Thursday, 07 June 2012

Ask the dentist…

Andrew Dawood, a dentist specialising in implant and cosmetic dentistry, answers the questions you might like to ask about dental health…

Written by Andrew Dawood
At what age should we start brushing our teeth?

You are never too young for supervised brushing. The best habits start early.

Are mouthwashes a good idea?

Always make sure your mouthwash is alcohol free. Fluoride mouthwash is a good idea for people who are at risk of cavities. Some mouthwashes are useful if you have gum problems. Discuss this with your dentist or dental hygienist.

Is there an alternative to bleaching for older teeth?

Tooth whitening is an effective option for older teeth. It is appropriate for teeth of all ages, but we do not recommend it for children.

What are the most common dental health problems that patients have?

We treat patients with concerns ranging from discoloured or broken teeth, to gum problems and extensive crown, bridgework, or veneers – major cosmetic issues. My own work centres around implant dentistry. The patients I treat usually have unattractive, missing or failing teeth, and may be wearing removable dentures – which they hate.

What types of implants are there and who should have them?

Dental implants are titanium fixtures that are carefully inserted into the jaw. Some implants are better in soft bone, and other implants are better in hard bone. When patients lack bone in the upper jaw, which is a very common situation, a dentist might use zygomatic implants, which overcome the problem of massive bone loss by extending to the cheekbone for anchorage. There are an extensive selection of implants and implant components available so that we can manage every situation.

What impact can implants have on someone's life?

Replacing a missing front tooth can make all the difference to somebody's appearance, confidence and smile. But it is an incredible source of satisfaction to see how providing implants for someone who has struggled for years with an ill-fitting, unattractive denture can transform their life. We've helped patients who couldn't socialise for fear of their dentures coming loose. One story that always makes me smile is that of a patient who had been a successful model, wearing dentures for 30 years when I met her. She returned to our practice after having implant bridgework, so excited because she could eat and taste chocolate, having only been able to suck it for years.

Is having implants a long, complicated and expensive process?

This used to be the case, but rarely is nowadays. Planning the right kind of treatment and appearance for our patient is important, and this must take as much time as is needed. But once we have the right plan, most of our patients are treated in a single session. It is entirely normal for us to remove teeth, place implants, and provide lifechanging fixed bridgework in a day.

How have implants changed over the last 10 years and how do you think they will change in the future?

Implant dentistry has changed dramatically over the last 10 years. The implants used are much more sophisticated, and the technology that we use for planning treatment and making the implant crown or bridgework has transformed the treatment process. Back then, surgery could take hours and involve making large incisions in the gum. Nowadays, treatment is planned with the benefit of 3D-imaging technology, which allows us to use much less invasive techniques, and sometimes to provide treatment in a matter of minutes. Ten years ago patients with extensive bone loss would often need extensive bone 'graft' surgery, building up the deficient jaw with bone taken from the hip. This is almost a thing of the past, as there are now so many ways to work around these problems.

What are your top tips to keep your teeth healthy?

Gum disease is the most significant cause of tooth loss for most people, and is easily avoided. Brush your teeth! Excellent cleaning and oral hygiene makes all the difference in the world. See your dentist and hygienist for regular hygiene maintenance, and use floss or interdental brushes to clean between the teeth. Smoking is also a major cause of problems. Give it up.

Andrew Dawood is a specialist in periodontics and prosthodontics. He lectures in the UK and abroad, and devotes time to research and development in implant dentistry. He can be consulted at Dawood & Tanner, 45 Wimpole Street, London W1: 020-7935 0080,

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