Author Archives: Simon

Christmas 2017 Opening Hours

We will be CLOSED on Christmas Day, Boxing Day, New Years Day, at the weekend and on the two bank holidays.

We will operate a service beginning at 09.00am for Serious emergencies i.e. severe pain/swelling/bleeding, on the following days:

Friday 22nd Dec @ 9am

Wednesday 27th Dec @ 9 am

Thursday 28th @ 9 am

Friday 29th Dec @ 9 am

If you have a serious dental problem and wish to be seen please ring at 9am. You will have to wait to be seen by our emergency dentist. Patients will be treated on a first come, first served basis.

On one of the days above if you cannot get through on our normal number 01761 413663 you can also try 07379893927, our emergency dentist will answer until the end of normal working hours.

After this time or at the weekend or on any public holiday day as above you should call 111.

Normal service resumes here on Tuesday 2nd January 2018

We wish you a Merry Christmas and Happy New Year.

Christmas 2016 Opening Hours

Christmas Opening at Northway Dental Practice

We will be CLOSED on Christmas Day, Boxing Day, New Years Day, and over the weekend.

We will operate a service beginning at 09.00am for Serious emergencies i.e. severe pain/swelling/bleeding, on the following days:

Friday 23rd Dec @ 9 am

Wednesday 28th Dec @ 9 am

Thursday 29th @ 9 am

Friday 30th Dec @ 9 am

If you have a serious dental problem and wish to be seen please arrive at 9am. You will have to wait to be seen by our emergency dentist. Patients will be treated on a first come, first served basis.

If you cannot get through on our normal number 01761 413663 you can also try 07946 381929, our emergency dentist will answer until the end of normal opening hours.

Outside of normal opening hours please call 111.

Normal service resumes here on Tuesday 3rd January 2017

We wish you a Merry Christmas and Happy New Year.

E-cigarettes – finally some guidance…

At Northway Dental Practice we have like many people in healthcare been considering how we should advise our patients about e-cigarettes also known as vaping.

This issue has been one of common sense versus the available evidence. We felt, as I am sure most people in healthcare who have considered it also did, that e-cigs are less likely to be harmful to our health than smoking tobacco. They do not contain carcinogenic (cancer causing) chemicals, although some products have nicotine which is addictive. But the evidence was lacking to say that they were less harmful, and like many things which are new there tends to be a natural apprehension.

However when we look at the harms of smoking which are very real such as cancer, heart disease, stroke, emphysema as well as the dental implications such as gum disease, mouth cancer, stained teeth and bad breath, it seems that moving over to anything less harmful is the right thing to do on the way to quitting altogether.

It seems the government have now decided it is time to clarify the situation in a press release this week (https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review) the conclusion drawn by Public Health England is that e cigarettes are 95% less harmful than smoking tobacco. My strong suspicion is that the remaining 5% is the unknown risk since this is a new phenomenon and this 5% will become clearer in time. It might even reduce in light of new evidence. They also determined that e-cigarettes were not a gateway or enabling route to more harmful behaviours, and they were not encouraging smoking in non-smokers.

So the message seems clear, if you smoke – quit. If you cannot quit – vape (as a way of lessening the harm or a help to quit).

I have had some personal experience of this having been a tobacco smoker in the past. I first tried an early version of an e-cigarette back in the late 2000’s and was fairly unimpressed, it did not taste like a cigarette, I felt no effect from the nicotine content and it seemed fiddly to use. At that point I decided perhaps they were just a fad.

It is much later and these products have developed into the wild array of devices and gadgets now available, which do provide to smokers the same sensation (minus 95% of the harm, it now seems) as smoking tobacco did, with the added benefit of a wide range of pleasant flavours. They also provide the nicotine smokers crave. Having tried one of these devices it seems that technology might offer the smoker who has tried everything to quit a chance to get away from the harms of tobacco.

It seems 2.6 million people in the UK are already convinced.

UPDATE 10-12-2015

So it seems there is a little more information to consider. One article I recently read (Harvard Gazette Article) links the disease commonly called popcorn lung, a serious and irreversible lung disorder to a chemical called Diacetyl. It also goes on to suggest that since 74% of e-liquids tested contained Diacetyl there may be a risk which was previously unknown.

Whilst this sounds worrying there are obviously several angles from which to view any given piece of information. My objection to the article is that it is titled on-line “popcorn-lung-seen-in-e-cigarette-smokers” however the study it quotes did not find any cases of popcorn lung in e-cigarette users, to the best of my knowledge there have been no cases. Instead it found a chemical which has been linked to this disease in a different context – 8 individual industrial workers exposed to the chemical in considerably higher doses developed the disease.

Another article (The Truth about Diacetyl) suggests that the evidence that diacetyl causes this disease might be questionable and also further goes on to point out that the chemical diacetyl is present in cigarette smoke and in much higher levels, but no cases of popcorn lung have been attributed to smoking tobacco cigarettes, something the world does have a great deal of data about.

So my advice would be if you vape it might be best to buy eliquid that does not contain diacetyl, a number of brands currently advertise as definitely free from this chemical and I suspect given this is likely to be newsworthy and induce a degree of panic the majority of the remaining main brands are likely to move to remove this chemical in their products.

In other news it appears that with e-cigarettes due to be regulated in 2016 they may be available on the NHS as a aid to quitting smoking.

Update 28th April 2016

The Royal College of Physicians have released a joint statement about e-cigarettes

https://www.rcplondon.ac.uk/news/joint-statement-public-health-bodies-e-cigarettes-emerging-public-health-consensus

In which they recognize that e-cigarettes are the best choice for smokers to switch to if quitting altogether is not possible, or as a way of quitting.

Prevention is better than cure but is it always easier?

Here at Northway Dental Practice we have always been heavily involved in prevention of dental diseases. People use the phrase ‘prevention is better than cure’ so much that we often don’t think about this phrase and what it means, it has become a throw away line.

Dentistry (and opthalmology) have always had an advantage over general medicine (i.e the GP), in that we are able to make a very thorough examination of our patient’s mouth without too much specialist equipment. Our GP colleagues by comparison often have to request expensive tests such as blood tests and scans to confirm their diagnoses. Because we have a relatively accessible part of the body  to examine, we have always been able to give advice on preventing disease. Rather than fixing things when they are broken, we stop things breaking by taking  preventative action. You need good information to do this well,  a dental check-up and occasionally a short follow-up appointment will usually gather enough information to do this.

The majority of prevention is about lifestyle. Although its not always a popular message, it is your choices  that determine much about your health i.e. you are responsible for it.

Because of this we need to find out about a person’s diet, habits, how they brush, what they brush with, how often they do it and the state of their general medical health; as many illnesses affect the mouth, including the consequences of stress. With this information which must be truthful and accurate, we can suggest ways to change things to improve health. The changes don’t always have to be big. It would surprise most people to know that having sweet food or drinks just 5 times per day (for example tea or coffee with sugar) can cause tooth decay whereas having it 4 times per day or less will usually cause no problems. The key to prevention is about changing our behaviour.

Prevention is however not as easy to do as it sounds. On paper it is quite straightforward. Make some changes and over time things improve. But in reality we are asking people to take responsibility for their own health and change their lifestyle, which is often a difficult message. Accepting this message requires taking personal responsibility for one’s own health, not something everyone we meet is willing to do.

Lets think about it in terms of a machine such as a car (or motorbike). We know that taking one for a service every year or certain number of miles, is an good way to achieve three things. 1) It is inspected by an expert who can advise if anything isn’t safe or might need attention. 2) Important things are replaced such as oil, brake fluid, brake pads etc.. which are items that wear out and degrade. 3) we get piece of mind and reassurance. This makes sense to most people, we know that a machine or a system needs maintenance, and we maintain it so that it doesn’t break down.

The mouth is essentially a system partly biological and partly mechanical, evolved to enable us to chew, speak, swallow (and smile). It is a biological system rather than a machine, but it is a system nonetheless which requires maintenance, cleaning and repair. Whilst many people see the logic of undertaking prevention and maintenance of this system, some others do not, perhaps feeling that it should maintain itself.

One group who do not follow preventative advice are those who have a severe anxiety about, or phobia of, dentistry. This group rarely attend and when they do they often have pain or swelling due to dental problems, this is often so bad that attendance is no longer optional. This can require complicated or difficult treatment which can be expensive. Once the problem is solved its easy to breathe a sigh of relief and not return until there is another serious problem. As such this behaviour reinforces the belief that what dentists do is always big, complicated, expensive (and often in their experience) – painful. As such they elect to avoid this experience by convincing themselves that everything is okay. This rarely works out as toothache or infection generally returns. It returns as lifestyle changes are not put in place, and other minor problems are not addressed.

There is another group of people who are even more puzzling to the dental profession some of this group have mild anxiety, others none, but when offered preventative advice say “if its not broken, don’t fix it” or words to that effect. Why is this? For some its financial – money is tight and they are trying to cut costs. It is doubtful whether this saves money in the long term. TO use the car analogy saving money on a service, might result in a costly and inconvenient breakdown. The problems which could have been avoided or at worst treated in a minimal-way return later and often are more serious.They also cost more to sort out later, both in terms of money, time and inconvenience. For some there is no belief that prevention is going to work. I often encounter people who seem almost fatalistic. They believe that things are predetermined. A belief that what we do or they do themselves, will not make a difference. Maybe they feel that their parents had bad teeth, so they will have bad teeth too. They do not think that using more fluoride, eating sugar less often and brushing better will decrease the amount of tooth decay they will suffer from, despite these measures being very effective. Because of this prevention seems like a load of  trouble that should be avoided.

The interesting  thing is that when dentists see healthy people who hardly ever have any trouble with their teeth, we do not think- ‘this must be a lucky person’! Almost always that healthy person is healthy because they made choices which are more compatible with health, and they have fewer problems. Fate, I am afraid, has nothing to do with it. If it did how would we explain that many people undergo a big turnaround in their health? Going from poor dental health to excellent in the space of a few years, by making small changes based on sound knowledge.

Is our current system of informed consent making the situation worse or better? Informed consent is a process (not a piece of paper) whereby a dentist or doctor explains what the diagnosis or problem is to their patient. They explain what they recommend as a solution, in the case of dentists, it might be avoiding frequent sugars, getting more fluoride, or perhaps a treatment such as a filling or crown. They discuss the risks of this solution and how likely it is to be successful. They explain what might happen if this solution is not put in place, i.e. toothache might begin or an infection set in. Then they offer alternative solutions and finally they ensure their patient understands the information and has had a chance to ask questions. This system was put in place to ensure that each of us when we are accessing medical or dental care, are involved with our care, consulted about our wishes and offered choices.

Again like prevention, on paper it seems like a very good idea. Most of the time it is. Engaged and interested people find the process to be exactly that, engaging and interesting. However those who are not so interested will often say “you’re the dentist you do what you think is best”. Unfortunately the age when this was acceptable has passed. This would go back to the bad old days when “doctor knew best” and in today’s blame-and-claim culture, it is impossible to practise in this way. For most people, informed consent is the cornerstone of good dental care but for others it might act as a barrier. They are unwilling to undergo a procedure when they know the full ins and outs of it and all the risks. Maybe for some ignorance was bliss.

Another issue that we often face when we are successfully preventing problems is that prevention itself, unlike toothache, cannot be seen,felt or measured easily. It is hard to notice that something did not happen! Many patients who’s gum disease is being kept at bay by their good brushing, our scaling and polishing and other treatments may not realise that although the problem cannot be cured it would be much, much worse if these beneficial things were not taking place regularly. As such it is important when we prevent something to make sure we draw attention to it, otherwise it often goes unnoticed. A good example of this is the much lower rate of heart disease, as a result in part of treating high blood presure, high LDL (bad) cholesterol and diabetes management. We see the rate of heart disease falling but it is hard for someone who resents all the tablets to appreciate that the alternative might be a lot worse. For someone who has had a heart attack (due to a lack of prevention) then the medication afterwards is greatly appreciated, it was broken and so the acceptance of “fixing it” is greater.

A situation where we struggle to decide on the best way to help someone is that of the person who actually objects to prevention. This person has a firm belief that they only go to the dentist to have their teeth cleaned or to have a filling, and that they don’t want to hear anything else. This type of person is particularly challenging. On the one hand it is a tempting train of thought to ask them in future, if they are sure about this approach, to sign a form to say they do not wish to have any preventative advice and thereafter not to provide any. I’ve never heard of any dentist actually doing this, and certainly do not know if this would be legally binding if the patient later decided to make a complaint that they were not offered preventative information. Once problems have set in people often decide that they do want to do something done about it, and despite being anti-prevention before, they suddenly see the point of it, and forget that they chose to ignore the earlier advice. These are questions that would have to be asked in order to solve this problem in this way. Another solution is to offer the prevention in a very round-about way and very tactfully, but this is difficult and is not always effective. Dentists have to record when they recommend something such as recommending flossing, or a filling or crown, in the patient’s notes. If later a patient says that no-one ever told them that their tooth might decay, the notes will show this to be incorrect.

Measuring prevention is especially problematic for the government and the NHS. If you as an NHS commissioner want to get funding for a programme to prevent disease you have to be able to show results. Since it’s extremely difficult to measure cavities that did not form, or teeth that did not break, the approach adopted is often one of measuring treatments such as fillings, which are only being done because they weren’t prevented. This means that governments and the NHS often talk a good game about prevention but struggle to actually deliver it.

Despite being very difficult to do, I strongly believe that prevention is better than cure. Changing your behaviour might be hard  and certainly moves the responsibility for your health on to you as the patient, but it is by far the easier, cheaper and more convenient way to ensure good health in the long term. Prevention is healthcare being done right. In dentistry, some of the treatment only happens when prevention fails. So when people say, in a throw away fashion “prevention is better than cure” that’s because it is! Its up to you to decide what you are going to do about it. Prevention is an active process, it means doing things to prevent problems, instead of doing nothing and hoping for the best. The other throw away phrase “if it isn’t broken, don’t fix it” should read “just because it isn’t broken doesn’t mean we shouldn’t look after it”.

Northway Dental Practice has been caring for the oral health of people in the Midsomer Norton area for over 40 years.

Fluoride – Why the controversy?

Fluoride often comes as sodium fluoride, and is a mineral salt much like table salt. The key difference is that when it is applied to the surfaces of the teeth (such as when you use fluoridated tooth paste) or when it is consumed by drinking fluoridated water, it hardens the teeth against being dissolved by acids. Tooth decay happens because acids produced by bacteria (i.e. plaque) dissolve the tooth and allow a cavity to form.

Fluoride has been known about for a long time, it was noted in American frontier towns in the 1850-1900 period that some towns had little dental decay and some had a lot. Eventually the cause was discovered – some towns had more fluoride in their drinking water! Fluoride’s use in preventing tooth decay is thought by the US Centres for Disease Control to be one of top-10 most important public health advances in human history, along with things like sanitation and vaccination.

In the UK most of our drinking water is not fluoridated. Some parts of the country have fluoride added to their water supply and some have a little fluoride in the water naturally. See this map if you want to know more.

So what is the controversy? There are groups of people who seek a “natural” solution to problems who feel fluoride might cause harm. Despite fluoride being a natural substance, that is naturally in the water in many parts of the UK.  No strong (or even reasonably strong) evidence exists to support this idea. I was horrified to visit YouTube and see hundreds of videos by people saying fluoride is terrible, its a government conspiracy etc and only a few by reputable organisations saying it is beneficial. Until I realised these hundreds are offering their opinion, and very little credible evidence. It was a powerful reminder, that just because a lot of people shout loudly (as they do on YouTube) it doesn’t mean they are right!

I will consider one strand of anti-fluoride thinking and that is that water fluoridation is giving medication without consent, but I reject this position. If you feel this way you can avoid fluoridated tap water by drinking mineral water (which might contain natural fluoride anyway, it is a mineral after all)  – do not deprive the least well off of the chance to have fewer fillings.

If we look at those who support using fluoride to protect your teeth they include:

  • US Centres for Disease Control
  • British Dental Association
  • American Dental Association
  • World Health Organisation
  • The NHS

The list of reputable organisations goes on and on. They use evidence to guide them not rumour/here-say/conspiracy theories.

I personally use fluoridated toothpaste as do most people, I also prescribe higher strength fluoride toothpaste for people at risk of tooth decay with spectacular results (many people I have treated have avoided multiple fillings due to timely introduction of increased fluoride, along with better diet and brushing). I would like our water supply to be fluoridated, which would bring the greatest benefit to the most deprived, who might not have good quality toothpaste available, or be using it very much at all.

As a conclusion I will summarise by saying that all of the good quality evidence (and there are thousands of studies to support this position) say that fluoride in the correct doses, by toothpaste and/or drinking water, is safe and effective at reducing between 20-50% of tooth decay.

Parking Issues

We recently noted that Argos Midsomer Norton had changed their parking policy, to impose fines and restrict parking in their car park. This came as news to us, as Argos did not notify us, despite our having an informal agreement with them. Our patients were able to use their car park and in exchange we would leave catalogues in the waiting rooms and bring this kind gesture to our patients attention.

Our advice to any of our patients or visitors is NOT to use the Argos car park when visiting the practice, unless you are also shopping at Argos and complying with the parking time limit they have imposed.

We normally have sufficient parking at the practice on most days. Further parking is available in/around Midsomer Norton.

New Xray Facilities at Northway Dental Practice

Here at Northway Dental Practice we have always had the facility to take x-rays to help with diagnosis and monitoring of various dental problems. However technology moves on and we have recently, to compliment and facilitate our branching out into orthodontics, commissioned a digital OPG machine.

What is an OPG machine? Well an OPG or OrthoPantomoGram is an x-ray which spins around the head and takes a picture of the jaws, the jaw joints, the sinuses in the cheeks and the teeth. It is very useful for a number of purposes, such as monitoring gum disease (it shows the bone levels around all of the teeth in one image), assessing wisdom teeth, as an alternative to x-ray films placed in the mouth, in order to see the jaw joints or nasal sinuses, and for assessment prior to and after orthodontics.

Being a digital system the x-ray dose is lower than it used to be with film based machines, and the machine is capable of taking images of part of the mouth so as to minimise dose.

We can then manipulate the images to improve the useful information contained within.

We are able to use this technology to help us to diagnose and treat our patients and as a referral service from other nearby dental practices, who might not have this technology on site.

FastBraces® comes to Northway Dental Practice

After much research and careful deliberation Northway Dental Practice through Dr Simon Khoury and Dr Bjorn Heisler are able to begin offering orthodontic services i.e. braces for straightening the teeth. Working with FastBraces® from the USA, we are using a system that has been in development for the last 20 years. This system is new to the UK and is revolutionary. Using state of the art technology FastBraces enables us to straighten your teeth not in 20 months like traditional braces but in just 20 weeks! We do not routinely remove teeth.

We will be able to treat up to 80% of cases here at the practice and offer flexible payments to help with the costs. We are able to straighten your teeth, in most cases faster and with less cost than old-school orthodontists. This service is available for children and adults alike! Please be aware we cannot offer this service on the NHS. Some of our younger patients who qualify for NHS orthodontics will be referred to a traditional orthodontic specialist, for those who do not qualify we are happy to help with straightening their teeth here.

We achieve this by using the expert help offered by FastBraces to bring full orthodontics to you in your local dental practice. And what about retainers –  you only need to use them for 20-30 minutes per day.

Not only that but unlike any other orthodontic system out there,  we offer a lifetime guarantee on our treatment – provided you have retainers that fit you properly we will revisit your orthodontics should it ever need tweaking in the future with no further charge (except the retainers – which are necessary to keep the teeth straight afterwards!).

So if you don’t like how straight your teeth are and have always wanted them straightened – call us on 01761 413663 or email us today and ask about FastBraces®. Northway Dental Practice bringing you the latest technology and best results.

 

New Computer systems

Northway Dental Practice has this year invested in new computer systems. These computer systems mean that we will no longer be using paper records for our clinical dental notes. Notes will be recorded into the computer. In this way they can be backed-up and kept safe and they are easier to read. We will still have paper record cards for the rich history they contain, but as time passes we will need this information less frequently.

What does this mean for our patients and clients? Once we have the computer systems configured correctly for each of our patients, the process of having a dental check-up and having treatment planned will be faster (it is a little bit slower the very first time we see you, as we have to set-up your records on the system). You will be able to have a printed estimate of your treatment. This also acts to provide recording of consent, so please sign these forms and leave them with us.

Other exciting features include the ability to send reminder text messages or emails.

Hopefully in the future we will be able to add digital x-rays to the system to further reduce our need to have paper record cards.

Whilst adopting a new technology when it is very new is always a potential source of problems, adopting tried and tested technology in a timely manner will keep Northway Dental Practice up to date.

Tooth whitening at Northway Dental Practice

Here at Northway Dental Practice we’ve noticed that wanting teeth whitened has become much more frequently requested over the last 10-15 years. Partly due to the rise of celebrity culture and partly due to improved living standards and expectations/aspirations.

We can broadly divide the types of patient who come to us asking for whitening into two groups. 1) Young patients who often want super-white teeth, often these patients have normal (not very dark) coloured teeth to begin with. 2) Older patients who’s teeth have darkened over time and who want them to look whiter as they did when they were younger. Often these patients do have quite dark teeth.

So what colour should teeth be? 

Naturally most teeth (around 95%) have a yellowish colour. The teeth are made of enamel on the outside which is translucent/white colour, and dentine inside which is usually yellowish. The colour we see is a combination of these two colours and the hue of the light which is shining through the teeth. A smaller number of people perhaps 5% have light grey teeth or other colours such as light brown. Some people have teeth with bands or spots of unusual colour caused by a variety of disorders of tooth development.

Do teeth get darker as we get older?

Yes. Three processes cause this to happen. Enamel thins over time and therefore, since it is the white component of the tooth, the dentine shows through more – which is the usually yellower or darker component. So as your teeth wear, which is normal as we age, they appear darker. The second process involves stains from foods and drinks, which usually remain on the surface of the teeth, but gradually over many years permeate into the enamel and dentine, causing the colour to change – we call this intrinsic staining. The third process is that fillings can leak causing staining to get into the teeth, or just look dark themselves as they are metallic coloured and this shines through the tooth making it look dark or grey.

What can we do about it – why not just use whitening toothpaste?

Whitening toothpaste is, in my opinion, a little misunderstood. What it should be called is extra-cleansing toothpaste. It is designed to scrub the surface of the tooth harder to remove stains. In doing so the teeth should look a little brighter. This is useful but it is not quite the same as tooth whitening since it does not change the actual underlying colour of the teeth it just removes stains. If your teeth were yellow AND stained before using whitening toothpaste they will still be yellow afterwards but no longer stained. Some people suggest that using these products too much can lead to more tooth wear, which in the long term is harmful. Our advice would be to use whitening toothpastes occasionally but not daily.

What does professional tooth whitening do?

Basically it bleaches the teeth. In the same way you can bleach your hair or your clothes to remove stains or whiten the colour, you can do the same thing to the teeth. The process though is a little different since teeth are not made of fibres like hair and clothes are – they are made of hard mineral much more like stone or rock. The bleach used is NOT household bleach, but a special formula designed for teeth. Never use anything on your teeth that is not designed for teeth and never use anything on teeth unless it is supplied by a reputable person who you trust and can go back to in the event of problems, the best person is your dentist.

The professional whitening process involves measuring your tooth colour and photographing your teeth, then making some trays to put the bleach into, providing you with the trays and whitening formula and showing you how to use the system, you doing the treatment at home over (usually) 1-2 weeks, then a review appointment to see how it all went. We do not do “one-hour whitening” or “laser whitening” all of which are methods to make marketing the treatment easier, not of achieving a better result. We have carefully considered the system we use as it is gentle, easy to control and kind to the teeth.

How white will they go?

Usually over 1-2 weeks the shade improves considerably but the teeth remain a natural white. If you carry on the treatment for a longer period than the usual 1-2 weeks lets say for 4-6 weeks you will normally achieve a very white shade indeed. You can carry on as long as you wish the decision when to stop is yours.

Is it safe?

Yes. Provided you use the right whitening formula such as the system we use and use it as directed, there has never been any harm caused to the teeth or gums. Since teeth are not like cloth or hair they do not get damaged by the bleach, they are much tougher to begin with.

Are there any drawbacks?

There are some considerations. We need to carefully assess the teeth before treatment. If you have white fillings or white crowns/bridges/dentures they will not change colour. This might make them look too dark, if so do you will need to plan to change these items after whitening. This makes the process quite a bit more complicated.

Sensitivity is one complication that sometimes occurs and we will not easily be able to predict. Some people will experience sensitive teeth temporarily during the treatment (it does resolve afterwards). For some it will be quite noticeable for others hardly anything at all. Those who get most sensitivity will often whiten fastest so it is not always a bad thing.

Cost is also a factor – whitening treatments can be expensive since there is a lot of preparation involved in doing the treatment properly with predictable results. However the ongoing cost of maintaining the white colour is low as you will already have the trays, and be experienced with using them. You might need a refill pack of whitening formula.

How long does it last?

This is a good question and the answer is often not the one people expect. Unfortunately it cannot be permanent as the processes which darken the teeth (wear & tear/fillings/intrinsic staining) are going to continue after treatment finishes. So you will notice the colour gradually fading, over perhaps 1-2 years. At this point you can re-whiten the teeth using just 1-3 nights treatment; so maintaining the colour is easy and simple. Some people go for a one night per month method as a way to keep the colour white on an ongoing basis. Once the initial treatment is complete we leave you to maintain things as you see fit, with help and support if you require it,  and we can supply refills of the whitening formula at very reasonable prices.

Why shouldn’t I use kits from the internet/beauticians/market stalls?

The simple answer here is that the kits can contain harmful chemicals or ineffective chemicals and they are often sold very cheaply and therefore produced very cheaply also. The people undertaking the treatments can have little or no training, and are unable to assess the health of your mouth (you need to be a qualified, registered dentist to do this). Taking impressions is considered to be the practice of dentistry and it is illegal to take an impression for someone unless you are a dentist or properly trained dental hygienist or in some cases, dental nurse. The EU now specify that whitening gels of effective strengths are only to be supplied by dentists to patients and that dental supervision must be in place when teeth are whitened.

If you want to know more about tooth whitening please book in to see us. We will very happily assess your mouth and if appropriate begin the process. See our website for more details.