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21 St Mary's St, Malmesbury
01666 822220
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Snoring is an increasing problem for many adults. It is caused by the throat and airways narrowing while you sleep and the soft palate and uvula vibrating. It can be quiet but can also be very noisy disrupting a partners sleep.

It tends to become more common as we age and is made worse by increasing and sedatives or alcohol. Smoking can also make it worse. 
If you actually stop breathing and obstruct when snoring this is called apnea and it leads to sleep deprivation and a lot of physical and mental issues.
Apnea is more of a medical issue, and it is recommended that anyone with it has sleep studies done and sees a specialist, but there are few available on the NHS.

Stop Snoring the easy way

An ENT surgeon has written a book suggesting that regular exercises can strengthen the throat and tongue muscles and help diminish or stop snoring. It is available here:

The gold standard for treatment of snoring is continuous positive airways pressure (CPAP) which involves a tight-fitting face mask that pushes air into your airways and so keeps them open. I understand it is noisy and uncomfortable.

I ( Mr Morden) have made a few mandibular advancement devices for snoring - these effectively hold the lower jaw forward, which if you try it with a finger behind your front teeth makes it almost impossible to generate a snoring sound.
The main issues have been that they require a reasonably complete dentition in good condition as the devices need to attach firmly to the teeth and they are inevitably bulky.

Most have been SleepWells from S4S dental whose website covers it all quite well. The device is adjustable so if you get a cold the device can be advanced a bit more, and then backed off in a few days.

sleepwell

More recently digital CAD-CAM technology has entered the fray with a French company ResMed producing the Narval CC  which is 3D printed with a type of nylon. It is also adjustable and is comfortable to wear ( or so I have been told).  It is probably the best on the market at present. ResMed's website is here.

Narval        

Fixed brackets and wires are the standard tools of orthodontists for very good reasons - they offer excellent control of the tooth position in 3D - they can rotate, tilt, upright and generally move the tooth where it needs to go in a controlled fashion. Unfortunately all that stainless steel, even dressed up with coloured elastics to match your hair or favourite football club colours is still not particularly aesthetic.

Clarity 2clarity brace 1

We are using the latest 3M ceramic brackets and white coated wires and clear elastics so the whole system is as invisible as possible. We usually review the pateint monthly and nominally anticipate cases will take about six months to complete.

By scanning the teeth with our 3M TrueDef scanner the orthodontic laboratory can produce an ideal setup of the brackets as well as a digital mockup of the likely finished result, so you can see it in 3D before commencing treatment. For an additional fee, the lab can print a final model for you to see as well.

Ring today to arrange a free consultation.

This video is for lingual brackets, which we certainly don't offer - looks amazingly fiddly - but it does illustrate the technique of indirect bonding that we do use and how we get to the end result without too much fine-tuning.

 

At Barley Mow all the dentists routinely provide white (tooth-coloured) fillings primarily using dental composite in the vast majority of situations.

We still do use silver amalgam in some instances as it is a solid product with a reliable history. It is just unfortunate that it is a silver to black colour and contains mercury!

At the same time we have all had a lot of practice using composite and can usually achieve an aesthetic and functional result. it is a trickier product to use and get the best resluts from so usually it takes a few minuted longer for the appointment.

With the 3M True Definition intraoral scanner we can take highly accurate, digital impressions of your teeth...
Picture1Barley Mow is still unusual to be using this cutting edge digital technology to make our crowns, veneers and bridges and provide orthodontic treatment.

The new model we recently purchased allows us to:
* scan all your teeth to create 3D models for orthodontic, crown and bridge purposes.
* scan your teeth and construct very accurate dentures.
* scan teeth that have had orthodontic treatment and produce very accurate retainers at any time, on demand.
* scan teeth that are worn or damaged by acid erosion and monitor ongoing wear.

Today there is an increasing number of digital dental scanners on the market as the digital revolution moves on in dentistry.

The 3M True Definition Intra Oral Scanner is an updated version of the scanner we had previously. It has  3 video cameras operating simultaneously on 3 different axes recording the surfaces of the teeth at 20fps. The system is able to build a 3D model of the teeth accurate to microns in a few minutes. The STL is then transferred into the cloud and can then be downloaded by a laboratory or printed in Germany where a physical model of the teeth is built using stereolithography (SLA).

Stereolithography is an additive manufacturing process using a vat of liquid UV-curable photopolymer "resin" and a UV laser to build parts a layer at a time. On each layer, the laser beam traces a cross-section pattern on the surface of the liquid resin. Exposure to the UV laser light sets the resin and so the model is slowly built up, layer by layer.

After a pattern has been traced, the SLA's elevator platform descends by a single layer thickness, typically 0.05 mm to 0.15 mm (0.002" to 0.006"). Then, a resin-filled blade sweeps across the part cross-section, re-coating it with fresh material. On this new liquid surface, the subsequent layer pattern is traced, adhering to the previous layer. A complete 3-D part is formed by this process. After building, parts are cleaned of excess resin by immersion in a chemical bath and then cured in a UV oven.

The models are then airfreighted to our laboratory in Thornbury, CBC, who may have already designed and milled any CAD-CAM components. They also have a laser sintering device that can create metal components in a similar process to the model construction above. In either case, the True-Def scanner enables the most accurate models to be made, ensuring your crown, bridge, inlay or onlay will fit like a glove when it comes to the fit appointment.

As dentists we are seeing crowns that fit perfectly first time, with little need for adjustments in the vast majority of cases. This must improve the survival and longevity of the tooth you have invested in compared to conventional impressions and crowns.

For our orthodontic applications the appliances and aligners usually fit well the first time and every time, making treatment more predictable

Here at Barley Mow Mr McNulty & Mr Morden are able to offer several options to straighten your teeth.
Most of the options have been developed to deal with limited problems involving the front 6 teeth in the upper and lower arches.
These treatments are called Limited Treatment Objective (LTO) or Short Term Orthodontics (STO) for obvious reasons.
They focus on providing a cosmetic/ aesthetic treatment to uneven crowded or spaced front teeth - they are not able and do not try to fix problems with jaw relationships and arrangements of back teeth. To resolve such problems needs the attention of a more fully qualified practitioner and more importantly almost always fixed orthodontics and a longer course of treatment.
Our techniques move teeth at the same speed as more traditional systems, but by focusing on less complete treatment they are perceived as faster - closing extraction spaces, straightening back teeth and rearranging bites take time.
This makes STO/LTO treatment  ideal for retreating orthodontic relapses as these often involve just the front teeth.

Mr Morden can also provide limited aesthetic fixed treatment (ClearSmile Brace (CSB)), which can resolve more complex problems and is ideal if teeth are tilted or rotated.

So what are the options: [ click on the links to see fuller descriptions]

Inman Aligner  - removeable / moderately visible / quick

ClearSmile - clear aligners - almost invisible and little bulk / slower / often more expensive

ClearSmile Brace - classic fixed braces and wires but reworked in clear ceramics and white coated wires - not removeable but very effective 

Around half of our cases involve patients who had their teeth straightened as a teen and either did not effectively wear the provided retention or have fallen foul of the tendency of all the teeth to move forward and become more crowded. To avoid this happening again as much as we can we usually provide fixed retention where it is possible as well as a vacuum formed retainer.
There are a number of other alternatives becoming available as the industry tries to find the perfect solution to long term retention.

 

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