Preventative Dentistry

The core of what we do here at Plumfield.

What is general dentistry?

General dentistry is the practice of oral health care and preventative dentistry, including cleaning, x-rays, cavity prevention, tooth extraction, and fillings. General dentistry covers the basics of keeping a healthy smile.

By scheduling regular visits, your dentist can identify problems early and help prevent minor dental issues from becoming more serious. In addition, good oral health can affect your overall well-being and quality of life.

  • A routine examination is at the centre of creating your dental plan. It lets your general dentist clearly define what treatment is necessary for oral health.

    Sometimes referred to as a “dental check-up, " a routine examination will thoroughly inspect the tissues of your head and neck, jaw joints, mouth, teeth, and gums. Identifying underlying oral health problems such as disease, tooth decay, and cancer.

    A routine examination can spot early signs of any irregularities and treat them before they progress further. This is extremely important as many oral health issues are “silent” and go unnoticed.

    Most routine examinations will involve your general dentist physically looking at your mouth and taking pictures using X-rays to evaluate your oral health further. This is to check how your teeth line up when you bite, check for cavities, check the positioning of all your teeth and jaw, and check for any abnormalities, including bone loss. X-rays will provide a more in-depth look at your situation.

    Just to let you know, a routine examination will not prevent oral health complications. Instead, it assesses your situation to build a plan to help avoid problems and improve your oral health.

  • Why do I need a hygiene appointment?

    Your oral health owes a lot to your gums, so it is essential to look after them. Your brushing and flossing routine at home can remove most plaque build-ups on your teeth. Still, a regular professional clean is vital to remove stubborn tartar deposits, protecting your smile from bacteria.

    Your dental hygienist is best placed to look after your gum health, able to spot and treat any early signs of gum disease. The symptoms are mild and often overlooked, but gum disease can lead to receding, swollen and inflamed gums and, if left untreated, result in tooth loss and affect overall health. We can help prevent these issues from developing and leave you with a brighter, healthier, more confident smile.

It’s proven that our membership plan patients are more likely to visit the practice at regular intervals.

Periodontal Treatment

‘Periodontitis’ is a form of gum disease and it can be more common than you think to be diagnosed with it. As well as regular hygiene visits, you may be advised that a course of ‘Perio’ treatment is needed.

We know this can sound scary so we have gathered some in-depth information on this topic that we hope you find useful.

  • Periodontitis causes irreversible destruction of the bone and tissues that hold the teeth in the jaw. The disease is usually slowly progressing, but it can go through periods of rapid destruction and in rare cases it can be very aggressive. You will need to make changes to your lifestyle and daily routines if you wish to keep your teeth. You will also require continuing support to prevent it from getting worse and detect any relapse.

    This will mean regular dental examination appointments in the initial phase, until the disease is stabilised.

    The end result of periodontitis can be tooth movement and eventual tooth loss. Periodontitis is usually a painless, silent disease, causing problems in the late stages, usually due to pain associated with tooth mobility (‘looseness’) and recurrent gum abscesses.

    Periodontitis is treatable and we can stabilise the disease, but this only works with your daily cooperation.

  • • Bleeding gums - healthy gums DO NOT bleed during brushing or use of floss/interdental sticks

    • Swollen and tender gums

    • Bad breath

    • Recession of the gums

    • Tooth loss

    • Sensitivity of the teeth

    • ‘Lengthening’ of the teeth  

    • Loose teeth

    • Gum abscesses

  • Periodontal treatment or therapy involves cleaning the teeth and root surfaces from calculus (‘tartar’), plaque, toxins and diseased tissues. This is called deep scaling and is often done under local anaesthetic (‘numbing’) to avoid discomfort and allow thorough cleaning to be done. The aim of the treatment is to systematically clean all affected root surfaces from the harmful material and toxins that can cause further destruction of bone and supporting tissues. This is often done over more than one visit, following a detailed assessment of your gum health.

    There are many risk factors for periodontitis, but the main risk factor is plaque – a sticky ‘film’ which forms on teeth and gums and contains harmful bacteria.

    In order for periodontal treatment to be successful, it must be supported by very high standards of daily home care, to help control plaque. This will inevitably mean that cleaning your teeth will now take longer than before. This can be up to 20 minutes twice daily, in order to achieve the high standards of oral hygiene needed.

    If periodontal therapy is not supported with excellent hygiene at home, it will not be successful, leading to more bone loss, tooth looseness and eventual tooth loss.

    The disease works in a very similar way to type 2 diabetes. Just as a diabetes patient has to keep tight control of their diet and monitor their blood sugar levels, similarly you will need to keep tight control of your brushing and reduce levels of plaque in your mouth.

    Apart from plaque, the other risk factors for periodontitis are smoking (including other tobacco and nicotine use), poorly controlled diabetes, genetic factors and a diet high in refined sugars, low in antioxidants (found in fruit and vegetables).

    If you are a smoker, it negatively impacts upon how you heal, making periodontal therapy less effective. Therefore, it is important that you stop smoking or using other oral tobacco for treatment to work well. If you would like some support to stop smoking, please speak with your dental team.

    Likewise, uncontrolled diabetes with high blood sugar levels causes increased destruction of the bone and tissues supporting the teeth and patients do not heal well after treatment. It is vital that diabetes is controlled with the help of your general medical practitioner.

    After periodontal therapy, you may notice:

    •Increased sensitivity of the exposed root surfaces to hot, cold or sweet food/drinks

    • Increased susceptibility to root surface decay

    • Temporary increases in tooth mobility/’looseness’

    • Recession of the gums and exposure of the root surfaces

    • Elongation of the teeth

    • A black ‘triangle’ appearance between the teeth where gum has been lost.

    ‘Black triangles’ and sensitivity are irreversible, but if treatment is successful, can be masked, either by your dental team, or with the help of a specialist.

    These side effects arise as the gums begin to heal and the deep pockets below the gum reduce.

    The aim of treatment is to reduce these deep pockets where bacteria live, which are inaccessible to daily home cleaning and therefore require deep scaling. Your role is central and crucial in maintaining low plaque levels in the mouth, as well as managing the other risk factors. For this reason, periodontal therapy does not guarantee stabilising the condition.

    In most cases, when the main risk factors, such as smoking and uncontrolled diabetes are eliminated, and immaculate oral hygiene is maintained, periodontal disease will stabilise. This will work for many people.

    However, periodontal disease can sometimes be challenging to treat and you may need a referral to a specialist in gum disease (periodontist).

    Referral to a gum specialist can also be done from the onset, and if you would like to be referred immediately, please discuss this with your dentist.

  • If you don’t like the appearance of discoloured or dark fillings in your mouth or would prefer more natural fillings, why not talk to a member of our team?

    White fillings are made of composite resin, which can be more aesthetically pleasing than some of the conventional materials traditionally used, such as silver amalgam.

    Composite resin bonds to the enamel of your teeth and can be closely matched to the colour of your teeth. It requires minimal tooth preparation compared to amalgam fillings, veneers or crowns. When applied correctly, composite resin can even fill teeth towards the back of your mouth.

  • Composite can be used to restore the shape and colour of natural teeth. However, if the tooth is heavily broken down, with no enamel, the composite will not bond as strongly to your tooth. Other options, such as amalgam fillings or crowns, may be more suitable for rebuilding the shape and function of your tooth. If you have any concerns, please talk to your dentist.

  • Some patients believe replacing metal fillings with composite fillings will improve their health. However, this has not been proven scientifically, and there are no promises or guarantees that the removal of silver fillings and the subsequent replacement with composite fillings will improve, alleviate or prevent any current or future health conditions.

  • Yes. The technique for placement of white (composite) fillings can differ from amalgam, but it can be equally strong once set in the mouth.

    Though composite resin technology continues to advance, extreme chewing pressures or other traumatic forces, such as tooth grinding or clenching habits, may cause white fillings to be dislodged or fractured. The resin-to-tooth enamel bond can fail, resulting in leakage and recurrent decay.

  • Yes. We recommend waiting at least four weeks after tooth whitening to have your white filling placed or replaced for best results.

    Existing white fillings will not change colour with tooth whitening.

  • A crown entirely covers or "caps" a damaged tooth. A crown can be used to improve its appearance. Porcelain or ceramic crowns can be matched closely to the colour of your natural teeth.

    Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger or allow the conservation of more tooth structure and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is strong and attractive.

    Your dentist may recommend a crown to:

    • Replace a large filling when there isn't enough tooth remaining

    • Protect a weak tooth from fracturing

    • Restore a fractured tooth

    • Attach a bridge

    • Cover a dental implant

    • Cover a discoloured or poorly shaped tooth

    • Cover a tooth that has had root canal treatment

  • A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into empty spaces, affecting your bite or ability to keep the area clean.

    Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost.

    Crowns and bridges are custom-made in a dental laboratory, following the preparation of the teeth and moulds of the mouth taken by your dentist. Therefore, they require at least two visits to complete.

  • A denture is a removable appliance which replaces a missing tooth or teeth and is an alternative to implants or bridges.

    Dentures consist of a flesh-coloured acrylic, flexible or metal base which fits over the gums and around any remaining natural teeth. The base of an upper denture may cover the palate (the roof of the mouth), while that of the lower denture is shaped like a horseshoe to accommodate the tongue. A partial denture may require crowns or natural teeth to anchor it.

    Dentures are custom-made in a dental laboratory from impressions and measurements taken of the mouth. Dentures typically require more than one visit to complete. Conventional full or partial dentures will require healing time following any necessary extractions and at least three visits to complete.

    A denture may also be used as a temporary replacement for missing teeth if you need time to heal before having a bridge or dental implant fitted or as a permanent form of treatment if your teeth cannot support bridges or crowns.

  • Usually, a local anaesthetic is used, and it should feel no different to having an ordinary filling done. There may be some tenderness afterwards, but this should gradually decrease over time.

  • The treatment aims to remove all the infection from the root canal. The root is then cleaned and filled to prevent any further infection.

    Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist.

    The infected pulp is removed at the first appointment, and any abscesses can be drained. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in, and the tooth is left to settle.

    The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled. This may also require x-rays, before, during and after the treatment.

  • In the past, a root-filled tooth would often darken after treatment. However, with modern techniques, this does not usually happen. If there is any discolouration, there are several treatments that can help to restore the natural appearance.

  • Root canal treatment is usually successful. However, if the infection comes back, the treatment can sometimes be repeated. This may require referral to a specialist.

  • The alternative is to have the tooth out. Once the pulp is destroyed, it can't heal, and leaving an infected tooth in the mouth is not recommended.

    Although some people would prefer to have the tooth out, keeping as many natural teeth as possible is usually best.