Author: craigentinny

Beating your dental fear or phobia does not need to be a lonely experience, there are lost of resources out there on the internet to help. Here are just a few that my patients have found to be very helpful.

DentalfearCentral.org -a great resource complete with a forum where users can share their experiences and encourage each other

British Dental Health Foundation produces a leaflet on dental fear you can find it here

Find out  how  Panic Disorder works and what to do about it. If you have ever had that overwhelming feeling of panic as part of your dental fear  / phobia this is another great resource.

Try our 7 day beat your dental fear e – course- 7 small steps to help get you in the right frame of mind to make contact with a new dentist
If you know of a great resource on the web to help with dental fear or phobia why not let me know and I can share it with all of our readers.

There is a new idea catching hold in main stream cosmetic dentistry and to be honest, it is a change that is long overdue. In my  career to date as a  preventive dentist and a cosmetic dentist I regularly have had to balance my patients desire for a lovely smile versus my own personal view that we should always treat healthy tooth tissue as precious. For more than 15 years the team at Craigentinny have taken the view that that we should avoid  drilling away tooth  if at all possible. As a result  I have on many occasions declined to carry out treatment that patients have requested when it  would involve grinding away significant quantities of  a  tooth and lead to what I believe is  long term damage or complications.

You see,  when a tooth is prepared for a crown  there is a 5 – 15% chance that the nerve in that tooth will die at some point in future. And if the nerve dies then a root treatment becomes necessary. So when an alternative exists that is kinder to the  tooth  its seems to me a no brainer that we should look seriously at this option. As a result in the last 10 years I have carried out a lot of resin bonding rather than place veneers or occasionally crowns for my patients. Resin Bonding (Composite Bonding)  usually requires little or no removal of the underlying healthy tooth and as such is completely reversible. Indeed resin bonding is so conservative that very often we are able to complete it with no need for injections or anaesthetics. A real winner for my more nervous patients.

As a treatment Resin Bonding (Composite Bonding) or Composite veneers as they can be known, matches crowns or porcelan veneers for speed as they can usually be completed in one or two visits. Resin bonding does not suit everyone. It is a bit more prone to gathering stain so smokers probably should consider alternatives, that said in normal use any minor staining is easily polished away. This simple before  and after series  from a few years ago shows just what can be achieved. The cost was significantly less than using poreclain veneers to achieve a similar result and my patient was delighted.  Better still the natural teeth were completely untouched. Today we  may well treat this lady differently as we have fast orthodontics available with  the  Inman Aligner  or 6 Month Smiles however as the resin bonding can be stripped off back to the natural tooth at any time this patient  still has these options available to her. If we had chosen to place 6 veneers that flexibility would have been lost. Don’t get me wrong veneers and crowns are still a great option for the right patient, and I still provide a lot of these treatments  but  if you do nothing else before having some cosmetic dentistry carried out, please do make sure that you consider all of your options, their advantages and disadvantages before starting.

With the holiday season upon us, we always find a surge in patients asking us about teeth whitening at Craigentinny Dental Care. So here is the low down on  one of the most straightforwards cosmetic dental procedures.

With many millions of tooth whitening procedures having been carried out by dentists worldwide we can say with some confidence that it is simple, safe and fast. With take home whitening or 1 hour whitening  to choose from here are a few things that you should  know.

1 Hour Teeth whitening
1 Hour tooth whitening works wonders to kick start the process, but unless you follow up with at home whitening trays it is highly likely that the results will not be as long lasting as you might wish. All tooth whitening dehydrates teeth which is why they look so much better immediately after treatment yet many patients report a bit of a fade back in the two weeks afterwards. Particularly if the 1 hour treatment is not followed  up.  See some examples of tooth whitening at our dental practice in Edinburgh.

Take Home Teeth Whitening
The at home systems where you wear custom made tooth whitening trays overnight are in many ways the most effective and kindest to your teeth as they use lower concentrations of gel to achieve the necessary results. For the very best results with this system you need really well mad and snugly fitting bleaching trays.

How long does it last?
On average tooth whitening, when done well, is believed to take around 7 years on average to relapse back to where it came from. Obviously there will be quite a bit of variation depending on your diet and tooth cleaning habits. It is usually possible to maintain your final results with a simple touch up for 1 or 2 nights per year using at home whitening trays. At my dental practice in Edinburgh we offer this service free of charge to patients who become members of the practice.

Is Teeth Bleaching Safe?
In the right hands yes it is. Naturally we hope that you will chose our Dental Practice in Edinburgh for this treatment but if you are further afield bear in mind that only dentists are legally permitted to carry out dentistry – of which tooth whitening is part. Teeth whitening by a dentist is safe and  effective. Since a mistake in treatment can cost a dentist their livelihood,  we  tend to take the process seriously. This means using materials from reliable, traceable sources, having great infection control procedures (and believe me this is much much more than just wearing gloves), as well as insurance to protect you in the unlikely situation that a problem does occur. Tooth whitening in any other location is a riskier endeavour especially  if you do experience problems during or after treatment.

Enjoy the summer months and whiten with care!

I speak to lots of nervous patients every week, and one question that often comes up is “can’t you just knock me out for my treatment?” I guess what I am really being asked is what can you do for me that will reduce my level of consciousness such that I don’t know anything about what is going on. In days gone by a general anesthetic was the standard approach but in these more enlightened times most of patients would rather avoid this whenever possible. This leaves us with sedation.

Dental Sedation can be done with a small injection in the back of the hand ( called IV Sedation ) or using a gas called Nitrous Oxide ( often called RA sedation).  Clearly for anyone with a needle phobia the IV option already sounds challenging!  Either way the aim is that you remain conscious throughout treatment but at such a low level that you will not be hugely aware of what is going on and preferably remember very little or none of it when you recover.

At Craigentinny Dental Care we have in the past provided some sedation services and found that for patients who were really anxious dental sedation was not always the answer they hoped for. Firstly as you are largely unaware of what is going on you have no learning experience. i.e. after treatment you will be just as nervous as before. So as a result you are still likely to feel very anxious on the run up to each and every visit. So over time your fear of the dentist and dental treatment is less likely to diminish.

A second issue which is really the most significant one for me, is that should you be unfortunate to experience toothache, and it does happen to the vast majority of the population at some time in their life, you cannot always guarantee the availability of a sedation service.

Generally dentists who provide sedation have had additional training as have the dental nurses who support them, so you simply cannot arrive to see any dentist and be guaranteed sedation. Even if a practice does offer sedation, there may be issues if the right combination of staff are not on duty that day. This then leaves you with a terrible dilemma of living with the problem or facing your fears head on in a crisis situation. Neither option is a good one and likely to help you in your quest to feel more relaxed about dentistry.

For these reasons, I feel that the best approach for the majority of patients is to address their fears slowly and gradually with a caring and sympathetic dentist and nurse who have a genuine interest in helping them. This way we can treat your dental fear as well as treating your dental problems. In time most patients find that this approach leads to a reduction in their anxiety levels and they are more able to cope with routine care.

A typical example that I often hear from patients who come to our dental practice in Edinburgh is “I used to take a whole day off work when I came to the dentist even if it was just for a very short visit but now I just come along before or after work .”

I know that  the non sedation route  is not the fastest but   in terms of treating dental fear in Edinburgh it has  proved to be very  effective for our patients in the long term.  Let me know your thoughs on this……..

There is no doubt that short term orthodontic treatment for adults is currently a hot topic. The ability to rapidly move a limited number of teeth into better position is without doubt an attractive proposition for many adults. A question I am often asked is what are the advantages and disadvantages of choosing what seems like a shortcut to the end result.

• all teeth front and back in their optimum positions
• the roots of the teeth will be neatly aligned in the best possible arrangement
• the orthodontist will have very close control over the whole process and can move teeth in almost any direction.

The price that you pay for this level of control is time which is why the traditional approach takes 12 -18 months or longer.

Short term orthodontics such as the Inman Aligner  do not tick so many boxes.

• Generally no attempt is made to change the way your back teeth meet together
• Movements are limited to the front most teeth
• While great improvements can be achieved, this technique cannot achieve every single movement that traditional braces can.

For some examples of what can be achieved why not take a look at our Inman Aligner Edinburgh web site

So where do Inman Aligners fit in? overall my feeling is that they should be looked at first and foremost as an alternative to more aggressive cosmetic dental treatments such as crowns or veneers. If I had a choice to improve my smile by moving teeth over 12-18 weeks to a better position or having them ground away to receive crowns or veneers then I would choose the orthodontic option every time. If I had a problem with my bite or the way that my back teeth  met ase well then I would probably lean towards more traditional treatments.

Ultimately the only way to be really sure what the best option for you, is to speak to a suitably qualified professional. A good cosmetic dentistry consultation should follow a framework to make sure things are not missed and our patients leave with all of the information that they need. Here are just a few of the things that we talk about in a Cosmetic Consultation at our Edinburgh Dental Practice

• what are the things that bother you about your smile
• what are the most and least important items on your list?
• a clinical assessment of your mouth
• a discussion of  ALL of the options open to you as a patient
• what are the advantages and disadvantages of each option

Why not tell me what else do you like to speak about?

As dentists we  love to tell patients with some degree of  pride that dentistry has moved on and improved over the last 20 years.  Truthfully this really has happened, but it occurred to me today that if you are afraid of the dentist  and  have one specific fear then unless you know what has improved then you will not feel a whole lot different about booking a  visit. What  I hope to do over this and future posts is give you some really practical examples of how things have moved on.

I hate the smell of the dentist – We now rarely use the materials that the used to give dental practices that really strong and characteristic  smell. Most modern alternatives are odour free. Even allowing for modern materials we still to some lengths to make sure that the practice generally does not have the old fashioned smell of the dentist. Fresh flowers,  essential oils and air purifiers all feature in the range of things that we have at our disposal to help keep the place smelling lovely. You will also be pleased to know that you won’t be subjected to some of the more lively aftershaves from the 70s either!

I am Scared of injections– this is another area of great progress. We have 3 main strategies;
1. We now use  surface anaesthetic gels to pre numb your gum, these are fantastic and really do help a lot
2. we use a very very slow and careful technique that makes most injections entirely pain free. I have a had a lot of dental treatment and was nearly 20 before I realised first hand that injections didn’t have to hurt. It really changed the way I feel about treatment which is lucky given all that I have had done inthe last 17 years.  ( so you can guess where my dental fears used to lie! )
3 modern equipment allows us to do all this in a much more comfortable way.

I hate the noise of the drill – although we have not yet perfected the silent drill and alternatives like lasers are yet to do everything that we need them to,  we can still do lots to help with this. We encourage  our patients to bring along  music that they find  relaxing to listen to  or better still you can try our B-Calm device which acts as an auditory anaesthetic blending  white noises with natural sounds to help create a relaxed state of mind.

These are just a few of the many things that we can do.  If you are scared of the dentist then the very best place to start with any new dentist is with a good conversation, it does not amtter whether this is  by e-mail, in person or telephone. Dentists who are interested in helping nervous patients will be happy to do this becasue it helps them to understand your fears better. And when we understand what your fears are we can start to develop a plan to help you redeuce your anxiety and start to feel better about your dental health.

Finally, why not make a start on  your dental fear today. It does not matter how small a step you take but  fears are overcome one step at a time so  whether  it is taking our Free 7 day Beat Your Dental Fear E-course or gathering a list of questions that you want to ask,  go for it….and if we can assist  in any way just get in touch and one of our Edinburgh Dentists will be happy to help.

I have practiced in Edinburgh for around 15 years,  and in that time  the face of dentistry has changed dramatically. 15 years ago dentistry was all about health and function, very  little was said about cosmetic dentistry. While there is no doubt that the cosmetic revolution has helped to drive improvement in dental techniques, materials and choices for patients  I think it is important that we also remember the important lessons of the past.

In my Edinburgh dental practice our records system has been fully computerised for the last 12 years. Every document we receive is scanned, and all of our notes and treatments  are recorded digitally. As a result of working not only as a Dentist in Edinburgh but at the same Dental Practice in Edinburgh I have had the opportunity to watch how treatments and materials  survive over time. Thankfully the answer is remarkably well and  our computerised records system allows us to see at a glance, how long a particular filling or crown or veneer has lasted.  At Craigentinny Dental Care we have never abandoned the mantra of dental heath first and last.  We believe that whatever we do for our patients should stabilise or promote their dental health even if the treatment is for cosmetic purposes, and when the treatment is completed it should be maintainable by you the patient.

Here are the 4 questions I think everyone should ask before having cosmetic treatment carried out.

1. how likely is it that this treatment will shorten the lifespan of my teeth?
2. are there alternative treatment options that are kinder to the teeth available?
3. if so, what  are there any compromises in the end result that I would need to accept?
4. how often will this treatment need to be replaced / re done?

Personally I love it when someone asks me these types of question as invariably it leads to a good discussion and, I hope a more informed patient. Not every one of the questions above  has a simple answer but the conversation that they provoke will invariably help you to make better decisions about your smile.

As a final parthing thought, follow our 4 tips for dental health and no matter what treatment you choose it will be much more likely to stand up to the test of time.

I thought I would share  a bit of feedback from the patients at our Dental Practice in Edinburgh to our latest gadget.  Called the B-Calm it is  designed to help patients who suffer from dental anxiey or fear and  I mentioned it briefly back in Januarys blog posting. It specifically reduces the anxiety caused by the noises of the dental environment by playing a  mixture of relaxing audio tracks blended with white noise at just the right level. Like many good ideas it a very simple concept. Having experiemented with noise cancelling earphones before I was initially doubtful that this device would be any different however, am happy to admit that I was wrong and our patient feedback on this has been excellent.

Although at present nothing will block out every single dental noise, this device really does make a difference and I have been amazed to watch even  my more skeptical patients become converts as they visibly relax while using it. We were  fortunate to be among the the first clinics in scotland to offer this technology and I am very grateful to Dr Rich Varlisky  in  California for helping to make that happen. The audio tracks on the B-Calm device clearly seem to aid relaxation and are  much more than something to drown out the sounds of the drill. When asked, most of my patients say that it beats wearing their MP3 player  hands down. So we are giving this our seal of approval  as something that really does make a difference. We plan  to incorporate this into our dedicated nervous patient programme  and offer it to all patients who suffer from dental anxiety, dental fear or dental phobia.

Having just about thawed out from the deep freeze that ushered in the new year, 2010 is now well underway. 2009 finished on a real high at our Dental Practice in Edinburgh when we found out that we had won the Best Dental Team ( Scotland) category at the Dentistry Awards. It provided a real boost and increased our motivation to take the practice to new levels in 2010.

In 2010 we have big plans to develop the care that offer at the practice further. The aims of our dental team remain the same; providing, pain free and stress free, beautiful dentistry that places the dental health of our patients first. We aim to do all this in a welcoming, non judgemental and positive environment. This year we will continue to push our standards higher than before and increase the range of treatments that we offer to our patients.

For our patients who suffer from dental anxiety we are currently trialling a new device that significantly reduces the noises that you hear when treatment is taking place. The device blends a relaxing sounds from nature with white noise that acts to cancel out a lot of the higher frequency noises in the dental surgery.

This means that the usually high pitched drilling noise that many people hate is significantly reduced. When combined with our injection free cosmetic treatments such as Inman Aligners or Resin Bonding (Composite Bonding) it does represent another step forwards in making dentistry more accessible to patients who suffer from dental anxiety. The initial response from our nervous patients has been very fantastic. I will report back more on this as the year progresses.

Finally if you know someone who has a new years resolution to beat their dental anxiety why not suggest that they try out 7 day Beat Your Dental Fear E-course. Over 150 patients have successfully completed the course since it launched last autumn.