Dental health and the elderly

There is clear evidence that gum disease is a risk factor in systemic diseases such as osteoporosis, cancer and respiratory disease, so the importance of good oral health in the elderly goes beyond the cosmetic. Now, a new review has brought together first-hand accounts of older patients, revealing what concerns might be stopping them from attending regular dental appointments.

Common barriers cited were dental anxiety, poor general health that made visits difficult, the cost of treatment and physical limitations on travel.

 Barriers to dental visits

dental care and the elderly

  • Forgetfulness was mentioned often
  • Cost was a common concern
  • Not caring about dental health in the same way as they did when they were younger
  • Access was mentioned as a problem, as older patients often require help getting to the surgery
  • Illness was frequently mentioned – one patient said: “I’ve been so ill that I haven’t got around to it”
  • Others that were interviewed admitted that dental anxiety only worsens as you get older

Drilling down into possible barriers to seeking regular dental care is even more important in the light of a new UK study that has found that poor oral health increases the risk of frailty in older men. Published in the Journal of the American Geriatrics Society, researchers observed over 1,000 men over a three-year period and found a link between poor oral health and problems such as weight loss, exhaustion, reduction in walking speed and a reduction in physical activity.

One in five men had no teeth, over half had gum disease, nearly a third had dry mouth and one in ten had trouble eating.

Common dental problems in the older patient

Root decay: as we age gum tissue recedes and the roots do not have the same enamel protection as the tooth, making them susceptible to decay.

Risks of other diseases: oral infections can make blood sugar levels spike which can potentially lead to the development of diabetes.

Dry mouth: many of the medications that older patients require to treat degenerative diseases can cause dry mouth. The mouth requires saliva to protect the teeth from decay and, if left untreated, dry mouth can lead to the development of tooth cavities and gum disease.

With the link between poor oral health and overall health, it is essential that urgent and preventative intervention is required.

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Introducing interdental brushes

 

By the time we reach adult life, many of us have adopted a tooth brushing regime that we are fairly comfortable with. Nevertheless, there is always room for improvement. As dental technologies evolve and improve, new products become available that can help push your oral hygiene even further, and help maintain healthy teeth and gums.

There are new ways of brushing teeth that many people are not aware of – the dental industry has a responsibility to ensure that people know what is out there and what is best for their teeth. The staff here at CK Dental think it’s important that patients are kept up to date and are made aware of interesting new dental innovations.

One such new innovation is the interdental brush, which offers a modern alternative to flossing.

A new, tiny type of brush is available that can be used in conjunction with a traditional (manual or electric) toothbrush. These tiny brushes are called ‘interdental brushes’, they are conical shaped and specially designed to get into the small spaces between your teeth.

Interdental brushes are effective in removing plaque and bacteria by interproximal brushing (in laymen’s terms, getting in between the tiny gaps between teeth). It is not possible to remove all plaque and bacteria by conventional brushing alone, hence why flossing has always been recommended. Interdental brushes can offer a different approach that can be less fiddly compared to trying to squeeze a length of floss in-between your teeth.

Interdental brushes can be used every day as part of your regular brushing routine, and they come in lots of different shapes and sizes. Some people will opt for a series of interdental brushes, as they require different sizes to get into the different sized gaps between teeth. Once you’ve started to weave this into your oral hygiene routine, it soon becomes second nature, and your teeth and gums should feel cleaner as a result.

Many people find that using interdental brushes is a lot more user-friendly compared with floss, so they are less likely to become discarded and ignored at the back of the bathroom cupboard. When you first start using an Interdental brush, you may experience some slight bleeding from gums as they get used to the intrusion. This should be temporary and is usually the case when you first begin flossing too. This should clear up fast and as long as you’re not forcing the brushes into gaps that are too small for the size of the brush, you should not feel any discomfort.

Interdental brushes: what’s best, Vision or Tepe?

Having discussed the merits of interdental brushes, the next question is how to choose what type of interdental brush to use. There are a variety of offerings, but the two main types are Vision brushes and TePe brushes. Here at CK Dental, we look at the differences between the two, so you can make an informed choice which is best for you and your oral needs.

Vision brushes

  • Vision interdental Perio brushes claim to be an “easy, effective and great value for money solution” to keeping your teeth and gums healthy
  • They are available in a variety of different sizes, which means you can squeeze them into the different sized gaps between your teeth. Your dentist will be able to help advise which size(s) are going to be most suitable for you
  • The brush has a curve to it (similar to the shape of an elongated hockey stick), which allows easier access into the hard-to-reach areas of the mouth
  • The USP of the vision brush is that it “compresses gum tissues for a deeper clean than other brushes or dental floss.”

TePe brushes

  • TePe interdental brushes are “designed to clean between teeth, around bridges, fixed appliances and implant abutments. They help to maintain a high standard of oral hygiene .”
  • There are also available in a variety of sizes
  • These brushes are conical in design, with a soft, ergonomic handle and a plastic coated central wire to ensure that teeth and gums are cleaned safely and gently
  • TePe brushes can be straight or on a curved handle, depending on whether you’re tacking the teeth at the front of your mouth of the trickier ones at the back.

Thumbs up for interdental brushes

Both styles of brushes have their merits and it will largely be down to personal preference with once you feel most comfortable using. Regardless of which you’re leaning towards, the concept of interdental brushes has the experts convinced. A review of nine dental studies recently concluded “interdental brushes used as an adjunct to [normal] toothbrushing removes more plaque than just toothbrushing and that dental floss and woodsticks are surpassed by interdental brushes in plaque removal.”

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What should you do if you suffer from extreme dental anxiety?

 

There are many things in life that can make us feel unsettled or generally ill at ease, and for some people, a trip to the dentist is one of those things. If visiting the dentist is something that makes you feel extremely anxious, here at CK Dental we want to do everything we can to reassure you that it really isn’t that bad.

The first thing to let you know is that you’re not alone. In fact, far from it. A fear of going to the dentist actually has its own medical terminology – those who are nervous about booking a dentist appointment are believed to suffer from a condition called ondontophobia. This literally translates to fear of the dentist. The very severest of cases are where people will refuse all together to ever see the dentist and people who suffer with this condition are known as dentally phobic.

We’re not that scary! Honestly

All jokes aside, it’s a serious matter. Without regular check-ups at the dentist your teeth and gums are at risk of developing abnormalities such as plaque, tooth decay, cavities, gum disease or maybe something even more serious such as mouth cancer.

If you are suffering from ondontophobia or dental phobia, some of these symptoms may sound familiar:

  • Feelings of stress of anxiety in the days leading up to your appointment
  • Insomnia the night before you’re due to see the dentist
  • Feelings of sickness and unease in the waiting room
  • Gagging or a feeling that you might physically struggle to breathe properly if a dental tool is inserted into your mouth

The underlying cause of this worry may come from one (or several) reasons. Some people worry about pain caused by dental inspections or treatments, while others may worry about the pain caused by administering anaesthetic with a needle. Some people feel an oral inspection is too close to their personal space and feel uncomfortable by the process, and others really don’t like the feeling that they don’t have control over what is happening in their mouths.

How to make the dental experience more positive

While all these fears may be rational, here at CK Dental we do everything we can to put you at ease, respect your worries and fears and to make you have a pleasant experience with us. One option for those suffering from extreme dental phobia is having your dental treatment performed under general anaesthetic. We are one of the few private dental clinics in the UK that can offer this option and all procedures are performed in one of Bristol’s leading private hospitals.

If you find visiting the dentist is making you feel stressed, nervous or nauseous, let us know that you’re feeling that way and we will do everything we can to make you feel more comfortable.

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Invisalign Q&As

Many people will remember train-track braces from when they were younger, as they are the standard NHS orthodontic fix for jumbled or protruding teeth. However, many people don’t realise that teeth don’t stop always moving. Quite often, if teeth were straightened when you were young, they may move again with age, hormonal changes or when wisdom teeth come through. Other people may not have opted for teeth straightening when they were younger, yet decide to go down that route when they are older.

Invisalign provider in Bristol

The idea of train-track braces as an adult may not be the most appealing idea and so here at CK Dental in Bristol we offer a newer, more visually appealing, modern alternative.

What can be done if I want straighter teeth but don’t want a visible brace?

Invisalign does what the name suggests – it straightens your teeth while being hardly noticeable. Instead of a wire which is cemented to the front of your teeth and tweaked to adjust their alignment, treatment with Invisalign braces is done with a series of plastic ‘trays’ or ‘aligners’, that fit over your teeth and are adjusted every few weeks.

How does Invisalign work?

Imprints are taken of your teeth and gums, and then aligners are custom-made to fit your mouth perfectly. The aligners slot in and out of your mouth easily, which means you can take them out when you want to eat or drink, brush your teeth and so on. Ideally you’ll keep them in for the majority of the time and this will ensure the process works as quickly as possible. They are very discrete too, at first glance you would not know that they are being worn, as they are transparent and do not protrude.

Does Invisalign hurt?

Although your teeth will ache when a new aligner is fitted, as there is no wire or attachments, these won’t cause discomfort inside the mouth in the same way that a train-track brace might do.

How long has Invisalign been available? I don’t want to be a guinea pig

Rest assured that even though Invisalign is relatively new to the UK market, it has been established since 1997 and has helped millions of people around the world achieve a smile that they are happier with.

How long will I need to wear my Invisalign braces for?

The process typically ranges from 9-18 months, depending on how much your teeth require adjusting and how complex the treatment is. Your dentist will be able to give you a good indicator of this at the initial consultation.

So, if you’ve decided that for 2018 you’re going to invest in a beautiful smile then now is the time to find out more about Invisalign.

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New plans for helping A&E departments tackle dental emergencies

 

If you’re involved in an accident resulting in any type of serious injury, calling 999 or taking a trip to your local A&E department is the first thing that many people think of. While in many cases, this is the correct course of action, if you have suffered an injury to your teeth you may find that A&E is not the best place for you.

At CK Dental Practice we know that the issue with patients seeking emergency departments at hospitals is that they are unlikely to have doctors who are qualified in dentistry, so are therefore not necessarily the best practitioners to be dealing with the issue.

Dr Chet Trivedy who is the chair of a newly formed group set up to tackle this issue, comments “thousands of people go to A&E each year with a dental problem, however, the issue is that many doctors aren’t trained in dentistry and are likely to have limited experience and resources to help these patients.”

The group has a more memorable acronym than many, “D.R.E.A.M.S” – the Dental Review of Emergency Attendances Multi Stakeholder group. Its aim is to identify and find solutions for the way that dental problems are dealt with in A&E departments.

The new committee comprises representatives of a number of high profile medical groups, including the Faculty of Dental Surgery, the British Society of Paediatric Dentistry, the Royal College of Nursing, the British Association of Dental Nurses and NHS Islington Clinical Commissioning Group.

Seeking dental treatments at A&E can be costly

The other problem for struggling hospital budgets is that if people use A&E departments for issues where they should be seeing their dentist, the cost to the system is significant. It is estimated that each year, patients seeking dental treatments at A&E costs the health service £18million.

Many dental practices are not in a position to offer out of hours services that are able to step in and help when a dental emergency occurs, leaving patients with no choice other than to attend A&E.

One of the aims of the D.R.E.A.M.S group is to help ensure that A&E doctors are sufficiently trained in dealing with some of the most common dental concerns, including a lost tooth, broken tooth or excess bleeding following a tooth extraction.

The group recognises that it will face the age-old problems of time and money, but is hoping to work collaboratively with all dental stakeholders to try and find a suitable resolution to help patients, the health services and dental practitioners.

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The Big C – the importance of knowing what to look out for with mouth cancer symptoms

mouth cancer symptomsThanks to awareness-building advertising campaigns over the years, many of us now feel sufficiently informed to know about the warning signs of cancer in different parts of the body.

From checking for lumps and bumps, to persistent headaches and changes with moles and freckles, cancers such as breast, prostate, testicular, brain and skin are well known, and there is a reasonably good awareness of how to perform ‘bodily MOTs’ – checking for changes that could signal a problem.

But we are as clued in when it comes to mouth cancer?

Mouth cancer is one of the lesser known cancers, although according to Cancer Research UK, the incidence of mouth cancer in the UK is on the increase. “Oral cancer incidence rates are projected to rise by 33% in the UK between 2014 and 2035, to 20 cases per 100,000 people by 2035.”

What this means in real terms is that the number of people each year in the UK who are diagnosed with oral cancer is now in excess of 7,500.

Although it is becoming more prevalent, it is believed that the vast majority of mouth cancers are linked with lifestyle choices. What this means is that with greater opportunities to educate people about the causes of mouth cancer, there are things that people can be doing on a day to day basis that can help reduce their risk.

How to mitigate your risk of developing mouth cancer

Here at CK Dental we always advocate oral hygiene and good oral health, and this is the first important starting point. A regular brushing routine and a good awareness of the state of your teeth, tongue, cheeks and gums is essential in being able to spot if anything looks or feels different.

There is a proven link between excessive alcohol consumption and mouth cancer, so ensuring you are keeping alcohol intake with the recommended weekly units is a good starting point to ensure that you’re not putting your mouth at risk. There is also an increased risk for smokers, as tobacco usage has also been linked with higher incidences of mouth cancer – in fact three quarters of those diagnosed with mouth cancer are reportedly smokers.

Signs to look out for

Mouth cancer can start out as a mouth ulcer that does not cause discomfort or irritation, but that fails to heal.  It is also important to keep tabs on any red or white patches that form within the mouth and that do not seem to be healing or clearing up. The same is true for any unexpected lumps, bumps or rough areas within the mouth.

As with many cancers, the sooner it is detected, the greater the chance that it can be treated effectively, so if you have any areas of concern within (or around) your mouth, book an appointment to come and see a dentist for an expert assessment as soon as you can.

At CK Dental, our routine exams always include an examination of the teeth, gums and tissues of the mouth for any signs of a serious health condition that needs further examination.

To arrange an appointment at our Bristol dental clinic, call us on 0117 906 4868.

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Ensuring your teeth are looked after while you’re on holiday

holiday dental routineIf you’re planning on jetting off for some out of season sunshine, or you’re considering hitting the slopes for some fun in the snow, your teeth are probably not high up on your checklist. Here at CK Dental practice in Bristol, we believe your teeth should definitely earn their place on your pre-holiday checklist, to ensure that they don’t give you any cause for concern while you’re away

Find time for that last-minute dental check up

It is sensible to arrange a dental check-up before you leave. This way your teeth can have a quick inspection before your holiday and you can have the peace of mind that they are in good health and shouldn’t cause you any unexpected troubles. It is a good idea to have this check-up a couple of weeks before you are due to go, just in case a filling or any other treatment is required that may need a follow-up appointment.

Be mindful of what you eat and drink

Holidays are often a time when we let our hair down and eat and drink things that we wouldn’t always indulge in at home. On holidays, there is probably a tendency to treat ourselves to fizzy and surgery drinks, so make sure that you’re giving your teeth a really thorough brush in the mornings and evenings to wash away all these holiday naughties.

Don’t forget your dental routine

Even if your usual routine is completely thrown by the wayside, ensure that your dental routine doesn’t suffer. As well as remembering to brush your teeth in the morning and evening, why not treat yourself to a post-siesta brush as well?

Don’t forget your toothbrush!

Finally, remember your toothbrush! In fact, we’d recommend taking two. Anyone who has been delayed on a flight can relate to that feeling of needing something that you have packed that is tucked away in the suitcase and unobtainable if you’re hanging around the airport for longer than envisaged. Packing an extra toothbrush and a small tube of toothpaste (under 100ml due to liquid restrictions) can make all the difference when you want to freshen up.

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State of children’s teeth in England exposed

[From The Guardian] Twice as many children under the age of 10 receive hospital treatment for tooth decay as those treated for broken arms, figures for England show.

There were 34,205 cases of patients under 10 needing hospital treatment for dental caries in the year to March, the youngest less than a year old, according to the faculty of dental surgery (FDS) at the Royal College of Surgeons.

Over the same period there were 17,043 broken arms, as well as 19,584 cases of asthma, 10,397 cases of epilepsy and 3,805 cases of appendicitis needing hospital treatment in the age group, according to analysis of NHS Digital data.

Read the full article in the Guardian… 

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Trick or treat? It’s that time of year again when sweets are calling…

Good dental habits HalloweenWith Halloween comes all kinds of fun and excitement, ranging from pumpkin carving and dressing up, to spooky stories and trick-or-treating. But, even once Halloween has been and gone, the legacy of the ‘treats’ from trick-or-treating live on. Whether your children have come home with hoards of sweets they have procured from the neighbours or if you stocked up for trick-or-treaters and have got lots left over, the chances are your house might be looking a lot like a sweet shop at the moment.

Here’s some ideas from CK Dental in Bristol on how to keep Halloween fun while keeping your teeth a bit more healthy….

Make fun substitutions

Instead of a bag of sweets, think more creatively about what ‘treats’ might look like. Stickers are a great alternative, cheap, fun and a big hit on the playground. Especially if they happen to be sticker packs that your little ones can swap with their friends.

Bubbles and balloons are another good party bag offering that would substitute for sweets nicely. Children love blowing bubbles, especially younger ones. At this time of year, it’s very easy to pick up some ghoulish-themed bottles of bubbles or some black and orange balloons which will keep them entertained for ages.

This can extend to other Halloween dress-up items, like some witches fingers, a set of vampire teeth, a (pretend) spider, a plastic eyeball or two….these items can be picked up very cheaply at supermarkets and discount stores and kids will have great fun customising their outfits with them.

Make sure you’re still encouraging good dental habits

Although these spooky substitutions will help reduce sugar intake, they won’t evade the problem entirely, so be prepared to embrace the fun of trick-or-treating and make sure you reiterate the importance of a thorough teeth brushing session once the sweets have been consumed. Also, bear in mind that if your children have acquired a lot of sweets these may need to be consumed over a number of nights. If this is the case then make sure to explain that this is all part of the Halloween hangover, and that having sweets after tea is not to become a habit, otherwise you may find it is hard to break!

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Babies and toddlers – how to avoid tooth decay by giving sensible snacks

tooth decay in childrenAll parents out there will understand, relate to or remember the transition from milk to solid foods. The weaning process. This can be an exciting time or this can be stressful, and everyone crosses their fingers that their baby will not turn out to be a fussy eater.

For some parents whose little darlings are picky with what they eat, they may fall into the trap of giving them food/snacks that they like, just because they are pleased that they are eating something. It’s worth remembering though that bad habits can start young, and if you want your child’s teeth to remain healthy for as long as possible, here are some snacks that you may wish to avoid.

Some snacks to be mindful of

  • Dried raisins – these are a handy, convenient snack that appear healthy (they’re fruit right, so must be good for infants?). Although they do contain vitamins and are great for helping babies develop their fine motor skills, the ‘pincer’ motion, they are very sticky and can become attached to milk teeth. The natural sugars within the raisins then can damage the teeth unless they are brushed thoroughly.
  • Fruit juices – although they are definitely a healthier alternative to sugary, carbonated drinks, fresh fruit juice contains natural acid which can wear away the delicate enamel of new teeth.
  • Flavoured milk – although most babies will continue having milk before bed for several years, try to keep this natural and unsweetened. Adding flavours to milk undoubtedly means adding sugar, and unless you’re planning on brushing their teeth again before they go to sleep, this means that overnight their teeth are at risk of decay. Even if these are marketed as suitable for babies, that does not mean that they are necessarily good for their teeth.

The best kind of snacks you can give your children are raw vegetables such as carrot sticks and cucumber, or fresh fruit such as orange segments and bananas. Snacks such as rice cakes and toast are also good for plugging the gaps between meals.

Getting into good habits early

Just remember, even if your little one doesn’t have a full set of milk teeth yet, you should be brushing their teeth twice a day for up to two minutes per clean. This will be hard for the very youngest babies, so don’t worry if it’s only a short brush before they aren’t willing to cooperate any longer. Regular brushing helps babies and toddlers associate this as part of their regular daily routine.

And also make regular trips to your dentist part of your routine. In shocking figures released earlier this year, the Faculty of Dental Surgery at the Royal College of Surgeons pointed to a 24% rise in the number of tooth extractions on children under four over the last decade.

Professor Nigel Hunt, Dean of the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons (RCS), said: “When you see the numbers tallied up like this it becomes abundantly clear that the sweet habits of our children are having a devastating effect on the state of their teeth. That children as young as one or two need to have teeth extracted is shocking.  It’s almost certain that the majority of these extractions will be down to tooth decay caused by too much sugar in diets.”

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