Cosmetic Dentistry

Professional tooth whitening is the process by which teeth are made lighter and brighter in colour. Many would agree that tooth colour is one of the most important factors which contributes to a beautiful smile. Unfortunately, teeth are not always as light as we would like them to be and stains and discolouration can make them appear dull in colour.

There is an overwhelming amount of information in the media about tooth whitening and it can be confusing to know whether or not you will be a suitable candidate to whiten your teeth. That is why we encourage our patients to ask questions and seek advice from our dental professionals as they will be able to explain your options and help you achieve a whiter, brighter smile, which can be a confidence booster.

There are two main types of staining which can affect teeth, extrinsic and intrinsic staining and understanding which one is present will allow you and your dentist to decide which treatment is appropriate for your specific situation.

Extrinsic stains are superficial and are found on the outermost surface of teeth (enamel). They are largely due to environmental factors such as smoking and pigments in foods and beverages. Intrinsic stains are deeper stains which affect the inner layers of teeth (dentine). They usually occur before birth or during childhood and can be due to oral trauma; use of certain medications such as tetracycline antibiotics in childhood; over-exposure to fluoride and discolouration of teeth with age.

Extrinsic stains respond well to professional tooth whitening and can be removed through mechanical methods such as:

Tooth polishing using prophylaxis paste,

Airflow (hyperlnk),

Toothpaste.

Intrinsic stains are harder to treat with professional tooth whitening and do not always respond as quickly or predictably. More extensive dental treatment such as porcelain veneers, crowns and composite bonding may be required to achieve a whiter smile.

There are two types of professional tooth whitening:

In-office treatments and

Take-home products.

At Heswall Dental Practice, we offer take-home tooth whitening kits for our patients.

Professional tooth whitening takes place over several visits.

A full mouth examination will be carried out by your dentist to determine whether you are a good candidate for tooth whitening. You must be dentally fit before whitening begins, which means that you may require treatment if you have any cavities or gum disease.

Impressions (moulds) of your teeth will be taken to make whitening trays (clear mouthguards). Your dentist may take a photograph of your teeth before whitening begins so that they have a baseline to work from. A standardised shade guide will be used to record the shade of your teeth. A demonstration will be carried out in surgery to show you where to apply the bleaching gel and how to insert and remove the whitening trays. Tooth whitening gel will be applied to the trays and worn for a specified period of time as advised by your dentist. Your dentist will provide you with a tooth whitening instruction leaflet to take home (hyerplink tooth whitening instruction leaflet).

After you have completed your whitening regime, you will attend a review appointment where your dentist will examine your teeth to evaluate the whitening treatment’s success.

Every treatment has risks as well as benefits. It is important to have an understanding of the risks involved with tooth whitening before you proceed with treatment. A discussion over potential risks and limitations of tooth whitening will take place during your initial consultation with your dentist. Risks include:

Tooth sensitivity

Sensitivity to temperature changes is the most common risk associated with tooth whitening. It is important to inform your dentist of any pre-existing sensitivity issues before commencing tooth whitening as modifications to your treatment can be made to reduce the risk. If you experience sensitivity, you should stop whitening for several days. Sensitive toothpaste can be applied to your bleaching trays and rubbed into your teeth to ease discomfort. If you are concerned, please contact the dental practice for further advice.

Gum and soft tissue irritation

If excess whitening gel is used within the trays, it can cause temporary irritation of the gums and soft tissues. It is important to carefully follow instructions from your dentist. Do not exceed the recommended amount of whitening gel within the trays.

Leaking fillings or cavities

Leaking fillings or dental decay can allow whitening gel to enter the inside of a tooth and cause irritation to the nerve. To reduce this risk, a full mouth examination will be carried out prior to treatment commencing and teeth requiring restorations will be identified.

Cervical abrasion/erosion

Cervical abrasions are grooves or notches found near the neck of teeth (where the tooth meets the gum). These grooves are generally darker in colour and lack enamel. They do not lighten with tooth whitening and have the potential to allow whitening gel to penetrate the teeth and damage the nerves. These areas should not be whitened and should be filled after whitening is complete.

Root resorption

Root resorption is when the outside or inside of the tooth’s root dissolves. Teeth which have undergone whitening are at an increased risk of root resorption.

Effects on fillings/crowns

Tooth whitening lightens teeth, but does not affect the colour of existing crowns or fillings. Meaning that white fillings or crowns at the front of the mouth may need to be replaced to match the shade of whitened teeth.

Level of whitening

We cannot predict how light your teeth will be following treatment. Individuals respond differently to tooth whitening and although most peoples’ teeth are significantly whiter, there may be some who only improve by one to two shades.

Relapse

There may be a gradual relapse in shade once whitening is complete as day to day eating and drinking can result in a regression of shade through the normal staining process. This can normally be managed through a good oral hygiene maintenance program at home. Periodically you may be required to wear you trays to maintain the shade of whitened teeth.

Whilst most patients will qualify for tooth whitening, some may not be eligible. There are however several alternative treatment options to lighten teeth:

Airflow (hyperlink),

Professional tooth cleaning by a dentist or dental therapist to remove extrinsic staining (hyperlink to dental hygiene),

Porcelain veneers,

Composite bonding,

Crowns.

Please see our Private Fee List (hyperlink) for costings.

Guided Biofilm Therapy (GBT) is a method of controlling dental biofilm. It is full mouth deep clean, provided as a spa-like experience that will make your mouth feel cleaner and healthier.

Dental biofilm, also known as dental plaque contains millions of bacteria and can be visible on your teeth and gums as a jelly-like substance. It is the cause of dental decay, periodontal diseases, infections around dental implants and white spots around orthodontic braces. Periodontitis caused by dental biofilm has also been associated with an increased risk of systemic diseases such as cardiovascular and respiratory disease, arthritis or diabetes.

GBT is a systematic, predictable solution for dental biofilm management, which uses state of the art AIRFLOW®, PERIOFLOW® and PIEZON® technologies.

Treatment is given with the highest level of comfort, safety and efficiency. Compared to conventional methods of removing dental plaque and managing biofilm, GBT is:

• Minimally invasive and gentle

• Comfortable

• Does not use rubber cups, brushes or messy pastes

• Reduces the need for hand instruments

Regular oral hygiene, combined with GBT keeps dental biofilm under control, which results in better oral and systemic health.

Both adult and child patients can have GBT. It is an effective treatment for all patients especially those with a high risk of developing dental decay, patients with gum disease, patients who have dental implants, and patients with orthodontic braces.

GBT is based on an individual patient diagnosis and risk assessments. You will be given an extensive examination before treatment is prescribed, so that it may be tailored to your needs.

Before treatment, the biofilm is highlighted by being disclosed with a dye solution. This means that your dentist or therapist can show you where the biofilm has accumulated and teach you how to remove these deposits more thoroughly at home. It also ensures that our focus is guided by the disclosed biofilm during the treatment, so you achieve a truly professional clean.

Soft deposits and young tartar are then easily removed with AIRFLOW® and PERIOFLOW® which use a warm, fine mist with gentle powders to work above and below the gumline for a comfortable experience. If needed, any hard deposits are removed with PIEZON® PS No Pain piezoceramic instruments.

For further information please visit https://www.ems-dental.com/en/guided-biofilm-therapy

There are no risks. GBT is safe and effective, it gives a superior cleaning compared to traditional methods and is more comfortable.

Conventional biofilm removal is traditionally performed by the removal of tartar with hand instruments and scalers, which may be painful, invasive, and scratch dental and implant surfaces. This is followed by polishing with rotary rubber cups and brushes, which is time-consuming and often messy. Many areas cannot be reached, and the gingiva will be affected mechanically.

Treatment costs and appointment times will vary with your individual need. Prices start at £85.

Botulinum Toxin Type A is a naturally derived protein. It acts by blocking the release of chemicals from nerve endings that supply our body’s muscles. This stops the muscles from being able to contract.

Botulinum Toxin Type A can reduce the strength of facial muscles that cause lines and wrinkles. The most commonly treated areas are horizontal forehead lines, vertical frown lines and smile lines at the side of the eyes.

Botulinum Toxin Type A has been used for over two decades cosmetically. Side effects are rare.

Botulinum Toxin Type A is injected with a fine needle into specific muscles with very minor discomfort. The injection technique is extremely important and it is essential that you consult an appropriately trained clinician to get the best results.

It usually takes Botulinum Toxin Type A three to seven days to take full effect and lasts three to six months. After this time muscle action will gradually return and the lines and wrinkles will re-appear. You can then choose to be re-treated. Lines and wrinkles often appear less severe with re-treatments because the muscles are being trained to relax.

As dentists we have extensive knowledge of head and neck anatomy and are experts at administering comfortable injections. We take time to discuss your aesthetic concerns and use techniques to ensure accurate site administration. We pride ourselves in offering a professional and confidential service to our ever-increasing base of loyal clients.