Questions and Answers about Receding Gums
June 24th, 2010Q&A with our dentist
Dr Keith Cohen answers online readers’ gum related questions including what to do about white patches or white gyms, as well as handling stains revealed by receding gums
Quickly receding gums
Q: My gums are starting to recede very quickly. I have asked my dentist for advice, but he only tells me to use sensitive toothpaste. Can you suggest methods to stop this from getting worse?
A: Gum recession is usually caused by a gum disease or from incorrect brushing techniques. If your dentist is unable to help you with this, ask if you can be referred to a ‘periodonist’ who specialises in gum treatment or to the ‘periodontal department’ of one of the dental schools for further advice.
•Dairy goodness for gums
Receding gums and stained teeth
Q: The gums across my top front teeth are receding and the area is stained and cannot be cleaned. My dentist proposes to cover the stains with the material used for composite fillings which costs £700 for nine front teeth and is an hour’s work. The stains are not visible as they are above the “smile line”. But my dentist says if I don’t have the work done, my teeth will get worse. What would you advise and is the cost reasonable?
A: There are many causes for stains, but treatment will not be required unless it is for decay on the tooth surface. Unless your dentist is a fast worker, he may not be able to complete nine filings in an hour. If you have any doubts, I think you should consult another dentist to confirm the diagnosis and treatment.
White patch on gum
Q: I had an upper molar extracted a month ago and the next day I noticed a white area, about 1-2 cm on my upper gum. My gum is sore in the region over the adjacent two teeth. The white area which I initially thought was gum bruising is not clearing up. The other gums are slightly sore and my saliva seems thicker than usual. Will it eventually clear up or is there anything to worry about in the long run?
A: The ‘white area’ may be an ulcer in the region of the extraction which would heal up within a week. If this persists ask your dentist to check for any other cause. The saliva may also be modified by any medication which you are taking. Following an extraction it usually takes about one week to get back to normal.
White gums
Q: I recently noticed that my lower jaw gums are white and quite hard on one side of my mouth (which was not the case before). I clean my teeth twice a day, but do not really pay attention to my gums. They seem to have receded a good deal. What should I do? I know someone who transplanted the insides of her cheeks on her gums and they look very healthy. I am an NHS patient but have not seen a dentist since I was ill in hospital last year. Can my dentist undertake this procedure?
A: First you need to understand that everyone’s mouth is different, so it is not advisable to assume you can apply the procedure your friend received to yourself. Dentists receive complete training on treating teeth and also the entire mouth and jaws. Those who smoke usually get white patches in the mouth, but there may be other causes. Check with your dentist for a proper diagnosis and treatment. If he/she cannot help, ask to be referred to an appropriate specialist.
Questions and answers about dental implants
June 22nd, 2010
Q&A with our dentist
Dr Keith Cohen answers online readers’ implant related questions about the impact of smoking on dental implants, tooth loss, gaps between teeth, osteoporosis and ulcers.
Dental implants and smokers
Q: I have been told that I cannot get dental implants because I smoke. And even if I gave up smoking, it would be at least a year before I could get them. Is this true?
A: It is true that smoking reduces the success rate of implants and can even cause complications for surgical procedures. However, there are many factors that have to be considered like how much you smoke and over what time period, as well as general medical health and how straightforward the procedure will be. This depends on how much bone is there to place the implant in. If you insist on going ahead with the treatment and there is a dentist to carry it out, you must accept that there are chances of reduced success. This means that one or more implants might not integrate and will need removing or replacement.
Tooth loss and Implants
Q: I have lost most of my teeth because of chemotherapy and my dentures have gone loose as well. Is it possible to get implants and what would be the cost of this treatment?
A: Generally, it is possible to get dental implants after radiotherapy or chemotherapy. Success rates may be reduced as your bone healing might be affected. For further advice and referral, contact the specialists who previously treated you. Usually, with medical history like this, treatment can be carried out within the hospital service and often without charge.
Growing gap
Q: I am 57 years old and have undergone routine dental treatment all through my life. I have a gap between my two front teeth and with age, the gum is receding and increasing the gap. My gums seem a bit delicate, but my dentist says that I do not have any dental problems. Are there any cosmetic treatments that do not involve extractions for this problem?
A: It is natural for the gums to recede with age, but incorrect brushing and gum disease can make this worse. The simplest way of reducing the gap between the teeth would be by bonding composite restorations to the side of the teeth, if they are healthy. If your teeth are more heavily restored, you can reduce the gap with crowns or veneers. If there is a large space, partially closing it can improve the appearance.
Ulcers and Implants
Q: 12 years ago I had implants done in my lower jaw from a dental hospital. Ulcers have now developed around some of them and I am unable to return to the hospital because of ill health and because I moved to another area. Private treatment will cost £12,000, which is more than I can afford as I am a pensioner. NHS dentists will not touch my teeth. I live in a small town without facilities and cannot travel. Can you suggest anything I can do?
A: It is not easy to make a diagnosis without seeing you. Ulcers are not the only cause for concern. I think you need further advice and would suggest that you ask your dentist to refer you to a local dental hospital or private specialist for an opinion as to the cause and possible lines of treatment. (Initially, it may also be possible for your dentist to email pictures and X-ray images of your mouth to the specialist.)
Osteoporosis and dental implants
Q: I take alendronic acid tablets for osteoporosis. Does this mean I am unable to safely have a dental implant? What about Nonviva injections for the same condition?
A: Some medications used to treat osteoporosis have been associated with ‘osteonecrosis’ in a small percentage of patients. This means, with surgical dental treatment or extractions, areas of bone in the jaws become non-vital. There is more association with intravenous usage than when the medication is taken by mouth. If you need to have some form of surgical treatment, consult the doctor who has prescribed the medication and ask their advice on your particular case before undergoing treatment.
*Dentists may pick up on osteoporosis
Implant insurance
Q: Six years ago I had four implants and have not experienced any problems whatsoever. In fact, the bridge they support feels rock solid. Although the policy doesn’t cover wear/tear, I still insure the implants for £200 every year against treatment costs incurred through accidental damage. Do you think this is worthwhile or can I safely assume the implants are “part of me” now?
A: Unfortunately, there is no treatment which is 100% successful and as time passes there are more chances for problems. Implant treatments are usually very successful, but problems may occur with the implants, screws and even the structure on top which can fracture or chip. Your dentist should be able to check your mouth and give you an idea of whether or not any problems will occur later, so you can decide if it is worth continuing with the policy.
Image Source: wordpress.com
Developing an underbite
June 17th, 2010Question: I am 62 and my teeth are badly worn. I had an even bite but due to excessive wear I now have an underbite and my teeth are getting smaller by the year. I have been advised by a consultant at the dental hospital that it is impossible to halt. I can see my appearance changing as my lower jaw is beginning to jut out and my upper lip loses its support. I am desperate restore my appearance. I haven’t had a lot of work done to my teeth and they are fairly good. Please help me. I wear a night shield.
Answer: Tooth wear is a relatively common problem and in severe cases the teeth can be worn down to gum level. The damage can be reduced by wearing a soft or hard ‘nightguard’. Restoration is often by means of dentures on top of the worn teeth (overdentures), or crowns and bridges, depending upon how many teeth are missing and how much tooth structure remains. Normally this type of treatment can be carried out by the ‘prosthodontics’ department of a dental hospital or by a dental specialist.
Lower denture difficulties
June 17th, 2010Question: I have recently lost my remaining lower teeth and find the lower denture not very stable. I have heard of ‘denture clinics’ which offer more satisfactory dentures, and also of mini implants. Your comments on the advantages of either of these (quite expensive) options would be gratefully received. Also how one finds recommended clinics offering these options.
Answer: It is true that complete lower dentures are very often a source of discomfort and looseness. Dental implants or mini-implants will provide the most benefit in your situation. Although mini-implants are smaller and less traumatic to place, they have generally been less well-researched. They are weaker and may not last as long as conventional implants although they are much less costly. The denture will clip onto the implant with various types of attachment, although these often require regular maintenance. You will usually need to make a new denture although in some cases the existing denture can be modified. Any type of implant work can be complicated so you need an experienced dentist. There are now a number of postgraduate implant qualifications or you can contact a General Dental Council registered ’specialist’.
Growing Gap – Dr Keith Cohen answers
June 17th, 2010Question: I am 57, and have had regular dental treatment/care all my life, but have always had a gap between my two front teeth. As I get older and my gums recede, this gap is growing and I hate it. Can I do anything cosmetic about it without extractions? My gums do appear to be fairly delicate, though my dentist does not say that I have any particular disease. I have asked his opinion about this, but he was not very forthcoming.
Answer: As we grow older, gums quite often recede, and this can be worsened by gum disease and brushing out teeth incorrectly. If the teeth are healthy the simplest way of reducing the space would be by bonding some composite restorations to the side of the teeth. Another option would be with veneers or crowns if the teeth are more heavily restored. However, if the space is quite large then the appearance can also be improved by partially closing it.
Smoking and Implants – Dr Keith Cohen answers
June 17th, 2010Question: I have been told that I cannot have implants as I smoke – and even if I gave up it would be at least a year before I could – is this true?
Answer: Smoking does reduce the success rate for implants and with regards to surgical procedures, it can produce complications, so to an extent this is true. Having said this, a number of other elements need to be considered, for example, how much you smoke, and over what time period, your general medical health and whether or not the procedure is likely to be straightforward – which will depend upon how much bone there is in which to place the implant. Another dentist may be prepared to carry out the treatment, depending upon your situation, so it may be worth asking for an opinion from a ‘dental specialist’. If you are determined to proceed, and a dentist is willing to carry out the treatment, you need to accept that there may be ‘reduced success’ which means that one or more implants might not integrate and need to be removed or replaced.
Dentexcel launches new website
May 30th, 2010Dentexcel – London’s premier cosmetic dentistry practice, has launched it’s new website and corporate identity!
Built and designed by Stickycreation, the site will allow patients to find out more about Dentexcel, and will provide information on specific treatments, give profiles on all our dentists, and will keep you up to date on the latest developments in the world of cosmetic dentistry.
The site will be updated regularly and the blog will allow us to post details of all our latest offers, including the current 30% off pearly whites in an hour, and a free checkup for children whose parents are patients of Dentexcel.
The site will also make it easier for patients to contact us, and we look forward to serving all your dentistry needs!
Please get in touch if you have any queries or would like to book an appointment.
Our number remains the same: 020 7636 9393
Thanks!
How to choose a dentist
May 30th, 2010It may seem a silly question – but a lot of people want to know how they can choose the best dentists. If you think about it, are the general public expected to know what dentist qualifications stand for? Do you know the difference between a veneer and a crown, between an implant and a mini implant, and invisalign or conventional braces?
Ok – so we’ll address the terminology shortly and provide a glossary in another post, but the next question is “how good is the dentist?”. This is so important, and again, how are you supposed to know the difference in our qualifications, what being accredited as a specialist means, and what sort of work we carry out.
We have put together a few guidelines to follow when choosing a dentist. We hope you find them helpful, but please let us know if you have any other suggestions, or elements that you have specifically looked out for!
Guidelines:
a) Basic Dentistry Qualifications
Probably the most important aspect, you need to be able to see that your dentist has qualified as a dentist, and has had the correct training. All dentists should have studied dentistry, and it’s worth looking at where this has been done. You can look up the university or college to get an indication about the degree.
b) Advanced Qualifications
Has the dentist studied or gained any other relevant qualifications? You should be able to see a profile or request some information on the dentist you are thinking of booking an appointment with, so check to see what other experience they have
c) Are they part of a registered company
Dentists, like other businesses, should be registered with Companies House. If you can’t find the company number on their website, why not ask them for it? A properly registered company will have to do tax returns etc, and is a good sign of legitimacy!
d) Are they a registered member of the British Dental Association?
The British Dental Association (BDA) is the professional association and trade union for dentists in the United Kingdom and was founded in 1880. Membership, which is voluntary, stands at around 23,000.
e) The dentistry practice
Check the location of the dentist, and that it adds up with business directories.
There are a number of other things to look out for, and questions you can ask, but we hope this has given you a foundation for finding a great cosmetic dentist.
What is the invisalign technique?
April 15th, 2010The Invisalign technique is a great way of straightening mildly irregular teeth for people who want to see an improvement in their smile, but don’t want to wear fixed braces.
A series of clear plastic aligners are worn over a period of time to straighten teeth. The aligners need to be worn a minimum of 22 hours per day and are taken out for eating and drinking. They need to be changed every two weeks and so the patient is given several aligners to take home between orthodontic visits, but still need to be seen by an orthodontist every 6-8 weeks. Often the teeth need to be reduced in size (filed) by a fraction of a millimetre as part of the treatment. The advantages of this technique are that the aligners are very aesthetic and can be removed for social occasions and cleaning. However, they won’t work if they are not worn for a substantial part of the day!
Invisalign cannot solve every orthodontic problem, but the results for many people can be impressive. Our orthodontists are Invisalign accredited and have experience of using this technique.
In “She” – October 2008
October 14th, 2008Answer from Dr Keith Cohen about whether teeth whitening can be damaging
Question: I want to whiten my teeth, but is it true this can be damaging?
Answer: According to Dr Keith Cohen of Dentexcel, there is no evidence that teeth whitening can cause damage. “If you have receding or sensitive hums, it can be a little painful, but there are no real adverse effects,” he says. Go to a reputable dentist and don’t buy prescription whitening kits over the internet. Professional whitening should last for a couple of years; use whitening toothpaste to help maintain your gleaming teeth.
