Spotting the early signs of mouth cancer

spotting the early signs of mouth cancer

Spotting the early signs of mouth cancer

Mouth cancer is one of the most treatable cancers however this is only if it is caught early. This article is dedicated to the early warning signs of oral cancer, what you can do at home and how it can be spotted.

What is mouth cancer?

Mouth cancer is when a tumour develops somewhere within the oral cavity and on the oral tissues, this could be on the inside of your cheeks, on your tongue, the roof of your mouth your gums or your lips.

Mouth cancer has a higher proportion of deaths than breast cancer, cervical cancer or skin melanoma with a mortality rate of just over 50%. However the biggest factor in this is detection, people tend to have routine screening for breast and cervical cancer and they can see their skin and report concerns quickly.

Mouth cancer can often progress unnoticed and unless you regularly check your own mouth and also have a routine oral cancer screening at the dentist it is likely to go unnoticed until it has developed further.

What do the early stages of mouth cancer look like

When you look for mouth cancer you should check your tongue, the roof of your mouth, your lips and inside of your cheeks initially.

Look for red, white or dark coloured patches, also gently feel for any kind of protrusion or raised area. Make sure you lift your tongue towards the top of your mouth and then move it left and right to look underneath.

Then examine your cheeks manually, gently squeeze your cheeks between your thumb and index finger very gently, this is one of the best ways to detect any lumps, bumps or slight swelling.

After that, check your neck area, run your fingers gently along the side of your neck feeling for any lumps and bumps for anything out of the ordinary. Note any slight tenderness or swelling.

Oral cancer is usually painless so don’t expect to feel sharp pain.

Oropharangeal cancer

Oral cancer further towards the back of the throat or soft palate may be labelled as oropharangeal cancer, this may be difficult to detect visually but common symptoms may include a lump in the neck, difficulty swallowing or persistent sore throat.

How to prevent early signs of oral cancer?

a common cause of all cancer is the human papilloma virus (HPV) it affects the skin and mucosal cells in the body. Whilst different human papilloma viruses infect different parts of the body studies have been shown that people who are infected with HPV are 32 times more likely to develop oral or throat cancers.

This makes HPV a greater cause of mouth cancer than smoking and drinking!

There are a couple of forms of HPV which are sexually transmitted and pose a serious health risk. They cause tissue growths which are usually flat and almost invisible, these are known as dysplasia. The growth in themselves are not cancer but they may be a sign of tissue change prior to cancer developing. Dysplasia can be detected on the female cervix through a smear test and the most dangerous HPV viruses are transmitted through sexual contact and known to cause up to 95% of cervical cancers. There are now known links between these 2 HPV viruses and oral cancer.

What is the difference between mouth cancer and oral cancer?

Generally speaking mouth cancer and oral cancer are different names for the same thing.

How to prevent oral cancer?

Approximately half of all cancers can be prevented by good diet and healthy living, the primary risk factors which increase your chances of developing mouth cancer are as follows:

  • Tobacco use. The use of tobacco has been widely documented and is well known to cause a variety of cancers.
  • Avoid or limit alcohol use. Excessive amounts of alcohol are also known  to increase the chances of cancer developing, particularly oral cancer due to the length of time that alcohol is in contact with the mucosal tissues.
  • Eat healthy food. Antioxidants have been shown to reduce the risk of cancer developing, maintaining a healthy diet rich in these nutrients can help keep you fit and healthy.
  • Maintain a healthy weight. Cancer research UK has shown that one in 20 cancers are caused by people being overweight. It is suggested that obesity stimulates the inflammatory response which can promote cancer development. It also has an impact on the hormones and endocrine functions which may also contribute to the growth of cancer cells.
  • Exercise moderately most days.  This keeps your internal systems working effectively including blood and hormone levels.
  • Avoid casual sex. Increasing the number of sexual partners or choosing partners with several prior partners increases risk. Reduce your risk by using condoms & barriers during oral sex.

How to detect mouth cancer?

Examining your tongue, inside of your cheeks, floor of your mouth, lips, roof of the mouth and gums is one of the best ways to routinely detect mouth cancer at home.

Look in a mirror and stick out your tongue, ensure you look for any unusual lumps or obvious changes in colour, particularly those which don’t disappear. Pay particular attention to ulcers which you have been unable to get rid of.

A persistent cough or hoarseness of the voice could also be a sign of mouth cancer further down towards the back of your mouth.

When you visit the dentist they will also undertake a routine mouth cancer screening, this should form part of your 6 monthly health check. If your dentist doesn’t say explicitly that they have carried out a mouth cancer screening then make sure you ask. Dentists are trained on the anatomy of the mouth and to spot the early warning signs, they can then refer you for further examination and more detailed detection processes.

If in doubt, check it out!

Is oral cancer curable?

Early detection is absolutely key with oral cancer, if you’re not having regular oral cancer screening this can mean oral cancer goes undetected, this then means that once it becomes more noticeable it may have likely spread to the lymph nodes of the neck, thereby reducing survival rates significantly.

There are typically 3 primary ways to treat oral cancer:

  1. Surgically. This is often used in the early stages to remove the tumour and any affected lymph nodes. Any surrounding tissue may also be removed to prevent recurrence.
  2. Radiotherapy. Targeted treatment with radiation, usually twice per day for 5 days per week for around 6 weeks is also often used. If cancer is in more advanced stages then radiotherapy is often combined with chemotherapy.
  3. Chemotherapy. This is the drug treatment for cancer, it is usually given as an outpatient treatment without the need to stay in hospital, although this depends upon your reaction to the drug and your specific dose.




Bicarbonate of soda teeth whitening

bicarbonate of soda teeth whiteningAs the demand for cosmetic dentistry increases people are often wondering if there are alternate ways to whiten teeth, we’ve heard of people trying coconut oil, charcoal, and bicarbonate of soda. This post is going to focus mainly on bicarbonate of soda teeth whitening.

In order to know if baking soda is effectively using teeth whitening, indeed, in order to know if ANYTHING is effective in teeth whitening let’s look at how teeth whitening works in conjunction with cleaning your teeth (coconut oil, charcoal, and bicarbonate of soda are all typically used as a toothpaste to whiten teeth).

Ways to whiten your teeth

In order to whiten teeth you need to do one of the following:

  1. abrade the surface to remove any surface stains
  2. remove the surface stains altogether by bleaching

Teeth bleaching works by having a released amount of hydrogen peroxide in a gel. The oxygen molecules in the gel react with the discoloured molecules in your teeth, this reaction breaks down the bonds that hold these molecules together, consequently, the discolouration disappears.

Removing tooth surface gives the illusion of whitening by removing any surface stains. However, if the tooth itself is actually darker then you’d like no amount of surface abrasion is going to whiten it.

Throughout the following questions we will always be linking back to this part of this blog post and asking the question, how is this whitening your teeth?

What does toothpaste do?

This is the next important question we need to consider. Because coconut oil, charcoal, and bicarbonate of soda are typically used in toothpaste it’s important to understand what toothpaste does and how it works. We can then compare any toothpaste against this standard and ask ourselves if the toothpaste is actually working.

Toothpaste typically has 3 main ingredients:

  1. a mild abrasive.
  2. fluoride.
  3. A mint taste.

The mild abrasive is often dicalcium phosphate, calcium carbonate or similar. The particle size and quantities are carefully measured to ensure the toothpaste cleaned adequately without damaging your teeth.

The fluoride is there as it has been shown that fluoride helps in the remineralisation process which is required in order to keep the enamel of your teeth healthy. Throughout the day your teeth will be subject to acid attack and they become demineralised, it’s important that the remineralisation process is maintained and fluoride helps with this.

The mint taste is simply to make the whole process more palatable.

It’s really important that any toothpaste you use contains fluoride as without it the toothpaste is not working as effectively as it could.

So now we know how teeth whitening works and what toothpaste does, let’s look more specifically at baking soda products.

Does baking soda really help whiten teeth?

The very simple answer is yes, however it only whitens teeth by abrading the surface and removing surface stains. This comes with a couple of potential problems:

  1. excessive abrasion causing tooth wear
  2. if you only use baking soda to clean your teeth you aren’t adding any fluoride to your tooth

If the tooth abrasion continues for a long period of time you can find that the hard outer layer of the tooth (enamel) gets worn away, this is particularly prevalent around the neck of the tooth where it joins the gum. This can cause sensitive teeth in the long-term!

If you only use baking soda to whiten your teeth and don’t use regular toothpaste then you will be missing out on the protection that a toothpaste provides if it contains fluoride.

The other problem with using a mixture of baking soda and water is that whilst it may effectively remove stains, such as coffee, tea or red wine it won’t actually whiten the inherent colour of your tooth. in order to whiten the tooth beyond removing surface stains when you will need to use conventional dental teeth whitening products.

Does brushing your teeth with Sodium Bicarbonate damage them?

If used in the long-term then yes sodium bicarbonate could damage your teeth. Sodium bicarbonate can lighten teeth by removing surface stains but it does this by simply being an abrasive. If you use an abrasive on anything for an extended period of time then one of the side-effects could be that you lose vital tooth structure.

This could result in increased sensitivity of your teeth making an extremely uncomfortable or even painful.

If you are not using conventional toothpaste you could also exacerbate this process by not having any fluoride, fluoride helps with the remineralisation of the enamel and if this remineralisation is not happening then the abrasion could be more aggressive.

Does lemon and baking soda whiten teeth?

We highly recommend that you do not use lemon juice to whiten teeth. Lemon juice is extremely acidic with a pH level between 2 and 3 meaning it is 10,000 – 100,000 times more acidic than water! This acid, when coupled with the naturally occurring acid which is excreted from the bacteria in your mouth could lead to excessive dental decay.

Does baking soda prevent plaque in teeth?

Baking soda will not prevent plaque in teeth. Plaque is caused by the thin biofilm which covers your teeth forming into a sticky layer. If this sticky layer is not removed each day by cleaning adequately then it can harden into tartar. This tartar collects in between your teeth and looks very yellow. The tartar also stains extremely easily which can then make your teeth look even darker.

The way to keep this tartar buildup to a minimum is to clean your teeth with the fluoride containing toothpaste and then use an interdental brush or floss to clean between your teeth, using a brush or floss then removes the sticky layer which then does not harden into the yellow tartar.

All baking soda would do to your teeth is a abrade the surface!

Can baking soda and hydrogen peroxide be used?

This is one of the most dangerous things we have heard, if you use hydrogen peroxide in an uncontrolled way on your teeth then you risk damaging the soft tissue around your tooth. Hydrogen peroxide will burn and should NEVER be used outside of the controlled dental environment where it is precisely measured into a gel to ensure you use the barest minimum.

How to whiten my teeth?

So now we come onto actually whitening teeth and how to do it safely without damaging the surface or affecting your long-term dental health.

You can start the tooth whitening process at home by ensuring you have a good oral health care routine and watching your diet. Cleaning your teeth twice per day with a fluoride-containing toothpaste for 2 min and then cleaning in between your teeth with an interdental brush or floss will help keep plaque to a minimum (it’s often the plaque in between your teeth which picks up sustain darker and gives the overall impression of dark teeth, keeping plaque reduced means your teeth will look whiter).

Once you have got your oral health care under control you can then consider dental teeth whitening. This should always be undertaken by a registrant of the General Dental Council, this ensures that your treatment is safe, legal and effective.

cosmetic guide download

Find out:

  • The costs and lowest price alternatives
  • Your options and choices for treatment
  • Are you suitable for treatment?
  • How you can have whiter, straighter and better looking teeth
  • How long does each treatment take?
  • Plus lots more…
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Dental bridges vs. dental implants

Trinity blog title

There is very often talk at our dental practice in Devon around the pros and cons of dental bridges versus dental implants, in this blog post we seek to answer some of the most common questions that people ask about this popular topic when seeking to replace missing teeth

What do bridges and implants mean?

Bridges and implants are both ways to replace missing teeth. However they have a slightly different approach to doing this.

Bridges effectively bridge the gap where the tooth is missing, bridges can either be attached to existing teeth or to dental implants.

Dental implants effectively replace the root of a natural tooth where the tooth has been lost. Dental implants within themselves don’t replace a missing tooth, they simply support the final restoration which can be either a dental crown (to replace a single tooth), a dental implant supported bridge (to replace multiple missing teeth) or an implant supported removable denture (to replace all missing teeth).

What is a dental bridge?

A dental bridge will classically be attached to your remaining teeth. The teeth either side of the gap will be prepared (trimmed down) in order to allow the new false tooth or false teeth to be attached to them.

Dental bridges come in a variety of formats:

  • The Maryland bridge. This requires far less preparation of the adjacent teeth as it is simply a wing which supports the new false tooth.
  • A cantilever bridge. This can be used to suspend a tooth off of a single tooth.
  • Traditional bridges. This is where the teeth either side of the gap are prepared.

The different types of dental bridge

What does getting a fixed bridge involve?

The full process depends on exactly which bridge you are having however typically process involves:

  1. An initial consultation with the dentist to decide on what type of bridge is best.
  2. The preparation appointment. You will be given a local anaesthetic to ensure the area is completely numb so that the treatment is comfortable and pain-free.
  3. A temporary bridge will be made out of a hard wearing plastic.
  4. Two weeks go by whilst your permanent metal or porcelain dental bridge is manufactured.
  5. The fitting appointment. You will be given a local anaesthetic again so that the plastic temporary can be removed comfortably. The permanent bridge will then be tried in to ensure you are happy. The bridge is then permanently fitted using a special dental bonding material.

What is a dental implant?

A dental implant basically replaces the root of a natural tooth. Implants are often placed into the empty tooth socket after a tooth is removed. Bone grafting is sometimes undertaken by your dentist or surgeon if there is not enough bone to anchor the implant adequately.

A dental implant is then used to support:

  1. A single dental crown.
  2. One end of a dental bridge. Typically you would have more than one implant to support the entire dental bridge.
  3. A denture. Typically you would have up to 6 dental implants to support a full denture.

In and of themselves dental implants do not replace the missing tooth, it is the type of restoration on top of the implant which replaces your missing tooth or teeth.

What does getting a dental implant involve?

Dental implant treatments are usually split into two:

  1. The implant placement.
  2. The restorative phrase.

Dental implant placement procedure

Typically the procedure involves:

  1. An initial consultation with your dentist or oral surgeon.
  2. A planning phase in conjunction with a dental laboratory, typically taking 2-3 weeks and 2-3 appointments at the dental practice. At this phase it will be worked out how many implant you need and the type of restoration that will be fitted afterwards.
  3. Dental implant placement itself. This is usually a fairly quick procedure and is often undertaken with local anaesthetic only. If you require sedation this can also often be arranged.
  4. The healing phase. Typically 3-6 months. This allows the dental implant to integrate fully into the surrounding bone.

Dental implant restoration procedure

After the implant has fully integrated and the healing phase is complete the restorative phase can begin. This is where you have your bridge or dentures fitted.

The procedure normally involves:

  1. Discussion about what the final restoration should look like, colour, shape, arrangement of teeth etc. The restoration can be made to look like your natural teeth or you may to look completely different, the choice is usually yours.
  2. Initial impressions. Dental impressions will be taken and a temporary restoration made.
  3. The manufacturing stage. A dental laboratory will then take up to a couple of weeks to manufacture your restoration.
  4. Try in stage. If your final restoration is a denture then there will be a try in stage, This is to ensure you are happy with the look and feel of the denture prior to final processing. Sometimes are trying stage is also used with a dental bridge to verify that everything is okay prior to finishing.
  5. The fitting stage. This is where your final restoration is fitted.

Which is better, dental implants or bridging?

There really isn’t a definitive answer as to which is better, it entirely depends on outcomes you wish to achieve.

However, dental implants are usually preferred for the following reasons:

  1. They are less invasive on surrounding teeth and don’t require removal of possibly healthy tooth structure.
  2. Because they are fitted into the empty tooth socket they support the surrounding bone and can often prevent bone resorption which can make them look better in the long run.

Why would someone choose dentures over bridges or implants?

Very often patients will prefer a dental bridge, either supported by natural teeth or implants over a denture. This is because dentures are removable and many people prefer not to remove their teeth and have them permanently fitted.

However, dentures come with the following advantages:

  1. They are often cheaper than natural tooth supported bridges.
  2. They are often cheaper than dental implant supported bridges.
  3. In some instances they are used to support the surrounding gum. You may find that you have excessive bone loss and that your gums have receded, if this is the case dentures can be used as they give lots of support to the gum. This can help to support your facial shape and remove lines and wrinkles around your mouth.


We hope you have found the discussion between dental implants, bridges and dentures useful. The thing to bear in mind is that there is no single generic best alternative, there is only the alternative that is best for YOU and so you should discuss all of your options with your dentist before making a decision.

Top questions people ask about bruxism

Bruxism (Teeth grinding) is a common condition in dentistry so we thought would be useful to dedicate an entire article to bruxism

How is tooth grinding diagnosed?

Your dentist will be easily able to see if you grind your teeth. They will be looking at the back teeth and checking for wear patterns over the cusps (the pointed parts) of your teeth. These wear patterns will indicate how your jaw moves from side to side and backwards and forwards and will give the dentist an idea as to the extent of any teeth grinding problems.

Can teeth clenching cause my sore gums?.

Yes, grinding and or clenching your teeth can indeed cause sore gums. The forces can be transmitted down the outside surface of your teeth, this can lead to a complex form of enamel erosion. This can subsequently irritate gums and lead to sore gums.

Do I really need a night guard for bruxism?

Night guard are just one of the forms of bruxism treatment. This type of mouthguard helps to keep teeth apart at night, because the teeth are apart the muscles reset and relax, this means you wake up in the morning having not ground your teeth during the night. Because there has been minimal muscle activity at night not only will tooth wear be reduced but also the side effect of bruxism can be limited such as headaches and jaw joint pain.

How to get relief from jaw pain?

You need to see your dentist for treatment of bruxism if you have any of the following problems:

  • Headaches – bruxism can cause headaches because of excessive pressure on the muscles of the face and those which help in chewing.
  • Tooth Sensitivity – excessive teeth grinding can cause tooth wear. As a result, teeth become sensitive to hot or cold foods.

A night guard can then help with jaw joint pain once bruxism has been diagnosed.

How to cure myself from sleep bruxism?

The trick to treating yourself at home with sleep bruxism is to look at the cause.

  • Do everything you can to reduce stress or anxiety.
  • If you believe you have a sleep disorder consider visiting your doctor, MA mandibular advancement device may help with any sleep apnoea which may in turn help with any nighttime bruxism.
  • Look at your lifestyle, do you smoke or drink alcohol excessively?
  • Read any prescription drug information carefully to ensure there is no side-effect which may cause bruxism.
  • Practice relaxing your jaw with general muscle relaxation techniques.

You may however find that some form of dental treatment can help better than simply trying to cure bruxism at home.

What causes bruxism?

Bruxism can occur due to a variety of reasons:

  • Stress – this is one of the most common reasons for grinding teeth. Most people start to grind their teeth during exam season, when they are stressed out at work or when they are dealing with a personal crisis. This form of bruxism usually occurs during the daytime.
  • Improper Bite – when the upper and lower teeth do not mate properly, it can lead to excessive stress on the teeth. This situation can also result in the bruxism.
  • Sleep Disorders – sleep problems like obstructive sleep apnea, can also result in teeth grinding during sleep.
  • Medication – Bruxism can also be a side-effect of some medications. It has been particularly linked with a group of drugs known as the “selective serotonin reuptake inhibitors (SSRI[1]s). The use of recreational drugs can also cause bruxism.
  • Lifestyle – excessive smoking and alcohol intake is also linked with bruxism.

Can asymmetric jaw muscles cause bruxism?

Theoretically yes. Bruxism occurs if there is excess muscle activity, this may be caused by stress or anxiety as well as problems with the muscles. Occlusion splints to prevent tooth grinding can certainly help in this area.

What are some treatments to cure bruxism?

Treatment of bruxism for children and adults involves the identification and correction of the underlying problem. In the meantime, your dentist will give you a mouthguard to protect your teeth from further damage because of grinding and clenching. In case the underlying problem is stress, you should change your lifestyle habits. Your dentist may also advise you to see a therapist for cognitive behavioral therapy[2]. Finally, if you are grinding your teeth because of an underlying sleep disorder, you should consult a medical professional who specializes in sleep therapy.

Bruxism can be easily managed and controlled. However, what most people don’t recognize is that failing to seek treatment for this condition can cause serious damages, like tooth erosion, headaches, and even temporomandibular joint disorders. Therefore, if you or your partner realize that you are grinding your teeth, you should seek treatment right away.

Can tooth damage from bruxism be repaired?

The good news is yes. It depends on the amount of damage that has been caused. The first thing to consider would be to have a mouth guard as this can help to prevent any tooth damage getting worse.

Dental veneers, crowns or composite fillings can then be used to repair any damaged tooth area. Sometimes this is on the surface of back teeth, it can however occur on the incisors age (tip) of front teeth or even on the outside surface of back teeth where the forces transmitted down the tooth.

What would cause someone to wake up with broken teeth?

Teeth grinding is the most likely cause of waking up with a broken tooth. You may not be aware that you grind your teeth at night so if you wake up with a broken tooth we strongly recommend you visit your dentist as soon as possible. They will be able to assess the way your teeth bite together and let you know if you are grinding your teeth at night.

[1] “SSRI Fact Sheet –” 13 Sep. 2016, Accessed 5 Nov. 2018.

[2] “In-Depth: Cognitive Behavioral Therapy – Psych Central.” Accessed 5 Nov. 2018.

What are cosmetic dental procedures?

Trinity blog titleSo many patients are asking about cosmetic dentistry in Devon that we thought we would explain some of the treatments involved and how they might work together.

One of the things we are passionate about is what is known as ‘Minimally Invasive Dentistry’ – this means we do the absolute smallest amount of treatment possible to achieve the desired result, and that desired result could be better dental health or better aesthetics. Modern thinking is to align teeth, whiten teeth and then apply some minimal bonding to correct the tooth shape – Most certainly, this is the thinking to which we subscribe as it maintains as much of your natural tooth as possible.

Up until fairly recently the only option for cosmetic dentistry was to have healthy tooth structure removed to make way for either crowns or veneers, this is still a common treatment option and in many cases is the right thing to do. However modern advances in 3 key areas have changed this dramatically.

Our ability to move crooked and misplaced teeth in to the perfect alignment with modern orthodontic techniques that are almost invisible.

  1. Modern advances in Teeth Whitening and bleaching techniques to reduce the dark and/or yellow colour on teeth
  2. Advances in materials for dental bonding to restore broken tips and make minor changes to the shape of teeth

This philosophy is known as ‘Align, Bleach, Bond’ for obvious reasons, and so this guide is written in that order to reflect our conservative and minimal approach. This guide, whilst containing information about veneers, is primarily aimed at showing and explaining how you can have the smile with the least amount of dentistry… great news for you and your teeth.

Common questions about cosmetic dentistry

Are braces considered cosmetic dentistry?

Generally speaking yes, orthodontic braces are now part of regular cosmetic dentistry. Sometimes patients prefer a more rapid approach to straightening crooked teeth, if this is clinically possible then dental veneers or dental bonding may be chosen instead of orthodontic braces.

Do dental crowns look natural?

Dental crowns can be made to look extremely natural with modern techniques. If you are concerned about how natural a dental Crown looks then ask your dentist for a metal free crown, these crowns can be made from alumina or zirconia giving high-strength and high translucency and avoiding the opacity of a crown which is made with a metal substructure.

Is it bad to get your teeth whitened?

So long as the teeth whitening is done by a dental professional then it is safe and effective way to whiten teeth. The bleaching agent contains hydrogen peroxide and this needs to be prevented from touching your sensitive gum areas. Prior to any teeth bleaching your dentist will also ensure that your gums and teeth are dentally fit, this is important to ensure that the bleaching does not irritate any underlying dental problem. Only a dental professional will be able to tell you if you are dentally suited to teeth whitening.

Is it normal to have yellow teeth?

The problem here is defining what is yellow? The definition of yellow has changed in recent years due to the advent of Snow White dental veneers. Comparing your teeth next to these Hollywood white veneers will always make your teeth look yellow!

White teeth

This shade guide is used by dentists to determine the colour of your teeth when making restorations or teeth whitening. The three white shades off to the left are these new snow white Hollywood colours. They have been made in addition to the classic teeth colours which, by comparison tend to look yellow, although in reality are not!

How do you whiten your teeth overnight?

The best way to whiten teeth overnight is to have teeth whitening trays made by your dentist. These trays are custom made to fit you precisely and ensure that the bleaching gel which is placed inside the tray does not touch your sensitive gum area. Overnight bleaching for approximately one week is normally what is required to achieve the desired shade.


How to reduce the number of fillings you need

In this blog post our Barnstable dentist walks through some of the key principles to help you reduce the number of fillings you need. Reducing the number of fillings you need at the dentist has multiple benefits:

  • You spend less money at the dentist.
  • You spend less time at the dentist.
  • You have fewer injections.
  • You keep your teeth natural which means they are for more likely to last longer.

… And who wouldn’t want all of that?

You will only need a dental filling if you have a broken down tooth, usually this is caused from tooth decay so reducing the number of fillings you need depends upon a few factors:

  1. Your genetics.
  2. Your diet.
  3. Your dental health routine.

Genetic factors which affect tooth decay

  • Tooth enamel strength
    • Some people are born with thin tooth enamel which is just more prone to breaking down which consequently exposes the underlying softer dentine which becomes more susceptible to decay.
  • Saliva
  • The microbes in your mouth
    • Your mouth contains a large amount of bacteria, this is quite normal and nothing to worry about so long as your body’s immune system is working well. These communities of bacteria can change in size if your body becomes immunosuppressed

There is often nothing you can do about genetic factors which affect tooth decay but if you are susceptible to any of the above then following a good diet and dental health care routine will certainly be of increased benefit.

How does diet affect tooth decay?

The biggest contributor to tooth decay in diet is sugar. Tooth decay is caused when the bacteria in your mouth excrete acid during the day congestion of the sugar in your diet. It is this acid which attacks the enamel on your teeth causing it to decay.

Your saliva is alkaline so is designed to counteract this excessive acidity but if there is too much acid created then the saliva can’t keep up.

When thinking about sugar don’t just think about added sugar, think about sugar which naturally occurs in fruit, this can also create that acid attack on your teeth.

Ready-made meals also very often have sugar added to them to make the more flavoursome. Reducing the amount of ready-made meals you eat will, in turn, help to reduce the amount of sugar in your diet.

Reducing cavities with a good dental health routine

Having a good dental health care routine is one of the key ways to reduce dental cavities. Following a simple 3 minute routine twice a day can help to reduce the chance of developing cavities, that routine is:

  • Wait 20 min after eating before brushing your teeth to give your enamel chance to recover from the acid attack.
  • Brush using a pea sized amount of fluoride toothpaste.
  • Brush your teeth the 2 min. 1 min brushing the top teeth and 1 min brushing the bottom teeth.
  • Clean in between your teeth using dental floss or incidental brushes (the bacteria love to lurk in between your teeth so this is a vital step to keeping buildup at bay).

Using a fluoride containing mouthwash after meals can also help to reduce the chance of developing cavities, however do not use mouthwash after cleaning your teeth as mouthwash contains less fluoride than toothpaste and you will actually reduce the amount of fluoride in contact with your teeth if you use mouthwash after cleaning with toothpaste.

…and lastly, but definitely by no means least, visiting your dentist and dental hygienist regularly Is one of the key factors to keeping tooth decay at bay.

At home you may only notice if you have tooth decay when there is a visible hole or pain. Your hygienist and dentist will be able to spot the very early warning signs of tooth decay (such as enamel becoming soft) at an earlier stage than you could ever possibly achieve at home.

This means a very tiny filling can then be placed early on in the decay process, rather than leaving the decay to get bigger and then requiring a larger filling.

Doing this means your dentist is able to preserve as much natural tooth structure as possible which is always the goal of every dentist.


Is there a future for silver fillings?

The European Parliament has agreed that the use of dental amalgam for fillings is going to be phased out by 2030. This phasing out is part of the European Union  Mercury pollutant legislation in the 2013 United Nations Minamata Convention, although where we will stand after Brexit is anyone’s guess!

What is dental amalgam used for?

Dental amalgam is used when there is dental decay in your tooth, the decay is removed by the dentist and then the hole is often replaced with the dental amalgam (Many other techniques to get the same outcome exist). Amalgam is a mixture of mercury (50%), silver, copper, tin and zinc. Due to the Mercury and silver the amalgam appears silvery in colour.

Why have the Europeans decided to phase out amalgam?

Mercury is harmful to both the environment and humans. It is poisonous to the nervous system  and gets into the system mainly by inhaling vapours.  These vapours are absorbed into the body via the lungs and can easily move through the bloodstream to the brain. However, when elemental mercury is eaten or swallowed there is very little that is absorbed into the body.

What is the alternative to dental amalgam?

If dental amalgam is to be phased out following  ratification by the European Council than one needs to consider what the alternatives are.fillings

White fillings

These fall into a few different categories:

  • Dental bonding
  • Dental inlays
Dental bonding


Bonding involves your dentist using a specially light cured resin to replace the missing tooth structure after the dental decay has been removed, it is used very similarly to dental amalgam.

Advantages: Quick, simple and painless

Disadvantages: Stains more easily, wears more than amalgam

Dental inlays

These are often made by a highly skilled dental technician and will usually be made out of a dental ceramic material.

Advantages: restorations last an extremely long time

Disadvantages: more than one injection required as the restoration will take approximately 2 weeks to make

Is dental amalgam safe?

The British Dental Association says that:

The European Parliament agreed on 14 March 2017 to the final version of its Regulation on Mercury. The Regulation is the EU’s instrument to ratify the Minamata Treaty of 2013

They go on to say:

.. amalgam remains one of a range of safe and effective filling materials that are available to dentists to provide the most appropriate treatment for the needs of each individual patient.

The EU’s Scientific Committee has recommended that, from 1 July 2018  :

“To reduce the use of mercury-added products in line with the intentions of the Minamata Convention (reduction of mercury in the environment) and under the above mentioned precautions, it can be recommended that for the first treatment for primary teeth in children and in pregnant patients, alternative materials to amalgam should be the first choice.”

The British Dental Association stress that the EU regulation on Mercury is an environmental regulation, not a health regulation as the EU can’t make laws that directly change the way health systems in member states are arranged.

The best way to cut down on the amount of dental amalgam used is to increase the preventative measures that many practices and patients take as standard, this includes dental health advice and information, brushing your teeth twice per day for 2 minutes each time using a fluoride toothpaste and cleaning in between your teeth each day with an interdental floss or brush.

Patients can play their own part in the reduction of amalgam use by looking after their dental health and ensuring they have a good dental health routine, whilst working in conjunction with the dentist to treat any dental health problems which may arise.

If you are concerned about any of the issue is raised in this blog post, please contact our Devon dentist in Barnstaple  who will be pleased to help.

Is it finally possible to regrow teeth?

regrow-teethAre you one of the many people that would really rather not go to the dentist to have dental fillings? Well, a new scientific breakthrough by King’s College London may be just what you were looking for.

The researchers have found that The Alzheimer’s treatment drug Tideglusib can enhance your tooth’s ability  to rebuild  naturally the dentine which is lost when acids dissolve the tooth structure causing cavities.

“The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities, by providing both pulp protection and restoring dentine.

“In addition, using a drug that has already been tested in clinical trials for Alzheimer’s disease provides a real opportunity to get this dental treatment quickly into clinics.”

said Professor Paul Sharpe.

So what happens when the tooth is damaged and how could this new drug help?

dental-caries-stepsShould the bacteria in your mouth buildup then the amount of acid which attacks teeth after eating will also build up as it is excreted by this bacteria as they digest sugar. Once the acid has removed the hard outer layer of the tooth (enamel) it will then begin to remove the softer inner surface of your tooth (dentine).

However,  your tooth will naturally fight this process.  Underneath the dentine are the nerves and blood supply to the tooth  (pulp), your tooth will naturally  create a layer of secondary dentine which is harder than the regular dentine but not as hard as enamel.

This process can only continue for so long and only repair relatively small holes in the tooth.

What the researchers found is that when a biodegradable sponge was soaked in the Tideglusib, the natural repair process of the tooth was enhanced and larger cavities could be covered over. The scientists called this a

“complete, natural repair.”

During the process the biodegradable sponge was absorbed  and the dentine formed  around it.

At the moment the trial has only been completed on mice but if it could be modified to work for humans it could reduce the need to have fillings at the dentist!

Other ways to reduce the need for fillings.

Of course, none of this would be necessary if we didn’t have cavities in the first place!

Cavities form when bacteria builds up naturally in our mouth, as the bacteria digests sugar in our diet they excrete acid and it is this acid which attacks the outer surface of our teeth.

This is a natural process and your saliva is designed to be alkaline and counteract the acid from the bacteria. This is why chewing sugarfree gum after the meal can redress the acidic balance in your mouth and neutralise the acid from the bacteria.

However, two factors affect this natural process:

  1. A diet which is high in sugar
  2. Not adequately cleaning teeth to remove the bacteria

With a diet that is very rich in sugar the natural neutralisation of this acid by the saliva  cannot work at such a high level, this means that acid remains in contact with your teeth causing the cavities.

Likewise, if the bacteria are not adequately removed by brushing and flossing then again the neutralising effect from the saliva can’t keep up with the acid production.

Interstitial cleaning brushes
Interstitial cleaning brushes

Being aware of one’s diet and keeping sugar to a minimum plus cleaning your teeth twice per day with a fluoride toothpaste and then using interstitial brushes or floss to clean in between your teeth will radically reduce the likelihood of developing tooth decay and cavities.

For further advice and information please contact our dental practice in Barnstaple, North Devon and book an appointment with our dental hygienist who can give you advice and information about looking after your dental health plus a tailored treatment plan  should one be required.

Report Shows That 42% of Children Have Not Had a Dental Checkup in the Last Year

NHS Digital (the new name for the Health and Social Care Information Centre) recently uncovered some alarming statistics regarding children’s dental health In the UK.

That equates to almost 5,000,000 children not being seen by an NHS dentist in 2015/16. Guidelines state that children should visit the dentist regularly, at least every year.

The NHS Digital report showed that:

  • 917,346 tooth extractions were performed on children..
  • Extractions were most common in South Tyneside  with one for every six children and adults.
  • The Blackpool and Medway region was next with one’s extraction for every seven people.
  • The lowest in the country was Richmond-upon-Thames with one extraction on the NHS in every 39 people.

Professor Nigel Hunt, dean of the faculty of dental surgery at the Royal College of Surgeons, said of the new data:

“There is nothing to smile about in these woeful statistics.

“With the average five-year-old now eating their own weight in sugar each year, it is alarming that 42.1% of children failed to visit an NHS dentist at all in the last year.

“It is appalling that in the 21st century, tooth decay remains the most common reason why children aged five to nine are admitted to hospital. In some cases, these children undergo multiple tooth extractions under general anaesthetic – despite the fact that tooth decay is almost entirely preventable.

“We are failing to address this issue of improving children’s access to an NHS dentist and we urge ministers to act.”

Looking at things a little more locally, the NHS Oral Health Strategy 2012 – 2015 (Devon and Torbay) states:

Oral health is an integral part of general health and wellbeing. Good oral health enables individuals to communicate effectively, to eat and enjoy a variety of foods, and is important in overall quality of life, self-esteem and social confidence

We all know that children learn their behaviours from adults, so it’s vitally important to ensure you look after your own teeth and oral health, for yourself and your children.

The effects of poor dental hygiene on your body.

Oral health affects your whole body

As can be seen from the image here there is a significant link  between your oral health and your overall body health.

Diabetes. 95% of adults in America with diabetes also have periodontal disease and a third have advanced periodontal disease that has led to tooth loss.

Erectile dysfunction. Periodontal bacteria can travel through the bloodstream, inflaming blood vessels and blocking blood flow. Men with periodontal disease are seven times more likely to experience erectile dysfunction than men with good dental hygiene!

Heart disease. A study in the Netherlands of more than 60,000 patients showed that people with periodontal disease are twice as likely to develop heart disease. The researchers in the study found that 4% of patients with peritonitis had  atherosclerotic cardiovascular disease, compared to 2% without periodontitis. Even after taking other risk factors for cardiovascular disease into account such as diabetes, smoking and high blood pressure those with periodontal disease was still 59% more likely to have a history  of heart problems.

How to brush your children’s teeth and stay dentally fit

How to brush children's teeth

  1. Divide the mouth into six sections (Upper left back teeth, upper front teeth, upper right back teeth, lower left back teeth, lower front teeth, lower right back teeth) and take 20 seconds to brush each.
  2. Within each section brush the inner,  outer and biting surfaces of each tooth.
  3. Use a fluoride toothpaste.
  4. Supervise brushing up until the age of seven  years old.
  5. Brush twice a day.

If you follow this guide you will stand a much lower chance of developing tooth decay and cavities which can lead onto periodontal disease if left untreated.


Dental Cavities and Fillings, What You Need to Know

Decay and cavitiesIn this blog post our Barnstaple dentist takes a detailed look at dental cavities and fillings.

What is a dental cavity?

tooth decayA dental cavity forms when the outer surface of your teeth are attacked by acid excreting bacteria. The bacteria excrete acid as they digest sugar in your diet. The cavities can become larger as more bacteria sit in the cavity, excreting more and more acid.

In the beginning small cavities may have zero pain as they are in the outer surface of the tooth, but as they deepen and get closer to the nerve your teeth may become more sensitive or even painful whilst eating or drinking, particularly hot or cold food/drink.

This deteriorating process is known as a dental decay.

What is a dental filling?

A filling is simply filling up this cavity with a suitable material, your dentist will remove any decay and then fill the cavity back up to the original contour of the tooth.

What do they fill cavities with?

The exact material used to fill a cavity depends upon various factors:

  • The size of the cavity
  • The location of the cavity (in between the teeth, on the biting surface, on the front of the teeth etc.)
  • The philosophy of the dental practice, some practices prefer not to use mercury containing amalgam.
  • Affordability

What is a filling made of?

Depending on the criteria listed above there are a variety of filling materials which can be used.


This is a malleable metal alloy containing mercury. It has been shown to be extremely durable as a dental filling material and lasts many years. It does not however look particularly attractive.


Gold is virtually inert and is very well tolerated by the body. It’s highly polished surface also very closely matches the surface of dental enamel when viewed microscopically. This means it does not wear the opposing teeth and can be considered a highly biocompatible material.

Many people like the look of gold, it does not however look particularly natural and some people prefer to have a more natural looking filling.


Dental porcelain is made by combining various minerals with quartz, effectively making dental granite, an extremely hard and durable material! The porcelain is naturally tooth coloured and can be made highly aesthetic to blend in with the surrounding teeth. A porcelain filling will be made by a dental technician; this adds time to the procedure which means a porcelain filling often takes two weeks to complete.

Dental bonding.

Your dentist can also use a tooth coloured composite material to pack into the cavity once the diseased area has been removed. This has the advantage of being highly aesthetic and also highly convenient as it can be placed in one appointment. Dental bonding does however tend to discolour over time so may need to be replaced more often.

The cavity filling procedure

The procedure for having a cavity filled depends upon the material being used, generally the procedure will be similar to the following:

  1. Either your dentist or you notice the cavity and decide to take action.
  2. A discussion is had as to the best material to use clinically, there may be a few options which can be discussed that have different prices.
  3. A decision about the material is made, based on this decision the dentist will prepare the cavity accordingly. Some materials require specific shaped cavities in which to fit and so your dentist will prepare the cavity in the correct way.
  4. If you are having a direct dental bonding them the composite material will be placed directly, if not your dentist will take an impression of the prepared cavity, place a temporary filling and send this impression off to the dental laboratory to have the new restoration manufactured.
  5. If you had a dental bonding composite filling then step 4 would have been your last stage, if a dental laboratory is manufacturing your filling then this will be returned approximately 2 weeks later and you will visit the dentist to have this fitted.
  6. A review of this filling will take place at your six monthly check-up at the dentist.

Tooth cavity fillings at home

There are cavity filling kits available in various pharmacies and online. They may seem like a cheap and convenient option however they should never be used as a permanent solution.

Home kits may well fill the cavity however the chances are you will be filling over bacteria which will continue to cause dental decay underneath. This means you may not notice this decay until it has reached the nerve of your tooth, by which time more expensive dental procedures may be required.

If you need to use a tooth cavity filling at home, consider this an emergency repair and always make an appointment to visit your dentist within the next week or so.

Preventing dental cavities

It is always better to prevent problems arising in the first place rather than try to cure them once they do. The best way to prevent dental cavities is to:

  • clean your teeth twice per day for 2 min using a fluoride releasing toothpaste.
  • Clean in between your teeth with an interdental brush or floss.
  • Use a fluoride mouthwash after meals but NOT after brushing.
  • Visit your dentist regularly as they will be able to detect the tiniest cavities in places that you cannot see.

By doing everything you can to prevent cavities forming and then visiting your dentist regularly so that if there is any decay it can be dealt with quickly and simply, you can keep the cost of dentistry down and ensure you remain fit and healthy for life.

Our North Devon based dentist is here to help you stay dentally fit for life, keeping dental decay and cavities to the absolute minimum.