Scale and Clean
to daily brushing and flossing, visiting the Dentist every six
months for a regular examination and clean, is important for
maintaining good oral health and hygiene, and for early detection
of any dental problems.
A scale and
clean involves the removal of tartar (calculus) from the tooth
surfaces by special dental instruments. Plaque, a soft, sticky
film containing bacteria which builds up on teeth, can be removed
by normal brushing. However, if plaque is not removed, it hardens
to become tartar, and if left untreated, it will damage healthy
teeth and gums, and can cause tooth decay, gum disease, supporting
bone loss leading ultimately to tooth loss.
Going to the
dentist regularly helps in several ways. For a start, you get
to know the dentist, the staff and the routine. But, most importantly,
you catch problems early when they are simple and easy to treat.
there’s less likelihood of having to have a major and possibly
more uncomfortable procedure.
You also develop
a trusting relationship with your dentist, and hear about new
advances that will improve the health of your teeth and your
experience at the dentist.
contain deep grooves that cannot be reached by the fine bristles
of a toothbrush are susceptible to plaque (bacteria) building
up in the groove and causing decay. To prevent this, is a protective
tooth coloured resin coating, known as a fissure sealant, is
placed in the groove of the tooth to stop decay from forming.
are ‘plastic’ colourless protective liquids, which are painted
onto the biting surfaces of the back teeth. They are then hardened
by the application of a concentrated beam of ultraviolet light.
They are permanent and remain in place for many years.
have been used in Dentistry for many decades and provide a very
effective means of preventing tooth decay. They are usually
placed in the adult molar teeth soon after they present themselves
in the mouth. The first molar teeth come through at about six
years of age and are fissure sealed soon thereafter. The second
molar teeth present at twelve years of age and are subsequently
fissure sealed. Other teeth can also be fissure sealed, especially
in cases where tooth decay is likely to occur rapidly.
finds adult molar teeth in children which have suffered from
a small amount of decay. It is now possible to use painless
and drill-free techniques such as special pastes or air-abrasion
devices to disinfect and remove this decay and fissure seal
the tooth. This prevents the tooth from developing a ‘full blown’
cavity and thus, needing more unpleasant treatment at a later
guidelines exist for two groups of patients: those with heart
conditions that may predispose them to infective endocarditis,
and patients who have total joint replacements, who may be at
risk for developing hematogenous infections at the site of the
the Australian Heart Association (AHA) recommended that patients
with certain heart conditions take antibiotics shortly before
dental treatment. This was done with the belief that antibiotics
would prevent infective endocarditis (IE), previously referred
to as bacterial endocarditis. The AHA’s latest guidelines were
published in its scientific journal, Circulation, in April 2007
and there is good news: the AHA recommends that most of these
patients no longer need short-term antibiotics as a preventive
measure before their dental treatment.
Dental Association participated in the development of the new
guidelines and has approved those portions relevant to dentistry.
The guidelines were also endorsed by the Infectious Diseases
Society of Australia and by the Pediatric Infectious Diseases
are based on a growing body of scientific evidence that shows
the risks of taking preventive antibiotics outweigh the benefits
for most patients. The risks include adverse reactions to antibiotics
that range from mild to potentially severe and, in very rare
cases, death. Inappropriate use of antibiotics can also lead
to the development of drug-resistant bacteria.
found no compelling evidence that taking antibiotics prior to
a dental procedure prevents IE in patients who are at risk of
developing a heart infection. Their hearts are already often
exposed to bacteria from the mouth, which can enter their bloodstream
during basic daily activities such as brushing or flossing.
The new guidelines are based on a comprehensive review of published
studies that suggests IE is more likely to occur as a result
of these everyday activities than from a dental procedure.
say patients who have taken prophylactic antibiotics routinely
in the past but no longer need them include people with:
• mitral valve
• rheumatic heart disease
• bicuspid valve disease
• calcified aortic stenosis
• congenital heart conditions such as ventricular septal defect,
atrial septal defect and hypertrophic cardiomyopathy.
The new guidelines are aimed at patients who would have the
greatest danger of a bad outcome if they developed a heart infection.
antibiotics prior to a dental procedure are advised for patients
artificial heart valves
2. a history of infective endocarditis
3. certain specific, serious congenital (present
from birth) heart conditions, including
- unrepaired or incompletely repaired cyanotic
congenital heart disease, including those with palliative shunts
- a completely repaired congenital heart defect with prosthetic
material or device, whether placed by surgery or by catheter
intervention, during the first six months after the procedure
- any repaired congenital heart defect with residual defect
at the site or adjacent to the site of a prosthetic patch or
a prosthetic device
4. a cardiac transplant that develops a problem
in a heart valve.
The new recommendations apply to many dental procedures, including
teeth cleaning and extractions. Patients with congenital heart
disease can have complicated circumstances. They should check
with their cardiologist if there is any question at all as to
the category that best fits their needs.