Archive for May, 2008

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My teeth are crooked and twisted in same direction and tooth is broken off

Thursday, May 29th, 2008
Q. Hi, I have a question about treatment for a problem with my lower teeth – the four between the incisors on the lower jaw. They’ve always been crooked, all of them are twisted in the same direction. I always brush twice a day at least, however, I still have had problems. Whilst brushing I felt a piece of what felt like tooth come out. I checked and I noticed a yellow buildup all along the inside of them 4 teeth. And the tooth which part of came away from now feels broken from the bottom of it and sharp. It feels as if the lower quarter of the tooth has just come off. Also, the yellow deposits will not brush off at all. I have no idea why I have these as I always brush a minimum of twice a day. perhaps it’s because the crookedness stops the brush from reaching there. My question was two-fold:1) What can be done for the tooth which has been chipped away?

2) What is the yellow buildup on the teeth? 3) As a long term solution, can braces be used to straighten the teeth and to ensure that there aren’t any nooks for nasty stuff to build up in?

4) What would be the cost of such treatment?

5) How much of a tooth has to chip off before there\’s a risk of it falling out?.. Thanks very much for your time.

 

A. The yellow deposit that has fallen off the neck of your tooth is calculus ( hardened food ). It has developed over time due to food been left behind your lower teeth that has calcified. Some people develop calculus quicker than others and some areas ( especially crooked teeth) can be especially a problem to clean. If you did keep this area meticulously clean the calculus would not develop. You have 2 things you may want to do:

1. Visit a dental hygienist to have the calculus removed and been shown how to keep the area clean. You will be amazed at just how precise you need to be to keep this are clean and how necessary it is to clean between the teeth with something like floss or interdental brushes.

2. Have your teeth straightened with a invisalign.html” target=”_self”>brace. This will certainly make this area easier to clean. I guide to the cost is that it can range from about £1500 to £5000 depending what is needed to done. However you would need to get an estimate from your dentist or orthodontist as costs can vary.

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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Does it hurt to have dental veneers and how much do they cost

Thursday, May 29th, 2008
Q. How much do veneers cost? and is it painful to get done?

 

A. The cost of veneers are usually between £600 and £ 2000 depending on the experience and location of the dentist and the dental laboratory that they use to make the veneers.

Veneers require in the majority of cases a small amount of tooth to be removed from the front and tip of the tooth. This can lead to some sensitivity but it is rare for this to be for a prolonged time provided the veneers are placed correctly.There is far less tooth removed for veneers than when conventional crowns are made. For this reason I try and place veneers where ever possible if I am improving someone’s smile instead of using crowns. On rare occasions the nerve inside the tooth may be affected requiring root canal, treatment- this is usually when the tooth to start with was heavily filled or in poor alignment with the other teeth.

All in all veneers are a good form of treatment to give you an immediate improvement in your smile. If your teeth are in poor alignment I would always recommend braces first to correct this prior to veneers.

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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What are used at the dental hygienist plastic or ultrasonic scalers

Thursday, May 29th, 2008
Q. At the hygienist appointment plastic scalers are used can the ultra sonic scaler be used also ?

 

A. The hygienist has an array of equipment available to them. Certainly plastic scalers and utrasonic scalers are some of them The hygienist usually uses an ultrasonic scaler to clean the teeth , followed by fine hand scales if required.Plastic scalers are usually used around dental implants.

Hope this helps,

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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Haven’t been to dentist in 16 years and my wisdom tooth is very sore

Thursday, May 29th, 2008
Q. Hi i have not been to a dentist in 16 years..but for the last month on and off my wisdom tooth has been very sore. im so scared of coming to dentist ,but need help with this pain

 

A. It has been a long time since you have been involved with dentists and dentistry. Things have come a long way in 16 years. You obviously need to have something done to help you with your pain so I would advise you to ask your friends whether they know of a gentle dentist in your area and at least let them have a look at your problem. You never know it may only require a course of antibiotics and to teach you how to clean the area better. Certainly if you leave it, it will probably get worse.

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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What is the cost of a denture for three teeth and a bridge

Thursday, May 29th, 2008
Q. I have just had my three front teeth taken out and dentures fitted i had to have one taken out as it was a crown and that was coming out so i asked my dentist to take the other two out as i had never had straight teeth or two front ones since i was sixteen, i would like a bridge once my gums have settled down could u tell me the cost of this.

 

A. It is very difficult to give you a cost for the treatment as it depends on how many teeth will be used to support the bridge, what type of material is used to make the bridge and the experience/ location of your dentist

My best advice is to ask your dentist for an estimate of the fee as they are in far better position to guide you in this matter.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I had a tooth extracted can I wait one year before having an implant

Thursday, May 29th, 2008
Q. Dear Sir, I had the extraction of a tooth following an abscess. The dentist who is providing me with the dental treatment is proposing a dental implant. I had the dental extraction in early March. Do you think I can wait one year before deciding to have the dental implant?

 

A.. By waiting a year there is an increased potential of having the teeth either side of the gap and above the gap growing into the space. Also there is an increased chance of loosing valuable bone necessary for implant placement. Certainly with an abscess present you are well advised to leave the area for 6 months to heal but a year is a long time.

Many dentists have financial packages to help you overcome the costs of the implant – this is usually the reason for delaying the treatment. My advice would be to have the implant placed as soon as biologically possible.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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Which teeth whitening – bleaching system should I use ?

Thursday, May 29th, 2008
Q. I am looking into getting my teeth whitened – but with so many different procedures out there i am little confused on which is the best and safest option to take. Healing Hands do Professional laser teeth whitening in 1hr – would you recommend laser teeth whitening or would the home kit be the best option? please advise. Thanks in advance.

 

A. You are quite right there are a myriad of bleaching techniques and products available and it can be extremely difficult even for a dentist to decide on the right type. There are dentists who swear by one technique and others by another technique. In my experience the home bleaching has the best effect and uses a much lower concentration of bleach in comparison to the “laser” bleaching.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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My teeth don’t show when I smile and my top tooth needs braces

Thursday, May 29th, 2008
Q. I have two questions:
1) The tooth adjacent to my middle top two teeth is at an angle and allows air though when I trying to say ’s’ and as a result makes it difficult for me to speak correctly. I am 42 so can this tooth be straightened with a brace or would it require a crown or are there other alternatives?2) When smiling my teeth don’t show, I think I have short gums. Can anything be done so that my teeth show when I smile? Many thanks.

 

A. Thank you for your questions. Taking them in turn:

1. You certainly can have your teeth straightened using a brace as an adult. This may solve this escaping air problem when saying your “S’s” . However there is a possibility that following brace work that the spaces are still present. If this is so a veneer or crown may improve the situation.

2. You mention that you think you have short gums. This may be the case but the more likely reason will be that you have worn your teeth shorter and so cannot show enough tooth. the easiest way for you to assess that for yourself is to measure the length of your front teeth. The average length of a front incisor is between 10.5 and 11.5mm . If your teeth are markedly shorter – say 9 mm – you probably have a wear issue. this may require crowns and veneers or a combination of braces and crowns and veneers to lengthen the teeth. Most adults that I offer these options to go for the first option due to the speed that the treatment .

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I have acid erosion on my teeth is there a better solution than composite fillings

Thursday, May 29th, 2008
Q. I have a problem with acid erosion, my dentist keeps putting compitions fillings over-its only the 4 front incisors-is there a more permanant solution?

A. My first concern would be why you have acid erosion on your teeth in the first place. I would also be concerned about the way your teeth bite together as it sounds as though you are having to have the composites replaced. Flexing of the neck of the teeth can often cause the composites to “pop” off.

A more permanent solution would be to place porcelain veneers over the front of the teeth. I would not advise this if you are in your teenage years due to the size of the nerves within your teeth and the chances that your teeth may continue to move. The porcelain veneers also require some tooth removal. However , provided the bite is not excess , they can last for many years.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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My second tooth is missing would invisilgn open a gap for a implant

Thursday, May 29th, 2008
Q. I’m a 21 and my teeth have really started to bother me. My second tooth at the top is missing (it just never grew) and the rest of my upper teeth have spread to fill the gap, I therefore need a brace to make a space for an implant to replace the missing tooth. Would invisilgn treat this? or if not a brace that goes behind the tooth? as I really don\’t want visible braces. My bottom teeth are a little crowded and could do with straightening so would it be possoble to get invisilign for these even if i have to have more severe treatment on top? I know that a lot of information but would you take a guess at a rough estimate in price and length of treatment?

 

A. invisalign.html” target=”_self”>Invisalign predominately tilts and rotates teeth with a little bit of vertical movement possible. If all that is needed is this type of movement then invisalign may well work for you. Any other type of movement may require a fixed ( train tracks) brace. These can often be placed behind the teeth but obviously at an extra cost.

The lowers could be treated with invisalgn provided that the tooth movement needed is as described above. However, if you do have to have a fixed upper brace it may be simpler have to have the same on the lower.

Costs vary depending on the experience and location of the dentist. A guide would be about between £3500 and £4500 for invisalign ( uppers and Lowers) . Unfortunately fixed brace work is more complicated and you would need a proper assessment to have an idea of the cost.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I have some movable teeth can I have fixed stable teeth

Thursday, May 29th, 2008
Q. I have some very movable teeth and I want to know if there is anyway I could use the stable teeth (approx six) to have a bridge fitted or is it better to have them removed and replaced with a full denture as this will probably be inevitable in the future.

 

A. The first thing that needs to be assessed is whether you have gum disease that is on going. If this is treatable it may be possible to splint all your teeth together to increase there strength as a group of teeth. Your bite would also need to be assessed to make sure that there are no excessive forces causing your teeth to wobble.

If the assessment shows that the teeth are not treatable ( not enough bone left would be the usual reason)then you have 3 possible treatments:

1. denture
2. denture with implants.
3. bridge work with implants.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I have very bad teeth what would it cost to get them replaced

Thursday, May 29th, 2008
Q. I have very bad teeth. In fact i would not say I have a viable tooth left. I am only 27 and do not want to be left with dentures. Is there any way I can get them repaired/replaced with permanent fixture and roughly how much is that

 

A. Very bad teeth are often very savable at your age. It’s the underlying tooth (the root) and the bone support around it that is crucial as to whether the tooth needs to come out. What you need is a full assessment of your mouth including a reason found why your teeth are in such a bad way. This is often due to a dietary problem( too much sugar) and would need to be resolved before any major work was carried out. X-rays will reveal how much root and bone is left. The health of your gums need to be assessed as well. Finally the way your teeth come together needs to be considered to make sure that the major work that is undertaken will last you along time. There are other things a dentist may look at but the above would be a good starting point.

It is impossible for me to give you even a rough estimate of the costs involved. I am sue a dentist in your area will give you a an estimate once the initial assessment is completed.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I broke a tooth should I have a tooth implant or bridge

Thursday, May 29th, 2008
Q. I broke a tooth and a half sometime last year. I am currently contemplating to either have the tooth implant or the bridge. What are the good and bad of having a tooth implant and a bridge?

A. There are a number of pros and cons in having a bridge or an implant.

Bridges used to be the only way of replacing a missing tooth with fixed solution. The advantages of a bridge are that they are a relatively quick to make and fit ( approx 2 weeks) and can look very life-like. If the teeth used to hold the bridge in place are already heavily filled they will be protected from the possibility of fracturing, and they can also have an aesthetic improvement. Localised bite problems can be improved.

The disadvantages of bridges is the need to prepare adjacent teeth for crowns to hold the bridge in place. This can lead to nerve problems with these teeth. If in the future there was a problem with one of these teeth then the whole bridge will probably need to be replaced. The success rate of a bridge is about 80% over 10 years. This is fairly high but not as good as for implants ( in the 94% region often)

Implants have a very high success rate and do not affect the teeth either side when properly placed. Obviously surgery is involved but in most cases this is very manageable by the patient. The main downside with implants is their cost. However a single implant cost compared to a private bridge is usually in the same region. Only when multiple implants are placed does the cost begin to escalate in comparison to standard bridges.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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Can my black fillings be the same colour as my teeth

Thursday, May 29th, 2008
Q. The Fillings at the back of my mouth are black is there anything u can suggest to get them the same colour my teeth?

 

A. Nowadays there are 2 main ways to get rid of the old black fillings

1. Composite fillings - these are white plastic fillings that are used to make your tooth look white. There use is generally limited to small fillings as they tend not to last too long if they are too big.

2. For medium to large fillings porcelain fillings can be placed.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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Mum has premature menopause and gum disease please help

Thursday, May 29th, 2008
Q. My Mum has gone in to premature menopause and is now suffering from receding gum disease. She already has a bridge for 70% of her top teeth that she has lost. Apparently the actual jaw bone is rotting and there is nothing for the teeth to hang on to but the teeth themselves are healthy. The remainder of her top teeth are now becoming unstable and her dentist has advised her she will loose them soon and will have to have a denture. This terrifies my Mum who is only 47 years old. Can you advise us of any treatment options to slow her condition down or alternatives to a denture? Implants may not be an option due to the problem being her crumbling jaw bone. She already takes Co Q-10 and Grapeseed Oil to try and strengthen the gum tissue. I would be so very grateful for your help.

 

A. I am very sorry to read about the problems your mother is having. Your Mum is obviously suffering from something we call chronic adult periodontitis (gum infection with bane loss). This is a difficult disease to control and depends on how far it has progressed to whether anything can be done. From your description it does sound like she is likely to loose the remainder of her upper teeth.

If this happens the 3 options your Mum will have are:
1. denture
2. denture with implants.
3. bridge work with implants.

Although your Mum has probably lost a lot of bone around her teeth this does not usually make implants impossible to place. There are techniques , such as bone grafts, that allow us to create bone to place the implant into. There are some medical conditions which would prevent implant placement but, provided your mother isn’t a smoker and she is reasonably healthy, implants are a great solution.

Kindest regards

dr julian caplan

Dr Julian Caplan – Director on the board of the BACD
Aviva Cosmetic Dentistry
101 St Peters Street, St Albans, Hertfordshire, AL1 3EN
Web: www.avivacosmeticdentistry.co.uk Tel: 01727 854429

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I cannot talk to my dentist about dental implants and grafting

Thursday, May 29th, 2008
Q. How can I get an honest answer to my questions about bone grafting for implants and implants in general as I just cannot talk to MY dentist.

 

A. This is a great one to answer. If you can get to Birmingham City Centre I will have a look for free. You pay for Xrays If you need them.

I have 12 years experience of implants with moderate bone grafts and refer to a range of surgeons for major graft cases 0121 643 0610 without obligation or a further Sales Pitch

Regards

dr rob tennet

Dr Rob Tennet
St Johns Dental Practice
18 Bennett’s Hill, Birmingham, B2 5QJ
Web: www.e-dentalpractice.co.uk  Tel: 0121 643 0610

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Home tooth whitening kit which is FDA approved will it damage my teeth

Thursday, May 29th, 2008
Q. I have bought a home tooth whitening kit and on the website it says it has been endorsed by the American Dental Association and licensed by the FDA (American Food & Drug Administration, and has a full licence throughout the rest of Europe. It also says that Fifteen years of published research by international dental experts concludes there are no side effects when using 10%, 16% or 22% gel in custom fit trays. Please let me know whether this percentage is too high as I am worried that it will damage my teeth. Thank you

 

A. It is true in saying that all the concentrations you mentioned are available for teeth whitening. However, it does depend on a few things. The safe concentration depends on what the whitening agent is. – either Hydrogen Peroxide or carbamide peroxide.

Also, whilst the concentrations or whitening agent may be safe, they are only safe when used with the whitening system they were originally tested with. In conjunction most approved whitening systems were tested with customised fitting trays. Nowdays trays are available which you mould to your teeth by immersing the trays in hot water. These are not ideal, and again outside the “approved tested method” .

Whilst they may work, there are too many variables for me to clearly say if the particular system you are using is safe. The whitening system i used, is very strict with its technique and criteria, and i find it hard to achieve that level of regulation from internet websites.

If you have any further questions please do not hesitate to contact me.

Regards

dr safeer butt

Dr Safeer Butt
S3 Dental – Synergistic Smile Studios
Clinics in Kent, Surrey & Sussex
Web: www.s3dental.co.uk  Tel: 020 8398 6322

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Can I get veneers even if my teeth are not straight

Thursday, May 29th, 2008
Q. I would like to get the veneers however my teeth are’t straight and i was wondering if my teeth can be drill and then the veener can go on over it as i dont want braces and i dont want it to take a year before i can do it cause i really need to get it done cause i dont have any confidents when it comes on to my smile.
A. Thank you for your enquiry.

If orthodontics is not an option for you then veneers certainly can be utilised to straighten teeth or at least give the illusion that they are straight.

Before embarking on any permanent work carried out to your teeth make sure you have what is called a diagnostic wax-up carried out which is basically a preview of what can be achieved by having the veneer work carried out – if you like the results of this then you are on the right track with your dentist to getting the smile you are looking for

dr justin glaister

Dr Justin Glaister
Umbrella
11 Harley Street, London, W1G 9PF
Web: www.umbrellasmiles.com  Tel: 020 7612 9810

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My front teeth are overcrowded and I look like a vampire

Thursday, May 29th, 2008
Q. Hello, I’m considering cosmetic surgery on my teeth because they are overcrowding my front teeth- on either side- i look like a vampire! Do you think you can straighten them out?

 

A. Hello, gone are the days that you have to live with crooked teeth. there are many ways to straighten your teeth out and sometimes this can even be with out extractions of teeth and also without the need for the typical train track view. there are products such as invisalign. i think he best thing would be to consult a cosmetic dentist to try to help clear your mind with what is needed to improve your smile.

dr kailesh solanki

Dr Kailesh Solanki
Kissdental – UK Practice of the Year 2007
157 Woodsend Road, Flixton, Manchester, M41 8GN.
2 New Street, Altrincham, Cheshire, WA14 2QS 13
Stanley Street, Manchester, M8 8SH
Web: www.kissdental.co.uk Tel: 0161 748 5250

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My jawline is misaligned and I cant open my mouth wide what can be done to fix this?

Thursday, May 29th, 2008
Q. My jawline seems to be misaligned or broken on the left side of my face. It makes my face look asymmetrical, and my left eye is also protruding, i also have problems opening my mouth really wide. What can i do to get this fixed?

 

A. The complaints you mention could be as a result of a number of different factors and as you can imagine it is impossible for me to diagnose this from the brief description you have provided.

The restriction in jaw opening can be as a result of Jaw joint (TMJ) problems which can be helped via wearing a certain type of appliance on the lower teeth to relax the jaw muscles and allowing a greater range of movement.

Regarding the jaw line and eye issues only a full and detailed examination will determine if these issues are related to TMJ and whether they can be improved or not.

Kind regards

dr justin glaister

Dr Justin Glaister
Umbrella
11 Harley Street, London, W1G 9PF
Web: www.umbrellasmiles.com  Tel: 020 7612 9810

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