A dental implant (‘screw in tooth’) is designed to replace the missing root and to hold an artificial tooth in place. It is made of titanium and placed into the jaw bone under local anaesthetic. It is used as a base from which a false tooth, bridge or denture can be attached. There are seen as the ‘gold standard’ or ‘ideal’ way to replace missing teeth as they do not involve any neighbouring teeth, are secured in place and when placed correctly, are a very predictable treatment.

At Blairgowrie Dental Care we work very closely with specialist oral surgeon, Paul Stone and his team at Blackhills Specialist Referral Clinic in Aberuthven. Paul has been registered as a Specialist Oral Surgeon since 2001 and has been involved with implant dentistry for more than 25 years placing several thousand implants over that period. Once the implant is placed we can then proceed with the required restoration at Blairgowrie Dental Care.

Not all missing teeth can be replaced with dental implants. Your dentist will discuss all treatments options with you and explain which are suitable for your own situation.

Blairgowrie Dental Care is committed to high quality dentistry with a great team consisting of dentists, nurses, hygienists and front of house staff. We are keen to hear from you about your experiences.

If you would like to leave a compliment or comment, it would be helpful if you can provide us with as much detail as possible. You can contact us in writing, by telephone, by email or face to face.

Where possible, it would be helpful if you can tell us:

• Are you the patient (yes or no).  If no, please give your name and relationship to the patient
• Patient’s name and date of birth
• Your contact details (a postal address, email or telephone number)
• Brief description of compliment
• Date

Thank you.

Feedback and Complaints Officer Michelle Gormley
Blairgowrie Dental Care

64 High Street

Blairgowrie PH10 6DF
Telephone: 01250 875 136
Email: [email protected]

Blairgowrie Detnal Care Complaints Policy

We consider all feedback, comments, concerns and complaints as a way of looking at what we do and making changes to improve our service to patients. A written copy of our complaints policy is available on request.

We always try to resolve your complaint at the most appropriate level. If you can, first talk to a member of staff involved with your care. We will try to sort out the complaint at that time.

If you are unable to talk to the member of staff involved with your care, ask to speak to Michelle Gormley, our Feedback and Complaints Officer.

We aim to try to resolve your complaint at the time it is made –  this can be in person, in writing, or by email/fax. However, if we can’t resolve your concern at the time then we will write to you within 3 days explaining our processes.

All views will be taken seriously and our procedures will provide a full written response within 20 days following our investigation.

In the unlikely event that we can’t resolve your complaint then there are further options available to you:

Scottish Public Services Ombudsman (SPSO)
4 Melville Street
Edinburgh
EH3 7NS
Tel.: 0800 377 7330
www.spso.org.uk
Freepost EH641, Edinburgh EH3 0BR
Open from 9.00am – 5.00pm (Mon – Fri), from 10.00am – 5.00pm (Tues)

General Dental Services (for complaints about private treatment)
Dental Complaints Service
Stephenson House
2 Cherry Orchard Road
Croydon
CRO 6BA
Tel.: 08456 120 540 at local rate (Mon-Fri, 9.00am – 5.00pm)
[email protected]
www.dentalcomplaints.org.uk

There is another method of tooth whitening available which is often termed 'laser' (although no laser is used) or 'power' whitening. It is carried out in the dental surgery using a strong whitening product and a light source. We do not favour this method for several reasons:

1. There is an increased risk of sensitivity of your teeth
2. You have less control over the final shade of your teeth and you can over whiten. With 'at home' whitening you can watch as your teeth change shade and stop when you have the shade you are happy with.
3. Whitening does not permanently lighten your teeth and you will need to 'top-up' periodically. With 'at-home' whitening this is straightforward as you already have the trays and all that you require is more of the whitening gel which is available from our reception desk costing around £25. Whereas other methods require another whitening session.

Contact Blairgowrie Dental Care to arrange an emergency appointment. If it is outwith practice hours contact NHS 24 on freephone 111.

Do not be tempted to put anything such as aspirin or clove oil directly onto your gum. If you are in need of pain relief then take your usual painkiller, otherwise, consult with a pharmacist about alternative products.

Avoid handling the root.

If the tooth is very dirty, rinse it with milk to clean it.

Hold the tooth by the crown and put it back into the socket firmly, root first. Bite on a clean handkerchief for 15-20 minutes.

If you cannot get the tooth back in, keep it in the space beside your cheek until you can get emergency treatment, or if this isn't possible, keep it in milk.

The tooth has more chance of being successfully re-implanted if it is done within 30-60 minutes.

If the tooth is a baby tooth, do not place it back in the mouth. Just arrange an appointment with your dentist as soon as possible.

We normally recommend a medium size head with a medium bristles. Electric toothbrushes have been shown to remove more plaque than traditional toothbrushes and are particularly good for people who struggle to brush their back teeth. There are a selection of electric and manual toothbrushes on display in our reception area. Please ask for advice on which wold be best for you.

Gently try to remove the object with dental floss.

If you are not successful, visit your dentist.

Do not try to remove the object with anything sharp or pointed.

Clean the area with a cloth.

Apply cold compresses to keep swelling down.

If the bleeding is excessive or doesn't stop period of time, go to the dentist or Accident and Emergency Department.

Many parents panic when they see a permanent tooth erupting behind the baby tooth. But, in reality it is quite okay for the permanent tooth to erupt before the milk tooth has wobbled out. Normally what happens is that the permanent tooth will make the roots of the baby tooth weaker and the baby tooth will fall out on its own. This space will be then occupied by the permanent tooth. However, if there is not enough space available in the child’s mouth, or if the baby tooth hasn’t loosened quickly enough to fall out, then the permanent tooth will start erupting behind the baby tooth. This is most commonly seen in children who are six years old and in the lower front teeth with around 10% of children experiencing it as their teeth develop.

Normally the teeth do not need much assistance from a dentist as the baby teeth eventually wobble out. But, there are times when they don’t and we say the baby tooth is ‘retained’. If this happens then your dentist will have to create space for the adult tooth to erupt in to, most commonly by removing the baby tooth. The adult tooth will then go on to slowly and gradually move forward and take the place of the baby tooth. This might take a long time with the results seen in months or weeks.

Adult teeth are almost always more yellow than baby teeth for two reasons

Is there anything you can do to improve the colour, then? As long as you make sure that there’s not a yellow film covering your child’s teeth, you should just leave the tooth alone. We do not recommend any whitening toothpastes for children or that professional whitening be performed before the age of 18.

Yellow permanent teeth are not only perfectly normal, then, they’re expected! And as soon as the rest of the primary teeth are lost, you might not even notice that there was ever a difference at all.

We ask that you bring your baby with you for dental check-ups as soon as possible, even if they don’t have any teeth! We find that if the child becomes used to the surroundings then they are happier coming to the dentist in the future. Don’t worry if they won’t allow a proper check-up, they are learning a lot by watching everything that is going on around them, especially watching you and any brothers or sisters having their teeth checked. It is also a good opportunity for your dentist to chat with you and your child about their teeth and to give useful advice on tooth brushing, eating and drinking.

As soon as your child’s first tooth has come through it is important to start brushing. We recommend brushing twice a day, at the same time each day to create a routine - normally in the morning and then, most importantly, before bed.

When your child only has a few teeth, try sitting behind them and supporting their chin to allow better access and sight of the teeth.

Once they have all their teeth through, brush in small circles ensuring you are getting all sides of the teeth and down to the gums. Allow your child to join in and try to make it fun!

All children up to three years old, should use a smear of toothpaste with a fluoride level of no less than 1000ppm (parts per million).

After three years old, they should use a toothpaste that contains 1350ppm -1500ppm

Thorough tooth brushing and cleaning in between your teeth with dental floss or brushes is essential. It is important to maintain regular dental check-ups and where appropriate hygienist appointments. Stopping smoking will greatly improve the health and smell of your mouth.

Gum disease is caused when plaque is allowed to build up around teeth and gums. Plaques causes the gums to become red, inflamed and bleed easily. If left untreated, the gums will start to peel away from teeth resulting in ‘pocketing’ around the teeth and a loss of the bone support that holds the teeth in place. If this carries on eventually teeth will become loose and painful and require removal.

Make an appointment at your dentist for a check-up. Sometimes your dentist or hygienist needs to clean away tartar build up from your teeth before you can effectively clean them yourself. Once this has happened it is important to keep brushing your teeth twice a day and cleaning in between your teeth with floss or small brushes to prevent more tartar build up. A regular appointment with your hygienist and/or dentist is essential to ensure the gums stay healthy in the future.

Don’t stop cleaning your teeth if you see blood when brushing. It is actually a sign you need to brush your teeth more often and more thoroughly.

Adults should use a pea sized amount of fluoride containing toothpaste. If you suffer from sensitive teeth your dentist may recommend a toothpaste designed for sensitive teeth.

Remember after brushing, spit don’t rinse! You don’t want all the goodness of the toothpaste going down the sink.

All children up to three years old, should use a smear of toothpaste with a fluoride level of no less than 1000ppm (parts per million).

After three years old, they should use a toothpaste that contains 1350ppm -1500ppm of fluoride.

It is important to clean your dentures regularly as they can cause a build-up of plaque and tartar around your natural teeth and even on the denture itself.

Remove the denture from your mouth and clean any remaining natural teeth with a Fluoride toothpaste. Pay particular attention to the teeth which come into contact with denture as these are more at risk of gum disease, especially the inside surface of the teeth next to your palate and tongue.

Clean them twice a day, either over a sink filled with water or a towel and brush your dentures (using a different toothbrush) using normal soap (toothpaste is too abrasive and causes unsightly scratching and staining of your denture) to remove any food debris and to kill off all the germs but remember to rinse them well afterwards.

Leave your dentures out at night, kept safe in a container with a little water.

There are several reasons for bad breath or ‘halitosis’.

• Insufficient oral hygiene leading to food and plaque particles accumulating around and in between teeth.
• Strong smelling foods such as garlic and onions.
• Smoking
• Dry mouth
• Certain medical conditions

Mouth ulcers are small red or yellow areas that appear inside your mouth. Single mouth ulcers are usually caused by trauma to the area such as over vigorous toothbrushing or a particularly crusty piece of bread. These ulcers will heal within 7-14 days assuming the cause of the trauma is removed. If you have more than one ulcer then you may suffer from ‘recurrent apthous ulceration’. These can be large ulcers or several small ulcers and are more common in young people. They are not infectious and should resolve within 2 weeks. Any ulcer which lasts for more than 2 weeks must be checked by your dentist as a ‘non healing ulcer’ can be the first sign of mouth cancer. Mouth cancer can affect anyone – young/old, with teeth/without teeth. If in doubt then ask your dentist to check it out.

Traumatic ulcers are solved by removing the cause e.g. sharp tooth, rough denture. Recurrent ulceration can commonly occur when you are feeling generally ‘run down’ due to illness or stress but can also be a sign of nutritional deficiencies and your dentist may consider referring you to your doctor for routine blood tests. Good oral hygiene, good maintenance of your toothbrush and a well-balanced diet can all help prevent ulceration.

Tooth decay is caused by plaque in your mouth reacting with sugar creating cavities or holes in your teeth. These holes either need to be ‘filled’ with a dental filling or if they are too large the tooth needs to be removed or ‘extracted’.

To prevent decay you need to remove the plaque from your teeth (by brushing and cleaning between your teeth) and reduce the amount of sugar in your diet.

Sugar can be found in most foods and some drinks, even those which advertise ‘No added sugar’. It is always important to read the label and ask your dentist if you are unsure.

Different food and drinks have different levels of acidity. Drinks which have high acid levels include fizzy juice, straight fruit juice, wine and herbal teas and those with the lowest acid levels include water and milk. Regular intake of food and drink with high acid levels cause your tooth enamel layer to be worn away. This can result in your front teeth looking shorter and starting to chip at the edges. Your teeth can also become very sensitive.

Best way to prevent erosion or to stop it from getting any worse is to -

It is also important not to brush your teeth directly after ‘acid attack’ as this can speed up tooth enamel loss. Instead rinse either with water or a fluoride mouthwash or chew some chewing gum. Wait for around an hour before then brushing your teeth.

A lot of people have sensitive teeth from time to time. It is most commonly caused by the more sensitive ‘root’ or ‘dentine’ of the tooth being exposed in your mouth. Sensitive toothpastes really work, so use twice a day, spit but don’t rinse and rub a little on the sensitive area before bed to help relieve the sensitivity. They can take a few days to be effective. If however this does not help then it is important to arrange an appointment with your dentist as it could be a sign of a more serious dental problem such as a cavity or a cracked tooth.

To prevent sensitivity try not to press too hard with your toothbrush when brushing and consider getting an electric toothbrush. Reduce the amount of sugary and acidic food and drink consumed. Consider changing to a sensitivity toothpaste for long term use.

If you play any contact sport e.g. cricket, hockey, football, boxing and rugby you should wear a mouthguard. They protect against breaking teeth/jaws but also can help prevent concussion and damage to the brain and neck. Mouthguards made by your dentist provide better protection than ‘off the shelf’ mouthguards as they are designed for your mouth and will be checked to ensure a good fit and bite. There are a variety of designs and colours available at Blairgowrie Dental Care, please phone to find out more.

Around 1 in 4 suffer from problems with their jaw joint which are commonly caused by grinding or clenching of their teeth. These can range from clicking, crunching, pain and difficulty when opening and closing their mouth. If left untreated it can lead to broken teeth, headaches and loose teeth. After and assessment your dentist may recommend a mouthguard that you wear at night to protect your teeth or may decide to alter fillings or crowns. If the situation is more serious a referral to an oral specialist may be required.

It is common for a denture to be fitted straight away (termed ‘Immediate Denture’) after a tooth is extracted as it provides good aesthetics as an ‘instant tooth’ i.e. no space is left, but it also protects the healing socket. Your dentist will probably advise you to keep the denture in for the first night following the extraction and then remove it the following morning. After this it is really important to remove your denture every night to prevent red and sore gums and to keep any remaining teeth healthy. When the denture is first removed it is important to clean it thoroughly as well as your teeth. We advise warm, soapy water and a toothbrush for routine cleaning (toothpaste is too abrasive and causes unsightly scratching and staining of your denture) and a denture cleaning solution as and when required. Over the next few months your gum will heal under the denture and shrink away which can affect the fit and appearance. A reline of the denture may be required over this period to fill in this space. This is why we usually use Immediate Dentures as a temporary measure until the healing tissues have stabilised (around 3-6 months) allowing for a predictable permanent solution. This can be a new denture, a bridge or a dental implant depending upon the individual situation.

Remember a clean, healthy mouth heals quicker than a neglected one.

On the day of the treatment –

• Rest for a few hours but try not to lie down flat
• Strenuous exercise and heavy lifting is best avoided for a few hours
• AVOID hot fluids and alcohol until the next day
• AVOID smoking for as long as possible (forever would be ideal!) but at least until the next day.
• The blood will tint your saliva which is normal but should the wound start to bleed, apply pressure using a compress or clean cotton hanky. Bite firmly on this for 30 minutes whilst sitting upright.
• Take your normal painkillers 2-3 hours after the extraction to help with any discomfort
• If prolonged bleeding or pain occurs contact Blairgowrie Dental Care or if outwith practice hours NHS 24 on Freephone 111

For the seven days following treatment –

• Rinse after meals and before bed using warm, salty water (dissolve a heaped teaspoon of salt in a tumble of water and gently rinse then discard)
• Repeat this once in between each meal

Being told that you require an extraction can be a distressing and an emotional experience. Don’t panic there are always options to fill in the resulting space. Your dentist will explain these inmore detail and in direct relation to your own situation.

However in general terms you have four options

1. Leave the space
2. Have a denture to replace the tooth (this can be used as a temporary measure)
3. Use neighbouring teeth to replace the tooth by placing a bridge
4. Place a dental implant to hold a crown, bridge or denture.

During the discussion with your dentist please share any worries or concerns about the processes involved with any of these procedures. If, as so often happens, you only think of the questions when you step out of the surgery please phone, email or arrange an appointment for further discussion. We want to hear from you.

Rinse your mouth with warm water to keep the area clean.

Contact Blairgowrie Dental Care for an appointment.

If required you can get a temporary dental filling kit from most pharmacies and many supermarkets which can help prevent food trapping and cover sharp edges on teeth. These are TEMPORARY and it’s important you visit your dentist to have the area checked. Can be a good idea to buy one of these before your holidays!