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Dentistry in EC1

established over 50 years in the City

Providing highly aesthetic dentistry in our comfortable and spacious Chiswell Street practice.

  1. How to whiten your teeth

    February 7, 2017 by City Dental

    How to whiten your teeth

    Teeth whitening was discovered in the 1980s when dentists discovered that hydrogen peroxide whitens teeth. Teeth whitening as a dental treatment has evolved greatly over the years.

    If you search online today for teeth whitening products, you will see there are thousands of options. With so many options available, it is hugely important to know what types of treatments work, and which don’t. There are many myths which I’ll try to address, but it really helps if you have a brief understanding of the science behind teeth whitening, so you can make an informed decision as to what will be right for you.

    How Does Teeth Whitening Work

    The active ingredient in teeth whitening is hydrogen peroxide. It’s important to understand that teeth are naturally made of white crystals and are naturally porous. This allows whitening gels to sink into them. When applied to teeth, hydrogen peroxide seeps into the enamel and dentine and breaks down the large staining molecules, resulting in the teeth’s natural white crystals being left to shine.

    Will My Teeth Be “Hollywood White”?

    City Dental Blog Picture Teeth Whitening Smile

    Natural teeth will only whiten up to a certain point, which dentists call the saturation point, at which your teeth will not whiten any further. This is about as white as the whites of your eyes, and is considered a natural bright white smile. I often hear patients worry that their teeth will become too white. The advantage of tray whitening techniques vs in-surgery whitening is that the former give the patient the control. People who have “Hollywood white” teeth have usually had crowns or veneers which are white beyond the natural spectrum. This is not what most people tend to be looking for.

    Teeth Whitening Myths: What Doesn’t work

    Teeth whitening toothpaste
    I often get asked whether teeth whitening toothpaste does what is says on the label. The answer is no. The minimal amount of hydrogen peroxide that this type of toothpaste contains (usually around 0.1%) is so low that it will make no noticeable difference to your teeth. They are only available in the supermarket because people keep buying them, not because of their results. Although they contain a whitening ingredient, don’t expect them to whiten your teeth.

    Teeth whitening light
    In days gone by, the teeth whitening light was used to activate whitening gels by starting a reaction with UV light. In the UK and the rest of the EU, it is no longer legal to use whitening gels that contain more than 6% hydrogen peroxide. There is therefore no longer any need for them to be light activated. Some dentists still use a whitening light, even though none of the whitening gels are light activated… maybe they are so fond of their light that they can’t give it up!?

    City Dental Blog Picture Teeth Whitening

    In-surgery whitening

    Home Whitening

    This technique involves taking impressions of your teeth which are turned into moulds. The moulds are used to make whitening trays which are essentially thin gum shields for the top and bottom teeth. The whitening trays are used to carry whitening gel and hold it against your teeth. Patients are often instructed to wear the trays overnight which allows the gel time to sink in and whiten the teeth. The most common gel used for this technique is called carbamide peroxide which comes as either 10% or 16% gel. The carbamide peroxide turns into 4% or 6% hydrogen peroxide respectively before turning into water. The gel is active inside the trays for approximately 4 hours. It is important to understand that hydrogen peroxide is deactivated when it touches the water in saliva and is therefore not harmful to the body in any way.

    Advanced Whitening

    For more difficult cases, or for people who are looking for something extra, I would recommend a professional teeth whitening package. The science is the same as described above but it utilises a more complex routine to achieve better and faster results.

    The dentist takes silicone impressions instead of alginate impressions. These are very detailed impressions which are taken using the same material that is used when making crowns. The impressions are poured into stone models instead of plaster models. The models are modified in a dental laboratory to create bumps on the teeth which results in reservoirs in the superior whitening trays. The effect of these upgraded materials and added attention to detail is that the tray is extremely tight fitting. In addition the reservoir creates a pool of whitening gel against each tooth. The tight fit holds saliva and water out away from the gel and prevents it from being deactivated, and allows the gels to penetrate the teeth more deeply.

    The specific product I recommend is Enlighten, and as part of the supplied package, the patient is supplied with sensitive toothpaste called Evo-white and with desensitising gel called Tooth Serum. These products are used to reduce sensitivity and make the whitening process as comfortable as possible for the patient. The patient is supplied with large tubes of 10% carbamide peroxide gel to use in the first week and 16% carbamide peroxide gel to use in the second week. The increasing concentration of gel is designed to reduce the sensitivity the patient experiences and increase the depth of whitening.

    After 2 weeks of night time whitening the patient attends the dental surgery for a 1 hour whitening appointment. The dentist uses a retractor to retract the lips and keeps the mouth dry using the dental surgery suction. The controlled environment prevents the teeth getting wet and deactivating the gel. During this appointment, the dentist applies 4 applications of 6% hydrogen peroxide gel directly to the teeth (this is the point at which some dentists can’t resist but to use the light in the hope that is still does something – it doesn’t!).

    As you can see, the advanced whitening is a more complex and comprehensive process.
    City Dental Blog Picture

    Top Tips For Tray Whitening Techniques:

    • Use sensitive toothpaste for a few weeks before you start whitening.

    • Dry the teeth before you put the tray and the gel on your teeth. Saliva near the gum line can prevent the necks of the teeth from whitening fully.

    • Frequency of gel application is more important than volume. It is better to use a very small amount of gel and use it many times, rather than fill the tray with gel and only use it a few times.

    If your teeth become too sensitive to complete the two week course, take a night off and wear the trays overnight loaded with sensitive toothpaste, then continue whitening the next night.

    How Long Does Teeth Whitening Last?
    Diamonds may last forever but unfortunately teeth whitening does not: it should be thought of as an ongoing process. This is because, after you have whitened your teeth, they will gradually absorb food colourings which will inevitably make them fade darker or more yellow over time. This has led to dentists favouring tray based whitening techniques because trays can be used over and over to top up and keep the teeth white.

    Summary
    Both techniques are highly effective and can be used to great effect to brighten your smile. The decision as to whether home whitening or advanced whitening is more appropriate for you will depend on what your goals are.

    Hopefully this answers any questions you may have about your options for teeth whitening, and how it all works. If there is something you want to know that I haven’t covered off, please feel free to ask in the comments below.

    Alternatively if you are interested in finding out more about advanced teeth whitening packages, please don’t hesitate to get in contact with me using the online booking form.


  2. Tooth Wear

    September 8, 2015 by City Dental

    Tooth wear and the associated sensitivity has become an increasing dental problem but can anything be done about it? Many of you will have noticed and read dentists can now use and record exceptionally high quality intra- oral images of the teeth. This proves a useful measure for tooth wear whilst referring to any existing patients teeth stone models.
    The commonest reason for losing that all important enamel (the 2- 4mm hard protective shell of the tooth) is by night time grinding or “Bruxing”. Additional acidic food and drink consumed just before going to sleep at night is to be avoided as it can soften the precious protective hard enamel tooth layer and accelerate the enamel wear. Sensitivity in these cases follows
    where teeth develop areas of exposed dentine (the inner part of the tooth next to the nerve). “Bruxing” can also cause supporting bone loss around the tooth leading to gum recession and exposure of yet more sensitive dentine along the root faces not covered by the hard enamel.


  3. Dental Specialisation is on the rise…but why?

    August 3, 2015 by City Dental

    10 years ago there were no specialist dental registers. With increasing diversification within dentistry there are now registers for Prosthdontics, Oral Surgery, Orthodontics, Periodontics, Endondontics and Paedondontics.

    At City Dental Clinic we have Dr Paul Begley registered with the General Dental Council as a specialist in Prosthodontics however like a number of experienced dentists he has diversified due to patient demands into mainly offering endodontics and dental implants. In addition, Dr Robin Beveridge now carries out cosmetic and adult orthodontic cases which also would not be possible without further postgraduate training. There are orthodontic specialists for example who work predominately on children and adolescents. However large demand for less complex adult orthodontic solutions are often best dealt with by general dentists with multidisciplinary training.

    Whilst we welcome the increase in specialists in dentistry, in many cases with the right postgraduate training now readily available from the many continuing professional development courses patients can still be conveniently treated by general dentists successfully under one roof. Where specialist care is required, it is fortunately easier than ever for patients to get access to this treatment either at or local to City Dental Clinic.


  4. Is it possible that my teeth are still moving?

    March 23, 2015 by City Dental

    Contrary to popular belief teeth are not fused or ankylosed to the bone like a dental implant and will move throughout your life.
    We like and want tooth movements like aligning teeth with “Invisalign” but not so happy with splaying of the teeth in advanced gum disease and relapse movements after the teeth have been straightened or ageing.

    Stopping unwanted tooth movements will depend on the cause of the tooth movements in the first place. Our “Invisalign” clear aligner orthodontic patients usually maintain their nice straight teeth by wearing a night time removable clear retainer replaced periodically and reordered through the “Invisalign Vivera Retainers scheme”.

    Alternatively “Fixed fibre or wire retainers” offer permanent retention particularly for loose gum diseased teeth. However nothing is permanent in dentistry and future maintenance and re-bonding will be required.


  5. Diet is much more significant than ever for 2015?

    January 23, 2015 by City Dental

    We all hope to live longer and healthier lives than our ancestors but an unhealthy mouth can indicate ones chances of this could be at risk. “Oxidative stress” is the buzz – word referring to a free radical imbalance at the biomolecular level brought about by the increasingly harmful 21st century foods we choose to eat. A recent Swiss TV show a bit like Big Brother took volunteers prepared to live in a stone age created environment for 4 weeks. They ate a stone age diet of chicken, goat, fish, fresh fruit and vegetables, potatoes, stone-ground bread and milk. They did not brush their teeth either for this period.

    Logic would expect that, apart from bad breath coming from their bacteria plaque ridden mouths, their gums would be bleeding, swollen and in a pretty bad state. The outcome however was very surprising. Their gums bled less and were actually healthier. We now know that certain foods high in saturated fats, and refined sugars will increase “oxidative stress” induced chronic inflammation. The latest research is suggesting that the more chronic inflammation like gum disease going on in our bodies the more the bodies systems get overloaded and chronic illness
    takes over.

    If your gums are bleeding, this could be a sign that your lifestyle could be effecting your oral health as much as your brushing techniques and frequency.


  6. Porcelain v Plastic…which is the winner?

    May 27, 2014 by City Dental

    The original Porcelain and Plastic restorations are not longer used anymore and the dental world talks about ‘Ceramics’ and resin based ‘Composites’ instead.

    Composites (usually directly placed tooth colour matched fillings) have the advantage of their friendly wear characteristics with natural tooth enamel and the ease of repair if they break. This will tend to occur more often than the stronger ceramics. At CDC we particularly like the lab made ‘indirect’ composites for larger cavities where increased strength is attainable over the direct materials but retaining tooth structure using the optimum tooth wear properties.

    ‘Ceramics’ are now extremely strong and the latest ‘Lava’ ziconia oxide cores for example are rapidly replacing the traditional metal under porcelain restorations even for bridges. Ceramics may be more abrasive than composites but the long term colour stability and superb aesthetics with lack of wear are big + points.

    To sum up small cavities are usually filled with ‘direct’ placed one visit composites. Medium to large cavities where possible are now restored with lab ceramic made two visit ‘indirect’ composites and larger than this with veneers, crowns and bridges etc.


  7. Dental Implants now the number treatment option

    May 23, 2014 by City Dental

    In the last 50 years tooth replacement in dentistry has come from plastic denture teeth to bridge-work to dental implants and recently stem cell research producing the first differentiated teeth. This ‘tooth germ’ differentiating into teeth will be a treatment option in our lifetimes but in the meantime tooth loss in 2014 is best dealt with in many cases with titanium dental implants which were pioneered back  in the 1960’s by Professor Branemark in Sweden.

    Previous Dental Implants started off with unsuitable materials and techniques and coupled with high costs and poor success rates were rightly avoided by patients. This is all behind us and the latest dental implant placements are carried out under strict protocols backed up by correctly trained dentists and staff who can produce dental implants at relatively reduced financial outlay, often costing little more now than traditional poorer survival rate treatments like root canal/post crowns or bridgework in tooth replacement.


  8. Clear Aligners

    February 4, 2014 by City Dental

    Many of you will now be aware of the new clear aligner technology that is now available in the UK. At City Dental Clinic we now offer the Invisalign System. This has revolutionised the world of adult orthodontics and opened up treatment possibilities for those who understandably until now, did not want the traditional orthodontist ‘railway track’ look. Crooked and abnormally unaesthetic worn teeth can now become aesthetic and easy to clean again with clear aligners.

    Dr Robin Beveridge who has completed his treatment, made the following comments ” Clear aligners enable you to carry on with normal everyday life with the minimum of disruption or discomfort. My patients only know you have the aligners in when you show them.”


  9. 3D CT Cone Beam, MRI and mSv levels

    December 9, 2013 by City Dental

    3D digital technology is mentioned everywhere and dentistry is no exception.
    Hospital CT’s have enabled excellent 3D images using multidirectional xrays fired at the patient. The drawback particularly in dentistry has been the relatively high radiation dosage. Cone
    beam 3D CT has arrived in dentistry because the dosage can be 1/10 of the hospital CT scans.

    Radiation has the potential to cause cellular disruption and the more a patient is exposed the higher the risks of cancers etc. in the future. It is very difficult to escape radiation entirely as it comes from many everyday sources like the suns cosmic rays, radon radioactive gas in the ground, microwaves, mobile phones etc.

    Milliseiverts mSv are the measure of radiation absorbed by the body and Microsieverts 1/1000 of this. Putting things in perspective a flight from here to Spain can be a 4-7microSv whole body irradiation. 1 dental x-ray by comparison is also 4-7microSv but of course only irradiating the mouth area where fortunately there is very little in the way of radiation sensitive rapidly dividing cells. 2 D Panoramic x-rays are in the region of 17 to 26 microsv. The diagnostic advantages of these using relatively low doses of radiation are considered to far outweigh the risks. 3D Cone Beam CT can be 20 to 100microsv but the Hospital CT 1000microSv. Speak to your clinician beforehand about your radiography and be sure the image wanted outweighs any radiation concerns


  10. Hygienist Corner

    July 26, 2013 by City Dental

    More and more patients are wearing dental appliances such as Nightguards, Orthodontic retainers Partial and Full dentures which if you are not careful can aggravate and accelerate any predisposing decay and gum disease. Wherever the dental appliance comes into contact with the teeth and gums this potentially can act as a plaque trap in stagnation areas. Dental appliances are best cleaned using soft denture or tooth brushes and left to soak in cold cleaning solutions like “Retainerbrite”.

    In the mouth the stagnation areas are often on the tongue side, palatal and lingual teeth interspaces. As always, interspace brushes such as Te-Pe and Curaprox are the gold standard for cleaning. Every day please!