Gingivitis

Gingivitis, Periodontitis And Bleeding Gums


Bleeding Gums don’t matter right?  What if every time you brushed your hair there was blood on the hairbrush; most of us would be running to the doctor faster than we’ve ever run before.

Bleeding Gums are an indication of local infection, called gingivitis.  Left untreated the infection can spread into the jaw bone around the teeth (a disease called periodontitis) causing wobbly, sensitive and painful teeth. The good news is bleeding gums are easy to treat.

Bleeding Gums (periodontitis) can be a serious health concern in people with diabetes, heart disease and other chronic disease.


Orthodontics

Orthodontics


When Is The Right Age?


The best age to have an assessment is about 8-9 years old. Some children are best to start treatment at this age, but most will likely need to wait for more of their adult teeth to erupt.  In general orthodontics is most effective if combined with the pubertal growth spurt between ages 12-16.

Orthodontics is safe and effective at any age, although treatment time can often be longer in adults.


Invisalign, Braces Or Lingual Braces?


Invisalign is more comfortable, and less noticeable, but actually requires mental discipline to make sure the Invisalign trays are worn almost constantly.  One of the big advantages though is that they can be removed, making cleaning your teeth just like normal.  They aren’t suitable for all patients, treatment times can be longer and sometimes the finished result isn’t quite as perfect as moving teeth with braces.

Braces are getting better.  Ceramic brackets are almost invisible, and all that is really seen is the wire which moves the teeth.  Braces take some getting used to, and require very contentious teeth cleaning.  Treatment can sometimes be quicker and more precise.

Lingual braces have the advantage of hiding the braces bracket on the inside of the teeth instead of the front surface.  They can be difficult to clean and treatment can take longer than normal braces.  They are also the most expensive.


Are There Other Options?


Not everyone can wait 6 months to 2 years for a perfect smile.   Cosmetic Dentistry and Veneers can provide an immediate solution which looks as natural to those who need it.

Sensitive Teeth

Sensitive Teeth


There are many causes of sensitive teeth, the most common are:

  • Dental decay
  • Gum disease exposing the exposed root surface of the teeth
  • Dental erosion
  • Cracked tooth
  • Scrubbing too hard, a toothbrush that is too hard, or using whitening toothpaste.

The most common solution is to switch to using a sensitive toothpaste, and also a soft or ultra-soft brush. Because tooth sensitivity can indicate dental disease it’s always a good idea to consult with your dentist to make sure you don’t have an underlying dental problem causing the sensitivity.

Teeth Grinding

Teeth Grinding


Teeth grinding or clenching, most commonly occurs whilst sleeping.  You may have heard someone else in your house grinding their teeth through the night it can be particularly disconcerting especially in children.

Long term it can lead to all sorts of problems, such as:

  • Worn teeth
  • Loose teeth
  • Cracked teeth or broken fillings
  • Jaw joint pain, damage and stiffness
  • Facial muscle pain, headaches and earaches

What Causes It?


Often triggered by stress.


How To Treat It?


If it’s caused by stress, sometime no treatment is needed at all as it disappears on its own accord as the situation resolves.

In children, it can relate to a particularly stage of development in which the adenoids and tonsils enlarge causing partial airway obstruction.  It is thought, that grinding promotes tension through the airway to help the child sleep.  It is also possible that this same pattern occurs in adults, and some consider it to be a pre-sleep apnoea indication.


Wearing A Protective Bite Splint


A bite splint can protect the teeth and prevent some of the side effects of grinding.  Bite splints are custom made and fit snugly over the top teeth while you sleep.  It has a smooth biting surface to prevent the teeth from locking together. It also provides a space to slightly stretch the jaw muscles and relieve pressure on the jaw joint. So if you do grind your teeth can slide over it harmlessly.


Physiotherapy


Often a referral to neck and jaw physiotherapist will also be helpful to correct and local muscle imbalances and provide acute pain relief.


Addressing The Stress – Relaxation Therapy


It’s not always possible, but sometimes the best way to address tooth grinding is to learn to relax.  Whether it is regular exercise, yoga, meditation, or simply taking some time out.

Tooth Decay

Tooth Decay


Unlike bones, teeth can’t fix themselves.  Tooth decay is caused by plaque.  Plaque is a combination of:

  • food stuck on the teeth
  • bacteria, which eat the food and turn it into acid, which rots the tooth

Not all bacterias cause tooth decay. The bacteria that can cause tooth decay are simple sugars. They like to live in an acidic environment, which we can accidently create for them by drinking delicious things like juice, soft drink, wine, etc. with too much frequency.

Preventing tooth decay is as simple as brushing and flossing regularly.  The most important time to brush is just before sleeping at night, as our bodies natural protection against tooth decay (our saliva) turns off while we sleep.

Decay left untreated can lead to root canal infection.

Bad Breath

Bad Breath


If you had bad breath, your friends would tell you wouldn’t they?  It can be a difficult topic to broach.

The main cause of bad breath are bacteria, particularly the bacteria that live along the gum line and often cause gingivitis and periodontitis.  Often the bacteria are attached to the tooth just below the gum line, making it impossible to remove them with just a toothbrush.  The smell is often a result of the bacteria infecting into the gum, resulting in a rotting or decaying odour.

Most people who have bad breath can resolve the problem easily, by having their teeth professionally cleaned and being shown how to keep them clean more effectively. Once the bacteria are removed, the gum heals and the problem resolves.
Tongue scrapers, mouthwash and trying a different toothpaste can also be of benefit after a professional clean, but tend to have little effect without it.

Not all bad breath is caused by gum infection.  A post-nasal drip, chronic sinusitis or a variation in diet can also be contributing factors.  If good oral hygiene doesn’t resolve bad breath, sometimes a referral to an Ear, Nose and Throat surgeon is warranted to investigate other solutions.

Pregnancy

Pregnancy

Visiting The Dentist When Pregnant


Can You Go To The Dentist When Pregnant?


Yes, although it might be the last thing on your mind. It is a good idea to visit the dentist when you are planning a pregnancy or already pregnant.  The main reason to attend is to detect and treat any underlying infection which may potentially affect your health during pregnancy. The second trimester is often the easiest time to attend, as morning sickness has generally subsided.


Can You Get Dental Treatment When Pregnant?


All routine dentistry is safe during pregnancy, and preferable to developing a tooth ache shortly before or after labour.


Does Pregnancy Cause Gum Disease?


No, but it does make it more noticeable.  Hormonal changes during pregnancy can affect your gums, making them more likely to bleed and show a stronger response to gum infection.


Morning Sickness And Gagging


Sometimes it’s just not possible to brush your teeth, if your gag reflex is too strong.  Using a small toothbrush and a tiny amount of toothpaste can help.  Whilst brushing, concentrate on breathing through your nose, with slow deliberate breaths.

After morning sickness, if possible rinse your mouth with water to remove the bad taste and stomach acid off your teeth, preventing tooth erosion and decay.  A bicarbonate mouthwash or other tooth remineralising products can also help.


Bacteria And Your Baby


Baby teeth are softer and more prone to decay than adult teeth, and normally erupt at about 6 months of age.  At birth your baby does not have the decay causing bacteria in their mouth.  Bacterias are passed on through kissing, food tasting or cleaning their pacifier with your own mouth.  The best thing you can do to give your baby’s teeth a good start in life, is to have healthy clean teeth.

Babies and Preschool

Babies And Preschool

Baby Teeth And Teething


Baby teeth don’t matter right? Wrong. Baby teeth guide the adult teeth into position.  The early loss of a baby tooth through infection or dental trauma, can not only be painful but also contribute to unnecessary crowding in the adult teeth.

We see children of all ages right from birth, particularly if parents or children have a concern.  It is important to clean and check your children’s teeth as soon as they erupt.  A first dental visit for a family with no dental concerns is often around the age of 4.

We recommend children be encouraged to brush their own teeth as early as possible to build the skill, but with mum or dad always doing a check second brush until they are 8-9 year old.

The best thing parents can do for their children’s dental health, is to have healthy mouths themselves.  The bacteria that can cause decay are passed from one person to another.  Having a healthy mouth and good dental cleaning habits provides children with the best chance of success.


Teething


Teething can be easy for some children and very painful for others.  The normal time for baby tooth eruption is between 6-18 months.  Although some children are born with teeth.

Teeth Cleaning for Children


Toothpaste


  • Toothpaste for children has a low fluoride content.
  • Children should use child strength toothpaste, until their adult teeth begin to erupt (6 years old).

Toothbrushes


The most important time to brush is just before bed; food left on your teeth will cause decay while you sleep. Whether you use a manual or an electric toothbrush, you should brush for 2 minutes at least twice a day.


Children need their teeth brushed for them until they can write their own name in cursive handwriting (8 – 9 years old).

Teenagers

Teenagers


Acid Erosion

Sports Drinks And Soft Drinks


Acid Erosion is the process whereby teeth are dissolved or eroded by acidic chemicals. There are two main sources of acid:

  • Dietary (soft drinks, sports drinks, wine, cordial, juices and many more)
  • Gastric (vomiting, reflux, morning sickness). This loss of tooth structure can result in sensitive, weak teeth which are easily damaged and have a poor appearance. Staying well hydrated with water can prevent acid erosion. Saliva protects your teeth by neutralising acid. The major cause of poor salivary flow is dehydration. People who live in hot climates like Queensland are particularly prone to dehydration, especially those who work outside or have physically demanding occupations. Some medications cause a dry mouth; please tell your dentist what medications you take.
  • Every time you drink something acidic, rinse your mouth with plain water immediately afterwards.
  • Only brush with a soft or ultra-soft toothbrush.
  • Don’t use whitening toothpaste as it is very abrasive.
  • Wait at least 30 minutes before brushing your teeth after drinking or eating something acidic.
  • Don’t dwell on acidic drinks. Every time you take a sip you replenish the acid attack on your teeth.
  • If vomiting or reflux occurs rinse your mouth with baking soda to neutralise the acid. Mix half a teaspoon of baking soda in a glass of water.
  • Avoid ‘acidic rehydration’. Cut down on acidic drinks and totally avoid them after physical activity and before bed.

Treatment


  • Find the cause
  • Prevent further damage
  • Repair Severe Damage with restorations

Eating Disorder


Eating disorders such as bulimia are often obvious to a dentist due to the characteristic pattern of tooth erosion.  Usually the tooth damage can be easily addressed by covering the eroded tooth surface with white filling material, which prevents further tooth wear.

Other helpful preventative measures can be discussed with your dentist.  If the dentist notices the characteristic pattern of tooth wear, it will be discussed confidentially. However it is often a good idea to involve the patients GP to ensure there is not a systemic or other cause for the reflux/vomiting.


Adults

Adults

Teeth Cleaning

Toothpaste


  • Adults should use any toothpaste containing fluoride. The more expensive toothpastes are not necessarily any better.
  • If you have decay, or have had many fillings previously, talk to your dentist about using a high strength fluoride toothpaste.
  • Whitening toothpastes are more abrasive and can damage teeth, however are reasonably effective at limiting staining from smoking.

Toothbrushes


The most important time to brush is just before bed; food left on your teeth will cause decay while you sleep. Whether you use a manual or an electric toothbrush, you should brush for 2 minutes at least twice a day.


Manual Toothbrush
Look for a toothbrush with soft or ultra-soft bristles. Never use a medium or hard brush.

Electric Toothbrush
Electric toothbrushes can be great for kids, people who tend to brush too hard or have manual dexterity difficulties.


Floss


“You only need to floss the teeth you would like to keep”

  • Find a floss that works for you!
  • If you are finding it difficult to get the floss between your teeth, try a ribbon or ‘satin’ floss.
  • If you can’t manage to floss, there are many widgets on the market to help including floss holders (Reach access flosser) and interproximal brushes (Piksters, TePe brushes).
  • Interproximal brushes are good for large spaces and braces.
  • Many people find it difficult to floss initially. Please ask your dentist to show you how.
  • Don’t flick the floss down onto your gums but gently rub the floss down the side of each tooth
  • Try and floss every time you brush.

Mouth Wash


Using a mouthwash never replaces brushing and flossing.  Most people do not need to use mouthwash regularly. However your dentist may suggest a specific mouthwash for you, for a short duration to help resolve bad breath after your teeth have been professionally cleaned.

Alcohol Free

  • If you do want to use a mouthwash, alcohol free is preferable.
  • Children should only use alcohol free.
  • Some mouthwashes feel like they are burning your mouth. Unfortunately, this does not mean they are doing a better job cleaning your teeth.

When to Use
After brushing, flossing and rinsing with water.