Author: Dr Nishan Dixit

Who does veneers, a dentist or orthodontist?

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…


Why do I have tooth sensitivity?

Many people suffer from sensitive teeth for a variety of reasons, this article highlights why you may suddenly develop sensitive teeth, what you can do about it at home, what treatments the dentist may be able to offer you and how to reduce the pain from tooth sensitivity.

What causes tooth sensitivity?

diagram of a toothYour teeth are made up of three primary layers:

  1. The nerve and pulp. This is the deepest living part of your tooth, it contains the nerve and has blood flowing through it to keep your tooth alive, it is protected by two out of protection layers.
  2. The dentine. This is the softer portion of your tooth, it gives the tooth it’s primary colour and its role is to support the hard yet brittle outer enamel.
  3. The enamel. This is the hardest substance in the human body and protects the outer portion of your tooth.

Sensitivity occurs when hot or cold substances, such as eating ice cream, get too close to the nerve, there are many reasons this could happen, including:

  • Tooth wear caused by over brushing.
  • Gum recession caused by over by over brushing or general ageing.
  • Cracked teeth caused by trauma.
  • Decay in teeth caused by poor oral hygiene.
  • Tooth grinding or clenching.

Why are my teeth suddenly sensitive?

The key to understanding this is to think about how the hot or cold feeling may be getting through to the nerve. If you have had a recent trauma then perhaps the tooth is correct. If you haven’t been to the dentist for a while perhaps there is an area of tooth which is decayed.

The image below shows gum tissue recession around the gum line, possibly caused by over brushing. The enamel is thin in this area which can easily lead to teeth sensitivity.

Image Credit:
Image Credit:

If you can’t immediately identify what the problem is then visiting a dentist or dental hygienist may be best option.

How do you stop sensitive teeth pain

If you have sensitive teeth with no obvious cause then you may find that using a protection and relief toothpaste such as Sensodyne may help.

How does Sensodyne work?

These toothpastes work because there are tiny holes, called tubules, in the dentine of your tooth. If the enamel becomes eroded away then these tubules can transmit the hot and cold through your tooth. These toothpastes work by quickly creating a barrier so that the hot and cold feeling can’t be transmitted to the nerve.

However, it’s worth noting that these types of toothpastes WILL NOT work if the sensitivity is caused by excessive enamel or dentine loss such as cavities, excessive wear or cracks caused by trauma.

How long does tooth sensitivity last?

Tooth sensitivity is usually only instantaneous when the nerve becomes exposed to hot or cold. Remove the hot or cold and the sensitivity goes away. However, the reality is that this is not practical to do on a day by day basis, we have to eat and drink after all! Unfortunately, if your teeth are sensitive they won’t get better on their own, you will either need to use a relief and protection toothpaste or visit a dentist to ascertain why your teeth are sensitive.

What does the dentist do for sensitive teeth?

The basic premise for reducing tooth sensitivity is to protect the outer surface of the tooth to prevent the hot and cold sensations been transmitted through to the nerve, or in extreme circumstances to remove the nerve itself. There are a variety of ways of treating sensitivity at the dentist, including but not limited to:

  • Fluoride treatments to strengthen tooth enamel. These fluoride gels can be applied topically at the dentist or trays can be provided for use at home.
  • Bonding. Composite bonding materials can be used to bonded to the outer surface of the tooth to rebuild the enamel where it has been lost. This can cover up the dentin hypersensitivity.
  • Surgical gum graft (Please see the explanation video below). If the sensitivity is caused by excessive gum resorption which exposes the more sensitive root of the tooth then a gum graft to replacing some of the gum tissue may be undertaken to cover up some of this exposed area around the gum line.
  • Root canal. In extreme circumstances a root canal can be used to remove the nerve of the tooth. This is not normally a preferred option and will only be undertaken in extreme circumstances.


One of the key things to focus on is brushing your teeth and maintaining good dental care throughout your life, ensuring you brush and floss regularly. Tooth sensitivity is a common problem, particularly in later life as the gum becomes more exposed and the teeth wear. Certainly, this is one of the best ways to prevent tooth sensitivity. If you are older then be aware about using a soft bristled toothbrush, watching to ensure you don’t consume too many acidic foods and drinks and be aware if you grind your teeth. Cold air can also affect sensitivity, so you may find you need to wear a scarf in cold weather.


Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

Top tips for whiter teeth without treatment

Most people want to have teeth that aren’t brown, yellow or badly stained. Teeth whitening is often the first port of call but there are also many things you can do at home, come to that, there are many things you can avoid at home to help you have whiter looking teeth.

We’ve broken the list down into:

  • Things you SHOULD do for whiter looking teeth
  • Things you should NOT do
  • Things you might want to consider
  • Things to avoid when looking for whiter teeth

We then finish off our list with one final secret for whiter looking teeth… Read on to find out more.

Things you SHOULD do

In order to have the whitest looking teeth without going for teeth whitening treatments we recommend:


  • Watching your oral health care routine. If you keep your teeth clean then plaque will not build up, stains adhere more to plaque then they do to tooth enamel so if your teeth are clean then they are more likely to look whiter.
  • Using an electric toothbrush. It has been shown that using an electric toothbrush means you are more likely to clean your teeth adequately. Many electric toothbrushes have a timer pressure sensor to ensure you don’t press too hard and clean for the right amount of time.
  • Cleaning in between your teeth. By using floss or an incidental brush you will keep your teeth cleaner and prevent the buildup of plaque which can look dark, yellow or discoloured.

Things you should NOT do

As well as taking positive action to do things to keep your teeth looking monitor, there are also things which we recommend you should not do:

  • Smoking. Smoking dries out your mouth, if the mouth is dry it has less saliva and it is saliva which neutralises the acid from the bacteria. This means that smokers are more likely to have tooth decay which can look dark, brown or black. If you have plaque buildup around your teeth then smoking will also discolour this plaque giving your teeth are very yellow look.
  • Avoid anything that can stain, think of your teeth like a white T-shirt, anything that can stain the T-shirt can stain your teeth! That doesn’t mean stopping eating food which is healthy for you, it just means think about how much you eat and cleaning your teeth afterwards.

Things you might want to consider

In addition to things you definitely should or should not do there are a few extra things which you may want to consider in your pursuit of whiter teeth.

  • Eating Strawberries. Now we don’t mean eating tons of strawberries every day, however strawberries contain malic acid, in small doses it has been shown that malic acid can whiten teeth… But don’t go overboard as it is also an acid and can actually damaged teeth if used too much.
  • Eating crispy or firm food can clean your teeth naturally as you go. Eat them towards the end of the meal as they will then help to naturally clean your teeth with their rough and crunchy edges, think about things like carrots or celery.
  • Chewing gum after eating stimulates production of saliva which neutralises and cleans your teeth by washing away debris. Always use a sugarfree gum.

Things to avoid when looking for whiter teeth

  • Coconut oil pulling. This seems to be a modern trend but there is no evidence to show that coconut oil whitens teeth in any way at all. In fact, some toothpastes are now including coconut oil but may not include enough fluoride. In this instance, this can lead to tooth decay due to a lack of fluoride. The same also applies to activated charcoal.
  • Beauty salon whitening. people often believe that you can go to a beauty salon for teeth whitening, however teeth whitening is not legal for anyone other than a dentist (or a dental hygienist or dental therapist working to prescription of the dentist) to carry out tooth whitening.
  • Using hydrogen peroxide/bleach. Whilst teeth whitening gel at a dental practice utilises hydrogen peroxide it does so in an extremely controlled and limited way. Using home bleach or any other form of non-dental hydrogen peroxide without the strict supervision or control of the dentist can be extremely dangerous as the soft tissue/gums can burn easily.

A final secret for whiter looking teeth

So here is our final secret for whiter looking teeth… Wear red lipstick! It’s a tip used by many celebrity and make up artist as the red lipstick forms a contrasting frame around your teeth making them look whiter.

red lipstick and white teeth

Image credit: Miki Hayes 2.19.15

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

Crowns vs Veneers vs Bonding

It’s often a dilemma knowing which to choose, crowns, veneers or bonding so we thought we would explain the differences between each in order that you can make the best decision based upon your own requirements and clinical needs.

What are the main differences between crowns, veneers and bonding?

  • Cost
  • Strength
  • Removal of tooth structure
  • Ability to change appearance of the tooth
  • Frequency of replacement

Crowns vs Veneers vs Bonding Cost

The cost of crowns, veneers and bonding is determined by a couple of factors:

  1. The time it takes.
  2. The cost of materials.
  3. The cost of laboratory fees.

Bonding usually takes a little less time than veneers and particularly crowns, but the biggest difference is the cost of laboratory fees. Bonding is done directly onto your tooth and therefore there is no third-party laboratory required in order to manufacture the restoration, this keeps the cost down considerably.

Bonding typically starts from between £345-£445 depending upon the complexity.

Dental veneers and crowns Usually take longer than dental bonding as the dentist needs to prepare the underlying tooth structure in a very precise way in order to receive the new dental veneer and Crown. Once the dentist had prepared the underlying tooth an impression will be taken and sent to a dental laboratory, the dental laboratory then makes the veneer or crown. This extended procedure adds to the cost.

Veneers and crowns typically start from £650 depending upon the complexity.

Crowns vs Veneers vs Bonding Strength

These three restorations can be ranked in order of strength.

  1. Dental bonding-lowest
  2. Dental veneers
  3. Dental crowns-highest

With any type of restoration on a tooth one needs to be aware and be sensitive to the fact that what you have is not an entirely natural tooth. Dental bonding is most prone to fracture, however because the bonding is done directly onto the tooth it is the easiest to be repaired by the dentist. If veneers or crowns fracture they will need to be removed and sent back to the laboratory for repair, sometimes repairs are not possible and a full remake is required.

Crowns vs Veneers vs Bonding Removal of tooth structure

Most dentists will prefer to keep as much natural tooth structure as possible, this is generally the preferred option wherever clinically justified. Removal of tooth structure is needed in order to receive the new restoration, particularly with veneers and crowns although sometimes a small amount of tooth structure is removed for dental bonding.

The three restorations can be ranked in order of the amount of tooth structure generally required to be removed.

  1. Dental bonding-lowest amount of tooth structure removed
  2. Dental veneers
  3. Dental crowns-highest amount of tooth structure removed

Crowns vs Veneers vs Bonding Ability to change appearance of tooth

Depending on what change of appearance is required may define which type of restoration your dentist uses.

  1. Minor chips and shape defects can be corrected with dental bonding.
  2. More major chips and shape defects plus the colour of the tooth can be corrected with dental veneers.
  3. The most severe chips, shape defects, tooth rotations and tooth wear can be corrected with dental crowns.

Crowns vs Veneers vs Bonding Frequency of replacement

The frequency of replacement will usually be determined by the following:

  • How quickly the materials used becomes worn or discoloured.
  • How well you look after the restoration, teeth and gums.
  • How careful you are when eating.
  • How well do you protect your teeth during sport.
  • Not having any accidents!

As you can see you will play an active role in maintaining the restoration and ensuring it lasts as long as possible.

Typical problems and reasons for replacement are as follows:

  • Dental bonding
    • The composite bonding material can discolour due to strong coloured foods being consumed or smoking etc
    • The restoration can chip due to excessive biting forces.
  • Dental veneers & crowns
    • The restoration can chip due to excessive biting forces.
    • The surrounding teeth change colour (either darker through age or whiter through whitening) and the dental veneer no longer matches and needs to be replaced.
    • The gum margin on the tooth recedes due to age (a natural phenomenon), this can then expose the underlying tooth which often look starker. This necessitates remaking the veneer or crown in order to cover up his newly exposed underlying tooth.


As you can see, the decision about whether to have crowns, veneers or bonding is not a simple one. It involves taking into account many factors and balancing out the risk factors in order to ensure you have the very best restoration for your budget, requirements and clinical suitability. Cosmetic dentistry such as this is very often as much an art as it is a science.

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)

Looking for an emergency dentist? Here’s what you need to know

The search term “Emergency dentist near me” gets almost 4000 searches in the local area per month, so we know that people looking for an emergency dentist and that they need information about treatments and options available.

We have broken this article on emergency dental treatments down into a few headings:

  1. Teeth which have come out completely.
  2. Loose teeth.
  3. Broken teeth.
  4. Tooth abscesses.

1. Teeth which have come out completely

What to do if the tooth comes out completely

If the tooth has come out completely you may be able to replace it so long as it is not damaged. If there are still blood vessels or nerves attached do your best to keep these intact and only hold the tooth by the crown section and not the roots.

Where to hold a tooth if it has been knocked out

If you can, gently place the tooth back into the socket ensuring it is the right way round. Only do this if the tooth is completely clean and hasn’t been in contact with the ground.

If the tooth has been in contact with the ground place it into a clean (ideally sterile) plastic bag with some milk and take it with you to your dentist or accident and emergency at the local hospital.

If the socket is bleeding profusely then gently bite down onto a soft piece of gauze, when the bleeding subsides don’t immediately remove the gauze as this could dislodge the blood clot and the bleeding could start again. Alternatively use a cold teabag, it has been shown that the tea contains substances which can help to reduce the amount of bleeding.

Do teeth grow back in adults?

Unfortunately not. Once your baby/deciduous teeth have fallen out you only get one set of permanent teeth. The only teeth which may grow after this initial set have come through are the very last molars or wisdom teeth.

2.Loose teeth

Can a loose tooth become tight again?

If the looseness of the tooth has been caused by gum disease then yes, if the gum disease is treated and the problem resolved then the tooth can tighten up again. This shows the importance of the early treatment of gum disease and how the situation can be saved if caught early.

3.Broken teeth

Is a chipped tooth an emergency?

A chipped tooth is only an emergency if either the tooth is bleeding or the gum surrounding the tooth is bleeding and won’t stop. If the tooth has chipped and there is no pain or bleeding then this would not normally be considered a dental emergency, you should however make an appointment to see the dentist as soon as possible to rebuild the tooth if required.

Can a chipped tooth heal itself?

Amazingly, yes, a chipped tooth can heal itself but it won’t rebuild itself. If the tooth chips and the softer underlying dentine has become exposed the tooth will react to this and create what is known as secondary dentine. This secondary dentine is often much darker but is also harder and will protect the softer underlying tooth. If you want the full contour of the chipped tooth to be restored then the only way to do this is to visit your dentist who will then use dental bonding or possibly veneers or a crown.

How to fix a chipped tooth

A chipped tooth can only be fixed by your dentist. If the chip is small then they may use dental bonding to rebuild the full contour of the tooth. If the chip is significant then dental bonding may not be adequate and a full dental crown or veneer can then be used. This may require a small amount of reduction of the healthy tooth structure in some instances.

4.Tooth abscesses

Is an abscess a dental emergency?

Yes. an abscess is a buildup of pus from an infection around the tooth. It is characterised by significant swelling, redness and pain. An abscess will not go away on its own and in extreme circumstances can spread to other parts of the body and make you ill.

What helps a tooth abscess?

If you have a tooth abscess then we recommend you contact your emergency dentist as soon as possible, whilst you are waiting to see them you can reduce the pain by rinsing your mouth with warm salt water, this is particularly effective if the abscesses caused by gum infection. Saltwater can help to remove bacteria from the infected area.


We also recommend:

  • Taking recommended doses of over-the-counter painkillers.
  • Avoiding particularly hot or cold food and drinks as it may make the pain worse.
  • Eating on the opposite side of your mouth.
  • Using a softer toothbrush than you would normally and don’t floss around the affected area until it has been seen by a dentist.

Please note, these are all temporary solutions and you will need to see a dentist to get the abscessed sorted.

Dr Nishan Dixit

Dr Nishan Dixit

Dr Nishan Dixit is the founder and principal dentist of Blue Court Dental. Patients enjoy his relaxed, friendly and gentle approach while experiencing his meticulous attention to detail. He has a special interest in providing smile makeovers, natural-looking white fillings and cosmetic braces, but also provides a range of treatments from preventative and general dental care to complex dental rehabilitation.
Dr Nishan Dixit

Latest posts by Dr Nishan Dixit (see all)