Dental hygiene

At Dentistry in Canterbury we encourage you to have 6 monthly appointments pre-booked for your convenience. We send a reminder out a few weeks prior to your appointment, and can adjust it to a more suitable time if needed.

As part of good oral hygiene, it is vitally important to have your teeth examined and cleaned by Dr Julie Ghaly or a hygenist every 6 months.

This enables us to assess your home routine of cleaning and provide you with feedback as to the correct brushing technique, the appropriate toothbrush and toothapste to use and whether certain mouthwashes are necessary for you to use.
Nowadays, there is a plethora of products to use for oral cleaning, some of which are not advisable or beneficial to use; such as, hard/medium bristled tooth brushes, mouthwashes containing alcohol and herbal toothpastes not containing fluoride.

Commonly during this appointment, Dr Julie Ghaly will perform a full mouth scaling and cleaning to remove all the plaque and calcified tartar off your teeth and gums. A fluoride polish is also applied at the end of the visit to aid in fighting against cavities.

This appointment is a good chance for Dr Julie Ghaly to note if gum disease is active in your mouth and refer you to our gum specialist (Periodontist) Dr Mark Farmer for early treatment if necessary. As the gums form the foundation for teeth, disease presence may cause the teeth to lose their support and get very loose.

The importance of a healthy mouth has also been linked to the health of the body overall. Unfortunately, poor dental hygiene can affect the heart and has been proven to have a significant effect on heart disease. Gum disease has been found to have a direct relation to Diabetes.

Preventative Dentistry

At Dentistry in Canterbury our practice philosophy is to prevent disease before it occurs and increase your knowledge and awareness to acheive a healthy and beautiful smile for life.

Preventive Dentistry entails the study of risk factors in the mouth causing disease and modifying, reducing or eliminating those factors to prevent gum disease, tooth decay or cracked teeth.

Some of these factors are :

  • Bacteria and excess plaque in the mouth
  • Acidic or sugary diet
  • Certain medical conditions affecting saliva
  • Traumatic or heavy natural bite (clenching/grinding)

The first step in retaining your natural teeth for life is to have them checked regularly every 6 months by Dr Julie Ghaly and establishing good Dental Hygiene practice at home.

Commencing dental check-ups at a young age reinforces the importance of correct brushing techniques with appropriate Fluoride toothpastes, flossing regularly as well as provides parents and their children with advice regarding diet and its effect on teeth.

Regular check ups also increase the chance of detecting cavities at an early stage (especailly with the aid of digital radiography) or even preventing them before they occur by placing a protective ‘Fissure Sealant’.

During your checkup Dr Ghaly will review your medical history to detect changes to your medication which may impact your saliva.
Saliva plays an important role in protecting teeth from cavities and if saliva is affected then Dr Julie Ghaly will reccommend certain products such as Fluoride mouthwash or ToothMousse as preventative treatment to reduce risk of cavities.

Commonly, Dr Ghaly will also use an intraoral camera to highlight and show you any cracks on your teeth which may be as a result of clenching or grinding. The cracks can be treated by placing porcelain crowns and future cracks can be prevented by providing you with a nightguard (splint).

Fissure sealants

Fissure sealants are a great preventative treatment for permanent molars. Permanent molars tend to develop with very deep grooves and pits on the biting surface. These grooves are often very narrow and fine and are virtually impossible to clean with a conventional toothbrush as the bristles are too wide.

Commonly, once food, plaque and bacteria accumulate on the grooves, decay and cavities start to form quite rapidly under the surface and can go unnoticed for a long time.

To prevent this from occurring, a flowable resin material is placed in the grooves and pits to ‘seal’ them and prevent decay.

The process of applying fissure sealants is best done as soon as the permanent tooth is completely erupted from the gums, before the grooves have a chance to decay.

For first molars, this is at the age of 6-7 years. Second molars usually appear at the age of 12- 13 years.

Sealants are much better method of protecting teeth than waiting for them to decay and filling them, as they are much more cost- effective and comfortable to place.

The procedure of fissure sealants is a very simple one, that does not require any anaesthetic, or drilling into the tooth.

The grooves of the tooth are cleaned from food particles, then a blue coloured cleaning gel is applied to the surface of the tooth.

This is left on for 20 seconds then washed off and dried throughly.

The flowable resin material is then placed into and on top of the groove and special blue wavelength light is used to harden that material.

Paediatric Dentistry

At the Dentistry in Canterbury we love seeing and treating young children. We understand that it is common for kids to be slightly anxious about visiting the dentist and we aim to create a fun relaxed atmosphere. Dr Julie Ghaly recommends for parents, during their own checkup appointments, to bring in their children from the age of 3 years old.

This creates a sense of safety and reassurance for the child to see their own parent getting a dental checkup in a calm and easy manner.
During this visit Dr Ghaly will offer a free ride in the chair for the child to get them used to sitting in the dental chair.

Once the child is cooperative in the dental chair, Dr Ghaly will perform a comprehensive examination of all the teeth. She generally likes to take some intra oral images of the teeth and show the children what their teeth look like.

If cavities are present then this intraoral camera is a good visual tool for parents and children to encourage good brushing technique and diet control.

Baby teeth normally complete formation at the age of 2 years, and some molars can remain in the mouth until the age of 14 years. Thus baby teeth are very important as they:

  • Provide space and for permanent teeth to come through (erupt) correctly
  • Are important for a child’s self esteem
  • Aid in speech development and correct chewing function

Hence, premature removal of baby teeth can have a negative effect on even the undeveloped permanent dentition.

Restorative Dentistry

A dental restoration (dental filling) is where a dental material is used to restore the function, integrity and shape of the missing tooth structure. Missing tooth structure typically occurs following decay or trauma or can be intentionally removed to allow for improved aesthetics.

There is a variety of dental materials available for use depending on the application and desired results, which includes:

  • Resin Composite fillings
  • Amalgam fillings
  • Glass Ionomer Cement
  • Porcelain restorations

Resin Composite Fillings:

Composite resin is a plastic-based tooth coloured filling material which is bonded to the natural tooth structure. These materials are always being updated and improved, and their colour, strength, and bond to natural tooth structure has improved dramatically in recent times.

Composite resin is a more popular alternative to the amalgam fillings, due to it’s natural tooth-like appearance. It is available in a wide range of colours and can be closely matched to your natural tooth colour. During the placement procedure, the resin has a soft putty-like consistency, which can be sculpted and moulded very easily. Once in place, it is then hardened by a blue light which sets the filling to full strength within 20 seconds.

Composite resin can be used to fill both anterior and posterior teeth. Like any material, composite resin does have limitations and is generally not recommended for extremely large restorations. In these circumstances, a tooth coloured alternative such as porcelain veneers, crowns, inlays and onlays would be recommended.

Amalgam Fillings:

Dental amalgam is a metal alloy consisting primarily of silver, tin, copper and mercury. It is a very strong material that has been used to fill teeth for well over a century. Due to it’s unaesthetic grey/silver appearance, the use of this product is rapidly ceasing. An amalgam filling is placed mechanically not bonded to tooth structure, by the way the cavity is prepared.

In recent years, concerns have been raised over the safety of using dental amalgam fillings as it has been claimed that small amounts of mercury can be released from the filling overtime and be absorbed into the bloodstream. Research has shown that the amount of mercury released is negligible, and to date there has been no conclusive evidence to prove that dental amalgam fillings lead to health problems. The current stance of the ADA (Australian Dental Association) is that dental amalgam filling material is safe to use.

Glass Ionomer Cement (GIC):

A glass Ionomer cement is a dental restorative material used in dentistry as a filling material. These tooth-coloured materials were introduced over 40 years ago and as they bond chemically to dental tooth structure and release fluoride for a relatively long period of time, modern day use of GICs have greatly expanded.

This material is not as strong as composite resin, but is particularly useful in difficult and dentally compromised cases, such as treating children and the elderly.

Porcelain Restorations (INLAYS/ONLAYS):

Porcelain inlays/onlays are an indirect procedure, where they are made in our laboratory, similar process to crowns and porcelain veneers. The process is very simple, which requires two appointments:

Appointment 1:

  • Preparation of the cavity as you would with any restoration
  • An impression of the prepared cavity is taken
  • Also a shade will be taken, so that the colour match is perfect
  • Temporary restoration will be placed as it takes approximately 2 weeks for the laboratory to fabricate the restoration

Appointment 2:

  • Remove the temporary filling material and clean out the cavity
  • Try in the new inlay/onlay restoration and check for colour match, fit and shape
  • Then the restoration is bonded to the natural tooth structure with luting cement

Root Canal Therapy

Root Canal Therapy is the treatment for a tooth that has an infected or inflamed nerve (pulp). The treatment is done over three visits to remove the infection from the nerve and place a ‘root filling’ in the tooth.

Once the treatment is completed, the tooth will no longer be able to sense heat or cold but will still be a functioning tooth.

When is root canal treatment needed?

The classic ‘toothache’ symptoms are associated with painful throbbing ache and uncomfortable sensation to hot, cold or pressure.

Commonly, the toothache is so severe that it interrupts sleep and is not well controlled with pain medication only.

If the infection is left untreated for a prolonged time it can result in a large abcess that can spread to other areas of the face.

An infection in the nerve can result from a variety of causes:

  • A large amount of decay or a deep cavity
  • A crack in the tooth or filling
  • High impact trauma to the tooth
  • As a result of gum infection
  • Rarely following orthodontic treatment

How is root canal therapy done?

Dr Julie Ghaly prefers to perform all three visits of root canal therapy under Local Anaesthetic as it much more comfortable.

All visits are carried out under sterile conditions, and an isolation mask (rubber dam) is placed on the tooth to prevent bacteria from re-entering the nerve.

Visit 1: An access is made into the nerve to remove dead pulp tissue and bacteria. Medication is placed to relieve symptoms and disinfect nerve. A temporary filling is placed.
Visit 2: Instruments used to ensure the full length of the nerve (up to and not beyond the root tip) is removed and cleaned. Tooth is checked to confirm no more infection is present.
Visit 3: The root is filled with a permanent filling and x-rays are taken to confirm this. A permanent filling is placed in preparation for a crown.

In some cases root canal therapy can be very complex and Dr Julie Ghaly may feel it necessary to refer you to our root canal specialist (endodontist) Dr Luke Borgula

What happens following root canal therapy?

Front teeth: Following root canal therapy front teeth can discolour. This occurs as there is no longer a blood or nerve supply in the tooth. To treat this, a bleaching process of the tooth is needed and is done over 2-3 visits depending on the level of tooth discolouration.
Back teeth: Molars and premolars are subjected to a lot of force during chewing and as a general rule they need a porcelain crown following root canal therapy. These teeth become very brittle after losing their nerve and blood supply and have a high risk of fracturing without the protection of the crown. If a crack or fracture occurs they cannot be saved and require extraction.

Wisdom Teeth

Wisdom teeth or third molars, are the last teeth to erupt into your mouth, and ususally do not appear until people are in their late teens, twenties or even older.

Most people have four wisdom teeth, others have two/three present, and some people have no wisdom teeth at all. In many cases, there is not enough space at the back of the mouth for wisdom teeth to come easily through the gums. If this occurs, the tooth will become wedged in or “impacted”.

Some wisdom teeth that are impacted, can remain in place and cause no trouble, however the majority of impacted teeth can cause many problems including:

  • Infection of adjacent gum tissue
  • Dental decay of adjacent teeth
  • Crowding of front teeth
  • In rare cases, they can cause cysts

Symptoms associated with impacted wisdom teeth include:

  • Severe pain and discomfort
  • Facial and gum swelling
  • Infections
  • Inflammation

Removal of a wisdom tooth/teeth is a very common procedure and if they are troublesome, they should be removed as soon as possible before the problems get worse.

If the removal of your wisdom teeth are likely to be difficult or complex, then Dr Julie Ghaly may refer you to our Oral and Maxillofacial Surgeon Dr Nick Rutherford.