Our case of the month for December 2018 involves one of our favourite techniques: ABC A is for alignment. Straightening teeth using a discreet treatment method, usually in a short space of time. B is for bleaching. Whitening teeth to brighten your smile. C is for cosmetic bonding. Enhancing the overall shape and symmetry of teeth by adding to teeth rather than cutting away healthy tooth enamel. Our case presented with quite severely crooked lower front teeth which bothering him a great deal. They were rotated, overlapping and worn down from years of tooth grinding. Initially, they front 4 teeth were straightened using the Social 6 lingual brace. Aligning the front teeth means that any future cosmetic dental procedure such as composite bonding or porcelain veneers requires minimal tooth preparation if any at all. After alignment, the teeth were whitened using a take home kit with Phillips ZOOM gel 6% hydrogen peroxide, which lifted the overall shade by 4-5 levels. Cosmetic bonding was then performed on the front 4 teeth to level the edges. Not only does this enhance the overall aesthetics but this will also improve the bite. Having even edges on the front teeth allows a smooth guidance when eating and chewing. In turn, this will protect the back teeth also. Before and after photos:
 

Mouth cancer causes more deaths per number of cases than breast cancer and cervical cancer however awareness of it is relatively low. New cases have increased by 49% in the last decade and 135% compared to twenty years ago. Last year, 2722 people in the UK died from mouth cancer. The key risk factors are: 


- Tobacco use including chewing betel nut 

- Excess alcohol (those who smoke and drink heavily are up to 30 times more likely to develop mouth cancer)

- Poor diet 

- HPV (Human Papilloma Virus) transmitted through oral sex.

Mouth cancer can develop in most parts of the mouth including the gums, lips, tongue, palate and even the throat. The most common symptoms are : 

- Persistent non healing ulcers Persistent lumps in the mouth or lymph glands 

- Pain when swallowing 

- Numbness or bleeding from the mouth 

- Changes in speech 

- Teeth that become loose for no obvious reason 

- Tooth extraction sockets not healing 

- Difficulty moving your jaw 

- Red or white patches or striations in the mouth 


Early detection is critical to a full recovery as well as life style changes. In general, if any of the symptoms have been present for more than two weeks, seek medical advice. At Progressive Dentistry, we routinely check for mouth cancer at every examination appointment with a thorough soft tissue analysis. This will involve a detailed history and a soft tissue check. During this part of the examination, we check the tongue, underneath the tongue, floor of the mouth, cheek surfaces, soft palate, hard palate and the entire gum line. 

If you have any concerns about mouth cancer or would like some general advice, please contact us.

Our case of the months for November is a simple yet effective teeth straightening case involving the lower front teeth. Straightening lower front teeth has a number of benefits which include:
 

1. Improved aesthetics
2. Improved access for cleaning
3. Improved anterior guidance (bite)
4. Reduces damaging forces on the edges and reducing tooth wear
5. Improved contact

For those of you who are not dentally trained, point 3 is how the lower teeth move up against the upper teeth forwards, right and left movements. The smoother the guidance the better. Teeth that are very crooked cannot, by nature, have smooth contacts with the upper and often one or two teeth take the force and are damaged as a result. A simple test is to stand in front of the mirror and bring your teeth edge to edge. Do they meet evenly? Does one tooth make most of the contact? Are your lower/ upper teeth worn and uneven? If so, it is worth considering treatment. Here are the before and after photos for our case:
 

Our case of the month for October 2018 is one which involves a fully customised crown. What is this, you may ask. Well, we mainly advise a fully customised crown for single front teeth where the aesthetics are incredibly important. Essentially, this technique is the very best we can offer in terms of aesthetic dentistry. The process involves:


1. Full planning and diagnostic wax up if required.

2. Initial shade testing at the laboratory to ensure the base shades are all correct

3. Preparation of the front tooth and records. We now use intra oral scanning which eliminates the need for messy dental impressions.

4. Placing a temporary crown made from a mixture of acrylic and a resin.

5. Trying in the crown prior to any final customisation to ensure that the fit, margins, emergence profile, embrasure spaces, contact points and bite is all fine.

6. Placing the temporary with a soft cement and then a journey to the laboratory straight after the try in.

7. Full customisation of the crown until you are 100% happy with the overall aesthetics.

8. Straight back to the practice for fitting.


Although this may seem a long winded approach for one single tooth, we can assure you it well worth the effort. After all, it is your front tooth! Here are some photos of a recent case:
 

Pregnancy causes hormonal changes to a woman's body and increases their risk of developing oral health problems including tooth decay, gingivitis or periodontitis. Research shows that almost 70% of pregnant women at some stage during the pregnancy will develop some oral health problems which can have a detrimental effect on both mother and the unborn child. Pregnancy gingivitis (gum inflammation) is the most common condition in pregnancy and is caused by poor oral hygiene (mainly plaque) and increased hormone activity. While pregnancy gingivitis can occur anytime during the pregnancy, being at it worst during the second trimester, it is often a pre-existing condition. Managing pregnancy gingivitis is very important so that it doesn t progress to a more serious form of gum disease called periodontitis. Periodontitis can cause serious oral health problems that eventually leads to tooth loss. Research suggests that untreated oral conditions in pregnancy can lead to pre-term labour, low weight of baby at birth and even miscarriages. 

Hence it is paramount for a mums-to-be to take a great care of themselves and their mouth. If you find that your gums are painful, swollen and bleed easily or just want to double check that everything is fine please contact the surgery or arrange an appointment with our dentist or dental hygienist. 


Oral care tips for a healthy pregnancy:

1. Regular check-ups and hygiene visits.

2. Strict home care routine and meticulous plaque removal even before you are pregnant.

3. Flossing and cleaning in between teeth is paramount.

4. Find time for oral care at the time of the day when sickness is not present.

5. Use fluoride toothpaste and employ spit don t rinse technique.

6. Choose a softer toothbrush if your gums are sore or bleeding.

7. Alcohol-free fluoride mouthwash can help with nausea and after frequent snacking.

8. Rinse your mouth after morning sickness to prevent the acids from affecting your teeth.

9. Stop smoking and have a healthy diet (if possible reduce the amount and frequency of snacking on sugary food and drinks).


And remember that giving special attention to your gums and teeth will prevent any complications in the future and set a great example to your new child. 

Should you have any questions, please e mail us: info@progressivedentistry.co.uk

Our case of the month for September involves a dental implant to replace a missing molar tooth. Initially, the tooth was lost due to extensive tooth decay that was not treatable. This resulted in a space which affected eating. Although back teeth are not particularly visible, it is important to replace them for a number of reasons:
 

1. Restore the bite
2. Prevent movement of the adjacent teeth
3. Prevent movement of the opposite teeth
4. Preserve the jaw bone
5. Aesthetics if visible on smiling

In our case, the missing tooth was on the upper right side:
 

Our case of the month for August involves a combination treatment called ABC. A is for alignment. Teeth straightening initially will not only give a greater aesthetic appearance but allow for further cosmetic treatments with a minimally invasive approach. B is for bleaching. Whitening your teeth can make a huge difference to your smile and self confidence. C is for cosmetic bonding. Teeth can be enhanced with bonding to the existing tooth structure rather than cutting away healthy enamel for veneers for example. Here is the initial smile for our patient. There is crowding of the teeth where the right lateral tooth is hidden from view, uneven edges and discolouration.
 

Our case of the month for July 2018 involves teeth straightening using lingual braces. Lingual braces are placed on the inside of the teeth rather than on the outside, which makes them the only INVISIBLE brace. If you dread the thought of traditional metal train tracks or just could not commit to the regimented regime of Invisalign, this could be the technique for you. Here is our case: