Surgery@102 Limited
(formally named SR Vora & Associates)
Dental Care and Oral Health

What is dental care?

Dental care involves everything in order to keep your mouth healthy. This allows you to eat, speak and socialise without active disease, discomfort or embarrassment and contributes to general well-being. Your dentist and their team will help you achieve this and maintain it for life. There are four key areas to achieving and maintaining dental care and a healthy mouth as recommended in the Health Development Agency’s document ‘Scientific basis of Dental Health Education’:

1. Diet: Reduce the consumption and especially the frequency of intake of foods and drinks with added sugars. The number of times that sugars enter the mouth is the most important factor in determining the rate of decay. When consumed, they should be part of a meal rather than between meals. Snacks and drinks should be free of added sugars, whenever possible, and the frequent consumption of acidic drinks (such as squashes or carbonated drinks) should be avoided.

2. Tooth brushing: Clean your teeth thoroughly twice every day with a fluoride toothpaste. Effective plaque removal is essential for the prevention of periodontal disease. The toothbrush is the only means of plaque removal that should be recommended on a public health basis. 

Other oral hygiene aids, apart from disclosing agents, are a matter for personal professional advice. Thorough brushing of all surfaces twice every day is of more value than more frequent cursory brushing, and a gentle scrub technique should be advised. The toothbrush size and design should allow the user to reach all tooth surfaces and gum margins easily and comfortably. Tooth brushing by itself will not prevent dental decay, but the use of fluoride toothpaste would be beneficial.
Please go to the following link for further information: http://www.colgateprofessional.co.uk:80/patienteducation/generateRemoteContent?id=Brushing-Guide&type=guide

3. Dental attendance: have an oral examination at least every year. Everyone, irrespective of age and dental condition, should have an oral examination approximately once a year so that cases of oral cancer or other oral diseases can be detected early and treated. This advice also applies to those without any natural teeth. Children and those at risk from oral disease may need to be seen more frequently, at intervals determined with professional advice. Plaque is a white, soft, sticky substance that is made up of bacteria and food. It forms on your teeth and causes that ‘furry feeling’.It often builds up in between teeth and at the gum line and turns into calculus (tartar) if left for long enough. When you eat, the bacteria in plaque eat as well. The plaque bacteria then produce acids, which can dissolve the tooth minerals and result in a hole (cavity) otherwise known as decay. The acids produced by plaque also damage the structures that hold the teeth in the jaw.

What is tooth decay?

Tooth decay is a disease caused by bacteria
which lives in plaque. Plaque is a thin layer of food and bacteria that lives on our teeth, which can only be removed by effective tooth brushing. The bacteria breaks down sugar in our diet, into acids. This can dissolve away the tooth enamel, and could make a hole in the tooth. Tooth decay can be prevented by limiting the amount of sugar in your diet.

What is acid erosion?

This occurs when the tooth surface is worn away by acids.

Acid is found in fizzy drinks, fruit, fruit juices, pickles and vinegar.

To prevent acid erosion, only consume these foods/drink at meal times (3 times a day). When drinking fizzy drinks use a straw and try not to swish the drink around your mouth. Sugar free chewing gum and foods such as cheese are a good way to neutralise acid.

How should I clean my teeth properly?

Teeth should be cleaned twice a day for two minutes, using a fluoride toothpaste. It is also important to clean between your teeth with floss or mini interdental brushes daily. A mouthwash may also be useful.

What is gum disease?

The signs of gum disease are swelling and redness of your gums, these may also be sore and may bleed when brushing. This indicates that the gums may be infected and require treatment from the dentist or hygienist.

The main causes are plaque and calculus (calculus or tarter is plaque which has become hard and can only be removed by a dentist or hygienist).

The formation of calculus can be prevented by brushing twice a day to clean all the plaque off your teeth, and seeing your dental healthcare professional regularly who will clean any calculus off your teeth.

What causes bad breath (Halitosis)

This is an unpleasant condition which can cause embarrassment. If you are concerned, please mention it to the dentist who can help to identify the cause, and if orally related, develop a treatment plan to help eliminate it.

Bad breath can be caused by smoking, eating strong foods such as garlic or by the bacteria that live on teeth and gums, which cause gum disease.

This can be prevented by routine cleaning of the teeth and gums, 2-3 times per day. This can include daily flossing and mouth rinses. The use of a tongue scraper and sugar free chewing gum may help.

It can also be a sign of medical conditions such as diabetes, lung or liver and kidney problems, stomach disorders or sinus infections. Some medications may affect breath odour.

Bad breath can also be caused by dry mouth (xerostomia), which is reduced salivary flow. Saliva is essential to cleanse the mouth and remove particles which may cause odour. Medications, saliva gland problems or continuous mouth breathing may all cause a dry mouth.

Your dentist may prescribe artificial saliva, recommend sugar free gum, or frequent sips of water may help this problem.
Lifestyle habits can also play a major part. This includes smoking and chewing tobacco.

What will happen on my first appointment?

On your first appointment please try and arrive at least 10 minutes early.

This will give you time to complete a medical history . Please bring a list any medications you are taking, so a copy of your prescription will be useful.

On your first appointment, the dentist will welcome you to the practice and carry out a thorough dental history and examination.

After this has been carried out, a diagnosis and treatment plan will be discussed.

Please feel free to ask questions. Patients will be given a full estimate of the cost of treatments advised, unless treatment is lengthy or complicated, in which case it will be provided after further discussion at the next appointment.

How often should I visit the dentist?

This is dependent on a number of factors, which your dentist will take into account during your routine examination.

These include:

- How clean your teeth are
- If your diet is high in sugar or acid
- Smoking and alcohol intake
- Exposure to fluoride
- Low saliva flow
- General health – e.g. diabetes
- A family history of gum disease
- History of decay

Each individual is different and should always follow the dentist’s recommendations.

Generally, children and young people under 18 years should be seen at least every 3-12 months and adults 6-24months.

For more information, please follow the link to the National Institute of Clinical Excellence (NICE) website.

What are white fillings?

White fillings may be referred to as ‘tooth coloured’ or ‘composite fillings’ by your dentist. Your dentist will advise you whether a white filling is appropriate for the tooth you need restoring.

What are amalgam fillings?

Amalgam fillings are silver in colour when first placed but tarnish with time. They are made from a mixture of silver, tin, mercury and copper.

How long will a filling last?

It is impossible to say how long a filling will last as it depends on so many variables, such as-
- What filling material was used?
- How big was the filling?
- How much of the tooth was left?
- How difficult was the filling to place
- What forces the filling will undergo in your mouth
- How clean the mouth is kept 

What does the dentist mean when they say I have pockets around my teeth?

The gums usually fit like a tight collar around your teeth. If the gums are damaged this tight collar can loosen and a pocket will form around the tooth.

Why does my dentist call out numbers to the nurse when they look at my teeth?

Dentists can be calling out numbers for two main reasons. They may be carrying out something called a basic periodontal exam (BPE exam). This is a screening technique to check the health of your gums around each tooth. The dentist will walk a probe around your gums and depending on what they find will assign a number from 0-4

0 means the gums are perfect
1 means the gums bleed but no pockets, calculus or plaque retention factors are present and you only need to improve your removal of plaque in the areas your dentist shows you.
2 means the deepest pockets are <3mm and/or calculus or plaque retention factors are present below the gum line.
This would indicate you need the teeth scaling to remove the calculus and removal of any plaque retention factors. (You will also be advised how to stop the plaque and calculus reforming)
3 means the deepest pockets are 4 or 5 mm, so the situation is a little more advanced than 2 but you require the same treatment.
4 means you have a tooth or teeth with pockets >6mm. Your dentist may recommend you see a periodontal specialist.
The second set of numbers the dentist may use during this examination refers to the different teeth in your mouth which is like a code corresponding to each one -
1=centralincisor 2=lateralincisor 3=canine 4=firstpremolar 5=secondpremolar 6=1stmolar 7=2ndmolar 8=3rd molar or wisdom tooth

How does a dentist’s drill work?

The drill works by using compressed air which is passed through fine tubes at a very high pressure, and that turns miniature turbines connected to the drill itself. There are two types of drill a dentist will mainly use.

A high speed drill which is very fast and used for cutting enamel and old fillings.The high speed drill usually has water spraying out at the tip of it to prevent the drill getting very hot when cutting and damaging the tooth.

A slow speed drill is mainly used to remove decay.

What options are there to replace a missing tooth?

There are many options for replacing a missing tooth-

Leave a gap. It may be that the tooth doesn't need replacing
A denture
A bridge
An implant

Your dentist can advise you which options are available to you and the pros and cons of each of them.

What is a dental implant (screw in teeth)?

Dental implants is a way of replacing missing teeth.

There are many advantages to having implants, but they may not be suitable for everyone.

You need to have healthy gums and be in good general health.

You also need enough jaw bone to take the screw and support the replacement teeth. Some chronic diseases, such as diabetes, osteoporosis or chronic sinus problems could interfere with healing and make implants more likely to fail.

Because they are a complicated form of treatment, implants can be expensive.
Your dentist may refer you to an implantologist.

The dentist or specialist will expose the bone in the jaw where the tooth is missing. Then they will drill a hole and insert a screw into the bone. This is usually done under a local anaesthetic or under sedation. The gum is then stitched over the screw and it is left to heal for several months, while the bone grows around the post, making it secure. After this period, there will be a second operation in which replacement teeth are mounted onto the metal screw. This requires a small cut in the gum above the implant. The replacement teeth might be single or in a group, and possibly as a 'bridge', attached to neighbouring natural teeth. They may be fixed permanently or attached in a way that lets you remove them for cleaning.

After surgery, it is essential to maintain good mouth hygiene and visit your dentist regularly.

Smoking reduces the chances of success of the implant.

What is plaque?

Plaque is a white, soft, sticky substance that is made up of bacteria and food. It forms on your teeth and causes a 'furry feeling'. It often builds up in between teeth and at the gum line and turns into calculus (tartar) if left for long enough.

Why is plaque bad for my teeth?

When you eat, the bacteria in plaque eat as well. The plaque bacteria then produce acids which can dissolve the minerals which make up the tooth and result in a hole (cavity). This process is called decay.

Why is plaque bad for my gums?

The acids produced by plaque not only damage the teeth but also damage the structures that hold the teeth in the jaw.

What are plaque retention factors?

These are any irregularities around the teeth which plaque can stick too. Calculus is the most common example of a plaque retention factor, other examples include overhanging or rough fillings, crowns or veneers with ledges, some types of dentures and crooked teeth.

If plaque is white how can I see it?

Plaque isn't easy to see so dentist and hygienists recommend disclosing tablets. Disclosing tablets often called plaque check tablets are made of a vegetable dye called Erythrocine (E127).

Can anyone use disclosing tablets?

Disclosing tablets can be used by anyone over the age of 6, under the supervision of an adult. If allergic to Erythrocine or any of the other ingredients in disclosing tablets they should not be used.

How do I use disclosing tablets?

Chew one tablet thoroughly until no bits are left and spread saliva to all areas of your mouth with your tongue. Spit out residual saliva and gently rinse out mouth with water. DO NOT SWALLOW THE TABLET.

Look in the mirror - areas where plaque and food are present will be stained a bright colour. Clean the mouth step by step. (It is best to disclose teeth at night because the mouth may remain coloured for several hours).

How often should I use disclosing tablets?

Disclosing tablets should be used about once a week. With children it may be quite revealing to use a disclosing tablet after they have (allegedly!) cleaned their teeth to show where they have missed. Offering extra pocket money every time the teeth are found properly cleaned is a good incentive to encourage thorough cleaning.

What is calculus?

Calculus and tartar are the same thing (tartar is the term more commonly used by Americans). Calculus forms when plaque if left on the surface of a tooth for about 72 hours. It results from minerals found in saliva entering plaque, turning it hard (mineralization). Once plaque has mineralised to calculus it won't come off by brushing alone, you will need to visit your dentist or hygienist who will scale (or scrape!) it off.

What is the best way to stop the build up of calculus?

Simply clean the plaque off your teeth before it mineralises to calculus. Clean the teeth using the steps described earlier.

Why does the dentist always find calculus behind my lower incisors?

This is a difficult area to reach with a toothbrush so is often not cleaned as well as other areas in the mouth. This area tends to get bathed in more mineral rich saliva than other areas of the mouth, so any plaque turns to calculus more rapidly. Some people find that an electric toothbrush with an oscillating rotating head helps reduce the build up of calculus in this area, because it is easy to manoeuvre and reach behind the teeth.

Which is better to clean my teeth an electric toothbrush or a manual one?

If your dentist or hygienist feels you are doing a good job at cleaning your teeth with a manual toothbrush there is no reason to change to an electric one. However, if you are constantly being told ‘your teeth could be cleaner ', it is probably worth trying an electric toothbrush as you may well find it more effective at cleaning your teeth.

Which is better a sonic toothbrush or an oscillating rotating head electric toothbrush?

Independent research would suggest the oscillating rotating type toothbrush is more effective at cleaning teeth.

What is the best toothpaste to use?

Always use a toothpaste containing fluoride. Ask your dentist to recommend what toothpaste is best for your needs.

Should I rinse out after brushing my teeth?

It is best not to rinse out or to only rinse with a small amount of water. Young children should be encouraged to spit out excess toothpaste otherwise they may develop fluorosis.

When should I brush my teeth?

Teeth should be brushed last thing at night and at least once more during the day.

Why is it important to brush last thing at night?

Less protective saliva flows at night and fluoride from toothpaste remains around the teeth longer giving added protection.

What is flossing?

Floss is a thread like material used to clean the point where two teeth touch. Dentists and dental hygienists will often recommend that you floss your teeth as part of your oral care routine.

Ask the dentist or hygienist to show you how to use floss.

When flossing for the first time you may find it difficult, but be patient and persevere with it - you will get used to it in time, and the benefits are well worth it.

Why do my gums bleed when I floss?

You may find your gums bleed a lot when you first start flossing - this is because the gums between the teeth can be very fragile due to the damage from plaque bacteria. As you floss more regularly and remove the bacteria, the gums will thicken up and the bleeding will reduce.

What are inter-dental brushes?

These are special brushes to clean between your teeth. They look like miniature bottle brushes. They come in various sizes according to the spaces between the teeth and are colour coded. Your dentist or hygienist will be able to recommend which one(s) to use.

What is oral health?

Dental health or oral health as it is often called has been defined by the Department of Health as:

‘a standard of health of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort or embarrassment and which contributes to general well-being’

The two most common dental diseases are tooth decay (dental caries) and gum disease (periodontal disease).

The main cause of tooth decay is frequent consumption of sugars in drinks and foods. The sugar is eaten by bacteria found in plaque on the teeth. Plaque is a white soft sticky substance. It forms on teeth and causes a furry feeling. It can often build up in between teeth and at the gum line and turn into calculus (tartar) if left for long enough.

When you eat, the bacteria in plaque eat as well producing acids which can dissolve the minerals which make up the tooth and result in a hole (cavity), which is the process of decay. If left untreated, this can result in pain and a possible abscess.

Gum disease is caused by poor cleaning of plaque from around the necks of the teeth. The waste products of the plaque bacteria’s digestion of sugars causes damage to the gums, often causing them to swell, look red and bleed easily. The dentist may refer to this as ‘gingivitis’ (the old fashioned term was known as pyorrhoea). If left untreated gingivitis can progress to ‘periodontitis’. This is the stage when the bone that holds the teeth in the jaw is destroyed, resulting in the teeth becoming loose or ‘mobile’ and maybe painful.
People who smoke are more likely to develop gum disease.

Gum disease is a much slower process than tooth decay but both can result in the loss of teeth.

Mouth cancer can develop in any part of the mouth including the tongue, gums, lining of the mouth and the lips. This obviously affects dental health. It is more common in men than in women and is rare in people under 40. The most important causes of mouth cancer are:
Smoking tobacco (cigarettes, cigars and pipes)
Chewing tobacco or betel quid with tobacco
Regularly drinking more than safe levels of alcohol .

People who use tobacco and drink too much alcohol have the highest risk of mouth cancer. Three-quarters of mouth cancers are caused this way. Early diagnosis is essential. Signs and symptoms of possible oral cancer are:
- A sore or ulcer anywhere in the mouth that - does not heal
- A white or red patch in the mouth that will not go away
- A lump or thickening on the lip or in the mouth or throat
- Difficulty or pain with chewing or swallowing
- A sore throat that does not get better
- A feeling that something is caught in the throat
- New pain in the tongue or ear that persists
- Unusual bleeding or numbness in the mouth
If you are concerned you should see your dentist or doctor.

The risk of mouth cancer can be reduced by contacting your dentist at an early stage if you discover any of the signs and symptoms listed above.

Stopping smoking or chewing tobacco; keeping within the safe limit for alcohol; and eating a healthy diet, are all factors which could help reduce the risk of mouth cancer.

Trauma of the mouth will reduce dental health, it is therefore important to protect your teeth with a gum shield when playing contact sports.
Although the aim of the dentist and their team is to maintain dental health, this is only possible if patients follow their recommendations and attend for regular check-ups.

Why would my dentist recommend I see an orthodontist?

An orthodontist is a dental specialist concerned with preventing or correcting irregularities of teeth. An orthodontic problem is called a malocclusion, meaning "bad bite."

Children and adults can both benefit from orthodontics. Your dentist will check how your child’s teeth are developing at each routine examination and decide if a referral to an orthodontist is required.

Treatment may take a little longer for adults. Because an adult's facial bones are no longer growing, certain corrections may not be accomplished with braces alone. The average treatment time is about 24 months and varies with individual patients

What should I do if I need to cancel my appointment?

Please give at least 24 hours’ notice of changes to your appointment day otherwise there will be a short notice cancellation recorded on your notes. If you cancel at short notice on two occasions, you run the risk of loosing your dental place with the practice.

For more details or to request a quote, contact us on

020 8902 5082

We welcome all patients including those requesting National Health Service treatment, children and private patients.