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The Art of Conscious Sedation

Conscious dental sedation

Conscious sedation is the act of administering a relaxing sedative, either with or without analgesics. It is often given before minor treatment, either to make a procedure more comfortable or to calm the nerves of an anxious patient.

Conscious sedation can be given through an IV line, orally or sometimes intramuscularly. Generally it will take affect quite quickly, though oral sedation can sometimes take up to an hour depending on the medicine and dose used. Feelings of drowsiness have been used to describe the sensation of conscious sedation, alongside the feeling of having had too much to drink. There is a possibility you may fall asleep during the procedure due to the relaxation, but it will be a natural sleep from which you can be easily woken by the voices of the care team. You will also be regularly monitored throughout the procedure to check that your blood pressure, blood oxygen levels and breathing are maintained.

Because the sedatives are not necessarily painkillers, you will still need to be given local anaesthesia in the area of the dental procedure. However, if you are uncomfortable with being given injections, the dentist will wait until the sedative has taken effect before administering the local anaesthetic.

It is likely that after the procedure is finished you may not remember it. You will also feel drowsy and possibly slightly sick so it is recommended to take it easy for 24 hours without alcohol or exercise. Eating a good meal is recommended to help restore some of your energy and you can return to your usual activities the following day.

Conscious sedation is a very safe procedure, practiced frequently. Blood pressure and blood oxygen levels are monitored throughout the procedure and during recovery.

At Scott Arms Dental Practice some of our dentists are trained in conscious sedation and are happy to offer it alongside any treatment you may be having that distresses you. The intravenous method is used, whereby the sedative is injected into a vein prior to treatment. It is a popular choice because it takes effect quickly. It is frequently opted for during the placement of tooth implants.

If you are interested in having conscious sedation during a procedure, speak to your dentist who will assess you for suitability. Most people can have conscious sedation but some contraindications include pregnancy, some instances of glaucoma and certain allergies.

Posted in: General Dentistry

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Frequently asked dental questions in March

March dental questions

Q. I have teeth implants and I want to whiten my teeth. Will the implants whiten too?

Unfortunately dental implants do not whiten. They can be cleaned by a hygienist, which may help them appear whiter. You should be sure to let your dentist know that you intend to whiten your teeth before the dental implants are fitted, so the shade can be adjusted.

Q. Should I brush my teeth before or after my breakfast?

There is actually no evidence to say whether you should brush before or after breakfast. The ideal situation would be to brush before breakfast, and then again half an hour after breakfast but most people are too busy in the mornings for such a routine.

Brushing before breakfast reassures you that the bacteria that has accumulated in your mouth over night is removed before it is given a food to turn into acid – however this can make your breakfast taste unpleasant. Brushing after breakfast can be damaging to your teeth if you have not waited half an hour (as the enamel softens slightly after meals and needs some time to harden again). I would recommend brushing before breakfast and then chewing xylitol gum on your way to work.

Q. Why should I be using mouthwash? My breath doesn’t smell so I’m not sure how it could benefit me.

Mouthwashes don’t only tackle bad breath – they are antibacterial and also contain fluoride, which helps strengthen your teeth. The best time to use mouthwash is at a different time to brushing (preferably after lunch) to kill the bacteria and give your teeth a boost of fluoride.

Q. My dental implants feel like they are moving – what should I do?

Make an appointment to see your dental implantologist as soon as you can. Dental implants are not 100% successful and can fail in some rare cases. A wobbly implant suggests that the titanium screw and jaw bone have not fused together correctly.

Dental implants are also susceptible to a type of gum disease – invading bacteria cause the tissue around the implant to break down, allowing it to wobble. Be sure to clean around your implants daily with either floss or interdental brushes.

Q. My front tooth got knocked about ten years ago and I think it is changing colour now. It seems to look darker than all the rest. Is there anything I can do?

The tooth sounds like it is either dead or dying due to the trauma. Though it may not be causing you any pain, it would be a good idea to have a root canal treatment done (a type of filling that goes down the root canal of the tooth) to rid the tooth of any dead tissue.

The breakdown products of living tissue inside teeth can stain the dentine brown and yellow, meaning that some dead teeth look darker than others. You could have the tooth internally and externally bleached. This would involve having a small hole made at the back of the tooth that you can insert a tooth whitening bleach into at home, along with laying it over the front of the tooth. Speak to your dentist about root canal treatments and internal tooth whitening.

Q. Why do dentists call out numbers when they look at your teeth?

Normally when a dentist speaks to his/her nurse during your examination, it is merely to inform them which teeth and fillings you have. Each tooth is allocated a different number. They may also mention teeth that need some treatment doing, but not every number you hear suggests you need work done!

Dentists will also check your gums for disease and will grade their findings on a scale from 0-4, where 0 means healthy gums and 4 means severe gum disease. Ask the dentist to clarify if you are ever unsure about what they have said, or you do not understand.

Posted in: General Dentistry

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Halitosis – causes and treatment

A woman with fresh breath

Bad breath is one of the most common reasons that people visit the dentist, and for most people it is something that can be fixed with simple hygiene and perhaps a change in diet.

The tongue is one of the main causes of halitosis. Its anatomy makes it a perfect environment for flourishing bacteria, which can produce foul odours during their natural metabolism. Cleaning the tongue with a dedicated brush is one of the easiest ways to solve this problem, though it is rarely practised.

Gum disease is another significant cause of bad breath. When unnatural ‘pockets’ form around teeth, bacteria can thrive in protected envelopes of gum.

A bad taste in the mouth can often signify a dental problem and is usually coupled with an unpleasant smell. The cause of this is most likely due to a decaying tooth and/or a pus-filled abscess – both of which contain bacteria, necrotic tissue and debris.

These causes of bad breath can all be solved by the following:

  • Cleaning the tongue regularly (along with the rest of the teeth and mouth)
  • Resolve any gum disease by visiting a hygienist
  • Fix any areas of decay and other dental disease by seeing a dentist
  • Chewing gum can temporarily mask bad breath, but will not help eliminate the cause.

Lots of people (and their partners!) complain of the unpleasant, but common, phenomenon known as ‘morning breath’. At night, the mouth is less active and saliva production decreases by up to 90%. Without the mechanical washing action of saliva and the antimicrobial products it contains, the amount of bacteria (and consequently bad smells) increases. This can be decreased by cleaning the mouth efficiently each night.

However, for some people bad breath is a side-effect of a systemic condition. Some types of cancer, liver failure, diabetes and various infections have all been linked to foul breath. In these cases, treating the underlying cause and managing the bad breath symptomatically with chewing gum and mouthwash are the most viable options. Some medications have also been known to dry out the mouth, causing bad breath; saliva substitutes and stimulants are often called for in these cases.

Below are some substances known to increase and decrease the chances of having bad breath:

Good Products Bad Products
Chewing gum – chewing gum can dislodge food from teeth, remove bacteria, smell nice and encourages saliva production, which helps flush bacteria from the mouth.Alcohol and coffee – both of these dry out the mouth, inhibiting it from naturally washing away bacteria.
Water – drinking water helps flush the mouth and reduces the amount of bacteria and food debris.Onions and garlic – notorious causes of bad breath caused by lingering sulphur gases.
Some herbs – herbs like parsley release oils that help freshen breath.Smoking – not only does smoke itself smell terrible, but the act of smoking dries out the mouth, restricting it from cleaning itself.
Fruit and vegetables – vitamin C-containing products can help reduce the chance of gum disease, a notorious cause of bad breath.Protein-based foods such as meat and dairy – don’t stop eating these products, but be aware that they break down into amino acids, which can linger in the mouth and cause bad smells.

Posted in: General Dentistry, Periodontal Disease

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How to look after your dental implants

Dental implants are simple to take care of, with regular brushing and flossing they can last a lifetime.
Teeth implants are placed in three stages: the initial placement of the implant screw, the revealing of the implant and placement of an abutment, and finally the attachment of the crowns. After the first procedure, when the implant itself is placed, it is recommended not to partake in anything physically exerting for the initial few days. Abstaining from alcohol and smoking are also recommended as they both slow down the healing process. As the area could be relatively sore, it is advised that you continue to brush the remainder of your mouth as normal but refrain from cleaning the treated area as not to disturb the stitches or the healing process.

Uncovering the dental implants and placing the abutment is a not a particularly invasive procedure. Though it is still highly recommended to avoid alcohol and smoking for a few days either side of the appointment, you will be able to clean the new abutments right away with care. Soften a soft-bristled toothbrush in water and use it to gently clean the abutments, taking care not to disturb the surrounding gum.

Once the dental implant crowns have been placed it is important to take good care of them; well-maintained dental implants can last ten years or more!

Clean your implants day and night with a soft-bristled toothbrush that has been softened in running water. Use circular brushing movements, angling the head of the toothbrush slightly towards the gum so that the margins of the implants are cleaned too. Be sure not to scrub at the implants, or the gum around them. Use the toothbrush to clean the inside and outside of the implant, along with removing plaque and debris from the top.
A toothbrush is essential for keeping good oral hygiene and helping to look after your implants
• Use an anti-plaque toothpaste on your implants. It is also beneficial to use a toothpaste containing fluoride: even though the fluoride is not able to incorporate itself into the implant structure like it does with normal teeth, there is evidence to show that fluoride inhibits the action of periodontitis-causing bacteria, and so using it can help protect the gums around your implant. You will most likely want to use the same toothpaste to clean your implants that you use on the rest of your mouth, so sticking with a fluoridated toothpaste for your implants as well as your teeth makes for ease of cleaning.
• Find an interdental technique that works for you. Some people find flossing a bit fiddly: if this is the case, experiment with tepe brushes, water flossing, or dental picks. Be sure to clean in-between your dental implants at least once a day.
• Specialised implant brushes can be purchased in some stores: these are brushes with only a few tufts, angled to make cleaning the sides of implants easier.
• Use an anti-plaque mouthwash twice a day to help keep the gums around your implants free from bacteria.
• It is never recommended to eat very hard foods on with dental implants. If you are eating something particularly hard, try and chew it on the side of your mouth away from the implants, if at all possible.

Though dental implants are free from the threat of decay, their foundations (bone and soft tissue) are still prone to inflammation caused by bacteria. Dental implants can suffer from peri-implantitis, a condition similar to gum disease: it is characterised by the irreversible loss of foundation tissue, resulting in wobbly implants. It is a rare condition and with adequate oral hygiene it can be mostly avoided. If you are concerned about peri-implantitis, or think you are more prone to it due to previous or present gum disease, speak to your dentist or hygienist.

Posted in: Dental Implants, Replace Missing Teeth

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Wisdom Teeth Advice from an Emergency West Midlands Dentist

Wisdom Teeth advice from a West Midlands emergency dentist

Wisdom teeth are your third molars (the most posterior tooth in your mouth) and can be one of the most common causes of dental pain, luckily our emergency dentists in the West Midlands have years of experience dealing with these emergencies. Wisdom teeth are unpredictable teeth, which can either erupt (generally between the ages of 18 and 21) or not erupt at all. In some situations they may not even form; this is relatively common and is arguably beneficial for the person as wisdom teeth have very little functional involvement. Most problems that occur with wisdom teeth happen when they become impacted (stuck against another tooth) or partially erupted (where they only partially protrude from the gum). These problems can cause significant tooth and gum pain. If you are suffering from either of these problems, see one of our dentists as soon as you can. If the tooth is healthy and does not require extraction, he/she will advise you on how best to look after it and how to keep yourself out of pain. If the tooth is infected, decayed or causing damage to other teeth it may need to be extracted, though there is a degree of reluctance in taking out such a posterior tooth (which is renowned for its complex anatomy) if not completely necessary; some people may have to learn to live with wisdom tooth flare-ups and tackle them symptomatically.

Here are some ways to relieve the pain:

  • Place an extra pillow under your head at night – most people find their wisdom teeth cause most pain whilst they are trying to sleep; by lying down more blood can flow to the wisdom tooth, which aggravates the pain caused by the inflammation. Less blood will flow to the area, resulting in less pain, if your head is slightly elevated.
  • Take standard pain medication – One of the most successful medications in combating dental pain is co-codamol, which is a codeine and paracetamol combination medication. You can take ibuprofen alongside co-codamol for maximum pain relief. Two further medications recommended in combating tooth pain are Tylenol (acetaminophen) or Aleve (naproxen sodium). Be sure to always read the label before taking any medications and never exceed the recommended dose.
  • Clove oil – use a standard clove to alleviate your pain by placing it onto the wisdom tooth, or place a few drops of clove oil onto it instead.
  • Ice pack – hold an ice pack to the sore area to numb the pain. Make sure you only use it for a few minutes at a time as not to cause further pain.
  • Vanilla extract (not vanilla essence) – add a few drops of vanilla extract to the wisdom tooth. It works by numbing the area (as it contains low levels of alcohol) and the scent had proved to be relaxing.
    To ease the gum pain:
  • Warm salt-water rinses – if your wisdom tooth is partially erupted and the gum around it is sore, rinse with warm salt-water. Be sure to force the water to the back of the mouth so it bathes the wisdom tooth.
  • Difflam – this is a liquid that can be purchased from chemists and is good at easing discomfort from sore gum tissue around partially erupted wisdom teeth.

Wisdom tooth care:

  • Interdental cleaning – flossing around your wisdom teeth can be nearly impossible. Try different ways of interdental cleaning like water floss, tepe brushes, dental sticks, etc. to see which one may work for you. If it is futile, try to rinse hard with mouthwash in that area.
  • Keep your wisdom teeth really clean – you can buy special single-tufted brushes, which are good at accessing the back of the mouth, and cleaning under flaps over gum overlying wisdom teeth.

If you’re experiencing further problems with your wisdom teeth and would like to see one of our emergency dentists in the West Midlands please contact the team on 0121 357 5000 where we will be happy to help.

Posted in: Emergency Dentist

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Is Going To The Dentist Painful?

Dental phobia and anxiety is a common problem in Birmingham

At Scott Arms Dental Practice we, as a team, strive to remove discomfort from our patients through either painless treatment or the removal of toothache. We are keen to help nervous patients overcome their fear of dentistry and help them to realise that pain-free dentistry is the way of the future.

With the practice of modern-day dentistry and the introduction of new technology and medicine, dentistry can be practised efficiently and effectively without the patient being in pain. In fact, it is often the dentist who relieves people of dental pain, rather than introducing it, and is one of the reasons that Scott Arms Dental Practice works 365 days a year as an emergency dental practice: emergency dentists work up until 11pm every day and over-the-phone advice is available all through the night.

Most dental treatment involves the patient needing to keep their mouth open for a period of time. This can sometimes be slightly uncomfortable, but for patients who find it more difficult than others, regular breaks will be offered. Dental treatments generally involve the use of water to keep the teeth clean and cool throughout the procedure, but a nurse is always present with a suction device to remove the water before it bothers you.

All our surgeries have comfortable, state-of-the-art dental chairs installed so you can relax during your time in the practice.
Furthermore, for treatment that would otherwise be painful, local anaesthetic injections are always offered. This involves the introduction of a numbing agent into the tissues, which stops you being able to feel anything. Injections are often hardly felt, but if not, the discomfort will last only a few seconds before the numbness starts to take effect. As a rule, we take every possible action to reduce the discomfort of any procedure, including injections: we purchase the thinnest-gauge needles, which cause minimal tissue trauma, and warm our anaesthetic cartridges to body temperature, both of which reduce the likelihood of the injection being felt. Furthermore, we offer a topical numbing agent, which is placed onto the tissue before the injection is given. After a couple of hours the numbness of the injection will wear off; very rarely there can be mild discomfort following a procedure but this is often eased by the taking of standard pain medication. Nobody likes injections, but rest assured that we at Scott Arms Dental Practice are constantly on the lookout for investments in technology that increase the comfort of our patients.

For people who don’t like going to the dentist at all and would rather be treated under sedation, Scott Arms Dental Practice is the right place to come. We have dentists who have a special interest in dental sedation and as a practice we are keen to provide dental care under your terms. We practise intravenous sedation at our clinic, which is carried out by placing a small needle into the back of your hand and monitoring the levels of sedative we introduce into your bloodstream. Many people opt for dental sedation, whether they are nervous patients or not, as it makes longer dental treatment fly by at maximum comfort. Though it is a conscious sedation, many people cannot remember the experience at all, as if they had been asleep, whilst others describe it as a very relaxing feeling, like having had a few glasses of wine. Speak to your dentist if you’d like to have any of your dental treatments carried out under sedation.

Posted in: Emergency Dentist, General Dentistry

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Why should you get denture implants?

The reasons why you should have denture implants.

You could be a perfect candidate for dental implant supported dentures if your current dentures are:

  • Unstable
  • Hurting
  • Uncomfortable
  • Coming loose when you eat or talk
  • Requiring a fixative to remain in place
  • Restricting your taste
  • Making you gag
  • Too bulky
  • Making your face look older or ‘sunken’

Implant supported dentures are complete acrylic dentures that clip onto dental implants which solidly sit in your gums much like natural teeth. This can be such that the denture is removable by the patient, or fixed and only removable by a dentist. They are very successful at eliminating or greatly reducing the above problems.

  1. Stability – dental implant-supported dentures are very solid and stable in your mouth like your natural teeth would be. The mechanism of attachment (indirectly to your jaw bone through the dental implant screw) allows for only the natural minimum movement and flexion that would be expected with real teeth.
  2. Comfort – dental implant-supported dentures don’t require a strong retentive grip around your gums for support as they gain their retention from the underlying implants. Because of this they are much less likely to rub or cause sores.
  3. Retentive – dental implant-supported dentures have a unique mechanism of attachment, mimicking the way natural teeth are kept in place. It is because of this that dental-implant-supported dentures are very stable during eating or talking, and will only be removed through a technique that your dentist will teach you. Because of this conversation and chewing will be much more natural and pleasant.
  4. Fixatives – dental implant-supported dentures do not require any gluey, unpleasant fixative to keep them in place because of the successful fastening with the underlying implants.
  5. Taste – dental implant-supported dentures are much less likely to restrict your taste as it is not necessary to have material covering the majority of the palate as retention is gained mechanically from the dental implants. The less tissue covered, the more naturally you will be able to taste; this is a huge advantage of dental implant-supported dentures.
  6. Gagging – dental implant-supported dentures are unlikely to make you gag as they don’t take up as much room in the mouth as traditional dentures, which require a larger amount of material to keep them in place.
  7. Bulky – dental implant-supported dentures are often less bulky than traditional dentures as retention is gained through attachment to dental implants and not through the addition of extra dental material.
  8. Anti-aging – when dental implants are placed into the mouth the bone around them attaches, greatly reducing the chances of bone recession, which happens naturally in the absence of teeth. It is because of this that the presence of dental implants can prevent the face from appearing ‘sunken’ as most dental bone is maintained, which is integral for a natural face shape and profile. Furthermore, as bone height is maintained, the likelihood of needing denture adjustments reduces which results in long-term, comfortable dentures.

Two options are available at Scott Arms Dental Practice for dental implant-retained dentures and each come with their own significant advantages:

Locators: These types of dentures fasten into place over a number of single, discrete implants. This works much like press-studs on items of clothes and is often the desirable option when patients like to minimise the feeling of a prosthesis in their mouth, as only a thin later of acrylic is needed to support the denture.

Milled-bar with clips: Dental implants are placed in the same way as locators, yet they are splinted together by a metal bar onto which the denture attaches. Though this option is slightly bulkier it is easily tolerated by most people and provides a more even load across all dental implants and even better retention.

Posted in: Dental Implants, Dentures, Replace Missing Teeth

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Work available for a Dental Student in Birmingham

Dental Student in Birmingham needed for work experience and our dental practice

We are looking for a dental student to help write, edit and organise information used to inform new patients seeking dental treatment through our new online gateway. This is a paid position, with flexible hours and an excellent source of work experience for a career in dentistry.

Scott Arms Dental Practice is one of the largest dental practices in the West Midlands, treating thousands of patients each month and is one of the leading practices for Dental Implant treatment. There will be a large emphasis on Dental Implant treatment with the new project.

We require help during July and August. The position is based at the Scott Arms Dental Practice in Great Barr, Birmingham. The successful candidate must be able to demonstrate excellent reading and writing skills, self-motivation, enthusiasm for dentistry and the ability to work to tight deadlines. For more information please contact Tom at tom.kavanagh@scottarmsdentalpractice.com.

Posted in: General Dentistry

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The role of a Dental Therapist in Birmingham

The role of a Dental Therapist in Birmingham

Our award winning dental team doesn’t just consist of dental implant dentists, nurses and office staff. There is another important role in our Birmingham based team that is there to help patients understand the connection between oral health and their overall health, the Dental Therapist.

Dental Therapists have an important role in promoting dental health, something which a large proportion of the population fail to take care of. They are able to work in all sectors in dentistry including our dental practice. They are experts in helping to prevent and dealing with Gum Disease, a common problem which has affected at least half of the UK population at some point.

How Dental Therapists help prevent gum disease

Dental therapists in Birmingham are trained to carry out a wide range of procedures including intra and extra oral assessments and scaling and polishing. They are are able to identify gum disease in patients and access just how severe it is. Even if you maintain good oral hygiene plaque and tartar (hardened plaque) can build up which can’t be removed by brushing alone. Dental Therapists are trained to remove this using a process of Scaling and Polishing the teeth, this physically removes the hardened substances from the the tooth surface preventing even more accumulating. It’s advised that everyone sees their dental therapist or dentist for scaling and polishing every few months to keep their teeth and gums healthy.

Dental Therapists are also known as oral health practitioners, they work with patients to ensure they are educated in how to maintain good oral hygiene, basically they are the people who can really teach you how to brush your teeth properly. A large number of us use an improper technique when brushing our teeth, which can cause us not remove plaque proper or even damage your gums from brushing too hard. A dental therapist can show you the proper technique to ensure your teeth and gums are kept healthy. Brushing your teeth twice a day for at least two minutes, using a fluoride-containing toothpaste, daily flossing and regular dental checkups is the best way to prevent most dental problems.

Other roles of the Dental Therapist

Some of the other procedures a dental therapist in Birmingham can help you with are:

  • Taking and interpreting dental x-rays.
  • Monitor the stage of gum disease.
  • Apply fissure sealants to your teeth.
  • Can extract milk teeth under local anaesthetic.
  • Take impressions of your teeth, which can be used to make things such as bite guards and bleaching trays.
  • Can apply both white and metallic fillings to adults and children.
  • Therapists treat adults as well as children.

If you’re interested in finding out more about Dental Therapists in Birmingham feel free to contact the Scott Arms Dental Practice on 0121 357 5000. We’re open 7 days a week and have our own expert therapists on hand ready to help you with any dental problems you may have.

Posted in: General Dentistry

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Getting a Scale and Polish in Birmingham

Scale and Polish treatment from our Birmingham Dentists to remove plaque and tartar

Simply brushing alone won’t help in the war against plaque, sometimes you’re going to need the help of a scale and polish from your Birmingham Dentist.

Every day a white, sticky film of bacteria called plaque forms on the surface of your teeth. These bacteria are the ones that cause gum disease, they can be removed with correct brushing and flossing but sometimes we miss them in those hard to reach places. After 24 hours the plaque hardens into a substance called tartar (calculus), sadly this can’t be removed by brushing alone and requires the help of a dentist. A build-up of calculus on the teeth can provide the optimum conditions for bacteria to thrive next to the gums, leading to gum disease.

How does your dentist remove the hardened plaque?

Your Birmingham dentist or hygienist has undergone training to use special tools that gently remove tartar deposits without damaging the surface of the teeth. Before scaling and polishing takes place your dentist will carefully assess the condition of your teeth and gums. One way of achieving this is by using ultrasonic instruments which use vibrations which cause the hardened tartar to break away from the tooth surface, whilst spraying water to wash away the debris. This device usually makes a high pitched whistling sound which is quite distinct in the dental surgery. Once the larger pieces are tartar are removed the dentist will make use of a scaler, these are used gently to scrape off the smaller pieces of tartar from the teeth, leaving the surface of the teeth clean and smooth. FInally the teeth are polished, leaving them looking shiny and clean.

Sometimes after a Scale and Polish from your dentist your teeth may feel sensitive, this is quite normal and reversible so there is nothing to worry about. If any sensitivity problems persist you should visit your dentist for more help.

The most important thing to remember when it comes to dental treatment, preventing dental problems occurring is a lot cheaper and easier than having to treat the dental problems themselves. With a good standard of oral hygiene and regular scale and polishes, you should be protected against the onset of gum disease.

If you’re looking for Scale and Polish treatment in Birmingham or simply more information of the procedure and how to prevent gum disease, contact the Scott Arms Dental Practice on 0121 357 5000. We’re open 7 days a week and our friendly team can help you with any dental problems you may have.

Posted in: General Dentistry, Periodontal Disease

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