Periodontal Disease
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Information on Dental Decay

What should I know about it?
A tooth with a cavitated dental decay lesion must be restored as soon as possible. Delays will likely lead to further damage to the tooth and if severe, the tooth may not be restorable and will then need to be extracted. Delays also increase the risk of bacteria spreading to the pulp of the tooth, which will then need root canal treatment (if the tooth is still restorable) or extraction. 
The main causes of dental decay are inadequate cleaning of teeth and/or excessive exposure to sugary food or drinks.

What treatment do you recommend?
Generally, with a small cavity, we recommend a direct restoration (white filling) that can be completed in one visit.

With larger cavities that affect about half the tooth, we recommend an indirect restoration (onlay or crown) that normally require two visits to complete. Such restorations are stronger and therefore more durable.


Additional notes
After a tooth has been restored, it may have post-operative sensitivity that may last 1-4 weeks.

Direct restorations can absorb stains from food and beverages due to the presence of micro-porosities.

We expect 50% of composite restorations to remain functional for more than 5 years and 50% of indirect restorations to survive for more than 10 years. 
The two main causes of restoration failures are dental decay and fractures. Therefore, to maximize the longevity of the restorations, you must develop good dental habits (i.e. good oral hygiene, healthy diet and regular dental check and clean visits) and avoid excessive forces on the teeth (e.g. chewing hard food such as nuts, removing bottle caps with your teeth and managing night-time grinding or clenching).

The larger a direct restoration is, the higher the risk of fracture.



Information on Periodontal Disease

What should you know about it?
Periodontal disease is a chronic complex multifactorial infection. The main factors include the presence of dental plaque, dental calculus (tartar) and host susceptibility.

The disease initially presents as inflamed gums that bleed easily and usually noticeable when cleaning one's teeth thoroughly with brushing along the gumlines and flossing. As the disease progresses, one may notice recession of the gums that exposes the root surfaces of affected teeth. If periodontal disease is left untreated, it may lead to the loosening of teeth and/or painful gum infections that are usually best treated by extractions.

There is increasing evidence that suggests periodontal disease may be linked to diabetes, heart disease, pregnancy complications and other medical conditions. Research in these areas are ongoing.
Periodontal disease is usually a slow-progressing disease that is asymptomatic, very much like heart disease. Most affected patients are not even aware that they have a problem. 

What treatment do we recommend?
Depending on the severity of the disease, treatment may involve scaling, polishing and oral hygiene instructions only for mild cases. In advanced cases, additional treatment will involve deep scaling and making the root surfaces smooth to enable soft tissue healing. For severe cases, referral to the periodontist (a specialist) is indicated.

The main benefits of undergoing treatment are keeping teeth where they belong (in the mouth and not in the waste bin), maintain chewing efficiency, and removing a common cause of bad breath.

The treatment time required varies considerably. After an initial phase of treatment to control the disease, regular continuous care visits are required (e.g. 3 to 6 monthly recall check-ups, scaling and polishing).


Additional notes
If you are a smoker and/or have uncontrolled diabetes, your risk for periodontal disease increases significantly. The success of treatment in such cases will also be significantly lower.

Periodontal disease is a chronic disease. There is no cure. Our treatment goals are to control the disease and to prevent its progression. Any gum recession that has occurred will remain or recede more as it heals. Regular maintenance visits are required.




Oral Care Advice

Our standard advice on daily oral care is to gently brush your teeth and gums twice a day (once in the morning and again before going to bed at night) for at least 2 minutes with a fluoride-containing toothpaste, and to also clean the surfaces between your teeth on a daily basis with a dental floss, interdental brushes or a water-spray device. 

We also advise that you watch your diet by avoiding high-sugar containing food or beverages. Realistically, it is impossible to avoid sugar completely so we need to be aware of the two aspects regarding sugar which causes damage to teeth, that being quantity and time.
Regarding the quantity of sugar, most people are aware of food or drinks which have high sugar content. It is a good idea to look at the sugar content in the food labels. 
Regarding the issue of time of exposure to sugar, there is less awareness about it. The more time teeth are exposed to sugar, the risk of dental decay increases. Frequency of eating, time taken to complete a meal and certain food that sticks around teeth are factors to think about. We recommend 3 meals a day (breakfast, lunch and dinner) and nothing with sugar in-between the meals. Rinsing your mouth with plain water after meals can be helpful as well.

For extra protection, you may wish to consider some products in the market such as high-fluoride containing toothpaste, remineralisation pastes, mouthrinses and sugar-free gum.
Dental Emergencies

We understand that dental pain can be severe and can happen at short notice.

We try our best to look after our regular patients. We have reserved emergency time slots during the week and can usually attend to emergencies on the same day or the next day. In the event that we are unable to do so, please try the alternative contacts listed below.
 
Royal Dental Hospital of Melbourne
720 Swanston Street
Carlton
Tel: 9341 1000

Emergency Dental Clinic
114 Barkers Road
Kew
Tel: 9853 1811