#savetheCDBS

The Medicare CDBS (Chrildrens Dental Benefit Scheme) was implemented to give eligible children access to government funded dental care through their private dentist. 

There are indications that the upcoming May Budget will not provide any further funding for the scheme, effectively axing it and cutting off the thousands of families that benefit from it.

We are asking all patients to sign the petition

https://www.change.org/p/federal-minister-for-health-the-hon-sussan-ley-mp-stop-the-government-axing-free-dental-care-for-kids

to let the government know that such a decision will lead to a loss of quality healthcare for many Australian children aged 2-17. 

The petition is a last ditched effort to save the benefit, however it appears as though more than likely the scheme will be ending soon. Any patients who are currently eligible for the scheme are encouraged to make an appointment for their children before July to have any necessary treatment completed.

Orthodontics : Braces or Invisalign

Orthodontics are a great way to improve your smile and overall dental health. There have been rapid advances in recent years with how we can correct your crooked smile, and often times we can avoid traditional braces.

Braces however still have their place in modern orthodontics. There is still no better way to control tooth movement and improve skeletal imbalances. Whilst they may not be as discrete as other methods, we at the Dental Surgery St Marys still believe they are the gold standard when it comes to achieving optimum results, especially for children and adolescents. 

The newer methods of straightening teeth involve a series of clear aligners that you change every 2 weeks. These aligners are completely see through, and are close to invisible. Each set of aligners moves your teeth slightly, so that once you complete the progression of aligners your teeth will be in their ideal position. The ability to remove the aligners for eating and cleaning means neither of these is more difficult to do during treatment, compared to braces which are fixed onto the teeth for the duration of the treatment. The main drawback of invisalign however is there is not as much control over tooth movement compared to braces, and more complicated cases may be not appropriated treated using these appliances. 

Whether you are thinking about braces or invisalign, our dentists at the Dental Surgery St Marys can guide you through which options are appropriate for your case, in order to achieve that big, bright, beautiful smile you've always wanted. 

Dental Implants

Dental Implants have gained widespread popularity in recent years as a way to replace missing teeth or to help anchor loose and non-retentive dentures.

A dental implant is a titanium post that is placed surgically into the jawbone. On this post attachments for a denture, or a tooth (crown) can be placed. Crowns placed onto implants are not removable and aim to be a complete tooth replacement. 

Advantages of implants include

1) not requiring preparation of neighbouring teeth to have a fixed replacement of a lost tooth (e.g. a bridge).

2) the tooth is not removable, so doesn't require taking it out of your mouth like dentures for cleaning.

3) Can be surgically placed under local anaesthesia, much like the majority of dental procedures. In healthy patients with good oral hygiene, implants can be a simpler procedure than extractions, and often don't require more than mild analgesics (pain medications) post operatively. 

4) high success rate of 95-97% in healthy patients with good oral hygiene and no risk factors. Titanium is biocompatible and has an affinity for bone (osteointegration), so actually becomes 'stuck' into the jaw as the bone heals. 

The Dental Surgery St Marys can offer a number of implant solutions whether you are missing one , two or even all of your teeth. Book an appointment on (02) 9623 1756 to discuss your case with one of our dentists.

Crowns and Onlays

 So you've seen a dentist and they've advised your heavily broken down tooth requires a crown or onlay to fix it. What exactly is a crown/onlay? And are there different types?

Crowns and inlays are types of dental restorations compromising of porcelain, metal, or a combination of both which are cemented onto a tooth. They provide extra strength and improve the aesthetics of the teeth they are used to fix by covering all or part of the biting surfaces of the tooth.

Traditional crowns use a metal internal layer (the 'coping') which is then covered in a layer of porcelain. These are still widely used and when done correctly can look very natural. The main drawback with these crowns is that any gum recession can sometimes expose a dark margin, which is the metallic internal layer showing through the side of the tooth. 

Full porcelain crowns do not have any metal component. With modern techniques and materials these are very close to the strength of natural tooth enamel, and offer superior aesthetic/cosmetic properties to the traditional metal/porcelain combination crown. As with most modern materials these often cost a little more than the traditional combination crown, and also require a little more tooth preparation as the porcelain requires a thicker cross section to attain its strength.

Full metal/gold  are the third type of crown/onlay. These restorations offer superior physical properties to other materials, however cosmetics/aesthetics are a concern for those who prefer natural looking teeth. (note that some cultures find visible gold teeth desirable). Using metal/gold to make crowns/onlays also means that a tooth can be prepared minimally (a good thing as to reduce the amount of tooth structure removed), as metals can be made to be very thin yet still remain strong.

If you've been told you require a crown, onlay, inlay, or veneer, please book a consult with the doctors at the Dental Surgery- St Marys and we can discuss what type would be best for your situation.

Our next blog entry will discuss orthodontics, the difference between traditional braces, and Invisalign.

Root Canal Treatment. What is it and Why have I been told I need it?

It's something most patients dread to hear, and yet most are unaware exactly what is involved in root canal treatment. So what is Root Canal Treatment?

Root canal or 'Endodontic'  treatment is the process where the pulp (the nerves and blood vessels) in a tooth are removed due to infection and/or inflammation. Unlike other areas of the body where the body has a good blood supply to repair damage and send an immune response, teeth have a poor bloody supply. This means that inflammation and infection often are irreversible on their own and will not completely subside until some form of treatment is done. 

The inflammation in a tooth can be caused by numerous things, the most common being a very deep cavity/hole or trauma to the tooth. A deep cavity introduces bacteria into the inside of the tooth, which infects the nerve and causes pain. Trauma to a tooth can rupture the blood supply to it and cause irreparable damage.  Whatever the reason, the only way to remove the inflammation is to remove the damaged pulp tissue inside the tooth ( or if the patient wishes, the entire tooth). 

To perform a root canal the dentist will first anaesthetise the region to ensure no pain is felt during the procedure. Once numb a dental/rubber dam is placed over the tooth to ensure a sterile working field. An access point is prepared through the top of the tooth into the area of the nerve, and a series of instruments and medicaments (medicines) are used to clean the roots of the inflamed and infected nerve tissue. Once clean, the entire inside of the tooth is filled with a special rubberised filling to seal it off. 

So in short the aim of Endodontic/Root Canal Therapy is to remove the infected internal parts of a tooth so that 1) the tooth is not extracted and 2) the patient is no longer in pain. The treatment itself, although simple in its description, is a very intricate process (our measurements during treatment are often down to increments of half a millimetre!), which can span from 1 to 3 visits depending on the difficulty of the tooth. Some cases which are deemed very difficult are referred to a specialist in root canal treatments, called an 'Endodontist'. 

Here are the Dental Surgery - St Marys we are equipped with the latest in Endondontic instruments to ensure treatment is carried out as efficiently and accurately as possible. We use specialised hand pieces, electric apex locators (a device which ensures the entire tooth is cleaned out) and digital x-rays for all root canal cases. 

Certain teeth, once root canal therapy has been completed, will then require a crown or onlay to protect it. We will discuss in our next blog what the different types of crowns and onlays are and the pros and cons of each. 

Mouthguards, Which is the right one for you and your children?

Sporting accidents are one of the most common causes of dental injury. Many of the dental injuries we encounter at the surgery can be prevented or minimised by wearing a custom fitted, protective mouthguard.

Why wear a mouthguard?

Common dental injuries sustained during sport include broken or knocked out teeth, broken jaws, and cut lips. Custom fitted mouthguards help absorb and spread the impact from trauma to the face, which will help reduce or prevent injury to the mouth and jaw.

Dental injuries can be disfiguring, painful, and may involve lengthy/complex dental treatment and surgery. The cost of an injury to your teeth or jaw far exceeds the cost of a mouthguard.

Which type of mouthguard should you wear?

There are many types of mouthguard available, ranging from cheap over the counter types sold at sporting good stores and pharmacies, to professionally fitted custom -made mouthguards.

The Australian Dental Association strongly recommends wearing custom fitted mouthguards to ensure maximum protection. 

Custom fitted mouthguards are made by your dentist. An impression of your teeth is taken and plaster models are created. With the models the dentist can assess the best type of mouthguard appropriate for you and your activities.  Being individually made, they are comfortable, well-fitting, allow proper speech, won't fall out, and won't restrict your breathing. 

Over the counter mouthguards are far less effective than those which are custom fitted. These include both stock mouthguards that don't require fitting and 'boil and bite' self fitting mouthguards. 

How long does a mouthguard last?

Its important to bring your mouthguard with you when having your regular dental check-up. This is to make sure it still fits well to ensure maximum protection.

A new mouthguard may be needed if it has been damaged, or if secondary teeth have erupted in the case of children. 

How do you keep your mouthguard its best?

Here are a few tips to help maintain your mouthguard :

Rinse with cold water after use, and occasionally with mouthwash. 

When not in use, store in a rigid plastic container.

Keep out of direct sunlight - warmth and UV rays will change the shape and fit of the mouthguard. 

What to do when a tooth is knocked out.

A common dental injury and one of the only real dental 'emergencies' is when a tooth has experienced trauma and has been displaced or 'avulsed' out of its socket. The time and actions taken immediately following such an incident can dramatically change the long term outlook for the tooth.

So what should you do if your own tooth or someone you know has had their tooth avulsed?

Ideally the tooth should be put back into its socket. Pick up the tooth by its crown (the white part you normally see in the mouth), and if it has picked up a lot of debris a gentle 10 second rinse with cold water is needed. Place the tooth back into the socket and have the patient bite down on a tissue/gauze until you get to the dentist.

If getting the tooth back into the socket is not possible there are a number of suitable storage mediums to place the tooth in until you reach the dental surgery. Milk, Hanks solution (special storage medium for avulsed teeth), or saline would be best. Alternatively the patient can keep the tooth in their mouth e.g. between the molars and cheek. DO NOT USE REGULAR WATER!

The critical time frame when a tooth has been avulsed is 60 mins. Once an incident has been identified, call the nearest dental office and inform them of the situation ahead of time so that they can prepare a treatment room for the patients arrival. Depending on the state of the tooth, time taken to arrive, age and health of the patient, your dentist will then be able to assess what treatment will be needed in the weeks and months following the incident.

Ideally such problems would best be avoided, so in our next blog entry we will discuss the different types of mouthguards available and which is best for you and your children.

Which toothpaste is the right toothpaste?

A common question we get presented with is 'which toothpaste is the best toothpaste'?

Whilst the marketing gurus at the large dental companies will lead you to believe that their product is vastly superior to the competition, all toothpastes are made up of same basic ingredients. Fluoride, abrasive particles, some surfactant to get some bubbles and flavouring (generally mint).

Brushing your teeth serves 2 purposes, the toothbrush providing mechanical plaque and food removal (which should be complimented with flossing), and the toothpaste providing the fluoride which will remineralise and re-strengthen teeth after the exposure to acid which the plaque produces. The surfactant in theory helps remove the plaque by dissolving it, but if plaque is removed quickly enough after it forms it is soft and easily brushed away.

Whitening toothpastes work by having larger abrasive particles to help remove surface stains. These will help those who acquire stains on their teeth from coffee, tea, smoking etc, but will only provide very limited 'whitening' of the actual tooth. 

Sensitive toothpaste have an extra component that work by blocking the small channels/tubules that are present on the tooth surface. These channels are exposed if the enamel or gum covering them is worn away by erosion, teeth grinding, decay or gum disease, and these channels lead straight into the nerve of the tooth. Sensitivity is felt when something cold/hot/sweet hits the channels and the stimulus is carried to the nerve. Blocking the channels with sensitive toothpaste will then prevent this transmission and therefore the sensitivity. 

So what then is the best toothpaste?

If you don't experience any sensitivity, we recommend any fluoridated toothpaste that you don't mind the taste of (and hopefully is on sale!). Sensitive patients will benefit from 'sensitive' labelled toothpastes. The key to using toothpaste effectively is to only spit out the excess toothpaste once you've finished brushing, and not rinsing with water. This gives the fluoride more contact time on your teeth to remineralise and desensitise (if using sensitive toothpaste). Use a soft bristled toothbrush (medium and hard toothbrushes are too abrasive and destructive), or better yet an electric toothbrush. 

Welcome to the new Dental Surgery-St Marys website!

We are currently in the process of constructing a brand new website!

Please have a browse through.

-The Dental Surgery- St Marys Team