Preventive dentistry

Preventative dentistry is the core of our practice at Surbiton Smile Centre. Regular examinations and check-ups form the basis of this. Our specialist dental hygiene service is a vital and integral part of our dental health programmed for every patient.

Sport mouthguard

A custom made sport mouthguard or gum shield is a specially made, rubber-like cover which fits exactly over your teeth and gums, protecting them from damage during sports.

It is important to wear a professionally made sport mouthguard  whenever you play sport that involves physical contact ;this includes: cricket, hockey and football - which can cause broken and damaged teeth. Custom-made mouthguard can prevent damage to the jaw, neck and even the brain - helping to prevent the concussion and damage caused by a heavy blow.

Mouthguard are made by taking an accurate impression of your mouth registering the way your jaws bite together to make sure the mouthguard meets properly with your teeth. Surrey mouthguard are made in professional laboratory based on our dentist's instructions.

The Surrey Custom made Mouthguard come in a range of vibrant colours and can be customised to your country's flag, to your team's colours or to display your name.

Depending on your age, your mouthguard might need to be replaced regularly. If you are still growing, the mouthguard may become too tight or loose, and will need to be remade in order to fit the new shape of your mouth.

Adults may not need to have their mouthguard replaced quite so often. But they are like any other form of sports equipment and will suffer from wear and tear. It is recommended that you take your mouthguard along to the dentist when you go for your check-up, so it can be checked.

An effective mouth guard should be comfortable, resist tears, be durable and easy to clean, and should not restrict your breathing or speech.

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Oral cancer screening

Oral cancer screening here at Surbiton Smile Centre is performed during your routine dental visit. During an oral exam, the Surbiton dentist look over the inside of your mouth to check for red or white patches or mouth sores. They also feel the tissues in your mouth to check for lumps or other abnormalities.

Many people have abnormal sores in their mouths, with the great majority being noncancerous. An oral exam can't determine which sores are cancerous and which are not. If the dentist finds an unusual sore or abnormality during oral cancer screening, you may go through more diagnostic tests to determine its cause. The only way to definitively determine whether you have oral cancer is to remove some abnormal cells and test them for cancer in a procedure called a biopsy.

Factors that can increase the risk of oral cancer include:

  • Tobacco in cigarettes, cigars, pipes, chewing tobacco and snuff, among others
  • Heavy alcohol use
  • Previous oral cancer diagnosis

We carry out the oral cancer screening for all our patients during each routine dental exam. Ask our Surrey dentist about ways you can reduce your risk of oral cancer, such as quitting smoking and not drinking alcohol.

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Dental Hygiene / Preventive Dentistry

Dental check-ups can almost always be combined with a visit to our Hygienist to give your teeth a thorough cleaning.

Our Dental Hygienist will scrape along and below the gum line to remove built-up plaque and tartar that can eventually, if left alone, cause gum disease, cavities, bad breath and other associated problems. Finally, our Hygienist will polish and floss your teeth and give you advice for your daily routine of cleaning your teeth.

Sometimes it is necessary for the Hygienist to deep clean your teeth. This might sound like something you should do after you have missed a few visits to the Dentist or eaten a particularly sticky meal. The term ‘deep cleaning’ is actually a specific procedure performed by us to treat gum and periodontal disease. Quite often the procedure does not get completed in one visit.Usually this happens because the patient has not had regular professional cleaning appointments every six months.

Deep Cleaning Without Hygienist

At the Surbiton Smile Centre our Hygienist uses an instrument called a probe to measure the area around your teeth to see if you have any pocketing (i.e. the area between the tooth and gum in which bacteria will form). The depth of the gum tissue between the teeth and gums are called pockets when this distance is five millimetres or more. The European Periodontal Association recommends that every adult should receive a periodontal evaluation each year in order to determine whether additional treatment is needed. Measuring pocket depth is just one part of our comprehensive dental evaluation.

According to the National Institute of Dental and Cranio facial Research (NIDCR) the depth for normal healthy pockets is ideally no more than 3 millimetres. If the pockets are greater than 5 millimetres, we might prescribe a deep scaling and root planning appointment with our Hygienist.

Case Study:In this poor oral hygiene example of a 15-year-old boy you can see that this has led to stains (mould) on his teeth and caused tooth decay.

Deep Cleaning Process

Deep cleaning is also known in Dentistry as scaling and root planning. Scaling involves the removal of plaque and tartar from the surface of the teeth and from the pocket area between the teeth and gums. At the Surbiton Smile Centre out Hygienist is able to perform scaling and root planning using either an ultrasonic instrument or a range of manual scaling tools.

The other part of deep cleaning is root planning. Our Hygienist uses a scaling instrument to remove plaque and tartar from the surface of the roots of your teeth. A scaling and root planning procedure requires a minimum of two appointments. A follow-up visit may be necessary to confirm that your gums and teeth are becoming healthier and there is no pocket depth.

Care After Scaling and Root Planning Appointments

Ideally, after a deep cleaning appointment, the bacteria in the pockets of the teeth have been removed and in a few weeks afterwards, the gums should become healthier, especially with a rigorous approach to oral hygiene every day. On some occasions an additional mouth rinse is required.We might prescribe an antibacterial mouthwash, to reduce bacteria in your mouth and help the healing of the gum.

If the deep scaling and 3-month visits to our Hygienist are not enough to reverse the periodontal disease, then we may recommend you have special treatment by Dr Simin Soltani, our Principal Dentist. She has a special interest in Periodontal Treatment.

Case Study: Poor oral hygiene if not treated can easily lead to periodontitis and tooth decay.

 

For further information, please refer to the periodontal section of our website.

Bad Breath

If you suffer from foul-smelling breath, it is usually caused by the breakdown of food by odour-causing bacteria. Other culprits could include poor oral hygiene, dry mouth, periodontal disease, diabetes, tobacco use, alcohol, sinus or throat infections, lung infections, abscesses, kidney-liver-gastrointestinal diseases and / or even severe dieting.

Should you have concerns and would like to learn about what is causing your bad breath, then consider making an appointment with us at the Surbiton Smile Centre.

By studying your full medical and dental history along with an oral examination we should be able to identify the cause.

Treatment of Bad Breath

It is important to carry out effective oral hygiene at home twice daily, by tooth brushing using antibacterial toothpaste and regular flossing to remove food debris and dental plaque on and between your teeth.

It is important to include all dental work, paying particular attention to your gum line. What you may not consider is that your tongue surface should also be brushed to remove odour-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased the bleeding of gums as well as reducing bad breath over a two-week period of time. Another clinical study confirmed that brushing twice a day with antibacterial toothpaste and using a toothbrush with a tongue cleaner could eliminate bad breath.

There are several toothbrushes on the market, that allow for both the cleaning of your teeth and your tongue. Our Dental staff at the Surbiton Smile Centre would be happy to recommend suitable products to you.

After brushing your upper and lower teeth with antibacterial toothpaste, you can then place your toothbrush on the surface of your tongue and then move it forwards toward the tip. After you have cleaned that portion of the tongue, rinse the tongue brush off with warm water to remove any odour causing bacteria. Then place the tongue brush onto the next area of your tongue surface and repeat again.

So to recap, the basic strategy is regular daily oral hygiene at home along with professional advice and recommendations discussed with us at the Surbiton Smile Centre. This in turn will lead to a clean, fresh mouth. If you wear dentures, then remember to brush these thoroughly before soaking them at night and before putting them back in.

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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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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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