Your first visit to us
Your treatment coordinator will welcome you to the practice, complete with you your medical history form and confirm all your personal and contact details. They will then discuss with you the appearance of your teeth and smile and your level of satisfaction with it. They will also record any problems you have been having with your mouth.
Following this you will see Nick for a thorough consultation which will include an examination of:
Your lymph glands
An assessment of your jaw alignment and motion
- Screening for oral cancer
The condition of your teeth
The condition of existing fillings/crowns etc.
A full assessment of the condition of your gums
Any necessary small x-rays
Time for discussion about your dental concerns, and any future treatment you may be interested in.
We will then move onto your annual hygiene examination. You will receive:
Screening of your oral hygiene
Removal of tartar and plaque
Oral hygiene advice, instruction of what hygiene products you should use and a demonstration on how to use them
If possible the annual dental examination will be completed at one appointment and should take about 1hour 30 minutes.
We advise that we also take a panoramic x-ray of both your jaws. This is an invaluable screening tool for us and allows us to view all of your teeth, jaw bones, sinuses, nasal cavity and jaw joints for any possible problems. A lot of problems are painless until very advanced. Since we have been providing this extra service we have found cysts in sinuses, detected a benign cancer in a jaw joint and found evidence of damage to jaw joints and teeth. All of which had no symptoms.
These act as an early warning sign of an infection being present. Although they cannot show us directly where the infection is, it provides us with a warning that a problem is occurring and needs to be addressed.
By feeling under your lower jaw and across your cheeks we can see if any of the facial lymph glands are swollen.
Most people do not have a correct jaw alignment. This can be caused by many factors such as jaw shape, dummy and thumb sucking, incorrectly positioned teeth, how you breathe and many others that affect our facial growth as a child.
Most people do not experience any symptoms, or if they do, they are not a major problem. A small percentage of people can get major symptoms, but due to the nature of jaw joint symptoms, they may not have realised that their jaw alignment was the cause. An incorrect aligned jaw can cause many different symptoms, such as:
Clicking in the joint with opening or closing or both.
Locking of the jaw with opening or closing
Crunching/grating sounds and feeling with opening or closing
Buzzing or ringing in the ears
Grinding or clenching of the teeth
Pain in the ears
Pain behind the eye
Neck and back pain
Vertigo like symptoms
Deafness in one ear
Many patients have received medical care for a lot of these symptoms with no real success. There are various treatment options available depending on the severity of the symptoms. Treatments will be tailored to each individual with a combination of treatments.
By feeling the motion in your jaw joints as you open and close we can detect any movements of the cartilage in the joint. We do this by placing three fingers over each joint while you open and close. Looking from above, we can see if your jaw swings to the side while you move your lower jaw. We will record how wide you can open, and also how far you can move your jaws side to side.
We can compare back to these measurements at a later date and see if any major changes have occurred that need to be addressed.
Condition of your Teeth, Fillings, Crowns and Bridges
When examining the teeth we are looking at various aspects; whether the teeth are worn down, have decay in them, are the fillings fully sealed and filling the cavity correctly, or do bridges or crowns fit correctly at the join with the natural tooth.
The teeth have to absorb the tremendous pressure that can be applied to them when we bite, chew and eat, so their condition will be important in working out your future dental needs.
Missing teeth should where ever possible be replaced with a suitable alternative. This is to stop movement of the adjacent teeth, to ensure that pressure is applied evenly to all teeth and to help maintain the position of the lower jaw in the jaw joint .This in turn keeps the opening to your airway at the correct level.
Your gums are the foundations of your teeth, and even if your teeth are healthy, you can still lose teeth through gum disease.
A natural space is present between your tooth and gum which should be about 2mm deep. We call this a pocket depth. We will measure 6 areas on each tooth, recording the depth of the natural space and if there is any bleeding from the gum where we measured.
The acceptable range of pocket depths is from 1 – 4mm. Any measurement above 4mm is deemed abnormal and the area will require some treatment.
Gum disease comes in two main types.
Gingivitis is the most common, but this is reversible and doesn’t have any long term affect. If gingivitis isn’t treated it will turn into Periodontitis.
Periodontitis is where permanent damage is caused to the bone around the teeth. This can lead to a bad taste or smell in your mouth, pain, abscesses and if serious enough, the eventual loss of your teeth.
X – Rays
X rays are an important tool that we have to allow us to monitor the health of your teeth and gums. We will only take x rays when we feel that we cannot get the full level of information from just visually examining your teeth.
By using digital scanning plates and other techniques, we can use the minimum doses of x rays possible. X rays are around us all the time, coming from the sun and other natural as well as man made sources. The amount of radiation that you get from two small x rays at the dentist is the same that you receive while sitting in an aeroplane travelling to Spain on holiday, or sitting in the sun all day.
We advise that we also take a panoramic x ray to monitor other structures such as your sinuses, jaw joints etc. in the facial area.
Time for Discussion
It is important that we have time to explain our findings, and then with your involvement develop a treatment plan to deal with any issues that we have found.
We will try and keep our explanations as non technical as possible and will use visual displays to aid us.
We have numerous information leaflets explaining treatment options and oral health issues to help you understand what is happening with your oral health.
Oral cancer is unfortunately on the increase at the moment in the UK. Poor diet, smoking and alcohol are linked to its causes, and if you do combine any of these you are hundreds of times more likely to get oral cancer.
More people die each year of oral cancer than either Breast or Cervical cancer. Unfortunately there is no organized screening of oral cancer, unlike breast and cervical cancer.
We will examine for oral cancer at your visit. We look at the roof of your mouth, back of your throat, cheeks, tongue and lips.
Oral Hygiene Screening
Most people have been taught to brush their teeth either by their parents or a primary school teacher, who in turn were probably taught by their parents or a primary school teacher. Very few people have had a dental professional guide them.
Dental plaque is a mass of bacteria that combined with some food debris causes decay in teeth and gum disease. It is not easy to see clearly, so at your visit we will place a disclosing solution on your teeth to see where the plaque is building up.
The solution tells us how long the plaque has been present and allows us to show you any areas that need extra attention with your oral hygiene routine.
We will show you how you need to clean your teeth and advise you if you need to consider any additional hygiene products to enable you to clean all your teeth and gums as effectively and as easily as possible.
Plaque and Tartar Removal
We will remove all stain, plaque and tartar from around the teeth and gums, with a scale and polish. Additional visits may be required depending on the amount present and if other problems have been found.