Treatments

What it is

A check-up (dentists call it an examination) is a careful look at your teeth, gums, tongue, cheeks, jaw joints and the skin of your face and neck. Its job is to find problems while they’re small and simple to treat, and to tell you plainly when everything is fine.

Who it's for

Existing patients, including people with dentures or implants, because we’re checking the whole mouth and not only the teeth. If you haven’t been to us before, you’ll start with a new patient consultation, which takes an hour.

What happens

1. We ask how things have been and whether anything is bothering you. We go through your medical history and any medicines you take, privately, in the surgery.
2. The dentist looks at each tooth and at any fillings, crowns, bridges or implants.
3. We measure the gum around your teeth to check for gum disease.
4. We check the soft tissues of your mouth and neck, including for early signs of mouth cancer.
5. We take X-rays only if your dentist decides they’re needed. How often depends on your risk of decay and gum disease.
6. We tell you what we found in plain English. If you’d like to see, we’ll show you with a hand mirror or a photo on the screen.
7. If you need treatment, you’ll get a written plan with the cost of each item. You don’t have to decide on the day.

How long it takes

Thirty minutes. If you’d like a hygiene appointment on the same day, we can book it straight after. If you’re nervous, ask for a quiet appointment when you book.

What it costs

£72 for adults. Small X-rays, when needed, are £18 each. Children’s check-ups are £40, and free for children of plan members. Membership plans include two check-ups a year and routine X-rays.

Aftercare

Nothing special. Your dentist will suggest when to come back, which could be anything from three months to two years depending on your teeth and gums. We’ll send a reminder by text or email, whichever you prefer.

What it is

A hygiene appointment removes the hard deposits (tartar) that brushing can’t shift, above and just below the gum line, and polishes off surface stains. It’s also a good chance to get specific advice on cleaning between your teeth. Gum disease is common and often without pain in its early stages, so regular cleaning and checking matters even when everything feels fine.

Who it's for

Most adults. Regular visits are particularly useful if your gums bleed when you brush, if you’ve had gum disease before, if you have implants, crowns or bridges, or if you smoke or have diabetes. You can book with Grace directly; if she spots anything a dentist needs to see, she’ll tell you and help you book.

What happens

1. Grace asks how your gums have been and goes through your medical history.
2. She measures the small gaps between your gums and teeth (gum pockets) and notes any bleeding.
3. She cleans your teeth with an ultrasonic scaler, which vibrates gently and sprays water, and with hand instruments where needed. If your gums are sensitive, numbing gel or a local anaesthetic is available: just ask.
4. She polishes your teeth. Air polishing, a fine powder spray that lifts staining, is available as an add-on.
5. She shows you which brushes to use between your teeth and which sizes fit, and you can try them there and then.

How long it takes

Forty minutes for a standard appointment. If it’s been a long time since your last clean, we’ll book sixty minutes so nobody is rushing. Treatment for established gum disease is usually two to four sessions of an hour.

What it costs

£95 for 40 minutes, £135 for 60 minutes, £180 for a gum treatment session. Air polishing is £30. Membership plans include one, two or four hygiene visits a year.

Aftercare

Your gums may feel tender or bleed a little for a day or two, and your teeth may be sensitive to cold for a few days. Keep brushing gently and keep cleaning between your teeth, even if they bleed at first; bleeding usually settles as the gums heal. A warm salt-water rinse can help. If bleeding carries on for more than a week, call us.

What it is

A filling repairs a tooth where decay has been removed or where a piece has broken off. We use composite, a tooth-coloured resin that bonds to the tooth and is shaped in layers and set with a blue light. For small and medium cavities it’s usually the simplest repair. For very large ones, a crown or onlay may protect the tooth better, and we’ll explain the difference.

Who it's for

Anyone with decay, a chipped or cracked tooth, a worn edge, or an old filling that has broken or started to leak. If you have old silver (amalgam) fillings that are sound, we’ll usually suggest leaving them alone, because removing a sound filling takes healthy tooth away with it.

What happens

1. We check the tooth and explain what the filling involves and roughly what size it will be. You’ll know the fee before we start.
2. We numb the tooth with local anaesthetic. If you dislike injections, we put numbing gel on first and inject slowly. We check the tooth is numb before we go further.
3. We remove the decay or old filling and clean the tooth. Where it’s practical, we place a thin rubber sheet around the tooth to keep it dry.
4. We build the filling up in layers, set each one with the light, then shape and polish it.
5. We check your bite with thin coloured paper and adjust it until it feels right to you.

How long it takes

Thirty minutes for a small filling, up to an hour for a large one. Most fillings take one visit.

What it costs

Small (one surface) £150. Medium (two surfaces) £210. Large (three or more surfaces) £275. A temporary filling is £70. Plan members pay 10% less.

Aftercare

The numbness wears off in two to four hours. Until then, avoid hot drinks and take care not to bite your cheek or lip. The tooth may be sensitive to cold for a week or two, which usually settles. If your bite feels high, or the sensitivity is getting worse after a few days, call us. Adjusting a bite takes a few minutes and there’s no charge.

What it is

A crown covers the whole visible part of a tooth. It’s made in a dental laboratory to fit your tooth and your bite, then cemented in place. We usually suggest one when a tooth has lost so much structure that a filling alone is likely to break, after root canal treatment on a back tooth, or when a tooth is cracked. Sometimes an onlay, which covers only part of the tooth, does the same job and keeps more of your own tooth; we’ll tell you if that’s an option.

The four materials:

• Porcelain bonded to metal (£795): a metal inner layer with porcelain on top. Strong and long established. A thin dark line can show at the gum over time.
• All-ceramic (£925): no metal, and good at matching the colour of the teeth next to it. Often used at the front.
• Zirconia (£950): a hard ceramic, useful where the bite is heavy. A little less translucent than other ceramics.
• Gold (from £1,250): needs the least tooth removed of the four and is gentle on the teeth it bites against, but it’s gold in colour. The price moves with the gold price.

Who it's for

People with a heavily filled, cracked or broken tooth, or a back tooth that has had root canal treatment. A crown isn’t the answer for every weak tooth, and sometimes the sensible choice is to wait and keep an eye on it. We’ll give you the pros and cons of each option.

What happens

1. First visit, about an hour: we numb the tooth, shape it, and take a 3D scan. We choose the shade together, in daylight by the window. You leave with a temporary crown.
2. The laboratory makes your crown, which takes about two weeks.
3. Second visit, 30 to 45 minutes: we try the crown in and check the fit, colour and bite with you before cementing it.

How long it takes

Two visits about two weeks apart. If the tooth needs a post and core or root canal treatment first, that’s included in your written plan.

What it costs

£795 to £950 depending on the material, and gold from £1,250. The fee includes the laboratory, the temporary crown and the fitting. A post and core, if needed, is £195. Plan members pay 10% less.

Aftercare

Temporary crowns are held with softer cement, so avoid sticky food on that side and slide floss out sideways instead of pulling it up. If the temporary comes off, keep it and call us; we’ll refit it. Once the permanent crown is in, look after it like a natural tooth: brush, clean between the teeth and come to your check-ups. How long a crown lasts depends on the tooth underneath, your bite and how you look after it.

What it is

An implant is a screw-shaped post, usually titanium, placed into the jawbone where a tooth is missing. Over a few months the bone grows closely around it. A connector (the abutment) and a crown are then fitted on top, giving you a fixed tooth that you clean like the others. Implants can also hold a denture in place or support a bridge.

Who it's for

Adults missing one or more teeth who have healthy gums and enough bone, or who are suitable for a bone graft. Smoking, gum disease and poorly controlled diabetes all make implant problems more likely, and we’ll talk about that openly at your consultation. An implant isn’t the only option: a bridge, a denture or leaving the gap are all reasonable choices, and we’ll set out the costs and trade-offs of each.

What happens

1. Consultation (45 minutes, £120): Tom examines your mouth, talks through the options and may take a 3D scan (CBCT) to measure the bone. You get a written plan with every cost.
2. Placement (about an hour): under local anaesthetic, Tom places the implant. IV sedation is available if you’d like it. Most people describe the following few days as similar to having a tooth out.
3. Healing (usually three to four months): the bone bonds to the implant. If the gap shows when you smile, we can fit a temporary tooth.
4. Crown (two short visits): we scan the implant, then fit the abutment and crown.
5. Reviews: we see you during the first year at no extra cost, then at your usual check-ups and hygiene visits.

How long it takes

Usually three to six months from placement to crown, and longer if a bone graft is needed first.

What it costs

£2,950 for a single implant with its crown, including planning, the 3D scan, placement, the healing review, the abutment and crown, and reviews in the first year. A bone graft, if needed, is from £450. A lower denture held on two implants is from £6,200. The consultation is £120. Implant fees are the same for members and non-members.

Aftercare

Expect some swelling and tenderness for two to three days. Take the painkillers we recommend, eat soft food, and from the next day rinse gently with warm salt water after meals. Please don’t smoke while it heals. Once the crown is fitted, clean around it carefully, including with small brushes between the teeth, and keep coming to hygiene appointments. Implants can last many years with good care, but like natural teeth they can develop problems, and regular checks help catch them early.

What it is

Clear aligners are thin, removable trays made from a 3D scan of your teeth. Each set is slightly different from the last, and you move to the next set every week or two. Small tooth-coloured bumps (attachments) are bonded to some teeth to help the trays grip. You wear them for 20 to 22 hours a day, taking them out to eat and to clean your teeth.

Who it's for

Adults whose teeth have become crowded, have drifted or have gaps, and whose teeth and gums are healthy. They suit people who’ll wear the trays as asked; if the trays spend too long out of your mouth, the teeth won’t move as planned. Some bites are better treated with fixed braces, and some need a specialist orthodontist. If that’s you, we’ll say so and refer you.

What happens

1. Consultation (45 minutes, £95): we examine your teeth and gums, take a 3D scan and talk about what you’d like to change.
2. Planning: we design the tooth movements and show you a computer preview. The preview is a planning tool, and your final result may differ from it.
3. Fitting: we place the attachments and give you your first trays, with written instructions.
4. Reviews every six to eight weeks, to check progress and hand over your next trays.
5. Fine-tuning: many courses need a few extra trays near the end. The comprehensive course includes them; for shorter courses we’ll tell you the cost before you start.
6. Retainers: at the end, we remove the attachments and give you your retainers.

How long it takes

Three to eighteen months, depending on how much movement is needed. You’ll get an estimate at the planning stage.

What it costs

Short course (up to six months) £1,950. Moderate course (six to twelve months) £3,250. Comprehensive course (twelve to eighteen months) £4,350, including fine-tuning trays. Each includes all trays, attachments, reviews and your first set of removable retainers. The consultation and scan are £95, and a fixed retainer is £295 per jaw. Aligner fees are the same for members and non-members.

Aftercare

Teeth tend to drift back after any straightening, so retainers are for the long term: most people wear them every night. Take the trays out to eat and to drink anything other than plain water, brush before putting them back in, and rinse them in cool water. The first few days with each new set usually feel tight, and that eases.

What it is

Whitening uses a peroxide gel to lighten the natural colour of your teeth. You wear thin trays made to fit your teeth, with a little gel inside, for a set time each day or overnight. With the combined option, the first session is a longer one in the practice and you carry on at home. Whitening changes natural teeth only: crowns, veneers and fillings stay the colour they are.

Who it's for

Adults with healthy teeth and gums, with no untreated decay or gum disease, who’d like their teeth lighter. It tends to work better on yellowish shades than greyish ones. It isn’t suitable for under-18s, and we suggest waiting if you’re pregnant or breastfeeding. If you have crowns or fillings at the front, we’ll talk about whether they’d need replacing afterwards to match, and what that would cost.

What happens

1. Check-up: you need a check-up with one of our dentists first, unless you’ve had one here in the last six months. The dentist decides whether whitening is suitable and writes the prescription.
2. Scan and shade: Grace takes a 3D scan for your trays and records your starting shade, so you can compare later.
3. First application: about a week later, Grace fits the trays and supervises your first use of the gel in the practice. With the combined option, this is the longer in-practice session.
4. At home: you wear the trays with gel for the time Grace recommends, usually each night for two to three weeks.
5. Review: we check your teeth and gums and compare the shade with where you started.

How long it takes

Two to three weeks of home use for most people. The combined option includes one in-practice session of about 90 minutes.

What it costs

Home whitening £395, including trays, gel, the supervised first application and two reviews. In-practice session plus home whitening £695. Top-up gel £45 for four syringes. If you haven’t had a check-up recently, that’s £72. Plan members pay 10% less.

Aftercare

Sensitivity to cold during whitening is common and usually settles within a day or two of stopping. If it bothers you, whiten every other night and use a toothpaste for sensitive teeth. Coffee, tea, red wine and smoking will darken teeth again over time, and many people use a top-up now and then. Keep your trays in their case and bring them to your check-ups.