Winning Smiles

How long do Dental Implants last

2010-04-27T11:49:39Z

The truth about Peri-implantitis….(which in English means HELP, my implants are failing!!)

I recently had a new patient consultation with a chap who had had a quote for implant work at another practice. Nothing extraordinary about that I hear you say….except that

he had been told – your implants will last a lifetime

Which prompted some immediate questions from me, like for instance

who’s lifetime, the dentist, the patient or the implant?!
who’s going to guarantee those implants for a life-time?

Because it’s all very well making longevity-promises to people but without a back-up plan and some ‘what-ifs’ in the

contract, those promises start to sound rather hollow!

Here’s what we do at Winning Smiles to ensure that our implants survive for the longest time possible

Having the right attitude helps!

Admit that implants can and do fail both short term and long term (denial is indefensible, see above)
Keep abreast of the latest evidence-based studies on what causes implant failure and what the best failure avoidance strategies are recommended – (Like the European Forum on Peri-implantitis held in London in January 2010)

Having a clear, well defined follow up protocol for each and every implant patient, tailored to individual needs eg

- Regular implant-hygiene sessions with our implant-trained hygienists
- Bi-annual inspections (x-rays when indicated) with the implantologist
- Hygienists trained to carry out our screening protocol for signs of early problems (eg the beginning of peri-implantitis)

Giving patients the right information

Peri-implantitis leads to implant failure if undetected (or not looked for – head in sanditis)
15% of implant patients will suffer from some form of peri-implantitis (from recent long term studies in Europe)
Patients who have lost their teeth from gum disease have a much higher risk of losing implants
Patients who don’t manage to keep plaque off the implants also at higher risk
Patients who smoke have a much higher risk of peri-implantitis and implant failure
Patients don’t know when they haver peri-implantitis because it doesn’t hurt, right up until the implant tooth falls out!

But look on the bright side!

we detect problems early using our screening protocol
we can treat them easily in the early stages
late stage treatment is more complex but still possible

And most of all, as with teeth, as with implants: keep them clean, stay off the fags and please please turn up for routine checks

and maintenance…..implants are not fit and forget…

To: Our dental implant page

Pain Control and Dental Implant Surgery Part I

2010-04-10T18:54:52Z

It is quite common that patients who are considering, or about to undergo dental implant surgery to be in the dark when it comes to predicting how much pain to expect.

We hope this will help understand the implications from

a) the surgery itself
b) during the recuperation period immediately post-surgery (ie the next week or two)

And although at Winning Smiles we always encourage new implant patients to have a chat with patients who have had the whole ‘implant experience’, most patients won’t actually take us up on that offer – even though our previous implant patients are usually very happy to talk about it!

So I thought it might be useful to pen a broad classification of what pain and trouble you might expect from our implant procedures here at Winning Smiles. All implant surgery is not the same, so I have divided it up a bit (with a note on sinus surgery/bone grafts at the end)

1) Simple implant surgery ie 1-2 implants, no ridge splitting, no sinus work, no grafting

No need for sedation unless you are a nervous patient

Pain during surgery: none

Recuperation period: 2 days, mild soreness around gums, most patients will go back to work next day without the need to take even an aspirin.

2) ‘Middle of the road’ cases ie 3-4 implants or 2 implants with ‘extras’ like sinus surgery/sinus ‘tap up’/simple bone grafting/ridge expansion

Sedation recommended

Pain during surgery: none! (No, really!)

Recuperation: 3-10 days. Mild to moderate soreness around gums, mild swelling. Individual patients respond very differently in these cases.

For some patients it is very easy and they get only minor post-op soreness. At the other end of the spectrum a few patients will have to take painkillers for a few days and may bruise (in fair skinned patients the bruising can be quite noticeable).

3) Complex cases ie a whole upper jaw/lower jaw, 4-16 implants, ‘block’ bone grafts, etc

Sedation strongly recommended

Pain during surgery: none

Recuperation: 7-14 days. Moderate soreness around gums, moderate swelling, pain killers for the first week. Bruising can be quite widespread in fair skinned patients (ladies – buy concealer before you come!)

4) Sinus surgery:

no pain during surgery, little or no pain afterwards with mild swelling. Bruising on fair skinned patients.

5) ‘Block’ bone grafts – where we take bone from the chin or lower jaw and screw it into place somewhere else (often upper front area)

Ok, again we would expect no pain during the surgery but considerable soreness/bruising and some swelling for 1-2 weeks afterwards.

Similar to ‘complex’ cases above, it’s not something we enjoy doing to patients but in some cases the only way forwards – and they do work very well.

This is a lot of detail, but we find people would rather know these things up front, rather than find out after the event.

Dental Bridges or Dental Implants

2010-01-13T14:06:02Z

A video!

Andrew explains the pros and cons of the implants vs bridges argument and why he generally prefers to use dental implants to replace missing teeth these days. This is the blog about dental bridges referred to in the video.

Length: 1 minute 50 seconds.

Why quality dentistry will save you in the long run

2009-12-18T10:09:02Z

Can you spot the grotty ‘white’ filling in the middle of the picture? Believe it or not this filling was not done at the turn of the century but completed a couple of years ago!

If you look at the tooth to the left of the one with the grotty ‘white’ filling you may be surprised to know that 15 mins previous to this photo it looked exactly like the grotty one. We are replacing this chap’s ugly white fillings with nice shiny new ones that look their age (ie well into the 21st century)…

People often ask if we enjoy dentistry. But who wouldn’t like being able to take out that grotty old filling and replace it with a nice shiny new one. We can get this invisible effect using our beautiful italian white filling materials, and a little bit of technique to go with it!!

Ok here’s the rub:

Grotty white filling in the middle of the picture
Estimated cost £20
Estimated time involved 5 mins
No guarantees
Replace every 2 years?

Shiny new Italian composite filling on the left
Time involved 15 mins
Cost £70
Cost of filling material: at least double that of the cheap stuff
5 year guarantee.

Quality dentistry costs less over time and makes you feel good.

Spot the crown competition

2009-11-12T22:44:29Z

Just for fun

Winning Smiles spot the crown competition take 2:
Clue: there is one crown in this picture, can you tell which one?

Spot the crown

Some of the simplest jobs are the most satisfying.

Invisible filling in front tooth – as good as new

2009-07-08T10:58:02Z

Sometimes its the little jobs that make such a difference.

This chap said he had been hiding his smile for years. His main issue was the general yellowness of his teeth and an old filling in the upper central incisor.

We carried out some (minor) bleaching and replaced that old filling with a new one using Enamel Plus HFO material with Dr Lorenzo Vanini’s technique – see our best white fillings blog article.

Not sure if these pictures do it justice (it may depend on your computer settings). The real-life difference was more remarkable, but I’m sure you can see the difference anyway.

Recent dental implant case studies

2009-06-23T14:48:12Z

Dental implants are an increasingly popular choice for my patients as I’ve been doing a lot of them recently.

So I thought it was about time I posted a few case studies. Here they are:

Tooth replacement and smile makeover: Case Study

A full set of replacement teeth: Case Study

Implant bridge: Case Study

Implant retained dentures: Case Study

I’d love to hear what you think – or if you have any questions about dental implants at all, please do post something in the comment box below.

Closing gaps between teeth

2009-06-11T16:29:27Z

I thought it worth jotting a few words down about this one – it’s such a common problem for people, and frankly so easily fixed (without breaking the bank)!

Here at Winning Smiles we’ve been closing gaps between teeth for years, using our Italian composite-filling system (the same white filling system we use for tooth decay) – see our best white fillings blog article.

The beauty of using ‘Cosmetic bonding’ with a top class tooth-coloured filling system (like Enamel Plus) is that:

the teeth don’t need to be cut or ground down;
it’s over and done with in one visit (no waiting for crowns or veneers to come back from the lab);
it’s painless, really, I don’t even use anaesthetic for this technique!

So what are the drawbacks?

Nothing too serious really, I recommend having them polished once or twice a year to maintain their ‘lustre’ and I usually do the polishing during routine 6 month examination appointments (at no extra charge).

They can get chipped/broken, but so can veneers, the difference is that these bonded build-ups can be repaired seamlessly (chipped veneers have to be replaced completely).

And all for around £400. Something worth talking about? In fact, it’s such a popular treatment I don’t know why I haven’t mentioned it before!

Here’s an example of the before and after pictures:

Are your teeth stained on the inside?

2009-06-04T17:39:37Z

Many people are familiar with the techniques used to whiten teeth from the outside, but I doubt many of you know that discoloured teeth can also be bleached from the inside, out!

There are times when the teeth are discoloured from within rather than from run of the mill red wine and coffee stains on the outside. It usually involves one or two front teeth (upper or lower) that have been root-filled in the past and have become severely discoloured (brown, yellow or orange).

When these badly discoloured teeth are combined with a generalised yellow appearance of the other teeth (from years of staining) this makes for the hand-over-mouth, or lip over teeth, smile that so many patients seem to put up with.

Standard dental bleaching involves either using trays at home or a special light source used in the dental chair (see my teeth whitening blog for views on which works best). However it is also possible to bleach the inside of these very dark (root-filled) teeth, and at Winning Smiles we use a technique that combines both bleaching the outside of all the teeth and bleaching the inside of those extra-orange ones. The results are quite spectacular and often avoids the need for drilling and crowning these individual problem-teeth.

In the photo, two of these front teeth were ‘off-the-scale’ orange, the rest were just a creamy shade of yellow from normal staining. The patient had 10 days to go before his dream wedding in the caribbean. This is how he looked after a week of Inside-Out-Bleaching. Can you tell which ones used to be orange?

If you look really closely, two of the teeth are whiter than the others – yep, you guessed it, those are the ones that were orange a week ago!

Perfect smile not required

2009-02-17T08:59:18Z

Someone came to the surgery the other day, and this happens a fair bit, they apologised for their teeth.

It reminded me that I should put ’something on the website’ about this, as we’re really not here to judge anyone and people should not feel the need to be embarrassed (even if it is human nature).

You see, its only when people really need us that we get to make the most difference.

And if its not too selfish of us, we’d be delighted to see you.