Pulling teeth: reasons for dental extraction

tooth extraction under general anaestheticPatients understandably want to avoid having a tooth extracted and dentists, too, will do everything possible to save a biological tooth, but sometimes a tooth extraction is the best option and, in many cases, is unavoidable. Removing a significantly damaged or decaying tooth will be required to save the surrounding teeth and ensure optimal dental health.

  1. Severe damage or decay: Whether it’s the result of injury or trauma to the tooth or because of severe decay and infection in the gums, a tooth may need to be removed to prevent further damage. At CK Dental we always adopt a conservative approach and it may be possible to restore the natural tooth, utilising a crown or a filling. If these options are not suitable, then removal of the damaged tooth will take place and a dental implant used to replace the missing molar.
  2. Smile alignment: Some patients will have a very crowded jawline and the teeth fail to align properly. Orthodontics is the dental practice of correcting tooth alignment, typically with braces, but sometimes teeth need to be removed to allow the remaining teeth to become properly aligned. Often, more than one tooth will need to be removed – one from both sides of the mouth – to maintain symmetry and balance of the bite. In this instance, dental extraction will take place first and then we can begin the process of aligning the teeth.
  3. Abnormal development: Sometimes teeth fail to erupt through the gums or become impacted and this is most often seen with the wisdom teeth.

For most patients, tooth extraction can be performed in a dental clinic without any need for anything more than local anaesthetic injections to numb the area. However, for severely impacted teeth or for patients that are suffering from extreme dental anxiety, then a general anaesthetic can be the best option and many dental surgeries are not able to offer this option. At CK Dental in central Bristol, we can carry out dental procedures under general anaesthetic, safely and effectively, in a hospital environment.

Current NHS waiting list times for teeth extractions are growing and, in some areas, patients can be waiting for 22 weeks and up to a year, often suffering discomfort and pain in the meantime. At CK Dental, we can usually see a patient in clinic within a week and, from there, arrange an appointment for a tooth extraction under general anaesthetic within two to four weeks.

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Brushing children’s teeth

brushing children's teethAny parents out there will know that getting children to brush their teeth can sometimes be challenging. Parents are encouraged to brush their children’s teeth from the minute the tiny milk teeth arrive, and anyone who has tried to inset a toothbrush into an unwilling baby’s mouth while it is clamped firmly shut will agree that juggling with jelly is probably easier.

The importance of establishing good dental health routines is crucial, though, as new research shows. A recent study from the University of Cardiff has found that one in seven toddlers has tooth decay. The researchers analysed 1,400 parents and 25% failed to start brushing their children’s teeth from a young age. The author of the study, Maria Morgan, said: “People don’t realise that you should start that early. We are having some children at five, six or seven who are having five, six, seven, eight, nine teeth removed in one go.”

Although we understand it’s not easy to start this routine, as babies grow into toddlers and then into small children, things should improve. If you’re still finding resistance, here are some helpful hints and tips to help your children establish a good oral routine from an early age.

Make it a shared activity

Brushing your teeth at the same time your child is brushing their teeth is a great idea. Children love to mimic their parents, so if they can watch you doing it, they are more likely to want to have a go themselves. A lot of young children also like looking at themselves in the mirror, so why not sit with them in front of a mirror while they’re brushing too.

It doesn’t have to be serious

Dance around, hum while you’re brushing, have a race to see who can brush the fastest for 20 seconds… anything you can do to make the tooth brushing fun and entertaining will certainly appeal more to your little ones than standing over them in the bathroom nagging them to clean their teeth.

A little treat every now and again can help

Although we wouldn’t recommend bribing children to brush their teeth, setting up a rewards-based plan for slightly older children could work nicely. If they get a full week’s worth of tooth brushing points then maybe this could be rewarded with a weekend treat to celebrate how well they have done.

Here at CK Dental practice in Bristol we want all parents to be aware that children’s dental hygiene is no different from adults, they should be brushing their teeth at least twice per day for around two minutes per go. If you can get a routine established with your children nice and early this should help ensure that tooth brushing is something they regard as a normal and necessary part of their daily routine.

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Understanding why people have different bites and how this can affect your teeth

under bite treatmentIf you’re one of the lucky ones, you may have been born with a perfectly straight set of teeth that fit together seamlessly. If, like many people, you may feel like your adult teeth were thrown into your mouth at random, then this may be because of issues with how your ‘bite’ is working.

In orthodontic terms, your ‘bite’ is the term for how your teeth sit together when the top and bottom teeth are shut together. If your bite is not aligned correctly then this can mean that your teeth don’t look neat and tidy, they might stick out or may become worn down by unnatural contact with other teeth in your mouth. The three main issues with a person’s bite are as follows:

  • Under bite
  • Over bite
  • Cross bite

Under bites

This is where the teeth in the lower jaw sit in front of the upper jaw. Under bites are often hereditary and they can be caused by overdevelopment of the lower jaw or underdevelopment of the upper jaw. They can affect people’s confidence and also cause speech problems.

Over bites

When people have forward, protruding teeth, this is often due to an overbite. This is where the top teeth are pushed out in front of the teeth below, meaning that they meet at an unusual angle or in some cases the top and bottom front teeth don’t meet at all. People can feel very self-conscious of an overbite, as teeth can look extremely prominent. Overbites can also result in wear and tear on the lower teeth and sometimes discomfort in the jaw bone.

Cross bites

This is where one tooth (or several teeth) slots behind or in front of other teeth when most of the others are aligned correctly. This can be unsightly if it occurs at the front of the mouth, and it can also cause unnatural wear on the teeth that are misaligned. More often than not, a cross bite occurs with a top tooth slotting behind a tooth on the bottom row.

Here at CK Dental Practice in Bristol, we can effectively treat under bites, over bites and cross bites. There are many different treatments ranging from braces to full jaw operations, so if you are worried about your bite, or the bite of your child, get in touch to discuss what options are available for us to help you.

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Regulated by the CQC – what exactly does this mean?

 

You may have noticed that on our CK Dental home page there is a banner showing that we are regulated by the Care Quality Commission, commonly known as the CQC. This is something we’re proud of, especially as we are meeting all CQC national standards, but unless you work in a CQC-regulated profession, it may not be clear what this is. So, here’s what it means to be relegated by the CQC.

CK Dental and CQC regulation

The Care Quality Commission is an independent regulator of health and social care, whose remit is to ‘monitor, inspect and regulate services that provide health and social care’. As part of this remit, the CQC ‘make[s] sure [dentists, and other regulated professionals] meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care’.

 

Some professions receive CQC ratings, whereby different providers are ranked against one another. Dental practices are not rated and ranked in this way by the CQC.

Information via a variety of sources

The CQC uses different data collection methods to regulate dentists, including developing close working relationships with the practices themselves, gathering feedback from patients and receiving reports from CQC inspectors.

In consulting with the public, the CQC is keen that it gives a voice to those who are using the services. By encouraging open dialogue, they believe they can really get to the heart of what’s important to the service users, and ideally ensure that there is a ‘you spoke, we listened’ attitude taken to any thoughts, suggestions or concerns raised.

If there is a problem that is identified, then findings, recommendations and suggestions for improvement are published so that dental practices are fully accountable for how they run and the way in which they are managed. All findings and recommendations are available within the public domain, ensuring high levels of transparency.

Wider reading – have a flick through the report

As all reports are available in the public domain, if you’re interested in reading the full CQC report on CK Dental Practice, please click on the link here to see how we did.

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How long does a tooth crown fitting take?

dental crownA ‘crown’ is a cap that is fitted in top of an existing tooth to improve its overall appearance. Usually a tooth crown fitting is an option if there has been a problem with the tooth, for example if it has become damaged, broken or discoloured. Unlike a filling, a crown covers the whole of the affected tooth and sits seamlessly along the gum line.

A crown is usually recommended if the problem is too significant to be fixed with a filling or another more superficial method of fixing the problem.

A tooth crown fitting is usually done over at least two separate appointments with your dentist:

  1. On the first visit the preparatory work is done, which can involve shaping the existing tooth so that it is ready to receive the crown. Once this is done your dentist will then take a mould of the tooth so that a crown can be made that fits it perfectly. The mould is taken by inserting a ‘putty’ into your mouth and taking an imprint of your tooth. It might feel a bit strange, but it is a quick process and the putty doesn’t have an unpleasant taste. You’ll often be given a temporary crown at this stage to wear while your permanent crown is being crafted.
  2. The second appointment is generally a minimum of two weeks after the initial one. This is because it takes time to create a perfect crown – it needs to be perfectly shaped and match the colour of your other teeth. If you and your dentist are happy with the look and feel of the permanent crown then this will be attached with strong adhesive (‘dental cement’). This cement is extremely hard wearing and (assuming it is looked after correctly and does not suffer a severe knock/impact) your crown will be attached for many years.

So overall, considering the longevity of a crown and the improvement that it can make to your smile, the process to have a crown fitted is pretty quick.

If you have a damaged tooth and feel that a crown would improve how confident you feel about your teeth, get in touch with the team here at CK Dental in Bristol and we can arrange an assessment for you. If other fixes are not suitable (fillings, cleansing, whitening etc) then we can arrange for you to be booked in to have a crown fitted.

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Understanding what ‘receding gums’ are and what to do about them

receding gumsGum disease takes various forms and is actually very common. Many people suffer with it – in fact some of these people won’t even realise that their gums are in need of attention. The term ‘receding gums’ refers to the condition whereby the roots of your teeth start to become visible instead of being neatly covered by your gums.

What causes receding gums?

Gum can begin to recede when you don’t look after your oral health well enough and plaque is allowed to build up on your teeth. Plaque is a breeding ground for bacteria, and it’s these bacteria that get into the gums and cause problems. Other factors that can contribute to this condition include overzealous tooth brushing, using a toothbrush that has very hard bristles, smoking, diabetes and hormonal changes (such as those that occur during pregnancy and the menopause). Some of these causes can be managed, others are much more challenging to address.

Knowing what to look out for

The tell-tale signs that your gums are receding are if your teeth begin to feel more sensitive than normal (although this can be symptomatic of various things) and also if your teeth begin to look a bit longer. If this is caught early and the symptoms are not too serious then it can be treated.

Here at CK Dental Practice in Bristol, we would recommend an intensive professional cleaning treatment as the first step to see if this alleviates the problem. In some instances, the gums may have become infected, and if this is the case there will also need to be a course of antibiotics to rid your gums of the infection.

In very serious, advanced cases, gum surgery may be required to help rectify the problem.

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Teeth whitening pens – gimmick or great idea?

A recent advert for a ‘teeth whitening pen’ caught our attention, so here at CK Dental we have been investigating what this is. Is it something that people can really benefit from or it is simply a fad and something that is more of a gimmick than a good innovation? Let’s investigate….

Apparently the whitening pen is to be used as part of your daily brushing routine, and within three weeks your teeth can expect to be three shades whiter. The dental pen claims to contain a whitening gel that begins working straight away to lighten the appearance of your teeth: “Apply the whitening pen directly to teeth. No waiting, no rinsing. Its stay on formula deeply whitens your teeth.”

Is the tooth whitening pen safe for my mouth?

According to the manufacturers, this dental pen is completely safe and is very unlikely to cause any discomfort in your mouth. They say that if you have particularly delicate gums then you may experience some slightly tingling and a slight sensitivity, but this should pass quickly. If you apply the whitening pen to your teeth and this does cause pain or discomfort then stop using this straight away and if the pain does not subside, seek a dentist’s opinion quickly.

So does it really work?

Interestingly, consumer feedback seems to be positive, with feedback sites suggesting that then pen is indeed true to its word: “After using for 7 days I have noticed remarkable results and am very happy with the purchase. Will definitely recommend”. However, at CK Dental we provide an at-home teeth whitening system using trays that are worn at night. Our chief concern with the teeth whitening pens are that they just won’t be effective rather than dangerous.

These over-the-counter products typically contain a much lower percentage of  hydrogen peroxide than the tray system that dentists can provide. A tray will also keep the bleaching agent in contact with the surface of the teeth and away from saliva that can wash it away.

It is also important to remember  that even though inventions such as this may indeed be able to increase the whiteness of our teeth, this is no substitute for regular check-ups with your dentist and a good dental hygiene routine. If you’re brushing twice a day for at least two minute per brush then this will ensure that your teeth and gums are kept as safe as possible from harmful bacteria and plaque that can build up if overall dental hygiene is poor.

Whitening products such as a dental pen can indeed help with the shade of your teeth, but there are also other ways to try and keep teeth whiter. These include reducing intake of liquids that can stain your teeth (such as red wine, tea and coffee) and stopping smoking, as nicotine will also cause discolouration.

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Is vaping bad for your teeth?

vaping and gum diseaseLast month, the new Tobacco Products Directive came into power, including its strict new laws on e-cigarettes. Health campaigners welcomed this new legislation, due to concerns over the unknown, long-term side effects of vaping.

Although a report published last month by the charity Action on Smoking and Health suggested that half of all British vapers have now given up smoking cigarettes, there are still some worries about vaping. Not all e-cigarettes contain nicotine, most do and nicotine is a highly addictive drug. Also vapers tend to smoke more than somebody that smokes cigarettes so are inhaling more nicotine overall.

Vaping and your teeth

Smoking cigarettes cause a range of oral health problems including plaque and tartar build-up, inflammation and mouth cancer, and although these are mainly linked to the chemicals found in cigarettes rather than nicotine, but that isn’t to say that nicotine is free of harm.

Nicotine is a vasoconstrictor which means it constricts your blood vessels, meaning there is less oxygenated blood reaching the tissues of the mouth. As a result, it can lead to gum recession, gingivitis and periodontitis, commonly known as gum disease. It can also mask the signs of gum disease which makes it even more dangerous; typically, there is increased blood flow to the gums when you’re suffering from periodontitis and one of the first signs is inflammed gums that bleed when you brush your teeth, but this is less likely to occur if you have a nicotine habit.

Nicotine is also a stimulant so if you have a tendency to grind your teeth then you may find your more likely to start grinding them more intensely. And, last but not least, nicotine limits your ability to produce saliva, one of the chief causes of bad breath!

Dr Nigel Carter, CEO of the Oral Health Foundation, a charity dedicated to improving oral health in the UK, was one of the many health campaigners that praised these stricter regulations. “One of the biggest areas of concerns e-cigarettes remained that the industry operated without regulation. Given the sustained and rapid growth of the number of people switching to e-cigarettes, regulation was an absolute necessity and we’re delighted to see it finally being brought into force.”

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Evolution of the toothbrush

 

A toothbrush is such a common household staple that we completely take it for granted. Along with many bathroom accessories such as the hairbrush, the face sponge and the razor, these items exist to help make our lives and routines easier and better. But has anyone stopped to wonder who invented the humble toothbrush?

Early tooth and gum care

The first signs of man using an implement to clean teeth and gums date back thousands of years to 3500 BC, where historians have found evidence that people were chewing tatty-ended twigs to help keep their mouths clean. They used the frayed fibres within the twigs to help dislodge food from between teeth and prevent gum disease. Although this may sound far removed from our perceptions of a good teeth cleaning regime now, this is still practiced in some areas of the word today. In some areas of Africa, a tooth twig called a “datun” is used and can be surprisingly effective.

Bristol dentist evolution of toothbrushIn the fifteenth century, the Chinese first invented a bristled toothbrush. These resembled the modern toothbrushes we use today but were made from materials available then. The handle was something rigid, usually bone or bamboo, and the bristles were made from hair taken from a hog’s neck. These hairs were rough and thick, so essentially did the same job of removing food and bacteria from teeth and gums as the man-made toothbrushes we use today. Not the most appealing thing to put in your mouth though.

The modern toothbrush

Incredibly, toothbrushes with bristles made from animal hair survived all the way into the twentieth century, and it wasn’t until 1938 when they were replaced with nylon bristles. The French company DuPont de Nemours first thought to use nylon as a substitute for animal hairs and this approach has been used ever since. Nylon, although commonplace now, had only just been invented at this time, having been launched in 1935/36.

Interestingly, electric toothbrushes are a lot older than many people realise. They were pioneered in 1939 in Switzerland but were not readily available on the mass market until the 1960s. Nowadays people can choose whether they favour the manual or electric toothbrush and there are thousands of options available.

Here at CK Dental we have evaluated the benefits of brushing with electric versus manual toothbrushes (click here to read our post on this) and believe that both have merit. Providing you are using either type of brush correctly and spending an appropriate length of time brushing your teeth each day (we would recommend twice a day for at least two minutes per session) then this should help maintain healthy teeth and gums.

 

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Implications of knocked out milk teeth on adult teeth

baby teeth Bristol dentistsMilk teeth is the name given to the tiny teeth that young children get before their adult teeth come through. Milk teeth start to come through from as early as five to ten months old and stay with infants until they are around 5 or 6 years old before they gradually start falling out. This continues, with milk teeth being replaced by adult teeth for a number of years, with most children losing most of their milk teeth by around 10 or 12 years old. However, some people don’t lose their back milk teeth until well into their late teens.

Although the milk teeth are temporary, they are paving the way for the adult teeth that you’ll keep for the rest of your life. So what happens if one gets knocked out?

Prematurely lost milk teeth

If an adult tooth is knocked out, the advice is to put it back in as quickly as possible and to seek urgent dental help. If a milk tooth is knocked out it is important that you do not try and place it back into the hole it came from as it is impossible to tell how developed the adult tooth is underneath. If you try to re-insert a knocked out milk tooth then you can accidentally harm the adult tooth below.

If a child has lost a milk tooth prematurely, keep the tooth clean, don’t touch the root and store it in milk until you can get to the dentist – which you must do urgently.

If a milk tooth is knocked out before it is ready then it can have implications on the adult teeth below. Adult teeth will move in to fill spaces vacated by missing milk teeth, so if one gets knocked out and leaves a space earlier than it should do then this can lead to overcrowding of adult teeth later in life.

Overcrowded teeth can be fixed by a range of different orthodontic options like braces, but it is always better to try to avoid overcrowding occurring, rather than having to fix it later in life.

Here at CK Dental we advise taking great care of milk teeth as they set up your child’s mouth for the rest of their lives. Keep milk teeth clean, brush them regularly and if your child is interested in sports then encourage them to wear a gum shield to protect delicate milk teeth from taking a knock. Remember, if an accident occurs and a milk tooth is damaged, come to see us as quickly as possible so that we can help prevent further damage.

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