Dr V.J. Vadgama BDS (Lond) LDSRCS (Eng) and Associates

Web site: www.Dental-Cosmetics.co.uk

E-mail: info@Dental-Cosmetics.co.uk

Dentistry of Distinction and Excellencefor Private Patients

CENTRE FOR COSMETICAND RECONSTRUCTIVE

DENTISTRY

Dr.Vadgama qualified from University College London Dental School in 1981. TheRoyal College of surgeons awarded him LDS by examination in 1982. He is a fellowand Diplomat of the International Congress of Oral Irnplantologist. He takes a keeninterest in cosmetic & aesthetic dentistry and is a member of the Association ofDental Implantology (U.K) and the Academy of American Aesthetic Dentistry (USA).Between 1995 and 1997, he completed a two year intensive training in ImplantDentistry and Restorative Dentistry at the prestigious Eastman Dental Institute forDental postgraduate studies. In the early 1980’s, he established two practices inKent, when initially most patients received their treatment from a public fundedgovernment system and before hi-tech modern technology and evidence baseddental knowledge had made an impact on dentistry. Equipment and techniques wenow taken for granted had not even been thought of, despite these limitations, DrVadgama quickly established both practice’s that became known for their excellenceand very personal relationship with each individual patient. Between 1998 to 1999,he undertook a programme to completely refurbish both the practice’s with the stateof the art facilities together with the installation of hi-tech imaging equipment and thepursuit for excellence is a continuous and evolving routine embedded into ourpractice philosophy. In early 2001, the practice was awarded the prestigiousinvestors in people award, and at present, the practice is developing an onlineinformation database and integration of dental payment schemes so that patientscan receive cosmetic and aesthetic dental procedures information, whereby thepatient involvement in understanding the cost and consent process is clear andsimple to grasp. The pursuit for excellence and offering evidence based Cosmeticand Implant Reconstructive Dentistry treatment options to the patients continues intothe next millennium.

In The Beginnings…

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WOODBURY DENTAL PRACTICECENTRE FOR COSMETIC AND RECONSTRUCTIVE DENTISTRY

149 High Street, Tenterden, Kent. TN30 6JSTel: 01580 762323 Fax: 01580 766140

www.dental-cosmetics.co.uk

Our MissionTo practice the art and science of Cosmetic and Reconstructive dentistry to attain

desired aesthetic and functional enhancement using evidence based protocols.

Our practice had been established for over 20 years and we have built a reputationfor being leaders in our field.

We pride ourselves in provision of dentistry of distinction and excellence in modern,caring and relaxed surroundings.

To achieve and surpass our patients expectations we utilise state of the art facilitiesand our team members believe in continuing professional development.

We have compiled this information brochure in simple and clear format so that ourpatients can obtain a quick insight into the procedures and techniques we employ to

achieve the desired Aesthetic and Cosmetic enhancements.

We would welcome comments and suggestions in order to further improve thecontent of our brochure and these can be communicated to the above address or

submitted via our web site e-mail: feedback@dental-cosmetics.co.uk

Dentistry of Distinction and Excellence.

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Welcome to the Practice

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The aim of our long established practiceis to provide you with the highest possible level of care, tailored to your needs, withemphasis on prevention with minimumintervention and treatment. The philosophy of our team ofReceptionists, Nurses, Dental Technicianand Dentist is always to provide this carein a relaxed and friendly atmosphere.

Freedom of Choice

Our team, together with the help of our practice co-ordinator will discuss all thetreatment options and with the guidance of the dentist, formulate a suitabletreatment plan. The cost implication of all treatment will be fully discussed beforeproceeding with the treatment and your budget consideration will be taken intoaccount.

Care and Reassurance

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At our dental practice you will not onlyreceive the best dental care possible, but more than that, a personal, caring attitudewhere your wishes are considered as well as your dental needs.

The use of multimedia education is very valuable in communicating the procedures in simple format to the patients. Use of CASEY(Clinically advanced learningeducation system) forms a vital part in informing patients about the procedures and options available to them.

We reassure all our patients of painless anaesthetic procedures using specialflavoured gels and needle free injection techniques.

We strive for high professional standards and believe in total commitment to patientcare. All our team members attend numerous postgraduate courses, so that youmay benefit from the latest proven techniques of treatment.

Examination and Diagnosis

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Our practice philosophy is prevention! Wewant to help you prevent dental problems and avoid treatment. Before embarkingupon any dental treatment it is essentialto have a good understanding of yourmouth which requires a very thoroughpatient examination/ survey.

Our aim is to enhance your smile and confidence andhelp you to maintain healthy teeth and gums for life.

The full patient examination

This includes:• A complete medical history questionnaire.• A detailed pre-examination questionnaire

(done by the dentist)• A full clinical examination which includes:

-Oral cancer screening-Gum condition assessment-Examining the condition of all teeth and existing restorations-Analysis of biting patterns and tooth wear.

• Special investigations-Modern radiographic scans-Photographic computer imaging using our intra-oral camera-Study models

Advanced Technology

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We have the latest advanced pieces of equipment to enable us tocarry out efficient, high quality dentistry for you.

Intra-oral Camera and X-raysUsing the latest fibre-optictechnology, a micro camera cannow be used inside your mouth togive an immediate computerimage of you gums and teeth.

Cad-Cam one visit ceramic restorationsWe can now fabricate ceramic restorations in asingle visit. These restorations are verybiocompatible and have wear and functioncharacteristics similar to enamel. Compared toother restorative systems, they exhibit minimalcomplications rate.

Radiograph We use the latestradiographic imaging techniquesto allow an accurate evaluation ofyour whole mouth.

Sterilisation

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We would like to reassure our patientsthat cross infection procedures arefollowed vigorously to provide maximumprotection. All the instruments areautoclaved (Sterilised in high pressuresteam) as in hospitals.

Sterilisation procedures are donebetween every patient and your future issafe in our hands.

A list of what our practice follows every day.

• Scrub hands before and after each appointment and always put on a new pair of disposable gloves.

• Wear gloves and protective clothing.

• All instruments are sterilised with an autoclave, hand pieces are always heat sterilised between patients.

• Use protective barriers on exposed surfaces and disinfect all other surfaces according to government standards.

• Dispose of biodental waste and sharp instruments in safe containers provided through a biomedical disposal

company.

• Staff members are vaccinated for hepatitis B

• Regularly updated infection control procedures for all staff members.

To ensure that the sterilisation proceduresare to the highest standard, all ourequipment is certified and servicedregularly.

Prevention

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To maintain healthy teeth and gums for life requires good oral hygiene habits to be practiced from an early age. Once good dietary and oral habits are formed,maintenance becomes easy and regular visits to the dentist become a comfortable routine.

After eating sweetswait 20 minutes.

Proper Brushing.

Use Flouride Tooth Paste.

Effective Flossing.

Early Prevention and Children’s Dentistry

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Our youngest patients come in to look at our gadgets and play with the chair (to them it’s a space ship) at two and a half years of age. By the time they’re three they thoroughly enjoy coming to visit us; there are not many places where they have so much fun and receive so much attention. And at the same time we check their teeth

What is a sealant?• Sealants are clear or white plastic that are placed in the grooves of the biting

surface of back teeth

Why are sealants important?• Back teeth have deep grooves and pitsthat are very difficult to keep clean. Food collects in these grooves. Every time youeat, the bacteria in plaque forms acid.Without sealants, these acid attacks cancause the enamel to break down and you get a cavity.

How are sealants placed?• It’s easy to place sealants, you don’t

even have to be numb.• First we thoroughly clean and dry the

teeth.• A blue conditioning solution is applied,• Then the sealant material is brushed into

the grooves.• Some types of sealant harden on their

own, while others harden when exposedto a special light.

Benefits

Prevention is always better then cure.Fluoride, and the fissure sealants wenow use, ensure that fillings arealmost never needed. But if they are,tiny white fillings set by “magic” lightsare a fascinating experience.

Healthy Gums for Life

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Most of us suffer from some level of gum problems in our life time. Red, swollen,tender and bleeding gums are a sign of gum disease. This is often associated with constant bad breath or bad taste and mobile teeth to a varying degree. As patientscan have gum disease and not be aware or exhibit all the above symptoms, ourpractice policy is to monitor the gum health of every patient and formulate aprevention plan to treat and maintain optimum gum health.

Most treatments for adult periodontitis focus primarily on reducing the number of bacteria on the surface of your teeth. For example, your dental professional is likely to perform SRP (scaling and root planing). This is an important part of your treatment because periodontal disease begins with a bacterial infection on the tooth surface, and by reducing the number of bacteria, the symptoms of periodontitis such as bleeding can be reduced.

Recent research has shown that it is also important to suppress your body’s overproduction of gum- and tissue-destroying enzymes. That’s where PeriostatÆ comes in. It is the first and only medication that works by reducing the activity of the enzymes that destroy tooth and gum tissue. PeriostatÆ is available only by prescription from your dentist or periodontist and should be taken in conjunction with SRP delivered by your dental professional to reduce pocket depths and improve clinical attachment levels.

Before gum treatment After gum treatment

Most patients are given a choice of whether they would prefer to have their failed or leaky amalgam fillings replaced with ceramic material. These tooth colouredrestorations are, either made from ceramic blocks using CAD- CAM technology or,built layer by layer and bonded to the tooth surface with a special bonding technique. Each tooth requires thorough assessment and our practice policy is to give you allthe pros and cons so that you can make the right choice.

Tooth Coloured Restorations

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Before

After

Tooth Replacement with Fixed Bridges

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Before After

Why have a bridge?Having a bridge placed after a tooth has been lost can prevent a chain reaction of problems that would affect your entire mouth. A bridge is an excellent way to replace a missing tooth and keep a good looking smile. It’s custom crafted in a dentallaboratory to precisely fit your teeth. A missing tooth really changes a persons smile, but a bridge is a good way to get your smile back.

How to place a bridge.• The first thing we do is make sure it’s pain free.• Then we remove any decay and shape the teeth with a comfortable air driven device.• Impressions are taken, these are then used to make accurate working models of

your teeth.• A temporary bridge is then made for you to use until the dental lab makes your new

bridge.• Then at your next visit your new bridge will be tried in and when it looks good and

fits well it will be cemented in place.

I was very distressed with a dentureprovided to replace one of my front teeth asl could not chew most food comfortably.Ever since I had the denture replaced withfixed adhesive bridgework, my confidence toeat almost any food item has improvedimmensely.

Cosmetic Dentistry

There are many things that terrific smiles have in common. Firstly the teeth are all straight and not crooked, they are all evenly spaced with no gaps. They are whiteand not stained, the top teeth show when you smile but not the gums. The gum line is smooth and not uneven, and lastly the edges of the top teeth smoothly follow the curve of the lower lip.

The goal of cosmetic dentistry is to turn an average smile in to a terrific smile.

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BeforePorcelain Veneers

AfterPorcelain Veneers

I was very unhappy with my front spacedand stained teeth. Having porcelain veneersenhanced my smile and confidence in acouple of visits. The improvements andbenefits were immediate.

Orthodontic treatment (wearing of braces) can create beautiful smiles. As it is easier to move children’s teeth, we assess each child’s orthodontic requirement at an early age and refer to an orthodontic specialist as soon as the child is ready to proceedwith treatment.

The availability of tooth coloured brackets and the scientific breakthrough in materialshas made it possible to realign and move teeth with great precision. The use ofnickel and titanium arch wires enable the orthodontist to move teeth in a muchshorter time with more control. However, it is very important for patients tounderstand that once the teeth have been moved into a good position the patientshas to wear a retainer for an appropriate length of time to ensure that the teeth donot relapse back in to their old position.

Orthodontic Dentistry

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Before After

Lingual Orthodontics (Adult)

Very often adult patients are discouraged from undertaking orthodontic treatmentdue to the notion that they will have to wear braces similar to the visible brackets and wire braces commonly worn by children. Children however are less fussy, whereas adults often reject the visible brackets. Now with the advent of invisible brackets it is possible to move teeth into a more aesthetic position without the unsightly wires and the visible brackets. These brackets are fixed on the inside surface of the teeth and their nickel titanium arch wires are used to move teeth safely and precisely into the desired position.

The treatment normally takes 9 to 15 months and once the final position is achieved the braces are deactivated and left in situ for a further appropriate period to retainthe teeth in their final position. Thus the need to wear a removable retainer is notnecessary.

Most adults are happy to wear these invisible brackets as they can continue withtheir day to day activity while their teeth are gently being moved into perfectalignment - the result is a pain free beautiful SMILE!

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Before After

You can now have a brightwhite smile safely andeffectively.

You can choose from our inoffice procedure, which canbe completed within anhours. The procedure is quickand pain free as we usespecially formulated gentlebleaching agents. Or a homekit which will take a couple ofweeks to achieve the desiredresults. The home bleachingprocedure involves goodcompliance from the patients.

Each case is analysed forsuitability and most patientswho have their own teeth canbenefit from a beautiful smile.

Most patients can benefit from tooth whitening procedure, however theenhancement will only last for a couple of years and will require re-treatment. Ifpatients request long term enhancement to improve their smile, placement ofporcelain veneers is an excellent option to consider.

Bleaching Options

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Before

Aging

Smoking

Genetic

After

Microabrasion Technology

Air abrasion is used to remove small amounts of decay. This works by using a mixtureof air and powder. By controlling the intensity of both the air and powder we can make this virtually pain free. This also means that there is no need for us to give you injections so when you leave our office you wonít have the irritation of a numb lip.

The Air Abrasion device that we use isstate-of-the-art. Its technologyeliminates the odour, noise, vibration,micro-cracks and, in most cases, noinjections are required. After the tooth isprepared, an adhesive fluoride toothcoloured sealant restoration is placedand set hard with a blue high intensitylight, lasers or chemically cured.

Air Abrasion is perfect for children andadults. Most cavities that are detectedearly can be treated immediatelywithout a drill and without a needle. Thetooth is then restored with naturallooking materials to strengthen andprotect the remaining tooth structure.Most children are not even aware ofwhat the dentist is doing. Fewer dentalappointments for the young patient areusually required because with AirAbrasion many more procedures canbe completed in a single appointment!

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What are benefits of the Waterlase(TM) ?

• The Waterlase(TM) significantly improves patients’ comfort in the dentist’s chair:98.5% of patients treated with the Waterlase(TM) system reported no discomfortduring the procedure in a randomised, double-blind clinical trial conducted at theUniversity of the Pacific.• Because it does not cause heat or vibration in the mouth, Waterlase(TM) may ease the pain and anxiety of patients who fear the vibration and high-pitched whine oftraditional drills. In contrast, the Waterlase(TM) makes a gentle “tapping” noise.• Waterlase(TM) uses a cool-water spray to cut teeth without generating heat.Conventional drills and lasers can overheat teeth during procedures, inducingdiscomfort and irreversibly damaging the soft tissue or pulp underneath.

What is the Waterlase(TM) ?

• The Waterlase(TM) system is arevolutionary new dental device thatuses laser-energized water to cut teeth.

• BIOLASE received FDA clearance tomarket the Waterlase(TM) Millennium® system for use on hard tissue (teeth) onOctober 9, 1998.

• This combination of laser energy andwater-spray, called “HydroKinetic®tissue cutting system,” is a patentedtechnology invented by BIOLASEscientists and engineers.

How does Waterlase(TM) work?

• The Waterlase(TM) system uses laserenergized water to cut teeth.

• The Waterlase(TM) emits a laserbeam that energizes a highly precisespray of air and water.

• Water droplets absorb the laserenergy and become laser-energizedwater particles that, when directed atthe tooth, rapidly remove enamel,dentin and decay/caries

Laser Technology

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Implant Dentistry (single tooth)

I lost my front tooth due to an accident. Iwas given very many different options onhow to replace it after looking at them all Ichose to have an implant placed. This wasone of the best decisions I have ever madebecause not only does it look like myoriginal tooth but I can treat like my owntooth.

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Above, four stages in modern implant therapy.

Forty years ago losing all our natural teeth was normal. Dentures were very common so much so that in many parts of the country a set was a present for a 21st birthday!

Today it is no longer necessary to suffer the loss of self confidence and the dietary restrictions often associated with dentures. It is possible to eat an apple in publicwithout embarrassment.

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Implant Dentistry (few tooth)

It was only after I lost a couple of myback teeth, I realised how difficult it wasto eat certain foods. I tried to adapt towearing a denture, but was unable towear it as food continually got under it, Idiscarded the denture soon after it wasmade for me.I have now had these missing teethreplaced with an implant retainedbridge, and they feel just like my naturalteeth. I now make great effort inmaintaining my new teeth.

When a few teeth are missing, replacement of missing teeth retained with implants, now is the preferred option. Reconstruction with implants will preserve bone andenhance aesthetics.

Implant Dentistry (full mouth)

We both decided to get rid of our dentures as they had causednumerous problems and the inability to eat our favourite fooditems was the main reason we opted for implant retained fixedteeth. Dr Vadgama and his team, were marvellous and the wholeprocedure which was fairly complex was completed over a 12months period. The most amazing aspect of the treatment wasthat the pain and discomfort we anticipated from the surgeryinvolved was so minimal that we are still unable to comprehendhow easy and pain free the whole procedure was.

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What are implants?Missing teeth can often be replaced by implants. Implants act like roots of teeth.After they have been fitted and have healed in place, dentures or crowns may beattached to them. When dentures are held in place by implants they do not sliparound. If crowns are fitted on implants they act like normal teeth

The option to have missing teeth replaced with dental implants is now a verypredictable and safe procedure. The benefits of replacing dentures with fixed teeth retained with dental implants can have a profound positive effect on the patientslifestyle .Ability to chew most items of food and smile confidently, normally, enhances most patients outlook to socialising.

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Tea Time Teeth

The technique, developed in Sweden,can be done for less than half the costof traditional dental implant surgery.

The method is faster and lessexpensive because the hardwarecomes “off the shelf”, usingstandardised fittings into which the teethare housed.

Prof Per-Ingvar Branemark, said thatwith the old method, implanted titaniumscrews were left sleeping in the bottomjaw for about three months before anew round of operations to fix and alignthe teeth individually. He said: “Thewhole process would take six monthsand cost £12,000 to £15,000.” The newsystem, developed by Prof Per-IngvarBranemark, from Gothenberg, costsabout £9,500.00

Now you can get a new smile in less than a day

A REVOLUTIONARY technique that gives patients a new set of implanted teethwithin a day, instead of months, has been successfully used by a British dental teamfor the first time.

The new procedure involves two ready-made plates. The first plate is screwed into the jaw and receives a second plate into which the teeth will be screwed. The screws on which the teeth are fixed go through to the first plate, making everything secure.

When the second plate is in place, impressions are taken for alignment with theupper jaw. The second plate goes to the dental technician with the impressions, who makes the teeth and fits them to the plate. The second plate, with new teeth, is then fitted to the patient’s jaw.

Implant and Sinus Bone Grafting

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Even though some patients are medically fit and healthy to have implant therapy in some cases they lack enough bone to support implants. Long term success ofimplants depends on the availability of good dense bone and in most cases where there is a deficiency in bone we can graft either “synthetic” or “patients own bone”and create a sound foundation to support implants.

Very often, we use guided bone regeneration technology to build and fill bonedefects. The procedure involves using resorable and non-resorable membranes orbone expansion techniques to increase the bone volume.

The procedure can vary from minorgrafting around a signal implant to sinus elevation procedure and graftsupporting several implants.

Bone grafting into sockets left after anextraction is a simple procedure thatpreserves good bone height and in mostcases no further grafting is required. All bone grafts require 4-10 months to healand mature.

To gain enough height for implants, a bone graft canbe placed into the sinus. This graft will serve as a newfoundation to place implants.

Bone Graft

MaxillarySinus

MaxillarySinus

New crowns can then be placed onto the implantsrestoring function and esthetics. Without this procedurea fixed bridge could not be fabricated.

Empty socketimmediately aftertooth extraction.

Socket filled withBioplant HTR-24immediately aftertooth extraction(Advanced ExtractionTherapy)

Socket shown afterone year healing withBioplant HTR-24acting as the matrixfor generating newbone

U N T R E A T E D T R E A T E D

Untreated socketshown two years postextraction. Note thebone loss of 40%to 60%

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Osteodistraction

OsteoGenic Distraction is a process where by we can accomplish bone and softtissue enhancement and lengthening. This avoids the need for conventional boneand soft tissue grafting and streamlines the surgical procedure.

The procedure is similar to placing an implant and employs monofocal distraction,osteogenic principals. Once the distracter is inserted it is left in latency to heal for 7 days. Once this time is up it is adjusted 1mm per day until the desired length isachieved. The device can then be removed and replaced with a screw type implant.

Benefits.• Increases bone and soft tissue volume without the need for bone grafting/• Streamlines the surgical procedure.• No need to use synthetic bone graft material.• Strong and reliable.Enables us to obtain more soft tissue for improved aesthetic

and profile emergence of the implant retained teeth.

After 7 day latency,begin distraction at1mm per day.

Insert ACE DentalImplant into newlyformed bone mass.

Packaged Sterileand mounted foreasy insertion.

7 day latency healing screwin place prior to distraction.

Smile Makeover

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The goal of Cosmetic dentistry is to turn an averagesmile in to a terrific one.It is done by analysing every aspect of the smile, andthen correcting the problems one by one.

What things do terrific smiles have in common?• Smiles have a lot of things in common, The teeth are

straight not crooked.• They’re evenly spaced with no gaps.• They’re white not stained.• The top teeth show when you smile, but not the gums• The gum line is smooth not uneven.• The edges of the top teeth smoothly follow the curve

of the lower lip

Procedures that can be done to make aterrific smile

Any problem that you have with your smile there isalways something that can be done to correct it. Hereare just some of the choices:• Implants • All ceramic crowns• Bridges • Lingual Orthodontics/ Normal Orthodontics• Tooth whitening• Veneers • Tooth coloured restorations.

Benefits of having a terrific smile

• It gives you more confidence.• Makes you feel younger.• The teeth are easier to keep clean.• So leads to a healthier oral status.

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Many people are looking for that slightly fuller shape for their chin. Just a touch ofadditional volume can make an enormous difference in your appearance. Orperhaps you want a rounder, more sensuous line along your cheeks? And lipfashions are always changing with the times.

Q-Med has three approved products within facial aesthetics which together canmeet various correctional needs. Their products RESTYLANE, RESTYLANE FineLines and PERLANE offer you a natural safe and long-lasting beauty lift. No otherinjectable implant can offer this concept.

These are the results that Restylane can give you!

RESTYLANEis intended for wrinkle correction and lipenhancements

RESTYLANE Fine Linesis used for correcting thin superficial lines,for example around the mouth, foreheadlines and smile lines

PERLANEcan be used for shaping facial contours,such as cheeks and chin, correcting deepfolds, and for volume augmentation of thelips.

Restylane

Before After

CAD-CAM Technology

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What is the CEREC 3?CEREC 3 means we can quickly and economicallyrestore damaged teeth using a durable ceramicmaterial that matches the natural colour of other teethin your mouth. CEREC is an acronym for Chair sideEconomical Restoration of Esthetic Ceramics

The restoration material: Natural ceramic.Durable and attractive. Just like real enamel.CEREC restorations are made from a ceramicmaterial from a natural substance that isparticularly compatible with the body. TheCEREC ceramic has the same characteristicsas normal, healthy dental enamel.

CEREC conserves the original enamel andtherefore the restoration will last a long time.

CEREC restorations are almost as strong asdental enamel the hardest of all materials in thehuman body. This strength and durabilitycomes from the ceramic material and also thevery careful bonding of the restoration to thetooth.

Yet this is not enough : We always try toconserve as much of the original dentalmaterial as possible. The CEREC method isideal for this. A CEREC restoration, bondedfirmly and durably gives your teeth greatstability. This means that we can frequentlydispense with the need to have a full crown.This has been proven time and time again forover a decade, in restorations all over the world

What can it be used for?

Partial and full crowns

Veneers, inlays, onlays

& All other single-tooth restorations

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TMJ syndrome is a cycle of pain,muscle spasms, and joint imbalance inthe area where the jaw meets the skull.Five muscles support this joint.Clenching or grinding the teeth, a badbite caused by missing teeth or poorly-aligned teeth, a blow to the joint,arthritis or emotional stress, can be thecause of this.

Here’s how it worksYou place the sensor in patientís mouth using a special handle and cable assembly.As the patient bites on the ultra-thin sensor, the T-scan II software serially scans anddisplays the bite on our computer screen.

The force and timing of the tooth contacts are shown in easily understandablecolour-coded contour images. These allow instant diagnosis of the occlusion, as wellas instant MIP, centre of force and force trajectory.

TMJ Problems

Bite Appliance

Snoring

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Snoring affects 45 per cent of the populationfrom time to time and an estimated 25 percent of people are habitual snorers. There area number of reasons why you may snore.

• Age can be a factor. The older you get, the weaker your throat muscles become. Weak throat muscles cause the surrounding tissues to sag and vibrate.

• If you are overweight, your throat tissues are less firm and more inclined to vibrate when you breathe.

• A low-set, thick soft palate, or enlarged tonsils or adenoids (the spongy tissue between the back of the nose and throat) can narrow your airway.

• A longer-than-normal uvula (the triangular piece of skin that hangs from your soft palate) can limit airflow and increase vibrations as you breathe.

• Nasal blockages caused by allergies or a deviated septum (when the partition between your nose is crooked) can limit airflow through your nose. This forces you to breathe through your mouth where more flabby tissue is located.

• Alcohol and certain drugs (such as tranquillizers) affect your central nervous system, causing extreme relaxation of your muscles, including those in your throat.

• When you sleep on your back, your tongue falls backwards into your throat which can narrow your airway and partly block airflow.

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The recession of gums and wearingaway of teeth occurs commonly inadults

Our main aims are:1.To identify the cause of the problem.2.To give preventive advice so that the

problem does not get worse. 3.To provide appropriate restorative

treatment where necessary.

Causes of gum recession/tootherosion:1. Use of a hard toothbrush. 2. Inappropriate brushing technique. 3. Frequent use of abrasive toothpaste. 4. Diet related and other more complex

reasons

Problems with gumrecession/tooth erosion:1.Sensitivity of teeth. 2.Possible decay of the affected areas. 3.Unsightly, discoloured and worn

appearance of the tooth. 4.Plaque and food collection.

Receding Gums and Dental Erosion

Plaque

Sensitive Teeth

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What is Sensitivity?Sensitivity is a sharp, shooting pain in the teeth, usually experienced when eatinghot or cold food and drinks. It is very common, affecting 11% to 25% of adults, withwomen suffering more frequently than men. Sometimes the pain can persist as adull ache in the affected tooth.

What causes it?Sensitivity is caused when the dentine of the tooth is exposed, usually due to some trauma, such as erosion of the enamel from acidic drinks, over-brushing, anaccident, or a cavity. It may also be caused by plaque build up which leads to gum inflammation or recession that exposes the sensitive dentine beneath. Sensitivitycan also result from a crack running through the dentine of the tooth. The dentinecontains tiny tubules, the fluid contents of which are thought to act as sensoryconductors to the nerves in the pulp at the core of the tooth. When the dentine isexposed, the teeth become particularly sensitive.

How do you treat it?If dentine sensitivity is diagnosed, a range of sensitive toothpasteís and mouthrinses are available, as are gentle brushes suitable for sensitive teeth. Some dentistsrecommend applying a small amount of sensitive paste to affected tooth or teethwith the finger at intervals through the day, rather than brushing with it in the normalway. This enables you to build up a protective layer, like a varnish, over the affectedarea. Fluoride in the toothpaste, especially in high concentration, appears to havean effect in reducing sensitivity, as well as being important for preventing decay.

If the cause off the sensitivity is gum recession due to over brushing, you maybenefit from advice on correct brushing technique. If you drink a lot of acidic drinks, such as fizzy drinks or orange juice, these may be contributing to the problem byeroding the enamel. Brushing your teeth immediately after an acidic drink actuallyincreases the damage, so it is advisable to let the acidity in the mouth return tonormal levels, alternatively chew sugar free gum instead. Which helps neutraliseplaque acid. The dentist may suggest carrying out treatment of the teeth, if thesensitivity is severe.

Before Treatment After Treatment

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C.T. scan technology now allows us toview the bone structure and soft tissuein 3-D and 2-D (three dimensional andtwo dimensional). C.T. scan imagestogether with surgicase software, wecan now simulate the implant surgeryprocedure, before performing surgery toplace implant, The image guidedtechnology is an excellent tool to precisely plan and execute theprocedure with great accuracy

In CT scanning of the head, the X-ray tube revolves around the area being examined as the table slowly moves the patient across the area in question.

Test procedureïYou will be asked to lie on a narrow examination table, which slides into the scanner

Other names Computed axial tomograph (CAT) scans.

C.T. Scans (Computer Tomography)

Purpose • To obtain a two-dimensional view of across section of the brainor other internal organ. • To detect tumours,bone density, and otherabnormalities that maynot show up on anordinary X-ray.

I.V. Sedation

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What is sedation and why is it used in dentistry?Sedation involves the use of a variety of drugs to relax the patient during a medicalor dental procedure. It can vary in depth from very light sedation, where the patentis tranquillised but fully aware of what is going on, to almost general anaestheticwhere the patient is unconscious. In dentistry, CONSCIOUS SEDATION is used,whereby the patient may be relaxed enough to drop off, but can easily be roused.Sedation does not control pain, but can alter a patientís perception of it, and canoften raise the pain threshold in those patients who find that local anaesthesia doesnot always work. A variety of drugs may be used singly or in combination, deliveredeither by mouth, nose or by injection. Pain control is carried out by local anaesthesia.

Some dentists use RELATIVE ANALGESIA, commonly known as gas and air, whichhas the advantage of being suitable for all ages and does not depend on the patientbeing in good health and wears off very quickly.

Is it safe?Sedation is a very safe technique, provided it is carried out by a qualified andexperienced person and patients are carefully monitored. Some patients experienceamnesia for a few hours or sleepiness for a day or so afterwards. However, allpatients that have been sedated are advised not to drive for the rest of the day or totake any major life decisions, and should be given a number to contact for the first24 hours in case of concerns. For safety reasons, full general anaesthesia is notcarried out in the dental surgery.

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Oddly enough, bad breath is also called “halitosis” it is anaffliction you can have and not even know it. Cuppingyour hands in your mouth and sniffing the air that comesout wonít tell you if your breath is bad; the offending odourcomes from the back of the mouth and is only forced out when you speak.

Here are a few methods to try that might revealunpleasant breath odour:

• Pull your tongue forward with one hand, and with theother, wipe the back of your tongue for about 15 secondswith a clean cotton ball. Wait a few minutes and smell thecotton ball; if it smells unpleasant, this could mean youhave bad breath.

• Floss a few of your back teeth with a piece ofunflavoured, unwaxed dental floss. Again, wait a fewminutes and then smell the floss. Itís likely that this iswhat your breath smells like.

• Do you frequently have a bad taste in your mouth? If youdo, that’s a clue that you might have bad breath.

• Ask for a truthful answer from a trusted friend or familymember. Yes, the truth can be embarrassing, butknowledge is power! Now you can do something about

Unfortunately, none of these methods are foolproof. A visit toour practice for an examination is the only way to find out

TREATMENT OF BAD BREATH (HALITOSIS) Studies have shown that about 85% of patients suffering from halitosis have an oralcondition as the source. If a person has healthy teeth and gums (i.e. no cavities,periodontitis, or abscesses), the next most common source oforal malodour is the tongue. Bacteria which produce volatilesulphur compounds (VSCs) have been found to congregateon the tongue, especially the posterior one third. Saliva fromnearby glands drips down on the posterior region of thetongue, which is full of irregularities where bacteria love tohide. The anaerobic bacteria (bacteria which thrive without oxygen) break downspecific components (amino acids) of the saliva, creating certain gases or VSCs.These VSCs have been implicated as a major contributing factor to halitosis. Othercontributing oral factors include inflammatory conditions, oral cancer and oralcandidacies.

Fresh Breath

Needle Free Injection

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Traditional technique of numbing teethhave in the past involved use ofinjections and needles. For mostpatients this is an accepted procedureand slight discomfort experiencedduring the procedure is part and parcelof their visit to the dentist.

Now with the introduction of needle freeinjection techniques, we can do awaywith the traditional needle technique inmost cases.

For those patients who suffer from needle phobia, the use of needle free injectiontechnique is an excellent alternative, including children. As a general rule mostpatients requiring simple procedures can benefit from this technique.

The INJEX jet injector is an alternative to needle syringes and offers a nearlypainless, safe and cost effective INJEXION in a broad rage in dental anaesthesiaprocedures. The concept of needle-free injection (=INJEXION) eliminateswidespread fear of injection-related pain among patients and at the same timeeliminates the risk of transmitting infectious diseases by contaminated needle stickaccidents.

Features & Benefits• Virtually painless and needle-free• Convenient for delivering variable doses• Eliminates accidental needle sticks• Eliminates cross- contamination • Reduces disposal costs• User friendly and extremely compact• Easy to operate and long- lasting

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What is Oral Cancer?There are many types of oral cancer, affecting differentparts of the mouth. The commonest site is the side of thetongue, but cancers can also occur anywhere in themouth: on or under the tongue, on the floor or roof of themouth, behind the teeth, on the gums or inside the cheek.Oral cancer accounts for about 1% of all cancers in theUK, and is a serious disease, killing around four peopleevery day. About 3400 new cases are reported each yearand this figure is rising

Below are examples of some of the lesions and theirappearance in the mouth. During your routine check-upwe will check all the soft tissues for signs of anyabnormality

What can we do?At each dental check-up we will check your whole mouth,not just your teeth, looking for signs of cancer or otherdiseases of the mouth. Special mouthrinses are becomingavailable which may reveal signs of oral cancer that areinvisible to the eye. The government is keen to encourageregular screening for oral cancer for those at risk.

Oral Cancer

WHAT SHOULD BE LOOKED FOR?

• Red patches • Lumps or nodules • White patches • Non-healing sore

Routine and preventive dental care (All Free and Included)All routine check-ups ( 2 per year)All X-raysAll necessary white sealant dressingsAll Hygienist visits (2 per Annum)Preventive advice, therapy, and counsellingAll routine emergency extractions

Major restorative care (20% discount) Crowns, bridges, dentures, inlays and root fillingsPeriodontal and surgical treatmentDental Implant therapyCosmetic veneersTooth whitening proceduresChildren and adult orthodonticsOne visit CAD-CAM ceramic restorations

Worldwide emergency cover24 hour worldwide trauma and accident cover up to £5,000.00 per year,emergency treatment up to £95.00 per incident. (All necessary treatment will be provided by Centre for Cosmetic and Reconstructive centres exclusively)

Hospital Cash payment£60 cash for every night spent in hospital under the care of a consultant dental surgeon. Max of 10 days.

Oral Cancer CoverUp to £1,000.00 cover for patients under 60 and Up to £700.00 for patients over 60

Smokers are not excluded NO evaluation is required by a dentist . Depending on your dental experience and treatment required you can self-select the level that suits you best.

Dental Plan (CCRD Membership)

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CCRD Direct Debit Form

Please fill in the whole form using a ball pointpen and send it to:-

CCRD

T/A as Centre for Cosmetic & Reconstructive

Dentistry

Woodbury Dental Practice

149 High Street

Tenterden

Kent TN30 6JS

Name and full postal address of your Bank orBuilding Society:-

To: The Manager

Bank / Building Society

Address

Postcode:Instruction to your Bank or Building SocietyPlease pay (CCRD) Direct Debits from the accountdetailed in this instruction subject to safeguardsassured by the Direct Debit Guarantee. I understandthat this Instruction may remain with (CCRD) and, ifso, details will be passed electronically to myBank/Building Society.

Name(s) of Account Holder(s)

Bank / Building Society account number

Signature(s)

Branch Sort Code

Bank or Building Societies may not accept Direct Debit Instructions for some types of account.

This guarantee should be detached and retained by the Payer.

The Direct Debit Guarantee• The Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme.• The efficiency and security of the Scheme is monitored and protected by your own Bank or Building Society.• If the amounts to be paid or the payments dates change (CCRD) will notify you 10 working days in advance of your account being debited or as otherwise agreed.• If an error is made by (CCRD) or your Bank or Building Society, you are guaranteed a full and immediate refund from your branch of the amount paid.• You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us.

Date:

Instructions to yourBank or Building Societyto pay by Direct Debit

Originator’s Identification Number

For (CCRD) Official Use OnlyThis is not part of the instruction to your Bank or Building Society

Initial monthly debit sum £

6 5 4 7

Reference Number

DIRECTD e b i t

Woodbury Dental PracticeCentre for Cosmetic Reconstructive Dentistry

149 High Street, Tenterden, Kent, TN30 6JSTel: 01580 762323 Fax: 01580 766140

Web site: www.Dental-Cosmetics.co.ukE-mail: info@Dental-cosmetics.co.uk

How to find us

DELTA

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CAR PARKINGFree on-street parking (1 hour) in High Street (Crowded). Large off-street car park

behind High Street, £1.20 all day. Entrance via Bridewell Lane. Look for ‘Tollgate’ orbaptist Zion Chapel. Park in corner furthest from entrance and take pedestrian exit to

High Street. Only 2 minutes walk to surgery.