Why Should I Get Fissure Sealants?

Fissure Sealants are a popular treatment option in preventing tooth decay

All back teeth have lines and grooves running across them; these are known as fissures and are notoriously hard to clean effectively. A technique to cover these fissures, known as fissure sealing, was devised in the 1960s and involved placing a flowable filling material into the fissures of teeth. Over the years, this technique has progressed to the extent that we are now not only able to use fissure sealants as a preventative measure, but also as a minimally invasive procedure to ‘seal’ in early signs of decay to stop them progressing further. Fissure sealants have been studied since their manufacture and have been shown to reduce the risk of decay by 33-71%. Despite the range in efficacy, fissure sealants have proven themselves to be a valid measure for decay prevention.

At Scott Arms Dental Practice we recommend fissure sealants for:

  • Children who’ve got their first permanent molars through
  • Adults with oral health concerns
  • Adults with naturally deep fissures
  • Adults with a history of dental decay

Whilst fissure sealants are popular amongst adults, especially those with a history of tooth decay and those with prominent and susceptible fissures, they are primarily used for the prevention and treatment of decay in children’s newly erupted adult teeth.

The first adult teeth come though around the age of 6: these are the first molar teeth that are at the back of the mouth, behind the baby teeth. Because these teeth will have to last for many years we recommend having fissure sealants placed within the first two years of these teeth coming through. Studies have shown that this makes a huge impact in decay incidence amongst children. The fissure sealants make cleaning the teeth easier and have a profound effect when coupled with good oral hygiene, fluoridated toothpaste and a balanced diet.

Fissure sealants prevent (and sometimes reverse) dental decay, protecting a child’s newly formed teeth – which need to stay with them throughout life – and therefore reduce the likelihood of the child needing fillings. Avoiding the need for restorative work during childhood can help eradicate dental phobias and support lifelong dental visits and dental health.

Benefits of fissure sealants:

  • Make deep fissures easier to clean
  • Prevent decay by 33-71%
  • Can reverse the initial stages of dental decay
  • Protect children’s newly formed adult teeth
  • Prevent the need for fillings in childhood, which can be frightening
  • Fissure sealants are quick and easy to place

Fissure sealants normally last for many years but can chip or wear over time, so it is important to have them checked at frequent intervals by your dentist. Adding to (or replacing) a fissure sealant is a quick and straightforward procedure.

At Scott Arms Dental Practice, fissure sealants are £25 each and can be placed quickly and easily, without the need for any drilling. If you would like to make an appointment for you and your child to discuss having fissure sealants placed, please call 0121 357 5000.

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A Tax on Sugar and the Obesity Crisis

Fizzy drinks are linked to obesity and dental problems.

It has been long suggested that taxing the causes of conditions that strain the NHS is the way to a healthier, less economically costly future. There has been talk recently about the introduction of a “fat tax”, a tax we’ll shoulder for the unhealthy choices we make, which includes a 20% tax on sugary fizzy drinks. The tax could potentially raise £1 billion a year, which could benefit a Children’s Future Fund: this recently proposed fund would spend the money raised from a sugar duty on improving children’s health through providing healthy, free school meals with more fruit and vegetables. Furthermore, as consumption of sugar diminishes, the NHS would find itself under less strain as obesity levels fall: it has now been suggested that obesity is a bigger killer than smoking and increases the risk of heart disease, stroke and type II diabetes, all of which burden our National Health Service.

So why are fizzy drinks in particular under scrutiny when fast food chains and cheap junk food are available at every corner? The government describe it as a ‘starting point’, stating that taxing sugar-sweetened fizzy drinks is straightforward to apply. They argue that the results could be profound: if a person were to cut down by one can of fizzy drink a day, at approximately 140 calories a can, they could lose a pound a month. With some predictions stating that nearly half of the UK will be obese by 2030, it is a change that some of us can’t afford to ignore.

We in the West Midlands are particularly culpable: Birmingham has been vying for title of ‘Europe’s Fattest City’ for a number of years. In 2010 we were named and shamed as a city where a quarter of our 11-12 year olds were clinically obese.

Though the ‘fat tax’ aims to tackle our nation’s obesity crisis, pursuing the path of a tax on sugar has a dental benefit for all. Fizzy drinks have always been a concern in dentistry and these days children in particular are drinking them more and more. Non-diet soft drinks are often drunk between meals and consequently wash our teeth in sugar when our saliva is too inactive to defend them. This constant bathing in sugar lowers the average pH of the mouth and increases the chance of dental decay. Furthermore, fizzy drinks of all kinds contain acid – often citric and phosphoric – which softens the surface of teeth, leaving them vulnerable to both dental decay and tooth erosion.

Despite the benefits – reduced tooth decay and erosion, a drop in obesity levels and, consequently, heart disease and diabetes, the raising of money for child health schemes – the proposal has been met with disdain from those who fear the rise of a ‘nanny nation’ that punishes us for our poor health choices. But regardless of one’s stance on the tax, something needs to be done to halt the epidemic that has befallen us. Without establishing a plan of action, we risk not only our waistlines but also our NHS wards bulging at the seams.

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Scott Arms Dentists Goes Mercury Free

Birmingham Dentist stopped the usage of amalgam dental fillings

The use of amalgam in dentistry, and why Scott Arms Dental Practice has made the change

Scott Arms Dental Practice has decided to lead the environmental movement in eliminating amalgam from dentistry following the United Nations’ newly appointed international aims to reduce the use of mercury. As of April 2013, the practice has been operating mercury free, offering only white fillings.

Since it first began being used in dentistry in the early 1800s, dental amalgam has received both widespread support and controversy. While its function as a dental material is arguably unmatched, dental amalgam has become increasingly unpopular over the years: a desire for white fillings coupled with fears about health and environmental damage has led to the disregard for this material.

There is no argument against the fact that the mercury in dental amalgam poses an environmental risk; though recommendation states that amalgam should be made and disposed of appropriately, there is an amount that finds its way into the environment. However, there is no substantial evidence to prove that amalgam fillings cause any harm to a patient’s health, despite concern.

This January 2013, a global treaty on mercury as part of the United Nations’ Environmental Program was agreed on: the latest talks, involving 140 nations, have confirmed a policy to reduce the emissions of mercury, which are considered toxic on their own and less so when mixed as a filling material. While the mercury in dental amalgam was not a high priority for the talks, new policies were put in place to establish a reduction in its use. Dentists are united in their delight: the new guidelines allow the continued use of amalgam, recognising it as a necessary dental material, but show efforts to reduce the impact that its use has on the environment. National objectives aiming at minimising the use of amalgam, promoting the use of alternative materials and encouraging the research into mercury-free filling alternatives are all amongst the guidelines.

Following the widespread desire to reduce the use of mercury, Scott Arms Dental Practice has decided to take its environmental and patient dedication a step further. Scott Arms Dental Practice, based on the Walsall Road, aims to stay at the forefront of aesthetic, ethical dentistry and such is the reasoning behind their becoming an amalgam free practice as of 1st April 2013. While the Scott Arms Dental Practice has always invested in cosmetic dentistry, offering their patients a variety of white filling materials and shades, they now wish to propel themselves into the mercury-free dentistry of the future. Their dentists believe that with high-quality materials and professional expertise, white fillings can prove to be every bit as effective as their silver counterparts. ‘We’ve always practised safe amalgam disposal but now realise the time has come to remove mercury from our practice altogether,’ claims Scott Arms Dental Practice owner, Dr Phil Tangri. Giving patients white, healthy smiles in an ethical, professional and friendly manner is our primary aim.

We do not recommend having current amalgam fillings replaced unless the tooth requires it. ‘Mercury vapour is mostly only released on the removal of these fillings, so it is best to wait until the tooth calls for a new filling before replacing it for a white one,’ Dr Tangri says.

With the 1st of April changeover proving to be a success, the staff at Scott Arms Dental Practice hope that their hard-work and conscientiousness will help to make the future of dentistry less silver, and more green.

If you’d like more information on this topic please call Dr Phil Tangri on 0121 357 5000 or email him at [email protected]

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BDA good practice award

At Scott Arms Dental Practice, we are advocates of high-quality patient care and have been recognised as a leading company in dental healthcare by the BDA (British Dental Association), who have offered us sought-after Good Practice Scheme membership.

The BDA Good Practice Scheme is a leading quality assurance programme that encourages quality service, commitment to high standards and the development of a confident, professional dental team. Becoming a member of the scheme involves compliance with a considerable number of key principles, which are deemed the height of dental professionalism and quality. As a practice, you work through each individual requirement of the scheme, conforming to its high-standards, and submit your application to the BDA. They will then want to investigate your practice documentation and perform an on-sight assessment to be sure your practice is worthy of Good Practice Scheme membership. If your practice is successful in its application you can profit from all the benefits the Good Practice Scheme has to offer.

To become a member of the scheme involves adherence to ten codes of conduct, including demonstrating a consistent standard of dental care, providing dentistry that meets the wishes of the patients, offering comfortable and convenient dentistry, offering a medically safe environment and other obligations including demonstration of adequate infection control procedures, oral cancer screenings for every patient and continuing professional training.

Being a member of the scheme has many advantages: alongside gaining the status of an award winning practice, the scheme helps keep practices up-to-date with new quality requirements across a range of criteria. This makes sure that high-standards can be maintained at all times. Furthermore, the BDA Good Practice Scheme aims to improve and maintain high standards of patient communication and care through the implementing of its practice models and information materials. However, one of the most important aspects the BDA Good Practice Scheme is its emphasis on practice teamwork: the scheme offers the opportunity for continued training alongside encouraging ownership of dental roles and responsibilities.

Being a member of the BDA Good Practice Scheme is a very important achievement for Scott Arms Dental Practice. We are pleased that our high-standards of patient care have been recognised by a governing body and are keen to maintain our award winning status and lead the way in quality assurance for many years to come.

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Does an apple a day keep the dentist away?

It is suggested that ‘an apple a day keeps the doctor away’, a tribute to the fruit’s vitamin C content and other immune boosting qualities. However, there is more to the healthy fruit than meets the eye: recent studies have shown that the sugar content in apples has increased over the years to satisfy the sweet tooth of modern society. Apples are naturally high in sugar anyway, and contain acid, both of which are detrimental to the health of teeth.

Foods that are high in sugar provide a substrate for the bacteria in the mouth, allowing them to use the sugar for their own metabolism. For some bacteria, the waste product of this conversion is acid. It is the acid that attacks the mineralised surface of teeth, weakening them and allowing the invasion of more bacteria, some of which continue to produce acid, further weakening the mineralised structure of the teeth. Other bacteria are also allowed to penetrate, some of which are able to break down the organic tooth structure, resulting in the initiation of dental decay. Not only does sugar encourage this process by giving the bacteria a substrate to initiate the production of acid, but it also allows the bacteria to secrete a sticky mesh, which encourages the colonisation of other bacteria; an endless cycle of bacterial destruction and recruitment.

Some sugars are worse than others at allowing the above processes to occur. Sucrose is particularly harmful as it is easily converted to acid, readily stored inside the bacteria, and easily converted into a sticky mesh. Apples contain sucrose, amongst other natural sugars, and such is one of the reasons they can be so damaging to teeth if snacked on regularly.

The natural acid in apples is also harmful to teeth. Apples contain malic acid (this is what gives the apple its sour taste) and ascorbic acid amongst others. Ascorbic acid is a form of Vitamin C, of which apples are rich in. Whilst it has many beneficial properties it is still an acid that damages teeth: it attacks the mineralised outer surface. The effects of this are twofold: the tooth is weakened, making it susceptible to erosion, and gives bacteria an opportunity to attack, which can increase the chance of dental decay.

The best way to eat apples is to have them with your meals instead of as snacks. This way the acid is naturally neutralised by your saliva, which is produced in excess during meals. Snacking on apples doesn’t give the saliva a chance to reach its highest pH so it is less effective at neutralization. Snacking of any kind also adds another acid and sugar attack to the tooth, which it otherwise wouldn’t have had.

Do not brush your teeth straight after eating an apple, as the tooth will be slightly weakened by the acid and brushing may remove some of the tooth tissue. It is also recommended to chew gum after snacking as it removes debris and stimulates saliva, which can neutralise the acid from the fruit. A small piece of cheese is also slightly alkaline and will help to neutralise the acid.

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My teeth wobble, what should I do?

As a child, losing a tooth was often an exciting event, with the anticipation of the tooth fairy’s arrival and the promise of a new, grown-up tooth taking its place. However, as an adult, the discovery of a wobbly tooth can be concerning, as it may indicate a more serious dental issue. If you have a wobbly tooth as an adult, here are some steps you can take to address the issue.

Don’t panic

The first step when you notice a wobbly tooth is to remain calm. It’s essential to remember that adult teeth can sometimes become loose due to a variety of reasons, and it doesn’t always mean that you will lose the tooth. Staying calm can help you think more clearly and take appropriate steps.

See a dentist

You will need to see a dentist. How soon you need to see a dentist will depend on the cause of your wobbly tooth.

Wobbly tooth due to trauma

If you have recently suffered trauma to your mouth or face, the wobbly tooth could be a sign of a dental emergency, and you should see a dentist immediately. Come to our clinic or call us to make an emergency appointment for immediate medical attention.

Wobbly tooth due to tooth decay

Other common causes of wobbly teeth include gum disease or tooth decay. If you suspect that the wobbly tooth is due to gum disease or tooth decay, an emergency appointment may not be necessary but make an appointment with us anyway as soon as possible. We will be able to examine your mouth and teeth and determine the cause of the issue.

Depending on the severity of the problem, your dentist may recommend treatment such as a filling, root canal, or extraction. Early intervention can prevent further damage and reduce the likelihood of tooth loss.

Take care of your teeth

Regardless of the cause, taking good care of your teeth can help reduce the risk of further damage. Brushing twice a day with fluoride toothpaste, flossing daily, and using an antibacterial mouthwash can help reduce the amount of bacteria in your mouth, which can contribute to gum disease and tooth decay. Additionally, avoiding sugary and acidic foods and drinks can help prevent further damage to your teeth.

Consider replacement options

In the unfortunate event that the tooth cannot be saved, you may need to consider replacement options. Leaving gaps in your teeth can cause issues with your bite, lead to jawbone deterioration, and increase the risk of gum disease. Your dentist can discuss options such as dental implants, bridges, or dentures to replace the missing tooth.


In conclusion, if you have a wobbly tooth as an adult, don’t panic. Take good care of your teeth, identify the cause, and visit your dentist as soon as possible. Early intervention can prevent further damage and increase the likelihood of saving the tooth. Remember, your dentist is there to help you maintain good oral health, so don’t be afraid to ask questions and seek advice.

Posted in: Emergency Dentist, General Dentistry, Toothache

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What a dentist recommends you should eat

Chewing gum is recommended by our Birmingham Dentists

Cheese and chewing gum after meals – acid (found in many foods and drinks, and produced by the bacteria in the mouth) weakens enamel, the outer layer of your teeth, making it prone to wear and decay. The body naturally tries to counteract the acid through the production of an alkaline saliva, causing neutralisation. You can speed up the process of neutralisation by eating a small amount of cheese (an alkaline substance) after meals, or by stimulating salivary flow by the chewing of gum. Chewing gum is also a good way to dislodge foods that might have stuck to your teeth.

A balanced diet – Generally, these days there is too much emphasis on what you can’t eat. Dentists agree that no foods are off limits: it is just a matter of having a balanced diet (one which doesn’t contain too much acid or sugar, both of which jeopardise teeth) and eating your treats at the right time. It is best to have chocolate/sweets/fruits as a pudding rather than a snack as your saliva is already stimulated into action by the main meal and this also reduces the number of daily attacks on your teeth. The fewer attacks per day, the less likely acid wear and decay is. Sugar in tea and coffee is often a silent problem: It means you can be washing your teeth with sugar numerous times a day, not to mention your meals and snacks. The best way to combat this problem is not necessarily through reducing the number of sugars you have (though this does help slightly), but by reducing the number of times a day you drink a sugary tea/coffee. It is best to either restrict drinks containing sugar to meal times, or switch to using a sweetener.

Fruit – Dentists and doctors sometimes give conflicting information regarding fruit. While fruits contain many necessary vitamins, they can be harmful to your teeth because of the high levels of acid they can contain. Both dentists and doctors recommend the intake of these foods, but dentists would advise that they are not snacked on regularly throughout the day. Instead they should be consumed as part of a meal, like a pudding. This is especially important for high-acid fruit like oranges, and also for grazing fruit, like grapes and cherries, which you could be snacking on over a period of hours without realising.

Flouride– Fluoride is also something that a dentist recommends. While fluoride can be toxic in large doses, dentists always advise the use of a fluoridated toothpaste, provided it is not swallowed. In Birmingham, we are lucky enough to be part of the 10% of the UK that receive artificially fluoridated water. The process of fluoridating water means to increase it from its natural levels (of about 0.5 part per million) up to 1 part per million. This figure was decided upon from research, which showed 1ppm roughly halves decay prevalence without increasing the incidence of dental fluorosis (an adverse effect of excessive levels of fluoride, causing a mottled discolouration of teeth). Though children mostly benefit from the water fluoridation (the fluoride as they grow up helps the formation of stronger teeth), fluoride also continues to prevent dental decay in adults through a number of mechanisms. By drinking your 2L of water a day in Birmingham, you can rest assured that you’re not only receiving adequate hydration, but also benefiting dentally.

If you are unsure about your diet and how it affects your teeth, or would like more information, speak to your dentist. Another way to keep on track of how your diet affects your teeth is to keep a food diary: this way you can see the number of sugar and acid attacks your teeth experience a day.

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Can you go to the hospital to see a dentist?

A dentist working at a hospital.

Medical hospitals do not treat standard dental problems, though sometimes more complex dental treatment can be referred to those with oral and maxillofacial surgery departments. However, there are a number of dental hospitals around the UK, such as the Birmingham Dental Hospital, which treat both regular patients and emergencies (much like a dental A&E). As an emergency, you can check in at the hospital and wait to be seen without having made an appointment. Your problem will be diagnosed and often treated by a supervised dental student, rather than a qualified practitioner. In many cases, the department will remove the cause of pain but recommend that you follow up the procedure by either visiting your dentist, or registering with one of the students at the hospital. Though there is often a considerable waiting list, this gives you the opportunity to see one of the students for treatment on a regular basis as they undergo their training. This option is very popular; qualified dentists supervise the students and any treatment undergone (except the making of dentures) is free.

However, if you have a dental problem outside of the dental hospital’s opening hours, there are other emergency dental practices that can see you. Scott Arms Dental Practice specialises in fast and effective emergency treatment and has seen thousands of emergency patients over its many years in business. You don’t need to be registered and can always guarantee a same-day appointment. Scott Arms Dental Practice sees emergency patients from 9am right up to 11pm, 365 days a week. Outside of these hours there is a 24hr helpline for emergency advice.

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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.

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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.

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