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Your Dental Health ReportDr Amit Devlukia

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Contents

Your Goals and Wishes ......................................................................................

Your Concerns ....................................................................................................

Tooth notation and Charting ...............................................................................

Radiographs and Clinical Photos........................................................................

Clinical findings and diagnoses...........................................................................

Treatment plan....................................................................................................

Home Care advice ..............................................................................................

Ongoing maintenance once your mouth is healthy.............................................

Don’t keep us a secret! .......................................................................................

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Goals and Wishes

Your Concerns:

1. Overall oral health

2. Bad breath

3. Broken tooth UR side

Your Goals

1. Healthy teeth and gums

2. Straighter teeth

3. Whiter teeth

4. Replacement of gaps

My Concerns:

1. Plaque build up and gums

2. Decay

3. Position of teeth

4. Colour of teeth

5. Worn teeth

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Tooth notation and Dental Chart

Below is a guide to tooth notation in my report

Your Dental Chart

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Radiographs and Clinical Photos

Radiographs

Clinical photographs

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Our comprehensive examination

Below is a guide to our comprehensive and thorough 12 point check completed during your examination.

You will note these points referred to in your treatment plan under the examination below.

1. Jaw joints and muscles: We assess the temporo-mandibular joint for anyclicks and deviations and assess the muscles of mastication fortenderness.

2. Lymph nodes: We check for tenderness and inflammation of the lymphnodes on the neck and face.

3. Intra-oral soft tissues: We check to ensure the soft tissues of the palate;tongue and cheek are free from abnormalities.

4. Oral cancer screening: We check to ensure there are no signs of oralcancer are present.

5. Broken teeth: We check to ensure there are no broken teeth presentwhich would benefit from being restored.

6. Decayed teeth: We check to ensure teeth are free from decay.

7. Possible early decay: We check toensure there are no teeth with earlysigns of decay which could benefit fromadditional protection and fluoridetherapy.

8. Tooth wear: We check your teeth forevidence of three different types of toothwear called attrition, erosion andabrasion.

9. Recession: The check for evidence of gum recession, which can lead totooth sensitivity and root decay.

10.Gum Disease screening: We check the pocketing between your gumsand teeth to ensure your gums are healthy. Gum disease can lead toinflammation and loss of the bone holding your teeth in.

11.Heavily restored teeth: We check for heavily filled teeth,which may be at risk of fracture and benefit from a crown oronlay. Your dentist will discuss your suitability these options.

12.Mercury fillings: We check to inform you of any mercuryfillings present. Some patients exhibit a sensitivity towards mercury.

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TreatmentCourse of Treatment 17318

<AD> Estimated Fee

£3,450.00

Details Provider Length Amount

03/10/2019 EXNP, New Patient ExaminationNormal price £110 currently half price at £55Extra oral tissues: Temporomandibular Joint - bilateral click Lymph nodes - Nothing Abnormal Detected

Intra-Oral Soft Tissues - ridged buccal mucosa

Cancer Check - UR4Broken teeth - NADDecayed teeth - UR4, UL6Defective restorations - NADPossible Early decay - NADTooth Surface loss - UR3, UL3Recession - NADPeriodontal Health - PoorHeavily Restored Teeth to consider cuspal coverage - NAD

Oral hygiene - improvement required, recommended TEPE brushesPlease see www.smilecliniq.com/oral_health.php

AD 00:50 £55.00

03/10/2019 EXRAY-S, Small Radiograph(s)Digital Low Dose radiograph(s)

AD 00:00 £40.00

Hyg & Filling 10/10/2019 @ 18:00 03:35 £635.00

Treatment Plan

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03/10/2019 HYGIENE2, AD 00:30 £95.00Service: Preventative Hygiene TreatmentNotes: Includes basic gum screening, extensive hygiene and stain removal and oral hygiene instructions

03/10/2019 FCO,UL3 I AD 00:40 £95.00Service: Anterior Composite RestorationNotes: Technique - Tooth isolation to prevent moisture/bacterial contamination-Incremental build up of 2mm to reduce shrinkage and post operative stresses-Shade matched and shaped according to occlusal (bite) surface and adjacent teethLocal Anaesthesia: to prevent any pain/discomfortMaterials: Etch for increased micro-mechanical retention for restoration Bond - Optibond FL by Kerr (Reality 5*), high bond strength, low post operative sensitivity

Composite - Venus Diamond or GC G - aenialProperties: High strength, Low shrinkage, Excellent aestheticsReality rated materialsMatrix System - Triodent sectional matrix system if neededPlease see www.smilecliniq.com/whitefillings.php for more information

03/10/2019 FCO,UR3 I AD 00:40 £95.00Service: Anterior Composite RestorationNotes: Technique - Tooth isolation to prevent moisture/bacterial contamination-Incremental build up of 2mm to reduce shrinkage and post operative stresses-Shade matched and shaped according to occlusal (bite) surface and adjacent teethLocal Anaesthesia: to prevent any pain/discomfortMaterials: Etch for increased micro-mechanical retention for restoration Bond - Optibond FL by Kerr (Reality 5*), high bond strength, low post operative sensitivity

Composite - Venus Diamond or GC G - aenialProperties: High strength, Low shrinkage, Excellent aestheticsReality rated materialsMatrix System - Triodent sectional matrix system if neededPlease see www.smilecliniq.com/whitefillings.php for more information

03/10/2019 FCP,UL7 O AD 00:40 £150.00Service: Posterior Composite RestorationNotes: Technique - Tooth isolation to prevent moisture/bacterial contamination-Incremental build up of 2mm to reduce shrinkage and post operative stresses-Shade matched and shaped according to occlusal (bite) surface and adjacent teethLocal Anaesthesia: to prevent any pain/discomfortMaterials: Etch for increased micro-mechanical retention for restoration Bond - Optibond FL by Kerr (Reality 5*), high bond strength, low post operative sensitivity

Composite - Venus Diamond or GC G - aenialProperties: High strength, Low shrinkage, Excellent aesthetics

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Reality rated materialsMatrix System - Triodent sectional matrix system if neededPlease see www.smilecliniq.com/whitefillings.php for more information

03/10/2019 FLUORIDE,UR4 M AD 00:00 £20.00Service: Fluoride ApplicationNotes: Full mouth flouride varnish application

Evidence shows fluoride therapy must be completed twice a year for maximal preventative effect

03/10/2019 SXLA,UR4 AD 00:45 £180.00Service: ExtractionNotes: Local Anaesthesia to prevent any discomfortInstruments: Periotomes and Luxator elevators to gently loosen tooth and preserve bone and reduce post operative pain and swelling

Hyg & RCT UL6 04:00 £645.00

03/10/2019 HYGIENE2, AD 00:30 £95.00Service: Preventative Hygiene TreatmentNotes: Includes basic gum screening, extensive hygiene and stain removal and oral hygiene instructions

03/10/2019 RCT2,UL6 AD 02:00 £550.00Service: Root Canal Treatment

Crown Preparation UL6 01:00 £275.00

03/10/2019 C1, AD 00:40 £0.00Service: Crown Preparation And Impression(s)Notes: Local anaesthesia to prevent any discomfortConservative tooth preparation to keep tooth structure loss as low as possible reducing the chance of post-operative problems and increasing longevity of restorationImpressions using Accurate Flexitime vinylpolysiloxane monophaseimpression material and light-body for fine detail recordingTemporisation and any adjustmentsPlease note research shows, roughly one in five teeth that have been prepared later go on to need a root canaltreatment, although we have found we have a much lower incidence at Smile Cliniq til presentPlease see http://www.smilecliniq.com/dentalcrown-dentist-london.php for more information

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Restoration made by General Dental Council registered laboratory and technicians.please see http://www.smilecliniq.com/dental_crown_london.php for more informationon alternatives, risks and guarantees

03/10/2019 W2, AD 00:20 £275.00Service: Home Whitening Impressions

Crown Fit & Whitening 00:35 £1,150.00

03/10/2019 CEMP1,UL6 AD 00:25 £850.00Service: Zirconia Crown

03/10/2019 W3, AD 00:10 £300.00Service: Home Whitening Trays Fit

Maryland Bridge Preparation 00:00 £0.00

03/10/2019 B1.,UR4 AD 00:00 £0.00Service: Maryland Bridge Prep & Impression

Maryland Bridge Fit 00:00 £650.00

03/10/2019 BMFW,UR5 AD 00:00 £0.00Service: Maryland Wing Fit

03/10/2019 BMF,UR4 AD 00:00 £650.00Service: Maryland Pontic Fit

Treatment Review 00:00 £0.00

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Home Care Advice

1. If using a mouthwash, rinse AT A DIFFERENT TIME to brushing so that youdon’t rinse off the toothpaste after brushing. A daily fluoride mouthwash is advised, such as FLUORIGUARD. For acute gum conditions, CURASEPT mouthwash is advised for 2 weeks

– rinse for one minute at a DIFFERENT time to brushing.

2. Dental floss daily..What is the Right Way to Floss? Starting with about 18 inches of dental floss,

wind most of the tape around each middlefinger, leaving an inch or two of tape to workwith.

Holding the tape tautly between your thumbsand index fingers, slide it gently up-and-downbetween your teeth.

3. Water Pik - like a jet wash over the teeth. You can use Curasept mouthwash in place

of water for added benefit

4. TePes brush use daily Come in a range of sizes, Use the biggest brush that fits through the gap.

Usually this is orange/red at the front andblue/yellow at the back

Push through the gap between your teeth, twistand remove.

Rinse after use – brushes are reusable, todispose of once too bent or frayed.

5. Brushing technique: Brush every surface of yourtooth angling the toothbrush below the gum tosweep the bristles below the gum with gentlepressure. Small circular motions Brushing for 2 minutes twice a day If you are able to invest in an electric

toothbrush, I would advise the Oral B range.

6. Duraphat 5000 ppm toothpaste 2 x daily – DO NOT RINSE OUT AFTERBRUSHING.

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Flouride is the active ingredient in toothpaste which acts to prevent decay and promote early areas of decay to heal where possible. The usual concentration is 1450 (parts per million) ppm

This toothpaste contains over 3x the amount of fluoride compared to standard tooth pastes. 5000ppm opposed to 1450ppm

This is a prescription only toothpaste provided byyour dentist only – this can be purchased fromreception under my prescription.

7. GC Tooth Mousse – after using the above, place a small amount oftooth mousse on your finger and rub into the areas advised (areas ofgum recession, sensitivity and early decay)

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On going maintenance once your mouth is healthy

We put everyone into a risk category for dental decay, gum health and tooth wear according to their past history, and how they presented to us.

Patients are categorised as High risk, Moderate risk or Low risk.

We have put you into risk category High risk at the moment due to the current state of your mouth.

We update this risk category every time Dr. Amit Devlukia carries out a dental health evaluation:

Long term recommendations to maintain / reduce your risk category

Hygiene visits every 3 months to monitor your gums plaque depositsplaque. (As your gums improve, we may be able to reduce this to suit yourindividual needs). We advise you implement our recommendations for cleaning asa daily part of your home care, and keep a good diet low in sugar, fruit sugars, andacids to reduce your decay/tooth wear risk. Professional Fluoride application every 12 months. Fluoride reduces yourdecay rate (meaning less fillings!), and strengthens the enamel preventingsensitivity also, and is toxic to the bacteria in plaque that cause harm to your teethand gums. Use Duraphat 5000 toothpaste daily (prescription only – you can buy thisfrom reception)

Dental Health Evaluations with Amit Devlukia

- these can be combined with one of your hygiene visits, and are advisedevery 6 months Regular routine screening radiographs (X-rays) so that we can monitor thehealth of your teeth. These are advised every 12 months. (However note ifpocketing stabilises then these can be done every 2 years as opposed toyearly).

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DON’T KEEP US A SECRET!In order that we continue to grow as a business, we are always taking on new patients, and of course, the best way we can do that is through word of mouth. I therefore would be most grateful if you would pass on our details to your family/friends that you feel would benefit from our services of general or cosmetic dentistry. If you do recommend someone, don’t forget to ask them to mention you referred them,

so we can send them a letter to say ‘thank you’!

We are also on social media, so if you are too, and you are happy to do so, please rate us on social media

Thank you warmly for choosing us, and we look forward to continuing to look after the health of your mouth, and helping you smile with confidence!Warm regards and thank you

Dr Amit DevlukiaBChD