Dental Practice Information

Independent Living, Hostel and Nursing Home Residents

Since 1985, Dr Roger Lindsay, Dr Oliver Cvekus and their team from the Pennant Hills Dental Centre, have continued to provide a comprehensive dental service to the independent residents at the ARV and to other residents in the Sydney area, from the Anglican Villages network and Pennant Hills Dental Centre.

Independent residents can utilise the services of our team at the ARV Village Dentist clinic which is a branch of the Pennant Hills Dental Centre.

Our experience at the ARV which offers the most modern resident aged care dental facility in a NSW retirement village setting, suggests that as a new independent living resident, hostel or nursing home resident we strongly advise a dental check before or early upon your arrival at the ARV. An early assessment of your dental situation followed up by regular checkups and hygiene treatments will greatly assist in the maintenance of teeth, gums, dentures and implants.

The days of full dentures are almost gone and most new residents have some or all of their teeth. Medications, dry mouth and poor oral hygiene can create significant dental decay and breakdown in a very short time. All residents of hostel and nursing homes are considered at very high risk of developing severe decay, gum disease and mouth infections, all of which can impact on general medical health. Rational dental care provides comprehensive care plans that take into account these many modifying factors that effect peoples lives and seeks to deliver appropriate oral health care for each one of us at the ARV.

Our Resident Welcome Information Pack provides simple guidelines for residents and carers for dental care at the ARV.

Our preventative dental care programs, individual care plans and computerised dental recall system will help to maintain your oral and general health. The enjoyment of one of life’s greatest pleasures – the tasting, chewing and eating of good food should be your goal. Your family can rest assured that ongoing dental care is always close at hand.

Your First Appointment

Usually 45 minutes. Prior to your appointment, a pre-appointment planning and patient information checklist will be completed. In the case of emergencies, written consent from family or staff should be provided in cases where a resident is incapable of providing the relevant permission. At a routine checkup the dentist will carry out a comprehensive examination of teeth, gums and surrounding tissues. Any concerns can be discussed during this consultation.

All patients are required to complete a medical history form prior to their first appointment, in addition hostel and nursing home patients or their carers should also complete the manual handling and consent forms.

Download forms here, print and complete.

Pre-Appointment Planning

In order to provide the most appropriate and rational dental care for our patients the dental team need to collate information from many areas which may include:

Independent Living Patients

Transport and mobility needs
Requirement for an accompanying person
Timing of appointments
Need for premedication
Consent – form included in information pack
Dietary plan (if any) i.e. varied, chopped, thickened, pureed

Hostel and Nursing Home Patients

Communication issues
A current health summary
Current medications

Call the team on (02) 8820 3047 well before an appointment to ensure the information we need is available to make your appointment safe and enjoyable.

Fees and Payments

The Village Dentist aims to provide a sophisticated and caring dental service that enhances the dental experience for all residents at the ARV.

In many instances dental treatment may require shorter and more frequent treatment sessions due to non- ambulatory patients requiring the use of a lifting hoist or carer assistance. Our time is not charged for but considered a necessary part of providing such a special care dental service.

The Village Dentist provides care to all patients private, DVA, Health Care Card holders and pensioners. A discounted fee schedule is the norm at the ARV.

Treatment plans and care plans for residents and carers are all provided free of charge.

Insurance

We utilise the HICAPS system to process immediate claims. Health Fund Plans offer rebates for a part of the cost of dental treatment. The level of rebate varies significantly between funds (0-80%) and you should check with your health fund prior to treatment if you wish to calculate out of pocket expenses.

Our aim is to provide…

Pre-Appointment Planning
Patient Information
Preventative Dentistry and X-ray
Dental Care Plans (DCP)
A Rational Approach
Wheelchair Access and Lifter
Whitening
Bridges
Caries & Filings Cosmetic
Crowns
Implants
Dentures
Gum Disease Orthodontics
Root Canals
Wisdom Tooth
Oral Surgery

In dentistry prevention is better than cure even in the later stages of life. We take care to focus on simple and thorough dental hygiene – including brushing, flossing and tartar removal – as the best way to prevent cavities and gum disease.

Enamel stains and discoloured teeth and teeth discoloured by childhood trauma can all benefit from bleaching. Bleaching is sometimes the step prior to crowns or veneers to provide a pleasing appearance. The bleaching process is quite easy. First, you come for an examination to make sure that bleaching is appropriate for you.

At-Home Bleaching – Simple and Effective

The bleaching gel is applied to your teeth with a bleaching tray (a thin plastic flexible mouth guard) so only the teeth to be bleached are covered by the gel. We take impressions of your upper and lower teeth, these impressions are used to make a bleaching tray which fits your mouth exactly. This usually takes about a week. When the tray is complete, you’ll come back for instructions and supplies. We will shown you how to use the gel and to apply it correctly. We usually advise wearing the trays overnight for up to two-weeks. Bleaching results usually last a long time, but will gradually fade, therefore we usually recommend a 6 monthly “touch up” treatment of 1 – 2 days duration. Your mouth is unlikely to change and so your trays will still fit. Should you run out of bleach we can provide more as needed.

Bridges can be used to replace missing teeth if there are teeth on either side of the missing tooth. The two teeth are prepared for crowns, then a dental technician can fabricate a bridge with the missing tooth attached to the two crowns. This is all made in one piece to look like three separate teeth.

Depending on the difficulty of the situation it will take about 90 minutes to prepare the teeth for a bridge. An impression (mold) is taken of the prepared teeth and sent to a Dental Laboratory.

Three weeks later the dentist takes about 60 minutes to fit and cement the bridge. Your new bridge should last for many years as long as the supporting teeth stay healthy.

Dental caries is the disease process of tooth decay. It occurs when bacteria (which accumulate as plaque) consume sugar and produce acid that can dissolve tooth enamel and tooth dentine.

How To Prevent Dental Caries

Your best protection against dental caries is attention to diet and restriction of sugar- containing food and drink. Daily brushing, flossing and the use of an anti-cavity rinse are also essential. Regular in-surgery fluoride treatments (for people who live in areas with non-flouridated water) together with at home prophylaxis are essential for caries prone patients.

Fillings – Materials Used for Tooth Restorations

There are many types of fillings available, the dentist will help you decide which is right for your particular case. Your Choices for Fillings include:

Silver Amalgam

Average longevity is 15 years, silver color; low initial cost; best in small-to-medium-sized restorations of posterior teeth. This material is no longer used in our practice

Gold Inlays and Onlays

Gold color; moderate-to-high initial cost; may be used in any size restoration in any location where metal is not displayed. Rarely used in our practice

Composite Resin (plastic)

Tooth-coloured; moderate cost; best-used in small-to-medium-size restorations for any teeth; direct one-day placement.

Glass Ionomer

Tooth-coloured, fluoride containing plasticised glass filling. Moderately strong so has limited application. Good for fillings in childrens’ teeth or as a temporary filling in a patient with a lot of tooth decay, or for gum-line fillings

Ceramic Direct (CEREC)

Tooth-coloured; moderate-high initial cost; excellent restorative service completed in one appointment.

A crown is a covering that goes completely over a tooth. They can be made from various materials but usually from pure porcelain that is fused to a metal substructure, o en a gold alloy or from porcelain only.

Crowns are used to replace the damaged crown of a tooth as when a tooth has been heavily filled or root filled and the remaining tooth is weak, or there is not enough tooth structure le to hold a filling in place. Crowns are also used for aesthetic reasons when we need to change the shape or colour of a tooth.

The length of time it takes to prepare a tooth for a crown depends on the situation. Usually a minimum of one hour is required in the dental chair. An impression (mold) is taken of the prepared tooth and sent to a Dental Laboratory which takes approximately two weeks to construct the crown. A temporary crown is made of plastic and is placed on the tooth for this time, so that you can eat properly and the tooth looks normal.

It takes approximately 40 minutes to cement in the new crown on the next visit.

Generally a crown fails not because there is something wrong with the crown, but rather due to decay in the tooth around the crown or the rest of the mouth changes (such as teeth becoming darker but the crown stays the same colour) and this makes the crown stand out or the gum recedes around the crown.

Porcelain veneers are used to improve the colour of a tooth and/or change the shape of it. You can treat one tooth or a segment of teeth to completely change the way you smile.

Dentures are another way of replacing missing teeth, compared to implants or bridges which are fixed or removable.

Full Dentures

These are made when no teeth at all are present on the upper or lower jaws. Dental implants are proving very successful in retaining dentures.

Partial Dentures
Cast Metal

The best of the partial dentures. But the supporting teeth must be healthy as it can be difficult to add to these dentures if a supporting tooth is lost. So a full examination by your dentist must be carried out prior to constructing a cast metal partial denture.

Acrylic (Plastic)

A cheaper form of partial denture that is constructed when cost is a factor or when the supporting teeth are not healthy, as it is easier to add to these dentures if another tooth is lost.

Dental Implants

To overcome traditional denture problems, dental implants are now available as an alternative. The dentures are matched to your existing tooth colour so they blend in with your smile.

Gingivitis

Many of us will experience gingivitis at some time in our lives. (Nearly 75% of people over age 35 now have gum disease or have experienced it previously.) Fortunately with immediate proper care, this type of gum disease is completely reversible.

Gingivitis is caused by infrequent or incorrect brushing and flossing which results in plaque build up on tooth surfaces, between teeth and under the gumline. Symptoms occur when bacteria in the plaque produce toxins that irritate gum tissue, causing gum tenderness, inflammation pain and bleeding.

If the disease is allowed to progress there will be a tendency for the gums to bleed during brushing. In cases of acute gingivitis, more severe symptoms occur. It is very painful and smelly

Prevention of Gingivitis

Proper brushing and flossing, and the use of an anti-plaque rinse and plaque-fighting toothpaste all help to inhibit the plaque build-up that causes gingivitis. Regular “maintenance” visits to your dentist ensure plaque is kept to a minimum

Periodontitis

Periodontitis is a disease that occurs when bacterial toxins penetrate the structures under the gingiva and cause inflammation of the periodontal ligament and the bone structure which supports the teeth. Although the effects of this inflammation may be irreversible, the disease’s progress can be halted and controlled.

Because periodontitis may occur without visible symptoms, it is important for your dental professional to examine regularly for increased gum pocket depths, one of the earliest signs of the disease.

Early Periodontitis

may be associated with tooth sensitivity: throbbing or tightness may be felt in the gum tissue. Periodontal disease can, however progress slowly without any visible signs or symptoms.

Moderate Periodontitis

may cause loosening of the teeth, and an intensification and increased incidence of early periodontal symptoms.

Advanced Periodontitis

is associated with gum recession, root decay, pus between teeth and gums, and loosening or loss of teeth.

Prevention of Periodontitis

Regular attendance at your dentist’s surgery for assessment and maintenance is the best way to prevent the onset of Periodontitis. About 15% of the population has a form of periodontal disease that is very destructive and in spite of control will lead to the eventual loss of teeth.

A dental implant is a titanium post that is inserted into the bone. A crown can then be constructed to attach to the implant to replace the missing tooth. Implants are proving to be a very effective way of replacing teeth as they are free standing and do not require other teeth to support them.

When implants were originally invented, four to six months of healing was required for the implant to fuse to bone, before a porcelain crown could be attached to it. With today’s newest technologies, some situations can have a crown placed on it immediately.

Latest research is showing that a er ten years the success of implants is approximately 90%. But the porcelain crown may have to be reviewed for replacement.

Root Canal treatment involves removing the nerve (called the pulp) from within the tooth and then sealing the cavity. The pulp lies in the tooth centre within a thin canal extending from the crown of the tooth through to the tip of the root.

Root canal treatment may be required when the tooth becomes painful, tender to bite on, is particularly sensitive to heat and cold, or may have an obvious large cavity, which extends into the nerve of the tooth, or suddenly becomes dark in colour. Sometimes the pulp of the tooth will die without causing any noticeable pain.

This is performed under a dental anaesthetic.

Frequently Asked Questions

Following a comprehensive dental examination and x-rays if required an OHP aims to provide for the future dental health of a patient. It takes into account a patient’s health situation, medications, mobility and diet. Whether you are living independently or residing in a hostel/nursing home, oral care is very important for maintaining your teeth or dentures. Some may require some degree of assistance to attain this level of oral care and so home care regimes are prepared and reviewed regularly. Recommendations are made on dental products that will help protect teeth, gums, implants and dentures.

Almost all patients over the age of 70 have some or all of their own teeth. We are all living much longer thanks to the miracles of modern medicine. With age comes a reduction in salivary flow. Many medications keeping us well also cause a further loss of salivary flow. Dry mouth, poor oral hygiene and gum disease are directly linked to increased dental decay and an increased risk of heart disease, stroke and pneumonias. Poor oral hygiene also interferes with blood glucose levels in patients suffering from diabetes.

Regular dental checkups can help protect against future problems.

The dentist can ensure the dentures are fitting well and comfortably. The tissues can be checked for oral irritation particularly from fungal infections or trauma causing ulcerations. Dentures need to be cleaned professionally and in some cases the base of the denture relined to improve fit or remove the old lining of the denture which can become infected contribute to chronic fungal infections in the mouth. Oral cancer can develop from traumatic irritation caused by dentures or other past habits including smoking.

Dry mouth (xerostomia) can cause rampant dental destruction. It is the most significant of all oral problems facing us in our senior years. Residents in hostel and nursing homes are most vulnerable.

Aging, certain medical problems, many prescription medicines and some over the counter drugs can effect salivary flow. Without saliva to lubricate the mouth food becomes difficult to swallow and rapid dental decay and gum
disease can result.

Cleaning

Like natural teeth, dentures attract plaque, become stained and collect food. It is vital for oral health that they be removed and cleaned daily.

Clean dentures with a soft toothbrush or denture brush and soap. Toothpaste is an abrasive and will scratch dentures, which will increase plaque build-up and staining.

As a precaution when cleaning your dentures fill the sink or basin with water or place a wash cloth in the bottom. This will prevent the denture from breaking should it be accidentally dropped.

Gums under dentures should also be cleaned with a soft toothbrush to remove food debris, bacteria and provide stimulation for the tissues.

Cleaning your dentures:

  1. Fill sink with water or place a wash cloth in the bottom of the sink.
  2. Remove dentures.
  3. Clean denture and wash with regular soap.
  4. Clean gums with a soft toothbrush.
  5. Clean remaining teeth with a soft toothbrush and fluoride.
  6. Store dentures in water overnight.

Storage and Maintenance

Dentures should be removed and left out of the mouth every night. This will provide the soft tissues with relief and keep the dentures fitting nicely.

Many denture soaking solutions contain harsh bleaches. These will eventually strip the colour from the denture. We recommend that you store the denture in a container of water overnight.

Soak acrylic dentures in either a diluted solution of “Milton’s” or a steradent tablet solution for 1 hour every week to prevent bacterial and fungal build-up. Do not soak metal partial dentures in any bleach solution, just steradent.