Frequently Asked Questions
Crown & Bridge Work
Dental bridges are one option for the replacement of a missing tooth that is permanently cemented in place. The teeth either side of the gap (abutment teeth) are shaved down, and a precise impression is taken and sent to a lab. When it returns, the bridge is a single piece of hardware that has ceramic teeth on a custom built framework. The framework is cemented onto the abutments.
When a tooth has broken down to the point that a filling will most likely break or lead to further problems, your dentist may suggest you have that tooth crowned. As opposed to a filling, which is a procedure where the decayed portion of the tooth is removed and replaced with a plastic or resin material, a crown is a hard ceramic shell that sits over the remaining portion of a tooth, as an external support. Crowns when placed appropriately are a much more durable, and natural looking option than a filling.
The time taken and skill required to prepare the tooth are much greater for a crown than they are for a filling. A typical crown would require up to 2 hours of chair time, as opposed to 20-30 minutes for a filling. In addition to the materials used in the mouth, the crowns are manufactured either by an external lab or are milled using a CAD CAM unit, at significant additional expense.
Crowns, even though they do have higher associated costs initially, they provide greater value, due to their superior long-term survival rates, and increased chance of you keeping the tooth throughout your life.
Dental Emergencies
A severe toothache will require a trip to the dentist ASAP. In some cases the use of pain medication may offer little relief. Avoiding triggers such as cold, hot or pressure is advisable.
Rinse with luke warm water to remove any food/debris. Gently floss between the teeth to remove anything that may be stuck, and make an appointment to see your dentist. Don’t wait until the tooth becomes painful. Early interventions are often longer lasting and cheaper. Once the nerve is involved, as indicated by increasing pain, then you are starting to look at the more complicated, more expensive treatments.
Time is critical for successful replanting of a lost tooth. It is important to handle to the tooth by the crown (not the roots) and ensure that the tooth is clean. If the tooth is dirty, ask the patient to suck on the tooth or rinse the tooth in milk. Once the tooth is cleaned, immediately replant the tooth into the socket. If unable to replant the tooth, keep it moist by placing it in milk, or in the patient’s mouth next to the cheek & immediately make your way to us.
Fillings
A filling is essentially the replacement of damaged tooth structure within the mouth. Thanks to advancements in dental technology fillings can be placed practically pain free. If you are told you require a filling you should not put it off, delaying the required filling can result to decay entering the nerve canal or the tooth continuing to chip/break and may result in more extensive/costly treatment being required.
Unfortunately not all fractured or decayed teeth can be filled, an oral exam and x-ray will be required to determine the correct treatment. There are numerous circumstances in which would prevent treating a broken/decayed tooth with a filling e.g. decay into the tooth’s nerve, broken under the gum line or fractures in the tooth’s roots.
We use a material known as a composite resin, which is a mixture of tooth coloured glass and resin. Using composite allows us to match the colour of your natural tooth making your filling practically unnoticeable. The material is positioned and cured with a bright light, immediately giving the material its full strength.
Gum Disease
Gum disease comes in two main types:
- Gingivitis – this is the first stage of gum disease. In gingivitis your gums become inflamed and bleed on brushing/flossing. This stage is REVERSIBLE. Simply perform good oral home care and attend your regular maintenance appointments to get back on track!
- Periodontitis – this occurs if the gingivitis is not controlled. In simple terms, the bone supporting the teeth is compromised. In severe cases teeth can lose so much support that they become quite loose – even fall out! There are also some risk factors to look out for – this can include smokers and the medically compromised.
If you have been told that you have periodontitis it is essential to keep your regular maintenance appointments to stabilise the condition – this is essential if you plan on keeping your teeth!
Implants
Implants are another option for permanatly replacing a missing tooth. A dental implant is an artificial tooth root that is surgically submerged into your jawbone to hold a replacement tooth (crown), bridge or full set of dentures in place. They are made from titanium, look a little bit like a wood screw and will fuse to the bone over time.
Dental implants are a wonderful technology that CAN outlive you and your teeth in favourable conditions. Tooth decay will not affect implants, but gum disease can, so it is important to understand that to get the most out of your implants, you need to commit to a lifetime of dental care.
The process varies depending on the amount of bone, number of implants and position of implants. It usually takes several appointments. The first appointment is usually for taking xrays (and other records such as study models/photos) and planning for the implant placement. This may include planning for a denture for use while the implant “knits” with the bone. The next appointment is where the implant/s is screwed into the bone and then the gum stitched over the top to heal. The implant is left for a minimum of three months (often longer) to fuse with the bone. Finally the implant is exposed, checked for “integration/fusion” with the bone and moulds are taken for a crown. The crown is subsequently either screwed or cemented into place. These steps usually take between 3 and 12 months from start to finish.
Unfortunately this great tooth replacement solution isn’t suitable for everyone. For an implant to be successfully placed it needs to be inserted into a certain amount of good quality bone. If a tooth has been missing for a long time there may have been significant bone loss. In some cases a bone graft procedure can be completed to allow the treatment of an implant. Again, this is not possible in all cases.
With this in mind we often recommend that patients consider bone grafting sockets on the day of the tooth extraction. This will preserve as much bone as possible and give the best chance of keeping an implant as an option for down the track.
Implants have a good reputation and many people have heard that they last a lifetime. Although, this is true in some cases it is important to point out that there are several reasons that implants can fail. Implant failure rates are higher in people who are smokers and/or who have had a history of periodontal disease.
Paediatric Dentistry
As soon as the teeth appear (usually around 6 months of age) brushing them gently twice a day with a very soft brush or cloth is recommended. No toothpaste is required until the child is 2 years old – just wet the brush with water. From 2-6 years of age a children’s toothpaste can be used. Children do not have the manual dexterity to clean their teeth efficiently until they are about 7 years old so we recommend that, where possible, a parent or carer help with brushing once a day up to 7 years old.
We recommend that children start coming for ‘a ride in the chair’ from 1-2 years old. Why not bring your littlies along to your dental visit so we can start familiarizing them with the dental environment. You’d be surprised at how much they absorb just by watching you! Little baby steps can go a long way. For instance, letting him/her have a ride in one of our super comfy chairs and getting a prize. We offer education to the parents on how to best look after their teeth from a young age and parents arm their children with good oral health habits to last throughout their life.
Our team recommends that kids from the age of 6 use adult strength toothpaste. This is around the age where your child is often starting to get their first adult teeth. The higher fluoride concentration helps to mature and protect these newly erupted adult teeth.
Yes children’s teeth can decay. Decay can be the result of a number or problems including enamel defects, inadequate plaque control, high frequency of sugar and/or acid or poor quality saliva to name a few. Decay is often undetected and painless until it is very deep. Deep decay can cause teeth to abscess and become infected. Front baby teeth are usually lost between 6 and 8 years of age but the baby molars do not fall out until 10-12 years old. The baby molars are important to hold the space for the adult teeth forming underneath. Early loss of baby molars can result in crowding or crooked adult teeth. For this reason we will usually try to fill decayed baby teeth and keep them as natural “space maintainers” for as long as possible!
Root Canal Therapy
Root canal treatment (RCT), which is also referred to as endodontic treatment, is a dental procedure that removes a tooth’s dead or infected pulp replacing it with a rubber filling material. There are numerous reasons in which teeth require RCT. Damage to the pulp may have been caused by; decay, tooth trauma, grinding or gum disease. People usually assume that teeth requiring RCT would be painful, this is not always the case. Some teeth with dead/infected pulp may be silent and not painful. It is usually when dental x-rays are taken that these ‘silent’ abscessed teeth may be detected.
Once a tooth has been root canal treated it is recommended that a crown be placed on the tooth to minimize the increased risk of fracture (and potential loss) of the tooth. A tooth in which has been root treated and has had a crown placed can remain as a solid working tooth for many years. In fact, research predicts that 85% of such teeth are still functioning 10 years later!
Teeth Cleaning/Oral Hygiene
Brushing your teeth is essential for healthy teeth and gums – preventing tooth decay as well as gum disease. Medical research shows a strong link between oral health and our general health. This is why we strongly recommend that brushing should be carried out at least twice per day. Brushing removes the soft bacterial deposits (“plaque”) from the teeth. When exposed to sugar these bacteria produce acids that erode the tooth surface and cause decay. Removing the plaque thereby removes the bacteria and prevents tooth decay.
We often joke that you should ‘only floss the teeth that you want to keep!’
Brushing alone does not remove all the plaque left on our teeth after eating. A common site for tooth decay and gum disease to become apparent is in between the teeth. If you find difficulty in using dental floss it is important to know that there are many alternative dental aids for cleaning between teeth. that one of our Hygienists may recommend for you at your “Active Maintenance” visit.
Another tip is to tie a few knots in the floss, and then drag them through the space between the teeth.
Bleeding gums is an early sign of gum disease, gingivitis. If plaque/bacteria is not removed in a timely manner the bacteria causes an inflammatory response in which the gums can become inflamed and bleed quite easily when brushing/flossing. Bleeding gums is NOT a sign of aggressive brushing.
Put simply, performing your oral care routine (prescribed by your Hygienist) should reduce the bleeding. If bleeding persists you should make an appointment with your Hygienist as other factors can also contribute to bleeding gums such as medications, medical conditions and hormones – Just to name a few!
Not everyone experiences sensitivity following a clean by his or her Hygienist. Factors such as gum recession or tooth erosion can make the teeth more sensitive prior to having a professional clean as well as afterwards. Gum recession exposes the roots of the teeth leaving them unprotected by tooth enamel. If a lot of tartar build up has been removed around the gum line you can expect some mild sensitivity. This can usually be managed by using sensitive toothpaste for a few days. Pain relief can be taken if needed.
It is NOT recommended to avoid getting a professional clean done. A professional clean carried out every 6 months is vital for not only our oral health but our general health as well. Failing to remove tartar buildup can cause periodontal (“gum”) disease and loss of bone support for the teeth. The longer the buildup sits on the teeth the longer it will take to remove, similar to food being left on dirty dinner plates. Unfortunately, once bone is lost through gum disease it cannot be grown back so prevention is better than cure. Our caring and gentle Hygienists are trained to manage patients with sensitive teeth. Local anaesthetic can be administered making your visit more comfortable.
Tooth Whitening
As teeth age, the pulp tends to disappear from the crown part of the tooth, and in its place, there is a deposit of the yellowish dentine. Numerous lifestyle choices can also stain our teeth such as tea, coffee, smoking, certain foods and medications.
With our take home Opalescence kit, your teeth will be whiter in just 5-7 days. We have chosen to use Opalescence whitening because it has been shown to be the most effective and efficient professional whitening system with the least sensitivity. In your kit you will receive your custom fit trays, bleaching agent and sensitive toothpaste to use throughout the duration of whitening your teeth. Insert a small amount of the whitening agent into your trays and wear for half an hour each day for 1-2 weeks. The best part about choosing a take home kit to whiten your teeth, you have it forever. Over time your teeth will slightly lose their whiteness, every 6 months we recommend using your trays for 2-3 days to maintain the colour.
Wisdom Teeth
Wisdom teeth (3rd molars) usually erupt into the mouth around 17 – 21 years of age. They erupt into the very back of the mouth, behind the 12 year old molars.
Not every person will have a full set of 4 wisdom teeth, some are naturally missing one or more of them. Rarely, some people can even have an additional set, so 8 wisdom teeth in total.
Not all wisdom teeth need to be removed. Generally, if the wisdom teeth are causing pain, have infections around them, or if they are positioned in such a way as to cause problems for other teeth then your dentist may advise their removal.
You may have been told that you have impacted wisdom teeth; Impaction means that your wisdom teeth will not erupt into a functional position in your mouth. Most commonly impacted wisdom teeth require extraction, as they are known to cause other dental complications, whilst in other cases non-erupted wisdom teeth can sit quietly under the gums without causing any complications.
Dental Extractions
Wisdom teeth (3rd molars) usually erupt into the mouth around 17 – 21 years of age. They erupt into the very back of the mouth, behind the 12 year old molars.
Not every person will have a full set of 4 wisdom teeth, some are naturally missing one or more of them. Rarely, some people can even have an additional set, so 8 wisdom teeth in total.
Not all wisdom teeth need to be removed. Generally, if the wisdom teeth are causing pain, have infections around them, or if they are positioned in such a way as to cause problems for other teeth then your dentist may advise their removal.
Sports Mouthguards
The Australian Dental Association (ADA) recommends anyone who participates in a sport that carries a risk of contact to the face should wear a professional “custom fitted mouthguard” to prevent dental injuries from occurring or reducing the severity of them.
Many teeth are broken or lost in sporting accidents. Although mouthguards are worn by some participants playing sport there are still many injuries because “stock mouthguards” or “boil and bite mouthguards” ARE NOT EFFECTIVE.
Dentures
Dentures are the third option for the replacement of missing teeth. They differ from implants and bridges in that they are designed to be inserted and taken out by the patient. They are often preferred due to the lower expense, and their ability to replace many missing teeth.
Several steps are required in preparing a denture, and getting it right. Initially a set of impressions are taken, that allow us to make a set of stone models that exactly match your teeth. We then use those models to build the base on which the teeth can be placed. We then test the fit in the mouth, and make sure you are happy with the look etc, before we send it off to the lab to be finished. The whole process can take as many as 5 visits, spaced over weeks.
The bones of the face tend to change with advancing age. As a result, a denture that is custom fitted to a patient at one point of time, will fit less perfectly as the bone changes. Relining a denture can restore that perfect fit.
