- 18-64 years old
- No dental benefits, private or government funded
- Low income - as determined by financial screening
- Trauma to your face or mouth.
- Pain that is not managed by over the counter pain killers such as advil or tylenol.
- Swelling inside your mouth or on your face or neck that is worsening.
- A fractured or knocked out tooth caused by a specific incident/accident.
- Prolonged bleeding in the mouth.
- Missing teeth that affect your smile or your ability to eat properly
- You will be asked questions about your medical history including any medications you are taking.
- The dentist will ask you questions about your symptoms and the history of your symptoms.
- The dentist will do an examination of your face / neck / jaw joint and check for enlarged lymph nodes
- The dentist will examine your gums and teeth to check for swelling, infection, cavities and cracked or loose teeth.
- The dentist may do special tests such as tapping on your teeth, putting something cold on your teeth or taking X-rays.
- These tests will help the dentist to find out what the problem is.
- The dentist will explain their findings and discuss treatment options with you. This may include a temporary or permanent filling, an extraction, gum treatment or a prescription.
Fillings
If you have a cavity (hole) in your tooth you may need a filling. Some small cavities can be monitored, but most cavities need to be filled to prevent further damage and/or pain.
A cavity can occur when part of your tooth decays or when your tooth chips or fractures. Cavities can cause pain but sometimes they go unnoticed for some time. Decay can form on an untreated tooth or it can happen under an old filling.
You may get sensitivity to cold or sweet substances. Sometimes you will have no symptoms, even when you have a large cavity. If you get spontaneous throbbing pain, it could mean that the cavity has progressed close to the pulp. In this case you may need root canal treatment or an extraction.
Different kinds of filling materials can be used to fill a cavity. The most commonly used filling materials are:
This material can be used for back teeth and is the most long lasting directly placed filling material..
This filling material is used for front and back teeth and is also long lasting. Fillings usually last for 5 years but may last much longer.
Fillings usually last for 5 years but may last much longer.
To fill a cavity, your dentist may first give you "freezing" ( local anesthetic), so you do not feel any pain. Your dentist then takes out all traces of decay, shapes the hole and fills it. Most of the time, a filling can be completed in one appointment.
Extractions
Advanced gum disease and extensive tooth decay and two of the main reasons for tooth extraction. Both of these conditions can cause severe pain and /or swelling. Severe gum disease can sometimes be treated by deep cleaning or gum surgery but in some instances the tooth has to be extracted. Extensive decay can sometimes be treated by a filling, a root canal or a crown, but in some instances the tooth needs to be extracted.
To carry out an extraction, the dentist will first give you ‘freezing’ ( local anesthetic), so you do not feel any pain. You will be asked to sign a consent form giving your permission for the dentist to go ahead and remove your tooth. The dentist will then use instruments to remove your tooth. Most of the time extractions are painless. You will feel pressure but generally not pain. You will then be given instructions on how to care for the healing tooth socket.
Gum Treatment
Scaling is a procedure that is carried out in the management of gum disease. It involves the removal of dental plaque and calculus from the tooth surfaces at or below the gum. A dentist or dental hygienist uses hand scalers or an ultrasonic scaler to carefully remove these deposits from the teeth. Scaling alone cannot resolve gum disease - regular brushing and flossing is essential for maintaining healthy gums.
Dentures
Dentures are artificial teeth that replace lost or removed natural teeth. Dentures can either be full or partial, meaning that they can either replace all of the top or bottom teeth, or just a few missing teeth.
The dentist will take impressions of your mouth to ensure a custom fit, and the final denture will visually match your existing teeth. There are several stages involved in making dentures, and the dentist works with a dental laboratory to make the final product.
The whole process generally involves 3-5 appointments with the dentist at weekly intervals.
X-rays:
Dental x-rays are images of your teeth that are used to help diagnose dental conditions such as decay, gum disease, infections and impacted teeth.
The radiation levels emitted during x-ray taking are so low that they’re considered safe for both children and adults. Many dental offices now take digital X-rays which expose the patient to even lower radiation levels than conventional x-rays.
Prescriptions
There are occasions when the dentist needs to write a prescription rather than carry out a dental procedure. The most common medications prescribed by a dentist are pain killers and antibiotics.
Antibiotics may be prescribed when a patient has an infection or after some dental procedures. Pain killers may be prescribed in emergency situations when the dentist is unable to carry out a procedure to stop the pain, or after certain dental procedures. Other medications may be prescribed for certain specific oral conditions.
What is Gum Disease?
Gum disease is one of the major causes of tooth loss in adults. There are 2 types of gum disease, gingivitis and periodontitis. Gingivitis is a more mild form of gum disease and can lead to periodontitis if untreated.
Both types of gum disease are caused by plaque (bacteria) collecting at the gum / tooth margin. This is caused by inadequate oral hygiene. Gingivitis can be reversed with good oral home care.
The symptoms of gingivitis are: red gums, swollen gums, bleeding gums. The symptoms of periodontitis are often mild but if untreated may lead to infections, loose teeth and eventually tooth loss.
Some of the factors that contribute to gum disease include, diabetes, smoking, aging and genetic predisposition. However the main cause is inadequate oral hygiene. For this reason, excellent oral hygiene is an essential part of treatment.
Effect of severe gum disease on general health conditions:
There is evidence that if someone has periodontitis, bacteria from the diseased pockets under the gums can enter the blood stream and trigger low levels of inflammation in the blood stream and body in general.
Across the lifetime this seems to increase the risk of developing heart disease including heart attacks and strokes later in life. It can also make diabetes harder to control or increase the complications of diabetes in the heart and kidneys.
Conversely, high blood sugar levels in diabetes can make gum disease worse. If gum disease is treated successfully it will have a positive impact on ones general health.
Healthy Eating
Avoid sugar: Its best to avoid sugar as much as possible, but for those who have a sweet tooth, it’s not so much about the amount of sweets you eat, but the length of time your teeth are exposed to sweets. It is better to eat sweets at mealtimes rather than between meals, as the amount of saliva produced at mealtimes will help protect your teeth. If you cannot avoid sweets between meals, choose something with lower levels of sugar. Sticky sweets like toffee or hard candy should be avoided as snacks. Don’t forget to check the nutrition labels on food items. Many unexpected foods contain sugar such as ketchup and flavoured yoghurts.
Healthy Snacks Include:- Peanut butter
- Cheese.
- Nuts and seeds
- plain yogurt
- Popcorn
Prevent Acid Erosion: Some drinks and snacks may contribute to acid erosion. Acid erosion happens when acidic food or drinks are consumed. The acid can linger in your mouth, and soften the enamel surface of your teeth. This makes your teeth more susceptible to damage and often leads to increased sensitivity and may require treatment. Some of the big offenders are soft drinks, fruit juices and white wine.
- Try to avoid acidic food and drink between meals as there is less saliva in your mouth at these times to protect your teeth
- Don’t clean your teeth right after eating. If you brush while the acid is still in your mouth you will remove some of the enamel. Wait at least an hour before brushing and always use a soft brush.
- Consider finishing your meals with a little cheese or milk as these products help cut down on the acid in your mouth.
Maintaining good oral hygiene.
Brush for 2 minutes twice per day after breakfast and just before bed.
The proper brushing technique:
- Place your toothbrush at a 45-degree angle to the gums.
- Gently move the brush back and forth in short (tooth-wide) strokes.
- Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth.
- Use a soft brush and take care not to scrub aggressively to avoid damaging the tooth
- To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
Use floss or an interdental brush to clean between the teeth once per day. The bacteria that causes tooth decay lingers between the teeth where toothbrush bristles can’t reach. Flossing helps to remove plaque and food particles from between the teeth and under the gum line
- The Proper Flossing technique to:
- Break off about 18 inches of dental floss. To hold the floss correctly, wind most of the floss around both of your middle fingers. Leave only about 1 to 2 inches of floss for your teeth.
- Hold the floss taut with your thumbs and/or index fingers.
- Place the dental floss in between two teeth and curve the floss to form a C shape around one of the teeth.
- Gently glide the floss up and down, extending just under the gum margin to allow the floss to enter the space between your gums and your tooth.
- Next, form a C shape around the adjacent tooth and floss that surface in the same manner before removing the floss.
- Repeat the steps as you move from tooth to tooth. With each tooth, use a new, clean section of floss.
- Interdental brush technique:
- Try to find an interdental brush with a snug fit between your teeth. People with gum disease may need a larger sized interdental brush.
- The brush should be held at a 90° angle to the interdental space and gently pushed between the teeth
- Use some pressure to insert the brush but no force
- Push through once and pull out to remove.
Denture Care
- Taking care of your dentures is important for the following reasons:
- to keep your gums healthy and avoid infection
- to prolong the life of your denture.
- Daily routine:
- Always remove your denture before going to bed, clean it and store in water. This will prevent the denture from drying out and losing its shape.
- To clean your denture, fill the sink with water first to prevent breakage if the denture is accidentally dropped
- Place a small amount of liquid hand soap on a soft bristled denture brush and brush all surfaces, including the metal clasps
- Rinse with water before wearing
- Do not use an abrasive brush, toothpaste, whitening products or bleach on your dentures as they can cause damage.
- Weekly routine:
- Once a week, clean your denture with a special denture cleanser solution (available at pharmacies) - follow manufacturers instructions. This will help to remove micro-organisms and prevent the build up of plaque and tartar.
- Avoid soaking your denture in hot water, warm water is best.
- Always rinse thoroughly with water before inserting into your mouth.
- Metal dentures can be damaged by some cleaning solutions so check the label to ensure that the solution is suitable for use on metal dentures.
Maintaining good oral hygiene.
Brush for 2 minutes twice per day after breakfast and just before bed.
The proper brushing technique is to:
- Place your toothbrush at a 45-degree angle to the gums.
- Gently move the brush back and forth in short (tooth-wide) strokes.
- Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth.
- Use a soft brush and take care not to scrub aggressively to avoid damaging the tooth
- To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.
Use floss or an interdental brush to clean between the teeth once per day. The bacteria that causes tooth decay lingers between the teeth where toothbrush bristles can’t reach. Flossing helps to remove plaque and food particles from between the teeth and under the gum line
- The Proper Flossing technique
- Break off about 18 inches of dental floss. To hold the floss correctly, wind most of the floss around both of your middle fingers. Leave only about 1 to 2 inches of floss for your teeth.
- Hold the floss taut with your thumbs and/or index fingers.
- Place the dental floss in between two teeth and curve the floss to form a C shape around one of the teeth.
- Gently glide the floss up and down, extending just under the gum margin to allow the floss to enter the space between your gums and your tooth.
- Next, form a C shape around the adjacent tooth and floss that surface in the same manner before removing the floss.
- Repeat the steps as you move from tooth to tooth. With each tooth, use a new, clean section of floss.
- Interdental brush technique:
- Try to find an interdental brush with a snug fit between your teeth. People with gum disease may need a larger sized interdental brush.
- The brush should be held at a 90° angle to the interdental space and gently pushed between the teeth
- Use some pressure to insert the brush but no force
- Push through once and pull out to remove. Once should be enough and will avoid damaging the teeth.