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4 surprising uses for Botox

June 5th, 2018

Did you know that Botox is a prescription drug and therefore it is not possible to walk into any clinic and ask specifically for Botox? Botox may be one of the treatments offered to help resolve your problem and indeed, the practitioner may decide that another form of botulinum toxin is preferable over the use of Botox. Throughout this article the terms botulinum toxin and Botox will be used interchangeably for the same treatment.

There are however a considerable number of uses for Botox which you may be unaware.

Facial lines and wrinkles

This is the most common use and is the most widely known use for botulinum toxin injections. The toxin works are relaxing the muscles and as they relax facial lines and wrinkles also disappear. Botox can also be used for:

Chronic migraines

This was first reported by Dr William Binder back in 1992. He was a doctor in Beverly Hills and he noticed that as he used Botox on his patients they tended to report fewer headaches after treatment. One of the manufacturers of Botox then began Testing his claims and found that they were indeed true.

Whilst the research conducted did indeed show a link between the use of botulinum toxin and headaches, it didn’t conclude as to whether the link was medical or placebo.

Excessive sweating treatment

This was also a side effect noticed by many clinicians in the early days of using Botox to treat facial lines and wrinkles. Botox stop excessive sweating (hyperhidrosis) by blocking the neurotransmitters that stimulate the sweat glands. Hyperhidrosis is a condition which affects approximately one percent of the population and doesn’t discriminate between men or women. The treatment was approved in the United States in 2004 and involves several injections around the affected area, usually in the armpits. The treatment last for around eight months each time.

Reducing gummy smiles

A “Gummy Smile” is a phenomenon that when some people smile, their upper lip elevates too far above their upper teeth, exposing gums and producing an unattractive smile. This happen due to a number of causes which can be assessed by your dentist/practitioner (This is one of the advantages of having a dental practice work with botulinum toxin as well as treatment). One of the causes is hyperactivity of the muscle which elevates the upper lip. Occasionally, the gummy smile is also aggravated by a thin upper lip that further contributes to the problem by exposing the upper gum even more.

Simply and safely we can help correct your gummy smile by reducing the muscles strong pull on the upper lip. To make a thin lip look fuller you may also wish to have some dermal filler treatment.

Bruxism or tooth grinding treatments

Bruxism is a medical term that describes the act of grinding the teeth and clenching the jaw. Regular and persistent grinding of the teeth can result in an ache in the jaw, headaches, earache, disrupted sleep and can also contribute to the wearing down, darkening and breaking of the teeth.

Most cases of bruxism occur subconsciously during sleep. It is usually associated with contributing factors, such as stress or anxiety. Severe bruxists often have overvdeveloped muscles giving them a swollen square like face.

It’s possible to treat patients with bruxism using a combination of botulinum toxin and mouth guards to help relax the muscles involved.

As mentioned previously when we were talking about headaches, you may also notice a reduction in the headaches after treatment for bruxism with botulinum toxin.

A word of warning About Botox

You should not be treated with BOTOX® if you have:

  1. a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease], myasthenia gravis or Lambert-Eaton syndrome).
  2. allergies to any botulinum toxin product
  3. had any side effect from any botulinum toxin product in the past
  4. a breathing problem, such as asthma or emphysema
  5. swallowing problems
  6. bleeding problems
  7. plans to have surgery
  8. had surgery on your face
  9. weakness of your forehead muscles, such as trouble raising your eyebrows
  10. drooping eyelids
  11. any other change in the way your face normally looks
  12. are pregnant or plan to become pregnant. It is not known if BOTOX® can harm your unborn baby.
  13. are breast-feeding or plan to breastfeed. It is not known if BOTOX® passes into breast milk.

8 Tips to Relax at the Dentist

April 18th, 2018

It is estimated that around 5% of the population have some form of clinically significant phobia, however when we look at dentistry it is estimated that between 9% and 15% of people avoid seeing the dentist because of some fear or anxiety (1). That equates to millions of people missing out on an opportunity to keep their dental health in excellent condition and smile with confidence.

To help go some way to overcoming those fears we’ve written, 8 tips to relaxing at the dentist:

  1. Talk to your dentist beforehand
  2. Book an introductory meeting
  3. Agree a stop signal
  4. Come early in the morning
  5. Bring a friend
  6. State educated and engaged about your treatment
  7. Stay sober
  8. Consider Sedation

Let’s look at each in turn:

Talk to your dentist beforehand

It might sound simple, but a dentist is trained to understand how patients feel when they visit. If your dentist knows that you are anxious or afraid then they can modify their treatment to help suit you. Your dentist can offer more frequent rests and check-in more often with you to make sure you are okay. They can also possibly modify the treatment to be quicker and have fewer appointments, so it’s always worth letting your dentist know and being honest about any anxiety.

Book an introductory meeting

Most dental practices will allow you to pop into visit them at any time, if you speak to one of the team members you may even be able to have a visit to the practice beforehand. This can help to allay your fears and concerns and get to know the surroundings in which you will be seen. This is of course entirely your choice, some people prefer to spend the least amount of time at the dentist as possible, and this is equally okay.

Agree a stop signal

Whenever you begin a treatment agree a stop signal with your dentist. Shouting out with your mouth full of dental equipment can often be difficult, agreeing that you will raise your left hand, for example, if there is a problem can be a good way to stay in control. Many people find that when they feel more in control that their anxiety and fears can reduce.

Come early in the morning

Rather than wait to the end of the day it’s often best to come to the dentist earlier in the morning if you are anxious. This means you don’t spend the whole day worrying and being concerned and can just get up, come to the dentist and then get on with your day. Again, if you talk to your dentist beforehand and explain that you would like an early appointment then they may be able to be more accommodating.

Bring a friend

Bringing a friend can be a good distraction from the dentist, but decide what you are going to talk about beforehand. There’s nothing worse than sitting in the patient waiting room with your friend staring blankly into space! Taking a little bit of time before your appointment to think about what you will discuss can be a great way to fill the time, think about holidays, celebrations or perhaps discuss happy memories with your friend.

Stay educated and engaged about your treatment

Sometimes the temptation can be to withdraw from treatment and not understand what’s going on. However if you stay engaged with your dentist and your treatment, within reason, it can help you feel as though you are more in control. Fear of the dentist often comes from a lack of control over the process and being engaged with your treatment means you can give your feedback and feel more confident.

Stay sober

The temptation may be to have a stiff drink before you come to the dentist but this can often have the opposite effect. Alcohol may make you feel even more anxious or afraid than you were before and in extreme could make you behave irrationally, there is certainly a link between alcohol and your dental fear as found in a 2014 study (2)… Not to mention needing to go to the toilet more often if you had a drink!

Consider Sedation

One way that can really help with dental anxiety and even phobia is to consider dental sedation. Dental sedation comes in a couple of forms allowing you to relax and drift off into your own world whilst treatment commences. If you have intravenous sedation you will need to come with a trusted friend who will need to stay with you for a few hours afterwards to ensure you are okay.

Summary to overcome dental anxiety

Communication is the real key, talking keeps you engage with treatment which means you are more in control and communicating accurately how you feel with your dentist will mean your dentist can modify the treatment and/or appointment times to suit you and feel more comfortable. As the old advert says… It’s good to talk, and it really is!

(1) https://www.colgate.com/en-us/oral-health/basics/dental-visits/what-is-dental-anxiety-and-phobia

(2) https://bmcoralhealth.biomedcentral.com/articles/10.1186/1472-6831-14-86

Questions to ask when finding a new dentist

February 23rd, 2018

Questions to ask a new dentist

If you’d ever tried to find a new dentist it can be quite a mine field. Patients at our dental practice in Oxford often ask questions so we thought it would be good to summarise some of those questions in an article to help you find the best dentist in your local area.

If you’re looking for a new dentist you will most likely be either because you are dissatisfied with your current dentist or have a particular dental issue which you need to resolve in a short period of time, either of those situations can be quite stressful, hence writing this article.

Are you taking all new patients.

It seems quite obvious to ask this question, the reality is that most dental practices will be taking on new patients but not all will be able to take on new NHS patients. NHS contracts have a specific number UDAs (units of dental activity) this needs to be carefully managed by the NHS dentist to ensure they have enough UDAs to go round all patients that need them. Private dentists on the other hand are usually limited in the number of patients they can see purely by the hours in the day and the length of time they wish to spend with each new patient.

What if I am anxious of the dentist.

Most people admit to having some kind of anxiety about going to the dentist. If this extends beyond this into a fear of phobia it’s always worth mentioning this to the dentist beforehand.

Many dental practices will have special protocols to help deal with anxious nervous patients, some dentists also offer dental sedation which can help you drift off into your own world during treatment.

Always mention any fear or anxiety about going to the dentist to the receptionist when you initially call, they can then put your mind at rest and modified their procedures if need be to help you relax.

 

do you have any areas of special interest?

Some dentists, whilst being fully trained in general dental procedures will undertake further training in more specialised areas of dentistry. Some dentists take a Masters level degree in one of the specialist areas, these specialist areas are regulated by the General Dental Council in the UK.

Not all dentists decide to take this Masters level education but do however attend many ongoing and high quality training courses, in particular areas such as cosmetic dentistry or dental implants. If you have a particular concern which you would like addressed by your dentist it’s worth asking them if they have a special interest in or specialism in that particular area.

What patient reviews do you have.

Ask for dentist reviews

Knowing that you are seeing a dentist that has happy patients will always be helpful at setting your mind at rest. If the dentist doesn’t clearly display their reviews and testimonials on their website don’t be afraid to ask. Any good dental practice will keep a record of these testimonials and have them freely available whenever you wish.

can I pay by credit card.

If you have a particular means by which she would like to pay always remember to ask before treatment. Credit cards and debit cards are taken by most dental practices now but it’s good to ask just to be sure.

do you have a membership scheme.

It might sound odd being a member of a dental practice, it’s hardly like being a member of a local gym! However, membership of a dental practice will often give you travel insurance, discounted rates for treatment and access to emergency dentistry which is not available to non-members. Membership at a dental practice can begin from approximately £12 per month.

Do you have a payment plan available?

Payment plans can be extremely useful for expensive treatments. Some dental implant and orthodontic or restorative treatments can run into many thousands of pounds so having a payment plan facility can make things more affordable on a monthly basis. Many dentists offer either payment plans or finance.

Will I have all recommendations in writing before going ahead?

This is an extremely important question to ask. No one wants to be taken by surprise with treatments they weren’t expecting or costs they hadn’t budgeted for. Your dentist should always give you a written treatment plan of exactly what is required prior to beginning treatment. The treatment plan should include the treatment specific to you, exactly what will happen and all costs involved.

What is your cancellation policy?

Unfortunately it is sometimes necessary to cancel appointments at the last minute. Being aware in advance of what your dentist cancellation policy is can save heartache and upset. Most dental practices will have a 24-hour cancellation policy, after this time many practices will charge if appointments are cancelled without very good cause.

We hope you have found this article useful in discovering what questions to ask when looking for a new dentist. Do let us know of any other questions you can think of…

Dentures – Are they really as bad as people think?

February 5th, 2018

If you have missing teeth dentures are one of a variety of ways to help you smile, eat, laugh and chew again with confidence. As well as dental bridges and dental implants dentures may be the perfect option for you. Dentures tend to be cheaper than bridges and dental implants, because they also replace soft tissue (gum) they can also be a more cosmetic way to replace missing teeth in some situations with patients that have lost a lot of bone. Patients are often asking what are the best dentures on the market?

This blog post will answer that very question.

Types of dentures

Dentures come in 2 primary varieties:

  1. Full dentures
  2. Partial dentures
Full denture

A full denture

Full dentures replace all of the teeth in a single arch, either the upper or lower arch. Partial dentures are used for patients wishing to replace missing teeth but who still have some of their own natural teeth. Very often these existing natural teeth can be used to anchor the partial denture.

A partial denture

A partial denture

The different types of dentures can also be made from different materials:

  1. Plastic/Acrylic dentures. Specifically Poly Methylmethacrylate.
  2. Cobalt chrome
  3. Gold (not used much nowadays due to the cost)
  4. Thermoplastic nylon materials (flexible dentures)

Plastic dentures

Classic plastic dentures have been around for many years, however they have improved in quality significantly, especially in the last 5 to 10 years where technicians have been able to contour and colour the pink plastic gum to exactly match the natural shapes and colours of the human gum tissue. This makes modern cosmetic plastic dentures highly aesthetic and almost undetectable from natural teeth.

Plastic dentures are most commonly used for full dentures, replacing all of the teeth in a single arch. Fully plastic dentures are less common when being used for partial dentures due to strength issues.

Cobalt chrome Metal dentures

Chrome is extremely strong and very light at the same time. It is also relatively easy to process and manufacture plus is highly biocompatible making it an ideal material to be used in partial dentures. When chrome is used to make a denture it is almost invariably used on the inside of your teeth closest to your tongue, keeping it hidden in this way means we can get all of the strength from the metal yet hide the unsightliness of it, covering the outside surface with tooth and gum coloured plastic.

Gold dentures

Gold is used in the same way as cobalt chrome, it is slightly more aesthetic but is much softer and of course, comes with a much higher pricetag. For this reason it has fallen out of favour for use in partial dentures.

Flexible dentures

Plastic and metal dentures have been around for many years now with little change. Flexible dentures on the other hand utilise modern advances in material technology which has enabled dental technicians to manufacture dentures from thermoplastic, nylon materials. These modern materials are virtually unbreakable, highly aesthetic, biocompatible and much softer than plastic or metal dentures. This makes them far more comfortable to wear with the wearer often finding they get fewer ulcers as a result.

Permanent dentures

Permanent dentures are also often known as fixed dentures. In essence, they can be made of the same plastic materials as regular dentures but they often have an internal high-strength core made of metal, most typically chrome cobalt or titanium. Utilising the most modern production methods dental laboratories can now make this high-strength framework using CADCAM technology, this ensures some of the best accuracy and consistency in manufacture around.

Permanently fixed denture on dental implants

Implant retained dentures

Permanently fixed dentures are most commonly fixed to dental implants, these dentures are known as implant retained dentures. They can be used to replace multiple missing teeth or to replace all missing teeth. If you need a full denture typically for to 6 dental implants can be placed, the implants have an attachment on top into which the permanently fixed denture is screwed. These fixed dentures can be removed by your dentist but cannot be removed by yourself at home.

This means you need to be particularly careful and vigilant of cleaning to ensure you clean adequately under and around the fixed denture in order to keep it clean and your breath fresh.

Living with dentures

If you have dentures it doesn’t mean that you can ignore your dental health. You will still need to look after your delicate gums and clean around existing teeth if you have a partial denture. Your denture itself also needs to be looked after.

How to clean dentures

Typical advice for cleaning dentures involves not using regular toothpaste as this can be rather abrasive, especially on plastic dentures. It is possible to purchase ultrasonic cleaning baths to clean dentures, as well as using special cleansing tablets.

We also recommend cleaning dentures over a sink filled with water. One of the most classic ways that dentures get broken is if they are dropped into the sink whilst cleaning. Filling a sink means that if you drop your denture it will at least fall into water rather than break against the sink bowl.

Loose dentures?

Loose dentures can be caused by a variety of reasons, if you have partial dentures then the clasps (clips) which grip hold of the natural teeth holding your denture in place can move or bend. If these move then the grip on the natural teeth can reduce and the denture can become loose.

Clearly, if you have a full denture there won’t be any clasps, so why does a full denture become loose?

The reason is that our bodies are living and breathing organisms, constantly changing. As we get older the bone in our jaw has a tendency to resorb. As it resorbs it takes the covering gum with it meaning your jaw is continually changing shape. This even happens if you have all of your teeth, the bone resorbs pulling the gum with it and the teeth become more exposed and look longer… Hence the expression ‘longer in the tooth’.

If you have a denture, this movement of the bone and gum can mean that the denture can become loose, if this has happened then you will need to visit a dentist and your dentist can reline the denture. This effectively keeps the teeth and gum on the outside of the denture in exactly the same place and relines the inside of the denture with new acrylic to fit over the new shape of your gum. Whilst not looking any different this can have a dramatic impact on how well your denture fits.

Fixing a lose denture

Fixing a loose denture with a reline by replacing material where your bone has resorbed.

How much do dentures cost privately?

Dentures will vary in price depending upon the material used, the complexity of the tooth replacement and the dentist you visit. A typical denture will start at around £700. This can be much cheaper than a dental implant which can cost from £2500.

 

 

 

The habits that cause dental problems

January 4th, 2018

Everyone wants to do all they can to keep their teeth fit and healthy for life, with healthy teeth we look good, can eat what we want and ultimately healthy teeth cost us less at the dentist. There are however a series of habits which can cause a range of dental problems, this blog post is dedicated to those habits and helping you understand some of the problems that these habits can cause.

Smoking

Yes, you guessed it were going to ask you to give up smoking! Without mentioning the risk of oral cancer, smoking fundamentally changes the fine balance of pH level in your mouth. Your mouth should ideally be at a neutral pH 7, this balance is kept because the bacteria which naturally reside in your mouth excrete acid as they digest their food, this acid naturally reduces the pH level and your saliva counterbalances this by being alkaline. If you smoke,  your mouth will be dry and the saliva cannot neutralise the acid, this means your teeth are bathed in a more acidic environment which can be more prone to tooth decay.

Smoking after tooth extraction

As well as altering the fine balance of acid and alkaline in your mouth smoking also tends to prevent healing. A research paper By a Consultant Oral and Maxillofacial Surgeon [1] on this subject states that,

Tobacco affects postoperative wound healing following surgical and nonsurgical tooth extractions, routine maxillofacial surgeries, implants, and periodontal therapies. In an experimental study, bone regeneration after distraction osteogenesis was found to be negatively affected by smoking. Thus, tobacco, a peripheral vasoconstrictor, along with its products like nicotine increases platelet adhesiveness, raises the risk of microvascular occlusion, and causes tissue ischemia

The research showed that because tobacco restricts blood vessels the healing process is not as effective as it is in non-smokers.

Thumbsucking

Thumbsucking can act like an orthodontic appliance. Whilst your teeth are generally stable in your mouth it doesn’t take much pressure to move them, if this pressure is continuous. Prolonged thumbsucking can put pressure on the inside of your teeth pushing outwards.

The effects of thumbsucking

Thumbsucking pushes the top teeth forwards creating a ‘buck teeth’ look, clinically called an anterior open bite. If this has happened from a very young age it can be extremely difficult to correct as the thumb pushes on the palate of the mouth and actually moves the bone as well as the teeth. It may not always be possible to simply push the teeth back to where they were before if the underlying bone structure has also been moved. The thumb sucking habit should ideally be broken as early in your child’s development as possible to prevent this bone movement.

The British Orthodontic Society have written a useful information sheet on thumbsucking. You can download this information sheet here.

Thumbsucking treatment

Thumbsucking appliance

Image source: https://dentagama.com/news/thumb-sucking-appliances

There are various thumb sucking treatment appliances available. Thumb sucking appliances such as these prevent the child creating a seal with their thumb, this means the sucking action has no force behind it and therefore the pressure cannot be put on the teeth and bone.

Brushing teeth excessively

Brushing your teeth twice a day is recommended by virtually every dentist, when this is coupled with  cleaning in between your teeth with either floss or an interdental brush and regular fluoride mouthwash in between brushing you stand the highest chance of maintaining excellent oral hygiene… However, you can go too far.

Your gums are resilient however I can only stand so much brushing. If you over brush your gums can begin to recede, this can give you the effect of looking ‘long in the tooth’. If you continue to brush the same area too much then as the gum pulls away it can reveal the softer dentine/root part of your tooth (usually hidden underneath the gum). Because this is softer it is more susceptible to damage from excessive brushing.

The following image clearly shows the gum which has receded from the teeth, you can see the darker (and softer) roots becoming exposed.

Gum recession

Image source: http://www.gumrecession.com/thinfragile.html

Brushing teeth excessively can wear away the enamel on the outer surface of your tooth, once this has been done and the softer denting has been exposed the wear will increase.

The effects of excessive toothbrushing

Image source: http://www.smileartsny.com/main-reasons-gum-recession/

How to brush your teeth

If you are experiencing either of that this use above we highly recommend purchasing an electric toothbrush with a pressure sensor. Many Modern electric toothbrushes have pressure sensors which let you know if you are pressing too hard, this can be one of the easiest ways to prevent excessive toothbrushing, especially as these toothbrushes have a timer.

When you brush your teeth, always keep the toothbrush at a 45° angle to your teeth, this is the optimum angle to keep your teeth clean.

 

Teeth grinding (bruxism)

Teeth grinding, otherwise known as bruxism is a common way to damage your teeth. Grinding teeth in your sleep is extremely common. The causes can be many, including stress & bite problems. Grinding teeth not only affects your teeth but can also lead to headaches as the muscles which power your jaw become tired and overworked.

Wearing a night mouthguard can help prevent teeth grinding, these work because your teeth cannot fit together, the mouthguard provides a smooth surface so your teeth slide over one another and it becomes impossible to grind. This means you will wake up in the morning and your muscles around your jaw, neck and head will have relaxed. This can have a significant effect not only on very affects of tooth grinding but on any associated headaches.

Using teeth as tools

Yes, some people use their teeth to open beer bottles, and guess what, the teeth break! Your teeth are designed to eat, please don’t use them for anything else.

Drinking too much sugar

This is the final one in our list, drinking too much sugar feeds the bacteria in your mouth. The bacteria love sugar and when they digestive they excrete acid and this acid attacks your teeth causing dental decay. The secret to having healthy teeth is to combine an excellent oral health care routine with a suitably matched diet. The sugar comes from many sources, not just added refined sugar, so it’s good to be aware of your complete sugar intake throughout the day.

 

[1]  Tobacco smoking and surgical healing of oral tissues: a review. Balaji SM1 2008 Oct-Dec;19(4):344-8.

What is Botox, is it safe and how does the procedure work?

November 10th, 2017

Questions and answers about Botox

A quick search on Google trends shows that the interest on the web for Botox is ever increasing, with more people searching it’s good to take advice on the safety, treatment and procedures for Botox. This blog post takes a look at some of the most commonly asked questions about this popular treatment.

The increasing searches for BOTOX

Common questions and answers

What is Botox?

In Botox is one of the leading brands of botulinum toxin,  typically used to treat the course and the signs of ageing, facial rejuvenation, excess sweating (hyperhidrosis) and gummy smiles.

What is it made of?

Botox is the brand name for botulinum toxin type a, it’s made from a bacteria which blocks nerve activity in the muscles causing a temporary reduction in muscle activity.

Is it safe?

When administered by professional in measured doses Botox is safe. You should however avoid Botox if have:

  1. a disease that affects your muscles and nerves (such as amyotrophic lateral sclerosis [ALS or Lou Gehrig’s disease], myasthenia gravis or Lambert-Eaton syndrome).
  2. allergies to any botulinum toxin product
  3. had any side effect from any botulinum toxin product in the past
  4. a breathing problem, such as asthma or emphysema
  5. swallowing problems
  6. bleeding problems
  7. plans to have surgery
  8. had surgery on your face
  9. weakness of your forehead muscles, such as trouble raising your eyebrows
  10. drooping eyelids
  11. any other change in the way your face normally looks
  12. are pregnant or plan to become pregnant. It is not known if BOTOX® can harm your unborn baby.
  13. are breast-feeding or plan to breastfeed. It is not known if BOTOX® passes into breast milk.

What is Botox used for?

Botox is typically used as an antiwrinkle treatment in the following areas:

  • Forehead lines.
  • Frown lines.
  • Eyebrow reshaping.
  • Bunny lines.
  • Gummy smiles.
  • Crows feet.
  • Lip lines.
  • Dimpled chin.
  • Marionette lines.
  • Platysmal bands.

Botox treatment areas

How long does itlast?

The effects of treatment will usually last between 4 and 6 months.

Does it hurt?

Any discomfort from the Botox is usually minimal and brief. Your practitioner may none the area to be treated prior to injecting the Botox. A cold pack or numbing anaesthetic cream may be used.

What does Botox feel like?

Botox won’t radically change your facial appearance, you won’t feel as though you have had a huge amount of work done and a full facelift. Botox works very specifically on just the muscles into which it has been injected. You will still be able to smile, laugh and frown after you have had Botox. The treatment usually lasts approximately 20 min.

Does Botox stop sweating?

Whilst Botox is not a miracle cure for excessive sweating (hyperhidrosis) it can have a dramatic effect and improve the symptoms immediately. The injections work by blocking the nerve action around the sweat glands located under your arms. The Botox is injected under your arms in a grid like pattern in a procedure which lasts approximately 30 min. The effects last between 6 and 12 months.

Does Botox wear off?

Yes, the effects of Botox wear off and you will be required to have top ups if you wish the results to continue.

How long does it take to wear off?

When used to treat facial lines and wrinkles Botox lasts between 4 and 6 months, it last a little longer, up to 12 months, if it is used to treat hyperhidrosis.

Does Botox stop blushing?

No, Botox does not help with blushing or hot flushes.

Does Botox lift eyebrows?

Yes. Our eyes and brows can be pulled down by the action of the muscles around our eyes. As we age this is exacerbated. Botox injections work by relaxing the muscles around your eyes and this results in a temporary inhibition of their movement and they no longer pull your eyes down.

What are the side effects?

Side-effects are rare but can include infection, inflammation, tenderness, swelling and localised pain. An experienced Botox practitioner will be able to keep all of these to a minimum.

Can it be used for migraines?

Yes. Botox was approved for migraine use in 2010. Because migraines are often chronic the treatment is given every 12 weeks approximately, it takes around 15 min each time to give the injections. When your muscles contract they release a chemical, Botox blocks this release and prevents the contraction of these muscles, this causes the muscles to become less stiff and it is thought that it is these muscles which are sensitive to pain, because they are less stiff they are less painful.

Botox or fillers?

Botox and fillers are typically used in different ways. Botox blocks the nerve receptors which prevent muscles from moving, if the lines and wrinkles caused by this muscle movement in Botox will help. Fillers fill in deeper lines and crevices around your face, typically these lines are not caused by muscle movement. Fillers and Botox may be used in conjunction to rejuvenate your face.

Free info pack

Download a free information pack

A 14 page report full of the most useful information, ideal if you’re thinking about any facial treatment

  • The costs and lowest price alternatives
  • Your options and choices for treatment
  • Are you suitable for treatment?
  • How do Botox and Fillers compare?
  • How long does treatment take?
  • 5 Easy Steps to Great Skin
  • Plus lots more…

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Free guide to facial rejuvenation

Tooth wear and abrasion, what can you do about it?

October 29th, 2017

Have you found that as you have got older your teeth have begun to wear? You might have noticed that the teeth look squarer at the edges, have yellow stains in them and generally look worn down? So what causes this and what can you do about it?

In this blog our Oxford dentist walks you through the tooth wear index, what to do if you have wear and abrasion to prevent it getting worse and what your dentist can do to restore your teeth.

What is tooth wear caused by?

The wearing down of teeth is caused by one of three phenomenon namely abrasion, erosion and attrition.

Tooth wear by abrasion

This is where a tooth wears by some action other than the teeth rubbing together or by chewing. The most typical type of abrasion is abrasion from pressing too hard whilst brushing your teeth with a toothbrush. Other forms of abrasion can be caused by wearing lip or tongue piercings or chewing things like toothpicks and pens for excessive periods of time.

Tooth abrasion from a toothbrush is usually most apparent on the cheek side (buccal surface) of the tooth as this is where many people put too much pressure, the abrasion is very often down towards the gum margin where the enamel is thinner.

Tooth wear by erosion

This is where tooth structure is lost via chemical contact. This can chemicals which are ingested such as highly acidic drinks like fizzy drinks or excessive consumption of fruit juice. Tooth wear by erosion can also be caused by naturally occurring bodily acids which come into contact with the teeth, this is typically from reflux disease or various eating disorders.

Tooth wear by attrition

This is the most common cause of tooth wear and can be attributed to the teeth grinding together either during chewing (mastication) or teeth grinding (bruxism). Teeth will naturally where as we age but this wear rate can be increased if the teeth do not bite together properly.

Measuring tooth wear classification using the tooth wear index

Your dentist can measure tooth wear using this index as originally described by Smith and Knight, this can be useful if you feel that your teeth are wearing over an extended period, your dentist can use this index to monitor the wear of individual teeth. The index is as follows:

  • 0 – No loss of enamel surface characteristics and no change of contour.
  • 1 – loss of enamel characteristics and some minimal loss of contour.
  • 2- enamel loss which is just exposing the denting and less than 1/3 of the surface. Defect areas less than 1 mm.
  • 3 – enamel loss just exposing the dentine which is more than 1/3 of the surface. Defect areas 1-2 mm.
  • 4 – complete enamel loss or pulp exposure. Defect more than 2mm.

You may begin to notice sensitivity in your teeth when your tooth wear index reaches level 2.

Tooth Wear Management

The first place to start with managing tooth wear is to speak your dentist. They can assess the amount of wear using the index above and advise as to the cause, abrasion, erosion or attrition.

Tooth abrasion management

Advice and guidance on how to brush your teeth can be provided by the dental hygienist. They will be able to assess the location of the abrasion and work out what is causing it, very often it’s caused by pressing the toothbrush in difficult to reach areas.

Many electric toothbrushes also have a pressure sensor which let you know if you are pressing too hard, this can be very useful adjunct in controlling tooth abrasion.

Once you have the cause of the abrasion established and eliminated your dentist can then look to replace missing tooth structure. In minimal cases this will often be done using dental bonding, in more severe cases dental veneers dental crowns may be required.

Tooth erosion management

If the erosion is caused by external assets being ingested then the dental hygienist will be able to give you dietary advice on the amounts of these acidic drinks you should be drinking. If the erosion is caused by medical condition their medical advice will need to be sought.

Tooth attrition management

Your dentist will be able to assess the way your teeth move together, how they work as a unit and how your jaw functions. This is known as your ‘occlusion’ and your dentist will be able to spot malocclusions and recommend the best treatment. Sometimes this is rebuilding back teeth using dental bonding, ceramic overlays or dental crowns. It may also involve orthodontics to move teeth to a better position.

Before and after tooth wear treatment

After treatment, notice how the upper teeth have been rebuilt on the incisal edge ( this is the tip of the tooth on the opposite side of the gum). A more natural rounded shape has been achieved using dental crowns.

Why You Should Stop What You’re Doing and Book a Hygiene Session!

May 13th, 2016

Dental hygienists are experts in the field of freshness and treatments that keep oral diseases at bay. If you suffer from gum disease or have a high risk of developing the condition, your dentist might advise you to see the hygienist. However, you don’t need to be suffering to benefit from hygiene treatment. Whether you’re battling with bad breath, are prone to plaque or simply want to treat your mouth to a fresh, clean feeling, why not book yourself in for an intensive cleaning experience?

What can a hygiene session do for me?

Dental hygiene sessions can make a massive difference to your oral health, especially if you’re at risk of dental disease. Cleaning treatments remove stubborn plaque, tartar and bacteria that your toothbrush can’t get, as well as giving your mouth that clean, fresh feeling.

Our amazing hygienists also offer preventative treatments and can offer advice about oral hygiene at home, healthy eating for your teeth and giving up smoking. We aim to promote good oral health and help you enjoy a beautiful, healthy smile.

Oral hygiene and gum disease

Dentists and hygienists work together to effectively treat and manage gum disease. Regular hygiene sessions are an essential way to tackle plaque and prevent gum disease from developing or getting worse.

How can I find out more?

To find out more about dental hygiene and the services we offer, contact reception today.

Discover the Convenience of Invisalign Braces

April 16th, 2016

Although metal braces are extremely effective at straightening teeth, they are highly visible and can have a huge impact on your self-confidence in social situations.  Thankfully metal braces are no longer the only option if you’re unhappy with your teeth. Invisalign braces are virtually invisible and straighten your teeth comprehensively without the metal brackets and wires.

What you need to know

Because they are made from clear plastic, Invisalign braces are often known as ‘see through braces’ or ‘invisible braces’.  Like traditional braces they are constructed to fit the exact shape of your mouth so that the maximum effect is achieved.  Modern dentists use computer technology which means that Invisalign aligners can be made and fitted quickly, without the need to wait while dental putty moulds are made into impressions.

Invisalign braces are completely removable, but for the best results you should wear them for at least 20 hours a day.  They are more comfortable than traditional braces too, because there is no tightening of wires involved. Instead, your dentist will provide you with a new set of Invisalign braces as and when you need them to continue the process of adjusting your teeth.

The Problem with Wisdom Teeth

March 18th, 2016

3534882_blogHumans have a complicated relationship with wisdom teeth. In ancient Arabic they are referred to as being the “teeth of maturity” and the Korean culture calls them “love teeth” due to the pain they can cause when growing in. Wisdom teeth, the latecomers to the mouth, can also be the cause of many dental problems for patients in Oxford.

Most people begin to start experiencing problems with wisdom teeth between the ages of 16 and 25. When wisdom teeth come in they generally produce pain and make chewing uncomfortable. The emergence of these new teeth tends to disrupt the entire alignment of the jaw and mouth, enhancing the pain they cause. This drastic altering of the jaw’s alignment can lead to tooth decay, inflammation and gum problems.

Although useful in later life (once fully formed, wisdom teeth function as any other molars and can be used for grinding and chewing), wisdom teeth can bring with them a host of problems. Common symptoms of wisdom teeth problems include stiffness in the jaw, swelling of the gums around the emerging tooth, pain and irritation and tooth decay.

Because wisdom teeth tend to force their way into a mouth that is already aligned and has been aligned with its adult teeth for some time, crowding is a common problem resulting from the arrival of wisdom teeth. It is a problem that is so serious that it warrants the removal of the wisdom teeth by extraction.

In addition to problems with overcrowding, wisdom teeth are removed for the pain they cause when they rub against the inside of the cheek and jaw. Wisdom teeth are also removed if they haven’t come in properly and remain impacted either in the jaw bone or beneath the gums.

Wisdom teeth commonly pose a lot of problems and in fact only 10 percent of all adults report never experiencing discomfort or pain associated with wisdom teeth. While they do seem troublesome, it is important to know that wisdom tooth extraction is a routine procedure at dentist surgeries around the world and is usually performed effortlessly and with few negative side effects.

I am dropping a note to say thanks for all the work you have done for me, I am aware that I am not the easiest of patients. Your patience and explanations whilst work is underway was very much appreciated. The bridge work is really outstanding, here’s hoping I need nothing more than routine checks for some time.
- Mr R G
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