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Mar 22 19

Fluoride toothpaste & your baby’s teeth

by Dr Jay Padayachy

Fluoride toothpaste and baby teeth

It’s often thought that there is no need to look after your children’s teeth because they are going to lose them at some point! This isn’t particularly great advice for a range of reasons:

  • Habits form very young. If your young child does not look after their teeth then this habit is likely to go through to adulthood,  their permanent teeth are then at risk.
  • The risk of other diseases. If your child does not look after their teeth and they develop excessive caries then the bacteria can travel around their body causing other health problems.
  • The adult teeth risk being affected also. Your child adult teeth fixed immediately underneath their baby teeth, if an abscess forms around the baby teeth then the bacteria in this abscess can begin to attack their underlying adult teeth also.

So, yes, it’s incredibly important to look after your children’s teeth… Here’s some more advice.

Should I use toothpaste on my baby’s teeth?

Yes, however always use a dedicated children’s toothpaste. The outer surface of our teeth, known as the enamel is made up primarily of minerals. Over time, teeth require remineralisation in order to keep them strong. Fluoride has been shown to help with this remineralisation process which is why it is added to toothpaste. However there is a limit on the amount of fluoride that we should use, especially when our bodies are small, for this reason toothpaste manufacturers make a children’s toothpaste with a lower dose of fluoride.

When should you start brushing your child’s teeth?

Ideally you should start brushing your child’s teeth before they have any! Keeping their gums clean and free of bacteria is also really important. Regularly allowing your baby to experience the sensation of a toothbrush in their mouth also gets and used to what it feels like, making them less likely to object to teeth cleaning when their teeth finally come through.

You can read more teething advice here.

Is it bad if I use a natural, fluoride-free toothpaste?

The general advice we always give is to use a fluoride containing toothpaste. Fluoride helps the remineralisation process of your teeth and without it you stand a higher chance of developing tooth decay. The same principle applies to children.

How to care for my baby’s new teeth?

A checklist of ways to look after your baby teeth is as follows:

  1. Allow a baby to get used to a toothbrush before any teeth come through.
  2. When the teeth finally come through, use a grain of rice sized amount of fluoride containing children’s toothpaste.
  3. When your child reaches three years old then use a piece sized amount of fluoride containing children’s toothpaste.
  4. Supervise your child is cleaning until they are released 7 years old.
  5. Clean your children’s teeth from behind. If they are a baby then sit them on your knee facing away from you, if they are a toddler then stand behind them.
  6. Clean all tooth surfaces, remember the cheek side, tongue side and biting side on the upper teeth and lower teeth.
  7. Brush in a circular motion. Your child will have 20 primary teeth and it’s important to ensure they are clean each day.
  8. Encourage your child to spit out excess toothpaste but do not rinse with water as this will wash away the fluoride. Whilst fluoride is added to the drinking water in many places around the UK it’s still important to apply topically to prevent cavities.

As an adult, why shouldn’t I use children’s toothpaste?

The quantity of fluoride in the toothpaste is designed specifically for the average body size. Because the child is much smaller than an adult the fluoride dose is much smaller in children’s toothpaste. This would mean that if you used children’s toothpaste as an adult you would not be having the correct amount of fluoride on your teeth which could lead you to be more susceptible to tooth decay.

What is the cause of a baby’s tooth decay before two years?

The primary cause of any tooth decay, leaving out any congenital disorders, is poor oral hygiene. in the year to 2018 26,111 children aged between 5 & 9 were admitted to hospital as a result of tooth decay.

In total 44,047 children under the age of 19 were admitted to hospital, that’s more than children admitted for acute tonsillitis, viral infections, asthma, abdominal and pelvic pain!

Some of the primary causes include:

  1. Children not cleaning their teeth at least twice per day.
  2. Consumption of too much sugar with out adequate cleaning afterwards.
  3. Drinking sugary drinks from bottles with teats.

In summary, it is that adults responsibility to ensure that children keep their sugar consumption in check whilst ensuring that their children clean their teeth adequately each day.

Feb 14 19

What are teeth made of?

by Dr Jay Padayachy

What are teeth made ofSometimes when we think about dental health it’s a good idea to consider exactly what teeth are made of, this allows us to understand more about how our dental health is impacted by our habits and what we eat.

We going to break this blog post down into two sections, firstly we will look at the basic biology and an anatomy of the tooth, in the second section we will then look at how this anatomy can be compromised and what you can do to look after it.

The basic anatomy of a human tooth

A Tooth Diagram – showing all aspects of the tooth

A tooth diagram

What are human teeth made of?

A tooth consists of three parts:

  1. The crown. This is the part above the gum which you see.
  2. The neck. This is the section of the tooth where the crown meets the root.
  3. The root. This is the section of the tooth which anchors it into the bone and it is not normally seen.

Within these three parts there are principally three biological sections:

  1. The enamel. This is the hard outer layer of the tooth, it is the hardest substance in the human body. It protects the tooth and is 96% hydroxyapatite mineral, this is a crystalline form of calcium phosphate. The remaining 4% is made up of organic material and water. This highly mineralised content gives the enamel its characteristic quite/translucent appearance.
  2. The dentine. This is a slightly softer in part of the tooth surrounding the sensitive root canal which contains the nerve the blood supply. The dentine consists of 45% hydroxyapatite mineral with 33% organic material and 22% water. The organic material gives the dentine slightly yellow colour.
  3. The blood vessels and nerves. These are the living tissues in the tooth and feed the it keeping it alive, they also provide proprioception to your brain so that you can feel what is going on. The blood vessels are held in the dental pulp.

The whole tooth is held in place by a soft cushioning mechanism called a periodontal ligament.

Are teeth made of bone?

No. In contrast to teeth which are made up primarily of the mineral hydroxyapatite, bone is mostly made of collagen and is a living growing test you. Collagen is a protein which gives the soft framework to the bone whilst calcium phosphate is the mineral which provides additional strength to this softer framework. It is the combination of collagen and calcium which provide the strength and flexibility of bones.

The uses of each type of tooth

The 32 teeth in your mouth are broadly broken down into 2 areas:

  • Incisive biting, for example biting into an apple.
  • Chewing and grinding.

The sharper and more knife like teeth are towards the front of the mouth, as we move towards the back of the mouth, where we are able to get far more pressure on them from grinding, they become larger so that we can distribute the pressure over a larger surface area, thereby making them more efficient. Back teeth also have much larger groups enabling us to put larger amounts of pressure to grind our food.

Right at the back of our mouth we have wisdom teeth, in modern-day humans these seem to cause many problems, often being impacted. It is for this reason that wisdom teeth are often removed.

There doesn’t seem to be any evidence to suggest that our more pointed canines are there to tear meet. In actual fact they are more likely to be a throwback to our ancestors millions of years ago.

Looking after the anatomy of a tooth

Why do I have black lines on my teeth?

Black lines on teeth have a few different causes:

  • Poor oral hygiene. If the natural anatomy of your tooth has lines and bridges then these can fill with plaque, if this is not cleaned off regularly then it can become dark, particularly if you have habits such as eating very strongly coloured foods or smoking.
  • The tooth dying. If the tooth dies then the blood supply is reduced and the tooth have a tendency to go black.
  • Root canal treatment. A root canal treatment can sometimes cause the tooth to look darker than it did originally, this is because the blood supply will have been removed from inside the tooth.
  • An old dental crown. Some dental crowns have metal inside them, towards the gum line this can begin to look black as the gum recedes during the natural ageing process.

What are the best way to take care of your teeth?

Taking care of your teeth is actually relatively simple, just follow this simple advice:

  1. Clean your teeth twice per day (morning and evening).
  2. For adults use a pea sized amount of fluoride toothpaste.
  3. Clean in between your teeth once per day using either dental floss or an interdental brush or stick.
  4. Use a fluoride mouthwash after meals and never directly after cleaning your teeth. Mouthwash contains less fluoride and toothpaste, if you brush your teeth and then use mouthwash you will actually rinse off some of the helpful fluoride.
  5. Visit your dentist regularly. Your dentist is able to spot the very early warning signs of any dental disease, such as softening of the enamel in the pits and fissures of your teeth. You won’t be open to spot this yourself and if you leave these areas then decay can develop.
  6. Visit your hygienist regularly. Your dental hygienist will be able to clean your teeth on a regular basis and evaluate your own oral hygiene routine, making suggestions about how you could clean your teeth better.

Why do humans have carnivorous teeth?

In actual fact we don’t. Canines are usually considered the carnivorous teeth, yet some of the largest canines in the animal kingdom along to herbivores… Gorillas and hippopotami both have extremely large canines and yet are both herbivores. Canines are usually used in the animal kingdom for fighting and it’s probably this fact which means that modern-day humans still have slightly more pointed teeth as a throwback to our ancestors. Long canines have also been shown to be used by gorrillas as a display to fend off other gorillas… Something which humans don’t really need to do any more!

What chemical element make up teeth?

A tooth is broken down into many parts, each have a unique composition:

  • The enamel in a is the hardest part of the tooth, it is made of an extremely hard mineral called calcium phosphate. The enamel is relatively clear although it does have a slightly blue/grey tint.
  • The dentine is a slightly softer layer underneath the enamel, This is the part of the tooth which gives it the most colour. the dentine is 45% mineral hydroxylapetite, 33% is organic material and the remaining 22% is water. The dentine is not as little as the enamel due to the reduced amount of mineralised content.
  • The pulp is the inner part of the tooth, it is extremely soft and provides the living section of the tooth carrying the blood vessels.

The process of tooth decay can only be reversed or stopped by removing the decay altogether and then filling the void with a hard wearing filling material. If you have tooth decay it is unfortunately not possible to reverse it at home as it will need to be removed and filled.

The best thing you can do at home is to prevent the tooth decay in the first place by following good oral hygiene routine.

Jan 22 19

Everything you need to know about dental crowns

by Dr Jay Padayachy

Everything you need to know about dental crowns

Dental crowns have been in common use since the 1960s when the techniques to manufacture them were first understood, Nowadays, with better preventive techniques crowns aren’t used quite so much but they still play a key part of many dental treatments. We’ve found that many patients can often be confused about types and uses of tooth crowns so we thought we would write an extensive article to answer all of your questions.

What is a dental crown?

A tooth crown

In simple terms, a dental crown is a full replacement for everything you see on your tooth above the gum. They are usually used when the natural tooth has become severely broken down and can no longer be restored with either fillings or inlays. Your crown will fit over your natural tooth which the dentist will prepare and reduce to a stump. So long as you have high quality crown then it will blend in with the remainder of your teeth and no one will know you have one fitted.

Which crown is better for front teeth?

Light shining through Crown

A crown which allows the like to shine through will look best at the front

For front teeth it is usually aesthetics which take the priority, function and strength are still important however. For the highest athletics it is better to use a more translucent material which allows the light to shine through the crown, a porcelain crown is often the best choice. This allows a more natural appearance than having a crown which has metal inside. For this reason the best crown for a front tooth will be some form of metal free crown.

What is the best dental crown to get for back teeth?

Full-back teeth it is usually function and strength which are a priority over aesthetics. Your back teeth are capable of exerting extreme pressure and therefore strength is a priority. Modern zirconia crowns can be extremely strong as well as aesthetic, however very often classic porcelain fused to metal or indeed full metal crowns are still preferred for back teeth.

What are Zirconia Dental Crowns?

Zirconia is the common name for zirconium dioxide, this is effectively sand or ceramic and it is what makes beautiful white beaches look very white. Zirconia has been used for many years in hip replacement surgery as the body does not reject it and it has little or no wear. Zirconia is also able to allow the light to shine through making crowns made from the material extremely lifelike. Zirconia is one of the most biocompatible materials it’s possible to use due to the fact it does not react with anything.

What is the best dental crown material?

The best types of dental crowns will always be selected, but this will differ depending on your clinical situation. The two criteria which are usually used to decide which crown material you should have are:

  1. Aesthetics. Especially important at the front. Very often metal free or crowns are chosen.
  2. Strength. Especially important at the back. Crowns containing metal, such as porcelain fused metal crowns are often chosen however modern advances in technology means zirconia crowns are approaching the same strength.

How long will a tooth crown last?

A tooth crown will last thousands of years… So long as it is not put under any stress and is left alone! So actually the question should be how long will the tooth crown last in MY mouth? The things which affect how long the tooth crown last are:

  • Failure and/or fracture.
  • Gum recession exposing the Crown margin.

You can reduce the chance of failure and/or fracture by ensuring that you look after it. Only use crowns for eating and chewing, not opening bottles! Also, be aware that a common way to fracture ceramic crown is to knock it with a ceramic mug whilst drinking.

You can reduce the chance of gum recession by ensuring that you maintain good oral health and have a regular visit to the dentist to ensure that your gums are in the best condition possible.

Why is palladium not used in dental crowns?

Palladium is used in crowns occasionally however it is falling out of favour for a few reasons:

  • It is a precious metal and therefore expensive, there are lower cost alternatives which offer similar advantages.
  • It is a precious metal and therefore open to fluctuations in price depending upon what the stock market is doing, more stable pricing materials are available.
  • It is metal and therefore does not allow the light to travel through like a natural tooth, this can sometimes make a crown with metal alloys such as those containing palladium look not as good as an all ceramic crown.

What is the typical cost for a dental crown?

The price will vary depending on the type of crown, you should expect to pay anywhere between £300 to more than £1000 per tooth, depending upon where you visit the dentist. Understanding dental prices can be quite difficult so it’s good to speak to your dentist beforehand.

What are alternatives to dental crowns?

If you only have a small amount of damaged tooth then a dental inlay or filling may work, other filling materials are also a possibility. If however there is a large amount of tooth to restore then there really isn’t any alternative to a dental crown, if you want to keep the tooth.

Doing nothing is always an option and should always be considered, if you need to have a tooth restored then doing nothing could lead to additional dental health problems in the future or possibly losing the tooth completely.

How to take care of my dental crown?

You should take care of a tooth crown exactly the same as you would a natural tooth, ensuring you clean it twice per day for 2 min with toothpaste. You should then clean in between the crown and the next tooth with either floss or an incidental brush, just like you do natural teeth, this ensures you keep those difficult to reach areas clean as well. One of the weak areas of a crown is where it joins your natural tooth, often under the gum margin, this area needs to be kept particularly clean.

What is the process for putting on dental crowns?

The process for having crowns is as follows:

  1. Diagnosis that a crown is required, a treatment plan should be produced with all options including prices.
  2. Agreement of the treatment plan. Any root canals or root canal treatment will be done first.
  3. Preparation of the tooth. This involves removing any decayed or broken down tooth and preparing it to be the correct shape to accept the new crown. You will receive a numbing anaesthetic beforehand.
  4. Fitting a temporary crown. This will be made chair side by the dentist at the time of preparation, you wear this temporarily crown for two weeks whilst the final and definitive crown is made.
  5. The final crown is manufactured by a dental technician.
  6. The fitting appointment. You will have a numbing anaesthetic, the temporary crown will be removed, the final crown will be checked for fit, aesthetics and function. If everything is okay the permanent crown will be fitted using a special dental cement material.

We hope you have found this blog post useful, what other questions do you have about crowns?


Dec 10 18

Understanding a private dentist price list

by Dr Jay Padayachy

Private dentist price list

Any good dental practice will understand that fees and prices are a major factor in the decision-making process by which dentist to visit. That’s why we have decided to tackle this issue head on, we hope that by the end of this blog post you will have more information about private dentist prices in the UK, why those fees and prices are as they are and how to make the best choice.

Whenever you have a treatment undertaken you should always have a fully itemised treatment plan in advance, the question we recommend you ask your dentist is:

What is included in treatment?

Things which may get left out of your budget in a treatment plan could include:

  • X-rays. Always ask if x-rays are included in any treatment, particularly in a dental health assessment. Some practices offer an initial dental health consultation for new patients which do include x-rays, others don’t, so it’s important to find out beforehand.
  • Follow-up appointments. After complex treatments you may need a series of follow up appointments, think about treatments such as dental implants or orthodontics. Does the fee includes all of these appointments?
  • Retainers. When you have orthodontics you may need retainers after the treatment to ensure your teeth stay in a new position, some practices include a couple of retainers in the treatment fee whilst others include retainers for life. It’s important you find this information out before going ahead with treatment.
  • Sedation. If you are particularly anxious or nervous and think you may require sedation then find out if this is included. Almost certainly inhalation sedation or intravenous sedation will not be included but it’s worth asking about oral sedation.

A good private dentist price list will include everything and not have any hidden extras.

What are the best options for paying for dental fees?

Most private dentists in the UK will offer a range of different ways to pay for the treatment. This could include:

  1. Paying for the entire treatment in one go and enjoying a small discount, often around 10%.
  2. Staged payment for each treatment, particularly useful for expensive treatments over a long period of time.
  3. Finance. Many practices offer 0% finance over one year and then interest-bearing finance thereafter.
  4. Membership plans. Practices offer membership in exchange for a monthly fee. The membership comes with certain benefits including discounted appointments and usually includes routine hygiene and dental appointments.
  5. Bupa Dental plans are also covered by some practices.

Why choose a Private Dentist instead of an NHS dentist?

Many people wonder what is the difference between NHS and private? NHS treatments typically cover the most basic level of care. An NHS dentist is actually still a Private dentist but has a contract to deliver a certain number of Units of Dental Activity (UDA) to the local primary care trust, in the bidding process each bidder for these UDA’s will place their bid, the trust will then decide which provider wins the contract.

The contract will include the total number of UDA’s that must be delivered within the contract period. Each type of treatment has a different number of activities attributed to it.

This is potentially an unstable system, if, towards the end of the contract period the dentist has not achieved the number of UDAs required then there may clawback where the local trust claws back any money paid to the dentist, on the face of it this seems fair but sometimes the target number of UDAs set by the trust is unachievably high, this can leave dentists in a very difficult situation, short of cash and then possibly unable to invest. The flipside to this is if patients come in which needed lots of treatment, in this scenario the dentist may use up their UDA allocation, no matter what treatments patients need the dentist will not be paid for them. This may result in dentists closing their books to NHS patients when the required number of UDAs have been delivered.

Private dentistry avoids all of this. You get exactly what you need, when you need it!

Because the amount that an NHS dentist often get paid for each unit of activity they have a tendency to want to keep treatment very basic and quick, this means treatments may not be as complex or personalised as private dental treatments. High-quality private treatments overcome this problem by giving the dentist the freedom to operate at whichever level they wish.

Where can I get affordable dental treatment?

Affordable treatment is, without doubt a touchy subject. It is also rather subjective. After all, what is affordable? Many people would be happy to spend £5000 on a new car or £2000 on holiday but would not want to spend the same amount of money on their teeth.

Your teeth are used 24 hours a day, 365 days a year, they allow you to eat, smile and chew with confidence. Having great teeth is an investment in yourself!

Having said that, there are ways to make dentistry more affordable.

The advent of private membership plans has made dentistry much more affordable. These plans can bring complex treatments like dental implants or root canal work down by about 5%. Paying for treatments booked in advance can also pay dividends, dental practices can offer up to 10% discount for treatments booked in this fashion. Many practices also offer finance, this is often 0% if the entire treatment is paid off within a year.

The key to finding affordable dental treatments is to speak to your dentist, don’t be afraid to let them know exactly how you feel, what your concerns are… This allows them to come up with the best price list and dental charges for you.


Oct 24 18

Dental implants abroad, what you need to know

by Dr Jay Padayachy

The full cost of dental implants can often run into many thousands of pounds and it is for this reason that people seek cheap dental implants abroad. This article is dedicated to providing information and advice for those patients interested in dental tourism from the perspective of a UK dentist.

What are the reasons Dental tourism occurs?

With the NHS struggling to cover a wide variety of dental treatments it’s left to private dentistry to fill this gap. Cosmetic dental treatments and particularly dental implants are very rarely available on the NHS which means patients will need to pay the full rate for any treatment they have. Dental treatments in the UK can seem relatively inexpensive but this is mainly due to the fact we are used to paying virtually nothing on the NHS.

With anything we buy we are always looking for value, so if we purchased a brand new BMW car for £5,000 that would be excellent value and most people might jump at the chance. Equally a brand new 5 bedroom house for £30,000 would be excellent value and again many would purchase due to the extreme value offered.

So it’s not about the definitive amount, rather the value that can be achieved from spending this amount.

Dental implant prices often begin much lower than £5000 but could approach £30,000 for a full set of dental implants. A car will almost certainly wear out after a few years, and we don’t even use a car 24 hours a day. A new set of teeth supported on dental implants are used all day everyday and will certainly last much longer than a car making them good value.

Unfortunately this value is not always fully recognised and people seek to have the cheapest dental implants possible… Which often means not such good value!

Why are dental implants are expensive in the UK?

The easiest way to understand this is to look at the components of a dental implant treatment in the UK to discover where each of the costs lay:

  • Initial consultation. Your dentist will want to have an initial consultation with you, this may involve CT scans, x-rays and consultations with more specialised dentists. Prior to this detailed dental initial consultation some practices may offer a free consultation .
  • Planning. Once you have decided to go ahead a full and detailed treatment plan will have to be done, this is very often provided by a dental laboratory in conjunction with the dental implant surgeon. With the highest quality comes the ability to use computer assisted diagnostics and planning, this means the dental implant is placed in exactly the right place and avoidance all of the vital nerves and blood vessels supplying your teeth.
  • Dental implant placement. After the planning stage the placement will go ahead, this will often involve the whole team including nurses, surgeons, dentists and technicians.
  • The dental implant surgery. As well as providing the practical skills your dental implant will be placed in a sterile surgical environment, as you may know this kind of facility is very expensive to run and maintain.
  • Dental implant training. Of course you will want to know that the person placing your dental implant has had the best training and continues to do so, the training courses for dental implants can be very expensive and will need to be undertaken by all of the dental professionals involved.
  • The dental implant itself. The dental implant itself will be made from high-grade medical titanium, implants are very often computer milled meaning they have tolerances of a few microns.
  • The trans-mucosal element. This is an abutment which connects the dental implant itself to your final restoration, this could either be a Crown, Bridge or denture.
  • The restoration. This is the only part of the dental implant you will actually see a it is the part that provides your new smile and enables you to eat and chew again with confidence.
  • Post operative care. After the implant is placed there will be a time of healing during which you will need to visit the dentist a few times.

As you can see, there are many elements which make up the price of the dental implant, if any of these are compromised in order to provide a cheaper dental implant than the value of the implant may be reduced and you may not receive the quality of service you expect, or indeed receive the most cost-effective treatment.

How to choose the right clinic and dentist for a dental implant

Here are our top questions to ask any clinic you are looking for:

  • What experience do you have? Ask how many dental implants they have placed in the previous year, this will give you an idea of the level of experience.
  • What do your patients say about you? Ask to see reviews by current patients, look for reviews specifically by patients that have had dental implants.
  • What dental implant system do you use? Whilst we don’t expect you to have heard of the dental implant systems if you know which system your dentist is using you will be able to do further research. Ensure that the implant system used is one of the major brands and not a cheap copy.
  • What are your qualifications? In the UK we have a list of dental specialists, these specialists have additional Masters level training. Some dentist also have additional training at postgraduate level in order to place dental implants.
  • What a professional bodies do you belong to? Ask about voluntary and compulsory membership. In the UK dentists have two comply with the Care Quality Commission and the General Dental Council regulations and are regularly audited. A foreign dental clinic may only have voluntary membership or comply to voluntary schemes this may not be as high standard as the compulsory ones in the UK.
  • What other options are there? If your dentist only offers you dental implants you may like to consider the possibility that they are not seeing the bigger picture. There are other alternatives such as bridges, dentures and sometimes doing nothing may be the best option.

How to save on full mouth reconstructions

There are often many ways to save on a full mouth reconstruction. It’s not always necessary to place multiple dental implants. Modern techniques such as All-on-4 allow your dentist place only 4 dental implants and then placed either a fixed bridge or removable denture over the top. Dentures are often a cheaper option and can provide a good way to save on full mouth reconstructions.

Some final advice

Most dental practices really do appreciate that  UK dental work can be relatively expensive, to help finance options are often available, similar to when you purchase a car. Please do let your dental practice know that you would like to find out about finance options and making treatment more affordable, there are very often ways that they can help. So don’t forget, being prepared to be open about the cost with the UK dentist may be the best option rather than travel abroad for dental implants, in order to ensure high-quality treatment.


Jul 30 18

Bruxism – Are You at Risk?

by Dr Jay Padayachy


Bruxism – a cause of enamel degradation and tooth wear. What causes it, how to stop it and how to treat it.

With the stress of modern day living more people are finding they have enamel degradation and tooth where from bruxism. This article is dedicated to helping those people and to helping you find a solution to teeth grinding /bruxism.

How do you diagnose bruxism

The first signs of bruxism will be noticeable by you at home:

  • tenderness in and around the jaw muscles
  • possible headaches
  • visible signs of tooth wear and erosion resulting in Chipping or flat edges on the front teeth

Your dentist will be able to confirm the diagnosis of bruxism by:

  • checking for additional tooth wear towards the back of your mouth where you can’t see yourself
  • checking for the signs of underlying tooth and bone damage using x-rays
  • checking the condition of other teeth for visible signs of abrasion

What is the treatment for bruxism

The treatment for bruxism is usually done in stages:

  1. understanding why you are grinding your teeth
  2. physical mechanisms and barriers to stop you grinding your teeth e.g. mouth guards
  3. drug therapies such as non-steroidal anti-inflammatory drugs like Ibuprofen to relieve pain and reduce any swelling

Understanding why you are grinding your teeth

This is the first stage in treating bruxism, if the underlying cause is stress then this will need to be addressed. If the underlying cause is something physical e.g. dental malocclusion then this can be treated with equilibration (selective and careful tooth grinding by the dentist to remove any cuspal interferences).

Bruxism mouthguards

Mouthguard can help you stop your bruxism by keeping your teeth apart. They usually fit on the lower teeth and will be custom-made for you. The surface of the mouthguard usually flat and smooth meaning your top teeth can’t lock together with your lover teeth.

This has a double effect, not only can’t your teeth meet to actually grind but the muscles around the head, face and neck will relax to then natural position. This relaxing of the muscles can also help relieve headaches caused by bruxism

Sleep bruxism

Exact causes of sleep bruxism are not actually known although there has been research which linkage to factors such as anxiety, alcohol, cigarettes smoking and stress. However, sleep bruxism is considered sleep related movement disorder and because of this if you have sleep bruxism you are statistically more likely to suffer from other sleep disorders such as snoring and possible sleep apnoea.

Can bruxism go away

Bruxism can go away depending upon its causes. If the bruxism is caused by anxiety, alcohol, cigarettes or stress then clearly reducing these factors will help with the bruxism.

There may also be other physiological causes of bruxism which, unless treated mean that the bruxism won’t go away.

Other common questions and answers about bruxism

Is it bad to grind your teeth

We all grind out teeth a little bit, after all that’s what they are therefore, to enable us to grind food into small enough chunks to eat. Teeth grinding only becomes a problem when it affects things like tenderness in around the jaw muscles, headaches and tooth and bone loss. Your dentist will be able to diagnose the extent of any teeth grinding and let you know whether it is a problem for you.

How do you relax your jaw


How do I stop clenching my teeth in my sleep

If your intention is to rely entirely on home remedies to stop clenching your teeth in your sleep then you have two primary ways of doing this:

  1. understand the cause of your teeth clenching and treat that, is it anxiety, alcohol, stress or cigarette smoking perhaps?
  2. Consider taking over-the-counter ibuprofen, this is a non-steroidal anti-inflammatory and can help to reduce pain and swelling. Always follow your doctor’s instructions and the labels on any medication.

How would you know if you grind your teeth and night

It’s not such an infrequent occasions that patients tell us the first thing they know about grinding their teeth and night is that their partner tells them… It can be a rather loud grinding noise!

Other symptoms of night time grinding could be you wake up with headaches or pain around the jaw joint or muscles in your jaw.

Is teeth grinding a sign a sleep apnoea

Teeth grinding is not a sign of sleep apnoea but the two conditions are link in that they are both sleep related movement disorders. There is no causal link between the two conditions but there may be other links worth investigating.

Can you get headaches grinding your teeth

Yes, you most certainly can get headaches from grinding your teeth, this is because the muscles which put your jaw together connect high up around the side of your head. If these muscles are under tension from grinding then this can be translated into headaches.

This blog post was written by Senova Dental Studios in Watford

Jun 28 18

What are the different types of teeth whitening?

by Dr Jay Padayachy

teeth whitening traysThere are a whole plethora of different techniques to whiten teeth, some of them available from your dentist, others not… Some of them work, whilst others have a more dubious background. These are the different types of teeth whitening that many people search for online.

  • Teeth whitening kits
  • Teeth whitening strips
  • Teeth whitening toothpaste
  • Laser teeth whitening
  • Charcoal teeth whitening
  • Coconut oil teeth whitening
  • Teeth whitening with toothpastes

Teeth whitening kits

The best teeth whitening kits available of those available from your dentist. But why is this so?

Teeth whitening at the dentist uses a higher concentration peroxide gel which is only available on prescription from a dentist. This peroxide whitening gel will whiten your teeth faster and lighter than any other whitening kit or system. Your dentist will also make highly customised whitening trays into which the gel in placed. These trays will be customised to fit your mouth precisely and ensure there is a seal around the tooth/gum margin. This seal prevents the gel from touching your delicate gums and ensures it stays on your teeth.

Teeth whitening strips

Teeth whitening strips are available from many places online, they can work in some cases but because the level of peroxide will be limited its whitening ability will also be reduced. One must also be very careful to keep the strips solely on the teeth and not have too much of them on the delicate gum area.

Laser teeth whitening

Rather than use peroxide to remove the microscopic staining within your teeth some dental practices use lasers. Later teeth whitening can work extremely effectively to whitening your teeth in one appointment. For this reason laser teeth whitening is often used as a rapid teeth whitening system but because of the high level investment required is often more expensive than other forms of whitening.

Charcoal teeth whitening

The Oral Health Foundation took a look into the effectiveness and safety of charcoal tooth whitening toothpastes and have since suggested that there is very little evidence to suggest that charcoal teeth whitening works. Whilst this may be increasingly popular as an alternative (and possibly cheaper option) to conventional teeth whitening at the dentist you may find it’s a complete waste of money if nothing happens at all. At the very worst, The Oral Health Foundation found that the charcoal whitening toothpastes may actually be harmful as they do not contain sufficient levels of fluoride which is used to prevent tooth decay.

Whilst you may see celebrities endorsing charcoal teeth whitening, one would need to question whether they have actually had professional dentist teeth whitening prior to their endorsement.

Coconut oil teeth whitening

We will leave this firmly in the same description as charcoal teeth whitening. There is no evidence to suggest that coconut teeth whitening works and indeed, it may be harmful as many of the toothpastes do not contain adequate levels of fluoride.

Teeth whitening toothpastes

Conventional over-the-counter teeth whitening toothpastes can lighten teeth slightly. They often do this by being more abrasive than regular toothpastes thereby being able to remove more surface stain. Teeth whitening toothpastes do not contain enough peroxide to be able to whiten teeth as much as regular whitening at the dentist. Whenever using a whitening toothpaste we always recommend ensuring that it has at least 1350-1500 ppm (parts per million) of fluoride.

This blog post was written by Senova Dental Studios, your local dentist in Watford

Jun 1 18

What are dental implants – plus 8 other questions you might ask

by Dr Jay Padayachy

As more and more people consider their options to replace missing teeth and opt for dental implants we are finding that the questions relating to this treatment are becoming more and more common. This article takes a look through some of the common questions and gives an in-depth answer.

What are dental implants?

Dental implants are a titanium replacement for a lost tooth. The essentially replace the root of your tooth by fixing into the bone around where the tooth has been lost. Ideally dental implants are replaced immediately the tooth has been removed, this is less traumatic for the bone and means the dental implant can support the bone and prevent bone loss due to bone resorption.

How painful it is to get dental implants

Generally speaking dental implants should not be painful although there will be mild to moderate discomfort after the procedure. Your dentist will always ensure that you are fully anaesthetised around the area in which the dental implant will be placed. Many dentists also offer dental sedation which can help you relax during treatment. Don’t be afraid to mention this to your dentist if you would like to have sedation for your implants.

After the dental implant has been fitted you may feel mild to moderate pain as the nerves return to normal after the anaesthetic. Over-the-counter painkillers will help to keep the pain at bay. Any pain should only last for a day or so will begin to subside once the swelling goes down.

If you have anything more than moderate pain or the pain lasts for more than a couple of days after having dental implants then it is advisable to see your dentist for a quick checkup.

How many years do dental implants last

The simple answer to this is, it depends. If the dental implant was left alone with no impact from the adjacent teeth then it would last for ever… But this isn’t the real world! Dental implants are in a rather hostile environment, your teeth are capable of exerting immense force on each other and this puts the dental implant under a huge amount of pressure each time you bite.

However, The dental crown on top of the dental implant will typically last approximately 10 years, however with good care and maintenance a crown on top of the dental implant could easily last 15 years or longer.

What are the side effects of dental implants

There are no real side-effects from dental implants. The titanium used is completely inert and integrates into highly with the body, making it a highly biocompatible material. Any side-effects felt are usually from the surgical aspect rather than the implant itself. Side-effects from the surgery can include mild to moderate pain, swelling and bruising… This will usually subside within a few days.

The only other side-effect from dental implants is that you can now eat, smile and chew again with confidence… A rather good side-effect we think!

Can you take out dental implants

The dental implant itself cannot be removed in normal everyday use. If you have a denture which clips over the top of the dental implant then this can be removed. Dental bridges which screw onto the dental implant can be removed by the dentist but not the patient.

If there is a clinical reason for the dental implant itself to be removed this can be done but will be done only as a last resort if there is no other way to save the implant.

Can a dental implant fall out

No. A dental implant has two mechanisms by which it attaches into your mouth:

  • Primary stability by way of a thread
  • Secondary stability by way of osteointegration

When the dental implant is placed it will be gently turned and screwed into the hole that has been prepared for it. This provides a primary mechanism for stability. The human body is also not able to detect the titanium oxide layer on the outside of the implant as a foreign object, the bone will actually integrate with the implant itself. This provides secondary stability and ensures the dental implant cannot fall out.

Why does a dental implant fail

There are a few levels at which a dental implant can fail:

  • The dental implant itself. Failure at this level would typically be where it has failed to integrate into the bone. The most likely cause is infection.
  • The screw connecting the dental implant (The part you don’t see) to the restoration on top (The part you do see). Modern dental implant design means this happens extremely rarely nowadays.
  • The restoration on top of the dental implant (the part you see). This is the most likely cause of failure, it can be caused by chipping or breaking of the restoration. The good news is that the restoration can usually be removed (if it has been screwed in) and then either replaced or repaired without affecting the dental implant underneath.

What are the symptoms of dental implant failure

If a dental implant is failing you may notice:

  • Moderate to severe pain around the area of the dental implant. This would indicate that the integration into the bone is beginning to fail or that there is infection in this area, you should seek dental advice as soon as possible.
  • The restoration over the implant becoming loose. You may notice that the restoration, if it is screw retained, has become loose. This is not a dental emergency but you should see your dentist as soon as possible in case the restoration comes out completely.

How much does a dental implant cost for one tooth

Dental implant costs vary considerably depending on what is required. If the implant is complex and includes things like bone grafting then the cost will be considerably higher. You can expect a typical implant consultation with an oral surgeon to be around £112. Placement of the dental implant can be from around £1300 with the final restoration on top from £1300.

Whenever you have a dental implant you should always ensure you have a full treatment plan from the dentist before you begin, this ensures you know exactly what the process is and what the cost is going to be, before you go ahead.

Mar 20 18

What alternatives are there to silver fillings?

by Dr Jay Padayachy

Amalgam/silver coloured fillings are becoming less and less popular in the UK, Our experience is that patients are becoming more concerned about the biocompatibility of the mercury in the fillings as well as the cosmetic appearance of them. So what alternatives are there?

Our Watford dentist takes a brief look at the different types of fillings and discusses your alternatives.

What are the different types of dental filling?

Fillings fall into two categories:

  1. Tooth coloured
  2. non-tooth coloured

Non-tooth coloured fillings

There are two types of non-tooth coloured filling:

  1. Gold
  2. Amalgam

Both of these types of fillings are not used anywhere near as much in the UK as they used to be, gold is used less now because of its cost and appearance, whilst some people like the gold colour, many people prefer something more cosmetic and less obvious.

Amalgam fillings are a mixture of mercury, copper, tin and other trace metals.

Tooth coloured fillings

There are two types of tooth coloured filling:

  1. Composite
  2. Ceramic

Tooth coloured composite fillings

These tooth coloured fillings are made directly in your mouth by the dentist. The procedure is for the dentist to remove any decayed tooth structure, the clean cavity wall then be prepared with the bonding agent. Composite resin is a tooth coloured putty like material which the dentist applies to the cavity. Once the resin has been sculpted to the correct shape to match with the surrounding tooth structure it is then set hard with a high-powered light.

Tooth coloured composite fillings can also be used in the front teeth, not only to fill them after decay but to provide a better shaped tooth.

Tooth coloured composite fillings typically take about 45 minutes to do and can usually be completed in a single appointment.

Tooth coloured ceramic fillings-inlays

Ceramic fillings are more commonly called inlays. The porcelain/ceramic inlay procedure Is for the dentist to remove the decayed tooth structure, once all of the decay has been removed the cavity will be cleaned out and an impression taken.

You will then be fitted with a temporary filling.

The impression of the tooth, which will include surrounding teeth and opposing teeth will then be sent to a dental laboratory. A dental technician will then manufacture the ceramic inlay to exactly match the colour and morphology of the surrounding tooth.

Between 1& 2 weeks later the dental laboratory will return the inlay to the dentist.

The dentist will remove the temporary filling and ensure that the new ceramic inlay fits perfectly. Once you are happy that the ceramic inlay feels and looks good the dentist will permanently bond it in using a light cured composite resin.

Ceramic inlays typically take 2 weeks from start to finish and will always require 2 appointments.

What is the difference between porcelain and ceramic?

Porcelain and ceramic in the context of dentistry are exactly the same thing and are two terms to describe the same material.

Should I have amalgam fillings removed?

Ceramic inlays

Old and broken down amalgam fillings removed and replaced with ceramic inlays

We generally recommend leaving amalgam fillings if there is nothing wrong with them clinically. Most dentists prefer to go for the most minimally invasive treatment and leaving things alone is generally the best option. Amalgam fillings are usually removed if:

  • The filling is leaking. This can lead to decay underneath the filling.
  • The filling has broken.
  • The surrounding tooth structure has broken.

Amalgam fillings can also be removed for cosmetic reasons.

What about exposure to mercury?

Exposure to mercury with an amalgam filling is highest whilst they are being placed or removed. This is one of the main reasons why your dentist will probably suggest that amalgam fillings should be left alone unless there are underlying clinical reasons for removal.


As you can see, the primary decision is around whether you have a tooth coloured filling or a non-tooth coloured filling. Our dental practice in Watford always prefers to place tooth coloured fillings wherever possible, these are far more cosmetic and work just as well as the non-tooth coloured alternatives.


Jan 31 18

I’m scared of the dentist what can I do

by Dr Jay Padayachy

scared of the dentistIt is estimated that approximately 75% of the population are scared of the dentist and have some degree of dental anxiety with approximately 10% of the population of avoiding seeing a dentist because of that anxiety. The problem becomes self compounding, the more one does not go to the dentist for fear of what will happen the more likely it is that more work will need to be done when one does eventually go.

It really is important to see a dental professional on a regular basis to ensure that dental work is kept to a minimum, which everybody wants.

We have written this blog post to help you if you are scared of the dentist or have some level of anxiety, we hope you find what follows useful.

Definition of anxiety

Why are people scared of the dentist?

Anxiety is defined as: ” a feeling of worry, nervousness, or unease about something with an uncertain outcome”, According to this definition it can be clearly seen how an anxiety of the dentist can come about, you may be worried about what will happen what the outcome will be.

Anxiety symptoms

This anxiety can manifest in a few ways and may include some of the following:

  • Dry mouth.
  • A feeling of nausea.
  • An inability to stay calm and still.
  • Feelings of fearfulness and and ease.
  • A racing heart.
  • Shortness of breath.

Anxiety about going to the dentist is often concerned with what will happen when you are there, this is a specific anxiety about the uncertain outcome at the dentist and should not be confused with Generalised Anxiety Disorder (GAD) where one feels anxious about almost everything for no real apparent reason.

Definition of phobia

A phobia is defined as: ” an overwhelming and debilitating fear of a place, situation or feeling”. The emphasis on phobia is the fact that it is debilitating, a phobia will prevent someone from doing that thing completely. A phobia can also be described as: “…an irrational fear”. It is quite rational to be anxious about any uncertain outcome at the dentist but if that anxiety becomes overwhelming it can then become debilitating and become irrational. This is when an anxiety becomes a phobia.

Scared of the dentist but need to go?

Here are some suggestions on what you can do.

When you first start thinking you need to come to the dentist, or that you need some form of treatment it can often seem like a huge mountain to climb. But we want to assure you that the journey of 1000 steps always starts with a first step. And it’s just like the joke:

“How do you eat an elephant?”

Answer… one bite at a time.

Overcoming dental fear is the same… overcome it one small step or bite at a time, take things slowly and easily and in simple small steps.

We often find that overcoming dental fear is about realising that you have a choice.

Think about it now, you weren’t born with a fear of the dentist, babies are a blank canvass and have no such irrational fears. However, as we get older we have certain experiences that shape our views, so think about it now… what experience led you to believe you were afraid of the dentist?

When you come to see us we will ask you what was the trigger that taught you this behaviour, this will then help us to help you overcome this irrational fear.

The problem is that we have these experiences once and they then shape our thought patterns by teaching us new behaviours i.e. to fear the dentist, this is a key point to understand, your fear is a learnt behaviour – and if it can be learnt, a new way of thinking can also be learnt.

Top Tips for relaxing at the dentist

  • Book an appointment in the morning, this will ensure you can relax for the rest of the day as your appointment will be over.
  • For regular appointments, make sure you have a good breakfast. This will set you up for the day and ensure your energy levels remain high.
  • Lay off the alcohol! Not only does it dehydrate you but it can also make you worry.
  • Bring a friend. Decide before hand on what you are going to talk about, make it subjects that relax you and keep you calm. Perhaps discuss a recent holiday, or where you are going next time.
  • Talk openly to us. We will NOT judge you or tell you off for not coming to see us… honestly
  • Agree a stop signal with us, this will ensure that YOU are in control

Specific dental anxieties

Scared of the dentist drill

The key to overcoming fear of the dentist drill is to learn the art of distraction. All dental treatments should be undertaken with adequate anaesthetic meaning you should only feel light pressure and vibration. Anxiety about the dentist drill comes from an association which has been created between the drill and pain.

Wearing headphones and listening to your favourite music can help drown out the sound of the drill. A couple of words of warning though:

  • Wear headphones that don’t popout easily so that your dentist can work as quickly and efficiently as possible.
  • Choose music which has a faster beat with fewer gaps between the tracks.
  • If possible don’t wear headphones at all, most dentists will prefer to have an open channel of communication to you to offer help and advice. Your dentist can’t do this if you can’t hear them.

Scared of dentist pictures

Some people find they are scared of the pictures around dental practices or scared of the photographs they may see in books at the dentist. The easiest way to overcome this fear is to speak to your dentist beforehand, let them know you are anxious and scared of the dentist pictures, this gives both yourself and the dental practice time to prepare.

Most dental practices however don’t have gruesome pictures of dental procedures on the walls, dentists want to help you relax and will ensure images around the practice facilitate this.

Scared of gagging at the dentist

Gagging is one of the biggest fears people have of the dentist, sometimes this reflex is physiological, sometimes it is psychological. The feeling of panic as one gags can be quite overwhelming.

Here are our top tips to overcome that gag reflex:

  1. Fit bit in relax modeAlways breathe through your nose, this way you know you can always catch your breath.
  2. Remember to breathe. Whilst breathing through your nose, gently breathe in… Wait… breathe out… Wait… breathing in and repeat. This gentle breathing can really help.
  3. If you have a modern FitBit activity tracker these can sometimes be set on ‘relax’ mode, this gives you a guided breathing pattern which is tailored to your heart rate.
  4. Over the counter throat sprays with a numbing action, the ones typically used to help with throat coughs may help.
  5. Talk to your dentist, let them know you have a gag reflex and they can help you relax.


Modern dentistry users some of the best equipment available, needles are now so sharp you almost certainly will have no pain during any injections, anaesthetics work so well that numbing is complete and gone are the days of forcing a patient to breathe in gas through a mask.

Dentistry today is designed to be calm and relaxed, offering you a range of treatments and alternatives truly able to help.

One of those alternatives is dental sedation, sedation can help you gently drift off into your mind in a calm and relaxed world, allowing the dentist to treat your dental problem with ease.





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