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Latest News From Our Blog

Welcome to the Lakeside Orthodontics Blog. Our aim is to provide our new and existing clients with the latest industry news and advancements in technology, while keeping you up to date with the latest goings on at Lakeside.

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Posted on in General Health and Dentistry
Gum recession

Gum resession is a problem that affects many adults, especilaly over 40, and can be unsightly if it shows on smiling. In some cases it can be a sign of gum disease (periodontitis) but for others it can be a result over-zealous brushing, thin gums (a thin tissue biotype), tooth grinding (bruxism) and it can also be related to small areas of missing bone (dehiscence). I often look out for these areas of dehiscence on skulls in museums and my next article about the MARY ROSE will demonstrate this.

This lady clearly showed gum recession on the two front teeth when she smiled. One tooth also has a very dark root (dead tooth). We decided to extract the dark tooth and move the canine tooth, behind it, into its position. Often this type of recession that shows on smiling needs a gum transplant from the back of the mouth (free gingival graft) to repair it

There was almost total resolution of the recession on the other affected front tooth (see blue arrow) which is great news as it saved her from an operation with my Periodontist friend.

 

Posted on in Historical
The Battle of Waterloo and Dentistry

Real teeth were used in tthe most expensive dentures and were often illegally obtained from exhumed corpses and the bodies of executed criminals (nice!).
The Battle of Waterloo in 1815 left 51,000 dead. The day after the battle a whole army of scavengers started to strip the dead of everything including their teeth. Suddenly there were  mountains of teeth flooding the London markets, making real tooth dentures more affordable.
The name ‘Waterloo teeth’ came to mean any dentures made with real teeth (as in this photo). They were very sought after as they were made with teeth supposedly taken from a brave soldier cut down in his prime.
Thankfully Claudius Ash, a silver and goldsmith invented a denture to hold Porcelain teeth in, so denture wearers no longer had to wonder about the provenance of their teeth.

Posted on in General Health and Dentistry
Impacted canine teeth

The canine is the longest tooth in our mouths, and is critical for guiding the lower jaw into the proper bite.

It starts to form at 4-5 months of age, almost 11 years before it is due. At first it is just under the eye socket yet it is one of the last teeth to come in.

The Upper canines ,like wisdom teeth, have a tendency to go off course (probably because they are the last ones in). Impacted teeth are ones that cannot fit in. 2/3rds of impacted canines are in the roof of the mouth (see photo) and unfairly this happens more often to girls.

If we catch these 'off course' teeth early enough (normally at 10ish), then some can be encouraged into the mouth by extracting the overlying baby canines. In extreme cases (like above) the impacted canine may need removing surgically as some can damage the neighboring teeth.

Posted on in Information
Not so 'wise' Wisdom teeth

Wisdom teeth (3rd molars) normally erupt  between 17 and 25, hence the name.

A very long time ago, they were very useful in helping us break down foliage, but are now they are pretty vestigial. There may be several reasons for this. Our more refined diet has led to much less wearing down between the teeth (which helped to make room at the back) and there has also been a reduction in jaw size with this softer diet, and yet our teeth have not significantly changed in size to adapt to this.

Every week I hear Wisdom teeth being accused of causing incisor teeth to crowd up. There is lots of evidence comparing people with wisdom teeth and those missing wisdom teeth that have shown they all have identical amounts of crowding so Wisdom teeth are atleast vindicated of this crime.

These days Wisdom teeth seem to rarely fit in properly leaving them unerupted or partly erupted and hard to clean right at the back. NICE (National Institute of Clinical Excellence) produced guidelines in 2000 limiting the cases in which wisdom teeth can be removed to mostly cases where the wisdom tooth is diseased or where it is causing other problems with the mouth. That is very different from the approach 20 years ago when I was relieved of all four of my symptomless and unerupted wisdom teeth under General Anaesthetic!

Posted on in General Health and Dentistry
Diastemas

A “diastema” is a dental term referring to a space or gap between two teeth, often the two upper central incisor teeth (upper front teeth). There are several causes including small teeth and a prominent lip attachment (fraenum), but they can occur as part of a disease process like gum disease.

Famous diastemas can be seen on Jade Jagger, Vanessa Paradis and Madonna.

They can actually be healthy as they are brushable and for children they may not qualify for NHS treatment.

They can be treated with orthodontics, though if it is due to small teeth, then adding some white filling OR placing veneers can either reduce or eliminate them.

Diastema at the start of treatment with Invisalign 

mind-the-gap2

Diastema half way through Invisalign treatment

mind-the-gap3 

Diastema Mythology

In the Canterbury Tales, the "gap-toothed wife of Bath" the diastema was associated with lustful characteristics. 

In some African countries it is considered a sign of fertility. In France, they are called "dents du bonheur" ("lucky teeth"), and in Australia, they are said to be a predictor of future wealth

Posted on in Cases

Kate was missing the upper left lateral incisor, so the pointy canine (that is the second tooth on the right as you look at her smile) was in its place. The priority for both of us was to give her the best and most attractive smile. Apart from just straightening her teeth, this involved placing the incisors in the centre of her smile, with the gum margins in the correct position relative to her upper lip as well as broadening her smile to maximise its appeal. Treatment also involved reshaping the canine to mimic a lateral incisor and adding some white ‘composite’ filling to the tooth behind to make it look like a canine. She was thrilled with how great her smile looked when we took the brace off!

caitlin before 3   Caitlin after 3

Posted on in Celebrities
Rylan and his new Pearly white teeth

Rylan has re-ignited an argument led by Martin Kelleher (consultant in restorative dentistry at King's College) about the inappropriate use of Porcelain veneers and crowns.

A veneer is a glued-on facing, whereas a crown covers all the exposed tooth (front, back and sides). Normally a tooth is prepared for crowns and veneers by removing some healthy tooth structure to accommodate them. With crowns this can be up to 73%.

Veneers and crowns are the best treatment for some patients but not all. They are useful if teeth are very discoloured, broken or have had a lot of decay. The recent demand for instant straight white teeth has led to perfectly healthy teeth being reduced down.

I liked Rylan’s teeth before he had this treatment. They were a little out of line but were a little quirky and had some character. Orthodontics and tooth whitening (or some ‘bonding’ – adding white filling material) could have given him natural straight white teeth if that was what he wanted. In addition his teeth would have still been healthy and should have lasted a lifetime.

Instead Rylan opted for a very un-natural look, which undoubtedly has been achieved by aggressively reducing down his natural healthy teeth.

Research suggests that around half of veneers are no longer in place, require further treatment or are in a poor condition after 10 years. So prepare yourself for more changes in Rylan’s smile in the future as he goes through subsequent sets.

Posted on in General Health and Dentistry
Mouth Cancer awareness

In Britain, the incidence of mouth cancer has increased faster than any other cancer in the past 25 years. Alarmingly, the rate of mouth cancer in women has increased significantly at a rate of 3% per year since 1994. At Lakeside Orthodontics we regularly screen adults for mouth cancer and signs of secondary cancer in neck nodes.

One in 3 people diagnosed with oro-pharyngeal cancers are infected with a form of Human Papilloma virus (HPV), the simple wart.

Although most people will be infected with HPV at some point of their lives, two particular strains HPV16 and HPV18 are most likely to cause cancer. The % of patients with HPV16 was 35 times greater in those with throat cancer compared with the cancer free population.

Early detection of mouth cancer greatly improves the chances of survival. A simple mnemonic is the RULE for suspecting oral cancer:

  • Red and/or white lesion
  • Ulcer
  • Lump
  • Exceeding THREE weeks duration.

Other common causes of mouth cancer are alcohol and Tobacco

Tooth wear - a silent risk to the modern generation

Severe tooth wear is becoming more prevalent. Some of this is because people are living longer and tooth wear naturally progresses over the years. The 2009 Adult Dental Health Surveys highlighted a trend toward increasing toothwear which has got 10% worse over the last 11 years.

Of particular concern are the 16-34 year olds. Much of the increase here seems to be related to poor drink choice (carbonated/fruit juices) and eating healthy food too frequently (!) (such as a lot of citrus fruit), Eating disorders and stress-related bruxism (tooth grinding). Citric acid in fruit and fizzy drinks is very good at loosening enamel.

Once the enamel (outer coat of the tooth) is breached, the dentine wears SEVEN times faster!

To help reduce the rate of tooth wear consider the following:

  1. Avoid fizzy drinks – it is alright to make your own with fizzy water and sugar-free squash (e.g. tooth-kind Ribena)
  2. Try to avoid citrus fruits and eat them with food (not between meals)
  3. Consider a night guard if you grind your teeth
  4. Consider getting any exposed dentine covered over by your dentist

To see how we treat severe tooth wear in a 21 year old see http://www.lakesideortho.co.uk/our-cases/148-case-study-13.html

AdvanSync - new treatment introduced at Lakeside

New Treatment introduced at Lakeside

We always strive to improve the service we deliver. For that reason we have just introduced AdvanSync.

When the top teeth stick out ahead of the lowers it is most often due to a small lower jaw. Ideally we want to encourage the lower jaw to grow forward (rather than the more traditional approach of extracting two upper teeth and moving the top front teeth back to meet the small lower jaw).

More recently removable twin block braces have been used to help move the lower jaw forward and it took at least 9 months before the other train track braces could be fitted.

See what we did with a twin block and no extractions for Jess here.

Now we can fit train track braces at the same time as AdvanSync – saving 9 months and also eliminating the age old problem of braces just not being worn.

Thanks to Callum for volunteering to be the guinea pig and be the first one to try them out!

Posted on in Treatments

Attached to the inside of the teeth, Harmony braces are completely invisible, and as they are fixed dirctly onto the back of the teeth, they offer very precise tooth positioning.

See Steph's treatment with lingual braces here.

Unlike Invisalign, which is 'almost' invisible, it does not rely on patients to change aligners every two weeks – we do all the adjustments for you.

Designed using digital scans of the teeth and constructed using CAD-CAM technology, each part of the brace is completely customised each tooth and the wire joining them is bent into very complex 3D shapes by a robot.

Kate had lived her whole life with very ‘wonky’ teeth and following the removal of one premolar we fitted Harmony braces and we are very close to  finishing in just 15 months. Kate comes all the way from Manchester and no one has yet noticed that she has braces!

Kate before   Kate almost finished

Posted on in Development
Laura Horton

The Lakeside Team have just enjoyed a fantastic 2 day course with Laura Horton who has been helping us to deliver outstanding Customer Service as well as introducing the role of 'Treatment Coordinator', further developing the responsibilities of the Team and their relationship and involvement with the patients.

Posted on in Information

Early toothpastes - The Greeks used crushed bones and oyster shells. Later on 'tooth powders' were made with chalk, salt and brick dust!

Modern toothpastes have several more sophisticated components

Abrasives- like Aluminium Hydroxide and Silicas. If too abrasive it can dull the enamel, cause sensitivity and make enamel more translucent (showing up the
yellow dentine below)

Fluoride- Sodium Fluoride (NaF) is the commonest. It strengthens enamel, repairs early decay and controls gingivitis. 'Full-strength' toothpaste (<1500ppm) is advised for all ages (just a 'smear' of toothpaste for under 3s).

Surfactants Sodium Lauryl Sulphate is a foaming agent which helps distribute the toothpaste evenly.

Other Additives - Strontium Chloride and Potassium Nitrate can reduce sensitivity. Sodium polyphosphate can reduce the formation of tartar.

Whitening toothpastes - The abrasive in these toothpaste remove the stains but cannot alter the natural color of teeth. Abrasives polish the teeth and agents like Sodium Tripolyphosphate help break down stains. Two of the most effective seem to be Beverley Hills and Colgate Max White One.

Weird Facts  - After using toothpaste, orange juice and other juices have an unpleasant taste. This may be due to a chemical reaction between Stannous Fluoride and the acetic acid in the juice. Sodium lauryl sulfate (surfactant) alters taste perception. It can inhibit taste receptors for sweetness, making food taste bitter. However Apples can taste more pleasant after using toothpaste!

Posted on in Clinic
Lakeside reduces light energy by 87%

We have now moved over to LED lights saving a massive 87% energy on lighting which other than heating (we also have air-source heat pumps) is a major source of energy usage at Lakeside Orthodontics. Working hard to reduce our carbon footprint.

Posted on in Information
Affordable invisible braces - Open evening

This is a one off offer so book a place as soon as possible. Spread the word!

Posted on in Clinic
Lakeside in Bloom

Its November, the Day after Hurricaine Dai arrived from Wales and these fellows have just decided to go into bloom!

Hola! - Visit to secret Invisalign 'factory' in Costa Rica

Jonty is one of only a handful of Orthodontists in the World invited to see the very secretive Costa Rican Invisalign factory. He enjoyed a very informative one to one tour to show him how the process works from the initial moulds that are taken anywhere in the world through the preparation and planning of cases. The Software used was incredible and Invisalign is constantly looking to improve the product through Research and Development. I was able to share some of my ideas on areas of improvement, meet Annie who has been looking after my cases over the last 10 years and now have to lecture on some of the less sensitive information to a group of orthodontists from the North  West.  

 

Posted on in Clinic
Invisalign TV Advert shot at Lakeside

We were lucky enough to be asked to film an advertisement about the benefits of Invisalign, to be screened on TV in the Republic of Ireland later this year. Here I am with Barry Buckley and MMAdigital equipment in the middle of the shoot in my surgery.

Posted on in Historical
Emma's wedding

Best wishes to Emma and Andy on their Wedding. We all wish them the best for the future and hope they have an amazing honeymoon. 

Posted on in Awards
Lakeside increase GB medal tally

Jonty has just been awarded the highest award of PLATINUM ELITE for his experience with Invisalign. There are only a handful of UK Specialist Orthodontists who have achieved this.

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  • Special thanks to Jonty for the amazing work you have done on my teeth. I am so happy with them, I can't stop smiling. My family and friends can't get over the difference............. I can at last say that I feel like the girl with the perfect smile. It was well worth going through the treatment and has given me the confidence to feel proud to show off my smile
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