LIBRARY – Dental Health Service

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Toothbrushing for kids The 6 most important things to remember about brushing your child’s teeth: Use a fluoride toothpaste (1000-1500ppm). Brush twice daily – at night time before bed, and one other time – ideally first thing in the morning. Time brushing for 2 minutes – with older children you should time brushing to ensure a full 2 minutes to help the toothpaste soak in and help make sure they are being thorough with their brushing. With younger children its okay to take what you can get. Aim to brush in the 1) insides, 2) outsides and 3) biting surfaces of both the upper and lower teeth. Spit, don’t rinse after brushing, so some toothpaste stays behind and gets longer to soak into the teeth, helping to protect against tooth decay. Children should be supervised when brushing, at least until the age of 7. How much toothpaste to use Children aged under 3 should use only a smear of fluoride toothpaste. Children aged 3-6 should use a petit pois size amount of fluoride toothpaste. Children 6 and over (and adults) should use a garden pea size amount of fluoride toothpaste. Should children use adult toothpaste? Often children describe minty adult toothpastes as having a spicy flavour because they are very minty. Children’s toothpastes usually have milder flavours that are easier for these children to tolerate, but the level of fluoride may be less in some children’s toothpaste. You should use a toothpaste your child will tolerate – with the correct level of fluoride for your water supply – see below. What strength fluoride toothpaste should children use? All children should use a fluoride toothpaste of 1000-1500ppm to help protect them against tooth decay. The level of fluoride recommended for your child depends on whether there is fluoride in your water supply. Areas with fluoridated water supplyIf you live in an area with fluoride in the water supply, your child should use a toothpaste with 1000ppm of fluoride. This can be a children’s toothpaste or family toothpaste as long as it is 1000ppm of fluoride. Areas without fluoridated water supply If you live in an area without fluoride in the water supply, your child should use an adult strength toothpaste with 1400-1500ppm of fluoride (usually 1450ppm). This can be a children’s toothpaste (usually the older age ranges) or ordinary adult/family toothpaste as long as it is 1400-1500ppm of fluoride. You could also consider using your power to help change UK dentistry by writing to your MP and asking why we don’t currently have all of our water supply fluoridated, when water fluoridation is a proven effective, cheap and safe way to reduce dental decay for everyone. We have some more dental themed suggestions for what else you could ask. What type of toothbrush should my child use? Choose an age appropriate toothbrush so the head easily fits in your child’s mouth. If an electric toothbrush makes your child more eager to brush then its fine to use a model aimed specifically for children or you can just swap the head to a children’s head on an adult electric toothbrush handle. How to improve children’s toothbrushing Time brushing for 2 minutes – not only will this give the fluoride in toothpaste time to strengthen your child’s teeth, it will also encourage thorough brushing Supervise brushing to ensure a full two minutes and to encourage and guide their brushing technique Guide your child’s brushing by encouraging brushing on the outside, inside and biting surfaces, for both the upper and lower teeth Try using disclosing tablets Use a brushing chart to reward good brushing How to time brushing2 minutes is longer than you think, and it can be hard to keep children’s focus. Its good to help your child time her or his brushing using: The stopwatch function on your phone Play a song that lasts for at least 2 minutes An electric toothbrush with a built in timer A brushing app like the Oral B Disney Magic Timer App or Brush DJ App A musical timer An egg timer What does supervised brushing mean? All children should be supervised when brushing their teeth at least up until the age of 7. This means an adult should brush a younger children’s teeth for them, but encourage them to have a go themselves. As children get older and better at brushing themselves, the adult won’t need to help as much until the adult is just watching to make sure they are brushing well, for long enough, and spitting out but not rising. How to use disclosing tablets Disclosing tablets help to show the places missed after brushing by staining dental plaque bright pink. They should be chewed up (but not swallowed) and rinsed out. The pink staining can be easily brushed away. Some brands of disclosing tablet will stain older plaque (that’s been there longer than a day or two) a purple or blue colour. Should children use a mouthwash? Children don’t need to use a mouthwash. Its important to understand that using mouthwash is not a substitute for brushing with fluoride toothpaste. Some mouthwashes can be harmful if swallowed so its important that you only allow your child to use a mouthwash if you are confident they can be trusted to spit out. Do children need to floss? No, children should concentrate on brushing. Their dentist will introduce flossing to them when required – usually as a teenager. When should children start visiting the dentist? Children should be taken to the dentist soon after their first teeth erupt – usually around 6 months old. How often should children have a checkup at the dentist? Children should be taken for a checkup with a dentist at least every 6 months. For higher risk children, their dentist may wish for them to be brought every 3 months.

Monitoring gum health is essential for maintaining overall dental hygiene, and using incidental brushes (often referred to as interdental brushes) to check for bleeding and odor can provide significant insights into your periodontal health. Here are the advantages of this method for monitoring gum health: ### 1. **Early Detection of Gum Disease** Regularly checking for bleeding and odor while using incidental brushes allows for the early identification of potential gum disease, such as gingivitis or periodontitis. Bleeding gums are often the first sign of inflammation caused by plaque accumulation. Noticing this symptom early can prompt a visit to the dentist before more severe conditions develop. ### 2. **Improved Interdental Cleaning** Incidental brushes are specifically designed to clean between teeth and along the gum line, areas where traditional toothbrushes may struggle to reach. By using these brushes regularly, individuals can remove food particles and plaque more effectively, thereby reducing the risk of gum disease and promoting healthier gums. ### 3. **Enhanced Oral Hygiene Awareness** Incorporating incidental brushes into your oral care routine fosters greater awareness of your gum health. The act of checking for bleeding and odor serves as a reminder to pay closer attention to your dental hygiene practices. This increased mindfulness can lead to better overall care, such as improved brushing technique and more consistent flossing. ### 4. **Monitoring Progress Over Time** By documenting instances of bleeding and odor, individuals can track their gum health over time. This ongoing assessment enables patients to measure the effectiveness of their oral hygiene routine or any changes made after a dental visit. Consistently monitoring these factors can motivate individuals to maintain better practices. ### 5. **Enhanced Communication with Dental Professionals** Practicing bleeding and odor checks with incidental brushes can facilitate more productive conversations with dental professionals. By being aware of signs of gum disease, patients can provide their dentists with accurate information during dental check-ups, leading to tailored advice and improved treatment strategies. ### 6. **Reduction of Bad Breath** Monitoring for odor, particularly in areas that are difficult to clean, can help address issues of halitosis (bad breath). Discovering a persistent foul smell can prompt individuals to take immediate action, such as better cleaning techniques or seeking professional help to ensure that underlying issues are resolved. ### 7. **Prevention of Systemic Health Issues** Gum health is linked to overall health. Conditions such as cardiovascular diseases and diabetes have been associated with periodontal disease. Regular monitoring of gums through incidental brushing can help in preventing gum disease, thereby potentially lowering the risk of these systemic health issues. ### 8. **User-Friendly and Accessible** Incidental brushes are easy to use and can be incorporated seamlessly into daily oral care routines. Their accessibility makes them a practical option for individuals at any stage of life, promoting consistent gum health checks without requiring special equipment or extensive training. In conclusion, using incidental brushes to monitor gum health by checking for bleeding and odor is a proactive approach that provides several advantages. This method not only allows for the early detection of gum diseases but also enhances oral hygiene awareness, supports effective dental care practices, and facilitates better communication with dental professionals. Regular use of incidental brushes ultimately contributes to improved gum health and overall well-being.

Importance of Controlling Disease Understanding Gingivitis and Periodontitis: Key Differences and Their Impact on General Health **Introduction** Welcome to our comprehensive guide on oral health! Here, we delve into two common gum diseases—gingivitis and periodontitis. Understanding the differences between these conditions is crucial for maintaining not only your gum health but also your overall well-being. --- **What is Gingivitis?** Gingivitis is the earliest and mildest form of gum disease, characterized by inflammation of the gums. It typically arises when plaque—a sticky film of bacteria—builds up on the teeth and hardens into tartar. Key symptoms include: - Red, swollen gums - Bleeding during brushing or flossing - Bad breath **Causes of Gingivitis**: Poor oral hygiene is the primary cause, but factors such as smoking, hormonal changes, certain medications, and nutritional deficiencies can also contribute. --- **What is Periodontitis?** Periodontitis is a more severe, advanced form of gum disease that occurs if gingivitis is left untreated. It not only affects the gums but also the supporting structures of the teeth, potentially leading to tooth loss. Key symptoms include: - Gums that pull away from the teeth (recession) - Persistent bad breath - Loose teeth - Pus between teeth and gums **Causes of Periodontitis**: Similar to gingivitis, periodontitis is largely driven by plaque buildup. Risk factors include genetics, age, tobacco use, diabetes, and certain illnesses. --- **The Key Differences** - **Severity**: Gingivitis is reversible with proper treatment and care, while periodontitis can lead to irreversible damage and requires advanced dental intervention. - **Symptoms**: Gingivitis typically features mild symptoms, whereas periodontitis involves more severe issues, including tooth mobility and bone loss. - **Treatment Approaches**: Gingivitis can often be managed with improved oral hygiene practices. Periodontitis, however, may require professional cleanings, medications, and sometimes surgery. --- **Impact on General Health** Both gingivitis and periodontitis can have significant implications for your overall health: 1. **Systemic Inflammation**: Chronic gum disease can lead to systemic inflammation, which has been linked to other health issues, such as cardiovascular disease, diabetes, and respiratory problems. 2. **Diabetes Complications**: Poor gum health can make it harder to control blood sugar levels, while diabetes can exacerbate gum conditions, creating a vicious cycle. 3. **Respiratory Health**: Bacteria from periodontal disease can be inhaled into the lungs, increasing the risk of respiratory infections and exacerbating existing lung conditions. 4. **Pregnancy Complications**: Expecting mothers with untreated gum disease are at a higher risk for premature birth and low birth weight infants. 5. **Overall Wellness**: Maintaining healthy gums contributes to better nutrition and quality of life, supporting your body's immune response and reducing the burden of chronic diseases. --- **Conclusion** Understanding the difference between gingivitis and periodontitis is crucial for protecting your oral health and overall well-being. Regular dental check-ups, good oral hygiene practices, and prompt attention to gum health can help prevent these diseases and their serious health implications. Take charge of your health today—healthy gums pave the way for a healthier you!

The Advantages of Teledentistry: A Modern Approach to Oral Health In today's fast-paced world, **teledentistry** is emerging as a valuable tool in providing accessible and efficient dental care. With the ability to connect patients with qualified health professionals remotely, teledentistry offers a range of benefits that make it a compelling option for individuals and families alike. Key Advantages of Teledentistry 1. **Convenience and Accessibility**: Teledentistry allows patients to access dental care from the comfort of their own homes. This is particularly beneficial for those with busy schedules, mobility issues, or living in remote areas where traditional dental offices may be less accessible. 2. **Preventive Care at Your Fingertips**: Preventive advice and consultations can easily be conducted over the phone or via secure video calls with qualified dental professionals. This means that patients can receive guidance on oral hygiene practices, dietary recommendations, and routine care without the need for a physical visit. 3. **Reduced Anxiety for Patients**: Many individuals experience anxiety about visiting the dentist. Teledentistry can alleviate some of this stress by allowing patients to communicate with their dental professionals in a familiar and comfortable environment, leading to a more relaxed experience overall. 4. **Better Communication for Children**: Children may respond more positively to dental advice delivered by an expert over the phone than they do from a parent. Teledentistry provides a platform for children to hear preventive care tips and encouragement from trained professionals, making them more likely to listen and engage with the information. This can be especially helpful for parents who may feel like they are nagging when reminding their kids about proper oral hygiene. 5. **Quick Access to Expert Advice**: With teledentistry, patients can quickly consult with their dentist or dental hygienist about any concerns or questions they may have without waiting for an appointment. This immediate access can help address issues before they escalate into more significant problems. 6. **Cost-Effectiveness**: Teledentistry can reduce the costs associated with in-person visits, such as transportation and time off work. Many consultations can be conducted at a lower fee compared to traditional office visits, making dental care more affordable for everyone. 7. **Continuity of Care**: Teledentistry maintains a direct line of communication between patients and their dental providers, ensuring that patients receive ongoing support and follow-up care, especially during times when in-person visits may be less feasible. ### Conclusion Tele-dentistry represents a significant leap forward in enhancing dental care accessibility, convenience, and patient engagement. With the ability to receive preventive advice from qualified health professionals through phone calls and video consultations, it offers a practical solution for individuals and families seeking to prioritize oral health. By encouraging children to hear expert advice directly, teledentistry fosters healthier habits and empowers them to take charge of their dental health. Embrace the future of dental care with teledentistry—where your oral health is just a call away!

Disclosing tablets are an effective and time-honored method for monitoring oral hygiene, specifically in assessing plaque buildup on teeth. Here are several advantages of using disclosing tablets in dental care: ### 1. **Visual Feedback** Disclosing tablets stain plaque, allowing individuals to visibly see areas of their teeth that they may have missed during brushing and flossing. This immediate visual feedback is crucial in identifying specific regions that require more attention, helping to improve overall oral care. ### 2. **Understanding Plaque Accumulation** Using disclosing tablets educates users on plaque accumulation. Many people are unaware of how quickly plaque can develop or where it tends to accumulate most in their mouths. By systematically using these tablets, individuals can begin to recognize patterns in their oral hygiene habits, leading to improved prevention strategies. ### 3. **Motivation for Better Oral Hygiene** The use of disclosing tablets can serve as a motivational tool. Seeing the visible areas of plaque can encourage individuals, especially children, to improve their brushing and flossing techniques. This accountability can result in a positive change in their daily oral care routines. ### 4. **Optimal Technique Training** For dental professionals, disclosing tablets are invaluable in training patients to practice better oral hygiene techniques. Dentists can demonstrate the representative areas of plaque and guide patients in correcting their brushing and flossing habits, leading to more effective oral hygiene practices. ### 5. **Cost-Effective and Easy to Use** Disclosing tablets are relatively inexpensive and easy to incorporate into any oral hygiene routine. They can be used during regular dental check-ups or at home as an educational and assessment tool. This accessibility makes them an attractive option for enhancing dental care without requiring advanced technology. ### 6. **Promotes Regular Monitoring** Using disclosing tablets encourages regular monitoring of oral hygiene. By incorporating them into a routine—like once a week or once a month—individuals can consistently assess their dental care habits, helping to maintain good oral health over time. ### 7. **Supports Preventive Dental Care** By identifying plaque buildup, individuals can take proactive measures to prevent tooth decay and gum disease. Monitoring plaque in this way can lead to earlier intervention and treatment, significantly reducing the risk of more severe dental issues in the future. ### 8. **Educational Tool for Children** Disclosing tablets are especially useful for educating children about the importance of dental hygiene. The fun aspect of seeing their plaque highlighted in a colorful way can engage them in learning about proper brushing techniques and the significance of maintaining a clean mouth. In summary, disclosing tablets are a practical and educational approach to monitoring dental health. They provide visual cues for plaque buildup, motivate improvement in brushing habits, and serve as an effective preventive tool in dental care. Their simplicity and effectiveness make them an indispensable part of an individual's oral hygiene routine.

NHS Dental Charges JULY 2024 Any and all NHS dental treatment costs one of three charges: £25.80, £70.70 or £306.80. The NHS dental charges usually go up by a few pounds each April, but went up substantially more (8.5%) in 2023. The revenue raised will not go to your dentist or towards improving your care. Amid a cost-of-living crisis, this hike is covering government cuts. Our patients shouldn’t have to pay more just so Ministers can pay less. British Dental Association #TaxOnTeeth Rather than paying for each individual item of treatment you receive, you pay for a ‘course’ of treatment. Each course of treatment falls into one of five ‘bands’: NHS dental charge bands 2024: Urgent Treatment – £25.80 Emergency appointments and any emergency or urgent treatment you need that cannot be postponed. Band 1 – £25.80 Dental checkups and if your dentist finds you need any X-Rays or a basic clean (scale) then these are included at no extra cost. Band 2 – £70.70 Everything in Band 1 plus NHS treatment provided directly by your dentist (such as fillings, deep cleaning, simple root canal treatments, extractions), and simple changes to dentures (such as adding an extra tooth or relining the fit surface). Band 3 – £306.80 Everything in Band 1 and Band 2 plus complex NHS treatment requiring the help of a dental lab such as crowns, veneers, bridges, dentures and mouthguards. Help with NHS dental charges If you have a low income, you may be eligible for free NHS dental treatment. You can check if you are eligible, and you can apply for help towards the cost of NHS dental charges. NHS dentistry – Value for money and limitations The true cost of the treatment provided is usually much more than you are required to pay. NHS dental treatment is heavily subsidised by public funds and by each individual dentist’s goodwill, and therefore excellent value for money. The NHS has a duty to provide you with the most cost effective treatment possible. This is so the limited budget available from the government can help as many patients as possible. NHS dental treatment aims to provide the cheapest appropriate treatment, therefore some options are not routinely available on the NHS: Sometimes an appropriate treatment option is ‘no treatment’ (eg leaving a space when a back tooth is extracted). Cosmetic treatments such as cosmetic fillings, crowns, veneers, onlays, inlays, dentures, bridges and implants are only available as a private option when there is another cheaper functional alternative available on the NHS. A polish is not considered essential to maintain your oral health, and so should be a private treatment option. Tooth whitening is a cosmetic treatment and so only available privately. The only exception to this is if you have a single tooth which has already undergone root canal treatment, when no alternative treatment options are more appropriate. Setting the record straight on NHS dental charges The British Dental Association wants to set the record straight on the increase of NHS dental charges: The revenue raised by this increase [in patient charges] doesn’t go to dentists. It will do nothing to help the practices struggling or the millions of patients unable to secure an appointment. Ministers are simply making our patients pay more so they can pay less. These hikes are never a substitute for sustained government investment. British Dental Association #TaxOnTeeth If you feel unhappy about NHS dental charges in England then you should use your power to improve NHS dentistry by writing to your MP.

Wisdom teeth Wisdom teeth can be very troublesome and commonly cause episodes of pain and infection. Many people incorrectly assume the cause of wisdom tooth pain is the wisdom tooth erupting or growing. There is a common misconception that wisdom teeth cause so-called “over-crowding” of teeth. Around 8% of people have no wisdom teeth, and not everyone with wisdom teeth will have problems. Eruption timing of wisdom teeth Wisdom teeth normally start to erupt at around age 18-25 but can erupt any time after this. They normally take a few months to a few years to fully erupt. Impacted wisdom teeth Wisdom teeth often get stuck bumping into the tooth in front. Sometimes they get stuck bumping into the gum or bone at the side or behind. When teeth are stuck and cannot fully erupt they are described as impacted. Wisdom tooth pain Most people tend to incorrectly attribute the cause of any wisdom tooth pain to the tooth erupting or growing. Instead the pain is usually caused by food and bacteria being left around the tooth or under the flap of gum that might cover some of the tooth. The bacteria then cause swelling and soreness of the gum around the tooth. Sometimes the bacteria can produce pus and this might cause more swelling and pain. The condition of swelling and soreness of the gum around a partially erupted tooth is called pericoronitis. Treatment for pericoronitis at home The first line of treatment for a sore wisdom tooth should always be to improve your oral hygiene and to use an antibacterial mouthwash. This means: Ideally use an electric toothbrush to reach and massage the gum as well as cleaning the tooth. Use dental floss to clean between all of your teeth. Use a chlorhexidine mouthwash like Corsodyl. Very hard-to-reach wisdom teeth which are only partially erupted can often be cleaned better with a single tufted toothbrush. Treating pericoronitis with mouthwash Chlorhexidine mouthwashes like Corsodyl are antibacterial, and should be used as a first line treatment for a sore wisdom tooth. Usually the pain will improve over 2-3 days and resolve in 5-7 days. If the pain is getting better, you can continue to manage your wisdom tooth pain at home. If there is no improvement after 5 days then you should seek advice from a dentist. Brush your teeth at least twice daily, but wait around 45 minutes after brushing before you rinse with Corsodyl. Applying directly with a baby bud is preferable to avoid staining. Apply Corsodyl at least 4 times daily, ideally after eating. Time your application for 60 seconds using a clock or timer. Stop using a chlorhexidine mouthwash when your pain and swelling have resolved. Alternatives to Corsodyl Corsodyl is a popular brand of chlorhexidine mouthwash, but other brands are available. Corsodyl can stain teeth. An alternative to a chlorhexidine mouthwash is a peroxide mouthwash like Peroxyl, which can be used in the same way. A warm salty mouthwash may be of some benefit until you can obtain some chorlexidine or peroxide mouthwash to use. You should make the warm salty mouthwash using a teaspoon of salt in small a cup of warm water. Antibiotics are for treatment of whole-body, spreading and blood infections. Wisdom tooth pain is usually caused by bacteria located directly around the tooth. Antibiotics are therefore usually not appropriate for the treatment of wisdom tooth pain. Misuse of antibiotics in humans is partly contributing to the global threat of antibiotic resistance. Antibiotics should not be used when they wont help or there is a more appropriate alternative. If caught early enough, most episodes of wisdom tooth pain can be easily and successfully treated at home. The best treatment is to simply improve your oral hygiene and use an antibacterial mouthwash. If left too long before starting treatment at home, or in circumstances where there are complicating factors (such as tooth decay or extremely difficult to clean impactions), then the bacteria around the tooth and gum can spread into your blood and around your body. At this point, antibiotic treatment may be advised by your dentist. Pain control for pericoronitis Wisdom tooth pain can usually be controlled with use of painkillers bought over the counter. Paracetamol and ibuprofentaken together or separately are very effective for most dental and oral pain. If you are unsure if it is safe for you take ibuprofen or paracetamol (e.g. if you have an allergy, asthma sensitive to NSAIDs, stomach ulcers, gastrointestinal bleeding, heart failure, or you are pregnant) or you already know you are unable to use them, then ask your pharmacist for advice or visit the NHS 111 website. Paracetamol is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy paracetamol online from a pharmacist (or from Amazon: Panadol tablets). Ibuprofen is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy ibuprofen online from a pharmacist (or from Amazon: Nurofen tablets). When to get emergency or urgent advice from a dentist for wisdom tooth painYou should seek advice from a dentist as soon as possible if you: have severe facial or oral swelling cannot open your mouth fully or your tongue is swelling have swelling which is rapidly getting bigger feel unwell, excessively tired, or have a fever feel your glands (lymph nodes) in your neck are sore or swollen have been using an antibacterial mouthwash strictly (as detailed above) for 5 days with no improvement EMERGENCY Dentist –Need an emergency dentist? Read our guide on How to access an NHS emergency dentist near you. Wisdom tooth extractions Lower wisdom teeth are not preventatively extracted in the UK. This is because of the risk of damage to a nerve in your lower jaw bone during the extraction procedure. Nerve damage is thankfully a rare complication of lower wisdom tooth extraction, but can leave some patients feeling tingly or numb. Sometimes the numbness is temporary but it can be permanent. All dentists in the UK (NHS and private) have to follow UK guidelines set by the National Institute for Health and Care Excellence (NICE). The guidelines state that your lower wisdom teeth should only usually be extracted if they are decayed, causing decay in the next tooth, or if you have been to your dentist with several episodes of wisdom tooth infection that were severe enough to need treatment with antibiotics. Unfortunately, the guidelines have resulted in many patients having to suffer with their wisdom teeth problems for a few years before they meet the criteria for extraction. During the delay, the next tooth often starts to decay and then requires a filling, root canal treatment and a crown, or extraction. The guidelines may be preventing a few cases of nerve damage, but in doing so, causing many more episodes of pain and suffering, and causing lots of tooth decay. After much criticism by dentists and oral surgeons, the guidelines are currently under review and hopefully will be updated soon. What to expect after a wisdom tooth extraction and aftercare at home The Royal College of Surgeons have produced an excellent Get Well Soon guide to help you make a speedy recovery after wisdom teeth extractions. Wisdom teeth and crowding It used to be believed that wisdom teeth might cause “over-crowding” of teeth by pushing forwards from the back of the mouth. However the gradual crowding of teeth can be seen equally in people with no wisdom teeth. It is now understood to be a normal part of the ageing process. It is caused by a tendency for teeth to drift forwards toward the front of the mouth. Extraction of wisdom teeth unfortunately does not prevent tooth crowding. Text and further advice from dentalchoices.org Chat GPT advice.....after my input Wisdom Teeth: Understanding Problems, Comfort Management, and Removal Options Often referred to as third molars, wisdom teeth can lead to various dental issues if they don't erupt properly. Understanding the problems associated with these molars, how to reduce discomfort, and the options for their removal is essential for maintaining healthy oral health. --- **Problems Associated with Wisdom Teeth** Wisdom teeth typically emerge between the ages of 17 and 25, but many people experience complications due to limited space in the mouth. Common issues include: 1. **Impaction**: Wisdom teeth may become impacted, meaning they cannot fully emerge through the gums. This can create pressure against neighboring teeth and cause pain. 2. **Infection**: Partially erupted wisdom teeth can trap food and bacteria, leading to infections, characterized by swelling, pain, and bad breath. 3. **Crowding**: In some cases, wisdom teeth can push adjacent teeth out of alignment, leading to crowding and bite issues. 4. **Cysts**: Impacted wisdom teeth may lead to cyst formation, which can damage surrounding tooth structures and bone. 5. **Gum Disease**: Difficulty cleaning around impacted wisdom teeth can contribute to gum disease, causing inflammation and even tooth decay. --- **Reducing Discomfort** If you're experiencing discomfort due to wisdom teeth, there are several strategies to help manage pain and discomfort: 1. **Over-the-Counter Pain Relief**: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help alleviate pain and reduce swelling. 2. **Warm Salt Water Rinses**: Rinsing your mouth with warm salt water can help soothe inflamed gums and wash away food particles. 3. **Cold Compress**: Applying a cold compress to the outside of your jaw can help reduce swelling and numb pain. 4. **Maintaining Oral Hygiene**: Good oral hygiene, including regular brushing and flossing, can prevent additional irritation or infection. 5. **Diet Modifications**: Eating soft foods and avoiding chewing on the side with the impacted tooth can help minimize discomfort while you manage symptoms. --- **Removal of Wisdom Teeth** If the problems associated with your wisdom teeth persist or worsen, removal may be necessary. There are two main approaches for the extraction of wisdom teeth: 1. **General Dental Practice**: - Many general dentists can perform wisdom tooth extractions, especially for teeth that are fully erupted or easily accessible. - The procedure typically involves local anesthesia to numb the area and may be done in-office. Recovery is generally straightforward, with post-operative care instructions provided. 2. **Specialist Oral Surgery**: - For more complex cases, such as impacted wisdom teeth or those with deeper roots, referral to an oral and maxillofacial surgeon may be recommended. - Specialists have the expertise and equipment to handle more challenging extractions (e.g., IV sedation for anxiety, advanced imaging techniques). - This surgical approach may involve a short recovery period, and patients will receive detailed aftercare instructions to ensure a smooth healing process. --- **Conclusion** Wisdom teeth can present various challenges, but understanding these problems, adopting pain management strategies, and knowing your options for extraction can alleviate concerns. Regular dental check-ups are crucial for monitoring the development of wisdom teeth and ensuring timely intervention when necessary. If you have questions or want to schedule a consultation regarding your wisdom teeth, please contact us today. Let's work together to safeguard your oral health for a brighter, pain-free smile!

Tooth Decay – How to prevent and treat at home What is tooth decay? Tooth decay is when a tooth becomes weakened by sugar attacks and plaque acid. The medical term for tooth decay is dental caries. Why does tooth decay matter? If left untreated, decay can spread within a tooth and weaken the enamel and dentine until the tooth crumbles. This can result in the tooth no longer being useful for chewing, can affect the appearance of your smile and the way you sound when you speak or sing, and can cause bad breath and a bad taste. Tooth decay can cause tooth sensitivity and, in some cases, severe pain and infections requiring emergency or urgent dental treatment. How do you know if you have tooth decay? Tooth decay is often seen as a black, grey, brown or white mark, or a hole in a tooth. Sometimes tooth decay can be sensitive or painful, but sometimes is not felt at all, and only detected by a dentist during a dental examination. What causes tooth decay? Tooth decay is caused by the normal bacteria living in your mouth eating some of the sugar in your diet and producing plaque acid. The acid removes calcium from the enamel and dentine in your teeth and so weakens their structure. These weakened areas of decalcification become soft and can eventually crumble into a cavity. How to prevent tooth decay Every time you eat or drink something sugary, the bacteria in your mouth produce plaque acid. The acid weakens your teeth for around 20 minutes after each sugar attack. The more sugar attacks you have, the longer each day your teeth will be weakened. Minimise the number of times you have a sugar attack each day by avoiding sugary snacks and drinks between mealtimes. If you have sugary treat, try to finish it in one sitting rather than picking or sipping over a long period of time. Brush twice daily using a fluoride toothpaste. Use a good tooth brushing technique. Consider using an electric toothbrush. Clean between your teeth daily, using dental floss and/or interdental brushes. Visit your dentist for a dental checkup every 3-24 months as directed by your dentist. A good base level oscillating rotating electric toothbrushOral-B Pro 1 – £26.00 Rotating oscillating Rechargeable Brushing timer Can use separate heads and share the handle between whole family Pressure sensor – lets you know if you are pushing too hard How to reverse tooth decay It may be possible to halt or even reverse early decay that has not yet crumbled into a cavity by making changes to your diet as well as using fluoride toothpaste and mouthwash. This should always be directed by your dentist after an dental examination usually including some dental X-Rays. You will need to follow the advice above for preventing tooth decay and in addition to this: Use a high fluoride toothpaste (prescribed by your dentist) twice daily. Rinse with a fluoride mouthwash at two separate times to brushing. In some cases your dentist may apply a concentrated fluoride varnish directly to your teeth. The early decay will need to be monitored closely by your dentist with a dental checkup probably after 6 months or as soon as 3 months. When does tooth decay need to be treated with a filling? Your dentist will advise if your decay needs treating with a filling or other dental restoration. This would usually be when there is a cavity that you will not be able to keep clean, if on a dental X-Ray your dentist can see that the decay has spread passed a threshold, or if you are experiencing any sensitivity or pain from the decay. Other factors that may influence how your decay should be treated might be your diet (specifically how often you have sugary snacks and drinks), your pattern of attendance at the dentist, your level of oral hygiene, and how well you usually follow your dentist’s advice.

Checking yourself monthly for signs of mouth cancer is crucial for early detection and intervention. The Mouth Cancer Foundation provides helpful guidelines on how to conduct a thorough self-examination, particularly focusing on changes in gum color and long-standing glosses or lesions. Here’s a simple step-by-step approach to self-checking for potential signs of mouth cancer: ### 1. Create a Comfortable Environment Choose a well-lit area where you can see your mouth clearly. You may want to use a mirror and have a flashlight on hand to help illuminate your mouth. ### 2. Inspect Your Face and Neck Begin your examination by observing your face, neck, and jawline for any unusual lumps, swelling, or asymmetry. Pay attention to any changes in texture or color of the skin. ### 3. Examine Your Mouth Open your mouth wide and use your fingers to gently pull back your cheeks. Look closely at the inside of your mouth, including the gums, tongue, cheeks, and the roof and floor of your mouth. ### 4. Check for Gums and Color Changes **Gum Color Changes:** Specifically, look for any changes in the color of your gums. Healthy gums are typically a light pink color. Watch for any instances where the gums appear red, swollen, or especially pale. Dark spots or patches can also be concerning and should be evaluated further. ### 5. Look for Long-standing Glosses or Lesions Identify any long-standing sores, glosses, or lesions that do not heal within two weeks. These may appear as white or red patches. Pay attention to any lumps, bumps, or changes in texture, such as rough or scaly areas—these may indicate precancerous changes. ### 6. Assess Your Tongue Gently lift your tongue and inspect its surface for any unusual changes in color or texture. Red, white, or discolored spots on your tongue can be potential warning signs. ### 7. Check Your Throat Tilt your head back to examine the back of your throat, looking for any unusual changes such as lumps or lesions. If you see any persistent changes, take note. ### 8. Note Symptoms for Follow-Up In addition to color changes and lesions, be mindful of any other symptoms you may experience, including: - Difficulty swallowing or chewing - Persistent sore throat or hoarseness - Numbness in the mouth - Swollen lymph nodes in the neck - Unexplained weight loss ### 9. Document Your Findings Keep a record of your findings from each monthly check. Document any changes over time, as this can provide valuable information during a consultation with a healthcare professional. ### 10. Consult a Healthcare Professional If you notice any significant changes, persistent lesions, or experience any concerning symptoms, be sure to consult a healthcare professional for a thorough examination. #### Conclusion Regular self-examinations for mouth cancer are a proactive way to monitor your oral health. By focusing on changes in gum color and long-standing glosses, you can detect potential issues early. Following the guidelines provided by the Mouth Cancer Foundation, ensure to consult a professional if any abnormalities are observed. Your health is vital, and early detection can be lifesaving.

Does “No Added Sugar” mean “Sugar Free”? Ribena, not so Tooth Kind: No Added Sugar drinks still contain sugar and so can cause tooth decayIn short, NO. “No added sugar” does not mean “sugar free”. No-added-sugar drinks and foods still contain sugar so they still count as a sugar attack on your teeth, and can cause tooth decay. A statement of no added sugar is used to promote a healthy image, but this may be misleading Lots of companies have taken to using the term “no added sugar” to promote a healthy image for their products. The evidence linking sugar consumption with diabetes and obesity is convincing. Less sugar certainly sounds appealing, but this healthy image is misleading when it comes to the health of your teeth. “No added sugar” causes tooth decay When talking about the risk of dental decay, the emphasis should not be on whether sugar is added or “natural“. Nor should it be on the amount of sugar that ultimately is absorbed into your body. Instead the emphasis should be on whether the sugar is “free sugar” available for fermentation by plaque bacteria in the mouth. This is because tooth decay is caused by plaque bacteria in the mouth fermenting free sugar, and producing plaque acid. The plaque acid demineralises teeth causing tooth decay and dental cavities. Sugar Confusion: “Free from added sugars” does not mean sugar free The term “no added sugar” gives no information about whether there is any free sugarthat could cause tooth decay. So products labelled as no added sugar likely do contain naturally occurring, free sugar that can cause tooth decay. If they did not contain any sugar, they would likely then be labelled “sugar free” or “zero sugar” rather than “no added sugar”. How to avoid tooth decay More frequent free sugar consumption presents more opportunity for plaque bacteria to ferment the sugar into plaque acid. The opportunity is also increased with sticky foods like dried fruit which stay on teeth long enough to slowly release free sugar over time. So if you wish to avoid tooth decay, try to limit your sugar consumption to mealtimes. Between mealtimes, try to avoid sugary and sticky snacks as well as sugary drinks. Safe drinks to have between mealtimes include still/unflavoured/tap water or sugar-free non-carbonated drinks, and tea/coffee without sugar. Ideally try to avoid snacking between mealtimes by having good nutritious wholefood meals with slow-release energy like brown pasta, brown rice and other whole grains, fruit, vegetables and legumes. If you must snack, choose healthy sugar free foods like nuts and seeds, sugar free jelly, low fat humus, fruit and vegetables.

Is there fluoride in my water supply? How to check if your water supply is fluoridatedYou can find out if your water supply is fluoridated to the optimum level by selecting your region and water company below. Some water companies have not been instructed by any local authorities to add fluoride to any of their water supply. For companies that have been instructed to add fluoride, you should follow the link provided and look up your postcode to check your local water supply. Which region do you live in? North England Central and Eastern England London and South East England Western England Why should my water supply be fluoridated? Since the early 1900s we have been aware that areas with higher levels of fluoride naturally occurring in the water supply have much lower rates of tooth decay. In 1945 we started to use that knowledge to fluoridate water supplies to help prevent tooth decay. The evidence shows that water fluoridation at just 1 molecule of fluoride to 1 million molecules of water (1ppm) is a proven effective, cheap and safe way to reduce dental decay. Water fluoridation can help avoid: children being hospitalised for dental extractions under general anaesthesia (by 45 to 68%) and the associated risk of death (always associated with any general anesthesia) pain and infection caused by dental decay to children and adults sick days off school and work caused by toothaches and infections time taken off school and work to attend the dentist for treatment the unpleasantness of receiving dental treatment the personal financial burden of dental treatment for adults Water fluoridation can also help save money and so stretch the NHS budget further. All NHS dental treatment in the UK is currently subsidised by public funds. Even when non-exempt adults pay NHS dental charges, the NHS ‘tops-up’ your payment to cover the true cost of your treatment. Every £1 spent on water fluoridation can save around £22 over 10 years by helping to avoid the need for treatment. As well as freeing up the NHS budget this would free up NHS dentists’ time so they can help more people access an NHS dentist. Is water fluoridation safe? Yes. Despite numerous conspiracy theories and claims of links to almost every conceivable condition known to medicine, water fluoridation has been researched and reviewed many times by many different groups of scientists from many countries and repeatedly found to be very safe. Fluoride occurs naturally in water to varying amounts and humans have been drinking naturally fluoridated water for centuries. At the correct level of 1 molecule of fluoride to 1 million molecules of water, there are no known adverse affects beyond tooth staining (called dental fluorosis). Research has also shown there is no chemical or biological difference between naturally and artificially fluoridated water. Why isn’t all the water fluoridated? Despite the science supporting fluoridation of drinking water, 72% of the population in England do not have access to fluoridated water. Currently, a health authority wishing to fluoridate public water supplies must hold a public consultation exercise and take its outcome into consideration before proceeding with any new fluoridation scheme. Ever wishing to be very accurate with healthcare messages, scientists are notoriously bad at communicating to the public. In the infamous words of Michael Gove “the people of this country have had enough of experts“. Sensational conspiracy theories are unfortunately more appealing and entertaining than accurate scientific messages. It has proven difficult for dentists and scientists to shout louder than than conspiracy theorists in order to gain public support for water fluoridation. Hope for more water fluoridation in the futureThe Health and Care Bill, currently passing through parliament, sets out a proposal to streamline the process for fluoridating water by moving the responsibility from local councils to central government. Under these new proposals, the Secretary of State for Health and Social Care would have the power to directly introduce, vary or terminate water fluoridation schemes. There would however still be a requirement for drawn-out and expensive public consultations and feasibility studies before introduction of new schemes. As the British Dental Association points out, there is currently no promise of the capital investment required to fund a successful rollout. What can I do to help get my water supply fluoridated?There are three things you can do to help get your water supply fluoridated: You can write to your councillors and request for your local water supply to be fluoridated to help reduce dental decay in your area. You can write to your MP and ask why all of our water is not fluoridated to help reduce dental decay for everyone. Share your thoughts on water fluoridation online and in real life with your friends and family.

Managing a Dry Mouth A dry mouth feeling can be very uncomfortable and can sometimes feel raw and sore. Saliva helps to protect your teeth against tooth decay by washing away food and bacteria, and by neutralising plaque acid. If you have a dry mouth these protective functions of your saliva can be reduced, putting you at a greater risk of getting tooth decay. Stale food debris and bacteria can also leave a bad taste and cause bad breath. Saliva normally lubricates your mouth to help you chew and swallow food, and to help avoid cuts and grazes to the skin in your mouth. Patients with a dry mouth may therefore have difficulty eating and swallowing their food, and may experience ulcers from more cuts and grazes. Manage your risk of tooth decay Brush your teeth twice a day with a fluoride toothpaste with at least 1400ppm of fluoride. Your dentist may wish to prescribe you a special high fluoride toothpaste. Use an alcohol-free fluoride mouthwash twice each day, at a separate time to brushing (E.g. after lunch and dinner). Avoid having sugary drinks (fizzy pop, squashes, cordials, fruit juices and smoothies) and snacks (chocolates, biscuits, cakes, sweets, ice cream, ice lollies) between mealtimes. Instead have your sugary treats with meals. Keep your mouth feeling comfortable Drink plenty of still (not sparkling) plain (sugar-free) water – take regular sips during the day, while eating, and keep some water by your bed at night. Suck (but don’t crunch) ice cubes or sugar-free ice lollies. Chew sugar-free gum or suck (but don’t crunch) sugar-free sweets or mints. Use a lip balm if your lips are dry. Ask a pharmacist about treatments you can buy to help keep your mouth moist such as gels, sprays, tablets and lozenges. Xylimelts – adhering sugar-free lubricant discs (with or without mint flavour). Biotene dry mouth spray – moisturising mouth spray Biotene dry mouth mouthwash – moisturising mouthwash Oralieve dry mouth gel – moisturising mouth gel Don’t have lots of drinks that may dehydrate you like those containing alcohol or caffeine (icluding tea and coffee). Avoid having lots of acidic foods and drink – like fruit and fruit juices (including lemons juice) and smoothies. Don’t smoke. Visit your dentist You should book a checkup with your dentist if you have a dry mouth feeling for the first time or if you haven’t discussed it with your dentist before. Patients with a dry mouth will usually be advised to have a dental checkup every 3-6 months. Your dentist may wish to refer you to a specialist in a dental hospital or general hospital for further investigations and advice.

How often should I have a dental checkup? Dental checkups are one of the best ways to keep your mouth healthy and smiling. Usually after your dental checkup or finishing your course of treatment, the dentist will ask you “come back” or “book a checkup” in a certain amount of time. Dental checkups used to be recommended every 6 months …but not any more. The recommended frequency of your dental checkup can vary between 2-24 months. 24 monthly checkups are usually only reserved for patients with no teeth. If its been over 2 years, then you are definitely due a checkup! If its been less than 2 years then there are a few things to consider. How to work out your dental checkup interval You can think of your check up interval as a traffic light system for your oral health, which is determined by your risk level in several areas. Your risk levels will be worked out by your dentist who will check your medical history, ask questions and examine your mouth. Your dentist will then consider your risk levels when suggesting your check up interval. Red – 3 monthly dental checkups Very high risk patients for dental decay and oral cancer, and high risk patients for gum disease or tooth wear might be asked to attend for a dental checkup as often as every 3 months. Amber – 6 monthly dental checkups High risk patients for tooth decay and oral cancer, and medium risk patients for gum disease and tooth wear might be asked to attend for a dental checkup every 6 months. Green – 12+ monthly dental checkups Lower risk patients might be asked to attend for a dental checkup every year to 18 months, and patients with no natural teeth remaining maybe only every 2 years. Dental checkup reminders Most dental practices will have a computer system set up to automatically send out text message, email or postal reminders. Computers however can make mistakes, so you should keep a note of when your dentist says to book your next checkup. If unsure, you can simply call your dental practice and ask the receptionist to check when you are due. If its been over 2 years you are definitely due, but you may need to register with a new dentist. Official limit for NHS dental checkups NHS dentist are contractually encouraged to suggest as longer checkup interval as possible. This is in an effort to help more patients access a purposefully limited number of NHS dentists and so stretch taxpayers’ money as far as possible. There is, however, no official lower limit to checkup frequency. Your dentist will always be happy to help when you are in need. Bear in mind though, your NHS dentist might get in trouble if you attend for too many checkups too soon!

Mouthguards –Use and care Night bite-guards are also known as mouthguards and soft occlusal guards or splints. They are sometimes suggested by dentists to help patients who clench or grind their teeth and/or to protect dental restorations like fillings, crowns or veneers. Dentist made vs Shop bought mouthguards Mouthguards should always be made by a dentist or bought with advice from a dentist. Despite claims on packaging and online, mouthguards bought in shops or online may not be appropriate for your particular situation and could cause problems. Possible problems that can be caused by using the incorrect type of mouthguard include unwanted movement of teeth resulting in an open-bite where only your back teeth (but not your front teeth) can bite together, pain and problems with your jaw joints, and pain and trauma to your gums. How to use your mouthguard Dentists usually advise wearing your mouthguard overnight. It is important that you always brush your teeth with a fluoride toothpaste and floss before wearing your mouthguard, and then again after you take your mouthguard out. If wearing your mouthguard helps then you should continue use. If using your mouthguard makes your symptoms worse then you should consult your dentist for further advice. How to clean your mouthguard The best way to clean your mouthguard is to use soap and warm water, perhaps with an old toothbrush. Never use boiling hot water, since this can melt and deform mouthguards. Disinfecting tablets can also be used to clean your mouthguard up to twice per week. When to replace your mouthguard Mouthguards often last for a few years, but soft/rubbery mouthguards tend to loose their elasticity over time. You should replace your soft mouthguard when it becomes hard and uncomfortable, or if you manage to grind holes into the biting surface. Some patients wish to replace their mouthguard if it becomes stained and unsanitary. Any of these issues would be justification for a new mouthguard. How much do mouthguards cost? Soft occlusal guards and night bite guards fall under the most expensive NHS charge band – Band 3. Some dentists may be able to offer mouthguards cheaper privately, usually in the region of £100-£200.

How to register with an NHS dentist This guide will tell you how to how to register with an NHS dentist, what to to expect at your first appointment and how to get an emergency dental appointment. Page contents: Find a dentist Register What to expect Emergency Appointments Difficulties finding NHS dentists Find an NHS dentist taking new patients Everyone is entitled to register with a NHS dentist. Finding a NHS dentist accepting new patients used to be the hard part, but we’ve made it easy for you. Just search on Dental Choices to get a list of your local NHS dentists currently taking new patients. The easiest way to find a NHS dentist is to visit our Find an NHS Dentist page to search for local dentists accepting new NHS patients, and click “Find a NHS dentist near me”. Our website will then ask permission to access your current location – click “Allow”. We can then search through all the NHS dentists in your area and make a list of the closest dental practices that have said they are taking new NHS patients. You should then work your way down the list and call each practice to check they are still accepting new patients and find out about their registration process. Dental practices do not restrict patient registration by area or post code like doctors’ surgeries, so you can choose which practice is convenient for you. Instead of searching near your current location, you could type in your work’s address or postcode to find a dentist near your workplace. You can even register at more than one practice at a time. Register as a new NHS patient It is not possible to register by email. You will need to call some of the dental practices on your list of local NHS dentists taking new patients to enquire about their registration process. If you are visiting Dental Choices from your mobile phone, just press on a practice’s phone number to make a call. The practices higher on the list are closer to the address or location you provided, so start at the top. When you call a practice, check that they are still accepting new NHS patients and ask what you would need to do to register. If a practice on your list tells you they are not currently accepting new NHS patients, then please politely ask them to update and correct their NHS profile online. Most dental practices will require you to travel to the practice to fill out a registration form before you can book an appointment. The registration form will typically ask for your name, date of birth, address, phone number, email address and a fairly detailed medical history including a list of any current medication you take. You do not usually need your NHS number. What to expect Your first appointment There will usually be a wait of several weeks for your first appointment. You might be asked to arrive early so that you can fill in additional forms. You would not usually be able to book straight in for treatment without a full examination first. If you need any dental treatment, this will usually be planned at your initial examination appointment, and you will then need to book again for the treatment at a later date. Missed appointments Most dental practices have a strict missed appointment policy. If you miss or are late to your first appointment, then you will not usually be offered a second appointment . So once you book your appointment, make sure you attend and do not arrive late. Emergency Appointments It normally takes several weeks from finding a new dentist to receiving any dental treatment. So if you urgently need some dental treatment and cannot wait, then you should seek an emergency NHS dentist. An emergency dentist will however only provide basic urgent and emergency treatment to treat any pain or infection. You should still register with a dentist right away so you can arrange a full dental checkup and treatment planning. EMERGENCY Dentist – Need an emergency dentist? Read our guide on How to access an NHS emergency dentist near you. Difficulties finding NHS dentists There is currently a problem with access in NHS dentistry. Find out what to do if you cannot find an NHS dentist close enough to travel to.

When and how to see an Emergency NHS Dentist How can you access a emergency NHS dentist if you are not registered with a dentist? What should you do if you are registered with a dentist but your practice is closed overnight, at weekends or on a bank holiday? Most NHS dentists are only contracted by the NHS to provide dental care for their registered patients, and only during their open hours. Whether you are registered or not, whether its night, day or a bank holiday – there will always be an emergency NHS dentist available in your area with emergency appointments usually available within the next 48 hours, and urgent appointments usually available within a week or two. (You can find out the difference between emergency and urgent appointments below.) NHS budgets are however limited, and the NHS has a duty to make healthcare as cost effective as possible. Managing dental problems at home You can read our online guides for managing the following conditions at home: Sensitive teeth Bleeding gums and gum disease Wisdom tooth pain and swelling Pain Relief Most toothaches can be controlled with use of painkillers bought over the counter. Paracetamol and ibuprofen taken together or separately are very effective for most dental and oral pain. If you are unsure if it is safe for you take ibuprofen or paracetamol (e.g. if you have an allergy, asthma sensitive to NSAIDs, stomach ulcers, gastrointestinal bleeding, heart failure, or you are pregnant) or you already know you are unable to use them, then ask your pharmacist for advice or visit the NHS 111 website. Paracetamol is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy paracetamol online from a pharmacist (or from Amazon: Panadol tablets, Calpol SixPlus, Calpol Infant). Ibuprofen is available to buy over the counter in supermarkets and pharmacies. Shop own brands are usually the best value. You can also buy ibuprofen online from a pharmacist (or from Amazon: Nurofen tablets, Nurofen for Children). Temporary fillings and cementTemporary filling and cement kits are available to buy for use at home and may be of some help for some conditions like a lost filling or crown. When and how to get help from an emergency NHS dentistDepending on your dental problem, you should access routine, urgent or emergency dental care: Routine Dental CareThe following issues do not usually require emergency or urgent dental care and should be attended to by a general dentist in a routine appointment: Bleeding gums Tooth sensitivity Mild dental or oral pain Cracked or chipped teeth Broken, lost or loose fillings Broken, lost or loose caps, crowns, inlays, onlays, veneers or bridges Loose, broken or lost dentures If you are registered with a dentist Check your dentist’s website for information on how and when to contact them for further advice. If your dental practice does not have a website then call them during their open hours and ask for advice instead. If you are not registered with a dentist Find a local NHS dentist and register as soon as possible for routine help and advice. Urgent Dental Care If you have any of the following issues then the NHS will provide help, even if your dentist if closed or you are not registered with a dentist: Signs of spreading infection (E.g. fever, tiredness, sore or swollen glands/nodes in your neck) Oral or facial swelling Severe oral or dental pain Dental trauma (E.g. a broken tooth which is sore or bleeding) Trismus (lockjaw) A dental or oral problem that might affect a medical condition Suspected oral cancer If you are registered with a dentist Check your dentist’s website for details on when and how to contact them during their open hours. If they are closed then try to wait until they reopen to contact them. If you are not registered with a dentist, or you cannot wait for your dental practice to reopenVisit the NHS 111 website for information on your local emergency and out of hours dental service, who can assess and triage your case. If its found that you need to see an an emergency NHS dentist, then an appointment will be offered within 48 hours – usually the same day or next day. Emergency Dental CareIf you have any of the following issues then you should seek emergency help right away: Persistent bleeding (after applying pressure for 60 minutes) Severe facial swelling which is rapidly worsening, spreading, closing your eye, preventing you from opening your mouth, or affecting your ability to swallow or breathe Severe dental trauma (E.g. a recently knocked out tooth) If you are registered with a dentist and the practice is open, then call your dentist right away for further help and advice. If you are not registered with a dentist or your dental practice is closed, then visit the NHS 111 website or call NHS 111for further help and advice right away. You may need to see an emergency NHS dentist or attend your local hospital’s Accident and Emergency Department.

Which drinks are tooth kind? …And which are tooth cruel? Which are the best drinks for your teeth to help avoid dental problems such as tooth decay and tooth wear? Is squash bad for your teeth? Tooth Kind Water. The simplest and safest drink for your teeth is: Tap Water! Everyone can drink tap water. Schools are very strict now at only giving children water, and even the stubbornest child will drink tap water when she or he is thirsty. This means parents and grandparents can confidently put children’s safety first and insist on children drinking only water too! Sugar Free (Still) DrinksFor those who prefer the luxury of flavour in their drink, sugar free still drinks (not to be confused with no-added-sugar) are the safe option: tea or coffee without sugar Fruit Shoot Hydro Zero Sugar Robinson’s Squash’d 0% Sugar Tooth CruelSquash and CordialsSquashes and cordials contain sugar and so cause tooth decay. They are usually also acidic and so cause acid erosion of teeth. Even squashes and cordials labelled as no-added-sugar still do contain sugar and so still cause tooth decay. Drinks on the no-added-sugar naughty list include: Robinsons Squash Vimto No Added Sugar Kia-Ora No Added Sugar Supermarket own brand No Added Sugar Diet and Sugar Free Fizzy DrinksSome drinks are sugar free but very acidic. The acid does not cause tooth decay but can cause tooth wear. These drinks should only be consumed occasionally and ideally only at mealtimes: Diet Coke Coca-Cola Zero Pepsi Max Diet Fanta Diet Tango Lilt Zero Sprite Zero Dr Pepper Zero Many fizzy/sparkling waters Sugar-full Fizzy Drinks Tooth Wear: Acid Erosion. These teeth have a yellow, shiny and worn appearance due to acidic food and drink.Some drinks are both very acidic and full of sugar, and should be avoided. If you drink these drinks more than occasionally then you will be at risk of developing tooth decayand tooth wear. Drinks on the tooth-killer list include: Coca-Cola Pepsi Fanta Tango Lilt Sprite Dr Pepper Fruit Juice Energy DrinksEnergy Drinks deserve a category all of their own. These drinks not only are acidic and contain ludicrous amounts of sugar, but they also contain caffeine which makes them addictive and potentially dangerous. Short energy boosts are followed by “sugar crashes”, encouraging you to drink more for another short boost. This regular washing of your teeth with addictive sugary acid results in terrible tooth decay and often leads to dental pain and infection. Major supermarkets have recognised the dangerous nature of these drinks and banned their sale to under anyone under 16 years of age. These drinks should form no part of your diet and should be avoided entirely: Red Bull Monster Energy Lucozade Relentless Alternatives to energy drinksInstead try to have good nutritious wholefood meals with slow-release energy like brown pasta, brown rice and other whole grains, fruit, vegetables and legumes. Slow release energy (complex carbohydrates) help provide you with energy throughout the day without the need for energy boosts. If you do need an energy boost, healthy wholefood alternatives to energy drinks are fresh fruit, vegetables, nuts, seeds and legumes.

Sensitive teeth What causes tooth sensitivity? Tooth sensitivity is usually caused by exposed dentine on your teeth. Teeth have 3 layers. Enamel is the outer shell, dentine is the middle layer, and the pulp is the inner most layer. The pulp is the living part of the the tooth containing the nerve and blood supply. Dentine directly overlays the pulp and can be porous. When dentine gets touched, the nerves in the pulp can sense the change though the pores, and respond by sending a pain signal to your brain. This painful sensitive response is common, especially with hot, cold and sweet stimuli. The sensitivity is usually a sharp sensation and lasts just for the duration of exposure to the stimulus, but can sometimes linger for a few seconds. Normally the dentine in your teeth is shielded by the outer layer of enamel or under the gum. Some things can however cause the enamel and/or gum to wear away and so expose the sensitive dentine: Tooth decay Dental decay can cause cavities through the enamel into the dentine. Tooth wear and trauma Overzealous brushing, acid from your diet or stomach, grinding your teeth and trauma can all cause enamel to wear away and expose sensitive dentine. Defective dental restorations A lost, leaking or broken filling, cap, crown, onlay, inlay, veneer or bridge can also expose dentine and cause tooth sensitivity. Gum recession and gum disease Gums naturally recede with age which exposes the root surfaces of teeth. The root surfaces do not have protective layer of enamel and so can be sensitive. This process of gum recession can be sped up with overzealous brushing. Conversely infrequent or inefficient brushing can cause gum disease which can also lead to gum recession. Dental treatment Some sensitivity following dental treatment is fairly normal. Especially after a scale or deep clean, after any drilling or placement of a new filling, and with tooth whitening. Most post-operative sensitivity resolves in 2-3 weeks. If you are experiencing severe sensitivity or there is no improvement after a couple of weeks then you should contact your treating dentist for advice. How to treat tooth sensitivity Treating sensitive teeth at home Generally speaking, most ongoing tooth sensitivity is caused by gum recession and/or tooth wear. A good first line home treatment is to switch to an electric toothbrush, avoid scrubbing your teeth, and use a good sensitive toothpaste. Sensitive toothpaste Not all sensitive toothpastes are equally effective. Some work in different ways. Colgate’s Sensitive Instant-Relief range and Sensodyne’s Repair and Protect range are some of the best sensitive toothpastes on the market. Sensitive toothpastes are readily available in supermarkets and pharmacies. Be careful shopping online and in budget high street stores to avoid cheaper foreign versions which may not meet UK guidelines. Sensitive toothpastes generally take a couple of weeks to work. If you find after 2-3 weeks that your sensitivity has gone then you may just need to continue using the sensitive toothpaste. If after 3 weeks, the sensitivity is no better, then you should definitely contact a dentist for further advice. Sensitive Mouthwash Some sensitive mouthwashes can work faster than sensitive toothpastes. Listerine’s Sensitive mouthwash can be effective after 3 days. Treating sensitive teeth at the dentist In order to treat tooth sensitivity effectively you really need to determine the cause. The best way to find the cause of and treat your tooth sensitivity is to book a checkup with your dentist. If the cause of your sensitivity is dental decay, tooth wear, trauma, a crack or a problem with a dental restoration, or gum disease then you may need some dental treatment such as a new dental restoration, root canal treatment or special cleaning. Dental decay, tooth wear and gum disease will likely require special advice on brushing and cleaning cleaning techniques, specific diet advice and/or further investigations by the dentist (and possibly also with your doctor). Sometimes the dentist can apply a desensitising varnish or paste to your exposed dentine.

Bulimia – Vomiting and your teeth People with bulimia may try to compensate for eating large quantities of food by vomiting. When you vomit, your stomach empties some of its contents out through your mouth. The stomach acid in vomit is very strong – with a pH in the range of 1.5-3.5. When stomach acid washes over your teeth it can damage your teeth. Acid erosion When your teeth are exposed to acid, minerals are dissolved from the enamel and dentine in your teeth causing a type of chemical tooth wear called acid erosion. Early stages of acid erosion Acid erosion can wear away the enamel and dentine from your teeth. Initially acid erosion can make your teeth look very clean and shiny, as your enamel begins to wear away just a little. Advanced stages of acid erosion Over time, as the enamel layer wears very thin, your teeth start to look more yellow. This is due to the yellow coloured dentine under your enamel becoming more visible. When the dentine is no longer covered by any enamel it can feel very sensitive to cold, hot, sweet, and touch. Severe acid erosion As the dentine wears thinner the sensitivity may get worse. Eventually the dentine wears so thin that the living part of the tooth (the pulp), becomes inflamed. An inflamed pulp can feel sore, cause a severe toothache and even death of the tooth. When a tooth dies, sometimes a dental abscess can develop causing pain and swelling. Acid erosion and other types of tooth wearIn addition to chemically dissolving the enamel and dentine from your teeth, the removal of minerals from your teeth causes your teeth to soften so they are more susceptible to mechanical tooth wear. Acid erosion and toothbrushing Brushing your teeth after vomiting can speed up mechanical tooth wear caused by your toothbrush called dental abrasion. The back and forth action of your toothbrush can rub one or more horizontal grooves into your teeth. This happens much faster if your teeth are softened by acid erosion before your brush. Acid erosion and grinding Grinding your teeth after vomiting can speed up tooth wear caused by your teeth rubbing together called dental attrition. Grinding your teeth can wear them down from the biting surfaces, and this happens much faster if your teeth are softened by acid erosion. Dental Treatment for bulimia and acid erosion Prevention- the best treatment for dental acid erosion is to try and avoid washing your teeth with more acid. If you haven’t already, you should book an appointment with your GP and ask for information about the best ways to treat or mange your eating disorder. Ultimately if you continue to vomit on a regular basis, the acid erosion will have an impact on your teeth and your ability to smile, talk and eat. Fluoride Unfortunately fluoride cannot reverse or fully prevent toothwear if you vomit on a regular basis, but it does strengthen enamel and dentine and so fluoride can help slow down tooth wear. Fluoride toothpaste The best way to apply fluoride to your teeth is to brush your teeth for 2 minutes, twice daily, with a fluoride toothpaste containing at least 1450ppm of fluoride. Avoid brushing after vomiting Avoid brushing your teeth while they are softened by acid. Wait at least 20 minutes (ideally 45 minutes) after vomiting or eating/drinking something acidic before you brush your teeth. Instead, if you want to wash away the bad taste and help strengthen your teeth, you should rinse with a fluoride mouthwash. Fluoride mouthwash The next best way to apply more fluoride, on top of brushing, is to rinse with a fluoride mouthwash separate times of day to brushing, ideally after eating and vomiting. Avoid rinsing after brushing You should spit out excess toothpaste after brushing but don’t rinse your mouth out to avoid rinsing away the fluoride from your toothpaste. Mouthwashes are instead best used at a different time of day to brushing – ideally after eating and vomiting. Visit your dentist Your dentist will be able to check your teeth for signs of toothwear caused by bulimia, vomiting and acid erosion and give you tailored advice for your situation. Your dentist may prescribe a special high fluoride toothpaste and fluoride mouthwash, may apply a fluoride varnish to your teeth, or suggest fillings, crowns or referral to specialist restorative dentist in a dental hospital.