and worldwide emergency and out of hours dentist cover.

PRACTICE PLAN is based in England and again arranged through your dentist on a private basis. It is similar to quality plan NI and typically plans on offer are:

Adults and children's plans covering exams and hygienist visits and usually 10 or 20% off treatments
membership and insurance schemes - patients are members of the practice privately and is typically discounted treatment
Family plans - allows entire family to make one payment a month to cover their exams and hygiene visits and give discount off treatment.

So What Does it all mean?

To Clarify..... dental insurance and dental plans may be suitable for some patients and not for others.

For those happy to accept NHS standard treatment and who are exempt from paying any fees or have fees capped due to other forms of exemption then these are an expensive option although they do offer worldwide and out of hours emergency care.
For Paying Health Service patients who require very occasional treatment and who have good oral health and good oral hygiene then again you may well be better off paying as you go.
For Paying Health Service patients who require treatment at most visits to the dentist then the core health service insurance options are often the best option for you and allows you to spread your treatment cost across the year.
For Paying Health Service patients who prefer private options when having treatment undertaken or who require treatment at most visits to the dentist then the mid range options such as those by Boots and Bupa.
For Private Patients then the Capitation plans are the best in our opinion as you do not need to pay the fees upfront like you do with the insurance policies as you are covered with your monthly payments. These give you peace of mind, are tailored to your dental needs and the full care package will cover all your restoration and treatment costs also.
One important feature of all the insurance policies and capitation plans is the emergency cover included worldwide to give further peace of mind.(please check this included in your policy before agreeing)

Summary

In summary it is entirely upto you, the patient. Like a lot of other insurance policies, the majority of these may not give you a massive saving on your treatment costs on average but they allow you to pay a manageable monthly amount so you do not end up having to pay a lump sum for treatment as well as giving you peace of mind with emergency, worldwide and oral cancer cover.

What best suits you?:

Pay as you go, dental insurance or capitation plan?

1. Are you a Health service patient and happy to remain a Health service patient?
Yes (Go to Qu.2), No (go to. Qu.3)

2. Do you usually require treatment at the dentist or have you had lots of treatment in the past?
No - Pay as you go, Yes - Health service dental insurance

3. Would you prefer to stay a health service patient but have private treatment when needed
Yes - Private cover plan like Bupa Dental 20, No (Go to Qu.4)

4. Would you prefer prefer a tailored plan where your monthly fee means you don't have to pay anything else out when you see the dentist as opposed to claiming back fro the insurance company?
Yes (Go to Qu. 5), No - Private Dental Insurance

5. Would you rather pay extra to cover all costs?
Yes - Capitation Full Care, No - Capitation Membership plans

For Capitation plans you need to speak to your dental practice in order to set one up or you can call Bupa about their dental centres, especially if you don't currently have a dentist

As Ever, any questions; ask our dentists here

]]><![CDATA[Root Canal Treatment]]>Fri, 18 Dec 2015 18:15:25 GMThttp://www.onlinedentists.co.uk/dental-a-z/root-treatment

Root canal treatments seem to have more stigma attached to them than any other dental procedure. You will often hear people say "Oooh a root treatment, that's painful" or "I remember having a root canal done and it was excruciating".

This is not true! They really are not that bad and for those of you who really cannot tolerate the idea then you can always have some sedation to relieve your anxiety

Video showing Root Canal Treatment Procedure

Root Canal Treatment - why?

The Nerve and blood supply inside your tooth is inflamed (irritated) to the point that, without it's removal, it will cause constant pain followed by repeated abscesses

OR the Nerve and blood supply inside your tooth is already dead, bacteria from this dead tissue repeatedly makes its way out of the end of your tooth to form an infection or abscess underneath your tooth. This can be painful to bite on, may spread in your bone or soft tissues, may cause a facial swelling and may resorb (eat away) bone supporting the teeth so as they become loose!

SO a Root Canal Treatment essentially removes the entire nerve and blood supply from inside the tooth, disinfects the inside of the tooth and fills the remaining space with inert soft filling material which will seal the tooth at the top and bottom so as to predictably and effectively stop the pain or infection and prevent from further pain and infection.

What do you need to be aware of?

For predictably high success rates, your dentist will use a protective sheet called a rubber dam when performing your root treatment (see video above at 1 minute 40 seconds)
This rubber dam not only protects your airway but prevents contamination of your tooth while it is being disinfected.
If it is not possible to place a rubber dam then the chances of success are reduced and thought should be given to extraction of the tooth with subsequent replacement for a more predictable long term solution.
Although the standard treatment is cheaper on the Health Service, your dentist may have more efficient and effective equipment that can be used on a private basis with higher chances of success so be sure to ask your dentist.
Like anything, there is always a chance of failure with a root canal treatment but it should be a small chance and in difficult cases that your dentist is unable to undertake successfully there are specialists that can be referred to who may be able to successfully complete the treatment.
Root treatments may be redone if they fail but the chance of success is lower than the initial root canal treatment.

Why does it take so long?

Front teeth usually have one straight canal, back teeth can often have four, five or six canals that may interconnect or have curves in them.
To clean all of this system effectively whilst preserving as much tooth structure as possible takes time and if not done properly then chances of success are greatly reduced. A root canals treatment may take anywhere from 30 minutes to 3 hours and sometimes require more than one appointment.
To numb your mouth effectively, place rubber dam, remove all dead tissue, effectively disinfect and clean the inside of the tooth, dry the inside of the tooth, fill this system to form a seal and then restore over the top of this takes times; especially when done properly.

How much should it cost?

The cost of root canal treatments can vary a lot from tooth to tooth and practice to practice.
On theHealth Service in the UK it will cost you £51.30 (at time of writing article)
On the Health Service in Northern Ireland it will cost you anywhere between £40 and £110
Privately a root canal treatment will cost between £120 and £350 if done by a general dentist
Privately a root canal treatment may cost upto £1000 if done by a root treatment specialist (An Endodontist)
It is important to note that the cost of the filling, onlay or crown will be in addition to this root canal treatment fee.

Why might you also need a crown afterwards?

A root canal treatment will usually be being carried out on a broken down tooth and as the root canal treatment removes an additional small amount of tooth structure, the biting surface of the tooth often needs complete coverage in order to protect it from future fracture
This coverage will be achieved by Crown, Onlay or Direct Restoration (often in composite (white filling material))
Without this coverage the tooth is at increased risk of fracture which would then make the root canal treatment a waste of time and result in the ultimate extraction of the tooth!

Why might you need referring to another dentist?

Some teeth may be saveable but their root canal systems are too complicated to clean and fill effectively with standard equipment or general dentist skills.
For these teeth; referral to a specialist endodontist who will have often undertaken an additional 3 year full time course based solely on root canal treatments is required.
It is often the sign of a good dentist who recognises a case that is treatable but beyond their own capability and refers to a specialist. The majority of dentists are more than capable of treating the majority of cases and it is not a sign of your own dentists inability if they feel referring you to a specialist is in your best interest.

Root Canal - take home messages

If you have constant or almost constant pain from a tooth then it may need a root canal treatment in order to save i

If there is insufficient tooth structure remaining to restore the tooth properly after root canal treatment then it is often better to plan to extract and replace your tooth by other means

If you are a health service patient, a private option may be available to give your root canal treatment a higher chance of success so ask your dentist about this.

A root canal treatment should not be painful as you will be numb (unless you request not to be numbed)

If you go to your dentist with toothache then you may get a small amount of discomfort at this initial appointment while the dentist relieves the pressure in your tooth (but it is less painful than constant toothache!)

Following this relief of pressure; discomfort, if any, should be very minimal and your dentist may even numb the inside of the tooth once they have access to the inside of it to further numb the area.

Root Canal Treatment is not a thing to fear and remember for those of you that are generally anxious at the dentist and need a little help in managing your anxiety - many dentists offer inhalation sedation or intravenous sedation to help you through your treatment.

ANY FURTHER QUESTIONS, ASK OUR DENTISTS HERE

]]><![CDATA[Importance of Brushing Teeth properly!]]>Wed, 09 Dec 2015 13:21:21 GMThttp://www.onlinedentists.co.uk/dental-a-z/brush-your-teeth

Why Not Brushing Your Teeth Properly will Ruin Your Life

1. Health - If you don't brush your teeth then you will get gum disease which can cause diabetes and halitosis (bad breath). You will get decayed teeth leading to constant toothache and jaw ache this can lead to life threatening cellulitis and death. You will get bleeding gums, problems when eating, the stigma of wearing dentures when still young and as a result decreased confidence leading to many more serious problems.

2. Career - As your confidence will be affected by early loss of teeth, bleeding gums, bad breath or having to wear dentures you will give off a poor image at job interviews; you will need time off work to visit the dentist or time off work to visit the hospital which could otherwise have been avoided. People with clean teeth have been shown to excel in their careers whereas those without lag behind.

3. Economy - At the very least your dentist will have to brush your teeth for you or have to treat you with costly health service treatments and get paid to do it. If you are a health service patient then your dentist will be paid by the government largely which will contribute to government debt which can lead to further debt and a need to raise taxes which could be your taxes!

4. Income - Your overall income is affected by reduced career prospects as a result of reduced confidence among other reasons. Your income is also indirectly reduced by increased taxes as described above.

5. Wealth - If you manage to still have a reasonable income whilst not brushing your teeth properly then this will soon be wiped out by the extra expense you will end up paying in unnecessary dental bills as these will need to paid first before you can have the cosmetic treatments that you have been saving for!

6. Relationships - Not only will your reduced confidence reduce your chances of success in relationships but your bad breath, missing teeth, poor fitting dentures, bleeding gums, reduced income and increased time spent at the dentist will have a massive effect on your happiness in a relationship

Now Lets look at this in a Positive way:

Why Brushing Your Teeth Properly will Save Your Life

1. Health - Brush your teeth and you will have healthy gums, fresh breath, less risk of diabetes. No tooth decay and as a result no toothache or jaw-ache and better quality of life! You are able to eat what you want when you want without embarrassment, not have to wear dentures and your confidence is increased!

2. Career - Increased Confidence will improve your job prospects, you will come across as a great candidate in job interviews and you will be more likely to excel at work. You won't have to take unnecessary time off work to have dental treatment that could have been avoided and so you will further excel in your career.

3. Economy - Less need for preventable treatments at the dentist will reduce the government expenditure on Health Service dental treatments, your increased income will mean you can now spend your savings on desired cosmetic dental treatment which in turn will help rather than hinder the economy and reduce the risk of increased taxes as a result!

4. Income - Your income is more likely to increase/improve if you brush your teeth properly for the reasons discussed above; Increased career prospects as a result of increased confidence will lead to you being happier at work and increase your potential to excel and earn more. It may also be indirectly increased by a relative reduction in your taxes.

5. Wealth - You will be able to maintain and build savings for yourself by avoiding unnecessary and preventable dental treatments and avoiding unnecessary time off work. You will reduce your expenses on unnecessary or unwanted dental treatment leaving you free to save for that house deposit, new shoes or cosmetic dental treatments!

6. Relationships - Increased confidence, fresh breath, healthy pink gums, non decayed teeth, increased income, increased free time and reduced expenses will all have a positive effect on your relationships with partners, friends and family and may in fact save your life!

SO? Ask your self again, why are you not spending just 4 minutes a day, ensuring your teeth are brushed as effectively as possible?

NEXT WEEK - How to brush your teeth properly and improve your quality of life!

Any Further Questions or Queries, ask our dentists here

]]><![CDATA[Electric Toothbrush heads]]>Wed, 28 Jan 2015 12:32:42 GMThttp://www.onlinedentists.co.uk/dental-a-z/oral-b-electric-toothbrush-heads-and-other-makesOral B electric toothbrush heads can become quite costly if bought on the high-street but they do not have to be. We have looked at the different Oral B toothbrush heads as well as their direct competitors/imitation heads and compared them so you know what to get next time you're looking for an Oral B electric toothbrush head to replace your current dog eared one!

Generally amazon is your best bet as they will have the cheapest price on both Oral B electric toothbrush heads and imitation heads (unless you are buying hundreds from a wholesaler!)

Here are our top picks and a direct comparison after our dentists used them on the same electric toothbrush:

Standard Oral B electric toothbrush heads - these are the standard heads made by Oral B and at a very good price, click to search on amazon for packs of more than 4.

Imitation heads for Oral B, we found these fit onto the electric toothbrush fine and do work BUT: they fray/become worn out in about half of the time and the difference in bristles results in very slightly less plaque removal; they are fine but the branded ones are better

Oral B PRECISION heads, again branded ones from Oral B are excellent and give an excellent clean, these precision heads are really good.

Imitation PRECISION oral b electric toothbrush heads, again as above, they fit on and work fine but we found exactly the same as the standard heads, that they fray or wear down in about half of the time and remove insignificantly less plaque, good value for money

ORAL B ELECTRIC TOOTHBRUSH HEADS vs imitation heads - Dentists conclusion

We still recommend to buy the Oral B ones, Yes they are a higher cost in the first instance but they will last longer, give you a lasting clean and you are guaranteed great quality Oral b electric toothbrush heads everytime! Although the imitation heads appear to be fine and are a lot lower cost we feel that for peace of mind and better quality go for Oral B!

As usual any electric toothbrush head questions, ask our dentists

]]><![CDATA[General Dental Council (GDC)]]>Wed, 21 Jan 2015 20:21:16 GMThttp://www.onlinedentists.co.uk/dental-a-z/general-dental-council

Who are the GDC (general dental council) and what do they do?

The GDC, general dental council are a council funded by the registration fees of dentists and other dental professionals who's aim is supposed to be to protect patients. There has been a lot in the press lately from the British dental association and other sources about whether they are actually doing their job properly and it has caused quite a rift between the council and dentists. The main issue in the latest news is that of reports showing that the GDC, based in Offices in London were very inefficient in the way they managed cases and as a result raised the registration fee for dentists from £576 a year to around £900 per year to make up for their shortcomings.

The GDC produce guidelines for dentists to follow as well as deal with complaints/fitness to practice proceedings from patients or dentists about dentists or other dentists. They advertise for patients to complain to them but often do not make patients aware that the best course of action is almost Always to contact your own dental practice directly. Often potential complaints and problems can be dealt with simply and easily just by talking to your dentist or practice manager about your concerns. The GDC are there for when a local resolution cannot be met and they will manage legal cases on patients behalf against dentists, usually for what is deemed negligence.

So the general dental council, really are there to protect patients, that is, if you cannot come to a local solution or resolution you can call them. If you call them in the first instance they will most likely refer you to make a complaint at your own practice (or at least they should)

The General Dental Council whilst regulating dentists and dental professionals, do not act as legal representatives for dentists or dental professionals in legal cases, dentists will have indemnity providers such as dental protection that will cover their own fees and act like their insurance company, that is if you decide something really needs taking up with the GDC as a local resolution cannot be met and the GDC have decided to take on your case then the GDC will cover your costs and the costs of legal proceedings (paid for by the registration fees of dentists and dental professionals) and your dentists insurance/indemnity company will represent them.

Dentists must have indemnity/insurance and pay their fees to the GDC to continue practising dentistry in the UK. So you can be rest assured that if in the unfortunate incident that you are not happy with your dental treatment and wish to complain:

You can complain directly to the dental practice in the first instance and hopefully come to a local resolution
If not, then you can complain to the GDC who will take on your case if the dentist is deemed to have done something negligent, criminal or otherwise unlawful.
If you win the case you will be compensated by the dentists insurance/indemnity company
If you do not win the case but the GDC deemed it appropriate then the GDC will cover the legal costs

We, as dentists, want you to be happy with your dental treatment, if you are not then tell us, TELL YOUR DENTIST so they can rectify the situation and give everyone peace of mind. If you cannot come to a solution and you really believe you deserve compensation then you know you have options without having to worry about the expense of legal costs. If your case does not seem compensatory worthy then the GDC, although acting on the behalf of patients will not pursue it as it would be inefficient use of funds to fight unworthy cases.

See the website for the GDC and dental protection here

]]><![CDATA[Accessing the dentist]]>Thu, 08 Jan 2015 22:23:12 GMThttp://www.onlinedentists.co.uk/dental-a-z/accessing-the-dentistPART 1 - MANAGING ANXIETY
PART 2 - MANAGING COSTS/FEES
PART 3 - MANAGING RELATIONSHIP WITH DENTIST

There are many reasons why you may feel unable to access your dentist or a dentist to attend to your dental needs but really there should be none. The following are the most common reasons we see and how we have found patients have dealt with them:

Disability and cannot get to the surgery
Disability and no wheelchair access at your current dentist
Work during the week and cannot get time off work
Can't get children out of school to come and see the dentist
Can't get to dentist yourself as a result of looking after children or babies
Can't get registered with a dentist and so cannot access dental treatment

Any other problems with access ask our dentists here

Disabilities and the dentist

your options:

1. Don't go to the dentist (not an option) - why use this option when the others are so easy

2. Find a way to get to the dentist (they're your teeth) - A lot of dental practices are wheelchair accessible whether they be ground floor surgeries with wide doors or upstairs surgeries with operating lifts. If your practice does not have these facilities and does not offer home visits then if you are a wheelchair user it may be wise to find a new dentist as the obstructions to you accessing your dentist may be enough to stop you from being seen!

Your local health service/PCT may offer free transport to and from your practice; you will be able to obtain more information on this by contacting your practice. If you are a private patient your practice might have an arrangement with a taxi firm to get you to and from the practice although there will often be a charge for this service

3. Have the dentist come to you - in the UK, some NHS dentists get paid for domicillary home visits (although certain dentists have contracts for this, others do not) Private dentists sometimes also do home visits but there will be a fee; Generally treatments are limited to simple extractions, dentures, check ups and prescriptions

4. alternatively if you are hospital bound or in a care home there are often dentists that work in the hospitals or do regular visits to the homes in your area to ensure your quality of life as a result of your teeth and eating habits are maintained.

Struggle taking children out of school or to dentist in working hours

your options:

1. Many dentists open late, early or on saturdays and will give preference to private patients and patients that really cannot make appointments during normal working hours. If yours does not and you do not have another choice research and find a dentist that does

2. Schedule childrens dental appointments in the school holidays and book exam appointments 6 months or a year in advance to ensure you maintain your childrens dental care without having to take them out of school

Can't get to dentist yourself as a result of looking after children or babies

1. If you cannot get someone to watch your kids then bring them along, you could maybe have a family appointment where your dentist sees you all together
2. If this family appointment is not an option then often schools may have dentists or dental professionals come and visit, this should really be happening more often and on a national scale so if it is not happening in your children's schools ask them why not!?

Can't get registered with a dentist and so cannot access dental treatment

1. There are many private dental practices around and most probably in your area, just have a search online and they do not have to be as expensive as some people might think what with payment plans and membership plans

2. Call NHS direct with these contact details to find NHS dentists taking on NHS patients in your area

Any questions unanswered ask our dentists here....

]]><![CDATA[Poor Relationship with the Dentist]]>Fri, 26 Dec 2014 18:51:34 GMThttp://www.onlinedentists.co.uk/dental-a-z/managing-bad-relationship-with-dentistPART 1 - MANAGING ANXIETY
PART 2 - MANAGING COSTS/FEES
PART 4 - ACCESSING THE DENTIST

There are a number of reasons why there may be a breakdown in relationship between a patient and a dentist, these include:

1. Bad treatment experience with particular dentist
2. Felt rushed during previous appointments
3. Felt uncomfortable discussing options with dentist or pressured into accepting expensive treatment plans
4. Did not trust dentist for one reason or another
5. Put off by other areas of the practice, leading to a poor view of the practice even if got on well with dentist.

Bad experience

A bad experience during treatment, this usually means you were willing to go ahead with treatment with a particular dentist but something during this treatment has stopped you from returning. This can be anything from the following or more:

1. Experienced pain during treatment

This can happen to any patient during a procedure. Different patients have different tolerances for pain and some patients will struggle to differ between pressure and pain; especially for a treatment they have not experienced before. It may be that an extraction was more sore on this occasion than with your previous dentist or that a root treatment almost made you jump out of the chair whereas your previous root treatment was pain free and done without any anaesthetic!

How can this be overcome/understood?

First off, dentists do not want to hurt their patients, as dentists our main aim is to provide pain free and effective treatment for patients; but sometimes some discomfort is unavoidable or unexpected. An extraction may be much more difficult than a previous one or a tooth to be root treated much more sensitive than the previous one.

First off you should call your dental practice and ask if you can speak to your dentist about your concerns or if you can arrange an appointment with your dentist to discuss your concerns.

The majority of dentists will want to know why you are feeling what you are feeling and what they can do next time to ensure you have a good experience. They may not even realise this is the way you are feeling until you don't turn up for your next appointment.

If they are not willing to discuss your concerns or problems directly on the phone at a separate appointment (or even over email) then you are best placed to find another dentist (either at the same practice or a different one) who will give the time to hear your concerns and help you reach your treatment goals.

2. Dentist continued treatment despite you wanting them to stop.

This is a communication error on both parts but can be very traumatic for you patients as we fully understand. If this has happened at your previous visit or with a previous dentist do not assume it will always be the case. Your dentist will not always say to let them know if you want to stop at any time; but if this is on your mind then mention it to your dentist. Discuss your concerns in a normal conversation and decide on a signal e.g. putting your hand up, for when you want the dentist to stop and they will stop at this signal. So long as you can decide on this between you then both parties can complete the treatment and end in a much happier result.

If you have spoken to your dentist about this and they continue to not stop when you make the signal then you should consider finding a new dentist who will respect your decisions either in the same practice or a different one in the area.

3. Treatment involved more than you thought, took a lot longer than you thought or needed more appointments than you thought.

Again this boils down to communication. you may be surprised to discover that different patients want to know differing amount of information regarding their treatments. Some are happy to know how many appointments they will need and the cost whereas others will want to know every exact detail of what is involved and what to expect afterwards. Both these views are completely valid and your dentist will respect your wishes with regard to this so long as you let them know.

If something takes longer than you thought or you seem to be having more done than you thought/agreed to then ask your dentist to stop and just explain again what they are doing, what the procedure is and be forthcoming about the exact amount of information you would like to know.

Your dentist will have given you the information they think is suitable and necessary for you to know but they will be happy to discuss in more detail if you so wish. Alternatively if your dentist is telling you too much information then just tell them you don't want or need to know all this but you are happy for them to proceed with what was agreed and is necessary.

4. The dentist said or did things during treatment that you deemed inappropriate.

This includes examples such as;

Speaking to nurse throughout treatment and seemed to not be concentrating on job at hand - This may happen in your practice and if you are concerned but otherwise happy with your dentist, tell the receptionist or practice manager or the dentist themselves if you are comfortable doing so and they will more than likely change this for your benefit

Using instruments that are unrecognised and look dangerous - standard instruments are used by almost all dentists so if something is concerning you feel free to ask your dentist what it is, what it is used for and they will more than likely be happy to explain this to you to put your mind at rest.

Not using safety glasses, mask, apron or other safety clothing - not all dentists or patients will wear different safety clothing/equipment but if you are at all concerned then discuss with your dentist or the practice manager in the first instance

Taking x-rays and leaving the room when doing so - the radiation dose in taking x-rays is very little as described in the x-ray blog article but as dentists can take hundreds a week they leave the room to limit their own radiation dose, as you can imagine this dose adds up over the weeks, months and years so do not be alarmed.

Felt rushed during previous appointments

There are a number of reasons for this and again communication on both parts is key.
reasons may be:

1. You were expecting your appointment to last longer - why was this? what has changed from your previous appointment? are you health service where you were previously a private patient? Were you expecting other things to happen during your appointment? if unhappy discuss with your dentist if comfortable doing so, otherwise tell your practice manager/receptionist and they will help you come to an understanding.

2. You felt the dentist did not care for you as an individual - if your dentists approach did not come across as very personal then again tell the receptionist/practice manager. It may be that the dentist is young and inexperienced, have a different approach to treatment to your previous dentist or simply that they are in fact rude, in which case it may be time to find a new dentist.

3. You felt your teeth were not checked thoroughly - Maybe your dentist was more gentle than your previous dentist or works at a faster pace but it is rare for your dentist not to check your teeth properly, again discuss with your dentist if you feel comfortable doing so or discuss with the receptionist or practice manager if you feel better doing this.

4. You felt the dentist is just after your money and doesn't in fact care about your teeth - in the very rare case that this is true then find a different dentist, most of the time however; even if you think this is the case, it won't be and a simple discussion about it with your dentist or dental practice manager/receptionist will help remedy the situation.

5. You felt as you were late going into your appointment, your dentist is just rushing through patients to try and catch up - again communication here is key with either the dentist directly or the practice manager/receptionist. The dentist may well be running late and appear rushed but more often than not this may just appear the case as they are a little out of sync due to something unexpected happening earlier in the day and if you feel this way then a full discussion with the receptionist at the time or a call back from the dentist when they are not busy should remedy the situation.

6. You felt that the person before or after you; or your partner was in for much longer and yet was charged the same amount as you - This again is quite common and is often the case if you have very good teeth and recent x-rays already on file compared to someone with a lot of tooth decay without recent x-rays. Your check up fees may be a standard fee but it takes longer to check all their bad teeth as opposed to checking your very clean, caries/decay free teeth. Otherwise if you are not happy then discussion with practice manager/receptionist or dentist themselves if again indicated!

Felt uncomfortable discussing options or did not trust dentist

Sometimes differing personalities may mean that you and your dentist cannot come to a mutual decision, the best way to proceed from here may be to find another dentist that you can be happy with treating you,once you have both tried your best to make the relationship work.

If you feel pressured into making a decision or accepting a certain treatment then let your dentist or receptionist/practice manager/nurse know. Dentists may not be natural salespeople and so they may come across in a way that they do not realise themselves is pushy or uncomfortable.

Always remember it is your decision at the end of the day, the dentist should give you all the possible options and prices and then it is upto you to make a decision, they may ask you to make appointments there and then so as you are not waiting for months to have your treatment completed or so as you do not forget to make the appointments later on, but you do not need to do this if you are uncomfortable doing so.

If you do not trust the dentist, ask yourself why; the reason has probably been explained in this article already and how to overcome it also.

Put off by other areas of the practice, leading to a poor view of the practice even if got on well with dentist.

Here there is not a lot that you can do as a patient, you can make suggestions to your dental practice about improving decor, layout of the practice, tidying the outside of the practice etc.

some practices will have suggestion boxes where you can anonymously make suggestions. This really is down to the practice to make the decisions to improve the appearance of their practice. If you are happy with your dentist and have built trust with them then say to them directly that the appearance of certain areas of the practice almost put you off coming, be specific. If they do not make changes on the back of patient suggestions then it is upto you to decide whether to stick with them or find a new dentist.

Generally everything comes down to 3 main principles:

1. Good Communication on both parts; If you are unhappy with the input or communication from the dentist then increase your input or help them understand the situation by discussing all of your concerns or apprehensions with them or another team member who can help.

2. Almost all reasons for a breakdown in the dentist-patient relationship can be managed and overcome simply by full and frank discussion.

3. On the rare occasion that problems/concerns cannot be dealt with by good communication or you still feel your dentist does not value you as an individual patient then it is time to find another dentist who can offer you what you want or need. One dentist, no matter how good they are will not please everyone just as in every walk of life, if you are not a good match then simply find a new dentist where you will both be more content!

any further questions ask our dentists here

]]><![CDATA[Dental Charges]]>Sun, 21 Dec 2014 19:57:44 GMThttp://www.onlinedentists.co.uk/dental-a-z/dental-charges

PART 1 - MANAGING ANXIETY
PART 3 - MANAGING RELATIONSHIP WITH DENTIST
PART 4 - ACCESSING THE DENTIST

Welcome to part 2 of this overcoming barriers to dentistry section, here we will discuss the different factors regarding cost and fees for dental treatment and how you can manage these or be helped to manage these in order to make sure you can attend the dentist and have the treatment you want or need.
We will not go into how best to overcome other social factors such as working hours, picking up and dropping off children etc as this will be covered in part 4

1. NHS (health service) fees for dental check up, scale and polish, x rays or for other NHS work
2. Private fees for dental check up, cleaning and x rays
3. Private fees for work £0-1000
4. private fees for cosmetic work over £1000 often case for more than one crown, implants, orthodontics
5. Childrens dentistry fees

NHS dental charges

The Health Service in the UK, despite its many shortcomings is still operating on a very large scale in UK dentistry and although more and more patients are turning to private dentistry a huge proportion still are seen on the health service.

Fees in the UK (minus Northern Ireland) are currently £22.70, £62.10 or £269.30 depending on the treatment you are having done on the NHS, the maximum fee per treatment plan is £269.30. In Northern Ireland and Scotland you pay for each individual treatment and so it gets a bit more complicated but as a general figure you will pay about £25 for a check up, clean and x rays, £10-£40 for a filling, £50-110 for a root treatment and about £120 for a crown/veneer, with a maximum payment of around £380 per treatment plan.

Or if you or your partner receive any of the following

Income Support
Income-related Employment and Support Allowance
Income-based Jobseeker’s Allowance
Pension Credit guarantee credit
Universal Credit

you are named on a valid NHS tax credit exemption certificate or you are entitled to an NHS tax credit exemption certificate
you are named on a valid HC2 certificate

Find out more about the NHS Low Income Scheme (LIS) here

A number of patients are exempt from NHS fees meaning they pay no fees at all.....These at present are:

those aged under 18
those aged under 19 and receiving full-time education
pregnant women or those who have had a baby in the previous 12 months
if you are staying in an NHS hospital and your treatment is carried out by the hospital dentist
an NHS hospital dental service outpatient (however, you may have to pay for your dentures or bridges).

Partial Help with dental costs
If your name is on a valid HC3 certificate, you may not have to pay for all your treatment. Checks are made on free and reduced cost treatment claims. If you say you have the right to free treatment when you do not, you may incur a penalty charge.

Medical conditions do not exempt patients from payment for dental treatment.

Children's Dentistry

All children are entitled to free dentistry on the NHS, if you have trouble finding or getting to an NHS dentist then private practices will often see children but usually will have the following restrictions to access, this varies between practices

1. Parents are private patients at practice then children will be seen on the health service
2. Parents are private patients, children will be seen privately for a nominal fee
3. Dental plan - children's rates which will often be as little as £5 a month and if applying as a family may in fact find that children can be added to the plan at no or very little additional charge.

Private Dental Fees

Here are your options:

1. Pay fees outright - a number of people may be able to pay their private dental fees outright, this will usually be for smaller amounts such as for dental check ups, single or multiple fillings, tooth whitening and other treatments.

2. Dental Plan - this is where patients pay monthly via a company e.g Bupa, denplan, quality plan, practice plan which is usually set up through the practice and covers the cost of their dental check ups, hygiene appointments, emergency appointments as well as often giving them dental cover at home and abroad which can be very useful. You will quite often receive discount on treatments at your practice as well if you are on their dental plan, some dental plans cover all your treatment but will often cost around £30 or more per month.

3. Dentists Who Finance - this is where you apply for finance through the dental practice which can often be interest free, in order to pay for a treatment plan that may costs anything from a few hundred to £20,000 or more. This will be interest free in some places and have a low rate of interest in others. You will have to be approved for this finance as you would for any other loan but it is a useful and common option allowing patients to pay for £5000 worth of dental treatment say for as little as £150 per month making multiple dental implants available and affordable to almost everyone that wants them

4. Pay during treatment - this is where you might pay in 2 or 3 instalments directly to the practice without having to apply for finance, this is often possible where treatment occurs in stages e.g. implants, orthodontics; and you pay for each part as you have it done and is often used by patients who have been unsuccessful in their finance application. Some practices may or may not offer this.

So - First decide whether you want to go NHS or PRIVATE

1. If you decide NHS and are entitled to free dental treatment on the health service, find an NHS dentist here

2. If you are not entitled to free dental treatment on the health service but still want to be a health service patient then still find an NHS dentist here

3. REMEMBER you always have a choice, even if you are a registered NHS patient you can still choose private treatment over the NHS option if you want say white fillings instead of silver or white crowns instead of gold coloured crowns but at an additional private fee

4. If you cannot find or access an NHS dentist or want to see a private dentist; then call a private practice in your area and ask about their monthly practice plan and finance options.

5. You will then see them for an initial appointment with a set notified fee (usually £25-£150)

6. From here you can decide to pay for all treatments outright; join a dental plan or apply for finance for more costly treatment plans

Either way there are options to make NHS and Private dental treatment costs manageable for everyone! So what are you waiting for, contact your dentist and get your dental check up made!!!

Ask Our Dentists any further questions here

Next week - Part 3 - Relationship with your dentist or dental practice as a barrier to accessing dental care

]]><![CDATA[Dealing With Anxiety]]>Thu, 18 Dec 2014 12:25:46 GMThttp://www.onlinedentists.co.uk/dental-a-z/dealing-with-anxiety

PART 2 - MANAGING FEES/COSTS
PART 3 - MANAGING RELATIONSHIP WITH DENTIST
PART 4 - ACCESSING THE DENTIST

There are a number of ways in which patients can be anxious of going to the dentist and often, especially in adults patients may say they are too busy to attend appointments when in reality it is the anxiety being provoked that is the real reason for not attending. Consider a few examples and think if you can relate to any of these

Case 1 - Andrew never had problem with the dentist but last time he went for a molar extraction he could feel everything and now will not return to the dentist except in case of emergency so as to avoid having to experience this pain again.

Case 2 - David is age 7 and will not sit still in the chair, every time the dentist goes anywhere near his mouth he clamps it shut, his mother is in the room also and is also every nervous, she continues to say that she was just the same when she was a child and that she was just as nervous.

Case 3 - A professional woman in her 40's gave the excuse of lack of time and always working as the reasons for missing her dental appointments but on further discussion with this lady it was discovered that the thought of having a local anaesthetic was the real reason for non attendance and therefore this is an anxiety matter rather than a lack of time matter.

There are many cases like these and each person is an individual and so may experience and deal with anxiety in a different way. The main thing to remember is that the dentist is there to help you reach your goal and that no matter what your level or reason of anxiety is, there is always a way to overcome it to reach your dental goals as discussed below

The patient who experiences a high intensity of anxiety together with a history of avoiding dental care can be classed as a dental phobic rather than anxious

Dental Anxiety in Children

As a barrier to accessing dental care, dental anxiety in children may be a consequence of the child's stage of personality development, dental anxieties of the parents or the parent's fears and wishes to deny their child any distress or anxiety. This wish may be a mix of the parents own anxieties together with their fear at the sight of their child's distress and unhappiness. Such difficulties on the parent's behalf may result in parents delaying care. This can be a problem and lead to children getting dental abscesses and advanced dental issues unnecessarily.

Sedation and other methods of anxiety management

1. Use of inhalation Sedation (laughing gas) for mildly anxious patients - children and adults
2. Intravenous sedation (IV sedation) for moderate to severely anxious patients who are medically fit and well
3. General anaesthetic- usually as a last resort for young children and those for which other types of sedation not viable
4. Giving patients more information or less information, tailored individually to exactly what they want and what they need to know
5. Behavioural management in children including offering rewards at the end of treatment, positive reinforcement, possibly having parents wait outside while treatment is completed (difficult for parents but sometimes essential)
6. Gradually getting used to treatment by doing a little bit of treatment each visit but gradually increasing on this until pt can tolerate advanced treatment, may require sedation also.
7. Discussion open and free between patient and dentist - the modern world, each dental treatment is a discussion between the dentist and patient; so as they can work with the dentist to give them the result they desire, there are so many new techniques and products on the market that there is more choice than ever for patients now
8. Bad experience with current dentist - Either talk to dentist directly if feel comfortable doing so and discuss your concerns, or ask to change dentists within the practice, alternatively search NHS dentists to find a new dentist if you feel the trust has been lost.
9. Hypnosis in Dentistry, this is a unique area beyond the scope of this article but read more about dental hypnosis here

Remember as always you can always ask our dentists if you want any more information

ASK OUR DENTISTS

]]><![CDATA[Dental Xrays]]>Wed, 17 Dec 2014 14:50:46 GMThttp://www.onlinedentists.co.uk/dental-a-z/x-rays

Why Dentists take X Rays

To find tooth decay, damage to the bones supporting the teeth, and dental injuries (such as broken tooth roots).
Find teeth that are not in the right place or do not break through the gum properly.
Find cysts, solid growths (tumours), abscesses.
Check for the location of permanent teeth growing in the jaw in children.
Plan treatment for large or extensive cavities, root canal surgery, placement of dental implants, and difficult tooth removals.
Plan treatment of teeth that are not lined up straight (orthodontic treatment).

Types - dental X rays

Bitewing X-rays show the upper and lower back teeth in a single view. These X-rays are used to check for decay between the teeth. They also show bone loss when severe gum disease or a dental infection is present

bitewing dental xray

Periapical X-rays show the entire tooth, from the exposed crown to the end of the root and the bones that support the tooth. These are used to find dental problems below the gums such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases.

periapical x-ray

Panoramic X-rays like that above show a broad view of the jaws, teeth, sinuses, nasal area, and temporomandibular (jaw) joints. These X-rays do not find cavities but do show problems such as impacted teeth, bone abnormalities, cysts, solid growths (tumors), infections, and fractures.

Occlusal X-rays show the roof or floor of the mouth and are used to find extra teeth, teeth that have not yet broken through the gums, jaw fractures, cysts, abscesses, or growths.

occlusal x-ray

Dangers Dental X rays

The amount of radiation used in dental X-rays is low, but there is always a slight risk of damage to cells or tissue from being exposed to any radiation, including the low levels of radiation used for this test. The risk of damage from the X-rays is usually very low compared with the potential benefits.

Pregnant women may not want to have routine dental X-rays taken until after they give birth. Although there is no proof that a routine dental X-ray could harm a developing baby (foetus). Dentists usually suggest you wait to have your X-rays until after the baby is born. Delaying the X-ray for a few months will not result in further harm to teeth in most cases. There are times when the severity of the dental problem requires an X-ray to deal with an urgent concern.

Why might you not be able to have a dental x-ray taken?

If you can't stay still or hold the X-ray plastic or cardboard in your teeth.
If you have braces, retainers, dentures, bridges, and certain body piercings (ear, tongue, lip, cheek, or nose)

*BUT WHY DOES THE DENTIST RUN OUT OF THE ROOM WHEN THEY TAKE THE X-RAY?*

The dental team might take hundreds of X-rays every week. Staff limit the amount of radiation they receive by moving away from the X-ray beam. However, the risk to patients from one or two routine X-rays is tiny.

Staff check how much radiation they are exposed to by wearing a small badge during working hours. This is sent off to be analysed at regular intervals.

Advances in dentistry over the years have lead to the low radiation levels emitted by dental X-rays. Some of the improvements are new digital X-ray machines that limit the radiation beam to the small area being X-rayed,

By law in the UK, annual checks on all aspects and safety, as well as annual updating of training for all staff using dental x ray equipment is mandatory so rest assured you are in safe hands

Who's Property are the X rays?

X-rays are an essential part of your health records and must be kept with your personal dental file. As dental records work differently to normal health records, your dentist must keep your dental records for at least two years from the date of your last course of treatment. You are entitled to copies of your records and X-rays under the Access to Health Records Act 1990. But you will have to pay for these copies. In most cases your X-rays and records will not be needed by your new dentist.

My Dentist wants to do a CT scan, WHY?

CT (computed tomography) is an imaging technique used in cases where normal 2d x-rays do not give enough information for effective, safe treatment planning and are increasingly used in implant cases in the UK.

Dental surgeries with this facility use cone beam CT which is a type of CT scanner with a much lower radiation dose compared to a normal medical CT scanner. The scanner goes around your head often in a similar way to the large x-ray at the top of this page it takes a lot of 2d slice images and converts them into a 3d image

As you can see below, the information means widths of bone can be measured accurately among other things and from these quite often templates can be made so as implants are placed in exact positions!

CT scan of jaws showing different views

SO HOW OFTEN DO I NEED X-RAYS/RADIOGRAPHS AT THE DENTIST?

Adults at low risk of tooth decay

Adults should have bitewing X-rays every 2 to 3 years.

Adults at high risk of tooth decay

Adults should have bitewing X-rays every 6 months to 1½ years.

Children at low risk of tooth decay

Children should have bitewing X-rays every 1 to 2 years.

Children at high risk of tooth decay

Children and teens should have bitewing X-rays every 6 to 12 months.

ANY FURTHER X-RAY QUESTIONS, ASK US HERE......

]]><![CDATA[DENTAL TOURISM (Dentistry Abroad)]]>Wed, 03 Dec 2014 18:39:49 GMThttp://www.onlinedentists.co.uk/dental-a-z/dental-tourism-dentistry-abroad

For those of you that don’t know; dental tourism is the act of going abroad for less expensive dental treatment, this is a booming industry in the UK amongst other countries and in many cases can mean you patients can get good quality dental treatment for half of the cost you would pay in the UK.

There are so many dental practices out there offering cheap dental treatment if you travel abroad that many people don’t know where to start looking or what to expect.

A simple google search for dental tourism Hungary and dental tourism Poland brings up hundreds of websites for dental practices all offering treatments for half the cost of what you would pay in the UK but ...

How can you decide what to have done, where to go and whether it is too risky or not?

Many practices are even offering packages where you get a two week holiday as part of your dental package in that country and still all for cheaper than your dental treatment plan in the UK.
It almost sounds too good to be true

Here are some links to google searches for dental treatment abroad:

http://www.kreativdentalclinic.co.uk/budapest_implant_cost.php?kdcpc=search&gclid=CPXz4Omip8ICFfMZtAodlF8Aow

http://www.smilesavershungary.co.uk/?gclid=CMbApYCjp8ICFVDKtAodGi4A6A

What You Should Find Out Before Having Dental Treatment Abroad?

Regulations, Facilities and Legal issues

1. Does the country have a regulatory body (in the UK this is the GDC) that regulates all dental professionals?

2. If something happens during your treatment, is this covered by your travel insurance?

3. What are your legal rights as a foreign patient in that country?

4. What guarantees are offered by the clinic and dentist that carry out the treatment? Say if something failed within a year or two through no fault of your own?

5. Are there any clauses to these guarantees? say in the small print?

6. Will the travel costs be covered for remedial work?

7. Is there an adequate complaints procedure?

8. Are they sufficiently equipped to deal with a medical emergency god forbid this were to happen? (if in a dentally regulated country they most likely will have to be equipped with emergency drugs and defibrillators)

9. Are you able to get a copy of the records of your treatment?

10. Are the records written in English and of sufficient detail for you and your own dentist to understand?

Treatment and Consent

1. Are the dentists suitably qualified to carry out the proposed work?

2. Are reliable references available? From people that have done the same at the same practice ? ask for some.

3. What about consent i.e. agreeing to an exact treatment plan? to consent properly you should understand everything involved including risks and complications. Is there a language barrier that might make this uncertain?

4. Who will maintain the advanced work when you return home; your own dentist?
And what will their fees be for this? Would this have been included if they did the work themselves?

5. Will your own dentist be able to deal with any complications or would you need a referral and would your own dentist be willing to do corrective work if you went against their advice?

ANY FURTHER QUESTIONS ON HOW TO GO ABOUT THIS, CLICK HERE

Individuals from the United Kingdom often obtain dental procedures in such countries as Bulgaria, Croatia, Hungary, Romania, and Poland.

And Finally

Most dental tourism companies require clients to sign waiver of liability forms. These documents are supposed to shield dental tourism companies from legal action. The forms state that if the client wishes to initiate legal action he or she must turn to the courts of the country wherein the dental clinic is located. Some dental tourists will find it costly, impractical, or impossible to obtain legal and financial redress after suffering harm while receiving dental care in another country so make sure all documentation is read and fully considered. your own dentist may even be willing to check over these documents for you and make recommendations for a fee.

]]><![CDATA[Silver (amalgam) fillings Vs White (composite) fillings]]>Sun, 23 Nov 2014 16:37:51 GMThttp://www.onlinedentists.co.uk/dental-a-z/amalgam-white-fillings

Amalgam

What you may call silver or metal fillings and what dentists call amalgam restorations have been around for many years. Many people have lots of these fillings in their mouths and there has been much debate about their safety in the past but despite this lots of these are still placed in the UK. read this article and in particular the conclusion on mercury and other amalgam issues if you are at all concerned.

This photo shows three Amalgam Restorations (silver fillings) after polishing

Amalgam fillings have a good track record with many patients having had them in their mouths for twenty years without need for replacement. They are strong, hardwearing and will not wear away the teeth that they are biting against any more so than your natural teeth would. They are cheaper for the patient not only as the materials are generally less expensive to buy but they generally take less time to place than white (composite) fillings

The disadvantages of amalgam fillings are that they do not add any strength to the tooth they are being used in, they are used to replace the decayed tooth substance so as the tooth decay does not progress. Large amalgam fillings may be difficult for the dentist to carve into the original tooth shape although there are many dentists that can do this very well!

There are a small proportion of patients that will be allergic to one or more of the alloys in the material which if so will usually cause a white patch on the gum or cheek next to the filling. If this happens they should be replaced with a different material

This shows a high standard example of amalgam restorations that have been replaced with composite restorations

Amalgam fillings do not bond to your teeth, they just fill the space where tooth is missing and so small cavities/holes need to be made so as when amalgam is packed into them it is held in. If this is not possible then sometimes small pins are placed to hold the filling in place but this is not ideal and in these cases a less damaging and more suitable option would probably be a bonded onlay whether it be metal or white (which in the case of an onlay would be porcelain) see onlay page for an explanation

So if you need small to medium sized fillings and you are not bothered about colour then amalgam may be the most cost effective choice, although use your own judgement in each case as well as your own dentists advice.

Fees vary greatly depending on the type and size of fillings as well as the experience of the dentist. A composite filling may range from £40 - £250 or more depending on the size; an amalgam from £30 - £150 depending on the size and onlays/crowns/veneers as discussed before from £300 - £1000 or more depending on materials, location and whether you need additional items such as extra models, visits to the lab for shade matching etc. If you have a query about a fee, your dentist will most likely be happy to explain what is involved and why the fee is set at what it is or you can always ask a dentist here. Amalgam restorations will be available from health service dentists at the health service fee and composite restorations may also be available on front teeth on the health service at health service fees. It may be worth asking about a private alternative if you are a health service patient but would like the best or most aesthetic treatment possible

White Fillings

White composite fillings take longer to place than silver fillings as they are generally placed in small increments and then require polishing afterwards. This means a medium sized filling which would take 20 minutes in amalgam may take 45 minutes in white composite filling material and so the fees will reflect this and the increased material cost. Some Dentists are more experienced than others when it comes to placing composite/white fillings and some have a special talent in making them look very realistic even under magnification! Others may not be quite as artistic but all dentists should be able to place an aesthetic white bonded filling which will match the colour and shape of your tooth closely.

The drawback with white fillings is that the area they are placed needs to be completely dry in order for them to stick onto your teeth properly. This is why many dentists will place a big rubber sheet around your tooth called a rubber dam to keep the area dry, others may use cotton wool rolls and suction but if the area cannot be kept dry throughout the entire procedure then this filling will not stick properly and it will not last. This may be why your dentist suggests crowns, onlays or amalgam fillings in very back teeth that they are struggling to keep dry whilst working on.

Example of a typical composite restoration repairing the cavity in this tooth

Now for white fillings/restorations - these bond to your tooth and are white and so can look very realistic. There are very few people allergic to the materials used for these and they should be the go to option for teeth with small to medium sized cavities/holes/fractures. Again these can sometimes be difficult to replicate the shape of the missing tooth they are replacing but really this depends on your dentists experience with the material and what they have found to work best in their hands. for smaller fillings it should generally be white composite filling material but in larger fillings they may suggest a lab made onlay instead if they feel this will be more cost effective for yourselves in the long term and give you a better result.

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Why do we get sensitive teeth?

Sensitive Teeth Treatment

When do baby teeth appear?

When are baby teeth lost?

How many baby teeth should we get?

Teething

Brushing childrens teeth

What is bad for baby teeth?

What is good for baby teeth?

Can decay, abscess or trauma to baby teeth damage adult teeth?

When to first take children to the dentist and why?

Should I be in the room during treatment?

Summary

What is Periodontitis?

Periodontal disease - signs and symptoms

Types of Periodontitis?

Chronic

Aggressive

Risk factors for Periodontitis

Periodontitis Treatment

Periodontal Surgery

Periodontitis - Summary

Gingivitis

Signs of Gum Disease

Causes of Gum Disease

Gum disease treatment

Receding gums and more

Gum Disease Summary

Impacted Wisdom Tooth

Wisdom Tooth Removal

Wisdom Tooth Extraction Procedure

Pain Relief

X rays required?

Wisdom tooth Removal - Aftercare

Wisdom tooth pain and Complications

Wisdom tooth Removal - Charges

What is Toothache?

Dental Abscess

Stages of Toothache

Managing toothache at home

How the dentist assesses toothache

How the dentist treats toothache?

What happens next?

The Next Stage

Impressions stage

After Impressions

The Fit Appointment for Crowns and Bridges

Screw retained vs cemented restorations

The Fit Appointment for implant supported dentures

Important points to note/expect

Dental Implant cost

Porcelain Veneers

Composite Veneers

Veneers cost

Celebrity Veneers

Compromised Results

Natural Looking Results

Reasons for Not Believing:

Now why we should believe?

The Benefits of believing in the Tooth Fairy

Who are they for?

Dental Plans

So What Does it all mean?

Summary

Video showing Root Canal Treatment Procedure

Root Canal Treatment - why?

What do you need to be aware of?

Why does it take so long?

How much should it cost?

Why might you also need a crown afterwards?

Why might you need referring to another dentist?

Root Canal - take home messages

Why Not Brushing Your Teeth Properly will Ruin Your Life

Why Brushing Your Teeth Properly will Save Your Life

SO? Ask your self again, why are you not spending just 4 minutes a day, ensuring your teeth are brushed as effectively as possible?

*NEXT WEEK - How to brush your teeth properly and improve your quality of life!*

ORAL B ELECTRIC TOOTHBRUSH HEADS vs imitation heads - Dentists conclusion

Who are the GDC (general dental council) and what do they do?

Disabilities and the dentist

Struggle taking children out of school or to dentist in working hours

NEXT WEEK - How to brush your teeth properly and improve your quality of life!