Specialist Services

There will inevitably come a time when we need a tooth extracted, whether though decay, periodontal disease or trauma.  Toothache can interfere with sleep, eating and work and if left untreated can affect your health.  Many patients have a fear of dental treatment, whether due to the surroundings, previous experiences, dental injections, or treatment and avoid going to their dentist.  We are here to make tooth removal stress-free and comfortable.  Come and meet our friendly team and we will talk you through the process in a calm and unrushed manner, with a little or as much detail as you wish.  We can provide topical anaesthetic and a range of local anaesthetic solutions and techniques tailored to each individual.  We also offer a sedation service, a popular and effective alternative to general anaesthesia, to allay your anxiety and make your treatment visit a pleasant one.  

With an appropriate radiograph (x-ray), we can often provide simple extractions at your initial visit, relieving pain and managing infection quickly and effectively.  Simple extractions usually require only one visit.

Sometimes extraction of teeth proves difficult, teeth snap, or roots remain.  Your dentist may ask us to see you to carry out treatment to avoid complications, to complete treatment or even just to provide specialist advice.  Difficult extractions often need a little surgery to complete, where we uncover the tooth roots and ease them out, before placing stitches to return the gum to its original position.  The stitches we use dissolve over time and do not need to be removed.  As with simple extractions this can usually be done by numbing the area and we can talk you through the procedure.  We can also offer sedation for surgical extractions.

Wisdom teeth usually erupt in late teens and may cause discomfort or swelling as they do.  Often there is not enough room in the jaw for wisdom teeth to fit and they get trapped or impacted.  When this happens swelling, pain, and infection can occur from repeated infections.  With time the teeth may decay because their position makes it difficult to keep them clean.  If you have suffered three or more episodes of pain and swelling or a single severe episode requiring treatment this may be an indication for the teeth to be removed.  When the teeth become decayed their position may make it difficult for your dentist to place a filling and this may be a reason for extraction.

Wisdom teeth are often removed by numbing the area only, although if you are anxious about the procedure we can arrange for sedation.  Once numb the procedure to remove the tooth depends on its position and the shape of its roots.  It is sometimes necessary to uncover the tooth and divide it into smaller pieces to remove it more easily.  You may have stitches, which dissolve and disappear as the area heals.

We will explain in detail all the complications which may occur at your consultation.  Most patients will experience pain, swelling and possibly some bruising.  You will be given full aftercare instructions on how to look after your mouth following surgery.  

If you are having braces fitted to straighten teeth, removal of teeth may be necessary to create space and to allow correct alignment of your bite.  These are often simple extractions and we can arrange these at your convenience and so that it does not delay your orthodontic treatment as teenagers are frequently conscious of wearing braces and hope to have their treatment completed before finishing school.

For many reasons, though frequently due to crowding, teeth may fail to erupt into their proper position.  Your orthodontist can often move these teeth into the correct place but may need help in uncovering the teeth, which may be hiding in the roof of the mouth or between the roots of other teeth.  We can find the position of unerupted teeth by taking radiographs or we can arrange three-dimensional scans for complex cases or at the request of your orthodontist and plan the type of procedure required.  Sometimes this simply involves creating a small window through which the orthodontist can reach the tooth.  On other occasions we may uncover the tooth, place an attachment temporarily onto the crown and cover the tooth back up.  The orthodontist can then use the attachment to help the tooth find its way to the surface in much the same way as a tooth would erupt.

We will liase closely with your orthodontist to plan the treatment that is right for you.  Treatments can be arranged for evenings or weekends to avoid missing school and to fit in with your orthodontic treatment schedule. 

We can also provide a soft tissue surgery service for orthodontic and young adult patients.  The most common procedure is a frenectomy, which is release of the band of soft tissue attaching you lip or tongue to the tooth line.  Such attachments may cause discomfort on eating or can affect alignment of teeth.    Occasionally wearing braces can cause irritation to the lining of the mouth and produce prominent areas of scar tissue.  If these persist after completion of your orthodontic treatment they may be readily removed and heal very quickly.

Most young adults have little or no experience of dental procedures and the thought of surgery can be daunting.  With our experience of carrying out such procedures we are able to put patients at ease and with careful explanation most will be reassured and happy to have the treatment with numbing alone.  For more complex treatments and for those who feel unable to tolerate the procedure under local anaesthetic we are able to offer a full sedation service for ages 12-adult.

Your orthodontist may provide you with a temporary appliance to wear in your mouth following the surgery.  We will give you full instructions on the wear of these appliances and how to look after your mouth after treatment.  Your orthodontist will usually want to see you two weeks after surgery and we usually do not need to see you again unless you are having problems, or your orthodontist contacts us.

We understand that many patients have a fear of coming to appointments, this may be due to the sights, smells and noises that you associate with dentists, and our team will do our best to help you through your appointment.  We can arrange non-treatment visits to meet the team, appointments at quiet times to suit you, as little or as much explanation of procedures as you prefer and information sheets to help you.  We can play music during your treatment, or you may wish to bring your own and some headphones. 

Many of the procedures we perform are simple, comfortable and take only a short amount of time to complete and local anaesthesia or numbing of the area is usually enough.  The numbness last around 2 hours, and although a strange sensation, you may leave as soon as we have finished your treatment, you can drive immediately, and if over 16 years of age, you do not need to be accompanied.  If you are anxious of the pricking sensation, we can apply a numbing cream before your injection.  

Some patients may have had a bad experience with dentistry in the past and we hope to show you that this is not the norm and your visit should be a stress-free, pleasant time.  Please feel free to share your concerns as we are here to help.

If you feel that you may be unable to cope with treatment under local anaesthetic, then we may offer you sedation.  Sedation relieves anxiety, is relaxing, and frequently leaves you with little memory of the procedure.  It is not a general anaesthetic, as you remain awake throughout and will respond to questions and requests, however you may feel detached or unaware of your surroundings and forgetful of the procedure.  It is useful in managing fear, for making longer or more complex procedures more pleasant, and can also help if you suffer from a sensitive gag-reflex.

Sedation is available to patients 12 years of age and over.

Unfortunately, sedation is not suitable for all patients.  We are happy to discuss this option with you and will review your medical history and current medication to ensure that this option is safe for you. Sedation is usually not available if you have breathing difficulties, sleep apnoea, or if you are pregnant.  Please be sure to bring a list of your current medicines if you are considering this option

We use single agent (midazolam or remimazolam) intravenous sedation to ensure safety and comfort.  This means that we give you a medicine through a small plastic tube placed in your arm or back of your hand.  Placing the tube involves a small scratch much like an injection or having a blood sample taken.  The medicine works quickly, and we adjust the dose to suit each individual patient and procedure.  Sedation lasts around 45 minutes, which is more than enough for surgical procedures.  Whilst you are sedated, you have a nurse who is there to look after you and monitor you in addition to the surgeon and assistant.  

 As you are a little unsteady on your feet and very forgetful after sedation we will look after you for an hour after your injection.  You must be accompanied by an adult who can take you home by car or taxi and stay with you for 24 hours.  Although you may only feel a little tired, you should not go to work, drive, or do any important tasks for 24 hours after having sedation. 

For simple procedures you do not normally need to be seen again and you will be returned to your referring dentist for your on-going treatment.  Verbal and written care instructions will be given to you explaining what to expect following surgery and how to take care of your mouth.  We will advise on pain relief and mouth rinsing and can prescribe medicines should these be required.  We will provide you with a 24-hour telephone contact number for your immediate post-surgery period and we are happy to arrange a telephone review service for the following day/week if this is convenient for you.  Should you experience any problems we will give you advice and arrange to see you if this is necessary. 

Occasionally we will ask you to return after surgery so that we can ensure you are healing well, discuss results of investigations, and to plan further treatment.  Where possible, we will return you to the care of your referring dentist for long term follow up and continuation of your comprehensive care.  Most surgery will involve only a single visit, simple and convenient.

Although we will do our very best to look after you and provide the highest level of care, there will always be something we can do better and we would love to hear your feedback on how we can improve our service.  If you have any concerns regarding your treatment, we will always be happy to listen and do whatever we can to address them.  We always want you to leave our care happy with the way we have looked after you and happy with the treatment we have provided.  We have a complaints procedure and will be pleased to share it with you.  And we don't mind you letting people know if you feel we have looked after you well!