Dental treatment

Permanent teeth can last a lifetime with good care. The risk of tooth decay, gum disease and tooth loss can be reduced with:

• good oral hygiene,
• a low-sugar and acid diet,
• use of a mouthguard when playing sport
• regular dental visits.

It is recommended that everyone, including young children, visit the dentist twice a year. Modern techniques mean that dental treatment can be carried out with no, or very little, discomfort.

Dental check-ups

When you go for a dental check-up, your dentist should ask questions about your general health and medications. Many health conditions have an effect on your oral health and vice versa. Some medicines can affect your mouth or need to be taken into consideration before dental treatment.

Your dentist will check each tooth using small instruments, 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 in the mouth (gums, tongue, lips, cheeks and palate) are also checked for signs of oral cancer and other possible problems. Your dentist may also check 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), x-rays may be needed. If there’s a problem, your dentist will explain the treatment options and give you an estimate of the cost and the time it will take.

Professional teeth cleaning

Professional cleaning removes built-up debris from the teeth. This may include food particles, soft plaque (bacterial growth) or hard calculus (caused by the mineral deposits from saliva onto the soft plaque, sometimes called tartar). Plaque and calculus are the main causes of gum disease.

The dental professional then cleans and polishes your teeth using a rotating brush with a polishing paste. Professional cleaning helps treat and prevent gum disease.

Your dental professional can give you advice on how to keep up your oral hygiene between appointments to maintain healthy teeth and gums.

Dental fissure sealants

Sealants protect teeth from decay. Any tooth that has deep grooves or fissures can be treated, but fissure sealants are usually placed on molars and premolars rather than front teeth.

A sealant is painted on to the biting surface of a cleaned tooth, and sets as a durable plastic material. It creates a barrier that stops food and other bacteria from collecting in the grooves of the tooth and causing decay. Fissure sealants are often recommended for children, as they reduce the risk of decay in permanent teeth.

Dental fillings

Dental fillings are used to treat tooth decay that has caused a cavity (hole). The dentist removes decay from the tooth, cleans the cavity, dries and seals it with a filling material.

A variety of materials can be used to fill the cavity. You will be given advice on the most suitable material based on the size, shape and location of the filling. A common choice is tooth-coloured filling material (such as composite resin or ceramic), which can restore the appearance of the tooth, as well as its shape and function.

Dental treatment for restoring 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:

• Composite resins - chipped, discoloured or oddly shaped teeth can be treated by bonding a tooth-coloured resin filling to improve the appearance of the affected tooth. This resin may need to be replaced in future if it chips, 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 porcelain, metal, or a combination of both depending on the area and the aesthetic or functional needs. Onlays cover the tooth less extensively than a crown and may be used if there is enough tooth structure remaining to support it.

Root canal treatment

Root canal treatment involves replacing a tooth’s damaged or infected pulp with a filling. The ‘pulp' (often called the nerve of the tooth) is contained within the hollow centre of the tooth and consists of blood vessels and nerve fibres that supply oxygen, nutrients and feeling to the tooth.

Injuries to the tooth or advanced decay can irreversibly damage tooth pulp and it can become infected.

During root canal treatment, the damaged pulp is removed. 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. A root canal may need to be performed in stages over a few appointments.

After root canal treatment is completed, the biting surface is covered with filling material or a crown. This also protects the tooth from breaking after root canal treatment.

Tooth removal (extraction)

Dental practitioners aim to preserve natural teeth. However, extensively damaged or badly decayed teeth may need to be removed (extracted). Dentists may also recommend removing wisdom teeth that are causing problems.

Wisdom teeth can contribute to various dental problems if they are below the gum (impacted), where the wisdom tooth grows at an angle and butts into the tooth next to it or the gum.

Wisdom teeth may be removed with local anaesthetic only (only the area around the tooth is numbed and the person is conscious). However, for more difficult procedures, sedation or general anaesthesia may also be offered where the person is partially or fully unconscious.

Dentures

Dentures (also known as 'false teeth' or 'plates') are removable artificial teeth that replace some or all of your natural teeth. An 'immediate' denture can be made while you still have some of your teeth, which is fitted on the day 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 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 need to be removed and cleaned every day. It is recommended that you do not sleep with your dentures in.

Mouthguards

Mouthguards protect the teeth, gums, tongue and jaws from injury. They are used while playing sport to prevent damage from accidental or deliberate knocks to the face.

A dental professional can take a mould (impressions) of your teeth and make a well-fitting, comfortable mouthguard for your protection. Custom made mouthguards offer a better fit and protection against dental injuries than ready-made mouthguards.

Dental implants

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 can be fitted on top of it. Several dental appointments are required for treatment planning, design and fitting of implants.

Titanium is a safe material that allows bone to grow around it. Implants generally have high success rates but they require an additional level of training and expertise so you may need to be referred to another dentist or specialist.

Orthodontic treatment

Orthodontic treatment is often recommended to correct the position of the jaw and teeth, to address issues such as crowding, protruding (‘buck’) upper teeth or protruding lower 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. After orthodontic treatment, a retainer appliance is needed to maintain correct tooth positions. Jaw surgery might be necessary where extensive correction is needed for best results, which requires referral to an oral maxillofacial surgeon.

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). Children aged up to 17 years old may be eligible for the Medicare Child Dental Benefits Schedule if they (or their parents) are receiving certain Centrelink payments.

You may also be eligible for public dental services if you fall into one of the following categories:

• Any student enrolled in a Victorian government primary, secondary or specialist school is eligible for Smile Squad services.
• 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 who are in out-of-home care provided by child protection services in the Department of Families, Fairness and Housing
• 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.

If you are eligible for public dental services, you may also have priority access. You will be offered the next available appointment for general dental care. You are not placed on a general care waitlist.

The following groups have priority access to public dental services:

• Aboriginal and Torres Strait Islander peoples
• children (0-12 years) and young people
• homeless people and people at risk of homelessness
• pregnant people
• refugees and asylum seekers
• people registered with mental health or disability services, who have a letter of recommendation from their case manager or a special developmental school.

Where to get help

• Your dentist
• Find a public dental clinic near you at Oral Health Victoria
• Australian Dental Association 'Find a dentist' Tel. (03) 8825 4600 in Victoria
• Oral Health Victoria provide public dental services through the Royal Dental Hospital of Melbourne and community dental clinics, for eligible people. For more information about public dental services, Tel. (03) 9341 1000 or 1800 833 039 outside Melbourne metro
• Australian Dental Association Tel. (03) 8825 4600.