Frequently Asked Questions

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 that smoking changes the saliva to a more harmful consistency.

With proper attention to diet, oral self-care, regular dental check-ups, and the correct use of mouthguards to prevent injury, the need for fillings can be eliminated, and the frequency of filling re-placement can be extended

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. You should brush for 2-3mins, at least twice a day, and floss at least once a day.

People accumulate plaque at different rates. Normally every 6 months is sufficient.

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!

Some people claim that the mercury in dental amalgam can cause or affect a wide range of medical conditions. In providing advice on this matter to its member dentists, the ADA draws its opinion from credible scientific and medical bodies such as the World Health Organisation and the National Health and Medical Research Council (NHMRC) in Australia.

The World Health Organisation and the World Dental Federation have released a joint statement confirming the safety of dental amalgam as a filling material.

The NHMRC released a working party report in 1999 that looked at this issue. You can view a summary here or view the entire report at www.nhmrc.gov.au. This report concluded that:

“No pivotal study has been published over the past 5-10 years providing unequivocal evidence of any hazard from the levels of mercury presently resulting from dental amalgam restorations.”

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.

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.

If the crack goes too far vertically, there is a possibility the tooth may need to be removed and replaced with an artificial one. (See bridgework, denture, and implant)

The nerve may sometimes be affected so badly that it dies. Root canal treatment will be required if the tooth is to be saved.

Your dentist is required by law to take and x-ray before a dental extraction. The x-ray helps the dentist to show where the nerves are to avoid lone term numbness, if your tooth has curved roots, and infections. If a dentist doesn’t take an x-ray there is a possibility of multiple complications which could have been avoided.

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 removal of the tooth. However, many cracks can be fixed without root canal or tooth removal.

No. Bleeding gums are common but not OK. In a healthy state 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 surface inflammation is Gingivitis. The bleeding may also arise from Periodontitis or traumatic cleaning. Bleeding gums are sometimes associated with serious medical conditions.

A dental practitioner should check bleeding gums.

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.

Healthy gum tissue does not bleed. This is most likely a sign of early gingivitis. If you experience bleeding gums, see us to review proper brushing and flossing techniques.

Gum bleeding must be taken seriously because if left untreated, it will lead to periodontal disease.

Dentists use an autoclave that is a steriliser which uses steam under pressure to achieve a rapid high heat sterilisation of instruments.

Dentists use autoclavable equipment and instruments. Otherwise they can use disposable items wherever possible. The general standard of infection control in all surgeries in Australia is excellent.

An independent survey conducted by Coopers and Lybrand in 1994 showed that each dentist is spending an additional $24,000 (approximate) per year on implementing responsible infection control measures.

No treatment can be “guaranteed”, either in terms of its ‘cure’ or by a length of time.

A dentist is a skilled professional who practices with the utmost care and responsibility. A dentist cannot foresee what may or may not happen due to natural causes (“Mother Nature”) or unpredictable complications.

A dentist should discuss with a patient the prognosis, or likely outcomes of various treatment options, on which a patient can base a final decision.

If you feel dissatisfied with work that has been provided, you should first discuss the matter with your treating dentist. After this discussion if you still feel you wish to take the matter further, you could seek a second opinion and/or contact the ADA Community Relations Officer, or the Health Services Commissioner. Both Officers have conciliatory roles in trying to resolve the situation to the satisfaction of the parties concerned.

• 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.

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.

Dentists who undergo further training after their initial dentistry degree are called specialists. Dental specialists restrict their practice to a specific area of dentistry. Your local dentist has had extensive training to be an “oral physician”. This training enables your dentist to treat you as a person and understand all your dental requirements. In most cases, your local dentist will be able to undertake most of your treatment needs. In some cases, he or she may elect to have the assistance of specialist dentists to ensure you receive the highest quality treatment. There are many forms of dental specialties, some of which are outlined below.

Endodontists diagnose, treat and help to prevent diseases of the root canal (dental ‘nerve’) and its surrounding tissues;

Oral/maxillofacial surgeons surgically treat injuries, abnormalities, and diseases of the tissues of the oral cavity and its adjacent parts and are called upon to remove difficult wisdom teeth and place dental implants.

Orthodontists rearrange the natural teeth for functional and cosmetic reasons. They diagnose and treat wrongly-spaced, crooked, misplaced or prominent teeth in children or adults.

Paediatric dentists deal with children’s oral health needs from birth to 18 years of age including those with special health care needs. Paediatric dentists focus on prevention and management of disease or growth disturbances in the infant, child or adolescent involving either the primary or permanent dentitions. Treatment under conscious sedation or general anaesthesia is an integral part of specialist practice.

Periodontists treat gum diseases and are called upon to place dental implants.

Prosthodontists undertake the advanced restorative treatment of teeth and surrounding tissues by artificial means (replacement of missing teeth and supporting structures e.g. dentures, crowns, bridges and implants).

Oral Pathologists diagnose pathological conditions in the mouth.

Sometimes your dentist will refer you to a specialist for an expert opinion and/or treatment.

The best way to overcome your fear is to discuss your concerns with your dentist. Experiences as a child may become distorted by time and reinforced by outdated media presentation of stereotypes. Much has changed, thanks to technology and education, and dentists are skilled professionals in dealing with patients who are apprehensive about seeking treatment.

This will obviously be a team approach between you and your dentist and his/her staff. Communication is the key. You must feel comfortable expressing your fears and concerns and have a sense that you are being listened to.

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.

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.

The Quit program from the Anti-Cancer Council gives excellent advice on how to help you give up smoking (www.quit.org.au).

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

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.

If you have your tongue pierced and have inserted a stud (or other adornment), you are risking painful damage to your teeth — like the eighteen year-old who needed repairs to six fractured teeth.

Tongue piercing carries a risk of injury to the vital structures within the tongue, as it is full of muscle fibres, blood vessels and nerves. Apart from its function in speech, the tongue also acts as the carrier of many specialised taste buds.

It is advisable to contact your dentist prior to having oral piercing done so areas at risk can be located and you are given enough information about future complications to make an informed decision.

Piercing can result in serious problems, such as trauma to teeth (due to constant hitting with a metal object), interference with chewing and speaking, hypersensitivity to metals, foreign debris in the pierced site leading to infection, and difficulty in breathing from airway obstruction due to swelling from infection.

The mouth is teeming with bacteria, which cause no harm unless they get into deeper tissues. Piercing allows these bacteria to penetrate to the inner tissues of the tongue, where they have the potential to cause serious infections.

Piercing also puts you at risk of contracting blood borne hepatitis. Additionally, this can result in secondary infection, which can also be serious.

Dentists point out that metal inserted into the tongue constantly hits the teeth and can chip or fracture the enamel, sometimes leaving the nerve exposed. Microscopic cracks, which are difficult to diagnose, may also appear, causing severe pain. Damage can be so severe a full crown may be the only way to save the tooth — and the smile.

Horror stories have also been reported of studs dislodging and pins becoming “lost” inside the tongue, requiring oral surgery to retrieve them.

A patient’s dental records and x-rays are the property of the dentist. They are a professional’s working notes used in the planning and performing of treatment.

You may seek access to the information held about you and the dentist will provide this access without undue delay. This access might be by inspection of your dental records at the time of appointment or by special access or copying of information at other times.

There will be no charge made for requesting this information but there may be fees levied just to cover the costs associated with the processing of this request or the copying of information.

Under the some state regulations, the owner of the x-ray equipment is required to provide a copy of an x-ray on receipt of a written request from the patient, but at the expense of the patient.

If you are changing dentists, you could give written permission for your new dentist to seek a copy of a record of your treatment from your previous dentist, or request your current dentist to forward them on to your new dentist.

It is far better for all records to be forwarded directly from dentist to dentist to prevent the loss of these important records during your move. Some dentists provide a summary of relevant treatment which is usually all that is needed by the new dentist. In most cases it is not necessary for your dentist to have your old records.

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 aluminum 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 30 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 neighboring tooth for a period of time while the injury heals

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.

Your dentist will monitor the vitality of any injured tooth and advise you if endodontic (root filling) treatment is necessary.

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 is the best person to advise you on the amount of fluoride needed to meet your child’s needs.

See http://www.ada.org.au/OralHealth/flnfront.aspx for more detailed information on fluoride and water fluoridation.

There is no reason why a pregnancy should cause you to lose your teeth unless you ignore them totally.

During pregnancy the gums become more sensitive to bacterial irritation and may show an increased inflammation response. The type of bacteria around the teeth may also change to a type more associated with the cause of periodontitis. It is very important to maintain good oral hygiene and have regular dental checks during pregnancy.

Periodontitis can show a family tendency. So if a mother or father has periodontitis then there is an increased risk for their children to have periodontitis. Regular dental checks for periodontitis are even more important for those at higher risk for periodontitis.

Tooth decay can still be a common problem in infancy and childhood. Over the past few decades, despite the general reduction in dental tooth decay, early childhood tooth decay is still common.

Early visits can prevent minor problems from becoming major ones. Your dentist will be able to detect early decay. Teach good habits early, as good habits start young for a lifetime of healthy teeth and gums. Brush frequently to keep plaque levels low, reduce snacking and begin dental visits early.

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.

For many people teeth whitening poses no serious risk if done correctly. However, if you choose the wrong treatment for your teeth or that treatment is applied incorrectly (e.g. whitening products are often used too frequently or applied for too long a time) then some damage can occur. The main problems and side-effects can be:

• Reduction in the hardness and strength of enamel
• Damaged and inflamed gums
• Blistering
• Severe tooth sensitivity
• Irritation and possibly bleeding in the oesophagus and stomach if some of the bleaching agent is ingested

If you have crowns, veneers or fillings these will not change colour at all after bleaching so you could end up with multicoloured teeth

On the product side, some whitening treatments are very highly concentrated and are well over the officially recommended level of 6% for the active whitening ingredient. Find out what’s in the product you want to use as they can range from 3% to 35%!

There are a couple of easy and cost effective ways to keep your teeth looking whiter and brighter, naturally. Chairman of the ADA’s Oral Health Committee, Dr Peter Alldritt, says the best way to keep a healthy white smile is to maintain good oral health.

“Practising good oral hygiene is a basic way to assist in making your teeth look whiter naturally.” “Brushing and flossing your teeth daily assists in removing surface stains on your teeth,” Dr Alldritt says.

For healthier and better looking teeth, you should:

• Brush your teeth twice a day for two minutes using a fluoride toothpaste
• Floss your teeth daily
• Chew sugar-free gum if advised by your dentist
• Drink water throughout the day
• Consume a sensible diet
• Visit your dentist regularly for a professional clean

Relining involves an additional fee, but this is going to be cheaper than a new set of dentures and it is often very much appreciated.

All dentures lose their fit through natural changes in your mouth. Chewing gum, biting your nails or grinding your teeth can accelerate this. You should see your dentist yearly for a denture check, when refitting or relining may be necessary. For example, many patients report that their full dentures are loose after a period of rapid weight loss.

Extrinsic stains are superficial stains found on the surface of the tooth, which are caused by dental plaque, tars (in tobacco), tannins, coloured foods and frequent use of certain mouthwashes. Common foods and beverages that stain teeth include:

• herbal and black tea
• coffee
• red wine
• spicy foods like curries

Smoking cigarettes also causes unsightly stains on teeth, which can be extremely difficult to remove

Extrinsic stains on the tooth’s surface can be removed by a dentist performing a professional scale and clean.

The common problems that can arise with impacted teeth are infections of the gum around the teeth, decay and resorption of adjacent functioning teeth, and gum disease around the molar teeth.

Rare complications are cysts and tumours that can grow around impacted teeth. Some people feel that impacted wisdom teeth can contribute to crowding.

For those who play contact sport, most fractured jaws occur at the site of impacted teeth, as they can create a point of weakness. Most footballers who have broken their jaws have not had their wisdom teeth removed.

Infections are by far the most common problem, and although they can respond to antibiotics, the only real way to treat it is to remove the source of the problem. A small number of people who do not treat these infections seriously, especially people with other health problems, can have severe, even life threatening complications with wisdom tooth infections.

All dentists are trained in removal of teeth, however sometimes you may need to be referred to a specialist Oral and Maxillofacial Surgeon who can remove your wisdom teeth for you. You will need to be seen for a consultation and have an OPG (Jaw x-ray) taken of your mouth so the dentist can make an informed decision to whether or not a specialist will need to be involved.

Yes, as with any surgery, post operative pain, swelling, bruising and infection can occur. Other consequences of wisdom tooth removal may include, difficulty in opening the mouth, sore lips, and bleeding.

There is a small risk with the extraction of lower wisdom teeth, of nerve damage that may cause numbness of the lip or tongue.

Discuss the above risks and consequences of wisdom teeth surgery with your dentist and/or Oral and Maxilofacial Surgeon before having your wisdom teeth out.

No. When there is adequate room the wisdom teeth can erupt into the mouth in the correct position and function as a valuable asset or they may remain unerupted and cause no problems. However, this is usually not the case.

It is usually wise to have an orthodontic consultation around nine years of age. Some orthodontic problems are easier to correct if detected early, rather than waiting until jaw growth has slowed. Early examination allows the orthodontist to detect and evaluate problems and plan appropriate treatment. Early treatment may prevent more serious problems from developing or make treatment at a later age shorter and less complicated. However, in other cases, treatment will not commence until all the baby teeth have been lost

After use, mouthguards should be rinsed in cold, soapy water. They can be disinfected occasionally with a mild disinfectant solution or mouth rinse.

A mouthguard should be stored clean and dry in a plastic container ready for its next use. As mouthguards can distort under higher temperatures, they should be kept in a cool place, not in the back of a hot car on a sunny day.

For adults, a mouthguard can last several years depending on the frequency of use. If major changes occur to the teeth, such as large restorations or loss of teeth, the mouthguard may not fit as well as originally and may need to be replaced. If the mouthguard material has been bitten through during use it should also be replaced.

For children, if changes occur to their mouth due to growth, the loss of deciduous teeth, or the eruption of the adult teeth, then their mouthguard may need to be changed annually or even more frequently. Remember, a poorly fitting mouthguard may be providing little protection and is less likely to be worn by children because they are uncomfortable.

If you currently wear removable dentures of any kind, it is advisable that you have these checked regularly. It is recommended if you have any remaining natural teeth you should have these and your dentures reviewed every six months or as directed by your dentist. If you have no natural teeth and wear removable full dentures, your dentures should be reviewed at least every two years.

We do expect payment on the day of treatment. This practice reflects the problems dentists have traditionally experienced of lack of payment of accounts, and the widespread availability of payment methods such as credit cards.

Interest free payment plans are available through zipMoney. You can apply for an account or payment plan by visiting www.zipmoney.com.au or call us at Fernvale Dental.

Often the large laboratory costs incurred by dentists for such things as crowns and dentures will be asked to be paid at the commencement of treatment. Your dentist will inform you of your obligations in this regard.

Health funds have assessors who determine the level of rebate for particular dental items. There is a balance between the rebate and the level of premium you pay, the type of cover and other factors such as waiting periods, annual limits and any promotional offers.

As a consumer, you choose the private health scheme that best suits your needs.

Most have fixed rebates for treatments irrespective of the actual fees charged. The rebates are generally not designed to provide full cover for dental fees or even a consistent percentage. In addition, most schemes do not include all treatment items. Some common treatments have no rebate at all.

Remember:

1. Your contract with the health fund is between you and the fund. It remains separate from the contract you have with your dentist.

2. There is no such thing as a ‘recognised fee’ or ‘schedule fee’ in dentistry and the ADA states categorically that any organisation that implies that their rebates are set to a percentage of a ‘schedule fee’ is misleading the public, regardless of whether it is an ‘internal’ schedule.