Peri-Implantitis – A Threat To Dental Implants

Dentist Harminder Sehmi

Dr Harminder Sehmi of the Cygnet Dental Practice discusses the problem and how it can be avoided.

As we have discussed before, dental implants offer an excellent option for anyone looking to replace a missing tooth, or teeth, with a secure and strong alternative. Advances in technology and a more advanced understanding of the process of osseointegration (where the implant fuses with the jawbone) have led us to the point where implant failure is very rare.

This does not mean that we can ignore their aftercare however, and making sure that we keep our implants clean will help us to remain problem free for the maximum time possible.

So what are the main threats to dental implants? These fall into a number of categories. Damage to an implant caused by a blow to the face is an obvious one, and one that we may not be able to avoid. If you play contact sports though, it would be a sensible approach to talk to our Wickford team about using a mouthguard during the activity. General poor oral care is also one of the main reasons for implant failure. This is particularly important in the period immediately following the procedure where it may lead to infections and poor osseointegration. Bad habits such as smoking and excessive drinking, will also increase the chances of a poor outcome.

Peri implantitis overview

One lesser known, but very real threat to a dental implant, is a disease known as peri-implantitis. It is closely related to the better known gum disease, periodontitis, but differs in certain ways.

As with periodontitis, if the area around the implant is not cleaned sufficiently, bacteria will start to multiply. If this is allowed to happen for a period of time, the soft tissue of the gums will start to become inflamed, worsening if not treated. It can also affect the bone structure into which the implant is placed.

There are two main stages of this disease:

Peri-implant mucositis

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Changing The Image Of The ‘British Smile’

Dentist doing examination

The state of the UK population’s teeth is often ridiculed by some living in the USA. Is it justified?

The idea of the British having ugly and discoloured teeth has long been a standard subject of American humour.

British characters are often seen to have crooked teeth, along with what often seems a very strange accent indeed! Although most countries do have stereotypical views on certain attributes of citizens of other countries, is it really true that our teeth are in such poor shape?

In fact, a study a few years ago showed that the British are less likely to have tooth decay than our American counterparts. This may be a symptom of a different medical care system and the fact that the USA has a large population, pockets of which contain families on very low incomes. Without the NHS dental care of the type that we are able to offer at our Wickford practice, regular dental care may be out of the reach for many people.

A whiter smile

What is true is that the Americans do spend more on cosmetic dentistry than those in the UK.  This is probably not surprising as cosmetic dentistry largely came about through the need to improve the smile of Hollywood stars in the industry. As many of the actors and actresses were then heavy smokers, a full screen shot of a smile could have been very unsightly. In order to correct this, dentists provided the first dental veneers to make their smile look as the public expected it to.

Although these veneers were probably fairly rudimentary, it would not be difficult to imagine that those who saw these new ‘perfect’ smiles would want to achieve the same, especially amongst the wealthier classes. With this new awareness that teeth did not have to be ‘as god intended’ the cosmetic dentistry industry was born.

Not just whiter teeth

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The requirement for pre-treatment consultations

treatment discussion

Why these appointments play an important role in your dental care.

Initial consultations at our Wickford dental practice are widely used when a patient is considering a new type of treatment. These are not usually necessary for routine dental care, but they are a critical part of some procedures to ensure the most appropriate treatment and the best outcome for the patient.

Many of our patients lead busy lives and are understandably keen to get started on the treatment straight away. For them, it may seem that an initial consultation is a drain on their already limited time; so today’s blog tries to explain why we consider consultations to be such an important part of the treatment process.

What happens at an initial consultation?

Unlike an examination where a thorough inspection may be made of your overall oral health, a consultation will also include a broader discussion between patient and dentist. There may well be an examination in a clinical consultation, but also an introduction to a treatment such as dental implants for example. This helps to make sure that there is a thorough understanding both of the patient’s desires and circumstances, and, on the patient’s part, what the treatment entails. For a procedure such as implants for example, a patient may have a number of concerns about the treatment, perhaps from reading some unreliable information on the internet. So the initial consultation serves as an excellent opportunity to fully explain the procedure, answer the patient’s questions and assess suitability.

Amongst the questions you are likely to be asked, are the following:

What do you want to achieve from the treatment?

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Professional And ‘Ready Made’ Teeth Whitening Kits Compared

Dr Krupa Thakrar at Cygnet Dental

Using shop bought tooth whitening kits may not be as effective, or as safe, as you might think.

Teeth whitening is, understandably, one of the most popular cosmetic dental treatments currently available. Having nice white teeth is something that most of us would aspire to, given a choice between that or discoloured teeth.

Those who choose to do something about it may not, initially, consult a cosmetic dentist about how best to achieve this, and instead, look to either find a DIY solution or purchase a ready made kit from a shop.

The DIY approach often involves searching YouTube for instructional videos, but we don’t recommend that you do this! Whilst some ‘natural’ whitening tutorials are relatively harmless, though nearly always ineffective, others are very likely to cause serious harm to your teeth and gums.

Safe and effective home whitening kits?

The other option for many is to buy a kit from a shop. The logic behind this is often that if you buy them from a reputable shop, they will be safe and effective. Although this is definitely a better option than randomly buying an unknown brand from an unknown online retailer, there are still some issues involved, issues that aesthetic dentist, Dr Krupa Thakrar explains below:

Poor results?

Before we look at any potential issues when using these kits, it is worth addressing the main reason why people buy them in the first place; namely, to have whiter teeth. The key question then is do they work?

The fact is that if you use these kits, you may well be disappointed with the results. All whitening treatments involve the use of a bleaching ingredient that works to lighten the inner part of the tooth. Typically, this is hydrogen peroxide. Because, with unrestricted use, this is a potentially dangerous substance, its use is regulated. Although a home whitening kit will contain more of this active ingredient than a whitening toothpaste, it is still restricted due to safety concerns. The amount allowed is much less than if the treatment is overseen by a dentist and you should, therefore, not expect the same level of success.

Won’t mask dental problems

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Your Six Monthly Dental Examination

Dentist Harminder Sehmi

Dr Harminder Sehmi explains why it is important to maintain regular visits.

Whether you are young or old, you should always try to see your local dentist for an examination every six months or so. Those in a high risk group, such as diabetics (1), may need to keep these appointments more frequently to be able to keep their teeth and gums in good health.

For most people though, once every six months should be sufficient unless any problems arise in between. If this does happen, you should not wait until your next check up date, but call our Wickford practice to make an appointment to be seen by a dentist as soon as possible.

Visiting us once every six months is a small price to pay for having a healthy mouth. Anyone who has neglected to do this for a lengthy period of time will almost certainly have problems such as sore gums or toothache, and burying your head in the sand is not a good idea when it comes to your oral health!

What happens at your examination?

Whatever your appointment time is, please try to arrive at least ten minutes or so beforehand. This will give our reception team sufficient time for any paperwork (though much of this is now done digitally). Making sure that you are on time allows our dentists to see patients at their allocated times and helps to reduce any delays.

Once the ‘paperwork’ has been done, you will be called in to see one of the clinical team. Once seated in our comfortable dental chairs, we will first of all make sure that your medical records are up to date. Please do be honest with us when we ask you questions about your general health. Neglecting to tell us about a medical condition could, potentially, put you at risk if you need certain treatments. The same applies to any medications that you are on. Blood thinning medication, for example, may mean that you need to receive treatment in hospital in certain instances.

During the examination itself, we look for a number of things. Most obviously, we look for any signs that you may have tooth decay. This can be quite minor at first, but will require treatment even if this is the case. Small cavities will not ‘heal’, and, if left alone, will almost certainly become larger and may even result in a very painful tooth. If we detect any small cavities, we will ask you to arrange a treatment appointment where we can complete a small filling for you. In some cases, very minor work might be completed on the same day.

It is not just your teeth that we inspect though. Your gum health is important and we will look for any signs of gum disease which is often straightforward to reverse if detected early enough. Symptoms such as inflamed or receding gums, means that a thorough clean by one of our hygienist team is necessary to clear the teeth and gum line of any hardened bacterial deposits known as tartar. If the issues have progressed, additional treatment may be required, possibly with a dental specialist.

Finally, we will look for any possible signs of oral cancers. This is a growing problem in the UK, and especially in smokers or heavy drinkers. Signs of possible oral cancers may include the likes of lesions or red or white patches on the tongue. These can be caused by other things too, but if we do detect anything, we will refer you to your GP for further investigation. It is important to have a an additional medical check quickly so that you can receive rapid treatment should anything untoward be uncovered.


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Stop Smoking – Jumping The Gun On ‘Stoptober’!

Dr Suky Ghuman

If you are planning to stop smoking in October, why not now? Says Dr Suky Ghuman of Cygnet Dental.

Traditionally, October is the month for the anti smoking campaign, ‘Stoptober’, run by Public Health England. Throughout the country, there are exhibitions and roadshows, along with general publicity to help people stop smoking.

Although we are a month away from the start of this campaign; if you are thinking of stopping anyway, or are a smoker who hasn’t yet taken action to do so, why not take the step a few weeks earlier?

There are many good reasons to stop smoking. The effect on your pocket is certainly one that deters some people, with a dramatic rise in the price of tobacco products over recent years. Whilst you will obviously benefit financially if you stop smoking, there are other reasons, from a health perspective, why you should do so.


Let’s start with the big one. Most people now understand cancer to be very serious, and potentially fatal. Lung cancer is the one most associated with smoking, but other cancers may be caused by the habit too. One type of cancer which certainly is, is of particular concern to the dentists at the Cygnet Dental Practice in Wickford i.e. mouth cancer.

Oral cancer

Smoking is considered to be the most significant risk factor for oral, or mouth, cancers. Whilst others, such as alcohol, may also contribute, stopping smoking is the biggest thing that you can do to prevent this problem which has seen a rise of just under 70% (1) in the past twenty years.

Oral cancer can prove fatal or life changing (2) and should not be ignored. As part of your regular six monthly check up at our practice, we make sure to check for any potential symptoms that may indicate oral cancers If we do find any, we will refer you to your GP for further investigation. If we do this, please remember that our role is a front line role to detect any changes in your mouth. We are not able to diagnose cancer directly, which is why we refer you to your GP. It may well be that there are other reasons for the signs that we have noted, so please don’t panic if we refer you.

Gum disease

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Fed Up With Your False Teeth?

If so, now is the time to consider dental implants, says Dr Michael Gulnezer.

False teeth, or more specifically, dentures, have been around for a very long time. Evidence has been found of early attempts, using stones or even seashells to replace a missing tooth. This would not have been very successful from a practical viewpoint, but may have achieved some minor success from an aesthetic angle.

Fortunately times have moved on considerably and we are now happy to offer a more practical alternative in the latest dental implants, for those who require them.

Dentures do still have a role to play of course. They do a reasonable job of maintaining the appearance of a full set of teeth, and have a reasonable level of functionality for eating. Despite this though, for some patients, there are restrictions on what they can eat successfully and a lack of stability can also be an issue, with the dentures moving around in the mouth.

Stable and secure implants

Whilst dentures act to replace lost teeth, they can ‘float’ around on the gum surface a little. Dental implants, on the other hand, replace not only the tooth, but the root of the tooth as well. This is an important distinction as placing the new artificial root of the tooth into the jawbone is what gives it its excellent level of stability and strength. With good aftercare, a dental implant can last for twenty years or longer, providing a ‘gold standard’ replacement tooth.

We do know, from talking to some patients of the Cygnet Dental Practice, that one of the biggest deterrents to having dental implants, is the thought of placing the implant into the bone. For those patients, we offer a few words of encouragement.

How ‘painful’ is a dental implant placement?

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Great Reasons To Floss Between Your Teeth

Dentist doing examination

Our hygienist, Samantha Henly, explains why this should be done on a daily basis.

Some people find the process of using dental floss to be tricky. Some attempt to do this and give up, whilst others either don’t attempt it or are not aware of why they should.

In fact, with only around 20% of us using dental floss to clean between our teeth, overcoming this challenge is probably one of the easiest and most significant ways of improving our oral health.

Why you should floss

The most obvious reason to floss between your teeth is to remove any pieces of food that have become stuck there. Nothing says ‘poor hygiene’ more than walking around with a piece of meat or spinach visibly stuck between your teeth. Whilst this may be immediately embarrassing, it is the least of your problems if you leave pieces of food between your teeth for any length of time. Even picking away the food with your fingers may still leave traces and even the smallest morsel of food will eventually break down, with the residual materials often leading to tooth decay.

The other reason to clean between your teeth is to remove bacteria that collect there. There are many different types of bacteria in our mouths, some good, some bad. Those bad bacteria though can lead to gum disease if not removed. This can have serious consequences. Much bacteria is removed when we brush our teeth, but toothbrushes can’t reach in some of the spaces between our teeth and therefore, dental floss is needed.

How to use floss correctly

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Keep Your Mouth Extra Clean When Wearing Braces

teeth and gum cleaning

Avoid dental problems when wearing ‘wire and bracket’ style braces.

Dental braces, or orthodontics, can be used to correct the alignment of your teeth, giving you a better bite, or simply to improve the appearance of your smile. Whatever the reason, many orthodontics, even modern ones, still use a series of wires and brackets to straighten your teeth.

Whilst patients of the Cygnet Dental Practice are able to take advantage of a range of discrete orthodontics that use finer, tooth-coloured materials; even these more user-friendly versions can still create a few problems for those who wear them.

Stay clean

Modern orthodontics may be more discrete and comfortable to wear than older versions, but the wiring used still means that it is easy for food to become trapped in them. Certain foods, spinach being a classic example, may be very visible when this happens, but even those that aren’t, can cause significant harm to your teeth and gums.

Everyone should pay attention to cleaning their teeth each and every day, but our Wickford orthodontic wearers should take special care to keep their teeth and gums clean. If you don’t, trapped food may well lead to decay and gum disease becoming a problem.

Cleaning your teeth

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The Difference Between A Hygienist Clean and A ‘Deep’ Periodontal Clean

A closer look at two different types of cleaning for gum disease problems.

The consequences of gum disease are often not fully understood by the general public.

Spitting the odd bit of blood after cleaning your teeth may not worry you too much, but this is just the start of a problem that, unless treated, could even result in the loss of some of your  teeth.

Whilst prevention is still key to avoiding gum disease, the use of dental procedures are sometimes necessary to restore your gums to good health and prevent further damage.

Dental hygienist cleaning

This is the most commonly carried out type of cleaning, and whilst it can be used to reverse the early stages of gum disease, it can also be considered to be a preventative treatment. We recommend that our Wickford and Rayleigh patients have their teeth professionally cleaned by our hygienist at least once every six months.

The procedure is non invasive and no anaesthetic is necessary. Any hardened bacterial deposits will be removed with a manual implement before the rest is painlessly shattered using a sonic tool. Finally, your teeth will be given a thorough clean using a high speed brush. Most patients find this to be a comfortable and effective procedure that leaves their mouth feeling much fresher and cleaner.

Deep clean

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