The most common dental decay problem seen in infants and younger children is nursing decay. Dental decay can affect baby teeth extensively. Teeth normally affected are the top front teeth. The back teeth in top and bottom may also be affected. Bottle and breast-fed babies are both susceptible. Babies left with a bottle as a pacifier and those who are frequently nursed, especially at night, run the danger of bottle or nursing decay due to the prolonged exposure to milk (human milk is no exception) or juice.

Another common decay problem seen in preschool children is due to frequent exposure to sugary, starchy and acidic foods, including all forms of juices, cordials and soft drinks. Snacking generally promotes dental decay, because the mere presence of food in the mouth feed the plaque that produces acid, causing decay.

Parents and would-be-parents beware; 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.

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.

In today’s age of technology, your dentist has a range of options to help your teeth look great. Stained teeth, dark teeth, chipped teeth, crooked teeth, and even teeth that are missing altogether, can be repaired or replaced. Cosmetic or aesthetic dentistry is the broad heading under which many dental procedures that improve the appearance of teeth may be described.

The latest developments in dentistry include tooth whitening treatments, micro-abrasion, bonding and veneers. These techniques can whiten and improve the shape and colour of your teeth, even close gaps.

Tooth Whitening – treatments are designed to whiten your own teeth without any artificial additions. There are several ways dentists can whiten your teeth:

Home bleaching works in most cases although the result depends on the initial level of staining of the teeth and the type of staining. It is less predictable on teeth that contain some specific discolourations such as those caused by tetracycline intake in childhood. Home bleaching usually takes about two weeks, wearing trays either during sleep or for a few hours a day, depending on the technique. Home bleaching will not whiten fillings, and it may be necessary to have visible tooth coloured fillings replaced with ones that more closely match the final tooth colour after whitening is completed.

Micro-abrasion – can be used to remove discolouration in the surface layer of the enamel. A paste containing acid and an abrasive is used to remove the outer surface of the tooth enamel. If the discolouration is deep in the enamel your dentist may need to remove the affected enamel with a bur and place an adhesive tooth coloured filling. Usually an anaesthetic is not required.

Bonding – is a process whereby your dentist cleans and prepares the surface of your teeth and then bonds tooth coloured resin fillings to them. Bonding can be used to repair chipped teeth, close small gaps between teeth, alter the shape of teeth and sometimes cover discolouration in teeth. Bonded resins are simple to re-polish and replace if they eventually discolour.

Veneers – are thin (usually about 0.5mm thick) pieces of porcelain, which are bonded to the front surface of the teeth. Veneers can be used to improve the appearance of teeth by changing the shape of the teeth, by changing the colour of the teeth, by masking stains and by replacing small fractured pieces of teeth.

To construct veneers, your dentist will need to remove a small amount (0.4-0.5mm) from the front surface of the tooth.

Your dentist will then take an impression of your teeth. This is sent to a dental technician, who makes the veneers. At the next appointment (usually one to two weeks later), your dentist will carefully clean the repaired surfaces of the teeth and bond the veneers in place. In some cases, because so little tooth is removed, no provisional restorations are needed between the two visits.

Porcelain is a very hard, wear resistant, non-porous material that will keep its appearance far longer than tooth coloured resins. Porcelain, however, is brittle and can chip if hit by hard objects. If you have porcelain veneers, it is advisable to cease habits such as fingernail biting, pen and pencil chewing, biting into stone fruits and barbecue chops and opening packets with the teeth.

Bleaching, micro-abrasion, bonding and veneers can improve many cosmetic problems with teeth. However if the teeth are badly aligned, severely broken down or teeth are missing, it may be necessary to have orthodontic treatment, crowns or bridges constructed or implants placed.

There are many excellent ways to whiten the teeth and all have advantages and disadvantages. Since each case is different there is no one best way.

When staining is present on the surface, an ADA dentist can professionally clean the teeth, often producing a fresher, whiter appearance.

On the other hand, when staining is actually in the tooth, below the surface, there are a number of ways to whiten the teeth. Sometimes simply replacing old, worn out fillings that are failing at the edges can produce better looking front teeth. Alternatively, when the enamel is heavily stained, crowns or facings may be the best option. ADA dentists have access to continuing education in the latest dental techniques and they can give advice as to the best choices for you.

Dental crowns (also sometimes referred to as ‘dental caps’ or ‘tooth caps’) cover over and encase the tooth on which they are cemented. Dentists use crowns when rebuilding broken or decayed teeth, as a way to strengthen teeth and and as method to improve the cosmetic appearance of a tooth. Crowns are made in a dental laboratory by a dental technician who uses moulds of your teeth made by your dentist.

The type of crown your dentist recommends will depend on the tooth involved and sometimes on your preference. They include porcelain crowns, porcelain-bonded-to-metal crowns, which combine the appearance of tooth coloured material with the strength of metal, gold alloy crowns and acrylic crowns.

A bridge is an appliance permanently fixed in the mouth to replace missing teeth. It uses remaining teeth to support the new artificial tooth or teeth.

A bridge is made up of two crowns for the teeth on either side of the gap –these two anchoring teeth are called abutment teeth– and a false tooth/teeth rigidly attached in between. The false teeth are called pontics. The bridge can be made from gold, alloys, porcelain or a combination of these materials.

An enamel-bonded bridge uses a metal or porcelain framework to which the artificial teeth are attached, and then resin bonded to supporting teeth.

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

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 with 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.

A denture is an appliance that replaces teeth. You remove it to clean it and it may be replacing all the teeth (full denture) or some of them (partial denture).

Removable dentures are those dentures (plates) the wearer can remove and replace at will. These types of dentures can replace one tooth, all your natural teeth, or any number of missing teeth in between. A crown or a bridge is fixed or cemented in place and cannot be removed.

Before any denture treatment is undertaken, it is recommended that you have a thorough dental check-up. If you are having full dentures, it will involve an examination of the mouth and an assessment of the health of the gums.

If you are having a partial denture, this check-up will include a full examination of your teeth, gums and other soft tissues of your mouth. At this check-up radiographs may be taken to ensure the teeth are healthy, and strong enough to help support a denture. Remember, the only oral practitioner who has the training and is legally able to undertake such a thorough check-up is your local dentist.

You then have impressions, bite records, trial wax insertions and then the final insertion and instructions.

A filling is a plug of material that is placed into a tooth to replace missing tooth substance and/or structure.

Tooth preparation, prior to filling placement, is usually done under local anaesthesia (making the tooth numb). Once all the decay is removed and the tooth is washed and dried, the filling is packed into the cavity and it sets.

After the filling is placed, it is shaped to match the original tooth contour and the bite is checked.

“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.

Yes.

In the vast majority of cases the progression of gum disease can be arrested with appropriate care. Management of gum disease becomes more difficult and less predictable the more advanced the disease. Therefore, the sooner periodontitis is diagnosed and treated the better. Regular dental examinations are important to check for the presence of gum disease.

The cause of gum disease is bacteria. To manage it, the bacteria must be reduced to a level the body’s defense mechanisms can handle. Treatment classically involves:
> achieving the best possible home care
> professional cleaning of the teeth above and below the gum line (into the pockets) to remove the plaque and hard deposits (calculus / tartar), and
> regular reviews
> trying to remove risk factors such as smoking.

Gum disease causes permanent damage to the supporting tissues; therefore the aim of treatment is to stop the progression of the disease through controlling the bacteria. This is an ongoing, lifelong activity.

Your general dentist is trained in managing periodontal problems. They may also use a hygienist to assist in your care. You may be referred to a Periodontist if your dentist considers your condition needs more advanced care. A specialist periodontist has gained additional qualifications and experience to satisfy the requirements of the State Dental Board and may therefore use the title “Periodontist”.

Prevention is best. To a large extent periodontitis can be prevented by good oral hygiene and early intervention when problems are identified. See your dentist regularly.

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’.

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.

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.

Some people do elect to wait until they are having trouble with their wisdom teeth. The only trouble is, sometimes the damage is done without any warning. Some people leave their wisdom teeth until they are older than sixty or seventy years. Often they have other health problems at this age and are much slower to recover than teenagers who have the same operation.

As a rule, your wisdom teeth will get more difficult to remove the older you are.

If they are impacted, an ounce of early prevention is better than a ton of late cure.

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 various forms of anaesthesia and relaxation that can be used effectively to change your negative thoughts into a positive experience.

Do all dentists use “happy gas”?

“Happy gas”, “laughing gas”, “relative analgesia”, “nitrous oxide” are all describe the same form of sedation which can be used for patients who are apprehensive of treatment done with local anaesthesia.