At the end of 2017 I had completed the FDI Certificate in Implant Dentistry and was looking forward to this new and exciting chapter of Dentistry. I just needed the right patient.
The key to starting anything new is to know your limits and when dealing with dental Implants you really need to start with a simple single tooth case, ideally in the upper premolar region. This reduces the aesthetic risk and there is little anatomy of concern (ideally no Maxillary antrum sneaking forward!)
For you first Implant you need a good team – At Broad Street Dental surgery we are very fortunate to have dental nurses with over 20 years of Dental Implant experience. A mentor is also key and is recommended by the GDC when starting out in dental implants. A good mentor will help guide you through the treatment planning phase, placement and restoration of cases.
In this case a single Straumann SLActive implant was placed in the upper right first pre-molar area. There was sufficient bone and no bone grafting was needed. The implant was restored with a Zirconia screw retained implant. The new implant has provided improved function and aesthetics for the patient who was very happy with the results.
Maintenance is now the key to long term success and the patient has regular hygiene appointments at least every 6months.
Dental implants are now being provided regularly at the practice
If you are interested in dental implants or any other information please contact Broad Street Dental Surgery
or 01432 266899
Dentist Andrew Farr BDS(Hons)
Whether you have been a regular dental attendee all your life or have avoided the dentist like the plague due to anxiety or other factors, all patients are welcome at Broad Street Dental practice.
We are a family run practice in the heart of Hereford, where you will always find a welcoming smile at every visit to our clinic. We are able to provide a wide range of dental treatment ranging from general examinations, maintenance to complex full mouth rehabilitation.
At every stage of your journey with us we will keep you informed of the treatment options and likely outcome of each option available to you, giving you an open and honest opinion of which treatment will best suit your individual needs.
November is Oral cancer awareness month.
Every patient at Broad Street Dental receives a complete examination of the hard and soft tissues i.e. we don’t just check for holes in your teeth but examine the health of your mouth, lips and neck for any signs of abnormalities and can make an appropriate referral if needed.
So if you haven’t seen a dentist for many years or are a regular attendee – if in doubt get checked out!
To book an appointment please call 01432 266899
Assoc. Dentist Andrew Farr
By Andrew Farr Associate Dentist
Broad Street Dental Surgery. Hereford
This young lady presented to Broad Street Dental Surgery complaining of a buccally placed mandibular left lateral incisor. She had undergone orthodontic treatment in her teens but due to a lack of retention her labial segment has changed as shown below.
Treatment options for this case included fixed orthodontics, removable orthodontics or accepting the current situation. With removable orthodontics using clear aligners Inter proximal reduction (IPR) would be needed to create space to allow the mandibular incisor to move lingual. It was decided therefore that a fixed solution would provide a more predictable outcome and would need very little if any IPR.
We use only clear/tooth coloured brackets from QST (Quick Straight Teeth) which are straightforward to use and provide excellent aesthetics. The treatment was estimated to take around 4-6 months and the patient would be provided with adequate retention following treatment to reduce the risk of relapse.
Post operative photos shows a nicely aligned lower arch. The patient was very happy with the final results.
If you or a friend are interested in having straighter teeth please visit Broad Street Dental Surgery
Why would you have a dental implant?
If you having missing teeth, Implants are a fantastic solution as you are not putting other teeth at risk to support the missing teeth. You can either have fixed restorations such as crowns and bridges that fix on top of the implants, or a removable denture that clicks into place over the implants. Having implants greatly improves the quality of your life if you are struggling with large spaces, or have a denture that is not retentive or stable. Implants can improve the look of your smile and regain confidence and function.
What is a dental Implant?
A dental implant very simply is a titanium screw that is placed in either the upper or lower jaw bone.
It serves as the tooth root where either fixed non removable replacement teeth or a removable appliance can be added on top.
There is no doubt that Implants are the best replacement option for missing teeth and they are the closest thing to getting back a natural tooth.
Although alternative treatment options to replace missing teeth such as bridges and dentures can be carried out, they are less stable and have higher maintenance costs. Therefore they will need to be replaced much sooner.
A major disadvantage of having bridge restorations is that teeth either side of the missing tooth have to be filed down, which could lead to problems with these teeth in the future.
Taking cost effectiveness into mind then, studies into Implants have shown having an implant is less expensive in the long term and that they do not involve restoration of any kind to adjacent teeth, which of course is a great benefit!
With the correct aftercare, an implant can last 20 years +, proving that implants are not only the more comfortable, reliable, functional and attractive option; they are indeed the best investment you will ever make in your quality of life.
Having an Implant with us at Broad Street Dental Surgery
We pride ourselves in careful and detailed planning, and we have the resources and equipment in practice to make sure you are being cared for to the highest possible standard.
You’re health and wellbeing is of upmost importance to us and our main goal is to give you exactly what you want, but in an ethical and non-detrimental way to your health.
Mr Farr has completed a Postgraduate certificate in Implantology with the Internation Team of Implantology and Straumann. Broad Street Dental Surgery have been placing and restoring dental implants for
We use the Straumann Implant system which is a leading implant company that provides technologically advanced, scientifically proven products that only ever get the best results.
Here are the reasons why we use Straumann to gain an exceptional results:
(From straumann.co.uk) –
- More than 35 years of clinical evidence with over 700 scientific publications1
- More than 14 million implants placed worldwide
- Precision and quality “Made in Switzerland”
- A trusted brand in over 70 countries
- SLActive® – Our unique implant surface for better predictability and shorter healing times
- Roxolid® – Our unique material for less invasive treatment options
- Lifetime guarantee for your Straumann implants
This patient presented a few weeks following a fall where all four Maxillary incisors were damaged. The delay in presentation was due to her upper lip being extremely swollen and painful that she did not want any sort of examination of her dentition.
As shown above the maxillary left central incisor has a complex dentine-enamel fracture and has devitalised. The Maxillary right central incisor also has a complex dentine-enamel fracture. Both lateral incisors have dentine enamel fracture with no pulp exposure and were extremely sensitive to air.
Both central incisors were root treated and due to the discolouration a crown was recommended. To improve the aesthetic outcome it was decided to crown both central incisors as a pair. The lateral incisors were treated with Filtek Supreme composite and Synergy enamel shades.
The patient was very happy with the final restoration.
Andrew Farr BDS(Hons), MJDF Associate Dentist at Broad Street Dental Surgery
Mrs K. presented complaining of upper and lower arch crowding. She had orthodontics completed in her adolescents and this has now relapsed due to a lack of retention following treatment.
Mrs K. had 4mm crowding in the upper arch with the Maxillary right first molar buccally placed. The lower arch had mild crowding of around 3mm as shown above. Treatment options were discussed and it was decided that fixed upper and lower arch short term orthodontics followed by fixed retention in the form of a bonded retainer would provide an acceptable outcome.
The treatment was provided at Broad Street Dental Surgery using the QST (Quick Straight Teeth) system and took approximately 6 months to complete. Excellent result were achieved and the patient was provided with fixed upper and lower retainers along with Essix retainers to wear at night.
If you are interested or know of anyone interested in short term orthodontics then please visit Broad Street Dental Surgery in Hereford.
Dr Andrew Farr (Dentist) BDS(Hons), MJDF
Dr Andrew Farr talks to The Revu about his recent experience of undertaking the ITI Foundation in Implant Dentistry (FID) course and why, along with the guidance of his mentor, he is now more than ready to place his first implants.
What first motivated you to attend the FID course?
We were already offering implant treatment at our practice, but I was keen to learn for myself how to place and restore implants. I qualified over 10 years ago and received no implant training at all at undergraduate level, so it was a question of looking at the introductory courses out there that could get me confidently started in implant dentistry and the FID course was definitely the one that suited me best.
How did you find the course content?
Because it’s a Foundation course it’s designed to give you a solid theoretical understanding of how and when to use implants and to guide you in implant selection. I believe that the theory is very important when you are starting out in implant dentistry and the FID course definitely gets you off on the right foot.
I was very impressed at the quality of the teaching from some of the most experienced implant dentists in the UK, including Dr Shakeel Shahdad, Prof Nikos Donos and Dr Nikos Mardas. Between them they have a vast amount of experience, and I found them to be very open and honest about real life situations in practice, both good, and occasionally not so good. It would be easy for the experts to just say how good they are at placing implants, but that’s not what the delegates need, nor what they did. It’s just as important to learn about the things that can go wrong as well as the vast majority of cases with highly successful outcomes.
The FID modular course is spread over six months and you successfully completed the course in September. What has been happening in that time?
The most significant thing I’ve done is to partner with my mentor, Michael Betteridge. Michael is a specialist oral surgeon who is very experienced in providing not just oral surgery care in the primary care environment, but also a highly-regarded dental implant service, and is therefore ideally suited to being a mentor.
Are you looking to now move on to an MSc course or similar in implant dentistry or is mentoring giving you everything you currently need?
For the time being, with the help of Michael, my plan is to first get the basics right in practice before considering moving onto further education and I’m already in the process of planning my first implant cases. It can be a bit daunting when you first start out, but it’s probably more a fear of the unknown and that’s why a mentor is such a good idea to guide you over those first hurdles until you find your feet.
How have you found the support from Straumann – do you plan to place Straumann implants?
Yes, that’s my plan. Straumann are market leaders and when you are starting out you want to place the implant that offers the best chance of long-term success and is backed by a huge amount of research.
The support they offer is terrific and our local Straumann representative Hayley has been a great help in terms of my surgery set-up and making sure I have everything I need to get me started. Everyone at Straumann really knows what they are doing and if I have any problems I know they are there to help. It’s about the whole support package – not just the implant.
What are your plans now going forward?
I want to be doing a lot more than just placing the occasional implant. My aim is to eventually place something in the region of 100 implants a year and be in a position to accept referrals from local colleagues.
Finally, would you recommend the FID course to other GDPs?
Yes, I would definitely recommend this course – it’s ideal for any clinician looking to get the best start in a career in implant dentistry.
In association with Straumann, the next ITI Foundation in Implant Dentistry course begins in February 2018. For further information or to reserve your place, please call the Straumann Education Department on +44 (0) 1293 651270 or visit iti.org/uk
Facebook: Straumann UK
Broad Street Dental Surgery, Broadway House, 32-35 Broad Street, Hereford HR4 9AR
Andrew Farr BDS(Hons), MJDF RCS Eng
Andrew joined Broad Street Dental Surgery, Hereford in October 2014. Born and raised in Caerphilly, South Wales he studied dentistry at the University of Cardiff, graduating with honours. He completed his vocational training in Plymouth, then spent a year as a Maxillofacial Senior House Officer at Derriford Hospital where his duties included emergencies in A&E, head and neck surgery and wisdom tooth removal. He has developed an interest in orthodontics and is qualified to offer Quick Straight Teeth short-term orthodontics.
Mr A. presented complaining of his lower anterior teeth being misaligned. The LL2 was buccally placed and due to it’s position had caused previous trauma to the lower lip. He also complained that his lower anterior teeth were rotated as shown below.
Treatment was provided in the form of lower fixed short term orthodontics using the Quick Straight Teeth system. Minimal inter proximal reduction was required for LR3 to LL3 and the treatment was completed in roughly 6 months.
Retention was provided in the form of a fixed lingual retainer and Essix retainer. Composite build ups were offered to complete treatment however the patient was extremely happy and decided to leave this for now.
This is a nice little case that I wanted to share. It shows that sometimes the simple treatment plans and simple minimally invasive techniques can have a profound effect on a patient.
Mrs A. a 68 year old grandmother was concerned regarding the appearance of her central incisor, which her granddaughter had said looked “dirty.”
The UL1 (12) composite had leaking margins and a stained buccal enamel crack. The composite was removed and the enamel crack was cleaned with air abrasion. The UL1 (12) was then restored with A2 and enamel shade Synergy composite. The patient was very happy and so was her granddaughter!
Dentist Andrew Farr