Dental caries (dental cavities, tooth decay) is the most prevalent oral disease. Bacteria in your mouth form a sticky film on your teeth called plaque. The bacteria digest food, particularly sugars, and release acid. Over time the acid dissolves the enamel and dentine on the outer layers of your tooth to create a hole or a cavity. It is important to visit your dentist regularly so cavities are detected early. In their early stages cavities are usually painless and easy to repair. Pain is not felt until they are large and are affecting nerves, or damage the structure of your tooth so badly a tooth fracture occurs. Left untreated tooth decay will destroy the pulp within your tooth and eventually the tooth will fall out. Untreated tooth decay can also result in the development of an abscess and serious illness. Once a dental caries has developed your dentist will need to remove the decay from the tooth and place a filling. More severe decay may require a crown or inlays or onlays to repair the structure of the tooth. If the nerve in the tooth has died a root canal treatment is usually recommended. Early Childhood Caries Early childhood caries (ECC) refers to caries that occur in the teeth of infants and young children and can lead to the destruction of their teeth. From approximately 6 months of age, or the age that teeth start to appear, children are at risk of developing ECC, generally as the result of prolonged exposure to sugar. ECC can be prevented by avoiding giving sweetened drinks to children or not allowing a baby to go to bed with a bottle of milk or juice.

There are two types of filling, direct and indirect restorations. Direct restorations occur in a single visit and are placed directly into a prepared cavity by the dentist. The material used is usually a plastic resin and it is set using a UV light. Indirect fillings occur over multiple visits and involve the creation of inlays and onlays, crowns or veneers that the dentist fits over your tooth. Materials used for fillings: Amalgam fillings: Amalgam fillings are a blend of metals such as silver, copper, tin and mercury. The mercury intake into the blood from a single amalgam surface is 0.2% of the World Health Organization (WHO) recommended daily intake. Amalgam fillings have been widely used for over 150 years and are cost effective, strong and durable. Cerec®: Cerec® is a material used for indirect fillings that can be set in a single visit. Cerec® fillings provide a natural appearance and are strong, durable and provide more opportunity to conserve your tooth structure. Using a Cerec® machine and CAD-CAM software your dentist takes an optical impression of your tooth to produce the restoration and they will then bond this to your tooth. For more information please view the SD Cerec® website. Composite fillings: the most widely used because of their natural appearance and they can be matched to the shade of your teeth. They are made from plastic resin and filler and are bonded to teeth. They are not as strong as amalgam and do not last as long. Glass ionomer fillings: not as strong as composite fillings, these are used along the gum line, in children’s molars and to cement dental crowns. They are made from polyacylic acid and resin.

Molars (teeth at the back of the mouth used for chewing) often have grooves or fissures. These can be difficult to clean and food particles can be trapped here. Bacteria may grow and release acids that can decay your tooth. Your dentist can apply a protective plastic covering (sealant) to the fissure to help prevent tooth decay. For more information please view the New Zealand Dental Association website - Fissure Sealants.

During sport and other activities your teeth can be knocked out completely from your gums. In some instances your dentist can put them back in. For information on how to reduce the probability of long term damage see the advice from the New Zealand Dental Association website, Dental Trauma.

Visiting the dentist can be a source of anxiety. Your dentist may be able to provide sedation or nitrous oxide (laughing gas) to help you feel calm. Fortunately, with advances in dentistry, your dentist can manage the discomfort during procedures to make the experience as pain free as possible. Your dentist will usually apply a topical anaesthetic to numb the surface of your gum and then inject a local anaesthetic that works for up to 2 hours and numbs the tissue deeper within the gum. In certain circumstances your dentist may recommend the use of a sedative or general anaesthetic so you are asleep and do not remember the procedure.

Your general dentist may be able to provide a plate for your child to prevent a malocclusion (bad bite) from forming or to correct a mild malocclusion. For braces and orthodontic treatment your dentist will refer you to an orthodontist.

Your dentist or dental hygienist will recommend you have a professional clean every 3 -12 months. Bacteria in your mouth form a thin film, called plaque, on your teeth. Over time the plaque and minerals in the saliva in your mouth form a hardened deposit called calculus (tartar). Regular brushing and flossing slows the build up of calculus but its removal requires a professional clean. If not removed calculus and plaque can lead to tooth decay and gingivitis (early gum disease). During a professional clean your dentist or dental hygienist will scale and polish your teeth using a variety of instruments. Scaling involves removing plaque and calculus from teeth and around the gum line. Polishing smoothes the surface of your teeth. A professional clean is usually painless, although you may experience some minor discomfort or sensitivity. Discuss this with your dentist as they may be able to administer pain relief.

Tooth extraction involves the removal of damaged, decayed or infected teeth. Healthy teeth may be removed that the mouth does not have space for, or in preparation for orthodontic treatment, or to remove teeth that are impacted or partially impacted and at risk of causing infection. Your dentist will apply a topical anaesthetic to numb the surface of your gum, followed by a local anaesthetic injection to numb the tissue around the tooth to be removed. If the tooth has not broken the gum line an incision may be required. Following extraction a blood clot usually forms within one hour and may take up to one week to heal. Over the following 1-2 months the socket will gradually fill in with gum tissue. Your dentist will refer you to an oral & maxillofacial surgeon if an extraction is outside of their expertise.

Wisdom teeth are the third molars right at the back of your mouth. They usually appear during your late teens or early twenties. If there is not enough room in your mouth they may partially erupt through the gum or not at all. This is referred to as an impacted wisdom tooth. Due to their location wisdom teeth can be difficult to clean and are more susceptible to decay, gum disease and recurrent infections. They can cause crowding of teeth and, on rare occasions, cysts and tumours develop around them. Your dentist will advise if some or all of your wisdom teeth need to be removed. Wisdom teeth will usually only be removed if your dentist believes they will be a significant compromise to your oral health. Impacted tooth extraction Your dentist may recommend extraction if you are at significantly greater risk of infection or tooth decay. Impacted teeth may be removed by your dentist or they may refer you to an oral & maxillofacial surgeon. An incision (cut) is made in your gum and access to the impacted tooth cleared by pushing aside gum tissue and, if necessary, removing some bone. The tooth is removed whole or in pieces and the gum stitched together over the hole.