We will be closed on Monday 19th September to show our respects for the Royal Family and the passing of our Queen. Queen Elizabeth was a world wide icon and loved in Britain and across the globe. She was a unique individual who devoted her life to public service for 70 years, a feat that is unlikely to be surpassed in our life time. 

We are deeply saddened by her death and our thoughts are with her family at this time. 

We will re open on Tuesday 20th September at 0900. Should you have a dental emergency on Monday, please phone 0207 7311162 and speak with our 24/7 reception team who will advise accordingly.

Our case of the month for August 2022 was a fabulous one! A real smile transformation done correctly. Forget 'Turkey Teeth'! A smile transformation should involve minimal or no biological damage to the teeth and gums to enhance the aesthetic and functional issues. The term 'Turkey Teeth' comes from social media posts where a smile makeover is done over a weekend by hacking away natural healthy tooth structure and placing multiple crowns and veneers. These are often linked together with no means of cleaning between them. This is a recipe for disaster with not only a high risk of nerve death and root canals but also gum disease and infection. The cost of rectifying this treatment will far outweigh the 'savings' from going abroad and also lead to life long maintenance.

Anyway, back to our case and happier news. We first started with careful planning to straighten the teeth using Invisalign full. One of the main issues was that the dental arches were very narrow which is why you cannot see the back teeth on smiling. This is called the buccal corridor. With expansion, we have the opportunity to create space and correct crowding without IPR ( in between teeth filing and slimming) which we always strive to achieve. Invisalign is simply the best at arch expansion in our opinion. After only 8 months, we had lovely straight teeth ready for the next stage.
 

The term root canal treatment often fills people with dread but the simple fact is that the procedure is one of the most common treatments in dentistry with the sole aim of preserving the tooth for everyday function. With the advances in modern technology, materials and equipment, the procedure is often pain free and quick especially for front teeth. One of the greatest improvements seen recently is the advent of 3-D CBCT scanning of a tooth prior to root canal treatment. This will show the number of roots, canals, location of infection and any strange anatomy that simply cannot be seen on a 2-D x ray. The root canal dentist, or endodontist, thus knows what to expect before even starting treatment. A game changer!
 

We are delighted to announce that Beata Kynsak has been awarded Best Dental Hygienist at the Dental Awards 2022! These awards are run by the Probe Magazine which has been in production for over 60 years. The fact that the award is a UK based one further magnifies the achievement and one that is well deserved.
 

Missing a front tooth is the thing of nightmares! A study done by Yu in 2012 showed that 39% of the population have had a dream about losing a tooth or teeth which is huge considering losing a front tooth is not a particularly common dental issue. However, accidents happen and in our case study our patient lost his front tooth whilst at school in a playground accident.
 

Our case of the month for March 2022 is a true smile transformation in every sense of the word. In this case, we successfully corrected a complete reverse overjet or underbite using Invisalign Full. We then enhanced the overall aesthetics using a home whitening kit (Philips ZOOM) and bonding.
 

Article written by Beata Knysak for dentists, dental hygienists and therapists.

Periodontal disease is a major public health concern due to its high prevalence. According to the data severe periodontitis is the sixth-most prevalent condition in the world [1]. In the United Kingdom, 62% of adults under 40 years of age are affected by moderate periodontal disease [2] and throughout the Covid-19 pandemic we have seen an immense increase in the number of patients with periodontal tissue breakdown and tooth loss.

While there is an increase in life expectancy and a significant decrease in tooth loss, periodontal disease puts a burden on the national healthcare systems across the globe.

Although bacteria arising from plaque is the main aetiological factor of periodontal disease, the host’s immune inflammatory response is accountable for the majority of the destructive changes seen in periodontal tissues. Even in healthy periodontium, host immune cells are continuously present, supporting the balance between microbial plaque and the host [6]. Any interactions between the host and oral microbiota will either support the homeostasis or results in dysbiosis within the community of pathogenic microorganisms [7].

Periodontal health-associated commensals are vital in protecting this equilibrium by for example inhibiting the growth of periopathogenic microorganisms. However, quantitative and qualitative changes within subgingival plaque biofilm may lead to disturbed homeostasis, which subsequently leads to the onset of the periodontal disease with various degrees of periodontal tissue breakdown.

This is not a continuous process but alternates between a period of inactivity and aggravation and it can be affected by local and systemic factors [3&4]:

• Microbial plaque-biofilm burden
• Patient’s age, ethnicity, genetic predisposition and patient’s immune response
• Systemic diseases i.e., Diabetes Mellitus, Osteoporosis
• Tooth morphological factor: i.e., defective restoration, malocclusion, bulbous crowns and dental bridge that unbales the patient to perform an adequate oral hygiene routine
• Patient’s socio-economic factors i.e., education and access to dental care
• Life-style choices i.e., smoking, obesity, poor diet, stress, sleeping pattern,
• Deficiencies in patient’s oral hygiene routine.

If not treated, periodontal disease leads to connective tissue destruction and alveolar bone resorption that eventually results in tooth loss [5]. It negatively affects patient’s chewing function and aesthetics, it is a source of social inequality, and significantly impairs their quality of life.

The main objectives of non-surgical periodontal therapy (NSPT) are to provide the least invasive treatment that gives the patient the best and most predictable outcomes through the promotion of periodontal tissue regeneration and restoration of tooth function. After successful treatment, periodontal ligament (PDL) cells (fibroblasts) migrate and attach to the microorganism free root surface. They proliferate, differentiate and synthesise extracellular matrix proteins to form collagen fibres. It is crucial to obtain newly formed PDL to prevent apical migration of junctional epithelium and to allow regeneration of PDL, cementum and alveolar bone; therefore, the application of laser irradiation has been proposed to allow for the compatibility of root surfaces with regenerative processes.

An increasing number of studies have demonstrated the benefits of adjunctive laser therapy in conventional NSPT due to its reported ability to significantly reduce pathogens, promote healing and to suppress the inflammatory cytokine cascade through to surgical ablation of diseased tissues [8]. As a result of its deeper penetration, diode laser has not only had bactericidal effects but also bio-stimulatory effects on periodontal ligament stem cells, osteoblasts and fibroblasts [9]. The Erbium Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser, however, allows selective subgingival biofilm and calculus ablation without causing any thermal side effects (carbonisation) or morphologic changes to the root surface to allow the attachment of these cells [10]. Also, when compared with conventional hand instrumentation, Er,Cr:YSGG laser therapy was not only found to promote PDL fibroblast cell migration and attachment, but it also increased the number of cells that differentiate in periodontal regeneration [11,12,13].

Although in the treatment of periodontal disease, surgical interventions (with the use of osseous graft material, barrier membranes or application of a biologically active material) deem to have more predictable outcomes than conventional NSPT, they may however, possess multiple shortfalls including high cost, painful healing and post-operative complications. Also, with regard to the application of local or systemic antibiotic there are multiple side-effects including antibiotic resistance, gastrointestinal complications or drug interactions.
 

Article written by Dr Nissit Patel BDS MClinDent (Pros) 

I am often asked about various different dental treatments and one of them involves porcelain onlays. Most of my patients know about porcelain veneers but in general, porcelain onlays are not well known. I will attempt to explain the treatment in simple detail, with explanation on the procedure, what to expect, why they are beneficial and the fee scales involved.
 

Mouth cancer is on the rise in the UK with over 2,700 people dying from the disease last year. This is an increase of almost 50% compared to 10 years ago which is a huge increase. One of the main issues is that over 45% of all mouth cancers are diagnosed in the late stages which means that the survival rate is much lower than early diagnosis. Not only this, but treatment is often far less invasive when caught early on leading to a far higher quality of life. During each dental examination at Progressive Dentistry, we undertake a thorough analysis of mouth cancer but with check ups usually every 6 months, we are encouraging our patients to check their mouth once a month for signs of the dreadful disease.