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The dental fear blog has been quiet for a while. Fear not though dear reader, we have been  busy  training and discovering new ways to help people with their dental fear rather than talking about them. I hope to redress the balance a little this year with a bit more talk! To start 2014 we have two new ideas that might help you to make this the year that you stop dental fear from affecting your life.

Sedation Service Launch

Firstly after much deliberation we have decided to start offering a sedation service as well as our traditional medication free, nervous patients programme. After nearly 20 years in practice,  as well as listening to the feedback from readers of the blog I have come to realise that despite all of the techniques we employ to help people beat dental fear without medication, there are still a good few people who simply cannot beat their fear any other way. For this reason we decided that starting

a dental sedation service seemed like the next logical step. As a result of much training our sedation service is launching this month

To introduce our new dental sedation service in Edinburgh  we are offering a free  sedation suitability consultation (opens in a new window) with one of our team where you can discover more and find out if sedation is right for you. Click here to request a visit ( opens in a new window

New E-Book

If you are more inclined to avoid sedation then we still have something new that might help.  After some time, and a few late nights we are launching our new “Beat Your Dental Fear” e- book. It is 36 pages of help information and advice that pulls together several years of blog posts and more than 40 years of collective experience treating  patients who would rather be anywhere else than at the dentist!  It follows on from the 7 day beat your dental fear e-course and goes into much more detail.  To Get your free  copy click here.(opens in a new window)

In the mean time enjoy the little quote above and remember that you are not alone!

A question we are often asked is ” I noticed that my gums some times bleed when I brush….. am I brushing too hard?”

Usually the answer to this question is no…. the bleeding occurs because on that given occasion you have managed to reach an area of your mouth that has not been reached for a few days. Generally bleeding gums indicate that there may be some level of gum disease present. At best this is something called gingivitis which means that the gums are inflamed. Gingivitis is usually due to a build up of plaque in a  hard to reach area.  When you give your teeth an extra thorough brushing you get the bristles in to some of these areas and stimulate the inflamed gum which then bleeds.

The best way to stop this is to make sure you are just as thorough the next time you brush…it can take 2-4 days for gingivitis to resolve fully so don’t expect an immediate miracle.  Better still why not follow our 4 point plan for dental health.

In all areas healthcare there are still treatments that exist based on assumptions and ideas that came into existence tens if not hundreds of years ago. This is not to say that all old knowledge is bad, far from it. Growing up many of us have benefitted from the great work of Alexander Flemming, the pharmacologist who discovered penicillin and its ability to eradicate bacteria. Equally there remain many outdated ideas that are slowly being challenged by what we call evidence based healthcare.

Dentistry is no exception to this. One misconception that persists is that when you have tooth decay you need a filling to treat it. In truth a filling only gets rid of the hole that is left by the tooth decay process. If you don’t address the underlying causes of tooth decay a new cavity will sooner or later develop elsewhere in your mouth .

That is why some people say “I always need fillings” and yet others never need any. Beating tooth decay is a relatively easy task with the right knowledge. The right knowledge does however extend to more than just avoiding sugary snacks and brushing twice a day.

So if you are someone who seems to experience a lot of tooth decay what should you do…
Ideally find someone qualified to help you examine at least some of the following things

• assess your diet, not just what you eat but when you eat it
• assess the types and quantities of bacteria present in your mouth
• assess your saliva flow rate and its ability to neutralize acids
• consider the role of any medications you maybe taking
• assess the right type of toothpaste and mouthwash for you
• assess what you should be using to clean between your teeth

Luckily in modern dentistry we have tests available to look at almost all of these things. Using computer modelling as well as experience a preventive dentist will work out a programme of relatively simple changes that can help you to prevent future decay in your mouth.

The changes, like all things often require active participation and commitment to achieve but in return you will be rewarded with fewer fillings caused by tooth decay. As well as the knowledge that you are in control of this aspect of your own health.

Craigentinny Dental Care is an Edinburgh based dental practice offering a wide range of preventive dental treatments for the local people of Edinburgh and beyond.

Christmas is often cited as one of the most stressful times of year and I do wonder if it is actually Christmas Day its self or in fact the huge build up that  causes the stress. Chatting with many of our  patients at our Dental Practice in Edinburgh  it seems that whatever your religious persuasion, a day spent with family,  eating nice food and perhaps even enjoying the odd tipple is a pleasant  thought for the vast majority and something to look forwards to.  Which leads me to conclude that it must be the build up that makes everyone so stressed and grumpy.

Maybe if we did not place such huge expectations on our own shoulders for the “perfect” Christmas day and recognised that some things can be imperfect  yet still immensely enjoyable  then it would all get a little easier. Perspective is a great thing and it always fascinates me how two people can look at the same situation and see completely different pictures.

I remember on one occasion not long after I qualified my flatmate and I decided to have a big party and cook a Christmas meal for all of our friends. Our ignorance was complete and we only learned how difficult it was to co-ordinate a feast for 30 people as it all went spectacularly wrong. Among the many disasters that happened  was the realisation that while our turkey looked crisp and golden ( ok burned ) on the outside the inside was still cold enough to keep the Haggen Daas at the right temperature till Ney years Day!   It was fortunate that  we had  paid enough attention in our microbiology classes at university to realise that the centrepiece of our feast was more likely to become the centre of  an outbreak of food poisoning.  With no fall back plan  we pressed on regardless without it using the time honoured  method of serving copious wine when the food is going badly wrong.   Looking back we have fond memories of that particular event and to this day it brings a smile to my face when I think of all the various stages of culinary disaster that we brought upon ourselves. When reminiscing on this with some of my  friends whom I have known since childhood it is funny how their recollection is different. Most of my friends do  remember the  fact that there was no turkey ( a raw but burned turkey is after all in some ways memorable)  but really remember what a good time they had.   It goes to show that for every situation two people will view the same facts quite  differently.

Reflecting now, I see that we had a great time because our friends were very  forgiving of our imperfections and made the best of the situation  with or without a full dinner plate.  Their actions made it easy for us to realise that our culinary incompetence was completely forgiven even though we were more than a little bit mortified.

It strikes me that when we are trying to tackle our dental fear we are a lot less forgiving of our own imperfections than  others usually are. Perhaps this Christmas is a time to reflect and be kind to ourselves. Maybe this is the year to stop beating yourself up about what you have done  or should have done to improve your dental situation in the past.  There are a group of interested people out there who will view your situation differently.  They are eager to help you move forwards without recriminations or judgement and what’s more they can help you to see your positive  dental future rather than worry about the past.

I hope this final pre Christmas blog post will encourage you to look forward and add “beating your dental fear” to your  list of new years resolutions and if there is anything I or the team at Craigentinny can do to help, just ask.

In the mean time have a very Merry Christmas

There have been many reports in the press about the importance of looking after your mouth and gums and its connection with looking after your entire body.

In September 2010 there was an article published in the BBC which talked about the link between heart disease and gum disease. There has since been much media hype about the connection and whether there is a causal link or some other factor which links heart disease and gum disease.

Certainly it seems reasonable to suggest that if you do not look after your entire body health then certain aspects will begin to deteriorate, and that will include your teeth, gums and indeed your heart.

Here is what Whoopi Goldberg thinks, the key information she departs happens at 1 min 30 seconds.

Watch on You Tube

So really the best way forwards is to do everything you can to look after your entire body keeping a healthy, which in turn will reward you with a healthy heart and healthy gums.

The BBC have also written an excellent webpage on looking after your heart, please do click here to visit this page and find out what you can learn.

As dentists it is part of what we do which enables you to look after your teeth and gums, and if you take this seriously the chances are you’ll take your whole body health seriously and enjoy a healthy heart too.

So here is our complete guide to looking after your dental health.

Tooth Decay

This  is a widespread disease of civilization and is preventable. The way decay affects teeth is essentially very simple. It happens when dietary carbohydrates in the mouth are degraded by the bacteria of the mouth.

These refined carbohydrates once broken down into acid cause the tooth surface to dissolve. Different carbohydrates have different potential to damage teeth. Sucrose is the most common sugar that can be harmful to teeth. Talk to us if you think you may be prone to decay or you feel that you have holes in your teeth.

 More information on gum disease and prevention.

Gum Disease

Even in the 21st century there is still no cure for gum disease. 10-15% of the UKpopulation are still at risk of losing significant number of teeth from gum disease. However, with early diagnosis and modern techniques the irreversible effects of this disease can be reversed. Talk to us if you find that your teeth are becoming loose or your gums bleed when you brush your teeth or you suffer from bad breath.

 Toothwear

As people are living longer and keeping their teeth for longer, now it is becoming increasingly common for people to wear away the outer hard surfaces of their teeth, other than by decay or trauma.

In some people teeth may become loose or develop cracks or they slowly chip away. In extreme situations teeth become hypersensitive or develop dental abscesses. People who cannot adapt to this wear often end up with jaw joint, biting or chewing difficulties causing teeth to fit incorrectly.

When the teeth do not fit correctly, further teeth may be lost, in time. The distinction between acceptable and pathological toothwear at a given age is based on a prediction as to whether the teeth will survive that rate of wear in a functional and reasonable aesthetic state until the end of an individual’s life expectancy. Talk to us if you are aware of your teeth showing any of the above problems.

Loss of teeth is now considered to be just as devastating to some people as loosing any limb. Apart from the initial trauma of tooth removal, there are also functional disabilities as well as potential of social rejection in western society.

Replacement of teeth can be very time consuming, costly and not always predictable. However, simple preventative techniques can avoid years of misery of having to live with difficulties in eating and speaking especially when socialising due to active dental problems or missing teeth. Such problems cause discomfort or embarrassment and take away the self-confidence which means that an important ingredient is missing in people’s lives.

 Mouth Cancer

Although it is rare, it is still the 5th most common cancer that can affect people who are susceptible. If diagnosed early, treatment is simple and straightforward. However, if untreated, its consequences are devastating.

 What can you do to ensure your mouth is healthy?

Our role as Dental Health Educator is paramount in helping you prevent dental problems so that you can keep your teeth for life. So we recommend you follow these simple six steps to help you keep your teeth fit and healthy.

1. Brush your teeth twice daily for 2 minutes with a fluoride containing toothpaste. You have to be shown how to brush for brushing to be effective and we recommend using a good quality electric toothbrush.
2. Get the correct dietary advice which is appropriate for your lifestyle.
3. Fluoride supplements may be necessary if you are at high risk of developing decay.
4. Floss your teeth at least once daily.
5. Use a mouthwash that is right for you to combat decay, gum disease or bad breath.
6. Have regular dental checks at an interval as agreed between you and your dentist

Looking after your own teeth is actually a simple process of getting into a routine daily. Watching out for any signs of redness or bleeding in your gums and coming to see us if you notice any.

If you follow the simple six steps above and don’t ignore any warning signs then you are sure to enjoy a healthy mouth and healthy body for life.

People also often ask what is the best tooth brushing technique? Well, here is your answer.

Craigentinny Dental Care is a local Edinburgh-based dental practice dedicated to ensuring the people of Scotland enjoy a healthy mouth and healthy life.

Truth be told I am sad to see 2012 ending. Maybe it is passing the age of 40 or just that I had 5 minutes to myself but I found myself reflecting back on the summer Olympics which already seems like a distant, but hugely pleasant memory. As a one time rower, and coach for many years myself I was lucky enough to get a ticket to see the last day of the Olympic regatta. Seeing team GB doing so well at the very highest level of competition is something that will stay with me for the rest of my life.

It also got me thinking of the similarities between embarking on a campaign to win an Olympic gold and the journey to beat dental fear. Both goals con seem utterly unachievable from a standing start. After all the guys and girls who won the medals had to be at their very peak on just one day out of four years and then, on that day they still had to beat the best in the world.

When you think about their actual statistical chances of winning a medal, it is incredible that anyone chooses to pursue Olympic Gold. You might feel the same way when you think about the journey to beat dental fear. So what can we learn from our Olympic Champions?

At some point every top athletes makes a decision and sets themselves a goal. At that moment they have no idea whether they will reach it or not. At the point of making the decision they must be thinking only of what they want to achieve, if they actually contemplated the journey and how the odds were against them I am sure most people would never start.

Do you think that an Olympian wakens up one morning and just becomes great at their sport? Not a chance, their improvement is based on thousands of small incremental improvements. Most athletes are happy so long as each day they are getting a little better. And without doubt the process is not a linear one, there are often setbacks along the way too, some big and some small. Onemember of Team GB this summer that used to share the Union Canal in Edinburgh with us lesser mortals took 3 attempts before finally sealing the seal and achieving her Olympic Gold in 2012

So where do these improvements come from? Some times it is just a case of getting better at something through repetition but more often than not great athletes have good coaches who make the difference. Many of the coaches have already made the journey several times and can help, guide and support them through the process.

Now thankfully beating your dental fear is much easier that winning an Olympic gold, and what’s more you are statistically very likely to beat your dental fear with some professional help. But when I compare the Olympic journey to what we recommend to our patients the similarities cant be missed.

Here are my top tips as a dental fear coach

1. Making a commitment to tackle your dental fear- no matter how tall an order it seems
2. Identifying and setting a series of small achievable goals – break the fear down into small bits
3. Getting professional help and coaching to make the journey easier at any or all of the stages
4. Don’t expect miracles overnight – one step at a time and you will be amazed where it leads
5. With time, patience and a bit of help the results can be remarkable.

Any dentist will tell you that our primary role is prevention of dental diseases, not only does this retain your natural teeth and keep them healthy, but it keeps the costs down to you to… Always a good thing!

In this blog post we want to highlight the main ways that you can look after your teeth and prevent tooth decay so that you can maintain your healthy smile free of any dental disease.

We also want to provide a resource where you can find out more about tooth decay advice.

As this BBC article explains tooth decay in children is a problem around the world with incident rates increasing due to the additional sugar that so many people are now eating in their diets. And whilst there are reports about treatments that can make your teeth cavity proof at the moment, this technology is in its infancy and so it’s far better to ensure you look after your teeth now rather than waiting until the future!

This video explains how tooth decay can start by eating sugar and not keeping your teeth clean.

One of the problems with avoiding tooth decay is that people think they can clean their teeth after eating sugar and that this will make everything okay. The reality is that when you eat sugar your teeth decay for about 40 min to one hour afterwards, and after this saliva can repair minor damage but this takes approximately 6 to 8 hours. This unfortunately means that brushing after eating sugary snack does not actually make much difference.

To make this all a little easier to digester (pardon the pun) we produced and infographics about tooth decay without top six tips for helping to prevent it.

Please do feel free to share the image above using the links at the top of this blog post.

What are the signs of tooth decay?

One of the biggest problems is that this is a silent disease and you may not even be aware of its attack on your teeth. One of the very earliest signs is a very light chalky area on your tooth, this is an area of demineralisation and as this increases it can turn a darker brown colour and may eventually proceed to turn into a cavity.

It is at this point of demineralisation that it is possible to turn back the clock and prevent the cavity from forming, however once the cavity is there and physical tooth structure has been lost it is not possible to replace it naturally.

If the tooth decay has progressed to the point where you have toothache then it means that the nerves have become exposed and the decay has progressed to a more severe level. Immediate action is now required to prevent the disease spreading even more.

This is why it’s important to visit a dentist regularly, as we are able to spot these early warning signs of dental decay before the demineralisation becomes too severe and turns into a cavity.

Things which can exacerbate tooth decay.

Here is a list of things which can result in an increase in tooth decay, often due to the way the substances or conditions affect with the saliva which creates and natural buffering effect in your mouth.

• Diseases of the salivary gland – these can reduce the amount of saliva produced which affects your body’s natural ability to fight decay.
• Some medications such as antidepressants can impair the flow of saliva.
• Methamphetamine stimulants also affect saliva with users having a condition known as Meth Mouth.
• Excessive cannabis use leading to a condition known as cotton mouth.
• Smoking reduces your bodies ability to fight tooth decay.

The NHS Choices website also has some good information on tooth decay as well as a fun video which kids will find entertaining and educating.

This video also explains a little more about what happens when you have your teeth cleaned at the dentist.

Maintaining your all hygiene is a key part of the principal we have at Craigentinny dental care in Edinburgh, please do visit our own website for more information on preventing tooth decay.

If if you have missing teeth then you really only have four options:

1. Do nothing and live with the space.
2. Wear a denture.
3. Have a dental bridge.
4. Opt for dental implants.

Option one is often not the right thing to do as the adjacent teeth have a tendency to drift and fall into the gap, overtime this can affect your bite and mean that replacing a tooth in the long run is actually more difficult.

Option two, wearing a denture. Depending on how many teeth you have missing this is a more viable alternative, however many people dislike the idea of having to wear a removable denture. Dentures, whilst often excellent, can also sometimes feel loose which means that eating some foods is more difficult.

Option three of having a dental bridge is also an excellent treatment alternative. However it means cutting down the teeth either side of the gap to provide a support for the bridge. In some cases this is not possible and we can suspend a false teeth in the gap, however this does nothing to support the bone. When a tooth is extracted the bone will fall into the gap and shrink over a period of time, this often means that even with eight dental bridge the bone underneath the new false to shrinks away and can end up leaving a gap over time.

The option of having a dental implant, therefore fulfils this last requirement and prevents the bone from collapsing into the gap where the tooth was, as this gap is now replaced with a dental implant.

If you already have dentures and find that the dentures loose and wobbly then we can often stabilise the dentures with dental implants in a number of ways.

How to stabilise a denture with dental implants.

One option is to completely replace the denture with a fixed bridge. This Fixed bridge can be suspended on as little as for dental implants, and is often known as All-on-4 and is where we place 4 or more dental implants and then use these to hold in place a full set of permanent teeth. These are often made of either high-strength dental ceramic or a high-strength acrylic or composite hybrid.

Another alternative is to work with your existing denture, or have a new one made if you wish, and place fewer implants which have a stud on top. This stud it can be used to stabilise the denture and hold it securely in place.

This final alternative often works out at one of the most affordable and best solutions, it can often be done with the least amount of dental surgery and with fewer dental implants keeping the cost lower.

If you have a loose wobbly denture then this may be the perfect solution to help you eat, smile, chew and laugh again with confidence.

As the weather has turned colder over the last few weeks there really is no doubt that Summer 2012 is gone for good.   I will remember 2012 for many reasons not least of which was my  passing a significant age milestone. I do think however I will remember 2012 most for the Olympics and Paralympics. In combination they accounted for more hours glued to our television that I would care to admit. More importantly then reminded me of  the fantastic things that humans can  achieve when we set our minds to a task.

I was fortunate enough to get a ticket to see the final day of the Olympic regatta and was just one of 30,000 people cheering the Team GB athletes on to two golds and a silver that day.With me in the stands was one of my best friends with whom I used to both row and coach. After the regatta finished I suspect  we were not the only people to reflect on what might have been had we stayed the course in rowing all those years ago.

When I was involved in coaching the thing that I found most rewarding was helping people who had never before competed to any standard in sport and often thought of themselves as un-athletic and helping them to realise potential that they did not even know existed within themselves.

Today I judge my chances of winning olympic medal  as beeing  remote to negligible you may consider your chances of beating dental fear as being pretty slim too.
So what can we learn from the Olympians? I am sure every child who sets their heart on competing at the Olympics realises that the odds are against them from the start. But simply by making small incremental gains in their training and performance

A question we are often asked by patients is about whether they can see some reviews of others who  have had teeth whitening completed. Being able to review the effectiveness of any treatment prior to starting is important for any patient, in many cases this is difficult to do, however a great way to review a treatment is to look at before and after photographs of previous patients that have been treated.

In our opinion it is also always best to ask your dental practice to show you images of tooth  whitening of their own patients. Many of the dental material providers to dentists have library images and stock photographs of teeth whitening, of course it is simple for any dentist to show these photographs, what is more difficult is for dentist to show actual cases of patients that I have seen themselves at their own dental practice.

Case 1:

In this teeth whitening u can see that the teeth have lightened considerably in the second photograph. The way we can measure this is by using a tooth shade guide, these are provided by the dental manufacturers and provide a way for us to look at the colour of your teeth before

teeth whitening, and then to review the colour after teeth whitening.

This means that you know for sure that your teeth have lightened as we can calibrate the new colour against a standard shade guide.

Case Review 2:

This case shows teeth lightening in a different context using our take home system.  A nice result obtained gradually where our patient has the ability to stop whitening  early if they feel that the results are good enough.

Case Review 3:

When a dentist shows photographs of cases that they have completed, it is tempting to only show people with completely perfect teeth. However in this instance you can see that teeth whitening is able to make a huge difference to this patients smile.

Not every single person wants to have a Hollywood smile, and rather than try to convince everybody to go over the same homogenous look at Craigentinny dental care we pride ourselves on listening to exactly what the patient wants, and then working with the patient to provide this. In this case, the patient wanted a whiter and brighter smile without excessive amounts of treatment… And this is exactly what they got.

More information about cosmetic dentistry and teeth whitening is here.

Summary:

As you can see teeth whitening is suitable for many patients in many different circumstances, the good thing with using home teeth whitening is that you are able to control the amount of whitening that you want by wearing the trays for a longer period of time.

You will also notice that we prefer to opt for the minimally invasive option, and actually perform the least amount of dentistry. This is apparent in case review number three where we have simply lightened the teeth.