Treatments

Your teeth function in a fairly difficult environment: severe temperature changes, bacterial attack from the plaque and lots of strongly discolouring food substances which can leave their marks after many years of service. These yellowing food stains are called chromagens and if you drink tea, coffee, red wine and especially smoke, there are ample opportunities for these chomagens to be absorbed by the enamel. These stains can now be removed by using oxidising gels like carbamide peroxide. This penetrates the enamel and oxidises the stains.

Craig Kennett is our resident implantologist- a very experienced, thorough and skilled dental surgeon.

With the use of a CBCT (3D scan) Mr Kennett can normally advise as to whether an immediate implant placement at the time of the extraction is viable or whether a delayed approach with socket preservation/bone grafting is preferable. If the latter is the case then the implant will be placed approximately 10 weeks after socket grafting. Socket preservation/grafting is done at the time of the dental extraction. The implant then needs to fuse to the jaw bone (osseointegration) which takes another 10 weeks. If the tooth in question is cosmetically visible, you may opt to get through this period with the help of a small temporary denture. The after effects of the surgical insertion of the implant normally consists of no more than a few days of mild discomfort, after which you will be unaware of the process of osseointegration. Once the healing is complete, we will take an impression or intaoral scan (different from the 3d scan) of the implant and have the crown or bridge made onto it. The crown or bridge may be cemented or screwed into the implant.

On the first photograph above you can see the implant after the healing has taken place and is ready for the abutment and the crown. The healing cap which has been in place during the last 10 weeks since the implant was inserted has been removed, showing healthy gum around the implant. On the right the crown is in place and the gap is filled beautifully.

The cost of the surgical phase of the implant is approximately £1950 but this figure may vary upwards if CT scans and/or bone augmentation are needed and may be lower if multiple implants are inserted at the same time. The cost of building the crown/bridge once the implant is in place is £1100 (per crown or bridge unit).

Implants are very reliable replacements for missing teeth but they will need to be looked after in a similar way as you would look after a natural tooth. Thorough but gentle brushing with a soft toothbrush and daily flossing and/or interdental brushing will make sure the surrounding gum and bone will stay healthy. Failing to take proper care can result in the bony support of the implant deteriorating as a result of the toxins of the dental plaque (bacteria). This process is very similar to what gum disease can do to a natural tooth.

In order to make a bridge, we therefore need other teeth around the site of the missing tooth/teeth to be in reasonable condition. Heavily filled adjacent teeth are not a problem but if the neighbouring teeth are mobile because of gum disease then a bridge may not be the best solution. Alternatives to a bridge are dentures (which are removable by the patient) or implants (titanium screws into the jaw bone). We will examine you first and advise you on the best possible solution.

We will then take an impression of your teeth so that the laboratory technician can make the crown. As it normally takes the laboratory two weeks to get the finished crown back to us, we make temporary crowns to protect the teeth for that period. It is advisable not to eat hard or sticky food during the fortnight you have temporary crowns as they are slightly fragile and are cemented on with a relatively soft cement. This enables us to remove the temporary crowns easily when the real crowns are ready. Also, during those two weeks, be careful with foods that contain strong stains or pigments like curry as they may stain the temporary crown.

For your front teeth, where the appearance is of the highest priority, we now recommend all porcelain crowns, like Cercon (Zirconia) crowns, which have superior aesthetics and excellent strength.

What are the benefits of Invisalign?

• Virtually invisible: Unlike traditional braces, Invisalign aligners do not use wires or brackets and are barely noticeable. They are thin, transparent and custom-made to fit your mouth.
• Quick results: The system can correct several orthodontic issues to give you a balanced, straight smile in as little as six months, in simple cases.
• Removable: Invisalign aligners are removable, so you will find it easy to brush and eat normally during treatment.
• Comfortable: The aligners are more comfortable than traditional braces. They are flexible and custom-made for a comfortable fit.

The Invisalign Journey

Step 1: Consultation. At the Dental Care Centre, our Invisalign practitioner is Dr Uddoh and your consultation will be with her. At your consultation, Dr Uddoh will examine your smile, discuss your needs and make recommendations. You will also be given an idea of the cost of your treatment.

Step 2: Impressions. If you are happy to proceed, impressions will be recorded, along with full mouth xrays and clinical photos. A treatment plan will be created and a request for a clincheq (animation of the anticipated tooth movements) will be made from Invisalign. The clincheq will be reviewed with you and on approval, the aligners will be ordered. A series of clear and removable aligners are custom-made to fit your mouth.

Step 3: Receive your aligners. Dr Uddoh will fit your aligners making sure they are comfortable. She will also explain what to expect during treatment and plan for your review appointments.

Step 4: Wear your aligners. You need to wear each set of aligners for at least 20-22 hours a day. You can remove them to eat, drink, brush and floss.

Step 5: Finish your treatment. Your treatment ends when you have worn each set of aligners. To maintain your straighter smile, you will need to wear a retainer every night. On occasion, refinement aligners are required, this would normally be at no additional cost and would be arranged before the retainers are ordered. Refinement refers to finishing movements required to achieve the straight teeth. The number of free refinement you can have depends on the treatment package you are having. Dr Uddoh will advise you about this at the time of consultation.

How long does treatment take?

The average Invisalign treatment takes 12-18 months, but this varies depending on your individual needs. Some cases can be completed in a s little as six months.

Is Invisalign treatment painful?

Invisalign treatment is not painful, but you may feel some discomfort initially or when you change aligners. This is only temporary; your mouth should quickly adjust so the aligners feel natural and comfortable. The edges of your aligners may rub against your gums and cheeks at first. This should improve over time, but if it continues, contact the practice.

Cost of Treatment

Invisalign price ranges from £2500 to £5500 depending on the complexity of the case. Retainers are essential after treatment. At the Dental Care Centre, we supply either a fixed retainer or a removable retainer or Invisalign Viviera retainer.

<Our Principal Dentist Stephanice Uddoh is a specialist in Invisalign treatment.
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Gum disease does not progress at an even pace. There will be periods when the disease will progress extremely rapidly and then slow down again. These period of rapid deterioration may coincide when you are feeling low or run down. The bad news is that the bone attachment that is lost during the active phases is virtually impossible to regain. The good news is that we can control the advance of the gum disease as long as you remove the plaque completely every day.

Because gum disease is on the whole a pain free disease, is can gradually creep up on you without you realising. It is most important to realise that just brushing your teeth, even if you do it really well, will leave the plaque behind in between the teeth, under the contact points. It is vital that once a day those areas are cleaned with dental floss or inter dental brushes. We will teach you how to use these and in the case of the inter dental brushes we will assess which size is the optimal size for your teeth.

Treatment becomes more difficult as the gum disease progresses but it can be very successfully treated in the earlier stages. Early detection is very important! One particularly important aspect of gum disease is the impact smoking has on it. The loss of bone, the attachment of the teeth, is lost much faster than in an equivalent non-smokers mouth. Definitely not something you would want to do!

There are other factors that influence periodontal disease like diabetes, medications, stress, excessive biting forces and a poor diet. On the issue of pregnancy it is good to know that with proper care, there is no need for a deterioration of your teeth and gums during a pregnancy. The gums are more likely to bleed though, caused by hormonal changes in you body. With meticulous oral hygiene and some straight forward dietary advice you will come through your pregnancy without any problems.

Alice Wilson is our hygienist here at Dental Care Centre. Alice is very much liked by her patients for her gentle yet thorough approach.

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The noise of snoring is caused by the vibration of the soft tissues in the upper airway. During sleep, the muscles of the upper airway relax, resulting in the formation of bottlenecks or even complete obstruction of the airways. The body reacts by increasing the velocity of the air which in turn causes vibration of the soft tissues which generates the noise of snoring. Research has shown that approximately 40% of the adult population snore. As a person gets older the chances of snoring increases. (i.e. in men aged 60 this increases to 60%.) The chances of snoring are also increased if a person is overweight or drinks alcohol.

Obstructive Sleep Apnoea
This is a medical condition. People suffering from it are heard to gasp for breath while they are asleep. Additional symptoms are daytime drowsiness or the feeling of not having a full nights sleep. Where Sleep Apnoea is suspected, an anti-snoring device may be prescribed but it is essential that you consult your medical practitioner. if they confirm that Sleep Apnoea is suspected, you should be referred to the sleep clinic of a hospital for further investigation. Not everyone who snores suffers from Sleep Apnoea – but nearly everyone who suffers from Sleep Apnoea will snore.

What help is available?
In the surgery we can make you an oral appliance which is worn at night to prevent snoring. This consists of two thin plastic formings which fit over the upper and lower teeth. They are joined together by two connectors that gently hold the lower jaw in a forward position.

You need to have most of your own teeth; if you have full dentures we will not be able to help you with this method as the appliance has to be inserted over you natural dentition. Further, there are some people who cannot get used to the more forward position of the lower jaw. The system we use has the ability to alter the amount of forward displacement to suit you.

Unfortunately it is not possible to guarantee that the appliance will work on everyone. Statistics demonstrate that in 62% of people who snore, it will totally eliminate the noise of snoring. In the remaining cases the noise of snoring may be reduced or it may not work at all. The appliance does require regular maintenance but the intervals between maintenance periods are difficult to predict because they depend on the individual case. If you grind your teeth at night the life of your appliance will be reduced.

The composite material is applied to the tooth after the tooth surface has been prepared with a dental acid, and bonding coat has been applied to the tooth surface. The material is then shaped, and then set with a special light. The shade of composite filling material is selected to match your tooth.

Further shaping and polishing is carried out until good aesthetics and a smooth surface is achieved. Stephanie Uddoh - our resident Principal Dentist - particularly enjoys doing such cases.

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