Dental Advice

Maintaining a healthy, balanced diet is important for promoting good general health and resistance to many diseases. However, it is also important to realise that eating and drinking habits also affect the health of your teeth and gums. We have all heard about dental plaque, a soft, sticky substance that builds up on the teeth. Plaque is mainly made up of bacteria which feed on the sugars in food and drink, producing acids as waste products. In turn, the acids attack the surface of the teeth which can ultimately result in tooth decay.

Many foods and drinks also contain acids which can dissolve away the tooth surface. This is particularly prevalent in fizzy drinks, squashes and fruit juices, pickles and citrus fruits.

Between meals it is best to avoid snacking on food and drink that contain high levels of sugar – instead try to select “safe” snacks which are not sugary or acidic for example, non-citrus fruits, bread and vegetables. Drinks like milk and water are “safe” as is tea and coffee as long as sugar is avoided. For the sake of good general health it is also sensible advice to try and eat five portions of fruit and vegetables per day.

Good oral hygiene is the best way to reduce the need for future treatment. It consists of three important procedures:

1. Tooth brushing

2. Interdental cleaning i.e. cleaning between the teeth

3. Cleaning the tongue

1. Why you need to brush your teeth?

Brushing your teeth at least twice per day is important to remove food and plaque residues which ultimately lead to tooth decay. Remember that teeth can “repair” themselves after an acid attack if given the opportunity and a good brushing regime is essential to assist this. You should brush with a fluoride toothpaste to help prevent tooth decay and gum disease. The way you brush your teeth is also very important – don’t use too much force and give your teeth and gums a gentle scrub for a minimum of two minutes. The bristles of the brush should be positioned against the junction between the gum line and the tooth at a 45° angle with ¾ of the bristles in contact with the tooth surface and ¼ in contact with the gums. Brush gently back and forth about 10 full cycles/strokes per tooth. A full cycle consists of a backward and a returning forward movement . Now starting from the original position with the bristles angled at 45° against the gum line, sweep in a rotational movement from the gum towards the tip of the crown about 3-4 times for each tooth. Now you can move on to the next tooth. After completing the outside of the teeth, you can repeat the procedure on the inside.

Remember to replace your brush when the bristles become misaligned or worn.

More recently, motorised toothbrushes, some with ultrasonic action have become available offering enhance tooth cleaning benefits.

We usually recommend an electric toothbrush. It simplifies the brushing procedure and is usually much more effective than manual tooth brushing. Most dentists and hygienists use electric toothbrushes for their oral hygiene.

2. Interdental cleaning

A tooth has five surfaces,

• the outside surface, towards the cheek
• the inside surface, towards the tongue or the palate
• the top surface, chewing surface or incisal edge
• the back surface ·
• the front surface

Brushing alone will only clean properly three out of these five surfaces. For good oral hygiene it is important to use dental floss, interdental brushes, dental sticks or a combination of the above. For professional advice regarding the right way to clean between the teeth do not hesitate to ask your dentist or hygienist. They will be happy to help.

Cleaning the tongue

Many of the oral bacteria get stuck on the back areas of the tongue. From there they multiply and colonize the teeth or the gums. It is good practice to use a tongue scraper twice per day in order to minimize the amount of bacteria in the mouth. 5-10 scraping movements starting from the back of the tongue and moving forward should be enough to get the tongue clean. Tongue cleaning is an often-missed step in the oral hygiene routine. It is very efficient in combating bad breath.

Bad breath is commonly caused by sulphuric compounds produced by certain bacteria. . Large active cavities as well as untreated gum disease are the most common reasons for bad breath. In most cases it is relatively easy to get rid of bad breath. Getting the cavities filled and the gum disease treated in connection with good oral hygiene routines not forgetting interdental and tongue cleaning is usually enough to solve the problem. Further measures involve ensuring that the mouth does not get dry, having a well balanced diet and for those who smoke, smoking cessation.

Mouth washes merely mask the odour temporarily but are not efficient on their own without treating the original problems i.e. filling the cavities or treating the gum disease.

Bad breath self test.

Many patients may be wrongly worried that they suffer from bad breath. A good test is to clean your hands thoroughly, rinse off the fragrance of the soap and dry your hands. Then, lick the back of the hand and let the saliva dry. While the saliva is almost dry or fully dry, smell the back of your hand. If it does not smell then you are likely not to suffer from bad breath.

For further information about bad breath you can read below:

The intensity of bad breath differs during the day, as a function of:

• Dry mouth
  • It occurs when the flow of saliva decreases
  • Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth
• Sign of a medical disorder
  • Local infection in the respiratory tract
  • Chronic sinusitis
  • Chronic bronchitis
  • Diabetes
  • Liver or kidney ailment
• Eating certain foods
• Smoking
• Alcohol consumption
• Lack of brushing and flossing

It may be disappearing following:

• Brushing
• Flossing
• Eating
• Rising with specialised mouthwash

Bad breath may also be persistent. The condition is called chronic bad breath and it is usually caused by the metabolic activity of certain types of oral bacteria.

It can negatively affect:

• The individual's personal self confidence
• Social and business relationships
• It may lead to poor self-esteem
• It may lead to increased stress

Your dentures should be kept as clean as possible to prevent further tooth loss, inflamed gums, or bacterial and fungal infections.

It is recommended that you clean your dentures thoroughly twice a day, and after eating when necessary.

Use denture toothpaste and brush and clean them as you would natural teeth. Do this outside the mouth.

Take great care not to drop your dentures. Always clean them over a sink half full of water to break the fall.

Occasionally thrush occurs. Immerse clean dentures in a diluted solution of Milton (half a tablet in a glass of water) for one hour. If it recurs, consult your dentist

You can remove your dentures at night to give your mouth a chance to rest. However, it is important to leave them in water to prevent any cracking.

It is important to visit us regularly even if you don’t have any of your natural teeth.

We do not only check teeth, but also the soft parts of the mouth, including the tongue and cheeks. Thus we can spot any infections, mouth conditions or even mouth cancer at the earliest stages.

Your dentist will tell you how often you should visit

Diligent cleaning and care of your dental bridge is as important as regular tooth brushing. This will ensure that your bridge will last for many years without having to be replaced. Bridges must be flossed and brushed regularly but extra care must be taken where the bridge meets natural teeth within the mouth. With fixed bridges it is important to keep the gums and teeth under the bridge or around the adjacent crowns plaque free.

A good method is the use of Superfloss, a specialized floss with a stiff end that can be threaded between the teeth or under the bridge. The working part is fluffy and removes plaque and debris efficiently.

Removable bridges may be cleaned using a combination of brushing, flossing and soaking – we will provide you with clear advice on the best cleaning regime for your particular bridge.

Fluoride is a natural mineral that is found in many foods and in all drinking water. Fluoride can significantly help dental health by strengthening the tooth enamel, resist acid and block the cavity forming action of bacteria. It also reverses early cavities. It is most efficient if it is used frequently as a mouthwash. It should not be ingested since it does not have any effect if it is swallowed.

Many studies have shown a reduction of 45-50% of cavity progression in individuals with active small cavities who rinsed 5-6 times daily with 0.05% sodium fluoride rinse. Fluoride works but it needs to be used the right way. Always consult a dental professional before starting to use a fluoride mouthwash.

Do not give your children fluoride mouthwashes or fluoride tablets without consulting a dental professional first.

Fluoride is found:

• Naturally in many foods (i.e. foods high in fluoride include fish, tea, and many different vegetables)
• All water contains some fluoride but the amount of fluoride in the water varies from area to area.
• Fluoride is also added to some drinking water supplies
• Toothpaste now contains fluoride, and most people get their fluoride this way. Fluoride toothpaste is very effective in preventing tooth decay.

Poor oral hygiene can lead to a variety of dental and medical problems such as gum disease, infection, cavities, oral cancer and more.

Regular check ups and cleanings can help us to keep your gums and teeth health as well as prevent any of the above problems.

How often do I need to see my dentist or dental hygienist?

Both children and adults should get a regular check up and dental cleaning every six months. Going to your regular check ups will help us to keep your gums and teeth healthy as well as detect any early problems such as gum disease, oral cancer and cavities.

You can enjoy a good dental health if:

• Brush your teeth twice a day using fluoride toothpaste
• Have sugary drinks and snacks less often
• Use small circular movements to clean your teeth.
• Change your toothbrush regularly
• Clean between your teeth using dental floss or wood sticks
• Visit your dentist every six months

All extractions are minor surgical procedures. Some pain and jaw stiffness can be expected which should ease over the next 4-5 days. You can expect have blood stained saliva for the next 24 hours ·

• You should keep to a soft diet and rest the jaws as much as possible
• Don’t apply hot face packs to the area of the extraction
• Take pain killers regularly as required (Paracetamol with or without codeine or dextropopoxiphen, Nurofen, Ibuprofen); don’t exceed the recommended maximum daily dose and if in doubt consult a pharmacist.
• If an antibiotic has been prescribed take as instructed and finish the course
• Avoid alcohol
• Do not smoke for two weeks after surgery as this impairs the healing process
• Clean your teeth as normal but take care around the operated area
• If the area bleeds excessively, roll up a handkerchief, place it over the extraction site and apply gentle pressure with a clean finger for about 10-20 minutes or by biting; it should stop bleeding

If you experience problems after leaving the practice please don’t hesitate to contact us for advice.

Oral cancer is not very common but the average 5-year survivability rate is only about 50%. Different sources suggest that 75%-90% of patients diagnosed with oral cancer are tobacco users. The earlier is is detected the higher the chances of surviving the disease. There are roughly 4700 cases per year in the UK.

1.7 % of all cancers in the UK occur in the mouth, i.e. 17 out of 1000.

Oral cancer is rare in people under 50 and males are affected more than females. The number of cases of oral cancer has increased since 1975.

Mouth or oral cancer often presents initially as a an ulcer lasting more than three weeks (80% of all cases of oral cancer present with an ulcer that does not heal). It could occur anywhere in the mouth but the majority of cases present under the tongue, on the back areas of the side of the tongue or behind the last lower wisdom tooth. Other signs of oral cancer can include lumps, sores, bleeding or rough patches, tenderness or even numbness within the mouth. Sometimes a sudden change in the fit of dentures getting increasingly worse over a period of a few weeks might indicate the onset of oral cancer. Any of these signs should be investigated immediately by a trained dental practitioner. Badly fitting dentures usually do not change their fit suddenly, they normally retain the way they fit for long periods and the pattern of pain on biting varies very little.

Risk factors

The risk of contracting it increases significantly if you smoke, chew tobacco or drink heavily. The typical mouth cancer patient is an elderly person who has abused alcohol, tobacco or both. Unfortunately in recent years, the incidence of mouth cancer has increased even among younger individuals who have not abused alcohol or tobacco but the risk among this group much smaller. Smoking is thought to increase the risk of developing oral cancer 4 fold and heavy drinking 4 fold. For patients who are both heavy smokers and drinkers the risk could be increased 16 fold.

Importance of regular dental examinations

Regular check-ups by your dentist are not only important for keeping your gums and teeth in good order but also to increase the chance of detecting conditions affecting the lining of the oral cavity ( surface of the tongue, soft palate, cheek mucosa)

Self screening

Checking the inside of your mouth should be part of the daily hygiene routine. Knowing what to look for is important but it does not replace the need to visit your dentist regularly. It is also equally important not to panic at the slightest sing of an oral ulcer, since they are very common. Many innocuous swellings appear in the mouth so if in doubt always contact us for an examination.

This is how to perform a check for oral cancer:

Mouth or oral cancer often presents initially as a an unexplained ulcer lasting more than three weeks (80% of all cases of oral cancer present with an ulser that does not heal). It could occur anywhere in the mouth but the majority of cases present under the tongue, on the back areas or the side of the tongue or behind the last lower wisdom tooth. Other signs of oral cancer can include red or white patches in the floor of the mouth, on the side of the tongue, lumps, sores, bleeding or rough patches, tenderness or even numbness within the mouth. If any of these signs are present for longer than three weeks call us or your GP immediately. Sometimes a sudden change in the fit of dentures getting increasingly worse over a period of a few weeks might indicate the onset of oral cancer. Any of these signs should be investigated immediately by a trained dental practitioner. Badly fitting dentures usually do not change their fit suddenly, they normally retain the way they fit for long periods and the pattern of pain on biting varies very little.

Report any unusual pain or behaviour of the oral tissues, like unexplained numbness, sudden change in the fit of dentures, sudden loosening or change in position of the teeth.

Most importantly, if in doubt, call us at any time for a check-up if you find something that worries you.