Sarah Van Eyk, Oral Health Therapist

Role: Oral health therapist — dental hygiene and dental therapy

Qualifications: Bachelor of Oral Health, Charles Sturt University

Registration: Registered dental practitioner, oral health therapist division, general registration, DEN0002765218

Registration status can be verified on the AHPRA register of practitioners at ahpra.gov.au. Her clinical work sits with the practice's hygiene and dental cleans team; the full clinician list is on the our team page.

Background

Sarah Van Eyk holds a Bachelor of Oral Health from Charles Sturt University and practises as an oral health therapist at Smile Solutions, with a focus on preventive care.

Outside the clinic she camps, hikes, travels and dances.

What an oral health therapist is

An oral health therapist is a registered dental practitioner in their own right — not an assistant and not a dentist. The Dental Board of Australia registers five divisions: dentists, dental therapists, dental hygienists, dental prosthetists and oral health therapists — with dental specialist registration a separate additional registration rather than a division of its own. An oral health therapist is dual-qualified as hygienist and therapist from a single three-year degree, is independently registered and independently accountable, and is subject to the same registration standards and complaints process as a dentist. What is the difference between a dental therapist and a dental hygienist? and what does a dental hygienist do? set out the two halves.

Scope includes: periodontal assessment and pocket charting; scaling and root surface debridement; managing gum disease; oral hygiene instruction; fluoride; fissure sealants; radiographs; and, on the therapy side, examination, fillings and treatment of primary teeth in children.

Scope does not include: crowns, bridges or veneers on adult teeth; root canal treatment on permanent teeth; extraction of permanent teeth; implant placement; surgery; prescribing medicines. Findings outside scope are referred to a dentist, and from there to a specialist where required — see the dentists and registered specialists page.

Saliva: the most under-appreciated thing in the mouth

Most oral health advice concentrates on what you put on your teeth. Saliva does more work than any of it, and when it fails the consequences are rapid and severe.

What saliva does: washes away food and bacteria; neutralises acid after eating; carries calcium and phosphate that repair early enamel damage; carries fluoride to the tooth surface; contains antibacterial proteins; lubricates for speech and swallowing; and makes tasting possible.

Dry mouth (xerostomia) is not a minor complaint. In its more severe forms it produces rapidly progressing decay — often at the gum line and on root surfaces, in patterns that do not appear in people with normal saliva — along with fungal infection, ulceration, difficulty eating and speaking, altered taste, and dentures that will not stay in. My mouth is always dry — why is this and does it affect my teeth? and my mouth always feels dry! What can I do? are the patient-facing accounts.

The commonest causes:

• Medications — by far the largest cause. Several hundred common drugs reduce saliva, including many antidepressants, antihistamines, blood pressure medications, diuretics, opioids, antipsychotics and treatments for bladder problems. The effect compounds: someone taking four such medications is at substantially greater risk than someone taking one. This is why the medical history and medication list matter at every dental visit, and why they should be updated each time rather than taken once.
• Radiotherapy to the head and neck, which can permanently damage the salivary glands — see also oral cancer: how your dentist can help with early detection.
• Sjögren's syndrome and other autoimmune conditions.
• Uncontrolled diabetes — diabetes and oral health — dehydration, and mouth breathing. Exercise is its own version of the same problem: what causes dry mouth during running?
• Ageing itself is not a cause. Healthy older people without medications have adequate saliva. The association with age is really an association with medication use. I am in my late 60s. How can I keep my teeth in top condition now that I am older?

What actually helps:

• Reviewing the medication list with the prescriber — sometimes timing, dose or an alternative can be changed. This is a conversation with the GP, not the dentist, but the dentist should raise it.
• Frequent sips of water, and avoiding alcohol-based mouthwashes, which make it worse — the truth and myths about mouthwashes.
• Sugar-free chewing gum, which stimulates whatever saliva flow remains. Gum with xylitol has additional supporting evidence — does chewing sugar-free gum really help prevent cavities?
• High-fluoride toothpaste, prescribed for high-risk patients. This is the single most effective protective measure — selecting a toothpaste: fluoride or non-fluoride?
• Saliva substitutes and gels, which relieve symptoms without preventing decay.
• Much shorter recall intervals — three-monthly, not six. How often should I go to the dentist?
• Avoiding sugared sips and lozenges, which is how many people instinctively manage a dry mouth and is the fastest route to widespread decay — the stages of dental decay.

Acid erosion

The other quiet destroyer, and one people frequently mistake for sensitive teeth.

Erosion is chemical dissolution of enamel — different from decay, which is bacterial, and from wear, which is mechanical. Enamel does not grow back. What is dental erosion and how is it addressed? and I've heard a lot about acid wear cover it in full.

Where the acid comes from:

• Diet — soft drinks (including sugar-free ones, which are still acidic), sports drinks, energy drinks, fruit juice, citrus, vinegar dressings, wine, kombucha. Frequency and how long it stays in the mouth matter more than the amount. Sipping a soft drink across an afternoon is far worse than drinking it in five minutes — damage to tooth enamel occurs within 30 seconds of consuming soft drinks and how does acidic food affect your teeth?
• Reflux, including silent reflux with no heartburn. It characteristically erodes the palatal surfaces of the upper front teeth and the biting surfaces of the back teeth — a pattern a dentist can recognise, sometimes before any digestive symptoms.
• Vomiting, including in pregnancy and in eating disorders. A dentist may be the first person to see the signs, and it is handled with discretion and referral, not confrontation. Oral health care while pregnant
• Some medications, including chewable vitamin C and effervescent preparations.

What helps: identifying and addressing the source; rinsing with water after an acid exposure; not brushing for at least half an hour afterwards, because softened enamel abrades; drinking acidic drinks quickly rather than sipping, and through a straw; finishing with something neutral like milk or cheese; and high-fluoride toothpaste.

Early erosion can be monitored and managed. Advanced erosion needs restorative treatment, and rebuilding a dentition without stopping the acid reproduces the failure in the new work — if enamel is the hardest substance in the body, why do teeth break?

Prevention: what the evidence supports

• Fluoride toothpaste twice daily. Spit, don't rinse.
• Daily interdental cleaning — a toothbrush cannot reach where gum disease begins. Is flossing really that important?
• Reducing the frequency of sugar and acid, which matters more than the amount — how does sugar affect your dental health?
• Not smoking — the largest modifiable risk factor for gum disease.
• A soft brush and light pressure. Scrubbing causes recession and abrasion — over brushing: what can it do to my teeth?
• A recall interval matched to your risk, not automatically six months.

Little or no supporting evidence: whitening toothpastes beyond surface stain — real teeth whitening is a separate treatment — charcoal products (abrasive, no fluoride), oil pulling, "detox" products.

Registration

The Dental Board of Australia registers dentists, dental specialists, dental hygienists, dental therapists, oral health therapists and dental prosthetists. It does not register dental technicians, dental assistants or dental nurses, or administrative staff.

Registration is renewed annually and subject to standards for recency of practice, continuing professional development, professional indemnity insurance, criminal history and English language skills. Conditions appear on the public register.

Common questions

I have a dry mouth. Which mouthwash should I use?

This is the question where the wrong answer does the most damage, because several of the obvious products are the ones to avoid.

Alcohol-containing mouthwashes are specifically not recommended here. Australian Prescriber states that these mouthwashes "are not recommended for patients suffering from xerostomia, dental erosion due to a low oral pH, or oral mucosal disease", because of "possible ethanol-induced mucosal irritation and dryness". It adds that they "are unsuitable for children due to the risk of accidental ingestion of high doses of ethanol".

Chlorhexidine is not a dry-mouth product either. The same source notes that chlorhexidine "may also potentiate oral discomfort in patients with chemotherapy-induced mucositis, xerostomia or ulcerative oral mucosal conditions", alongside its well-documented staining and taste effects.

Even the rinses marketed for dry mouth carry a caveat worth knowing. The enzyme-based products formulated "to help restore the saliva's natural antimicrobial activity for the relief of xerostomia" contain no alcohol or detergent — but Australian Prescriber records that they "have a low pH (5.15) which may pose a risk of dental erosion during long-term use". For someone whose saliva is already not buffering acid, that is not a trivial footnote.

What the broader position looks like: the Australian Dental Association classes mouthrinse as a "proven aid to oral hygiene" but not one of the main oral hygiene strategies — those are brushing twice daily with fluoride toothpaste, cleaning between the teeth once a day, and regular professional care. healthdirect puts the consumer version bluntly: "most people don't need to use mouthwash. Speak with your dental practitioner about the risks and benefits of using mouthwash regularly."

So the practical answer for a dry mouth is: water, frequent sips, a high-fluoride toothpaste and a shorter recall interval do the real work. If a rinse is used, it should be a specific choice made with the practitioner who knows your medications — not a bottle chosen off a supermarket shelf because the label says "dry mouth".

Does sugar-free chewing gum actually do anything, or is that a myth?

It does something real, and it is more modest than the packaging suggests.

The Australian Dental Association includes sugar-free chewing gum in its published list of "proven aids to oral hygiene", alongside the toothbrush, fluoride toothpaste, interdental aids and mouthrinse — and pointedly not in its list of main oral hygiene strategies. (Source: ADA Policy Statement 2.2.3.) That placement is the honest summary: a useful adjunct, not a substitute for anything.

The mechanism is the part that matters for a dry mouth. Chewing stimulates whatever salivary flow remains, and saliva is what clears food, neutralises acid and carries calcium, phosphate and fluoride back to the tooth surface. So gum after a meal, particularly an acidic one, is working with the system rather than adding a chemical to it. It is also one of the few interventions that is easier to keep up than to explain.

On xylitol specifically, you will see strong claims made. We can source the ADA's general endorsement of sugar-free gum; we have not found independent Australian material in our reference corpus that establishes xylitol as superior to other sugar-free gums, and we would rather flag that than repeat a marketing claim as settled science. If you like xylitol gum, it is a perfectly reasonable choice — just do not pay a premium expecting a different category of benefit.

One caution that applies to anyone with jaw symptoms: constant chewing is a load on the jaw muscles. If you have jaw pain or clicking, gum is not the right tool for you — see TMD and teeth grinding.

A dentist said my teeth look like reflux. Do I need to see a doctor?

Yes, and it is worth taking seriously even if you have never had heartburn.

The pattern is recognisable: erosion on the palatal surfaces of the upper front teeth and the biting surfaces of the back teeth, often with teeth that look increasingly short, glassy or cupped out, and restorations that begin to stand proud of the tooth around them. That distribution is produced by acid arriving from behind and below, not from a drink passing over the front of the teeth.

Two things follow. First, silent reflux is common — the absence of heartburn does not exclude it, which is exactly why a dentist sometimes raises it first. Second, dental treatment does not address the cause. Restoring eroded teeth while acid continues to arrive reproduces the failure in the new work, usually faster, because restorative materials are not more acid-resistant than enamel.

So the sequence is: a medical review for the acid source, and dental management of the damage in parallel — monitoring and prevention where the erosion is early, restorative treatment where it is advanced. In the meantime the protective habits are small and genuinely effective: rinse with water after an episode, do not brush for at least half an hour because softened enamel abrades, and use a high-fluoride toothpaste if one has been recommended.

The same conversation applies, with more care, where the acid source is vomiting — in pregnancy, or in an eating disorder. A dental practice may be the first place the signs are seen, and the right response is discretion and a referral, not a confrontation.

What should I bring to a first appointment, and what will it cover?

Four things, and the first one is the one people leave behind.

1. A current list of your medications — everything, including over-the-counter products, supplements and anything started in the last few months. This is not administrative box-ticking. Several hundred common medicines reduce saliva, the effect compounds when several are taken together, and it changes what a sensible preventive plan looks like. Bring the list rather than trying to remember names in the chair.
2. Your medical history, including diabetes and how well it is controlled, any autoimmune condition, past radiotherapy to the head or neck, allergies and previous reactions.
3. Any radiographs taken elsewhere, or the name of the practice that took them — this is the simplest way to avoid repeating an exposure.
4. Your health fund details if you have cover, so the rebate can be checked rather than guessed.

What the appointment itself covers: a history, an examination of the teeth, gums and soft tissues, periodontal charting where indicated, radiographs if they are justified, cleaning, and a preventive plan built around your actual risk rather than a default. If anything is found that sits outside an oral health therapist's scope — a cracked tooth, a failing restoration, a tooth that may need root canal treatment — it goes to a dentist, and to a specialist from there if required.

Two things worth saying out loud, because they are acted on: if you are anxious, which changes how the appointment is set up, and if your mouth is dry, which changes almost everything about the plan. See dental anxiety.

Practical details

Sarah Van Eyk's registration can be checked on the AHPRA public register. Bring a current list of your medications — it changes what a preventive plan should look like. Call 13 13 96, or use the contact page. Indicative fees are on the price guide.

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment.

This page records qualifications as published by the practice. General information only — it is not a diagnosis, a treatment plan or a promise of any particular clinical outcome. Do not change or stop any prescribed medication without speaking to the prescriber.

Smile Solutions trades under ABN 28 193 514 103.