Oral Cancer

Many people do not know that cancer can arise form the mouth. Oral cancer is among the 10 most common cancers worldwide and its incidence is on the rise. There is 32% increase of incidence over the last 10 years. There are approximately 5000 new cases per year in UK.

This type of cancer still has high mortality and high morbidity. Generally speaking the earlier the cancer is diagnosis the better is the prognosis. Public awareness of oral cancer is low, patients of- ten delay to seek professional advice. We should minimise time from onset of signs or symptoms to diagnosis.

Early signs or symptoms of oral cancer are:

– ulcers or sores of the oral mucosa persisting for more than 3 weeks

– lumps and bumps in the oral cavity or on the neck persisting more than 3 weeks – white or red patches of the oral mucosa

In case you have noticed any of the above please do not hesitate to seek professional help. Dental practices or general medical practitioner are a good starting point.

Oral health care professional including dentists, hygienists and therapists are trained to recognised suspicious lesions or signs and act accordingly.

Oral cancer is multifactorial disease with some well established risk factors. The key messages for primary prevention of oral cancer are:

– Quit smoking or the use of any form of tobacco

– Keep within recommended guideline for alcohol consumption – Eat plenty of fresh fruit and vegetables

Dental practices provide a great opportunity to initiate discussions and advice about smoking ces- sation, reduced alcohol consumption and the benefits of good nutrition. During your routine oral examination your mouth will thoroughly assessed and receive a cancer screening.

Ciro Gilvetti

Dr Ciro Gilvetti DDS, MFDS, AFHEA, MClin OS, Dip OM

Specialist Oral Surgeon

Associate Specialist

Oral and Maxillofacial Surgery

Queen Victoria Hospital

Associate Clinical Lecturer

University Collage London


lip fillers

Following on from my previous post, “What Getting BTX Injections is Really Like!”, I thought I’d write another blog about… You’ve guessed it, what a lip fillers lip enhancement procedure is like!

Again, many of the questions my friends ask me are along the lines of:
“Why would you get your lips done?”
“What do you get injected in your lips with, ‘Botox’ or fillers?”
“Do lip fillers hurt?”
“How much filler did you get on your lips?”
“How do dermal fillers work?”
“Are fillers permanent?”
And the list goes on…

The first time I had a lip augmentation procedure was on 8 November 2017, just before my 25th birthday! On the 23 January 2018, I had a top-up. Not going to lie, both procedures were a huge decision that I had been thoroughly contemplating and discussed with Leyla at Sonria about for a few years now. However, I opted for small incremental enhancements to the lips at a time.

Firstly, let’s understand the concept of what dermal fillers do. They can be used for various cosmetic reasons, such as contouring, to fill out wrinkles and creases in the skin, and increase volume and definition of the lips, cheeks, and hands. Depending on your particular case and area that you would like to be treated, you will require particular fillers. There are many fillers produced by many different companies, such as Merz Aesthetics and Allergan.

At Sonria, you are offered either local anaesthetic cream or anaesthetic via injection, which completely numbs your lips. Before commencing the treatment, Leyla thoroughly disinfects the areas to be injected to ensure hygiene and prevent any infections.

Lip fillers with anaesthetic injections

For my first procedure, I opted for local anaesthetic in the form on a needle, which saw both my lips and mouth go numb, as I was very nervous about the treatment and any pain associated with it. The anaesthetic took minutes, if I that, to take effect. Leyla then promptly proceeded to inject a 0.55ml Juvederm Ultraline syringe filler, that was used evenly on the top and bottom lips. As she inserted the fillers, she would massage the lips to ensure the hyaluronic acid distributed evenly. Understandably, due to the perforation of the skin with the needle, my lips began to swell up shortly after treatment.

Lip fillers with local anaesthetic cream

For my second 0.55ml filler syringe, approximately ten weeks later, I opted to have the procedure carried out using local anaesthetic cream. I piled the cream onto the lips and the surrounding area. I asked Leyla for more and more cream until my lips were completely numb. Once they were numb, I gave Leyla the go-ahead to begin treatment. As the anaesthetic is not being injected into the desired areas, but rather being absorbed through the pores, although it is pain-free, you can feel some discomfort. Apart from that, the procedure is the same as if you were getting it with an anaesthetic injection. Leyla injected the fillers, massaged my lips, and they soon began to feel tender and swell up.

Regardless of whether you opt to have anaesthetic injections or local anaesthetic cream applied to reduce the pain and discomfort experienced during the lip enhancement procedure, your lips will begin to swell up, feel tender, and become red during, or shortly after, treatment. This is normal, and, for me, continue for, approximately, 48 hours before they began to go down. During this post-treatment time, you may be advised to avoid coffee, alcohol, hot drinks, and intense sun exposure.

The whole appointment itself lasts approximately 20 minutes, and then I am back to my daily routines.

And with that… I will leave you with a few post-treatment instructions following Dermal Filler injections:
• Do not perform activities involving rigorous exercise, straining, and heavy lifting for at least 24 hours after treatment.
• Avoid extensive sun or heat for 72 hours after treatment.
• Do not consume excessive amounts of alcohol and salts post-treatment to avoid excess swelling.
• Avoid significant movement of the treated area.
• Avoid massaging the treated area unless instructed by Sonria.
• Take Arnica for at least two days before treatment to help prevent bruising. Post-treatment, apply Arnica cream to help any bruising and swelling that may develop.

Always ask your aesthetician if you are unsure about the time frame of treatments that you are considering carrying out. Leyla and her team are still more than happy to answer any questions. Also please have a look at our dermal fillers option

What is it like to get BTX injections? The reason I am doing this is that since I have been posting my lip filler and anti-wrinkle injections on my very limited social media, to which only my friend has access to, I have been bombarded with questions!

This particular blog post will be about anti-wrinkle, BTX injections…

Some of these questions include…
“You are crazy, why are you having facial injections done?”
“What did you get on your forehead, ‘Botox’ or fillers?”
“Do the facial injections hurt?”
“Why would you get ‘Botox’? You don’t have any wrinkles.”
“How do anti-wrinkle injections work?”
“How does ‘Botox’ work?”
And the list goes on…

I’ve been getting anti-wrinkle injections, what some would call “Botox” [BTX injections], at Sonria since 2013, making me 21 years old at the time. My first experience experiment with facial aesthetics was administering BTX injections  in the glabella (the area between your eyebrows). This has gradually developed into getting PRGF (plasma rich in growth factors) facials, teeth whitening, and, most recently, lip enhancement.

The reason I started at such a young age was that thanks to my father’s genetics, I had a solid muscle in the glabella that was gradually, but surely, leaving an undesirable dent in my skin (a wrinkle!). Not only can lines make you look that slightly bit older, but it can make you self-conscious and, sometimes unhappy, about your appearance. To me, it also made me feel like my facial expressions were always, somewhat, negative. Getting anti-wrinkles injections was an easy decision for me.

Not long after, I bumped into Sonria at the London Olympia Beauty 2013 where I had the anti-wrinkle injections administered for two reasons: (1) to relax the glabella muscles, and (2) brow lift. However, I would only get seven units per important point. This means that the muscles are weakened enough to prevent wrinkles, but not sufficient, so you still have some movement. Therefore you can even create facial expressions. This technique I have kept up until today. I visit Sonria every five to six months to get the same seven units administered in the glabella.

During my anti-wrinkle appointment at Sonria, I am welcomed by the lovely team and made feel like I am at home right way. Shortly after, Leyla calls me into the practice where I sit in her beautiful chair looking up at the beautiful decor. I have the option of putting Elma Cream, a local anaesthetic numbing cream, to prevent pain associated with injections or minor surgical procedures. Given that the needle is skinny and delicate, I find that the discomfort is not that great and opt not to have it.

Before commencing the treatment, Leyla thoroughly disinfects the areas to be injected to ensure hygiene and prevent any infections. To identify the body of the muscles that need to be treated, Leyla asks me to frown as much as I possibly can, while she marks them with a while cosmetics pencil. She then proceeds by injecting the seven units per point that need to be treated. Leyla then gently wipes away any small pimples of blood as a result of the injection.

The whole appointment itself lasts approximately 20 minutes, and then I am back to my daily routines.

And with that… I will leave you with a few post-treatment instructions following BTX injections:
• Do not manipulate the treated area(s) for, minimum, three hours following treatment.
• Do not undergo facial/laser treatments or microdermabrasion for at least ten days following treatment.
• Do not lie down for at least four hours after treatment. This will prevent the toxin from tracking into the orbit of your eye and causing drooping eyelid(s),
• Do not perform activities involving rigorous exercise, straining, and heavy lifting for at least six hours after treatment.

Always ask you, aesthetician, if you are unsure about the time frame of treatments that you are considering carrying out. Leyla and her team are still more than happy to answer any questions.

Note – it can take approximately four to seven days for results to be seen!

Have a look at another of beauty treatments Mesotherapy

Teeth whitening

Professional teeth whitening has been around for decades, coming in all shapes and sizes, with all sorts of fancy tech to go alongside it, each format claiming to be better than the rest. There have also been some significant changes in the Professional Teeth whitening industry in the past five years, and I’m here to go through the good, the bad and the ugly.

Firstly let’s discuss the different methods of whitening out there…

1. Home-whitening kit

This usually consists of two visits to the dentist, where an upper and lower mould is taken, and two thin mouth-guard looking trays are made. The second visit is to check the fit of the trays and to show you how the bleach should be placed. The bleaching trays in this Professional Teeth whitening treatment are typically worn at night and results can be expected after a couple of weeks depending on the consistency of use. Home bleaching kits come in two strengths – 10% (hydrogen peroxide) and 16% (carbamide peroxide which is roughly 4% hydrogen peroxide). The 16% is usually for nightwear or patients with sensitive teeth; results will take a little longer than the higher strength. The 10% is used for 1-2 hours during the day (it is essential that you do not eat or drink with the bleaching trays in the mouth). Best results are usually achieved after two weeks of consistent wear, but can heavily depend on the patient’s dietary habits, start colour and desired colour. Relatively risk-free, it can sometimes lead to sensitivity if overused. However, the sensitivity is usually transient and will resolve just by having a break day of no bleaching. Sensitive toothpaste such as Sensodyne has also proven useful in tackling sensitivity in conjunction with painkillers if necessary. This method is excellent for maintaining a consistently white smile in a reasonably low effort manner at your leisure and works well in conjunction with chair-side whitening (which can act as a booster for the home kit).
Professional Teeth whitening

2. Chair-side/laser whitening

This is a great way to boost the brightness of your teeth in just 1 hour! This Professional Teeth whitening procedure is usually about 1 hour long from start to finish and will include the dentist having a quick look to ensure that you are dentally sound for the process, followed by drying and isolating the teeth and then brushing the bleach onto the teeth. The bleach is then activated by a unique light (not an actual laser, contrary to popular belief), which sets it all into motion. The product is renewed every 15-20 mins either two or three time to ensure maximum results. Following some issues with overly sensitised teeth and gum damage following chair-side whitening, in 2012 the laws changed to prevent such damage from occurring so haphazardly. The percentage of hydrogen peroxide (the active ingredient that causes the tooth to whiten) has been decreased to 6%. This procedure can only be carried out by a dentist or under the direct supervision of a dentist and is only available for.Teeth whitening

Now time for the mythbusters

Will your teeth get sensitivity?

Possibly, but unlikely. Due to the decrease in the strength of the bleach for the chair-side whitening, sensitivity is very unlikely. You may have a little bit of tenderness straight after the procedure purely due to the teeth being so dry. But it is usually a very temporary and short-lived side-effect. You may notice that you might get sensitivity when using the home kit – if that’s the case just reduce the length of time wearing the bleaching tray or give yourself a day or two breaks, as mentioned previously.
Professional Teeth whitening diagram

Will it damage your gums?

Extremely unlikely unless the bleach has been rubbed into the gums, which shouldn’t be happening. If you have opted for the chairside whitening, then the dentist will ensure your gums are clear. If you are using the home kit, the dentist will show you how to place the bleach to prevent any overspill into the gums. It’s essential that when you put your bleaching guards, that you run your finger or cloth around the edge of the bleaching guard to ensure that any excess is wiped away. It is challenging to cause any damage following any whitening provided you follow the instructions carefully and use FDA approved bleach given by the dentist. Most patients suffer from issues after whitening by using black market products or not employing the product correctly.

Will I look like Simon Cowell?

This is a common worry; it is quite hard to achieve that level of white in one sitting. Bleaching teeth both chair-side and at home are following treatments. It is difficult to guarantee what shade you will have by the end of the procedure. On average, you can go up two shades using chairside whitening. With the home kit, it varies greatly depending on how often and for how long the bleaching guards are worn. As it is an extremely progressive option, you can keep going until you achieve the shade you want and then stop. You are in control! If you want just a little bit of brightness, or if you wish to individual spotlights on your teeth, you get to choose!

Will it be white forever?

Unfortunately no. Professional Teeth whitening effects can last anywhere from 3 months to 3 years. It’s tough to say, as it is slowly dependant on your eating habits and your desired shade. Avoiding foods like red wine, coffee, black tea, curries and other coloured foods will increase the longevity of your whitening treatment, but the teeth will naturally dim down with time, as with anything that is shiny! But fear not, not all is lost, you can either come in again for a top-up of your chair-side whitening or just continue with your home kit until you go back to the shade that you wanted. On average, patients come every six months or so for chair-side whitening to maintain their brighter tone. The home kit should be reused in a similar time frame.

Can I pick what shade I want to achieve?

It is hard to predict how well chair-side whitening will work and what shade will be achieved per visit, as every patient is different. On average, most patients can achieve up to 2 shades lighter in one visit and can either return for a top-up visit a couple of weeks later or to continue with the home whitening kit until they achieve the desired shade. Home kits are considered to be more consistent and predictable with their results. However, the time is taken to make the desired shade can vary considerably patient to patient.

Can I get sick if I swallow the bleach?

You’d have to swallow the whole syringe pretty much! There may be some small amounts of excess bleach that will get lost in the saliva, but as long as you follow instructions, there shouldn’t ever be a sufficient amount of product free floating around to cause any sickness. Some patients may be allergic to bleach, in which case they should be avoiding this Professional Teeth whitening treatment all together!

Do I have to avoid all dark foods and drinks?

Generally, the longer you avoid such foods or at least cut them down in your diet, the longer lasting the results will be. Food colourants are the primary cause of dark teeth and build up with time. Avoiding or limiting such foods and also seeing your hygienist regularly, will allow for longer lasting optimum results. We understand that not everyone can live without coffee, so even by rinsing your mouth with some water after having any staining food or drink will also help.

Do oil pulling and other over the counter whitening products work?

Tricky to answer accurately, but overall the whitening effects are very minor and very short lived. Stores are not legally allowed to sell the strong stuff. Therefore anything that you can buy from a pharmacy or supermarket is going to be significantly weaker than what the dentist can provide you with.

So there you have it, tooth whitening, stripped bare! The new no-frills whitening has proven itself a great success amongst regular clients who are extremely happy with their pain-free long-lasting results. Feel free to pop in or give us a call if you want any further information. We look forward to providing you those pearly whites you deserve!

Also have a look at the risks of unsafe teeth whitening.