Frequently Asked Questions

In this section we provide answers to many of our patients’ most frequently asked questions. If you cannot find an answer to your questions here please contact us and we will be happy to help. Some of the information provided below has been obtained from the Australian Dental Association.

What is a filling?

A filling or restoration is used to restore the function and structure of a tooth that has been affectead by decay or fracture. They can be made from a variety of materials ranging from metallic (gold or amalgam) to tooth coloured (porcelain, composite or GIC).

Can all teeth with holes or fractures be filled?

Weather a tooth can be restored or not and the type of restoration it requires depends on how badly it had been decayed or fractured. Teeth with only slight decay or fractures may be easily restored with small fillings. Teeth that have been affected by larger decay or fractures may require more complex treatment. In some instances, the tooth may be so badly broken down that there is not enough tooth structure to allow the dentist to save the tooth.

How do I know if I need a filling?

Often dental caries (decay) gives no indication that it is present. Small to medium “holes” may give no sensitivity or pain. Often, by the time a tooth is sore or sensitive, a filling will no longer fix the problem and the tooth may require much more complex treatment to fix the toothache. Prolonged sensitivity or pain that last longer than several seconds should be investigated by your dentist. A regular check up, with the help of regular dental radiographs (x-rays) allows a dentist to check under existing fillings and in between teeth to identify early decay that may not cause any sensitivity or pain.

How long do fillings last?

How long a filling lasts is determined by many factors including, the size and shape of the filling, the position of the tooth in the mouth and the functional loads it’s subjected to, and the material it is made from. Larger fillings tend to break down quicker than smaller fillings while direct materials (amalgam, composite, GIC) tend to last break down quicker than indirect restorations (gold, porcelain).

How well you maintain your oral hygiene and how regular you are with your dental visits also has an influence on how long a filling lasts.

Is it possible to avoid fillings?

With proper attention to diet, oral self-care, regular dental check-ups, and the correct use of mouthguards to prevent injury, the need for fillings can be eliminated, and the frequency of filling re-placement can be extended.

Should baby teeth have fillings too?

Yes, baby teeth should be filled to prevent toothaches, to maintain the baby teeth for eating, and to hold the right amount of space for the adult teeth. If the baby teeth are going to be exfoliated (fall out) soon, then it is not always necessary to fill the teeth. This should be discussed with your dentist.

What is a crown?

A crown (also known as a “cap”), is a specialised restoration that covers and wraps around the tooth. It is used to rebuild and strengthen heavily filled or decayed teeth and to protect these teeth from the potential of cracking and splitting. It also has the advantage of allowing the dentist to make improvements in the appearance of the tooth .

Crowns are made by a dental technician based on a set of moulds made by your dentist. It can be made from gold or porcelain, or a mixed of both.

Why are crowns more expensive than fillings?

The materials, time required and complexity of treatment make crowns more costly than normal fillings. The materials are often expensive and technically sensitive, and the laboratory fees incurred in their preparation makes them more costly. The amount of time and number of visits required by a dentist to prepare the tooth, make an impression of the prepared tooth (mould), fit a temporary crown and then finally bond the final crown in place is greater than would be required for a normal filling.

What is a bridge?

A bridge is an appliance used to replace missing teeth which is fixed in the mouth and does not require removal. The new tooth is supported by one or more of the adjacent remaining teeth. A conventional bridge consists of crowns that are fixed to teeth either side of a gap with the false tooth being rigidly fixed to these crowns. In certain cases, where the bite allows, a conservative option such as a resin bonded bridge may be favoured. The artificial tooth is supported by a framework which is then bonded to the supporting tooth/teeth.

What are Dentures?

A denture is a removable appliance that replaces all the teeth (full denture) or some of them (partial denture). It is removed to allow cleaning of the teeth and tissues and to allow the tissues to rest and recover.

What is the difference between a denture and a crown or bridge?

A removable denture is a replacement option which is designed to be removed by the wearer to allow adequate cleaning of the teeth. They can be designed to replace from a single tooth to multiple teeth in a jaw. A bridge is a fixed option that cannot be removed by the patient once it is bonded into place by the dentist.

What is gum disease?

“Gum disease” describes one of a series of conditions that affect the supporting tissues of the teeth. These tissues include the gingiva (gums), the bone surrounding teeth and the special ligament that attaches the tooth to the bone.

In the great majority of cases, the disease is entirely preventable if precise steps are taken to control the formation of plaque, and the invasion of bacteria.

What causes gum disease?

The cause of gum disease is multifactorial and is linked to how your body reacts to the presence of bacteria at or below the gum line. Bacteria form a ‘plaque’ which is a sticky, colourless film that forms on your teeth, particularly around and below the gum line. This plaque elicits a response from the body. How the body responds can be altered by genetics, smoking, diabetes, certain medications and other modifying factors.

What are the most common forms of gum disease?

The common form of this disease is called Gingivitis and it affects the surface tissues, the gums. If left untreated, this may progress to affect the deeper supporting tissues and is called Periodontitis. The effects of gingivitis are largely reversible with appropriate care. Once this has progressed to periodontitis there is permanent damage to the ligament and bone that supports and holds the teeth. Often a space develops between the gum and the tooth called a pocket. The pocket forms a protected environment for more bacteria and the condition progresses. If left untreated periodontitis may cause abscesses and tooth loss.

Can gum disease be treated successfully?

Yes. In the vast majority of cases the progression of gum disease can be arrested with appropriate care. Management of gum disease becomes more difficult and less predictable the more advanced the disease. Therefore, the sooner periodontitis is diagnosed and treated the better. Regular dental examinations are important to check for the presence of gum disease. The cause of gum disease is bacteria. To manage it, the bacteria must be reduced to a level the body’s defence mechanisms can handle. Treatment classically involves:

  • Achieving the best possible home care
  • Professional cleaning of the teeth above and below the gum line (into the pockets) to remove the plaque and hard deposits (calculus / tartar), and
  • Regular reviews
  • Trying to remove risk factors such as smoking.

Gum disease causes permanent damage to the supporting tissues; therefore the aim of treatment is to stop the progression of the disease through controlling the bacteria. This is an ongoing, lifelong activity. Your dentist is trained in managing periodontal problems. They may also use a hygienist to assist in your care. You may also be referred to a Periodontist if your dentist considers your condition needs more advanced care. A specialist periodontist has gained additional qualifications and experience to satisfy the requirements of the State Dental Board and may therefore use the title “Periodontist”.

My gums bleed. Is that OK?

Healthy gums do not bleed. Bleeding gums are often an indication that there is some inflammation or infection present and may indicate the presence of gingivitis or periodontitis.

Who gets periodontitis?

Anyone is susceptible. Many people will have a small amount of periodontitis, which gradually increases with age. However approximately 15% of the population will have a significant degree of periodontitis. The destruction of the tooth’s supporting tissues caused by periodontitis gets worse over time when left untreated, and is often seen more severely in the 45+ age group. However the different types of periodontitis may affect people of all ages. The risk for periodontitis is increased with poor oral hygiene, smoking, diabetes, a family history of periodontitis and a range of medical conditions, in particular those affecting the immune system.

What are some of the warning signs of periodontal disease?
  • Bleeding gums when you brush your teeth.
  • Bad breath or a bad taste in your mouth.
  • Receding gums.
  • Sensitive teeth or gums. Loose teeth or teeth that have moved.
What can I do?

Our dentists at Joondalup City Dental will examine your gums as part of a normal dental check-up. X-rays are often needed to help diagnose periodontal problems. Good dental hygiene is one of the most important factors in preventing gum disease. Your dentist will show you proper brushing and flossing techniques that will help ensure healthy teeth and gums. Treatment involves careful, deep cleaning of the teeth to remove the cause of the problem. This can be done with local anaesthetic.

What are the latest developments in cosmetic dentistry?

The latest developments in dentistry include tooth whitening treatments, micro-abrasion, bonding and veneers. These techniques can whiten and improve the shape and colour of your teeth, even close gaps.

Tooth Whitening – treatments are designed to whiten your own teeth without any artificial additions. There are several ways dentists can whiten your teeth – with very high peroxide gel concentrations, the dentist may very carefully apply the whitening agent to your teeth and the whitening process is activated via a special light source. This technique is useful in gaining the whitest possible result in the shortest possible time frame. Alternatively, specialised trays are custom-made by your dentist using models of your teeth, and then you administer the treatment yourself using safe-strength gels at home.

Micro-abrasion – Micro-abrasion can be used to remove discolouration in the surface layer of the enamel. A paste containing acid and an abrasive is used to remove the outer surface of the tooth enamel. If the discolouration is deep in the enamel your dentist may need to remove the affected enamel with a bur and place an adhesive tooth coloured filling. Usually an anaesthetic is not required.

Bonding – Bonding is a process whereby your dentist cleans and prepares the surface of your teeth and then bonds tooth coloured resin fillings to them. Bonding can be used to repair chipped teeth, close small gaps between teeth, alter the shape of teeth and sometimes cover discolouration in teeth. Bonded resins are simple to re-polish and replace if they eventually discolour.

Veneers – Veneers are thin (usually about 0.5mm thickness) pieces of porcelain, or composite material, which are bonded to the front surface of the teeth. Veneers can be used to improve the appearance of teeth by changing the shape of the teeth, by changing the colour of the teeth, by masking stains and by replacing small fractured pieces of teeth.

What is the best way to whiten teeth?

There are many excellent ways to whiten the teeth and all have advantages and disadvantages. Since each case is different there is no one best way. When staining is present on the surface of your teeth, then having the teeth cleaned by one of our dental professionals can often produce a fresher, whiter and cleaner appearance. If the staining is actually in the tooth, below the surface, there are a number of ways to whiten the teeth including tooth whitening for slight discolourations, to bonding or veneering for more stubborn staining. Sometimes simply replacing old, worn out fillings that are staining at the edges can produce better looking front teeth. Our dentists are well trained in the latest dental techniques and they can give advice as to the best choices for you.

What is home whitening?

Home whitening involves wearing very thin, transparent plastic trays molded to your teeth, which are used to hold a whitening agent in contact with the tooth surface. The active whitening agent in is usually carbamide peroxide. This is a chemical that quickly breaks down to hydrogen peroxide, which is the chemical that lightens the teeth.

How effective is home whitening?

Home whitening treatments can be very effective but the degree of whitening and how quickly these results are achieved can vary tremendously from one patient to another, depending on the colour of the teeth at the start of treatment, the nature of the colour and the possible cause of discolouration. Some discolouration such as those from certain antibiotics may require longer treatment times and may then require additional procedures to complete the result. Our trained dental professionals will be able to assess your individual needs and discuss the effects expected with the whitening treatment.

Is home whitening safe?

Yes, when bleaching is carried out according to your dentist’s instructions, it appears to be a safe, simple procedure. Hydrogen peroxide (the whitening agent) is actually produced in the body in small amounts and the effects have been studied for many years, it has even been used as a wound cleanser for nearly a century. Even though tooth whitening is safe, the whitening process should not be abused. Minor complications are rare cases of slight gum irritation and heightened cold sensitivity in the enamel, which improve once treatment is stopped. It would also be wise to check first with your dentist to see if all your teeth will be likely to bleach evenly. Bleaching will be unlikely to alter the staining effects of certain types of antibiotic drugs (e.g. tetracycline) that may have been used during childhood.

How long does the whitening effect last?

This may vary depending upon the circumstances, as teeth can still stain from normal function and they will continue to age in a normal way with the passage of time. People that consume higher amounts of red wine, coffee and heavily pigmented foods and smokers may require more regular “top-ups”. You should keep the trays that are provided to you even after your whitening treatment is completed. Provided that you do not have significant treatment to your teeth after, the trays will continue to fit your mouth for many years in most cases. These trays can then be used for a periodic whitening “top-up”, usually after a professional clean.

Are whitening toothpastes very effective?

Whitening toothpastes are aimed at removing surface stains rather than a deeper level of whitening such as a professional system offers. Often the active ingredients of whitening toothpastes are in much lower concentrations than in professional kits meaning their actual effect is very low. Some whitening toothpastes contain harsh abrasives which aim at removing surface stains. Prolonged use of such products can result in damage to the tooth enamel which may require more extensive and costly treatment to fix later.

What should I do in a dental emergency?

Joondalup City Dental is open 6 days a week to also cater for any emergency needs. Phone us on 9404 9500. Our phones are also manned after hours where a dentist may be able to offer you direct advice relating to your emergency.

Why does a cracked tooth hurt?

The crack will expose the inside of the tooth (the ‘dentine’) that has very small fluid filled tubes that lead to the nerve (‘pulp’). Flexing of the tooth opens the crack and causes movement of the fluid within the tubes. Biting on and releasing pressure off a crack will cause a sudden movement in fluid within the tubes which stimulates the pain receptors in the tooth.

How can I prevent my teeth from fracturing?

Most fractures cannot be avoided because they happen when you least expect them. However, you can reduce the risk of breaking teeth by:

  • Trying to eliminate clenching habits during the day
  • Avoiding chewing hard objects (eg bones, pencils, ice)
  • Avoiding chewing hard foods such as pork crackling and hard-grain bread
  • Having heavily filled teeth reinforced with a crown or onlay which serves to strengthen teeth.

If you think you grind your teeth at night, ask your dentist if a night guard or a splint will be of use to you. It is very important to preserve the strength of your teeth so they are not as susceptible to fracture. Try to prevent dental decay and have it treated early. Heavily decayed and therefore heavily filled teeth are weaker than teeth that have never been filled. Individuals who have problems with tooth wear or “cracked tooth syndrome” should consider wearing a night guard while sleeping. This will absorb most of the grinding forces. Relaxation exercises may be beneficial.

How does the dentist treat a cracked tooth?

This depends on how severely the tooth has been affected by the crack. If the crack is small enough, the dentist may be able to simply replace the existing the filling or rebuild the fractured area with a new filling. If the tooth is painful, a preliminary filling may be required to attempt to resolve any pain, if this settles the tooth, the tooth can then be restored with a special filling that covers either part or the whole biting surface of the tooth. More severely affected teeth may require gold or porcelain fillings or crowns and if the nerve has been affected the tooth may require root canal treatment. In some instances or if left too long, a crack line may cause a fracture to extend too far vertically, rendering a tooth too difficult to save. In this instance, the tooth may require removal and then replacement.

Will my tooth become better?

Unlike other parts of our body, teeth are unable to be repaired through regeneration so cracks in teeth do not heal. If you have symptoms of a cracked tooth or have been told you have large cracks in teeth, you should have the tooth treated as soon as possible to prevent the risk of the crack getting worse. If left untreated, the tooth may require root canal treatment or removal. If treated early, most cracks can be conservatively treated without root canal treatment or removal.

What causes teeth to crack?

Teeth can crack/fracture due to a number of reasons. They can be cracked by trauma to the teeth and jaws, typically more common in front teeth. Back teeth are subjected to heavy biting forces which can cause cracking of the tooth enamel. Large fillings can also weaken teeth and cause cracks to develop. Such heavily filled teeth may benefit from crowns or onlays to help support the tooth and prevent it from cracking further.

What can I do if I'm scared about dental treatment?

The best way to overcome your fear is to discuss your concerns with your dentist. Experiences as a child may become distorted by time and reinforced by outdated media presentation of stereotypes. Much has changed, thanks to technology and education, and dentists are skilled professionals in dealing with patients who are apprehensive about seeking treatment. This will obviously be a team approach between you and your dentist and his/her staff. Communication is the key. You must feel comfortable expressing your fears and concerns and have a sense that you are being listened to. There are various forms of anaesthesia and relaxation that can be used effectively to change your negative thoughts into a positive experience.