Dental Courses Winter Series 2009 & 2010

The following course dates are available:

Anterior tooth preparation 26 November 2009

Posterior tooth preparation 10 December 2009*

Occlusion & articulation 14 January 2010

Book before the end of October for £199 per day, or late for £250.
Please make cheques payable to ‘Cheshire Smile Clinic’ or make a credit card payment by calling Hannah on 07804 707 062.
Courses fees include refreshments, lunch and handouts.
Each course day attracts 51/2 hours of verifiableCPD
* includes mince pie for added Christmas Cheer!

Course details
Taken together or individually these course days will benefit dentists who wish to develop their restorative skills. The course design will accommodate experienced and inexperienced operators. The main emphasis is on you gaining hands-on experience of all techniques, equipment and materials.

Anterior Tooth Preparation including Composites, Crowns and Veneers Hands-on tooth preparation for composites, ceramic and porcelain bonded crowns, veneers and rubber dam.

Posterior Tooth Preparation Tooth preparations for crowns and bridges, plus impressions, fabricating provisionals, adjusting cast restorations and cementation.

Occlusion and Articulation seminar Theory plus lots of practical skills which you can incorporate into your everyday dentistry. Includes occlusal assessment, adjustment, facebow transfer, pantograph tracing to help understand articulation and occlusal schemes for simple to complex restorative cases plus complete dentures. Places are limited so please book early, many thanks Peter

Dental Treatment Liverpool Dental

Treatment
The primary objectives of treatment are to help you achieve great dental health, an attractive smile, a comfortable mouth with smooth teeth, restore function (eating and speaking) and prevent future dental disease.

Dr Smyth’s day to day clinical is primarily concerned with:

1. Treating patients referred to the clinic by local dental colleagues for root fillings and restorative dentistry

2. The restoration of adult dentitions that have gum, tooth or dental nerve problems, broken, worn or missing teeth

3. The maintenance of children’s and adult dentitions after dental trauma

Dental Implants Liverpool
Implants are titanium screws that can be placed into the jaw bone and used to support replacement teeth. Nobel Biocare dental implants have been used in dentistry for over 30 years and have a proven track record. They are very successful and often the best way to replace missing teeth.

One tooth can be replaced using a single implant, a gold attachment and a crown. The cost of a dental implant is a commonly asked question. At this clinic a guide of £1,000 for the dental implant first stage of surgery and £1,500 for second stage surgery, gold attachment and crown is a good estimate. However dental patients must bear in mind that each individual is different, some cases are simple, some are complex e.g. require bone grafting. Fees will vary depending on the complexity of the treatment.

Several teeth can be replaced with multiple dental implants that support a bridge (linked crowns).

All the upper and lower teeth can be replaced with 8 to 10 implants in the upper jaw, and 5 to 6 implants in the lower jaw. These are used to support two large bridges.
Very large bridges, that replace all the teeth in either the upper or lower jaw would cost from £15,000 per jaw.

Alternatively conventional dentures can be constructed and implants placed beneath this to help stabilise the denture during eating and speaking.

Implant surgery is very comfortable. It is a relatively painlessly procedure with local anesthetic. A simple sedation procedure is recommended for dental implant surgery.

It is a fact that dental implants may be used to support teeth immediately after they are placed into the jaw bone. However, more often than not it is advisable to wait 4 to 6 months to enable full healing to take place before using the implants to support replacement teeth.

Amalgam Fillings / Silver Fillings / Alloy Fillings
Amalgam is a silver or light grey filling material which is very strong and long lasting. This material remains a good option for medium to large fillings in back teeth. Amalgam is often placed inside root filled molar teeth in order to build them up ready for a crown.

Tooth Coloured Fillings Liverpool
Tooth coloured fillings or composites are best for repairing small/medium sized repairs in front teeth, and small repairs in back teeth. They can be used to provide imperceptible repairs. However, they are much more time consuming and require much more frequent maintenance and replacement than their amalgam counterparts.

Rubber Dam
Rubber dam is used routinely to prevent saliva and the bacteria that it contains from contaminating teeth whilst they are being repaired or root filled. Rubber dam enables teeth to be repaired under optimal conditions (clean and dry). This helps make sure the materials adhere to the enamel and dentine this avoid post-operative pain too. In addition the dam helps protect your lips and tongue whilst work takes place on your tooth. The dam prevents the risk of a patient swallowing a piece of equipment and it improves the dentists’ visibility of your tooth.

Tooth-coloured Porcelain Onlays and Inlays
When substantial amounts of tooth tissue have been lost and their restoration will be too big for tooth coloured filling materials, laboratory made porcelain onlays or inlays can provide aesthetic restorations. Occasionally due to a very heavy bite a gold restoration rather than porcelain would be the material of choice.

Crowns & bridges, Veneers Liverpool
When a large amount of tooth has been lost, or when teeth are severely discoloured or misshapen, porcelain crowns are frequently the restoration of choice.

Two types of crown are used:

(1) All porcelain crown
These are vital looking crowns and very natural.

(2) Metal ceramic crowns
Porcelain is fired onto a precious gold sub-structure. These are the most common crowns used to restore broken down teeth and they have excellent longevity.

Bridges Liverpool
When teeth are missing, they can frequently be replaced by fabrication of a bridge supported on the teeth either side of the gap. These bridges are often made from metal ceramic restorations, they are first fabricated in small sections. Each section is tried in the mouth to check and ensure quality of fit and appearance before joining them together in the dental laboratory – to form the bridge.

Veneers Liverpool
When only the outer surface of a tooth needs to be restored, this can frequently be accomplished by fabrication of a veneer which is glued to the tooth. Dr Wise uses porcelain veneers, fabricated by the laboratory technician, rather than plastic or composite veneers. These restorations are not as strong as metal ceramic crowns. But they are often the restoration of choice because they require much less tooth preparation.

Tooth Wear
Treatment often includes fabricating a plastic bite-guard to be worn at night and if necessary during the day to reduce the damaging effect of tooth-grinding habit (bruxism). Or all teeth can be restored back to their original shape using metal ceramic restorations.

Gum Disease / Adult Gum Disease / Periodontal Disease Liverpool
This is the most common human disease. It is the main reason people loose teeth in adulthood. In susceptible patients the body overreacts to the natural bacteria in their mouths and the inflammation around the teeth damages the gums.

Over time the supporting gums and bone are lost. This process is largely painful and patients can be unaware of the problem until the disease has progressed to the stage were teeth become loose, painful gum and tooth abscesses develop and teeth are lost.

This disease is frequently amenable to treatment to either decelerate the progression of the disease or regenerate lost tissue. Unfortunately, the disease often occurs with little sign to the patient, other than bleeding gums, bad breath and eventually loose teeth. Early detection and treatment is therefore desirable.

Stages of treatment would frequently be:

    * Examination
    * Diagnosis
    * Multiple visits with the hygienist
    * Sometimes surgery to the gums
    * Long term maintenance programme with the hygienist in conjunction with Dr Smyth

Tooth extraction
Some teeth cannot be repaired or fail and require removal. Dr Smyth attempts to remove teeth painlessly, with a local anaesthetic and a simple sedation procedure for nervous patients.

It is important to carefully remove teeth from the jaw bone to minimise post-operative discomfort, enable you to heal fast and to preserve as much bone as possible for future implant placement, should this become necessary.

Wisdom tooth removal is often carried out with a simple sedation procedure.

Preventative Care
Dr Smyth’s philosophy is that it is better to prevent dental disease than treat it. Also that once treatments are complete the recurrence of dental disease such as tooth decay and gum disease is undesirable. After treatment a maintenance program is recommended with regular hygienist appointments, dietary advice, application of topical fluorides and a regular recall appointments.

Root Canal / Root fillings / Endodontic therapy / Endodontics Liverpool
Teeth with problem dental nerves no longer need to be removed. Modern root filings are successful. The procedure is time consuming however it means the tooth can remain healthy for many more years.

The procedure is very comfortable with a local anaesthetic. This is often contrary to what friends and family will tell you. X-rays are taken to investigate the shape of the roots, dental pulp space and the canals inside the tooth.

The space inside the tooth where the dental nerve resided is cleaned, shaped and dressed with medicine that carrys on cleaning the inside of the tooth between appointments and helps healing as inflammation resolves.

At a second visit 2 weeks later the tooth is cleaned once again and then sterile gutta percha (the natural rubber used inside golf balls) is used to ‘root fill’ the space inside the tooth.

The tooth is then sealed up. This seal is very important because it prevents the ingress of saliva and bacteria which re-infect the root canals and cause the root filling to fail.

Often teeth that require a root filling are heavily repaired and broken down. After a root filling a tooth is like an empty cardboard box that if you stood on it – it would collapse. A foundation restoration is necessary, this is like putting stuffing inside the empty card board box.

Root filled back teeth are routinely crown to protect them from the risk of tooth fracture.

Root filled teeth are fragile. However, they can be repaired with a high degree of predictability and the procedure is very successful. To put this in perspective over the last 3 years root fillings for recently infected teeth have been 100% successful. Teeth that have had long term infections (e.g. 12 to 18 months) have been successfully treated in 95% of cases. Moderate post-operative pain has been experienced by approximately 5 patients in the last 3 years.

A clinical microscope is used to illuminate and magnify the tiny canals within the teeth.

For safety and reliability the sets of small files that are used to shape and clean the canals inside your tooth are brand new and they are carefully disposed of after use. They are not used within another persons tooth.

Orthodontics (tooth movement)
Occasionally orthodontics is employed to realign teeth into more favourable positions as part of a restorative dental plan. In most situations, patients are referred to a specialist orthodontist. Adults can benefit from orthodontics and it is often best to have teeth realigned rather that rely of expensive cosmetic treatments that involve irreversible tooth preparation.

Dentures Liverpool
Partial dentures are one possible solution to replace some missing teeth. The denture will usually be fabricated from a metal frame that supports tooth and gum coloured plastics. These are often the most cosmetic solution when replacing several missing teeth.

Complete dentures are fabricated when all the natural teeth are extracted. Sometimes they are used as a stepping stone when the ultimate goal is to plan for dental implants to support large bridges and eventually replace the dentures.

Rather than delegate the setting up of the denture teeth in wax to the dental technician who is remote from the clinic, Dr Smyth sets the teeth up at the chair-side. This enables the teeth to be tried in the patients mouth as the trial denture is fabricated to help recreate a natural and attractive smile. Several tooth shade and moulds are often used and our technician completes the denture by hand carving the gum work so it is anatomically correct and staining it shades of red and pink to recreate realistic prosthetic teeth and gums.

Sedation Liverpool
A simple sedation procedure is often recommended for nervous patients. This involves taking a tablet the night before your dental treatment. And then taking a second tablet 1 hour before your appointment.

Sedation is helpful in the following situations:

    * Anxious and nervous patients
    * Long and tiring restorative and surgical appointments

Treatment for Periodontal Disease (GUM DISEASE)

Gum disease is the most common human disease. Some people are not susceptible, some develop severe gum disease even though they have meticulously clean their teeth.

After we clean our teeth and brush away the dental plaque, this soft bacteria layer slowly builds up once again. In some susceptible adults their bodies immune system over-reacts to this bacteria. In doing so the body not only damages the bacteria it also damages itself. The enzymes that the bodies immune cells release dissolve the bacteria and the bone and gum that support the teeth. Over time this means bone loss, loose teeth and deep gum pockets around teeth that makes them very difficult to clean.

Very rarely, gum disease can affect children’s teeth. Gum disease is however the main reason for the loss of teeth in adulthood. The signs that you have gum disease are:

1. Red, swollen gums
2. Bleeding gums on tooth brushing
3. Bad taste or smell

Gum disease is not really that painful a condition until the advanced stages when teeth become very loose and painful gum or tooth abscesses develop.

Your dentist checks your gums carefully each time you have an examination and regular dental x-rays help identify any bone loss around your teeth.

The good news is with regular treatment the progression of gums disease can be decelerated.

Periodontal Detoxification
This treatment usually requires 3 visits, one long visit then two short ones. Afterwards you attend a dental hygeinist for maintenance treatment with regular check-ups with your dentist.

At the long appointment your teeth are meticulously scaled and the hard deposits which house bacteria and their toxins are removed. This is a largely painless procedure using a local anesthetic. If your a nervous patient you may prefer a simple sedative procedure to make this time consuming treatment more pleasant.

The aim of this treatment is to remove as much of the bad or ‘vandal’ bacteria from the gum pockets as possible. An antiseptic gel is applied around all teeth and in the gum pockets and this give the gums the opportunity to heal.

This treatment is very successful and afterwards patients experience gum healing. The follow up appointments enable the application of the antiseptic gel.

Afterwards the improvements in gum healing are maintained by the patients home care. This involved meticulously cleaning the dental plaque of teeth twice a day using tooth brushes, Tee-pee brushes (small brushes) and dental tape or superfloss. It is this ‘home care’ that is the most important treatment in keeping gum disease away.

A professional tooth cleaning by a dental hygeinist is beneficial to keep the difficult to reach placed spotless and prevent bad bacteria building up in the gum pockets. They are expert at using specialist instruments shaped to clean every surface of every tooth in our head! They also polish our teeth after cleaning. Smooth, polished surfaces attract less bacteria and this makes our teeth feel fresh and clean too.

What about antibiotics?
After treatment if gum disease is slow to heal, antibiotics may be considered. If patients are very susceptible the periodontal disease and the healing is poor after treatment a referral to a specialist periodontologist is recommended for a specialist opinion and treatment.