Dr Sahil Patel

Severe Underbite

Our top teeth should overlap our bottom set, and occasionally this does not occur, resulting in a crossbite.

An Underbite is a form of crossbites that involves several front teeth biting in a reversed 'under' position.

Biomechanically, it's not a good position to be in as teeth tend to wear down faster than normal, and there tend to be cosmetic concerns attached!

Two options to fix underbites - specialist orthodontics (moving the teeth with braces) or using ceramics

Spaces, sometimes they develop with time as we grow older, other times it's genetics.

This case was a lot of both. The option of braces is not a good one in my opinion, as closing spaces around the midline is notoriously tough to stop from re-opening.

We opted for ceramics to redistribute the space across the front 10 teeth. The excess space is moved backwards to allow us to create teeth that are a 'normal' proportion.

Proud of this case 😀

✅ After decades of bad experiences/neglect, he was considering going to Turkey (even had his flight booked) to have all his teeth removed in favour of implants.

✅ We managed to save most of his teeth by using ceramic bridges, crowns and veneers to improve the shape and colour as well.

✅ He also had an underbite, which resulted in us redesigning his bite from scratch.

This is only phase 1, phase 2 involves implants to replace his back teeth.

Root Canal Therapy

Some of our colleagues in Switzerland feel that a root canal treatment is similar to a 'death sentence' for a tooth. Perhaps a little dramatic but it has some truth to it...

Adult teeth start to develop before we are born, and they each have a dedicated nerve and blood supply. Occasionally the nerve and bloody supply needs removal and capping off, to prevent pain, infection and otherwise early loss of the tooth.

◼️The problem is the tooth becomes dark, brittle, weak and overall has a shorter lifespan. Aesthetically the challenges are to balance colour, reinforce rigidity and not disturb the sealed root canal.

🦷Our preferred and longest lasting method for addressing this is using ceramics, designed in a way to biomechanically support the tooth from buckling, and improve the shape and colour simultaneously. Very few dental treatments can handle multiple issues in one method

Dyson has engineered a £420 oral-care system. But has it solved the clinical problem that matters?

The device combines three familiar elements: sonic electric brushing, water flossing and mouthwash. Bringing them together is innovative. Whether that integration produces meaningfully better oral health is a different question.

There are three areas I would consider before recommending it.

First, the toothbrush uses sonic technology. This does not make it a bad toothbrush, but the stronger evidence base currently sits behind oscillating-rotating designs. At this price, I would want the brushing function itself to represent a clear clinical advance.

Second, the water jet may help remove loose debris, but it does not replace mechanical cleaning between the teeth. Interdental brushes is still the gold standard for gum health.

I also see limited clinical value in the mouthwash component. The need for compatible toothpaste is another consideration, as conventional SLS-containing toothpaste can foam and obscure the device’s camera.

Third, there is the question of adherence. The system asks users to brush for three minutes, twice daily, while moving the brush slowly enough for the technology to function as intended. When consistent two-minute brushing is already difficult to achieve, a longer and more technique-dependent routine may create additional friction.

My verdict is therefore measured:

It is an intelligent integration of an electric toothbrush and water flosser. But it does not replace interdental cleaning, it is priced outside many households at £420, and I do not expect it to revolutionise gum health.

Innovation deserves attention. Clinical improvement still requires evidence.