Air Abrasion Dentistry

Many thanks to Dr Gardee of GlasgowSmileClinic.co.uk for this informative article on a new technique to us. Dr Gardee is one of Glasgow’s foremost dental implants dentists, and this article covers a new technique for nervous patients.

Some dentists in Glasgow and beyond are using a new technique called air abrasion which allows them to remove tooth decay without using a drill. Effectively air abrasion tools work like a small sand blaster, spraying away dental decay. Afine spray of aluminium oxide particles is blasted into the decayed part of the tooth and a suction tool removes the debris as it comes away.

The advantages of air abrasion are many – there is no drill noise, ( there’s not really any noise), there is no heat generated, no pressure and very little vibration. Air abrasion requires less anaesthesia and also leaves more of the healthy tooth tissue untouched. The mouth remains dry throughout the process which helps with the placing of composite fillings, and multiple sites within the mouth can be targeted with a single patient visit. There is a also a reduced chance of splitting or chipping the patients’ teeth.

The disadvantages – the procedure can be a little painful for the patient, especially if there is a sensitivity issue, and air abrasion is not recommended for deep cavities. The other drawback is that only composite fillings can be used following air abrasion because the surface left behind is so smooth.

Air abrasion is a great new technique for patients with a dental phobia or for children who may be frightened by the noise of a drill.

Air abrasion can also be used to remove old composite fillings or to prepare a tooth for sealants or bonding procedures.

Just a footnote here to someher other health related musings over on our other page.

Glasgow Private Investigators Did A Great Job

Vaguely health related, well certainly dental health related story of what happened in Glasgow a couple of months ago . We had a friend visiting from Canada, and we decided to go into Glasgow city centre for a night out one Saturday night. We had a great time, but were unfortuanate to be attacked on our way home. We were wandering along Argyll street looking for a taxi, when we were jumped by a couple of guys who took our phones, wallets and for good measure assaulted my Canadian pal, who had to go to hospital after having a couple of his teeth punched out.
When his parents found out about it, they went ballistic and after some research they decided to get the guys at www.veritas-investigations.com to try and find the morons who attacked us. I guess if you’re private investigators Glasgow is a bit of a goldmine with a load of business coming in every Monday morning after the mayhem of the weekend.

Anyway, cut a long story short, Veritas Investigations had a result for us in four days !  Four days after we contacted them, we had the name and address of one of the guys who had attacked us. Not only that, Veritas had managed to obtain CCTV footage of the attack, which will be admissable in court.  We went to the police and they arrested the guy, who has now been charged. We didn’t get our money back (yet) but at least we got the guy. I can’t thank Veritas Investigations enough, all their investigators are ex police detectives, so they obviously know what they’re doing. They were polite, professional and discreet. A really big thumbs up from me and my pal.

What is a Cosmetic Dentist ?

What does a cosmetic dentist actually do ?

The simple answer is that he or she is a qualified dentist who can perform dental work which will improve the appearance of your teeth and smile although it is possible that the actual function of your teeth is not improved greatly. In many ways, the term “cosmetic” used in this context, refers to an “on the surface” improvement. However,  some cosmetic dentistry procedures do have a tremendous impact on the performance and function of your teeth. Many thanks to our friends at Dentalfx.co.uk for their input to the following :

There can be no doubt that cosmetic dentistry is more popular and fashionable than ever before with many people desiring “Hollywood” smiles . This has produced an unprecedented demand for cosmetic dental procedures and Dentalfx in Glasgow are at the forefront of many advanced techniques. Let’s take a look at a few of the terms contained under the umbrella of the term “cosmetic dentistry” :

Dental crowns

- also known as dental caps, can be made out of resin, metal or ceramic material and completely cover an existing tooth, giving a far better appearance . These are usually placed when a patient has a discoloured or poorly shaped tooth problem, or a weakened tooth or teeth. Dental crowns are also used widely to restore broken and worn teeth or to hold a dental bridge more firmly in place , and are also used in dental implant and root canal treatment. Dental crown treatment may require a couple of visits, and may appear relatively expensive, however they can last a very long time with good maintenance.

Teeth whitening

is the single most popular form of cosmetic dentist treatment on the planet. Basically, over a period of time, the surface of the teeth become discoloured due to the effects of heavily staining food and drinks, smoking and also some medications people take which have teeth discolouring side effects. Although many cosmetic dentists now perform laser whitening, at Dentalfx the procedure is still one where a custom mouthguard is manufactured and a prescribed amount of teeth whitening solution is applied over a period of time into the mouthguard and onto the teeth, all of which can be done at home, and usually results in an excellent outcome. Stephen Jacobs, the lead practitioner at Dentalfx Glasgow, is not yet convinced as to the safety of the laser whitening procedure and therefore prefers to dispense the “old fashioned” teeth whitening trays and solutions, at least until the evidence is more robust for the laser treatment.

We will continue an analysis of cosmetic dentistry procedures in another post in the future.

Dental Implants Process

While many people have heard of dental implants, very few people know much about the actual process involved so we produced the following article courtesy of  dental practice www.orthodontistglasgow.org

First of all, the good stuff !

Dental implants are the best way of replacing lost teeth and are almost universally recommended for patients who fit the profile for having implants placed. Essentially, the implant is screwed or gently tapped into the jawbone and replaces the original tooth root. Modern implants actually merge into the real jawbone and become a part of it, meaning the dental implant is rock solid and should give many years of excellent service. Properly placed implants will help to save adjacent teeth, because additional stress is placed on these teeth when you have gaps due to lost teeth, so you protect your natural teeth from even more losses. Patients report much easier chewing and more confidence in smiling and eating after having the procedure, and there’s no doubt that patients experience is much improved – you must have heard peoples’ dentures clicking or slipping when they speak ? Well, there’s zero embarrassment when you have dental implants placed. Also, they look really good !

Now on to the actual process itself ….

Implant placement can take anywhere from 6 weeks to 6 months depending on the individual patient and the number of implants required. You will have an initial visit where the dentist will do an assessment as to your suitability for the treatment. This visit will involve a dental xray and also a CT scan if required. At this visit, an impression of your jaw may also be taken.

Assuming you are suitable for the dental implant procedure, then the next stage will be to discuss the anaesthesia, which will take the form of local, sedation or general anaesthetic. With the information from the first visit available, the dentist will now know if any bone grafts are required. If so, a general anaesthetic will be necessary. If it is a “straightforward” procedure not involving bone grafts, then the dentist will administer a local anaesthetic – you should not eat or drink for around 4 hours before this and it is probably advisable to have someone on hand if you need a lift to get home afterwards. The most used procedure involves two steps : In the first stage, a small screw or tap will be placed into your jawbone. This is effectively a new tooth root, and will become the base for the crown to be attached in the second part of the process. The dentist drills a small hole into the jaw and places the implant into the hole. The incision is then closed and the jaw is given time to heal, perhaps up to 3 months. This allows the dental implant to fuse to the bone.

The next stage is the restoration – the dentist will reopen the incision, and fit a small collar on to the implant called an abutment. The crown or replacement tooth is then attached to the abutment. Depending on the scale of the work involved, a single tooth or a bridge or denture can be attached. Finally, there will be regular check ups in the post- implant period to monitor your progress.

 

Cosmetic Dentist Glasgow Innovation

We’ve noticed a really interesting facility built into a Glasgow dental website which allows people to make, change or cancel dental appointments without phoning a dental receptionist. Basically, the facility, called Appointmentor, is an online booking system which you can use not only from desktops and laptops but also from mobile devices. I guess if you’re a cosmetic dentist in Glasgow or maybe you can perform specialist treatments like Veneers Glasgow is becoming a real city of dental innovation and advancement. Certainly worth keeping an eye out for more dental software coming along.

Cosmetic Dentistry

A very interesting article courtesy of Dr Jameel Gardee of the Glasgow Smile Clinic – if you are looking for quality dental work such as  dental implants Glasgow appears to be one of the top places in the UK for cosmetic dentistry :

In order to complete exceptional cosmetic dentistry that follows the perfection of nature and in addition provides ultimate patient satisfaction, it is necessary to have a holistic approach to smile design and its treatment process.

Dentistry in this field that takes into account only the clinical treatment of the teeth has had some degree of success, but in many cases falls short of achieving the optimum aesthetic effect, primarily due to the fact that other vital components of the smile were not – or were only superficially, considered.

The cosmetic dentists objective is to create a beautiful smile, not just beautiful teeth 1. This can only reach its end point by starting off with a comprehensive evaluation and analysis of the different factors that play a part in the smile, such as facial form, lips and gingivae in addition to the teeth 2 .

Treatment in this holistic manner also allows those undergoing this type of work to be treated with a greater quality of care and provides information to the patient before commencement about those aspects of the smile that may have a deleterious effect to the final cosmetic result if not treated or at least considered. This in turn gives some protection to the dentist 3 as the majority of those seeking cosmetic dentistry may only expect the teeth to be manipulated to provide the result that they are hoping for, being unaware of the importance that the lips and soft tissue play in a beautiful smile. Keeping patients informed about this will lead to more realistic expectations and a greater satisfaction with the cosmetic outcome, with greater predictability comes a greater peace of mind. Unfortunately when this is not done, disappointment may necessitate re-treatment in some cases leading to further costs, time and effort.

Davis in his seminal article on smile design proposed that the successful creation of beautiful smiles requires “artistic skills as well as technical skills” 1 . These artistic skills involve training the eye to see the smiles unseen or overlooked aspects and improving them to make the smile even better. The hard and soft tissues of the teeth and gingivae between the borders of the lips make up the “smile zone” and are in effect the “canvas”of the dental artist. The balance and symmetry between these structures is what cosmetic dentists must evaluate and learn to manipulate to achieve the optimum aesthetic effect 4.

The cosmetic dentist should view things differently from the general dentist. By paying attention to the finer details of the smile which are often hidden to the untrained eye, and improving those aspects, them masterpieces may be created.

Davis further described that artists would look at the canvas and see the hard and soft tissues representing POSITIVE SPACE (light areas ie. the teeth) and NEGATIVE SPACE (dark areas ie. gingivae, space between teeth etc) respectively. Viewing the dental structures in these terms allows the dentist to reshape the positive and negative areas to compliment the shape of the smile zone and as a result bring equilibrium to the smile 5. Ideally the marginal gingivae should be symmetrical right and left, with the lateral incisor zenith about 1mm below the central incisors and canines zenith. The upper limits of the central and canine should be balanced with the internal border of the upper lip as well. The Smile Line which is an imaginary line that follows the incisal edges of the upper anterior teeth should be in harmony with the internal border of the lower lip 5.

The balance of positive and negative space can be shifted using cosmetic re-contouring or cosmetic restorative procedures to adjust the level of the soft tissues, alter tooth form, fill in space and even fill in the buccal corridor 1 .

Achieving this level of cosmetic excellence requires the whole, the parts and the details of the smile to be viewed respectively 6 and to accomplish this the dentist must learn to view his subject from an artists perspective. To aid this process, especially to the untrained eye, digital photography and various imaging softwares may be used. This will allow the dentist to closely examine the relevant components of the smile and train their eyes artistically.

There are many structural aesthetic rules relating to facial form, lips, gingivae and the teeth 5 which are beyond the scope of this article to detail fully. However an appreciation of these in relation to an artists perspective to smile design may be gleaned from the following case studies which have been completed using the principles already described.

CASE 1
A young woman presented, complaining about the unsightly appearance of two old anterior crowns relating to teeth 11 and 12 (Fig 1). She also wished to improve the rest of the smile zone to make it more ideal cosmetically. After a thorough history and full examination (including radiographs, photographs, study models etc), smile evaluation was conducted. When viewing the computer shaded images as part of the evaluation, certain noteworthy findings were recorded and are detailed below :

1.Facial form was charted as being of an Ovoid variety.
2.The smile zone shape was eliptical in nature with an average depth. The upper lip was slightly thin with a slight asymmetry on the patients right side (Fig 2).
3.The positive space did not fill the smile zone and the teeth were generally uneven and misshaped. The right and left sides of the smile zone were asymmetrical particularly due to the worn and rotated canine 13, longer lateral incisor 22 and slightly deeper incisal embrasure between the 14 and 13 (Fig 3). This image also made the excess amount of gingival tissue visible more apparent.
4.Close examination of the gingival tissues in Fig 4 revealed a “gummy smile” with oedematous tissue related to the 11 and 12 probably due to invasion of the biologic width during provision of the unsightly crowns.

After these findings were communicated to the patient, she decided not to proceed with correction of the lip discrepancies but was happy to continue with treatment to address the imbalances in the positive and negative spaces.
A facebow record and bite were taken. From this, a functional diagnostic wax up to golden proportions was completed to include crown lengthening which would help establish proper size, symmetry and proportion of the teeth.
Once the crown lengthening had been done, provisional prototype restorations based on the wax up were placed to further help shape the soft tissue, check occlusal forces and allow a preview of the final result which could be adjusted until the patient was satisfied with the cosmetic appearance. The tissues were then left to heal. Finally two Empress crowns (Ivoclar Vivadent) and four Empress veneers were placed on the six upper anterior teeth and the upper premolars reshaped by stoning. A maxillary occlusal guard was provided and the final “after” photograph shows the completed case with the smile now balanced in the smile zone (Fig 5).

CASE 2
In the second of the two cases a similar complaint presented. However, no violation of the biologic width with the old restorations had occurred and instead there was exposed margins related to the 11 and 21 (Fig 6). The patients facial form was charted as square/tapering. It is worthwhile noting the facial form, as a pleasing shape and tooth form to be used in the final restorations can be identified easily when a Trubyte Tooth Indicator guide (Dentsply) is used at the same time (which can be of use to the Dental Technician in some cases).
Upon examination of the computer shaded images, salient points noted included :

1.Smile zone shape was of a straight/rectangular variety with an average depth. Lip thickness was full and symmetrical (Fig 7). Excess soft tissue from the oral mucosa presented in the smile zone especially above the central incisor region and lip commissure areas. The buccal corridor was charted as narrow.
2.Positive space did not occupy enough of the smile zone (Fig 8). The lateral incisors were short and the 22 in particular was darker than the rest. Exposed root dentine was evident on the 11 and 21. The canine 13 was longer than the 23 affecting the balance of the smile and the gradation effect of the premolars posteriorly was excessive. The lower anterior teeth were crowded and tilted.
3.A large amount of negative space caused by too much displayed gingivae was noted especially over the 22 and 12 (Fig 9).

After consultation with the patient, a treatment plan was designed to include crown lengthening and leveling procedures. Because central incisors tend to be the focal point of the smile, the symmetry of these teeth is key in most smile makeovers so particular attention was paid to the areas above the 12 and 22. Creating dominant central incisors is another element in making a smile appear more youthful 1 which is why symmetry in this area is so important.
Three Empress crowns and three Empress veneers were placed in a treatment process similar to that described in Case 1. The final result shows a more harmonious, fuller looking and balanced smile (Fig 10).

Conclusion
By blending artistic and scientific principles, holistic treatment of the smile zone is made easier. To this end, digital photography and computer imaging are an invaluable tool in training the eye to assess and evaluate the smiles more subtle and hidden elements, not to mention a powerful way of educating those considering cosmetic dental procedures.
By utilizing the principles described in this article, the final end point of the treatment process can hopefully be described a work of art.

REFERENCES
1 Davis N (1999). An artistic approach to smile design. Dentisitry Today 18(8):57-60

2 Mclaren E and Rifkin R (2002). Macroesthetics:facial and dentofacial analysis. Journal California Dental
Association 30(11)839-846

3 Yamalik N (2005). Dentist-patient relationship and quality care. International dental journal 55(2):110-112

4 Levin E (1978). Dental esthetics and golden proportion. Journal of Prosthetic Dentistry 40:244-252

5 Rufenacht C (1990). Fundamentals of Esthetics. Carol Stream III:Quintessence Publishing

6 Tolleth M (1987). Concepts for the plastic surgeon from art and sculpture.Clinical Plastic Surg 14:585-89

Financial Health

Your physical health is very much affected by your financial health – that is an undoubted fact of life. Wealthy people live longer and are healthier than their poorer counterparts, and this is true not only in the UK but also throughout the world. We use an IFA Edinburgh based called City Financial Independent for all our financial planning, corporate mortgages and insurance services, and they have been great over the years. It is increasingly important that people start to make provision for their financial health, particularly as we are all living longer and companies like City Financial Independent are definitely the way forward. Efficient tax planning services mean that often the cost of the professional Edinburgh IFA services are offset by the savings so we recommend that you get saving today!

ifa edinburgh

Dental Marketing

Dental marketing has come of age – and how !  Years ago, dentists relied on word of mouth or the odd advert in their local paper to generate business, but an entire dental marketing niche has sprung up over the last couple of years which has changed the game forever.  Based mainly online, specialist businesses like Dentist-SEO.co.uk have entered the fray, and are busily making savvy dental practices tons of cash by providing laser targeted local search engine optimisation services.   If you are a dentist based in Manchester, for example, how much money do you stand to make if your dental practice comes up No 1 for the search term “dental implants Manchester” ?  The answer, of course, is a lot !  With the price of a single dental implant averaging towards £3000,  dental SEO services can very quickly pay for themselves and start generating serious additional revenue for the enlightened dental practices out there.

How does this type of dental marketing work ?  Simple answer is , the dentist doesn’t need to know – all he or she will see ( if they’ve chosen their dental marketing provider wisely) is a huge increase in traffic to their website, followed by more local clients picking up the phone…..

If you’re a dental practice looking to grow your business you should really check out the links above – the new era of dental marketing has arrived.