Archive for March, 2008

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5 teeth extracted and an immediate denture

Tuesday, March 18th, 2008

Q. I have just had 5 teeth extracted and a immediate denture fitted the front top denture tooth is lower than my own teeth will these change as my gums heal.

A. Dear L

I would expect the denture to bed down into the gum during the first week. This would move the edge of the denture tooth towards the gum. The bone around the tooth sockets will take 6-12 months to heal to a stable shape. Most people would replace the “immediate” denture after 12 months.

Please contact me for further advice should you need it.

Regards

Dr Rob Tennet BDS

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hypermobile high lip line surgery

Tuesday, March 18th, 2008

Q. hi there, when i smile i show lots of gum. my top lip seems to lift to far up. i’ve looked on the net and come across hypermobile high line lip surgery but cant find anywhere that does it. is it a cosmetic dentist i need as they don’t seem to know what im talking about they keep saying gum contouring but its not that!!! can you point me in the right direction and any idea on price. please help

A. Dear T,
The person you want to speak to is a dentist called Peter Fairbairn. He has lectured on this subject in the UK and is the only dentist I know of who carries out this procedure. This procedure was first performed in the 1970’s so its not a new procedure as such. Have a look at his web site – scarsdaledental.co.uk .

He gives an estimate of £800 for lip repositioning but this may have changed since the web site was edited.

Hope this helps and please mention my name to Peter – always good to know who is supporting you.

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

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Posted in Dr Caplan's Answers, Experts Answers, Q. General dentistry | 40 Comments »

im worried teeth bleach will make my teeth too sensitive

Tuesday, March 18th, 2008

Q. I have a bridge at the front and considering having it replaced with a whiter colour and having my teeth bleached. Im worried it will make my teeth too sensitive and i wont b able to keep up with bleaching when nec. do u have any advice i’d b v grateful. Thank you.

A. Hi C,

In my experience any sensitivity associated with whitening, is transitory. It settles down relatively quickly during the process, and any sensitivity is generally manageable with a standard painkiller.

Make sure you have the bleaching done before the bridge, since the bridge will not change colour and its always easier to match the colour of the bridge to the teeth, rather then the teeth to the bridge.

Hopefully that should address your concerns.

Regards
Dr Safeer Butt
Principal S3 Dental
Synergistic Smile Studios

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how long to dental vaneers last?

Tuesday, March 18th, 2008

Q. how long do Vaneers last at what damage can it cause to the teeth??

A. Dear S

Porcelain Veneers last an average of 10 -20years. The appearance could deteriorate before this time if the gums recede at the neck of the tooth. With the first veneers the resin used to glue the veneer was a weakness; however the technological advances in the last 10 years have been stunning. So today’s veneers should last a long time.

The reason for having veneers, colour changes, alignment correction or gap closure ; and the severity of the condition will determine how much if any tooth preparation will be required. Some veneers in some situations do not need any tooth removed, in this case the “damage” would be limited to having to clean any residual resin from the tooth if you wanted to revert to your original state. Other veneers require significant tooth reduction.

Kind Regards

Dr Rob Tennet BDS

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Immediate implant placement post extraction advice

Tuesday, March 18th, 2008

Q. My question is about immediate post-extraction implant placement. I have had a crown on 1 upper front tooth for 18yrs recently the post broke and according to my dentist the post is too short for another crown. I am contemplating various options to replace the crown,one of them being a titanium implant.I have already had X rays, blood tests etc…to assess suitability to implant. I am in favour of an immediate post extraction implant placement which i mentioned to my dentist,he stated it was a “possibility” but would not elaborate. I am aware you cannot answer what would be best in MY case but i would be grateful for some general info on potential dangers/difficulties of immediate post extraction implant. I am 65 yrs old with no major health problems. I have had a successful hip replacement (titanium) a few years back.Many thanks for your advice. Regards. F

A. Hi many thanks for your enquiry, the main points to look at when contemplating whether or not to perform an immediate placement dental implants“>dental implant are the following:

1: is there a lot of palatal thickness of bone as this is the bone which is generally drilled to house the implant.

2: is there any infection around the root, as if this is the case it is not a wise move to place a dental implant into an area where there is still some infection.

3: there is good evidence that the rate of success is of immediate placement implants is reduced.

But i do a lot immediate placement implants and generally when you are fit and well with no infections around the root they work and help to maintain the bone in the area and more importantly the gum tissue. So if possible i feel is the best way to do implants. Hope this makes sense and if you require any further information please email back.

Dr Kailesh Solanki
kissdental

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I am getting married and want my teeth whitend

Tuesday, March 18th, 2008

Q. Dear Sir, I am intrested in getting my teeth whitend as i am getting married in october and find it hard to smile as i am embaressed about my teeth. I have a few fillings that need doing but can not get into a dentist to have them done. I would like to know if it is safe to have my teeth whitend beforr haveing these fillings performed. Thank you D

A. Dear D,

It is not a good idea to have your teeth bleached with poorly fitting fillings or decay present in your mouth. The bleach could severely irritate the nerves of your teeth and provide you with serious tooth problems that may require root canal treatment.

If your existing fillings are basically sound but just aesthetically unpleasing then bleaching your teeth first would be the thing to do. You may find that the difference in colour of your old fillings to your newly whitened teeth will look odd. You will then need to have your fillings replaced with fillings that match your new colour- wait for 2 weeks to allow your new colour to stabilise before having the fillings replaced.

Have a great wedding!

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

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Posted in Dr Caplan's Answers, Experts Answers, Q. Teeth Whitening | 4 Comments »

what subjects do i need to study for dentistry?

Tuesday, March 18th, 2008

Q. hi just wanted to say firstly that your really pretty for a dentist. i’m a 15 year old boy in high school my question is that i would like to know what subjects are needed to further a carrer in dentistry because i’m realy interested in it i would also like to know what the required courses are and your opinion on the best universities to study preferably your’s but basically the best thank you.

A. Hi G, Thanks for the compliment and the question.
Biology and chemistry are definitely required and then third can be any subject. It doesn’t necessarily have to be another science, it is best to double check on the UCAS forms though. Universities are looking for diversity amongst their applicants. I studied biology, chemistry and physics at A- level. I think that the grades needed now are A A B, but some universities may vary. I went to Leeds, which is a fantastic school but Newcastle, Birmingham, Sheffield, Bristol are all very good Universities. If you fancy London then there is Guys Hospital Dental School. It is hard work but its all worth it in the end.
Good Luck with all your endevours

Kind Regards

Dr Komal Suri

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My crown fell off and my tooth has split and i need to have the root removed

Sunday, March 9th, 2008

Q. Hi My Crown fell off my front tooth and when I went to the dentist he said I would have to have the root removed as it has split but that I would have to wear a Denture for 6 months before he could put a fixed crown back there no other way of having this done as I cant imagine having to wear a denture, he has fixed the crown back on for now M

A. Dear M, thank you for your question.

If the tooth has fractured then unfortunately the only treatment is to remove it. Normally when a tooth is extracted there is a period of 6 months during which the bone remodels and there is normally some shrinkage as well. This may be why your dentist suggested waiting for 6 months before a permanent replacement was made.

There are 2 options for the replacement of the tooth:

The first is a dental implant. if an implant is to be placed then the remaining roots need to be removed very carefully to maintain as much of your natural bone as possible. the socket is then packed with synthetic bone to make sure the integrity of the ridge is maintained. This way the bone does not shrink back. A period of 4 months is the normal waiting period for the bone to become strong enough to place an implant. Due to the fact that the teeth on either side of the gap are not going to be involved in supporting the new implant, a denture is the usual method for temporary replacement of the tooth during the healing period.

Occasionally a fibre bridge can be made. This is a reversible treatment and one that I do for my patients if they can’t tolerate a denture. It is made primarily made of white filling material, it can be laboratory made or made at the practice. This is something that if you are a suitable candidate can be very satisfactory for the healing period. It does require more work by the dentist and if it is made by the dental laboratory will also be a more expensive option.

If you have decided to have a bridge to repalce the tooth then the teeth on either side of the gap will ultimately be shaved down slightly so that the bridge can be placed. If one of my patients was in the same situation as you are, the tooth would be removed, the socket would be packed with synthetic bone crystals and stiches would be placed. On the same visit I would prepare the teeth on either side of the gap and place a tempoaray bridge which I make myself or get the laboratory to make it. This is then glued in with temporary glue for the healing period. Over the next 10 -12 weeks the temporary bridge is modified so that I can make sure the gum and bone remodels around the false tooth to make it look as if were growing out of the gum. It can occasionally take longer 12 weeks. Once I am happy with the contour of the gum tissue I will replace the temporary bridge for a permanent one.

It sounds like the dentist you go to is planning on making a bridge for you which will probably be functinal but if the bone is allowed t recede and shrink back the final aesthetics may not be perfect and also you are limiting yourself for future implant treatment. Bridges on average can last for 10 -15 years but they do ultimately fail and when they do it is because one of the teeth that the bridge is attached to fails. This may then leave you with 2 gaps which will then need to be filled.

Talk to your dentist a little more about options available to you and express you concerns and hopefully he/she will be able to come up with a treatment plan that your are more happy with

Kind Regards
Dr Komal Suri

Posted in Dr Suri's Answers, Experts Answers, Q. Broken teeth, Q. Dental Bridges, Q. Dental Implants | 1 Comment »

My dentures are uncomfortable how mucg would a full mouth of dental implants cost

Sunday, March 9th, 2008

Q. i have had false teeth from age of 16 age now 45 i am finding dentures very uncomfortable on bottom they keep slipping i was at dental hospital years ago and they thought i would need implants in year to come how much would it cost for a full mouth of dental implants what is involved time wise thanks

A. Hi E,

Your problem is not uncommon at all. The tongue does not like sharing space with anything in the mouth and always dislodges lower dentures. Over time the bone you have in the jaw does resorb decreasing what the denture can sit down on.

With dental implants you do not need to replace every missing tooth with an implant but you can get away with having just 5 – 6 dental implants which has dental bridges attached to them. This should restore you back to function. Time wise you are looking at approximately 9 months of healing following the placement of the implant to get the best possible chance of implant integration.

From a cost prospective you are looking at about £2000 per dental implant which includes the crown that goes on top of the implant. Most practices offer a finance package that allows patient to take up treatment and pay for it in an affordable manner.

I hope this helps

Regards

Dr Safeer Butt
Principal – S3 Dental
Synergistic Smile Studios

Posted in Dr Butt's Answers, Experts Answers, Q. Dental Finance, Q. Dental Implants | No Comments »

Cost of lumineers veneers

Sunday, March 9th, 2008

Q. I know you cannot be precise but what would be average the cost of lumineer veneers ?
A. Hi D,

The cost of lumineers does vary depending on where you are in the country and who’s doing the treatment. Another factor for the variation of the cost is your cosmetic requirements. i.e How particular about the shade of them.

On average our prices range between £400 – £575 per lumineer but you need to be aware that the criteria to have lumineers successfully is very strict.

Hope that helps!

Regards

Dr Safeer Butt
Principal S3 Dental
Synergistic Smile Studios

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one of my back teeth has rotted away and i have a minor rot in my front tooth

Sunday, March 9th, 2008

Q. I have a minor rot in 1 of my front teeth that doesn’t cause me problems but isn’t a great sight, but i also have 1 of my back teeth that has gradually rotted away and now has a huge hole that really needs filling and is giving me quite considerable pain, how do i go about getting them sorted because i really need a dentist?

A. Dear D,

My best advice to you is to talk to your family and friends to find a dentist that they recommend. Then book in as soon as possible before things get worse and the treatment becomes more complex.

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

Posted in Dr Caplan's Answers, Experts Answers, Q. General dentistry | 1 Comment »

What can be done to stop badly receded gums

Sunday, March 9th, 2008

Q. My gums have receded fairly badly is there anything I casn do to stop this
A. Dear B,

Receeded gums is usually due to an underlying gum disease. The first thing you need to do is have the gum disease treated and stabilized. Only after this can any cosmetic procedures be carried out. These may include gum grafts and restorations (veneers or crowns) .

Please contact a dentist near you who has a dental hygienist to begin treatment. They may want to refer you to a gum specialist.

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

Posted in Dr Caplan's Answers, Experts Answers, Q. gums | 1 Comment »

I am getting married next year and my jaw is not straight and my teeth are to long

Sunday, March 9th, 2008

Q. Hi my jaw is not straight and my top teeth are not perfectly straight and i have an over-bite, also my top 2 front teeth are longer than the teeth next to them. I did wear a top brace at about 14/15 years old but only for a few months, this was all due to sucking my thumb from a young age. I find it difficult to smile in photos and I am getting married next year, so would love to be able to smile at ease! What do you recommend, veneers or some sort of brace? How can my jaw be corrected? also what would I expect to pay for the required treatment?

A. Dear G,

Thank you for your questions, It is not uncommon for people to seek a beautiful smile for their wedding. Normally it is next month rather than next year! That gives you time to get your smile correct.

Even though we have a year it still probably means that braces are not an option. Some form of brace work would help your jaw discrepancy but this usually takes about 2 years to accomplish. in this sort of situation veneers are often a good immediate solution. They will allow a vast improvement in your smile with the minimal amount of shaping of your teeth. You may also require the gum line to be changed to allow for an even well proportioned smile. The important thing is for you to find a dentist who is adequately trained is this sort of procedure. As a ball park figure the cost of this treatment is usually in the region of about £10000.00 . This can vary from dentist to dentist depending on their expertise and experience.

Hope this helps,

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

Posted in Dr Caplan's Answers, Experts Answers, Q. Smile Makeovers | No Comments »

My enamel is worn will teeth whitening damage my enamel more?

Sunday, March 9th, 2008

Q. I am considering teeth whitening“>teeth whitening, however the enamel on my incisor teeth is worn somewhat-particularly at the edges. Will teeth whitening cause further damage to the enamel in that area and make it more noticeable? Also in the future, will it speed up erosion of enamel in the worn areas?

A. Dear H,

When you have your teeth bleached it is for a relatively short period of time. The enamel does lose a small amount of calcium from the surface but this is replaced by the calcium in your saliva in the following weeks after you stop bleaching. This is provided the correct bleaching solutions are used. It is extremely important that you have your teeth bleached by a dentist and not a beautician as incorrect solutions have been used in the past by people who are not correctly trained. ( In fact it is illegal for any one who is not a dentist to carry out any treatments involving teeth.)

Your worn enamel may be a problem as this is the main part of the tooth that is bleached and also it protects the underlying sensitive dentine. If a large amount of enamel is missing your teeth may not whiten sufficiently and they may become very sensitive to temperature changes. Your dentist will be able to advise you whether bleaching really is for you.

Dr Julian Caplan BDS
Aviva Cosmetic Dentistry
Director on the board of the British Academy of Cosmetic Dentistry

Posted in Dr Caplan's Answers, Experts Answers, Q. Teeth Whitening | No Comments »

My gums have receded and my teeth woble what can i do for £1000?

Sunday, March 9th, 2008

Q. Hi my gums have receded at at the front in my lower jaw which are causing my teeth to wobble also my teeth are moving around and it has caused one of my front teeth to protrude the natural teeth line what would need to be done and how much would it cost i only £1,000 to spend thank you.

A. Dear J

Its sounds like you are suffering from periodontal disease. This affects a majority of the population to some degree. In its most extreme the teeth become very loose and fall out. Periodontal disease effects the underlying bone which is the foundations for your teeth. It is very difficult to tell you what you need without seeing x-rays and carrying out a full consultation.
Sorry to be vague but I hope this helps.
Dr Riten Patel BDS

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How long to wait after a back tooth extraction before I can have a dental implant?

Sunday, March 9th, 2008

Q. I have recently had a back tooth extracted. How long must I wait before I can begin the dental implant process??

A. Dear C
The length of time after an extraction often depends on the condition of the underlying bone. If there has been minimal infection the implant can usually be placed after six weeks. If there was a lot of infection or there is a lack of bone present a synthetic bone graft can be placed to allow new bone to grow, the implant is then placed about 4-6 months after this.

I hope this helps you

Dr Riten Patel BDS

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I had my peg tooth extracted and it got infected should i have an inplant

Sunday, March 9th, 2008

Q. I have recently had a front ( peg ) tooth extracted, it had a crown on it for years but developed an infection which was not noticed/ treated the last time i got my crown put on. I was then going to have a bridge, but the tooth next to it which it was going to be fixed to ( eye tooth ) now needs root canal. My dentist thinks i might have to have an inplant. Would i have to have an inplant or can a bridge be attached to this tooth? it is such a tiny tooth i was thinking it might be ok. Or do you think it would be benificial to have the implant in the long run? – i am 35years old thanks Mrs B

A. Dear Mrs B,

Thank you for your question. An implant is usually the ideal replacement for a missing tooth. I know that if I was in the same situation as you that I would consider having an implant placed. The tooth that you are referring to, the peg lateral, is the weakest tooth in the mouth in all people. It doesn’t take much of the biting or chewing force. If you want to consider having a bridge, it is a treatment option, however to have a bridge the teeth or tooth on the side of the gap need to be shaved down to place a cap over it and the false tooth is attached to it. From a dental point of view it is a slight compromise on the implant. You need to decide what is best for you. An implant is a more expensive treatment option but it will last longer than a bridge and doesn’t require the other teeth to be crowned. The canine tooth is strong and even though it needs root canal treatment it would successfully support an extra tooth for a number of years. Bridges do ultimately fail and at this stage you would be faced with similar dilemas. The situation could also be worse because at the point when the bridge does fail, the cainine may also be damaged. I guess it is a question of damage control. If it was me I would explore the option of an implant.

I hope this helps you

Kind Regards

Dr Komal Suri

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Posted in Dr Suri's Answers, Experts Answers, Q. Dental Implants | 1 Comment »

My tooth has been pulled out as well as bone will my bone renew in 4 months?

Sunday, March 9th, 2008

Q. Hi. I’ve just had my bridge removed. I was going to have a implant, but as my tooth was being pulled out my bone came out as well. My dentist said i’ll to wait about 4 months for the bone to renew. Do you think my bone will renew?

A. Dear E,

Thank you for question. Usually when a tooth is removed the bone remodels and usually shrinks back. When a tooth is removed with a view to placing an implant in the resulting gap it is done very carefully. This helps preserve as much bone as possible. The resulting socket is then packed with synthetic bone crystals to keep the integrity of the boney ridge. There is normally a waiting period of approximately four months before the implant is placed. In some cases it takes slightly longer. It is difficult to let you know if your tooth could have been removed in a more careful manner without seeing exactly what the situation was when you had it removed. It may still be possible to place an implant in the area. The nasal cavity is above the bone theat surrounda the front teeth so if there isn’t enough bone to place the implant a bone graft may be needed. It depends on how much bone you have there now and how much came out with the tooth.

I hope this answers your question

Kind Regards

Dr Komal Suri

Posted in Dr Suri's Answers, Experts Answers, Q. Dental Implants, Q. Missing teeth | No Comments »

I have a loose tooth receding gums and a broken tooth will a dental implant be suitable

Sunday, March 9th, 2008

Q. I currently have a loose tooth that needs to come out i think the gum has receded and i cannot chew food properly i also have a broken tooth on the other side would i be able to have a dental implant. B

A. Dear B, thank you for your question.

It is very difficult to let you know whether or not an implant would be suitable for you. The answer depends on a number of factors;

If the mobility is due to gum disease. This causes infection and bone loss from around the tooth. Implants need to be placed in infection free environments. If bone has been lost there may not be enough to place the implant in. A bone graft may be needed.

If the tooth is in the top jaw near a sinus, there may not be enough depth of bone to place the implant into. A CT scan and bone graft may be needed.

If the cause of the mobility and fracture of the other tooth are due to forces incurred during biting and chewing, this may need to be corrected before an implant is placed.

There are certain other considerations; implants have a much higher failure rate when placed in people that smoke.
If you immune system is slightly weaker than normal, ie diabetes, there is a higher failure rate.

In either of these circumstances the dentist placing the implant may not guarentee it for a period of time after placement.
Before any dentist carries out treatment, full records of your mouth should be taken, this would include, x-rays, photos, casts of your teeth, gum survey. this will allow a thorough diagnosis and treatment plan to be formulated for you.

I hope this helps
Kind Regards
Dr Komal Suri

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I am sufferneing from gum disease my gums are recceding very quickly

Sunday, March 9th, 2008

Q. I think that I am suffering from gum disease as my gums are receeding quickly. I am only 50 years of age, can anything be done for this?

A. Dear C
As gum disease is painless – the problem can be more advanced than you realise so it is important to visit your dentist as soon as you can possibly with a following referral to a Periodontist ie gum specialist – to see if the problem can be rectified

Kind regards

Dr Justin Glaister

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