FAQs

Most fractures cannot be avoided because they happen when you least expect them. However, you can reduce the risk of breaking teeth by:

• Trying to eliminate clenching habits during waking hours;
• Avoiding chewing hard objects (e.g. bones, pencils, ice) and using teeth as a tool;
• Avoiding chewing hard foods such as pork crackling and hard-grain bread.

If you think you grind your teeth at night, ask your dentist if a night guard or a splint will be of use to you. Individuals who have problems with tooth wear or “cracked tooth syndrome” should consider wearing a night guard while sleeping. This will absorb most of the grinding forces.

Relaxation exercises may be beneficial.

It is very important to preserve the strength of your teeth so they are less susceptible to fracture.

Try to prevent dental decay and have any dental decay treated early. Heavily decayed and therefore heavily filled teeth are weaker than teeth that have never been filled.

How does the dentist treat a cracked tooth? It depends on the direction and severity of the crack. If the crack is small enough, a filling may be used. 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. Your dentist may first place an orthodontic band around the tooth to keep it together. If the pain settles, the band is replaced with a filling that covers the fractured portion of tooth (or the whole biting surface). Other options include the placement of gold or porcelain fillings or even a crown.

Unlike fractures elsewhere in the body, this crack will never heal. There is a small chance that the crack will get worse even with a crown placed. This may lead to the need for root canal treatment, or even the removal of the tooth. However, many cracks can be fixed without root canal or tooth removal. Seeking treatment early is key to minimising the extent of treatment required.

Front teeth usually break due to a knock, an accident or during biting. Back teeth can also be fractured from a knock. They are much more likely than front teeth to crack from forces applied by the jaws slamming together rapidly. This is why sportspeople wear mouthguards to cushion the blow. Other forces occur during sleep because people grind their teeth with a much greater force than they would ever do while awake. The first sign of problems may be what we call “cracked tooth syndrome” –a sore or sensitive tooth somewhere in the mouth that is often hard for even the dentist to find. In some individuals the grinding, called bruxism, causes tooth wear rather than fracture.

Many people are nervous or anxious about visiting and being treated by the dentist. Fortunately there are a number of techniques dentists have at their disposal to help their patients. These include inhalation sedation, intravenous sedation and general anaesthetic.

The most common technique is the use of a nitrous oxide and oxygen mix or the so-called ‘laughing gas’. The Nitrous Oxide mixture –

• Reduces pain,
• Reduces anxiety, and
• Reduces the gag reflex.

Patients will often experience a feeling of well-being and euphoria.

The technique involves placing a mask over your nose, and then breathing through your nose.

The gases have a slightly sweet smell and are well tolerated by even the most sensitive noses. The dentist will adjust the percentage of nitrous oxide to oxygen to suit you.

The technique has a number of advantages over other techniques:

• It is less expensive than other techniques
• It is simple
• No escort is required
• No fasting is required
• There is a rapid onset and fast recovery

It is suitable for children

Unfortunately, the technique is not suitable for all. Some anxious and phobic people require a deeper form of sedation. In general, pregnant women should not receive inhalation sedation. People with nasal obstructions and mouth breathers may also find this method unsuitable.

For people who require a greater degree of sedation, or if the procedure is of a nature that requires the patient to be sedated, intravenous sedation may be suitable. With this technique a sedative is injected into a vein in the arm by a qualified seditionist or anaesthetist.

The advantages are –

• Patients usually remember nothing of the procedure, and
• An escort is required
• Fasting is required

It is suitable for a wide range of people and procedures.

The ‘ultimate’ technique for the phobic patient is for the patient to be completely anaesthetised by an anaesthetist. Some surgeries offer this technique ‘in house’ or at their local hospital / day surgery.

At Dental Avenue, we follow strict guidelines on infection control. We use state-of-the-art cleaners and steam sterilisers to achieve a rapid high heat sterilisation of instruments.

Our practice utilises sterilisable dental equipment and instruments. Otherwise we use disposable items wherever possible. The general standard of infection control in all surgeries in Australia is excellent.

Gloves should be worn wherever there is a risk of exposure to blood or body substances, which is almost always the case.

No. However, there are two things that a smoker should do to help protect his or her oral health.

1. Arrange to have a regular half yearly check-up with a dentist.
2. Give up smoking. If smoking is stopped in time it is often possible to maintain a healthy mouth and keep the teeth for a lifetime. In 3-5 years after stopping smoking the chance of getting oral cancer is halved and gets less and less with time.

Yes. Most people are becoming aware that smoking poses a problem to general health. It contributes to heart disease, stroke, and to a third of all cancer deaths, to name just a few conditions. In 1992 it was estimated that almost five thousand deaths in Victoria resulted from smoking.

What is less well known is the effect it has in the mouth.

The main damage is to the gums and mucosa, or lining of the mouth. Smokers develop more oral cancers than non-smokers (about five times more) and invariably suffer some degree of gum or, periodontal disease.

Other than staining, smoking does not affect the teeth. However, it also has a profound effect on the saliva, promoting the formation of the thicker ‘mucous’ form of saliva at the expense of the thinner watery ‘serous’ saliva.. There is a reduction in the acid-buffering capacity of their saliva.

This effect of nicotine explains why some heavy smokers get decay even if they are brushing well.

No, but it increases your chance of getting it by about six times and increases the severity by the same factor. However, it can hide the signs of periodontal disease which can take years to progress. The condition can be very advanced before a person actually notices the damage. Gum disease is normally coupled with plaque and calculus that collects at the base of the tooth, which leads to bacteria infecting the gums. Smoking reduces the body’s ability to combat this condition.

Slight infections around the edges of the gums are common and easily treated, but smoking allows the condition to progress more deeply and seriously. Plaque and tobacco are a dangerous combination. X-rays taken of the teeth of even young smokers usually show that bone support has begun shrinking away from the tooth roots.

Flossing and careful brushing tends to slow down the deterioration, but smokers often have reduced sensation in their mouths and it is difficult to detect and remove all the plaque at the gum margins. (See Gum Disease)

Yes, smoking is a major cause of cancers in the mouth. It is the single biggest risk factor.

Even when cancer is not present, dentists can often detect changes in the lining of the mouths of young smokers. When these changes become pronounced they predispose to cancer. The mucosa becomes hard and white and develops corrugations. Such areas should be observed routinely and are one more reason why people should have regular dental check-ups.

Detecting and treating precancerous lesions and early cancers is vital in improving survival rates.

Yes. Smokers are six times more likely to have serious gum (periodontal) disease. Periodontal disease is a deep-seated form of gum disease. It involves not just the pink gum, but also the supporting bone and the membrane that holds the teeth in place. When gum disease damages these supports, the teeth become less stable and move too easily. Eventually they can become painful and loose, and need to be extracted.

Smoking affects the immune system and lowers its ability to reduce harmful bacteria that can cause gum disease.

Yes. Tobacco staining on the teeth is often superficial in the first few years of smoking and your dentist can usually readily remove it. Unfortunately, as the years pass, the staining tends to spread into microscopic cracks in the enamel (the outer layer of teeth) and this is far more difficult to remove. Teeth can become permanently stained.

When brushing your teeth it is best to position your toothbrush at a 45-degree angle to your teeth, aiming the bristles of your brush toward the gum line. The join between the teeth and the gum is a nice area for bacteria and plaque to accumulate, so it is important to get to this area.

Once you have the brush at the correct angle, all you need to do is jiggle the brush gently back and forward, only brushing one or two teeth at a time. Don’t be excessively vigorous but also don’t be too mild.

Remember. You are trying to penetrate the bristles into the gaps between teeth to remove a very soft plaque.

You need to be systematic – brushing all teeth in order, inside and outside – and you really should do it in front of a mirror so you can see what you are doing.

Proper brushing should take two to three minutes.

Good brushing is very important to help prevent dental decay and periodontal disease, however brushing alone is not enough. It is also very important to clean between your teeth. This is why flossing is so important.

You should floss at least once a day, every day.

Holding floss is the key. You should have a decent length and make sure it is tightly wrapped around and locked onto the middle finger of each hand. Some companies also make small flossing aids. You should floss using a gentle sawing motion, against the sides of your teeth. If you find this tricky — speak to or team at Dental Avenue. They will be able to advise you on the best oral hygiene aids for you, and show you exactly how to use them. Remember — prevention is the key!

If your gums bleed or become sore after flossing, do not panic. If you have not been flossing regularly then the gums will be inflamed and will bleed more easily. If the bleeding persists — see us at Dental Avenue.

The best toothbrush is one with a small head and soft bristles. Electric toothbrushes can also be very good, particularly for people who find proper brushing techniques difficult to master.

Always use a toothpaste containing fluoride. Fluoride combines with minerals in your saliva to strengthen your tooth enamel and help stop decay.

Dental caries, or dental decay, is a common disease, which causes cavities and discoloration of both permanent and primary “baby” teeth. As the disease progresses in a tooth it becomes weaker and its nerve may be damaged.

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.

If you have a sensible diet, a good flow of saliva, a cleaning routine and your teeth get an

appropriate fluoride exposure, you are unlikely to get decay. So, you can prevent decay by:

• Being careful with how often you eat sugary foods or have sugary drinks.
• Brushing and flossing your teeth carefully to reduce the amount of bacteria on their surfaces.
• Using fluoride toothpaste. This will make the surfaces of teeth more resistant to acid. The fluoride in our water supply strengthens the developing teeth of infants and children.

Saliva is the best natural defence against decay. The acid from bacteria can be neutralised by saliva. A reduced flow of saliva (dry mouth) can increase your risk of decay. Causes might include:

• Medications that you may be taking that may have a drying effect in the mouth
• Excessive intake of caffeine. Caffeine is found in coffee, tea, chocolate and cola drinks. It draws fluid from the body and reduces saliva.
• Working in a dry environment and not rehydrating often enough
• Some specific diseases or conditions such as Sjogren’s syndrome
• If you have a constant dry mouth, you should consult your dentist to find the cause.

In the mouth, there is a constant battle between demineralisation (tooth being dissolved by acids) and remineralisation (tooth being re-deposited on the teeth from saliva). If your demineralisation is happening at a greater rate than remineralisation, you get loss of tooth substance.

If your mouth is acidic a good deal of the day from, say, excessive and constant intake of acidic soft drinks or constant sugar intake, then the demineralisation wins and you have problems.

If you are careful with the diet, then your saliva is more neutral and you will get good

remineralisation to constantly repair the teeth.

Early dental caries is reversible. Mineral can be deposited back onto the tooth surface if you can modify your diet and oral hygiene. Your dentist can treat early areas of caries without the use of the drill (ICON). Another way of treating early decay is application of topical fluoride, and if you are careful with your diet and cleaning no other treatment may be required.

A more advanced area of dental caries will require a “filling”. Your dentist will remove the

damaged and infected soft tooth structure and repair the tooth. It is important to have this done as early as possible to preserve the strength of the tooth and prevent bacteria damaging the tooth pulp.

It is very important to listen to your dentist’s advice on how to eliminate the cause of your caries. Don’t think that just fixing a cavity will stop the disease from occurring in other areas of the mouth.

Being careful about how often you have sugar in your food and drinks is the best way to prevent and treat dental caries.

How often you have sugary food and drinks is more important than how much sugar you have in your food and drinks.

Other ways you may help prevent dental caries with your diet are:

• Rinse your mouth with water after having sugary food or drink
• Have a small amount of cheese after sugary food or drink. This will help to neutralize the acid produced by oral bacteria.
• Using sugarless chewing gum may help protect your teeth by stimulating extra saliva. Saliva is very important in protecting your teeth from decay.
• Do not put any sugar or other sweeteners in babies’ bottles.
• Remember the drying effect of excess caffeine.
• Remember that smoking changes the saliva to a more harmful consistency.