Policy and Advice

There is 40-60 hours of surgery time are wasted every month due to failure to attend appointments or cancellation at short notice.

We have introduced charges for missed appointments or short notice cancellations or you may be asked to leave a deposit which will be returned to you once treatment has been completed:

• In an attempt to prevent this from happening
• To recover a part of the cost of the wasted time
• To encourage patients to cancel with at least 24 hours notice allowing the surgery to become available to patients in urgent need of care

Many people welcome the provision of NHS dental care locally. We make every effort to operate efficiently under the NHS regulations for the benefit of the local population and we must be careful throughout all our business operations to prevent the waste of time and money. The charge does not recover all the costs of the missed appointment.

Any future appointments in the book will be cancelled and not reinstated until the charge is paid.

A clean and healthy mouth aids healing.

The following steps will help prevent bleeding and relieve soreness:

REST: Rest for a few hours following treatment and avoid strenuous exercise.

RINSING: Do not rinse for at least 4 hours. For several days following treatment rinse your mouth gently after meals and before retiring using a mouthwash made by dissolving 1/2 teaspoon of salt in a glass of warm water. Hold the solution in your mouth for several minutes, discard and repeat 2-3 times.

FOOD: Avoid hot fluids, alcohol, hard or chewy foods. Choose cool drinks and soft or minced foods. Avoid sucking at or interfering with the wound.

BLEEDING: Should slight bleeding occur sit upright with head and shoulders raised. Apply pressure using a small pad of gauze or clean linen clamped firmly between the jaws for 15 minutes – repeat if necessary.

PAIN: It is not unusual to experience swelling or discomfort for a few days. However, if pain, swelling or bleeding persists, contact your dentist.

Take any pain-killing tablets as advised by your dentist.Follow any instruction regarding the dosage carefully.

If excessive bleeding, undue pain or other symptoms occur contact your Dental Surgeon for advice without delay or if this is outwith normal working hours then contact NHS 24 on 111

This procedure involves the use of customized bleaching trays, and carbamide peroxide gel as an accessory.

• Clean your teeth thoroughly before each use, including use of floss or specialist brushes. Rinse any toothpaste away.
• Fill the supplied bleaching trays with a small amount of the gel. Care must be taken not to overfill the tray, as this will be forced out over your gums when inserted. You should aim to use approximately half a capsule of gel for each bleaching tray per use – i.e. one capsule per day.
• Excess material should be removed from the gums with a tissue, cotton wool or a dry toothbrush after insertion of the trays.
• The filled trays are usually worn for 2-4 hours at a time. They can be worn overnight. You should not eat, drink or smoke whilst wearing the trays. If they are removed during this process, then the tray will need to be refilled with new gel.
• The whitening process works at different rates for each individual. Most patients report that a noticeable effect after just four treatments. Sufficient gel is given for the initial process to work with some remainder for topping after six months or a year.
• Rinse your mouth with lots of lukewarm water to remove any remaining gel when the trays are removed. Wash the tray with cold water and dry thoroughly with tissues before storage.
• It is possible to over-lighten the teeth. Stop using the trays and gel when you are happy with the colour. Remember that the natural colour of teeth is never pure white. The whitening gel will lighten your teeth, but not necessarily remove internal stains; in these circumstances the teeth may never achieve a harmonious colour.
• The gel will not lighten crowns, veneers or fillings. If you have any of these restorations then the teeth should be lightened prior to their replacement.
• It is not necessary to lighten the back or molar teeth, the tray may not even cover these areas.
• Do not eat or drink for an hour after removing the bleaching trays and gel

Cautions

• Sensitivity is a normal feature of the whitening process. It usually lasts for a few days after the duration of the whitening period. Due to sensitivity, you may choose to wear the trays every other day.
• If sensitivity is intense, then the trays can be filled with sensitive toothpaste, such as ‘Duraphat’, ‘Sensodyne’ or ‘Tooth Mousse’ and worn for a few hours. All products are available at the Clinic.
• The whitening agent is Carbamide Peroxide gel in either 10%, or 16% strengths. The higher strength gel will work quicker but will result in more sensitivity. If the gel comes into contact with skin, wash with soap and water. If you swallow a significant amount of gel drink large amounts of water or milk. Refrigerate for prolonged storage and keep out of reach of children.
• In rare cases, an allergic reaction to the gel may occur. You will have widespread swelling of the mouth and some discomfort. Discontinue use and contact your dentist.

What is root canal treatment (endodontics)

This is a micro-surgical treatment to remove material from within the root systems of teeth. It is also known as root treatment and sometimes ‘taking the nerve out’. The removal of this material is necessary if it is infected or likely to become infected, following previous decay or trauma. Once the root system is cleaned it is then shaped to receive a permanent root filling usually in the form of a flexible rubber called gutta percha.

When is root treatment necessary

Root treatment is an option if the tooth is infected. This usually follows from decay in the crown of the tooth invading the living contents of the tooth pulp and root canals. It may also be necessary following trauma to a tooth. An infected tooth can cause pain characterised by a constant pain, pain on biting or touch. It can also be diagnosed from radiographs (x-rays). The alternative option for root treatment is extraction of the tooth. Sometimes it may be necessary to stabilise the infection prior to treatment with antibiotics but they are not routine.

How is it performed

Treatment is often very intricate and complex so it will require some time and may involve magnification. Treatment is usually performed with local anaesthetic in either one or two visits depending on the complexity and available time. To isolate the mouth from disinfectants rubber dam is placed. This is a sheet that covers all the teeth apart from the tooth involved. It should also be noted that due to equipment and experience requirements, it may be necessary to refer the procedure to another colleague.

What are the outcomes following treatment

Dependent on the underlying condition of the tooth, the outcomes are variable. For example if the infection is diagnosed early and the canals are straightforward to prepare, then the prognosis can be over 85% at 5 years. Most treated teeth will go on to last much longer than this. In complex anatomy, difficult access or larger infections then the prognosis will be reduced. A prognosis is an estimate and patients will report individual experiences.

Once a tooth has been root treated it may become more brittle or discoloured. In many cases a crown will be required to strengthen the teeth and a separate fee will be payable.

Post-operative care after root canal treatment

As stated previously, this is a micro-surgical procedure and the area can become sore. It will be expected that there is some pain on biting and discomfort after treatment. This can usually be treated with anti-inflammatory pain-killers such as ibuprofen (nurofen) if you are suitable, otherwise paracetamol. In a small number of cases discomfort can persist after three days and further treatment will be required which may include antibiotics.

Key points

• Micro-surgical treatment to remove infection within a tooth.
• Alternative is an extraction.
• The outcome and prognosis is variable.
• The tooth may require a crown following treatment.
• Antibiotics may be required but are not routine.
• Complex treatment over one or two visits.
• The tooth will be tender following treatment.
• Take ibuprofen (nurofen) to control discomfort if you are suitable.
• Contact the clinic if symptoms persist after.

Replacing missing/lost teeth with dentures is important not just for appearance but to enable you to eat, and speak properly. We will try our hardest to make you a denture that fits well and is functional. However, coping with dentures is not easy! Everyone has heard jokes about false teeth, but for many people dentures are a fact of life and are no laughing matter!

What type of denture do you have?

A complete or full denture is a set of teeth replacing all the natural teeth in the top and/or bottom jaw. It is usually made of acrylic. A partial denture fills the space where individual teeth are missing. These can be made in acrylic or sometimes a combined metal/acrylic approach.

Will it take long to get used to them?

Yes, it may take a while. Perseverance is the key! Eating and speaking can be difficult at first. At first, chew with the teeth at the sides of your mouth. Soft foods only and cut into small pieces, before long you will be able to eat normally. Talking may take some practice! Read out loud and practice difficult words at home. Practice with saying the days of the week. If the denture slips occasionally reposition it by biting down. A denture adhesive may be necessary. Consult your dentist if the problem continues. Dentures should not feel sore. If your dentures are still sore/uncomfortable after 2 weeks contact the dentist.

Should I wear them all the time?

No, take your dentures out at night.

Cleaning your dentures

Dirty dentures are unattractive and could be harmful to your gums and any remaining teeth. Food particles, stains, calculus (Tartar) and bacteria (plaque) can gather just the same as they did on your natural teeth. Certain foods and drinks (e.g. tea, coffee, red wine) and tobacco can cause staining. A dirty denture will stain quicker than a clean one!

• Rinse your denture after every meal.
• Brush your dentures every night with a soft brush and a denture toothpaste or liquid soap.
• Clean the dentures over the wash hand basin filled with water to prevent the denture breaking should it slip.
• Soak your denture overnight in clean, cold water. For acrylic only dentures you should use a denture cleaner in the cold water. Do not use a denture cleaner for metal dentures.
• Rinse and brush your dentures before you out it back in the next morning.
• Never allow your denture to dry out-always keep it moist For all other problems contact the dental practice.