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22 APRIL 2008

Your guide to looking good in the dental maze

ORAL HEALTH

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Pick and mix this Spring

CONTENTS

Cosmetic dentistry 4-5

Treatment forsensitive teeth 4

Regular care 6

Dentistry Abroad 7

Teeth Whitening 8

Policy 9

Dry mouth 10

Mouth ulcers 11

Nutrition 12

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Now is the best time of the year to get your teethfixed, with prices in the private sector at all timelows and NHS funding high at the start of itsfinancial year. Tom Rowland on how to playthe system.

and see which ones are offering somefree treatment. All now also do paid forwork.

A recent survey carried out by theCitizen's Advice Bureau estimated some4.7 million people in Britain have optedfor private dental care due to lack ofNHS access.

Official statistics concede that50,000 fewer patients were treated onthe NHS in 2006-7 compared to theprevious year.

The April watershed is important be-cause the new contract pays dentists onthe basis of “units of dental activity”(UDAs) and thecoffers are replen-ished each year inApril.

Go now and youare much less likelyto have the dentisttell you apologeti-cally that at themoment they donot have the NHSfunding for the procedure you require.Go next January and they are morelikely to have run out of NHS fundingand only offer expensive private alter-natives.

But you really have to watch like a

hawk now.“Patients are confused bythe complexity of the current charg-ing regime, with the result that manyfind themselves paying for privatetreatment when they had thought theywere being treated under the NHS”,says the Citizens Advice Bureau.

It is vital to get the dentist to spellout exactly what can be done on theNHS in advance of any work starting

and then to quoteaccurately for thework to be done pri-vately.

If you do not likethe figure he or shecomes up with, thenkeep on shoppingaround.

Dental implantsand many of the cos-

metic procedures are not funded on theNHS but many local dentists with aNHS sign on the door are set up to dothe work.

For most of us the alternatives are togo to one of the new cut-price special-ists in Central London - or to go abroad.Both options offer complex treatmentsat a fraction of the sky-high prices tra-ditionally charged in the UK. Cosmeticdentistry in particular has come downin price in the last few years and is nowmuch more affordable.

At least there are more dentistsavailable to do the work now. Untilrecently, the UK was regarded as

under-supplied with dentists, com-pared to many Western nations.

This is now being addressed insubstantial part by an increase in theimmigration of overseas dentists,particularly from former eastern Eu-ropean countries (Table 1).

Recent research carried out on be-half of Denplan showed that about aquarter of the adult population – orabout 11.5 million people – had hadprivate dental care, and that lack ofNHS access was the primary reason.But we could still be doing far moreto help ourselves.

Between 1994 and 2006 the pro-portion of men classified as obese inEngland increased from 14 per cent to24 per cent, while the proportion forobese women rose from 17 per cent to24 per cent.

Only 14 per cent of men and 27 percent of women in England consumedthe recommended five or more por-tions of fruit and vegetables a day,while eight per cent of men and sixper cent of women consumed none(Table 2).

Consumption of vegetables hashardly increased at all over the past 35years, if potatoes are excluded, al-though fruit consumption has gone up.We do not believe “an apple a day keepsthe dentist at bay” it seems. Apple andpear consumption has not changed.

Fruit juices in comparison are up bya massive 10-fold increase and grapesand other soft fruit by four times.

Foreword

Source: Social Trends 2008.

NHS general, dental and opthalmic practitionersUnited Kingdom Thousands

2000 2003 2006GPs 35.2 37.2 40.2Dental practitioners 21.9 23.1 25.3

Opthalmic practitioners 10.1 10.5 10.9

STEP BY STEP GUIDE

1. Check your local NHS optionsvia www.nhsdirect.nhs.uk

2. Get some quotes3. Shop around4. Check out the cut-priceprivate cosmetic dentists

Source:Social Trends 2008/ Department for Environment, Food and Rural Affairs

PURCHASES OF FRUIT AND VEGETABLESUNITED KINGDOM

GRAMS PER PERSON PER WEEK

1974 2005/06Total vegetables 2,578 1,998Fresh potatoes 1,318 587Other fresh vegetables 769 802Processed potatoes 119 255Other processed vegetables 372 354Total fruit 731 1,292Total fresh fruit 515 856Oranges and other citrus fruits 136 151Apples and pears 229 226Stone fruit 16 78Soft fruit 25 108Bananas 84 225Other fresh fruit 25 68Fruit juices (ml) 34 350Other fruit products5 182 87

▲ Table 1

▲ Table 2

It is the best of times and the worst oftimes to go to the dentist. The worst be-cause last year the government lum-bered them with a funding system thathas been pretty much universally con-demned.

The best because one of the conse-quences was to free patients. If you areprepared to shop around there are somevery good deals on offer in both publicand private sectors.

NHS dentistry has been transformed.Under the old contract patients regis-tered with a dentist, who was paid bythe NHS on piece-rates for the workdone. This created a “drill-and-fill”mentality.

The new contract gave primarycare trusts responsibility for NHSdentistry. Patients no longer need toregister: they can approach any prac-tice offering NHS dentistry and askfor an appointment.

If you live in London or the SouthEast the reality is that you have neverhad more choice – so long as you areprepared to travel and pay the goingrate for those pieces of work that youcannot get done for free.

Use the dental services finder on theNHS Direct web site as a first step. Youcan search on postcode for a dentist

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Sky high charges for cosmetic dentistry in London and the South East are under attack from a newgeneration of ultra-glamorous dentists offering super-rich looks at affordable prices.

The sweet smile of success

savodent

Until recently if you wanted to getyour teeth fixed for cosmetic reasonsthen the only option was to handover a substantial fortune to a spe-cialist cosmetic surgeon – but nolonger.

If sporting bad teeth has tradition-ally been as British as a liking for agood night out and a soft spot for co-median Ken Dodd andhis protruding incisors,in the last few yearsthere has been a revo-lution in attitudes.

It is the young whoare leading the way.According to a recentsurvey, people in the25-34 age group are the most likelyto have had teeth whitening; thoseaged 35-44 tend to opt for white fill-ings, while makeover shows are apopular vehicle to gauge cosmetictreatments, with almost half of

women (49 per cent) occasionallytuning in.

The prices charged for cosmeticdentistry in London have tumbled,partly because changes in the tech-nology of tooth whitening havebrought the treatments within thereach of many more.

Tooth whitening and ceramic ve-neers are nolonger the pre-serve of thesuper-rich.

But you need tofind somebodycompetent to dothe work. Whiten-ing is even of-

fered in tanning salons now; it wouldbe tragic to come out with lily-whiteskin and brown teeth.

Teeth are part of one's head afterall, and there are obvious advantagesin going to a proper dentist, not the

least being that they will fix struc-tural problems as well.

“Function first, aesthetics after,” adentist firmly told me. Currently anydentist can offer cosmetic dentistryregardless of training or experiencebeyond the basic dental degree.

There are no specialist qualifica-tions and no specialist register. Tech-niques constantly progress and thepublic are becoming increasinglydentally educated and discerning soyou want somebody who is stayingup-to-date.

The British Academy of CosmeticDentistry(BACD) a trade associationfor dentists who specialise in treat-ments, lists 52 members in a varietyof central London and suburbanpractices around the capital. (The listis on its web site at www.bacd.com.)

At least you have some guaranteethat they are interested in trends anddevelopments in the subject. To get

onto the list a dentist has to notch up75 hours of career development andattend society meetings, although theorganisation is slowly trying to bringin a more rigorous qualificationregime based on examinations.

To date it has three members inLondon who have become fully ac-credited after exams.

Tooth whiteningNo longer the preserve of celebritiesand the super-rich, the market inteeth-lightening products has ex-ploded in popularity in recent years,ranging from home kits to in-surgeryprocedures.

There are two main methods ofbleaching - one performed by dentistor technician and one done at home.A dentist or technician applies a highconcentration of oxidising agent fora short period of time, which pro-duces quick results. To reduce the risk

of chemical burns to the soft tissues,most use a light-cured protectivelayer that is painted on the gums.

One of the most popular systemsworks by applying awhitening gel to theteeth, which is activated by a safe,'wavelength-matched' blue light. The ef-fects claim to be almost instantaneous,and lighten teeth by up to eight shades.

At-home whitening involves pur-chasing a thin mouth guard or stripthat holds a relatively low concen-tration of oxidising agent next to theteeth for several hours.

You need to do both. If you do notcarry on at home, there is no point inhaving the in-office procedures. It isa bit like getting your hair cut justonce and never again. Once a month

SWISS MAGIC

Switzerland's next great export isgoing to be gleaming white teethswathed in five-star hospitality butselling for low Continental prices.

That is the promise made by thestylish Abivardi sisters, Haleh, 38,and Golnar, 35, both dentists whohave just opened the doors of SwissSmile positioned on Brook Street,off New Bond Street in London W1.

The idea is to combine Swiss qual-ity, fair prices, smart interiors anddental excellence and to offer it for365 days a year.

London dentistry is shockingly ex-pensive says Haleh and she and hersister are determined to offer a highquality alternative at an affordableprice.

They are offering tooth whitening insurgery for half price at £195 until30 April.

Cosmetic dentistry

Hypersensitive dentine is a common chroniccondition which affects a high proportion of theadult population.

New treatment for sensitive teeth

Tooth whitening treatments, fizzydrinks, fruit juices, wine and incor-rect or aggressive brushing can allcontribute to the problem of sensitiveteath, a problem that now plagues upto an estimated 40 per cent of adults.

The condition is triggered by expo-sure of the dentinal tubules at thebase of your teeth.

A new treatment works by sealingthese dentinal tubules and blockingpainful sensations. The makers claim

it is quick acting and needs one 10minute application to provide up toa month’s protection.

To accurately deliver the active in-gredient, it uses a double–tray systemand foam strips impregnated withpotassium oxalate, which has beenproven by several clinical studies tobe the most effective formula fortreating dental hypersensitivity.

The application of Savodent makes

it the easiest to use product for treat-ing sensitivity compared to tooth-pastes and paint-on treatments, whileachieving the best results.

It can be bought as either a ‘1 monthkit’, which contains 1 double tray forupper and lower teeth with 1-applica-tion of Savodent Sensitive Teeth Treat-ment, or a ‘3 month kit’ which alsocontains a double-tray but with a 3-ap-plication supply of Savodent SensitiveTeeth Treatment.

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swiss smile offers top quality and dental excellence, set in exclusive surroundings and providing five star hospitality at fairprices. All treatments are performed by our highly specialised, well-coordinated team with the highest precision. The swisssmile dental clinics are dedicated to promoting healthy and beautiful teeth. Equipped with the latest technology, a team ofhighly qualified Swiss and German dental specialists take care of our patients providing a truly first class experience.

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THE LEADING DENTAL CENTER OF THE WORLD FOR DENTAL IMPLANTS AND SMILE MAKEOVER

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Fax +44 (0)845 094 3003 • brookstreet@swiss-smile.com

T +44 (0)845 094 4004www.swiss-smile.com

SPECIAL OFFER until 30/06/08

Consultation for dental implants £20

Consultation for smile makeover £20

Zoom 2 Advanced Tooth whitening £195*

Porcelain veneers from £595

Single implants (incl. material & crown) from £1'300

* Please note a consultation and hygiene care treatment may be required prior to the tooth whitening and is not included in the price.

�

for 40 minutes should be enough formost people, say the experts.

VeneersA dental veneer is a thin layer placedover a tooth surface, either to im-prove the aesthetics of a tooth or pro-tect a damaged surface. There are twotypes of material used, composite andporcelain.

But patients who receive veneersshould understand that they mayonly last 10-15 years and then mayhave to be replaced.

The big advantage of using a ve-neer to restore a tooth is that it canbe made to look dazzling withoutmuch preparation.

The artistry is in making it looknatural by matching the shade of anindividual veneer to the remainingteeth. If the surface is not properlyprepared and the tooth too thick thenyou can end up with white slabs be-hind bulging lips and looking like achipmunk.

Why we are going for cosmetic den-tal treatments?What once cost several thousand cannow be obtained for a few hundred,although there is still some way to go.The findings of another recent surveyshowed that almost 60 per cent ofBritons feel down in the mouth abouttheir smile, and that flashing a daz-zling set of teeth would help boosttheir confidence.

Dentists recommend brushing teethfor two minutes twice a day with anelectric tooth brush, three minuteswith an ordinary one, to ward offplaque-causing bacteria. However,88 per cent of men admitted to notmeeting this target

So how can you achieve a super-star beam - without having to forkout £2,500 per tooth on surgicaltreatments, as Victoria Beckham wasrumoured to have done last year?

Cure yourselfThere is quite a lot you can do foryourself, says Dr Surinder Hundle,the official dentist on Channel 4'smakeover show, “10 Years Younger”.

Diet and lifestyle"Cut back on sugary snacks betweenmeals to prevent tooth decay, and re-duce your caffeine intake to stopthose tell-tale signs of discolourationsetting in. It is also important tochew sugar-free gum after eating tostimulate saliva because it protectsteeth and flushes away food," says DrHundle.

Another tip for perfecting a mega-watt smile is to follow a tooth-friendly, “white teeth diet.”

This involves swapping red winefor white, black coffee for the whitevariety and finishing a meal withmilk to neutralise acid in yourmouth.

Oral hygieneDr. Oliver Harman, one of the three ac-credited members of the BACD says:"Brushing teeth with fluoride-basedtoothpaste is vital to keep gum diseaseand tooth decay at bay. We advise com-bining this routine with using a mouth-wash and regular dental check-ups."However effective these techniquesmay be, those in pursuit of the per-fect smile should remember that non-surgical treatments can only go so farin enhancing what nature has blessedus with.

Cosmetic dentistry

“Toothwhitening andceramic veneersare no longer thepreserve of thesuper-rich. Theprices chargedfor cosmeticdentistry inLondon havetumbled.”

▲ Cosmetic specialists: Haleh and Golnar Abivardi

HIGH STREET WHITENING

Simon Gallier of Smile Store hasopened cosmetic dentistry outletsin Superdrug shops.

“The idea started as tooth cleaning.My brother was a smoker and hejust wanted to get his teethcleaned, without going through theprocedure of seeing a dentist'” heexplains.

The aim is to target the 50 per centwho never see a dentist. By goinginto a Superdrug the service ismore approach.

The techniques they use slow theageing process, make your teethlook 10 years younger, he explains.

Smile Store electronically take thecolour of the teeth, a claimedunique feature.

“I guarantee you will have brighterteeth at the end, I will not guaran-tee the end shade but they will bewhiter,” says Dr Gallier.

Whitening costs. In store, £350 in-cluding electronic monitoring, traysand home gel to carry on at home.

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NOT SOLD

As you clean Oral B's Triumph Smart-Guide toothbrush transmits its preciselocation to the electronics in the basestation. It works on the same princi-pal as Bluetooth headsets for mobilephones and the brush can be set todifferent modes ranging from sensi-

tive teeth to polishing, via gum mas-sage.

Sensors detect the level of pressureyou are putting onto the cleaninghead and a warning light lets youknow if you are pushing too hard.

The four speed brush was tipped as per minute for its price and is veryeasy to use. It cleans teeth very welland for people on a tighter budget, itis an ideal buy. At just £10, the OralAdvance Power 900 is a great buy ndwell within most people’s budget. It isalso rechargeable and is very easy touse and has a rotating head. The re-placement heads are just £4 making itan affordableand reliable alter-native to some of the more ex-pensive models.

There are many other electrictoothbrushes which are under £10but most are not fitted with arechargeable battery. However atsuch a low price, they shouldnot be disregarded because manyof them still offer

excellent performance and as most ofthem are a lot lighter in weight thanrechargeable toothbrushes, they areperfect for travel.In this category, one of the best

models is Pearl Drops’ Pro-whiteningtoothbrush. This is just £5 but the ef-ficiency is not totally compromisedby the price. It is very easy to use, hasgood rotation frequencies and is

lightweight, says the Which? re-port. The rotating head offers agood clean and the replacementheads are just £3.There are many things to con-

sider when you buy an electric tooth-brush but the main aspects whichyou need to look at are its efficiency,frequency of rotation and of courseyour budget.

You might think that you know your way aroundyour own mouth but the latest electric toothbrush isthere to prove you wrong. Here is our guide to thelatest in high-tech toothbrushes guaranteed tomassage both your gums and wallet.

TOOTH CARE AS RECOMMENDED BYTHE BRITISH DENTAL ASSOCIATION

* Brushing your teeth twice a day with a fluoride toothpaste not only helpsprevent tooth decay and gum disease, it can also prevent bad breath.

* A toothbrush with a small head is best, so you can move it around yourmouth better. The bristles should be either soft or medium as you run lessof a risk of damaging your teeth by brushing too hard.

* Using a mouthwash can help get rid of the last bits of bacteria or left-over food that you might have missed with your toothbrush, especially inthe hard-to-reach areas.

* Flossing your teeth helps remove plaque and bacteria from between yourteeth and from under your gum line, helping you in the battle againsttooth decay and gum disease.

* When you're choosing a toothpaste, the most important thing to look foris that it contains fluoride. This is a vital ingredient and helps to protectteeth against decay. Most of the leading brands will contain fluoride, aswill supermarket and chemists' brands.

* Smoking can have a massive effect on your mouth. Not only will it giveyou bad breath, it can reduce your ability to taste things, stain your teethand cause mouth cancer.

* Teaching children how to brush effectively - including those hard toreach areas - will set them up for life and will help spare them toothdecay, fillings and bad breath.

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“Consider switching to an electric toothbrush as these have been shown toclean the teeth more effectively than manual toothbrushes.”

“To protect your teeth from tooth decay and gum disease, it’s vital tobrush your teeth with a fluoride toothpaste at least twice a day. Use a flu-oride mouthwash and visit your dentist as frequently as they advise.”

"To prevent tooth decay, cut back on sugary snacks between meals. Sugaris used by bacteria in the mouth to produce acid that dissolves toothenamel forming a hole.”

“After meals, chewing sugar-free gum can help to protect teeth by stimu-lating the production of saliva which neutralises enamel-dissolving acidsproduced by sugar in our diet.”

“To ensure that teeth remain as white as possible, my best advice is not tosmoke. Smoking not only stains teeth but also damages your gums as well. Ifyou drink tea, coffee and red wine, its especially important to brush your teethregularly in order to prevent stains building up on your teeth.”

Electric toothbrushes are best - official

Regular care

“Check theefficiency of the

brush, itsfrequency of

rotation and ofcourse, yourbudget”

▲ The Philips Sonicare FlexCare. £140with UV sanitiser and three brushingmodes.

Open wide for the £140 Satnav toothbrush

the top buy by the Consumers' Associ-ation magazine “Which?” in its latestsurvey of electric toothbrushes where itclocked up an 82 per cent score.

Runner up with 76 per cent was the£100 Sonicare Elite e9500 fromPhilips. This brush has two speeds. Italso has a timer to prompt you tobrush for the recommended time.

“It is very simple to use and com-fortable to hold and the brush headsare easy to change,” said Which?

The Sonicare was marked down to 76per cent by Which? because therechargeable battery only lasted 57minutes, but that still gives roughly twoweeks use between charges, and batterylife hardly a huge issue with recharge-able equipment of this kind.

Philips new top of the range offeringis the Sonicare FlexCare, also £140. Itis rather easier to use in different modesthan Oral B's Triumph Smart Guide andcomes with a UV Sanitiser rather thanthe Bluetooth guide.

Which? recommends its memberskeep clear of the Tesco Daily Care 2-Way Action, which scored lowest inthe test. The Colgate Actibrush did lit-tle better and the magazine says it,“gave teeth only an average clean, haspoor battery life and is not very com-fortable.”

Its other “Don't buy” recommenda-tion is the Tesco extra care Vibra-Tech “one of the least comfortablebrushes to hold.”

Electric toothbrushes are becomingincreasingly popular and with goodreason. They might not be intrinsicallymore efficient than manual brushes butthe timers and pressure gages on goodquality modern ones help keep youcleaning your teeth properly.

Children aged six or seven whobrush their teeth on their own willnot have the coordination problemsthat can arise when using a manualtoothbrush and they enjoy theprocess more.

While prices for electric tooth-brushes can get very high, you do nothave to spend a fortune on one. Pricesstart from just £3.

The Oral B Vitally sensitive modelis £22 and again is even lighter thanany of the more expensive models. Ithas a good number of rotations

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Smile Savers

Thailand boasts some of the best den-tal clinics in Asia. Many peoplechoose to take a holiday and havetheir dental work completed whilethey are enjoying the sunshine.

Hungary is in sharp contrast tomost European countries in that it hasa hugely competitive army of highlytrained dental professionals fightingfor a relatively small home market.

Competition has been stoked furtherby waves of foreign clients initiallycrossing the immediate borders from

Austria and Germany in search of abetter deal. Now, with the recent entryof Hungary into the EU, the market-place has expanded and competitionhas grown fiercer producing some ofthe best clinics Budapest has ever seen.

This reporter can testify to the skill,efficiency and kindness of the staff ofthe Grace Dental Clinic in ChiangMai, northern Thailand. The modern,high tech facility sits on a quiet leafystreet and offers some of the bestdental care in Asia. The dentists are

very highly qualified, with many ofthem having studied internationallybefore returning to Thailand to work.

A dentist in London told me that Ineeded periodontal work to removesome pockets that had developed inmy gums. The quote from Londonwas in excess of £5,000. I got thework done superbly in Chaing Maifor under £1,000.

Every kind of treatment is availablefrom simple check ups to cleaning, im-plants, cosmetic work, oral surgery andorthodontic work. Prices are very rea-sonable with a general check up costingthe equivalent of about £3.50. Obvi-ously the more treatment required, thehigher the price will be, but whateveryou require, you will be guaranteed amuch lower price than in the UK. Forexample tooth extractions are just £10while tooth whitening costs less than£200; cheaper than usually available atany dentist in the UK.

Tourists withtoothacheHaving dental work abroad is becomingincreasingly popular. Many countries offer excellentservice at a fraction of the cost of the UK making itan appealing alternative, reports Tom Rowland.

“Dr Jaruneetrained in

Germany andoffers a holisticapproach to

peridontal careat highly

competitiveprices”

▲ Dr Jarunee Wattanakla

▲ Emily Mayer lost several of her teeth fromperiodontal gum disease when she was in her40's, and had many others were loose.

Tourism

The clinic specialises in periodontalwork with Dr Jarunee Wattanakla pro-viding exceptional service at a very rea-sonable price. Dr Jarunee has been atGrace Clinic for five years but has beenpracticing in Chiang Mai for over 17years. She trained abroad and pridesherself on offering a holistic and hu-manised approach. She works togetherwith the patient and other specialists inthe clinic to offer the best service andresults possible.

Others tell similar stories about thehigh quality of dental work on offerin Hungary.

Emily Mayer lost several of her teethfrom periodontal gum disease when shewas in her 40's, and had many othersthat were loose.

Her treatment with the Smile Saversclinic in Budapest included 18 im-plants, bone grafting and 28crowns/bridge, she was quoted in theregion of £60,000 in the UK but in Bu-dapest the work cost £20,000, a savingof £40,000.

Smile Savers is now offering Lon-don consultations, so clients can meetone of the specialists and get a fullquote prior to traveling to Budapest.

PricesMany people assume that the qualityof materials used in dentistry must bemuch lower or the staff less qualifiedbut materials are usually identicaland often superior to UK counter-parts and the staff every bit as welltrained.

Perhaps the biggest factor that in-fluences prices in both locations isthe number of highly qualified den-tists competing in the same market.The end result is escalating qualityand plummeting prices.

The two golden rules of dentaltourism are: one check on the repu-tation and qualifications of your den-tist before you start treatment. Theyshould be able to supply testimonialsfrom happy clients from the UK. Donot try to fit too much into a singletrip and leave plenty of time for workto settle before leaving.

Contact details Grace Dental Clinic: www.gracedentalclinic.comSmile Savers. UK office: Tel. 0845 8386278

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Smile Store

The colour of our teeth is largely deter-mined by our DNA just like our hairand eye colour. If your parents sufferfrom stained teeth, the chances are thatyou also will.

The process of having teeth whitenedgives many people the confidence tosmile with pride.

The tooth whitening business hasexperienced a boom in recent years.Many people arechoosing to have in-house cosmetic sur-gery to improve theirsmile, while otherswho do not have sucha large budget areusing home kits.

A bleaching agent isused in most cases tochemically remove any discolouration,but this does mean that not everyone isable to enjoy a whiter smile. Certainconditions, such as gum disease, pre-vent people from having the cosmeticsurgery and need to be treated beforehaving any cosmetic surgery.

If you decide that you want yourdentist to carry out the procedure, youwill have to have a dental check-up toensure your teeth and gums are healthy.

Your gums and lips will be coveredto prevent them from being damagedor becoming overly sensitive after theprocedure. The bleaching agent is ap-plied to every tooth before being ex-posed to ultra-violet light. This is thenrepeated three times to make sure thedesired effect is achieved. The entireprocess takes no longer than two hours.

If you are considering having yourteeth whitened but are also looking tohave dental restoration work, youshould have the whitening completedfirst so that any crowns and veneerscan be matched to your new toothcolour.

The results are very successful andwhile they will vary for individuals,there is no doubt that you will have a

bright, white smileonce it has been com-pleted.

Another option,and one which is par-ticularly appealing tothose on a tightbudget, is a do-it-yourself bleachingkit. These kits have

similar results but take much longer toproduce results. You will still need tovisit your dentist, as a mould of yourteeth will need to be made. You will begiven this mould and the solutionwhich you wear overnight for severalnights until the desired effect isachieved. While the process does takelonger, you actually have more controlover the colour you want to achieve.

You need to make sure that you willnot damage your teeth and gums andthat the mould fits the shape of yourmouth exactly. By trying to savemoney, you could harm your teeth for-ever. Whiten your teeth under the su-pervision of a dentist.

If you use a home kit, you may findthat your teeth are sensitive for about24 hours after each application, but this

is only a very temporary side-effect.The length of time it takes for yourteeth to whiten depends on a numberof different factors; however it is veryimportant never to lose patience andgive up before the solution has had timeto work.

Whitening toothpaste and chewinggum do not contain the bleachingagents vital in the tooth whiteningprocess. Whitening your teeth requiresmore than a deep clean; you actuallyneed to change the colour. So they willwork until you have your next cup ofcoffee or glass of red wine.

They can also contain coarse ele-ments, which scrub the teeth whilebrushing and may remove a protectivelayer of enzymes, which could result indamage to your enamel or recedinggums.

While you may be desperate to havewhiter teeth, it is important that youtake the correct steps to get them. Youmust always consult a dentist, regard-less of whether you have cosmetic sur-gery at the dentist or whether you use atake-home kit. The bleaching agent candamage your teeth and gums forever ifyou do not take professional advice.Because if this, you should steer clearof over-the-counter remedies claimingthat they offer a brighter smile at a frac-tion of the cost.

Smiling with confidence couldchange your everyday life dramatically.If you are self-conscious about yourdiscoloured teeth, having themwhitened could be the answer you arelooking for.

A whiter shade of paleFor the majority of people the discolouration of teeth is an unavoidablepart of getting older caused by factors including caffeine and red wine. Butthere is lots of help available to undo the damage.

TOOTH WHITENING BARGAINS INLONDON THIS SPRING.Swiss SmileZoom 2 Advanced Tooth whitening (in office) £195 until the end of April.Usual price £390.

First consultation, including two X-rays, full examination, explanation oftreatment plan and quotation. Until end of April. £45.

Swiss Smile dental clinics�10 Brook Street, London W1.Tel: 0845 094 4004

Smile StoreIn-Surgery power whitening �This system involves initial power whitening(using 25 per cent gel) followed by a continuation, at home, using custom-made trays (using 10 per cent gel).

The at-home continuation should be carried out weekly for three months.

The package includes all the materials and gels necessary in the price.£350

London 130 Kensington High Street, London, W8 .7 Tel: 020 7938 4847Brighton 78 Western Road, Brighton. Tel: 01273 327 402Milton Keynes Unit 4, Woolworth Development, Midsummer Arcade, Milton Keynes. Tel: 01908 673 271Guildford - coming soon 101 High Street. Tel: 01483 535258

“Ultra violetlight help shinethings up”

Whitening

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ORAL HEALTH

The statistics are crystal clear, even ifthe water supplies are not. Dental healthis better in those parts of the countrywhere the water is treated comparedwith those where it is not.

Now the Department of Health ismaking a concerted push to corralmore areas into the fluoride fold, andLondon is high on its target list.

Authorities are expected to carryout a public opinion survey, set upfocus groups and consider all lettersand resolutions.

The Department of Health has drawnup a "model agreement" covering themain terms to be included in anyarrangements between England's 28strategic health authorities and thewater companies.

They can go ahead with a schemeif they are "satisfied that the healtharguments in favour of proceedingwith the proposal outweigh all argu-ments against proceeding".

The government argues that thereis clear evidence that fluoridated tapwater offers significant benefits todental health.

“Fluoridation is an effective and rel-atively easy way to help addresshealth inequalities - giving childrenfrom poorer backgrounds a dentalhealth boost that can last a lifetime,reducing tooth decay and thereby cut-ting down on the amount of dental

work they need in the future. We havea duty to help the areas with the worstrecord on tooth decay to discuss thisissue and take the necessary steps toimprove their dental health,” saidAlan Johnston, the Health Secretary.

Fluoride has been added to Birm-ingham’s tap water for over fortyyears and children living there havehalf the instances of tooth decay thanchildren living in non-fluoridatedManchester.

A review of water fluoridation bythe University of York in 2000 foundwater fluoridation increased thenumber of children without toothdecay by 15 per cent.

Water fluoridation schemes alreadyexist in the North East and West Mid-lands affecting 5.5 million UK citizensand a further half a million people livein areas in which fluoride occurs natu-rally in the water.

In the US 70 per cent of people usefluoridated water and it has been addedto the supply of all major US cities. InAustralia the figure is 67 per cent.

In the Republic of Ireland, where 70per cent of water is fluoridated, the av-erage number of decayed, missing andfilled teeth per child is just 1.32 com-pared to 2.31 in Northern Ireland wherefluoridation has not been implemented.

In a survey of 5 year olds’ oral healthconducted by the British Association for

the Study of Community Dentistry, allten of the worst PCTs for oral healthrepresented areas where the tap wate-was not. The average number of de-

cayed, missing and filled teeth per childfor England is fluoridated (see tablebelow).

Anti-fluoride campaigners say thatthe science is unproven and that fluor-idation poses significant risks to health(see table below).

Critics also claim that fluoridation is"indiscriminate mass medication", andshould not be forced on people againsttheir will through their water supply.

Supporters say the biggest argu-ment in favour of water fluoridationis that it works. Although a largegroup of people mistakenly believesits supplies are fluoridated, only asmall part of England is covered byschemes, principally around Birming-ham and eastern England.

The last major battle over fluorida-tion was in the North East in the early1990s, when health authorities, backedby 70 per cent of the local population,had a scheme that would have coveredone million people rejected byNorthumbria Water, and the courts.

Dentists say that in countries where water fluoridation is widespread, suchas America, Australia and New Zealand, dental health is far superior toLondon's. Now the Government is encouraging local strategic healthauthorities who want to introduce schemes to fluoridate water supplies.

Fluoride - health food or compulsory medication?

Policy

▲ The best and worst areas for tooth decay

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The worst areasBlackburn 3.21 NoKnowsley 3.20 NoNottinghamshire City 3.10 NoManchester 3.01 NoMiddlesborough 2.84 NoRochdale 2.68 NoOldham 2.6 NoWestminster 2.58 NoBradford 2.56 NoNewham 2.36 NoThe best areas Havering (Essex) 0.61 Some naturalNE Essex 0.65 Some naturalW Essex 0.66 Some naturalDudley 0.7 YesBassetlaw 0.83 YesWest Kent 0.84 NoSurrey 0.84 NoSuffolk 0.87 Some naturalEast Sussex 0.88 NoBedfordshire 0.9 Yes

PRIMARY CARE TRUST DECAYED, MISSING AND FILLEDTEETH PER CHILD

FLUORIDATED

Source: Department of Health

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ORAL HEALTH

Anglian pharma

It is not something the healthy care todwell on, but on average adults se-crete around three pints of salivaevery day. The quantities decreasewith age as the salivary glands pro-duce less; thirst receptors in yourbrain become less responsive to thebody’s need for fluids.

This precious liquidlubricates the mouthand contains enzymeswhich help to breakdown food and assistsin swallowing. It alsoacts as a cleanser, con-stantly washing aroundthe mouth and teeth,helping to keep teethclean and fight decay.Dry mouth or ‘xerosto-mia’ is a condition which affects theflow of saliva, causing a dry sensationin the mouth.

Symptoms include saliva that seemsthick and sticky making it difficult tospeak or swallow. Some experience a

prickly or burning sensation in themouth and become sensitive to certainfoods.

Soreness can also develop in themouth or split skin appear at the cor-ners while bad breath may also follow.Saliva limits bacterial growth that candissolve tooth enamel or lead to

mouth infections.Its shortage mayincreased plaque,cause tooth decayand gum disease.

Most dry mouthis nothing to dowith ageing how-ever, it is relatedto medicationsand there are over400 prescribed

and over-the-counter medicationswhich list dry mouth as a side-effect.

They include drugs used to treat de-pression and anxiety, antihistamines,high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for

urinary incontinence and Parkinson’sdisease medications.

It is also triggered by certain con-ditions including the autoimmune dis-ease Sjogren's syndrome, endocrinedisorders, Alzheimer's disease, stroke,anxiety disorders and depression.

Those undergoing chemotherapycan be prone to dry mouth as thedrugs may change the nature ofsaliva and the amount produced.Radiation treatments to the head andneck can also damage salivary glandscausing a marked decrease in salivaproduction and diabetes sufferers aremore prone to oral infection due toan overabundance of bacteria fromless saliva.

Blood tests and imaging scans ofthe salivary glands can identify thecause and where it is possible, doctorsmay adjust the dosage of medicationor switch to another brand which ale-viates the symptom.

A drug may also be prescribed tostimulate saliva production.

There are a number of products de-signed to provide moisture and com-fort, usually gels or sprays.

Some have extra ingredients whichmay help prevent tooth and gumproblems.

There are also specially formulatedproducts to help with your normaloral hygiene.

ParchedA dry mouth is a side-effect of taking a varietyof medicines and also increases with age but itcan be treated.

“Blood testsand imagingscans canidentify thecause”

Dry mouth

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ORAL HEALTH

Dexcel Pharma

Between one fifth and one third ofthe population in the UK suffers froma variety of mouth sores, which in-clude mouth ulcers, brace sores anddenture sores.

The lining of the mouth can bedamaged by physical or chemicaltrauma or by infection. Acidic foods,the sharp edge of a toothbrush orcrispy foods can all cause damageleading to a mouth ulcer.

About 20 per cent of the popula-tion also suffer from Recurrent Aph-thous Ulcers (RAUs) which can occuras a response to stress, hormonalchanges, allergy, nutritional deficien-cies, drug therapy, altered immuneresponse or systemic disease.

Without treatment healing usuallystarts after a week and is completedwithin 14 days, although there are re-ports of individual ulcers lastingmuch longer.

The traditional treatments availableare essentially gels and gelatipastels

laced with local analgesics to reducethe pain, anti-inflammatory agents toreduce inflammation and sometimesan antiseptic to help fight infection.They can also contain alcohol.

Bonjela is a pain-relieving gel thatcontains the medicine Choline Salicy-late. It can help relieve the tears ofteething in infants, the sores causedby teenage braces and the stress ofadult mouth ulcers and finally to easeyou through the denture sores of laterlife.

Rinstead Pastels have been aroundfor decades but they are an effectivemeans of bringing relief, and they arereasonably palatable.

Aloclair works by creating a shieldover and around the ulcer to help re-duce irritation and soreness. By gen-tly adhering to the insides of themouth, the Aloe Vera extract it con-tains soothes mouth ulcers, minor le-sions, chafing and irritation causedby braces and ill-fitting dentures and

prevents further damage to the sensi-tive tissues in our mouth.

The makers claim it avoids the sting-ing sensation associated with someother treatments, which in some casescan lead to further irritation. Unlikethese treatments, Aloclair does not stingon application, and its soothing actionpromotes healing whilst providing fastacting and long lasting pain relief.

Aloclair contains no alcohol and issuitable for the whole family, includingchildren.

Why do Mouth Ulcers Occur?Despite being quite a common ail-ment, the actual cause is unknown.

The most common reason that peo-ple think they get mouth ulcers isbeing stressed or run down. As withmany ailments, it is far more likely topop up when you are overdoing itand your immune system is low.Other reasons for mouth ulcers arecuts in the mouth caused by nickingthe gum or cheek with your tooth-brush or food. Ill-fitting or newbraces and dentures can sometimescause sores that are painful whenthey are rubbed against or certainfoods are eaten.

Brace sores occur as a result ofbraces rubbing against your gums orlips. It is normal to develop bracesores, especially when you first startto wear braces. Brace sores can bepainful, but it is possible to ease thispain and help heal sores caused as aresult of braces.

Sore spotsWhile ulcers in the mouth are not life threateningthey can be very painful to the sufferer. Fortunatelya lot can be done to minimise the discomfort.

CURE YOURSELF TIPS

Watch your diet. Plenty of freshfruit and vegetables to supply essential vitamins.

Try to get plenty of rest.Clean your teeth after meals andthen use an antiseptic mouthwashto keep your mouth clean and tohelp prevent infection.

Do not smoke.Avoid spicy food and food thatcauses mouth ulcers to sting.

Try to avoid stress.Consult your doctor if mouth ulcersare still present after 14 days.

Top foods to avoidCurrySaltHot drinks

“Many believestress leads toulcers althoughthe exact causeis not known”

Mouth ulcers

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ORAL HEALTH

DAIRY AND DENTAL HEALTH Promotional feature

Milk and dairy products contain calcium and phosphorus, which are important forthe growth, development and health of teeth. These elements are believed to helpprevent demineralisation (release of minerals from the tooth) and promote rem-ineralisation (laying down of minerals into the tooth).

Apart from water, milk is one of the few drinks that are safe to have betweenmeals. The milk protein casein can also help reduce the damage to teeth. By form-ing a thin film over the enamel on the tooth surface, it helps prevent bacterial at-tack on the tooth.

Casein can also bring about an increase in the pH of plaque (make it lessacidic), which means teeth are less likely to be damaged by acid in the mouth.Eating a matchbox-sized piece of cheese after a meal or as a snack can actu-ally neutralise acids in the mouth, which can help prevent tooth decay. Thechewing of cheese also stimulates an increase in saliva production, and thishelps to wash away bacteria in the mouth that may harm the teeth and gums.

The Dairy Council provides evidence-based nutrition information on the role ofdairy foods in a healthy balanced diet and lifestyle. To help people understandtheir bodies’ nutritional needs, The Dairy Council provides a selection of free ed-ucational resources for all ages available for order fromwww.milk.co.uk.

Dairy products are good for teeth be-cause teeth need calcium to grow andstay healthy. Milk, cheese and yogurtall contain lots of calcium.

Milk and dairy foods provide manyother nutrients and active ingredientswhich help protect teeth and help keepthem strong and healthy. They alsocontain the mineral phosphorus, whichalong with calcium is believed to helpprevent demineralisation, the release ofminerals from the tooth, and to pro-mote remineralisation, the laying downof minerals into the tooth.

The milk protein casein can also

help reduce the damage to teeth. Ca-sein forms a thin film over the enamelon the tooth surface, and in doing sohelps prevent bacterial attack on thetooth. Casein can also bring about anincrease in the pH of plaque (make it

less acidic) which means teethare less likely to be dam-aged by acid in themouth. In addition ca-sein can form complexes

with calcium and phospho-rus which are known as casein

phosphopeptide-calcium phos phatecomplexes (CPP-CP), which stabiliseboth the calcium and phosphate in

the tooth enamel and make it lesssusceptible to solubility.

Hard cheese has been shown to bebeneficial for dental health and teeth.In particular, hard cheese chewed aftermeals and snacks helps to maintainhealthy teeth. The chewing of cheesestimulates an increase in saliva produc-tion which washes away bacteria in themouth that may harm the teeth andgums. Eating a matchbox-sized piece ofcheese after a meal neutralises acids inthe mouth, which can help preventdental erosion. The cheese also contains

calcium, phosphorus and casein whichare important for dental health.

The National Diet and NutritionSurvey showed that nearly 60 per

cent of 4-10 year olds had tooth ero-sion and almost a third of 4-6 yearolds had evidence of tooth decay. Bydrinking milk and dairy, children andadults will benefit from the toothfriendly nutrients they contain. It hasalso been shown that foods such aschocolate milk are less likely to con-tribute to dental caries than sucrosealone or solid snack foods since theyalso provide calcium, phosphorusand casein.

Good oral health, which involvesregular brushing with fluoride tooth-paste, is also critical.

NOT SOLD

A 200ml glass of whole, semi-skimmed and skimmed milkscontain 243mg, 247mg and 258mg of calcium respectively.

A 150g pot of whole-plain yogurt and low-fat plain yogurtcontain 300mg and 243mg respectively.

A 30g piece of hard cheese, such as cheddar, contains 222mgof calcium.

For further information, or nutritionadvice relating to dairy, please contact TheDairy Council at info@dairycouncil.org.uk or on 020 7395 4030.

“Eating amatchbox-sizedpiece of cheeseafter a meal

neutralises acidsin the mouthand can helpprevendental

erosion.”

Nutrition

Liquid healthin a bottleMilk and dairy foods are a source ofcalcium which is necessary for the normalstructure of bones and teeth.

How much calcium?

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