Treatments

What is it?

General dentistry focuses on maintaining your teeth, gums and overall oral health through regular examinations, prevention and appropriate treatment.

I take a personalised approach to general dentistry, looking beyond individual dental problems and considering your long-term oral health and wellbeing.

Who is it for?

General dentistry is suitable for adults, children and families who want to maintain healthy teeth and gums, prevent dental problems and address issues such as:

• Tooth decay
• Broken or damaged teeth
• Tooth sensitivity
• Gum problems
• Damage caused by tooth wear
• Clenching or grinding

Benefits

• Helps maintain healthy teeth and gums
• Identifies problems at an early stage
• Focuses on prevention as well as treatment
• Provides personalised advice based on your individual needs
• Supports long-term oral health
• Helps you understand and take control of your oral health

What happens?

Your appointment will usually begin with a discussion about your dental history, concerns and goals.

I will examine your teeth and gums and, where appropriate, recommend further investigations or treatment.

As part of your assessment I can also identify signs of clenching or grinding, and discuss ways of controlling and managing these habits where appropriate.

Questions patients ask

How often should I have a dental check-up?

There is no single interval that is right for everyone. Your recommended recall period will depend on your individual circumstances and oral health needs.

Can general dentistry help prevent future dental problems?

Yes. Regular examinations, good daily oral care and personalised preventive advice can help identify and manage potential problems before they become more serious.

Treating the whole person rather than the presenting problem: what you eat, how you sleep, how you hold your jaw, what is going on in the rest of your life. It is a way of working rather than a separate treatment, and it runs through everything else on this page.

What holistic dentistry means →

What is it?

Preventive dentistry focuses on maintaining healthy teeth and gums and reducing the likelihood of dental problems developing.

It includes regular examinations, hygiene appointments where appropriate, personalised oral hygiene advice and identifying potential problems early.

Who is it for?

Preventive dentistry is for everyone, whether you currently have excellent oral health or have experienced dental problems in the past.

Benefits

• Helps prevent tooth decay and gum disease
• Detects problems early
• Supports healthy gums
• Can reduce the need for extensive treatment
• Gives you a greater understanding of your oral health
• Puts you in charge of maintaining your oral health

What happens?

Your preventive care will be tailored to your needs. This may include:

• Dental examinations
• Hygiene appointments
• Oral hygiene advice
• Dietary advice
• Advice regarding habits and lifestyle
• Monitoring of existing dental conditions
• Identifying signs of clenching or grinding

Questions patients ask

How often should I have a dental check-up?

There is no single interval that is right for everyone. Your recommended recall period will depend on your individual circumstances.

Can prevention reduce the need for fillings?

Good preventive care can reduce the risk of developing tooth decay, although no approach can eliminate the risk completely.

What is it?

Mercury-free dentistry refers to an approach where mercury-containing amalgam is not used for new restorations and alternative restorative materials may be considered.

For patients who already have amalgam fillings and would like to consider replacing them, I can assess the fillings and discuss how this may be achieved safely and appropriately.

Who is it for?

This may be particularly relevant to patients who:

• Prefer alternatives to amalgam fillings
• Want to discuss replacing existing amalgam fillings
• Have concerns about dental materials
• Have been advised by another health professional to discuss replacing their amalgam fillings
• Want to understand their options before making a decision

Benefits

• Helps you understand your restorative options
• Provides alternatives to amalgam where appropriate
• Supports an individualised approach to treatment
• Allows you to discuss dental materials in detail
• Helps you understand the advantages and limitations of different materials

What happens?

I will assess the tooth and the existing restoration, and discuss the available restorative options with you, including their pros and cons.

The most appropriate material depends on factors such as:

• The tooth involved
• The amount of remaining tooth structure
• Your bite
• The condition of the existing restoration
• Your individual circumstances and preferences

Questions patients ask

Can all amalgam fillings be replaced?

This depends on the clinical findings and your individual preference. I will assess the tooth and discuss whether replacement is appropriate, together with the available options.

Are white fillings suitable for everyone?

They can be suitable in many situations, but the best option depends on the individual tooth, the amount of remaining tooth structure, your bite and other circumstances.

What is it?

Some patients with existing amalgam fillings may wish to discuss having them replaced.

Where removal is appropriate, I take a careful approach designed to minimise unnecessary exposure to amalgam material during the procedure.

Who is it for?

This may be appropriate for patients who:

• Have damaged or failing amalgam restorations
• Prefer alternative restorative materials
• Want to discuss replacing existing amalgam
• Have been recommended to discuss amalgam replacement by another health professional
• Would like to understand their options before making a decision

Benefits

• Allows existing restorations to be assessed
• Provides an opportunity to discuss alternative materials
• Treatment can be carefully planned
• Allows you to understand the advantages and limitations of your options
• Helps you make an informed decision

What happens?

The tooth and existing restoration will first be assessed.

If replacement is appropriate, I will explain the procedure, the available materials and the precautions used during treatment.

The replacement restoration is then planned according to the condition of the tooth and your individual needs.

Questions patients ask

Should healthy amalgam fillings always be removed?

No. Removal is not automatically necessary. The decision should be based on clinical considerations or patient preference, following an informed discussion with your dentist.

Is amalgam removal suitable for everyone?

Your individual circumstances need to be assessed before treatment.

What are they?

Tooth-coloured fillings, commonly made from composite resin, are direct fillings used to repair teeth affected by decay, wear or damage.

In some cases an indirect filling, such as an inlay or an onlay, may be more appropriate. These restorations can be designed to blend with the natural colour of your tooth.

Who are they for?

They may be suitable for patients who need to restore a tooth and would prefer a natural-looking restoration.

Benefits

• Natural-looking appearance
• Can often be closely matched to your tooth colour
• Allows preservation of healthy tooth structure where appropriate
• Suitable for many front and back teeth
• Different restorative options can be considered depending on the tooth

What happens?

The tooth is assessed and the appropriate restorative option discussed.

For a direct composite filling, the affected area is carefully prepared and the tooth-coloured material is placed, shaped, hardened and polished.

If an indirect restoration such as an inlay or onlay is more appropriate, I will explain the process and why it may be preferable.

Questions patients ask

How long do composite fillings last?

Their lifespan varies depending on the tooth, the size of the restoration, biting forces, oral hygiene, clenching or grinding and other individual factors.

Will my filling look natural?

Composite can be carefully colour-matched to blend with the surrounding tooth.

Are composite fillings always the best option?

Not necessarily. I will assess the tooth and discuss whether a direct filling, inlay, onlay, crown or another option is most appropriate.

What is it?

Gum disease occurs when inflammation affects the tissues supporting your teeth. It can range from early gum inflammation to more advanced periodontal disease.

Who is it for?

Treatment may be suitable for patients experiencing:

• Bleeding gums
• Swelling
• Bad breath
• Gum recession
• Loose teeth

It may also be appropriate for patients at increased risk because of:

• Family history
• Smoking
• Medical history
• Previous gum disease

Benefits

• Helps control gum inflammation
• Supports healthier gums
• Helps protect the supporting tissues around teeth
• Can reduce the risk of progression
• May reduce the long-term risk of tooth loss and the need for extraction
• Encourages better long-term oral health

What happens?

I will assess your gums and determine the level of gum health or disease present. Treatment may include:

• Improved home care
• Professional cleaning
• Hygiene treatment
• Personalised oral hygiene advice
• Ongoing monitoring

More advanced cases may require additional periodontal care.

Questions patients ask

Do bleeding gums always mean gum disease?

Bleeding can be a sign of gum inflammation and should not be ignored.

Can gum disease be treated?

It can often be controlled successfully with appropriate professional treatment and consistent home care.

Can gum disease lead to tooth loss?

Advanced gum disease can damage the tissues and bone supporting the teeth and may eventually contribute to tooth loss. Early assessment and appropriate treatment are important.

What is it?

Cosmetic dentistry focuses on improving the appearance of your smile while maintaining the health and function of your teeth.

Treatment may involve one or more procedures depending on your goals, needs and preferences.

Who is it for?

Cosmetic dentistry may be suitable if you are concerned about:

• Tooth colour
• Alignment
• Shape or size of teeth
• Small chips
• Gaps
• Worn teeth
• Uneven smiles
• Old or discoloured fillings

Benefits

• Can improve the appearance of your smile
• Can improve tooth shape and alignment
• Treatment can be personalised
• May involve minimally invasive options depending on your needs and preferences
• Can be planned around your individual expectations

What happens?

Your concerns and expectations will be discussed first.

I will assess your teeth and explain the available options, including the advantages and limitations of each.

In some cases pre-treatment simulations may be recommended, to help demonstrate the proposed result and make sure treatment is planned around your expectations.

Questions patients ask

Will cosmetic dentistry look natural?

Treatment can be planned to maintain a natural appearance rather than creating an overly uniform smile.

Do I need cosmetic treatment on every tooth?

No. Depending on your goals, treatment may focus on one or a small number of teeth.

Can cosmetic dentistry improve alignment?

In some cases cosmetic treatment can improve the appearance of minor alignment concerns. I will discuss the most appropriate options following an assessment.

What is it?

Teeth whitening is a cosmetic treatment designed to lighten the colour of natural teeth and reduce certain types of staining and discolouration. It can provide a brighter smile in a conservative manner.

Who is it for?

It may be suitable for adults who want to brighten their natural smile in a conservative manner.

Benefits

• Brighter-looking smile
• Can improve the appearance of stained or discoloured teeth
• Can create a younger-looking smile
• Non-invasive cosmetic treatment
• Can be tailored to individual needs

What happens?

Your teeth and gums will first be assessed to make sure whitening is appropriate. You will then be advised about:

• The whitening process
• Expected results
• Possible sensitivity
• How to maintain the results

Questions patients ask

Will whitening work on crowns or fillings?

Whitening affects natural tooth structure, not most existing restorations.

Can whitening cause sensitivity?

Some patients experience temporary sensitivity. I will discuss this with you and explain ways of reducing or controlling sensitivity if it occurs.

Small changes can make a big difference.

Composite bonding is a minimally invasive cosmetic treatment that can be used to improve the shape, colour and appearance of individual teeth.

It can often be completed without removing significant amounts of healthy tooth structure.

What is composite bonding?

Composite bonding uses a tooth-coloured resin material that is carefully applied to the tooth.

The material can be shaped and polished to improve the appearance of the tooth and blend with your natural smile.

It may be used to repair small chips, close certain gaps or improve the shape of teeth.

Who is it for?

Composite bonding may be suitable if you are concerned about:

• Small chips
• Uneven tooth edges
• Small gaps
• Tooth shape
• Minor imperfections
• Discolouration of individual teeth
• Worn or shortened teeth in suitable cases

It may also be used as part of a wider smile makeover.

Benefits

• Can provide a natural-looking result
• Usually requires little or no removal of healthy tooth structure
• Can improve tooth shape and proportions
• Often completed relatively quickly
• Can be used on individual teeth
• Can be more conservative than some alternative cosmetic treatments

What happens?

1. Consultation

I will discuss what you would like to change and assess your teeth, gums and bite.

It is important to understand what you want to achieve before treatment begins.

2. Smile assessment

Your teeth will be assessed to determine whether composite bonding is appropriate.

I will consider factors such as your bite, tooth position, existing restorations and the amount of tooth structure available.

3. Planning

Where appropriate, photographs, digital planning or a pre-treatment simulation may be used to help you understand the proposed result and make sure your expectations are realistic.

4. Bonding

The tooth-coloured composite material is carefully applied to the tooth and shaped to achieve the desired form.

It is then hardened and polished.

5. Review

Your smile and bite will be checked to make sure the restoration is comfortable and functioning appropriately.

How long does composite bonding last?

The lifespan of composite bonding varies.

It can be affected by:

• Biting forces
• Clenching or grinding
• Oral hygiene
• Diet and habits
• The position of the tooth
• The size and extent of the bonding

Composite can sometimes chip or become worn and may require maintenance or repair over time.

Looking after composite bonding

To help maintain your bonding:

• Brush and clean between your teeth regularly
• Attend regular dental examinations
• Avoid biting very hard objects
• Avoid using your teeth to open packaging
• Tell your dentist if you clench or grind
• Follow your personalised aftercare advice

There is a fuller aftercare guide in Patient guides.

Questions patients ask

Does composite bonding damage my teeth?

Composite bonding is often a conservative treatment and may require little or no removal of healthy tooth structure. However, the amount of preparation required depends on the individual tooth and treatment.

Will composite bonding look natural?

The composite can be carefully shaped and colour-matched to complement your natural teeth.

The aim is not simply to make teeth look bigger or whiter, but to create a result that works with your smile, facial features and bite.

Can composite bonding close gaps?

It can sometimes be used to close small gaps. However, the most appropriate treatment depends on the size of the gap, tooth position and your bite.

In some cases, orthodontic treatment such as Invisalign® may be more appropriate.

Can composite bonding straighten my teeth?

Composite bonding can sometimes improve the appearance of mildly uneven teeth, but it does not physically move the teeth.

Where alignment is the main concern, orthodontic treatment may be more appropriate.

Can composite bonding be whitened?

Whitening affects natural tooth structure but does not whiten existing composite in the same way.

If you are considering both whitening and bonding, whitening is generally planned before the final shade of the bonding is selected.

Can composite bonding be repaired?

In many cases, chipped or damaged composite can be repaired or refreshed without replacing the entire restoration.

Is composite bonding right for you?

Composite bonding can be an excellent conservative option for some patients, but it is not suitable for every situation.

I will assess your teeth, bite and smile goals and explain the available options, including the advantages and limitations of each.

A discreet way to straighten your smile.

Invisalign® uses a series of clear, removable aligners to gradually move your teeth into a planned position.

It can be an attractive option for patients who want to improve the alignment of their teeth without traditional fixed braces.

What is Invisalign®?

Invisalign® treatment uses a series of individually designed clear aligners.

Each aligner is worn for a period of time before moving on to the next one. The aligners apply gentle, controlled pressure to gradually move the teeth according to your treatment plan.

Who is it for?

Invisalign® may be suitable for adults and some teenagers who would like to improve concerns such as:

• Crowded teeth
• Gaps between teeth
• Mild to moderate alignment problems
• Relapsed teeth following previous orthodontic treatment
• Certain bite problems

Not every case is suitable for Invisalign®, so an assessment is important before treatment begins.

Benefits

• Clear and discreet
• Removable for eating and drinking
• Allows you to brush and floss normally
• Custom-made for your teeth
• Can improve the alignment and appearance of your smile
• No traditional metal brackets and wires

What happens?

1. Consultation

I will discuss your concerns, what you would like to achieve and whether Invisalign® is appropriate for you.

2. Assessment and planning

Your teeth, gums and bite will be assessed.

Digital scans, photographs and other records may be taken to help plan your treatment.

3. Treatment plan

Your planned tooth movements will be reviewed with you so that you understand what is involved before deciding whether to proceed.

4. Wearing your aligners

You will receive a series of clear aligners.

For treatment to work effectively, the aligners need to be worn as instructed.

5. Reviews

Your progress will be monitored throughout treatment and adjustments made where necessary.

Looking after your teeth during Invisalign®

Good oral hygiene is particularly important during orthodontic treatment.

You should:

• Brush your teeth regularly
• Clean between your teeth
• Follow your dentist’s instructions
• Remove aligners when eating unless specifically instructed otherwise
• Clean your aligners as advised
• Attend your scheduled reviews

There is a fuller guide to caring for your teeth and aligners in Patient guides.

Questions patients ask

Is Invisalign® painful?

You may experience some pressure or temporary discomfort when starting a new aligner. This usually settles as you become accustomed to it.

How long does Invisalign® treatment take?

Treatment time varies depending on the complexity of your case and the tooth movements required.

I will discuss your expected treatment time following your assessment.

Can I eat normally?

The aligners are removable, so you can take them out when eating and drinking. They should then be cleaned and replaced as instructed.

Will I need a retainer afterwards?

Yes. Teeth can move after orthodontic treatment, so retention is an important part of maintaining your result.

Can Invisalign® fix every orthodontic problem?

No. Invisalign® is suitable for many cases, but some more complex orthodontic problems may require a different approach.

Is Invisalign® right for you?

The best way to find out is to have an assessment.

I can discuss your concerns, explain the available options and help you understand what treatment would involve.

What is a crown?

A dental crown is a custom-made restoration that covers and protects a damaged or weakened tooth.

Who is it for?

Crowns may be recommended for teeth that have:

• Significant damage
• Large fillings
• Extensive decay
• Cracks or fractures caused by function or accidents
• Undergone root canal treatment

Benefits

• Protects weakened teeth
• Restores shape and function
• Can improve appearance
• Provides a durable restoration when appropriately planned

What happens?

The tooth is assessed and prepared for the crown. A suitable crown design and material will be discussed with you.

The crown is then custom-made and fitted to restore the tooth's appearance, function and strength.

Questions patients ask

How long does a crown last?

Longevity varies according to the material, the tooth, your bite, oral hygiene, clenching or grinding and individual circumstances.

Will a crown look natural?

Modern crowns can be designed to closely replicate the appearance of natural teeth.

What is a dental bridge?

A bridge replaces one or more missing teeth using the surrounding teeth or other supporting structures. It provides a fixed restoration, meaning that in most cases there is no need for you to remove it.

Who is it for?

Bridges may be considered for patients who have one or more missing teeth and want to restore appearance and function with a fixed replacement.

Benefits

• Replaces missing teeth
• Restores chewing function
• Can improve the appearance of your smile
• Provides a fixed alternative to a removable denture in suitable cases
• Can restore the appearance and function of the dental arch

What happens?

I will assess:

• The gap
• The surrounding teeth
• The gums
• Your bite
• The suitability of the supporting teeth

If a bridge is appropriate, the treatment options and design will be discussed before treatment begins.

Questions patients ask

Is a bridge removable?

Most conventional dental bridges are fixed in place and do not need to be removed by the patient.

Are implants the only alternative to a bridge?

No. Depending on your circumstances, alternatives may include dental implants, acrylic dentures, chrome cobalt dentures, flexible dentures, or leaving the space untreated. I will explain the advantages and limitations of the available options.

What are dental implants?

Dental implants are used to replace missing teeth. An implant acts as an artificial tooth root and can support a crown, bridge or denture depending on the treatment plan.

Implants can provide a replacement that is closer to natural dentition in appearance and function.

Who are they for?

Implants may be suitable for patients who have lost one or more teeth and want a fixed replacement option that can provide a natural-looking and functional result.

Benefits

• Replaces missing teeth
• Can restore chewing function
• Provides a fixed solution
• Can look and feel natural
• Helps restore the appearance of the smile
• Can provide a replacement closer to natural dentition

What happens?

Implant treatment involves detailed assessment and planning before the implant is placed. Once the implant has integrated with the surrounding bone, the replacement tooth or teeth can be attached.

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.

Your suitability will depend on factors including:

• Oral health
• Bone levels
• Gum health
• Medical history
• Bite
• Individual circumstances

Questions patients ask

Can everyone have dental implants?

In most cases patients can be considered for implant treatment, but a detailed assessment is required to determine suitability and whether any additional treatment may be needed first.

How long does implant treatment take?

Treatment times vary depending on the individual case and whether additional procedures are required. Depending on the complexity of treatment, the overall process may take approximately three to twelve months. I will explain the expected timescale following your assessment.

What is children's dentistry?

Children's dentistry focuses on helping young patients develop healthy teeth and gums, and positive dental habits, from an early age.

Who is it for?

Children of all ages can benefit from regular dental care and prevention.

Benefits

• Encourages good oral hygiene habits
• Helps prevent tooth decay
• Allows problems to be identified early
• Helps children become comfortable visiting the dentist
• Supports healthy development
• Helps parents understand how they can play a part in preventing dental problems in the future

What happens?

Appointments are adapted to the child's age and confidence. Depending on their age, the appointment may focus on the child, the parents or both.

The focus is on creating a positive experience while checking their teeth and gums and giving age-appropriate advice.

Questions patients ask

When should my child first see a dentist?

It is beneficial to introduce children to dental care early, rather than waiting until they have a problem.

What if my child is nervous?

Appointments can be kept relaxed and introduced gradually to help build confidence. Parents can also be given practical advice about how to support their child's oral health at home.

Dentistry for nervous patients

Feeling anxious about visiting the dentist is extremely common. Previous experiences, fear of pain, or simply not knowing what to expect can all contribute to dental anxiety.

I believe patients should feel listened to, respected and in control of their care.

Who is it for?

This approach is for anyone who feels nervous, anxious or uncomfortable about dental treatment.

Benefits

• A calm and supportive environment
• Time to discuss your concerns
• Clear explanations before treatment
• Treatment planned at a comfortable pace
• No pressure to proceed before you feel ready
• Gradually building confidence
• Use of relaxation techniques where appropriate
• A step-by-step approach to treatment

What happens?

Your first appointment can simply be an opportunity to meet me, discuss your concerns and understand your dental needs.

You can ask questions and agree a treatment plan before deciding how you would like to proceed.

Treatment is often staged, starting with the simplest procedures and gradually building confidence.

Questions patients ask

What if I haven't been to the dentist for years?

You will not be judged. The first step is simply understanding where you are now and discussing what you would like to achieve.

Can I stop treatment if I become uncomfortable?

Your comfort is important. We will agree a clear stop signal before treatment, so that you can indicate if you need treatment to pause.

What is teeth clenching?

Teeth clenching and grinding can place additional pressure on the teeth, muscles and jaw. Some people notice the habit during the day, while others may clench or grind their teeth during sleep without being aware of it.

Who is it for?

You may benefit from an assessment if you experience:

• Worn teeth
• Chipped teeth
• Jaw tension
• Headaches
• Facial muscle discomfort
• Tooth sensitivity
• Awareness of clenching or grinding
• Broken fillings
• Teeth taking longer to settle after new fillings

How can clenching affect your teeth?

Clenching and grinding can contribute to:

• Tooth wear
• Chipped or fractured teeth
• Broken fillings and restorations
• Increased sensitivity
• Muscle discomfort
• Jaw problems

Benefits of assessment

Identifying the causes and effects of clenching can help protect your teeth and improve comfort. There are a number of ways clenching and grinding can be managed and controlled, depending on the individual situation.

What happens?

I will assess your teeth, bite, jaw and symptoms, looking for signs of tooth wear, damage to fillings or restorations and other indications that clenching or grinding may be occurring.

I will then discuss appropriate ways of managing the problem.

Questions patients ask

Does everyone who grinds their teeth need a mouthguard?

Not necessarily. Treatment should be based on your individual circumstances and the condition of your teeth, bite and jaw.

Can clenching be controlled?

In many cases clenching and grinding can be managed using a combination of approaches, depending on the individual patient.

What if my fillings keep breaking?

Repeatedly broken fillings can sometimes be associated with heavy biting forces or clenching and grinding. An assessment can help identify whether this may be contributing.

What is the TMJ?

The temporomandibular joints, or TMJs, connect the lower jaw to the skull and allow the jaw to move when speaking, chewing and opening the mouth.

Problems affecting the jaw joint or the surrounding muscles can sometimes cause discomfort or restricted movement.

Who is it for?

An assessment may be appropriate if you experience:

• Jaw pain
• Clicking or popping
• Difficulty opening your mouth
• Facial discomfort
• Headaches associated with jaw tension
• Changes in your bite
• Jaw locking

What happens?

I will discuss your symptoms and examine your jaw, muscles, teeth and bite. Where necessary, further investigations or referral may be recommended.

Questions patients ask

Is clicking in the jaw always a problem?

No. Jaw sounds can occur without requiring treatment. An assessment is advisable if clicking comes with pain, locking, restricted movement or other symptoms.

Can TMJ problems be treated?

Management depends on the cause and severity. Many cases can initially be approached conservatively, with treatment tailored to the individual patient.

Is TMJ related to clenching and grinding?

Clenching and grinding can contribute to jaw muscle discomfort in some patients, but jaw symptoms can have many possible causes. An individual assessment is therefore important.

I hold the Licentiate in Dental Homeopathy, taken in 2002, and it shaped the way I think about whole-person care.

Where I feel it may be helpful, I may suggest a homeopathic remedy as a complementary approach alongside dental treatment. It sits alongside your dental care rather than in place of it: any dental problem is assessed and treated in the usual way.

What is it?

A gum infection can cause inflammation, swelling, tenderness and sometimes bleeding around the gums or a particular tooth.

In some cases, infection can develop around a tooth or underneath the gum and may require prompt dental assessment and treatment.

Who is it for?

You should arrange an assessment if you experience:

• Swollen or painful gums
• Bleeding gums
• Persistent bad breath
• A painful or swollen area around a tooth
• Pus or an unpleasant taste
• Increasing discomfort when biting

What happens?

I will examine your teeth and gums to identify the cause of the problem.

Treatment will depend on what is causing the symptoms or infection, and may include professional cleaning, gum treatment, medication, treatment of the affected tooth, or further investigation where required.

When should I seek urgent help?

If swelling is rapidly increasing, or you develop significant facial swelling, difficulty swallowing or difficulty breathing, seek urgent medical attention, either privately or through NHS A&E.

What is it?

Wisdom teeth are the last teeth at the back of the mouth to develop and come through. They can sometimes become difficult to clean, or may not have enough room to come through properly.

This can lead to pain, inflammation or infection.

Common symptoms

• Pain at the back of the mouth, sometimes keeping you awake at night
• Swollen or tender gums
• Difficulty opening your mouth
• Food becoming trapped
• Bad taste or bad breath
• Swelling around the wisdom tooth

What happens?

I will examine the area and, where appropriate, take or arrange appropriate X-rays to assess the wisdom tooth.

Treatment will depend on the cause and may include cleaning around the tooth, managing inflammation or infection, monitoring the tooth, or discussing further treatment where necessary.

Questions patients ask

Does every painful wisdom tooth need to be removed?

No. Removal is not automatically necessary. The appropriate treatment depends on the position of the tooth, your symptoms and your individual circumstances.

What is it?

A dental abscess is a collection of pus or infection that can develop around the tip of the root of a tooth, or within the surrounding tissues.

It can cause significant pain and swelling, and should be assessed promptly.

Symptoms can include

• Severe toothache
• Swelling around the tooth or face
• Pain when biting
• Sensitivity
• A bad taste or discharge
• Fever or feeling unwell

What happens?

I will assess the tooth and surrounding tissues to determine the source of the problem.

Treatment may involve addressing the source of the infection, such as treatment of the tooth, or other appropriate dental care.

Where necessary, antibiotics may be considered, but they are not a substitute for treating the underlying dental problem.

Important

If you have significant facial swelling, difficulty breathing or swallowing, seek urgent medical attention, either privately or through NHS A&E.

What is it?

Teeth can chip or break due to accidents, biting forces, tooth wear, decay or clenching and grinding.

Even a small chip should be assessed if it is causing sensitivity or discomfort.

What should I do?

If possible:

• Keep any broken piece of tooth
• Avoid biting hard foods on the affected side
• Keep the area clean
• Arrange a dental assessment

What treatment may be available?

Depending on the size and location of the damage, treatment may include:

• Smoothing a small chip
• A composite filling
• An inlay or onlay
• A crown
• Other restorative treatment

I will explain the most appropriate option after assessing the tooth.

What is it?

A filling can sometimes become loose or fall out.

This may happen because of normal wear, further decay, tooth fracture or heavy biting forces.

What should I do?

Keep the area clean and avoid hard or sticky foods around the affected tooth.

Arrange an appointment so the tooth can be assessed.

What happens?

I will check the tooth and determine whether it can be repaired with:

• A new filling
• A larger restoration
• An inlay or onlay
• A crown
• Other appropriate treatment

The underlying reason for the filling failing will also be considered.

What is it?

Sometimes a dental crown can become loose or come off.

This can happen due to wear, changes in the supporting tooth such as decay, the cement failing or heavy biting forces.

What should I do?

If your crown has come off:

• Keep the crown safe
• Do not throw it away
• Avoid chewing on that side
• Contact the practice for advice

Do not attempt to permanently glue the crown back yourself.

What happens?

I will assess both the crown and the underlying tooth.

If the crown is suitable and the tooth is healthy, it may sometimes be possible to recement it.

If the crown or tooth has been damaged, other treatment may be required.

What is it?

A dental bridge can occasionally become loose or detached.

A loose bridge should be assessed, because the supporting teeth may need attention.

What should I do?

Avoid chewing on the bridge, and contact the practice.

Keep the bridge safe if it has completely come out.

What happens?

I will assess:

• The bridge
• The supporting teeth
• Your gums
• Your bite
• The reason the bridge has become loose

Depending on the findings, the bridge may be recemented, repaired or replaced.

What is it?

Inlays and onlays are restorations used to repair and protect teeth.

They can occasionally become loose or come out.

What should I do?

Keep the restoration safe and avoid chewing on the affected tooth.

Arrange an appointment so that the tooth and the restoration can be assessed.

What happens?

I will determine whether the restoration can be securely replaced, or whether the tooth requires further treatment.

What is it?

A veneer can occasionally become loose or detach from the tooth.

What should I do?

Keep the veneer safe, and avoid attempting to glue it back yourself.

Avoid biting directly with the affected tooth until it has been assessed.

What happens?

I will assess the veneer and the underlying tooth.

Depending on the condition of both, the veneer may be suitable for recementation, or may need to be replaced.

What is it?

Retainers help maintain the position of your teeth after orthodontic treatment.

If you lose or damage your retainer, your teeth may gradually begin to move.

What should I do?

Contact the practice as soon as possible.

The sooner the situation is addressed, the better the chance of maintaining the position of your teeth.

What happens?

I can assess the situation and advise whether you need:

• A replacement retainer, or a repair in the case of a fixed retainer
• A new scan or impression
• Further orthodontic assessment

What is it?

A loose or broken orthodontic wire can irritate the tongue, cheeks or gums.

What should I do?

If the wire is causing irritation:

• Avoid playing with it
• Try not to pull on the wire
• Use orthodontic wax if appropriate, to protect the cheek or tongue
• Contact the practice for advice

What happens?

The wire will be assessed, and appropriate adjustment or repair can be arranged where required.

What problems can occur?

Dentures can sometimes:

• Crack or break, either the denture itself or the wires that help hold it in place
• Become loose
• Become uncomfortable
• Develop a sharp edge
• Become difficult to insert or remove
• Break a tooth, or part of the denture

What should I do?

If your denture is damaged, keep any broken pieces and contact the practice.

Avoid attempting to repair it yourself using household glue, as this can damage the denture and make professional repair more difficult.

What happens?

I will assess the denture and your mouth.

Depending on the problem, treatment may involve:

• Denture repair
• Adjustment
• Relining
• Replacement
• Assessment of the supporting teeth and gums