Bridge Of Earn Dental Practice FAQ

To register as a patient of the practice all you need to do is call or come into the practice, fill out a medical history questionnaire and arrange an appointment to see one of our dentists. After this appointment you will be registered at the practice.

It is important that your dentist has an accurate medical history, including a list of any prescribed and non-prescribed medications as these can impact your dental treatment options and the planning of your dental care. If you receive exemption from paying dental charges please bring your current evidence for our records.

Please contact the practice on 01738 813 080 to arrange an emergency dental appointment, our dentists hold emergency spaces; the earlier you contact us the higher chance we have to fit you in that day if you require urgent attention. If you require help outwith our practice hours please contact NHS 24 (111) and they will provide a triage service, advice and an emergency appointment if required.

Contact the dental practice at your earliest convenience, a broken tooth is not a dental emergency unless you have toothache accompanying it. If the tooth is sharp you can get a temporary filling kit from most pharmacies or supermarkets to cover the area until your dentist can examine the area and provide you with treatment options to restore your tooth to a functional unit.

If the tooth is a baby tooth- DO NOT TRY TO REPLACE IT this could damage the adult tooth above it, contact the practice to arrange an appointment as soon as possible.

If the tooth is an adult (permanent) tooth:

Don’t panic, pick up the tooth by the crown (the white part)- do not handle the root.

If the tooth is dirty gently rinse it with milk or saliva (do not clean it with water as this can destroy the cells on the surface that can re-integrate it to the ligament)

If you can place the tooth back in the socket, if you cannot or your child is too distressed either keep it in the space inside your cheek (the saliva will help keep the cells alive) or in milk. The quicker the tooth is implanted and the more immature the tooth is the higher the chance of the tooth surviving. Contact the surgery as this is a true dental emergency.

A dental examination allows us to check more than just teeth, we check the health of your gums and also check the soft tissues of your cheeks, tongue, lips, palate and the lymph nodes around your head and neck for any abnormalities, early signs of mouth cancer or infections which could indicate problems elsewhere.

We also check that your dentures fit well are functional and are not too worn which may indicate the requirement for a new set of dentures or a modifications to your current set.

Nicotine and tar in smoke stain your teeth and can cause (and accelerate the progression of) gum disease that leads to bleeding gums -this early sign is usually decreased in smokers due to the reduced blood flow to the gums due to smoking, tooth mobility and ultimately tooth loss (which may or may not be painful). Smoking is one of the biggest causes of mouth cancer, in patients who smoke and consume more than the recommended amount of alcohol the risk of mouth cancer can increase by almost ten fold.

If you are thinking of quitting speak to your dentist or nurse practitioner for help and advice, http://smokefree.nhs.uk/ can help you find information and advice to help you along your journey.

The amount of radiation received from a dental x ray is extremely small, a set of dental x rays taken during a routine check up equates to approximately one day of background radiation or the amount of radiation received during a short airplane flight. Our practice has a modern, digital x ray system which reduces the dose further.

We use x rays to produce radiographs (pictures) to aid our diagnosis of dental decay (especially between teeth and around fillings/crowns) and to check for problems with the root or bone (infection or bone loss due to gum disease). Your dentist leaves the room during these exposures as she/he may take dozens of radiographs every day!

We recommend you fill out a medical history to register your baby to the practice and bring your baby along with you for your check up as soon as possible. Frequent exposure to your dentist, the dental environment and observing you being relaxed means that they will be happier coming to the dentist as they get older. These early appointments (even before your little one has any teeth!) allow your dentist to give you advice on toothbrushing, weaning and diet. For more information regarding toothbrushing and diet for your child please see our Childsmile section.

You should start brushing your baby’s teeth twice a day with toothpaste containing 1000ppm fluoride as soon as the first tooth starts to erupt. Please see the Childsmile section for detailed information on toothbrushing and diet advice for children.

Baby teeth contain significantly less dentine than adult teeth- dentine is the yellow substructure of the tooth that provides strength to the brittle enamel. The greater proportion of dentine causes the adult teeth to have a yellow hue compared with their baby teeth.

When your child has a mixture of baby and adult teeth it may look like the adult ones are significantly darker/yellower, once the rest of the adult teeth erupt and the enamel has continued to mature you may not notice the yellow colour at all. Ensure that your child’s teeth are clean- that there is not a yellow/creamy layer of plaque covering them and ensure they are getting the appropriate amount of fluoride (1450ppm for children over 3 years) twice a day.

The small bumps at the tips of the adult incisor teeth are called mamelons, these are often quickly removed/worn down by use during eating and biting.

Bleeding gums are one of the earliest signs that your gums are unhealthy. Plaque, the white creamy substance that builds up on your teeth, contains a mixture of bacteria some of these bacteria cause decay, others if left in contact with the gums cause gum inflammation (gingivitis- which can be reversed) and ultimately gum disease (periodontitis- which causes irreversible damage to the gums and bone surrounding the teeth).

It is important if you see blood when you brush or clean between your teeth you don’t stop cleaning, you are not causing damage to your gums, it is a sign you need to brush/floss more frequently (and sometimes with a different technique).

Make an appointment to see your dentist, or tell your dentist about the bleeding at your next check up, often advice to improve your cleaning technique and removal of tartar (hardened plaque) by your dentist or hygienist can help improve the health of your gums. Ensure you see your dentist regularly -every six months, or more frequently if advised.

Tooth erosion is caused by acid from your diet or acid from your stomach. The acid causes the enamel (or dentine) to soften, the action of chewing or something brushing against your teeth (toothbrush/tongue) removes this soft layer. Over time what you may notice is your front teeth becoming ragged and shorter, also increased sensitivity to hot, cold and sweet things (dentine hypersensitivity).

Pickled foods, some fruits, fizzy drinks, fruit juices, wine and herbal teas have very high levels of acidity, try to limit these foods and drinks to meal times and avoid brushing you teeth for at least an hour after. The layer of enamel that has softened during the acid attack can re-harden using minerals in the saliva. Also drinking through a straw can help protect your front teeth.

Sensitivity is a common problem and affects many people from time to time. Sensitivity that is not caused by decay or a fracture of the tooth is generally caused by exposure of the sensitive dentine below the enamel or exposure of the root, this is commonly caused by erosion (see above), abrasion (something hard wearing the enamel down- toothbrush/pipe/chewing pens etc) or attrition (the teeth grinding against each other) in general these three causes overlap and are interlinked however the result is the same- a short sharp severe pain when the teeth are exposed to hot, cold, sweet or touch. Gum disease, which causes the gums to recede and expose the root, can also lead to sensitivity.

There are many desenstising/’sensitive’ toothpastes on the market, they generally work in two ways- blocking the small tubes (‘pores’) found on the exposed dentine surface or ‘calming’ the nerve. These toothpastes do work. however they require patience and continued use (even after the pain has subsided). Ensure you are not brushing too forcefully; this can cause recession of the gums and attrition (wearing down) of the enamel, use a medium firmness toothbrush and small circular movements (not horizontal scrubbing) to brush your teeth. Your toothbrush should be changed every 6-8 weeks and during this time the bristles should not be splayed or split as this causes you to increase the pressure during brushing. Changing to an electric toothbrush with a pressure indicator is often a good idea if you suffer from sensitive teeth.

If you are unsure of the cause of the pain or you are struggling to control your sensitivity contact your dentist.

Approximately 25% of the population suffer from problems with their jaw joints. A common cause of pain from the jaw joints is clenching the teeth or muscles around the mouth or grinding the teeth (often during the night or during times of stress/concentration) many people are unaware of these habits. The jaw joints may click, crunch or lock during use. People often experience headaches, jaw pain, pain from the teeth or pain in the neck, some people have a history of breaking teeth/fillings or crowns and sometimes the jaw joints have limited opening causing problems with eating. Grinding and clenching can also lead to wobbly teeth.

It is important you consult your dentist if you are experiencing these problems to rule out other causes of pain. After an assessment of your mouth and jaw joints your dentist will provide advice to help reduce the pain/increase the range of movement in the jaw and/or recommend a mouthguard that you wear at night (this can protect your teeth and in some cases can break the habit of grinding/clenching). Some situations require a referral to an oral medicine specialist for an assessment.

General advice for painful jaw joints:

• Try a soft diet to help give the muscles around the jaw a rest
• Avoid chewing gum/pens/biting fingernails
• Anti-inflammatory pain relief medication (please consult your dentist or pharmacist for advice)
• Relaxation/meditation to reduce tension

Gentle jaw exercises (your dentist can provide advice on these)

Yes we do, we use safe tried and tested whitening systems to effectively and gently lift the colour of your teeth. It is illegal for anyone other than a dentist or a dental therapist to provide tooth whitening, we can prescribe custom fitting trays and the correct concentration of bleaching agent. Not everybody is suitable to have tooth whitening therefore an initial consultation is require prior to starting. We can also plan the whitening to be part of a bigger treatment plan that may include or providing fillings, crowns, veneers, bridges or dentures.

Please see the section on whitening (tooth bleaching) for more information and advice.

Yes we do, we offer a range of facial aesthetic treatments using Botox^® and dermal fillers using Teosyal and Teosyal Puresense. Aesthetic treatments should only be provided by qualified staff, Helen Dennis carries out all our injectable aesthetic treatments. If you are interested in a consultation please contact the practice for more information.

Antiwrinkle injections (using Botulinum Toxin Type A) are muscle-relaxing treatments that are targeted to specific muscle groups causing a reduction in the activity of the muscles. The reduced movement prevents or reduces the overlying skin creasing, hence reducing or eliminating the appearance of lines.

The results are a smoother, younger-looking appearance that lasts for 4 to 6 months. The results can take from 4 days to two weeks to fully develop. After approximately 3-4 months the muscles begin to regain activity gradually.

Botulinum toxin is very safe, it has been used for treating patients for over 30 years and most treatments go very well. There are minimal risks associated ranging from mild bruising, headache, tenderness, there is a <1% risk of a temporary eyelid or eyebrow ptosis.

Dermal fillers are injectable treatments used to soften and contour lines and folds, these unwanted lines/folds are plumped up or supported so their appearance is reduced resulting in smoother, more youthful skin. Dermal Fillers most commonly contain Hyaluronic Acid, which is a naturally occurring protein in our body, it draws up water and essential plumps the area up, there fillers last approximately 6-12 months and are naturally broken down by enzymes in our body (with repeated treatments the results can last longer).

The treatments work well for the lines between the nose and mouth (naso-labial lines) and the lines below the mouth these can make the mouth, appear sad or angry (marionette lines). Dermal fillers work well to enhance or return volume to the lips (as we age volume is lost from the lips), they can also be used to define the border of the lips gently enhancing the appearance (this can also help reduce small wrinkles around the mouth and help prevent lipstick bleeding).

There are very few issues and problems with hyaluronic acid fillers but these are in general very rare, most commonly in the days after the treatment there may be some redness, bruising and minimal swelling, which normally settles in a couple of days. Your practitioner will go into detail about side effects and aftercare.

Your dentist will discuss all the options that are suitable to your personal situation, in general there are four main options: accepts and leave the space, have a denture to replace it (this can be a good option to replace the tooth temporarily while your gum and bone heal) have a bridge constructed (using your remaining teeth as anchors) or have a dental implant placed with a crown or bridge placed on it.

Your dentist will go over post operative instructions with you and will also provide you with a written sheet to refer to.

After having a tooth extracted the most important thing to do is to rest, do not do any physical activity or anything strenuous for the rest of the day, do not rinse your mouth out for the rest of the day (you can eat and drink gently once the local anaesthetic has worn off) and do not smoke as all of these things can disturb the blood clot and can increase the risk of bleeding (and also infection). Take some pain relief before the local anaesthetic wears off (it is easier to prevent the discomfort than try to get on top of it later).

It is normal to have some blood oozing from around the socket for a short while after the extraction, this will gently taint your saliva, however if bleeding does occur, wet the clean gauze you are supplied it and apply firm pressure to the socket for 5 minutes.

Starting the day after the procedure place a teaspoon of salt in a small amount of warm water and rinse your mouth out gently after each meal and before bed for 5 days.

If you have any problems with excessive bleeding or pain that gets gradually worse after a few days (this could be a sign the socket has become infected) please contact the practice or if the practice is closed contact NHS24 (111).

It is important you remove and clean your dentures twice daily as they are just as prone to building up plaque and tartar as your teeth, this can affect your teeth and gums (leading to decay and gum disease) as well as affecting the aesthetics of your dentures.

• Remove the denture from your mouth and clean any remaining teeth with a toothpaste containing no less than 1450ppm fluoride, paying special attention to where your denture sits and your palate

The following information relates to hard acrylic or metal dentures (not Flexible Valplast dentures- these should be cleaned with a specialist brush and the cleaning solution supplied and never allowed to dry out)

• Clean your dentures twice a day with warm (not hot) water and a denture brush (toothbrushes are too abrasive and damage the material of your denture)
• Use normal liquid hand-soap to clean your dentures (this is an effective way to remove debris and bacteria from you denture)
• Rinse well and leave your dentures in a little liquid over night

It is a good idea to soak your dentures in a cold water or Steradent or Milton (made up to manufactures instructions) once a fortnight. However do not use Milton bleach on metal dentures as this can degrade the metal.

At Bridge of Earn Dental Practice our aim is to provide you with the best possible service and care from making your appointment to your aftercare. We welcome feedback both positive and constructive (either written, in person or via a review on our website) and aim to deal with any concerns or complaints promptly and effectively, all our procedures are in line with the NHS Complaints Procedure.

When you scheduled your appointment your dentist set aside time to provide a consultation or treatment for you. If you fail to attend your appointment or cancel with less than 24 hours notice (without a good reason) we will charge a fee. This fee is aimed to deter serial missed or late cancellations.