Patient Guides

Healthy gums start with good daily care.

Your gums play an important role in supporting your teeth. Looking after them every day can help prevent gum disease and keep your mouth healthy.

What do healthy gums look like?

Healthy gums are generally:

• Pink or naturally darker depending on your skin tone
• Firm
• Not swollen
• Not painful
• Not regularly bleeding when you brush or clean between your teeth

What is gum disease?

Gum disease happens when bacteria and plaque build up around the teeth and cause inflammation of the gums.

Early gum disease is often called gingivitis. If it is allowed to progress, it can affect the tissues and bone supporting your teeth, and in cases give rise to loss of teeth.

Signs to look out for

You may notice:

• Bleeding when brushing
• Red or swollen gums
• Bad breath
• Tender gums
• Gum recession
• Teeth becoming loose
• Changes in the way your teeth meet
• Significant drifting of teeth

How can I look after my gums?

Brush twice a day

Use a fluoride toothpaste (alternatives can be discussed) and a medium-bristled toothbrush. Brush gently around the gumline.

Clean between your teeth

Use interdental brushes, floss or another method recommended by your dental professional.

Don’t ignore bleeding

Bleeding gums can be a sign of inflammation. If bleeding continues, arrange a dental assessment.

Visit your dentist and hygienist

Regular professional care can help identify gum problems early and provide personalised advice.

When should I see my dentist?

Arrange an appointment if you have:

• Persistent bleeding
• Swollen or painful gums
• Persistent bad breath
• Gum recession
• Loose teeth
• A change in your bite
• Drifting of teeth

Remember

Healthy gums are an important part of a healthy smile.

Understanding tooth decay.

Tooth decay is one of the most common dental problems. The good news is that there are simple things you can do every day to reduce your risk.

What is tooth decay?

Your teeth are constantly exposed to food and drinks.

Bacteria in dental plaque can use sugars to produce acids. These acids can gradually damage the tooth surface and lead to decay.

If decay progresses, it can cause sensitivity, pain and damage to the tooth. At worst it produces an abscess and sometimes you end up losing a tooth.

What increases the risk?

Your risk can increase if you:

• Frequently consume sugary foods or drinks
• Snack regularly throughout the day
• Do not brush effectively
• Do not clean between your teeth
• Have dry mouth
• Have certain medical or lifestyle factors

How can I prevent tooth decay?

Brush twice a day

Brush your teeth with fluoride toothpaste for around two minutes.

Clean between your teeth

Brushing does not reach every surface. Clean between your teeth once a day.

Reduce frequent sugar intake

Try to keep sugary foods and drinks to mealtimes rather than having them regularly throughout the day.

Choose water

Water is a good choice between meals.

Attend regular dental appointments

Your dentist can identify early signs of decay and advise you about your individual risk.

What are the signs of tooth decay?

Sometimes there are no symptoms at first.

As decay progresses, you may experience:

• Tooth sensitivity
• Pain
• A visible hole or dark area
• Pain when eating or drinking
• Food regularly becoming trapped

What treatment might be needed?

Treatment depends on how advanced the decay is.

It may involve:

• Preventive advice
• Fluoride treatment
• A filling
• More extensive restorative treatment

The earlier decay is identified, the more easy and straightforward treatment may be.

Remember

Good daily habits and regular dental care can significantly reduce your risk of tooth decay.

Nervous about visiting the dentist? You are not alone.

Many people feel nervous about dental appointments. You may have had a difficult experience in the past, worry about pain or simply feel uncomfortable about what might happen.

There is no need to feel embarrassed.

What can cause dental anxiety?

Everyone is different. You may feel anxious because of:

• A previous unpleasant dental experience
• Fear of pain
• Fear of injections
• Feeling out of control
• Embarrassment about your teeth
• Fear of receiving bad news
• Not knowing what to expect

What can you do?

Tell us before your appointment

Let the practice know that you are nervous when booking.

This allows the team to understand your concerns and help make your visit more comfortable.

Ask questions

It is completely reasonable to ask what will happen before treatment begins.

Understanding the process can make things feel more manageable.

Agree on a stop signal

You can agree on a simple signal, such as raising your hand, to indicate that you need the dentist to stop or pause.

Take things slowly

If you are very nervous, your first appointment can focus on talking, getting to know Hitesh and assessing your oral health.

You do not have to feel rushed into treatment.

What if I haven’t seen a dentist for years?

Don’t worry.

You will not be judged.

The important thing is taking the first step and finding out what is happening with your oral health now.

When should I book?

The longer dental problems are left untreated, the more complicated they can sometimes become.

If anxiety has stopped you from attending the dentist, contact the practice and explain how you feel.

We can discuss the best way to approach your appointment.

A brighter, more confident smile.

Professional teeth whitening can help lighten the colour of natural teeth and reduce certain types of staining and discolouration.

Why do teeth become darker?

Teeth can become darker over time due to:

• Ageing
• Tea and coffee
• Red wine
• Smoking
• Certain foods
• Natural changes within the tooth

Some staining is on the surface, while other types of discolouration occur within the tooth.

How does whitening work?

Professional whitening uses a whitening gel to lighten the natural colour of your teeth, in a customised tray that fits your teeth like a glove.

Before whitening, your teeth and gums should be assessed to make sure treatment is appropriate.

What can whitening improve?

Whitening may improve the colour of natural teeth affected by certain types of staining.

However, whitening does not change the colour of most:

• Crowns
• Bridges
• Veneers
• Fillings

This is important to bear in mind if you have existing dental restorations.

Is whitening safe?

When appropriate products are used according to professional instructions, whitening is generally considered a safe cosmetic dental treatment.

Some people experience temporary sensitivity.

How long do results last?

Results vary from person to person.

Your lifestyle, diet, oral hygiene and habits can all affect how long your teeth remain bright.

How can I maintain the results?

• Maintain good oral hygiene
• Attend regular dental appointments
• Avoid frequent staining foods and drinks
• Avoid smoking
• Follow the aftercare advice provided
• Follow advice on regular top-up whitening

Before whitening

Your dentist should check that your teeth and gums are healthy enough for whitening.

Looking after your composite bonding.

Composite bonding is a minimally invasive cosmetic treatment that uses a tooth-coloured composite material to improve the shape, size, colour and overall appearance of your teeth.

With the right care, your composite bonding can stay looking natural and beautiful for many years.

How to care for your composite bonding

Brush twice a day

Brush your teeth twice daily for around two minutes using fluoride toothpaste and a medium toothbrush.

Pay particular attention to the gum line around your bonded teeth, where plaque can build up.

Clean between your teeth

Floss or use interdental brushes every day. Keeping the areas between your teeth clean helps protect your gums and the edges of your bonding.

Your dentist or hygienist can recommend the most suitable interdental cleaning method for you.

Avoid biting hard objects

Composite bonding can chip or fracture if excessive force is placed on it.

Avoid biting directly onto very hard foods, ice, pens, fingernails or other objects with your front teeth.

Be mindful of staining

Composite bonding can develop surface staining over time.

Coffee, tea, red wine, curry and other strongly coloured foods and drinks may contribute to staining. Good brushing and regular professional hygiene appointments can help keep your smile looking fresh.

Don’t use your teeth as tools

Avoid using your teeth to open packaging, tear labels or hold objects, and try to control clenching, grinding and nail biting. These can damage both your natural teeth and your composite bonding.

Attend regular hygiene appointments

Regular professional cleaning helps remove plaque and surface staining while keeping your gums healthy.

Your hygienist can also give you personalised advice on caring for your bonding.

Maintain your dental check-ups

Regular dental examinations allow your dentist to check your natural teeth, gums and composite bonding.

How long does composite bonding last?

Composite bonding is designed to be durable, but it is not permanent. Its longevity depends on factors such as your bite, oral hygiene, lifestyle and how you use your teeth.

With good care and regular dental maintenance, composite bonding can provide long-lasting results.

Your new smile starts with healthy teeth

The best cosmetic results begin with healthy teeth and gums. Maintaining excellent oral hygiene and attending your regular dental appointments will help protect your smile and your investment in your treatment.

Caring for your teeth and aligners during treatment.

Invisalign® uses a series of clear, removable aligners to gradually move your teeth into their planned positions. Looking after your teeth and gums throughout treatment is just as important as wearing your aligners.

Good oral hygiene helps keep your teeth and gums healthy while supporting your Invisalign treatment.

How to care for your teeth during Invisalign

Brush your teeth twice a day

Brush for around two minutes, twice a day, using fluoride toothpaste and a medium textured toothbrush.

Because your aligners fit closely over your teeth, keeping your teeth clean is particularly important to reduce the risk of plaque build-up and tooth decay.

Clean between your teeth every day

Use floss or interdental brushes daily to clean between your teeth.

Your dentist or hygienist can show you the most effective technique and recommend the right size of interdental brush for you.

Remove your aligners when eating

Your Invisalign aligners should generally be removed before eating.

Food can become trapped between your teeth and the aligner, increasing the risk of tooth decay and staining.

Water is usually fine to drink while wearing your aligners. Remove your aligners for other drinks unless your Invisalign provider has advised otherwise.

Clean your aligners

Rinse your aligners with cool water when you remove them. Avoid eating or drinking sugary things between meals to avoid decay.

Clean them regularly according to the instructions provided by your dental team.

Avoid using hot or boiling water, as heat can distort the aligners and affect their fit.

Wear your aligners as instructed

For Invisalign treatment to work effectively, your aligners need to be worn for the recommended amount of time each day.

Only remove them for eating, drinking, brushing and cleaning, unless your dentist or orthodontist gives you different instructions.

If you regularly leave your aligners out for long periods, treatment may take longer than planned.

Look after your gums

Healthy gums are an important part of successful orthodontic treatment.

If your gums become swollen, sore or bleed regularly when brushing or flossing, speak to your dental team.

Keep your aligners safe

When you remove your aligners, place them in their protective case rather than wrapping them in tissue or leaving them loose.

This helps prevent them being accidentally thrown away, damaged or lost.

Keep them away from pets, as animals can easily chew and damage them.

Don’t forget your regular dental appointments

You should continue attending your routine dental examinations and hygiene appointments during Invisalign treatment.

Your dental team can monitor your teeth and gums, provide professional cleaning where needed and make sure your oral health remains in good condition throughout your treatment.

After Invisalign treatment

Once your Invisalign treatment is complete, wearing your retainers as instructed is essential to help maintain your new smile.

Teeth can naturally move over time, even after orthodontic treatment. Your retainer helps keep your teeth in their new positions.

Continue brushing, flossing and attending regular dental appointments to protect your smile long after your Invisalign treatment has finished.

Your smile journey

Invisalign is about more than straightening your teeth. Maintaining healthy teeth and gums throughout treatment helps ensure that your new smile is both healthy and beautiful.

If you have any concerns about your teeth, gums or aligners during treatment, speak to your dental team for advice.

Replacing missing teeth.

A missing tooth can affect your confidence, chewing and the appearance of your smile.

Dental implants are one option for replacing missing teeth.

What is a dental implant?

A dental implant is a small structure placed into the jawbone to act as an artificial tooth root.

Once the implant has integrated with the surrounding bone, it can support a replacement tooth such as a crown.

Implants can also be used as part of treatment to support bridges or dentures.

Who might benefit?

Implants may be considered if you have:

• One missing tooth
• Several missing teeth
• Multiple teeth that need replacing
• A loose or uncomfortable denture

However, suitability needs to be assessed individually.

What are the benefits?

Dental implants can:

• Replace missing teeth
• Restore chewing function
• Provide a fixed replacement
• Improve the appearance of your smile
• Avoid relying on neighbouring teeth in some situations

What happens?

My role is in the assessment, planning and restorative stages of implant treatment. The surgical placement of the implant itself is carried out separately, and I will explain how that part of your treatment would be arranged.

1. Consultation

Your dental health, medical history, gums, bite and bone levels will be assessed.

2. Treatment planning

Your dentist will explain the available options and whether an implant is appropriate.

3. Implant placement

The implant is carefully positioned in the jawbone.

4. Healing

The implant needs time to integrate with the surrounding bone.

5. Replacement tooth

Once appropriate, the replacement crown, bridge or denture is fitted.

How long does treatment take?

Every case is different.

Treatment time depends on factors including your oral health, bone levels and whether additional procedures are needed.

Are implants suitable for everyone?

For most patients.

A detailed assessment is needed to determine whether implants are appropriate for you.

Understanding your options.

If you have amalgam fillings, you may have questions about the materials used in your mouth and whether an alternative would be appropriate.

Hitesh takes a mercury-free approach to new restorative treatment and is happy to discuss your concerns.

What is dental amalgam?

Amalgam is a silver-coloured filling material that has been used in dentistry for many years.

It contains a mixture of metals, including mercury.

What are tooth-coloured alternatives?

Composite resin is a commonly used tooth-coloured restorative material.

Depending on the tooth and your individual circumstances, other restorative materials may also be considered.

Should I have my amalgam fillings removed?

Not necessarily.

When patients are interested in changing amalgam fillings, existing fillings should be assessed individually.

Removing a filling that is functioning well may not always be necessary.

Your dentist can discuss:

• The condition of the filling
• The condition of the tooth underneath
• Whether replacement is clinically appropriate
• Alternative materials
• The benefits and limitations of treatment
• Any other issues related to replacing if applicable

What is mercury-free dentistry?

A mercury-free approach means avoiding mercury-containing amalgam for new restorative treatment and considering alternative materials where clinically appropriate.

What happens if I want an amalgam filling replaced?

First, the tooth and filling will be assessed.

If replacement is appropriate, Hitesh will explain the procedure and the alternative materials available.

Where amalgam removal is undertaken, appropriate precautions should be used to minimise unnecessary exposure during the procedure. It can also take time for the tooth or teeth to settle after treatment.

Questions to ask your dentist

Before replacing an existing filling, you may want to ask:

• Does this filling need replacing?
• Is the tooth healthy underneath?
• What alternatives are available?
• What material would you recommend?
• What are the benefits and limitations?
• What will happen if I leave the filling in place?

Helping your child build healthy habits.

Good dental habits can start from the moment your child’s first tooth appears.

Making oral care part of your child’s everyday routine can help them develop healthy habits that can last a lifetime.

When should brushing start?

Start brushing as soon as the first tooth appears.

Brush your child’s teeth twice a day using an age-appropriate fluoride toothpaste.

Make brushing fun

Young children may not always want to brush their teeth.

Try:

• Brushing together
• Letting your child choose their toothbrush
• Using a fun timer
• Singing a song, or listening to a song while brushing
• Making brushing part of the morning and bedtime routine

Children need help

Young children often cannot brush effectively on their own.

Supervise and help them until they are able to brush properly themselves.

What about sugar?

Frequent exposure to sugary foods and drinks can increase the risk of tooth decay.

Try to:

• Keep sugary foods to mealtimes
• Avoid frequent sugary snacks
• Choose water between meals
• Avoid sugary drinks in bottles or cups throughout the day

When should children visit the dentist?

Introducing children to dental care early can help them become familiar with the dental environment. This can be as early as two years.

Regular visits also allow their teeth and oral development to be monitored.

What if my child is nervous?

Tell the dental team before the appointment.

A child’s appointment should be adapted to their age, confidence and individual needs.

Remember

Your child’s baby teeth are important. They help with eating, speaking and maintaining space for adult teeth.

Understanding clenching, grinding and tooth wear.

Many people clench or grind their teeth without realising it.

This can happen during the day or while sleeping.

What is clenching?

Clenching means holding your teeth tightly together without necessarily moving them.

Grinding involves moving the teeth against each other.

Both can place additional pressure on the teeth, the jaw muscles and the jaw system.

What signs should I look for?

You may notice:

• Worn teeth
• Chipped teeth
• Flattened tooth surfaces
• Tooth sensitivity
• Jaw tension
• Facial muscle discomfort
• Morning headaches
• Jaw clicking
• Awareness that you clench your teeth

Why does it happen?

There can be several contributing factors.

These may include:

• Stress
• Habit
• Sleep-related factors
• Your bite
• Certain medications or other individual factors

There is not always one single cause.

What can I do?

Become aware of clenching

During the day, check whether you are holding your teeth together unnecessarily.

When your jaw is relaxed, your teeth generally do not need to be touching.

Look after your teeth

Maintain good oral hygiene and attend regular dental examinations so that tooth wear can be monitored.

Manage contributing factors

Where appropriate, consider ways of managing stress and improving sleep and general wellbeing.

Speak to your dentist

If you are experiencing significant wear, pain or jaw problems, your dentist can assess the situation and discuss appropriate options.

What about a mouthguard?

A mouthguard or splint may be recommended in some circumstances.

However, it is not automatically required for everyone who clenches or grinds their teeth.

Your dentist should assess your individual needs first.

When should I book an appointment?

Arrange an assessment if you experience:

• Persistent jaw pain
• Significant tooth wear
• Broken or chipped teeth and fillings
• Frequent headaches associated with jaw tension
• Difficulty opening your mouth or keeping it open during an appointment
• Jaw locking
• Ongoing sensitivity