What causes tooth decay and how do I avoid it?SUGAR!!! Everyone’s mouth is inhabited by bacteria. Within minutes of consuming a sugary food, oral bacteria start to produce the acids that cause tooth decay. Oral bacteria then forms organised colonies which are referred to as “dental plaque.” Ultimately, decay occurs in those areas where dental plaque accumulates on a tooth’s surface.
To prevent decay you need to minimise the exposure your teeth have to bacterial acids:
- Consume less sugar or reduce the number of times you eat sugary foods in a day. The less time you allow sugars to remain in your mouth, the better. In other words, if you want to eat or drink something sweet, consume these fairly quickly.
- Use artificial sweeteners rather than natural sugars.
- To minimise how long sugars remain in your mouth, brush and floss or, at the very least, rinse with water promptly after consuming food.
How do I prevent my child’s teeth from decay?The first sign of decay in young children may appear as white spots on the teeth, that are opaque and whiter than the tooth’s actual colour. Eventually, as the spots enlarge, they may change colour to yellow or brown and form a hole in the tooth.
Recommended preventive dentistry measures for young children:
- Cleaning their teeth before bedtime. Using a wash cloth is fine.
- Never allow your baby/young child to settle to sleep with a bottle of milk. Offer water or a clean dummy only.
- Introduce drinking from a cup around the age of 6 to 12 months.
- Choose healthy snacks such as fresh fruit, cheese, milk, yoghurt, sandwiches, eggs, meat and vegetables.
- Encourage your child to drink water. It is best not to introduce fruit juice until your child is 12 months old and even then, it should be diluted with water.
- Establish cleaning routine at a young age.
Are baby teeth important?Baby teeth are in fact just as important as permanent teeth. Early loss of baby teeth can lead to:
- Crowding of teeth: Baby teeth maintain the space needed for adult teeth to erupt in. If a baby tooth is lost early, it can cause the remaining teeth to drift into the space where the adult teeth is supposed to erupt.
- Speech problems: Premature loss of baby teeth can result in speech difficulties, especially with the “s” sound.
What do I need to know about oral hygiene for my kids?All parents know that establishing routine and consistency with children should start at an early age. They need to be “trained” to know what is expected of them and what they expect from you. This concept is important with oral hygiene preventive dentistry. Hopefully, cleaning sessions at home happen more regularly with less stress and more effectiveness.
We find that 80% of kid’s decay is between the two baby molar teeth. It only happens after the 2nd baby molar erupts at age 3 and starts touching the 1st molar. So, in theory, the best thing you can do to prevent decay in kid’s teeth is to floss between just the 2 back teeth in each quadrant after age 3. Good in theory!We do understand that brushing, let alone flossing, is a challenge for parents and kids but with flossing gadgets it is surprisingly quick and easy to do and to teach kids how to do it themselves. Much quicker and easier than brushing. Even if you don’t brush the kid’s teeth, when everybody is tired and “fed up” at night, it is actually better to floss just those 4 places than to brush before bedtime.
The main benefit of toothpaste is a way of getting some fluoride on the teeth everyday. Fluoride makes the teeth more resistant to decay. If your child can’t spit the toothpaste out yet, just use a light smear of kid’s toothpaste (which has less fluoride in it) and rinse. When they are old enough to spit it all out and not swallow it, they can use adult toothpaste about the size of 2 grains of rice, brush for 2 minutes and spit out – no rinsing. The reason for brushing for 2 minutes is that it takes that long for the fluoride ions to diffuse into the tooth (diffusion gradient). This is the reason electric toothbrushes have 2 minute timers. Brushing for 3 seconds on the outside surfaces and 3 seconds on the inside surfaces of each tooth is about 2 minutes. Saying “elephant 1, elephant 2, elephant 3” takes 3 seconds. So, we should aim for 3 elephants on each surface of each tooth!In the real world, very few adults or children, or adults brushing children’s teeth, can reach the 2 minute mark – so don’t feel too bad if you can’t do it! It is however what we should do – if and when possible.
- Children 3 – 6 years of age still lack the fundamental skills necessary to brush their own teeth. Kids can usually brush their own teeth between the ages of 6 and 9 – depending on the child.
My child may need braces but I’m not sure. When should I get him/her checked?Many orthodontic problems are apparent by the time the adult front teeth and first molars come through, so the recommendation is that all children have an orthodontic assessment around age 7 – 8 years. Traditionally, orthodontic assessment and treatment was confined to the teenage years, once all the adult teeth had erupted and facial growth was mostly complete. We now realise it is better to make that assessment at a much earlier age, while a child still has significant facial and jaw growth potential left.
This does not necessarily mean all treatment should start at age 7. The aim is for the child to spend the least amount of overall time in treatment, while at the same time maximising its effectiveness. Often this will mean regular monitoring of the child until he or she reaches the most appropriate stage of growth and development for treatment of their individual problems.
The earlier problems are diagnosed, the more treatment options are available.
How often should I have my teeth cleaned by the dentist?The principles of preventive dentistry recommend having a scale and clean at least once every 6 to 12 months. Even the most diligent regular brushing at home does not stop the build up of plaque and calculus altogether. It is therefore necessary to visit the dentist to ensure that all plaque and calculus that has built up under and around the gum line is removed.
If plaque and calculus build up is left untreated for too long, it can lead to gum and periodontal disease, which will eventually lead to tooth loss. The good news is that periodontal disease is treatable and reversible.
How often should I floss my teeth and what if I don’t?There is a well known saying “only floss the teeth you want to keep.” Flossing is a misunderstood necessity of our daily oral hygiene routine and is often more important than brushing your teeth as far as preventive dentistry goes!
Flossing removes plaque between the teeth that cannot be removed with a toothbrush. Plaque between the teeth can cause decay, gum disease, periodontal disease and bad breath. Some patients are reluctant to floss because they feel that they are not doing it properly, and maybe that may be the case. If you are shown how to floss correctly, flossing becomes a very easy and a much more pleasant experience, which will increase the likelihood that it will be part of your daily oral hygiene routine.
If you have any issues around flossing, make sure you discuss these with your dentist/hygienist at your routine checkup appointment.
Why do my gums bleed when brushing?Healthy gums do not bleed!
Periodontal disease most often goes unnoticed because it is usually painless. Bleeding gums when brushing or flossing and bad breath are possible signs of gum disease. The early stages of gum disease is known as gingivitis. Gingivitis can be completely reversed with daily brushing and flossing, as well as regular cleaning by a dentist or hygienist. If gingivitis is left untreated, it can advance to periodontitis, which is a chronic, more serious infection that could result in considerable bone loss and tooth loss.
Do not ignore bleeding gums. This needs to be checked by a dentist or hygienist as soon as possible.
Why is saliva important?Saliva is the best, natural defense against decay. Saliva protects teeth by neutralising the acids that are produced after eating and drinking. Saliva also contains immunoglobulins which help fight mouth infections and it also reduces the stickiness of bacterial plaque to teeth.
Saliva quality and quantity can be affected by a number of things. A reduced flow of saliva is called “dry mouth” which can lead to an acid environment in the mouth, decay and severe dental problems and bad breath.
Dry Mouth may be caused by:
- Medications that you may be taking that may have a drying effect in the mouth.
- An excessive intake of caffeine (mainly found in coffee, tea, chocolate and cola drinks) draws fluid from the body and works as a diuretic, which can lead to dehydration. This, in turn, reduces saliva.
- Not hydrating often enough after physical exertion or whilst in a dry working environment.
- Smoking, which slows down the production of saliva and therefore increases dry mouth.
- Specific diseases or conditions and their treatment (e.g. cancer treatment).
- Commercial mouthwashes which contain alcohol. Although alcohol kills bacteria, it also has a severe drying effect on mouth mucosa.
- Sports drinks. These are very high in acid and can be very destructive during and after strenuous exercise and sport. This is because sport and exercise can be dehydrating and so decreases salivary flow. If the protective saliva is lacking, the high acids in sports drinks can attack the enamel and tooth structure.
Simple ways to reduce the effects of Dry Mouth:
- Drink lots of water, especially during and after strenuous exercise and sport.
- Chewing on sugar-free gum, or calcium-fortified gum, specially formulated to remineralise the teeth (e.g. Recaldent).
- Use an alcohol-free mouthwash – available through your dentist.
If you have a constant dry mouth, you should consult your dentist to find the cause.
I worry I have bad breath. What can I do?Many people have bad breath that is not associated with foods or gum disease. Everybody has an epithelial lining or “skin” on the inside of their mouths, tongue, under the tongue, down the throat and up into the nose. This “skin” is constantly shedding and renewing itself. These epithelial cells are broken down by bacteria. Some people have a particular mix of bacteria that produces volatile sulphur compounds (VSC’s) which have a “rotten” smell i.e. bad breath. Everybody has a different mix of bacteria in their mouths, resulting in a variety and intensity of “rotten” smells, ranging from no discernable smell (i.e. very little VSC’s) to particularly noxious smells.
Many of our patients (and their partners!) have been grateful for a product we recommend for the elimination of VSC’s, called Closys. It is the most effective product we have found, much better than more well-known mouthwashes, and it is alcohol-free. It also comes in a toothpaste and a handy pocket-sized spray bottle.
Of course, we can all suffer from sporadic bad breath or “halitosis” by eating certain foods like garlic, onions and cheese. High protein diets and highly acidic foods and drinks can also cause temporary bad breath. If bad breath persists, it may also be associated with general oral hygiene, gingivitis and periodontal disease.
A build up of bacteria in the mouth will cause your breath to become offensive to others. Bacteria thrive on the tongue, around dentures, where there is decay of any sort, if there is gum or periodontal disease or plaque build up. Also, anything that has a drying effect on the mouth and reduces saliva, can cause bad breath, as a dry mouth is an ideal environment for bacteria to thrive.
Simple ways to eliminate bad breath:
- Good oral hygiene practices – regular brushing and flossing is essential.
- Brushing or scraping your tongue.
- Regular scale and cleans by a dentist to remove plaque and tartar and prevent them from building up.
- Treatment for gum or periodontic disease by a dentist or hygienist.
- Usage of alcohol-free mouthwashes containing chlorine dioxide (such as Closys).
- Meticulous cleaning of dentures, if used.
If you have any concerns about your breath, consult your dentist, as bad breath is likely to persist until the cause is diagnosed and correctly treated.
Do you (or your partner) grind your teeth at night?Bruxism is the medical name for teeth grinding and teeth clenching. As it is an unconscious reflex, many people are not even aware that they grind or clench their teeth during sleep. Occasional grinding is not really of any concern, however, grinding of the teeth on a regular basis causes damage and needs attention by a dental practitioner.
Bruxism is usually caused by a malocclusion and poor bite, when teeth don’t fit together properly when the mouth is closed. Stress, alcohol, excessive intake of caffeine and smoking can also cause grinding of the teeth and can make an existing condition worse.
Chronic teeth grinding can result in:
- Fracturing, chipping, loosening and wearing down of teeth
- Total loss of the teeth
- Detrimental damage to the jaw, which can lead to hearing loss and TMJ (Temporomandibular joint)
- Intense headaches and migraines
- Severe neck and shoulder pain
Whilst children can also suffer from teeth grinding (particularly up to the age of six or seven), they usually grow out of it. However, teeth grinding may still cause jaw pain, headaches and tooth sensitivity in children.
Teeth grinding can be successfully treated by a custom-made, specially-fitted dental night guard that is worn during sleep. The night guard or splint is made of plastic and fits over some or all of the upper and/or lower teeth to prevent further damage to the teeth.
Is there anything I can do to stop my partner from snoring and keeping me awake all night?Snoring is a result of partial blocking of the upper airway, which can easily be treated successfully with a snoring mouth guard. However, loud snoring may be a sign of a more serious problem – obstructive sleep apnoea (OSA). This is where the airway becomes completely blocked and breathing stops.
During sleep, the muscles that hold our airways open relax. In some people, these soft tissues at the back of the throat, relax too much and collapse, leading to obstruction of the airways. Oral appliance therapy, like snoring mouth guards, use a dental device fitted in the mouth to prevent the airways from collapsing during sleep. These appliances look similar to orthodontic retainers and are safe, painless, effective, small, light and extremely portable. The device is very discreet and it is possible to speak, yawn or drink whilst wearing the appliance.
Dentists with special training in oral appliance therapy can treat troublesome snoring and have expertise in the types of oral appliances that will best suit your needs. So, if snoring is a problem and the cause of an unhappy bedtime environment, come and talk to one of our specially trained practitioners in the area of sleep dentistry.
What is an OPG and why do I need to get it done?An OPG is a rotational panoramic dental xray that allows the dentist to get a broad view of a patient’s facial bones and teeth. An OPG image shows the upper and lower jaws, teeth, joints and also gives a clear view of the dental nervous system.
An OPG image uses a machine with a rotating arm which rotates around your head, from ear to ear and the image is captured on film. The whole thing takes about 5 minutes and patient exposure to radiation is very low. It is particularly useful for patients who have restricted opening of the mouth and normal xrays are difficult.
An OPG image gives the dentist a real idea about what is going on in your mouth, as often dental issues cannot be seen until pain or discomfort is felt. OPGs are most commonly used to determine the status of wisdom teeth and any trauma to the jaw (through accidents) but are widely used for the following:
- Diagnosis and treatment planning for impacted wisdom teeth
- Determining the source of dental pain
- Detection of any decay and caries
- Periodontal treatment and bone loss
- Root Canal Treatment
- Orthodontic assessment – both pre and post treatment
- Assessing placement of dental implants
- Jaw issues such as TMJ
- Trauma to the face and jaw, primarily through accidents
Apart from the diagnostic value of OPGs, they are also an excellent visual aid for patient education and allows the dentist to very clearly explain and demonstrate what the dental issues are.
How much radiation exposure am I getting when I have dental xrays?Fortunately, the relative risks associated with dental radiography are quite low and it is being consistently reduced by new technology. Digital imaging technology has reduced exposure to radiation by 80% – 90%, delivering a very small dose only with each film. To illustrate how low the radiation exposure is, a flight from Sydney to London is equivalent to having 225 dental xrays!
Dentists, however, should not be complacent and have a professional responsibility to use radiography appropriately. Because the effects of radiation may also be cumulative, practitioners should not ignore the number of previous radiographs (especially medical) a patient has had and be prepared to discuss any concerns a patient may have.
Xrays during pregnancy is discussed in “Is dental treatment safe when you are pregnant?”.
Is dental treatment safe when you are pregnant?Ideally, dental treatment is best avoided in pregnancy, however, pregnant woman should continue to have their routine (preventive) checkup appointments. In fact, it is even more important to maintain excellent oral hygiene throughout your pregnancy as it is common (70% of pregnant females) to experience increased gingivitis or pregnancy gingivitis. This usually begins in the second or third month of pregnancy and increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue. It is also important to note that there is a threefold increase in periodontal disease if there is gestational diabetes. Studies have shown a possible relationship between periodontal disease and pre-term, low-birth-weight babies.
If you are in pain, it is probably likely that you have an infection. If so, the infection itself could lead to complications. In that case, having the tooth treated would be advisable. On the other hand, if the tooth is not painful, it might be better to wait until the baby is born before treating the tooth.
Dental treatment is relatively safe whilst you are pregnant, however, the possibility to experience any adverse effect, does exist, however remote. It is always necessary to weigh the risks against the benefits. There are studies that have shown that emergency treatment of an infection can be achieved successfully and without any adverse effects to mother or foetus/baby. (Australian Dental Journal 2012).
Dental xrays and pregnancy: If it is imperative you have dental xrays, make sure the dentist knows you are pregnant. Dentists usually prefer not to take any xrays in the first trimester, however, unless the xray is an emergency, postpone it until after you have the baby. It has been shown that doses of less than 50 to 10 centigrays (cGy) have no association with increased development of congenital defects or intra-uterine growth retardation. (Australian Dental Journal 2012). Thus, generally, for a patient with a spreading infection, a single OPG (full mouth xray) will provide sufficient information at an acceptable radiation exposure.
Why is my tooth sensitive to hot liquids?Sensitivity to heat usually indicates that a tooth’s nerve is dead or dying. Nerve damage is most often caused by either severe decay or periodontal disease, or by trauma to the tooth or jaw sustained through sport, violence or accidents.
The tooth nerve is called and referred to as the dental pulp. It is a complex organ composed of connective tissues, blood vessels and nerves. The space in the centre of your tooth that once held a healthy nerve now contains dead tissue and one of the components of decaying flesh, methane gas. When heat is applied to the tooth, the gas expands causing significant pressure to build up, which then results in pain. It may start as mild discomfort but if left untreated, it will eventually cause an abscess to form at the tip of the root, which is extremely painful and can lead to fever.
Root canal treatment is essential for symptoms to disappear. The dentist may also prescribe a course of antibiotics to clear the infection and save the tooth. In a root canal procedure, the surgeon opens the top of the tooth (crown), removes the infected tissue and cleans the inside of the tooth. The tooth is then filled with antiseptic medication and sealed off. The dentist will also advise that a crown be placed on the tooth, as it is brittle in nature and tends to break away.
The only teeth that actually require root canal are those whose pulps have died. The dentist can determine this by applying an ice test. An ice probe is placed on the tooth and the patient is asked if they can feel the cold from the tooth. Adjacent teeth are also tested to see whether they respond differently. An xray will confirm the diagnosis and show black areas where the bone has dissolved because of the infection.
If you start to experience any pain whilst consuming hot foods or liquids, it is advisable to seek immediate treatment and care, as this can prevent the situation getting worse and may spare you considerable pain.
What do I do in a dental emergency?Whilst it is preferable that you remain calm, it is important to stress that time is critical to prevent permanent damage and future consequences.
Tooth knocked out: If a permanent tooth has been knocked out during an accident you should:
- Stay calm.
- Immediately wash the tooth with milk or your own saliva until it is visibly clean. DO NOT WASH WITH WATER. Do not touch the root of the tooth with your fingers or a toothbrush.
- Place the tooth back into the tooth socket as soon as possible.
- If you are not able to place the tooth back into the socket, place it in some cold milk or wrap it in cling film and take it immediately to a dentist. DO NOT STORE IT DRY OR IN WATER as this will damage the sensitive cells that allow reattachment of the tooth.
Toothache: A toothache that does not go away is a sign that you need to make an appointment to see the dentist. In the meantime, relief may be achieved by:
- Rinsing your mouth with water and trying to remove plaque and food from the area by flossing and brushing.
- If you have some swelling, an icepack on the cheek next to the area may help and will also help relieve pain.
- Pain killers such as ibuprofen may also provide relief till you can be seen by a dentist.
Broken Tooth: If a tooth has broken due to an accident:
- Place an icepack on the face next to the injury to minimise swelling of the face.
- Try and find and collect any pieces of tooth, as it may be possible to rebond the tooth back.
- Brushing and flossing carefully and rinsing the mouth out with water may also help the gums.
- If you have a toothache, take a painkiller such as ibuprofen and make an appointment to see the dentist.
Broken/fractured jaw: If your bite feels different to usual, your jaw may be broken. You should:
- Seek immediate medical help at a dentist or hospital. A broken jaw requires emergency dental care and must be set back into its proper position and stabilised with plates or wires while it heals. Healing may take six weeks or longer, depending on the patient’s age and the severity of the fracture.
My dentist said I should get my wisdom teeth removed but I am not in any pain?A small number of people are born without wisdom teeth. Others have enough room in their mouths to accommodate third molars (wisdom teeth) without incident. However, in some people wisdom teeth can cause a number of problems, the most common being – decay, infection and crowding or damage to other teeth.
Most people don’t think about their wisdom teeth until they experience painful symptoms. Wisdom teeth may cause pain and swelling in the following situations:
- An infection develops beneath the gum flap of a wisdom tooth that has incompletely erupted and only partially pokes through the gum. Bits of food and bacteria can get trapped under the flap, causing swelling and an infection called pericoronitis.
- Pain and/or jaw stiffness caused by an impacted tooth. Wisdom teeth that are blocked from coming through, usually by bone or other teeth, are referred to as “impacted” teeth.
- Pain, irritation or discomfort from a tooth that is tilted at an awkward angle and is rubbing against your cheek or tongue.
In rare instances, more serious complications can occur, when cysts and tumours can develop, which can cause permanent damage to bone, teeth and nerves. Even when wisdom teeth are not causing you any pain or other problems, they could potentially cause you problems at some point in the future. The following situations may be asymptomatic but could lead to future problems:
- Tooth decay or gum disease due to difficulties in cleaning and caring for wisdom teeth and surrounding teeth, usually because there is not enough room to do so properly.
- Crowding of other teeth.
- Situations where a dentist can see potential problems on an xray. The dentist can usually explain what the issues are by showing you on the xray.
As a rule, wisdom teeth get more difficult to remove the older you are. For this reason, if there is any chance your wisdom teeth will cause problems, it may be easier to take them out sooner rather than later. Regular visits to the dentist will enable them to follow the progress of your wisdom teeth and detect any problems early.
I have sore jaw joints. Is there anything that can be done?Painful jaw joints may be a sign that you have TMD (Temporomandibular Joint Disorders). The temporomandibular joint (also referred to as TMJ) is the joint just in front of each ear, where your jaw bone connects to your skull. The temporomandibular joints are complex and are composed of muscles, tendons and bones so any problems with the TMJ are diagnosed under the umbrella of TMD.
The causes of TMD are believed to be a combination of problems with the joint and stress on its surrounding structures due to arthritis, injury, dislocation, bite problems (malocclusion), jaw clenching and teeth grinding (bruxism) or missing teeth.
Dull, aching pain, which varies in strength and severity, is the most common symptom of TMD. Whilst the pain is usually felt in the jaw, it can include the face, ear and teeth. The pain may also radiate to the neck or shoulders, especially when chewing or moving the jaw.
There are many different treatments available for TMD, depending on the cause of the problem. If grinding your teeth at night is the problem, then a night guard or splint will be helpful by preventing jaw clenching and teeth grinding, which will ease the tension in the jaw muscles. If you have problems with your bite or need teeth to be replaced, then you should see your dentist. For short term symptoms of TMD, pain relievers, muscle relaxants, and hot and cold packs can help relieve pain. Avoiding stimulants such as caffeine and sugar, especially within four hours of going to bed, sleeping on your back if possible to take pressure off the jaw, and placing a cushion under the knees to take pressure off the back, can also help manage symptoms of TMD. Managing stress and anxiety, regular exercise, yoga and meditation can also reduce muscular stress and improve TMD pain.
Can anything be done for my gummy smile?When a person smiles and a significant amount of their gums can be seen, it is referred to as a “gummy smile.” Some people with gummy smiles are very self-conscious about it and seek out procedures to correct this. Whilst a gummy smile is not considered to be abnormal, it does make oral hygiene more difficult than for patients without a gummy smile.
There are two cosmetic procedures used to correct a gummy smile:
- Gingivectomy: This procedure involves removing the excess gum tissue and reshaping the gums using a dental laser. This procedure is quite straightforward, relatively painless and does not require sutures. Generally, the gum tissue heals within two weeks.
- Crown Lengthening: This procedure is performed under local anaesthetic and involves contouring the gum tissue around each individual tooth. Excess gum and bone tissue is removed and reshaped to expose more of the natural tooth. Sutures are removed once the gums have healed – usually seven to ten days.
The dentist will determine which procedure is appropriate for your particular situation. Even though these procedures are quite straightforward, they can create a beautiful, new smile.
I have a gap between my teeth. Can anything be done to fix this?There are a number of treatment options that are available to fix this cosmetic problem. The type of treatment that is appropriate will depend on the size of the gap, the desired cosmetic outcome and the timeframe the patient desires treatment to be completed in.
- Bonding: Bonding is a quick solution for closing a small gap between two teeth. Much like a filling, the composite bonding is used to make the teeth larger and close the gap. Whilst the results are instantaneous, it will not last forever and will eventually need to be redone.
- Porcelain Veneers: Veneers offer a more longterm solution and are commonly used for gaps between the two front teeth.
- Orthodontics/Invisalign: The most comprehensive longterm solution is some form of orthodontics. There are many different types of braces available – fixed, lingual, aligners. Invisible braces such as Invisalign are also very effective in closing a small gap in between teeth. If a patient chooses this option, they need to be prepared to undergo treatment for many months.
I suspect my daughter has an eating disorder but I am not sure. Can a dentist help?Dentists and hygienists are frequently the first health professionals to observe signs of eating disorders, as changes in the mouth are usually the first physical signs of an eating disorder. The frequent vomiting and nutritional deficiencies associated with eating disorders can severely affect oral health.
Although some parents may not recognise that their child has an eating disorder, chances are that if the child visits the dentist regularly, it will be detected. Parents that suspect their child may suffer from an eating disorder should visit a dentist sooner rather than later so that an oral care plan can be developed to limit the damage to the teeth.
Dentists, like doctors, will deal with these issues in a non judgemental, supportive and confidential manner and encourage the patient to seek professional help.
If you would like to make an appointment, please call us on (02) 8456 6789 or submit the contact form.