Check-up at Sydney dental clinics
A check-up is a regular preventative measure to control the health of teeth and gum and stop minor problems from becoming major ones.
We contact our patients every 6 months for such a periodic examination when we can thoroughly and carefully inspect their teeth, gums and oral tissue to ensure these are in the best of health.
At an initial visit, we take care to ask about your medical and dental history and any medication you are taking. These things can have an impact on your dental health, for example, diabetes can affect your gums, or gum disease can have an impact on your heart and certain medications can cause bad breath or dry mouth.
To confirm our clinical findings, we might take some X-rays to make sure there are no hidden issues between the teeth or under the old fillings.
If a female patient is pregnant, we make sure that they inform us before we take any X-rays, so we can prevent from any radiation exposure to the baby. So we either use a lead apron or postpone the X-ray examination.
We complete this periodic check-up by taking some photos of your teeth and gums.
After analysing all the data collected, we discuss everything with you. We carefully explain any treatments needed and the reasons for these.
We show you the X-ray and photo records so you can better understand the reason for our recommendations.
At this time, you also have the opportunity to pose questions or suggestions. We always take all your concerns into account in our treatment planning.
Normally our treatment plans are in 5 phases:
Phase 1 is the emergency phase to stop any pain or discomfort. It might vary from just a simple dressing of sensitive teeth to a pulpotomy (the first visit of nerve treatment), or even the extraction of a painful tooth or just a prescription for some medication.
Phase 2 is the prevention phase. Scaling, cleaning and minor fillings are done at this stage. We also give you oral hygiene instructions and some tips to keep your teeth healthy.
Phase 3 concerns major dental work, if necessary. These treatments could vary from root canal treatment, the extraction of wisdom teeth, to advanced gum treatment.
Phase 4 is replacing any missing teeth, if needed, and restoring the whole dentition to help patients consume a variety of foods for a healthy diet and to maintain sound digestion. This phase includes crown, bridge, denture or implant treatment.
Phase 5 is the cosmetic phase and can be started as soon as the third stage if you don’t need any advanced treatment. Phase 5 treatments can range from tooth whitening to orthodontic treatments to close gaps or align crooked teeth. For a Hollywood smile we can put veneer on your front teeth. This changes the shape and shade of your front teeth.
Implants offer the ground-breaking solution for replacing missing teeth that people have been dreaming of since the dawn of time.
What are implants?
Dental implants are manufactured replacements of teeth that are as natural and as comfortable as normal teeth. These implants are made of titanium metal with hydroxyapatite coating which makes them biocompatible and tolerable for the body. In fact, after an implant Osseo integration occurs, which means bone tissue grows over the implant and bonds seamlessly with the surface of the implant. This makes the implant very stable and strong.
As a result, you can return to normal life and enjoy eating and smiling again.
What is the implant procedure?
Before we start implant replacement, we perform some initial assessments to ensure the right outcome of the treatment.
Firstly, we check the patient’s medical history. Some medical conditions, such as diabetes, cancer (radiotherapy), gastric reflux, and periodontal (gum) disease can impact on the integration of the implant.
Smoking is also an important risk factor, especially during the healing phase of an implant after the surgery. Smoking can affect the vascularization of the tissue and Osseo integration of the implant.
Next we need a complete dental check-up to assess the dentition and the gingival tissue around the missing area. If there is any decay or there are tilted teeth around the missing part, these issues have to be fixed beforehand by fillings or braces. This ensures that there will be no food impaction around the implant where bacterial plaque can damage the gum. Another important factor that can affect the implant later down the line is gum disease. This could cause peri-implantitis (gum disease of the tissue, supporting the implant). This is another issue we need to fix before the surgery.
The next step is to take X-rays and 3D CT-scans to check the bone and make sure we have the right amount of bone and select the right size of implant as determined by the thickness and height of the alveolar bone.
After the initial assessment we prepare for the surgical stage which can be done under local or general anaesthesia.
During surgery we retract the gum, prepare the implant site inside the bone and install the implant. Depending on the primary stability of the implant, it can be exposed, or if the supporting tissue is not ready yet, we cover the implant with gum and wait for 2 to 6 months for the Osseo integration and then expose the implant with second-stage surgery. Sometimes we need to add some bone grafts around the implant to increase the strength of the bone.
After the implant is bonded to the jaw, we continue with the prosthetic part and take an impression to make a crown for the implant. The final stage is to attach the crown to the implant by screw or cement.
How do I maintain an implant?
It is very easy to maintain an implant. All you need to do is brush and floss the implant and rinse your mouth with non-alcoholic mouth wash. In addition, you continue your regular 6-monthly check-up
Root canal treatment
Root canal treatment is the procedure of pulp removal from the tooth roots and the filling of the root canals.
Pulp is the vital part of the tooth that consists of blood vessels and nerves and other soft tissue.
Tooth decay, if not treated early, can expose the nerve and cause sensitivity of the tooth to cold and heat. If this irritation of the nerve continues, severe pain can start, which can worsen if the pulp becomes infected due to necrosis of the vital tissue. At this late stage, the tooth has more pain so that biting on it causes pain to spread to the face, neck and the ear.
The treatment normally involves cleaning away the tooth decay and removing the infected pulp. The root canal will then be disinfected and filled. Finally, the decayed part of the tooth will be restored and capped to prevent fracture of the treated tooth.
During this procedure the tooth becomes numb by dentist and the patient almost doesn’t feel anything.
It is recommended to protect the tooth after root canal treatment by a crown as the treated tooth gets dry and fragile after losing its vitality and can break easily.
Do you have crooked teeth? We can be fixed by orthodontic treatment to improve the alignment of your teeth regardless of your age.
We use braces which are metal or ceramic appliances fitted onto the teeth to correct dental or jaw alignment problems.
They exert a gentle constant pressure on the teeth and jaw to move these to the desired position.
Normally the brackets are glued to the tooth surface and a wire sequence is used as engine to move the teeth slowly into the right position.
In most cases we use Damon brackets which are very small, smooth and delicate. The Damon bracket is known as the “Rolls Royce” of braces, as this system is gentle, helps maintain a high standard of oral hygiene, and it is less painful, more comfortable, allows shorter treatment time and requires fewer (if any) extractions.
Traditional brackets used to have elastic O-rings around them to secure the wires inside the brackets. However, the Damon brackets have gates to slide and keep the wire inside so the friction between the wire and the base of the bracket is reduced significantly. This helps the bracket and the teeth to move freely on the wire and align quicker.
The Damon system has clear brackets too for the front upper teeth so they are hardly visible and less noticeable.
With every orthodontic treatment we do a full analysis of the patient’s X-rays and profile and we focus on non-extraction orthodontics as much as possible. Only if the face profile is too full, do we recommend extraction.
A strict oral hygiene is necessary during orthodontic treatment as you get more food stuck between your teeth. The food needs to be removed after each meal to make sure you don’t get any tooth damage or gum disease. You need to keep your teeth and periodontal tissue healthy until the braces are removed.
After orthodontic treatment retention is very important. We glue fixed wire permanently behind the front teeth and give you a plastic retainer to wear at night to hold the teeth in their final position.
What is tooth whitening?
Tooth whitening is the removal of stains and changing the colour of teeth by using special medication.
The main substance used for whitening is a hydrogen peroxide gel, which is activated by light and releases oxygen on the tooth’s surface to remove stains and discolouration.
Why are my teeth yellow?
There are different reasons for having tooth discoloration. Sometimes teeth are naturally yellowish and some get darker as you age.
The biggest cause of the discoloration of teeth is what your teeth are exposed to. Smoking, dark-coloured drinks, such as wine, black tea or coffee, coloured foods, such as beetroot, cherries and mulberries, and even some medication taken at the early stage of teeth growth, can create dark patches on the teeth.
What happens when I get my teeth whitened?
Tooth whitening is a different procedure than teeth cleaning, which is the mechanical removal of stains, calculus and build-up from the teeth to have healthy gums. In contrast, the whitening process lightens the tooth colour a few shades, the results depending on the original reason for the discoloration.
First you need a complete check-up to make sure your teeth are suitable for tooth whitening and whether there are some contra-indications. This means we make sure you have healthy gums and teeth and if there are any concerns, we fix them before performing whitening.
If there are any fillings or crowns on the front teeth, you need to be aware that they are not going to change colour, so there is a possibility of ending up with a shade difference between your natural teeth and the artificial ones at the end of treatment. In some cases, we may have to renew your fillings and crowns to match the colour of your new naturally white teeth.
There are mainly two techniques to whiten teeth. One way is to have a professional in-office treatment by your dentist. we use Philips ZOOM whitening system to get the best result and normally you can see 2 to 3 shade difference instantly. Alternatively, you can use an at-home whitening kit. If this is your preferred method, your dentist will provide you with a custom-made tray that fits your teeth and instructs you on how to apply the medication.
Teeth can get some slight sensitivity after a whitening procedure. This is usually temporary and can be relieved by painkillers.
After the treatment you should avoid darkly coloured foods. Remember, the better you keep them clean, the longer you can have a whiter and brighter smile.
When there is some decay in a tooth, it can spread and damage the whole tooth, so it is very important to clean out the decay and prevent tooth loss. Our objective is to leave as much of the healthy tissue as possible and to be as conservative in our treatment as we can.
Normally before we start the procedure, we gently numb the tooth so the patient is entirely comfortable and doesn’t feel any sensitivity. Then we continue with cleaning out the decay and disinfecting the cavity. We use filling material to restore the original shape and function of the tooth.
Composite is the most commonly used filling material nowadays. It is a resin-based material which is malleable and can be formed according to the tooth anatomy. It is then cured by light to make it hard. This material is entirely biocompatible and has no side effects.
After the completion of a filling, we recommend the patients not eat until the anaesthesia has worn off, since they might inadvertently bite the insides of their cheeks and lips.
Sensitivity can occur some days after the filling. This is no cause for alarm.
Children should start having regular dental check-ups from age two. This enables us to check their oral health and the growth of their teeth and jaw.
We understand that dental visits can be stressful for small children so we go out of our way to make the dental visits as pleasant as possible and allow children to get used to the dental office.
The visit normally starts with a conversation so they get to know and trust their dentist. We also use this opportunity to let the child get accustomed to the high tech dental chair and let them touch the instruments and even play with the buttons and handpieces.
We never use potentially negative words such as ‘needle’, ‘pain’ or ‘drill’. We prefer to use funny alternatives like tickling the teeth instead of drilling.
A note to parents: kids are very intuitive and can sense a parent’s anxiety, so relax and remain upbeat when your child visits the dentist.
During the visit, we also educate the kids (and parents) on brushing technique and teach them about the importance of good oral hygiene and healthy nutrition for the health of their teeth.
During the oral examination we check the mouth and teeth. We check for any decay or missing teeth and we especially consider the jaw growth to make sure all teeth have enough space to erupt.
Sometimes X-rays are necessary to assess the teeth.
Finally, we might need to follow-up with some treatment like filling or cleaning.
Sometimes the fissures and pits on molar teeth are very deep, making it impossible for brush bristles to get in and properly clean away food residue. We then clean the fissures and seal them with special filling materials, called fissure sealant. This procedure makes brushing easier and more effective. It is also entirely pain free and doesn’t need any anaesthesia. We recommend fissure sealants mostly for kids as soon as they get their permanent molar teeth.
Wisdom teeth are the four very last teeth on each side of the jaw. These are the final teeth that grow during the late teenage years and early twenties. They are not extra teeth and if we have enough jaw size they grow properly and work very well.
As they are the last teeth to develop, normally the jaw has been occupied with other teeth and if the jaw size is not right, they can’t erupt in the right position so they become either impacted or half erupted. They tend to push against the front teeth to open space for themselves causing pain on the jaw or crowding of the front teeth.
Sometimes, in cases of poor oral hygiene, food gets stuck between the gum and a half-erupted tooth and gum swelling and a painful infection called as pericoronitis, can occur.
It is very important to keep the wisdom teeth clean as they tend to get more food impaction than other teeth and they are prone to decay earlier than other teeth.
Wisdom tooth extraction:
If the wisdom tooth is erupted but is decayed or infected, it is extracted like a normal tooth. However, if it is embedded in the bone, we need to access the tooth through the gum. In the case of hard tissue impaction, the bone needs to be removed from the tooth.
Sometimes, if there is a risk of damage to the front teeth during the surgery, we need to section the tooth and remove it in pieces.
It goes without saying that all these procedures are done under topical or general anaesthesia and the patient doesn’t feel any pain.
After the removal of the tooth, we pack the wound with sterile gauze. Sometimes small stitches are needed to prevent any bleeding. Recovery time is normally 48 to 72 hours.
Biting on the gauze for an hour and avoiding spitting or drinking anything through a straw helps to prevent secondary bleeding.
Applying an ice pack on the face around the surgical area every 15 to 20 min prevents swelling and inflammation
Maintaining oral hygiene is very important during the healing phase and regularly using a mouth wash in addition to brushing will prevent any secondary infection
Pain killer tablets, and sometimes antibiotics can be prescribed
Smoking and drinking alcohol should be avoided
A crown is a manufactured cover for damaged, weak, discoloured or missing teeth. It is normally made of porcelain fused to a metal or zirconia frame.
The tooth has to be shaved and reduced to create space for the crown and then an impression is taken from the tooth and sent to the lab to fabricate a custom-made cap for the prepared tooth. The cap is then fitted and cemented to the tooth.
It preserves the tooth’s structural integrity and makes it stronger and prevents any tooth fracture.
While we are waiting for the crown to be made by the lab we cover the tooth with a temporary crown to prevent it from chipping and to ensure the patient does not experience any sensitivity.
Sometimes crowns and bridges are used to replace a missing tooth. In this case, we fit 2 crowns to the teeth on either side of the missing tooth and a false tooth is attached to these crowns. In this way we can replace one or several missing teeth.
The maintenance of a crown is the same as taking care of natural teeth, since it needs brushing and flossing. To clean under the bridge, super floss or micro brushes can be used and recently water jets have become available to rinse under the bridge where it is difficult to reach with normal brush.
The denture is an artificial appliance replacing missing natural teeth. Dentures can be removed from the mouth and need regular maintenance to keep them clean. They normally fit precisely to the ridge and make it possible to again chew the food you love and restore the appearance of your face.
There are two different types of dentures:
Partial dentures are used when we have some missing teeth. They attach to the remaining teeth by wire, tooth-coloured clasps or some precision attachments installed on the artificial crowns. They are made of acrylic resin and sometimes the frame is metallic to make it lighter and slim fitting.
we can make Valplast flexible dentures which doesn't have any wire and has pink flexible retainers not to show when you smile.
Full dentures are applied in cases where all the teeth have been lost. These replace the whole dentition in the mouth. After receiving these removable dentures, patients may at first find them awkward and even bulky, but they get used to them very quickly.
We recommend that you initially eat soft food and take small bites of food to get used to these artificial teeth.
As we age, we lose bone volume, especially when we have teeth missing.
As a result, after some years of using removable dentures, the adaptability of dentures and underlying gum tissue is compromised. Some maintenance such as relining and polishing can be done to address this condition.
If you lose most of your bone structure, your dentures might get very loose and the best option to fix them will be an implant supported denture.
When your bone structure is not strong enough to support removable dentures, we can use implants to return stability to dentures.
The procedure entails using normal implants with locator attachments or mini implants with ball-and-socket attachments. In both cases we put a small number of implants in each jaw and attach the implants to the dentures with removable fittings.
The procedure normally takes an hour and doesn’t need any cuts or bone exposure.
The implants are installed in the jaw through a very fine insertion into the gum.
The dentures are fitted to the implants straight after the surgery so you can have your dentures tightly fixed to your jaw in the same visit.
The dentures are still removable and you have to take them out for regular cleaning as before.
We also have treatments to help with snoring and give you (and your partner) a peaceful night’s sleep.
What is obstructive sleep apnoea (OSA)?
Obstructive sleep apnoea (OSA) is a serious and lifelong medical condition that affects 750,000 Australians. Data released by Deloitte Access Economics in 2011 showed that the incidence of OSA increases as we get older.
OSA is a hidden condition that can affect sleep, health and quality of life. It has been linked to hypertension, diabetes, heart disease, work- and driving-related accidents and stroke and it can have a serious impact on a person’s quality of life, work, education and relationships.
What causes OSA?
During sleep, muscles relax, including those that control the tongue and throat. The soft tissue at the back of throat can sag, narrowing and constricting the airway.
The symptoms can vary from snoring to excessive daytime sleepiness, pauses in breathing or teeth grinding while sleeping.
What are the treatment options for OSA?
Devices in the SomnoDent® family of products treat OSA by stabilizing and/or moving the lower jaw slightly forward. This optimal positioning of the jaw prevents the patient’s airway from collapsing during sleep.
Your doctor and/or dentist will make the decision on which treatment type is right for you and that often depends on the severity of your obstructive sleep apnoea. One type of treatment is the use of a Somnodent device such as continuous open airway therapy (COAT).
COAT™ — Continuous open airway therapy
Worn during sleep, continuous open airway therapy (COAT) is a first-line treatment option for people with mild to moderate OSA and consists of devices with two components that fit over the upper and lower teeth.
These oral devices are comfortable and simple for patients to use which is why many patients prefer COAT therapy to other options. COAT is also a viable option for those who do not respond well to other treatment options.
Who prescribes COAT?
A sleep physician will diagnose you with OSA and determine the most effective treatment option for you.
After the physician prescribes COAT therapy, a qualified sleep dentist will conduct a thorough oral exam to confirm your oral health status, as well as ensure you are dentally appropriate for the device.
Dental impressions and a bite registration are required to fabricate the SomnoDent. These items are then sent to SomnoMed where the device is made.
Once customized for you, the device will be fitted by the dentist, who will instruct you on how to insert and remove it, including how to clean and take care of it.
The main symptom of a dental emergency is pain. Sometimes it is accompanied with swelling, fever, headache, or the pain even transferring to the neck and shoulder.
This type of emergency is usually related to a decayed or cracked tooth which has gradually developed into decay deep inside the tooth that irritates the nerve.
Initially a decayed or cracked tooth is sensitive to cold or hot drinks or food. If the tooth is not treated at this stage the bacteria will leak inside the pulp and will contaminate the tooth and nerve. The tooth will lose its vitality and the dead tissue inside the tooth will create an infection which will expand to the jaw and tissue around the tooth. At this stage the pain will be more severe and the tooth will be tender to touch and when biting down. If it still remains untreated, the infection can transfer to the surrounding anatomy and can become life threatening.
Sometimes pain starts after food impaction between teeth and the resulting gum inflammation. If this is the case, you can clean around the tooth with a brush and gently floss the subgingival area (the area below the gum line) before contacting your dentist for an assessment and treatment.
Sometimes a dental cleaning and antibiotic therapy can fix the problem, but in some circumstances it might need root canal treatment and in more severe cases it might require the extraction of the tooth.
If crooked teeth are getting in the way of your beautiful smile, the TRU-LINE IOS uses the proven principles of orthodontics to gently and gradually move teeth to their ideal positions in your mouth, without using unsightly metal braes.
Using the latest technology, the TRU-LINE IOS can give you the smile you’ve always wanted, easily and cost-effectively.
How does it work?
Tru-line uses a series of custom-made transparent plastic trays - often called aligners, positioners or correctors - to gently move your teeth to a more ideal position.
Each aligner is worn for approximately 2 weeks, but no longer than 3 weeks.
Tru-line will only work if there is 100% compliance from the wearer.
The aligner is worn 24/7 and only taken out to eat, brush and floss.
Who can use Tru-line?
Many orthodontic problems can be treated with Tru-line, but since every case is unique, only your Tru-line dentist can diagnose your suitability.
Aligner therapy works very well in those patients it is suited for.
What are the advantages of Tru-line?
There are no wires, metal or ceramic brackets, or metal bands to irritate your mouth.
The convenience and ease of use of Tru-line makes it the ideal choice for the image-conscious patient.
Other people won’t notice you’re in treatment.
When considering orthodontic treatment for children, we examine the face and teeth at the same time and predict jaw growth to make sure we get the right size and position of the jaw to accommodate all the teeth.
We therefore assess the child’s growth from as early as 5 years and if we notice any skeletal and growth discrepancy, we include it in the orthopaedic treatment plan.
As long as the child is growing, so we can encourage the jaw to grow to its maximum size and into the right position to prevent any future dental complications such as teeth impaction or under- or over-growth of the jaw.
As part of the treatment, we need to take X-rays to analyse the positions of the upper and lower jaw in relation to each other and to the base of the skull.
We consider the size and position of the teeth and if we notice any abnormalities, we can make some appliances to be installed on the teeth to expand or advance the jaw to achieve the optimum size and position.
At early stages we use some trainers to correct postural or habitual problems which can limit and affect dental and skeletal growth.
We get a second opinion from an Ear Nose and Throat Specialist at this stage to check the airway and make sure there are no blockages in the respiratory track.
The second stage mostly involves upper or lower jaw expansion and advancement using a removable or fixed expander. The final stage is orthodontic treatment to align the teeth.
TAD or a temporary anchorage device is a mini screw-like implant installed in-between the teeth to control tooth movement without affecting the position of other teeth.
In the past, dentists used the other teeth as anchor points. However, this caused unwanted teeth movement and increased the treatment time.
Now we install TADs in the jaw so we get stronger and faster movement with no side-effects on the opposing teeth.
After a thorough assessment of the teeth and the X-rays, a small amount of anaesthesia is applied to the gum and a screw placed into the jaw. The screw is engaged to the teeth using elastics or coil springs.
The procedure of TAD-installation is very quick and easy. No cutting is necessary and no bleeding results. Normally there is also no pain during or after the treatment.
A mouth guard is a custom-made appliance used over the teeth to protect them from wear and damage while sleeping or doing contact sports.
People with the habit of clenching and grinding their teeth while sleeping put a lot of pressure on the teeth and gums and feel pain on their temporomandibular joint (TMJ) when they get up in the morning. In the long term this can result in a loss of tooth tissue, mobility of teeth, TMJ disorders and pain.
A mouth guard or night guard relaxes the TMJ and protects the teeth from unwanted pressure and damage.
Another type of mouth guard is a sport guard which prevents injury or fracture of teeth and surrounding tissue. Sport guards can be made from hard or soft material.
To make a mouth guard, we take an impression of the teeth and make the mouth guard on a plaster model of your teeth. The mouth guard is then fitted and adjusted to your exact specifications.
To understand gum disease, we’d like to briefly explain what periodontal tissue is.
Periodontal tissue has 2 parts: soft and hard tissue. The soft tissue consists of the gum, vascular system and the ligaments that attach the tooth to the jaw. The hard periodontal tissue includes the tooth and alveolar ridge or the jaw bone.
Gum disease is an inflammation caused by poor oral hygiene that affects the attachment of the tooth to the soft and hard tissue. This inflammation can progress to the bone and eventually lead to tooth loss due to a lack of periodontal support.
There are 3 stages of periodontal disease: gingivitis, periodontitis and advanced periodontitis.
The main contributing factor to gum disease is the bacterial plaque gathering around the gum line. The toxins produced by those invisible microorganisms damage the bond between tooth and gum. There are some risk factors that can increase the effect of those toxins, such as smoking, diabetes, pregnancy, stress and poor oral hygiene.
It is very important to diagnose gum disease at an early stage and fix it before the destruction of the soft and hard tissue starts and gingival recession or bone loss occurs around the tooth.
Gum disease normally starts with getting build-up and calculus around the gum. Unfortunately, this provides an excellent breeding ground for bacteria and plaque accumulation. So it is very important to notice the calculus and remove it at an early stage, before it penetrates to the deeper layers and detaches the gum from the tooth. Left too late, the periodontal tissue will recede and the tooth will be compromised.
Symptoms of gum disease: (most of these symptoms are painless):
Bleeding with brushing
Gingival recession (gum moves down)
A wobbly tooth
It is very important to contact your dentist as soon as you notice any of these symptoms.