For many people a trip to the dentist can strike fear into their hearts. Dr Melissa Goddard, the Principal of Apollonia Dental and Cosmetic Centre in Liverpool, believes this is usually as a result of negative experiences in childhood or early adulthood. For this reason, she is giving free initial consultations to children to make sure they are truly on the road to a completely healthy mouth. Dr Goddard has also employed staff who have specialist training and experience in dealing with children, with many of the techniques being transferred across to nervous adult patients too as the surgery specializes in IV sedation in extreme cases. Here Dr Goddard discusses her views around the issues of children’s dental treatment and introduces one of her patients, who is a perfect example of the benefits of preventative versus restorative treatments.
There are many similarities with children and young people’s reactions to dentistry if they are afraid, to that of adults who are anxious. A child could have directly had a bad experience themselves, or have taken on board a negative feeling that their parents or close relatives have.
Although Restorative Dentistry is clearly very necessary in many cases, the ideals of preventative treatment should always be the end goal. Once the dental health of a patient has been improved to an acceptable standard, then it is obvious to impress upon the adult that they must strive to give up any bad dental hygiene habits in order to maintain this state.
But more emphasis should be placed on children and young people’s attitudes towards dental health, in a more intelligent and comprehensive way than just brushing twice a day and not eating too many sweets. If the young person is comfortable and relaxed in the dental surgery, it gives the practitioner the opportunity to educate them about the treatment they are receiving and why, how they can prevent restorative work being done in the future and give them a long term view about the health of their teeth and mouth. Children are more open to learning when they are relaxed. The rest of the team at Apollonia reinforce messages to patients as they are leaving the centre and are out of the clinical environment.
The Bigger Picture
But it is not just about oral health, the number of diseases and conditions that present in the mouth is considerable. Poor dental health can increase a patient’s risk of diabetes; cardiovascular disease; stroke; lung infections; low birth weight babies and respiratory diseases. So a six-monthly check up is imperative for general as well as oral health and can detect problems as small as nutritional deficiencies right through to heart disease. In young people’s critical developmental phases, to have this added diagnostic tool is essential.
NHS and private care
In the NHS, it is understandable with the constraints put upon dentists that they have less time and resources to put this into practice as those in the world of private dentistry. At Apollonia, our team is deliberately made up of people who can effectively work with children and young people and our techniques are tailored to providing a positive lasting outcome, both in treatment and emotional reaction to those procedures.
Our latest member of staff, Dr Lena Sofia Ravn, trained in Denmark where Preventative Dentistry is much more the norm. She is bringing that concept to Liverpool and we are learning from each other all the time, sharing best practice.
Charlotte Anders, aged 11 has two fillings in her deciduous teeth and is well on her way to having healthy adult teeth. Her Mum Nicola is a Clinical Co-ordinator and Dental Surgery Assistant and has taught Charlotte well over the years about the importance of dental health.
Mum Nicola said: ‘Charlotte has a very positive attitude towards going to the dentist, she realises how important it is and is happy and relaxed in the dentists’ chair most of the time. I guess we’re lucky in that she isn’t that keen on sweets so we don’t have to stop her eating sugary things all the time, which helps, but attending regularly, not having to endure needles and drills plus being treated with kindness and respect also help greatly.’
Charlotte said: ‘It’s OK going to the dentist, I’m glad I only have two fillings at the moment as some of my friends at school have a lot more. And I’m going to lose those two baby teeth and will hopefully not have any more fillings. I know I will have to have some orthodontic treatment, so the shorter that can be, the better, but I know that having straight healthy teeth is important. At this dentists’ I can watch DVDs while I have my checkups so it’s a good distraction!’
Dr Goddard added: ‘We’re going to treat Charlotte’s emerging adult teeth with fissure sealants to avoid the need for fillings in the future.
One of the tools used by the team at Apollonia is DIAGNOdent, which uses fluorescence to detect the difference between sound and unhealthy areas of tooth. This technique lessens the need for probes to be used which can often be an unpleasant experience for young children. This laser scanning system is 100% accurate in diagnosing even the earliest tooth decay, unlike the usual method of probing and x-rays which can miss around 76% of dental decay. It actually detects decay so early that treatment is minimally invasive, therefore making drills and injections less likely to be needed and more tooth is saved.
The science behind the tool is that enamel mainly consists of carbonate-substituted calcium-deficient hydroxyapatite plus a lesser proportion of water and organic material. The fluorescence of this is different to that of a decaying tooth because the composition will be different. Fluorescence in the red and infrared regions are used and baselines readings are compared within the patients mouth to detect where decay lies. Light is transmitted with an optical fibre to the tooth; and a bundle of nine fibres are arranged around this light to gather readings of the tooth’s reaction to the light. Results are sent to a digital display for ease of diagnosis.
Principal Dr Goddard said: ‘This is a tool which makes our job a lot more effective while providing the type of experience that I want to give all our patients, ideally treatment without pain, distress or discomfort.’
Patients are used to the usual advice about caring for their teeth, like avoiding sugary foods, brushing twice a day, using mouthwash and floss and avoiding staining habits like drinking red wine or smoking. Apollonia fully support saliva testing which is a more modern way of giving tailored dental advice to patients. Measuring the quality, quantity, consistency and rate of flow of saliva gives a great deal of information which can be used by the dental practitioner to be passed on to the patient in order to change bad habits and reinforce good ones.
Providing a bespoke maintenance plan has great advantages, because no two mouths are the same. Treatment will then be most effective for that individual’s needs.
Apollonia Cosmetic and Dental Centre is offering free 20-minute private consultations to children and young people under 18 years of age who are accompanied by a parent or guardian. A thorough check will be made of oral health, and recommendations made about preventing any tooth decay, gum disease or damage from any other dental threat. The consultation has no obligation, but if young people wish to become patients, Dr Goddard can guarantee sympathetic and professional care at all times. Apollonia Cosmetic and Dental Centre is based in Liverpool, call 0151 709 9146 or visit the Apollonia website for more information.