Magee Dental Surgery: Camberwell, Victoria 3124

Dental information -Special topics- Accidents Anorexia Arthritis Bad breath Bisphosphonates Bleeding gums Boot camp for kids Braces Bruxism Burning mouth & tongue Burning mouth & tongue Cancer treatment Caries Chewing gum Cleaning kids teeth Crowns Decay Dentures Diabetes Diet and Acid erosion Drinks Dry mouth Dummies Eating disorders Endodontic treatment Erosion Erosion Eruption dates Fluoride Genetics and gums Geographic tongue Gingivitis Grinding Heart Risks Hormones Implants Infection control Jaw pain Joint pain Knocked out tooth Lichen planus Morning sickness Mouthguard Info Mouthguards Musican's mouths Oral health rating Orthodontics Osteonecrosis Osteoporosis Periodontal disease Porcelain veneers Pregnancy advice Radiation therapy Radiographs Research pain paper Research to help gaggers Root canal treatment Scaling and cleaning Sensitive teeth Smoking Sports drinks Sterilization Stroke Risks Teething (babies) Thumb sucking TMJ TMJ pain Tongue piercing Tooth brushes Tooth mousse Toothpaste Trauma Trigeminal neuralgia Unreal pain Veneers Vitamin C When teeth grow Whitening teeth Wisdom teeth Xerostomia X-rays

Accidents
What do you do if a tooth is knocked out?
Anorexia
Eating disorders can have serious dental consequences. Dentists can be part of the team who helps with your health while you deal with the eating disorder.
Arthritis
Is there anything that would help me?
Bad breath
Read some odd research on this common problem
Bisphosphonates
These medications used in cancer and osteoporosis treatment are a real concern to dentists. Find out why and let the dentist know if you are taking these drugs.
Bleeding gums
When you clean your teeth and your gums bleed should you be concerned?
Boot camp for kids
Are your kids ready for a fun challenge? The ADA has a web site just of them. You can start your kid's Bootcamp program anytime-just click on the first day and get them started with Day One's Basic Training.
Braces
Orthodontics seems so common today. When should I have my child checked out for braces?
Bruxism
Bruxism or wearing down your teeth from grinding is not uncommon. Other symptoms are more common in bruxers. What?
Burning mouth & tongue
Burning mouth: You should be confused because we are !
Burning mouth & tongue
A tongue or mouth with burning sensation is not uncommon. This condition is linked to certain ages and stages in life.
Cancer treatment
Remembering to keep your mouth and gums healthy before and during treatment for cancer is very important
Caries
Caries or decay is a disease caused by bacteria. Diet and prevention are linked to successfully managing this disease.
Chewing gum
Chewing gum can help prevent and heal teeth - if you make the right choice.
Cleaning kids teeth
Help avoid the 'bathroom' fights morning and night!
Crowns
Should you have a filling or a crown? What is involved and how will you benefit?
Decay
Getting holes in your teeth is preventable. Become informed so you can make a difference.
Dentures
How do you live well with new dentures? Hints and suggestions for success
Diabetes
What should you do 'dentally' if you have diabetes? What about the gums and diabetes?
Diet and Acid erosion
Diet and erosion: cause and combating!
Drinks
Acid and sugar content of drinks is a great concern in looking after your teeth for a long life. Find out what sort of damage may occur - even with diet drinks.
Dry mouth
Medications and illness can dry our mouths. Find out our hints for relief.
Dummies
Sucking is natural for babies and it is comforting. Will that dummy affect my babies teeth later in life?
Eating disorders
Anorexia and bulimia may be seen by a dentist before any other health professional. Find out why the teeth are affected.
Endodontic treatment
A 'dead' tooth causes pain and needs to have endodontic treatment. It sounds very complex. Find out what and why the inside of the tooth is treated.
Erosion
Are you wearing your teeth down or out! What causes erosion and how do you make sure this insidious condition doesn't cost you money.
Erosion
Are you wearing your teeth down or out! What causes erosion and how do you make sure this insidious condition doesn't cost you money.
Eruption dates
When should teeth start to grow? Is it better for teeth to be early or late?
Fluoride
This is added to water supplies to help prevent tooth decay. Why shouldn't you remove it with your water filter?
Genetics and gums
Largest study ever using genetic testing to help with gum health
Geographic tongue
Do you have a 'road map' in your mouth? Geographic tongue affects up to 4% of the population.
Gingivitis
The most common infection dentists see is gingivitis. It is preventable and treatable.
Grinding
Don't wear away your teeth. Night grinding is a real problem.
Heart Risks
Research is becoming clearer and showing gum disease is linked to heart attacks.
Hormones
At different stages of life different hormones affect our gums.
Implants
The newest major change to dentistry has been the ability to replace teeth. Dental implants may be an option if you have a missing tooth or dentures that are always loose.
Infection control
You need to know that the dental surgery is concerned with your general health and safety. Infection control is how we make sure we don't share 'bugs'.
Jaw pain
My teeth don't ache but my face does. Should I see a doctor or a dentist?
Joint pain
Does it 'click' when you open your jaw. Find out why.
Knocked out tooth
Emergency help - you need to act quickly.
Lichen planus
Lichen planus is a common disease of the skin and mouth. Why, how and what?
Morning sickness
If you suffer from this it is important to take our advice so you don't cause long term tooth damage.
Mouthguard Info
New ADA information resources for sports clubs
Mouthguards
Be safe when you play sport. A mouthguard can save 1,000's of dollars.
Musican's mouths
Did you know that people who play musical instruments and sing are prone to certain types of mouth and face pain?
Oral health rating
New studies rank Aussies 1st or 2nd in nine different oral health indicators when compared to UK, USA and Germany
Orthodontics
When should my child have orthodontics, why and what?
Osteonecrosis
This is a rare but serious condition of the jaw bone. The symptoms and risk factors are discussed.
Osteoporosis
If you have osteoporosis you may be taking medications which the dentist needs to know about. Find out why.
Periodontal disease
80% of Australians have this disease in some form. Be informed to reduce its impact in your mouth
Porcelain veneers
Fine coatings of porcelain can cover defects in teeth and make them look stunning and perfect again.
Pregnancy advice
Cravings, morning sickness, bleeding gums and how do I have a healthy baby?
Radiation therapy
How can I maintain the health of my teeth and gums while I have radiation therapy? Loss of appetite, dry mouth and nausea!
Radiographs
Why do dentists want to take radiographs of teeth? Can't they just look around your mouth for holes?
Research pain paper
German brain scan research gives new insight into dental pain
Research to help gaggers
Having pressure applied to the palm of the hand can reduce gagging
Root canal treatment
The inside of the tooth root is treated by dentists. Find out what and why and how of root canal treatment.
Scaling and cleaning
Removing buildup around the teeth may not be a favorite part of the dental visit. Why does it matter and what causes the buildup?
Sensitive teeth
Ice-cream -ouch. Cold water -ouch. Find relief from sensitive teeth.
Smoking
You know it affects your lungs but why is your dentist talking about gum damage and smoking?
Sports drinks
Sports drinks are great for rehydrating but terrible for teeth. Find the sensible balance.
Sterilization
Your health is important so we take extra special precautions to keep you safe.
Stroke Risks
Gum health and strokes have been linked. Prevent the risk of strokes with healthy gums?
Teething (babies)
What is normal? When should teeth come through? How can I survive as a parent?
Thumb sucking
What is worse - thumb or dummy? Will they ruin my childs teeth and mean we will need braces later in life?
TMJ
My dentist said I have TMJ problems. What does that mean and how can it be fixed?
TMJ pain
My face aches and my teeth ache on BOTH sides of my face. Why?
Tongue piercing
Is tongue piercing dangerous to teeth or is it all a rumor spread by old people?
Tooth brushes
Which toothbrush do I need? Soft? Hard? Electric? Some hints on what to look for and how to decide what you should do.
Tooth mousse
Prevention of dental caries is important to Aussie's
Toothpaste
Low dose children's toothpaste does little to protect against decay
Trauma
Find out what to do if you have a tooth accident. Quick and correct action is very important.
Trigeminal neuralgia
What is trigeminal neuralgia? What is the cause and how is it treated?
Unreal pain
It's not a 'normal' toothache. What is it and how can we make it go away.
Veneers
Appearance is important and veneers are an option for making your teeth look better.
Vitamin C
Vitamin C is not just good to stop colds and flu.
When teeth grow
When should teeth come through? What is 'normal'?
Whitening teeth
Please make my teeth whiter! How do you do that?
Wisdom teeth
Everyone seems to be getting their wisdom teeth out and you want to know what's going on! Do you have any wisdom teeth and will they need to be removed?
Xerostomia
A dry mouth is uncomfortable and causes tooth decay. The things you need to know.
X-rays
Is taking xrays really necessary in your mouth if you don't have any pain or discomfort?

Magee Dental Care
575 Riversdale Rd
Camberwell 3124
Ph 9882 4444
Information sheet from www.mageedentalcare.com

Endodontics (Root Canal Treatment RCT)

What is Endodontic (Root Canal) treatment?
Structure of teeth
Why do RCT?
Pain and RCT
How of RCT

What is Endodontic or Root Canal treatment?

• Treatment of the nerve space or root canal of the tooth.
• Endodontic treatment and Root Canal treatment usually refer to the same thing.
• 'Endo' means internal, therefore inside and 'odont' is a tooth.

The structure of teeth
The outside of the tooth is covered with enamel. The next layer is the dentine. Inside the dentine is a space with nerves and blood vessels.
The root canal is the space in the root of the tooth which contains the pulp (blood vessels and nerves). The pulp of the tooth supplies nourishment and sensation to the tooth.
The pulp tissue gives the tooth the ability to heal minor damage to the dentine - particularly in response to a low grade irritation or damage e.g. slow dental decay. The pulp protects the tooth giving it greater resistance to decay. The pulp gives the tooth the ability to feel hot and cold sensation.

Why do RCT (Root canal treatment)?
When the pulp in the tooth is destroyed or "dies" the pulp chamber or root canal becomes empty or full of "dead" (necrotic) body fluids then bacteria can enter this space. The body's defense mechanisms can not remove the bacteria so an infection forms.
Common causes of pulp damage:

• Decay occurring close to the pulp - unfortunately this is not always deep cavities. The anatomy of some teeth result in the pulp being close to the surface of the tooth.
• Trauma (accidents) . Moderate trauma may cause injury to the pulp that the body will be able to repair. Sometimes the pulp in the tooth 'dies' years after trauma and the mechanisms and reasons are not always well understood.
• Effect of having large restorations or fillings over a period of time
• Irritation over an extended time

Non-painful death!
Some people have pulp damage without any symptoms. They have no pain. A dentist may discover a 'dead' tooth via radiographs (x-rays) showing bone destruction or in finding a very loose tooth or finding pus formation or a hole in the bone near a tooth that releases pus slowly (draining sinus).
Attention should be paid to removing the infection and healing the bone. Long term dental infections have been linked to heart attacks and strokes.

Pain and the root canal
Tooth pain that may result in the need for endodontic treatment may include:

• Sensitivity to cold and hot. Severe pain which lasts for some time after the hot or cold has been removed is a sign that the pulp may have irreversible damage. Sensitivity to hot and cold may also be due to dental decay, gum recession or a tooth crack.
• Pain on chewing or pressure. This may also indicate a crack in a tooth, or periodontal disease or a endodontic abscess.

Prolonged pain sensitivity to hot and cold is usually one of the early symptoms of pulp damage. The pulp is 'alive' at this stage but the damage to it has been so great that the pulp tissue is unable to heal itself and will continue getting worse until it degenerates totally and 'dies'. Hot and cold expands and contacts the pulp tissue causing pain. Often at this stage hot causes pain which may take minutes to subside and this may be relieved by the placement of cold on the tooth.
In an undamaged pulp the tissue has mechanisms to control this expansion/contraction so pain isn't experienced.

The cause of pain when a tooth 'dies' is the pressure, of the 'dead' contents of the inside of the tooth (consisting of dead pulp tissue, debris, and bacteria), on the surrounding bone and gums (periodontal ligament ) so the tooth often feels painful to touch yet may not be sensitive to changes in temperature. Symptoms most commonly associated with a 'dead' nerve are a tooth that hurts to bite on, becomes sore to touch or push on, and in acute stages facial swelling occurs.

Why do root canal treatment?
An infection in the root canal of a tooth can cause:

• a swelling with pus in the area around the tooth root
• a swelling that may spread to other areas of the face or neck or head
• bone loss around the tip of the root of the tooth
• a drain hole (called a sinus) between the root of the infected tooth and outside the bone. This can be thorough the side of the tooth into the periodontium or through to the cheek or tongue areas.

Root canal treatment doesn't only aim to get rid of the result of the infection e.g. pain and swelling, but it aims to get rid of the cause of the infection. This is done by cleaning the damaged pulp or debris from the root canal and sealing the root canal against bacteria (germs).

How do you do root canal (endodontic) treatment?
Before treatment commences a dentist or specialist endodontist will try to determine whether a tooth is likely to be able to be successfully treated and to be restored as a functional or cosmetic part of your mouth. This is done using radiographs (x-rays), visual examination and periodontal examinations.
Endodontic treatment of a tooth involves:

1. 1. Making the tooth comfortable
   Most times we make the tooth numb (usual way - you just shut your eyes and start planing your next major birthday and ... easy isn't it!).
   Sometimes we don't need to make your tooth numb because the nerve is goooooone!
2. 2. Rain Coat
   We need to keep the tooth free from any other germs and bacteria that live in your mouth. A rubber cloth (RUBBER DAM) is placed over your tooth to keep saliva out.
   This is great for you because you don't have to worry about the water getting into your mouth or the strange tasting liquids used to wash your tooth.
3. 3. Preparing the tooth
   It may be necessary to remove any restorations (fillings or crowns) in teeth before the root canal treatment. This to attempt to seal out bacteria. Usually a temporary restoration (filling or crown) is placed in the tooth until the root canal treatment is completed. Then a final restoration will be placed in the tooth.
4. 4. Finding the root canals of a tooth
   To find the root canals we drill through the biting surfaces of the back teeth and through the back of the front teeth.
   Each tooth is unique. Teeth have differing numbers of root canals and different shapes. Research has show us the most common positions of canals and the most common numbers of canals and we even have some idea of the standard lengths of roots of teeth.
5. 5. Cleaning the root canals
   Tiny metal files are used to carefully clean the 'gunk' (pulp, bacteria, pus etc.) out of the root canals. These tiny metal files are used to shape the root canals to accept the filling material.
   The canals are also washed with special liquids.
6. 6. Filling the root canals
   Root canals are cleaned, dried and then filled. The filling is aims to fill and seal the root canal so bacteria reentering the root canal. Different materials can be used for this. A common filling material is called "gutta percha" and it is cemented in the tooth.

Notes: