The aim of filling teeth is to close off spaces where bacteria can enter to prevent further decay from occurring. When you require a filling, the dentist will remove the decay in the tooth, clean the affected area, and then fill the cavity with a filling material. Materials used for fillings include gold, porcelain, composite resin (tooth-coloured fillings), glass ionomers and amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

At your initial consultation appointments we like to discuss the treatment options for your tooth. The choice of material is based on a number of things:

• the size and depth of the space to be filled,

• the area is going to face a high amount of biting forces (especially those located at the back of the mouth or if you’re a grinder) and requires a stronger material,

• the restoration is in your smile line and aesthetics is a concern

• if the tooth needs to be monitored or restored in the near future and needs to be temporised

The most common restoration we place are composite fillings. Composite fillings are tooth-coloured fillings and are placed in layers within the cavity being repaired. Each layer of the composite material is hardened by exposure to a special light. After the cavity is filled, we will trim it so it does not obstruct your bite and polish it for smoothness and prevention of discolouration. 

The major advantages of composite materials are that they bond directly to the tooth, they are more attractive than amalgam restorations, and they can be fitted into very small cavities so less drilling is required in order to retain the filling. The most common reasons for why we replace restorations include; new or recurring decay as seen in leaking restorations that appear with stained margins, missing restorations, cracked amalgam fillings and cracked teeth. 

Sometimes a filling is not sufficient to restore the tooth to full function or aesthetics and further restorative measures need to be taken such as posts, crowns, bridges and implants.

Veneers

Veneers are tooth-coloured porcelain or composite shells that cover the outer surface of your front teeth to improve their appearance. Compared to a crown, veneers are much more conservative because they utilise your otherwise strong and healthy teeth. Veneers are excellent for treating discoloured, chipped, slightly misaligned teeth or gaps between the front teeth. Pending assessment of your bite, it is a great option for those who would like to correct crowded front teeth and do not wish to go through lengthy treatment with braces. 

Crowns

Crowns are artificial teeth made from strong materials such as porcelain or in combination with metals. Porcelain can be closely matched to the colour of existing natural teeth, and is resistant to staining. When used in combination with metals, crowns can be very strong and durable, particularly when it must endure the forces of grinding and crushing in the back molar teeth. Crowns involve reshaping the natural tooth to allow for the artificial crown to replace the natural crown.

Teeth Whitening

Teeth whitening is a procedure which can lighten the colour of stained or discoloured teeth that have not otherwise responded to professional dental cleaning. We take an impression of your teeth so that a custom-made mouth tray can be made. This tray is used to hold the bleaching gel. The procedure can be carried out at home until you are happy with the appearance of your teeth.  

Dental Implants

Dental implants are artificial metal tooth roots that integrate into the jawbone and anchor the artificial tooth (crown) into the jaw. They are commonly used to replace missing natural teeth and closely resemble their look, feel and function. 

Dental implants are an alternative to dentures and bridges and do not require the cutting and reshaping of adjacent healthy teeth (bridges), and are more comfortable than conventional dentures. 

The option to have an implant placed is dependant upon your medical and dental history, remaining bone levels and density in addition to sufficient restorative space. We also need to check we aren’t near any nerves or sinuses!

Bridges

Bridges are another option when it comes to replacing one or more missing teeth. They are also an option if a tooth is too badly decayed to save with a crown. A bridge is an artificial tooth that is anchored to one or two adjacent natural teeth via crowns. Its preparation is similar to that of a crown whereby the natural teeth on either side are reshaped to allow for the artificial crown to be placed. Bridges are also made from porcelain or in combination with metal.

Dentures

Dentures are artificial teeth placed onto a acrylic or metal framework that is removable from the mouth and aren’t fixed like dental implants or bridges. They enable you to retain your normal chewing ability, speech and general appearance but must be removed and cleaned of an evening. We offer two types of dentures; partial and full dentures. Partial dentures are used where there are a few missing teeth. They are held in position by using a clasp to secure the denture to a nearby natural tooth. Full dentures are used to replace all of the upper and/or lower teeth. 

1. Oral Sedation

Before treatment, we prescribe an oral sedative to reduce pre appointment nervousness. This also improves comfort levels during the treatment. 

2. Nitrous Sedation (“happy gas” or “laughing gas”)

This method of sedation has been used for many years, and is referred to by many in popular culture as treatment for anxiety control. A small nose mask is placed, and a mix of nitrous oxide with oxygen is inhaled by the patient. Upon inhalation, the patient becomes very relaxed and even perhaps sleepy. 

In addition to the generally anxious patient, it is very effective for young children, whom have difficulty understanding what is going on, are in a lot of pain, maybe physically or intellectually disabled.

3. Intravenous Sedation

This mode of sedation is very effective and requires a travelling specialist to attend the surgery to administer. The medication is directly and painlessly placed into a vein and provides profound anaesthesia as well as anxiety relief. The patient transitions into a state of lethargy and relaxation. Not necessarily suitable for very young kids. A consultation with the specialist may be required prior to the sedation appointment. 

Orofacial pain is the term used to describe a general pain felt in the mouth, jaws, face, sides of the head, ears or behind the eyes. This also includes tooth pain that is not associated with decay. 

The common causes of orofacial pain include grinding; trauma; diseases of the soft tissue structures of the mouth; jaw muscle pain due to inflammation, overuse or fatigue; and jaw clicking. Orofacial pain can also be a result of referred pain (where pain from one area of the body is felt in a different area). 

There are many descriptions we hear from our patients that alert us to consider the possibility of orofacial pain – symptoms such as tingling, throbbing or burning sensations that may come and go, or be constant. Orofacial pain can range from mild to severe and can impact on work, family and social life. 

Jaw Clicking

Jaw joint pain can vary from mild discomfort to severe pain. While the cause is often unknown, there are a number of factors such as the grinding or clenching of teeth, missing teeth, jaw damage, a bad bite or emotional/physical stress that can aggravate the condition.

At our surgery, we can provide a full oral and facial examination to help diagnose and treat you according to your symptoms. Potential treatment options include custom-made splints or the adjustment of your teeth and bite to ensure that they fit together correctly. 

Splints

Occlusal splints are hard acrylic appliances that are custom-fitted to your upper jaw to cover the biting surfaces of the teeth. They are designed to be worn at night. While an occlusal splint will not stop you from grinding or clenching, it aims to take the pressure off the jaw joints and teeth by guiding the jaw into a neutral position. Furthermore, a splint will protect your teeth against the destructive forces of grinding.

Adjustments

Occlusal adjustments involve adjusting the biting surfaces of the teeth so that the upper and lower teeth are in harmony with each other. This form of treatment will often be enough to relieve the pressure on the jaw joints. 

The purpose of root canal therapy is to retain your natural tooth and to avoid a missing space due to extraction. We commonly hear from patients, “Why don’t you just extract and place an implant?” While this is a great question and plausible treatment option – retention of natural teeth should always be paramount. 

The aim of any dental treatment is to extend the life cycle of a natural tooth as much as possible.

Root canal therapy often requires multiple appointments in order to remove the dying/dead nerve tissue/s (pulp), disinfecting the chamber/s in which it lies with medicaments, filling the empty chamber/s with a filling material, and then placing a final restoration on the tooth. Depending on the tooth that requires the root canal therapy, there may be one to four nerves to be cleaned out. 

In the first ‘relief of pain’ appointment, the tooth will be tested to confirm that the nerve is dead and then we will proceed to numb you with a numbing cream and dental anaesthetic. To reach the nerve chamber, we make a conservative opening through the tooth and using special instruments called files, we remove the inflamed and infected pulp. We then place a medicine in the chamber to alleviate the pain you were experiencing and close the access cavity with a temporary filling material. In some cases, such as a severe abscess forming at the root tip, we may prescribe antibiotics to help treat the infection.

At the next visit, often within a fortnight of the first appointment, we aim to thoroughly disinfect, enlarge and shape the canals. We use anti-bacterial and anti-inflammatory medicines inside the root canal in order to thoroughly cleanse the inside of the tooth. We then place a material to fill and completely seal the canals. Adequate sealing is critically important to prevent them from become reinfected with bacteria. Again, a temporary filling material may be placed to allow the tooth to settle before replacing this restoration with a permanent one. 

Often times we will discuss restorative options in the form of a crown, especially prior to beginning the root canal treatment. The reason for this is due to the nature of removing the pulp tissue from the tooth causing the tooth to have insufficient structure to withstand natural biting forces (despite our best conservative efforts). We may encourage you to proceed with root canal therapy with the condition of final restoration with crown in order to gain the best long-term outcome for your tooth. The most common reason for failure root canal treated teeth is not due to decay but due to fracture of the tooth! This would be a shame after all of those appointments dedicated to saving your tooth.

Tongue and Lip Tie 

Tongue/lip tie is a short string-like attachment of the tongue to the floor of the mouth or the lip to the gum. Such presentations affect breastfeeding and the ability of the baby to latch, speech development, tooth alignment (such as gaps between front teeth). 
 

Fissure Sealants

Fissure sealants are coatings of thin varnish material over the pits and grooves of posterior teeth. They provide a barrier against dental decay and can give your children’s teeth added protection for years. 
 

Mouthguards

If your children play sports where tooth/mouth injuries are likely, a mouth guard is recommended for protection. A mouth guard is a thick shield that fits over your child’s teeth while they play sports that involve a high risk of facial impact. A mould is taken of your child’s teeth to construct a custom-fitted mouth guard suited to the shape and contours of your child’s teeth.

We do not advocate pharmacy-bought, boil-n-bite mouth guards as these are poorly-fitted moulds that offer limited safety in impact situations and can in some cases worsen injury.
Space maintainers
Losing a baby tooth prematurely can cause problems with the eruption of your child’s adult tooth. It may cause the adjacent teeth to move out of alignment so there isn’t enough room for the adult tooth to come through, or the underlying adult tooth may drift and erupt in the wrong position. To avoid this problem, we are able to fit your child with a space maintainer, which act to fill the space left by missing teeth. 

Orthodontics

A very common concern for many of our parents’ is whether their children will require braces. Our preliminary screening for kids include a thorough assessment for teeth crowding, bite, snoring, palate shape and airway space. These factors allow us to determine if early intervention is required either in our treatment rooms or in conjunction with an orthodontist.

Braces – the fixed-to-the-teeth option

Braces are appliances that are bonded to your teeth in order to move or tilt the teeth to their desired position over a course of time. Braces can not be removed by the patient and remain fixed to the teeth throughout the duration of the treatment. The braces we use are tooth coloured and more aesthetic than metallic braces. Often the treatment time with braces is less than that of Invisalign. Most commonly patients like using braces to fix lower dental crowding in the anterior (front) region of the mouth. 

You must maintain good oral hygiene practices by using alternative methods of flossing between and under wires as normal flossing becomes difficult with the wire banding across the teeth (for example, using super floss). During your follow up appointments, we will monitor your dental health and ensure that you are maintaining a good oral hygiene.

Invisalign - the removable option

Invisalign is the company name for a type of removable orthodontic appliance or aligners used to correct dental alignment issues. In your initial Invisalign consultation, photographs of your teeth and facial profile will be taken, as well as dental x-rays and intra oral 3D scans. Also on this appointment, our advanced 3D scanner can provide you with a quick outcome simulation for your teeth with Invisalign, basically giving you some idea of what is achievable. Using all this information, we get to work formulating a week by week plan for your teeth and generating an accurate three-dimensional computer simulation of your Invisalign treatment plan, which suits your lifestyle and offers you a way to see the result at the end of treatment. Subsequent appointments include placement of tooth coloured buttons on your teeth that will allow for the plastic aligners to click on and this is how movement of the teeth occurs. Every fortnight you will be required to change aligners and you must be reviewed every 6-8 weeks to track the progress of your treatment. 

One advantage of using Invisalign is that the plastic aligners are nearly invisible in appearance making it almost impossible for others to see you are having orthodontic treatment, while your teeth are being moved over time. Another advantage is that you will find it easier to brush and floss your teeth because there is no wire banding the teeth together. However, you will need to remove the plastic aligners each time you eat or drink as they can distort and break. It is also essential to wear the aligners for 22 hours a day in order to achieve the desired outcome.