checkupsThe dental consultation shows how healthy your mouth is.

The dentist will take a comprehensive history - your general health and any medicines you may be taking; your diet  (sugary snacks and drinks cause use tooth decay); how you clean your teeth ( correct cleaning helps prevent tooth decay and gum disease); smoking and drinking (both can harm your mouth).

The dental examination includes several areas. Your face, neck and under your jaw are checked. The lips, cheeks, tongue and back of throat are checked to ensure they look healthy. Every tooth and all your gums are checked for any signs of decay, wear and gum disease. X-rays may be taken to gain more information.

The dentist will explain all their findings and discuss your choices and the cost and help you make a decision suitable for you.

Scaling and polishing

Scaling and polishingWhen you go for a check-up, your dentist may do a 'scale and polish'. Essentially, this is a deep clean of your mouth, where the dentist or hygienist will use a special tool to get rid of the hard build up of tartar (calculus) then follow up by giving the teeth a thorough polish. The dentist will probably concentrate on the areas just below the gum line, behind your teeth and in the gaps in between them, as these are the bits that we sometimes miss when we're brushing our teeth. The scale and polish will help fight against gum disease - although you still need to do your bit by brushing properly twice a day with a fluoride toothpaste.

Fillings and Restorations

Fillings and RestorationsIf part of a tooth has been lost through decay or damaged due to an accident, your dentist may put in a filling. A filling will plug the hole and stop any future pain or discomfort. A filling can be made out of a variety of materials. The most common of these are amalgam (silver) or composite (white).

Silver fillings are made of a material called amalgam, which is a mixture of mercury, silver, tin, copper, and other metals. Amalgam fillings are very hardwearing which is why they are often put into the back chewing teeth.

Some people opt for white fillings, which match the colour of the natural tooth better. White fillings are becoming more popular.


CrownsA crown is like a special sleeve made of metal or porcelain, or both, that goes over a damaged or weak tooth.  Your dentist will match it up to the shape – and, in the case of porcelain crowns, colour - of your other teeth so it will look natural. The crown will probably last for many years, depending on the health of the tooth underneath, and depending on how you look after your mouth.

The dentist will shape the tooth so that, with the artificial crown, it will be the same size as a normal tooth. Preparation time will depend on how damaged the tooth is and whether it needs to be built up with a filling. The tooth might have to be root-filled first - this is sometimes called 'removing the nerve'. The crown is sometimes held in place by a peg in the root canal if a lot of the tooth is missing.

Your dentist will use a soft mouldable material to make an exact 'impression' of the tooth that is to be crowned and the nearby teeth. A dental technician uses the impression to make the crown the exact height and size needed. A thin cord may be used to hold the gum away from the tooth so that the impression is accurate round the edges.

A temporary crown made of plastic or metal is put over the tooth until the permanent crown is made. You can chew on a temporary crown but it won't be as strong as the finished one. When the crown is fitted, your dentist will make small adjustments to make sure you can bite comfortably. The crown is tried on first, and then glued into place.

Tooth extraction

Tooth extractionHaving a tooth out is the same as having an operation and, because of this, you must look after the area to speed healing and to reduce the risk of infection. Here are some pointers:

  • For the first 24 hours, try to avoid eating hot food, don't smoke, don't drink any alcohol and try not to disturb any blood clot which might have formed.
  • Don't rinse your mouth for six hours after extraction. After that, rinse gently with warm salty water - half a teaspoon of salt in a glass of water is enough.
  • Brush your teeth as normal to keep your mouth as clean as possible.
  • You may feel some small pieces of bone work their way out of the socket - don't worry, this is perfectly normal.
  • There may be some swelling and a bit of discomfort in the first two to three days. If you need to, take some ordinary painkillers - aspirin, ibuprofen or paracetomol will be fine.
  • If you feel pain immediately after the tooth has been removed, it might be where the blood clot has broken down leaving an empty hole in the gum. This is called a 'dry socket' and will need to be looked at by your dentist. Simply go back and the dentist will pack the wound to ease your discomfort.

Your dentist may have given you some gauze to place onto the area where the tooth has been removed - if not, a clean cloth handkerchief will do just as well (but not a paper tissue).

  • Roll it into a small firm pad large enough to fit over the gap (probably around 1 cm by 3 cm).
  • Sit up and gently clear away any blood clots around the gap using the gauze or handkerchief.
  • Put a clean pad over the gap (from tongue side to cheek side) and bite down on it firmly for 10 to 15 minutes.
  • Take the pad off and check whether the bleeding has stopped. If not, apply a fresh pad and contact your dentist.

Wisdom Teeth Extraction

Sometimes there may not be room in your mouth for your wisdom teeth and, as they start to come through, they push against the teeth already there or may start to come through at an angle. When this happens, you might feel some pain or discomfort, so the best thing to do is to visit your dentist.

The dentist will probably take an x-ray of your mouth to see how - or if - your wisdom teeth are coming through. From this, they will be able to make a judgement on whether or not to take them out, and how easy or difficult it might be.

Often - especially if the teeth are already partway through - your dentist will be able to remove the wisdom tooth at their practice. However, if they think it might be difficult, they will probably refer you to a dental hospital where you can have them removed under general anaesthetic.

Root Canal Treatment

Root fillingsRoot canal treatment, also known as endodontics, is required when the nerve/blood supply (called the pulp) is infected. This is usually a result of decay or injury to the tooth. The tooth may cause no pain in the early stages of infection. It may darken over time. Some symptoms include a dull ache, severe pain and at times a painful or pain free noticeable swelling in the mouth. As pour collects and spreads the swelling may increase and spread onto the face or under the jaw. If the tooth is not treated the infection usually spreads and the tooth may need to be taken out. If the tooth is not heavily broken down we would recommend it to be saved.

Root canal treatment aims to get rid of the infection from the tooth. Local anaesthetic is used to make you comfortable and the root is cleaned and filled when infection free. The procedure can take one or two visits, occasionally more if necessary. On the first visit, the pulp is removed and and any infection is drained. The canals are shaped and cleaned ready for filling. A temporary filling is placed to allow the tooth to settle. At the second visit, if the tooth is pain free and has no signs of infection the tooth is permanently filled. The tooth becomes brittle after treatment and hence is more prone to fracture. With this in mind, your dentist may recommend a crown to protect it.

Root canal treatment is usually very successful. However there is a small chance that the infection may return. In this case the treatment can be repeated or the tooth may need to be removed. Root canal is routinely carried out in general dental practice. Root canal specialists, known as Endodontists are also available at a patients request or if deemed necessary.

Treating gum disease

Treating gum diseaseIn some cases gum disease can be treated easily by a dentist, although more severe cases may require further treatment. Remember the best way to reduce gum disease is by looking after your mouth well, so don't forget to ask your dentist for tips on how best to brush your teeth.

One thing your dentist is likely to do is to scale your teeth. This removes the hardened plaque - known as tartar or calculus - from the tooth, especially behind your teeth and just below the gum line. To find out more about the scale and polish, click here.

If you have advanced gum disease, your dentist may advise that you have a longer, more intensive treatment. This is known as root planing or curretage, and is basically an extension of the more usual scale and polish. The dentist - or hygienist - will give your teeth a really deep clean, going below the gum line and clearing any pockets of plaque.

Snoring Appliances

Snoring is caused by the vibration of soft tissues in the throat and behind the tongue. Studies indicate that at least 30% of adults snore. Snoring can be a major factor in sleep disturbance and the resulting stress, leading to lack of energy, poor concentration, mood swings, and irritability. In the long term it can also lead to high blood pressure and heart problems.

The good news is that the overwhelming majority of people suffering from problematic snoring can be effectively treated using an appliance specially made for snorers. The appliance is such an effective treatment for snoring because it 'takes the problem at its root cause'. It is designed to gently hold the lower jaw and tongue in the 'recovery position' while you sleep, keeping the airway open.

These appliances are a practical alternative to surgery and other uncomfortable options.

Conscious Sedation

Conscious Sedation is a form of anxiety control which makes treatment more pleasant and acceptable for the patient. This procedure has replaced General Anaesthesia used in the past. Various methods are used to sedate a patient, the most popular being Intravenous (IV) Sedation. This procedure involves the placement of a cannula or butterfly needle in the hand or arm in order to introduce the sedative drug.

A sedated patient will feel sleepy and relaxed, with little recollection of the dental procedure performed. It does not affect any part of your memory before the drug is given. Following sedation, the patient will need to be accompanied home by a responsible adult. They will have to avoid driving or using any machinery for the next 24 hours.

St. John's Dental practice has been providing conscious sedation for over 30 years and it has proven to be a safe and effective way of reducing anxiety to allow dental treatment to be carried out for the highly anxious patient.