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Dr Conner Reynolds looks at dentures.....

By Dr Laura Hunter-Shaw As a mum of a now one year old and a dentist, I have realised that nobody really tells you how to start to care for your baby’s teeth - and how difficult it can be! Here are a few tips that I have learnt this year which have made things slightly easier for us! *Start as Soon as Their First Tooth Arrives* - Decay can occur in a tooth as soon as it breaks through into the mouth. Brush twice a day, every day! It doesn't have to be for 2 minutes to start with, but getting a toothbrush with some toothpaste on it in the mouth is essential! *Have a Routine* - Do it at the same points in the day, every day! Last thing before bed and in the morning (it doesn't really matter whether it's before breakfast or after breakfast but be consistent). We brush after breakfast, before we walk the dog and after his bedtime milk during a story. *Get a Brush They Can Hold* - One with a chunky handle works great as they can grasp it better. If it is too fiddly they will just drop it and it makes getting them to engage more difficult! *Start With a Children's Mild Mint Toothpaste* - Use a flat smear of fluoride toothpaste (with at least 1000ppm fluoride) until they are 3 years of age. Unfortunately older child/adult toothpastes are minty. If you always give your child a minty form of toothpaste they don't know any different and will be a lot less upset when they realise you can't get adult toothpaste in bubblegum flavour! *Brush Your Teeth at The Same Time* - Baby's love to copy, if you are brushing your teeth, they are much more likely going to want to brush theirs! If they want to, let them have a go at brushing your teeth too - fair's fair! *Sit on the Floor or a Chair Behind Them* - It's a much easier angle and as if you are brushing your own teeth. It is comfortable, you have much more control, it is safer if they try to throw their head back (we've all been there) and everyone is more stable! *Persevere* - No baby likes having their teeth brushed initially. They cry, they scream, they wriggle. But all of a sudden one day they will just let you do it. It is much easier to have this argument when they can't run away, it's easier to hold them still and when they won't remember it! The quicker you make it a routine and normal, the easier you will find getting them to do it as they get older - I hope!! All parents and guardians are advised to ensure that young children in their care are taken to see a dentist as soon as their first teeth come through, and before their first birthday so they become familiar with the experience. Their first visit might be to accompany you or someone else in the family for a routine appointment. If you are worried about going to the dentist, you might also like to ask your partner or a grandparent to attend. It is important that you are positive about your forthcoming visit so that your child does not become unduly anxious. Don’t worry if your child doesn’t want to open their mouth on the first visit to the dentist. The important thing is they get used to being in a dental practice while you have time to ask the dental team for advice on caring for your child’s teeth. Your child should see a dentist regularly. Until their 18th birthday, we usually recommend they visit the dentist every 6 months to keep an eye on how their teeth are developing and any problems can be spotted early making treatment easier. For more information about children’s dental care, please contact the practice on 01476 563181.

Why become a dental nurse? Listen to what our team members say…… My name is Stacey, and I am a qualified dental nurse, I have been at the Malting’s dental practice for 5 years’. Previously I had been working in a local gym and being a mum to my little boy. I decided to make a change, and wow it has been the best decision I have made. I am so grateful for the opportunities that the maltings have given me over the years. I started my dental nursing qualification in 2018, where I attended Nottingham college 2 days a month along with on the job learning each day, I completed this course within 18months. This enabled me to gain a level 3 qualification in Dental nursing that is recognised across the world. During my time at the Maltings, I have been fortunate enough to work alongside a dentist who has a busy NHS/Private diary, who also provides additional care in periodontal therapy. We have built the best working relationship throughout my time here and helped each other in many aspects of working life. I have also been given an ability to work alongside the oral surgeons who come into the practice to remove difficult teeth. I am proud to work for such a diverse and caring team here at the maltings, I will with no doubt continue to grow throughout my career as a dental nurse here at the Malting’s. Stacey Beardsley I have been a proud member of The Maltings Dental Practice team since 2008 and have worked as a dental nurse since 1992. During my career I have seen a lot of significant changes in the dental world and over the years dental nursing has become more than a job. I am always enthusiastic and passionate to provide the best care to patients and value all their needs with a desire to always give the best clinical care possible. Qualities required of a dental nurse include showing patients compassion and empathy, a caring nature is important. The Practice see the importance of our professional development and enhancement of skills with regular personal development meetings. This is extremely beneficial to the nurse, the patient and also the practice so we are able to meet the needs of the patients we care for. Since being at the practice I have gained extra qualifications in Radiography (Xray taking), Sedation, Delivering Oral health Education, Impression taking and application of fluoride. All these skills I can utilise at the practice on a day-to-day basis such as running my own clinics.  The most recent Skill I completed was the Sedation qualification in 2019, since then it has broadened more of my scope of practice and increased the areas of the job previously I was not involved with, the reward of this qualification is knowing that you are helping the most nervous of patients in receiving the care they need, helping people achieve something they didn’t believe they could otherwise do. To me this is very rewarding and the best part about my job. Susie Verow If you would like to consider a career as a dental nurse we would love to hear from you!

Making Your Dental Appointments More Relaxed and Comfortable using Sedation Have you put off going to the dentist even though you’re in pain? Do you dread your dental appointments from the moment that you book them? Do you have a procedure coming up that’s going to be difficult for you to tolerate? You are not alone! Dental anxiety and phobia affects over half of the UK population and as a team we do our best to help you overcome these fears. Our sedation team, led by Dr Laura Hunter-Shaw, have a special interest in helping patients who struggle with dental anxiety and phobia and treat these patients on a daily basis. Many of Laura’s patients come to see her after many years of avoiding dental treatment and she works with them to build their confidence, resolve any issues they have and give them their smile back. Laura is enthusiastic and down to earth and is committed to trying to change patients’ perceptions of dentistry and make a trip to the dentist a more positive experience, based on trust and honesty. She endeavours to create a comfortable, relaxed environment where you are in control and can take the time needed to complete the treatment in a way that works best for you. Laura and her team have undertaken further qualifications in Dental Sedation and Dental Anxiety Management which means they are able to provide this on a private basis for both adults and children upon request and it is suitable for most patients (medically permitting) following consultation. Conscious Sedation is a safe and effective way of helping someone to comfortably get through their dental treatment journey, either through inhaling nitrous oxide or by injecting a sedative intravenously for a deeper sedation. It also can help to suppress gag reflexes. Laura will discuss the best method for you and your treatment to make sure that your experience is a positive one. Consultations are from £90. We accept patients through direct contact with the practice or by referral from your own dentist. For more information, either contact The Maltings Dental Practice, or visit our website. Alternatively, get to know Laura better by following her - Facebook: “Just Laura – General Dentistry and Sedation” Instagram Page: @drlaurahuntershaw.

A common question from our patients is what dental products should they be using? The market is full of dental products all claiming to improve your oral health, but which products are worth the money and which ones would we as dentists recommend? Toothbrushes An electric toothbrush has been shown by research to remove more plaque than a manual and therefore most dentists would recommend an electric over a manual – providing it is being used correctly. If you are unsure ask your dentist for a demonstration. Which electric toothbrush you prefer is personal choice, however the research points to one with an oscillating, rotating head. A vibrating toothbrush alone does not show the same results as an oscillating rotating one. Many electric brushes now come with lots of settings and functions all at extra cost to the consumer, whether you go for the highest end brush or the basic one is personal preference. Toothpaste With so many on the market it can be difficult to decide. Guidelines advise a fluoride content of 1000ppmF for under 3 years and 1350ppmF -1450ppmF for all children over 3 years and adults. This is the most important thing to check when you pick a toothpaste. Whitening toothpastes will generally remove surface stain but will not ‘whiten’ teeth. More cosmetic brands including charcoal toothpastes that claim to whiten can be very abrasive and would not be recommended as they can remove surface enamel. Sensitive toothpastes do work well as long as used cumulatively over a period of time, which one you choose is personal preference. Gum toothpastes aimed for patients who suffer with gum problems can be useful however they will never ‘cure’ the condition, often they only reduce symptoms allowing the disease to continue progressing with less discomfort to the patient. Most importantly any toothpaste should contain fluoride to the appropriate level and be used twice daily, spitting after brushing but not rinsing. Mouthrinses Generally mouthrinses are not recommended. Plaque biofilm is very resistant to anything but mechanical removal so the low level of chemical disinfection provided in most mouthrinses is unlikely to be of any great benefit. Fluoride mouthrinses are advised during orthodontic treatment and for patients who have high levels of decay. Mouthrinses for gum disease will reduce symptoms but not slow the progress of underlying condition usually leading to worsening of the condition as the patient feels the condition is improving as the symptoms have reduced. Never use mouthrinses immediately after toothbrushing. Interdental cleaning Floss can be useful if you have very tight spaces between the teeth. Generally most patients will benefit more from the use from interdental brushes, which can be sized for the individual gaps. Water flossers can be a useful adjunct to interdental brushes for hard to reach areas and around implants, they should not replace mechanical cleaning with interdental brushes altogether though. We have no affiliation to any brand or product. By Claire Simpson, Dentist

The jaw joint – or temporomandibular joint (TMJ) – sits just in front of each ear. It’s a pretty complex joint that’s controlled, moved and stabilised by a lot of anatomical structures. When one or more of these stops working in harmony with the others, we head towards the territory of TMJ dysfunction, also known as TMD. What are the signs of TMD? - Aching in, or just in front of, the ears - Headaches, often that are worse on waking - Pain or difficulty chewing, eating, talking - Swelling - Limited range of opening - Clicking, popping or grating joint noises What causes TMD? - Trauma, for example a knock to the face or jaw - Unexpected wide mouth-opening, eg a very wide yawn - Eating very hard or chewy foods - Clenching or grinding teeth – usually while asleep - Stress - ‘Parafunctional habits’ – eg nail-biting, pen-chewing, use of chewing gum I’m worried I have TMD – what can I do? The first instance would be to speak to your dentist. GPs normally can’t do much for the condition, whereas your dentist is perfectly equipped to assess your jaw joint and suggest methods to reduce discomfort and inflammation. Most cases of TMD are self-limiting, lasting up to a couple of months with minimal active treatment. Get in touch if you’re concerned about your jaw joint and one of our dentists will be happy to investigate for you! What can I do to treat TMD now it’s been diagnosed? - Firstly, don’t worry! Most cases resolve after a period of time with many people not requiring any further treatment. - Try a soft diet – excess chewing over-works muscles that are already very tired. - Pain relief – if you can take it, ibuprofen helps to reduce both pain and inflammation associated with TMD. Paracetamol can be helpful too. - Local heat, eg a hot water bottle, can be soothing and improve blood flow to the muscles which helps them relax. - Rest the jaw as much as possible, and support it when yawning with the palm of the hand. - A splint – your dentist can make you an appliance similar to a gumshield that is designed usually to be worn overnight, helping to support the joint and muscles around it. - Trust in the process! There are a lot of approaches to managing jaw conditions, and in the rare circumstance that these initial management approaches don’t give much relief, your dentist can refer you to a hospital-led service that has more advanced techniques at their disposal. Very rarely, this can include surgery – but there are a number of steps before this. If you have, or are worried you may have, an issue with your jaw joint, we’ll be happy to help at The Maltings. You can get in touch on 01476 563181 during working hours to book in for a consultation and assessment! Dr James Edwards Dental Surgeon

This year the practice has supported mouth cancer awareness by participating in the 10km walk from home. Team members have united to walk around the Vale of Belvoir helping to raise funds for this cause. Donations are still being accepted through the following link https://www.justgiving.com/fundraising/maltings-dental-practice The charity is encouraging as many people as possible to step out and make a difference during Mouth Cancer Action Month. Jason Wong, Mouth Cancer Awareness committed clinical ambassador, also joined the 10km in Hyde Park that was held in September. The practice also showed their support by participating in ‘Blue Wednesday’. Blue lips and accessories were worn by the team to raise awareness and images were shared on social media. What is mouth cancer? Mouth cancer is where a tumour develops on the surface of the tongue, mouth, lips or gums. The tumours can appear like a lump, an ulcer or red and white patches lining the surface of the lips/tongue/cheeks. Non-healing ulcers should also be treated suspiciously as these can also be a form of mouth cancer. Who is at risk? Heavy smoking and alcohol consumption are the major risk factors for the development of mouth cancers. Chewable tobaccos used in cultures can also cause this. Recent links to HPV (human papilloma virus) and oral cancer have also been shown to be a significant contributory factor. People with diets lacking fresh fruit and vegetables are also putting themselves at an increased risk. How common is mouth cancer? 78% off cases occur in the Over 55 age group. Incidence has risen by 49% over the past 10 years. Mouth Cancer is TWICE as common in men than women, though an increasing number of women are being diagnosed with the disease. 5 year SURVIVAL rate has hardly improved in last few decades due to late detection. How can I reduce my risk of getting mouth cancer? 1. Maintain a well-balanced diet high in fresh fruit, vegetables, olive oil and fish. 2. Do not smoke. 3. Do not exceed the recommended alcohol consumption guidelines. 4. Visit your dentist regularly. As most forms of mouth cancer are often painless and symptom-free, your dentist plays a vital role in examining your oral soft tissues and look out for the warning signs and can refer you to the local specialist department if they are concerned about any areas. Remember, the earlier the detection, the less the spread, and the better the outcome of treatment. If you have any concerns, you should ask your dentist. It is really important for all patients to continue to attend their dental check-ups, including patients who have a full set of false teeth so that we can continue to check for mouth cancers. Mouth and throat cancers can grow and spread quickly. If anyone has any concerns then just call our reception team, we are more than happy to take a look, you aren’t “wasting our time” or “being silly”. We are here to reassure you and if needed help onto the right pathway if any further treatment is needed. If in doubt get checked out, be mouth aware. This month our practice is offering Free Mouth Cancer Checks to casual non regular patients. To take advantage, please call the practice to book in during November.

More than a third of women don’t check their breasts and this is higher in younger women. Often younger women don’t feel the need or see the benefit in doing this, but one in seven women will develop breast cancer in their lifetime and whilst the risk is higher the older you get, young women ARE diagnosed with breast cancer and it’s the checking that can ultimately save their lives. Breast Cancer can be caused by a combination of our genes, environments, and lifestyles. Just because a person doesn’t have a family history of the disease, doesn’t mean they won’t go on to develop breast cancer. Checking regularly is vital and it is so important to know your breasts. The earlier breast cancer is found, the better the chance of successful treatment. What are the symptoms of breast cancer? Signs and symptoms of breast cancer include: A lump or swelling in the breast, upper chest or armpit A change to the skin, such as puckering or dimpling A change in the colour of the breast – the breast may look red or inflamed A nipple change, for example it has become pulled in (inverted) Rash or crusting around the nipple Unusual liquid (discharge) from either nipple Changes in size or shape of the breast You are urged to see your GP if you notice a change in your breasts. Most breast lumps are not cancer but getting lumps and changes checked out is always worthwhile, and to put your mind at rest. Success Story Louise our Practice Manager was diagnosed with breast cancer in 2019 after discovering a small lump. Thankfully she didn’t delay in getting this checked and is now approaching three and a half years post diagnosis. Louise’s message is clear, knowing and checking your breasts can save your life. Never believe you are too young as unfortunately cancer takes no mercy and can strike amongst any age and in men as well. Louise is forever grateful to the NHS team that took care of her throughout her journey and enabling her to get back to her former self. Louise recalls that when you are diagnosed your world shuts down and it takes time to realise that you are not alone and see a future again. At the time of her diagnosis in 2019 there was a lack of local support in Grantham, but now ‘Breast Friends’ support group is up and running, helping to support each other with over 100 members. Knowing that there are others that have been through the same or similar really does help and knowing you aren’t alone. The Maltings team will show their support in the ‘Wear it pink day’ on Friday 21 st October. Raising awareness and sharing key messages is what the month is all about. We hope to share the message far and wide that regular checking of breasts will save lives.

With a team of nearly 50 members, The Maltings Dental Practice endeavours to work together effectively to provide the highest standard of dental care and services. Dentistry isn’t without its stresses, and having a team that share the same values and work ethics really does pull everyone together to deliver care in such a way that really benefits our patients. It is well recognised the strength in the relationships in the surgeries between dentist and dental nurses and how, when it works well, the surgery runs like clockwork. Developing these professional working relationships creates the perfect care environment. We hire for talent at the practice, seeking the friendly, adaptable and driven personalities who are supported to thrive within our team. We strongly believe that everyone within the practice should have someone to turn to, which is important to our approach to well-being within the practice. We have been known to call ourselves the Maltings family as this reflects the security and support felt by the team. To help develop and nurture a large team, we place a focus on team building within the practice. At The Maltings we organise events throughout the year, inviting everyone in the team to join in the event or activity. Previous events have been meals out, escape rooms, afternoon tea, paintballing and a visit to the theatre.  In preparation for each day, we get together before the start of the day to discuss any rota changes, share important information requiring discussion, any feedback and whether there are any visitors expected into the practice. These daily huddles help give the team a sense of purpose and clear expectations of the day ahead. The team also gets together for practice meetings to discuss significant events and information sharing. We’re hoping the team don’t just attend for the gifted Watkins roll! The team also keep in touch with work through a communication platform, giving ease of access to guidance, training and arrangement of such events described above. Our team is continually growing and we welcome further team members to allow us to help more people with their oral health needs; we always advertise our vacancies and we urge those that are interested in a career in a dental environment to come and meet us. We are very grateful to the team that we have created and thank them for their ongoing commitment to caring for our patients.