General dentistry

Dental Examination

Dental examination at Surbiton Dentist

dental examination is surbiton kingston

What happens during a visit to the dentist?

 Once you have decided that you would like to be a patient of the Surbiton Smile Centre, your next step would be to book a check-up, earlier rather than later and preferably before any problems arise. On your first visit to us, we will take a full health history. On subsequent visits, if your health status has changed, it would then be important to inform us of any alterations to your medications or treatments that you might be undergoing.

A full dental examination will be carried out as follows:

 Our Dentist will perform a thorough clinical examination of your teeth, gums and mouth, looking for any signs of disease or other problems. She will also take some X-rays, especially on your first visit.

Digital -X-rays

Depending on your age, risks of disease and symptoms, it is very likely that our dentist will recommend taking an X-ray. X-rays can diagnose problems otherwise unnoticed, such as damage to jawbones, impacted teeth, abscesses, cysts or tumours, and also notification of decay between the teeth. The Surbiton Smile Centre uses X-ray machines that emit virtually no radiation, in other words, no more than you would receive from a day in the sun or a weekend watching TV.

As a precaution,if you are pregnant, you should inform us, as X-rays should only be taken in emergency situations for expectant women.

Our dentist may want to take a Panoramic X-ray. This type of X-ray provides a complete view of your mouth, in one single image, the upper and lower jaws, your Temporomandibular (TMJ) joints, all your teeth, the nasal area and sinuses. This helps us to understand your bite and the relationship between your different teeth.The Surbiton Smile Centre is equipped with this latest technology.

Remember our goal is to help you maintain your good oral health and to prevent problems from becoming serious, by identifying and treating them as soon as possible. Some of the following issues will be discussed with you if they are found to be relevant:

  • Oral Hygiene
  • Tooth Decay
  • Gum Disease
  • Orthodontist Treatment (if required)
  • Gum disease Treatment (if required)
  • Teeth whitening (if required)
  • Temporomandibular joint problems (TMJ)
  • Broken fillings, or poor fitting fillings and crowns
  • Root Canal Treatment (Endodontic)
  • Cosmetic Treatment (if required)
  • Implant Treatment (if required)
  • Denture Treatment (if required)

After a full dental examination, our dentist will provide you with a full treatment plan and estimate for any treatment you may require.

Please be rest assured that most dental visits are just of a check-up nature. Regular check-ups (ideally every six months) will help your teeth stay cleaner, last longer and can prevent painful problems from developing.

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White fillings / composite bonding

White fillings, also known as composite bonding, is considered a direct technique toward improving your smile. White fillings are used for teeth that are slightly cracked, chipped, discoloured or misaligned.

Dr. Soltani, our Surrey cosmetic dentist will coat your teeth with a thin layer of acrylic resin and sculpt it into the desired shape. The acrylic is matched to the colour of your natural teeth. The results will be amazingly natural.

These fillings can often be completed in a single visit and can significantly change the appearance of your smile. The result is similar to porcelain veneers, but less expensive.

However, plastic resin is not as strong as tooth enamel and is more likely to stain, chip or break than natural teeth. Veneers are a more long-lasting solution for chips and gaps.

White fillings
White fillings

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Root canal treatment / endodontics

Endodontic therapy, also known as "root canal" treatment, is necessary when the pulp of the tooth is injured and cannot naturally return to a healthy state, and has to be removed. Some people experience symptoms of pulp damage immediately, while others experience no discomfort for years.

The only alternative to root canal treatment is extraction. This is biologically costly and may be less desirable. When teeth are lost they require artificial replacement such as fixed or removable bridges or dental implants.

Why you need root canal treatment?

The pulp is the soft tissue found within the canal spaces of the tooth, and largely consists of tiny blood vessels and nerves. There are many potential ways tooth pulp can become diseased or necrotic. Deep fillings, decay, trauma and periodontal disease are common causes.

 

Signs and symptoms:

Indications for treatment include:

  • Prolonged sensitivity to heat or cold
  • Tooth decay - if a tooth is very rotten, its nerves and blood vessels can die, leading to a painful abscess
  • Discoloration of the tooth
  • Swelling of the gum adjacent to the tooth
  • Tenderness of the tooth especially to biting or adjacent gums. Sometimes there are no symptoms and the first sign of a problem maybe radiographic evidence corroborated with additional diagnostic testing by the dentist

 

After root canal therapy is completed, a crown is usually placed over the treated tooth as a means of ensuring its future integrity. A tooth that has been subjected to extensive restoration and/or root canal therapy is invariably weakened in the process. The crown functions as a protective "shell," covering the tooth to help prevent it from cracking and breaking. It is important that the patient understands the value of this protective crown. The patient may jeopardises his or her entire investment without it. We urge all patients to follow this procedure when recommended.

Revision of root canal therapy:

Even though endodontic treatment is one of the most successful and predictable procedures in modern dentistry, failures can occur. Some indications of failure include swelling, soreness or the persistence of abscess at the root tip as identified in an X-ray. When this happens, a root canal revision procedure, also referred to as "retreatment," may be warranted.

Reasons for root canal retreatment:

  • Retained microorganisms (bacteria) in the root canal
  • Breakdown or corrosion of root canal filling materials
  • Contamination from decay or leakage from a failing restoration
  • Inoperable canals because of calcification or unusual anatomy
  • Sometimes tissues fail to heal for unknown reasons

Although retreatment is technically more difficult than the original root canal, it can usually rescue a failing condition without having to consider surgery. We at Surbiton Dentist especially well equipped to handle these difficult conditions because of our additional training and experience.

Endodontic surgery:

Conventional root canal treatment is not always sufficient to correct every patient's condition. Occasionally, endodontic surgery is required. This is because a previous treatment has deteriorated or because anatomic considerations such as the shape of the tooth or canal space make the traditional root canal treatment especially difficult to complete.

Sensitivity:

If you experience sensitivity following a root canal session, we recommend you take an anti-inflammatory drug such as ibuprofen to reduce inflammation, which will in turn reduce pain. You may also want to apply ice to the outside of your face next to the tooth, keeping the head elevated.

Medication allergies:

If you are allergic to specific medications, please be sure to inform your dentist. If you notice sudden rash, nausea, sudden swelling, shortness of breath, dizziness or any other unusual symptoms after the use of the prescribed medications call the practice immediately.

Note:

Under no circumstances should you apply heat to the outside of your face. Consistent medication is the key to comfort. It is essential to follow your dentist orders by taking prescribed medications to alleviate pain and to help prevent or fight infection. If discomfort lasts more than a few days or if you have severe pain or swelling, call our office. We will suggest medication or other steps to make you more comfortable.

 

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Cerec Crowns / Inlay / Onlay

A CEREC machine is a piece of dental equipment, that you will see standing in the corner of our surgery in the Surbiton Smile Centre. It allows us to offer a service that only takes a couple of hours such that our patients can have a new crown modelled and fitted, all on the same day.

The CEREC machine uses the latest CAD (Computer Aided Design) and CAM (Computer Aided Manufacturing) technology to create a CEREC crown for you in just one visit. This state-of-the-art digital mapping technology charts the inside of your mouth and then takes a computer image of your tooth, which gives very detailed and accurate measurements. Your new crown is milled out of a solid ceramic block in our surgery and bonded to your tooth after final preparation from our Dentist. It is really that simple! So, your tooth is encased by the new crown creating a permanent protective covering.

What is the typical process to get a Dental Crown?

Before using CEREC technology, a patient visiting us for a crown was faced with a time consuming and cumbersome process:

  • After an oral examination, that will include dental X-rays and other dental imaging we determine whether a crown or inlay is needed.
  • During the first appointment, the tooth is numbed and shaped so that the crown can fit onto the preparation.
  • Then a mould or an impression of that preparation is made.
  • Once this is done, the impression or the mould is sent to an outside lab to make the crown.
  • In the meantime, the patient is given a temporary crown, which is worn for one to two weeks until the laboratory completes the fabrication of the original crown. Unfortunately, the temporary crown is often weak and comes off easily, which can add embarrassment to a patient’s frustration.
  • During the second appointment, the actual crown is finally placed.

What is the typical process to get a CEREC Crown?

  • After your oral examination and necessary digital X-rays, our Dentist will determine if a crown is necessary.
  • If a crown is needed our Dentist will reshape your tooth, to allow the fitting of the crown.
  • An intraoral camera is then used to take a digital image (or impression) of your tooth.
  • Based on this image, the CEREC software creates a virtual model of your tooth. Our Dentist then uses this prototype to construct the tooth restoration on the screen and then passes the
  • finished construction wirelessly to an in-surgery milling machine (The CEREC machine).
  • A high-grade ceramic, plaque-resistant material is then milled, or manufactured, to complete your new crown by the CEREC device. If you like you can even watch this in action!
  • Afterwards our Dentist will add some finishing touches to the restoration, and then place the crown on your tooth. Usually very little bite adjustment is needed. Sometimes none at all
  • compared to crowns made in an off-site laboratory.
  • Your CEREC Crown (Inlay or onlay)will be perfectly sized, shaped, and shaded to complement your existing teeth and individual smile for optimal form and function.

This ‘same day crown’service offers an affordable solution for anyone wanting to minimize their time at the dental surgery. Some patients ask if the CEREC Crown is as durable as a conventional crown, made in the dental laboratory. There is no difference in the durability of these crowns.

Bear in mind too that this type of restoration can be matched to the colour of each your natural teeth, so the CEREC crown will look beautiful and natural. In fact, no one will notice that you have a crown.

With twice a day brushing and daily flossing, teamed up with six monthly dental examinations and Hygienist cleanings, these restorations will last for years and give you a confident, aesthetically pleasing smile.

Do you want to know more?

If you feel that you are in need of the restorative or cosmetic dental services to achieve the smile you have always dreamed of, then contact us at The Surbiton Smile Centre. Dr Simin Soltani (our Principal Dentist) will recommend the best treatment for you, based on thorough evaluation. You never know, CEREC technology may be the perfect fit for you!

 

CEREC

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Tooth extraction

Tooth extraction involves having one or more teeth completely removed from your mouth by a dentist. This can be done at one appointment or over a few sessions (if more than one tooth needs to be taken out). You may or may not want, or need to have the teeth replaced. Your dentist will explain all the options available to you.

There are a number of reasons why your teeth may need to be extracted. Some of the most common reasons include:

  • Severe gum disease (periodontal disease) - when bacteria build up on your teeth and damage the bone that holds them in place, the teeth may become loose.
  • Tooth decay - if a tooth is very rotten, its nerves and blood vessels can die, leading to a painful abscess.
  • A broken tooth that can't be repaired.
  • Crowded teeth - if you have a small jaw or lost your milk (baby) teeth early, your teeth may be crooked and you may need to have one or more removed so that the rest can be straightened.
  • Wisdom tooth problems - if there isn't enough space in your mouth for your wisdom teeth they may become impacted (stuck behind the tooth in front) and need to be removed.

What are the alternatives?

If you don't want to have your tooth taken out, sometimes alternative treatments are available at Surbiton Surrey dentist.

Painkillers or antibiotics may ease any pain and swelling, but these will just relieve your symptoms in the short term and won't get rid of the underlying problem.

If you have crooked teeth, it's sometimes possible to have them corrected without extractions. An orthodontist (a dentist who specialises in straightening teeth) will be able to explain the treatment options available to you.

If an infected tooth is identified early enough, you may be able to have root canal treatment instead of having the whole tooth removed.

Preparing for a tooth extraction

Your dentist will ask about your dental and medical history. It's important that you mention any medical conditions, allergies or recent operations. You should also tell your dentist if you use an inhaler or are taking any medication, including the contraceptive pill or over-the-counter medicines such as aspirin. If you're particularly anxious about having treatment, your dentist may give you a sedative - this relieves anxiety and causes temporary relaxation without putting you to sleep.

In certain situations, you may need to go into hospital and have treatment under general anaesthetic. This means you will be asleep and feel no pain while your tooth is being removed.

What happens during a tooth extraction?

So that you don't feel any pain during or immediately after the procedure, the Surbiton Smile dentist will give an injection of local anaesthetic into your mouth, which completely blocks feeling from the area. After the anaesthetic has taken effect, the dentist will widen the socket (the area your tooth sits in) using a tool called an elevator or a pair of special forceps and move the tooth from side to side until it is loose enough to be removed completely. During the procedure you will feel some pressure in your mouth and hear some noise. You should not feel any pain. In more difficult and rarer cases, your dentist may not be able to reach the root of your tooth, which in that case a small cut is made in your gum. If necessary for the Surbiton dentist then drill away some of the bone so the tooth root can be removed.

What to expect afterwards

There will be some bleeding and your dentist may put in stitches. After the extraction, you will be given a piece of soft padding to bite on to stop the bleeding.

If you have had your tooth removed under local anaesthesia, you will need to stay at the dental surgery until the bleeding is controlled. This will probably take about 10 to 15 minutes. You may need pain relief to help with any discomfort as the anaesthetic wears off.

If you have had general anaesthesia or sedation, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you until the next day. Both sedation and general anaesthesia temporarily affect your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents until your dentist tells you it's safe. This will be at least until the next day. Wait until the local anaesthetic has worn off before having hot food or drinks - you might burn your mouth or chew the inside of your cheek while it's still numb. Once you regain some feeling, stick to lukewarm, soft food and try not to chew in the part of your mouth where the tooth has been removed. Try not to drink alcohol or smoke for the first 24 hours after the extraction - this may cause further bleeding. It's best not to rinse out your mouth or do any exercise for the first few hours after the extraction. This is because any blood clot that may have formed could be disturbed and the bleeding could start again. After the first few hours, it can be helpful to rinse out your mouth with salt water (half a teaspoon of salt in a glass of warm water) a few times a day.

It's important to keep your mouth as clean as possible so continue brushing your teeth after the extraction. If you had stitches during the procedure, you may need to go back to your dentist to have them removed. Otherwise you probably won't need a follow-up appointment. Smoking is not permitted for the first seven days after extraction, because smoking prevents the healing of the socket, which will be very painful and it will be costly to stop the pain.

You may have some discomfort and swelling for a few days afterwards, and your jaw may feel a little stiff. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always follow the instructions in the patient information leaflet that comes with any medicine and ask your pharmacist for advice. It's normal for you to notice some slight bleeding for the first couple of days after having a tooth removed. Rinse the excess out of your mouth and then bite down on a clean pad of material such as a handkerchief. If the bleeding doesn't stop within 15 to 30 minutes, contact your dentist for advice.

Complications

Tooth extraction at is common procedure and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side effects and the risk of complications.

While such complications are not common, some people may develop some, after extraction of teeth. Usually, complications arise in patients with difficult root morphology or strong supporting tissues. Likewise, teeth with weak crown surfaces, with deep caries and brittle teeth may also cause complications during or after the extraction procedure. While some of the complications arise during the procedure itself, others develop after the procedure, sometimes, within a few days too. Contact your dentist immediately if you experience:

  • Prolonged bleeding
  • Swelling
  • Severe pain
  • High temperature (fever)
  • Dry socket

One of the most common problems that can occur after tooth extraction is called a dry socket. This is when there is no blood clot so the tooth socket doesn't heal as quickly as expected. This usually happens within two to four days after the extraction and is extremely painful. Call your dentist who will rinse the area, put a dressing on it, may give you antibiotics and keep you under observation until the problem is resolved.

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Mouth sores

The mouth can develop many different types of mouth sores. These maybe painful, perhaps unsightly and may just be due to the fact that you are run down and tired. Some might be the sign of something more serious. If your mouth sore does not disappear within 10 days, you should visit the Surbiton Smile Centre so that we can advise you. If you are aware that you have an infection, then again consult us as soon as possible so that we can avoid complications.

Signs and Symptoms

Burning Mouth: The Burning mouth syndrome is a painful burning sensation that occurs in the mouth, tongue, palate, gums, inside of cheeks and throat areas. It can persist for months or years.

Candidiasis (Thrush): Thisis a fungal infection that occurs in the mouth or throat due to an overgrowth of yeast. Symptoms include: white spots inside the mouth or on the tongue, sore throat, difficulty swallowing, and cracking at the corners of the mouth (cheilosis).

Canker Sores: These sores often develop as small white or yellow centre lesions with a red border. They develop in the mouth on the tongue, inside cheek areas, lips, gum line and throat area. They are not contagious. Canker sores may occur as one sore or several.

Cold Sores (Fever Blisters): These appear as clusters of red, raised blisters outside the mouth—typically around the lips — although they can develop under the nose or under the chin. They are highly contagious and can break open, which allows the fluid in the blisters to leak out and spread the infection. They typically scab over until they heal.

Leukoplakia: This is a white or grey area that develops on the tongue, inside of the cheek or on the floor of the mouth. Leukoplakia is not painful or contagious.

Sialadenitis: This is a bacterial infection that occurs when there is an interruption of salvia flow from the salivary gland to the mouth. The gland is firm and can be painful with swelling of the area. If the infection spreads, you may experience fever, chills and malaise.

Tooth Abscess: This occurs when there is a bacterial infection in the nerve of the tooth. Symptoms of a tooth abscess include severe toothache with pain, sensitivity to hot and cold beverages or food, fever, and swollen lymph nodes.

 

Causes for Mouth Sores

Mouth sores can be caused by bacterial, viral or fungal infections, a loose orthodontic wire, a denture that does not fit, or a sharp edge from a broken tooth or filling.

Burning Mouth: The cause for this is not clearly understood. Some common causes may be: nutritional deficiencies, dry mouth, oral thrush, diabetes, hormonal changes, certain medications, and anxiety or depression.

Candidiasis (Thrush): This is caused by a fungus and typically develops when the immune system is weakened. Some medications, such as steroid or cancer therapies, may increase the risk of developing this infection. Antibiotics also increase the risk of developing infection because they can alter the normal balance of bacteria in the mouth.

Canker Sores: In some cases, the exact cause of a canker sore is unknown, but trauma or injury to the mouth or oral soft tissues may be the culprit. Other possible causes are food sensitivities, spicy, salty or acidic foods, vitamin B deficiency, hormonal shifts and stress.

Cold Sores: These are caused by the herpes simplex virus (HSV)-1 and are highly contagious. The initial infection with the virus can be accompanied by cold or flu-like symptoms and can cause painful oral lesions. There is no cure for the herpes virus. Reoccurrence can occur when an individual has a fever, menstruation, fatigue, stress or exposure to the sun.

Leukoplakia: These can result from irritations that occur from fillings, crowns or ill-fitting dentures. Other causes include tobacco use, HIV/AIDS and the Epstein-Barr virus. Sometimes, leukoplakia is associated with oral cancer, so it’s important to see your dentist, if you notice any of these patches developing. Our dentist may recommend a biopsy if the patch appears suspicious.

Sialadenitis: This is a bacterial infection of a salivary gland and can be acute, chronic or recurrent. Pus may drain through the salivary gland into the mouth. These infections occur most often in the parotid gland.

Tooth Abscess: This occurs when bacteria invade the dental pulp, the nerve and blood vessels of the tooth. Bacteria enters the pulp and spreads to the root. The bacterial infection causes pain, bad breath and inflammation. The tight space, within which the inflammation occurs, forces pus into a pocket (abscess) at the tip of the root.

 

Diagnosis of Mouth Sores

At the Surbiton Smile Centre, we will carefully examine the inside of your mouth, tongue and glands. Although many of these sores and infections may be harmless, some are not, so it is important to talk to us about the problems you are experiencing and feeling in your mouth.

Mouth Sores Prevention: Regular check-ups will increase the likelihood that suspicious sores and infections in your mouth are found early. In between visits, get to know the signs, and what to do, if you find anything suspicious.

Treatment of Mouth Sores: Burning Mouth: Medications can be prescribed to alleviate underlying causes of burning mouth syndrome. You can take certain actions to reduce your symptoms by avoiding alcoholic beverages, tobacco use, acidic and spicy foods and beverages, and stress.

Candidiasis (Thrush): This is treated with a prescription antifungal medication. It is most commonly seen in HIV/AIDS patients, after cancer therapy, organ transplant, diabetes and in denture-wearers.

Canker Sores: These usually heal without treatment one or two weeks after they break out. However, if they are painful; so over-the-counter topical anaesthetics and antimicrobial mouth rinses may provide temporary relief.

Cold Sores: Cold sore blisters usually heal by themselves in about one week. Over-the-counter topical anaesthetics can provide some pain relief. We may prescribe antiviral drugs to reduce the healing time for these sores.

Leukoplakia: Treatment begins with identifying the source of the irritation. Once the irritant is removed, which may mean smoothing a rough tooth surface, repairing a dental appliance or quitting tobacco use, the patches should disappear.

Sialadenitis: Hydration is the first step in this treatment. Then a course of antibiotics is given to destroy the bacteria. If the infection does not improve, surgery may be needed to open and drain the salivary gland.

Tooth Abscess: Root Canal Treatment can eliminate the infection and save the tooth. If the tooth cannot be saved, we will extract the tooth and drain the abscess to eliminate the infection. An antibiotic will be prescribed to stop the bacterial infection.

 

Related Conditions

While most mouth sores and infections can be treated and/or managed effectively, some are more serious and in rare instances could be a sign of oral cancer. Be on the lookout for a white or reddish patch inside the mouth, as well as a lump or thickening of the skin or mouth lining. Other symptoms include tongue pain, loose teeth, jaw pain, difficulty in chewing or swallowing, or even just a sore throat. Oral cancer can occur anywhere in the mouth, including the gums, lips, tongue, roof of the mouth, floor of the mouth and inside lining of the cheeks and the throat.

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Dental Crowns & Bridges

Both crowns and most bridges are fixed prosthetic devices. Dentures, for example are removable devices which you can take out and clean daily. On the other hand,crowns and bridges are cemented onto existing teeth or implants and can only be removed by a dentist.

How Do Crowns Work?

A crown(sometimes called a cap)is used to completely cover a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve the tooth’s appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the colour of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive. At the Surbiton Smile Centre, we may recommend a crown to:

  • Replace a large filling when there is not enough of the tooth left
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discoloured or poorly shaped tooth
  • Cover a tooth that has had root canal treatment

Case Study A:

Ceramic crown with E-Max ceramic material from IVoclave Vivadent (Swiss company) By Dr Simin Soltani.

 

 

 

How Do Bridges Work?

A bridge may be recommended if you are missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges span the space where the teeth are missing. They are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, there is a choice of material for bridges. Our Dentist will help you decide which to use, based on the location of the missing tooth (or teeth), the function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the colour of your natural teeth.

How Are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth or teeth, our Dentist will take an impression to provide an exact mould for the crown or bridge. If porcelain is to be used, our dentist will determine the correct shade for the crown or bridge to match the colour of your existing teeth.

Using this impression, a dental laboratory makes your crown or bridge, in the material our dentist specifies. A temporary crown or bridge is put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How Long Do Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes become loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practise good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Always keep your gums and teeth healthy by brushing with fluoride toothpaste twice a day and flossing daily. As ever you should see us regularly for check-ups and professional cleaning. To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

What material is used for Crowns and Bridges ?

The most advanced material for bridges is metal free, using high-end Zirconi or E-max material IVoclave Vivadent (Swiss company).

Dental bridge

Dental veneer

Traditionally other material used for crowns would be either metal porcelain fused to metal crown or Gold which is still useful in some special cases.

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TMJ / TMD

TMJ is an abbreviation for “temporomandibular joint,” which is commonly known as jaw joint. These are the small joints in front of each ear that connects the lower jaw to the skull. The area of the face where the TMJ is located is an intricate network of bones, including the teeth, muscles, and nerves. Because of this, TMJ condition can affect many parts of the body. People suffering from TMJ / TMD, or temporomandibular joint disorder, can experience symptoms such as severe pain in the jaw, neck, ears, head and back. Other problems associated by TMJ/TMD are limited mouth muscle ability, Jaw clicking sound, facial pain, snoring, grinding of teeth, Swelling on the sides of the face

Image of bone structure of jaw and disc

In most cases, TMJ disorders caused from a condition called malocclusion, which means having a “bad bite” or accidents and trauma. Malocclusion means that your upper and lower teeth do not close together in the correct way—they are misaligned. When the teeth are misaligned, they cannot provide the support the muscles in the face need for chewing and swallowing. These muscles are then forced into a strained position, resulting in pain throughout the face, head, arms, shoulders, and back.

The treatment for this condition is to re-align the bite, and restore the jaw and joint to the right position. Once the malocclusion (bad bite) is corrected and the jaw is in the right place the pressure on the temporomandibular joint is relieved and the pain disappears.

Most people with TMJ disorders have relatively mild or periodic symptoms which may improve on their own within weeks or months with simple home therapy. Simple practices such as eating soft foods, applying ice or moist heat, and avoiding extreme jaw movements (such as wide yawning, loud singing, and gum-chewing) are useful in easing symptoms.

It is strongly recommends to treat TMJ disorders with the most conservative approaches. Treatment that is irreversible should be avoided, such as change to the structure or position of the jaws or teeth. Even when these disorders have become persistent, most patients still do not need aggressive types of treatment.

Proper diagnosis of TMJ begins with a detailed history and physical, including careful assessment of the teeth occlusion and function of the jaw joints and muscles. An early diagnosis will likely respond to simple and self-remedies

Other effective treatment for advanced cases of TMJ may include fabrication of an occlusal splint to prevent wear and tear on the joint, improving the alignment of the upper and lower teeth.

Here at Surrey dentist have extensive experience of treating patients with TMJ. Book an appointment with our dentist and find out how we can help you to manage and cure TMJ pain effectively.

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Bruxism

In our Kingston dentist we treat bruxism, which is the involuntary act of clenching and grinding the teeth. It can occur in various forms, some mild and some more severe. People with a mild form of bruxism may not have any symptoms whereas more sever cased of bruxism can cause problems such headaches, TMJ (temporomandibular joint discomfort), muscle aches, and abnormal tooth wear.

Bruxism

Bruxism can happen during both the day and night, although sleep-related bruxism is often the bigger problem because it is harder to control.

The main cause of bruxism is unknown, but possible causes might be the psychosocial factors; stress and anxiety. No specific drugs exist to treat this problem. The only treatment that is proven to be effective is the bite or splint.  This is a type of shield, when positioned between the upper and lower teeth, protects the tooth enamel and encourages realignment of the jaw, at the same time minimising the effects of bruxism.

If you are a bruxist, do not wait to protect your smile! Call us for a consultation and find out how we can help you.

 

 

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Sepsis infection

What is Sepsis?

A normal mouth will contain a large number of bacteria, many of them are potentially pathogenic. In a healthy patient there is usually no problem as your immune system protects you frommany illnesses and infections. However, it is possible for your immune system to go into hyperdrive in response to an infection. When this happens the chemicals in your immune system release into your bloodstream to fight an infection but cause inflammation throughout the entire body instead. This is known as Sepsis. It is a life-threatening illness. Sever cases of Sepsis can lead to a medical emergency, Septic Shock.

Generally, there are three stages to Sepsis:

  • Sepsis
  • Severe Sepsis
  • Septic Shock

It is vital for you to seek immediate medical attention if you ever have any of the following symptoms. The earlier you seek treatment, the greater your chance of survival is. You must have two of these symptoms before your GP or Dentist can diagnose Sepsis:

  •  A fever above 38C or a temperature below 36C
  • A heart rate above 90 beats per minute
  • A breathing rate higher that 20 breaths per minute
  • A probable or confirmed infection. In the case of dentistry this could be triggered by an oral infection

Contact dentist immediately if you have any of the following signs:

  • bad breath
  • hyper-sensitive teeth to hot or cold temperatures
  • constant toothache/pain which comes and goes
  • swollen gums
  • swollen glands
  • bitter taste in the mouth
  • fever
  • pain
  • headaches/sinus pain

Severe Sepsis occurs when there is organ failure. You must have one or more of the following signs to be diagnosed with Severe Sepsis:

  • Patches of discoloured skin
  • Decreased urination
  • Changes in Mental Ability
  • Low Platelet (blood clotting cells) count
  • Problems in breathing
  • Abnormal heart beating
  • Feeling cold due to a fall in body temperature
  • Unconsciousness
  • Suffering from spells of extreme weakness

Symptoms of Septic Shock will include those for Severe Sepsis, combined with very low blood pressure.

 

The effects of Sepsis

Sepsis if left untreated has the potential to be life-threatening. There is a high rate of recovery in mild cases. So, it is important to be treated as soon as the symptoms are recognised. Caught early, the outcomes are excellent. Left unchecked, the patient is likely to spiral into multi-organ failure, septic shock and death. It is estimated that, every year, sepsis costs the NHS £2 billion and claims the lives of at least 52,000 people in the UK and 6 million people around the world.

A case of having Severe Sepsis will increase the risk of a future infection. Severe Sepsis or Septic Shock can also cause further complications in the form of blood clots throughout the body. These clots will block the flow of blood and oxygen to vital organs and other parts of the body. Thereby increasing the risk of organ failure and gangrene.

What causes Sepsis?

Any infection can trigger Sepsis, but the following types of infections are more likely:

  • Pneumonia
  • Abdominal
  • Kidney
  • Bloodstream (oral)

Who is at risk for Sepsis?

  • Some people have a higher risk than others, but anyone can contract Sepsis. People who have a greater risk include:
  • Young children and OAPs
  • People with weaker immune systems for example due to HIV or Chemotherapy Treatment
  • People being treated in an intensive care unit
  • People exposed to invasive devices, such as intravenous catheters or breathing tubes

Can you recover from Sepsis?

Your recovery from Sepsis depends on the severity of your condition and any pre-existing conditions you might have. Many people who survive will recover completely whilst others report lasting effects. The UK Sepsis Trust reports that it can take up to 18 months before you feel like your normal old self.

Sepsis prevention

By taking steps to prevent the spread of infection you can reduce your risk of developing Sepsis by:

  • Stay up to date with your vaccinations, e.g. flu, and pneumonia
  • Practise good hygiene. To include proper care of wounds, hand washing and bathing regularly

Practise good oral hygiene to include:

a)    Visit your dentist at least twice a year for Hygienist cleaning and Dental check-ups

b)    Understand your own oral hygiene requirements.

c)    Examine your teeth regularly will help to prevent dental cavities and tooth decay

d)    Regularly remove the bacteria that live in your mouth, which in turn can stick to your teeth to cause cavities by brushing twice a day (2 minutes) and flossing and using inter-dental brushes once a day.

e)    Use a fluoride toothpaste to stop and prevent tooth decay and fillings

f)     Avoid tongue and cheek piercings

g)    Do not put up, for any length of time with an abscess in your mouth, call us immediately

h)   Contact the Surbiton Smile Centre immediately, if you are in pain directly after any form of dental treatment

i)     Take immediate action if you have any damaged tooth, sore or swollen gum, any form of toothache, or restriction in the opening of your mouth as these could be a sign of an infection.

j) Seek immediate care if you develop signs of infection. The sooner you obtain treatment the better the outcome will be.

Emergency examination procedure for Sepsis

At the Surbiton Smile Centre, we will give you a full dental examination followed by the use of X-rays (both small and large areas of the mouth) and a CT-scan if required.

The following aspects of your mouth will be investigated:

  • Teeth
  • Gums
  • TMJ
  • Submandibular Glands

If our Dentist manages to find the problem quickly then a diagnosis will be offered together with the appropriate cause of action/treatment.

In the rare case that our Dentist cannot help you at the Surbiton Smile Centre, then you will be referred immediately to Hospital for a proper in-depth medical investigation.

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