Who said I’m camera shy !

6th January, 2015

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“Please make me look nice for my daughter’s big day!”  These were the words of a loving mother who desperately wanted nice teeth for what was going to be one of the most important days of her life, her daughter’s wedding.   For most of her life,  she had lived with a smile she was very unhappy with.  Her top teeth were very uneven and discoloured.  The  old existing crowns towards the back of the mouth  had began to deteriorate, as well as a tooth which had become very stained and unsightly.   The gap in between her front  two teeth always seemed to draw attention to her not so great smile.  This  made her feel very self conscious and even embarrassed.   She would never smile in front of the camera,  and even in general conversation,  she would raise her hand to cover her mouth.  Friends and family always thought she was very quiet, but in reality, she lacked so much confidence that smiling, laughing and even talking was something she found very difficult.    She wanted a smile that would make  her  look and feel great.

With careful thought and planning, Dr Dixit achieved this transformation by using a combination of all ceramic crowns and veneers.  To make the teeth brighter , the teeth were whitened using the home whitening system.  The heavily filled teeth were protected with new crowns and the new veneers helped to improve the shape and position of the teeth.  The colour was matched exactly to the patients new teeth colour.  The crowns and veneers were made to look as natural as possible.

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The patient was very pleased with the results.   It had given her so much  confidence that she felt like a new woman.  She looked and felt amazing.  The discoloured front tooth and filling had gone and the visible black lines were no longer there.  She finally had the smile she always wanted.



What’s the Best Way to Whiten My Teeth?

20th December, 2014

Smiling woman Many people are looking for that brighter, whiter smile but did you know that research (1)  seems to indicate that it’s not actually a white smile which people find attractive, rather, it is a yellow smile which people find unattractive.

The researchers found that:

Whitening had no effect beyond that produced by natural colouration. This indicates that these colour induced alterations in ratings of attractiveness are mediated by increased/decreased yellowing rather than whitening per se.

As we get older our teeth yellow with age and whitening them back to their natural colouration is all that is required to achieve the most attractive smile, so what is the best way to whiten your teeth?

The best way to whiten teeth.

Here’s a simple list:

  1. Good oral hygiene.
  2. Over-the-counter teeth whitening products.
  3. Home teeth whitening.
  4. Restorative treatments such as immediate veneers, dental veneers dental crowns.

Good oral hygiene.

The first step to enjoying whiter teeth is to maintain good oral hygiene. Firstly this will help keep your natural teeth as white as possible, if plaque (2) is kept at bay then staining is less likely to build up on your teeth. Secondly, before you have any of the other teeth whitening treatments you’ll need to ensure that your teeth and gums are in good condition. Most dentists will not offer any form of cosmetic or whitening treatment if you’re oral hygiene is not up to scratch!

Over-the-counter teeth whitening products.

There are many products available to buy over-the-counter in your local pharmacy, However, the Daily Mail (3) says:

Experts warn that some products which claim to whiten could actually harm your teeth, gums and even your stomach lining.


While some of these products may work their effectiveness and safety isn’t monitored by a dental professional and therefore they come with some risk if you use them at home.

Another trend in teeth whitening is to go to beauty salons or other establishments other than a dental practice. Whilst this may be cheaper than going to a dentist it is also illegal! Teeth whitening falls under the category of “the practice of dentistry”, the General Dental Council (4) says:

The practice of dentistry is limited to GDC registrants. It is the Council’s view that applying materials and carrying out procedures designed to improve the aesthetic appearance of teeth amounts to the practice of dentistry. So too does the giving of clinical advice about such procedures. Therefore all tooth whitening procedures, including bleach and laser treatment, are seen as the practice of dentistry by the General Dental Council.


It is important to know the teeth whitening products contain an amount of peroxide, this peroxide can be dangerous if not used correctly and it is for this reason that we recommend you only visit a suitably qualified dental professional for your teeth whitening.

Home teeth whitening.

teeth-bleaching-tray-300x196When you have home teeth whitening you will be provided with a custom made and closed fitting bleaching tray, into this tray you will apply the bleaching gel which is held against your teeth.This bleaching tray has some unique features:

  1. It will be extremely close-fitting ensuring that you use the minimum amount of gel with each application, this means the gel goes further and lasts longer.
  2. The tray is customised for you, it can only be used by you.
  3. It will put a very slight amount of pressure around the tooth/gum margin. This is to create a seal in this area to prevent the peroxide gel from touching your sensitive gums.

These design features are extremely important to ensure that the treatment is not only effective but safe too, only a qualified dental professional is able to prescribe one of these trays.

Something to watch out for, the bleaching tray is made from a thermoplastic, this means you will need to keep tray away from hot/warm water as it could distort.

Restorative treatments such as veneers or crowns.

In some extreme cases with very dark teeth conventional teeth whitening is not able to lighten the teeth enough.

Before treatment

After treatment

As you can see from the case above these teeth were particularly dark and the patient wanted them particularly liked, there was also another complication, and existing Crown on the front tooth. Dental crowns and veneers cannot be lightened with teeth whitening techniques, so if you have an existing restoration then this will need to be replaced as part of the whitening process.

This lady wanted to improve her smile, have it more natural looking and whiter than it was before so we prepared her teeth for porcelain crowns to achieve an excellent result, what do you think?

>> Read more about this case here


Many times a combination of treatments can be used to whiten your teeth, you may have a single tooth which is too dark to whiten using the bleaching method, but we may be able to whiten the surrounding teeth and then use a single dental veneer or crown on the very dark tooth to whiten that the same shade.

The cost of teeth whitening treatments will also vary enormously depending on the complexity of your case. To give you an idea of dental fees please visit our fee guide. By far the cheapest way of maintaining unnaturally bright smile is to keep your teeth in excellent dental health. This will keep plaque at bay and ensure that the buildup of any staining on your teeth is kept to a minimum. The next most cost-effective method is to consider teeth bleaching however this is not always suitable for the reasons already stated.

Teeth Whitening References:

  1. “Evidence to Suggest That Teeth Act as Human Ornament Displays Signalling Mate Quality”  Colin A. Hendrie, Gayle Brewer  Published: July 31, 2012DOI: 10.1371/journal.pone.0042178  http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0042178 site accessed 18/12/14
  2. Information on Plaque From Wikipedia http://en.wikipedia.org/wiki/Dental_plaque site accessed 18/12/14
  3. The Daily Mail: DIY dazzlers: High Street tooth whiteners put to the test Read more: http://www.dailymail.co.uk/health/article-1282977/DIY-dazzlers-High-Street-tooth-whiteners-test.htm site accessed 18/12/14
  4. General Dental Council : Tooth whitening Q and A’s. http://www.gdc-uk.org/dentalprofessionals/standards/pages/tooth-whitening.aspx site accessed 18/12/14


Blue Court Dental Centre is a local dentist in the heart of Harrow, Middlesex. They offer a range of dental treatments including teeth whitening, dental veneers and oral hygiene programs to help keep your teeth looking fresh and bright for life.

Top Tips for People Wanting to Replace Missing Teeth

25th November, 2014

If you have missing teeth then there are a variety of reasons why you might want to replace them. Indeed, some people may not want to replace missing teeth and just leave the gaps so we are going to start this short article by explaining why you should consider replacing missing teeth. If you understand the reasons why replacing missing teeth is important (other than the obvious cosmetic reasons) then you may also be better placed to make the best decision about which option is right for you.

Preventing adjacent teeth from drifting.

Teeth drifting without replacing the one lostYour teeth are all in fine balance with one another, each tooth gently supports its neighbour which prevents it drifting. If you have a gap then that support is lost and the teeth either side of that gap can actually begin to move and drift into the space.

Preventing opposing teeth from over erupting.

The same applies with teeth on the opposing jaw. Having your teeth meet together on a regular basis during the day helps to keep them in the right place. If you have a tooth missing then it’s opposing tooth will have a tendency to over erupt and drift down into the gap.

The image to the right shows how both of these processes work. The black arrows show the drifting of the adjacent teeth and the opposing teeth, but why does this matter?

Drifting of teeth like this causes a few problems:

  • Cosmetic. Take a look at the gum line on the top jaw around where the tooth has moved in the image. The natural contour (known as gum architecture) of the gum line has changed which can cause aesthetic issues.
  • Bite problems. Your teeth are in fine balance with one another as you chew and eat. As you slide your jaw to the left and right the cusps of your teeth work in unison with one another. If you’re teeth move out of this fine balance the muscles of your jaw may have a tendency to overwork in order to compensate, by moving your jaw in a slightly different trajectory in order to eat.
  • Problems restoring the teeth later on. As the teeth move in the direction of the arrows the gap can become smaller and smaller. The adjacent teeth can drift and end up at such an angle that restoring them with either crowns or bridges at a later date can become difficult. Whilst this isn’t an immediate problem it can cause problems later on if you subsequently decide to replace the missing tooth with either a dental implant or bridge.

Your options to replace a missing tooth.

The replacing missing tooth is important as it prevents the problems above from occurring, but what is your best option? Let’s look at them in turn, your primary options are as follows:

  1. A dental bridge.
  2. A denture.
  3. A dental implant.

Dental Bridges.

dental-bridgeDental bridges have been around for many years now and are an excellent solution to replace missing teeth. They have an excellent lifespan, look fantastic and with modern techniques, should be indistinguishable from a natural teeth. There are however two problems with dental bridges.

  1. They often require reduction of the teeth either side of the gap. If these are healthy then reduction of healthy tooth tissue is required. Many dentists dislike doing this as they preferred to keep your natural teeth for as long as possible.
  2. The bone around where your tooth has been lost will continue to resorb over the years. Sometimes, this bone loss means that a gap forms underneath the false tooth of the breach. This can create a problem with speech, cosmetics and may become a food trap. In many instances remaking the breach to extend down to this new gum line is required, This can be an expensive option.


Dentures can also be used as a highly cost-effective way to replace missing teeth. They are often the cheapest option which makes them attractive to many people. Modern techniques can also make dentures look highly aesthetic and like dental bridges, be almost indistinguishable from your natural teeth.

The biggest disadvantage with dentures is that people often don’t like to have to remove them to clean them, they can affect the surrounding gum and cause ulcers if they don’t fit particularly well. Dentures need to be regularly maintained and so frequent visits to your dentist are required in order to ensure that your dentist days in excellent condition.

Dental implants.

Dental implant versus natural toothA dental implant is essentially a replacement for your natural tooth root. Once the dental implant is placed into your jaw a crown can be placed on top. These can look highly natural and be completely indistinguishable from your natural tooth. Whilst dental implants tend to have the highest initial outlay of all of the options to replace missing teeth they can be the best value solution over their lifetime.

Because a dental implant is actually placed into the bone the bone is supported. This means the bone loss which occurs with dentures and dental bridges does not happen, with the dental bridge or denture, when this bone loss occurs you may need to have the bridge or denture replaced. This can add to the cost of the overall tooth replacement. With a dental implant this doesn’t happen.

Many dental practices also offer interest-free finance for treatments such as dental implants allowing you to spread the cost over an extended period, this also makes the treatment much more affordable.

Further resources for dental implants.

The British Academy of Cosmetic Dentistry have a website with further information about dental implants and the likely costs. www.bacd.com

The Association of Dental Implants (ADI) Have a large resource library for patients, it includes answers to the most common questions and can be accessed here www.adi.org.uk


Blue Court Dental Centre is a local dentist in the heart of Harrow, Middlesex offering a range of teeth replacement options including dentures, dental bridges and dental implants. They offer a free consultation for dental implants and have a free guide for immediate download which offers information and advice about replacing missing teeth.

Why You Should Have Straight Teeth, This Might Surprise You.

14th July, 2014

Presentation1One of the main reasons people decide to have orthodontic braces to get straighter teeth is because straight teeth look better, but from a purely dental and health point of view this is not the main reason you should consider straighter teeth. Did you know that straight teeth are easier to clean? And being easier to clean means they are healthier…

Irritable Bowl Disease

Recent research has shown a link between oral bacteria and a flareup of irritable bowel disease, The research identified that the bacteria invaded the bloodstream which then aggravated any existing irritable bowel causing the flareup, these bacteria are commonly found in the mouth! This research is linked to additional research which shows that the bacteria associated with gum disease and the more severe periodontitis can act as a keystone bacteria, this means their presence can instigate other processes and pathogens in the human body which can lead to Colon cancer and other inflammatory diseases.

So it’s clear that not only will keeping your teeth clean ensure that your teeth are healthy, it also helps to promote overall body health… So where do straight teeth fit in?

Straighter teeth are far easier to clean as you can get into those difficult to reach areas between your teeth. If your teeth are crooked or overlapping then it is harder to reach these areas, particularly with floss. This can lead to a buildup of these harmful bacteria which could eventually lead to the onset of other inflammatory diseases around the body.

So now that you know the importance of straighter teeth, let’s look at some of your options if you decide to have braces.

Option 1: Cfast

cfast Orthodontic braces with clear brackets and tooth coloured wiresCFast is one of the most modern option for orthodontic braces in our Harrow dental practice. These braces is a combination of tooth coloured wires and clear brackets to straighten the front 6 teeth on the top and bottom jaw only.

Because we are only straightening these front teeth we can move them much faster than standard braces which may also be moving the back teeth also. This makes CFast excellent for cosmetic orthodontics and also helps to straighten the teeth making them easier to clean.




Option 2: Six Month Smiles

Six Month Smiles is is one of those orthodontic systems which does exactly what it says on the tin, straighter teeth in approximately 6 months!

Before and after six month smiles

Once again, this is the modern alternative to classic train track braces and works with a trademarked clear bracket which is bonded due tooth.

These brackets are barely visible and are able to achieve a predictable result using low forces with short overall treatment times which means the treatment is more comfortable, safe and allows you to keep your teeth cleaner, which is great if your overall body health.

The results with six months miles can be quite amazing.

Option 3: Inman Aligner

Inman alignerThe Inman aligner offers an alternative type of orthodontic brace. Both of the options above are fixed orthodontics, the Inman aligner is a removable option. This has the advantage of being able to use different forces in the way of springs to move your teeth.

As you can see in this image these braces push and pull your teeth at the same time, working from inside your mouth and outside in unison with one another. This unique way of using braces means we can achieve a straighter smile in approximately 12 to 16 weeks, much faster than any other orthodontic system.

You would need to ensure that the where these braces for a minimum of 20 hours per day, removing them only to eat and clean your teeth. This means your commitment to wearing braces needs to be high with you strongly motivated to achieve your straighter smile.

Once again, the Inman aligner is only used for the front six teeth to straighten them out providing you with an easier to clean smile.

Option 4: Clear Braces

Clear bracesThese braces, once again, do exactly what they say on the tin, they are clear! These clear braces work by applying a small amount of pressure to your teeth in the direction required to move them. Once this small amount of movement has been achieved you will replace the removable clear brace with a new one. Typically replacing each race every two weeks.

Treatment times are approximately one year with this system, depending upon how much your teeth need to move. Once again we are normally only moving the front six teeth into a straighter alignment to achieve a more cosmetic result which is easier to keep clean.

As with the Inman aligner you will need to wear your clear braces for approximately 20 hours per day, only removing them to eat and clean your teeth. You can even continue to wear them in full view of the public, perhaps whilst teaching or giving a presentation, nobody else will ever know!

How to get orthodontic braces

We recommend that you do some research online before deciding which dentist to go to to have orthodontics. The systems described above require that your dentist is certified to use them, we suggest you ask to see this certification at your initial consultation. Many dentists offer an initial consultation either at a discounted rate or for free, do spend some time looking at their website to see if this is on offer at the dental practice local to you.

We also recommend that you ask the dentist for a series of reviews of their practice, this will leave you with peace of mind knowing that you have found a practice that other people like.

A good dentist should also have a range of before and after photographs to show you, please ask to see them when you go for your initial consultation. The photographs should be presented nicely and you should clearly be able to see the difference between the before treatment and after treatment photographs. Seeing these images allows you to know that the dentist you have found can actually do what they say they can and achieve the results that you want. Most dentists will have a range of photographs, so asked to see photographs which are similar to your own situation.

If you live in the Harrow HA1 area of Middlesex Then why not pop in to see us on the Watford Road. We are a modern dental practice offering a range of orthodontic braces to help you achieve a straighter and healthier smile… And we also offer a free consultation to anyone considering braces, please click here to download a voucher entitling you to this free assessment.

My Sweet Treats

7th July, 2014

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This young gentleman came to us when he started noticing something very odd about his tooth.  It appeared to be changing colour.  It started off as a greyish shadow, and as months went by,  it became darker and more obvious.  A large groove had developed and every time the patient laughed or smiled, he would raise his hands to cover his mouth (picture 1).  For a very sociable young man, his confidence had started to drop.

After a consultation between the patient and Dr Dixit, it was found that the patient had a high sugar diet consisting of fizzy drinks, cakes and biscuits.  The frequency of the sugary foods and the inability to clean affectively caused his tooth to decay close to the gum margin.  To restore this badly decayed tooth,  the decay was cleaned out (picture 2)  and replaced with  a composite tooth coloured filling material (picture 3) .


The  filling material blended in with the patients existing tooth colour.  The patient was very pleased with the result.  His confidence had been regained and he no longer covered his mouth when he laughed.  He felt very proud and happy to show off  his natural looking new tooth.

A cosmetic dentistry article by Nishan Dixit

19th June, 2014

As a board member and scientific director and education chair of the British Academy of Cosmetic Dentistry, our very own Dr Nishan Dixit is often asked to publish articles on successful cases so that others in the dental profession can learn from his successes. Here is one such article published in The Dentist, Issue 76,  April 2014.

A Happy patient

Nishan Dixit describes a non-invasive composite restoration using a multi-layer technique.


Pre treatment

Pre treatment

67 year old male patient presented with a lingual cusp fracture in his lower right first pre-molar, which had an old amalgam restoration. He was not experiencing any pain, but was aware of the rough edge. Since the fracture had occurred, the patient had also become more self-conscious about the discolouration of the tooth.

The treatment options were discussed with the patient. The tooth could either be restored with a direct composite or an indirect laboratory-manufactured restoration. The patient decided on the composite option, as this would provide a more immediate and less disruptive solution. I prefer to offer composite treatment, rather than more invasive procedures, when the clinical situation allows. This is more affordable for the patient, and the durability of the material makes it a realistic long-term alternative.




Having been a provider of cosmetic dentistry for almost 20 years, I have observed a number of improvements in materials. Long-term studies have proved the reliability of modern composites. The latest developments have produced composites that are more resistant to wear and have better colour stability, combined with reduced polymerisation shrinkage rates.

Composite selection

For a number of years,I have used the Heraeus Venus range of composites exclusively, due to their handling properties and the results achievable. For this case, I chose to use Venus Pearl. It gives high aesthetic outcomes using a multi-layer technique, providing excellent colour adaptation and a natural finish. The material is easy to use, masks well and is highly sculptable and polishable. Compared with earlier technologies, the cured  composite is more flexible under stress and more durable over time.

Venus Pearl includes super-fine nano-hybrid filler particles. This provides even more natural light refraction and supreme aesthetic appearance, combined with a creamy application.

Treatment and outcome

At the treatment appointment, local anaesthetic was administered and the tooth was isolated with rubber dam and a clamp system. The old amalgam restoration was removed and the cavity was rendered caries free. The preparation margins were smoothed and the enamel margins bevelled. A matrix band was then adapted to the tooth. The prepared cavity was etched with 37 per cent phosphoric acid using a total etch technique. The cavity was thoroughly washed, gently dried and primed. Then a bonding agent was placed and polymerised.

Venus Pearl OMC (Opaque Medium Chromatic) was applied to the cavity in 2mm increments. The composite was adapted to the cavity, using a microbrush in a ‘patting’ motion, then polymerised . Approximately 20 per cent of the cavity was filled with OMC and the remaining 80 percent was filled with the Venus Pearl A3 shade. The build-up of the composite was done on a cusp-by¬cusp basis, gradually creating the tooth shape and fissure pattern. During the incremental build-up a small amount of dark brown stain was applied in the fissure areas using an explorer.

Finally, the restoration was polished with Venus Supra discs and a silicone carbide brush. The outcome was a restoration with good aesthetics, achieved with minimum loss of tooth substance and completed in one short visit. The patient was extremely pleased with the end result, leaving him feeling like he had “a new, natural-looking tooth”. He had absolutely no post operative sensitivity or pain. Subsequent recall appointments have shown this has continued to be the case. The treatment has left a healthy tooth and a happy patient.

Practice Update

14th May, 2014

Dr Nishan Dixit recently attended The American Academy of Cosmetic Dentistry’s (AACD) annual meeting in Orlando, Florida, USA.

The conference, AACD 2014, took place April 30-May 3 and was the Academy’s 30th anniversary scientific session. Dr Nishan Dixit had access to multiple hands-on workshops and lectures during the conference, which was attended by an estimated 1,700 dental professionals.

The conference is cosmetic dentistry’s premier event, with some of the world’s most well-known dental educators, live dentistry, access to the latest cosmetic dentistry innovations in the AACD Exhibit Hall, and much more.

Dr James Hastings, the current AACD President said:

“By attending AACD 2014, Dr Dixit is not only showing his commitment to education and the cosmetic dentistry field, but to his patients, the education he received in Orlando will help him provide the best care to those he cares about the most.”

Have your teeth become crooked again after having braces when you were younger?

21st February, 2014

 European Society aesthetic orthodonticsOne of the most common reasons for patients visiting the dentist for teeth straightening is relapse after having orthodontics when they were younger. Patients often find that once they stop wearing their retainers that their teeth can begin to move back to where they were before. Coupled with the fact that as we get older our teeth have a tendency to drift forwards and become more overcrowded.
So if you find that your teeth are becoming more crooked again, after having orthodontics as a child, then you are not alone.

So what is the solution?

The European Society of Aesthetic Orthodontics (ESAO) recognises the need for a variety of orthodontic treatments of this nature and ensures that its members provide a qualified, informed choice for patients when considering this type of treatment, Dr Nishan Dixit is pleased to be a member of the ESAO and can offer you a wide range of orthodontic options from his dental practice in Harrow.
Teeth-straightening  can be a relatively simple, speedy and painless option if you have crooked teeth, so let’s look at what those options are:

Rapid Tooth Straightening

Within this category of orthodontics fall 3 particular treatments:
  • Six Month Smiles
  • Inman Aligner
  • CFast

Six Month Smiles

Faith Hill has adult orthodontic bracesAs the name suggests Six Month Smiles offers orthodontics which take, on average, six months to achieve the new look. The system is fixed using tooth coloured wires and brackets to ensure that no one else knows that you have braces fitted. As with most of these aesthetic orthodontic options Six Month Smiles is only used to straighten the front six teeth, often known as the social six.

Inman Aligner

This is a removable appliance, which utilises a revolutionary spring design which both pushes and pulls at the same time depending on where we want teeth to move. The brace can only move your front six teeth by gently  de-rotating them and then realigning them. Unlike six month smiles you can take out an Inman Aligner, you need to resist this temptation as much as possible and ensure that you wear your aligner for around 20 hours per day, simply removing it to eat, drink and clean your teeth.
One of the big advantages with the Inman Aligner is due to the revolutionary technology in the springs which  enable it to move your teeth very quickly, often in around 12 weeks. If you have a short period of time to have your teeth straightened then the Inman Aligner could be your ideal option.


This technique is similar to 6 month smiles in that it utilises fixed orthodontics to move your teeth into their new positions. The system also utilises almost invisible orthodontics with clear braces in some instances. This makes Cfast one of the most versatile orthodontic systems around meaning you get the best teeth, straightening result with the minimum amount of hassle.

Almost Invisible Tooth Straightening

Clear Aligners

Clear Aligners - invisible bracesClear Aligners are exactly that, completely clear. They work by moving your teeth a small amount at a time. You will be provided with a series of aligners which you will typically wear for about two weeks each. Each aligner puts a small amount of pressure on your teeth to move them or rotate them to their new position. Once your teeth have moved a tiny amount you will replace the aligner with the next one in the series.
The art with using clear aligners is for  your dentist to choose exactly the right amount aligners for your particular case to ensure that your teeth move gently into their new positions.
Many people like clear aligners as they are virtually invisible to the naked eye, this means that if you have a high profile job or are in the public eye you can have straighter teeth with no one else knowing!

In Summary

Adult Orthodontics are one of the most popular cosmetic treatments requested by patients in many dental practices around the UK, and certainly, this is the case at our practice in Harrow, Middlesex. By offering you a range of treatments and being members of the ESAO you can be sure that you are offered something which fits not only your budget but your exact dental requirements.
We strongly recommend that you keep an open mind with regards to treatment, the descriptions listed above are relatively simple and there are additional requirements for each of them to be used. It may be that your dental situation is more suited to one system than another. So going to your dentist with an open mind allows you to be free to choose the best option to you.
Blue Court Dental Centre offer a free consultation, with our treatment co-ordinator, for anyone wishing to find out more about aesthetic orthodontics for teeth that have moved after having braces as children. Simply complete the download here to request your appointment.

How much sugar is too much sugar?

21st January, 2014

In the dental profession we have been warning about the intake of too much sugar for many years,  but why is this? It was originally the ancient Greeks that noticed that if they ate too many soft sweet things it destroyed their teeth, at first they thought it was the sugar which was directly responsible for attacking the teeth however we know today that this is not the case.

When you eat sugar not only does it act as a food for you, it acts as a food for the streptococcus bacteria in your mouth. As these bacteria feed on the sugar they excrete acids and it is these acids which eat away and attack the enamel outer layer of your teeth. These bacteria can be found in the plaque which often collects in between teeth or around the tooth/gum margin, this is why it is important to keep your teeth cleaned daily, flossing and rinsing to ensure that the plaque does not build up and give somewhere for the bacteria to hide.

So, back to our original question..

How much sugar is too much sugar?

The Journal of Dental Research carried out a systematic review to inform WHO guidelines on the effects of restricting sugar intakes in various age groups. The research looked at % of sugar in a daily diet and its relationship to the onset of decay. The problem has been that the research has been interpreted misguidedly.

Various newspapers have unfortunately taken the step of converting this % of sugar into a spoonful amount, probably to make it easier for the general public to work out how much sugar they should be having. These Papers have converted this into between 5 and 7 teaspoons per day. Unfortunately doing this leads people to assume that they can have 5 or 7 teaspoons per day on their cereal, coffee , tea or anywhere else they add sugar.

The biggest problem is they forget that most of the sugar we eat daily is hidden within foods, not added by us afterwards. If we only count the spoonfuls of sugar we add to our food then we will be dramatically exceeding the recommended amounts!

The research reported the following results in their abstract:

  • 42 out of 50 of the studies in children, and 5 out of 5 in adults, reported at least one positive association between sugars and dental decay
  • there was “moderate quality” evidence showing a lower risk of dental decay when sugar intake is less than 10% of calorie intake, compared with more than 10%
  • there was “very low quality” evidence showing a lower risk of dental decay when sugar intake is less than 5%, compared with 5-10% of calorie intake

So it seems that the research is suggesting if we keep our sugar intake below 10% of calorie intake then there is ‘moderate quality’ evidence to show a lower risk of dental decay… So perhaps we should start doing that!

How do we know how much sugar we are eating?


We thought we’d give a rough guide to the amount of sugar contained within various food stuffs so that you can be sure to keep your intake ideally less than 10%.

  • A can of Coke contains approximately 11 spoonfuls of sugar increasing to 28 spoonfuls in the largest bottle
  • a McDonald’s Coke also contains 28 spoonfuls of sugar
  • a tub of Haagen Das ice cream contains 21 spoonfuls of sugar
  • the average chocolate bar contains around 10 spoonfuls of sugar
  • one breakfast pop tarts contains approximately 4 1/2 spoonfuls of sugar
  • One bowl of frosted cornflakes contains 6 spoonfuls of sugar
  • One NutriGrain Contains 3 1/2 spoonfuls of sugar
  • A Starbucks Mocha Frappuccion contains 12 spoonfuls of sugar
  • A McDonald’s Medium chocolate milkshake contains 28 spoonfuls of sugar

Statistics taken from Sugar Stacks - They have included all forms of sugar in these statistics and have simply turned it into a ‘spoonfuls’ amount to make it easier to understand.


Research over the years has clearly shown that Eating too much sugar will directly impact oral health, the only question lies around exactly how much is too much. The new research seems to suggest that when we keep sugar intake below 10% (Or around 5 to 7 spoonfuls of all sugar intake per day) there is moderate quality evidence showing a lower risk of dental decay, and that can only be good.

Our advice therefore is to look at the quantity of sugar in the food that you eat, remember that sugar can be from many sources and it’s not just the sugar which we add to food that counts.

So how much sugar do you eat per day? Let us know in the comments section below this blog post, and then tell us what you’re going to do to cut down…


Teeth Whitening – An Honest Review

17th December, 2013

With more and more people looking for cosmetic dentistry, particularly teeth whitening in the Harrow area we thought we would write an article which outlines some of the problems faced by the general public when looking to have whiter teeth.

Driving down the cost of teeth whitening

whitening-productsTeeth whitening is often viewed as a quick fix and many people are looking for the cheapest option. This has driven many patients to the idea of whitening their teeth at home – just doing a search for teeth whiteners on Amazon brings up a whole host of options including home whitening kits, elastic gel whitening strips, advanced teeth whitening programs, toothpastes, laser lights and whitening pens.

Amazingly some of these products start from as low as 30p for the plasma whitening light and £3.17 for the whitening pens so it is easy to understand why the temptation is there. Here’s more detailed information on that search on Amazon.

Also reported in the Harrow Times a couple of years ago was a trading standards report which carried out tests on some DIY whitening products and found some of them contained 7.3% hydrogen peroxide which is way over 0.1% legal limit.

We’re aren’t suggesting that any of these products shown here contain these unacceptable levels of hydrogen peroxide, but it’s worth noting that when you purchase things on the Internet you don’t always know exactly what you’re getting as everything is unregulated.

Going to a Beauty Salon for Teeth Whitening

Whilst whitening clearly falls within the realms of helping one’s self look and feel better it is worth noting that the General Dental Council (GDC) say:

“We believe that teeth whitening is part of the practice of dentistry and dentistry must only been carried out by the professionals that are registered with us…”

This means that if you have your teeth whitened by anyone other than a dental professional it could be considered illegal and prosecution could follow. The process of whitening teeth uses hydrogen peroxide to bleach them, whilst this is in a very low concentration it needs to be carefully controlled around your delicate gum area. The way this is controlled is by manufacturing a highly customised and bespoke ‘tray’ which fits over your own teeth, this tray is designed in such a way to prevent leaking of the bleaching gel into the gum area.

The manufacture of these trays is something which needs to be undertaken by professional that knows exactly how to design them to prevent damage to your delicate gum.

jailed_OPTTeeth whitening is also not suitable for everyone, you need to have good oral hygiene and be free of certain dental diseases. Only a trained dental professional will be able to tell if your oral health care routine is good enough to have whitening, we have even seen cases where patients have had teeth whitening by non-dental professionals and that patient’s teeth was covered in plaque. The results of this was that it wasn’t the teeth which were whitened, but the plaque, and this will pick up staying again very quickly.

A dental professional would recognise this problem early on and recommend a course of oral hygiene education/treatment before the teeth whitening is carried out.

In rare circumstances we have also seen teeth whitening performed by non-dental professionals to cause burning of the gums. This can happen if the customised whitening tray does not fit well enough, once again it takes a fully trained dental professional to recognise this problem at an early stage.

The problem of non-dental professionals undertaking teeth whitening has become so great that a new organisation has come into formation.


The teeth whitening information group (TWIG) is a group of dental professionals and manufacturers who are concerned about the problem of harmful, illegal products and unqualified people carrying out teeth whitening. They offer a useful information leaflet and a facility to report any illegal teeth whitening happening around Harrow area and beyond.

If you notice any non-dental professional offering teeth whitening please do contact TWIG 

So, what do you do if you want safe teeth whitening?

The only way to know for sure that you will be safe during teeth whitening is to visit a dentist. This dental professional will have a detailed understanding of your oral health and be able to advise if teeth whitening is suitable for you. Unfortunately it’s not always that simple this article in the mail online talks about how one patient spent £600 on teeth whitening and saw no result at all, and that was with a dentist. Results can vary and can never be 100% guaranteed so we recommend asking any dentist that you go to see for before and after photographs of happy patients.

You also need to feel that you can trust your dentist, so ask them about the risks, discuss with them the possibility that the whitening may not work and what would happen then. Being open and honest with your dentist before any treatment is the best way to ensure that you get the excellent teeth whitening result that you will be looking for.


Having said all of that teeth whitening remains one of the easiest ways to look and feel more confident with your smile. It is generally available to anyone with a healthy dentition and with all of their own teeth (if you have crowns, veneers or white fillings then these will not whiten so you will need to discuss with your dentist the possibility of having them replaced after your natural teeth have been bleached).

When carried out by dental professional it is also one of the most predictable and safe techniques available in modern dentistry, you will find that many dentists have had their own teeth whitening in their own practice, and that says a lot in itself about how good the procedure can be when carried out by a dental professional…