Regular check ups are the best way to ensure that your teeth remain healthy. It’s a cliche, but prevention is certainly better than cure. During dental examinations we will:
ask about your medical history
carry out a full examination of your mouth, teeth and gums, checking for decay, defective fillings, tooth infections, gum disease, tooth wear and mouth cancer.
ask about your general health and any problems you have had with your teeth, mouth or gums since your last visit
ask about and give advice on diet, smoking and drinking habits
ask about your teeth-cleaning routine and give you advice on the best ways to keep your mouth, teeth and gums healthy
explain any risks, as well as dental costs, of all treatment you may need
discuss with you when your next visit should be
Hygienist appointments are an important part of good oral health care. Our hygienists have two main objectives. Firstly they will remove plaque and calculus from your teeth using ultrasonic or hand scalers, then they polish your teeth to remove marks or stains. If a lot of plaque or calculus has built up you may need to have more than one scale and polish.
Secondly, and arguably more importantly, they provide you with advice and instruction as to how to care for your teeth. They can show you the best way to brush, how to clean in between your teeth, what your trouble spots are and how to remove the plaque which is continuously forming on your teeth.
When you eat or drink, the bacteria in the plaque turn the sugar from the food into acid, which may cause tooth decay. Plaque also causes gum inflammation (gingivitis) and can cause bone loss around teeth (periodontitis) if it is not regularly and thoroughly removed. Our hygienists will also advise you on which oral care products are the best ones for you to use.
Gum disease is caused by plaque; a sticky film of bacteria that constantly forms on your teeth. If left, to build up on and between teeth it irritates your gums and causes them to swell.
When this swelling happens, it can allow a space or ‘pocket’ to form around the tooth. As the amount of bacterial plaque increases, so does the depth of the pocket. This causes gums (and the supporting bone) to recede, exposing the root of the tooth. If left untreated, the pocket can become so large that the teeth can become loose and may even need to be removed.
There are two stages of gum disease:
Gingivitis means inflammation of the gums. It occurs when the gums around the teeth become very red and swollen. Often the swollen gums bleed when brushed. If left untreated, long-standing gingivitis can develop into severe gingivitis or periodontitis.
More teeth are lost through periodontitis than through tooth decay. Periodontitis is an advanced stage of gum disease where bacterial plaque destroys the gums, soft tissue and eventually the bone that holds the teeth in the jaw thus causing the affected teeth to become loose. If left untreated, the tooth may eventually fall out or need to be removed.
How is gum disease treated?
The best way to treat all gum disease, including periodontitis and gingivitis, is to prevent it with good oral hygiene. Good oral hygiene involves:
Brushing your teeth for 2-3 minutes twice a day (in the morning and at night)
Using an electric toothbrush if possible
Using toothpaste that contains fluoride (fluoride is a natural mineral that helps protect against tooth decay)
Cleaning between your teeth with floss or little brushes daily
Regularly visiting your dentist
Scale and polish
This removes plaque and calculus (hardened plaque) that can build up on your teeth; we have two friendly hygienists available for this.
Our hygienists will remove calculus from your teeth using ultrasonic or hand scalers, then they polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up you may need to have more than one scale and polish.
They will also advise on possible improvements to your brushing technique.
In some cases of gum disease or periodontitis, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth. Before having the treatment, you may need to have an anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planing.
If you have severe gum disease, periodontitis or ANUG, you may need further treatment, such as periodontal surgery. In some cases, it is necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how it is carried out. If necessary, we will also be able to refer you to a specialist.
Smoking is the most significant risk factor for gum disease and periodontitis.
Giving up smoking can greatly improve your oral health.
If you need help or advice about giving up smoking, call the free NHS Smoking Helpline on 0800 022 4322. Advice is available from 7am-11pm, seven days a week.
Your GP can give you information and advice about giving up smoking, and you can also visit the NHS Smokefree website.
Over time, despite our best intentions, our teeth succumb to decay and gum disease. We offer a variety of restorative procedures to ensure your mouth remains in good health.
These include White fillings, Crowns, Bridges, Dentures, Implants
Most people have fillings of one sort or another but today, because we are much more conscious of our smile, we can choose a natural looking alternative – the composite or tooth-coloured filling.
A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.
Crowns are used for several reasons:
As a protective cover for badly decayed teeth or fractured teeth
As a permanent restoration for teeth with large fillings
To correct minor problems in natural teeth like spacing and irregular shape or severe discolouration.
What are crowns made from?
Crowns can be made from a variety of materials; plastic, ceramic or metal alloys, a combination of metal and ceramic is also possible. They are used to maximise strength and simulate the appearance of natural teeth.
How are crowns made?
Firstly, we would conduct a thorough clinical examination, taking any necessary radiographs. Your suitability for crowns is assessed and we will advise you on material choices, treatment sequence and any other concerns you may have.
At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthetic) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.
At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.
How long do crowns last and how do I care for them?
Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.
Ceramic on the surface may chip or fracture. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.
Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.
Teeth straightening, Teeth whitening and Veneers are services that we offer to improve the cosmetic appearance of your teeth.
As we get older our teeth naturally age too and become darker. The food that we eat and drinks we consume play a big part in this too. Teeth Whitening (or ‘bleaching’) is a process where the tooth discolouration is ‘whitened’ to a lighter shade. It removes the staining agent through chemical means. It is a safe procedure when carried out under professional supervision. Treatment results usually depend on the severity of the discolouration. Both vital (i.e. live) and non-vital teeth (e.g. tooth with nerve removed) can be bleached and may take several visits to complete. It is not effective on dental restorations such as amalgam fillings, metal or porcelain crowns, etc.
‘Take home whitening’ is often the most appropriate way to whiten teeth and this involves an appointment to take impressions of your teeth which are sent to our laboratory who construct special trays, designed to fit your mouth specifically. A week later we fit the trays and instruct you how to use the bleaching kit. Whitening via this method usually takes between 2-4 weeks and can last for 6-12 months. However, it is easy to maintain your newly sparkling smile with top up kits available from our surgery.
Veneers are thin, custom-made shells crafted of tooth-coloured materials designed to cover the front side of teeth to improve the overall appearance of teeth. They are made of either thin plastic resin or porcelain and can be placed to:
Correct poorly formed or mildly mal-positioned teeth
Close gaps between teeth
Mask internal stains
Restore partially broken-down teeth
Tooth preparation is minimal and confined to the enamel. The final veneer is bonded to the tooth with tooth-coloured resin cement. Two visits are usually necessary to complete treatment; the first to prepare the teeth, take impressions and make temporaries, the second to remove the temporaries and fit the final veneers.
Patients should be aware that this is usually an irreversible process because it’s necessary to remove a small amount of enamel from your teeth to accommodate the veneer.
Clear Aligner is the ideal solution for protrusion and crowding of the front teeth. It is quick, very safe and great value compared to other teeth straightening systems. By using the Clear Aligner system, your front teeth can be quickly, but gently moved to create beautiful smiles in a matter of weeks. Many cases complete in 6-15 weeks, the appliance is also removable, you can take it out to fit with your lifestyle.
What is Clear Aligner?
Clear Aligner's are simple removable appliance used to align front teeth quickly and safely. It’s ideal as a stand alone treatment or to prealign teeth prior to further cosmetic options such as bonding or minimal veneers.
How does it work?
Clear Aligner's consist of a set of aligner's that are similar to a nightguard. They are worn during the day and night but are removed for eating. The aligners provide a gentle force that moves the teeth into the correct position. Once the teeth have adpated to their new position, the next aligner is worn, and so on, until the teeth are in their final, and correct, position.
Clear aligner's are a painfree and simple to use system that provides excellent and reliable results. Most cases are completed within 3-9 months.
Bridges are used to fill gaps where teeth have been lost. They are usually made from a precious metal alloy with porcelain bonded to it to give a good appearance. Bridges are custom fitted to each patient and are barely noticeable. Although a bridge may seem costly they can be a wise investment that will give many years of good service. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand-made jewellery.
A denture is a removable prosthesis used to replace missing teeth. Commonly referred to as ‘false teeth’, a denture is usually made of acrylic or a combination of acrylic and metal. A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function, and often improves a person’s appearance.
How long does it take to make dentures?
The duration of the treatment will vary depending on the complexity, but usually takes four or five appointments. After the initial visit of examination and diagnosis, the subsequent visits will include taking impressions of the mouth, bite registration, try-in of the denture, fitting and review.
What to expect?
New dentures always feel strange when first placed in your mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies from person to person and often time and experience are essential before dentures can be worn comfortably and function effectively.
Useful suggestions to help you to adapt to the new dentures:
Eating – Eating will take a little practice. Starting with soft foods and cutting food into small pieces will help. Chew slowly using both sides of your mouth at the same time to prevent dentures from tipping. Once you become accustomed to chewing, include other foods until you return to your normal diet.
Increased salivary flow – You may experience an increase in salivary flow when the dentures are first inserted. This is a natural response of the salivary glands that will return to normal after a few weeks. You can improve the situation by swallowing more often.
Speech – New dentures may alter your speech initially. Pronouncing certain words may require practice. Reading out loud and repeating troublesome words will speed up the adaptation process. This problem rarely persists beyond two weeks.
Sore spots – Minor irritation caused by surface irregularities or pressure spots on the denture-bearing areas are quite common. We will relieve the discomfort by adjusting the denture surface. Stop wearing the denture if the irritation is very painful. Please get in touch immediately.
When Is Root Canal Treatment Needed?
The crown of the tooth is made up of the hard, white, enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves and extends from the crown to the tips of the root or roots.
Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. The pulp can be infected or inflamed due to either deep decay or an extensive restoration that involves the pulp, trauma that causes cracking or fractures the tooth, excessive wear of enamel and dentine exposing the pulp, and sometimes as a result of severe gum disease.
Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth. On the other hand, there may be no symptoms at all. If pulp inflammation or infection is left untreated, it can eventually cause pain, swelling and loss of the supporting bone.
What Are The Advantages Of Root Canal Treatment?
Root canal treatment saves teeth that would otherwise have been extracted.
After root canal treatment the tooth is pulp-less i.e. it has no vital tissues within. However, there are vital tissues surrounding the root e.g. the gum, periodontal membrane and supporting bone. A root canal treated tooth usually requires a crown or onlay to restore it to prevent fracture of the tooth or reinfection thus allowing the tooth to function normally and be maintained with routine dental care and oral hygiene measures.
Is Root Canal Treatment Painful?
Root canal treatment procedures are relatively comfortable and often painless as the tooth is anaesthetised during treatment. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking mild analgesics or painkillers available over the counter at the pharmacy. However, if the pain persists and is severe, or a swelling occurs, you should contact your dentist.
Properly diagnosed, designed, and custom fabricated mouthguards (gumshields) are essential in the prevention of athletic oral/facial injuries.
A properly fitted mouthguard must be protective, comfortable, resilient, tear resistant, odourless, tasteless, not bulky, cause minimal interference to speaking and breathing, and have excellent retention, fit, and sufficient thickness in critical areas.
Dental injuries are the most common type of orofacial injury sustained during participation in sports. Teeth that are knocked out and not properly preserved or reimplanted may cost many thousands of pounds, hours in the dentist’s chair and the possible development of other dental problems such as periodontal disease in a lifetime.
Over 90% of the mouthguards worn are bought at sports shops. The other 10% are of the custom made variety diagnosed and designed by a health professional.
Unfortunately, the word “mouthguard” is universal, generic and includes the good, the bad and the ugly.
The advantages of custom made mouthguards are:
Negligible deformation when worn for a period of time.
The ability to thicken any area as required as well as place any inserts that may be needed for additional wearer protection.
As health professionals, we highly recommend the custom made mouthguard, for the very best in oral/facial protection.
We encourage parents & guardians to bring their children to the dentist every 6 months as soon as they get their first teeth. Children under the age of 5 are treated free if their parent/guardian is a regular patient.
This allows us to familiarise children with our team, environment, sights and sounds of the Dental Practice. Almost all of our team are mum’s who are used to and are very comfortable dealing with children. We’re skilled at putting them at ease and explaining things using language appropriate to the child’s age. By coming early, and regularly, they grow up, as many of our patients have, with no fear of the dentist at all.
Visiting the dentist regularly allows us to offer advice and identify any potential problems as early as possible, and if necessary to take preventative action.
Deep pits and grooves can be found on the chewing surfaces of the back teeth. Such pits and grooves are termed ‘fissures’ and are usually so narrow that toothbrush bristles and streams of water are not able to clean them effectively. These form a favourable environment for bacteria to flourish, often resulting in tooth decay.
What can be done?
Fissure sealants can be applied to your tooth to seal off pits and fissures from the oral environment. Sealing the tooth surface protects fissures from bacteria and fermentable foods like sugar and starches to prevent decay from starting deep within the fissures. Any tooth with pits and fissures can be treated, provided the surface to be filled is sound and has not been previously filled. The most commonly treated teeth are the molars and premolars.
How are sealants applied?
Sealants are applied easily and painlessly, no drilling is required. The tooth is properly cleaned, treated, dried, and the sealant applied. A very bright light is then used to harden the sealant to form a protective coating over the tooth.
Tips for Children
At what age should I start brushing my child's teeth?
Start brushing when a child’s first tooth appears.
When should children brush their teeth?
Children should brush twice a day with a fluoride toothpaste, always before bedtime and on one other occasion, typically the morning. Brushing at a set time, or as part of getting ready for school helps establish a routine which helps with this. Tooth brushing removes plaque from the teeth surfaces, the fluoride within the toothpaste helps to keep teeth strong and fight tooth decay.
Parents/Guardians should assist with their child’s brushing until you think they are brushing all of their teeth each time, are brushing for a minimum of two minutes and twice a day
Which toothpaste Should I use?
For ages 0-2 use a smear of toothpaste containing at least 1000ppm (part per million) fluoride.
For ages 3-5 use a pea-sized amount containing between 1300ppm and 1500ppm fluoride
For 6 years + use an adult tooth paste or children’s toothpaste containing between 1300ppm and 1500ppm fluoride. Use a small pea sized amount to brush half of their teeth, let them spit and then use another small pea sized amount to brush the other half of their teeth and spit again.
For all children and adults: SPIT out the toothpaste BUT DO NOT RINSE. This allows a very small amount of toothpaste to remain on the teeth surfaces
What toothbrush should my child use?
The right toothbrush can help to get your child excited about brushing. It is important to use an age appropriate brush.
Ages 0-2: small soft manual brush Ages 3-5: small soft manual brush or a rechargeable children’s electric toothbrush Ages 6+: small to medium sized manual tooth brush or a rechargeable electric toothbrush.
We would recommend an Oral-B electric toothbrush. We are not sponsored or incentivised to say this, our dentists have reviewed all of the research and believe this type of toothbrush to be the best. Electric toothbrushes don’t need to be expensive, our dental team can advise you on these if required.
Why is sugar so bad?
The main cause of tooth decay is sugar in the diet. It is not only the amount of sugar that is important but also how often it is eaten or drunk. The more often your child has sugary foods or drinks, the more likely they are to have decay.
It is important to have sugary foods ideally just at mealtimes. If you want to give your child a snack, try to stick to cheese, vegetables and fruit. Try to limit how much dried fruit (particularly raisons) you give as they are high in sugar.
Don't give them drinks containing sugars, including fruit juices, between meals. Give them water or milk instead. For babies, don't add sugar to their drinks, or to foods when you introduce them to solids. It is also worth remembering that some processed baby foods contain quite a lot of sugar. Try checking the list of ingredients: the higher up the list sugar is, the more there is in the product. Generally anything ending in ‘ose' is a sugar, for example: fructose, glucose, lactose or sucrose.
If your child needs to take any medication, please remember to check with your doctor or pharmacist that you are being prescribed sugar-free medicines at all times.
After the age of one, introduce a golden hour before bed when your child has nothing to eat or drink except for water. Their teeth should be brushed just before they go to bed so the last thing in the mouth is fluoride toothpaste.
We understand that for many patients, attending the dental practice can be a nerve wracking experience and some patients can feel anxious. This can be for several reasons, some examples could be:
It’s their first appointment so they are unsure what to expect.
They haven’t been for some time or have had a previous bad experience.
Fear of being ‘told off’ about their oral health.
We believe we’ve created a very welcoming team at Caversham Heights. Our dental team’s number one aim is to try and put you at ease, to help you feel calm and relaxed. This begins with a warm welcome from our reception team, and extends through to our dentists, nurses and hygienists.
Our dental team are well versed to dealing with nervous patients and have developed many techniques to try and relax patients. Their character and excellent chairside manner is usually able to calm patients and most nervous patients leave with increased confidence about their next visit.
We don’t push unnecessary treatment (in-fact quite the opposite), we’re here to help with your oral heath, we won’t ‘tell you off’ or talk down to you. We want to make your visit as relaxed as possible and to build long lasting and trusted relationships.
If you do have a particular element that you are nervous about please speak to our team and we will do our very best to discuss this and to hopefully reassure you about your visit.
Please call us on 01189474848 or complete the contact form to see how Caversham Heights Dental Practice can provide the dental service that you deserve.