The Changing Face of Dentistry22 February 2018 Categories: Dentistry
By Dr. Antony Bellaries
This time of year often provides a period of reflection and an optimistic look to the future. This year it is the 70th anniversary of the inception of the National Health Service, formed as part of Clement Attlee’s (then Labour Prime Minister) “cradle to grave” welfare state reform policy in the aftermath of the Second World War. The NHS was the first universal health care system established anywhere in the world. Amongst other services, it provided greater access to dental care, in an otherwise dentally neglected population.
In the mid half of the twentieth century, dental disease was rife. The vast majority of dental treatment provided was tooth extractions and the provision of dentures. So what’s changed? A huge amount! However, below I have listed my top four significant changes to happen to dentistry over the last seventy years:
In the 1900s, prominent American dentists G.V. Black and Mckay investigated the effects of fluoride on teeth, however it wasn’t until the 1950s that it was scientifically proven that fluoride helps reduce tooth decay. The ‘Grand Rapids’ study involved adding fluoride to the water supply of a small Michigan town. The results were astonishing, reducing the decay rate in children by up to 60%.
As a result, Proctor and Gamble introduced fluoride toothpaste in the late 1950s and now almost every toothpaste on the market contains fluoride. Compared to the early half of the twentieth century, Fluoride has helped change dentistry into a prevention-orientated profession and surely must be the most significant advancement over the last seventy years.
Prior to the widespread use of dental implants, if a tooth was lost then most people either accepted the gap or had it replaced with a removable denture or a fixed bridge.
In the 1950s, Swedish physician Professor Branemark discovered the bone bonding properties of titanium and developed the first dental implants. Since the late 1990s there has been a huge increase in the provision of dental implants, which provide a predictable, conservative fixed solution for a missing tooth or teeth.
Implants are artificial roots that are gently placed into the jawbone where the tooth once was. As they are made of titanium, the implant not only has the ability to fuse to the bone, it is also bio compatible, which means that it will not be rejected by the body. Dental implants not only help create a beautiful smile, but most importantly, they help give patients a more secure bite and the ability to rediscover all of their favourite foods. Without question, dental implants are the gold standard in dentistry for replacing missing teeth, but they can also be used successfully to secure loose dentures and have literally changed patients lives.
Dental Hygienists and Dental Therapists
Periodontal (gum) disease is the biggest cause of tooth loss in the UK. It is a plaque related, chronic inflammatory condition of the structures surrounding a tooth. If left untreated, gum disease can lead to the teeth becoming loose and eventually falling out or having to be removed. It is often symptomless and as a result can go unnoticed for many years.
In the 1950s, dentistry was very much a “drill and fill” culture, rather than the preventative practice we see today. Dental hygienists and therapists now work in tandem with dentists to help prevent and treat periodontal disease and tooth decay. As a result, they have made a huge difference to the dental health of the population over the last forty years.
Minimally Invasive Dentistry
Back in the 1950s, “extension for prevention” often resulted in teeth being removed unnecessarily to create room for the restoration of a tooth. Up until recently, cosmetic treatments also involved aggressively shaving down the healthy tooth to prepare it for lab made restorations such as crowns or veneers.
At The Raglan Suite we are dentists first and foremost and although we want people to be happy with their smile, primarily we want the teeth to be healthy and remain healthy long-term. Modern, ‘minimally invasive’ dentistry focuses on preserving as much of the tooth structure as possible – i.e. the teeth and supporting tissue, through more conservative treatment options. By preserving and restoring healthy tooth structure (and ideally not affecting it all), any risk associated with treatment is dramatically reduced.
There are now exceptionally aesthetic ‘direct composite’ restorations that bond directly to the teeth, without the need for extensive tooth reduction.
The next seventy years?
Without a doubt, dentistry has changed beyond recognition over the last seventy years, but what does the future hold?
A big change that is already happening within dentistry is the impact of the digital age. Most dental laboratories and some dental practices have already embraced digital technology. Our on-site laboratory uses digital CAD/CAM technology to help design and construct our dental restorations. Laser printing and computer led milling is already here and will develop further in the future. Some practices, including The Raglan Suite, have replaced the uncomfortable mouthful of impression putty with state of the art, intra-oral digital scanners – a move which is greeted by huge relief from most patients.
It’s also entirely possible that at some stage in the future robots may be able to perform dental procedures on patients more accurately and at a significantly lower cost than a dentist. I will leave you with that scary thought!
Dr. Antony Bellaries BDS MFDS RCS (Ed) has practiced and studied extensively in the field of Endodontics (Root Canal Therapy) for over 20 years and is an active member of the British Endodontic Society.
I’m missing a front tooth! What next?23 January 2018 Categories: Dental implant Uncategorized
In the aesthetically driven world that we live in, missing a front tooth would be devastating. Rightly or wrongly, we are often judged by the way we look. This is why missing a front tooth is embarrassing and socially awkward. Ask yourself the question – if you lost your front tooth, would you leave the house?
The traditional approach to replace a single missing tooth
So what happens if you lose a front tooth in an accident or a sports injury, or are told that it needs to be extracted? It’s common knowledge now that dental implants are the best option to replace a missing tooth, but also often presumed that this procedure takes several months to complete. For example, the traditional approach involves removing the tooth and then waiting 6-12 weeks before the implant fixture is placed, and a further 3-4 months before the final crown is fitted. This tried and tested method works very well, however it does mean that you do not get your fixed implant tooth for at least 5-6 months.
Obviously, nobody wants a gap in their smile for that length of time, so dental implant surgeons can provide either a temporary denture or a temporary bridge. However, for many of our patients, the thought of wearing a temporary denture for up to 6 months is almost as devastating as losing the tooth in the first place! The problem with temporary bridges is that they are prone to pinging off.
Missing a front tooth – a new technique to replace it within 90 minutes
Because of these issues, a procedure has been developed, known technically as “immediate loading”. This is where the tooth is removed, an implant fixture is placed into the socket and a provisional dental crown is fitted, all in the same visit. That’s everything in around 90 minutes. A permanent crown then replaces the provisional crown after the jaw bone has healed, which is around 3 months.
This technique means that the patient leaves the dental clinic with a fixed front tooth that looks natural and not a temporary denture or bridge. In fact, assuming the patient has not been sedated, they can return to work the same day and none of their colleagues would be any the wiser!
This “immediate placement” is done under normal local anaesthetic and is completely painless. Recovery is also straightforward with minimal post-operative discomfort and bruising. Also, as there is no need to cut the gum, there is virtually no bleeding or need for any stitches. Although the procedure takes a little over an hour to do, the majority of this time is taken up making the provisional crown, which is mostly done outside of the mouth. The actual implant placement only takes 5 minutes!
The benefits of same day implants
A replacement tooth in a day may all sound too good to be true, however there are benefits to this technique and plenty of solid research to support it:
- It delivers a fantastic aesthetic result as the shape of the gum is much easier to preserve.
- Research suggests that the bone formed around the implant may be denser and of a better quality than an implant that is not immediately loaded.
The pictures below illustrate a recent case at The Raglan Suite. The first picture shows the broken root, which had to be removed. The other picture is of the provisional crown fitted to the implant at the same appointment. This will be replaced with the permanent porcelain crown after around 3 months healing.
It should be emphasised that not every patient is suitable for this technique. If the tooth that needs to be removed is very infected or the position of the gum is wrong before the tooth is removed, then the traditional staged implant approach may be needed.
Patients also have to be quite considerate of their new tooth for a few weeks after the initial surgery, to give the implant a chance to fuse to the bone. However, this is often a natural response by patients who prefer to avoid having to wear a temporary denture or bridge.
If you feel you may benefit from this procedure, please ask your dentist to refer you. Alternatively, you can contact The Raglan Suite direct to arrange a complimentary consultation with our Implant Dentist, Dr. Tim Doswell.
“Will my child need braces?”19 December 2017 Categories: Children's dentistry Orthodontics
By Specialist Orthodontist Dr. Megan Hatfield
We all watch our little ones carefully as they grow and that includes their dental development. Whether or not their child will need braces is one of the most common questions that parents put to dentists, partcularly if they have worn braces themselves as a child or currently need them. However, although parents may be looking for a simple yes or no answer, it’s not always so clear-cut!
As a Specialist Orthodontist, I monitor a child’s facial and dental growth, and detect problems with bones and the position of teeth at the ideal age to treat them. In some cases, problems are best treated early when there is a mixture of baby and adult teeth which can help simplify or avoid orthodontics later on. This might include a reverse bite (lower front teeth forward of the upper ones) or teeth not coming through in the right order. In other cases, it is best to wait until most or all of the adult teeth are through (from age 10-13) to help promote a successful treatment outcome.
Is it possible to enjoy your trip to the dentist?13 November 2017 Categories: Uncategorized
By Dental Surgeon Dr. Tim Doswell
Lets face it, not many people look forward to visiting their dentist. A trip to the dentist usually conjures up images of pain, anxiety, needles, drills and someone trying to have a conversation with you while your mouth is wide open! As dentists, we hear patients saying “it’s not you, I just don’t like dentists!” But with today’s technology and sympathetic techniques, is it possible to actually enjoy stress-free dental treatment?
It is my belief that a lot of dental fear originates from trips to the old fashioned “school dentist” who struck fear into a whole generation of patients with primitive techniques and lack of a kind bedside manner. So I would like to attempt to allay fears about dentists and outline some of the techniques we use at The Raglan Suite to make the treatment journey as comfortable as possible – perhaps even enjoyable!
Does having a tooth extraction hurt?10 October 2017 Categories: Dental Anxiety Tooth extraction
By Dr. Geoff Baggaley
One aspect of dental treatment patients are often anxious about is the possibility of a tooth extraction – when a tooth needs to be removed. The most common reasons that your dentist may feel it is in your best interest to have a tooth removed are:
- A tooth that has broken down and can’t be repaired
- Severe tooth decay
- An abscess
- Gum disease
- Crowded teeth – when extra space is needed prior to braces being fitted (orthodontic treatment)
- Impacted wisdom teeth – when growing wisdom teeth can’t break through the surface of the gum
FILLING A GAP WITH A SINGLE TOOTH DENTAL IMPLANT18 September 2017 Categories: Dental implant
By Dental Surgeon, Dr. Tim Doswell
The most common case we do at The Raglan Suite is fill a gap with a single tooth dental implant. There are a number of reasons why a tooth may need to be removed, such as extensive decay or infection, trauma, a root fracture, a failed post crown or failed root filling. As dentists, we always try to save natural teeth. However, if it is clear that the tooth can not be saved, a single tooth dental implant offers a long term, stable and predictable solution.
New Suction Denture15 August 2017 Categories: Dentures
NOT ALL DENTURES ARE THE SAME!
By Chris Egan (RDT Dip Lds, CDT Dip Rcs Eng)
In March 2017, I travelled to Japan to complete a course on the revolutionary new suction denture technique taught by Dr Jiro Abe. As a result, I am now qualified to provide Suction Effective Mandibular Complete Dentures (SEMCD) – the very latest in suction effective dentures.
One of the most difficult things to achieve in dentistry is suction and stability on a full lower denture. This new technique, which eliminates the problem of the lower denture lifting by creating effective suction, is rapidly becoming popular worldwide. After achieving great results on my own patients, I can understand why this new suction denture technique offers such a huge advantage over a conventional full lower denture system.
What is Peri-implantitis and how do we prevent it?25 July 2017 Categories: Dental implant
By Dr. Tim Doswell (BChD Dip.Imp.Dent.RCS(Eng) (Adv.Cert))
There is little doubt that the “gold standard” way to replace a missing tooth is with a dental implant. They are very durable and are completely independent of the adjacent teeth, which makes them by far the healthiest option, especially when compared to the more conventional tooth supported bridges. As a means of securing dentures, they come into their own; loose dentures which can barely bite through soft bread can be transformed into teeth which can bite into an apple!
Shopping around for a Dental Implant27 June 2017 Categories: Dental implant
By Dr. Tim Doswell (BChD Dip.Imp.Dent.RCS(Eng) (Adv.Cert))
There is little doubt that the “gold standard” way to replace a missing tooth is with a dental implant. They are very durable and completely independent of the adjacent teeth, which makes them by far the healthiest option, especially when compared to more conventional tooth supported bridges. As a way of securing dentures, they come into their own; loose dentures which can barely bite through soft bread can be transformed into teeth which can bite into an apple! No more fixative!
So it is little surprise that the demand for dental implants in Yorkshire and the UK is growing rapidly and in response to this growth, there are more and more dentists offering dental implants as a solution.
How do you cope with dental anxiety or dental phobia?19 May 2017 Categories: Dental Anxiety Uncategorized
By Dr. Geoff Baggaley
BChD DGDP(U.K.) RCS Dip.Con.Sed(Newc)
Dental anxiety is one of the body’s most powerful emotions. Anxiety in itself is a condition in which the body is preparing for something unpleasant to happen.
This ‘preparation’ is accompanied by both physiological and psychological responses. The psychological responses are often tension and a feeling of impending danger and lack of control. The physiological responses are perspiring, increased heart rate and a liability to faint.
A significant percentage of the population feel a high level of dental anxiety in response to visiting the dentist or having dental treatment. In reality, this means that people who suffer from dental anxiety or dental phobia will often limit their dental visits to emergencies only. The strength of this emotion dissuades them from going to the dentist for regular and essential dental check ups.