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Please e-mail your questions to contact@piperassociatesdentalpractice.co.uk or leave a message on the practice phone.

The British Dental Health Foundation of which I am a member is also another good reliable source of information.We have a connection to their web pages.

Popular Topics in descending order.

  1. Cosmetic dentistry
  2. Amalgam fillings
  3. Dental implants
  4. Mouth cancer
  5. Gum disease
  6. Joint problems
  7. Mouth ulcers

INJECTIONS

I am worried about injections?
The mouth is a very sensitive part of the body with an abundant nervous supply. We always rub some anaesthetic ointment gel onto the gum using a cotton wool bud to numb the skin first. After a minute wait the injection is given in this site. By numbing the skin first it makes the injection more comfortable especially as it is given slowly. The needles are very fine and always one use only.

We have 4 types of local anaethesia for different medical histories, ages, weights, types of treatments and regions of the mouth.

BLEACHING

What is tooth whitening or bleaching <highly recommended>?
It is a gel that is applied to the teeth and whitens teeth.It is very conservative and all patients have been pleased with the gentle results. There is hardly any downside and is a win win situation.

CLEAN INSTRUMENTS

I am worried about bacteria, germs and viruses?
All our instruments are sterilised at 136C to kill all bacteria and viruses. A lot of products with use are disposable and are thrown after one use. All surgeries are cleaned continually throughout the day after each patient and they are thoroughly cleaned and disinfected at the end of the day.

GUM DISEASE

My teeth are looking long and unsightly due to gum disease. Is there anything I can do about it?
As long as the gum condition is now healthy and stable a gum coloured veneer can be applied to the natural teeth.It is made of silicone with various natural shades of gum colouring.It makes the teeth much more aesthetic.

What are the factors that cause gum disease?
The factors are smoking, poor oral hygiene and hereditary.

CROWNS

What is a Crown or Cap?
When a tooth is very broken down or heavily  filled a crown a cap will build up the tooth to restore its appearance and function.

What is a Crown made of?
Crowns are made of tooth coloured porcelain or gold or a combination of the two materials.

How do I choose what sort of crown?
If the crown can not be seen choose gold because it is the strongest, most hygienic,finest margins and needs smallest amount of tooth removed. It is chosen by dentists for themselves and family. The only downside is the poor appearance. All-porcelain crowns are the choice for superb aesthetics.The margins are wider and strength is lower.Used specially at the front of the mouth.

A good compromise is porcelain bonded to gold.It is stronger but there is a compromise on margins and opaqueness. All the costs are identical.

BRIDGES

What is a bridge?
A bridge fills a space with a dummy tooth which is joined to a neighbouring tooth which is crowned. A bridge cannot be removed for cleaning.

How long does a bridge last?
Research papers have shown a typical 3 tooth bridge only averages up to 10 years before needing replacement. The simpler the design the better.The best is one dummy tooth joined to only one neighbouring tooth.

What are the different sorts of bridges?
The conventional is gold covered with porcelain.It can involve 2 units or 3 and above. A considerable amount of tooth or previous filling material needs to be removed to make space for the porcelain.

Another sort is a Maryland bridge which is a dummy tooth joined to the back of a neighbouring tooth by metal which does not show.It has a tendency to de bond after 5 years on average but can be rebonded.Only a very small amount of tooth substance is removed.

DENTURES

What are the different types of dentures?
There are plastic or acrylic dentures which are more bulky,cover the palate and tend to be food traps. They tend to mask taste and and can affect speech. They can be designed so that aesthetics are good.

There are dentures with chrome bases which rest on natural teeth, are more slender and take less space. The artificial teeth can be very aesthetic. Taste is better.

Can I wear my dentures at night?
For social reasons definitely yes.Be careful as saliva flow is reduced over night. Therefore you need both very good oral hygiene and very good denture hygiene and then no further snacks or drinks overnight except water.

EXAMINATIONS & X-RAYS

What is an examination or "check up"?
The patient is asked why they are attending,who recommended them, a medical and dental history, examination of external head neck and facial tissues,examination of soft tissues of mouth and front of throat, examination of gums, teeth and restorations and an x ray or radiological examination and any other tests as necessary.

What are dental x rays?
X rays are an invisible beam similar to a light beam which will pass through some parts of a tooth and cause an image to be formed on a sensitive film packet which the patient holds in their mouth. This film is very similar to a photographic film. The film is developed and fixed in a similar fashion to a photograph. A digital sensor can be used as an alternative to film with several advantages. We are upgrading to Kodak digital. It is the finest of the systems with the most detail due to the increased no of lines in a given area.The advantages are a sharp reduction in radiation dose, convenience, reliability of storage and display on all screens in the practice.

How much radiation does a dental X ray examination produce?
As a rough guide 2 dental x ray films are equivalent to the amount of radiation a passenger in a plane trip from London to New York would receive from the sun.

Why are dental x ray images taken?
They enable hidden parts of the tooth to be seen, e.g. curly roots, measure the length of roots for endodontics, hidden teeth, cysts and abscesses, decay under fillings and crowns.

ORTHODONTIC TREATMENT

Can adults have orthodontic treatment?
Yes and for aesthetics it is often the premier choice. White braces are available and treatment times are often quicker than children.

IMPLANTS

What is an implant?
An implant is an artificial root made of titanium which is embedded directly into the bone. A crown is attached to it. It will replace a missing tooth or hold a denture very firmly.

VENEERS

What are veneers?
They are porcelain facings or laminates that are bonded to the front teeth.They usually need replacing after 10 years.They give a very good appearance.

WHITE FILLINGS

Can I have white fills on back teeth?
Yes but there are considerations.

  • White fillings have superb aesthetics.
  • White fillings are weaker than metal fillings and need replacing more
    frequently.
  • White fillings are slightly acid and in deep fillings can be sensitive.
  • White fillings are more of a plaque trap under the gum.
  • On smaller 1 surface fillings white fills can be bonded to the enamel and
    these fillings can be stronger and more retentive than metal.
  • White fillings need more care and time to fabricate and are therefore about
    50% more costly than metal fillings.
  • With attention to detail and good moisture control a very good white coloured filling can be constructed.

BAD BREATH

What causes bad breath?

  • Persistent bad breath is caused by smelly gases (e.g. sulphur compounds) that are released by the bacteria that coat the gums,teeth and stomach lining.
  • Bits of food caught between the teeth and also on the tongue can cause an unpleasant smell.
  • Gum disease causes bad breath.
  • Strong foods like garlic,coffee and onions can add to the problem.

How can I prevent bad breath?

  • Good brushing and flossing of the teeth and gums.
  • Scrape the tongue with a spatula or tea spoon.
  • A scale and polish(prophylaxis) on a regular basis from a dental hygienist.
  • An anti-sulphur mouthwash.
  • Reduce heavy intake of red meats.
  • We have mouth sprays and mouthwashes for sale that clear the volatile sulphur products.

Are there medical conditions that cause bad breath?

  • Dry mouth with lack of saliva reduces natural oral hygiene.
  • Some medications and radiotherapy cause reduced salivary flow.
  • Infections of tonsils,throat,larynx,nose,lungs can cause this symptom.

SNORING

Can snoring be prevented?
Wear an orthodontic like appliance which thrusts lower jaw forward.This is a simple reversible inexpensive procedure which should always be the first choice before more complex procedures are tried. The practice construction appliance made by a maxillo-facial technician from Queen Victoria Hospital, East Grinstead. The cost is £165. The practice can then refer for complex and/or non-reversible procedures at Queen Victoria Hospital such as below.

Surgical trimming of the soft palate,tonsils and nasal passages can open the
airway.

Administration of oxygen under positive pressure with a diving type mask.

What are the problems of obstructive sleep apnoea?

  • Snoring
  • Socially embarrassing
  • Marital disharmony
  • Excessive daytime sleepiness
  • Cardiovascular implications
  • Road accidents increase sevenfold
  • Reduced quality of life
  • Increase of depression
  • Diabetes increase.

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