We are pleased to be able to offer new diagnostic services to our treatment list so that we may be able to be more precise on causes of decay and gum disease. Both of these diseases occur in people that exhibit a susceptibility to the bacteria that cause them.

GUM DISEASE

It has long been known that the bacteria that cause gum disease are extremely potent and pathogenic. It is also known that the bacteria can be passed from person to person via contact and sharing food and drink. This does not mean that if bacteria are passed on that the recipient would then develop the disease.

There needs to be the correct oral environment coupled with susceptibility to the disease. Progression and treatment of the disease is then further affected by modifying factors such as smoking, type 1 and 2 diabetes, other immunosuppressive conditions, conditions and/or medications which interfere with a person’s ability to perform acceptable plaque control or reduce their body defences against infection.

Gingivitis (gum inflammation) is the first response of the gum tissue to plaque and aggravating factors. This can be simply treated by removing the plaque and giving oral hygiene instruction to ensure that the condition does not occur again. The presence of gingivitis does not mean that the person will necessarily develop gum disease, there needs to be susceptibility, the correct bacteria and the above modifying factors.

Gum disease is mainly characterised by loss of attachment of gum tissue, loss of bone and eventually loss of teeth.

Gum disease can be present without the presence of gingivitis. Treatment of gum disease therefore differs greatly from a general scale and polish. Those of you that have undergone treatment for gum disease at the practice will be aware of this.

In order that we may be able to be more accurate in predicting progression of the disease and specific bacteria in the oral environment and treatment we now have diagnostic tools available to us.

DENTALYSE

PATHOGEN TESTING - we can now identify specific bacteria in the mouth that cause gum disease and treat them according to their pathogenicity. Antibiotics specific to these bacteria can be used alongside the correct treatment modalities. The test is carried out before and after treatment. The test after treatment will determine whether all of the harmful bacteria have been removed. The test can be site specific or can be carried for the whole mouth.

This test will be suggested for those people that have localised deep gum pockets or gum pockets that are not resolving with conventional treatments.

GENOTYPE TESTING- Everyone’s immune system is different; some people are more susceptible to bone loss that others. The immune system of susceptible people typically shows higher levels of inflammation leading to destruction of gum and bone tissues. We are now able to identify susceptible people by detecting the differences in their immune system before any other signs are visible. The effects of these immune differences are dramatically increased in high risk people such as smokers and those with particular medical conditions.

We will be using the genotype test on all potential implant patients to give an idea of healing capacity, healing time and to determine whether they will be at risk of losing the implant. It may also be used if patients with gum disease want to find out about susceptibility for their children or partners.

INFORM DENTAL

This is a process by which we can refer patients in the red category, high risk zone for gum disease to a specialist. There is a shortage of gum specialists in this country and the general dental council (GDC) states that all patients in the above category need to be assessed by a gum specialist. This means that patients may need to travel far and pay large sums of money to a specialist for this service. A typical consultation charge for a periodontist is £250 and treatment sessions can range from £250- £500.

Smile Design Dental Practice is one of the pilot practices for Inform Dental, an on-line referral site which gives us access to the expertise of a gum specialist, Dr Richard Snoad. Inform Dental has been approved by the GDC and Dental Protection. Carole Brennan and Dr Komal Suri have had specific training by Dr Snoad so that gum measurements taken at the practice are calibrated with him and are accurate.

Information gathered in an appointment at the practice, measurements, plaster models of the teeth, photos and x-rays, will be sent to Dr Snoad who will be responsible for creating the correct treatment plan for that patient. Treatment will be carried out at the practice by Carole Brennan and will be overseen by Dr Snoad. The patient will get a pack unique to their condition and treatment. You will also be able to access your own diagnosis, treatment plan and home care instructions on the Inform Dental website by using your patient number which will be assigned to you. All correspondence is confidential and cannot be accessed by anyone else.

Patients that we find are in the red high risk zone or the amber zone with modifying factors will be referred by this method to Richard Snoad in accordance with GDC guidelines. The price for the referral will be £150. Treatment session prices will not vary from our current periodontal therapy prices which are £145 per session.

Please contact the practice on 01296 624163 if you would like more information or to book an appointment.

Facts about Dental Caries (decay)

Cavities are the de-mineralized areas, or holes, that form in teeth as a result of a bacterial infection, this decay is also known as dental caries. The infection takes place when acid-producing bacteria replace the normal healthy bacteria in the mouth. 

Two main things are responsible for this shift in bacteria:

1.         Prolonged acidic (low pH) environment in the mouth: made worse by a lack of saliva, or a sugary/acidic diet that favors acid-producing bacteria

2.         Transmission: dental decay can be passed from person to person through exchange of saliva.

PREVENTION VS REPAIR

‘Drilling and filling’ has been the traditional method of treating cavities, but it doesn’t treat the bacterial infection, just the symptoms.  Brushing and flossing have been the usual method of prevention, but they do not change the pH (acidity) of the mouth or treat the infection once it is there.

Here at Smile Design Dental Practice we try to be at the forefront of dental technology and have made available several products that treat the cause of decay rather than wait until the damage is done – preventing rather than repairing tooth decay. So for less than the cost of one new filling you can reduce your risk of needing more fillings in the future.

What can you do to stop getting decay?

If you have a high risk of getting further decay there are several things you can do and several treatments we can offer:

1.         Try to limit both your intake of sugary/carbohydrate containing items in your diet, also reduce non-sugar containing acidic beverages (i.e. fizzy drinks, coffee, tea, sparkling water, and alcohol) especially between meals.

2.         Consider the acidity (pH) of the dental products you are using. The latest mouth rinses now available at reception can neutralize the acid (decay) causing bacteria.

3.         Fluoride in toothpaste is important, to remineralize (repair the damage done by decay) your enamel and make it stronger. Toothpastes with a higher concentration of fluoride are available at reception for anyone over 10 years of age.

4.         Chew Xylitol chewing gum (or use Xylitol containing gums, mints, rinses, or toothpastes) after and between meals. Xylitol is a very effective at limiting the acid produced by bacteria, and it makes fluoride more effective.

What is Xylitol?

Xylitol is a 5-carbon sugar that is commonly found in birch tree sap and naturally occurs in some fruits and vegetables.  Xylitol works to prevent cavities in a number of ways:

·         Bacteria cannot break down Xylitol into acid as they do from all other sugars

·         Xylitol helps prevent the bacteria from sticking to the tooth enamel, which prevents them from breeding.

·         Xylitol, used with fluoride, can be more effective at repairing the damage done to teeth from decay than fluoride alone.

·                    Xylitol actually works to control the number of acid-producing bacteria in the mouth, which can in turn prevent cavities, and is available in many forms; from gums and mints to toothpastes and mouth rinses.

What treatments can we offer to stop you getting decay

      ·         Remove decay and fill the affected teeth

·         Apply fissure sealants (clear plastic coatings) on vulnerable teeth

·         Apply Fluoride Varnish where indicated (this is especially effective for children)

The CariFree Treatment System

      ·         CariFree Treatment Rinse (twice a day for 1 month)

·         CariFree Maintenance Rinse, higher concentration Fluoride Toothpaste, CariFree Toothpaste, Xylitol chewing gum

What is the CariFree Treatment Rinse?

CariFree Treatment Rinse is designed to treat the cavity-causing plaque bacteria biofilm, reduce the overpopulation of cavity-causing bacteria, and neutralize decay-causing acids. It contains both Xylitol and Fluoride. It also freshens breath. It can be used by anyone over 10 for 1 month.

What is the CariFree Maintenance Rinse?

CariFree Maintenance Rinse is designed to be used following the Treatment Rinse. It promotes healthy bacterial growth and limits the growth of decay-causing strains.  It is alcohol free and again combines fluoride and xylitol to neutralize cavity-causing acids. It is non-staining, does not alter taste and contains green tea and cranberry extracts.

                                            For more information contact the practice on 01296 624163

                                                                 or go to: www.carifree.com

For a limited time only!

We are offering a reduction in the price of whitening treatment at Smile Design.

INSURGERY + HOME KIT       offer price £550               usually £700

INSURGERY WHITENING       offer price £375               usually £450                      

HOME KIT WHITENING         offer price £210               usually £250                      

Please call to book a free consultation before the end of September to take advantage of our great summer special offer.

01296 624163

Oral cancer is one of the few types of cancer that has not experienced a significantly reduced mortality rate in the last 30 years. The main reason for this is that 70% of cases are already in the late stages before it is detected and it is simply too late.

Traditionally mouth cancer has been associated with older males who use tobacco and alcohol, but an increasing number of people developing this deadly and disfiguring disease are younger males and females who do not use tobacco and alcohol. One reason for this trend is that mouth cancer is now known to be caused by exposure to the sexually-transmitted human papilloma virus (HPV). This means that anyone who is sexually active is at risk from mouth cancer.

You can reduce the risk of developing oral cancer by:

1. Not using tobacco. Not using tobacco is the single most important thing you can do to avoid oral cancer

2. Reduce excessive consumption of alcohol.  More than 15 alcoholic beverages a week may put you at greater risk of developing mouth cancer. If you must drink, do so in moderation.

3.  Reduce or stop the combined use of tobacco and alcohol. Using both tobacco and alcohol significantly increases the risk of developing oral cancer.

4. Excessive exposure to the sun. Unprotected exposure to the sun increases your risk of developing lip cancer. Use at least SPF30 sun block for your lips

5. Avoid the use of betel nut and bedis. Betel nut and bedis are causative agents for  oral cancer when chewed of smoked.

6. Eat a healthy well balanced diet. A diet rich in fruit and vegetables contains protective nutrients, reducing the risks of developing a variety of diseases including oral cancer.

The key to controlling mouth cancer is early detection.

Until recently, the primary method of detecting oral cancer has been by visual screening that relies on the naked eye of the clinician. Unfortunately, mouth cancer is often only apparent under these conditions at the later stages of the development of the disease. However, with new breakthroughs in technology, there is now a product called the VELscope Oral Cancer Screening System.    

Smile Design Dental Practice are the proud owners of the VELscope Oral Cancer Screening System

Through the use of light shining through the tissues Velscope assists in the detection of abnormal areas, including pre cancerous lesions that may not be apparent to the naked eye.

All patients attending Smile Design Dental Practice benefit from having the VELscope Oral Cancer Screening System incorporated into their Comprehensive Care appointments. 

The screening examination involves shining a safe blue light into the mouth. When viewed through special filters, abnormal tissue will appear as an irregular, dark area that stands out against the otherwise fluorescent green of the surrounding healthy tissue. In most cases the VELscope exam will indicate that there is nothing to worry about.

 If there is an area of potential concern, patient can be referred to the appropriate specialist for an accurate diagnosis at a considerably earlier moment in time.

Fortunately, the survival rate for oral cancer discovered in the early stages is extremely high.

That is why it is recommended that people should have an oral cancer screening once a year, or twice a year if you smoke or chew tobacco, and it is for this reason that we at Smile Design Dental Practice have invested in this technology. 

By promoting the early detection of oral cancer, it is hoped that the current mortality rate of this dreadful disease can be considerably improved.

Want to know more, then visit:

www.canceradvice,.co.uk

www.MouthCancerFoundation.org

www.rdoc.org.uk

www.wikipedia.org/wiki/oral-cancer

www.info.cancerresearch./org

The National Institute for Clinical Excellence (NICE) has just published a guideline entitled Prophylaxis against Infective Endocarditis.

The new guidance, arrived at following a comprehensive analysis and review of all published evidence, now states that antimicrobial prophylaxis is no longer considered necessary for any patients at risk of developing infective endocarditis when undergoing dental procedures.

This means that for patients that have heart murmurs, antibiotics are no longer necessary. However I fully understand if those patients who have taken antibiotics in the past want to continue. Dr Suri will be more than happy to discuss this with you when you attend the practice again.

The only cases that antibiotic prophylaxis is still necessary are within six months of a joint replacement.

LINKS BETWEEN GUM DISEASE, DIABETES AND HEART DISEASE

Gum Disease is a chronic bacterial disease that affects the gums and bone supporting the teeth. It is serious infection that if left untreated can cause major problems for your mouth including loss of teeth.

Prevention and treatment of gum disease is acquiring more importance amongst health care professionals due its links with diabetes and heart disease. Gum Disease can contribute to these illnesses through the addition of bacteria and inflammatory agents from the mouth into the bloodstream which carries them to the rest of the body.

HEART DISEASE AND GUM DISEASE

Presence of gum disease can increase a person’s risk of heart disease. Oral bacteria provoke inflammation which increases levels of white blood cells and a certain protein called C-reactive protein (CRP). This protein is found in the blood and linked to heart disease. In recent trials, treatment of gum disease reduced the patients’ levels of CRP. CRP levels can be tested for in the blood just like cholesterol can and this test can be requested from the doctor.

Studies also suggest that adults with the highest levels of some oral bacteria have thicker carotid arteries which can lead to heart attacks and stroke.

DIABETES AND GUM DISEASE

It is thought that a third of all diabetics will suffer from gum disease at some stage of their disease.

Patients with diabetes suffer from a list of impaired bodily functions, one of which is thickened blood vessels which reduces the efficiency of the flow of nutrients and removal of waste products from body tissues. The impaired blood flow weakens the gums and bones which makes them more prone to infection. If diabetes is poorly managed it can lead to higher glucose levels in the mouth which encourages the growth of bacteria that cause gum disease and decay. Once gum disease has developed in a diabetic patient it is difficult to shift. The relationship between diabetes and gum disease has a synergistic relationship. Periodontal disease makes it harder for diabetics to control their blood sugar levels as it increases the blood sugar in the body. The more severe the gum disease the higher the blood sugar levels which in turn leads to increase risk of diabetic complications.

Diabetics who receive good dental care and look after their gums are less likely to develop periodontal disease.

Although patient treatment hours remain from 7.40am – 4.00pm, Monday to Thursday, there will be now be reception cover at the practice from 7.30am – 6.00pm Monday to Thursday and until 4pm on Friday.

We hope that this creates more convenience for our patients.

We are pleased to welcome Allison Eldridge to the practice. She is our new receptionist and administrator.

Our front desk team now consists of our Practice Manager, Karen Hearn and Allison. They will handle all financial and appointment queries.

Karen Ignatowski and Claire McCorkell deal with all clinical enquiries.

Karen Hearn, Practice Manager is currently studying for a Business Management Degree and has also furthered her education in relation to dental matters after spending some time in America last year and attending numerous dental courses in 2008.

Claire McCorkell, Dental Nurse, has furthered her education in Dental Nursing and has recently undergone training regarding the most current practices of cross infection control.

Karen Ignatowski and Claire McCorkell are now fully registered members of the General Dental Council.

Carole Brennan, Hygienist, has been elected as Secretary for the British Society of Dental Hygiene and Therapy. She is the chairperson for the Thames Valley Regional Dental Hygiene Group.

Carole is now fully qualified to carry out whitening treatments without the presence of Dr Suri. Her teaching programmes this year include a two day course for hygienists at the Association of Dental Implantology.