Archive for April, 2011

How often should you have a dental check-up?

Tuesday, April 26th, 2011 by admin

The owner of a London dental practice talks about the subject of dental check-ups: how regularly should you return for one?

Earlier this month (April 2011) there was much media coverage given to a government warning that many dentists are advising patients to come back for check-ups far sooner than may actually be needed.

The warning comes seven years after health watchdog NICE recommended that traditional six-month dental check-ups for adults should be brought to an end.

In 2006, government guidance endorsed the view that it was safe for most patients to have a recall interview just once every two years.

However, newly-released Department of Health figures suggest that 71 per cent of NHS patients are called back to the dentist’s surgery within nine months.

In the period April to September of last year, 13 per cent of these patients returned within three months.

Reminder

The figures prompted England’s chief dental officer to send a letter to all dentists to remind them of the NICE recommendations.

The health watchdog still recommends that the shortest interval between oral health reviews for all patients should be three months. It believes that the longest period should be 24 months.

But a British Dental Association spokesman, commenting on the issue, said: “Many patients want to be seen more regularly.”

Private London dentist Ethicare has a policy that “examinations should only be carried out when needed”. Its website states that check-ups should “not necessarily mean every six months but instead the interval should be tailored to a patient’s individual requirement”.

We asked Glafcos Tombolis, who runs the practice with his wife Klaudia, about the issue of dental check-up intervals.

Question: “How do you determine when a patient should come back and see you for another check-up?

Glafcos Tombolis: “It depends on the oral health of the patient. We do carefully consider the state of a patient’s mouth before recommending when they should next return.”

Q: Do you have a formal check-list or ‘points’ system to determine when a patient should come back?

GT: No, there are just too many variables to take into account to compile a check-list – for instance consideration of patient’s history of decay and their dietary habits. We evaluate on a case-by-case basis.

Q: So, there’s no ideal one-size-fits-all check-up interval?

GT: No, sometimes it might be appropriate for a patient to be seen every three months. But if a patient’s mouth is free of decay then coming back in a year or even two years’ time could be fine. Sometimes, preventative measures such as an appointment with one of our hygienists can be more beneficial than a dental check-up as it keep bacterial levels low.

Q: On average, how often do patients come back to see you?

GT: 6-12 months tends to be the average check-up interval.

Q: Are patients’ financial considerations taken into account when you arrange the date for them to have their next check-up?

GT: Yes, we are always happy to give patients a clear idea of how much treatment will cost and how it will help them – we fully respect that it is the patient’s prerogative to accept or reject our recommendations.

We also try to offer affordable treatment which gives patients the options of making regular monthly payments so that they can spread the cost of their dental care over a year. For instance, the Ethicare Dental Plan bronze plan includes one consultation per year and two hygiene appointment, our Gold Plan offers two consultations per year and four hygiene appointments.

Q: What happens if someone doesn’t come back for a check-up for a few years, do they have to re-join?

GT: No, you won’t be de-registered after a fixed period of time and we know that long gaps between check-ups can mean that people forget the date of their next appointment, so we send out text reminders and e-mails.

Interestingly, Glafcos has heard little anecdotal evidence from new patients that their old dentists had asked them to come back for check-ups more often than was necessary.

Could it be time for the 2004 NICE recommendations about dental appointment intervals to be given another check-up?


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How to keep your teeth clean on holidays

Monday, April 18th, 2011 by admin

Holiday

Steps to take before going on holiday, dental products to pack in your suitcase and tips to keep your teeth in tip-top shape while you relax

With the early advent of warmer weather more of us will be thinking about packing a suitcase and going on holiday. Getting away from it all can mean indulging in mouth-watering delights – eating and drinking to our hearts’ content.

But going on holiday doesn’t mean that you should take a break from looking after your teeth’s health.

It is especially important to seek some pre-holiday advice from your dentist if you have recently had treatment which might make your teeth a little more sensitive than normal – for instance after having Zoom Teeth Whitening. London dentist Ethicare offers this treatment and its dentists are always happy to offer advice to patients who have whitened their teeth with a view to looking great on a beach holiday.

Many people clearly value looking after their teeth while on holiday – a 2009 survey of over-50s holidaymakers by Staysure.co.uk found that only two per cent could do without a toothbrush. (Five per cent were not bothered by going without underwear and 9 per cent viewed deodorant as non-essential!)

Before you go

Long before you go to the airport check-out gate you should have a dental check-up. Plan to go to your dentist about 12 weeks prior to departure and have a check-up.

This allows your dentist ample time to do fillings and get your teeth in great shape before you go on holiday.

During the check-up, when your dentist is engaging in small talk it is well-worth mentioning that you are going travelling as this can prompt your dentist to treat your teeth straight away rather than monitoring them.

Seek advice from your doctor on what action to take should existing dental issues re-appear on holiday.

Check out your travel insurance before you go abroad since emergency dental work is not cheap. Most insurance policies will only cover you for treatment involving the “relief of immediate pain”; cosmetic treatment involving fixing cracked crowns is not normally included.

Things to pack

Those over-50s we mentioned earlier in the article were right – a toothbrush should be the first item you think about packing. If you’re worried that they will take up too much space in your suitcase then think about investing in a travel toothbrush – they often can be split in half so that one part can be put inside the other.

A Tube Toothbrush Protector is also a good travel buy – it can stop your toothbrush leaking everywhere in your suitcase and will also prevent your toothbrush from being squashed until it is out of shape.

A dental first aid kit should be viewed as a last resort and only used if you can’t access a dentist. Typically they include items such as clove oil, temporary tooth filling, spatulas and adhesives – all items which are best used by professionals!

Dental floss – removing the food and plaque between teeth can help to prevent bad breath; essential if you are looking for a holiday romance! Dental floss also has other handy purposes; many travel site comment boards mention that they can be used to hang mosquito nets and hammocks and repair tents.

Pain relief tablets and bottled water – are also worth taking with you (please see later in this article).

While on holiday

In some destinations it might not be safe to use tap water. In such places it is best, if possible, to use bottled water to rinse teeth after washing.

If you do experience tooth ache while on holiday – then avoid very hot, very cold and very spicy foods. Curries and ice creams might have to be ticked off your holiday eating list. Pain relief tablets can alleviate the worst discomfort.

Hopefully, these tips will ensure that your teeth will look shiny and healthy when you have the holiday photos developed. Always remember to ask your dentist for advice if you have any doubts about holiday dental issues.

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Are you happy with gappy teeth?

Monday, April 18th, 2011 by admin

Gappy teeth

How widely do attitudes to ‘Diastema’ vary? And just how effective are modern treatments aimed at reducing the gaps between front teeth?

Question: what do Elton John, Madonna, Condoleezza Rice and Chaucer’s fictional The Wife of Bath all have in common?

Answer: they all have (or had) ‘Diastema’ – a noticeable gap between the two front teeth.

For the likes of Elton John and Madonna, the gap became a bit of a trademark.

But for those of us who don’t want to have a gap between their teeth, different types of treatment are available – including porcelain veneers, composite bonding and the clear braces manufactured by Invisalign. London dentist Ethicare has helped many patients seeking these forms of treatment.

Attitudes around the world

Attitudes to gap teeth vary from culture to culture. In Nigeria, gap teeth often signify wisdom, beauty and fertility while in France they are called dents du Bonheur (‘lucky teeth’).

The model look

Today, models Lara Stone and Georgia Jagger have taken to the catwalk and won praise for their natural gap-toothed. On America’s Next Top Model reality show, a judge controversially suggested that one of the contestants should  even consider a visit to a cosmetic dentist to “exaggerate the gap between her teeth”.

Some people don’t need to exaggerate the gap – gap teeth can be caused by factors such as tooth size discrepancy and genetics (Mick Jagger’s genes might explain Georgia Jagger’s Diastema).

Glafcos Tombolis, who runs London dental practice Ethicare with his wife Klaudia, stresses that gap teeth is mostly an aesthetic issue – it doesn’t tend to cause patients any dental health problems.

3 ways of reducing the gap

  1. Treatment involving Invisalign Braces is often favoured by Glafcos and his team when they are realigning teeth with gaps between them. As Invisalign Braces are clear, comfortable and easily-removable, you can remove the gaps without having your lifestyle cramped.
  2. Cosmetic porcelain veneers are also a great, reliably predictable way of correcting spacing issues. These veneers are constantly getting thinner, keeping removal of tooth structure to a minimum.
  3. Over the past 20 years, composite bonding has become a viable alternative to braces and veneers when it comes to realigning teeth. Composite bonding works by using white filling material to reducing gaps – one of its many advantages is the ease with which it can be repaired and added to.

Retainers

Patients are naturally concerned that the gaps should reappear after orthodontic treatment but the correct use of removable, clear retainers will ensure that this isn’t an issue.

Length of treatment

“How long does it take to correct gap teeth?” is the question on many patients’ lips. Dr Tombolis of Ethicare says: “The answer naturally depends on the extent of the gaps involved. Sometimes it takes a year but often it takes as little as a month.”

With treatments such as Invisalign, porcelain veneers and composite bonding now available, there are happily plenty of options open to people looking to have the gaps between their teeth reduced.

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Find out some more about Invisalign Clear Braces

Monday, April 4th, 2011 by admin
A London dentist reveals some things you might not know about Invisalign Clear Braces, including: the age range which favours the treatment, how you can track whether a teenager is sticking to the Invisalign schedule and why the treatment can help your dental hygiene and not just your appearance

You might think that you don’t know anyone who wears Invisalign braces. But because, they are clear, discreet and easily removable it might well be that you just haven’t noticed that a friend or relative is sporting them.

The results they get – when correcting crowded, overly-spaced or crooked teeth – are certainly noticeable.

Because these braces are so unobtrusive they perhaps don’t get the amount of attention they deserve. How can the treatment realign teeth in just a year when traditional braces take far longer to do this?

Too good to be true? Is this the case with Invisalign?

London dentist Ethicare, which is run by Glafcos and Klaudia Tombolis, has been offering the Invisalign treatment for some time.

The Ethicare website has a comprehensive section about Invisalign; below are a few more questions and answers about the braces which have been used by almost 2 million people worldwide.

How many people are suitable candidates for Invisalign treatment?

Glafcos says that an average of “about four or five people” per week come into the practice for the consultation which determines whether they are suitable candidate for Invisalign treatment – the vast majority are.

Occasionally, people with “complex” dental issues – for instance, they might need teeth removing – might find that this procedure is not appropriate for them. These people can be referred to an Ethicare orthodontist who can recommend alternative treatments.

Does the popularity of clear braces spell the end for more traditional metal braces?

Glafcos revealed that a lot less people are opting for metal braces now that clear braces are an option. He said: “Metal braces just aren’t as discreet as the clear braces used by Invisalign.” Ceramic braces can still be used by patients who don’t want to have metal in their mouth.

Who is the typical Invisalign customer?

At Ethicare, the typical Invisalign customer is a lady aged 25 to 50 but the clear braces have proved popular with men too. Glafcos says: “With the relatively new Invisalign Teen brace product we do get quite a few patients aged about 14 to 18 fitted with the clear braces.”

How do teens generally react to the idea of wearing braces? Do they prefer clear braces to more noticeable metal braces?

Glafcos acknowledges that teens, like all patients, should only wear braces that they are comfortable with.

It seems that tastes vary as Glafcos says: “We had a teenage patient recently who was really quite proud to have metal braces fitted.” (Perhaps this patient was happy to stand out in the crowd or maybe their peers all favoured metal braces!)

Other teenagers can be quite self-conscious about their appearance and so the idea of easily-removable clear braces which don’t cramp their lifestyle inevitably appeals.

According to YouTube Invisalign promotional footage, some American dentists quiz teenage patients to find out whether they are likely to lose books, contact lenses etc. as this will evaluate whether they are likely to lose the braces! Does Ethicare also take this line of questioning?

Glafcos says: “With the Invisalign Teen treatment, the aligners have ‘markers’ so that you can see whether a patient has been wearing them and how long they have been wearing them for.” (You have to wear each aligner for about a fortnight, before moving on to the next one).

With the adult Invisalign braces, no such markers exist – but people who don’t use them properly know that they won’t see the benefits.

Are Invisalign braces just a cosmetic product? Can they improve dental health as well?

The answer seems to be yes as studies have shown that having the braces can even improve your dental hygiene during treatment.

Many people wear the braces to realign teeth which are too crowded or too widely spaced.

Glafcos says:  “Spacing is normally just a cosmetic issue but crowding among the teeth can cause cleaning and flossing difficulties so realigning teeth, in this instance, isn’t just a cosmetic issue.”

Have there been any new developments in the world of Invisalign recently?

Invisalign Anterior (which used to just treat the front teeth) has now been cancelled. However, Invisalign Lite treatment, which is for mild (rather than pronounced) misalignment, has been introduced.

Glafcos says: “Invisalign Lite can be a great option as it’s cheaper than the Invisalign Full treatment, which although it treats all of the teeth in the mouth, isn’t needed by every patient.”

The news that newer, cheaper Invisalign Braces are appearing on the market is good news for the many people who are considering getting this innovative new treatment.

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Tooth whitening – a Q & A session with an expert

Monday, April 4th, 2011 by admin

How white are your teeth?

Some questions about tooth whitening you were too afraid or too embarrassed to ask

Supermarket shelves are groaning with tooth-whitening products such as gel strips, home-whitening kits and whitening tooth pastes.

Without expert advice it is hard to know when it is appropriate to use home whitening and when it is best to use ‘at-the-dentist’ procedures such as Zoom Teeth Whitening.

London dentist Ethicare is one of many practices which offers Zoom – a process which involves spending about 90 minutes in the dentists’ chair, with the Zoom Lamp activating whitening gel which has been carefully applied to your teeth.

Ethicare can also advise and supervise home-whitening schedules for patients, so who better to speak to for advice than Glafcos Tombolis, who runs the dental practice with his wife Klaudia?

Question: Glafcos, have you had tooth whitening yourself?

Glafcos Tombolis:Yes, about five years ago. I had home whitening which was very good and Zoom in-office power whitening which was fantastic. Having a combination of the the two treatments together had a ‘multiplier’ effect – far more effective than just having one type of treatment in isolation. I did experience some sensitivity afterwards, so I know how patients feel; but the end results were worth it.

Q: How many people are not suitable for tooth whitening?

GT:Most people are suitable for tooth whitening, but it is essential to evaluate whether you need treatment before starting the whitening process. Teeth with existing fillings and crowns won’t whiten – you might need to have dental work done before you have tooth whitening.

Q: Do you have a shade chart you offer patients before they undergo a whitening procedure – so you can choose a shade for your teeth in the same way that you choose a wall-paint colour?

GT: Yes we do take a shade before starting and it’s often very satisfying to show patients the finished result when whitening has been completed. Some people take to tooth whitening far more easily than others; some forms of discolouration are more responsive to teeth whitening. You can have a husband and wife undergoing the same tooth-whitening procedure and one takes to it far better than the other.

Q: What home whitening treatments would you recommend?

GT:Ones which are carried out under supervision. Expert advice can ensure that whitening trays fit your mouth properly and won’t expose your gums to harmful contact with gel. Super-sealed trays are great as they keep saliva out and lead to a more even whitening effect. Trays with specific loading points are also useful.

Q: Is tooth whitening a procedure which is constantly getting more sophisticated and effective or has it remained largely unchanged recently?

GT:The materials have remained the same but the process is getting fine-tuned all the time; further improving patient care. For instance, the Zoom Advanced Power lamp machine has been tweaked so that patients have far less sensitivity issues immediately after using it, compared to the original zoom lamp.

Q: Are there any products which should be avoided?

GT: It is best to bear in mind that chemists cannot sell products where the concentration of teeth-whitening hydrogen peroxide is too high. This means that, in order to comply with these regulations, the home kits found in chemists aren’t that effective. The products that they do sell can be acidic – causing enamel to be damaged and destroyed. Always seek expert advice before investing in home whitening materials.

Q: What do you think about tanning salons and other outlets which don’t have dental expertise offering whitening procedures? Some dentists in some states in the USA believe that only dentists should offer whitening treatments.

GT: You should avoid these tanning salons for tooth whitening procedures. They may be cheap, but tooth whitening procedures should be carried out by a trained dental professional. The General Dental Council has produced statements that non- dental professionals should not be allowed to offer specialist whitening procedures.

It’s worrying that places like shopping centres don’t offer initial consultations before carrying out tooth whitening. An initial consultation is vital to ensure that teeth and gums are in a healthy enough condition to undergo teeth whitening.

People with stained or tartar-covered teeth, as well as people with gum disease, should receive treatment before they have teeth whitening. You need a proper check-up before undergoing teeth-whitening and yet shopping centres don’t have the facilities to carry this out.

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Ethicare’s round-up of March 2011’s best dental news

Monday, April 4th, 2011 by admin

One per cent of us never use a toothbrush

Which member of Girls Aloud has just had cosmetic dental work done? How many Brits never use a toothbrush?  Why is brushing your tongue so important and what links Genghis Khan with running a dental surgery? Find out by reading Ethicare’s round-up of March’s best dental news

Girls Aloud singer gets a tooth makeover

Nicola Roberts of the all-girl pop group Girls Aloud has good reason to be smiling so much these days. According to Now Magazine, Nicola (the pale, ginger lady in the band) has spent £13,000 on having her teeth whitened. An unnamed friend told Now that Nicola has had veneers fitted after wearing clear braces of the type produced by Invisalign.

London is the most likely place for the star to have received her treatment; the source revealed that band mate Cheryl Cole advised Nicola to get the work done.

The before-and-after photos certainly prove how successful the makeover has been.

Adult Dental Health Survey

The second set of results from the once-a-decade Adult Dental Health survey contains good news and bad news. The good news is that ten per cent of British adults have “excellent oral health”.

It is also heartening that the proportion of British adults with no natural teeth has reduced dramatically since 1978 when 28 per cent of Brits were toothless.
Today just six per cent of the adult population have no teeth.

The bad news is that one in five of us have postponed vital dental check-ups and treatment because of financial worries.

Alarmingly, only three out of every four adults brush their teeth the recommended twice-a-day. One per cent claim to never use a toothbrush.

Over one in ten (12 per cent) admitted to suffering “extreme anxiety” about the prospect of having their teeth drilled or having an injection administered into the gums; a good reason why dentists like Ethicare have created nervous patient programs.

Tooth loss ‘increases the risk of a stroke’

How many teeth have you still got in your mouth? Adults should have 32 teeth and a new study suggests that if you’ve got less than 24 you are 60 per cent more vulnerable to having a stroke.

Researchers at Hiroshima University in Japan looked inside the mouths of 358 patients and found that stroke patients in their 50s and 60s had considerably less teeth than patients who hadn’t had a stroke.

Brush your tongue!

Other Japanese researchers, this time at Nippon University, have been looking into another dental issue: whether bad breath originates from the mouth or the tongue.

Somewhat surprisingly, they found that many types of bacteria are more likely to produce poor oral odours if they live on the tongue rather than the mouth – in fact, some only cause bad breath when they occur on the tongue.

It is easy to forget to brush your tongue but reading the report, which has been published in the Odontology journal, serves as a good reminder that teeth aren’t the only thing that needs brushing!

Dentist wins oddest book title of the year award

And finally, a book called ‘Managing a Dental Practice the Genghis Khan Way’ has won the prize for having the oddest book title of the year.

Author Michael R Young wrote the book to highlight how the leadership techniques of 13th century Mongolian warlord Khan can be successfully transferred to the 21st century art of running a dentist’s practice.

Mr Young does not suggest that dentists should ensure their surgery run smoothly by massacring entire civilian populations and invading Central Asia and China. But he does believe that Khan (were he still alive) would have a lot to teach dental practices about team building, managing conflict situations and planning for disaster.

Previous winners of the prize have included The Joy of Chickens (1980), Oral Sadism and the Vegetarian Personality (1986) and Living with Crazy Buttocks (2002).

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