APEX Solutions


Rebuild complete

Posted by Robert Pilcher

The rebuild of Mr Pilcher's Surgery is now completed as the photos below show. Mr Pilcher has bought a Castellini Skema 8 operating unit - Their top of the range unit - and cabinetry by Tavom. Both these are Italian, as shows in their fantastic design. These were supplied and fitted by RPA Dental based in Wigan - a specialist Dental Surgery design and fitting company. Building work was carried out AM Building Ltd who have ben working with RPA for 25 years. Mr Pilcher is 'over the moon' with the new surgery.








Reducing Decay

Posted by Robert Pilcher

A couple of days ago, we broached the subject of fluoride (29th). This contained some advice for toothpaste and mouthwashes, however fluoride is only one means of reducing decay. The approach must also tackle diet.

Dental decay remains at high levels in the UK.  Recent studies show 40% of 4 – 6 year olds and 67% of 14 – 18 year olds have decay.  A number of factors are involved in the development of decay, including composition of the teeth, presence or absence of fluoride and type and quantity of oral bacteria.  It is recognised that by far the most important factor is diet, and that sugars are undoubtedly the most important dietary factor in causing dental decay.  

The sugars associated with decay are the refined sugars e.g. sucrose, glucose and fructose.  The sugar found in milk (lactose) has a low potential for causing decay.   

Raw starch has a low potential for causing decay, but most starch is cooked or refined for consumption, and in this form it has the potential to cause decay.   

The following list shows those foods that have a high potential to cause decay.

Decay causing foods and drinks

Sugar and chocolate confectionary

Cakes and biscuits Buns, pastries, fruit pies.

Sponge puddings and other puddings

Table sugar

Sugared breakfast cereals

Jams, preserves, honey.

Ice cream

Fruit in syrup

Fresh fruit juices

Sugared soft drinks

Sugared, milk-based beverages

Sugar-containing alcoholic beverages (Alcopops)

There are a number of non-decay causing, non-sugar sweeteners that are permitted for use in the UK e.g Sorbitol, Mannitol, Xylitol, Hydrogenated glucose syrup (Lycasin), saccharin and Aspartame (Nutrasweet, canderel).  However sorbitol, Mannitol and Xylitol have only a limited use due to their laxative effect.

Foods and drinks with a low risk of causing decay are those with low sugar or have starch that is not highly refined or cooked.  The following list gives example of these food and drinks.  

Foods and drinks with low potential for dental decay

Low/No caries risk

Bread (sandwiches, toast, crumpets and pitta bread)

Pasta, rice and starchy staple foods.

Unsweetened or artificially sweetened yogurt.

Low-sugar breakfast cereals (e.g. shredded wheat)

Fresh fruit (whole and not juices)


Sugar-free drinks

Unsweetened popcorn

Some foods even have a potential to counteract the effects of dietary sugars.  These can help by neutralising the acids produced, or stimulating saliva production.  The following list has some of these foods and drinks.

Possible anti-cariogenic effect  




Sugar-free chewing gum

Fibrous foods (e.g. raw vegetables)

Xylitol sweeteners, gum and mints

Tea (unsweetened) – contains fluoride.  


The following are KEY dietary recommendations to control dental decay and dental erosion.


Key dietary recommendations to safeguard dental health

ü      Reduce the frequency and amount of sugary and acidic food and drinks and try to limit these to mealtimes.

ü      When a structured meal plan is not followed, limit the consumption of sugary foods to 3-4 times a day.

ü      Avoid sugary and acidic foods and drinks close to bedtime.

ü      Consume foods and drinks that do not cause, or are known to protect against, dental decay and erosion.

ü      Consumption of some sugar-free products may help achieve these goals in practice.

ü      Avoid brushing immediately after consuming acidic food and drinks.

ü      Chew sugar-free gum for 20 minutes immediately after meals. (Adults and older children only)

ü      Use a straw for drinking any acidic drinks.

ü      Read manufacturers labels to identify hidden sugars and acids and follow recommendations on the dilution of squashes and the use of products.

ü      Do not add any drink or food to a baby’s bottle, except formula milk, expressed breast milk, cow’s milk or water.

ü      Provide all drinks (including formula) in a cup or beaker to infants from the age of 6 months and cease bottle-feeding by 1 year.

Daily Mail Investigate Whitening Toothpastes

Posted by Robert Pilcher

It should be fairly obvious what I normally think of The Daily Mail. Well this time in the edition on 21 Jan 2013, they had a really balanced article on Whitening Toothpastes.


I have always told my patients, that whitening toothpastes can remove surface stain, but will not change the base colour of the teeth. Although not very scientifically done, the DM's little study showed the same. These toothpastes also make a lot of cash for toothpaste manufacturers - By 2008, sales were worth £63 Million. A tube of whitening toothpaste costs 4 - 9 1/2 times the cost of a standard toothpaste. The DM looked at 6 brands:

Arm & Hammer Advanced Whitening Toothpaste (£2.60, 75ml) - claims to 'remove stains... and buff the teeth into a brighter, whiter smile'. 3 shades whiter clinically proven - 3 shades of what? - grey. 3 shades means nothing unless you know what the shade guide is. The difference between them may only be discernable using a spectrophotometer.

SwissDent Xtreme Whitening Toothpaste (£9.70, 50ml) - says it 'penetrates even the tiniest fissures to produce perfect bleaching results'. That's a tenner, and it's only 50 ml!

Oral B 3D White Enamel Protect (£3.49, 75ml) - claims to 'whiten the front, back and visible surfaces between teeth'.

Beverly Hills Natural Whitening Expert (£3.49, 75ml) - makes the incredible claim that it can 'remove stains in just one minute'. No good here as extenxive studies show that the 'average' person in the UK cleans for 45 seconds!

BlanX Intense Stain Removal (£6.50, 75ml) - says it 'restores teeth to their original natural whiteness'.

Rembrandt Complete Whitening Mint (£8.31, 50ml) - claims to be 'clinically proven to whiten teeth beyond surface stains with daily brushing'.

The DM conclude that Whitening Toothpastes are not the answer to whiter teeth:-

So if whitening toothpastes aren't the answer, and a top of the range dentist's treatment is out of your price range, what can you do?

Don't be tempted to bypass the professionals by buying any of the products available online. Research by consumer group Which? found that about ten per cent of people who had bought tooth whitening products online to self-administer ended up with chemical burns on their lips.

A similar number reported brown stains on their teeth, suggesting that their enamel had been irreparably damaged.

So if you're serious about getting whiter teeth - safely - the most economic, and legal, way is to ditch your whitening toothpaste habit, and visit a dentist. They'll show you how to use the bleach gel to minimise burns, avoid discolouration, and get the whiter teeth you want.

After all, better to spend a couple of hundred pounds on a treatment that will work than on 20 tubes of ineffective toothpaste.'

How sensible!

7 Things you didn't know about TEETH WHITENING

Posted by Robert Pilcher

TOOTH WHITENING. Not that old chestnut again! Every man and his dog seems to be doing these days. Beauticians, Hairdressers, buy it off the internet. Well the law changed last November as to who can do what to whom.

This latest information has been released by the British Dental Association (www.bda.org/whitening).

1. Whitening is safe. If carried out by a trained dental professional, whitening is perfectly safe. Based on their knowledge of your oral health your dentist will discuss with you the options available, decide if tooth whitening is appropriate for you and develop an overall treatment plan that gives the desired result. (At Abbey Dental Practice, your Dentist will carry out a cancer examination, a gum disease examination, and a decay/filling/crown examination to ensure that there are no underlying problems. Do you know what infection control procedures are in place at the Beautician's etc. There are very strict and monitored procedures for Dental Practices, with severe consequences for breach by Dental Practices - GDC, CQC, and the Department of Health publication - HTM 01-05)

2. Only Trained Dental Professionals Can Whiten Teeth. It is illegal for anyone other than dentists or their teams to carry out teeth whitening. Anyone else offering teeth whitening (e.g. beauticians, hairdressers, and salon staff) won't have the right training and knowledge, could permanently damage your teeth and gums and can't help when something goes wrong.

3. The Preferred Option. Whitening won't remove the surface of your teeth or change their shape. It's often a better option than alternatives, such as veneers, because it doesn't involve permanently altering the tooth's structure and is easy to look after.

4. Selecting the Right Product for YOU. Your dentist is trained to know what whitening products will be safe for you teeth and gums. Products provided by non-dentists often do not have enough safety data and evidence to support their use; this can result in burned gums and/or blistered lips or even more serious consequences. Using products that are not appropriate for you will produce poor results.

5. How it works. A carefully-controlled concentration of bleach is applied to your teeth using specially made trays that fit in your mouth. Your Dentist will be able to discuss with you the level of whitening you want and give you an idea of how many treatments you may need to achieve the shade you're after.

6. What to expect. You may experience some sensitivity for a short time during your treatment but this is normal and will soon fade away after completion.

7. Over the counter kits may not be safe. The products you can buy online or from high street shops often fail to declare the precise chemicals used so it's very difficult to assess their safety. Because of this they should not be considered safe. These products won't produce the same good results you can expect by visiting your Dentist.