smilescription

8/14/2019 SmileScriptIon

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INDEX

To all my patients, mentors,colleagues and friends who haveinspired me and believed in me

theyre the ones who get me!

T x


3/15

After 15 years in dentistry and 5 years

in aesthetic medicine, having travelled

the world and libraries in search of

the latest techniques, technologies

& advancement. It never ceases to

amaze me how few questions you the

consumer clients asks of their dentists,doctors or professionals about the

maintenance of good dental health

and wellbeing.

I still regularly see clients from all walks

of life arrive at my practice and when

they open their mouth its clear theyre

oblivious to the poor condition of their

teeth or gums. Or in search for a solution

to their problems and concerns.

So why does this happen?

Why do so many individuals have less

than the average smile in Great Britain?

What makes a Beautiful Smile?

Good questions & all that many

professionals and consumers

could debate all day!

The answers multi-factorial really

Lack of availability of service?

Do we value a smile that

is provided free?

Are Hollywood smiles

really the answer?

Education yes an answer

to all lifes problems, Are you

the consumer educated?

And if so by whom

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Yes unhealthy mouths are my bread

and butter I could just sit back except,

diagnose & treat the never-ending stream

of decay and periodontal disease patients

bring to my practice. Or I could put into

words how my practice operates: team

work, high quality dentistry using cost

effective reliable procedures & crucially

educating & informing the consumer at

ever stage in the process. To you I give you

a simple book to educate and inform.

It is based on experience and its factual &

most of all truthful! The book is dedicated

to all the many patients, friends and

educated professionals I have gathered

over the years. These individuals either

educated me or trusted my advice and

will have healthy teeth for years to come.

So enjoy the read!

Dr Tracey Bell BDS Hons

Dentistry is more than a

necessity it is a want.

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Towards

A good smile is about how your smile works with the rest of you face

Perfecting and maintaining your smile is attainable for everyone

you just need the right information and education.

I n t r o d u c t i o n


4/15

You only need to turn on the TV or pick up a magazine

to recognise that Britain is certainly aspiring to the

perfect smile. But what is the perfect smile?

A question which causes great debate.

Do you the consumer know what choices

you have and what exactly the risks and

the long term features and benets are?

In Britain alone according to the BACD

(British Association of Cosmetic Dentistry)

c h a p t e r

o n e

C o s m e t i cD e n t i s t r y t o d a y

TO BE COMPLETED??? TRACEY

YOU HAVE NOT PROVIDED

WHAT YOU WANT HERE

So in conclusion you the patient certainly

knows what dont like about your teeth,

which may be chipped, worn, discoloured,

missing or crooked. As a practicing

Dentist I see regularly that you the patient

dont know what the best solutions are,

where to nd these solutions and what

questions you should ask of your dentist.

T h i s i s w h e r e I c a n h e l p .

A great smile can enhance a persons

physical beauty, but most importantly,

it can be life-changing, improve

self-esteem and condence.

When I started out in 1993 dental services

were still provided free or relatively

cheaply under the NHS. But 1-8 years

later and thousands of patients later I

came to realise I was providing a service

that I wouldnt want myslef. My team

was merely reghting decay and gum

problems, trying to salvage what we

could as quickly as possible. This certainly

wasnt how we would want to be treated,

so we converted to private practice

and it proved one of the best career

moves we as a practice ever made.

It meant we could perform treatments

that would last and offer the services of

specialist dental practitioners to ensure

the very best care for our patients.

The difference choice, time and

education. Listening to the individual,

solving and preventing problems

plus providing the consumer with

information. u

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5/15

Its hardly surprising that given

the amount of information

or misinformation available,there are so many misconceptions

and unrealistic expectations

surrounding cosmetic dentistry.

And with more and more dentists

marketing their practices as

cosmetic its difcult to nd anyone

whose advice you can trust, which

is why Ive written this book.

My patients know what they dont like

about their teeth they may be chipped,

worn, discoloured or crooked - what they

dont know is what the best solutions are,

where to nd those solutions and what

questions they should ask of their dentist.

T h i s i s w h e r e I c a n h e l p .

Ive created thousands of smile makeovers

using crowns, veneers, whitening and

implants. The aesthetic results can be

fabulous for the patient, while for me

the most satisfying result of all is seeing

the life-changing effects a perfect

smile can have on an individual.

Every 1.00 spent

on Dentistry the

public spend 630 on

cosmetic products.

We dont rely on

photo shop we rely on

Skill, Belief & Truth.

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T h e v a l u e o f ab e a u t i f u l s m i l e


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c h a p t e r

t w o

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H e a l t h yt e e t h :

T h e d e n t a l e x a m i n a t i o n


7/15

SmileScription

The practitioner will be examining your

mouth for dental decay, periodontal

disease and oral cancer, looking at the

condition of your lymph nodes and for

any temporomandibular (jaw joints)

joint and soft tissue problems all vital

information to be recorded and used as key

indicators of your general state of health.

Every patient should have regular dental

examinations and I believe their frequency

should be based on the patients

dental and medical history.

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I recommend that each time you go for a

checkup you ask your dentist to record the

condition of your gums by a BPE (basic

periodontal examination) score. This is

also the ideal time to discuss with your

dentist any concerns you may have about

your teeth and ask about any aesthetic or

normal work you may be considering.

The examination may involve taking

x-rays, particularly in the case of a

newly registered patient who may

not have any recent radiographs.

R adi o graphs

Taking radiographs by digital x-ray

minimises radiation levels, images are

produced instantaneously and data

inputted directly into the patients notes.

T y p e s o f x - r a y s i n c l u d e :

OPG (o rtho panto gram)

An x-ray that rotates around the head

to view the whole mouth. It diagnosesthe pathology of bones, presence of any

dental cariesand provides an indication

of a patients general state of health.

B i tew i ngs

Radiographs taken of the posterior

premolar and molar teeth as an aid

to diagnosing tooth decay. Should

be repeated every 12 to 36 months

depending on the history of decay.

Peri api cal

R adi o graphs (PA s)

Individual radiographs taken of

the roots of the teeth to diagnose

periodontal bone loss problems.

During the dental examination you can

expect a number of different procedures to

be performed including, impressions takenof your mouth if extensive work is to be

completed. Always ask to see their work /

photographs if you are considering Dental

treatment, my patients ask me all the time.

A basic dental examination should include:

Examination for dental decay

Diagnosis and recording of

periodontal (gum) problems

Soft tissue examination important

for the diagnosis of disease

and systemic conditions

Temporomandibular joint

(TMJ) examination. The TMJ

is a complex joint between the

upper and lower jaw. The aging

process can make the joint more

painful, click when opening or

limit its degree of movement.

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I often hear patients say: Oh, its only a checkup,

but a dental examination is one of medicines

most undervalued procedures as it provides the

opportunity to diagnose systemic disease and take

early preventative measures.


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H e a l t h yg u m s

c h a p t e r

t h r e e

Healthy teeth and gums are essential - not

only for eating but it aids speech, overall

maintaining good health. They also form

the internal scaffolding to the face, keeping

in place soft tissue and lips and helping

you sustain a youthful appearance.

Oral heal th and w el l bei ng

Theres a direct correlation between oral

health and overall health. Scientists world

wide agree that periodontitis (gum disease

such as bleeding gums, excess tartar,

unstable teeth, bad taste and bad breath)

can be a signicant cause of diabetes, heart

disease, low birth weight and pneumonia.

t h e f o u n d a t i o n

o f a p e r f e c t s m i l e

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Gi ngi vi ti s

Gingivitis is swelling of the gums. The gums become

red and swollen, indicating the area has becomeinamed through plaque colonisation (excess plaque

in laymans terms?) The condition is reversible but

if left untreated can lead to periodontal disease.

Myth: If you brush your teeth too hard your gums will bleed.

Healthy, vital gums should not bleed when brushed.

If they do bleed, its most likely due to inammation,

plaque build-up or, in some cases, systemic disease.

Peri o do ntal di sease

Persistent inammation of the gums

(gingivitis) can lead to periodontal disease,

which can present in a variety of forms,

all of which affect gums and bone.

In periodontitis the bone anchoring the

teeth in the jaw is lostleading to gaps,

loose teeth and shrinking gums, and, if

left untreated, the teeth may fall out.

T h e r e a r e t w o s i m p l es t a g e s t o g u m d i s e a s e :

Regular professional cleaning and proper oral care at home can help prevent gum disease

Gum disease is inammation or infection

of the tissue supporting the teeth.

Without thorough tooth brushing, regular

ossing and frequent dental checkups

an accumulation of plaque will build up.

G u m D i s e a s e

p e r i o d o n t i t i s / g i n g i v i t i s

Plaque contains millions of bacteria which,

if not removed, will stagnate, causing

inammation and infection. Other factors

causing gum disease are poor general

health, smoking and stress as well ashereditary and systemic conditions.

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W hat do I need to k no w ?

All patients should see a dentist or hygienist

on a regular basis. The timing of these

appointments is dependent on your oral

health and general medical health.

If you have gum disease or have had

it in the past I recommend you visit

the hygienist every three months. This

enables the hygienist to monitor your

gums condition. Maintaining a healthy

mouth is like building a house - your

teeth need strong foundations good

gums. Without a set of healthy gums

you cannot maintain a healthy smile.

Anaesthesia: local anaesthetic may be

prescribed for certain conditions.

Number of visits: one

Not all hygienists are the same. As well as

treating patients, the job of a good dental

hygienist is to educate and advise patients

on their home care regime. A good dentalhygienist should also record gum condition,

measuring bone loss using the BPE index.

You must accept, though, that thorough

removal of plaque above, below and

in between teeth (interdental brushes

are excellent for this) takes time.

Never accept a 10-minute scale and

polish you cant rush things if you

want to keep your teeth for life.

Pro tect y o ur smi l e

Proper oral care starts with

simple at home regime

1. Use a medium / soft small

headed toothbrush and

replace every three months.

2. When brushing the teeth, you

should spend 2-3 minutes,

ideally after each meal and

before bedtime to remove

all cavity-forming bacteria

and prevent gum disease.

3. Be careful not to brush hard, as

this can cause gums to recede

and tooth substance to be lost.

4. Instead brush gently in small

circular motions at 45o angle.

5. Flossing is so important do it

after every meal sliding up and

down the side of the tooth.

Indi cati o ns o f gum di sease

Bleeding

Redness and swelling

Bone loss

Gum recession

Sensitivity

Bad breath

Tooth movement

Tooth loss

Periodontitis and the destruction of

bone is not reversible. The damage to

the bone can be halted and maintained

but the bone will not grow back.

Myth: Growing long in the tooth is an

unavoidable consequence of ageing.

With regular visits to the hygienist and

good dental care a smile can last for life.

Treati ng gum di sease

Early stages of gum disease often

cause little or no discomfort, which

means the condition may remain

undetected for some time.

Initial treatment normally involves

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removal of plaque and tartar,

allowing the inammation to

subside and the gums to heal.

At this point your dentist or hygienist should

set up a basic periodontal examination

(BPE) and pocket charting record to

monitor progress of your gum disease.

Can gum di sease return?

Periodontal disease/bone loss is not

reversible, but it can be contained

through good oral hygiene, regular

maintenance and visits to the dentist.

A nti bi o ti cs

Where gum disease persists,

antibiotics may be prescribed, usually

for a three-month period, which can

lead to signicant improvement.

However, where periodontal disease

persists you should be offered a referral to

a periodontist - a specialist in gum disease

who can provide options such as gum

surgery, bone replacement and adjunctive

treatment which may include???

x-rays and bone measurement.

Helping patients achieve beautiful

teeth and healthy gums produces

people who love their smile

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W h i t e n y o u r s m i l e

t o o t hw h i t e n i n gThe colour of our teeth is inuenced by a

number of factors such as tea, coffee, red

wine, smoking, anti-biotics and also age.

Now there are many methods of enhancing

and whitening the smile for every lifestyle

and budget. This ranges from inexpensive

home bleaching, whitening trays to

professional in ofce laser treatments.

There are many different systems on the

market, all of which will achieve some

degree of whiteness, depending on

the concentration of bleach, how the

bleach is applied, the length of time the

bleach remains on the teeth, as well as

on the level of care taken in maintaining

the teeth after the procedure.

c h a p t e r

f o u r

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AgePerfectingPointersThe illusion of white

teeth can be as easy

as a fashion accessory.

Steer clear of brown

/ orange clothing,

which can make teeth

appear more yellow.

AgePerfectingPointersTo enhance your

smile use a cool

based (blue based)

pink or red lipstick.

If you smile needs a

pick me up whitening

is often the solution.


12/15

H o me reservo i rs/tray s

There are various methods of

home teeth bleaching but trays and

bleaching gel is the most popular.

This system uses mouth guards that

t the teeth. Carbamide Peroxide is

then applied to the trays which are

worn for between 90 minutes and

overnight. The Carbamide Peroxide

removes stains from tea and coffee.

The treatment normally takes two to six

weeks to achieve optimum whiteness

depending on the concentration of

bleach. More difcult cases are those

where the persons teeth are not such

stained but inherently darker, whitening

can take three to six months.

Age perfecting pointer Yes it is natural

for teeth to become darker with age.

Enamel the glossy part of the tooth

becomes thinner and darker, the inner

part of the tooth becomes yellower.

Rejuvenate a smile by whitening and

great anti-ageing smile solution.

S tri ps and Pens

Teeth whitening strips and pens are the

over the counter way to whiten teeth.

The SmileScription pen contains 6%

Carbamide Peroxide that is simply applied

once or twice a day to the teeth and left.

Strips also typically contain 6% and are thin

exible transparent strip that are applied

over the teeth for 30 minutes per day.

In-surgery o r

po w er w hi teni ng

Systems such as SmileScription,

Zoom and Britesmile offer accelerated

whitening. Procedures normally take

between 45 to 60 minutes, use stronger

concentrations of bleach and produce

dramatic results in a short time.

Deep bl eachi ng

Deep bleaching combines reservoirs with

power whitening. The process is favoured

by clients wanting whiter-than-white teeth,

as results are long-lasting and maintenance

is easier than with other procedures.

Number of visits: Varies according to

procedure chosen.

Anaesthetic - No

R i sk s:

Sensitivity: After all types of tooth whitening

procedures teeth will be temporarily

sensitive, usually due to the teeth hydrating

then rehydrating during the process.

Burns: Peroxide burns. It is essential

the soft tissues be completely protected

during the procedure, which should only

be carried out by a dental professional.

Blotchiness/whitening unevenness:In some cases unevenness may result

due to the properties in your tooth enamel,

therefore it is important your practitioner

examines your teeth before the procedure.

Some teeth - especially grey-toned teeth

- do not take to whitening and clients

with teeth of this colouring are advised

to consult their dental practitioner.

N o t al l to o th w hi teni ng

i s the same.

With the exception of proprietary

home kits tooth whitening is a dental

procedure that should only be carried

out by a dental professional.

Many horror stories have appeared in

the media about whitening procedures

damaging tooth enamel and soft tissue.

Always insist your dental practitioner

explains the type of procedure proposed

and the concentration of bleach to be used

and make sure you are shown

before and after case studies.

B uy er bew are

I often have people come to my practice

wanting pearly whites as seen on TV

celebrities. Its important you discuss

your expectations with your practitioner

and realise that many celebrities such as

Simon Cowell, Catherine Zeta Jones andKatie Price have achieved their Hollywood

smile not only through tooth whitening

but also major dental work involving

the tting of crowns and veneers.

Tip: Using desensitising toothpaste after

tooth whitening swiftly reduces sensitivity.

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c h a p t e r

f i v e

F i l l i n g s

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A lling replaces part of a tooth that has

been lost because of decay or trauma.

There are numerous ways to replace part of a tooth either

using amalgam (silver llings) or composite (white ll ings)

In some cases where the lling is very large the dentist may

choose to produce an inlay either in porcelain, composite or

gold. This is produced where the dentist takes an impression

and sends the impression to the lab. The dental laboratory then

produces an inlay that is lled into the hole in the tooth.


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A r e t h e y a s g o o d

a s S i l v e r f i l l i n g s ?

Yes, as long as they are placed

correctly and good moisture

control is maintained during the

placement and the bite is correct.

W h e n c a n t

w h i t e f i l l i n g s

b e c o m p l e t e d ?

1. If too much tooth is

missing, an inlay or crown

may be more appropriate.

2. If decay is too extensive

3. If good moisture isolation

cant be obtained

Not all white lling material is the same:

There are many types of white lling

material your dentist may choose to ll

your tooth with, such as: Glass Ionomer,

Compomers and Composites.

Composites tend to be longer lasting

and more aesthetic, but remember

there are many variations in composites

which will be reected in the price

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and overall result achieved.A m a l g a m s

Mercury is a very powerful Neurotoxin,

which has been shown to escape

from the llings and lodge into

the surrounding tissue.

However the American and English

governing bodies maintain that

it is perfectly safe although many

dentists have stopped using it on

health and aesthetic reasons.

Many men and women report that

on removing these amalgam llings

that the mouth feels fresher and looks

better. The newer white composites

and ceramic inlays can help prevent

tooth cracking and fractures.

W h i te f i l l i n g s /I n l ay s

Unlike silver (amalgam) llings

white lling material sticks to teeth

hence giving the tooth strength.

White llings come in all shades of white

and when colour matched correctly can

appear invisible restoring the natural

appearance of the tooth. This gives an

all white beautiful aesthetic smile.

Your dentist wil l

Numb (place local anaesthetic)around the tooth

In most cases a rubber sheet

rubber dam will be placed over

the tooth, isolating it i.e. providing

good moisture control.

Remove any decay and /or

old ling from the tooth

Wash and dry the tooth, prepare

the tooth with etch which is a

mild acid in order for the glue or

bond to stick the lling in place.

Places the composite lling into the

tooth and sets (cures) the lling insmall increments with a special light.

Trims and carves the lling to

produce a life like tooth.

Local Anaesthetic: Yes

Number of Visits: One

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3.

4.

5.

6.

W h a t h a p p e n s ?

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From making teeth whiter, straighter,

more proportioned and tting in with

the facial structure. Veneers could

be the solution to all your problems

the age perfector for the smile

They can be used to close gaps, x

chipped teeth, worn, discoloured

or misshapen teeth.

Yes they can be expensive, but veneers

are denitely stronger, more aesthetic,

thinner, whiter and of course more natural.

c h a p t e rf i v e

P o r c e l a i nv e n e e r s

AgePerfectingPointersThe anatomy of beautiful

teeth, the colour, shape

and alignment of teeth

all contribute to the

appearance of the smile.

AgePerfectingPointersIn some cases

veneers or branded

Lumineers can be

bonded to teeth,

requiring neither drilling

nor local anaesthetic.

smilescription

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