Author: Dr Nishan Dixit

Dr Dixit is the new President of British Academy of Cosmetic Dentistry

It’s with great pleasure that we can announce that our very own Dr Nishan Dixit is the new  President of the British Academy of Cosmetic Dentistry.

Being President of such a prestigious organisation is an incredible honour and privilege. It is also testimony to his dedication and passion to the profession of dentistry that he was elected to be the figurehead of the Academy.

The BACD is a world-leading authority on cosmetic dentistry and was formed in November 2003 by a group of dentists, many of them leading practitioners in the field of cosmetic dentistry, who saw a need to share their knowledge with others. Their aim was to create a dynamic, active group of dental professionals and an environment where everyone can come together to share their knowledge and experiences, so that everyone can become better at what they do – regardless of their level of prior knowledge.

IMG_1309The BACD aims to promote clinical excellence through continuing professional development, and undergoing peer review to ensure that any clinical dental work is up to the highest standards.

By visiting a dentist that is a member of the BACD, let alone President, you can be assured that your cosmetic dentist will be working to the highest standards.

Does Invisalign hurt?

As more and more people are prescribed Invisalign to straighten teeth invisibly, inevitably more people turn to the Internet to look for answers to their questions, in this blog post we are going to tackle the popular question of does Invisalign hurt?

Before we begin, let’s take a quick look at what the Invisalign treatment entails.

Orthodontic treatments utilise the principle that if you put a continuous gentle pressure on teeth then they will move. Studies have shown that the key factor  is to have gentle continuous pressure, rather than short bursts of lots of pressure, this same principle works for traditional braces also. For this reason orthodontic treatments often take up to 2 years to achieve the desired result.

Each orthodontic system puts pressure on the teeth in a different way, some use removable appliances with springs and wires, others use brackets which are permanently bonded to your teeth and Invisalign uses clear aligners. These clear aligners fit over your teeth and put pressure on them to move them in the desired direction. You replace the aligners once every 2 weeks, this is how Invisalign achieves the continuous pressure on your teeth.

So where does the pain come from?

Pain can come from a couple of causes:

  • the aligners themselves causing irritation
  • the movement of the teeth causing pain and/or sensitivity

Sharp edges on Invisalign

braces can have sharp edgesVery rarely the Invisalign aligners may have sharp or rough edges which are initially not noticed by Align Technologies when they send the Invisalign trays back to your dentist. If you find that the trays have sharp edges DO NOT try to adjust yourself. The material can warp if it is heated excessively and this warping will affect your trays ability to align your teeth. If you notice any sharp edges then tell your Invisalign dentist who can then book you in for an appointment to have the trays adjusted.

Invisalign hurts to take off

Sometimes you may find that a new set of aligners is a little difficult to remove initially and causes pain for the first week. This is because it is an active appliance and is actively pushing on your teeth, and therefore might be quite tight to remove.

To remove the aligner we don’t recommend pulling one side excessively and then the other, this can cause the aligner to flex which can result in a tear or fracture down the middle of the aligner. Instead, we recommend loosening one side very slightly, then loosening the other and then finally pulling on both sides at the same time to remove the aligner in one go.

If you’re still having trouble removing the aligner and it is causing you pain then let your dentist know as they may be able to help with more details and personalised instructions on removing the appliance.

Invisalign pain in one tooth

It might seem odd to experience pain in a single tooth but if an aligner is working on single tooth movements then this may be the reason why. Your whole Invisalign treatment will be planned from start to finish, at the beginning you may find that one tooth is being moved and/or rotated. Further aligners may then begin to move other teeth. If you have Short term pain in a single tooth don’t worry, this is probably part of the plan to move that single tooth before the others. Please do tell your Invisalign dentist if the pain persists.

Toothache with Invisalign

Because there is continuous pressure being put on your tooth you may find that you occasionally have toothache. This can usually be relieved with over-the-counter pain relief and should only last for a few days. Please do not be tempted to take your aligner out too often, you should be wearing your aligner for at least 22 hours a day in order to ensure that your Invisalign treatment stays on course. If you take the aligner out, you may find that the treatment takes longer than prescribed and may end up costing more in the long run due to an increased number of visits to the dentist.

Invisalign drinking with a straw

only drink water with InvisalignFor good oral hygiene it is recommended that you only drink water whilst wearing your Invisalign braces. Occasionally people recommend drinking other drinks through a straw, whilst this is better than drinking them from the glass it can still leave sugar covering your teeth as it washes around the aligner. This sugar then forms the food for the bacteria which excrete acid as they digest it, this acid can then lead to tooth decay.

The recommendation therefore is only drink water whilst wearing aligners and taken out to drink anything else, this includes drinking alcohol with Invisalign, particularly as alcohol often has a higher sugar content.

Do not drink any hot drinks whilst wearing your aligners as this can warp them meaning you have to have new trays made, this could be quite an expensive exercise!


Invisalign pain relief

If you are experiencing mild tooth ache with Invisalign then we recommend taking over-the-counter painkillers such as paracetamol. Invisalign pain should last longer than a few days each time you switch to a new aligner. If you have severe pain or the aligner seems to be rough then please inform your Invisalign dentist who can then make modifications to either the treatment plan or the aligner itself.




How Long Does Invisalign Take?

So many people ask questions about the length of time that Invisalign takes, whether that be to get the aligners in the 1st place or to resolve a particular dental problem. This blog post will take a detailed look at some of the most common questions that people ask about this modern cosmetic treatment. We have also included some Invisalign results in the relevant sections so that you can see how long it takes to achieve the ideal smile

let’s start at the beginning of the Invisalign process.

How long does Invisalign take to make?

The process for the Invisalign starts with an initial consultation. After this consultation, you will have your 3-D digital scans. The 3-D scans will be used to design your new smile and allow the computer software to calculate the number of aligners required. After all of these calculations have been done and you have approved the look of your new smile Align Technologies Inc can begin the manufacturing process. The actual manufacture of Invisalign often only takes a few hours as the most advanced 3-D manufacturing processes are used. Once the trays have been manufactured they can be sent to the practice.

How long does it take to get Invisalign trays after scans?

Once you have had all of your initial scans the trays will usually be sent to the practice within approximately 2 weeks. You will then be invited to revisit the practice to ensure that the train is 6 and that you are comfortable with taking them in and out.

How long does Invisalign take to put on?

You might find that initially, it takes you a little longer to put the Invisalign trays in each day, although it shouldn’t take much longer than 30 seconds each time to remove your aligners or to put them on, as you get used to how the trays clip in you should be able to pop them in and out in only a couple of seconds each time. This makes them extremely convenient, especially as you will need to remove them for eating and drinking.

Treatment times for different types of case

Treatment times for Invisalign will always vary, the general rule of thumb is that moving front teeth is quicker than removing back teeth and that the smaller amount of movement required takes a shorter amount of time.

How long does Invisalign take to close a gap

If you just have a couple of small gaps between your front teeth then you may be suitable for Invisalign Go, this treatment typically takes around 6 months. However, you may find that other forms of treatment such as cosmetic bonding or even dental veneers may be more suitable, particularly if you want results in a shorter period of time.

Invisalign results for closing a gap

“This lady was always unhappy with the gaps between her teeth. After discussing the various options with her we decided on Invisalign treatment followed by a course of teeth whitening. She is delighted with the results. Her next step will be some simple composite edge bonding should she desire. Invisalign followed by teeth whitening +/- bonding is a great non invasive way of achieving a new smile.” – Dr Nishan Dixit

Invisalign results for closing the gap

How long does Invisalign take for crowded teeth

Front crowded teeth can usually be corrected in between 6 and 12 months, depending on the amount of crowding. One point to note is to be aware of the fact that the reason teeth are often crowded it because there isn’t enough room for them in the jaw. There may, therefore, need to be additional treatments undertaken prior to Invisalign, such as possible extraction of teeth in order to make enough room. Whilst the Invisalign treatment may take between is 6 and 12 months, this additional treatment will add to the overall treatment time for crowded teeth.

Invisalign results for crowded teeth

“This lady had enough of her crowded lower teeth and decided to have them straightened. She had always found it difficult to keep them clean and free from staining due to the instanding tooth.  After a discussion of the various options available to her she decided on treatment with Invisalign clear aligners. We completed the short course of treatment in approximately 16 weeks.  She was very pleased with the result and also rewhitened her teeth again to give them a brighter look. This patient had mildly crooked teeth and so Invisalign treatment was relatively straightforward and simple.” – Dr Nishan Dixit

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“A course of Invisalign was the ideal treatment for this young man to correct the alignment of his teeth .” – Dr Nishan Dixit

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How long does Invisalign take for overbite

An overbite is one of the more complex problems to resolve with Invisalign. It may involve moving a larger number of teeth, particularly back teeth which have larger roots and are therefore more difficult to move. Typical treatments for an overbite with Invisalign can take up to 2 years.

How often should I use Invisalign cleaning crystals

If you decide to use the Retainer Brite Invisalign cleaning crystals it is recommended that these are used every day. the cleaning crystals are a great way to remove the biofilm which will build up on your Invisalign appliance each day. This biofilm is a naturally occurring layer which forms over your teeth, if it is not cleaned off it can then harden into tartar which can look unsightly and even make it difficult to get your Invisalign braces in.


Invisalign will always take a different amount of time depending on your clinical situation. Treatments anywhere between 6 and 12 months are to be expected. If you would like to book a consultation at our dental practice in Harrow,  please do visit our appointment request page.


Teeth Falling Out – Dreams, Myths and Facts

So many people have concerns about why teeth fall out, this is often borne out by the number of dreams we have about the topic! In this article we’ll take a look at the myths and facts about what really happens when teeth fall out… We’ll then also have a quick look at dreams!

let’s start by looking at how many teeth do adults have.

how many teeth does an adult have

Typically an adult will have 32 teeth, 16 on the top (8 each side) and the same on the bottom. The last teeth, labelled 8 in this diagram are the wisdom teeth and not everyone has these teeth come through.

Why do children lose their baby teeth?

The simple answer is down to size. A fully grown adult is much larger than a baby and therefore if the baby teeth were not lost then the teeth would not be big enough to enable the adult to eat adequately, the teeth would simply be too small.

Is it possible to lose baby teeth as an adult?

It is not uncommon for baby teeth to persist through to adult hood. The reason for this is the baby teeth don’t just fall out on their own, it is a process caused by the full-sized adult to growing up pushing through from underneath. If a baby tooth does not come out it was usually mean that the adult tooth underneath is either not present or is coming out in a different place to where it should. If it happens then the baby tooth doesn’t get pushed out.

Baby teeth, contrary to popular opinion, do actually have roots so if they last through to adulthood, whilst they are rather small, they can still be used for eating. The only reason that we don’t see any route when the baby teeth comes out is because it has been absorbed by the body as the adult tooth pushes through from behind.

Which diseases cause teeth to fall out?

There are 2 types of disease which cause teeth to fall out, the first is diseases directly affecting the tooth and/or surrounding tissue, and the second is diseases affecting the body which can affect your oral health.

Diseases directly affecting the tooth and/or surrounding tissue

The disease which will most likely ultimately result in tooth loss if left untreated is periodontitis. This is a severe inflammation of the surrounding bone and tissue is around the tooth. A precursor to periodontitis is the more easily treatable gingivitis. Gingivitis is an inflammation of the soft tissue (gum) which surrounds your tooth. Gingivitis progresses painlessly on the whole until it is in its more latter stages. Early treatment is therefore critical and also easy.

Diseases affecting the body which indirectly affect tooth loss

There are a range of diseases which have been linked in some way to tooth loss. It should however be noted that these are not always causal links (meaning that one disease may not cause the other).

A meta-analysis of a range of studies was conducted in 2009 by Mara Meyer et al, they looked at the relationship between tooth loss and oral , upper gastrointestinal, lung and pancreatic cancers in different populations.

In 3 of their studies they found links between pancreatic cancer and periodontal disease (the disease which leads to loss), however, they did not comment on the exact biological mechanisms involved and so conclusions are still rather difficult to draw.

Diabetes, on the other hand has stronger links. A professor of nursing in global health at Duke University in Durham said in a report published in 2015 that they have more evidence that poor oral health is related to diabetes, with diabetics using  approximately twice the number of teeth on average as those without the disease.

Heart disease also has links with tooth loss, although again, the exact connection between the 2 conditions is not fully understood. It is believed that the bacteria present in periodontitis is also present in patients with chronic heart conditions and that this bacteria may be a gateway bacteria for further heart problems.

Can stress cause your teeth to fall out?

Stress, will not directly cause your teeth fall out. However stress can lead to a lowering of the immune system in your body making you more likely to become susceptible to other diseases which may cause tooth loss. Tooth loss can be caused by various cancers, heart disease and diabetes – all of which are exacerbated by excessive stress.

If you are concerned about stress we recommend you take a look at the 10 Stress Busters on the NHS website

Does grinding your teeth cause them to fall out?

Grinding your teeth will cause them to wear down but won’t initially cause them to fall out. However, if you have additional dental diseases which result in loose teeth, such as gingivitis or periodontitis then grinding your teeth can exacerbate these conditions which could ultimately lead to tooth loss.

More information about teeth grinding can be found here, and here.

What can I do if my tooth fell out and now I have a hole?

If you have lost a permanent tooth and have a whole there are 4 options:

  • Do nothing. This can, however, result in the teeth either side and opposing the gap to drift, in the long run, this can affect your bite and the way your teeth meet.
  • Dentures. Modern dentures can be made to look highly aesthetic although most people don’t like the idea of removable dentures.
  • Fixed bridge. A fixed bridge can bridge the gap where the tooth has fallen out, however it does often require preparation/reduction of the teeth either side in order to accept the supporting part of the bridge.
  • Implants. Very often these are the most preferred option. Implants act as the replacement tooth root on top of which a new crown (the part of the tooth you see) is made.

Will periodontal disease definitely cause tooth loss?

Untreated periodontal disease will almost certainly cause tooth loss. However, if the periodontal disease is treated then teeth can be saved. It all depends on how advanced the disease is before treatment begins. If you are concerned that you have periodontal disease then we recommend you speak to your dentist as soon as possible. Remember, periodontal disease is the more serious form of gingivitis. Patients with gingivitis will typically have red, puffy or inflamed gums which bleed during flossing or brushing. If this gingivitis is left untreated infection can track down towards the route and cause the more serious periodontitis.

Teeth falling out dream – what does it mean?

So, you have a teeth falling out dream… What does it mean?

We’ve taken a look around the Internet and share with you 11 of the most common ideas about what dreaming of your teeth falling out means.

  1. Your dream may be associated with loss and important life changes.
  2. Worried concerned about dealing with stress.
  3. Major changes in your life are underway and you may be thinking about this.
  4. Concern about other people losing their teeth, particularly elderly relatives or children.
  5. You may be grinding your teeth yourself at night and dreaming about your teeth is your brain’s way of letting you know what you’re doing.
  6. Concerns about personal health. Perhaps you are concerned about your overall health? There may be a reason for this but sometimes it seems people dream about their teeth falling out whilst they are concerned about other health-related issues.
  7. Inferiority complexes, particularly feeling unattractive. Not many people like the idea of having to smile with no teeth, perhaps dreaming about them falling out is your minds way of reminding you that you have to deal with an inferiority complex?
  8. Being concerned about your appearance.
  9. Concerns about ageing.
  10. Concerns about your diet and what you may or may not be eating.
  11. Fear or anxiety about visiting the dentist. If this is you then speak to your dentist, let them know you are concerned and they can then take additional measures to help you relax.

Can you straighten teeth with veneers?

If you are researching straightening crooked teeth then you will know that there are a wide variety of options available from Invisalign or lingual braces to straighten crooked teeth invisibly, through to the Inman aligner which has the ability to straighten crooked teeth very quickly, right the way up to conventional fixed orthodontics which can straighten the most severely crooked teeth.

But did you know there are also quicker and simpler ways to straighten a few crooked front teeth?

Dental bonding and dental veneers can also be used to give the illusion of straighter teeth, but who does this type of teeth straightening? A dentist or orthodontist?

Difference between cosmetic dentistry and orthodontics

Orthodontics is very often thought about into distinct ways:

  • Functional orthodontics – This type of orthodontic treatment is because the teeth don’t bite together properly or there is some dramatic malocclusion which means there are additional problems such as jaw joint pain, headaches or the inability to eat and chew. There may or may not be cosmetic elements to this treatment.
  • Cosmetic orthodontics – This type of orthodontic treatment is primarily driven by a desire for the teeth to be straighter and look better, there may or may not be functional elements to this treatment.

Turning our attention to cosmetic dentistry, this is generally considered a treatment modality whereby we look to improve the appearance of the patients’ teeth, always taking into account the function.

Cosmetic dentistry has a range of treatments which can be used to fulfil that requirement, typical treatments could include:

  • Straightening crooked teeth
  • Rebuilding worn down or damaged teeth
  • Whitening dark teeth

As you can see, straightening crooked teeth is one of the treatments used within cosmetic dentistry… And this could definitely include orthodontics.

In summary, orthodontics can be cosmetic in its nature and cosmetic dentistry can include orthodontics as part of the treatment to design a new smile.

How can veneers straighten crooked teeth?

Dental veneers can be made from a variety of materials including high-strength porcelain and composite resin. Most of the time veneers don’t actually straighten the tooth  moreover, they give the impression of straightness when viewed from the front.

Straightening your tooth with a veneer is usually done when there are only a couple of teeth that are crooked.

Looking at this photograph from the front, if you look at the 2nd tooth from the centre on the right-hand side (this will be the patient’s left) you can see that this lateral tooth is rotated in as well as being misshapen.

straightening crooked tooth with veneers

A simple way to correct this misshapen and crooked tooth was to create an immediate dental veneer using a composite resin. This creates an instant result. In this case even if the tooth was moved with orthodontics it would still have been misshapen and required some bonding to achieve the full cosmetic result.

It’s also possible to correct more crooked front teeth with dental veneers, there are however some advantages and disadvantages:

Advantages of straightening crooked teeth with veneers

  • Quick – Can also be instant if composite resin bonding is used.
  • Can change the tooth colour.
  • Can change the shape of teeth.

Disadvantages of straightening crooked teeth with veneers

  • May require removal of healthy tooth structure in order to accept the new veneer.
  • Can, in some circumstances mean the tooth is quite thick due to the fact there is a natural tooth with a veneer bonded on the surface.
  • May need replacement at a later date as gums naturally resorb.
  • Can be susceptible to fracture.

Who does veneers, a dentist or orthodontist?

Now that we know that dental veneers can be used to straighten crooked teeth, who does them, a dentist or orthodontist?

In almost all circumstances it will be a dentist that undertakes the treatment of veneers. Generally speaking an orthodontist will be a specialist and dedicated solely to orthodontic treatments.


What can a cosmetic dentist do?

A cosmetic dentist will primarily be looking at resolving dental problems, rather than trying to prescribe a specific treatment… Therefore  a cosmetic dentist can:

  • Straighten crooked teeth.
  • Whitening dark teeth.
  • Rebuilt broken down, damaged or misshapen teeth.
  • Replacing missing teeth.

To do this, they use a range of specific treatments such as:

  1. Dental veneers – These can either be a porcelain veneer or immediate/direct composite material veneer. These require a small reduction to the front surface of your tooth enamel.
  2. Teeth whitening – This is often either performed in surgery or at home.
  3. Orthodontics – Usually simpler orthodontics are performed by the dentist with more complex cases being referred to a specialist orthodontist.
  4. Dental Crowns – Crowns are often used to restore teeth damaged by decay, ageing or trauma.
  5. Dental bridges – Used to replace missing teeth.
  6. Dental implants – Used to replace missing teeth.

At the same time as this there will also be looking out for your oral health to ensure that either your current or desired situation doesn’t compromise it.

There is therefore a wide range of skills utilised by cosmetic dentist to help create a beautiful smile for you.

Many cosmetic dentists will also be a member of the British Academy of Cosmetic Dentistry (BACD), this is an organisation which seeks to help dentists achieve excellence in their cosmetic dental practice.

What is the process for a smile design?

The process with any dental treatment will always start with the patient. The concept of keeping the patient in complete control throughout is incredibly important for modern cosmetic dentists.

The smile design process will usually be something along the following lines:

  • Initial consultation to discuss your requirements.
  • Assessment of dental health, this is to ensure that your teeth and gums are in a good enough condition to begin cosmetic treatments that will then look good, function well and last.
  • Basic treatment planning, this will then give you a range of options for how you can achieve your desired result, this should also include a full treatment plan and pricing structure.
  • Diagnostic stages – This may include combinations of scans, x-rays and study models of your teeth.
  • Full treatment planning. From the diagnostic models your dentist and technician will be able to see where your teeth are now and work out the best way to get them looking the way you ideally want.
  • Trial smile – In some situations it is possible to provide a trial smile which can clip in over your existing teeth, this is not always possible and is usually only available if you have veneers crowns which require no reduction of your existing teeth, in reality this happens rarely.
  • Completed study models. You may not have a trial smile but you should be able to see your full completed smile on a model of your teeth, this will be constructive in advance by the technician. If you are having Invisalign then this is achieved with a digital trial smile known as a Clincheck.
  • Tooth preparation – Your teeth may then need to be prepared or trimmed down by the dentist, if they are trimmed then you will be provided with temporarily veneers or crowns.
  • Manufacture of your new veneers or crowns.
  • Fitting of the new veneers crowns.
  • Review of the process and treatment.

As ever, if you have any concerns or questions about straightening crooked teeth with either veneers or orthodontics your friendly dentist in Harrow is always here to help.


Charcoal teeth whitening – a review

When it comes to having Beautifully white teeth, you have many options. You can either go for professional teeth whitening at the dentist’s office, or you can try whitening your teeth in the comfort of your home by using over the counter bleaching agents or trying various natural teeth whitening methods. Among them, charcoal teeth whitening is another natural method that has become one of the most popular methods, mainly because of celebrities talking about it. So, what has made charcoal teeth whitening so popular? Does it really work? Continue reading to find out.

What Is Charcoal Whitening?

Charcoal whitening does not mean you start rubbing your mouth with coals or using the artists’ charcoal as a brush for your teeth. The charcoal we are talking about here in the context of teeth whitening products is far superior in quality. Dentists call it the activated charcoal; a highly purified and finely ground form of charcoal which is added into teeth whitening pastes or powders, in addition to other minor ingredients like foaming agents, stabilizers and may be flavored. Of course, the formulation may be in the form of a paste or even a powder.

Activated Charcoal! What is it?

Activated charcoal is derived from the same sources as ordinary charcoal. Among the organic sources of charcoal, wood is the most common although waste organic material like coconut shells may be used. Charcoal may also be obtained from hydrocarbon minerals e.g. petroleum, peat, or coal, etc. The difference between ordinary charcoal and activated charcoal lies in the processing which modifies the enhances the absorption properties of the charcoal. Charcoal is exposed to a special gas so that the resulting charcoal is far more porous. That is activated charcoal with a highly enhanced ability to absorb. Such activated charcoal is also used in water filtration processes.

Ancient Tooth Powders Also Used Charcoal

The use of charcoal for teeth cleaning and brightening is not really new. It is a fact that ancient civilisations have also been using charcoal powder for preparing tooth powders and toothpaste for centuries.  They used (and use) the burnt coal which results from burning of fuel for cooking and baking. Burnt almond skin or peanut shells were also preferred, perhaps, because they were assumed to add medicinal properties. Charcoal powder has the additional advantages of acting a soft abrasive. It was also easily available at virtually no cost. To enhance utility, such formulations often added powdered alum {KAl(SO4)2. 12H2O}, because alum is considered an anti-bacterial agent in addition to being an abrasive when in the powdered form.

the substance is often used either in the toothpaste or in activated charcoal powder.

Does Charcoal Actually Whiten Teeth?

The popularity of practice since ancient times is not really proof of its efficacy. The argument in favor relies on the absorption properties of charcoal, and the activated charcoal. It is assumed that being highly absorbent it can absorb smelly gases from water. So, it should also be able to absorb and remove staining substances, such as red wine or tea stains from the surfaces of your teeth.  However, this is not necessarily a logical conclusion.

There is no denying the fact that powdered charcoal does act as a mild and cheap abrasive and thus be effective to remove plaque to some extent. Indeed, a recent study published in the reputed Journal of the American Dental Association in September 2017 concluded that further study on the subject of teeth whitening with charcoal needed.  The available scientific evidence was not sufficient to give a conclusive verdict.

But is it Safe!

Although there is currently insufficient information available to conclude with certainty whether charcoal or activated charcoal is effective in teeth-whitening, there is also no evidence of any harmful effects of charcoal or activated charcoal in teeth whitening. In addition, the cost-effectiveness and safety of this procedure have certainly made it an attractive option for getting those pearly whites.

Having said that, there are some reports which suggest that activated charcoal is a little too abrasive. Using a substance which is abrasive on your teeth can remove the outer layer (tooth enamel) over an extended time period, this could result in sensitivity at best or exposure of the softer dentine underneath which could lead to decay.

Another thing to consider is the use of fluoride in activated charcoal toothpastes. Fluoride acts to assist the tooth in the remineralisation process which is necessary after the acid attack that your tooth is subject to each time you eat. Fluoride has been shown to really help teeth remineralisation and therefore harden up again to prevent the onset of decay. Some charcoal toothpastes view themselves as being alternative ways to clean teeth and therefore don’t include fluoride. If you then add this effect to the abrasive nature of charcoal one needs to be very careful when using this type of toothpaste.

After that, all you have to worry about is about possibly blackening lips and parts of your face. Be sure to wash your lips thoroughly after use of such pastes or powders, and you won’t have to worry about their staining.

Other ways to whitening your teeth

Many people opt for natural teeth whitening such as using baking soda however, the same principles apply to this type of toothpaste as they do with charcoal whitening. Baking soda can be more abrasive and you need to ensure that any toothpaste contains fluoride.

Whitening toothpaste and whitening strips can also be purchased over the counter in many pharmacies, these don’t however contain very high contents of hydrogen peroxide which is required to whiten your teeth to any significant noticeable level.

In order to ensure a brighter smile that you were truly happy with it is recommended that you ask your dentist. Before carrying out any whitening treatment they will ensure your oral health is in the best condition and then offer you various options such as whitening teeth in the surgery or whitening teeth at home.

Do Braces Hurt?

We are very often asked a whole range of questions about the comfort of wearing dental braces. This blog post seeks to answer a range of these questions, particularly about braces being comfortable on your cheek and lips.

What is the effect of braces on face shape and lips?

You will usually not find that braces affect the shape of your face and lips unless you have a tooth which is particularly sticking out, you might find that until this tooth moves that the brace over this area stands out more noticeably.

If you have a tooth which sticks out and you’re worried that the shape of your lip will be affected then it’s worth asking about different types of braces. Some types of braces fit on the inside of your teeth and therefore don’t affect your face shape and lips. Other braces, such as Invisalign used ultra-thin clear aligners rather than conventional brackets and wires. These also can be more imperceptible than conventional orthodontic braces.

How do I stop biting my cheek after I get braces?

Biting your cheek after braces can be quite a common problem. You might bite your cheek once by accident but this area then swells and you end up biting it more often, creating a vicious circle. If you bite your cheek try eating on the other side and using a baby teething gel to relieve pain.

Using baby teething gel to help orthodontic brace pain

Orthodontic wax
Image credit:

If you have fixed orthodontic braces then make sure you apply your orthodontic wax over this area to ensure that your cheek doesn’t rub on the braces.


Do braces hurt?

Typically braces don’t hurt although there might be some mild discomfort. Whenever you have a new aligner (if you are having Invisalign) or have your wire adjusted then you will feel the initial pressure on your teeth. This can reveal itself as mild discomfort or feelings of sensitivity. You should however find that this begins to disappear after approximately 3 days. It’s also worth bearing in mind that each time you go the same procedure will cause the same feelings of discomfort, simply being aware of this fact can help enormously.

Do braces hurt during the procedure?

If you are having a removable orthodontic brace such as an Inman aligner or Invisalign then there will be no discomfort at all during the procedure. The only discomfort you might encounter is during the initial impression stages, many people dislike the impression goo which dentist use. If this is you then it will be worth looking out for a dentist which uses a digital scanner to take a 3-D photographic scan of your teeth rather than have to have the conventional impression. This can make the whole procedure of having braces extremely comfortable.

Even if you are having fixed orthodontic braces the procedure is also painless. You may, however, notice some mild discomfort a few days after the braces fitted whilst your teeth adjust to being under the pressure of orthodontic treatment. Staying power is of prime importance with orthodontic braces, not just when the braces are applied but afterward to ensure you get the best results.

How do I prevent braces from rubbing the inside of my cheek?

The secret here is to always use the wax which your orthodontist or dentist provides for you. The wax is easily mouldable to fit over the orthodontic brace/bracket and stick to it. It then ensures that the inside of your cheek glides smoothly over the wire and brackets without rubbing.

How long does it take for you to get used to braces?

You should find you get used to orthodontic braces quite quickly. You may find that you need to adjust your diet (avoiding sticky foods) and possibly sticking to soft foods initially. You might also require some over-the-counter pain relievers if you get any discomfort immediately after the braces are fitted.

How will your face change after dental braces?

no teethDental braces can have a dramatic impact on the way your face looks… If you want them to that is. Your teeth play a large part in supporting your lips and giving the appearance of use, just look at a photograph of someone without any teeth, their lips are wrinkled and they automatically look old even if they are not. Your orthodontic dentist will take this phenomenon into account when planning your treatment.

It’s also possible that during the process of moving your teeth you are able to exercise facial muscles in a new way. The muscles in your face can then build giving your face more defined features which is often a huge benefit.

Is it different playing an instrument with braces?

If you play a musical instrument such as the flute, clarinet or trumpet then it’s worth mentioning this to your dentist prior to going ahead with braces. You may find that having a removable orthodontic brace works better for you if you play such an instrument. You can then take the brace out whilst you play ensuring that you maintain your embouchure.

Photo by Toomaj F. Bungs from Pexels
Photo by Toomaj F. Bungs from Pexels

If the musical instrument you play involves a mouthpiece that your teeth rest on, such as a clarinet it’s worth considering that your teeth may have made an indentation in the mouthpiece of the instrument. As your teeth move they may not fit into this old indentation quite so well, meaning that your instrument playing might be affected. You may need to consider a new mouthpiece during or after orthodontic treatment.

How do you treat pain produced by the rubber bands in braces?

Just to be clear it’s not the elastic bands which cause any discomfort or pain, it is likely to be the brackets around which the bands are placed. The best way to keep paying to a minimum with these is to ensure that you apply the orthodontic wax which will be given to you when the braces fitted.

How long does it take to get braces put on?

You can usually expect an appointment for a couple of hours to have braces put on. If you are having Invisalign braces then the appointment will be much less as there is no actual fitting to be done.


We hope this article has given use and detailed information about the different types of pain or discomfort associated with different types of orthodontic brace. On the whole orthodontic braces don’t hurt and any discomfort can be easily remedied with pain relief bought in your local pharmacy. It’s also worth noting that this discomfort is temporary and should only last a few days after the braces are fitted and/or tightened.

10 Interesting Questions About Dental Implants

How strong are dental implants compared to real teeth?

As you will know, a chain is only as strong as its weakest link. A tooth implant has many links so it is clear to identify what we mean when we are talking about the strength of the implant. They are made up of the following:


  1. The implant itself which is implanted into your jawbone
  2. A trans-mucosal element which connects the dental implant under the gum to the restoration of the gum
  3. The screw which screws in the trans-mucosal element into the implant
  4. The restoration on top, the part that you see.

Some implant systems blend a few of these elements together, however the list above is relatively standard.

In times of extreme force applied to the restoration we don’t always want that force transmitted down to the dental implant. If the tooth implant were to fail then it can be a very costly procedure, therefore sometimes implants are designed with this screw which connects the transmucosal element to the implant as a failsafe mechanism. If too much force is applied to the restoration then this screw breaks, this protects the dental implant itself and means the repair, by way of replacing the screw is relatively simple, cheap and quick to do.

Nothing is as good as your natural teeth so we always recommend treating implants as second-best to keeping your natural teeth wherever possible.

Why are implants best for tooth replacement?

One of the things your dentist will always be wanting to do is to keep as much of your mouth intact and as healthy as possible. Dental bridges often mean reduction of the teeth either side of the gap in order to accept the new single tooth replacement. A dental implant on the other hand does not require reduction of adjacent teeth.

A dental implant also can help to stabilise gum in your jaw bone around the new tooth or teeth. When a tooth is lost the surrounding bone tends to collapse into the gap, this can lead to a loss of bone height around the gap. Having a dental implant placed immediately after a tooth is lost can help to prevent bone grafting in the future.

What are the pros and cons?

Dental implant pros:

  1. Can look like natural teeth.
  2. Support the surrounding bone and prevent it resorbing.
  3. Often the most cost-effective option when considered over the life of the implant.
  4. A wide range of options on how to restore the implant including crowns, bridges and dentures.
  5. Can last for many years.

Dental implant cons:

  1. May be the most expensive way to replace missing teeth in the short-term.
  2. A lengthy procedure including implant surgery.

Do dental implants work like real teeth?

A successful implant can work exactly the way a natural tooth works. They effectively work as a replacement tooth, looking and working the same as a natural tooth.


  1. A dental implant does not have a periodontal ligament around it like a natural tooth, this acts like a suspension mechanism to protect the tooth. All forces placed onto the dental implants are transmitted directly to the bone.
  2. The dental implant does not have any nerves and so you cannot feel any pain or sensation through the dental implant

What do they really feel like?

Once an implant is placed and the teeth and gums have healed then the restoration attached to the implants will feel like natural teeth. The only exception to this rule is if you have removable dentures.

Which is better, dental implants or bridging?

Bridging often involves removing tooth structure from teeth either side of the gap that you wish to fill. If this tooth structure is healthy then this can mean potentially compromising the dental care of adjacent teeth. Dental implants on the other hand do not need to involve teeth either side of the gap meaning they are a more conservative option.

What’s better, dental implant or partial denture?

Modern dentures can look extremely lifelike and be very effective. However if you have a partial denture it will almost certainly have some form of clasp around the tooth as well as a plastic area which touches the gum and other teeth. A poorly fitted partial denture can irritate this delicate gum and cause recession.

Partial dentures are however much cheaper than dental implants but because that are often made of plastic have a much higher fracture rate.

Are dental implants safe?

With proper care and attention as well as a dedicated dental team dental implants have a success rate of up to 98%. The implant itself will invariably be made of medical grade titanium, amazingly the human body does not recognise titanium as a foreign object and so the bone will fully integrate with the dental implant. This makes titanium a truly biocompatible material to use.

Why are dental implants necessary?

Implants are never necessary. They are always an elective procedure. An important option is always ‘do nothing’, you in your dentist should always consider the ‘do nothing’ option for any treatment, weigh up the alternatives and decide if any treatment is right for you. The definition of ‘right’ will always be an individual decision based upon:

  1. Desired results.
  2. Affordability.
  3. Timeframe.
  4. Acceptability of treatment e.g. surgery etc.


Is a dental implant painful?

A common question is do dental implants hurt? Whenever you have any invasive dental procedure you will always be given a numbing injection. This is usually the most painful part of any treatment.

To help with the injection we recommend asking your dentist to use a numbing topical gel first, this gel gently numbs the gum so that when the needle goes in there is minimal pain.

You may also find that there is some mild discomfort after the dental implant has been placed, particularly in the days immediately after the surgery. Over the counter painkillers can usually help with this and the pain normally subsides after a few days.

How many implants am I likely to need?

This depends on exactly what your situation is. Dental implants are normally used to treat 2 groups of people:

  1. People with missing teeth
  2. People with loose or unstable dentures

In both cases the outcome is the same, implants restore your ability to smile, eat, chew and laugh again with confidence. Many patients also find that their dignity is restored and their ‘dental comfort’ is massively improved.

For people with missing teeth (or tooth), without dentures

If you have more than one tooth missing, then we will often place 2 (or even more implants) and ‘bridge’ the gaps as highlighted by the arrow in this photograph.

The custom made crowns that fit over the top of implants ensure that you will not see any metal and will be made to blend in to your surrounding teeth invisibly… no-one will ever know you ever had teeth missing.

If you have all your teeth missing then you will either need a denture, or a ‘full arch implant bridge’, dentures are explained below, but a full arch bridge will usually involve the placement of around 4-12 dental implants (it depends on your exact situation as to how many you will need).

Screwed gently to these implants will be a full new set of teeth which you are not able to remove yourself (we can remove them for deep dental cleaning periodically).

This is often the preferred option for patients with no remaining teeth as often a full arch bridge can be made to look exactly like your own teeth.

In some instances, with all implants, we may find that additional surgical treatments such as bone grafting are required. These are explained later on in this guide, but only a full clinical assessment by one of our implant specialists will tell for sure.

For people with missing teeth with dentures

If you currently have dentures and find that they are loose, then dental implants can help enourmously. We simply place 2 or 4 implants gently in to your mouth, then place some ‘clips’ inside the denture (like a press-stud), this means you will hear an audible click as your denture locks in to place.

Depending on your exact situation we may decide that making a new denture is best for you, or we may even be able to convert your existing denture.

So if you wear dentures and feel you are not able to go out for a great meal with your friends then this could be a perfect solution for you.

Blue Court Dental Centre provides dental implants in Harrow for the local people, including Wembley, Stanmore and Greenford.

President elect of the British Academy of Cosmetic Dentistry

It’s with great pleasure that we can announce that our very own Dr Nishan Dixit is now 2018 president elect of the British Academy of Cosmetic Dentistry.

The BACD is a world-leading authority on cosmetic dentistry and was formed in November 2003 by a group of dentists, many of them leading practitioners in the field of cosmetic dentistry, who saw a need to share their knowledge with others. Their aim was to create a dynamic, active group of dental professionals and an environment where everyone can come together to share their knowledge and experiences, so that everyone can become better at what they do – regardless of their level of prior knowledge.

Did you know that currently any dentist can offer cosmetic dentistry irrespective of their training or experience beyond the basic dental degree. There are no specialist qualifications and no specialist register. Techniques constantly progress and the public are becoming increasingly dentally educated and discerning so it’s essential to stay up-to-date.

Because of this the British Academy of Cosmetic Dentistry is the voice of cosmetic dentistry in the UK, promoting clinical excellence which is carried out in an ethical, minimally invasive way, to ensure thorough understanding of this practice for Clinicians and patients alike.

Being president elect of such a prestigious organisation is an incredible honour, here’s why BACD are so important in dentistry…

Increased Trust

Through education for dentists, dental teams and laboratory technicians, the British Academy of Cosmetic Dentistry leads the profession to higher standards of dentistry. All members are encouraged to provide their dentistry to their patients in an ethical manner, whilst maintaining high aesthetic standards so that dental health and longevity of any dental work is ensured.

Thanks to advancements in modern cosmetic dental care, you can achieve a beautiful smile almost instantly; however, currently any qualified dentist can offer cosmetic dentistry and no UK postgraduate qualification is recognised in cosmetic dentistry.

Complete Confidence

Finding an appropriately skilled cosmetic dentist is essential to ensure treatments are beautiful, natural looking, and successful in the long term. This is where the BACD comes in.

The BACD aims to promote clinical excellence through continuing professional development, and undergoing peer review to ensure that any clinical dental work is up to the highest standards.

To be listed, BACD cosmetic dentists must have shown a very high commitment to attend lectures and courses based on cosmetic dentistry. As a demonstration of their skills, members may undergo BACD Accreditation, where submitted cases are examined and evaluated to ensure that treatments are of the highest standards.

By visiting a dentist that is a member of the BACD, let alone President Elect, you can be assured that your cosmetic dentist will be working to the highest standards.

Ways to manage your dentist fear

The British Dental Association estimate that around 25% of the UK population suffer from some form of dental anxiety with around 12% having extreme fears affecting their ability to attend the dentist.

Visiting the dentist is key to ensuring that your oral health remains good. Without good dental health gum disease can take hold meaning that more dental treatment is possibly required, thereby exacerbating the dental fear.

Finding ways to relax and stay calm at the dentist is what this blog post is all about.

Why are we scared of dentists?

The first thing to understand is that fear is a learned behaviour, think about it, we aren’t born afraid of the dentist, it is something that we have learnt to do as we have got older. Accepting this is an extremely beneficial thing to do as it means that if we can learn to be afraid then we can also learn to relax and be calm.


Fear of pain is one of the most common reasons people cite for being scared of the dentist, this is quite understandable especially if people have had bad experiences in the past. What is worth noting is that modern dental care has made extremely big advances in recent years. With topical numbing gels and fine needles injections can be extremely comfortable with no pain, this then also leads to painfree treatments.

Will dentists judge me and my teeth?

This is often another common reason people give for not visiting the dentist, a dentist is not there to judge or to criticise, we are here to help, encourage and educate you about how to stay dentally fit and healthy. A dentist cannot achieve this goal if they are judgemental so you will find that any good dentist will support and encourage you and not be judgmental.

What are my options if I’m afraid of the dentist?

The really important thing to understand is that you do have options. It’s quite common that people feel they have no options, especially nervous or anxious patients.

A good dentist that specialises in treating anxious or nervous patients will ensure you have as many options available to you as possible. Here are your options:

  1. Talking to your dentist. You should always ensure you have a dentist you can trust and talk to, a good dentist will take time to listen to your concerns and ensure they take your anxiety into account.
  2. Ensuring you stay in control. Make sure you agree a stop signal with the dentist before any treatment begins. Simply knowing that you can raise your hand at any point to take a quick break means you’re in control and can really help you relax.
  3. Breathe slowly and gently. Breathing slowly and gently helps muscle relaxation generally, if you just breathe slowly and gently throughout your treatment you will find you stay more relaxed.
  4. Ask about sedation. Some dentists offer gas and air via inhalation sedation. This can also help if you are feeling anxious.

How to stop being scared of the dentist

Relaxation techniques are a great way to stop being scared of the dentist. Understanding that fear of the dentist is a learned behaviour and can therefore be unlearnt is a key principle to accept.

Practising breathing techniques both before your appointment and during treatment can also help.

Requesting an early morning appointment is also a great way to ensure that any dental phobia is contained to a short period early in the day, rather than allowed to build throughout the day.

You may also find of bringing a friend with you can help to keep you calm.

Good ways to relax and calm the mind at the dentist

  • Enjoy a cup of green tea. Green tea has been shown to have a chemical, L-Theanine, which has been shown to elevate levels of serotonin and dopamine in the brain which can help you relax.
  • Chew sugarfree gum. This can help to keep saliva flowing and prevent your mouth from drying out. It’s also been shown to lower anxiety and control cortisol levels. Of course you can’t do this whilst in the chair!
  • Remember to breathe slowly and gently. You could do this in the waiting room of the dental practice and during treatment to help relax.
  • Visualise your happy place. Most people have a happy place that they think of, this could be a holiday or a time you spent with friends. Visualising this whole experience can be extremely relaxing and calming.
  • Listen to calming music. This type of music can be different for each person but listening to the music you find relaxing and peaceful can also help you with your dental anxiety.

We hope you have found the information contained in this blog post useful, our dental practice in Harrow is a friendly and calm practice, taking time to listen to your needs and concerns and help out wherever required with any dental fears.

Just remember, it’s good to talk…