Implant Care

Dental hygienists are the members of the dental team who focus specifically on your gum health. Hygienists do so much more than simply provide a “scale and polish”. They provide gum treatment to both prevent and treat gum disease and improve the aesthetics of your mouth. You don’t need to see a dentist in order to see a hygienist. This makes it easy to access a hygienist’s care and makes it even easier to fit in a hygiene treatment when it suits you best.

Some dental hygienists (including Nick) are dual qualified as dental therapists. Dental therapists perform routine restorations (fillings) in adults and children. They are particularly adept at children’s dentistry including extractions.

Nick's is an exceptional Hygienist who has a proven track record as a kind and caring clinician with an exceptional eye for detail

​Nick's treatments are tailored to your specific requirements with the aim of treating and preventing gum disease. He has built a wealth of experience in periodontal disease (gum disease) treatment in NHS, private and specialist private practices from Harley Street in Central London to West Byfleet, in Surrey. He also has a special interest in Dental Hygiene treatment for patients with orthodontics.

He is a regular speaker at local schools to help children learn good oral self-care from the outset. This passion is carried through to his adult patients, with whom he spends time ensuring they are using the right products to meet their specific needs.

• Nick cares about you not just your mouth.

• Nick is an exceptional listener who cares for people and their problems.

• Nick’s treatments go above and beyond ‘scaling and polishing’. Every treatment is tailored to your individual needs on that day. As your needs change over time so does his treatment approach.

• Nick’s approach is perfectly suited to phobic patients giving them the chance to start off gently and build up their confidence in the chair over a number of sessions

• Nick is an exceptional communicator who takes the time to explain his treatments and patient self-care.

• Nick is a perfectionist with a formidable eye for detail

Nick’s approach is preventative; aiming not only to treat periodontal issues but to stop their return.

• Nick regularly receives hygiene referrals from outside gum specialists (periodontists) to maintain their patients’ oral hygiene.

• Nick has a wealth of experience in diverse areas of dental hygiene such as implant care and orthodontics.

• Nick is constantly updating his knowledge and skills to ensure he is top of his game.

1. Prevention of bleeding gums. Bleeding gums or spitting out blood when you brush are signs of gum inflammation (and can be an early sign of gum disease). In most cases the bleeding is totally reversible. Nick stops the bleeding by removing hard and soft deposits (tartar and plaque) at the gum line and between the teeth. Always up to date with the latest product knowledge, Nick will show you how to prevent the bleeding coming back with a personalised oral care regime.

2. Treatment of gum disease. In more advanced cases of gum disease, the gums can become painful and sore, teeth can become mobile and infections can occur. Nick helps treat these issues by means of careful deep cleaning with a range of products, techniques and methods to ensure treatment is as comfortable as possible.

3. Treatment and access of hard to reach areas. No matter how well you brush and clean in between your teeth, there will just always be some areas that are hard to reach and require extra attention to stop tartar and plaque building up. For this reason, even hygienists needs to visit a hygienist from time to time!

4. Prevention of bad breath. The same bacteria that cause gum disease and tooth decay release odours that can lead to bad breath. Again, removal of the tartar and plaque deposits further helps to eliminate this.

5. Stain removal. Nick uses a combination of dental polish and airflow (jetwash) to remove stains that accumulate on the teeth from such things as food, drink and smoking. Not only does this make the teeth look great but they feel great too. There is nothing like that ‘just cleaned’ feeling.

6. Detection of dental and oral issues. Visiting Nick is no substitute for a dental check-up but nonetheless when working in your mouth, Nick is ideally placed to notice such things as early decay, lumps and swelling and chipped or failing fillings that you yourself might not have been aware of.

7. Disease prevention. Oral bacteria have been proved to exacerbate such issues as heart disease and diabetes. Regular hygiene treatments therefore form part of your holistic self-care routine.

Toothbrushing

• Brush twice a day in the morning and just before bed

• Brush your gums not just your teeth. Place the brush head where the gum meets the tooth, ensuring at least half of the toothbrush head is on the gum

  • Manual toothbrush: favour a small headed soft toothbrush. Choosing a children’s toothbrush is ideal as it allows you to focus on a few teeth at a time. Remember that pushing or scrubbing isn’t good brushing. Focus on lightly agitating (jogging) the toothbrush back and forth at the gumline over no more than 3-4 teeth at a time. Then circle up the tooth. Change your toothbrush every 3 months

  • Sonicare: (sonic vibrating technology) Choose a small head for targeted brushing. Follow the instructions as above for manual toothbrushing. Change the head every 3 months and the handle every 3 years (even if you think it is working well)

  • Oral B electric toothbrush (oscillating, rotating technology) Choose a small round head. Place the head halfway on the gum and tooth. Hold in position counting 2 seconds at the gumline of each tooth before moving on. Glide over the teeth like ‘a swan gliding over a lake’. Avoid pushing. Change the head every 3 months and the handle every 3 years (even if you think it is still working well).

Toothpaste

• Use a pea sized amount of fluoride containing toothpaste (1450ppm) when brushing

  • Fluoride helps teeth resist acid attacks and is proven to prevent decay

  • Spit don’t rinse: DO NOT rinse with water or mouthwash after brushing. Ths rinses the goodness of the fluoride away. Fluoride needs to stay on your teeth for as long as possible to maximise its efficacy

• Avoid whitening toothpastes for daily use (e.g. charcoal and bicarbonate of soda containing paste)

  • They are highly abrasive and used in the long term can wear away gums and enamel

  • Whitening toothpastes can only remove SURFACE stain. If you want whiter teeth, attend a hygiene treatment and consider followed it by bleaching

• There is no need to use specific toothpastes unless you have a particular problem e.g. sensitivity

  • Sensitive toothpaste

    • If you have sensitive teeth make sure you use the sensitive toothpaste you have selected for at least 2 weeks to give it time to work.

    • If after this time you don’t feel it is helping, try another. They all have different methods of action.

    • If using sensitive toothpaste isn’t working in the long term, discuss this your dentist (especially after deep gum treatment) as there are prescription only toothpastes and varnishes that can be prescribed

Mouthwash

• Mouthwash is not a substitute for brushing or cleaning in between your teeth

  • Some mouthwashes can hide the signs of your gum disease from you (e.g. bleeding) but this returns as soon as you stop using them

• There is no need to use mouthwash unless advised to do so by a dental professional (e.g. for an extra dose of fluoride)

• If you do wish to use a mouthwash, make sure it contains fluoride and use it at an alternative time to brushing to prevent rinsing away fluoride in the toothpaste

• Check the usage instructions on the bottle. More powerful mouthwashes can often only be used for a week or stain if used in the long term

• Nick might ask you to dip your TePe brushes in hydrogen peroxide based mouthwash (e.g Peroxyl). Peroxide based mouthwashes can help to kill the bacteria most associated with gum disease. They should not be used if you are allergic to asprin

Cleaning in Between Teeth / Interdental Cleaning

• Clean in between your teeth at least once a day. Brushing alone cleans only 60% of tooth surfaces, the remaining 40% of surface area is between the teeth.

• If you can, clean in between your teeth at night to prevent bacteria and other deposits being left on the teeth whilst you sleep. Bear in mind your saliva flow drops at night so the bacteria are not cleansed away as effectively as during the day

• If it bleeds when interdental cleaning, ignore it and keep going. Whilst it can be worrying to see blood, bleeding is a sign of active gum disease (enflamed gums due to the presence of plaque bacteria). If you continue to clean in between your teeth the bleeding will reduce and should eventually stop

Interdental Cleaning Aids

• TePe brushes. Colour coded bottle brushes in different sizes. The sizes you use can change over time, especially during the first few appointments, as gum inflammation reduces. The brush should offer resistance when being pushed through the interdental space (as otherwise you aren’t effectively touching the sides of the teeth). If you are in between sizes, choose the size that is most comfortable and make sure you swirl the TePe in the space going up and down making sure you touch both sides of the teeth. This will ensure you thoroughly clean both sides of the tooth

• Floss / floss tape: The aim of flossing is to go underneath the gum scraping one side of tooth root and then the other. Avoid sawing in a back and forward motion.

  • Most patients prefer using floss tape (such as Oral B Pro Expert premium tape or Oral B Satin Floss) as it easy to pass the thin side through the contact point of the teeth.

• Floss picks / flossettes. These are mounted floss on a handle which work well for those new to flossing and assist with access to harder to reach areas. Most patients find Oral B Glide Floss picks easy to use as the handle is bent enabling easy access to the back of the mouth.

• Wisdom brushes. Coming in 3 sizes – fine, medium and large these plastic toothpicks with a rubber tip are ideal for practicing cleaning in between the teeth especially for smaller gaps where a TePe brush might bend.

Interspace Brush

This versatile brush can be used to clean:

1. Orthodontic brackets

2. In between teeth

3. Into the pocket inserting the tip under the gum

4. Wisdom teeth covered by a flap of gum

• Use the interspace brush with a light swirling action (imagine you are drawing little circles with the tip of the brush).

Plaque disclosing tablets

• Disclosing tablets dye areas of plaque bacteria a bright colour e.g. pink, green or purple colour. This enables you to see where you are missing when you brush.

• After having brushed your teeth, simply chew the tablet and swill it throughout around your mouth and spit out.

• Focus your eye on where the gum meets the tooth and the sides (in between the teeth) see how much dye has collected in these regions. Be very strict with yourself as a little bit of dye shows you 1000s of bacteria. (Some tablets are also designed to dye older plaque a darker colour which shows you that you have been missing that spot for longer.

• As the tablets can dye your lips and tongue it is best to use them at night and spit the remainder of the dye into a cup rather than the sink.