Patient information leaflets

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Please bring a list of medications to your appointment, and any other appointments that have been made regarding your treatment.

Introduction

This leaflet provides you with information following a referral to see a consultant in Restorative Dentistry. 

It is not meant to replace the discussion between you and your dentist but may act as a starting point for discussion.  If you have any concerns after reading this leaflet, please let us know.

Pre Treatment Assessments

The Pre treatment assessment will ensure your  dental health is fully assessed and monitored throughout your treatment.

It will avoid unscheduled interruptions to chemotherapy/radiotherapy due to dental complications.

The assessment will enable comprehensive planning of your care to ensure the most appropriate treatment is provided in compliance with national guidelines.

The assessment should be carried out within the first week following your referral.  If you have not heard anything in that time please use the contact details at the back of this leaflet. 

What happens at the appointment?

• A full dental examination will be given by the restorative consultant.
• Dental X-rays will be taken if required.
• A treatment plan will be agreed and discussed with you.
• If further care is required with a dental therapist or dental extractions are necessary, a referral to other members of the team will be made.
• You may be given a prescription to take to your doctor.  This is for preventative mouthwashes and toothpastes.
• Further reviews and appointments will be made following this initial assessment as part of your on-going care.

Author: Restorative Department            

Reapproved: October 2025            Review Date  November 2028

Click here to view this leaflet as a PDF document.

Introduction 

This leaflet provides you with information about how to use Duraphat Toothpaste,  This will need to be used during and after radiotherapy.

Why do I need Duraphat Toothpaste?

A high concentration of fluoride toothpaste will help to strengthen and protect your teeth during and after treatment.  The brand is made by the Colgate Group and contains 5000ppm (parts per million) of fluoride.
There is an increased risk tooth decay due to the  reduction of saliva following head and neck radiotherapy.  This may mean more holes in your teeth.

The consultant will provide you with a letter advising your doctor or dentist to prescribe Duraphat toothpaste.  They will then convert this into a repeat prescription to collect from the pharmacy.

How to use Duraphat Toothpaste?

Use the toothpaste 3 times each day:

• In the morning before breakfast.
• In the middle of the day.
• At night time before going to bed.

You may prefer to use a soft toothbrush throughout your treatment.  Afterwards, continue to use a medium bristled manual or electric toothbrush.

If you run out of the Duraphat toothpaste, contact your doctor or dentist for a repeat prescription.

Fluoride trays

Fluoride trays are clear plastic moulds which fit over your teeth.
If you are provided with fluoride trays, you will need 2 visits:

1st visit.   Dental Impressions will be taken.
2nd visit   The fluoride trays will be fitted.

How to use fluoride trays

• Apply a small amount of toothpaste or MI paste (contains calcium and phosphate ions which you may be lacking from reduced saliva), into the tooth space on the trays and place over the teeth. 
• The trays should be worn overnight.  If you are not able to tolerate them at night they should be worn for 1 hour each day.
• Avoid eating and drinking for 30 minutes after the application. 
  Use a toothbrush and cold water to clean.
• Keep the trays safe in a box.

Author: Restorative Dept              

Reapproved:  October 2025    Review Date:  October 2028

Click here to view a PDF version of this leaflet.

Introduction 

This leaflet provides you with information about dental implants and is a general guide .  More detailed information can be provided by your clinician.

What are dental implants?

Dental implants are one of the options for restoring missing teeth. They are made from titanium posts which are surgically inserted into the jaw bones to replace missing teeth. 

They can support removable dentures, fixed crowns and bridges.
Their use is dependent on several factors such as :

• General medical health.
• Quality and quantity of bone.
• The gum condition.
• The health of the remaining teeth.
• Proximity to important nerves, blood vessels and sinuses.

What are the benefits?

• To improve appearance
• To improve eating and speech function. 
• To preserve the remaining jaw bone.
• Quality of life.

What can dental implants be used for?

• Patients with congenitally missing teeth.
• Patients with extreme retching difficulties who have difficulty with dentures.
• Loose dentures that cannot be improved conventionally.
• Patients with surgical defects.
• Patients who have a cleft palate.
• Are there alternatives to dental implants?

Any options will be discussed with you at your consultation. These may include:

• No treatment as an option.
• Removable denture or ‘plate’.
• A ‘fixed’ bridge.

Implant insertion

• This procedure can be carried out using a local anaesthesia in the dental chair or if necessary can be done under a general anaesthetic in theatre. 
• Specialist instruments are used to create a surgical hole or flap through your gum and bone.
• The implant is then inserted into the bone and the gum replaced.  This is held together with some dissolvable stitches which can take up to 5 weeks to disappear. 
• A follow up appointment will be made with the consultant a few weeks later to check the healing.  If necessary, X-rays will be taken.
• The implants will be left for at least 3 months before they are used.
• If you usually wear a removable prosthesis, such as a denture or retainer, you may be asked to leave this out for the first week to     help the healing. 

Implant exposure:

• A second minor surgical procedure usually under local anaesthesia is undertaken following healing. 
• This exposes the top of the implant and places a healing cap on to the implant.  
• The gum is then able to re-contour around the implant in preparation for the restorative phase.

Restorative phase

• This requires additional follow-up X-rays and impressions to assess healing.  
• Appropriate implant accessory parts will be ordered. 
• The number of appointments will depend on whether the space is to be restored with a denture or a bridge.
• Review appointments are made to monitor the implant restoration and underlying bone.

Potential complications

Following surgery there may be some degree of discomfort swelling and bruising.  

If you suffer from prolonged and severe pain you should report this to your clinician as these signs may be an early indication of complications.

Implants can be rejected resulting in pain loosening, infections and complete loss of the implant.

Types of implant supported teeth

Implants can support an acrylic removable denture, a fixed bridge or a single crown depending on them clinical situation.  Potential problems can include:

• If you grind or clench your teeth, the teeth can crack or break off the bridge or denture. 
• Attachment clips within the denture can become loose or break after long term use necessitating the need for repair.
• Appearance can be affected if you have advanced bone and gum recession.  This leads to longer looking teeth and dark triangles     between adjacent teeth.
• You need to maintain good levels of oral hygiene and care for your implants as you would your natural teeth.
• Smoking can result in delayed healing and  potential implant failure.  You are advised to stop smoking for this reason before and following completion of treatment.
• Maintenance work or repairs may be necessary from time to time.

Planning your treatment

Your clinician will carry out a thorough examination of your mouth and will ask questions about your general health.  This may involve several hospital visits and joint consultations with other specialists.

X- rays will be taken along with impressions to make a mould of your jaw to allow further examination.

Decision making

• The outcome of the planning stages will indicate whether implants are suitable and what alternative treatment is available. 
• As implants are more complex, they are generally more expensive. 
• You may be told that you have insufficient bone, which may require additional surgery such as a bone graft.  
• The graft could be taken from your chin, or the      wisdom tooth area in your mouth.  
• If larger quantities are needed, the graft may be taken from your hip or other sources.  The additional bone graft procedure could prolong the overall treatment by 4 to 6 months.

Time scale

The treatment, from the time of placement to  completion could take 6 months to over a year.  This will be dependant on the bone quality, how healing progresses and if bone grafts were placed.

Contact Details

Restorative Department

Tel: 01782 674182   

Monday to Friday 9.00 am to 4.00 pm

Mrs S Wilde, Secretary

Mr S Brindley, Consultant Restorative Dentistry

Miss R Taylor, Hygienist/Therapist

Author: Restorative Department        

Reapproved:  October 2025   Review Date: October 2028

Click here to view a PDF version of this leaflet.

Introduction 

This leaflet provides you with information about mouthwashes you may be prescribed to help support your oral care during treatment.

Mouthwashes

During radiotherapy treatment, it can be more difficult to keep your mouth clean as your mouth may become sore.

Mouthwashes will be recommended by your dental therapist for you to use.  You will need an advisory note which you will need to take to your doctors who will then issue you a prescription.

They can also be obtained over the counter from a pharmacy or supermarket.  

These include:

Chlorhexidine (alcohol free 0.2%)  mouthwash is an antiseptic mouthwash which will reduce the amount of plaque bacteria in the mouth. 

As certain ingredients in some toothpastes can reduce the mouthwash’s effectiveness, use 10 minutes before brushing in the morning and every night during your radiotherapy. 

Difflam mouthwash 0.15% can be used if you experience a sore mouth and have difficulty and or pain on swallowing.  

Difflam Oral Rinse belongs to a group of medicines called non-steroidal anti-inflammatory drugs or NSAIDS.

It contains a numbing agent called benzydamine hydrochloride, which will help to relieve any discomfort in the mouth.

You may use this mouthwash up to 4 times daily if required.

Fluoriguard mouthwash 0.05% can be used if you experience a reduction in saliva flow after radiotherapy, as it can increase the risk of dental decay in your mouth. 

You may also find that your diet changes to a high sugar frequency diet, which can also increase the risk of dental decay. 

Contact Details

Author: Restorative Department        

Reapproved:  October 2025    Review Date:  October 2028

Click here to view a PDF document of this leaflet.

Introduction

 
This leaflet provides you with information about crowns and bridges and is a general guide.  If you have any further questions after reading the leaflet, please let us know.

What is a Crown or Bridge?

A crown or bridge is a fixed prosthesis that can be used to fill a gap in your mouth to restore the natural shape or appearance of a missing or broken down tooth.

Crown:

This is an artificial restoration that fits over the remaining part of a prepared tooth, giving it the shape and appearance of a normal looking tooth.

Bridge: 

This can be used to replace a gap from missing teeth. The adjacent teeth from one side or both sides of the gap can be used to support  the bridge.

What to expect at the appointment

• Dependent on the need and severity of your treatment it can be provided on the NHS by a specialist restorative consultant .
  There will be a detailed discussion about which type of replacement is needed.
• An appointment is then made for preparation of the tooth/teeth. 
• Your appointment can take 1 to 2 hours and is done in the dental chair using a local anesthetic. 
• The tooth or teeth will be filed and prepared so that impressions can be taken.
• A prosthetic laboratory then uses the impressions to make the crown or bridge.
• A further appointment is made 2 to 3 weeks later to fit the crown or bridge.  This can take up to 1 hour. 
• Further appointments will be needed with the dental hygiene therapist for the long term care and maintenance of your teeth. 

Frequently asked questions (FAQ’s)

Contact Details

Author: Restorative Department            

Reapproved:     October 2025 Review Date:     October 2028

Click here to view the PDF version of this leaflet.

Introduction 

This leaflet provides you with information on denture care.  Your dentures have been made to fit your mouth, however, they are artificial and their success depends on how well you adapt to them.

If you have any concerns after reading this leaflet, please let us know.

Getting used to your new dentures

• In the first few weeks, your dentures may feel bulky and odd.  You will however get used to them.
• Inserting and removing the dentures needs practice. 
• Most people adapt well, but you may develop sore spots after initial wear.  These may take up to 1 week to heal.  Use salty mouth washes which may help.
• You can discuss any discomfort at your first follow up appointment. Please contact us  sooner if needed and we can help to ease the areas of discomfort by improving the fit of the dentures.  

Denture wear

• Dentures can be worn during the day and only need to be taken out to clean after meals.
• They must be removed before going to bed.  Always store them in a clean dry container as this allows the gums to rest and gives good oral health.

Eating with your new denture 

• Start with soft foods and gradually progress onto more solid food. 
• You may need to cut your food into small portions and chew using both sides of your mouth to prevent the denture tipping. 
• Avoid biting with your front teeth (like biting into an apple) as this will cause tipping at the back end of the dentures.

Speaking with your new dentures 

• Your speech may be altered initially and pronouncing certain words will require practice. However, your speech should be back to normal within a week.
• Reading out loud from a newspaper or magazine should help to speed up the process.

Excess salivation 

• It is normal to experience excess saliva for a few days.  This will slowly get better as your mouth gets used to wearing them.

Soaking

• Denture cleaning tablets or solutions for soaking are available to buy from supermarkets or chemists.  They help to loosen and remove stains and deposits. 
• You should avoid leaving the dentures in the  solution overnight.  A 10-minute soak once or twice a week should be sufficient.
• If you have a metal denture, find a cleanser that is suitable for metal dentures as some cleansers can damage the metal. 
• They can be effectively cleaned daily with a soft brush and warm soapy water. 
• Avoid soaking if your denture has a soft lining as some cleaning products could damage this. They can be cleaned by gentle brushing.
• Brush or rinse the denture after every meal to prevent the build up of debris.

Cleaning your dentures 

Daily cleaning of your dentures is necessary to    prevent build-up of:

• Food debris.
• Stains.
• Tartar.

This can cause problems with:

• Appearance.
• Mouth odour.
• Irritation to gums.
• infections.

Use a soft toothbrush or denture brush to clean your dentures with soap and warm running water (avoid hot water). This includes the cleaning of the fitting surface.

Avoid using:

Toothpaste.
Abrasive pastes.
Smokers’ toothpaste.

These can scratch the denture which can make it more prone to collect debris, stains and tartar.

As dentures can break if dropped and may slip out of your hand by accident whilst cleaning them, please use a towel in the bowl or sink.

Care of your mouth 

If you have partial dentures you will need to take extra care of your teeth and gums to reduce the risk of cavities and gum problems. 

If you have full dentures you need to take good care of your mouth.

• Brush your gums, tongue and palate with a soft brush twice a day. 
• This helps to remove plaque and improves the general health of your mouth.

Contact Details

Author: Restorative Department        

Reapproved:   October 2025    Review Date:      October 2028

Click here to view a PDF version of this document.

Introduction 

This leaflet provides you with information on ways in which chemotherapy or radiotherapy to the head and neck can affect your mouth. 

You will have been referred to the Consultant Restorative Dentist prior to treatment who works as part of the Head and Neck Cancer Team. 

How should I prepare for treatment?

A thorough dental examination will be carried out  before your treatment starts.  

You may be referred to other members of the team including a dental therapist.

Your oral health needs to be as good as it can be before starting treatment to avoid problems later on.

What happens when the treatment begins?

• About 2 weeks after the start of treatment, you may notice an increase in mouth ulcers and mouth soreness.  
• Your mouth may feel uncomfortable towards the end of treatment and for up to 6 weeks after the completion of your treatment. 
• Your mouth may become dry and your taste can be affected. This will make it difficult to swallow, eat and clean your teeth. 

What can I do 

• Take regular sips of water to keep your mouth moist.
• Try dry mouth gels, sprays, discs (Xylimelts) and lozenges  Please ask for advice. 
• Brush your teeth and tongue 3 times daily with    a soft small headed toothbrush, manual or electric.  If the toothbrush bristles are too rigid, soften them in warm water or use a soft toothbrush.
• Use the interdental brushes/floss regularly as advised by your hygienist to clean the spaces  in between your teeth.
• Brush with Duraphat 5000ppm toothpaste (prescription only) and spit out after brushing.  Do not rinse.
• Use Difflam Oral rinse 4 times daily during your treatment as this may help with any soreness.
• To reduce bacteria levels, use alcohol free Corsodyl (chlorhexidine) mouthwash 2 times daily.  Dilute if needed.
• Chew sugar-free chewing gum to encourage  saliva flow as this moistens and lubricates the mouth. It protects against tooth decay, erosion and sensitivity and aids swallowing and speech
• Have dietary foods such as milk or cheese at the end of meals to help neutralise any acid in your mouth.
• A teaspoon of sodium bicarbonate in a cup of warm water can be used as a mouthwash and help with a coated tongue.
• Soft, chilled foods and adding gravy/sauces to food can help with swallowing.

Prevention of Dental Decay

If you find it difficult to reduce your sugar intake, remember the frequency of sugar is more detrimental than the actual amount consumed.

Sugary foods or sugary drinks consumed over a short period of time are less harmful than if they are eaten over a period of hours.

Hints and Tips

• Nutritional drinks are needed as part of your recovery.   You should however try to consume these drinks within 5 to 10 minutes and rinse with plain water afterwards.  This minimizes the risk of dental decay.
• Do not scrub your teeth.  Brush gently
• Optimize your oral hygiene by including tooth brushing techniques and interdental cleaning.

It is understandable to want to have sugar and flavour during your treatment.

We recommend however you should avoid the following as they can be harmful to your teeth.

• Carbonated / Fizzy drinks
• Food or drinks containing sugar in between meals and especially 1 hour before bed.   Check with your doctor for alternative sugar free medicines.
• Avoid eating sugary mints, boiled sweets etc. as these can dramatically increase the rate at which your teeth decay. 
• Tobacco products including ‘vaping’.
• Alcohol and products containing alcohol.
• Spicy/acidic foods.
• ‘Hidden sugars’ in processed foods.  Check before you buy.
• Drinks with caffeine.  Switch to decaffeinated, as this can help with a dry mouth.
• Excessive periods of sugar intake per day.  Stick to meal times only.
• Sugar in tea and coffee.  Swap the sugar for sweetener.
• Medications containing sugar.  If in doubt check with your dietician what these are.

Side effects of the treatment

Radiotherapy sides effects

Radiotherapy frequency damages the  glands which produce saliva and can make your mouth dry. 

Mucositis is a common side effect affecting the lining of your mouth which can cause mouth ulcers and pain or difficulty in swallowing.

Chemotherapy side effects

• Chemotherapy can cause Mucositis which can also make the lining of the mouth very sore. 
• Chemotherapy can reduce the white cell count which may make you prone to dental  infections. 

Contact Details

Author: Restorative Department            

Reapproved:    October 2025  Review Date:     October 2028