News update 3/9/2013

Grow Up Smiling

‘Grow Up Smiling’ is part of the Government’s dental health reform and aims to expand access to dental services for children and comes into effect from 1 January 2014. It replaces the Medicare teen Dental Plan and will expand the age range of eligibility to children aged at least 2 years but under 18 years. It will also provide eligible children with increased benefits of up to $1000 capped over two calendar years for both basic and prevention and treatment services.

See: http://www.comlaw.gov.au/Details/F2013L00845

Excerpt taken from ADAQ news. Issue 595, July 2013

Q. Is sucking on a pacifier bad for my childs developing teeth or gums?

Sucking on a pacifier is not bad for a child’s developing teeth and gums unless they are still sucking a pacifier at age 6. The reason for this is that at age 6, the adult teeth are coming through and if the child is still using a pacifier, this can eventually lead to an open bite where a gap is formed between the top and bottom front teeth, or to be more exact, the space where the pacifier fits.
My daughter was on a pacifier and we chose Nuk orthodontic pacifier, because this had the thinnest neck.
Personally, if you can wean your child off the pacifier as early as possible there is less risk of your child developing an open bite.

Q. How long do dentures last for?

There are  2 things that we need to consider to answer this question. First we ned to consider the functional longevity of the dentures. The second is the aesthetic longevity of the dentures.

Functionally, the material that dentures are made of  can last a long time. Dentures  can last a long time depending on how well you look after them. A full denture which is made from pink acrylic can last for 8-10 years. Department of Veteran Affairs allows for a new one to be made for free every 8 years.
If however you lose teeth, or the supporting tissue for the denture shrinks, or there has been a  change in your biting vertical dimension, then the denture may not fit well, and therefore not last as long functionally.

For plastic partial dentures and metal cobalt chrome framework partial dentures, we generally suggest that they may last between 5-8 years.

Cosmetically, as long as full dentures and partial dentures are well cleaned and maintained, the denture acrylic should look as good as new for years. However it is in my experience that after 5 years of continual use, the acrylic on dentures tend to stain and capture plaque, which may be hard to remove. The metal wires and clasps in partial dentures can break, and teeth can chip and wear away.

Q. What are bleeding gums a sign of?
I flossed for the first time in several weeks and noticed that my gums were bleeding in a few places. What does this indicate?

Bleeding gums are usually a sign of having inflammed gingival tissues. In dental terms, bleeding gums are called gingivitis. Gingivitis is caused by bacteria and food stuck onto your tooth called a biofilm or plaque.  The gums don’t like all this bacteria and as a result the gingival tissues become inflammed as a result of the healing mechanism of tissue. When gums become inflammed they release antibacterial properties to try and kill the bacteria.

Sometimes localised bleeding maybe due to food impaction in which the gums in between the teeth are traumatised.

Q. Is an electric toothbrush better than a standard toothbrush?

Electric toothbrushes are generally better than manual toothbrushes because it does all the mechanical movements for you and there is less chance for you to damage your teeth and gums due to overzealous brushing.
Remember when you use an electric toothbrush, simply place light pressure on each individual tooth and its surfaces and and let the toothbrush work for you.
There are many electric toothbrushes on the market ranging from $20-30 right up to $200+ with all the bells and whistles.

Q. Will dentures impact the way someone talks?

If you have not worn dentures at all, then dentures will impact the way you talk. You will initially undergo what I would refer to as a shape shock process, whereby your mouth, tongue, cheeks and lips are not used to having something foreign in the mouth for long periods of time. With constant wear,  the muscles used for eating and talking will learn to accommodate and return you to normal speech, and function. Sometimes dentures can be a bit bulky in which case returning to normal speech can be harder. If so a simple denture adjustment may be all that is required.

Q. Will dentures impact the way someone eats?

Dentures of any sort will affect the way you eat. Natural teeth are connected to your gums by sensory fibers and as a result you have a better sense of awareness when you bite and chew food.
With full dentures you don’t have this sensory ability, however with partial dentures where you have some natural teeth remaining, your sensory ability is reduced.

Another disadvantage of wearing any sort of denture is food getting lodged under the denture, especially if the denture is a bit loose.  People do complain of having to take their denture out to clean after eating.

Q. What is the best way to prevent cavities?

The best way to prevent cavities is
1) reduced sugar and acid intake in the diet.
2) good oral hygeine like brushing and flossing twice daily.
3) regular 6 month visits to the dentist to have the teeth cleaned and maintained.
4) diagnostic dental x-rays every 2nd year to ensure that there is no decay that may be invisible to the eye.
5) drinking milk and water.
6) chewing sugar free gum to stimulate saliva flow after meals.
7) using GC Tooth Mousse to strengthen teeth.
8) If you are aware that you suffer from dry mouth because of the medications that you are on, you can substitute your saliva with GC Dry mouth or Biotene.

Remember prevention is better than the cure, so if you are unsure if you have a cavity, visit your local dentist or feel free to contact us.

Q. What is the best way to get rid of mouth ulcers in children?
My 8 year old has a mouth ulcer that has taken a few days to heal. It’s causing him pain so how can we get rid of it quickly? So far we’ve tried a salt water gargle and difflam gel.

I have a 3 year old daughter. We use SM-33 Gel which we find works wonders for children.
Sm-33 is indicated for children under the age 12.
SM-33 effectively and rapidly relieves the pain of mouth ulcers. It contains an anaesthetic to gently numb the area as well as pain killers to reduce inflammation and relieve pain. Antiseptic ingredients help fight infection. I usually paint the SM-33 gel onto the affected area with a cotton wool bud every 3 hours, using a fresh bud for each application. Sometimes my daughter complains of a slight stinging sensation initially.

Remember it is also important to find out what is causing the ulcer. There is no point having to continually treat ulcers if it can be prevented in the first place.
Ulcers are usually caused by injuring the mouth, (by accidently biting or burning oneself for example) and this open sore then becomes infected.

Occasionally, there seems to be no obvious injury involved at all. The ulcer is usually circular with a yellow centre and red rim and is extremely painful due to nerve cells being exposed.

As an aside Kenalog is suitable for ages over 12. It works the same as SM-33.

Q. How many times should I brush my teeth, and what times of the day?

At Just Dental Care we recommend brushing after all meals. If this is not practical then after breakfast and dinner.
There is no point brushing before breakfast as there may be residue food and plaque left after eating. If the food is not removed via brushing and flossing there is a greater chance for bacteria from inside your mouth to convert sugary foods or acids (from fruits) into acid for example.

If you can’t brush as often it is recommended to brush at least before you go to bed. When you are asleep, your saliva production decreases. As a result there is less saliva available to neutralise the acids that are being created in your mouth.

Q.Can I use my old retainer to shift my teeth back into place?

I had braces when I was a teenager and wore my retainer for several years after as instructed. However, since then my teeth have shifted slightly. I found my retainer and although it doesn’t fit perfectly, I can force it in (tight fit). Can I wear this over night to help shift my teeth back into place? I really do not want to get braces again or pay for invisalign.

In the case where you can fit in your old retainer abeit having to force it in, it is possible to use it to try and shift your teeth back into position. Ideally it should be worn more long term ie not just be worn at night time, so that your teeth have a constant force acting on it. However if you are damaging your teeth or gums to get it in and out or other teeth that have not been displaced are becoming painful, then it is best not to wear your old retainer.
There are alternative options to invisalign and braces like composite resin veneers, or Snap on Smile.

Q. What is the difference between a Dentist vs Oral and Maxillofacial Surgeon?

The main difference is that an Oral maxillofacial surgeon has had to study for and extra 6+ years. They have a dentist degree, a medical degree and a specialist degree. Oral Maxillofacial surgeons are specialist in the head and neck region and can deal with all complex cases that a general dentist do not touch. They excel at removing teeth especially wisdom teeth, trauma cases, and pathology.

Q. Is it necessary to use mouthwash?

I always wondered if it is necessary to use mouthwash. Does it really improve my oral health beyond routine brushing and flossing? How many times a day should I use mouthwash?

Mouthwash should be used as an adjunct to regular brushing and flossing and is most effective on clean teeth. Mouthwash also helps to get to those hard to reach places.
At Just Dental Care we recommend the use of mouthwash 3 times a week before you go to bed, and not to eat or drink afterwards. Mouthwash contains chlorhexidine which help to reduce plaque and fight gingivitis. Chlorhexidine molecules works most effectively when it attaches to clean tooth structure.
However if you find that your teeth have tartar and your gums still bleed, you may need to see your dentist for a comprehensive clean. After that the mouthwash will act more effectively.

Q. Can a dental guard prevent my wisdom tooth causing holes and ulcers?

I have had my wisdom teeth for about 5 or 6 years and never had any trouble with them. Tho the last year i have been getting a hole like a canker sore right were my wisdom tooth is and i noticed that the wisdom tooth sticks out and tends to rub against the cheek. However i rarely get this, maybe a few times in the last year, and i do not wish to have my wisdom tooth removed. I also bite down hard with my teeth at nights and strain my jaw. I am wondering would a dental guard prevent the tooth from rubbing my cheek and also prevent the biting down. I cant afford a guard from the dentist, but there is one on amazon that sends you a mould kit, which you complete and send back to them and they make you a guard to fit you. And it is relatively cheap. I am considering this, will it help? Any other information would be great! Thank you

First we need to address the sore around the wisdom tooth and your cheek biting issue. Is your wisdom tooth partially erupted or fully out? Although you may be getting this once in a blue moon, it tells me that you may be getting in dental terms what we call pericoronitis, a condition whereby the tissue around a partially erupted wisdom tooth has swollen up due to infection, causing you to bite on the tissue.  If this is the case then you may well get another episode of pericoronitis especially around stressful periods of your life or if the wisdom tooth gets food impacted in and around the gum. Ideally in the long term, the wisdom tooth should be removed, but if you don’t want it removed then we could try reducing the cusps down so that you don’t bite on your cheek tissues. End of the day,  why do you need to put up with the pain and discomfort, if you know there is another way. Ask your dentist to help you get an OPG of your wisdom tooth. It may not cost much to remove and it may be a straight forward extraction.

With regards to a night guard, they are good to prevent chipping of teeth and minimise headaches .
There are 2 night guards available. One is a full arch splint, the other is called an NTI splint which fits over your top teeth from canine to canine.
I believe it is better to get a dentist made splint as the impression taken will be potentially better than one taken by yourself. Also we take an impression of both arches as well as a bite registration, so we know how your teeth meet so that we can take this into account when we make the splint. A poorly made splint which will be a result of a poorly made impression may do more bad than good.

Q. What foods and drinks cause cavities?

My 12 year old daughter has already had quite a few cavities. I am beginning to wonder if it is partly due to her diet. Are there any foods and drinks she should avoid?

First of all we need to understand that all foods in moderation are fine, and that it is also important to have good oral hygiene practices to reduce the chances of getting decay. Frequent snacking of these foods will slow down the ability
The main foods and drinks that cause decay especially in children are fizzy drinks, sports drinks, lollies and dry fruits. Foods that are high is sugars like iced biscuits can also cause decay.
Acidic fruits like oranges and lemons, although healthy for you, can contribute towards decay if eaten frequently.

The best way to reduce decay is to drink water and standard milk, and  to eat cheese unless you are lactose intolerant..

Q. Does periodontal disease cause Type 2 diabetes?

Periodontal disease does not cause Type 2 diabetes. Diabetes however can exacerbate periodontal disease.  Type 2 diabetes is a metabolic disorder that is characterised by high blood glucose levels. It is caused by an insulin resistance or relative insulin deficiency. The symptoms are increased thirst, frequent urination and constant hunger.

Diabetes can exacerbate periodontal disease by

• diabetes slows blood circulation, which can make the gum tissue more prone to infection.
• diabetes reduces the body’s resistance to infection.
• high glucose levels in the blood can stimulate periodontal associated bacterial development.

If you have Type 2 diabetes, it is important to keep it under control. It is also important to see your dentist on a frequent basis to maintain good oral hygiene.

What causes stains on my teeth?

The main things that causes stains to teeth are

• coffee, red wine, tea, and foods that contain cumin.
• Smoking can also leave stains on your teeth.

For teeth to look yellow the potential causes can be

• old age, whereby teeth change colour over time.
• loss of enamel whereby the underlying dentine (yellow in colour) is exposed.

Q. What can I do to prevent my teeth from going yellow?

I have yellow stains on most of my teeth. Besides using whitening products, what else can I do to prevent them?

• reduce the consumption of foods and beverages that may stain your teeth
• rinse your mouth out after consuming your beverage
• stop smoking
• brush more gently and stay away from whitening toothpastes (they are abraisive)

Q. What is a dental bridge?

A dental bridge is usually defined as a laboratory made fixed prosthesis which incorporates 2 crowns supported by 2 natural teeth (abutments) either side of a gap, with a fake tooth (pontic) joined in between the two crowns.
Bridges can replace 1 or more missing teeth, however the longer the span or larger the bridge, the weaker it is as more pressure is placed on the 2 abutment teeth.
For dental bridges to be strong and reliable the abutment teeth must be solid, with plenty of tooth and boney support.

Dental bridges are usually fabricated from gold, alloy metal, porcelain or a combination of these materials.

Q. How can I stop myself from grinding my teeth at night?

My husband can hear me grinding my teeth at night and it has caused my teeth to become more run down. How can I stop this?

Grinding teeth at night tends to be habitual or because you are extremely stressed.
One option to reduce the grinding is through neuromuscular treatment with TENS and then an occlusal splint. The basis of this treatment is to change the dynamics of your jaw muscles, therefore reducing habitual grinding.

An occlusal splint on its own or with neuromuscular treatment is a way to prevent your back teeth from coming in contact at night. It is a preventative measure more so than stopping you from the grinding. If stress is a factor then stress relief may benefit.

Q. How often should I visit the dentist for a routine check up?

At Just Dental Care we suggest a routine check up every 6 months. In fact if you have health cover with dental extras, the health cover usually allows for 6 month check ups with maximum rebates back to you.

In some cases, 12 month or 3 month check ups may be required depending on your oral conditions.
In some cases if you have had a severe build up of tartar and have periodontal disease or gingivitis, and you have not seen the dentist regularly we may suggest an initial 3 month recall to see how your oral hygiene practice is improving and to see if your gingival health has improved. If there is improvement then we can then follow up with a 6 month routine check up.

Q. What do I do if I have a swollen face?                                                                                      21/5/13

If you have a swollen face, this is a sign that you have a large amount of infection within the tissue spaces of your face. This needs urgent attention. You need to visit your dentist initially for an assessment. Antibiotics are usually prescribed to reduce the swelling. If the swelling reduces, the suspect tooth is either removed or root canal treatment is required. If the swelling does not reduce then we always advise immediately going to a dental hospital to have IV antibiotics. If you can’t get to a hospital then a specialist Maxillofacial surgeon will be your next port of call.