Winning Smiles

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.

White filling photos

2009-02-14T09:56:32Z

More work inspired in Italy, crafted in Romford, Essex. We’re proud of this one

Readers are invited to guess which one is the filling, and which one is the crown.

I would take the opportunity to mention that our white fillings are always guaranteed to stay in.

Immediate dental implant techniques

2009-02-09T21:31:21Z

Just recently we’ve had an unusual number of patients coming in with serious problems with single front teeth. Perhaps it’s something in the Essex water!

Among the causes of these problems are

sports injuries (eg getting kicked in the face playing rugby)
‘other’ injuries (eg falling down the stairs or sliding on the ice)
old crowns that have failed and cracked the root
problems with old crowns with posts
problems with root filled teeth

in these cases extraction is often the only option.

In the past we would have had to wait months after extracting the tooth before putting the implant in, and then a few more months of waiting before the implant could have a tooth added to it…..6-9 months of waiting with a temporary bridge in place…

With Immediate Implant techniques we can often bypass this waiting time: if the bone is intact around the failing tooth and there is no infection present then we can (very) carefully extract the root (without damaging the socket walls) and put an implant directly into the tooth socket!

And if the implant is secure in the bone then we can even put the titanium post into place and put a temporary crown on top.

Where appropriate this treatment means that the patient can literally come to the clinic with a failed tooth and leave a short while later with their new implant tooth in place.

Painless Dentistry: Dental Wand Demo

2009-01-28T19:05:12Z

You may have heard of the dental wand, but if you haven’t seen it and want to know how it works, this is for you.

Although Matt told me this would be fun, I’m not sure now - it’s always horrible hearing yourself speak isn’t it?

Video length: 2 minutes and 50 seconds

All feedback and reviews welcome, I hope you find it useful.

Pain free dentistry, the secret ingredients

2009-02-01T18:45:50Z

I’ve written before about pain free dentistry, and that it shouldn’t be an optional ‘extra’. We’re all human, and none of us would look forward to needles and discomfort. We always use the dental wand to make the visit as painless as possible.

But, although this technology has been around for a while, most new patients are as wary as ever.

I’m hoping that some day this worry might simply just go away. It would certainly make for less stress the day before the visit - from most people’s accounts.

But a good friend set me thinking about this again the other day whilst in the chair. He asked if we were busy or not, which we pretty much always are. Its a common question, and then it dawned on me, as he was looking around.

He has a very sensitive mouth, and I can almost go and make a cup of tea whilst we’re waiting for him to be ready for treatment - except it’s nice to have the time catch up.

But the secret ingredient - its a ‘time’ thing

People do vary in the amount of time it takes for their mouths to numb. And the key is definitely ‘not to rush’. Don’t rush the anaesthetic, use the proper amount according to the patient, and don’t rush the treatment.

It’s been fairly second nature for quite some time in dentistry, and so perhaps we didn’t tell everyone we needed to (hence this post).

My view is that with the right planning, there is time to do everything we need to and communicate, which is our other key tool!

Time and communication.

Perhaps I will ask Damien to write about the dental sedation skills he’s bringing to the practice too, it might be useful for people to know a bit more about that, and we often work together. Watch this space.

update: Andrew recorded a video about the dental wand

Dental Patients being charged twice?

2008-12-18T17:41:54Z

Time to read exactly 2mins and 16 seconds

I heard on the radio today, ( BBC dentist article) that ’some NHS dentists’ are playing the system and charging patients twice for the same treatment.

It is a highly emotional subject for many, and it pains me that the some parts of our media take advantage and sensationalise aspects of this very difficult subject. A number of news reports have even neglected to point out that this situation is only relevant if you are an NHS patient.

This particular version originated with the Tory party, so I can only assume there are political points to be scored with the release of this latest ‘report’…

I do feel the need to stick up for the vast majority of dentists, because I know many who still work within the NHS system, and without exception they are honest hard working professionals providing the best service they can, within, what has to be said is a very narrow framework afforded by their NHS contracts (managed by the local Primary Care Trusts).

I know those of you who know me will have heard this before, but I think that the problems of providing government regulated (tax funded) ‘dentistry for all’ are once again shown up in sharp relief.

The main points as I see them are threefold

Dentistry is now not only about stemming pain, it is about the long term benefits of the work carried out. In our opinion, it is better to spend more time and money on something that lasts longer. There is a whole other conversation about how the work looks (aesthetic or cosmetic) and self esteem, but in this context we should also see it from the society’s point of view (government).
Where does the line get drawn between stemming pain, and providing long lasting quality work? The vast majority of us pay taxes. How much should we spend on medical ‘non-essentials’ that don’t save lives - of which dentistry is one.
The above issues mean that the government is forced to ‘ring-fence’ nhs dentistry to prevent dental costs spiralling out of control at the expense of those essential bits of medicine which save lives….

‘Ring-fencing’
in this instance means capping fees (forcing dentists to use cheap materials and work faster than they should) and limiting what treatments can be used and when (ie only ‘low cost’ treatments approved). The results are disgruntled dentists, disgruntled patients and a subject which recurs every time the media has a ’slow news’ day!

Now I’m just waiting for the obvious response to this email which is, ‘Fine, you think you can do any better?

What’s your solution, Einstein!?’

A subject for another day (soon)