Our grateful thanks to London dentist James Goolnik for his contribution to our report, which you can hear via the radio player further down this page. Our thanks also to the Oral Health Foundation for the use of the support information below.
Teeth The recent shocking story about the amount of HNS money spent on chilldren's teeth extractions in hospitals has led for calls for more to be done to educate children about good basic oral hygiene, but it's not just children that need to educated - research shows that up to half of us could be adding to the problems in dentistry through poor basic oral health routines. There is so much more we could do for ourselves - it’s not just the toothpaste we use - but how often we clean our teeth, the length of time we take to clean them and the brushes that we use.
We should be brushing our teeth twice a day and for a minimum of 2 minutes each time as we heard from Dr James Goolnik we must make sure that we clean our teeth and gums every night with a fluoride based toothpaste, in conjunction with flossing or using specialised brushes designed to get between our nashers to get rid of food deposits and clear plaque.
If you've never been taught how to brush your teeth or the type of brush you should use, you're not alone. Research shows the vast majority of us have never been taught how to clean our teeth properly or are aware of which brushes you should use - your dentist or hygenist can give you all the advice you need on this - so dont be afraid to ask!
It’s important to replace your toothbrush every three months and also to cut down on your intake of sugary drinks and foods.
You should get your teeth checked regularly as a thorough dental examination can spot decay or dental problems early, dentists also check whether you have signs of mouth cancer, which is on the increase. (see below for more on mouth cancer)
Cosmetic dentistry as we heard from James Goolnik, a past president of the British Academy of Cosmetic Dentistry it's important to do your homework when looking at cosmetic dentistry - take your time and think everything through- as he told us, most general dentist aren't trained in cosmetic dentistry, so ensure that the practitoners you are speaking to has the apporopriate qualifications and has experience - the vast majority will be members of leading cosmetic dentistry trade bodies - talk to friends and family about who they've used -your general dentist will also be aware of leading practitioners in the area. Ensure you get all the facts on the procedure before going ahead, ask to see before and after shots of actual patients - not model photos and talk every thing through with the dentist who will be doing the procedure.
Whitening Or bleaching your teeth Everyday life takes its toll on our teeth. Drinking too much tea or coffee, smoking or even eating strongly coloured foods can stain and discolour them. There are toothpastes available, which will help remove these stains, but they can't change the actual colour of the tooth underneath. The best person to discuss teeth whitening with is your dentist. Not every dentist agrees with or offers teeth whitening, however those that do are best served to meet your requirements.
The colour of your teeth is determined by your DNA, just like the colour of your hair or your eyes. As we get older, the dentine - the soft, pulpy substance below the enamel that protects the nerves and the blood supply to the tooth - changes colour, becoming more yellow. This is something which a stain-removing toothpaste alone cannot help.
Dentists can, though. By applying a bleaching agent to the teeth, they can whiten the teeth, giving you a sparkly white smile. This procedure is simple, harmless and practically painless.
It is important, though, to do it under your dentist's supervision. Don't be tempted to buy kits over the counter or on the internet. Not only are the trays used not made to fit your mouth exactly, bleaching isn't suitable for everybody, especially if you have gum disease or crowns and of course, you have to be extremely careful using the chemicals that are supplied. Dentists are trained and regulated in using these agents - the public aren't.
How will your dentist whiten your teeth? The most common way a dentist will whiten or bleach your teeth is using a special sleeve and some gel. First of all, the dentist will give your mouth a thorough check-up to make sure there are no other problems and that your gums are nice and healthy. Then he or she will take an impression of your teeth, upper and lower, using a special tray with dental putty. Using that impression, a plastic sleeve will be made which can fit snugly and exactly around your teeth.
The dentist will then show you how to put a small amount of the bleaching gel into the sleeve and then how to slide it over your teeth. Then you take the sleeve and the gel home and use it overnight, maybe every other or every third night, until your teeth are the desired colour. You may find that your teeth are more sensitive for about 24 hours after each application, but this is only temporary.
There are other ways a dentist may whiten your teeth, for example with the use of lasers, which may be quicker. The advantage of the 'sleeve' method, though, is that you have greater control over the colour.
Veneers Not all of us are happy with the way our teeth look. Maybe one of them is discoloured or chipped or perhaps it's slightly crooked. Although the tooth may well be healthy, the way it looks can make us really self-conscious. Your dentist can help by applying something called a veneer.
A dental veneer is a thin layer of tooth-coloured material - usually porcelain - which the dentist attaches to the damaged or discoloured tooth. Once it's been attached, it will look just as natural as your other teeth. Applying the veneer is a relatively simple procedure and can be done in a couple of visits to the dentist. The dentist will remove a tiny amount of the tooth's surface so that when the veneer is applied it doesn't feel bulky and mould - of your mouth so that a technician can make a veneer comfortable. They will then take an impression - that will match the size and shape of the rest of your teeth. On your second visit, the newly-made veneer will be stuck on with special glue.
Veneers can also be made out of the same material that makes white fillings. Your dentist will simply apply a small amount of acid to your tooth to make it a rougher surface and then gradually add layers of filling material to get the right look for you.
Orthodontics Having crooked teeth or large gaps between your teeth can cause problems. Food and bacteria could get stuck between the teeth which could cause decay. Similarly, if your teeth stick out, this could cause problems, either with mouth ulcers and decay, or with speech problems. Your dentist might suggest that you have your teeth straightened through orthodontics - by wearing a brace.
The majority of orthodontics are carried out on teenagers, but increasing numbers of adults are opting for orthodontics too. Your dentist will probably refer you to a specialist - an orthodontist - who will take examine and probably x-ray your teeth to see how best to straighten them.
Conventional dental implants Dental implants are an ideal solution for replacing missing teeth, bridges or dentures and the next best thing to natural teeth. Dental Implants are small titanium screws, that are placed into the jawbone to create a permanent new root. A robust tooth coloured crown is then placed over the dental implant.
Mini Implants Mini implants can be ideal for replacing missing teeth or securing dentures. Mini Implants can be placed in a much shorter time than conventional Dental Implants. The benefits with are that it’s a non-surgical, minimally invasive technique avoid cutting the gum, no stitches and often painless healing, placement can be achieved in minutes and are immediately usable) and are designed for thinner bone which avoids the trauma and cost of bone grafting.
Mouth Cancer can occur in any part of the mouth, tongue, lips, throat, salivary glands, pharynx, and other sites located in the head and neck area. These mouth cancers have a higher proportion of deaths per number of cases than breast cancer, cervical cancer or skin melanoma.
Oral and pharyngeal cancer is the sixth most common malignancy reported worldwide and one with high mortality ratios among all malignancies. As with most cancers, mouth and oropharyngeal cancers are more common in older people. There are very few cases in people under 50. Every year in Europe, around 100,800 people are diagnosed with head and neck cancer and almost 40,000 die from the disease.
Although there have been significant improvements in chemotherapy and surgical techniques, the disease is often particularly challenging to treat since most patients present with advanced disease, have secondary tumours and suffer from other co-morbidities.
In the UK, the survival rate is just over 50%, despite treatment, and this is because of late detection. An increasing number of young people are being affected and 25% of the cases have no associated significant risk factors.
They are also more common in men than women. But rates of these cancers in women have been increasing in recent years. This is because women took up smoking in large numbers much later than men and we are only now seeing the effects.
Tell tale signs In the very early stages, mouth cancers can be almost invisible making it easy to ignore. You can improve your chances of survival if the cancer is detected early and rapidly treated. It is important to have a self-awareness and to perform regular, self-examinations to help in the early identification of these symptoms, which include; A sore or ulcer in the mouth that does not heal within three weeks.
Reducing your chances of developing mouth cancer
Stop smoking and moderate/cease alcohol consumption. Smoking tobacco (cigarettes, cigars and pipes) and drinking a lot of alcohol are the main risk factors for mouth cancers in the western world. Cigarettes and alcohol contain nitrosamines and other chemicals that are known to cause cancer. Your risk increases the longer you smoke. If you are a smoker and also drink a lot, your risk is even higher because they act together to cause cancer.
Stop chewing tobacco or betel quid with tobacco is known to cause mouth cancer. This is very common in parts of Asia. It is also popular in some immigrant groups in Europe, North America and Australia. The harmful substances in tobacco and betel quid can cause cancer if they are in contact with your gums and tongue over long periods. Mouth cancer is much more common in parts of the world where people chew betel quid. Of the estimated 390,000 cases of oral cancer worldwide each year, well over half occur in Asia.
Maintain a balanced diet poor diet may increase your risk of certain types of mouth and oropharyngeal cancer. This may be because of a lack of zinc, or other vitamins and minerals. If you eat a well balanced diet, with plenty of protein, you are unlikely to be short of zinc. A diet high in fresh fruit and vegetables seems to reduce the risk of developing cancer of the mouth. This may be because these foods contain a lot of antioxidant vitamins and other substances that help prevent damage to body cells. Eating a lot of processed and salty meat may increase risk of mouth cancer.
Listen to this weeks radio report
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