• dental plaque
• food
• drinks
• smoking

• can cause difficulties in tasting, chewing, swallowing, and speaking
• can increase your chance of developing dental decay and other infections in the mouth
• can be a sign of certain diseases and conditions
• can be caused by certain medications or medical treatments

• a sticky, dry feeling in the mouth
  
• trouble chewing, swallowing, tasting, or speaking
  
• a burning feeling in the mouth
  
• a dry feeling in the throat
  
• cracked lips
  
• a dry, tough tongue
  
• mouth sores
  
• an infection in the mouth

• It helps digest food
  
• It protects teeth from decay
  
• It prevents infection by controlling bacteria and fungi in the mouth
  
• It makes it possible for you to chew and swallow

• Side effects of some medicines. Many medicines can cause the salivary glands to produce less saliva. Medicines for high blood pressure and depression often cause dry mouth.
• Disease. Some diseases affect the salivary glands. Sjögren's Syndrome, HIV/AIDS, diabetes, and Parkinson's disease can all cause dry mouth.
• Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.
• Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
• Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva. What can be done about dry mouth? Treatment will depend on what is causing the problem.
• If your dry mouth is caused by medicine, your doctor may change your medicine or adjust the dosage.
• If your salivary glands are not working effectively but can still produce some saliva, your doctor or dentist may prescribe a medicine that helps the glands work better.
• Your doctor or dentist may suggest that you use artificial saliva to keep your mouth wet. What can I do?
  
• Sip water or sugarless drinks often.
• Avoid drinks with caffeine, such as coffee, tea, and some soft drinks.
• Drinking during meals will make chewing and swallowing easier.
• Chew sugarless gum or suck on sugarless hard sweets to stimulate saliva flow; citrus or mint-flavours are good choices.
• Don't use tobacco or alcohol, they dry out the mouth.
• Be aware that spicy or salty foods may cause pain in a dry mouth.
• Use a humidifier at night

• Remove plaque through daily brushing and flossing
• Interdental brushes (small, narrow brushes), are recommended to clean between the recesses in your teeth
• Wooden toothpicks should only be used if recommended by your dentist
• Visit your dentist for a check-up, scale and polish, every six months.
• Children also should be examined.

• Gum recession
  
• Decay
  
• Worn fillings or crowns
  
• Inflammation of the nerve in the tooth
  
• Death of the nerve in the tooth
  
• Toothbrush abrasion

• Use warm water to brush and rinse if cold water makes your teeth too sensitive to clean properly.
  
• Use a toothpaste designed for sensitive teeth. This works by blocking the 'dentinal tubules', (microscopic tunnels running from the root to the nerve). Use of specialist toothpaste may help only if the problem is short-term.
  
• If tooth sensitivity is not eradicated by using an appropriate toothpaste, more effective remedies can be applied by your dental professional.
  
• Don't scrub at your teeth. A gentle, circular brushing motion is most effective. Our Hygienist is able to give advice upon brushing techniques.
  
• Seek advice from your dentist to establish the cause of the problem.

Toothache that persists for more than a minute is more likely to be caused by chronic irritation of the nerve, and needs treatment from your dentist.

Wearing Dentures
- Remove Dentures at Night
- Clean with a Toothbrush, Soap and Water
- Beware of Denture Cleaning Tablets such as Steradent
- Attend for Regular Dental Examinations
- Any Discomfort Caused by Dentures should be Checked by Your Dentist

Whether you have been wearing dentures for many years or are experiencing wearing them for the first time, there are a few points to consider:

1. Always remove your dentures when you go to sleep. By keeping your dentures in your mouth 24hours each day you are risking causing an infection in your mouth on the areas covered by your denture. The bacteria which cause this infection thrive in the conditions under your denture because it is a warm undisturbed environment with plenty of food. It is an infection similar to Athletes Foot. The area covered by your denture will become bright red and spongy and this may alter the fit of your dentures. This infection can be easily treated and is helped / prevented if you remove your dentures at night or when you go to sleep
   
   
2. To clean your dentures we advise that you clean them with a toothbrush, soap and water to prevent the build up of plaque, stain and calculus. We advise against using toothpaste as it can be abrasive. When cleaning your dentures always hold them over a sink with a small amount of water in it so that if you drop your dentures there is less chance of them fracturing. Leave your dentures soaking in water whilst you sleep.
   
   
3. If your denture has metal components beware of soaking them in the fizzy, effervescent tablets such as Steradent, as the metal part of your denture may corrode. Always check the instructions on the packaging of such products.
4. Even if you do not have any of your own natural teeth left, it is still very important that you attend for regular dental checkups When we examine your mouth we check your gums along with your teeth for any ulcers or any area which could develop into something more sinister. As with any form of cancer it is more successfully treated if it is caught earlier rather than later.
   
   
5. If you experience any discomfort it is important that you contact us and arrange to have it checked. The majority of cases will only require a small adjustment to your denture, but, as explained above it could be due to something more serious.

1. You may notice a small alteration in your speech. This is because the new denture will be a slightly different shape to your old one. The muscles in your mouth including your tongue need time to adapt. Speech usually returns to normal within a short period of time.
   
   
2. You may find that you produce more saliva than you did before you received your new dentures. This is quite normal and is due to the fact that you are not used to having these foreign objects in your mouth. As you become more accustomed to your new dentures the excess saliva production will reduce to normal levels.
   
   
3. You may find that your dentures are loose or slack initially. As much or the retention of your dentures is obtained from the muscles in your mouth including your tongue, you may need to give them time to adjust. In most cases as you become accustomed to wearing your dentures you will find that they become tighter as your muscles adapt.
   
   Wearing new dentures is similar to wearing a new pair of shoes. You may find that they irritate the skin in your mouth and cause a small ulcer to appear. If this occurs you will need to contact your dentist and arrange to have your dentures adjusted slightly. If you do need to have an alteration made we advise that you wear your dentures for 3 or 4 hours prior to your appointment so that we can see exactly where the denture has been irritating the gum and adjust the denture accurately.

Looking After Your Child's Teeth

• Dental examinations are necessary as soon as teeth are present
• Clean your child's teeth twice daily, in the morning and immediately before bedtime
• Use toothpaste specially formulated for children
• Avoid fluoride supplements
• Discourage thumb sucking and the use of a dummy as early as possible
• Limit the amount of sugar attacks on your childs teeth
  • encourage sugar free drinks and cordials
  • limit fizzy drink consumption
  • beware of the high sugar content in processed foods
• Ask for fissure sealant treatment for teeth at risk of decay
• Early good oral hygiene habits last a lifetime

1. It is important that you bring your child for regular dental examinations as soon as they develop their teeth. This is usually when your child is 6 months old
2. If your child has teeth, you should be brushing them twice daily. It is important that you use a toothbrush which is the correct size for your child's mouth. We recommend "Oral B Stages" toothbrushes. These are made in various sizes to coincide with your child's development
3. Whilst fluoride is important to the development and protection of your child's teeth it is important to use toothpaste specially formulated for children whilst their teeth are developing. Too much fluoride can cause unsightly white or brown stains to form on the teeth as they develop. Children's toothpaste contains a reduced amount of fluoride which will help to prevent these discolorations occurring. Your child should only use a pea-sized amount when brushing their teeth
4. As our water in Newcastle contains fluoride we advise against taking additional fluoride supplements for the reasons above, unless your child has a particularly high rate of decay. Your dentist will advise you if this is necessary
5. If your child has a dummy or sucks their thumb, it can prevent their front teeth from developing correctly. This occurs because the dummy or thumb prevents the front teeth growing down until they meet because the dummy or thumb is in the way. Once your child ceases to use their dummy or suck their thumb the teeth usually grow down and close the space. It is advisable to discourage the use of a dummy and thumb sucking as early as possible
6. Try to limit the amount of times your child eats in between meal times. Each time we eat our teeth are attacked by acids which help to break down the food. This causes the outer layer of our teeth to become soft and eventually leads to decay. Therefore, if the number of times we snack between meals is reduced so will the chance of our teeth decaying. We suggest you let your child have sweets after / with a meal so that they limit the number of sugary attacks
7. Try to avoid giving your child drinks which contain sugar especially if they are drinking from a baby's bottle or a trainer cup. The action of sucking the sugary drink through their teeth can lead to quite rapid destruction due to tooth decay. We advise the consumption of sugar-free cordials or water
8. Limit the intake of fizzy carbonated drinks. Even the sugar-free / diet varieties can erode our teeth
9. The adult teeth start to grow into our mouths when we are approximately 6 years old. To help prevent early decay your dentist may suggest applying fissure sealants to the biting surfaces of the teeth as they grow into the mouth. This helps to protect against decay and enables the teeth to be cleaned more easily
10. Always ensure that your child brushes their teeth immediately before going to bed. If they do not clean their teeth in this way, any food debris or sugary residues from food or drink will remain undisturbed on the teeth whilst your child sleeps. This will lead to softening of the outer layers and may lead to the teeth decaying
11. Beware of the high sugar content present in processed foods. Remember if your child is taught good oral care habits early, they should remain with them for the rest of their lives.

Flouride
There has been a significant reduction in the amount of tooth decay in the Western World. This improvement is largely due to the use of fluoride.

Sources of fluoride
Fluoride is found naturally in food and water. In order to be effective for dental health it can be added to public water supplies, milk and salt. There are specific dental products which incorporate fluoride, which include toothpaste, mouthwashes and tablet form.

How does it work?
Fluoride is incorporated into teeth as they develop; so making them resistant to the decay process. It helps reverse the decay process by interfering with the ability of bacteria in dental plaque to produce acid and so cause tooth decay.

Does it have any known side effects? The most common effect is called Fluorosis. This is caused by high intakes of fluoride during tooth development. It appears on the teeth as white or brown marks/stains when the permanent teeth come through. Sometimes cosmetic treatment is needed to mask the appearance of the teeth.

Fluoride and young children
In order to avoid fluorosis it is recommended that children under the age of 7 should use a toothpaste specially formulated for children. The amount of toothpaste needed is equivalent to the size of a small pea.. It is best for adults to supervise children and ensure that they clean all areas of the teeth and don't swallow toothpaste.

Diabetes & Oral Care
- Inform your Dentist if you are Diabetic
- Take your Medication and Eat as Normal on the Day of your Dental Appointment
- Arrange your Dental Appointments soon after Normal Eating Times
- Diabetic Patients are More Prone to Infection and Take Longer to Heal

The following suggestions help to ensure that your mouth remains healthy and reduces the likelihood of a hypoglycaemic episode occurring during your visit to the dentist:

1. It is important that you inform us if you have or develop diabetes. This includes insulin dependent diabetes and diet / medication controlled diabetes.
   
   
2. If you have diabetes it is important that you continue with your normal daily routine and arrange your dental appointments accordingly.
   
   
3. We recommend that you eat at your normal times and take your medication as normal on the day of your dental appointment.
   
   
4. It is advisable to arrange the time of your dental appointment to coincide with a time shortly after you have eaten and avoid arranging an appointment time immediately before you would normally eat. This is because your dentist may be running late.
   
   Being diabetic you are more prone to infection and you may take longer to heal after a dental procedure. The most important dental infection which can affect diabetic patients is gum disease. If left untreated, rapid destruction of the tissues supporting your teeth can occur. Hence, we recommend regular dental examinations and frequent appointments with our hygienist.

Special Dental Care
Joint Pain - T.M.D. (Temporo-Mandibular Dysfunction)

Symptoms include:-

• Pain
• Limited opening
• Stiffness

• Clenching the teeth together. This may be brought on when you are concentrating or extra busy, worried, annoyed or even by cold winds
• Grinding the teeth together. This often occurs at night but can also be during the day
• Straining the joints and muscles by chewing pencils, biting nails, holding things in your mouth, holding the telephone between your neck and shoulder
• Overworking the muscles by constant chewing, e.g. chewing gum etc.

• Jaw pain or soreness that may be worse either on waking or in the evening
• Jaw pain when biting, chewing or yawning
• Clicking from the joint when moving your jaw
• Stiffness or locking of the jaw joint.
• Earache without an infection
• Difficulty opening or closing your mouth
• Frequent headaches

• Keep your teeth apart. Do this when you are not wearing your splint. The proper resting position for your jaw is with the teeth slightly apart and your tongue resting gently on the floor of the mouth. This allows your jaw joints and muscles time to rest and heal. Your teeth should only touch during chewing, swallowing and sometimes speaking.
• Avoid opening your mouth very wide.
• Avoid habits like chewing fingernails or gum.
• Avoid straining your neck and shoulders by poor posture. This can occur when working at a computer or holding the phone between your neck and shoulder for a long time.
• Eat nutritious meals that do not require hard or prolonged chewing.
• Avoid caffeine and smoking. Both of these are stimulants which excite the nerves of your body. If you are having pain, any stimulants can make the pain seem worse and increase muscle fatigue.
• Follow your personal treatment programme. This will be developed specifically for your needs by a dentist in the clinic.
• Try to give yourself 10-15 minutes each day to relax.

• Always do the following exercises slowly and gently, relaxing the muscles as much as possible
• All movement must be slow, relaxed and pain-free
• To be effective, these exercises must be performed regularly
• We suggest each exercise is done 5 times in both the morning and evening
• If the exercises seem to be improving your jaw problem they can be carried out more often
• If the exercises appear to make your jaw problem worse, stop doing them