Gum Disease


Not all teeth need filling - but all teeth need a healthy foundation and supporting structure: your gums. 

Periodontal/Gum Disease 

If you have healthy gums you’ll also enjoy fresher breath, less decay and believe it or not, better general health. And who doesn't want fresh breath?! 

Cardiovascular disease, heart attack and stroke can be related to poor gum health. People living with diabetes are at particular risk of complications from chronically infected oral soft tissues.  

The good news is that a simple check will tell you if you’re at risk of gum disease. Healthy gums are also the key to keeping your teeth, as gum disease is the number one reason we might lose teeth and eventually need dentures. Don’t want dentures? Make sure your gums are as healthy as possible.  

  • All patients should be considered for whole-mouth periodontal charting  
  • We chart calculus, current pocket-depth, bleeding and plaque scores as well as swelling, bleeding, reddened or loose gingival tissues  
  • We consider bad taste and halitosis 
  • Each patient should have an ideal maintenance interval 
  • We use a plaque-disclosing technique at each maintenance appointment 
  • Carry out needed therapy: removing deposits of plaque, removing deposits of calculus, removing stain  
  • Individualised oral hygiene instruction, with your goals for home care, treatment recommendations, and next maintenance recommendation  
  • Identification of ongoing or new problems with individual teeth and old fillings  

Poor Gum Health Risks 

Cardiovascular disease, heart attack and stroke can be related to poor gum health. 

People living with diabetes are at particular risk of complications from chronically infected oral soft tissues. 

The good news is that a simple check at your dentist will tell you if you’re at risk of gum disease. 

Healthy gums are also the key to keeping your teeth, as gum disease is the number one reason we might lose teeth and eventually need dentures. Don’t want dentures? Make sure your gums are as healthy as possible. 

At Dr Patrick Meaney & Associates we aim to help keep your gums healthy.  

Dry Mouth Syndrome

Having a more-dry mouth is a natural part of the process of aging. BUT, there are some warning signs that your mouth might be too dry. 

Bacteria prefer a more dry environment and cause us more problems the drier things become. The dryness can cause two main effects: more decay, especially on root surfaces, and more periodontal attachment loss. Your gums need a firm and secure 'attachment' to your teeth and bone that supports your teeth. Progressive loss of attachment causes problems like tooth mobility or looseness, eventually leading to lost teeth. 

Here are some things to think about:

  • Do you keep a glass of water by the bed at night?
  • How about during the day-is water essential when eating?
  • Or do constantly needs a water bottle handy?

By the way, that last one is a really healthy habit to have, especially in our Australian summers, but it can also mean that you have a ‘dry mouth’. There are many reasons for a dryer-than-normal mouth: medication, disease, medical treatment, damage after trauma or surgery, and, simply, the aging process. You may also be merely dehydrated, of course! 

The main dental problem with a dry mouth is much more activity by decay-causing bacteria-they like it dry. Your saliva has wonderful natural ingredients that confer protection from normal bacteria in your mouth and plaque: if it dries up, or loses its normal qualities, you could be at risk of increased decay, and, other problems. 

Dry Mouth Syndrome Solutions 

There are some simple tests for the quality and quantity of saliva we're happy to perform for you. This might also include a food and drink diary, to work out what's going on in your mouth.

Based on what we find, we'll recommend a management program. It might be something as simple as drinking (water!) more regularly.

On the other hand, if your medical GP has prescribed a combination of medication known to cause a severely dry mouth, we can assess the effect and perhaps ask to have the medication reviewed. If that's not possible, we'll recommend a series of escalating but simple strategies for home care than can really help prevent problems. Finally there are some terrific new rinses, creams and innovative approaches like self-adhesive lozenges that dramatically improve comfort for people with a dry mouth. 


Evaluation & Assessment-A Periodontal Disease Risk Analysis

If you are new to our office (and you have teeth!) we'll ask to perform a 'P Chart'. A Periodontal Analysis-and-Recording or p-chart is the only way we can know how truly healthy you are. Periodontal/gum disease is 99% painless, and we can't really tell from a photograph or even the best x-rays exactly what's going on until we test and record the results. 

How do we test for gum disease? 

Our hygienists will gently test six points around each tooth, and record the results.

We’ll assess:
-gum recession or shrinkage;
-any hidden bone loss or general loss of support around individual teeth (this is called ‘attachment loss’);
-bleeding (obvious or hidden)
-purulence*, inflammation, swelling or other signs of infection

If you have special challenges with a dry mouth, or a lot of cavities, we can also test how acidic your saliva is and its ‘buffering capacity’. (Buffering helps us reduce the destructive effect of acid after we eat). 

On average, most adults should undergo this analysis and recording every 3-4 years, depending on initial assessment. 

We'll discuss the result with you because it tells us exactly what's going on in your mouth. We will frequently refer back to your 'p-chart' during future appointments to adjust your care and also decide on the next steps in hygiene maintenance. 

*a more scientific way of describing pus 

Fluoride Therapy

We Believe in Fluoride – there we said it. 

We think it assists in prevention of decay, life-long. 

It's necessary during pregnancy so first teeth resist decay, and adult teeth have a fighting chance. It's beneficial in growing children for the same reasons, and it's helpful for adults who are serious about prevention. 

Here's what the ADA says:

Water fluoridation is the safest and the most effective way to reduce tooth decay (dental caries). All Australians should have access to the benefits of fluoride.

Not convinced?

Here's some more detail

The use of fluoride in dentistry is one of the most important ways of preventing and limiting tooth decay and has the support of peak public health and dental authorities. International bodies such as the US-based Centres for Disease Control and Prevention (CDC), the World Health Organisation (WHO) and the US Surgeon General actively promote water fluoridation. The CDC placed water fluoridation in the top ten public health achievements of the 20th Century. Similarly, scientific bodies.

Here's a story from Patrick that you might find interesting:

"When I first started practicing in Moss Vale, in 1989, things were...normal. People were normal (people were friendly and happy!) and their teeth were the same as all the people in Sydney that I had been seeing for ten years. But after a few months, I asked Dr Ken Pogson, my boss at the time, "Why is it that I'm seeing the occasional child patient with lots of cavities?" .

"Check their address...they're probably from Bowral," was his reply.

But how could that make any difference, I thought? Turns out he was right (of course he was right!) and I found out there was no fluoride in Bowral's municipal water supply. This didn't happen until the mid 90s, whereas Yass was the first city community in New South Wales to be fluoridated. We celebrated 50 years of fluoridation in 2006.

As it turns out, Moss Vale was fluoridated in the early 1960s, and Ken was a chief public protagonist for that change. He and the introduction of fluoride saved literally hundreds of teeth from unnecessary decay in the decade since then.

Here's some more expert opinion:

Fluoridation of community water supplies benefits all age groups. The NHMRC found that water fluoridation reduces tooth decay by 26% to 44% in children and adolescents, and by 27% in adults. Recent Australian research states that access to fluoridated water from an early age is associated with less tooth decay in adults.

How Does Fluoride Work?

The effect of water fluoridation is predominantly from the fluoride being in contact with the tooth surface, that is, the effect is from the fluoride being in the fluid at the tooth surface. There are two ways in which the fluoride in drinking water acts to reduce tooth decay: • Reducing demineralisation (i.e. where the enamel begins to dissolve). This makes teeth more resistant to decay. • Enhancing remineralisation (i.e. recovery of weakened enamel). This helps repair the early reversible stage of tooth decay. Fluoride also slows the activity of bacteria that cause decay and combines with enamel on the tooth surface to make it stronger and better able to resist decay. 

Is Fluoride Safe? 

Yes, as far as Australian and International Health Experts (not Dr Google) can tell: 

There is reliable evidence that community water fluoridation at current Australian levels is not associated with cancer, Down syndrome, cognitive dysfunction, lowered intelligence or hip fracture. There is no reliable evidence of an association between community water fluoridation at current Australian levels and other human health conditions. Conditions where there is no evidence of association include chronic kidney disease, kidney stones, hardening of the arteries (atherosclerosis), high blood pressure, low birth weight, all-cause mortality, musculoskeletal pain, osteoporosis, skeletal fluorosis, thyroid problems or self-reported ailments such as gastric discomfort, headache, and insomnia. 

How Much Should We Use?

The Mayo Clinic states the following recommended daily amounts of fluoride:

  • Birth to 3 years of age: 0.1 to 1.5 milligrams (mg)
  • 4 to 6 years of age: 1 to 2.5 mg
  • 7 to 10 years of age: 1.5 to 2.5 mg
  • Adolescents and adults: 1.5 to 4 mg

What happens during a professional fluoride treatment?

We provide professional fluoride treatments a concentrated rinse, for home use, or a varnish applied directly with a brush.

These treatments have much more fluoride than your water or toothpaste. They only take a few minutes to apply and we'll ask you to avoid eating or drinking for 30 minutes after the treatment so the fluoride can be fully absorbed.

Are There Any Problems?

Dental fluorosis can affect the appearance of teeth, most commonly appearing as white lines/areas on tooth surfaces. It is caused by a high intake of fluoride from one or more sources during the time when teeth are developing. Almost all dental fluorosis in Australia, however, is mild or very mild, does not affect the function of the teeth, and is not of aesthetic concern to those who have it. Mild to very mild dental fluorosis has been associated with a protective benefit against tooth decay in adult teeth. Moderate dental fluorosis is very uncommon and severe dental fluorosis is rare in Australia. The very small amount of moderate and severe dental fluorosis in Australian children aged 8-14 years is not statistically different between fluoridated and non-fluoridated areas, meaning there is no evidence that community water fluoridation at Australian levels gives rise to these forms of dental fluorosis. In Australia dental fluorosis has declined, over a time when the extent of water fluoridation in Australia has expanded. The decline in dental fluorosis in Australia is linked to reduced exposure to fluoride from other sources such as toothpaste, due to the availability and promotion of low fluoride toothpastes for children and public health messages and guidelines about the appropriate use of these products. There are numerous causes of defective enamel formation not related to fluoride.  

Quite a number of 'baby-boomer' adults from the Sydney basin have slight white flecking visible on their front teeth, the result of slightly too much exposure to fluoride while growing up. It looks fine, though! 

Fluoride supplements in the form of drops and tablets are not widely available in Australia but are available in New Zealand and other overseas countries. 


57-59 Elizabeth Street

Moss Vale NSW 2577

02 4869 3111

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Opening Hours

Mon - Fri: 8:30 - 17:30

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