Extracting A Tooth – A Last Resort

dental surgery

Many dental treatments are available to restore damaged teeth, but sometimes an extraction is necessary.

One of the many reasons that we encourage our Purley patients to have six monthly dental checks, is that any problems, such as tooth decay, can usually be caught in its early stages. This will mostly mean that the tooth can be saved and preserved using a treatment such as a filling or perhaps a dental crown if damage is more extensive. Naturally, if you notice a problem in between appointments, you should contact us straight away for an appointment and not leave it until the next scheduled one.

Whilst we will always look at all possible avenues to save a natural tooth, this is not always possible and sometimes, the only available option is to remove the tooth. There are a number of reasons why we might have to do this, including:

  • Teeth too badly damaged to restore them
  • Damaged bone tissue caused by periodontitis
  • Overcrowding
  • Poor prognosis and ongoing problems for the patient
  • Impacted wisdom teeth

When you do need to have a tooth extracted, our Confidental Clinic dental team will take good care of you, making sure that the procedure is as comfortable as possible.

Having a tooth extracted

Now that a full anaesthetic is no longer used to perform this procedure, there is no need to avoid eating or drinking beforehand, Indeed, as you won’t be able to eat for a little while following the procedure, it is probably a good idea to eat something that will tide you over for a little while. Local anaesthetics are now widely used when we need to remove a tooth. These are very powerful, and, although you may feel some grinding sensations as the tooth is loosened, you should not feel any pain. For those who are very anxious or squeamish about the procedure, we do offer IV sedation to enable you to fully relax throughout it. Please ask our dental team about this service.

It is also important that we are up to date with your medical conditions and any medication that you may be on. Some medication, such as blood thinners, may mean that you will need to receive any necessary treatments in hospital, due to potential blood loss, as clots will not easily form.

Removing a tooth

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Is Brexit Making You Grind Your Teeth?

Sometimes, events that are out of our control can cause us to damage our teeth subconsciously, writes Dr Vinaya Soundrarajan.

Whatever your views are on one of the most hotly debated topics in recent history, there is a good chance that the outcome, or lack of outcome, may be causing you a certain degree of stress, anger or anxiety.

Subjects like this, which are largely out of our control, but which can potentially have a major impact on our lives, can often cause external signs of anxiety to manifest. One of these is that some of us will grind our teeth whilst we sleep. This can be very damaging and will eventually result in worn down teeth, and even breakages in more extreme cases.

Because grinding our teeth, or Bruxism, as it is also known, mainly happens when we are asleep, it can be very difficult to control, and ultimately, where it is caused by stress, the only permanent remedy is to deal with whatever it is that is causing this. Below, Dr Soundrarajan takes a more detailed look.


It is quite possible that you don’t even know that you are grinding your teeth. This can mean that a long period of time can pass before you notice some of the more obvious symptoms such as a worn or broken tooth. The following though, are some potential signs that you may be carrying out this tooth damaging habit in your sleep.

  • Aching neck or jaw
  • Sinus discomfort
  • Regular headaches, particularly upon waking
  • An increase in the sensitivity of your teeth
  • Discomfort or difficulty when opening your mouth

Whilst these may also be caused by other factors, they are often good indicators that you may be suffering from bruxism.

Dealing with teeth grinding

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Who Is Suitable For Implant Placement?

Image of a dental implant

Dentist Dr Sairah Shah offers some thoughts on who can benefit from having dental implants.

Along with our other Confidental Clinic practices, we are seeing an increasing number of patients coming to us wanting to find out more about dental implants. Now that these are becoming more widely known, they have become an increasingly popular alternative to dentures. This is probably not surprising as they have a number of distinct advantages over this older method of replacing missing teeth.

We have covered the benefits of dental implants, over dentures, in previous blogs, so, today, we will take a look at who might benefit the most from having implants placed instead.

Sufficient bone?

Before we look at groups of patients who may benefit, it is worth reminding patients that the amount of bone available for the implant to be placed into is very important. Whilst a bone graft can be used to build up the bone, for those who have insufficient, this does lengthen the treatment time and so may be a consideration for some.

Who can have implants?

Almost everyone is able to have dental implants, where bone structure is not an issue. There are exceptions however.

Implants should not be placed into patients whose facial features have not fully developed. This predominantly applies to children. To place an implant into an undeveloped jaw bone will almost certainly cause problems as the facial features change. The implant may gradually become out of alignment, and, aside from any aesthetic issues, could prove to cause some discomfort. Implants are also inadvisable for anyone playing a contact sport where a blow to the mouth could damage the implant and jawbone, potentially leading to it failing. Patients falling into this category may wish to consider a removable option such as dentures, until their sporting days are behind them. However for “normal” activities, implants should be fine.

Who benefits?

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Invisalign – a healthier option for teeth straightening?

Invisalign braces

Dentist Dr Tushar Patel explains just one of the advantages of Invisalign braces.

The majority of dental braces still use a system of wiring and brackets that are attached to the teeth and adjusted over time to straighten them. From older style NHS braces that use metal wiring, to modern cosmetic braces, such as Damon braces, which use tooth-coloured materials, these all slightly increase the risk of tooth decay during the period that they are worn.

Food that we eat, and bacteria, can easily become trapped in the wiring and brackets of the braces. This will inevitably lead to issues such as decay or gum disease if they are not removed effectively. Although we provide full information on how to clean your teeth whilst wearing braces, anyone who has tried to clean their teeth when wearing them would acknowledge that this is trickier than when you don’t have them. Inevitably, this increases the risk of oral health issues.

Invisalign – a healthier orthodontic solution.

Whilst care has to be taken whatever orthodontics you are using, life does become easier when you use Invisalign braces. These perform the same role as other orthodontic treatments, but are a newer method that avoids the use of wiring or brackets altogether. Patients of the Confidental Clinic that have had these, have been delighted to find out how easy and comfortable they were to use, as well as much more convenient.

What’s the secret?

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Dental Veneers – Improving Smiles For Older Patients

Practice Principal, Dr Tushar Patel, explains how more mature patients can benefit from this procedure.

At the Confidental Clinic in Purley, we find that one of the most common requests for cosmetic dentistry comes from those who are unhappy with discoloured or dull looking teeth.

We are always pleased to help our patients achieve a brighter smile with the various treatments at our disposal. Most younger patients, and many older ones too, can benefit from a teeth whitening procedure, but especially in the case of older patients, this is not always the case.

Wear and tear over the years can see teeth not only become discoloured, but also suffer from small chips and cracks of the teeth. Over time, this gradually worsens the way that they look.

Porcelain veneers

If your teeth are chipped, or cracked, to a point that makes them less than attractive, the use of porcelain veneers is a great way to restore them. In addition to this, it provides a great opportunity to brighten up your smile too.

Porcelain veneers are shaped similarly to a false fingernail and are used to replace the damaged front enamel surface of the tooth. This is done following the removal of a layer of enamel using a tool called a burr. Generally, only a very fine layer will be removed, after which we will then take impressions of your teeth and send them to a dental laboratory where your veneers will be made. You will be fitted with temporary protective veneers for a week or so, until the final veneers are returned. Once these are available, you will be recalled to our Purley practice and we will fit your new veneers for you using a high-strength, clinical grade adhesive.

Long lasting

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Periodontitis – Prevention and Treatment In Purley

This advanced form of gum disease can have devastating consequences for your teeth.

Having healthy teeth is important, but sometimes, we may pay less attention than we should to our gums. To some degree, this is understandable as our teeth are the most visible aspect of our mouth, and everyone wants to have a beautiful smile. If we neglect to keep our gums healthy though, any care we have taken of our teeth may well be in vain.

There are two main forms of gum disease, gingivitis and periodontitis. The former is a relatively mild form that can sometimes even be reversed simply through better cleaning. A scale and polish at our Purley dental clinic is also an excellent way to manage this stage of gum disease.

If early stage gingival problems are not dealt with, a much more serious condition, known as periodontitis, can occur.

What is periodontitis?

Periodontal disease is similar to that of gingivitis but is much more aggressive and has long term consequences. Whilst gingivitis affects our gums, often causing symptoms such as soreness, bleeding, and halitosis; periodontitis also has similar symptoms, albeit usually much more severe. Where the two really differ though is the reach of periodontal disease. When this happens, it is not only the gums that are affected, but also the roots of our teeth, along with the surrounding bone structure.

If periodontitis is present, there is every likelihood that you will start to lose bone mass in the area surrounding the tooth roots. This will eventually lead to teeth becoming loose, or even falling out.

Prevention and treatment

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Allaying Fear of ‘The Drill’ And Other Dental Anxieties

A look at some of the most common reasons for dental anxiety.

Dental phobia is probably one of the main reasons that some people suffer problems with their teeth and gums. Whilst a poor diet and irregular cleaning are also major contributors, the reality is that if you see your dentist on a regular basis for checkups, not only will your own knowledge of how to look after your teeth improve, but also any damage to your teeth can be addressed quickly.

Despite this, it remains a fact that many patients avoid seeing a dentist due to their anxieties about what will happen both at the checkup and during treatment. In today’s blog, our Purley dentists look at some of the most common reasons for dental anxieties and try to allay your fears by explaining the reality of what actually happens.

The ‘needle’

Given the invasive nature of some treatments, it may seem strange that one of the top dental phobias is actually the needle that is used to administer the local anaesthetic. As ‘knockout’ gas can no longer be used within a dental practice, this is the only sure way to minimise any discomfort that would be felt during essential treatment. Without it, even smallest dental fillings would be a challenge for many patients.

What few patients realise is that any discomfort that comes from the injection itself does not really occur when the needle enters the gum. What you feel, which may seem a little unpleasant, is when the anaesthetic enters the bloodstream. Our Confidental Clinic dentists are aware that this part of the treatment process can feel uncomfortable and will administer the anaesthetic as gently as possible to minimise discomfort.

The dental drill

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The Humble Scale And Polish

dental surgery

A closer look at this teeth cleaning process from your Purley dental hygienist

Many of us probably think that we clean our teeth well at home, and that, combined with our regularly six month check ups with the dentist, should be sufficient to keep our teeth healthy. There is no doubt that this is a good start, but it isn’t quite enough.

The reality is that there will always be small areas of our teeth that are very difficult to reach with a toothbrush, and sometimes also with floss. When these areas are not cleaned properly, bacteria will collect and gum disease is a real possibility.

Scale and polish

At the Confidental Clinic, we encourage all of our patients to see our dental hygienist on a similar basis to the dentist; i.e. approximately every six months. This allows your teeth and gums to be cleaned at regular intervals, ensuring that they have every chance of staying healthy.

There are a number of benefits to having your teeth cleaned professionally on a regular basis as follows:

Gum disease prevention

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Endodontic Care In Purley

Local dentist

Keeping the root canals of your teeth healthy and infection free.

The word ‘endodontic’ means ‘inside the tooth’, from the ancient Greek. Although some patients may think that a tooth is a solid block of material, it is much more sophisticated than that.

It comprises of three key parts; the enamel on the exterior, the softer dentin layer beneath it, and finally, the root canals of the teeth where nerves and blood vessels are stored. When infections reach this inner part of the tooth, we are likely to be very aware of it, with a severe toothache a distinct possibility.

You may ask how you can protect the inner part of the teeth as it isn’t accessible with a brush or other implement. The truth is that the only effective way to prevent a root canal infection is to keep the enamel exterior in good health.

Damaged enamel

The enamel on the outside of our teeth is very strong, but can still be damaged if we don’t take care of it correctly. Weakened and damaged enamel can allow bacteria into the more vulnerable parts of our teeth, often resulting in infection.

Enamel can be damaged in a number of ways:

  • Tooth decay
  • Damage through teeth grinding
  • Enamel erosion
  • Chipped teeth
  • Broken teeth
  • Exposure of the tooth root caused by gum recession

Once the enamel has become compromised and bacteria enters the dentin layer; unless detected and treated, perhaps with a filling, root canal infection is probably not very far away.

Prevention and treatment

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Z Is For ‘Zygomatic’

A look at Zygomatic dental implants, now available at the Confidental Clinic

We have discussed the applications of dental implants, in our blogs, a number of times. In our opinion, these are the best long term solution for missing teeth for most of our Purley patients. In order to be successfully placed though, they do require a certain amount of bone to be present into which they can be inserted.

Where an individual dental implant is required and there is insufficient bone in which to place it, there are two main procedures available which can restore sufficient bone and allow the implant procedure to go ahead. They are a bone graft and a sinus lift and we will discuss these in a future blog.

Zygomatic implants

There is also a third option for those who are using dental implants, for example, to support bridgework. These are called Zygomatic implants and they differ from a regular implant in a number of ways.

Like the regular version, the Zygomatic implant is also made from titanium which is important as the osseointegration (bone bonding) process still needs to take place. The Zygomatic implant however, is longer than a regular one. The reason for this is that it is usually used on the upper jaw and is placed into the cheekbone. Because this is a densely boned part of the face, lack of bone elsewhere should not be a problem. Once placed, the Zygomatic implant can be used to help hold a dental bridge securely in place.

Bone loss

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