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FAQ

Dentists replace amalgam fillings for a variety of reasons including recurring decay, fracture, endodontic treatment and appearance.

If you seek replacement of quite satisfactory amalgam fillings for other reasons, such as a concern about the effects of mercury, you may create problems that otherwise would not have occurred, such as:

  • Possible damage to or weakening of teeth;
  • Sensitivity or pain after the filling; and
  • Financial problems.

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 tooth. False teeth are rigidly attached to these crowns. An enamel-bonded bridge uses a metal or porcelain framework to which the artificial teeth are attached. Resin is then used to bond with supporting teeth.

Why does a cracked tooth hurt?

The crack exposes the inside of the tooth (the ‘dentine’) that has very small fluid filled tubes leading to the nerve (‘pulp’) of the tooth. Flexing of the tooth opens the crack and causes movement of the fluid within the tubes. When you release the biting pressure the crack closes and the fluid pressure simulates the nerve and causes pain.

How can I prevent my teeth from fracturing?

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.

Will my tooth become better?

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.

What type of forces cause teeth to crack?

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.

What is Invisalign?

Invisalign is the invisible new way to straighten teeth without braces. Invisalign uses a series of clear, removable aligners to gradually straighten teeth, without metal or wires. It combines 21st century technology and revolutionary manufacturing to customise a treatment for each individual patient.

Does Invisalign really work?

Yes. In both clinical research and in orthodontic and dental practices around the world. Invisalign has been proven effective at straightening teeth. Over a million patients have either been treated or are in treatment and over 44,000 orthodontists and dentists have been trained on how to use Invisalign.

Does Invisalign work as well as normal braces?

In most cases, Invisalign has proven to be effective at straightening teeth as traditional braces. The level of Invisalign experience will determine how an orthodontist or dentist decides how to treat a patient, be it with Invisalign or traditional braces. Some sever cases may require treatment using Invisalign together with another teeth straightening technique.

How does Invisalign work?

Invisalign uses 3-D computer imaging technology to depict the complete treatment plan from the initial position to the final desired position from which a series of custom-made “aligners” are produced. Each aligner moves teeth incrementally and is worn for about two weeks, then replaced by the next in the series until the final position is achieved.

Where can I see pictures of actual finished Invisalign cases?

To see what just a few of the many thrilled patients are saying about Invisalign, please visit the Invisalign website www.invisalign.com.au (click on the “Success Stories” tab). You will also be able to see the before and after pictures of patients who have been through Invisalign treatment.
What are the primary benefits of Invisalign?

There are four primary benefits of Invisalign:
1. Invisalign is nearly invisible – you can straighten your teeth without anyone knowing.
2. Invisalign is removable – you can eat and drink what you want in treatment; you can also brush and floss normally to maintain good oral hygiene.
3. Invisalign is comfortable – there are no metal brackets or wires to cause mouth irritation: no metal or wires also means you spend less time in the doctor’s chair getting adjustments.
4. Invisalign allows you to view your own virtual treatment plan before you start – so you can see how you straight teeth will look when your treatment is complete.

What are aligners made of?

Aligners are made of clear, strong medical grade non-toxic plastic that is virtually invisible when worn.

What do aligners look like?

Aligners are nearly invisible and look similar to clear tooth-whitening trays, but are custom-made for a better fit to move teeth. Some orthodontists have referred to them as “contact lenses for teeth”.

How long will treatment take?

The length of treatment is dependent on the severity of individual cases. Treatment may vary from anywhere between six months to two years with an average treatment taking around 12 to 14 months.

Is this a new way to straighten teeth?

For years, orthodontists have used removable appliances for limited treatment. Today, with the application of computer technology and mass-customised manufacturing, Invisalign is able to treat a broader range of cases with greater precision.

How old is the company?

Align Technology, Inc., the company that manufactures Invisalign aligners, was founded in 1997. It is listed on the NASDAQ Stock Exchange in the USA (Stock Code: ALGN). Invisalign is distributed and supported in Australia by Invisalign Australia Pty Ltd, an independent distributor.

How old is the technology?

In 1945 an American orthodontist Dr. H.D. Kesling envisioned that one day, modern technology would enable the use of a series of tooth positioners to produce the kinds of movements required for comprehensive orthodontic treatment. With Invisalign, this is now possible. Using advanced computer technology, Invisalign generates a series of customised appliances, called “aligners”. Each aligner is worn sequentially by the patient to produce extensive tooth movements in both upper and lower arches.

How many patients are being treated with Invisalign?

There are over 890,000 patients being treated with Invisalign and the number grows daily. Invisalign was launched in Australia in February 2002 and already over five hundred Australian orthodontists and dentists are accredited to treat patients with Invisalign.

Do orthodontists and dentists’ need special training in order to use Invisalign?

While Invisalign can be used with virtually any treatment philosophy, specific training is needed. All orthodontists and dentists interested in treating patients with Invisalign must attend a training course before cases will be accepted from their office.

How does Invisalign effectively move teeth?

Like brackets and arch wires, the Invisalign aligner moves teeth through the appropriate placement of controlled force on the teeth. The principal difference is that Invisalign not only controls forces, but also controls the timing of the force application. At each stage, only certain teeth are allowed to move, and these movements are determined by the orthodontic treatment plan for that particular stage. This results in an efficient force delivery system.

Does insurance cover Invisalign?

If your insurance policy has orthodontic coverage, Invisalign should be covered to a similar extent as conventional braces as Invisalign is normally prescribed for a full course of orthodontic treatment. However, as medical benefits differ significantly from policy to policy, each patient should check with their health fund.

My insurance company has not heard of Invisalign.

Invisalign is an emerging form of technology within orthodontics in Australia. It often takes insurance companies to formally recognise new technologies in their policies. Please consult your treating orthodontist/dentist to ascertain the type of treatment you will be receiving and determine their billing policies in relation to private medical insurance. Invisalign Australia can provide assistance if necessary.

Does insurance have a guarantee?

Invisalign is an effective at straightening teeth as tradition methods of orthodontics but largely depends upon a patient’s biology and compliance with treatment. As such, Invisalign cannot guarantee that a patient’s teeth will move exactly as predicted.
The treating orthodontist or dentist is responsible to use their experience and skill to treatment plan and monitor the appropriate treatment as it progresses. If necessary, additional treatment with Invisalign or other forms may be needed. Discuss this further with your treating orthodontist or dentist during your initial consulation.

Can I claim any rebate on Invisalign treatment?

Yes. There is a government rebate that is available to a taxpayer whose eligible net medical expenses in the year of income exceed $1,500 (net of Medicare and any health fund refund). The amount of the rebate is 20% of the excess over $1,500 but cannot exceed the amount of tax otherwise paid. The rebate is claimed when the patient lodges their annual income tax return.
For example, a patient undergoes Invisalign treatment at a cost of $6500. Assuming the patient can claim $1000 back from a private health fund and none from Medicare, the rebate would be as follows.
[($6500-$1000-$0) – $1500] x 20% = $800
CASE SELECTION

What can Invisalign treat?

Invisalign does not treat patients. Orthodontists and dentists do, and with experience they can use Invisalign to treat a vast majority of adults and adolescents who want a better smile. For more information on what types of cases can be treated or to see if your type of dentition is suitable for Invisalign treatment, please go to www.invisalign.com.au.

How do I know if I’m a candidate for Invisalign?

Align Technology defers to the professional judgment of the treating doctor in determining how Invisalign can be incorporated into the treatment plan. Align Technology almost never rejects the cases submitted by our doctors, as we currently accept over 98% of all cases we receive but only a orthodontist or dentist who has been Invisalign accredited can determine if

Invisalign is an effective option for you.

What condition would make me unsuitable for Invisalign?

Only the treating orthodontist/dentist is able to determine whether your particular case is suitable to be treated with Invisalign. Three types of tooth movements have found to be less predicably achieved with Invisalign alone:
• Severe derotations of cylindrical teeth
• Complex extrusions
• Closure of large spaces usually associated with extractions of teeth other than lower inscisors.
With more Invisalign experience, doctors may improve the ways they manage the treatment and increase the predictability of these movements.

What is the minimum age that Invisalign can treat?

Almost all teenagers over the age of 14 are eligible for treatment with Invisalign as long as their second (twelve year old) molars are fully erupted.

I am currently wearing braces – can I make the switch to the Invisalign?

Many patients are being treated with some form of combination of braces and Invisalign. You should consult with your orthodontist or dentist to determine the best treatment for you.

Does the procedure work on overbites (overjets) and how?

Yes, Invisalign can correctly mild to moderate overbites. The aligners create a force on the front teeth causing them to intrude, thus correcting the overbite.

Are there certain dental conditions that automatically exclude you from being an eligible patient?

Yes, certain dental conditions can restrict you from being an eligible patient – for further information, please consult your orthodontist or dentist. Cases that are difficult or unsuitable for Invisalign may exclude up-righting severely tipped teeth, cases where not all the permanent teeth have erupted, cases with multiple missing teeth, patients with poor periodontal condition or patients that want to change their facial profile.

Are crowns a factor in Invisalign treatment?

No, crowns are usually not a factor in Invisalign treatment. However, small composites called attachments are sometimes bonded onto teeth to help achieve certain movements. In these cases, the location of crowns must be carefully evaluated by an Invisalign orthodontist or dentist.

Will TMJ affect Invisalign treatment?

TMJ refers to the temporomandibular, or jaw joint. Individuals can have a number of problems with the jaw joint, some of which can be aggravated by appliances and treatments like Invisalign. To find out if your TMJ problem will adversely impact orthodontic treatment consult an Invisalign accredited orthodontist or dentist.

Can Invisalign close gaps (space closure)?

Yes. Spaces between teeth are generally easy to close with Invisalign. However, the size and location of the spaces will need to be evaluated.

Are bridges a factor in Invisalign treatment?

Because bridges firmly link two or more teeth together, they can offer significant resistance to tooth movement. Your orthodontist or dentist will be able to determine whether bridges will be a factor in your treatment.
WHILE IN TREATMENT

How long will it take to begin treatment after the initial consultation?

After or during the initial consultation, your treating orthodontist/dentist will need to take x-rays, photos and moulds of your teeth. These records will be sent to the US to be used to manufacture your custom made aligners. This process will take approximately 6 weeks (from the time the records are sent to the US to the time treatment can begin).

How often must I see the orthodontist/dentist?

Your orthodontist or dentist will schedule regular appointments – usually about once every six weeks. This is the only way your orthodontist or dentist can be sure that the treatment is progressing as planned.

Will the treatment be painful?

Most people experience temporary, minor discomfort for a few days at the beginning of each new stage of treatment. This is normal and is typically described as a feeling of pressure. It is a sign that the Invisalign aligners are working – sequentially moving your teeth to their final destination. This discomfort typically goes away for a couple of days after you insert the new aligner in the series.

Will wearing the Invisalign aligners affect my speech?

Like all orthodontic treatments, aligners may temporarily affect the speech of some people, and you may have a slight lisp for a day or two. However, as your tongue gets used to having aligners in your mouth, any lisp or minor speech impediment caused by aligners should disappear.

Are there restrictions on what I can eat while in treatment?

No. Unlike traditional orthodontics, you can usually eat whatever you desire while in treatment because you remove your aligners to eat and drink. Thus, there is no need to restrict your consumption of any of your favourite foods or snacks, unless instructed otherwise by your orthodontist or dentist. Also, it is important that you brush your teeth after each meal and prior to re-inserting your aligners to maintain proper hygiene.

Can I drink with aligners still on?

You should remove your aligners to drink anything else except water. Leaving aligners on while drinking may stain them and the patient risks decay drinking fluids with sugar in them.

Will smoking stain the aligners?

We discourage smoking while wearing aligners because it is possible for the aligners to become discoloured.

Can I chew gum while wearing aligners?

No, gum will stick to the aligners. We recommend removing your aligners for all meals and snacks.

What’s the best way to clean my aligners?

The best way to clean your aligners is by brushing and rinsing them in lukewarm water. Your treating doctor can also supply you with aligner cleaning crystals.

How often must I wear my aligners?

Aligners should be worn all day, except when eating, brushing and flossing.

Can patients use aligners for bleaching teeth while active tooth movement is occurring?

While we are aware that some patients are using aligners for bleaching, Align Technology, Inc. Has not examine the compatibility of currently available bleaching products with our aligners, nor have we demonstrated efficacy in clinical studies. Align recommends that you consult your orthodontist or dentist for more information on whitening teeth.

What happens after treatment to prevent my teeth from moving pain?

This depends on the outcome of the treatment. Some patients might need a positioner, or conventional retainer. Other patients might need a clear plastic retainer similar to Invisalign aligners. Discuss these possibilities with your treating orthodontist or dentist. Every patient is different and outcomes vary.

What happens if the aligners no longer fit?
In this case you should contact your orthodontist or dentist immediately who will diagnose what remedial action is needed to bring the treatment back on course. This may involve moving back one or two stages in treatment to a previous aligner or possibly some additional orthodontic treatment.

What are the different types of sedation available?

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.

Sedation type 1. – Inhalation sedation
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.

What are the advantages of Inhalation sedation?

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

Who is it not suitable for?

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.

Sedation type 2. – Intravenous sedation
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.

What are the advantages of Intravenous sedation?

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.

Sedation type 3. – General Anaesthetic
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.

Are dental instruments sterilised after each use?

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.

Do dentists and assistants have to wear gloves during treatment?

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

Should dentists and patients wear protective eyewear and face shields?

Such protection should be worn during procedures where splashing, splattering or spraying of blood or other body substances may occur.

Can I protect my mouth if I smoke?

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.

Does smoking affect the teeth, gums or mouth?

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

Does smoking always lead to gum disease?

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)
Does smoking lead to oral cancer?
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.

Does smoking make the teeth loose?

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.

Does smoking stain the teeth?

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.

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.

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.

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 defence 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.

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.

My gums bleed. Is that OK?

No. Bleeding gums are common but not OK. Healthy gums do not bleed. Bleeding is often an indication that the gums are inflamed. The inflammation is generally a response to the bacteria on the surface of the teeth. The bleeding may also arise from Periodontitis or traumatic cleaning. Bleeding gums are sometimes associated with serious medical conditions.

If you have bleeding gums you should get a dental check up.

Who gets periodontitis?

Anyone.

Many people will have a small amount of periodontitis, which gradually increases with age. However approximately 15% of the population will have a significant degree of periodontitis. The destruction of the tooth’s supporting tissues caused by periodontitis gets worse over time when left untreated, and is often seen more severely in the 45+ age group. However the different types of periodontitis may affect people of all ages.

The risk for periodontitis is increased with poor oral hygiene, smoking, diabetes, a family history of periodontitis and a range of medical conditions, in particular those affecting the immune system.

What are some of the warning signs of periodontal disease?

> Bleeding gums when you brush your teeth.
> Bad breath or a bad taste in your mouth.
> Receding gums.
> Sensitive teeth or gums.
> Loose teeth or teeth that have moved.

What can you do?

Visit your dentist, who will examine your gums as part of a normal dental check-up. X-rays are often needed to help diagnose any gum problems.

Good dental hygiene is one of the most important factors in preventing gum disease. Your dentist will show you proper brushing and flossing techniques that will help ensure healthy teeth and gums.

You may need to be referred to a Periodontist who is a specialist in treating gum disease. Treatment involves careful, deep cleaning of the teeth to remove the cause of the problem. This can be done with local anaesthetic.

What technique should I use?

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.

How long should I brush?
Proper brushing should take two to three minutes.

How often should I brush?
You should brush your teeth at least twice a day. Remember it is important to have the right brushing technique as poor brushing techniques can cause harm to the teeth and gums.

Is brushing alone enough?
NO. 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.

How often should I floss?
You should floss at least once a day, every day.

What is the correct way to floss?
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!

What should I do if brushing or flossing makes my gums bleed?
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.

Choosing a toothbrush
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.

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

Dental crowns (also sometimes referred to as ‘dental caps’ or ‘tooth caps’) cover over and encase the tooth on which they are permanently cemented. Dentists use crowns when rebuilding badly broken or decayed teeth, as a way to strengthen teeth and as a 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.

Why are crowns more expensive than fillings?

A crown is more complicated than a filling. Laboratory fees are incurred in its preparation and the materials used are more expensive than normal filling materials.

Two or three visits are usually required for the dentist to reduce the size of the existing tooth, make a mould, fit a temporary crown and finally adhere the permanent crown in place.

Sport, leisure and recreational activities are the most common cause of dental injuries that can often be very painful and require extensive treatment. Mouthguards provide a valuable layer of protection for your teeth during physical activities that carry a risk of dental injury. ‘Off the shelf’ and ‘boil and bite’ mouthguards commonly bought from sporting stores and pharmacies can be very bulky, provide inadequate protection and impede both breathing and communication while they are being worn. A custom fitted mouthguard, however, provides a custom fit that gives a high level of both protection and comfort for patients. The precise fit of our custom mouthguards covers all teeth with the correct amount of protection while fitting snugly into position, preventing the mouthguard from moving around in the mouth or falling out.

A custom fitted mouthguard is a small investment that will help ensure the health of your teeth and reduce the risk of dental injury during physical activity. Don’t put your teeth at risk of damage unnecessarily. Call our friendly team to make an appointment for your custom fitted mouthguard to be made.

Sport, leisure and recreational activities are the most common cause of dental injuries that can often be very painful and require extensive treatment. Mouthguards provide a valuable layer of protection for your teeth during physical activities that carry a risk of dental injury. ‘Off the shelf’ and ‘boil and bite’ mouthguards commonly bought from sporting stores and pharmacies can be very bulky, provide inadequate protection and impede both breathing and communication while they are being worn. A custom fitted mouthguard, however, provides a custom fit that gives a high level of both protection and comfort for patients. The precise fit of our custom mouthguards covers all teeth with the correct amount of protection while fitting snugly into position, preventing the mouthguard from moving around in the mouth or falling out.

A custom fitted mouthguard is a small investment that will help ensure the health of your teeth and reduce the risk of dental injury during physical activity. Don’t put your teeth at risk of damage unnecessarily. Call our friendly team to make an appointment for your custom fitted mouthguard to be made.

What technique should I use?

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.

How long should I brush?

Proper brushing should take two to three minutes.

How often should I brush?

You should brush your teeth at least twice a day. Remember it is important to have the right brushing technique as poor brushing techniques can cause harm to the teeth and gums.

Is brushing alone enough?

NO. 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.

How often should I floss?

You should floss at least once a day, everyday.

What is the correct way to floss?

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!

What should I do if brushing or flossing makes my gums bleed?

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.

Choosing a toothbrush

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.

Choosing a toothpaste

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

  1. Why does a cracked tooth hurt?
  2. How can I prevent my teeth from fracturing?
  3. How does the dentist treat a cracked tooth?
  4. Will my tooth become better?
  5. What type of forces cause teeth to crack?
  6. Why does a cracked tooth hurt?

The crack exposes the inside of the tooth (the ‘dentine’) that has very small fluid filled tubes leading to the nerve (‘pulp’) of the tooth. Flexing of the tooth opens the crack and causes movement of the fluid within the tubes. When you release the biting pressure the crack closes and the fluid pressure simulates the nerve and causes pain.

How can I prevent my teeth from fracturing?

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.

Will my tooth become better?

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.

What type of forces cause teeth to crack?

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.

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.

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.

How can you prevent dental caries?

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:

        1. Being careful with how often you eat sugary foods or have sugary drinks.
        2. Brushing and flossing your teeth carefully to reduce the amount of bacteria on their surfaces.
        3. 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.

Why is saliva important?

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:

        1. Medications that you may be taking that may have a drying effect in the mouth
        2. Excessive intake of caffeine. Caffeine is found in coffee, tea, chocolate and cola drinks. It draws fluid from the body and reduces saliva.
        3. Working in a dry environment and not rehydrating often enough
        4. 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.

What happens when my saliva is not adequate?

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.

How do dentists treat dental caries?

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.

How important is my diet in preventing and treating dental caries?

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.

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’.

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.

Is everyone suitable?

Some people may not be suitable for this procedure. Conditions such as alcoholism, some psychiatric disorders and uncontrolled diabetes can cause problems. Your dentist will also need to check to see how much bone you have and whether there is enough space for an implant. The adjacent teeth roots will also need to be away from the implant. If you don’t have enough bone, it is possible to grow bone or even graft bone from elsewhere in the mouth or places like your hip.

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.

What happens if an implant fails?

This means the implant has not attached or integrated to the bone. It usually fails at the second stage surgery. The failed implant is unscrewed, the bone left to heal for a while and a new implant placed. Other options such dentures or bridges are also available.

What is the procedure for implant treatment?

The gum is folded back and the bone drilled to receive the implant. You may have this done in the chair with local anaesthetic or go into the hospital for a general anaesthetic. The implant is generally covered over and left to heal until the implant is osseointegrated. Your oral surgeon or periodontist may also leave the implant uncovered by the gum at this first stage. A second operation may then be needed to uncover the top of the implant. Your dentist or prosthodontist can usually start construction of your crown or a bridge after a month.

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 is implant treatment expensive?

Because it is a complex process requiring expensive precision components and instruments.

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 function with you.

Are implants complicated?

The simple answer is no, if sufficient bone is available to accept the implant. The procedures can all be done in the dental surgery, using only local anaesthesia. In the first stage of surgery, the implant root component is inserted into the bone site.

This surgery generally takes about sixty minutes to complete. After six to ten days, the stitches are removed and the buried implant is allowed to heal for about three to six months. During this time, bone grows into the implant surface to secure it.

The second stage of surgery is very simple and lasts only about thirty minutes. During this stage, the buried, secure implant is uncovered using a small incision in the gum tissue. A post is attached to the implant until the final prosthesis is complete, which can take as little as two weeks. There is minimal discomfort associated with either of these surgical steps, certainly no more than having a tooth extracted, and usually less. Dentist prescribed medication can alleviate any uneasiness. Improved aesthetics, function and quality of life follows in a few weeks with your new prosthesis fitted.

How long will an implant last?

This is impossible to predict. Though research has demonstrated a long life once the implants have been integrated with bone, each patient is different, and longevity may be affected by overall health, nutrition, oral hygiene and tobacco usage. Individual anatomy, the design and construction of the prosthesis and oral habit s may also have an influence.

What is the cost of an implant?

In general, costs are closely comparable to those of other prostheses involving fixed bridgework. The uniqueness of each patient’s restorative needs means this should be discussed with your dentist.

Are there any limitations?

Discuss this with your dentist, as there are a few medical reasons preventing the use of implants. Sufficient bone to accept the implant is the major limiting factor. This can be assessed radiographically (x-rays), and bone can even be augmented where it is deficient.

Are there alternatives to water fluoridation?
There are no other cost-effective preventive schemes that benefit the total community like water fluoridation. Health conscious parents and individuals outside fluoridated areas can use personal fluoride supplements such as tablets and drops. But they do not work as well as fluoride in drinking water, are more expensive, require continuous motivation and compliance, and only reach a small part of the population.

What is fluorosis?
Dental fluorosis is a condition that occurs in teeth due to over intake of Fluoride. This can appear as small white flecks on the surface enamel of teeth. In minor cases it is usually not visible to patients but in more advanced cases it appears as large white patches or occasional pits in the tooth surface. After some years, stains may penetrate the white patches and they can appear brown. This can occur by eating or swallowing excessive amounts of toothpaste or exceeding the dose when taking fluoride tablets. It can also occur where there is excess fluoride in natural water supplies or a combination of all three. In extreme or severe cases of fluorosis the teeth are unsightly and may need treatment to improve their appearance.

Water fluoridation alone does not cause fluorosis but it can happen in combination with other sources of fluoride

Common questions about fluoride

WHAT IS FLUORIDE?
Fluoride is the ion that comes from the naturally occurring element, fluorine. Fluorine is never encountered in its free state in nature because it combines with other elements as fluoride compounds in the earth. Water dissolves these compounds, creating fluoride ions that are present in all water sources, including the oceans.

HOW DOES FLUORIDE STOP TOOTH DECAY?
Fluoride reduces the number of cavities an individual will develop in their life by about half. This is because it makes the enamel of the tooth more resistant to the acid attacks of plaque bacteria. Resistance occurs initially when the fluoride is incorporated into the teeth during their formation and secondly, as fluoridated water washes over the surface of the erupted teeth.

ARE SOME PEOPLE ALLERGIC TO FLUORIDE?
There has never been a case of an allergy to fluoride. If a person was allergic to fluoride they could not drink present water supplies because all water contains some fluoride. Similarly, because of its natural abundance in nature, fluoride is contained in virtually all food and drinks. People allergic to fluoride would also be allergic to tea, coffee, mineral water and seawater.

ARE THERE ALTERNATIVES TO WATER FLUORIDATION?
There are no other cost-effective preventive schemes that benefit the total community like water fluoridation. Health conscious parents and individuals outside fluoridated areas can use personal fluoride supplements such as tablets and drops. But they do not work as well as fluoride in drinking water, are more expensive, require continuous motivation and compliance, and only reach a small part of the population. There is also the danger of accidental overdose with any tablets or drops.

HOW MUCH FLUORIDE IS IN FLUORIDE TOOTHPASTE?
Children’s toothpaste contains between 400 and 500ppm (parts per million). One part per million is the equivalent of one milligram per litre. Adult’s toothpaste contains between 1000 and 1100ppm. Toothpaste should not be used on children under the age of two years. Over two years of age only a ‘pea-sized’ smear of toothpaste should be used, as young children have not developed an adequate spit-out mechanism.

WHAT IS FLUOROSIS?
Dental fluorosis is seen as small white flecks in the surface enamel of teeth. In minor cases it is usually not visible to patients but in more advanced cases it appears as large white patches or occasional pits in the tooth surface. After some years, stains may penetrate the white patches and they can appear brown.

Receiving excess doses of fluoride during the formation of teeth causes fluorosis. This can occur by eating or swallowing excessive amounts of toothpaste or exceeding the dose when taking fluoride tablets. It can also occur where there is excess fluoride in natural water supplies or a combination of all three. In extreme or severe cases of fluorosis the teeth are unsightly and may need treatment to improve their appearance.

Water fluoridation alone does not cause fluorosis but it can happen in combination with other sources of fluoride.

How much fluoride should I give my child?
Given at optimal levels, fluoride can strengthen teeth and help prevent tooth decay. The correct amount of fluoride to give your child depends upon his or her age and whether or not the local water contains fluoride. Your dentist at Dental Avenue can advise you on the amount of fluoride needed to meet your child’s needs.

Who should use fluoride toothpaste?
Regardless of the presence or absence of water fluoridation, or the taking of fluoride supplements, everyone should be encouraged to brush their natural teeth with fluoride toothpaste.

Fluoride toothpaste tubes should carry advice that for children under the age of six years, brushing should be supervised, and only a “pea” sized smear of toothpaste should be placed on the brush. Thorough rinsing is recommended and children should be instructed not to swallow the toothpaste.

Common questions about water fluoridation

WHAT IS WATER FLUORIDATION?
All water supplies have some natural fluoride in them and the water fluoridation process just involves adding or removing fluoride to the level that protects dental health. It does not involve adding anything to the water that is not already there. There is no chemical difference between fluoride present naturally and that which is added to the water supply.

WHAT ARE THE BENEFITS OF WATER FLUORIDATION?
Drinking fluoridated water increases the resistance of teeth to decay, resulting in fewer cavities. This means fewer fillings, fewer extractions, fewer visits to the dentist and lower dental bills – resulting in better smiles, fewer dentures and less pain and suffering. Fluoridation will help to reduce the number of school or working hours or days that are lost due to dental problems or visits to the dentist.

Fluoridation will also help in the prevention of aesthetic problems associated with decay, especially in the front teeth, problems with discomfort and problems with self-esteem. Fluoridation also indirectly reduces orthodontic problems.

This benefit applies to all teeth (baby and adult) and to all age groups in our community. All teeth, at all ages, benefit as the fluoridated water has a continuous topical action.

Despite the availability of other sources of fluoride (tablets, drops, toothpaste, professional applications), water fluoridation is still shown to be the most appropriate means of reducing tooth decay in the twenty first century. The magnitude of the fluoridation benefits has decreased in recent decades, but they are still in the range of a 20-40% reduction in tooth decay in fluoridated areas.

There is ample evidence that if water fluoridation ceases, the rate of tooth decay increases despite the use of fluoride toothpaste and supplements. The decay rate decreases again when fluoridation is re-introduced.

A community that fluoridates its water today will have teeth with approximately half as many cavities in 10 years’ time.

IF I LIVE IN A NON-FLUORIDATED WATER AREA, WHAT AMOUNT OF FLUORIDE SUPPLEMENT SHOULD I TAKE?

Fluoride tablets or drops should be used according to the following guidelines proposed by the Dental Health Committee Discretionary Fluoride Panel of the National Health and Medical Research Council.

Daily fluoride supplements are to be used ONLY in cases where the natural fluoride content of your drinking water supply is less than 0.3 mg per litre.

If you are not sure whether you water supply is fluoridated, check with your dentist at Dental Avenue for appropriate advise.

WHO BENEFITS FROM WATER FLUORIDATION?
People of all ages benefit from water fluoridation.

Children benefit from the tooth decay preventive effects of water fluoridation with less tooth decay in their first and second set of teeth. Existing fillings in teeth last longer where water is fluoridated as there is less decay starting again where the filling meets the tooth surface.

The elderly and those with disabilities that prevent adequate cleaning of their teeth (including those in nursing homes), or those who require assistance with tooth brushing, will benefit from water fluoridation. This group is particularly susceptible to decay around the gum line of their teeth and water fluoridation would lower this risk factor.

Water fluoridation reduces decay and lessens the need for dental intervention. Dental treatment creates additional problems for some (e.g. diabetics, haemophiliacs, transplant patients, the immune compromised) for whom a healthy mouth is essential.

Water fluoridation is particularly beneficial in providing a preventive health measure to lower socio-economic groups who may have difficulty in implementing their own preventive care. Public health education has been shown to be effective only in the higher socio-economic groups.

An enormous amount of research has been published on the safety of water fluoridation, including any effects on the older members of the community who may have very few teeth or none at all. This extensive research has revealed no adverse health effects on the elderly or any other age group.

IS WATER FLUORIDATION ‘MASS MEDICATION’?
No. Fluoridation is not mass medication any more than other disease prevention health measures. It is not a ‘foreign chemical’ in a water supply, but a naturally occurring element that reduces dental disease. Along with pasteurisation, water purification, and immunization, fluoridation is considered one of the four most important and successful public health measures of the twentieth century.

DOES MY WATER FILTER REMOVE FLUORIDE?

Some filters do and it is important to check with the manufacturer or supplier.

Generally speaking:

        • Filters That Remove Fluoride:
        • Ion Exchange Filters
        • Reverse Acinous Filters and Distillers

Filters That Don’t:

        • Carbon Filters
        • Ceramic Filters

ARE THERE ANY GENERAL HEALTH SIDE EFFECTS?
No. Drinking optimally fluoridated water is not harmful to human health.

Many cities throughout the world have large amounts of natural fluoride in their water supply without water fluoridation. Artificial water fluoridation was introduced over 50 years ago, providing many opportunities to study fluoridation’s side effects. The only effects of water fluoridation that have been scientifically proven are those that benefit teeth.

Numerous studies have shown that consumption of fluoride in community water supplies at the level recommended for optimal dental health has no harmful effect in humans. For generations, millions of people have lived in areas where fluoride is found naturally in the drinking water in concentrations as high as or higher than those recommended to prevent tooth decay. Research conducted among these groups confirms the safety of fluoride in the water supply.

Fluoride’s safety has been monitored for the past fifty years through over 30,000 studies, and no evidence has ever been found that water fluoridation causes any health side effects.

HAS THE ISSUE BEEN FULLY INVESTIGATED IN AUSTRALIA?
Five major inquiries have addressed the issue of water fluoridation in Australia. Most were prompted by claims that new evidence showed water fluoridation to be either harmful or ineffective. Each investigation took many months to examine all available information. All the inquiries found the allegations to be unproven and fluoridation to be safe, effective and economical.

These reports are:

        • Report of the Royal Commissioner into the Fluoridation of Public Water Supplies (Hobart, 1968),
        • Report of the Committee of Inquiry into the Fluoridation of Victorian Water Supplies for 1979-80 (Melbourne, 1980),
        • Inquiry into Water Fluoridation in the ACT by the Standing Committee on Social Policy (1991),
        • The National Oral Health Survey 1987-1988 (which provided a database for Australian oral health), and
        • Report by the National Health Medical and Research Council on the Effectiveness of Water Fluoridation (1991). See NHMRC document ‘The Effectiveness of Water Fluoridation’.

WHO SUPPORTS FLUORIDATION?
Water fluoridation is supported by the World Health Organisation (World Health Assembly, 1978), the Australian Dental Association, the Australian Medical Association and the National Health Medical and Research Council.

75% of Australia is currently fluoridated. In 1995, enabling legislation was passed in California for water fluoridation, so virtually all major cities in the United States of America are fluoridated.

HOW COST-EFFECTIVE IS WATER FLUORIDATION?
Water fluoridation is the most cost-effective and socially equitable method of tooth decay prevention for all members of a community.
Cost varies with the size of the population fluoridated, but averages about $1 per person per year according to American figures (Garcia, 1989). Therefore it is likely to cost less to provide a lifetime of fluoridation to an individual than it costs for a single dental filling.

CONCLUSION:
Water fluoridation is a safe, equitable, cost-effective public health initiative that responsible state and local governments should implement to reduce dental pain and disease throughout Australia.

What do I do first?
This is dependent on the severity of the problem. If there is a slight bruise or cut to the lip or tongue there may be no need for treatment. More severe lacerations will require treatment by your doctor of dentist. Any chips or fractures of teeth should be assessed and /or treated by a dentist. Traumatic injuries to the teeth and oral structures must be followed up in order to assess healing of tissues and provide further definitive treatment where indicated.

What if a tooth is broken, loose or missing?
It is common for a small chip to break from a tooth, a tooth to fracture, a tooth to be pushed out of position, or a tooth to be completely knocked out. Generally speaking, you should not try to replace a loose baby tooth, but you should always make an appointment with your dentist to have it checked. However, a loose, displaced, or knocked out adult tooth is a different story and requires immediate attention from your Dentist!

What can be done?
Small chips broken from teeth do not normally require urgent treatment. Often your dentist will just need to smooth the rough edges, or if the chips are larger, repair them with some tooth coloured resin. Make sure you try to find all the broken bits as some pieces can be re-bonded to the tooth with excellent results.

A tooth that has more than a small piece fractured needs careful assessment. If the tooth is acutely sensitive to breathing air, this is usually a sign that the fracture is deep and needs urgent care. Once the fracture is covered by a protective layer, the sensitivity usually subsides.

Your dentist should assess loose permanent teeth. An x-ray will often be taken of the tooth to rule out the possibility that the root has been fractured. If the tooth is very loose, your dentist may need to splint the tooth to the neighbouring teeth to stabilise it while the injury heals.

Teeth that have been displaced are easiest for your dentist to reposition very soon after the injury, so it is best to seek immediate treatment.
Will a root canal be necessary?
Your dentist will monitor the vitality of any injured tooth and advise you if endodontic (root filling) treatment is necessary.

Teeth that have been knocked out commonly require endodontic (root filling) treatment.

SAVE THAT KNOCKED OUT TOOTH

An adult tooth that has been knocked out should be immediately put back into the socket if possible, and you should see a dentist immediately! You should avoid touching the root section of the tooth. If the tooth is very dirty, rinse it quickly, preferably with milk, and replace it in the socket, using the position and shape of the teeth either side as a guide.

If the tooth has been out for a period of time it may be difficult to replace correctly . You can hold the tooth in position by folding several thickness of aluminium foil over the tooth and the teeth either side or hold in place with fingers. If you can’t replace the tooth in its socket, the next best thing is to put it in a glass of milk and take it to a dentist immediately. If you don’t have access to milk, place it in plastic wrap, and again, get to a dentist straight away! Handle the tooth as little as possible and do not touch the root section of the tooth. The sooner a knocked out tooth is replaced, the better the long-term prognosis for the tooth. Teeth replaced within thirty minutes have a good chance of surviving long term, but it is well worth replacing a tooth even if it has been out for a number of hours

Your dentist will stabilise a knocked out tooth by joining it to the neighbouring tooth for a period of time while the injury heals

1. 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.

2. Why do I need root canal treatment?
If you have a damaged or injured tooth, root canal treatment may help to save it. Inside your tooth is soft tissue containing nerves, and blood and lymph vessels, known as the tooth pulp. When the pulp cannot repair itself from disease or injury, it dies. A fracture in a tooth or a deep cavity commonly cause pulp death, as the pulp is exposed to bacteria found in your saliva.

When the pulp becomes infected, it is best to remove it before it spreads to the tooth and surrounding tissues. The whole tooth may be lost if the infection is left untreated. Root canal treatment can save your tooth.

3. What is root canal treatment?
Your dentist at dental avenue may perform root canal treatment to find the cause of your tooth’s problems. It is a safe and clinically proven way to save teeth. The diseased pulp is removed, while you keep your tooth.

4. What is the dental pulp?
The pulp is the soft tissue inside your tooth that carries the vessels (blood and lymph), nerves and connective tissue. It extends from the crown of the tooth right to the tip of the root (in the bone of the jaw).

5. 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 or pus can form in the root tip. This can eventually cause damage to the bone around the teeth.

6. Why does the pulp need to be removed?
Initially, you may experience pain and swelling from an infection. Damage to the bone surrounding your tooth can also result. Without root canal treatment, your entire tooth may have to be extracted.

7. What does treatment involve?
Root canal treatment may involve one to three visits to the dentist. A general dentist or an Endodontist (a specialist in pulp problems) will remove the pulp of the tooth. They will then clean and seal the pulp chamber and root canal/s.

STEPS INVOLVED IN ROOT CANAL TREATMENT:

  1. An opening is made through the crown of the tooth into the chamber where the pulp is found.
  2. The pulp is removed, and the root canal/s are cleaned and shaped into a form that can be filled easily.
  3. Medications to prevent infection may be placed in the pulp chamber.
  4. Your dentist may leave the tooth open in order for it to drain, however often a temporary filling is placed in the crown of the tooth to protect it until your next visit. Antibiotics may be prescribed to help prevent infection.
  5. The temporary filling will be removed, and after cleaning, the pulp chamber and root canal/s will be filled.
  6. Finally, your dentist may place a crown (either porcelain or gold) over your tooth.
  7. How long will the restored teeth last?

If you look after your teeth and gums, your root canal treated tooth may last a lifetime. However, you must have regular checkups to ensure that the tissues around it are nourishing the root of your treated tooth.