Permanent teeth can last a lifetime with proper care. The risk of tooth decay, gum disease and tooth loss can be reduced with good oral hygiene, a low-sugar diet, use of a mouthguard when playing sport, and regular visits to the dentist or other oral health professional. It is recommended that everyone, including young children, visit the dentist at least once every six months. Modern techniques mean that dental treatment can be carried out with no, or very little, discomfort.
When you go for a dental check-up, your dental professional will start by asking questions about your general health and medications. Many health conditions have an effect on your oral health and vice versa. And some medicines can affect your mouth or need to be taken into consideration before treatment.
Your dentist will inspect each tooth using small instruments inserted into your mouth, such as a mirror and probe (a fine, pick-like tool). The dentist looks for issues such as tooth decay, gum disease and other conditions.
Soft tissues (gums, tongue, lips, cheeks and palate) are also routinely inspected and screened for oral cancer and other possible problems. In some circumstances your dentist may also inspect your jaw joints and the lymph nodes in your neck.
If a suspected dental problem is difficult to see (for example, possible decay between two touching teeth, or an infection), the dentist may need to take x-rays. If a problem exists, your dentist will explain the treatment options and give you an estimate of the cost and likely waiting time.
Dental treatment – scaling and cleaning
Scaling and cleaning involves the removal of built-up debris from the teeth. This may include food particles, soft plaque (bacterial growth) or hard calculus (caused by the continual accumulation of plaque and minerals from saliva, sometimes called tartar). Plaque and calculus are the main causes of gum disease.
The dentist or hygienist then cleans and polishes your teeth using a rotating brush with a polishing paste. This helps treat and prevent gum disease.
You will be given tailored instructions on how to keep up your oral hygiene between appointments, as this is important to help maintain healthy gums.
Dental fissure sealants
Sealants protect teeth from decay. Any tooth that has deep grooves or fissures can be treated, but the most commonly treated teeth are the molars and premolars.
A sealant is a liquid solution that is painted on to the biting surface of a cleaned tooth, and which sets as a durable plastic material. It forms a physical barrier that stops food and other bacteria from collecting in the fissures of the tooth and causing decay. Fissure sealants are commonly recommended for children, as they reduce the risk of decay in permanent teeth.
Tooth decay that has caused a cavity (hole) is treated with dental fillings. The dentist uses a drill and other tools to remove the decay. The cavity is cleaned, dried and sealed with a filling material.
A variety of materials are available for filling the cavity. You will be given advice on the most suitable material based on the size, shape and location of the required filling. A common choice is tooth-coloured filling material, which can restore the aesthetic appearance of the tooth, as well as its shape and function.
Dental treatment for restoring damaged teeth
Your dentist can suggest various treatments to restore damaged teeth. These treatments help restore the appearance, shape and function of your teeth. They include:
- bonding – chipped, gapped, discoloured or oddly shaped teeth can be treated with bonding. A tooth-coloured resin filling is applied to achieve a more regular look to the affected tooth. This resin may need to be replaced with time as it wears or stains
- veneers – a veneer is a thin layer of resin or porcelain that is permanently glued to the front of the tooth. Sometimes the tooth needs to be slightly ground down to allow space for the veneer
- crowns or onlays – these are caps that are permanently cemented or bonded to a tooth. Crowns cover the whole tooth and can be made of just porcelain, porcelain and metal, or just metal depending on the area and the aesthetic or functional needs. Onlays only cover the tooth partially, and may be used if full tooth coverage is not completely necessary.
Root canal dental treatment
Root canal treatment is a procedure that replaces a tooth’s damaged or infected pulp with a filling. The ‘pulp' (often called the nerve of the tooth) is sensitive tissue that provides oxygen, nutrients and feeling to the tooth. It is housed in the hollow centre of a tooth (pulp chamber), along with blood vessels and nerves.
Extensive trauma or decay can irreversibly damage the pulp and it can become infected.
During root canal treatment, the damaged pulp is removed from a tooth. The dentist cleans and shapes the root canals with a drill and small files. The tooth’s interior is cleaned, dried and packed with a filling material that goes all the way down to the end of the root.
An artificial biting surface is created for the tooth out of filling material (tooth coloured or silver) or a crown. This also protects the tooth from fracture, which can occur after root canal treatment. A root canal may need to be performed in stages over a few appointments.
Dental treatment – tooth removal (extraction)
Modern dentistry and oral health practitioners aim to preserve natural teeth. However, extensively damaged or badly decayed teeth may need to be removed (extracted). The dentist may also recommend extraction to deal with wisdom teeth that are causing problems.
Wisdom teeth can contribute to various dental problems if they are impacted (the wisdom tooth grows at an angle and butts into the tooth next to it or the gum).
You may have a local anaesthetic before having a tooth removed (only the local area is numbed). Sedation or general anaesthesia may also be offered depending on the difficulty of the procedure.
Dental treatment – fitting of dentures
Dentures (also known as 'false teeth') are artificial teeth that replace some or all of your natural teeth and that you can remove at will. An 'immediate' denture can be made while you still have some of your teeth. It is fitted on the day your teeth are removed. However, changes to the jawbone during the healing process may cause the denture to gradually loosen. Within a few months, the immediate denture may need relining of its inner aspect to improve the fit.
Alternatively, a denture can be made a few months after teeth are removed. This allows time for the jawbone to heal and means that the denture should have a better fit.
Dentures needs to be removed and cleaned every day. It is recommended that you do not sleep with your dentures in.
Dental treatment – fitting of mouthguards
Mouthguards are protective devices that cover the teeth and gums to prevent injury to the teeth, gums, lips, tongue and jaws. They are frequently used while playing sport to prevent damage from accidental or deliberate knocks to the face.
A dentist or oral health professional can take impressions of your teeth and make a well-fitting, comfortable mouthguard for your protection.
Dental implants can be used to replace missing teeth. An implant is an artificial screw-shaped device made of titanium. It is surgically fixed into the jaw and an artificial tooth or prosthesis can be fitted on top of it. Several dental appointments are required for the adequate treatment planning, design and fitting of implants.
Titanium is a safe material that allows bone to grow around it. Implants have high success rates but they require an additional level of training and expertise so your dentist or oral health professional may need to refer you to another dentist or specialist.
Orthodontic treatment is often recommended to correct abnormalities in jaw and tooth position, such as crowding, an overbite or protruding (‘buck’) teeth. Your dentist may be able to treat these problems, or refer you to a specialist orthodontist for treatment. Corrective treatment may include braces or a removable device, and subsequently a retainer appliance to maintain correct tooth positions.
Referral to specialist for dental treatment
For treatment in difficult or complex cases, your dentist may refer you to a specialist dentist.
Subsidised dental treatment
All children aged up to 12 years are eligible for public dental services (non-concession card holders are eligible for general and denture care only).
You may also be eligible for public dental services if you fall into one of the following categories:
- young people aged 13 to 17 years who are healthcare card holders or dependants of concession card holders
- all children and young people up to 18 years of age in residential care provided by the Children Youth and Families division of the Department of Health and Human Services
- all youth justice clients in custodial care, up to 18 years of age
- people aged 18 years and over, who are healthcare or pensioner concession card holders or dependants of concession card holders
- all refugees and asylum seekers
- all Aboriginal and Torres Strait Islander people who are treated at The Royal Dental Hospital of Melbourne.
Where to get help