General dental treatments at Allure Dental Care, Barnet

Fillings

Our clinic is metal free and uses only composite (tooth coloured) restoratives for fillings. We do not use amalgam, but can employ techniques for its safe removal.

Most people have fillings of one sort or another but today, because we are much more conscious of our smile, we can choose a natural looking alternative-composite or tooth colour filling.

A composite resin is a tooth coloured plastic mixture fill with glass, first introduced in 1960s. Originally only used for front teeth because of the softer nature, modern improvements to the composition makes them generically suitable today.

Composite fillings are more difficult to place than silver fillings so may take your dentist 15 to 20 minutes longer to complete.

The life expectancy of your composite filling can depend on the depth of the cavity and its position in the mouth. The main advantage of composite fillings is their aesthetic appeal.

Root canal treatment

When is root canal treatment needed?

Signs of pulp damage may include pain, prolonged sensitivity to heat or/and cold, discoloration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth. On the other hand, there may be no symptoms at all. If pulp inflammation or infection is left untreated, it can eventually cause pain, swelling and loss of the supporting bone.

Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. The pulp can get infected or inflamed due to either deep decay or an extensive wear of enamel and dentine exposing the pulp and sometimes as a result of severe gum disease.

Is root canal treatment painful?

Root canal treatment procedures are often painless as the tooth is anaesthetised during treatment. After treatment the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues.

Dental Hygiene services

A good daily dental hygiene routine will ensure your teeth and gums are free from the daily build-up of plaque and tartar whilst regular dental hygienist appointments remove the plaque and tartar in those harder to reach places to prevent cavities, gingivitis and gum disease.

Periodontology (Gum Disease)

  • Do your gums bleed when you brush them?
  • Do you get blood in your mouth for no apparent reason?
  • Have you noticed spaces developing between your teeth?
  • Have you noticed your gums receding, i.e. your teeth looking longer?
  • Do your gums look red or swollen?
  • Do you suffer with bad breath?
  • Do your teeth feel loose?
  • Have your teeth moved position?
  • Do you suffer from recurrent infection in your mouth?

If you can answer to any of the above questions then you should see a dentist to be screened for gum disease and discuss your concern.

Unfortunately, gum disease often goes unnoticed by patients until it has advanced, which is why you should always look out for the signs and visit your dentist regularly, in order to identify any potential problems and treat them while gum disease is still in its early stages. Even if there are no obvious symptoms, a regular check up could end up saving your teeth. Should the condition deteriorate it will be harder to treat effectively and you will be more likely to lose teeth as a result.

For more information please visit www.bsperio.org.uk

Who carries out the gum treatment?

Like many areas of dentistry, periodontics is a specialised area that requires skills and experience to treat. Fortunately Dr Sam Parsno will be able to diagnose you properly and provide any treatment that may be required including advanced surgical treatment in conjunction with guided bone regeneration, which is a technique that stimulates new bone regeneration.

Dentures

A partial denture is fitted to replace some missing teeth whilst a complete denture is indicated when all natural teeth are missing. A good set of dentures helps you to eat, speak, function and often improves the appearance.

How long does it take to make dentures?

Depending on the complexity of each case the duration of the treatment will vary. After the initial examination and diagnosis, the subsequent visit will include taking impression, bite registration, try in of the denture, fitting and review. All these will take 4 to 6 weeks to complete.

What to expect:

New dentures always feel strange when first placed in your mouth. Several days or weeks will be required before you get accustomed to them. Adaptation varies with different persons and often time and experience are essential before dentures can be worn comfortably and function effectively. Useful suggestion to help you to adapt to new dentures.

Eating – will take little practice. Start with soft food; chew slowly using both sides of your mouth at the same time to prevent dentures from tipping.

Increase salivary flow you may experience and increase in salivary flow when then dentures are first used. This is the natural response of the salivary glands that will return to normal after few weeks.

Speech new dentures may alter your speech initially. Pronouncing certain words may require practice. This problem rarely persists beyond two weeks.

Sore spots minor irritation caused by surface irregularities or pressure spots on the denture bearing areas are quit common. Stop wearing the denture if the irritation is very painful and consult your dentist immediately.

Oral Surgery

From time to time, existing conditions will require that small operations are carried out in the mouth. These procedures fall into the category of oral surgery and a number of the most commonly encountered are listed below. These procedures are commonly carried out with the use of local anaesthesia only, however, depending upon the complexity of the procedure or the specific patient requirements, sedation techniques can also be used. All surgeries are planned and carried out on a case specific basis and this planning may involve special investigations such as x ray or CT scan to provide as much information as required prior to the procedure, ensuring a predictable outcome.

Virtually all of the oral surgical procedures are carried out by our team, but we also work closely with consultant surgeons for the more extreme cases.

Routine extraction:

If a tooth is deemed unrestorable in the mouth or has a poor long term prognosis, extraction may be advised. The tooth is removed as gently as possible and the area allowed to heal before replacement of the tooth is considered.

Atraumatic extraction: If a tooth is deemed unrestorable in the mouth or has a poor long term prognosis, extraction may be advised. Depending upon the options for the restoration of the area after extraction and especially if an implant is the treatment of choice, an atraumatic extraction technique may be advised. This procedure uses a periotome to gently loosen the tooth in the socket allowing it to be lifted out with as little trauma as possible. Following the atraumatic extraction technique, the area may be considered for a socket grafting procedure (see bone grafting section) and some small stitches may be placed to allow the area to heal.

Surgical extraction:

If a tooth is deemed unrestorable in the mouth or has a poor long term prognosis, extraction may be advised. In some cases the position of a tooth or its roots, the amount of decay in a tooth, or the decreased volume of tooth tissue may mean that conventional or atraumatic extraction is not possible. In cases such as this, a surgical extraction would be carried out. This would involve a small incision to access and remove the tooth or tooth portions from beneath the gum. In some surgical cases, bone removal may be required in order to facilitate the tooth removal. Bone removal is carried out using either a bur or piezo surgery which is considered one of the safest and most atraumatic techniques available for bone removal. Following the removal of the tooth or tooth fragments, the area is likely to be closed with some small stitches to allow the area to heal.

Wisdom tooth extraction:

One of the most common surgical extractions would be for the removal of impacted (stuck or jammed) lower wisdom teeth within the bone or against the remaining teeth. This prevents the teeth erupting as normal into the arch. In the clinic, we follow closely the Scottish Intercollegiate Guidelines Network (SIGN) guidelines for wisdom tooth extraction ensuring that teeth are extracted as safely and predictably as possible. Impacted or buried wisdom tooth removal requires careful planning and mat involve the use of CT scanning to determine the exact tooth position in three dimensions to ensure its safe removal without damage to adjacent structures.

Impacted canines:

On occasion, the upper canine teeth can become impacted (stuck or jammed) within the bone or against the remaining teeth. This prevents the teeth erupting as normal into the arch. These cases are generally planned following assessment by and discussion with our Specialist orthodontist. Impacted canines can either be:

1: Exposed the canine is accessed and a channel made between it and the mouth to allow the orthodontic eruption of the tooth into a more favourable position in the arch.

2: Extracted The canine position is such that eruption or forced eruption after exposure is not possible. In these cases, the impacted canine tooth would be accessed and extracted. In some cases, bone grafting would be placed in the area to retain/augment the bone volume of the area meaning that implant placement in the future would be possible.

Apicectomy:

Following the death of the nerve of a tooth, the standard treatment would be the removal of this nerve using standard root treatment or endodontic techniques. On occasion, when the end of the root canal is thin, branched or tortuous, simple root canal treatment may not be enough to allow the tooth to be treated to resolution. This means that there can be persistent or chronic infection (abscess) associated with the end of the tooth root which may or may not be symptomatic. In cases such as this, a surgical intervention is required to remove this small end piece or apex of the root. This procedure is known as an apicectomy and following the removal of the root end (apex) a small filling is placed in the end of the root (retrograde root filling). This procedure should remove the infection or granulation tissue, together with the source of this infected tissue (root apex) allowing resolution and the restoration of health to the area.

Cysts:

Small cysts can grow within the bone around teeth or areas where teeth have been extracted. These cysts can progress which will decrease the bone volume in the jaws and can affect remaining teeth and the restorative options. These cysts, on detection can be treated or removed using a number of techniques depending upon the specifics of each case.

Bone grafting, socket grafting and sinus elevation work together with all of the implant work we carry out in the clinic is classed as oral surgery. For more information on each of these topics, see our Dental Implants section.

Soft tissue surgery:

The soft tissue throughout the mouth is generally healthy , pink, soft and moist. Many and varied conditions or diseases can change this tissue, hence, it is extremely important to have the oral tissue checked regularly to ensure it is healthy. Small swellings in the minor salivary glands (mucoceles) can be dealt with surgically, as can small soft tissue swellings known as polyps. We have a close relationship with Oral medicine colleagues and regularly assist in the management and review of Lichen Planus and Sjoegrens Syndrome patients (dry mouth). In addition, for any lesions which require specific consultant assessment, referral via this route can be made.

The prevalence of oral cancer has increased in recent years and can affect any one from young to elderly patients and all age groups in between. Commonly, oral cancers are associated with patients who smoke, drink alcohol, or do both however, this is not always the case. If you notice any changes within the mouth such as white patches, red patches, or mixed red/white patches, painful areas, persistent painful or ulcerated areas, persistent hoarseness or changes in the sound of the voice, it is imperative that you have these areas examined or investigated by a dentist for appropriate, quick referral for further investigation if required.

With all soft tissue or biopsy surgery, any excised samples are sent for microscopy or histopathological examination as appropriate in order that the supposed diagnosis be confirmed as definitive and the most appropriate treatment be confirmed.

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