Decay occurs when bacteria present in plaque (a clear, sticky film that naturally forms on teeth everyday) feed on sugar in food we eat, and produce acid. This acid can attack the structure of the tooth causing holes to form.  This means each time food is eaten, your teeth will have an acid attack for around 30 minutes afterwards.  This is actually ok though as our saliva helps protect our teeth from this acid, which means we can eat safely 4 times a day without having any decay.

What this does mean, however, is that the most important consideration with tooth decay is how often you’re eating – or snacking.  Say for example you had a packet of biscuits or sweets and if you ate them all in one go, 30 minutes later all the decay would be over.  If you were to have the same bag of sweets, but split the bag into 10 portions and ate them separately, you’d get 10 separate episodes of decay even though you’ve eaten the same total amount!  This highlights to us the importance of timing our eating – eating everything in one go, and not snacking, is the biggest factor to preventing getting any tooth decay.

Often we will see families, where child A has a lot of holes in their tooth, yet child B will have none and they eat the same food.  This is often the lightbulb moment when Mum and Dad realise that child A will save their sweets and graze on them throughout the afternoon and evening, and child B eats them all in one go!

1. Stop snacking / sweet drinks between meals
As written above, timing when you eat, and not snacking is key to preventing decay. The same also occurs with any drinks with sugar added in them – such as tea and coffee. The worst offenders are office workers that have several cups of tea/coffee with sugar in them periodically during the day, between meals – with these you’re getting several extra rounds of decay that most people will not have! Other people that constantly get holes are those that suck sweets/mints during the day (think long distance drivers etc) or those constantly sipping on sweet drinks.

2. Eat only 4 times a day.
Limiting eating to 4 times a day will stop any further decay. We’re not stopping you from eating nice things though – you can still enjoy your treats – just try and eat sweet foods / desserts straight after meals and not at a separate time!

3. Use sugar free sweeteners or sugar free mints/sweets
As written above, sugar in drinks drunk between meals can cause massive amounts of decay. Switch to a sugar free sweetener to still enjoy your drinks – these won’t cause decay. The same applies to any sweets or mints – please ensure these are sugar free!

4. Use a fluoride toothpaste – spit out – and don’t rinse away
Fluoride in mouthwashes and toothpaste help prevent dental decay. Make sure your toothpaste is at least 1350ppm Fluoride (see the back of the packet to identify this). We tend to see that people not using fluoride toothpastes tend to get a more holes than those without! Another handy tip is after brushing, not to rinse away, but to spit out the foam afterwards and leave it there. The foam has a lot of the fluoride in and will help protect your teeth.

5. Use a fluoride mouthwash at a different time of day from brushing
The more often you can use a fluoride toothpaste or mouthwash, the greater the protective effect it has. This is why if you were to use a fluoride mouthwash straight after brushing, it wouldn’t be a great help in further protecting your teeth as your teeth are already being protected from the fluoride in the toothpaste. What is more beneficial is to use it at a separate time during the day – for example, after lunch, or after your evening meal. Mouthwashes need to contain ‘225ppm’ of Fluoride (or 0.05% – check the back of the bottle where it will say this). Using a mouthwash a few times a day after meals will help protect your teeth and give you fresh minty breath!

For tooth decay, it is essential that the mouthwash has 225ppm Fluoride (or 0.05%). Luckily, this type of toothpaste can be had from as little as around 50p from most supermarkets own brands (such as Morrisons, Aldi and Tesco). You don’t need expensive mouthwashes to protect your teeth from decay!

For gum disease – the most beneficial way to treat this is with mechanical cleaning and removal of plaque – not fancy mouthwashes! Lots of big companies have huge marketing budgets and love to advertise how great their mouthwashes are at treating gum disease – but the truth is, we would not routinely recommend any mouthwash to treat gum disease – it is much more effectively treated with interdental brushes. On certain occasions we may recommend a chlorhexidine mouthwash (such as Corsodyl) – but these are only in specific circumstances and not for routine, long term use.

Gum disease is inflammation of the gums which could lead to loose and wobbly teeth. In the early stages, gum disease is known as gingivitis, as only the gums are affected and is completely reversible by good brushing. Signs of gingivitis include, bleeding gums, sore gums and also bad breath.

If gingivitis isn’t treated it can then lead to inflammation of the tissues that support the teeth, which may cause them to become loose. This is called periodontitis. Periodontitis is a more serious condition which will need treatment from the dentist/hygienist/therapist. Signs of periodontitis include, bleeding gums, sore gums, bad breath and wobbly teeth.

Gum disease is caused by a sticky substance called plaque that contains bacteria. This is naturally present in the mouth and sticks to our gums and in between our teeth. When we brush our teeth we try to brush away and remove all the plaque on our gums and teeth. However if any plaque is left behind – that is – if you have missed anywhere with your toothbrush, or if you’re not cleaning between your teeth (with interdental brushes) the gums can become inflamed and become red, sore and bleed.

Don’t worry if you have experienced any of these signs, as gingivitis is a very common condition and at some point in their lives, most adults will have experienced these.

There are two main elements to treating gum disease:

1. Making sure your gums and teeth are perfectly clean every day
2. Having professional scaling and cleaning by your hygienist

Cleaning your gums and teeth thoroughly is the main way to treat gum disease. Because the condition is caused by plaque being left behind (i.e. where you’ve missed brushing), then the good news is that the only thing that needs to be done to treat your gum disease is to make sure they are perfectly brushed, on the gums, and also really importantly, between the teeth. The most common area that people miss when brushing is on the gumline – where the gums meet the teeth – and also in between the teeth – with interdental brushes. If you’re not cleaning between your teeth using interdental brushes then you’re only cleaning 60% of the surfaces of your teeth! So with some careful toothbrushing and interdental cleaning, your gum disease can be successfully treated. A dental checkup every 6 months is advised to make sure your gums are healthy.

Secondly, after ensuring your gums and teeth are perfectly clean, a professional scale by a dental hygienist or therapist can help clean your teeth and gums and remove hardened plaque (‘tartar’) that cannot be cleaned by your toothbrush alone. In some cases you may need to see your dentist/hygienist/therapist more often such as every 3-4 months to ensure good gum health. A dental checkup every 6 months is advised to make sure your gums are healthy.

Many people who have gum disease often do a great job of brushing their teeth, but actually miss brushing their gums (and the gum line) – which is the most important bit to brush when preventing gum disease. So when brushing your teeth, it is very important to remember to also clean the gums surrounding your teeth. This may mean you need to brush more towards the gum line, so your brush is half on gum and half on tooth. We recommend this as your gums can act as a little shelf where the harmful bacteria on teeth can sit, so if it isn’t removed can cause inflammation.

As well as brushing, it is also important to clean in between your teeth (interdental cleaning) with dental floss or tepe sticks every day. The head of your toothbrush is very big in comparison to the space between your teeth, so therefore unable to remove plaque and debris from in between these spaces. So even if you brush your teeth, if you don’t use interdental brushes you may find that you still get bleeding gums as there is still plaque present in between your teeth.

Did you know if you’re not using interdental brushes you’re only cleaning 60% of the surfaces of your teeth?

As above, a good oral hygiene regime including regular toothbrushing and interdental cleaning will aid in the removal of plaque.  This will help prevent plaquqe building up and causing inflammation.

Recently you may have heard via media outlets that flossing doesn’t work. Unfortunately, this wasn’t written by a dental healthcare professional with the relevant knowledge in this area.
We still maintain flossing is essential for keeping your teeth and gums healthy.

The confusion with the media is that previously dentists would have advised their patients to floss to treat gum disease – however we now know that only interdental brushes have been scientifically proven to treat gum disease, and that there is no evidence that flossing helps with treating this. Flossing however is still essential for stopping tooth decay by removing trapped food between your teeth that the brushes can’t remove. Flossing is also great for cleaning out plaque where it is too tight for an interdental brush to reach!
So to summarise – use interdental brushes to clean your gums. Use floss to clean your teeth. We recommend to use both 🙂 !!

This is our most common complaint by patients! And they’re right – using small interdental brushes can be really tricky! In the same way that you didn’t learn to ride a bike overnight, or have neat writing in a day, using interdental brushes well needs lots and lots of practice. We find that the more you practice, the easier it is to use the brushes without them bending.
Interdental brushes are a great way to clean and remove debris from in between your teeth. There are many sizes of interdental brushes – the small tepe brushes come in 10 different sizes and the long handled angle tepes come in 8 different sizes and colours. The colours correspond with how big the brushes are.
Most people have different size gaps between their teeth, therefore we recommend most people use around 2-3 different sizes of interdental brush for their cleaning regime.
The aim of the interdental brush is to clean the space between the teeth, and the only way it can do this successfully is if the brush has a tight fit so that both sides of the teeth are touched.
If the brush is too big, it may bend and not fully go through the space, this is because you are exerting too much pressure on the brush. Equally, a brush that is too small isn’t touching the sides and won’t be cleaning properly.
A good guide to find the right size:
– If the interdental brush fits through easily without you feeling it then it is too small.
– If the brush bends and doesn’t fit through at all, don’t force it as it is too big.
– If the brush fits through snugly without excess force then it is the right fit.
– If this seems confusing, we’d love to help you care for your gums – why not book yourself an appointment with the hygienist/ therapist or ask your dentist at your next appointment?

If you’ve already got crowns and veneers and wish the appearance to be improved, then getting them replaced could be a superb option to improve the aesthetics and appearance of your smile.

However, for veneers and crowns can require some drilling and removal of healthy tooth structure to be fitted.  For this reason, they might not be suitable for everyone and composite veneers may be a better option.
In order of drilling required, crowns require the most, followed by veneers, lastly composite veneers usually require very little or no drilling at all.

Can we tell you a little secret?

Did you know, that as dentists, we provide very few porcelain veneers and crowns anymore?  The demand for fantastic smiles is still there, but what we know now is that there are many better options to make your smile look lovely, but more importantly, not damage your teeth.

Porcelain veneers and crowns were very much in vogue and popular many years ago, popularised by the media advertising that celebrities had had smile ‘makeovers’.  The truth is, now we know that the best options are the ones that conserve tooth tissue. This means as a profession we are shifting our treatment from drilling (crowns and veneers) to minimising drilling (so called “Minimally Invasive” dentistry).  We find that the majority of beautiful smiles can be created safely with the following 3 treatments – tooth straightening, composite veneers, and tooth whitening.

As a rule, porcelain, made in a laboratory will look the best, all things being equal.  Composite veneers can look superb too, but patients need to be aware they can stain around the edges and may need to be repolished from time to time.

Any dentist should be technically capable of doing treatment to help improve your smile – the truth is, there’s no such category as a ‘cosmetic’ dentist.
However, a lot of dentists will not have the experience with the considerations and decisions required for perfect facial aesthetics.  Many factors, such as surface texture, translucency, emergence profile, porcelain type, cutback and layering techniques need to be considered.  At Perfect 32, our dentists have undertaken extensive postgraduate training to help get the result you want.

Any time a drill is lifted and used to drill a tooth, the nerve undertakes damage.  If the tooth already has had decay, and the decay is removed, drilling the tooth won’t damage the nerve anymore – the decay has already damaged the nerve and the drill is simply removing the rotten, weakened tooth tissue.  Fillings on decayed teeth doesn’t weaken teeth any more – the decay has already done that.   This is why as dentists we’re happy to drill a decayed tooth.
However, drilling a healthy tooth that has no pre-existing decay and no previous crown will damage the nerve.  Teeth are incredibly resilient and can undergo a significant amount of drilling before the nerve dies off.  Doing a very minimal veneer will unlikely cause any, if any, damage but if the nerve does die off, then a treatment called ‘root canal’ is required to treat the nerve which can significantly weaken the tooth.  Because of this, for the majority of cases we recommend not doing any invasive treatment to improve your appearance – this really means as little drilling as possible.
For this reason, for teeth that have not already been drilled, composite veneers – which are just glued on to your teeth – are our favourites as they are non-destructive and reversible veneers.

For the majority of people with healthy mouths and no problems then tooth whitening is a beautiful, safe and painless way to create a stunning smile.  If you don’t have an allergy to any of the ingredients in the whitening gel (namely Carbomide Peroxide or Hydrogen Peroxide) then you should be suitable.  Each patient is different and it is important we see you in person for a consultation first – if there are any fundamental problems with your teeth or gums, these will naturally need to be addressed prior to tooth whitening.

It is important to note that whitening ONLY whitens natural teeth and enamel. This means that if you have any white fillings, crowns or bridges (i.e. fake teeth) then these will not whiten. If they are on back teeth then they probably won’t be noticeable. However, if the crowns and fillings are on front teeth you may need to consider getting them replaced with a more similar shade if the difference is large. We can certainly advise on this.

We love our airflow – it’s simply amazing for removing stains. But sadly unless your teeth are the perfect colour underneath, AirFlow cannot change the colour of your teeth paste their natural shade. We think our AirFlow and whitening treatments go hand in hand and are the perfect complement to each other for a beautiful smile!
Whitening toothpastes are great to remove small amounts of superficial staining and to keep on top of any build ups of stain, however as above they cannot change the natural shade of the teeth. They also cannot remove the staining that accumulates between the teeth very well (which can be rather noticeable on the lower front teeth especially!).

Teeth will stay whiter for several months, however after this period they may start to darken again – this is normal. Repeating the whitening every 3 months or so can help maintain lovely white teeth!

There are 2 methods for whitening your teeth, so called ‘chairside’ whitening and ‘take home’ whitening.
Chairside whitening as the name suggests is done with a visit to the practice. It is quicker than ‘take home’ whitening, however it is much more expensive as it uses surgery time. The effects don’t tend to last as long. For this reason we don’t offer chairside whitening.
‘Take home’ whitening is where we construct you personalised, custom fit gum shields. Inside these gum shields our special whitening gel is applied, and then the gum shields are worn by you for anything from 45 minutes to overnight, depending on what we have recommended. After this, the whitening is complete!
If desired, the process can be repeated for several days in a row to achieve the level of whiteness required – it then only needs to be repeated every 3-6 months.

Tooth whitening is completely safe to healthy teeth. It is one of our favourite treatments to provide, as it’s not often in dentistry you can improve a smile without any damage to the teeth!

With that said, there are however a few minor side effects that can occur for a few days after or during your whitening treatment. A common side effect is getting temporary sensitivity to cold drinks after the treatment, or some discomfort when undergoing the whitening treatment. For those affected with mild sensitivity, we recommend using the use of a sensitive toothpaste either as a long term measure, or before and after whitening treatment. If you experience any discomfort during the whitening procedure, whitening for a shorter period of time, or with a weaker concentration of the gel, with analgesics such as paracetamol will certainly help.