We believe our clients achieve some of the best orthodontic results you will see anywhere. This is largely as a result that they have the best gum health. This is critical towards the quality orthodontic results as seen on this website with most images taken just a week after the brace were removed.
However, not everyone who attends here at the first visit will have good gum health: there is a history of gum bleeding on brushing, signs of gum swelling and inflammation. So what do we do to help towards a more ideal oral health status?
After years of getting it wrong and frustration in the 1980’s and 1990’s we worked a protocol which we have perfected. It was so good, we were invited to present our research at a British Orthodontic Conference.
Here is a typical summary of a possible conversation at the first visit directed towards improving the gums (of course, there are a few more questions we would undertake to understand your needs):
Client: ‘I really want my teeth straightened.’
Orthodontist at FIRST Impressions: ‘Sure. Let’s see how we can achieve this.’
Orthodontist carries out an examination which includes a gum health check.
Orthodontist: ‘ There are a number of options we can speak about. However, before orthodontics, there seem to be areas where the gums can be improved. This will help towards a more perfect and more comfortable orthodontic journey. Would you like us to show you some simple methods to get the gums better?
Orthodontist: ‘ Think of gums the same as skin. We know healthy skin does not bleed when we scratch it. Healthy gums, is the same. They should not bleed when we brush them. If one was to scratch the finger nail bed and it started to bleed one would think something is wrong and they would go to see their doctor. It is the same with gums. It is a warning sign that something is not quite right’
Depending on the presentation, we will show one of three methods which we can use to improve the situation:
- The most common is improved brushing technique with the right pressure and the right duration. It is surprising how this simple technique can make a significant improvement.
- Use of disclosing tablets.
- Use of disclosing solution. This is when it is particularly compromised and we feel the clients needs special help.
The third is the most comprehensive and sometimes the best in children. We will provide you with the right Tepe toothbrush and if necessary Curasept – an anti-inflammatory gel. Where appropriate we will also show the use of Tepe ‘Easy-picks’. Curasept and Easy Picks are two of the best products I have found in my career that has significantly made it easier to attain and maintain gum health.
The key to any advice is to demonstrate it so the clients gets to know how ‘it feels’ and how much pressure to use. This is critical and the main factor that dramatically changed our protocol with our clients. Asking clients to brush better or spend more time is not correct and does not give consistent results. Additionally, over-brushing or over cleaning will cause gum recession! We will focus on getting is just right. It is not complex or time consuming. It can be so easy!
Orthodontist: ‘Disclosing solution will show the cause of the problem.’
Below is a picture of the disclosed teeth of the same client as in the previous image.
Orthodontist: ‘The coloured bits is the plaque. This is bacteria irritating the gums that causes the bleeding on brushing. It normally takes 20 circles going over the part where the gum joins the tooth and then between the teeth to remove it. The bleeding will happened on brushing for the next few days and gradually less and less as they heal. The plaque will return over 12 hours which is why dentists recommend brushing twice a day and you have to keep up with it. If you ignore the gum bleeding or brush less it will only get worse.’
At the second visit the picture shows the huge improvement.
During treatment the patient maintained high standards by the use of disclosing tablets.
Two days after removing the brace:
10 visits and 14 months of orthodontics, another happy patient and orthodontist.
HOWEVER, ITS NOT ALWAYS GOOD NEWS
We assess gum health due to its importance at every visit. Preserving as much healthy gum as possible is the key to good oral health and general well-being.
Once gums have receded it is impossible, or very hard, to get it back.
We will be helpful and informative. If your gum health has deteriorated we will repeat or modify the technique or change the oral health aids. It is not about ‘brushing harder’. In fact brushing harder can be disastrous as it can easily cause gum recession and add to complications. Neither is it about using more floss or electric brushes. More information on electric brushes
Here is the good news:
Gums that bleed on brushing is a sign of disease – gingivitis. This is reversible with good oral care. Our approach to oral health promotion been researched and evidence based.
We are keen for our clients to have as perfect oral health as possible in an easy manner. We promote these useful aids which we have carefully researched and reviewed for your oral health gains and are all for purchase as a non profit making part of our service.
Eventually, gingivitis will causes bone
This is when it is called periodontitis. Bone lost cannot be regenerated and left to proceed the teeth will eventually loosen and often need extracting.
Here is a x-ray of a patient seen at FIRST Impressions as the teeth had drifted and the patient wanted to close the gaps and straighten the teeth. The x-ray shows the result of periodontitis: bone loss and loss of teeth!
WHAT DOES PLAQUE LOOK LIKE UNDER A MICROSCOPE?
Now you know why we want you to come here with a clean mouth.
Disclosure: all our sterilisation processes meet with the Health Technical Memorandum 01-05 decontamination in primary care dental practice.
We keep both manual and electronic audits and verification test results to ensure no cross-infection occurs in our clinic.
Mahesh Patel, Director and Clinical Lead.