FILLINGS
Dentists have two types of filling we can use. The old amalgam/silver
type and the newer white colored (composite). Most fillings we do
are composite these days. They look better and the dentist doesn’t
have to remove as much tooth structure compared to amalgam. This is because the composite fillings adhere to the tooth structure.
We most commonly use fillings for decay or broken teeth.
COMPOSITE (WHITE) FILLINGS
Are a plastic and glass mixture that’s close to the colour of your natural teeth.
Are strong and durable
Aesthetically pleasing
You may experience some sensitivity for a few days as the tooth settles
Will last longer if you practice good oral hygiene, have healthy eating habits and visit us for check – up and cleaning .
ROOT CANAL THERAPY:
RCT is required when the tooth in question is either infected (abscessed) or severely inflamed. The only alternative option is to extract the tooth.
Damage can occur from:
- Cracks in teeth and under fillings can cause a tooth to become abscessed or inflamed as well.
- Gum disease
- Trauma
- Extreme wear
- Prior extensive dental work
- Decay (bacteria) getting into the nerve system of the tooth (the root canals and pulp chamber)
In root canal therapy, we make a small opening to where the tooth’s nerves and blood vessels are. We clean the space, dress it, seal it and cover it with either a filling or a crown to strengthen.
Here at Boulton Dental we use a Zeiss microscope to assist with root canal therapy, which improves accuracy of treatment.
EXTRACTIONS:
Wisdom teeth:
Wisdom teeth can be a nuisance and start to show up around 16 years of age. If they come up properly (or don’t come up at all), you may go through life quite happily with no problems.
If wisdom teeth are half up and getting sore enough that you can’t eat, then that can be a problem.
Check with us for specific advice on your particular situation.
You’ll be happy to know we no longer recommend that you remove all your wisdom teeth.
General extractions:
Sometimes despite our best efforts, teeth are beyond repair and need to be removed.
They also may need to be removed for orthodontic treatment.
At Boulton Dental we are able to remove most teeth. Some are very simple and others require a surgical approach.
Contact us for an appointment to assess your teeth and provide options.
IMPLANT
A dental implant is an artificial tooth, which is inserted into the jawbone. They are designed to last for many years.
Dental implant techniques can replace one tooth or multiple teeth. Most implants are made from titanium, which strongly integrates with surrounding bone.
Treatment can take between three to six months and is dependent on many factors including;
- general health
- bone quantity/quality
- healing rate
- degree of integration between the bone and the implant
Stage One involves preparing the space for the implant to be placed into the bone. More than one space may need to be prepared depending on how many teeth are missing. The implant is then screwed into the prepared bone. The gum is stitched close over the implant while it all heals. This can be performed under local or general anesthetic. Over the next few months the bone will knit around the implant.
At Stage Two the dentist will make an incision in the gum and fit a cap called and abutment on top of the implant. This will provide stability for the crown (tooth) to sit on. X-rays are taken to ensure everything is placed correctly. A Dental impression is then taken to finalise the tooth design. This impression is then sent to the dental laboratory that creates the crown.
At Stage Three the crown (artificial tooth) is attached to the implant.
Dental implants are strong and long lasting. To maximise their longevity they require more care than a normal tooth. Regular Check – up and cleaning is recommended along with daily brushing and flossing. Smoking increases the risk of implant failure. Please call us at any sign of toothache or gum inflammation.
Every Procedure carries its risks. Please consult a qualified health professional and always seek a second opinion.
BRIDGE:
A bridge replaces a missing tooth/teeth and is a commonly used alternative to a dental implant.
Teeth can be missing due to:
- decay
- trauma
- genes
Missing teeth should be replaced for the following reasons:
- improve/maintain appearance and speech
- prevent stress and load on adjacent teeth
- stop the teeth near the gap shifting
- improve chewing
A bridge consists of an artificial tooth (made of porcelain or resin/composite), which is anchored to the adjacent teeth.
The natural teeth adjacent are fitted with crowns to provide strength to the bridge.
Here at Boulton Dental we work alongside a dental laboratory, which manufactures the bridge. If the bridge is made in composite we create these onsite.
On your first visit your dentist will take an impression of your upper and lower teeth (using a gel like substance) to make a record of their appearance and how your teeth sit in your mouth.
The area is then numbed using local anesthetic and the adjacent teeth. Another impression is taken at this point, which is then sent to the dental laboratory (for porcelain) or kept by us in resin to create.
A temporary bridge is attached to the adjacent teeth while the final bridge is being made.
At the second visit the temporary bridge is removed and the final porcelain or resin bridge is cemented on.
Meticulous planning and skill by both the dental laboratory and us ensures correct fit of the bridge and longevity of the restoration.
Correct care of your bridge is recommended, including twice yearly check – up and clean, along with twice daily brushing and flossing.
PERIODONTAL DISEASE:
Periodontal disease is a serious condition where the bone and supporting structure around the tooth is damaged and lost over time.
This is due to a long-standing bacterial infection. If left untreated teeth can become loose, painful and abscessed and usually need extraction.
Periodontal disease is the term given to a range of teeth and gum conditions from Gingivitis to more serious Advanced Periodontitis.
Periodontal disease increases risk factors for systemic medical conditions like diabetes, heart attacks and strokes and is one of the more common diseases of Australian adults.
Unfortunately it is painless in the early stages. Unless you are diagnosed early and start taking steps to manage the disease, it can be hard and expensive to control. Once diagnosed you should not ignore periodontal disease as it can lead to more serious problems.
Who is at risk of periodontal disease?
The following risk factors have been identified:
- smoking
- diabetic
- high blood pressure
- family history of periodontal disease
- poor general health
How can I tell if I have periodontal disease?
Common Signs and Symptoms include:
- Bleeding, inflamed, spongy gums
- Wobbly teeth
- Teeth changing shape/ moving / gaps appearing between teeth
- Toothache
- Bad breath
- Bad taste in mouth
- Abscesses
- Fit of the denture has changed
- Bright red gums
- Tender gums
- Bleeding gums while brushing, flossing or eating
- Receding gums
We test every single patient for periodontal disease as standard protocol. We use a periodontal probe, which measures the depth between the tooth and the gum.
How do you get periodontal disease?
Usually, periodontal disease begins because a person hasn’t managed to remove enough of the bacteria (we call it plaque or a biofilm) to stop their immune system overreacting.
If your immune system flares up, inflammation sets in and the build-up hardens around your teeth. This build-up of plaque, calculus and bacteria can become more aggressive and do more damage, attacking bone and gums unless it’s reversed.
Treatment
Treatment depends on how severe your case of periodontal disease is. For the mildest form, you might just need to change the way you clean your teeth, have a thorough check up and clean, or perhaps use different toothpaste.
For long-standing or more severe disease, our dental hygienist may need to perform an especially thorough type of cleaning (not just a scale and clean).
There are particular ways to brush, floss or “picksters” your teeth to reverse gum disease. Your dental hygienist or oral therapist will show you how to care for your teeth and gums (including brushing and flossing), and schedule a follow-up appointment to make sure the disease progressed.
If you have advanced periodontal disease, you may need a referral to a specialist, or surgery to halt its spread
TMJ and GRINDING:
The temporomandibular joints are located on each side of your head.
They make it possible to open and close your mouth, and work together when you speak, chew or swallow. These joints also control the lower jaw as it moves forward, backward and side-to-side.
Any problem that prevents this complex system of muscles, ligaments, discs and bones from working properly may result in a painful TMD or temporomandibular disorder.
Risk Factors for TMD/Clenching/Grinding:
- missing teeth
- stress clenching/grinding
- emotional or physical stress
- fractures or dislocations of the TMJ joints
- systemic conditions such as Rheumatoid Arthritis and Osteoarthritis
- wrong shaped dental work, crown/bridge
Signs and Symptoms include:
- restricted jaw movement
- difficulty opening mouth
- locked jaw
- clicking, grating, grinding popping sounds when opening
- pain with chewing, clenching, yawning
- cracked teeth
- pain around the ears and cheeks
- headaches and nausea
- earache, hearing loss and ringing in ears
- face, upper back and shoulder pain
- toothache
- uncomfortable bite
Treatment:
TMJ can be complex and is best treated conservatively. Treatment options include the following:
- Occlusal Appliance: Occlusal (night) splints are made by your dentist and are worn at night. These take pressure off the jaw joints and soften the ‘clench’. These are custom made by us and adjusted accordingly.
- Modified Diet: Eating soft foods and cutting up food into small pieces
- Avoid extreme jaw movements
- Physiotherapy/Osteopathy: Physical treatment to massage trigger points in and around the jaw joint and upper back and neck.
- Hot or Cold packs: to tender areas
- Relaxation and stress management
- Medication: In some cases your dentist may recommend short term medication to relieve your pain.
- Specialist Management: If pain and discomfort is severe and conservative treatment has been ineffective your dentist may refer you to a specialist
OTHER TREATMENT:
BOTOXILIUM:
Muscle Relaxants can be injected into the masseter and temporalis muscles to help reduce the amount of stress or force these muscles can generate.
EXTREME TOOTH WEAR FROM GRINDING:
If grinding continues for years it can severely wear all the enamel away and expose the dentine (which is the softer layer under the enamel) Over time this dentine will wear down, at a faster rate than enamel.
Wear can become so severe that teeth can become very small and even form decay, break and become abscessed.
There are several ways to protect and restore your worn teeth. These include:
- a mouthguard to wear at night time
- placing composite (white) filling veneers over the worn teeth
- placing porcelain crowns or veneers over the worn teeth.
These treatments can be complex and require proper treatment planning. Our dentists at Boulton Dental will be able to provide all necessary treatments to restore your teeth and prevent further wear.
CROWNS/ INLAY / ONLAY:
INLAY/ONLAY:
We use an inlay/onlay when the tooth can no longer support a basic filling.
The inlay is like a filling. An onlay is a bit larger and goes over the cusps of your tooth. Materials used are gold, porcelain and composite.
Inlays are more conservative than crowns because less tooth structure is removed in the preparation of inlays.
Preparation and cementation of an inlay/only normally occurs over two visits.
If there is more damage to the tooth and less supporting structure then a dental crown is best option.
CROWN:
An artificial crown is the best way to save and strengthen a tooth that has been damaged beyond repair due to:
- tooth decay
- trauma
- root canal therapy
- wear and tear
- cracks
Crowns are made of porcelain, zirconia and metal alloy. The crowns color can be made to match the adjacent teeth. The metal alloy used in crowns mean they are strong and durable making them the best option for molar teeth.
Here at Boulton Dental we work alongside a dental laboratory, which manufactures the crowns.
On your first visit your dentist will take an impression of your upper and lower teeth (using a gel like substance) to make a record of their appearance and how your teeth sit in your mouth.
The area is then numbed using local anesthetic and the tooth is reshaped. Another impression is taken at this point which is then sent to the dental laboratory.
A temporary crown is attached to the tooth while the crown is being made.
At the second visit the temporary crown is removed and the final porcelain crown is cemented on.
Meticulous planning and skill by both the dental laboratory and us ensures correct fit of the crown and longevity of the restoration.
Correct care of your crowns is recommended, including twice yearly check – up and cleaning, along with twice daily brushing and flossing along the margin of the tooth.
EMERGENCY DENTAL:
Firstly, don’t panic. If the whole tooth is out of its socket, pick it up, avoiding touching the root and rinse it with milk or water, for a couple of seconds.
Carefully put it back into its position in your mouth. Now come see us ASAP. Your tooth has a higher chance of surviving the sooner you see a dentist.
We hold space daily for emergency dental appointments.
If part of your tooth is chipped, keep it moist, and visit us ASAP so your dentist can see if the broken part can be re-attached. If you’ve lost it, don’t panic. We can take care of this too. Give us a call on (02) 4961 6300.
If the incident is serious please call 000 immediately.
For more detailed information regarding emergency dental visit our blog on dentistry and trauma.
PREGNANCY:
So you’re going to have a baby – congratulations!
Your body is undergoing many hormonal changes and you might change your diet. This can affect your gums (gingivitis). You may also have more acid in your mouth if you have been experiencing vomiting.
We recommend a checkup and clean In pregnancy to make sure there are no underlying infections, erosion and to check you for periodontal disease.
This is also a good time to start thinking about your baby’s teeth. If you have decay, your baby is more likely to as well.
Here are some oral hygiene tips for pregnancy:
- Brush your teeth at least twice a day with fluoridated toothpaste.
- Make sure your toothbrush is in good condition
- Floss your teeth daily
- Rinse every night with an alcohol-free mouth rinse (if you are at risk of dental problems).
If you can’t brush your teeth after eating (because you’re out), chew xylitol-containing gum, which can help reduce bacteria that can cause tooth decay.
SNORING/OSA:
Snoring may be a symptom of Obstructive sleep apnoea (OSA).
Obstructive sleep apnoea is a common condition. Apnoea means absence of breath and an obstructive apnoea episode is defined as the absence of airflow for at least 10 seconds. Most people don’t know they have it.
Causes of OSA:
- alcohol
- illnesses (goiter)
- enlarged tonsils
- medications
- nasal congestion/obstruction
- facial bone shape
- obesity
Treatment:
- weight loss
- side sleeping
- treatment of nasal congestion
- avoid alcohol before bedtime
- a dental appliance
- surgery
A Dental appliance can be used to treat mild and moderate sleep apnoea and snoring.
Here at Boulton Dental we make custom Somnomed night mouth guards. The guard gently moves your lower jaw and tongue forward to prevent snoring, open the airway and increase oxygen for those suffering OSA.
If you or your loved one is making noise at night phone us on 02 4962 6300 or direct book online.
DENTURE:
Full and partial dentures are prosthetic devices created to replace teeth that are missing. Dentures are normally made from plastic and/or metal.
A partial denture replaces only the teeth that are missing. They normally contain metal clasps, which grip to your natural teeth.
Dentures are made to fit your mouth.
Caring for your dentures is very important. We recommend cleaning them in the morning and at night before bed. Also, don’t forget to clean the rest of your mouth or any remaining teeth thoroughly.
Always remember to take your dentures out before bedtime to avoid fungal infections.
Dentures are best stored in cup of fresh cold water or a dry container.
We work alongside a dental prosthetist to ensure the most accurate fit for your full or partial denture.
Going into a full or partial denture can be daunting, please discuss any of your concerns with us, we are here to help.
DENTAL EROSION:
Dental erosion is loss of tooth enamel and other tooth structure from frequent exposure to acid.
Common causes of dental erosion include:
- Frequent intake of acidic foods and drinks including; wine, sports drinks, fruit juice, cordial, vinegar
- Acidic medications including; chewable vitamin C, cough syrups and antiseptic mouthwash
- Medications; asthma, blood pressure, chemotherapy, asprin, anti inflammatories
- Dry mouth
- Smoking
- Reflux, morning sickness, bulimia, peptic ulcer, Sjogrens syndrome
- Frequent exposure to swimming pool water
- Chronic dehydration
When tooth enamel is exposed pain and sensitivity are common. If severe the tooth may abscess.
Treatment:
Restorative work may be required when erosion is present including composite filling, porcelain veneer, inlay, onlay or crown.
Recommendation:
- drink more water if you suffer from dry mouth
- use fluoride toothpaste
- preventative sealants
MOUTHGUARDS:
Playing sport means you are at a high risk for serious dental injury.
We like you to have teeth for life! So we highly recommend a custom fitted mouth guard.
Mouth guards protect you from:
- broken jaw
- fractured, cracked and knocked out teeth
- cut lip and tongue
Custom fitted mouth guards offer superior protection and if properly stored, cared for and checked by your dentist, should last several seasons.
Custom fitted mouth guards allow you to talk and breath normally.
To keep your mouth guard in the best condition, keep it out of the sun, wash it in cold water and store it in its supplied container. Bing it along to your regular check up and cleaning so your dentist can monitor it.
For more information on dental trauma and dental emergency visit our blog.