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Dentistry has certainly been in the news recently with the dentist from Nottingham and his dubious cross infection techniques. This therefore puts the spotlight on dentistry as a whole but also allows us to respond and let our patients know exactly how our cross infection policy works. This is what we do: 

1. Alcohol hand rub prior to every patient and new gloves. 

2. Every single instrument is taken from a pre sterilised bag that has a date when it was sterilised and when it should be sterilised again it not used within the time frame.

3. All used instruments are hand cleaned and scrubbed using dental disinfectant.

4. Instruments are then placed in an ultrasonic bath.

5. Instruments are then sterilised in an autoclave.

6. The autoclave has a printer to verify that the correct temperatures have been reached and for the recommended time frames.

7. The instruments are then dried and sealed and dated within the bags. We have invested in a new autoclave recently, the Little Sister 2010 which is extremely reliable and effective. We also ensure all surfaces are cleaned thoroughly before and after every patient. The practice is also professionally cleaned every day after clinics have been run using high quality disinfection techniques. Earlier this year, we invested in high quality flooring within both surgeries to ensure effective cleaning. 

We constantly strive to improve our services to ensure to a safe environment for our staff and patients. However, we welcome feedback and if you feel we could be doing something better or could recommend an improvement, please let us know.

Our case of the month for November involves cosmetic bonding of a front tooth. The tooth in question was treated after orthodontic teeth straightening. Once the teeth were nice and straight, the smile was significantly enhanced with our minimally invasive technique of cosmetic bonding.

A brief overview of the technique:

1. The tooth is cleaned and polished. Any old composite filling material must be removed and any sharp edges smoothed.

2. Washing and drying with an etching gel.

3. Coating the tooth with a fine bonding layer. This is set with a special light at a certain wavelength.

4. Incremental layers of the composite bonding material are added until the new outline has been achieved.

5. Careful contouring and polishing of the new restoration.

6. Occlusal (bite) analysis and final aesthetic evaluation.

Here are the before and after photos:
 

Please read the following, which was taken from a BBC report into child tooth decay and gum disease. This is a worrying report which not be swept under the carpet. Action must be taken now as tooth decay and gum disease are on the whole, preventable.https://www.bbc.co.uk/news/health-29712453

At Progressive Dentistry, we are more than happy to provide tooth brushing clinics in school, nurseries and care homes. Prevention is better than cure and we would be glad to help. If you would like us to arrange a visit, please contact us via telephone or e-mail.

Our case of the month for October involves composite bonding of the lower front teeth which were heavily worn and using a principle called the Dahl technique. This technique is not very well known but it is fantastic method for treating worn down teeth where there is no space to restore them. For example, when your front teeth wear down due to grinding, acid erosion, bad habits (biting pens, nails etc), there is often little space to restore the teeth using conventional fillings. In the old days, the teeth may have been cut down for invasive procedures such as crowns or veeners. The Dahl technique involves the careful restoration of the worn teeth directly or indirectly with little, if any, tooth preparation. This must be with precision so that the contact on the new restorations is in such a way that the unworn teeth can slowly re-position and make contact over time. Usually this takes 12-16 weeks to occur but what a concept! For example, just take a look at our case below:
 

For those dentists out there who are curious about what is acceptable when fitting your indirect restorations such as crowns, bridges, implant crowns and bridges, inlays and onlays, here are some useful facts on marginal fitting: Quality ratings for marginal fitting:

1. Clinically excellent: no gap; smooth transition between margin and tooth; probe does not catch 
2. Clinically acceptable: space of 150 µm; slight probe catching 
3. Clinically unsatisfactory: space > 150 µm - 250 µm; probe penetrates into the gap, but no dentine exposed.
4. Clinically poor: space > 250 µm; probe penetrates into the gap and dentine exposed. 

It is possible to use probes with a tip size of 250um and therefore check the fitting with accuracy prior to cementation.

At Progressive Dentistry, we are advocates of non invasive treatment to produce the very best results. We believe that treatments kind to the teeth and gums will produce longer lasting, natural results yet still highly aesthetic. For example, this week in the Daily Mail, a double page spread on celebrities who have had their teeth done. This included Simon Cowell, Noel Gallagher, Cheryl Cole (sorry Fernandez Versini), Tom Cruise, David Bowie, Catherine Zeta Jones, Gordon Brown (yes, our ex Prime Minister), Mel C, Nicolas Cage, Demi Moore, Ronan Keating to name but a few. 

The key factor with all of these cases, was the use of porcelain veneers for the smile makeover. Whilst we agree that porcelain veneers can produce dramatic results within a few weeks, the fact remains that this technique requires heavy preparation of the underlying teeth. Therefore, the hardest tissue in the human body- tooth enamel- is completely destroyed. In the long term, there will be consequences. 

Why go for a quick fix when a non invasive solution will last for a life time? For example, take at look at our case below. Our patient hated her crooked front teeth. With the celebrity option, all of the tooth enamel would need to be stripped away for porcelain veneers. Crazy. We opted to straighten the teeth over the period of only a few months, and an amazing transformation was evident. Just take a look:
 

Our case of the month for September is one which involves dental implants to replace missing back teeth. It is crucial to replace missing teeth at the back for a number of reasons. These involve: 

1. To restore function. Without back teeth or molar teeth, it is very hard to chew food. 

2. To prevent unwanted movement of the adjacent or opposing teeth. This could have a detrimental effect on the occlusion (bite) and cause major dental issues for the future. 

3. To prevent the jaw bone from shrinking which can result in causing the soft tissue to shrink. 

4. Aesthetics. Having gaps at the back of the mouth can still be seen. Dark space is not attractive. 

5. For general well being, physical and psychological. In our case, the missing teeth were two molar teeth on the upper right hand side. 

Please view a photograph:
 

We are delighted to announce that Philips Whitespeed Zoom whitening is now available at Progressive Dentistry. Zoom is the most recognized tooth whitening brand in dentistry for good reason. The new LED accelerator offers gentle but fantastic results in only 1 hour! If you have yellow, dark, discoloured teeth and would like them whitened in just one visit, then Whitespeed Zoom whitening could be for you. With every treatment, we provide a take home kit to continue the whitening process and maintain the results. Below is an example of the results that are possible: