FAQs
Perio / Gums
Can gum disease be treated successfully?
Yes.
In the vast majority of cases the progression of gum disease can be arrested with appropriate care. Management of gum disease becomes more difficult and less predictable the more advanced the disease. Therefore, the sooner periodontitis is diagnosed and treated the better. Regular dental examinations are important to check for the presence of gum disease.
The cause of gum disease is bacteria. To manage it, the bacteria must be reduced to a level the body’s defense mechanisms can handle. Treatment classically involves:
- achieving the best possible home care
- professional cleaning of the teeth above and below the gum line (into the pockets) to remove the plaque and hard deposits (calculus / tartar), and
- regular reviews
- trying to remove risk factors such as smoking.
Gum disease causes permanent damage to the supporting tissues; therefore the aim of treatment is to stop the progression of the disease through controlling the bacteria. This is an ongoing, lifelong activity.
Your general dentist is trained in managing periodontal problems. They may also use a hygienist to assist in your care. You may be referred to a Periodontist if your dentist considers your condition needs more advanced care. A specialist periodontist has gained additional qualifications and experience to satisfy the requirements of the State Dental Board and may therefore use the title “Periodontist”.
Prevention is best. To a large extent periodontitis can be prevented by good oral hygiene and early intervention when problems are identified. See your dentist regularly.
What causes periodontal disease?
Periodontal disease is caused by bacteria. Bacteria form a ‘plaque’ which is a sticky, colourless film that forms on your teeth, particularly around the gum line. Other bacteria thrive deep in the gap between the gum and the tooth (the ‘pocket’). Some people are much more at risk of developing periodontal disease — smoking is one of the major risk factors. Other conditions such as diabetes, stress, pregnancy and various medications can all be contributing factors.
What is gum disease?
“Gum disease” describes a range of conditions that affect the supporting tissues for the teeth. The supporting tissues comprise both the surface tissues that can be seen in the mouth and also the deeper tissues of the bone, root surface and the ligament that connects the teeth to the bone.
Prosthodontics
Fillings / Caries
Implants
Orthodontics
What is a bridge?
A bridge is an appliance permanently fixed in the mouth to replace missing teeth. It uses remaining teeth to support the new artificial tooth or teeth.
A bridge is made up of two crowns for the teeth on either side of the gap – these two anchoring teeth are called abutment teeth– and a false tooth/teeth rigidly attached in between. The false teeth are called pontics. The bridge can be made from gold, alloys, porcelain or a combination of these materials.
An enamel-bonded bridge uses a metal or porcelain framework to which the artificial teeth are attached, and then resin bonded to supporting teeth.
What is a crown?
Dental crowns (also sometimes referred to as ‘dental caps’ or ‘tooth caps’) cover over and encase the tooth on which they are cemented. Dentists use crowns when rebuilding broken or decayed teeth, as a way to strengthen teeth and and as method to improve the cosmetic appearance of a tooth. Crowns are made in a dental laboratory by a dental technician who uses moulds of your teeth made by your dentist.
The type of crown your dentist recommends will depend on the tooth involved and sometimes on your preference. They include porcelain crowns, porcelain-bonded-to-metal crowns, which combine the appearance of tooth coloured material with the strength of metal, gold alloy crowns and acrylic crowns.
What is the difference between a denture and a crown or bridge?
Removable dentures are those dentures (plates) the wearer can remove and replace at will. These types of dentures can replace one tooth, all your natural teeth, or any number of missing teeth in between. A crown or a bridge is fixed or cemented in place and cannot be removed.
What is a bridge?
A bridge is an appliance permanently fixed in the mouth to replace missing teeth. It uses remaining teeth to support the new artificial tooth or teeth.
A conventional fixed bridge consists of crowns that are fixed to the teeth on either side of the missing teeth and false teeth rigidly attached to these crowns.
An enamel bonded bridge uses a metal or porcelain framework., to which the artificial teeth are attached, then resin bonded to supporting teeth.
Root Canal Tx
How does the dentist treat a cracked tooth?
It depends on the direction and severity of the crack. If the crack is small enough, it may be removed by replacing the filling. Bonded white fillings and bonded amalgam fillings will hold the tooth together making it less likely to crack.
Sometimes the cracked part of the tooth fractures off during the removal of the filling and this can be replaced with a new filling.
Why does a cracked tooth hurt?
The crack will expose the inside of the tooth (the ‘dentine’) that has very small fluid filled tubes that lead to the nerve (‘pulp’). Flexing of the tooth opens the crack and causes movement of the fluid within the tubes. When you let the biting pressure off the crack closes and the fluid pressure simulates the nerve and causes pain.
Should baby teeth have fillings too?
Yes, baby teeth should be filled to prevent toothaches, to maintain the baby teeth for eating, and to hold the right amount of space for the adult teeth. If the baby teeth are going to be exfoliated (fall out) soon, then it is not always necessary to fill the teeth. This should be discussed with your dentist.
How are fillings done?
Tooth preparation, prior to filling placement, is usually done under local anaesthesia (making the tooth numb). Once all the decay is removed and the tooth is washed and dried, the filling is packed into the cavity and it sets.
After the filling is placed, it is shaped to match the original tooth contour and the bite is checked.
What is a filling?
A filling is a plug of material that is placed into a tooth to replace missing tooth substance and/or structure.
What causes dental caries?
Dental decay occurs when bacteria in the mouth make acid which then dissolves the tooth. Bacteria only produce this acid when they are exposed to sugar.
What is dental caries?
Dental caries, or dental decay, is a common disease, which causes cavities and discoloration of both permanent and “baby” teeth. As the disease progresses in a tooth it becomes weaker and its nerve may be damaged.
Dentistry for Kids
What is the success rate?
The success rate depends on where in the jaw the implants are placed. The lower jaw has a very good chance of success (98%). The further back in the mouth you go, the lesser the prognosis, but this is generally over 90%. If you smoke, the chances of success drop by at least 10%.
Why dental implants?
A dental implant is the closest thing to a natural tooth your dentist can give you. They feel much more natural and secure than traditional removable dentures, especially if these are loose fitting because of extensive bone loss. If several adjacent teeth are missing, a fixed bridge may be attached to dental implants as an alternative to a removable partial denture plate. Dental implants allow for the replacement of a missing tooth without modifying adjacent teeth. Your dentist will be happy to discuss alternatives for restoring your dental fully.
What are the advantages of the implant treatment?
The adjacent teeth are not damaged or cut in any way. It helps to prevent bone loss. Implants are also used to stabilise loose dentures or even replace them with fixed bridges.
How long does it take?
It depends on the type of bone, and where the implant is placed into your jaw. It can range from a few months to over 9 months. Generally, implants in the front lower jaw need around 4 months; the back upper jaw needs around 9 months and elsewhere in the mouth around 6 months. These times may need to be lengthened if bone needs to be grown or grafting has taken place.
What is a dental implant?
A dental implant can be thought of as an artificial tooth root that is submerged into the jawbone. When dental work such as a crown, fixed bridge or a full set of dentures is added, one or more missing teeth can be replaced. A dental implant is fabricated from a very strong, biocompatible material placed in a simple procedure that, generally, is as convenient as a tooth extraction. After an initial healing period, during which the implant is buried in bone and left undisturbed under gum tissue, it is uncovered and connected to a small metal post that secures and supports the artificial tooth.
The implant material is extremely biocompatible. The bone grows to the implant and bonds to it. This makes the implant very strong. The process is called ‘osseointegration’.
Wisdom Teeth
What are ‘braces’?
Braces are the most efficient and accurate way of moving teeth. Brackets are adhered to each tooth with special dental glue and are usually made of stainless steel or a clear plastic material. These brackets act like a handle on the tooth so that it can be moved into its correct position using wires. The brackets remain on the teeth for the entire duration of treatment. Generally adjustments are made to the braces every four to six weeks.
During treatment, patients may need to wear such items as rubber bands. These provide important extra forces for the correction of the bite.
What are the benefits of orthodontic treatment?
Orthodontic treatment is frequently performed to improve a person’s appearance by straightening the teeth. However, an attractive smile is just one of the benefits. Crowded and overlapping teeth are harder to clean and can increase the risk of tooth decay, gum disease and eventual tooth loss. Having your teeth straightened will make it easier for you to look after them.
A malocclusion may also contribute to speech impairments and increase the risk of trauma if teeth are prominent. Abnormal or uneven wear of tooth surfaces can also occur if there is poor alignment of the teeth or jaws. In cases of deep bite, the lower front teeth can bite into the gum behind the upper front teeth causing damage. Bringing the teeth, lips and jaws into proper alignment results in better function, easier cleansing, increased confidence and self-esteem.
Trauma
What happens if the pulp is injured?
If the pulp cannot repair itself from disease or injury, it will die. A cracked tooth or deep cavity can allow bacteria to enter the pulp and cause pulp death. If the infection is not treated, an abscess can form in the root tip. This can eventually cause damage to the bone around the teeth.
What does root canal treatment really mean?
Root canal or endodontic treatment is a process whereby inflamed or dead pulp is removed from the inside of the tooth, enabling a tooth that was causing pain to be retained.
Dental pulp is the soft tissue in the canal that runs through the centre of a tooth. Once a tooth is fully formed it can function normally without its pulp and be kept indefinitely.
After removing the pulp, the root canals are cleaned, sterilised and shaped to a form that can be completely sealed with a filling material to prevent further infection. The treatment can take several appointments, depending on how complex the tooth is, and how long the infection takes to clear.
Subsequently a crown or complex restoration to restore or protect the tooth may be a necessary recommendation, as a tooth after undergoing treatment may be more likely to fracture.
