Well what’s happening in dentistry. For those of you out there that read my articles, I do go on about tooth whitening, and how good it is for both for appearance of your teeth and your well being, as a nice smile makes you feel great. I have always said that it is a straight forward procedure as long as it is carried out by a dental professional. Last month saw the first conviction of a person who worked in the beauty business, who was doing tooth whitening, but he was not a dental professional. He was fined over £6000. The danger of an unqualified person doing such a procedure is that they have no knowledge of the state of the individual’s mouth and there are certain conditions where whitening is not recommended. Some of the material used in the beauty business is not good for the teeth either and can cause long term problems.

I have been fortunate to have taken quite a lot of cruises, and tooth whitening has been offered as a treatment option in their beauty spas on board the ships. I’m please to tell you that this is now not the case on the more popular cruise lines, as they have seen the errors in their ways.

Another dilemma I have recently faced was that my dental x-ray developing machine stopped working, after 18 years of trouble free life. The engineer told me it could not be repaired as the parts needed were no longer available. The dilemma was should I buy a replacement or should I invest in digital x-ray machines. A replacement would cost about £3500 while the digital option would be £8500. I don’t mind investing in new technology if there is a benefit for my patients, but in this case the major benefit is time as a digital x-ray can be seen nearly instantaneously whereas the conventional machine takes 4 minutes to produce the x-ray. It was my staff who finally got to choose, and opted for a replacement machine as they said that the digital one relied on the computers always working, and we all know that they always seem to throw a wobbly when they are most needed.

By the time you read this we will have enjoyed Easter, a Royal wedding and possibly a referendum on a new voting procedure. What a busy time we live in!

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This April is also a special month for those of us who are still in work with an extra bank holiday to celebrate the latest royal wedding. While I wish the happy couple well, as an employer, this bank holiday is yet another cost that we have to shoulder. Why couldn’t they marry on a Saturday like the majority of couples in this country? I don’t think the abbey or palace were already booked for the Saturday!

I appreciate that I’m in a privileged position, running a private dental practice, as most of my patients realise that the old adage of ‘you get what you pay for’ is true in the dental field. While I admire my colleagues who run NHS practices, I know that they get very frustrated not being able to offer their patients all the options that are available.

I have recently had a few patients who are desperate to have something done to their teeth which have been badly worn down, as they unfortunately lost some of their teeth several years ago, and as a result the remaining teeth have had to work harder than they were designed for.

Modern dental materials are fantastic at replacing lost dental tissue, and most of the time they can just be stuck onto the remaining piece of tooth.

This patient had lost his back teeth and so the front ones had been worn down over the years. I managed to build up the teeth just using filling material and a special bonding system. A bonus to the patient was that there wasn’t any drilling to his teeth. Both the patient and I realise that these restored teeth will wear down again as he cannot tolerate a lower denture, but at least he will get several more years useful life from these teeth, and then they can be built up again unless a more suitable solution has been developed.

I hope you all have a happy Easter, and remember my perennial advice. Not too many chocolate eggs for the children as I don’t want to have to build up their teeth!

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This survey takes place every ten years and it gives us an indication on the state of the adult population’s teeth and their dental experiences. Well it’s no surprise to me but over the past thirty years the percentage of adults who have no teeth at all has dropped from 28% in 1978 to only 6% now. The average number of teeth adults now have has risen to 25, which is a phenomenal improvement.

Now the fact that I started my professional life in 1974 and it still continues, cannot be ignored, but modesty prevents me from taking all the credit for such an improvement. The biggest change I have seen is in the attitude of patients. It was accepted and expected 30 years ago, that after the age of 60, one would lose their teeth and see out the rest of their days eating with the help of dentures. Nothing could be further from peoples’ minds today. The overwhelming majority of my patients will do almost anything to preserve the teeth that nature gave them, and we dentists are there to help them achieve this.

In my opinion the biggest contribution to the improvement in the nation’s teeth has been the introduction of fluoride into our everyday lives. In the 70’s and 80’s fluoride was added to our drinking water at a level that would increase our teeth’s defences against tooth decay, but a lot of these schemes have now been cancelled due to political and legal worries that we were being mass medicated and individual human rights were being infringed. However there is still fluoride available in tooth pastes, and I would advocate that everybody should use them.

However our congratulations have to be muted, as those in the lower socio-economic levels still have poor dental health, and more depressing for us dentists, is that the state of children’s teeth is also getting worse again. Another survey covering children’s teeth is soon to be published, but the message from us at the ‘coal face’, is parents beware. You have benefited from a good diet and fluoride. Don’t let the ‘junk food’ and fizzy drink culture of today spoil your children’s dental future so much that fillings and dentures again become accepted as a fact of life.

Don’t let us return to this.

Finally I look forward to seeing you on Wednesdays at B&Q when I shall be using my new discount card!

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So how can I, a mere dentist, bring some sunshine and good vibes into your lives? Well it’s easy. Just Smile. Smiling and laughing have been shown to make people feel better and more able to cope with the normal day to day pressures of modern life.

Face a mirror and smile. If you are happy with what you see, great. You have either been blessed with brilliant teeth or your dentist has done a first class job. And doesn’t it make you feel good about yourself.

If you not too happy with what is staring back at you, don’t despair as help is at hand. Just pick up the telephone and call your friendly dentist. We are all trained to help you achieve the smile that you want and deserve. So give us a try and before you know it, you will like your reflection in the mirror and feel so much happier with life.

Who am I kidding? The majority of you out there dislike visiting your dentist, as you feel that we are purveyors of pain and suffering and the final insult is we make you pay for it as well. I can’t agree with these sentiments, but I’ve been in the business long enough to know that my profession is not one of your favourites.

However let me try and change your perspective. When it comes to pain and suffering, nothing can come close to the pain of a dental abscess. If you have had one, you know what I mean, when I say that the dentist is the most important person in your life at that time as we are the only ones who have the skill to relive the pain. Dentistry may have been painful in the olden days, when I was a lad, but with modern anaesthetics, ultra fine needles and a caring dentist, there is no reason why you should experience pain from any dental procedures today.

Like my fellow colleagues, one of the best feelings we get is when a patient turns round and says that the treatment wasn’t as bad as they had expected, and in fact they hadn’t felt anything at all.

The only complaint I get from patients is the pain caused to their wallets. Well they have to moan about something!

A nice natural smile. Santa had just come!

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Of course there is a cost to this registration, and although it is mandatory and if we have not registered by April, the Practice will have to close, they have not yet decided what the registration fee will be. Their initial indication is that it will be about £1500.00 per year, and who will ultimately pay for it. Of course, it’s you patients, as there is no other source of funding.

This will mean that dentists are regulated by The General Dental Council, The Care Quality Commission, Health & Safety Executive and for those in the NHS, another new body that will take over from the PCT’s when they are eventually abolished by this government. There are now more people employed in regulating the profession than there are dentists working in it. Makes sense does it? I thought we were meant to be getting rid of red tape! I know three of my friends are taking early retirement as they are fed up with having to jump through hoops which keep getting higher.

However I am still looking forward to the future. The art of dentistry marches onwards and upwards as new techniques are constantly being introduced to provide patients with a better and more reliable treatment outcome.

I am still humbled by the way people come to my surgery, and place their trust in me, to provide them with the most appropriate treatment for them. A new patient attended, after reading some of my articles in this magazine. He was unhappy with the metal fillings he had in his mouth, and was interested in Cerec porcelain replacements. Unbeknown to me, he had done his research on the how long these types of fillings lasted, and was impressed with the results he found. A Cerec restoration may be more expensive initially but as it lasts longer, it works out to be very cost effective. We ended up replacing all his mercury amalgam fillings with a combination of Cerec and white composite restorations. I am confident that he will have a Happy New Year knowing that he shouldn’t need any more restorative dentistry for years to come.

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December is always associated with Christmas, and this year my wife and I had our Christmas present early. We were lucky enough to go on the maiden voyage of the new Cunard ‘Queen Elizabeth’. The two weeks of cruising down to the Canaries and back were great, and we enjoyed a lecture from Sir David Frost and a special performance from Lulu. The service we experienced from all the staff was fantastic.

A visit to the dentist is not something people usually look forward to, but if we dentists can offer you a ‘Concierge Service’ similar to the one I experienced on the ‘QE’, then hopefully our patients will come to enjoy their visits. At Bingham Dental we have already implemented some changes which are getting the ‘thumbs up’ from my patients.

If you are having difficulty in thinking of what to give your nearest and dearest for Christmas, you could do worse than offering to pay for a smile makeover. It may seem an unusual present but it is one that will last for many years, used every day and be admired by all those who come into contact with them. This could range from complex work such as veneers or new dentures to more immediate treatments such as wrinkle reduction or tooth whitening. I appreciate that it takes spadefulls of tact to suggest that someone may benefit from Botox.

However to help you tackle this sticky problem, I am offering for this month only, and with the production of the advert on this page, professional tooth whitening for only £149.00, and also 10% off any non surgical facial enhancements.

I’ve been in Practice for over thirty six years and still enjoy my work, as every day is different. The other week I welcomed a new family to the Practice. I always take x-rays on new patients and was surprised to find that one of the children is not developing most of their adult teeth. It isn’t uncommon for people not to develop one or two second teeth, but not to have most of them, is rare. However to be forewarned will allow us to manage the case so that when the child is an adult, they should have as nice a smile as everybody else.

I mentioned a few months ago that my camera had been stolen, but I had to get another one so that I could not only record my patients’ progress but more importantly photograph my much awaited forth grandchild. Well Isaac William arrived, 11 days late weighing in at a mere 8lbs.15. I’m told by those that know that he is a big boy.

Finally Happy Christmas and a brilliant New Year to you all of you who have got this far!

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There is only a 50% survival rate of patients after five years, but early detection and treatment brings that up to 90%. Over two thirds of cases are detected in the late stages so reducing the chances of survival.

The warning signs are ulcers that do not heal after three weeks, red and white patches in the mouth or unusual swellings and lumps in the mouth.

Mouth cancer is more likely to affect people over the age of 40, but there are an increasing number of younger people developing the condition.

Fifty years ago it was five times more common in men than woman, but now it is only twice as common

Lifestyle choices can significantly reduce the chances of getting this horrible disease. The number one risk factor is that good old favourite, smoking. Closely behind is excessive alcohol intake. Alcohol increases the absorption of tobacco in the mouth, so those who smoke and drink to excess are up to thirty times more likely to develop this disease. Other factors that increase the risk are chewing tobacco, paan, guthka and areca nuts.

The human papilloma virus, which is transmitted in oral sex, has recently been identified as a risk factor, particularly in young people who don’t have any other apparent risk factors. Experts suggest that this virus will rival tobacco and alcohol and will be the key risk factor within 10 years.

The message is clear if you are concerned about anything in your mouth which you feel is unusual, get it checked. Go to your doctor or dentist. Dentists are used to looking into mouths, and usually have better lighting than the local GP, but the important thing is go and seek help and advice.

There is nothing better than to be able to tell patients that there is nothing to worry about, as is the case in the vast majority of those seeking help and advice. However if there is something that looks suspicious there is a fast track system run at most hospitals, which ensures that patients are seen within two weeks, but it is usually quicker.

I make no apology for not writing a more light hearted article this month, but this is so important.

I finally would like to pay my personal tribute to a very close friend of mine, Tim, who died in September from cancer. He was a true gentleman and the world is a poorer place without him.

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Nature dictates that if we eat a lot of sugary foods, then tooth decay will occur. If we do not remove plaque from our teeth and gums on a very regular basis, then gum disease will ensue. There are certain individuals who are lucky in their genetic makeup that they do not suffer these consequences, but for the majority of us it does.

If we all ate sensibly and cleaned thoroughly then trips to the dentist would be a lot different from what they are in reality. Dentistry nowadays depends on high tech solutions to try and repair the effects of nature on our oral health. When it comes to repairing teeth its’ mind blowing to see what technology is being used to restore the teeth to the way nature intended. White plastic fillings are now placed as a matter of routine, so that teeth do not have to have mercury amalgam, which show to the world that you have been a victim of tooth decay.

Cad Cam is now available to enable more complex and stronger restoration to be made so that they last longer and look more realistic. Porcelains have been developed so that they can be used in crowns and bridges with confidence that they with withstand normal wear and tear.

Lasers are used in treating gum disease along with modern antibiotics regimes. There are small television cameras that can go into the mouth, so that you can see what the dentist sees and this helps patients become aware of how they can improve things to help minimise the effects of nature.

We can’t fight nature and the aging process with its subsequent effects on our appearance, but there are technological advancements that can help slow the effects down. A few dentists, including me, are now trained in facial aesthetics, so with the careful application of dermal fillers and wrinkle smoothing injections, you don’t have to look the age that your birth certificate says you are.

I’ve just realised that as I am writing this, I am using technology on my teeth. I am wearing my tooth whitening trays so that the colour of my teeth does not reflect my age. My parents would have liked to have had some teeth to whiten when they were my age. Thinking of my grandchild what technology will impact on his or her life? Only time will tell.

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The Galapagos Islands are fascinating, and are under the control of the Ecuadorian National Parks Authority. They are doing a great job in the conservation of the Islands, and in fact they are now reintroducing species that had been lost due to the animals that man had released, namely dogs, cats and rats. This can now happen as they have managed to get rid of these foreign imports. We also saw the famous Darwin finches. It’s easy to see finches on separate islands, each with their unique beak shapes, but it takes a brilliant intellect, such as Darwin’s to connect them and then come up with the Theory of Evolution. I just thought they were nice looking birds!

On my return to the Practice, I was asked to telephone a man who thought I could help him. This was a little unusual as he lived in South Yorkshire. He told me that his dentist and in fact his local Primary Care Trust, had given up on him and were unable to treat him. His problem was that he had developed, over the past four or five years, a severe gag reflex, and so every time he opened his mouth wide or had any instruments placed in it, he would gag uncontrollably. Willing to try anything, he contacted me, as I am a member of the British Dental Acupuncture Society.

I’m delighted he did call me, as I have found that placing just one acupuncture needle in a specific place on the face, can significantly reduce the reflex and on some individuals it stops completely. On this gentleman it stopped it completely, and not only did I manage to do an examination, he also had two filling in his lower teeth, which are the worst to treat with this condition. He is also returning to have a fibre bridge made for a missing front tooth that has bugged him for years. I also find this technique works if I have to take impressions of peoples’ mouths when making dentures or crowns, and they have a gagging problem.

I thought it was awful that my fellow professionals had abandoned this patient, not because they didn’t have the expertise to treat him, but that they couldn’t be bothered to find someone who might be able to help him and they had left the patient to seek out help for himself.

I apologise that there are no photographs again this month, but during my holiday, I had my camera stolen. It was the old trick of spraying me with some disgusting material, and while I was distracted by wiping it off, my camera grew legs and went walkabout. One positive aspect to this sorry story was that a local man saw the incident and came to our aide. He accompanied us to the police station, acted as interpreter, helped to complete the incident report. He was with us for the best part of two hours, and at the end would not accept anything from us for his trouble. His actions helped to restore our faith in the local population.

I’ll have to get a replacement soon as grandchild number four is due in early October, and I haven’t found a more exciting subject to photograph.

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It got me thinking about what constitutes a Professional worker. In the old days, when I was a child, to work in one of the ’Professions’, was something to be proud of, as it was recognised by the public, that to be a professional, it had taken years of training and dedication to attain this status. The professionals also had a responsibility to the public, in that they would always act in a correct and proper manner, work to the highest standards possible and be prepared to ‘face the music’, if they were found not to have acted in the clients’ best interest.

Footballers cannot be classed as Professionals. We are told that they were tired though playing too many games in the Premier league or that they were having an off day. I class dentists as Professionals. What would a patient think if I extracted the wrong tooth or placed a crown that didn’t fit? I don’t think the patient would be too impressed if all I did was say sorry but I’m a bit tired and I’m having a bad day! Patients come to us as they know that we all work to strict guidelines, and should we be found wanting, then we face a wide spectrum of penalties from having to retrain in certain procedures to having our name removed from the Dental Register, which means that we are unable to work.

What will our England football Professionals face? A few days humiliation in the national press! Then it’s a holiday before returning to their Premier clubs for the ‘gravy train’ to start all over again. Professionals? I don’t think so!

Now I’ve got that off my chest, what is happening in the interesting world of dentistry? Well not much at the moment. It’s holiday season and like the rest of the population dentists like to have some time off.

However several members of my staff and I attended a full day course in Nottingham recently. One of the regulations that govern us, states that anybody who either performs or assists in treating a patient must attend at least fifteen hours of refresher courses per year. One of the lectures was given by Phil Hollows, who is a maxilla-facial consultant at the QMC. I didn’t realise that the A&E department at the QMC is the busiest in Europe and on average they have to treat 4 broken jaws every Saturday evening. My tip for the month is if you have to get a taxi in Nottingham on a Saturday evening do not use the rank outside the Victoria centre, as that is where the majority of Phil’s patients arise from.

Enjoy the summer and I shall endeavour to write a more dental orientated article next month.

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People have often said to me that my job must be tedious, as all it involves is looking into mouths all day. This would be true if that is all we did, but as every mouth is connected to an individual, with their own needs, it proves to be a very diverse occupation, requiring a whole range of different skills. I thought I would share with you a typical mix of patients which came through my surgery door one day, to illustrate that dentistry is not all ‘drill and fill’.

The names have been changed to protect the innocent. Mr A is in his fifties and has lost several teeth over the years, so he has to wear an upper denture. Although he has had dentures for many years he hates them, but thinks that is all he can have. Previously we had taken impressions of his mouth and a series of x-rays, and today he is with us to discuss what alternative treatments are available. The options range from a new denture to bridges to implants. All the pros and cons of these options are explored and he came to the decision that he would like to have implants, so that he can finally throw away his denture forever, and enjoy the rest of his life with a full set of teeth that are permanently fixed in his mouth.

Next is Mrs B. She is a lady who takes pride in her appearance and over the years she has noticed how the numbers of wrinkles are increasing around her eyes and mouth. After a thorough examination and discussion, we agree that some treatment with Botox® and dermal fillers would be appropriate. As she would like to start treatment as soon as possible, I administered the Botox® .

The next patients were Alice and Sam. Two children aged six and four. I had seen both before, and as usual we treated this check up visit as a game. As a dentist it’s great to see children who are completely at ease in the surgery, without the hang-ups of my generation. Alice had lost a couple of baby teeth since I last saw her, so she was telling me all about the fairies who didn’t bring as much money as her friend had received. She was growing some of her permanent teeth so her mum asked how best to protect them. We went over the usual stuff of tooth brushing, correct diet etc, and also having her molar teeth fissure sealed.

Finally was Mr C. A new patient to the Practice and he came as a result of one of my articles, which was very gratifying for me. He had a beautiful set of teeth, which had never required any fillings. His concern was a space between two of his teeth, which his wife didn’t notice, but he hated. The solution was to literally stick some filling material onto his tooth and shape it to fill the gap. This treatment does no harm to his own tooth, but transformed its appearance.

So as you can see. A mixed bag of problems and solutions and not a ‘drill and fill’ in sight.

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The mercury amalgam fillings, which were developed in the 19th century, and are still the commonest material used in the N.H.S., doesn’t have any adhesive properties, so the dentist has to prepare a bigger cavity than is really needed so that the metal filling doesn’t fall out.

A patient of mine attended the surgery after having had an accident at home. He had managed to fracture one of his front teeth completely at the gum level. However I was fortunate to have some new adhesive materials, and I was able to make a replacement tooth, and stick it onto has adjacent teeth, so that he left the surgery feeling and looking a lot better. The best bits of this procedure were that it only took 30 minutes, didn’t require any local anaesthetic and the patient loved the end result

Another problem I have found with the mercury amalgam fillings, is that because we have to make the cavities quite large, it weakens the remainder of the tooth. The result of this will not be evident for ages. A lot of my patients can be classed as from the ‘baby boomer’ years, when dentists appeared to fill everything in sight with mercury amalgam. Now as the years have past, the results of these big fillings is now starting to show. Large chunks of teeth are falling off around the metal fillings, which without modern adhesive materials would probably mean that the broken tooth would end up in the bin.

The Cerec machine that I purchased last year is proving invaluble in these cases. It produces a porcelain inlay, which is more durable than normal filling materials, and this inlay is then bonded to the broken tooth with an adhesive. This will allow the tooth to be used again for many years to come and it’s appearance is fantastic.

My advice this month is that if you need a filling, then ask your dentist for an alternative to an mercury amalgam one. It may be more expensive in the short term, but you will reap the rewards in the future, and it will also look better.

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