Cosmetic Dentistry – what can it do for me?

Here at Northway Dental Practice many of us have seen TV shows like “10 Years Younger” and have been exposed to celebrity-media portrayals of cosmetic dentistry but what does it really involve in the real world?

Cosmetic dentistry is a very wide ranging term which covers everything from just polishing the teeth to placing dental implants (screw-in-teeth). As such the best definition would be that cosmetic dentistry is “any process which brings about an improvement in the appearance of the teeth”.

For some people merely getting the teeth clean and keeping them clean will give the teeth the appearance they want. For others getting their teeth to look good will require a small or modest amount of treatment, for some the treatment might be complicated or extensive. The take-home message here is that we undertake a lot of cosmetic dentistry on a small and modest scale which yields good results for our patients for what we think are sensible fees. For example, whitening the teeth can improve their appearance dramatically and yet is simple and, compared with some of the alternative cosmetic treatments, low-cost. Often people assume there is nothing affordable that can be done to improve their teeth, whereas the reality is there are usually many affordable things that can be done.

It is worth saying that there is a firm line between what can be done on the NHS and what must be done privately. The NHS exists to keep us healthy, but not to make us beautiful. Procedures which are designed to give improvements in appearance are not available on the NHS.

Some say to “fail to plan” is to “plan to fail”. I find it helpful to think of the process of cosmetic dentistry as being all about planning. Why do I say this? It is relatively easy to do some of the available treatments but without being well planned they will often not result in the long term outcome our patients want. As such planning is more important than doing, since planning is difficult and doing is often straightforward.

The planning, simply put, consists of three aspects

  1. Finding out specifically what our patient wants from their teeth. It may be obvious or it may be very subtle indeed. We can offer some ideas and suggestions but as Plato said “beauty is in the eye of the beholder” so it is important that we make the teeth look the way you, the patient, wants them to look. To do this you need to know what you want them to look like and we need to be able to find out from you what you would like to see smiling back at you in the mirror.
  2. Working out what we can do with the teeth we have to work with. Sometimes the proposed treatment will be simple and at other times complex. Occasionally there will be problems and some compromises might need to be made. It is vital that these compromises are clear from the outset and that our patients accept them if they are to proceed. If the compromises are too many then it is often better not to proceed.
  3. Then we need to discuss how much will it cost and how long will it take, i.e the practicalities.

Once all these three things are agreed then the treatment can proceed.

Interestingly our patient’s expectations sometimes will change as the treatment proceeds. I have experienced situations with patients who at the start said that all they wanted was one tooth to look better but by the end they wanted much more extensive treatment. This is not a problem provided it is planned for. We often ask people to think about their teeth in an “ideal world” and then work backwards from there otherwise we risk not being thorough enough.

Here at Northway Dental Practice we have experience in planning and carrying out cosmetic dentistry, and have a sensible approach designed to achieve great looking teeth, safely and in many cases affordably.

Tooth wear another trap to avoid falling into?

Here at Northway Dental Practice we would like to help you to avoid a problem that is difficult to see or feel but which over the long term can cause a lot of difficulties – tooth wear. Dentists also call this “tooth surface loss”.

What is tooth wear?

Tooth wear is the process by which the teeth become worn at the surfaces, i.e. become thinner/smaller or become pitted. It is a problem as our teeth do not grow, they form completely (with the exception of a little internal growth) a few years after they come through the gum and from that point onwards they are gradually wearing out. There are three things that wear our teeth:

  1. Attrition – i.e.  chewing. As we chew the teeth rub against each other and chew against food and gradually small amounts wear away. This problem is worse if you have lost some teeth, as the remaining teeth have to work harder when you chew. This is a mechanical process.
  2. Abrasion – this means wear at the surface caused by abrasive things such as toothpaste, or tooth brushes. This is a mechanical process.
  3. Erosion – is where the teeth essentially dissolve because acids (from foods, drinks or plaque/bacteria) are destroying the surfaces. This is a chemical process.

What makes tooth wear more difficult to diagnose is that often all three processes are occurring at the same time.

Is it normal?

The answer is yes but the issue is how fast is it happening. This is vital in deciding if the wear we see is ongoing or perhaps it all happened in the past and isn’t happening at the moment. If you have mild tooth wear at 80 years old it is less of a problem; if you have severe tooth wear at 20 years old it is going to be very troublesome over the coming years.

Tooth wear is a problem that is becoming more common. There are a number of reasons why:

  • The population is ageing, there are more older people as a proportion of the population.
  • It is normal to keep our teeth longer as we get older. A statistic released in 2013 showed that in 1993 the number of people with no teeth at all was 27%. In 2013 it was just 6%!
  • We are eating more tough, unprocessed foods, as a result of moving towards a more “healthy” diet.
  • We are consuming  more acidic  foods and drinks including whole fruit, fruit juice, smoothies, beer, cider, wine and fizzy drinks. Often without realising it since diet fizzy drinks are also very acidic.
  • We are more inclined to use abrasive toothpastes such as those which are sold as whitening toothpaste.
  • As  we lose teeth  we end up with fewer chewing pairs of teeth, these then have to work harder and will wear away more quickly. Tooth wear accelerates as time passes, if teeth are lost.

One of the most troublesome aspects of managing tooth wear is that many people with it don’t realise they have it, either because they feel it is normal and therefore not worth trying to prevent/treat or because it happens very slowly and gradually and so they don’t notice it has happened. If the wear happened overnight it would be very dramatic and upsetting but it is a slow process so we get used it.

So how do we deal with tooth wear?

First we have to work out whether you have normal tooth wear for your age or advanced tooth wear for your age i.e. more than normal. This is one of the few areas in dentistry where age matters, since wear is more likely with the passing of time.

Next we have to determine if the wear is ongoing and at what rate it is happening. The way we do this is by measuring the thickness of the teeth, or by taking photos, or by making a set of models of the teeth. We can then come back to these in a few years time and measure again to see if things are getting worse, it is a slow process so it can be hard to tell by simply looking.

Presuming that you have advanced wear for your age, the wear process is ongoing, and the rate of wear is sufficient to cause future problems then we need to act to prevent and possibly treat the wear.

Prevention really is better than cure….

This is a much overused phrase but that’s because it’s true. The way to deal with wear is to minimise the amount we suffer from and avoid it. The best ways to do this are:

  • Cut down on acid drinks and foods – rinse your mouth after acids with water or mouthwash.
  • Do not use whitening toothpaste regularly – only use it occasionally.
  • DO NOT brush straight after sugars/acids. The teeth are soft after sugar/acid and brushing them immediately will cause more wear. Rinse straight after drinks/foods with mouthwash or water and wait 1 hour before brushing.
  • If you grind your teeth at night (i.e. wake up with soreness in your face/sides of head, or aching teeth in the morning, clicking jaw etc… ) consider wearing a niteguard to prevent wear. This is a soft plastic shield to wear over the teeth and is much less costly than treating tooth wear later.
  • Use plenty of fluoride which is in normal toothpaste and mouthwash or ask your dentist about high fluoride prescription toothpaste. More fluoride means harder teeth, less erosion and wear. It is sensible to avoid rinsing with water after brushing, just spit out the foam and leave the paste on your teeth – it is in contact longer and so has more chance to work.
  • Consider using a toothpaste designed to protect enamel, these are more gentle and less abrasive.

If tooth wear has already become a problem then treatment needs to be considered. It is very important to correct the causes first (see above) before treatment otherwise the problem will recur or the treatment may fail prematurely. There are a number of ways of restoring the damage caused by tooth wear:

  • Make sure you have a normal set of teeth to chew with, this might mean if you have lost some teeth, having dentures or implants to replace missing teeth. If missing teeth is the cause of your tooth wear this step is not optional, without it any repairs will quickly fail or wear out themselves.
  • You can have white fillings to build up the teeth if the damage is modest.
  • You can have crowns to build up the teeth especially if the damage is severe, they are stronger but they cost more and come with slightly higher risks of future issues.

The improvement after treatment can be dramatic cosmetically and can seriously improve your chewing, speaking and general confidence. With the right prevention further wear can be minimised and your teeth can be maintained in a good-looking, healthy state.

If there is a take home message it is “avoid wear by taking precautions” such as those above. Try to be objective about your teeth, generally none of us want dental treatment but when it is needed it will make a huge difference to our health. If the teeth aren’t functioning properly – seek help which is available from your dentist.

To speak to us about tooth wear see our website


Gum Disease – avoid falling into the trap….

What is gum disease?

When talking about this topic there are a lot of myths that go around. I have heard over the years people say they caught gum disease from other people or even from their cat! You don’t catch gum disease; it is often a change that comes with time (age).

Gum disease, put simply, covers a range of conditions which if left unchallenged will cause or accelerate the loss of the bone from around the teeth. When there is very little bone around the teeth they become loose and can be painful. At this point removing them is often necessary.

It is worth also saying that all adults are gradually losing this bone over time but unless you have gum disease it should not cause any major problems until you reach an advanced age say 80+ years. If you have gum disease these problems will occur at a much earlier stage.

What are the signs?

There are various signs which are easy to ignore, and often are ignored. Bleeding gums is a major warning sign, tender or swollen gums are another. Often gum disease will NOT cause pain, this is one of the traps you can fall into – assuming that because the gums don’t hurt that they are healthy. This is not always the case. In the later stages you might experience loose teeth or painful teeth or gums.

What makes it worse?

There are a range of factors which make gum disease more of a problem.

  • Genetics – about 50% of us are susceptible to gum disease, if we aren’t careful we will have problems with it, for the others the risk is less. If your parents lost their teeth at a young age, say before they were 50, then you might be susceptible and ought to be actively involved in avoiding developing the condition yourself. You can do this in consultation with your dentist. 
  • Bad oral hygiene. Plaque and tartar will cause irritation in the gums, bleeding and soreness, encouraging the bacteria which cause the disease to worsen, to form and grow. It is vital to brush well twice per day for 2 minutes, preferably use a good quality electric brush and clean between the teeth using floss or inter-dental brushes at least once per day.
  • Poor general health, conditions such as diabetes or anything which makes our immune systems weaker, increase the risk from gum disease.
  • Poor diet can have an impact, frequent sugary foods and drinks will encourage bacteria (plaque) to grow.
  • Smoking is a major risk factor for gum disease. Smoking reduces the blood flow in the mouth, weakening the immune system and allowing more bacteria to grow.

What can we do about it?

  • Give up smoking – a lot of help is available now, consider patches/gum/ lozenges/tablets to help you quit. Join a quit smoking group (in person or on-line).
  • Eat fewer sugary foods and drinks and have them less often, ideally fewer than 4 times per day.
  • Brush very well, take your time, get an electric brush and get between your teeth with floss/inter-dental brushes. Every minute spent on good oral hygiene will improve the outlook for you mouth in the long run. 
  • Get some treatment from your dentist or hygienist. Treatment includes advice on lifestyle and brushing as well as cleaning above and below the gums to remove bacteria. It only works if you clean well and are willing to maintain a very high standard of oral hygiene.

So what is the trap to avoid – it is assuming that it won’t happen to you and that this is a problem other people have. Many people we see presenting for advice and treatment have already missed the boat in terms of preventing the disease and for them it is a case of damage limitation, we won’t always save every tooth. If your gums bleed or your parents lost their teeth early,  then you should consider actively preventing gum disease by avoiding the causes above.

Furthermore, some scientific studies are showing a link between gum disease and heart disease. So far we don’t know how this works but it makes sense to be cautious and presume that healthy gums might be part of the puzzle in having a healthy heart.

At Northway Dental Practice, Midsomer Norton, we are keen to help you avoid these problems and treat them when they do occur. Visit for more information.

Whats the point of check-ups anyway?

Well, in answering this question there are a number of aspects to consider. One is about health, another about reassurance, and the third is about information.

Health – One of the most important reasons for a dental check-up is to make sure that you don’t have any signs of mouth cancer. It is a rare disease affecting roughly 5000 people each year in the UK (population 62.74 million) which is 0.008%. However there is a very large difference in the outcome, between early detection which can have an 80% survival rate at 5 years, to late detection where this drops to 20% survival. As such having a good look around the soft parts of the mouth every 6-12 months is a very good idea indeed. This is not a new thing we have been doing this every time we do a check-up for a very long time indeed,

Once we’ve done this check we can move on to the gums and teeth. There are some things a check-up can, and does find, such as tooth decay, gum disease and wear & tear. These are all problems that with a little warning can be prevented, avoided, or treated minimally and without any drama. Other conditions such as persistent dry mouth are very serious and can cause a lot of trouble, but with early detection and management can be reduced to a smaller problem.

There are however some problems that a check-up cannot always find such as cracking in teeth. Cracking teeth can be sensitive and painful to bite onto (some do not cause any pain at all). They are such a tricky problem to solve as teeth can break without warning, sometimes even in the days just after a check-up. The simple answer is that, with a few exceptions, we cannot predict which tooth will break or when. The exceptions are the rare cases when cracks can be seen on the surface. Although we still cannot predict when it will break, we might suggest some treatment, such as using low-shrink white fillings instead of metal fillings or even the crowning of teeth to strengthen them and prevent breakage.

The next reason for a check-up is to do with reassurance. Teeth are a cause of concern and stress for many of us. Getting the clean bill of (oral) health (or as close as we can get), takes the weight off the mind of the person worried about their teeth. It is normal for us to associate failing teeth with getting old and losing our strength and capability. In fact it is said that dreams concerning worry about the future often include teeth going bad or falling out. This need not be the case with good management of the long term problems such as tooth wear. The earlier the causes of these are addressed the less damage is done,

The last reason is about information and education. The key to health is education – what does this mean in practice? It means that it isn’t treatment that we need to improve our health (in fact that’s what we have when we fail to improve our health), it is knowing how to be healthy. What choices to make to prevent disease. On many occasions I’ve had to defend my decision to spend time speaking with patients about their health when in reality each minute spent talking about health can be worth many hours of treatment avoided later on.

The other main reason for information exchange at a check-up is to make sure that our patients know what their options are. It’s no use there being many hi-tech solutions to a problem if, as dentists, we aren’t telling people about them.

In conclusion it is my assertion that dental check-ups will, for most people, reduce the frequency and severity of dental problems (although not all the way down to zero), enable information to be exchanged about health and reassure our patients about their oral health. In comparison for those who do not attend dental check-ups there will be some who will be worse off for it and have more problems, and more severe problems, rather than fewer.

If you haven’t been for a while give us a call on 01761 413663 or email us via our website and we will be happy to book you in. And don’t worry, we won’t tell you off if you haven’t been for a while, we’re just happy to have the opportunity to help.

national smile month

Taking place between May 20 and June 20, National Smile Month is a great opportunity for us to learn a little more about our oral health and find out just why it is so important to our overall well-being.

You may not think it is true, but looking after your oral health really can make a difference to how healthy you are. So there are plenty of reasons for looking after your oral health. 

If you take a second to think about it, your mouth is the first port of call for lots of things. If you don’t keep it in a good condition, it’s an ideal place for bugs and nasties to get into the bloodstream. In fact, poor oral health has been linked to quite a few unpleasant things in the last 12 months:

  • Gum disease has been linked to high blood pressure during pregnancy
  • Dementia could be brought on by increased poor oral health.
  • Scientists have even discovered severe gum disease could lead to a higher risk of developing oral cancer

Never mind the serious stuff, your oral health is also really important as it enables you to do something very special – smile. It costs nothing and can make a real different to the recipient. It can make a difference to many walks of life – be it personal or professional. It’s a proven fact members of the opposite sex are attracted to a great smile. Studies into smiling, laughter and generally feeling happy suggest they can have a positive effect on your physical and mental health. If you don’t look after your oral health, one of life’s great intangibles could suffer.

Speaking of attraction, there’s nothing worse than talking to someone with bad breath. It’s a complete turn off and can often lead to lower self-esteem. National Smile Month is the perfect opportunity to do something about it. The smell is caused by gas producing bacteria on teeth and on the tongue, so taking better care of your teeth and removing plaque can really help the quest to rid you of bad breath.

Gum disease and tooth decay are the two biggest reasons to keep up good oral health. In fact, around a third of adults and children still have tooth decay in the UK. Both are entirely preventable, but they’re also very common. Gum disease is the largest cause of tooth loss in adults, and it’s something you’re likely to get at some point in your life. 

So there really aren’t any excuses to not to improve your oral health. The best way to do it – a visit to the dentist.

observations on Alcohol Consumption

At all dental practices we have to ask our patients about their general health, what medications they take (in detail), and any health problems or allergies they may have. We need this information as most medical problems and medications are relevant to dentistry. The relevance is not always obvious so we have to ask that our patients give us full and honest information.

One of the questions we ask is ‘how much alcohol do our patients drink in a week in units?’ We ask this as alcohol is a risk factor for mouth cancer and because dentists are well placed to offer advice on reducing alcohol consumption. The amount we drink is always a tricky question, as many people drink sporadically, maybe having a few drinks one week and none the next. Also alcohol units are often confusing. A 125ml glass of wine at 10% alcohol was considered to contain one unit. However glasses of wine now are often 250ml (1/3 of a bottle) and are 14% alcohol which is 3 units!

Perhaps the most striking observation made whilst medical histories are being taken, in the first quarter of 2013, is that an increasing number of patients are telling us that they have reduced their alcohol consumption. This is the first time we have seen a general trend of people reporting that they drink less than they used to.

What’s even more interesting is to consider what might be happening. Either people are drinking less and therefore honestly reporting that they drink less. Or people are continuing to drink the same amount but are reporting that they drink less. I suspect it is a little of both. The constant media coverage of binge drinking and the problems of drinking, all part of the “nudge agenda”, are possibly having an effect. But is the effect on alcohol consumption itself or just on reporting of alcohol consumption? A recent BBC news story ( reported on a study which compared the amount of alcohol people said they drink to the amount of alcohol sold. They found that there was a significant discrepancy between the two figures of “almost half” suggesting under-reporting of 40-50%.

In any case our advice would be if you wish to, drink alcohol responsibly, aiming for no more than 3-4 units per day for men, and 2-3 for women. Also try to have at least a few days each week, when you have none at all. If you can reduce your alcohol consumption then do so, you’ll potentially be healthier and wealthier.

See more information on our website

New website features added

Many thanks to everyone who has viewed and commented on our new website. I am very pleased to say it is going down very well. April showed we had 500 unique visits and 3400 hits.

So what’s new?

  • We’ve added a google map and updated our information with google. So you can find us easily.
  • We’ve added a resources section to the site where you can download the information leaflets that we use in our practice on a variety of topics from having less tooth decay to what a crown is and how it works.
  • We’ve added to our resources section a live feed from our powerpoint based display screen system in our waiting rooms. This has been in operation for around 5 years now providing information to our patients for the short time when they are waiting to be seen. If you missed any information you can view it on the resources section.
  • We are continuing to update our blog.

If there is anything you want to add about our site then please either leave a comment on our blog here or email us.


If you have had an accident and you’ve received a blow to/near your mouth – it is very important to get checked out promptly.
-If your accident was serious, you have lost conciousness, been sick or you think any bones are broken then you should go to a hospital A&E department straight away. Once the hospital give you the all clear then you should see your dentist.
-if your accident was less serious you should visit your dentist within 2-3 days of the accident to get checked over. Your dentist will take some x-rays and test your teeth to make sure they are healthy.

Injury to the teeth can cause problems much later on (even up to 10-20 years later) which are more manageable with early diagnosis and treatment.
Injuries to teeth can include chipped teeth, cracked teeth or teeth knocked out,

If you have knocked out a tooth….
-if possible put the tooth back in the socket in the gum and go immediately to a dentist.
-if it is not possible to put it back in the socket put it in your mouth or in milk and go to a dentist
-DO NOT put the tooth in any chemicals/cleaners.
-DO NOT scrub the tooth with any brushes

Most dental injuries/problems can be managed easily. It is far more difficult to solve these problems if they are ignored and left for long periods of time. We are only too happy to check out any potentially injured teeth, in most cases we can offer reassurance that the teeth are healthy.

Visit our website for more information.



Northway Dental Practice has been serving the local community of Midsomer Norton, Radstock, Peasedown St John, Paulton and the surrounding area since at least 1967.

Looking back through some old practice records we were always aware that the practice has been caring for the teeth of people in the area for a long time. Many of our patient records begin in 1967 when the practice was formed by Edward Shaw and John Redmond-Lyon. Andrew Keys-Toyer joined them later and the three dentists ran the practice for over 35 years. The three original founders have since retired and now the practice is under the direction of Gareth Davies and his team.

Many changes have occurred since that time, in terms of the décor, the treatments on offer, the comfort and modernity. We have had a few staff changes, although some of our staff have been with us for 3 decades.

Our aim is to continue to improve our service into the future by responding to the needs of our patients.

Find out more at our website


After many years just a very basic webpage with our contact details on, we are pleased to present our new website.

Aimed at being a way of helping people find us, we hope it will also be a way we can provide useful information about healthy teeth & gums, and brighter smiles.

We will add information here about new techniques, materials, oral hygiene, cosmetic procedures and oral health promotions such as national smile month.

If you have any suggestions about anything to do with our site then please email us and let know, or reply to our blog.