I have never heard the term’ phase-down’ before but have heard it a few times recently in relation to dental amalgam – the silver filling material long used by dentists to fill back teeth. This is the material that contains mercury.

There really is no evidence that amalgam is harmful to us…either to dental personnel or to you, our patient. There are, however,  real issues regarding its safe disposal in the practice setting and environmental concerns relating to mercury contamination. .

Dentists are being asked to ‘phase down’ its use though the article makes it clear this may take a generation.

So do we still use it at Salisbury House, and if so,  why? Well, yes we do. But only just.

Amalgam is a terrific material in many respects but its appearance lets it down. When first placed an amalgam filling doesn’t look too bad but over the years it tarnishes to almost black. Many patients dislike this and I don’t blame them at all. Modern white filling material often makes a great alternative. White filling material is, however, more difficult to manipulate and takes much longer to place. This is reflected in the cost of white fillings. On occasions we encounter very large fillings that need replacement and  in order to achieve an aesthetic result we have to advise an inlay or onlay (see the practice website for an explanation www.salisburyhousedental.co.uk).

I still have amalgam in the drawer and once or twice a year will use it. It’s great for building up heavily broken down teeth prior to placing a crown and for, well, building up heavily broken down teeth prior to placing a crown. At Salisbury House we have already phased down its use. It’s good to be so far ahead of the game.

Instead of sending Christmas Cards this year the practice is making a donation to SmileTrain – one of Ian’s preferred charities. The charity works in developing countries and provides cleft lip and palate services to children who would otherwise go through life disfigured and disadvantaged. Please look at http://www.smiletrain.org.uk/ for more information. This year one of our patients has also asked to make a donation and though, for reasons of patient confidentiality, I can only name her as Mrs SC we send her our thanks for helping a child with a cleft.

As always it has been a pleasure treating you this year. In many ways it has been a very difficult year and 2012 looks set to be challenging. Thank you for putting your faith in the practice to look after your dental care. We look forward to being of service to you next year too.

Merry Christmas

Ian, Diego, Toni, Shakeel and Francesco

“John Lennon came back from the dentist and gave it to his housekeeper and said to dispose of it ‘or better still give it to your daughter as a souvenir’.”

Now several thoughts spring to mind. Firstly the lack of infection control procedures involving taking an extracted tooth home and giving to the cleaner to give to her daughter! Ugh.

But it had me wondering- how much are your teeth worth to you? it seems JL’s tooth may have been gruesome but, by the sound of it, it wasn’t irreparable by today’s standards. Maybe a root canal treatment followed by a crown could have saved it but without seeing it I can’t really be sure.

In yesteryear many patients were really rather flippant about losing a tooth. Nowadays I find patients rightly expect to keep their teeth. When tooth decay has ravaged a tooth and the decay has spread under the bone then the tooth has had it. Prior to that, providing the gum support is in good order the tooth can usually be salvaged.

Patients that opt to have a savable tooth removed often regret it and end up asking for an implant. An implant will cost around £2400 on average and, whilst this is a lot less than the £19,500 that JL’s tooth was sold for, it’s more than double the cost of a root canal treatment and a well constructed crown. That’s worth thinking about.

Ian

http://ind.pn/qIZzVc

That is woefully inadequate. Eleven minutes is about how long it takes to greet a patient, bring him or her to the consulting room from the reception area, introduce oneself and one’s nurse, make a patient comfortable with a little chit chat and then take a full dental history.

This is what then happens at Salisbury House Dental Practice (SHDP):
I will make you comfortable and will ask why have you come to see us. Do you have an urgent dental problem that requires immediate relief? Do you, perhaps, just want an examination to ensure that your dental health is good? Do you want any changes to the appearance of your teeth? These are all examples of reasons why patients come to our door every week.

I will ask about your past dental history and will discuss your current and past medical history too.

While chatting to you I will have already observed you chatting and will have noticed much about your teeth – how much tooth shows when you smile which can be an indicator of whether you are a night grinder, for example. Indeed, I will have noticed IF you smile, which tells me a lot.
The first part of the clinical examination will be a thorough assessment of the soft tissues of your mouth – the insides of the cheeks, lips, tongue etc. I am looking for lumps and bumps, ulcers, white patches, red patches, swellings etc. Of course, I hope I will find nothing.

The dental examination consists of a thorough examination of each tooth and documenting this on dental software. I will need to look round the teeth several times in order to be thorough.

The gum examination is usually a screening – taking only a few minutes to gain an overall outline view of how good your gum health is. IF it turns out to be poor I would need to undertake periodontal charting which itself can take 15 minutes.

We then discuss and decide which radiographs (X Rays) to take. I use digital radiographs which appear on the screen within seconds of being taken and we will discuss the findings together.

Sometimes this could take seconds…’Everything looks great. I just want to suggest a visit to see the practice hygienist every 3 to 6 months to keep things this good’ or it could take the best part of an hour… ‘Yes you’re right. I see the problems. This is actually quite complex…’

I normally schedule 30 -45 minutes for a New Patient Consultation and if your needs are complex I will need more time. So as not to keep the next patient waiting I will usually invite you back, at no extra cost, for a treatment planning discussion. During the intervening period I will make time to sit down with your notes and radiographs and cogitate. At no extra cost to you.

When we meet again we will normally be able to discuss the treatment required, the schedule and the fees.

This is not possible in eleven minutes.

Remember to visit the practice Facebook page ‘Like It’ and we will send you the Salisbuty House Dental Practice Guide to Dental Health.

Ian Greenwood

Francesco is a Consultant Periodontist at The Eastman Dental Hospital- the UK’s leading postgraduate dental teaching institution. A periodontist is a specialist dentist who manages severe gum problems, helping patients to retain their teeth for longer. When matters have gone too far and teeth are lost, Francesco will be able to place dental implants to retore our patients smiles, comfort and confidence.

I will post a biography soon.

Well, sometimes it is good to start anew so this is the inaugural posting of the Salisbury House Dental Practice blog.

This afternoon we are all taking a break from clinical duties and are doing child protection training with Safechild. Just one of the many things we do in the practice to keep up to date with matters both dental and non-dental.