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Oral Health


At Gracefield Dental we welcome the opportunity to introduce your child to a life time of positive dental experiences. We would normally suggest that you bring your child to the dentist for the first time at around the age of 3 so that from an early age they can get used to the environment. We will encourage your child to learn good oral hygiene and the importance of healthy eating. We frequently hear from patients that they have had a bad dental experience as a child which has consequently made them nervous of visiting. We therefore try to make it a fun and positive experience where your child can play and chat to the dentist and of course get a sticker for their visit! We provide fissure sealants (tooth coloured sealants) which are applied to the biting surface of children’s teeth to strengthen them and prevent decay.

Dental Hygiene

Dental hygiene treatment, sometimes called scaling and polishing, is where the teeth are professionally cleaned together with advice and techniques for effective home cleaning, therefore keeping teeth and gums free of plaque deposits. Our dental hygienists, Paula Lowry and Clare Heffernan, provide a comprehensive pain free 45 minute appointment to ensure you teeth and gums are kept in the best possible health. We provide our patients with appointment recall reminders through our patient text messaging service.

Periodontal Disease (Gum Disease)

What is periodontal disease?

This is commonly referred to as gum disease. In it’s early stages it is called gingivitis. This is when the gum around the neck of the teeth is inflamed and bleeds. If gingivitis is untreated and progresses it may progress to periodontitis in which not only the gum, but also the bone underneath the gum supporting the teeth is also affected. The tooth is attached to the bone by microscopic fibres. As the disease process continues these fibres are destroyed and a cuff of loose gum results around the tooth. This is called a pocket. The pocket is an indication of the severity of the periodontal disease. The deeper the pocket, the worse the periodontal disease.


Periodontal disease is caused by bacteria. In a healthy mouth various types of bacteria co-exist in balance and cause no harm. However, if the teeth are not brushed effectively twice a day, bacteria will work on food left in the mouth to cause plaque. This is effectively a bacterial jam and is a sticky white substance, which sticks to the gum particularly by the gum line. The bacteria use the food to nourish themselves and harmful bacteria grow in numbers in the plaque. These bacteria produce acids, which decay teeth and also cause gum disease. This is a chronic (slow) process, which usually occurs over a period of years. The timescale however varies with each individual case.


The effect of the acids is to destroy the fibres attacking the teeth causing pocket formation. As deep pockets are extremely difficult to keep clean, a downward spiral of destruction is set up.

The following may occur:

  1. bleeding, swollen, spongy painful gums.
  2. shrinkage of gum down the tooth
  3. loss of tooth supporting bone
  4. foul taste in the mouth
  5. foul breath from the mouth
  6. repeated abscesses
  7. loose teeth, which may move. Typically front teeth have a gappy splayed appearance
  8. tooth loss.

Periodontal disease is the reason most teeth are lost in Ireland and not bad teeth. Perfectly sound teeth may be lost due to periodontal disease. In a persons mouth a few teeth may be affected or most/all.


The treatment is designed to stabilise the situation, i.e. to stop it getting worse. Unfortunately it is largely true that bone, gum and attachment can never be returned to original levels. However, most people these days wish to keep their teeth for life.

Life expectancy on average in Ireland is 80. It is therefore very important to look after the gums from an early age to avoid damage to the supporting structures of the teeth. Healthy gums mean a healthy dentition for life.

Treatment Aims are to achieve:

  1. Clean healthy mouth
  2. no tartar or plaque deposits
  3. pink firm healthy gums, which do not bleed or pain.
  4. no foul breath
  5. no foul taste
  6. firm teeth
  7. teeth which feel and look good
  8. teeth which last for life

The above are achieved to varying degrees depending upon the individual person and situation. In this dental practice the periodontal programme targets the above aims.

Periodontal disease affects the gums and bone supporting your teeth. It is caused by sticky plaque and hard deposits of tartar. It occurs when teeth are not kept clean enough. When you get really bad gum disease it is usually hereditary or an affect of malnutrition. This should be immediately investigated.
Thorough brushing can remove sticky plaque. Scaling and polishing can remove hard tartar. Without regular cleaning, the gum will come away from the tooth, making pockets around the teeth where food and plaque can collect. Pockets are more difficult to keep clean so gum disease will usually get worse if nothing is done.
Gum disease has two stages:

  • It starts with inflammation – redness and swelling. Dentists call this gingivitis. It can be cured with good oral hygiene.
  • The next stage is called chronic periodontitis. Some of the bone that’s supports the teeth are lost and the teeth become loose until they eventually have to be taken out. Periodontitis cannot be reversed once it starts but it doesn’t have to get worse if you clean your teeth properly and have regular root planning from your dentist or hygienist.

Decay Detection

An extremely important part of our regular dental examination is decay detection. Although decay might not cause discomfort or any pain, the tooth could still be deteriorating. We use the latest dental equipment and higher magnification to detect any decay in the early stages. This will then prevent future possible pain and costly dental treatment. Sometimes the tooth may look healthy, but only through the use of the very latest low dosage x-rays can your dentist properly assess the whole of the tooth including the roots and bone surrounding your teeth.

Mouth Cancer Screening

Mouth cancer is a malignant growth which can occur in any part of the mouth, including the lips, throat and tongue. Your dentist will routinely screen at every scheduled examination, however you should inform your dentist at once if you have any concerns. Research shows that Mouth cancers have a higher proportion of deaths per number of cases than breast cancer, skin cancer or cervical cancer. Despite treatment, the mortality rate is just over 50%, with over 1,750 deaths per year in Ireland and the UK. This is because of late detection, therefore highlighting the necessity for regular dental checkups to allow early detection of abnormalities in the mouth.

Temporomandibular (Jaw) Joint Problems

Your jaw joint, which is located just in front of your ears is known as the temporomandibular joint or “TMJ”. Just like any other joint in  your body, the TMJ has a cartilege disc. This can become worn or displaced resulting in TMJ problems such as pain, clicking or at worst locking.

Unlike other joints in your body that usually work in isolation to each other ie : (you can bend one of your knees on its own or together with the other one), the TMJ is comprised of two joints left and right  and they have to move together. If either is out of synchrony with the other can lead to disfunction.

If you grind or clench your teeth, over time damage can occur to your TMJ.

Wear of the joint over time can result in arthritis.

Where people have lost back teeth, the front teeth can undergo accelerated wear. The bite may also become unstable due to lack of supporting back teeth, resulting in TMJ dysfunction.

Symptoms and signs of a TMJ problem may include:

  • Clicks or crunching  sounds when your jaw moves.
  • Stiffness and tenderness of joints.
  • Ear pain with or without tinnitus, headaches and back pain (especially in the morning).

Anti inflammatory tablets and painkillers may help relieve symptoms. As can massage of the affected muscles, ice packs and avoiding hard or chewy foods. However, if there is an underlying cause such as a grinding habit or internal  derrangement of the joint, treatment may be required. A hard plastic mouth guard  worn at night is often the solution. This fits comfortably, allowing the jaw to move freely and taking the pressure of the TMJ’s,while protecting the teeth from further wear. If teeth are missing in the posterior of the mouth it may be necessary to repalce these.

Tooth erosion

In addition to tooth damaged caused by decay, the tooth can be eroded by acids in the mouth. Acids can come from food, drink or sometimes manifest from your stomach. Acids attack the tooth by dissolving minerals out of the hard enamel surface, making the tooth thin. The tooth can then become extremely sensitive to hot and cold food and drink.
Erosion can also be caused by the acidity in fizzy drinks. Even if they are ‘diet’ they are just as harmful. Your Dentist and Dental Hygienist will ensure that children and others affected by tooth erosion, are educated about the harmful effects are fizzy drinks.

You can help protect your teeth from erosion by following the tips below:

  • Elimiated fizzy drinks from your diet or reduce the frequency of them.
  • Drink them quickly and chilled.
  • Drink through a straw so it misses your teeth.

Some foods, like pickles, are also highly acidic.
Don’t brush your teeth immediately after eating or drinking something acidic, as the acidity temporarily soften the teeth. Preferable rinse your mouth with water and then brush your teeth about 30 minutes after have the acidity in your mouth.