Author: craigentinny

Do Not Blame Yourself For Your Dental Fear

It still surprises me when someone new comes to see me for an examination or consultation at my Edinburgh Dental  Practice how often they start our conversation by apologising for the “state” of their teeth or for not having attended a dentist within the last 6 months, year or even longer. What’s even more surprising is that people who are anxious or scared  are often the most apologetic. The tone of these chats also makes me believe past experience, the advice of friends or something else has led these  people to believe  that they are somehow going to be “judged” by the dentist when they do attend. Or reprimanded for the condition of their mouth and teeth.

If I had a bad experience and was as a result scared of the dentist  it would make me want to avoid repeating the process. It is a natural instinct and genuinely  nothing that you should feel the need to apologise for. Humans have finely tuned mechanisms to deal with stress or past unpleasant experiences. And one of the foremost  mechanisms is learning to avoid situations that have not gone well in the past.  For example, how many times did you as a child touch something that you were told was hot and would burn your fingers? ….not more than once or twice I bet…… Exactly, this is classic self preservation / learning in action.

So I can understand why people feel this way about their dental anxiety. Often their friends or family are able to attend for dental care. So the anxious or phobic person can often feel that somehow their fear is something they should just be able to “get over”. When they struggle to do so they feel ashamed and often assume that as time goes by their teeth have to be deteriorating. (An Interesting side note here is that in my experience  many anxious patients look after their teeth extremely well to “compensate” for not attending the dentist and often have very healthy mouths.)

I’d suggest instead that anyone who has managed to overcome their  dental fear and make that all important first contact with  a dental practice  deserves congratulations for overcoming their “natural” resistance to do so.  What’s more at that first visit, maybe it’s the dentist who should be apologising to you on behalf of our profession for making you scared or anxious in the first place!

Just a thought

Have a great week

The Future Of Cosmetic Dentistry

Happy New Year! May 2011 bring you plenty of smiles and only pleasant dental experiences.

I have been fortunate to enjoy a few conversations in the last 4 -5 weeks with both patients and colleagues that makes me think that the future of Cosmetic Dentistry is changing. The change may be coming from within dentistry its self but  I also think it is a wider phenomenon.

Whether this is the effect of so called “austerity” Britain or just a realisation that on planet earth we need to conserve our resources,  it seems that  many  people are looking to achieve more with fewer resources in all areas of their lives and dentistry appears to be no exception.

In the heyday of full on cosmetics as typified by extreme type makeover programmes, we saw porcelain veneers  and crowns being fitted like they were going out of fashion. If the teeth were not in the right position, then porcelain (from which these items are usually made) could sort the proble

m out. The only down side is that whenever you prepare a tooth for a crown or prepare it heavily for a veneer then you run a risk of killing the nerve inside the tooth. Depending on whose research you believe  between 5 and 15% of all teeth prepared this way will eventually die. So it is little wonder that more and more patients and dentists have been asking what the alternatives to crowns or porcelain veneers are.

Please don’t misunderstand me,  porcelain veneers are not intrinsically bad and if they are well placed and delicately prepared they can produce fabulous long lasting results. In patients prone to tooth staining they may indeed be the best restoration for the job but in many other cases resin bonding which adds highly polishable white filling material to the teeth can achieve similar results.

In situations where teeth are a long way out of position more patients are tending to align the teeth first to improve their overall position before they have the final veneers or bonds placed. This in turn reduces how much tooth needs to be removed. Though it may add 12-18 weeks to treatment time, is this really an issue when you are looking fro results to last for years and years?

Either way our practice goals is  to discuss all available options with our patients and the nature of those conversations is changing. In the past many people came to see us asking  specifically for porcelain veneers but after careful consideration of all of the options many patients chose either  short term orthodontics like the Inman Aligner or  Resin  Bonding as their ideal solution. Many more of our conversations now start with us being asked   about resin bonding and Inman aligners, a real change  from a few years ago…… maybe the good news about minimally invasive cosmetic dentistry is  spreading.
My Tip
Be sure you look at every option before choosing a treatment
Think how you wlould like your smile to look.
Now look at what you want to change about your smile
Then should  ask what are all of the ways  this  can be achieved?

2010 how will you remember it?

As 2010  draws to a very cold and snowy close I have been reflecting on the last 12 months  and realised that there  many, many things to be thankful for. I am indebted to my supportive family and great kids who make every day a joy, without doubt they are  responsible for a lot  of the high points and were invariably supportive and understanding when I experienced the odd low point too. I am grateful  to the many patients who have taken the leap of faith and  entrusted their dental care to our dental practice in Edinburgh. It has been my privilege to watch most of my  new patients  transition from terrified newcomers  to become confident  and happy people who enjoy coming to see us.  Without doubt the team of committed and talented professionals that I work with should take the majority of the credit for this.

So how will you remember 2010 and can I  help you to  make 2011 the year where you finally beat your dental fear?

I set up this blog  to help encourage people who  currently are too scared of the dentist to reach out and take the first step towards  beating their dental fear. To some extent it has worked and we have many success stories already but I would love to do more.   So I have a Christmas favour to ask? 

Please let me know how we can be more helpful in 2011 ?
What could this blog do to  help you move forwards and beat your dental fear?
And finally if you have taken our 7 Day Beat Your Fear e-course please  let me know what worked and what didn’t. Good or bad  I really would love to know.

So until next year I wish you a Peaceful and Happy Christmas

With all good wishes

Fraser

Fake or Real Cosmetic Dentistry?

I have just returned from a very enjoyable day at a conference focusing on the concept of Bio-aesthetic dentistry. This is the complicated way of describing what we aim for at my dental practice in Edinburgh namely improving the lives and smiles of our patients without aggressive drilling away of otherwise healthy teeth. It was also reassuring to find a room full of people that feel the same way . As part of the day I was reminded of a very powerful 60 second video by the manufacturers of the Dove range of soaps and cosmetics, that I first saw a few years ago. I think it is as powerful today as when it was released in 2005. Take a look and see what you think…..


 It serves as a timely reminder that in the field of cosmetic dentistry, aesthetic dentistry or whatever you actually want to call the process of enhancing and improving a smile that we need to keep our aims grounded in reality. More importantly it reminds us that almost every cover shot that we see on glossy magazines has been digitally manipulated in some way so these highly altered images are not the best benchmark by which to judge any part of ourselves. Don’t get me wrong I think that enhancing any aspect of ones self  or situation with which we are unhappy can be a positive and life affirming thing to do, be it eating healthily, a new hairstyle, drinking less alcohol, exercising more or indeed improving a smile. I simply believe that chasing a false image of perfection may not be route to happiness.

So if we want to improve our smile ( which is really the only area where I feel qualified to comment ) what can we learn from this? I can only speak for myself  but, for me the answer is that the medias portrayal of perfection can be an illusion and I think it highlights the importance of realising that any cosmetic treatment is done for ourselves and not for others.  If you start from this point your chances of having a great outcome that you love is greatly enhanced.
What do you think?

Smile Makeover Tips From An Edinburgh Dentist

A smile makeover can mean many things to many people from changing just a single tooth to changing them all.  Most patients that come to see me have an idea in their head of what they wish. I am often asked for a specific treatment for example Teeth Whitening, Inman Aligner, 6 Month Smiles or Porcelain veneers.  These requests are  very often the result of hours of web based research. As a dentist  I am always pleased to find that my patients already know  a lot about the treatments that they are looking for as this is a great way to move towards a situation where you can make a really well informed choice of the right treatment for your mouth.

Ironically none of us really wants any of the above treatments, what we really want is the results that the treatments can bring,  be it improved confidence or simply  a better appearance in photographs. So I often  find the best place to start is to discuss in some detail what  results my patients hope to achieve. After that we  carry out a detailed point by point assessment of all aspects of our patients dental health. the aim here is to  look at  how we can create a smile that our patients will love while maintaining or better still improving their overall dental health.

So to get the best out of any cosmetic treatment a great tip is to begin with the end in mind. By being clear about what you really want to change you can  aim to have the least amount of treatment  to achieve your goals.

Here are just a few questions that might help……

  • What do you notice most about your smile good and bad – tells us what things we need to preserve
  • When are you most aware of these features – can shed light on hidden problems that only show eg in photos
  • If you could change just one thing what would it be – helps us to prioritise

Here are 3 more questions that I am always keen to hear my patients views on

  • How do you feel about the colour of your teeth
  • How do you feel about the shape of your teeth
  • How do you feel about the position of your teeth
If you have a cosmetic problem that you would like to know more about why not drop us a line at our Edinburgh Dental Practice

Does Your Inner Voice Say "I Am Afraid Of The Dentist?"

I was chatting with my wife after work yesterday and  we got talking about what can make someone feel anxious about a dental visit or treatment We have both worked in Dentistry for more years than we care to count and interestingly we both identified one of the major causes of  anxiety being what people had “heard from a friend” or what they have read about a specific treatment.

I guess this is a common way to form opinions and judgements. We almost all subscribe to this approach in some aspect of our lives yet  it does not a particularly balanced, scientific or for that matter accurate way of doing things. For patients who suffer from dental fear or phobia in particular approach to forming opinions and judgements, while very natural,  can be less than helpful.

The way that we process  information  to make it useful to us  ( in theory ) is based on a mixture of  what we see, hear and  read which is then filtered by our underlying beliefs. Now those of you patient ( and kind )  enough to read my musings on all things  dental will know that I frequently describe our subconscious as having 2 voices. One is the voice of doom that tells us that everything will go wrong with our treatment  and “it” ( whatever “it”  is ) will be a dreadful experience.  The other voice is our rational one that reassures us that everything will be ok and that if  we choose the right people to help us with our dental fear and phobia everything will be fine.  This is true even if it is our own personal experiences in the past  that are forming our opinions and views today, the key here is finding someone who really is interested in helping you.

So here is my question for you if we want to beat dental fear  which of our two voices should we feed the most, the positive reassuring one or the negative one?

There are lost of places on the web where you can hear reassuring stories that affirm the positive reality; that modern dental care can be comfortable, informed, relaxed, and pain free. Dental Fear Central is just one great example. Whats more there a whole group  of people ( like the team at our Edinburgh Dental Practice  pictured to the right)  who are happy to have a chat by phone or e-mail  long before you ever have to actually visit to talk through your fears and concerns.

Talking to enthusiastic professionals and finding positive examples of detal care will not  solve dental fear entirely but if you want to change the way that you feel, they can help you to make a start, and in truth the hardest step is always the first.

So if you have a fear that is stopping you taking that first step why not take positive action and make contact with someone who can help to feed the positive voice that tells you that you can beat your dental fear. If we can help in any way just let us know…..

Have a great week!

Resources For Dental Phobia

Beating your dental fear or phobia does not need to be a lonely experience, there are lost of resources out there on the internet to help. Here are just a few that my patients have found to be very helpful.

DentalfearCentral.org -a great resource complete with a forum where users can share their experiences and encourage each other

British Dental Health Foundation produces a leaflet on dental fear you can find it here

Find out  how  Panic Disorder works and what to do about it. If you have ever had that overwhelming feeling of panic as part of your dental fear  / phobia this is another great resource.

Try our 7 day beat your dental fear e – course- 7 small steps to help get you in the right frame of mind to make contact with a new dentist
If you know of a great resource on the web to help with dental fear or phobia why not let me know and I can share it with all of our readers.

Kinder Than Porcelain Veneers, Faster Than Orthodontics?

There is a new idea catching hold in main stream cosmetic dentistry and to be honest, it is a change that is long overdue. In my  career to date as a  preventive dentist and a cosmetic dentist I regularly have had to balance my patients desire for a lovely smile versus my own personal view that we should always treat healthy tooth tissue as precious. For more than 15 years the team at Craigentinny have taken the view that that we should avoid  drilling away tooth  if at all possible. As a result  I have on many occasions declined to carry out treatment that patients have requested when it  would involve grinding away significant quantities of  a  tooth and lead to what I believe is  long term damage or complications.

You see,  when a tooth is prepared for a crown  there is a 5 – 15% chance that the nerve in that tooth will die at some point in future. And if the nerve dies then a root treatment becomes necessary. So when an alternative exists that is kinder to the  tooth  its seems to me a no brainer that we should look seriously at this option. As a result in the last 10 years I have carried out a lot of resin bonding rather than place veneers or occasionally crowns for my patients. Resin Bonding (Composite Bonding)  usually requires little or no removal of the underlying healthy tooth and as such is completely reversible. Indeed resin bonding is so conservative that very often we are able to complete it with no need for injections or anaesthetics. A real winner for my more nervous patients.
As a treatment Resin Bonding (Composite Bonding) or Composite veneers as they can be known, matches crowns or porcelan veneers for speed as they can usually be completed in one or two visits. Resin bonding does not suit everyone. It is a bit more prone to gathering stain so smokers probably should consider alternatives, that said in normal use any minor staining is easily polished away. This simple before  and after series  from a few years ago shows just what can be achieved. The cost was significantly less than using poreclain veneers to achieve a similar result and my patient was delighted.  Better still the natural teeth were completely untouched. Today we  may well treat this lady differently as we have fast orthodontics available with  the  Inman Aligner  or 6 Month Smiles however as the resin bonding can be stripped off back to the natural tooth at any time this patient  still has these options available to her. If we had chosen to place 6 veneers that flexibility would have been lost. Don’t get me wrong veneers and crowns are still a great option for the right patient, and I still provide a lot of these treatments  but  if you do nothing else before having some cosmetic dentistry carried out, please do make sure that you consider all of your options, their advantages and disadvantages before starting.
What do you think is the best way to enhance a smile?

The Truth About Teeth Whitening

With the holiday season upon us, we always find a surge in patients asking us about teeth whitening at Craigentinny Dental Care. So here is the low down on  one of the most straightforwards cosmetic dental procedures.

With many millions of tooth whitening procedures having been carried out by dentists worldwide we can say with some confidence that it is simple, safe and fast. With take home whitening or 1 hour whitening  to choose from here are a few things that you should  know.

1 Hour Teeth whitening
1 Hour tooth whitening works wonders to kick start the process, but unless you follow up with at home whitening trays it is highly likely that the results will not be as long lasting as you might wish. All tooth whitening dehydrates teeth which is why they look so much better immediately after treatment yet many patients report a bit of a fade back in the two weeks afterwards. Particularly if the 1 hour treatment is not followed  up.  See some examples of tooth whitening at our dental practice in Edinburgh.

Take Home Teeth Whitening
The at home systems where you wear custom made tooth whitening trays overnight are in many ways the most effective and kindest to your teeth as they use lower concentrations of gel to achieve the necessary results. For the very best results with this system you need really well mad and snugly fitting bleaching trays.

Deep Bleaching
For the whitest “Hollywood style look” combining 1 hour whitening with at home trays in a process called deep bleaching can work wonders. While not to every ones taste,   this combination gives you  the opportunity to reach the lightest shade on the regular dental shade guide as a bare minimum. Experienced providers often offer a shade B1 ( the lightest )  or your money back promise. Here is just one example of deep bleaching in action.
As a patient you need to know that any system that uses lights – be it Laser whitening , LED, or  halogen acts the same way. The light source  is warming up the active ingredients in the whitening product so it is more effective. In 1 hour systems we do use much more concentrated tooth whitening agents so an experienced pair of hands and familiarity with the system counts for a lot.

How long does it last?
On average tooth whitening, when done well, is believed to take around 7 years on average to relapse back to where it came from. Obviously there will be quite a bit of variation depending on your diet and tooth cleaning habits. It is usually possible to maintain your final results with a simple touch up for 1 or 2 nights per year using at home whitening trays. At my dental practice in Edinburgh we offer this service free of charge to patients who become members of the practice.

Is Teeth Bleaching Safe?
In the right hands yes it is. Naturally we hope that you will chose our Dental Practice in Edinburgh for this treatment but if you are further afield bear in mind that only dentists are legally permitted to carry out dentistry – of which tooth whitening is part. Teeth whitening by a dentist is safe and  effective. Since a mistake in treatment can cost a dentist their livelihood,  we  tend to take the process seriously. This means using materials from reliable, traceable sources, having great infection control procedures (and believe me this is much much more than just wearing gloves), as well as insurance to protect you in the unlikely situation that a problem does occur. Tooth whitening in any other location is a riskier endeavour especially  if you do experience problems during or after treatment.

Enjoy the summer months and whiten with care!

Why Dental Sedation Might Not Be the Answer

I speak to lots of nervous patients every week, and one question that often comes up is “can’t you just knock me out for my treatment?” I guess what I am really being asked is what can you do for me that will reduce my level of consciousness such that I don’t know anything about what is going on. In days gone by a general anesthetic was the standard approach but in these more enlightened times most of patients would rather avoid this whenever possible. This leaves us with sedation.

Dental Sedation can be done with a small injection in the back of the hand ( called IV Sedation ) or using a gas called Nitrous Oxide ( often called RA sedation).  Clearly for anyone with a needle phobia the IV option already sounds challenging!  Either way the aim is that you remain conscious throughout treatment but at such a low level that you will not be hugely aware of what is going on and preferably remember very little or none of it when you recover.

At Craigentinny Dental Care we have in the past provided some sedation services and found that for patients who were really anxious dental sedation was not always the answer they hoped for. Firstly as you are largely unaware of what is going on you have no learning experience. i.e. after treatment you will be just as nervous as before. So as a result you are still likely to feel very anxious on the run up to each and every visit. So over time your fear of the dentist and dental treatment is less likely to diminish.

A second issue which is really the most significant one for me, is that should you be unfortunate to experience toothache, and it does happen to the vast majority of the population at some time in their life, you cannot always guarantee the availability of a sedation service.

Generally dentists who provide sedation have had additional training as have the dental nurses who support them, so you simply cannot arrive to see any dentist and be guaranteed sedation. Even if a practice does offer sedation, there may be issues if the right combination of staff are not on duty that day. This then leaves you with a terrible dilemma of living with the problem or facing your fears head on in a crisis situation. Neither option is a good one and likely to help you in your quest to feel more relaxed about dentistry.

For these reasons, I feel that the best approach for the majority of patients is to address their fears slowly and gradually with a caring and sympathetic dentist and nurse who have a genuine interest in helping them. This way we can treat your dental fear as well as treating your dental problems. In time most patients find that this approach leads to a reduction in their anxiety levels and they are more able to cope with routine care.

A typical example that I often hear from patients who come to our dental practice in Edinburgh is “I used to take a whole day off work when I came to the dentist even if it was just for a very short visit but now I just come along before or after work .”

I know that  the non sedation route  is not the fastest but   in terms of treating dental fear in Edinburgh it has  proved to be very  effective for our patients in the long term.  Let me know your thoughs on this……..