A great smile just trying to get out....

Sometimes we say things that can cause so much damage. Mostly, it's not intentional, but the damage is so real. In dental care, its as true as in any other walk of life. Here's a story.

A nervous young lady came to see me recently. She was new to York Place, came on a recommendation. Her last dentist had told her that she "had the mouth of a 50 year old".

But she's in her 20's....

She thought she had gum disease and was going to lose her teeth. She was a very worried lady.

We checked her for health. OK, she had a few damaged teeth, and her gums bled because she had some plaque on her teeth. There were some food stains and some tar stains from her recently - ceased smoking habit.

But that was it.

• Her gums can be fixed - we will show her how.

• Her teeth can be fixed. 

• She's going to look GREAT and she has an excellent dental future.

....and the team can help to keep her like that with her own mouth care program.

She's now a lot happier, and we undid something that was careless and untrue. I so hope that we don't make the same mistake...

Has anything like this ever happened to you? Let us know....

A Cure for sensitive teeth?

Working with small whitish bits of peoples anatomy can be profoundly rewarding, and occasionally extremely frustrating. Luckily, technology moves on, and last year's impossibility becomes this years hot treatment...

Lasers, titanium implants, tooth whitening, ceramic veneers all make the headlines and occupy the column inches and lifestyle shows. 

A less sexy topic is tooth sensitivity. Most people suffer from it a bit, a few suffer a lot. Medicated toothpastes, care with diet and good mouth hygiene is usually enough, but there are a sizeable number of people out there who have a severe problem, and nothing seems to work. 

In particular, their tooth sensitivity makes their hygiene appointments a time of dread, their sweaty palms and fingers digging into the armrests of the dental chair. Sadly, its often precisely these people who need the most intensive hygienist support. Its all very well being offered a local anaesthetic  - but surely there must be alternative?

Enter Remesense. 

Some of you may remember a similar product called Savodent, which was sadly discontinued. This is pretty much the same stuff.

We've tried it on some our most sensitive patients in a totally non scientific trial, and it does seem to work where other products haven't. A ten minute gel application at home in a special gum shield can provide at least two week's protection.

Which means:

Comfort when eating.

Comfort when drinking.

and importantly comfort when visiting your hygienist or dentist.

Click the link below and ask your dentist next time you're visiting. 

http://www.remesense.be/template-l-ENG-m-werking-f-gebruik.htm

We have no commercial interest in this product, this information is intended to relieve pain and misery!

Have you got sensitive teeth? Get in touch with us and let us know what's bothering you...

Straight teeth in ten weeks : The Inman Aligner

Is this you?

• You've got crooked top or bottom front teeth.

• You had a brace when you were younger, but things have relapsed.

And you want to do something about it?

Inman Aligner could be the answer for you...

At York Place Dental we're delighted to be the first Practice in Carlisle to become a certified Inman Aligner provider.

Using hi tech removable braces, you could have the straight upper or lower front teeth that you've always wanted. Easy to wear, cheaper than clear aligners, in as little as six to sixteen weeks you could have straight front teeth. 

And for the first few cases we're throwing in tooth whitening for nothing :-)

No NHS waiting list, you could be starting your treatment in the NewYear.

Why not give us a call on 01228 533431 or check us out on facebook at https://www.facebook.com/yorkplacedental 

We look forward to hearing from you!

Mouth Cancer Awareness : Reduce the Risk

Preventive Dental Care is what it says on the can.

The dental team assess the risk of you developing dental diseases, and then work with you to keep you healthy. This could be tooth decay, it could be gum infection, it could be tooth wear. All diseases.

As I said yesterday, another one of those diseases is in fact a group of diseases that we refer to as mouth cancer - affecting the tissues in and around the mouth. In November the dental profession are working to raise awareness of mouth cancer in the community.

Here's a list of the things that increase the risk of developing mouth cancer:

• Smoking. Tobacco causes most Oral cancers. 75% of oral cancer sufferers have used alcohol, tobacco or both.
• Alcohol Consumption. Heavy alcohol consumption increases the risk. Obviously, reduction is the name of the game, as with smoking
• HPV Infection. A viral infection caused by sexual contact, affects younger people.
• Sun. Especially on the lower lip - I have a friend who has recently had an operation to remove a cancerous lesion - he spends a lot of time out of doors. Use of sunscreens, hats, avoiding the midday sun (when we get it..) will help.
• Previous Oral cancer. Mouth cancer sufferers are more likely to get it again, especially if they continue to smoke...
• Diet. Some studies indicate that not eating enough fruit and vegetables increases the risk.
• Gender. Studies show that men are twice as likely to develop mouth cancer as women.
• Immune Suppression. People on drugs to stop their immune system rejected grafted organs are more likely to develop mouth cancer.
• Betel Nut Quid. Commonly chewed in Asian communities - a mix of nut, lime and betel leaf with some tobacco.

Its not all doom and gloom - the positive side is that we know a lot more about prevention and campaigns such as this one are raising awareness.

So when you fill in your medical update on arrival at your dental practice, or when your dentist is looking at your face and neck and getting you stick your tongue out, you'll hopefully understand a little more what it is that we all doing for you. We're quietly looking and assessing...

If you're concerned about mouth cancer or any of the issues raised, please get in touch - we'd be glad to help.

Mouth Cancer Awareness : Know the Signs

Each year in November dental practices throughout the UK try to raise public awareness of mouth cancer, and the time is with us once again to beat the drum.


Cancer can occur in any part of the mouth, the tongue and lips, throat, salivary glands, and any of the surrounding tissues and organs. 


These "Mouth Cancers" have a higher proportion of deaths per number of cases than breast cancer, cervical cancer or skin melanoma - and yet there is no formal national screening program.


Sadly of the in excess of 6000 cases a year diagnosed in the UK, in excess of 50% of patients don't make it - often because of late diagnosis. 


So, what can you do about it?


Know the signs - and my thanks to the Mouth Cancer Foundation for this information:


It is important to have a self-awareness and to perform regular self-examinations to help in the early identification of these symptoms: 

1. A sore or ulcer in the mouth that does not heal within three weeks

2. A lump or overgrowth of tissue anywhere in the mouth

3. A white or red patch on the gums, tongue, or lining of the mouth

4. Difficulty in swallowing

5. Difficulty in chewing or moving the jaw or tongue

6. Numbness of the tongue or other area of the mouth

7. A feeling that something is caught in the throat

8. A chronic sore throat or voice change (hoarseness) that persists more than six weeks, particularly smokers over 50 years old and heavy drinkers

9. Swelling of the jaw that causes dentures to fit poorly or become uncomfortable

10. Neck swelling present for more than three weeks

11. Unexplained tooth mobility persisting for  more than three weeks - see a dentist urgently

12. Persistent nasal (especially unilateral)l nasal obstruction, particularly associated with mucus (clear, purulent or bloody) discharge causing difficulty breathing through nose

13. Unexplained persistent earache

So - you want teeth for life then?

When I ask my patients if they want to keep their teeth for life, they'll usually smile and say yes. It's not that it's funny, it's just that most people assume that dental health is a given.

Along with stuff like space flight, stem cell technology and the ability to make more telephones than you could ever imagine being necessary, surely the human race can sort a thing as simple as teeth - right?

Well, as with a lot of things, it's not a given.

Some of us are prone to diseases of the gums and tissues that hold our teeth in place - we call this periodontal or gum disease. In simple terms it's caused by harmful bacteria, growing in the bits of chewed up food that we leave behind on our teeth after eating and cleaning. Superb cleaning certainly helps, as does stopping smoking, controlling diabetes and having a healthy diet.

At York Place Dental we've been screening all of you for years, matching your personal dental hygiene program to the risk of you getting gum and other dental diseases. Kim and Michelle train and mentor you in how best to reduce the risk of tooth loss through gum disease, and they check your progress over time at review visits.

The big news this month is that we're trialling a computer program called Previser to help us to be even more confident that we are getting your care program absolutely right - at no additional cost to you.

At your next Dental Health Assessment, we'll be entering a few more readings than usual into the computer and getting an immediate online assessment of the risk of you suffering from periodontal disease, courtesy of Previser. We'll explain it to you, give you the correct care and advice , and you get a copy of your report to keep. The key is that Previser have gone to great lengths to match our observations to the latest in international thinking on how best to help you.

The benefit to you? The confidence that we are checking against the best knowledge to make sure that  we are getting your preventive dental care right. As long as you follow our advice, you're even more likely to have those teeth for life....

After your next visit we'll be asking you for your comments on this new system - and what we're hearing so far is extremely positive.

Do you have bleeding gums, loose teeth or bad breath? Is there a question you'd like us to answer? Contact us here and we'll help!

Do you feel like you are being ignored?

How many times have you been in a place where you've got a problem and you've gone for some advice?

Lets imagine the scenario. You've plucked up the courage to do something about an issue, perhaps an embarrassing one, and booked an appointment.

You arrive on the day at your destination, you exchange pleasantries with the person greeting you, and wait.

And then you wait some more...

And some more as well.

You check your watch, and accept that things must be busy, but are painfully aware that its getting toward the end of the working day and that maybe you're going to be shall we say - rushed along?

And then it happens - you're called into the office (or surgery, or room, or whatever) - and The Expert is sat there writing notes about the last person on the computer with their back to you, but its OK they can write and talk at the same time whilst facing the wall  - "Now what seems to be the problem Mr Smith..."

Not a good start - your name is Mrs Jones.

You find talking to the floor easier because there's no eye contact, no attempt at friendliness, and you feel faintly ridiculous and a bit stupid because your problem now seems to have been a bit of an ego trip, and hey, The Expert has obviously got a lot of other bigger things to worry about.

You're just floundering through your explanation with a mouth as parched as Death Valley when you find yourself cut off and handed a ...prescription  / excuse / another appointment / fobbed off.....

I dont think I need to go on do I.....

Its Friday afternoon, and we've had a lovely week and the privilege of meeting some genuine, often scared and occasionally traumatised people for the first time...because they've come to see us for some help.

And why do we keep hearing stories like the one above, over and over again. 

Dentistry is a people profession. Most of us have two eyes, two ears and one mouth - and they should be used in exactly that order.

Has this ever happened to you? Why don't you get in touch and let us know about it....

Its Your Choice

Great to welcome some new members to the Tribe at YPD today. Welcome!

Dental Care is a people job and we love it. As you'd expect, today brought a complete mix of unique people (aren't we all?), all with their own story to tell. Some long stories, some short, some of them had problems, others didn't...and as a team we've done our level best to give the best possible advice, explained in the most easy to understand way.

The common thread from all these stories is that until we can gain your respect and above all your trust, we're no use to anyone.

And gaining your trust takes time - lots of it. 

Time to listen to you, time to ask questions, time to think and plan, time to show you, time (we hope) to excel.

Which is why we think Slow is Okay - in a good way. 

• As much time as you like for your complimentary New Patient Assessment.
• At least an hour for your New Patient Consultation. 
• At least  at least 30 minutes with your hygienist. 
• No crammed waiting rooms.

So that you have the best possible advice, the time to ask your questions - and the time to make your choices.

We're here to advise and to care, with your permission.

At the end of the day, its your choice...

Unsung Heroes no.2: Your Dental Hygienist

Here's a guessing game with a massive clue in the title:

Who, in the Dental Health Team

• Renews their acquaintance with you on a regular basis.
• Puts you at ease, discusses your life, your kids, your holidays, what you've been doing since your last visit.
• ...and possibly spends more time with you than your dentist...so that you know them as a person and they gain your trust.

Who, in the Dental Health team:

• Has studied for at least two years full time at University to gain their qualification.
• Assesses your progress against your personalised treatment plan - which they have designed.
• Takes the right clinical readings and works with your dentist on your progress.
• Reinforces your pathway toward optimum dental health.
• ...and mentors you when things have perhaps gone a little awry (we know it happens - it's okay).

Who, in the Dental Health Team can:

• Discuss your healthy diet.
• Take your x rays.
• Whiten your teeth.
• Apply protective coatings to keep your teeth strong.
• Recommend the right home techniques to better your dental health - and find out with you really works and what doesn't?

And above all, who is it that teams up with you to help you keep your teeth and gums healthy for life?

I think most of you should have it by now. 

A big Hi to all the Dental Hygienists out there  - couldn't do it without them :-)  

Painless Injections - The Holy Grail?

An article on the Today Program prompted a lot of questions from our patients last week.

No one likes pain, and Dr John Meechan of Newcastle University has come up with a novel idea. Click on the link below to hear what he had to say.

Does it bother you? Would you like to see this being used by your dentist?

http://news.bbc.co.uk/today/hi/today/newsid_9506000/9506382.stm

I'm in pain - but its not toothache

Is it me or is there something in the water? 


This last couple of months we have found that there's been a run of people coming in to York Place with a problem called TMD - you might recognise some of the symptoms below:

• Pain or tenderness of your jaw joints
• Pain in and around your ear
• Difficulty eating
• Aching facial pain
• Locking of the jaw joints, making it difficult to open or close your mouth
• Headaches 
• Uncomfortable bite
• An uneven bite, because one or more teeth are making premature contact

And we are providing the appropriate treatment for it.

We're also finding that very few people have heard of it and many have been passed from pillar to post in the healthcare system and made no progress - so here's a link to a good summary from The Mayo Clinic. 

Hope it helps.

http://www.mayoclinic.com/health/tmj-disorders/DS00355/DSECTION=symptoms

Is the Message getting through?

Have you ever been in the situation where you're trying to explain something to someone you know, that is perhaps deeply personal or just plain difficult to put into words?

But then you look up and the person you're talking to has glazed over or is checking their texts?

How would you feel if that person you were talking to was your dentist?

Dental Care is a people job and most of us have two ears and a single mouth - and we should all try to use them in that ratio.

At York Place Dental we focus on allowing you, the patient, the time and space to get your message across....

Free Assessments for New Patients

In the month of June we’ve introduced a new service for you – FREE New Patient Assessments.

If you’re not quite ready to take the plunge and commit to join us with a full New Patient Consultation, here’s your chance to come and meet one of our experienced team and find out about dental care - with absolutely no obligation.

You’re welcome to see the facilities at York Place Dental, and over a coffee we’d be delighted to listen.

Perhaps you want to know about how we can help a nervous patient?

Maybe you have some cosmetic treatment in mind and want to know what is available?

Whatever your concern, we’ll do everything we can to help.

We look forward to getting to know you.

Ceramic Fillings

If you've had fillings on your back teeth, chances are that you'll have at least on grey coloured amalgam filling. Many patients ask me for a more aesthetic alternative, and of course we are happy to oblige.

For small to medium holes, we can use plastic resin fillings and if placed with care they can last for many years with little trouble.

For bigger fillings in more heavily damaged teeth, we need something stronger, and this is where ceramic fillings come in. We're not talking wash basin porcelain either - think of Ferrari break discs and industrial insulators....very high tech, very strong....

Made in partnership with an experienced dental technician on imprints of the prepared tooth, they look like a tooth, feel like tooth, and last for years. Biggest advantage - minimal drilling!

Here's a before and after pic of two we did at York Place recently.......

Have you got old tired grey fillings that show when you laugh?

The Dry Toothbrush Syndrome

An Easter Holiday Children's day at York Place today - great fun with some nice families.

We usually find that there are several common issues on these days, and today was no different. Todays big topic was :

"How on earth can I get (insert name) to brush his teeth. In fact how on earth can I get him anywhere near his toothbrush. He's 11 years old and its a constant running battle..."

Ring any bells? Here are some tips:

1. Firstly - have some comfort - its rife! You are not an inadequate parent and you are doing your best, which is fine. It will continue for about two more years until he discovers girls and hair gel.

2. Try good old fashioned nagging and ask your dentist to back you up at appointments. And stick at it.

3. Supervised brushing - get in there yourself with the brush

4. Mums - do as Mrs H does and threaten to kiss them in public - because nobody else will :-)

Here's a little bit of background from an excellent website - check out the link at the bottom if you want to know more...

How can I prevent tooth decay in my child?

The main cause of tooth decay is not the amount of sugar or acid in the diet, but how often it is eaten or drunk. The more often your child has sugary or acidic foods or drinks, the more likely they are to have decay. It is therefore important to keep sugary and acidic foods to mealtimes only. If you want to give your child a snack, try to stick to cheese, vegetables and fruit. Try to limit dried fruit as it is high in sugar and can stick to the teeth. It is also worth remembering that some processed baby foods contain quite a lot of sugar. Try checking the list of ingredients: the higher up the list sugar is, the more there is in the product. Sometimes, these are shown as fructose, glucose, lactose or sucrose.Thorough brushing for two minutes, twice a day, particularly last thing at night, will help to prevent tooth decay. http://www.dentalhealth.org/tellmeabout/topic/CaringforTeeth/Childrensteeth

Teeth and Tarmac - again

Heres an unfortunate picture of a delightful young lady. Lets call her Lucy. She's eight years old and I bet she likes pink things.

Lucy was at her dad's on Saturday. She tripped over and landed right on her teeth - just like the young lad I mentioned in a previous blog.

She scabbled her top lip and dented her pride. Dad quickly took her to the emergency dentist who patched Lucy up and sent her on to us for treatment.

Lucy's mum and gran came in with her - looking worried. Would Lucy lose her teeth? What will happen in the future? Does she have to have lots of nasty treatment and will it frighten her?

All legitimate questions. I'd do the same.

You know, its such a good feeling when you can look the parent, the grandparent and the child in the eye and say - "Its going to be alright, its going to be fine".

What did we do?

We took digital X rays to check the roots were intact - they were.

We told Lucy that we were going to put some numbing cream on her gums to make them go all cold.

We then explained that she would feel two tiny pinpricks, no more than a pinch.

And then her lip and nose would go tingly and numb - which they did.

Which would mean that I could make her teeth better again.

And today Lucy had her teeth back - it took just 30 minutes, no pain, and a bit of George of the Jungle on the ceiling to take her mind off what was going on.

In fact Lucy was so good I took the chance to have a bit of a play with the appearance of the teeth.

Heres a picture of a numb Lucy Smiling.

Thanks Lucy for being such a delight to care for!

Unsung Heroes #1: The Technician

The latest ten year survey of dental health in the UK shows what we all kind of know - more people are keeping their teeth for longer. Which is great if you're one of them.

But if you're not one of those fortunate people and have missing teeth, what do you do? Most of us have got, or have known, elderly relatives who went to their dentists and had false teeth made.

But here's a trade secret - the dentist didn't "make" them.

The dentist did check the mouth, plan the treatment, take the impressions and the measurements, did dictate the aesthetics and check the results, but actually they worked with a Dental Technician who crafted the final result. And it is these latter Heroes I want to give a big Up to today.

Dental technicians make precision stuff that we can't make in the surgery.

So that might be :

• Acrylic teeth to replace your missing teeth, from one tooth to a whole mouthful.
• Gumshields to protect your teeth when thumping round a rugby field.
• Ceramic teeth and veneers to create your fantastic new smile.
• Highly technical bits of precision engineering to sit on top of your new dental implants.
• Braces to straighten your teeth.
• Splints and plates to fix fractured facial bones.
• Mouth appliances to relieve your headaches.
• Bleaching trays to whiten your teeth.

And some of them have studied long hours to be qualified to actually make dentures directly for patients.

And they are in the most part entirely dependent on those prima donnas called dentists for their living and they run their own businesses to boot. Its not easy!

I can assure you, they're good. A bit like secret jewellers. Massive advances in dental technology, more post qualification training, new ways of team working, and more face time with the patient have pushed back the limits of the possible and its an exciting field to be in right now.

I have the pleasure of working with some fantastic technicians, locally and nationally, who produce little marvels on a daily basis. One of whom is in Carlisle and was in surgery with me yesterday working on a denture project with a patient. Its looking very, very good and we should be seeing a great result in a week or so. If you're interested, take a look at Rob Taggart's website:

http://www.roberttaggartdentallaboratory.co.uk/

...and lets not forget Steve, Andy, Melvyn, Lee, and all the others - thank you!

York Place Tips: Spit - Don't Rinse!

Most people use toothpaste when they clean their teeth (you'd be surprised how many don't......).

Most people are aware that there's usually some fluoride in there, along with little cleaning granules and some minty flavour.

Most toothpastes even have something to kill mouth bugs and some have stuff that stops sensitivity.

Some even claim to whiten your teeth - which they don't, so save your cash.

But none of the above works if it doesn't have time to soak in to your teeth. So, it follows that the toothpaste must remain in contact with your teeth long enough to have the desired effect. Even if you do brush for the recommended two lots of two minutes twice daily, you won't get the benefit if you then take a big old mouthful of water and rinse it all down the sink - think about it!

So - spit the excess toothpaste out at the end of brushing, but don't rinse! Better still, make sure your toothbrush is the last thing that goes through your mouth before you hit the sack.

Does that make sense?

The Power of Plastic...

Over the years, I've found that most people are genuinely surprised at what a dentist can do for them - right when they don't expect it.

At events where maybe we've been promoting our more "headline" services - such as tooth whitening and invisible braces - we also get into conversations about things which we don't realise that people don't know about and as a profession maybe take for granted......

So, heres an example: Invisible repairs to teeth.

How many people do I end up talking to whilst having to force myself to look at the floor, because they've got an alleged white filling on a front tooth that is the colour of vegetable soup and in dire need of retirement?

If this is you - rejoice - it needn't be like that. Neither do you need wall to wall veneers or a remortgage. You know how you can get stone chips in your windscreen fixed with that big sucky thing and some clever clear resin? I think its someone like Autoglass.....Well, this the toothey equivalent - we can repair the damaged bits and leave what is good well alone.

I spent an great day with a superb teacher in London last week building teeth, which to me is about as good as it gets - yes, sad I know. If you're brave you can check out the pic on my FB page: http://www.facebook.com/album.php?aid=62792&id=100000194880472&l=79d3fd0f7b

Using the latest plastic resin techniques, built up in tiny layers with coloured tints and spots to mimic tooth structure, we made the teeth of 20 year olds, of 50 year olds, and 70 year olds. All different, all constructed to reflect the effects of time on our little enamel friends.

The benefit? Simply that a properly trained dentist can make good the bits of a natural tooth that are missing or damaged, leaving the good bits alone - and you can't see the join.

I don't refer this work as "doing fillings" - its art.

How does that sound?

Teeth and tarmac don't mix....

A young lad , lets call him Zak, came in as an emergency with his mum this afternoon.

Zak’s eleven, and he’d taken a flyer over a skipping rope at dinnertime. Sadly, the inevitable impact was right on the end of one of his top front adult teeth, and the tooth snapped.

The school rang mum, and she quickly phoned us. Within an hour he was with me and we did what we needed to do.

We fixed the broken bit – you can’t see the join. Importantly we repaired the damaged nerve, which was there for all to see in all its glory and not a Good Thing at all. Zak didn’t complain because he didn’t feel a thing…..

Mum was distraught but bravely hiding it. After we’d finished, and no doubt feeling all the guilt that mothers feel in situations like this, she asked me what would happen to Zak’s tooth in the future.

I said that it’s not certain, but the chances of the tooth recovering, remaining healthy and staying put for life were massively improved by the quick actions of both the school and mum. She cheered up and smiled.

So:

If you have a kid who falls over and cracks a tooth, or worse, knocks it out – remember this:

If the tooth is right out, be brave, put it right back in the socket and get to your dentist fast.

If the tooth’s not out, but has snapped – get to your dentist fast – the nerve might just be damaged.

Nuff said

Throwing the (Forests) out with the Bathwater

A short one from the heart today. Like millions of the population I've spent many happy days mucking round in forests.

I grew up just over the water from the Forest of Dean and we walked, camped, caravanned, climbed (yes - there are rocks there too) and generally had a good time in a great resource.

I now have a choice of Mountain biking some of the best purpose built trails anywhere, here in the Lakes, at Whinlatter or Grisedale forests. I was out on the bike yesterday, and like hundreds of others we were enjoying a prize asset that is the result of some inspired thinking. Not to mention the walks for people of all ages, great cafes, and the opportunity for people from urban areas to get out into wild places for free.

So...the government think its a great idea to sell it all off.

I understand about economics. I understand about national debt.

I'm not at all certain that selling off national forests is going to save the economy.

And I don't believe that there would be anything to motivate a new private landowner to keep the existing facilities either in good condition or in fact open at all.

So - if you've got this far - how do you feel about it? If you're interested, follow the link below to 38 Degrees' website and sign their petition opposing the selloff.

There isn't a lot of time.

http://www.38degrees.org.uk/page/s/save-our-forests