We offer comprehensive NHS and private dental care for adults and children. For help with all of your dental needs, call Lerwick Dental Practice. Our friendly and highly trained staff are prepared to solve your dental problems, whatever their nature.
All dentists at the practice take part in continuing professional education and development. We are very interested in keeping up to date with all the latest developments in dentistry, including preventive care, which reduces the need to invasive treatment. We offer general dentistry, cosmetic dentistry, oral surgery and facial aesthetics.
Let us help you find the smile you’ve always wanted!
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EXAMINATION & ROUTINE CARE +During an initial consultation your dentist will inspect the soft and hard tissue in your mouth. By inspecting the soft tissue your dentist is looking for any abnormalities, halitosis (bad breath) signs of periodontal disease or mouth cancer. While inspecting your hard tissue (teeth) your dentist will be checking for decay, bite anomalies, seeing how your teeth can be improved functionally as well as how your smile can be enhanced aesthetically.
Prevention is better than cure
That is why we recommend regular dental checkups and hygiene visits which could be anything between 3-12 months depending upon your needs. Your dentist will recommend the most suitable interval for your next check-up.
Keeping your smile beautiful and healthy is an ongoing effort of both dentist and patient.
At Lerwick Dental Practice, we will always do what we can to preserve the tooth’s natural structure, and prevent the onset of dental diseases and other problems, but our work must be supported by consistent dental hygiene at home. Failure to care properly for one’s teeth could result in more serious problems later, which would require more costly dental procedures to fix.
To prevent such problems from developing, Lerwick Dental Practice offers a variety of prophylactic and consistent continuous hygienist care.
Regular examinations and cleaning are a necessity for healthy teeth, and the application of sealants and fluoride treatments will help greatly in maintaining the health and beauty of your smile.
At Lerwick Dental Practice, our highly trained staff will give you a complete and thorough dental examination as part of your regular check-up. Typically, these examinations will include the following procedures:
- Digital x-rays will be taken and examined for signs of decay, cysts, or tumours, as well as careful examination of tooth and root positions.
- An oral cancer screening will be conducted, examining the patient’s neck, lips, tongue, gums, throat, and tissues for any signs of cancer.
- Gums and bone around the teeth will be examined and evaluated for signs of periodontal disease.
- The surfaces of the patient’s teeth will be examined through the use of dental equipment designed to detect tooth decay.
- Sealants, crowns, fillings, and other restorative dental work will be checked to ensure that they are still intact and functioning correctly.
HYGIENIST THERAPY +Dental hygiene therapy plays a vital role in helping to keep your teeth and gums healthy by avoiding gum disease or by keeping this under tight control. Gum disease is extremely common and is caused by plaque which is a constantly-forming sticky film of bacteria. Initial symptoms of gum disease include sore or bleeding gums and bad breath. If left untreated, it can eventually lead to tooth loss.
The most important part of maintaining your dental hygiene is to schedule regular cleaning appointments. Such a visit will typically begin with an examination, and will be followed by:
- The removal of plaque. Plaque is a film comprised of bacteria, food particles, and saliva that adheres to the teeth and releases toxins that cause inflammation in the gums, which will lead to gum disease if left untreated.
- The removal of tartar, or calculus, a form of plaque that has been left on a tooth for too long without being treated, and has affixed itself to the tooth’s surface, becoming thick and hard.
- Tartar cannot be removed through normal means once it forms, and requires the use of dental equipment designed for this purpose.
- The teeth will be polished and cleaned of any stains or remaining plaque that was not removed during the brushing and scaling process.
Your appointment will conclude with a review of the condition of your teeth, and problems that need to be addressed, what you can do to keep your teeth healthy, and what treatment is recommended going forward.
We will provide you with advice on brushing and flossing techniques and advise on diet and the potential harm of sugars and fizzy drinks which may lead to dental erosion. Every time you eat or drink anything acidic, the enamel on your teeth becomes softer for a short while, and loses some of its mineral content. Your saliva will slowly cancel out this acidity in your mouth and get it back to its natural balance. However, if this acid attack happens too often, your mouth does not have a chance to repair itself and tiny bits of enamel can be brushed away. Over time, you start to lose the surface of your teeth..
Lerwick Dental Practice places the utmost priority on helping you to find the smile you have always wanted. In the interests of that goal, it is important that you, the patient, pursue it at home with regular, thorough dental hygiene.
DIGITAL X-RAYS +Digital radiography is the cutting edge of dental x-ray technology.
Rather than the x-ray films that were once used, digital x-rays use an electronic sensor that immediately saves the image to a computer, where they can be quickly viewed, and problem areas can be easily focused on, identifying any issues with your teeth faster and more efficiently.
X-rays are an essential part of regular dental examination, because they reveal internal problems that could otherwise not be detected with even the most thorough exam.
CHILDSMILE & FLUORIDE +Childsmile is a national programme designed to improve the oral health of children in Scotland and reduce inequalities both in dental health and access to dental services.
Visit the link Www.child-smile.org.uk for more information.
Fluoride is a natural mineral that already exists in most foods and sources of water. Its incredible effects in fortifying teeth against decay have been well documented and supported by experts for over 50 years. Although your teeth will gain some fluoride simply from eating and drinking, it is important that this is supplemented with professional applications and other sources. Generally speaking, there are two types of fluoride application:
This is the kind of fluoride we typically get every day from our regular food and water intake. Systemic fluoride is especially useful in strengthening new teeth, and those teeth that are still developing under the gums. Because this is so important for children in particular, your dentist may prescribe a systemic fluoride supplement in the form of a drop, which is typically recommended for infants, or a gel, which is recommended for older children and teens. Children should not, however, ingest too much fluoride at a time, as it can cause a condition called fluorosis in developing teeth.
This type of fluoride is applied through the use of toothpastes, rinses, gels, and other such dental products. Topical fluoride strengthens the enamel of teeth that have already emerged, and greatly fortifies the tooth against the effects of decay. Most dentists recommend that children receive a professional application of topical fluoride at least twice a year.
SEALANTS +Sealants are another useful tool in fighting tooth decay.
A thin coat of plastic is applied over chewing surfaces, pits, and fissures, where more than two thirds of tooth decay grows from.
Sealants protect your teeth against decay not only directly, but by giving the tooth a smooth surface that is significantly easier to clean.
Regular dental visits should include an examination of these sealants to ensure that they don’t wear down and become ineffective.
EMERGENCY TREATMENT +We can help with a range of dental emergencies.
We can investigate the source of your discomfort and carry out any necessary treatment.
In case of a life threatening emergency we will see you immediately.
If you are in great pain we will try to fit you in within 24 hours.
We will try to accommodate you and treat you as promptly as possibly if you have fractured teeth, trauma, crown, veneer, bridge re-cementation or first stage root canal treatment.
Outside normal surgery hours, please call NHS24 on 111
PERIODONTAL TREATMENT +Periodontics is an area of dentistry that focuses on identifying, preventing, and treating periodontal, or gum diseases. Gum disease typically begins with gum inflammation, called gingivitis, and progresses into more serious issues from there, leading to pain, irritation, and even bleeding.
Occasionally, periodontal disease is more insidious, and shows no easily identified symptoms. Periodontal disease is the number one cause of tooth loss in adults in first-world countries,and every measure should be taken to treat it before it becomes severe.
Periodontal disease can manifest itself in a variety of ways, all of which should receive attention before they worsen and begin to cause more serious problems, and eventually result in the actual loss of teeth.
Some of these warning signs of periodontal disease include:
- Swollen, sensitive gums
- Bleeding of gums
- Gums that recede, or pull away from your teeth
- Halitosis (bad breath)
- Changes in the way your teeth fit when they bite
- Loose or separating teeth.
If you are suffering from any of these problems, it is recommended that you schedule an appointment as soon as possible. If your periodontal disease is caught quickly enough, our staff can keep your smile intact and healthy.
SILVER & WHITE FILLINGS +Effective use of fluorides and other advances in dental care have done a great deal to prevent tooth decay, but teeth are still far from immune to decay and damage. Sometimes, restorative measures must be taken to fix the damage and prevent it from worsening, so your smile can be beautiful, healthy, and functional again.
Lerwick Dental Practice prioritizes your dental health above all else, and will make all of your restorative options known to you. We will only recommend the treatment that we believe is right for you and your teeth, and that will work best to give you the smile that you want.
Cavities, as well as cracks and breaks in teeth, will be filled by your dentist after removing decayed tooth material, to preserve the tooth’s form, function, and integrity. There are several different filling materials to choose from. A couple of the most popular options are:
Often called a ‘silver’ filling due to its silver-like appearance, dental amalgam is a strong, durable material, as well as being the most inexpensive kind of dental filling, which makes it one of the most popular fillings today. However, because of amalgam’s metallic appearance, many do not consider it to be very aesthetically pleasing, so it is typically used in back teeth, where it is less visible.
Created with a mixture of plastic and glass, composite resin is popular for its ability to mimic the appearance of your teeth, allowing it to blend in seamlessly and improve the aesthetic beauty of your smile.
Composite fillings provide strong support for tooth structure, and along with amalgam, are the other most popular filling in use. Because of their aesthetic value in your smile, composite fillings are frequently used to repair front teeth, where they are most visible.
EXTRACTIONS & ORAL SURGERY +The staff of Lerwick Dental Practice are highly trained and equipped to perform minor oral surgical procedures necessary to preserve and improve your smile, and your health.
We understand that the prospect of undergoing oral surgery can make some people anxious, but our patients can rest assured that they are in competent, capable, caring hands.
Basic tooth extraction is a very safe procedure that may be necessary for any number of reasons. Most commonly, a tooth is too badly damaged or decayed to be effectively repaired, and should be extracted to preserve the health of the rest of your mouth. Other times, severe tooth decay may reach the pulp of your tooth, causing an infection. If the infection is too severe to be treated with antibiotics or root canal therapy, the tooth must be removed to stop the infection from spreading. Teeth may also be removed if their size or position is abnormal to the point that they would greatly obstruct necessary orthodontic procedures.
If you need to have a tooth extracted, such a procedure will typically go as follows:
- Your procedure will begin with an anaesthetic injection to numb the area around the tooth that will be removed.
- If you are having multiple teeth removed, a stronger anaesthetic may be used that will cause you to sleep painlessly throughout your entire procedure.
- Once the area is fully numbed, bone and gum tissue may be cut away if necessary. The tooth will then be held with forceps, and rocked gently until it is pulled free of the jawbone. If the tooth proves very difficult to extract, it may be cut and removed piece by piece.
- After the extraction, bleeding will be stopped with gauze or stitches, and you’ll be free to leave. A full recovery will usually take a few days, during which you should take painkillers as prescribed, eat soft foods, and avoid the extraction area when brushing and flossing.
Wisdom Teeth Extractions
The four backmost teeth that emerge in your mouth are your third molars, or wisdom teeth. They usually come in during the ages of 17-21 (a supposed age of maturing, or gaining wisdom, thus the tooth’s common name) and tend to be not only unnecessary, but harmful.
In a few cases, wisdom teeth will come in healthy, correctly positioned, and functional, and in these cases, it may not be necessary to remove them. Very often, however, wisdom teeth do not have adequate room to erupt, and can cause very serious problems, the risk of which greatly outweighs the negligible benefit of keeping them.
Wisdom teeth can impact with your other teeth, damaging them and pushing them out of alignment. Unhealthy wisdom teeth may inflame the tissue of your gums, resulting in swelling, and even pockets between your teeth where bacterial colonies can grow. It’s even possible for cysts to form around the new teeth, causing lasting nerve damage if left untreated.
What should you expect after the operation?
It is normal to experience some postoperative pain, swelling and occasional bruising.There may be some difficulty in opening the mouth wide for several days and it will be easier to eat soft food for the time. It may take several weeks for your mouth to feel completely back to normal. You will be recommended suitable painkillers and antibiotics if required.
If you are taking the oral contraceptive pill its effectiveness can be reduced by antibiotics so alternative methods should be used.
Aftercare required the first two hours
- Do not bite your lip to see if the feeling has returned.
- Avoid hot drinks. You may burn your lip and cause bleeding.
- Continue to use bite packs for about 20 min after leaving the surgery to stop bleeding.
- It is pressure that you apply with the bite pack that stops bleeding. The pack alone, without pressure will merely soak up blood.
- You may take any mild painkillers before the anesthetic wears off. Avoid aspirin, it encourages bleeding.
- Do as little as possible to the affected side of the mouth.
Aftercare required the next 24 hours
- Avoid strenuous exercise. No work outs today.
- Avoid alcohol intake.
- Avoid smoking. It delays healing and encourages dry socket.
- Avoid eating hard food on the affected side.
- Keep your teeth clean with a soft brush.
- After 24 hours to keep the wound clean, rinse with warm salty water (1 tea spoon salt in tumbler of warm water.)
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COSMETIC & AESTHETIC DENTISTRY +Very often our patients indicate that they would like to improve the appearance of their smile. They may feel that their teeth are discoloured or stained, that their smile is too “gummy”, or they may even just wish they could start all over again with a great new smile.
Cosmetic and aesthetic dentistry can help with all of these problems. Sometimes patients only need a relatively simple and affordable treatment, at other times they may opt for a complete smile makeover, where we use a number of treatments together to provide them with the smile they have always wanted.
Our cosmetic and aesthetic treatments include:
- White cosmetic fillings
- Tooth whitening
- Dental Implants
PORCELAIN VENEERS +Porcelain veneers are thin pieces of porcelain used to recreate the natural look of teeth, while also providing strength and resilience comparable to natural tooth enamel. It is often the material of choice for those looking to make slight position alterations, or to change tooth shape, size, and/or colour.
Porcelain laminate veneers consist of a compilation of several thin ceramic layers which replace original tooth enamel, and an adhesive layer. To apply a veneer, a very small amount of the original tooth enamel must be removed, usually less than a millimeter. This is essential as it creates room for the porcelain veneer to fit within the mouth and most accurately restore natural tooth function while creating an even better appearance than the original tooth.
The bond between original tooth and porcelain veneer is critical as it not only provides the esthetic perfection desired, but also a strong bond which is essential for correct veneer function. Light-sensitive resin is placed between the original tooth and the veneer and then hardened using a special curing light.
Porcelain veneers are a very successful option in many situations where the original tooth has developed poor color, shape, and contours. It is also a good choice for fractured teeth, gaps between teeth, and in some situations where the tooth position is compromised and there are minor bite-related problems. For some people, superficial stains do not respond well to tooth whitening or bleaching. In these situations, a porcelain veneer may be the best option.
CROWNS & BRIDGES +A crown, or cap, is a tooth-shaped covering that completely encases a tooth to restore its strength, as well as its appearance
Crowns are commonly used to protect and restore weakened and damaged teeth, and are a strong and long-lasting restorative measure, but could eventually need to be replaced.
Like fillings, they come in a variety of materials, but because of a crown’s higher visibility, porcelain crowns that mimic the appearance of a tooth are by far the most popular choice.
On the NHS we can offer a white bonded crown for the front teeth, and a metal coloured crown for the rear teeth.
A porcelain fixed bridge replaces missing teeth by using the surrounding teeth as a foundation. This creates a literal “bridge” between the remaining teeth and the missing teeth.
Dental porcelain is a great product because it can be shaped to replicate original teeth and fit comfortably within the established bite pattern. Porcelain is also very durable, will withstand most natural tooth functions, and can vividly mimic tooth enamel with its glass-like whiteness and translucence, which allows light to penetrate and scatter as it does with natural organic teeth.
DENTURES +Dentures are removable dental appliances that are used to replace missing teeth, and help restore and enhance your smile. They come in two types, complete and partial, depending on whether all or only some of your teeth have been lost.
They could be made of metal, acrylic or plastic
Complete dentures are used if you have lost all of your natural teeth, and can be either conventional or immediate.
Conventional dentures are created to fit your mouth after your teeth have been removed, and are typically ready to be placed about two or three months after removal. Immediate dentures are made beforehand, and are ready for use upon removal of the teeth – however, the gums will gradually shrink after the teeth are removed, so immediate dentures will eventually stop fitting, and are best used as a substitute while conventional dentures are made.
Partial dentures are used if only some of your teeth are missing, and consist of replacement teeth affixed to a plastic base.
Partial dentures not only give you a complete smile, but protect your remaining natural teeth by filling gaps and and preventing the teeth from shifting position.
ROOT CANAL TREATMENT +A root canal is a restorative procedure typically used to repair and save a tooth that has become infected or badly decayed.
During a root canal, a hole is drilled to access the tooth’s damaged or infected nerve and pulp – that is, the tissue inside of the tooth – which are then removed, and the inside is thoroughly cleaned of bacteria and debris.
The tooth is then sealed up with special dental paste and compounds. Root canal therapy may be followed up with other restorative treatments afterwards, depending on the needs of the tooth.
Root canals are often thought to be painful, but the great majority of patients report no more pain than they experience having a filling replaced.
Root canals, in fact, not only save teeth that would otherwise have to be removed, but completely relieve the excruciating pain of tooth infection.
IMPLANTS +A dental implant is an artificial root, which is highly realistic, permanent replacement for one or more missing teeth. They look and feel very natural and enable you to eat and speak with confidence as well as improving the way your smile looks.
The implant itself is a small titanium rod which is precisely set into your jawbone. Over time the bone and implant bond together forming a strong and permanent base very much like a false tooth root.
Implants can have crowns or bridges fitted on top, replacing one or more missing teeth. Patients with many missing teeth can be fitted with special dentures, held firmly in place by implants, thus making it much easier to eat and speak without embarrassment.
At Lerwick Dental Practice we offer guided implant surgery. This involves taking a CT scan of your jaw area so we can ensure that before surgery you have sufficient bone tissue for an implant and can plan the implant placement with pinpoint accuracy. Where there is inadequate bone tissue we apply the treatment to regenerate the missing bone tissue using a variety of techniques (including bone grafting from other sites) when necessary.
Dental Implant services we offer include Implant placement
FACIAL AESTHETICS - COMING SOON! +Facial Aesthetics
Ageing typically removes skin volume, especially the facial contours.
At Lerwick Dental Practice we offer a range of treatments and skin rejuvenation products.
We offer Dermal Fillers which are completely natural substances to enhance your facial aesthetics. Whether you are looking for fuller lips, defined facial contours, softened facial lines, dermal fillers such as Restylane® offer you the flexibility to bring out the best in yourself. They can be used in conjunction with other skin rejuvenation products and with Botox® treatments.
MOUTH GUARDS & BRUXISM +
Recommended treatments for bruxism (teeth grinding) include behavioural therapies and using mouth guards or mouth splints.
Other treatments, such as muscle relaxation exercises and sleep hygiene measures, may also help you manage your symptoms.
Mouth guards and mouth splints
If you grind your teeth while you're asleep, you may need to wear a mouth guard or mouth splint at night. These even out the pressure across your jaw and create a physical barrier between your upper and lower teeth to protect them from further damage. They can also reduce any grinding noises you make at night.
Mouth guards are similar in appearance to those used in sports such as boxing. They're usually made out of bendy rubber or plastic and can be made by your dentist to fit your mouth. You'll usually have to pay for this type of custom-made dental appliance.
Mouth guards are also available to buy from your local pharmacist. However, it's unlikely to fit as well as one made by your dentist.
A mouth splint (also known as an occlusal splint or bite plate) is made from harder plastic and fits precisely over your upper or lower teeth. Mouth splints are no more effective than mouth guards in reducing the symptoms of bruxism. They tend to last for years, whereas mouth guards usually last for less than a year. However, mouth splints are more expensive.
Although mouth guards and splints may help reduce muscle activity in your jaw at night, they're only able to control the condition, not cure it.
Treating the underlying cause
Psychological treatments, such as cognitive behavioural therapy (CBT), can be used to treat any underlying psychological problems, such as stress and anxiety, that may be causing you to grind your teeth.
CBT aims to help you manage your problems by changing the way you think and how you act. A specially trained therapist will encourage you to talk about how you think about yourself, the world and other people, and how your actions affect your thoughts and feelings.
If your bruxism is stress related, it's important that you try to relax and get a good night's sleep. There are a number of things you can do to help you wind down before you go to bed. These include:
having a bath
listening to music
Different things will work for different people. Your GP will also be able to recommend some additional stress management techniques.
Breaking the habit
Habit-reversal techniques are designed to break your teeth grinding habit. However, there's no scientific evidence to suggest that using habit-reversal techniques will cure bruxism. If you grind your teeth while you're awake, it might be useful to record how often you grind your teeth each day. You can then work out when you're more likely to do it and why – for example, when you're concentrating or stressed.
Being more aware of your habit will make it easier to break. To break the habit, you could train yourself to relax your jaw when you feel yourself grinding or clenching. For example, you could open your jaw slightly or gently place your tongue between your upper and lower teeth.
Habit-reversal techniques may be used by a specially trained therapist, or you can try them yourself using a computer programme or self-help book. Your GP will be able to advise you.
Treating and preventing dental problems
It's important that you have regular dental check-ups and that any problems caused by your teeth grinding are treated as soon as possible to prevent further damage.
For example, if your grinding leads to a cracked tooth and is left untreated, the nerve in your tooth could die and a dental abscess might develop. As a result, you may need to have root canal treatment. In severe cases, your tooth could actually split in two. If this happens, your dentist won't be able to save the tooth and it will need to be taken out.
Dental problems, such as misaligned, cracked, crooked or missing teeth, can usually be treated with reconstructive dental treatments, such as false teeth, overlays and crowns. These treatments can sometimes reshape the chewing surface of your teeth and stop you grinding. You'll usually have to pay for this type of dental treatment and it can often be expensive.
Medication isn't usually used to treat bruxism. But non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help relieve any pain or inflammation you have around your jaw as a result of grinding your teeth.…
TMJ TREATMENT +
TMJ (the Temporomandibular Joint) is the jaw joint that allows the jaw to open and close. This is a complex area and problems that affect the jaw, such as your teeth not meeting together properly, or clenching or grinding your teeth, can go on to create further problems. If you suffer from difficulty in opening your mouth or pain on opening chronic headaches or migraines, or pain in the neck, shoulder, jaw and ear, we may be able to help. Treatments are often relatively simple, painless and can make a huge difference to your quality of life.
Our treatments include Occlusal analysis and treatment and suitable Bite Guards
TMJD, or temporomandibular joint disorders, also sometimes known as TMJ or TMD, is the set of diseases and disorders characterized by inflammation of the jaw joint.
Possible known contributing factors of TMJD include: injury to the jaw; teeth grinding or jaw clenching; arthritis; infection; hormones; auto-immune diseases and genetics.
An individual with TMJD may experience any or all of the following symptoms: discomfort when opening or closing the mouth; inability to close or open the mouth; pain in the neck, shoulder, back or head; clicking or popping sound in the jaw; feeling of an irregular bite; swelling of the face; and difficulty eating, speaking, swallowing, chewing or breathing.
TMJ disorders may fall under the following categories: inflammatory joint disease, such as arthritis, capsulitis, or synovitis; myofascial pain where trigger points are present in muscles around or near the jaw; and internal derangement of the joint, where the disc that acts as a cushion between the mandible and skull is displaced or deteriorated.
Another means of categorizing the set of conditions known as TMJ disorders is myogenous, which refers to affected muscles of the jaw and mouth, and arthrogenous, which refers to the hard and soft tissues or the temporomandibular joint.
High-risk groups include those with a structural deformity of the jaw or teeth, those who experienced an injury to the jaw, face or neck, highly stressed individuals and those with diseases such as osteoarthritis, rheumatoid arthritis, fibromyalgia, myofascial pain and sleep disorders.
As the causes and symptoms of TMJD are not fully understood, and because the symptoms of TMJD are also present in a number of conditions including toothache, ear infection and headaches, TMJD is often difficult to diagnose.
Treatment options for TMJD include: cold and hot compress; stretching and exercise; eating soft, small-bite-sized foods; relaxation techniques; over-the-counter and prescription pain management medications; and nightime dental appliances. Surgery and other irreversible solutions meant to alter the bite should be carefully considered, as they have not been shown to be effective in the treatment of TMJD.
TMJD symptoms may vary from mild to severe, and mild cases frequently become better in a matter of weeks or months with common-sense care such as applying ice and preventing additional strain on the jaw and surrounding muscles.
When cases of TMJD are severe and persistent, there may be no cure for the condition. Instead, ongoing management of symptoms is required. In these cases, becoming educated about the condition, seeking advice from healthcare professionals from a number of relevant specialties, and participating in support groups may be of help to an individual.