Thursday 5 December 2013

Do our children benefit from Fissure sealants?

Q. What are fissure sealants?

A. Fissure sealants are a safe and painless way of protecting children’s teeth from tooth decay. It is a plastic coating which covers the chewing surfaces of the back
adult teeth. The sealant forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth. Most tooth decay in children occurs in the back teeth.

Q. How are fissure sealants applied?

A. It is quick and straight forward, taking only a few minutes per tooth. The tooth is cleaned thoroughly and then a special gel is applied to the biting surface of the tooth to prepare the tooth for the sealant. The tooth is then dried with air. The sealant liquid is then applied and set hard using a special light. It is a painless procedure.

Q. How long do they last?

A. They can last for many years and will be checked at each check-up visit. They can wear over time and in this case more sealant can be added or sometimes some sealants will require replacement.

Q. Do children still have to clean their teeth?

A. Yes. Sealants are only one part of a child’s preventative dental care. It is still important that teeth are brushed twice a day with fluoride toothpaste. The sealed surfaces will now be easier to clean when toothbrushing.

Fissure sealants are only one way of helping to prevent tooth decay.

Remember also to:
  • Brush teeth and gums every morning and night.
  • Use a pea size amount of fluoride toothpaste.
  • Brush for 2 minutes (the length of a song).
  • Don’t eat a lot of sugary foods and drinks especially between meals. Keep these foods as treats or for special occasions.
  • Make sure you visit your dentist twice a year.


Follow on from traumatised teeth

Following on from my blog on what to do if your child has a tooth knocked out, here are some tips on how to manage the more common situation of a front tooth being chipped as a result of trauma.

1. Believe it or not tooth fragments can be reattached so try to find the tooth fragment that has been knocked off.

2. Place the fragment in a cup of water.

3. Seek dental treatment immediately, the sooner you get to a dentists office post accident the more chance they will have of successfully reattaching a fractured piece of tooth.
Hopefully this will never happen to anyone you know, but remember to reduce the chance of dental trauma always wear a gumshield for contact sports......and the best gum shields are custom fit made by your dentist!

Monday 25 November 2013

Ever wondered what to do if your child has an adult tooth knocked out?

Here's my guide to immediate treatment for a tooth lost as a result of trauma.
1. Find the tooth and pick it up by the crown not the root.
2. If the tooth is dirty wash it under cold running water for 10 seconds and then replant it into the socket.
3. Instruct the child to keep it in place with a handkerchief by applying gentle pressure.
4. If it wont seat in the socket it can be transported in milk or the patients mouth between the teeth and cheek.
5. Seek emergency dental treatment immediately.
6. It is not recommended to replant baby teeth.  In younger children wash the wound with plenty of water and stop the bleeding by applying pressure with gauze or cotton wool.

Remember your child should always wear a gum shield when playing contact sports, and the best of these are the custom fits made by your Dentist.
For as little as £80 we could save your child a lifetime worth of dental treatment!


Sunday 17 November 2013

Case to share with you

Thought I would share this recent case I did with you all. I had this delightful patient in this week, whom I diagnosed with interdental caries from localised radiographs taken. My patient didn't have any symptoms but the xrays justified treatment.

As you can see from the photo, I localised the area with purple rubber dam to protect the patient from debris and to provide a good field of view for myself to carry out treatment. You can see the decay/caries between the two teeth and the second photo showing the teeth restored with a white composite filling material.

The reason for showing you this case is to make you understand how important cleaning in-between your teeth is. If the bacteria is not removed on a regular basis, then eventually caries will strike and the enamel will demineralise. To stop this from occurring, the best way to stop this is to FLOSS!!


Flossing is an art and a hard habit to adopt, but once you can do this, it will reduce the chances of decay by over 75% and stop the chance of gum disease ( gingivitis ). So try it and do this every day. Make sure you have radiographs every 2-3 years to check for interdental caries.

Wednesday 6 November 2013


Botox
A drug prepared from botulin, used medically to treat certain muscular conditions and cosmetically to remove wrinkles by temporarily paralysing facial muscles.


How does Botox work?
Botox works by relaxing the contraction of muscles by blocking nerve impulses. The result is muscles that can no longer contract, and so the wrinkles relax and soften. It can take up to 10 days to see cosmetic improvement and the effects tend to last from four to six months. Most patients require retreatment to remove wrinkles and lines as they begin to reappear, but after each injection the wrinkles return less severe as the muscles are trained to relax more and more.
The procedure
The protein( a toxin produced by the bacterium Clostridium botulinum ) is injected into the muscle using a fine needle mixed with saline in order to minimize discomfort and maximise accuracy. 
Post operative effect
The effect of Botox is not permanent. So Botox treatment will need repeating every six months or so. The upside is that complications, which don't happen very often, also go away over time. Sometimes, a muscle that has been repeatedly injected, eventually loses its ability to contract and doesn't need to be treated anymore. 

Complications
The major complication of Botox is weakening of muscles in the vicinity that you didn't want treated. For example, improper injection of frown lines can result in temporary eyelid droop. This goes away in the same 3 to 6 month period!
Conclusion
If this procedure is carried out in a controlled environment with a clinician with a good background of the facial anatomy and experience, then I see no reason for this not to be carried out for patients. If the end result makes them feel and look youthful. 


What sugars can do to children’s teeth
Babies who are given sweet foods or drinks are more likely to get a taste for sweet foods than babies who are not. Giving babies food with added sugar can cause serious problems, such as:
  • Tooth decay of their deciduous teeth very quickly, especially with sugary drinks that are held in their mouths for prolonged periods of time.
  • Giving your baby a sweet tooth also means that they are more likely to keep pestering and crying for sugary things!
Instead of:
  • Chocolate bars 
  • Sweets 
  • Biscuits 
  • Cakes 
  • Pastries 
  • Ice cream 
  • Sugared or toffee popcorn 
  • Crisps 

Try these instead:
  • Canned fruit: toddlers love peach, pear and pineapple slices. Make sure it is in its own juice and not syrup. 
  • Fresh fruit: look out for fruit that's in season. 
  • Yoghurt: make sure it's unsweetened, and then add fruit.
  • Frozen yoghurt: make sure it's unsweetened. 
  • Frozen fruit: defrost slices of fruit and veg. 
  • Rice pudding 
  • Porridge 
  • Bread rolls or toasted bread, bagels, potato cakes or rice cakes. 
  • Dry cereal without added sugar. 

Hidden Sugars
  • Some sugars are found in food and drinks that many people think are healthy, so keep an eye on the sugar content of food and drink you give to your child. Examples are rusks, dried fruit, baked beans, tinned soups, some baby food, and drinks such as sweetened fruit juice, cordial, milk shakes and flavoured water can actually contain lots of sugar. 

Ideal option for children
  • Unsweetened fruit juice is a healthier option when it's been diluted, but better served with a meal as it's still high in sugar.
  • Milk (although not cow’s milk as a drink until 12 months) and water are the best drinks for children and things like fruit, toast, and rice cakes are a much better option instead of sugary snacks.

Friday 1 November 2013


How to keep your child interesting in brushing their teeth
Teaching your toddler to take care of their teeth is just one way you can show your growing child how to take responsibility for his body. This can be a challenge because 3-year-olds are motivated mainly by fun and pleasure. If you want to end potential tantrum situations, your best bet is to make this nightly chore a fun ritual for him. Here are a few tricks you can use to do just that:
Play copycat. Bring your child into the bathroom with you to watch you brush your teeth. While you're brushing, exaggerate a show of excitement and let them start copying with their toothbrush. 
Make the toothbrush a toy. Let them play with it. For example, show him how to brush his teddy bear's "teeth," or even let him brush yours. Create the impression that toothbrushes are fun to use.
Play show and tell. Explain to your little ones about how important tooth brushing is and that it is used to remove sticky stuff that collects on your teeth. The sugar bugs like the sticky stuff, and if they stay there long enough, they'll eat into your teeth, and then your teeth won't be strong and white.
Use your finger as a toothbrush. If they still don't seem excited by tooth brushing then use your finger to clean his teeth. Some toddlers find this less frightening than a long, plastic toothbrush. If you use toothpaste, choose one that has a flavour he likes. 



Sunday 20 October 2013

What to do about lisps?


A lisp is a lay term that describes the way a child mispronounces words. Typically it refers to the s sound being produced like a th sound. 
If your child has a lisp and he is only 6, then don't worry at this stage. This happens with many children and most will outgrow it by 7 years of age with no intervention at all. If your child is 7 and still has a lisp then you might consider getting some advice from a speech therapist.
Tips that I can recommend in the meantime would be:
  • Try not to talk about the lisp too much, as this can affect his self esteem.
  • Make sure they can breathe properly through their noses and not breathing through their mouths, this will allow the tongue to lie flat and not protrude out.
  • Keep your child's fingers out of his mouth as much as possible, since thumb-sucking can contribute to a lisp. This is not an easy task, but any distraction might help!
  • Pop a straw in his drinks; since you're using your lips instead of putting pressure on your teeth, this kind of sucking motion promotes good oral-motor strength, which is so important in language development.
  • Have your child blow into something with a small round mouthpiece. This is a good exercise because the effort needed to make a solid sound also strengthens the lips and cheek muscles, and tends to push the tongue back in. Blowing bubbles is another option.
  • Have your child look in a mirror and practice putting his teeth together while he makes an s sound. This exercise can help him remember to keep his tongue behind his teeth. 

Friday 11 October 2013


School visit

Laraine  ( hygienist at our practice) and myself went to the Village prep girl’s school in NW London today, to give a dental talk. There were three classes, aged from 3 up to 6 years of age. 
The girls were ultra cute and sat very quietly whilst they listened to us talk about what we did at the dental practice, explained about what causes holes, gum disease, the effect of sugar on teeth and how to brush teeth. We had a big demonstration model and toothbrush, seen below, and the girls enjoyed practising brushing on this.
At the end of our talk we had a quiz about what they had learned and they did really well. We also showed them some gruesome pictures of what could happen to them if they didn’t brush their teeth properly and look after their teeth and gums- that seem to get their attention!!
My favourite answer today from one of the younger ones to the question of “How many teeth do children have?” was 40!!!


Monday 7 October 2013


Why are baby (primary) teeth are so important
Primary teeth are necessary for your child’s ability to chew and speak, and they save space for future permanent teeth. A baby tooth remains in your child’s mouth until a permanent tooth underneath it is ready to emerge through the gums. The roots of the baby tooth dissolves and it becomes loose and falls out. Later, you’ll see the permanent tooth poke through the gum. Occasionally, a baby tooth comes out too early due to decay or trauma. In this case a space maintainer can be fitted by a dentist. This takes the place of the baby tooth until the permanent tooth is ready to emerge. If teeth on either side of the open space encroach upon the empty space, there may not be room for the permanent tooth, causing a knock-on effect for this tooth and adjacent teeth.


Thursday 3 October 2013


Shark Teeth...

Parents worry when they look in their child's mouth and see a permanent tooth growing behind the baby one, as the baby tooth usually becomes loose, falls out and then the permanent one starts growing in its place. Permanent teeth growing behind baby teeth are not an emergency! 

The norm is for the permanent teeth to push up and the roots of the baby teeth dissolve, causing the baby tooth to fall out. The permanent teeth then have space to erupt.  Sometimes, the baby teeth don't want to leave the mouth, and the permanent teeth come in right behind them.  This condition is technically known as lingually erupting mandibular incisors or shark teeth. There are a few ideas as to why shark teeth occur.  

Some dentists believe that this occurs because the roots of the baby teeth don't dissolve like they normally should and because of this the permanent teeth have nowhere else to go and  come into the mouth where there is the least amount of resistance. Others believe that the permanent teeth start growing behind the baby teeth because there is too much crowding in the lower jaw. Another theory is that the permanent teeth develop behind the baby teeth because they just didn't make it as far forward as they should have. All three are possible explanations and any of them might be true for a specific individual.

If your child's shark teeth fail to resolve on their own within a couple of weeks, ask your dentist to take a look. Removing the baby teeth usually resolves the problem.



Wednesday 2 October 2013

My Professional Bio...
I have been a dental practitioner for 20 years. After graduating from Leeds Dental School in 1993, my first job was as a house officer at Leeds Dental Hospital and this involved A&E and routine dentistry. After that I moved to King’s College Hospital as a senior house officer.  I specialised in wisdom teeth removal and assisted in maxillofacial surgery. I then started at a mixed NHS/ private practice and built up a dental list of over 2000 patients in a 15-year period. 
After I had my children I returned in a part-time capacity to a dental practice in Finchley and from there I moved to Harley Street and have never looked back.  
My training includes a 5-year postgraduate course in restorative dentistry, clear orthodontic  braces, facial rejuvenation and a 1-year course in cosmetic dentistry to date.