Fluoride – What does it do for my teeth?

Fluoride is a mineral found naturally in soil, rocks, air and water. Fluoride has been used in dentistry for its topical effects of strengthening enamel and making it more resistant to dental decay. Fluoride can be delivered in the dental office as a rinse, gel, foam or varnish. It is also found in toothpastes and mouthrinses.

The Canadian Dental Association recommends brushing with fluoridated toothpaste twice per day. In young children who are liable to swallow toothpaste (6 years and under) - it is recommended to avoid fluoridated toothpaste or if the child is at high caries risk to use only the size of a ‘grain of rice’ under close adult supervision. Ingesting too much fluoride can lead to fluoride toxicity, the Maximum Acceptable Concentration is 1.5mg/L.

It can also lead to a condition called Fluorosis, which can look like white or brown flecks on your teeth and can vary in severity.  There have been other associations made between high systemic fluoride intake and bone fracture, cancer and developmental issues however the research is still unclear. This is one of the reasons community water fluoridation is so controversial. The city of Toronto’s water supply is fluoridated at a level of 0.6 parts per million.

Dental Fluorosis – ‘white flaky’ appearance. 

Find further information at these links and make your own informed decision on the subject:
McDonagh Marian S, Whiting Penny F,Wilson Paul M, Sutton Alex J, Chestnutt Ivor,Cooper Jan et al. “Systematic review of water fluoridation” BMJ 2000; 321:855

Stephen Peckham and Niyi Awofeso, “Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention,” The Scientific World Journal, vol. 2014, Article ID 293019, 10 pages, 2014. doi:10.1155/2014/293019

http://www.cda-adc.ca/_files/position_statements/fluoride.pdf

Pregnancy and Dentistry

You’re pregnant – what does this mean for your oral health and dental visits? 

During pregnancy, it is imperative to keep your mouth as clean as possible to prevent infections or dental emergencies from appearing. This means brushing at least twice day (after breakfast and just before bed) and flossing at least once a day. If you are planning on getting pregnant, a pre-emptive visit to the dentist to make sure all is healthy in your mouth and to receive oral health tips is recommended.

During pregnancy, the second trimester is the safest to receive dental treatment. It is recommended to visit the dentist at least once during this trimester for a cleaning and to make sure everything in your mouth is healthy! Dental cleanings are completely safe and actually recommended for the pregnant patient. Due to the change in hormones during pregnancy, there is an increased risk of gingivitis.

During the first trimester, it is recommended to avoid all elective procedures, the only dental procedure recommended is emergency treatment – it is safer for the baby to eliminate any source of infections. Oral radiographs, (though they pose an extremely minor risk) should be minimized as well as drug prescription. Overall, maintaining a healthy mouth is the best thing for the pregnant patient.

Modern Crowns

What’s new with crowns?

In terms of crowns or ‘caps’ for single teeth and ‘bridges’ for one or more missing teeth - new materials are being used. Traditionally metal was used for crowns and bridges due to its strength. Then the use of porcelain fused to metal crowns became the material of choice because of their esthetics and strength. The inner layer is metal with a tooth-coloured porcelain outer covering to match the other teeth in the mouth. However, porcelain fused to metal crowns can sometimes have a small gray rim of metal at their base.

The newest crowns can now be made with a ceramic base which is white in colour. Introduced in the last decade, Zirconia has mechanical properties which are the highest reported for any dental ceramic. Zirconia bases can be used with a porcelain outer layer to deliver great esthetic outcomes. Ceramic crowns can either have two layers or just one layer. In our office we have Cerec crowns. These ceramic crowns can be finished in one appointment! Usually a crown requires 1 week fabrication at a dental laboratory. With Cerec the crown is milled in the office at the same appointment! Ask us today if you are a candidate!

Since they are relatively new, only short term follow-up studies have been conducted but they show promising results. Long-term studies are needed to further assess clinical outcomes.

 

Impacted Wisdom Teeth

 Sometimes there isn't enough room for the wisdom teeth to erupt into the dental arch which leaves them either completely or partially submerged in your jaw bone. The partial submersion can cause a food trap which leads to constant irritation, pain and infection at the back of your mouth. This condition itself can be treated by diligently cleaning the area.

However, it is often very difficult for patients to keep this area clean on their own, as it is hard to reach. If care is not given, the irritation over time can cause bone loss at the back of your second molar (the one right before the wisdom tooth). This can lead to constant infection of the partially erupted tooth, called ‘pericoronitis’. This is what is happening when someone tells you his or her wisdom teeth hurt.

Braces and Wisdom Teeth?

Q: I already had braces but now I need to get my wisdom teeth out – Will my teeth shift?

A: No!

There is no evidence in studies that says wisdom tooth removal affects the alignment of straightened teeth in front of them! Also, if there is crowding in the front of your mouth, removal of the wisdom teeth will NOT fix it. Sometimes orthodontic treatment can ‘relapse’ or go back to the position of the teeth before treatment but this is usually due to not wearing a retainer!

Q: Can my dental implant get a cavity?

A: No! 

Implants are made of a different material than natural teeth, which makes them resistant to tooth decay. This doesn’t mean that you don’t have to brush and floss! Dental implants can still experience inflammation of the tissues surrounding them and even bone loss! This is called peri-implantitis. Your implants can be best maintained with diligent home care (brushing and flossing) and hygiene visits to have them professionally cleaned along with the rest of your teeth.

So many people get their wisdom teeth removed... Is it really necessary?

The quick answer is: sometimes! 

Your wisdom teeth, also known as third molars, are the most posterior teeth in the mouth and they erupt last. Some people have lots of room in their jaws and the third molars are able to grow into the arch and function well – in this case there is no need for removal. 

Unfortunately, a lot of the time this isn't the case. Usually there is not enough room in the jaws for these teeth to come in. When there is not enough room, sometimes the wisdom teeth only partially erupt. Sometimes they don’t erupt at all and remain ‘impacted’ or stuck in your jaw bones. Sometimes,  they can even grow in the wrong direction – sideways, downwards, horizontal etc.  These improper eruption patterns can cause problems. 

Math and Beauty

The golden proportion [1.618:1] can be found in plants, butterflies and elsewhere in nature. It has also been proposed that we perceive teeth to be more esthetically pleasing when the width of a central incisor related to the lateral is found at a ratio of 1.618:1.This ratio is also found in nature in butterfly’s wings, plant’s leaves and more. When things are arranged in this ratio, we perceive them to be more esthetically pleasing.

So you have a dental emergency...

My tooth just came out? What do I do?!

If it is a permanent (adult) tooth, your dentist may be able to put it back if you see them within about 1 hr of the incident!. Here’s what to do to improve your outcome:

• Handle the tooth by the crown only (the whiter part  -avoid touching the root)
• If dirty, rinse in salt water
• The tooth can be transported in milk,  saline, or if there’s nothing around just keep it in your own mouth! Don’t put it in plain water!
• Go to your nearest dentist or emergency center

More information for parents from Sick Kids Hospital: http://www.sickkids.ca/pdfs/dentistry/12902-dentalinjuries.pdf




I broke a piece of my tooth! What do I do?!

If you can find the piece, bring it to the dentist. Depending on how large the fracture is you may need either a filling or a crown (cap). If the nerve was injured or exposed, you may need a root canal as well.

Blood Pressure & Teeth

Q: What is a normal blood pressure for an adult over 18 years?

A: 120/80

Stage 1 Hypertension > 140/90

Stage 2 Hypertension > 160/100

Why is it important for my dentist to check my blood pressure? What does that have to do with my teeth?

Checking blood pressure at the dental office is a great way to screen for high blood pressures and make an early referral to your doctor if an abnormal blood pressure is encountered. High blood pressure is a risk factor for heart disease. 30% of people with hypertension are unaware

If you know you have high blood pressure, be sure to inform your dentist. Some local anaesthetic agents (dental freezing) contain epinephrine. Epinephrine is also found in your body normally and can increase your blood pressure. This is especially possible in people with an already elevated blood pressure. If your dentist is aware of your high blood pressure, they can be sure to use just the right amount of local anaesthetic to make sure you receive the best care.

What Causes a Toothache?

A toothache usually means that the nerve of your tooth is inflammed. In dental terms this is called ‘pulpitis’. The inflammation can be caused by a number of factors: trauma, bacterial ingression from cavities, biting pressure (clenching and grinding) or anything that irritates the nerve of your tooth. There are two types of pulpitis – reversible or irreversible. With reversible pulpitis, the nerve can become healthy again and remain vital. With irreversible pulpitis, the nerve is doomed to die.

Death of The Nerve

So what if the nerve dies, there’s no more feeling? If the nerve dies, it is a great environment for the growth of bacteria. If left alone bacteria can collect at the apex (end of the root) and cause a granuloma or a cyst. This can flare up and cause a toothache that can be more painful than the one felt with the pulpitis while the nerve was still vital.

Treatment

What is the treatment? The treatment for this is a ‘root canal’. A root canal is a procedure in which the entire nerve is removed from the tooth. The canal is cleaned out to remove as much bacteria as possible and then the canal is sealed with a  material. Antibiotics can help calm the infection down but only to a certain extent, eventually the canal must be physically cleaned out. Also the tooth can be extracted to remove the infection, this is usually the option if the tooth is broken and there is not enough structure left to place a crown or filling.

New Studies Show That Vitamin D Deficiency May Cause Compromised Immune Function:

Vitamin D not only plays an important role in helping our bodies absorb calcium for our skeletal system, but it also helps us maintain the health of our immune system.

Our bodies naturally produce vitamin D when exposed to sunlight, and by absorbing small amounts from certain foods. 

Today it has be estimated that approximately one billion people worldwide are vitamin D deficient due to limited exposure to the sunshine.

So if you are unable to enjoy enough sunshine this summer, some food that you can add to your diet for a little more vitamin D include:

• Fish
• Oysters
• Caviar
• Tofu and Soy Milk
• Fortified Dairy Products
• Eggs
• Mushrooms
• Fortified Cereals

For Denture Wearers

Having a Healthy Mouth is Important At Any Age

If you wear a partial or complete dentures, it is especially important to take good care of your gums and any natural teeth, and to keep your dentures clean and properly fitted.

When gums dentures and remaining teeth are not cleaned properly, you are likely to experience a build-up of plaque, a type of bacteria that collects at the gum line and can harden on teeth into deposits called calculus. Too much plaque can lead to bad breath, cavities, gum disease and further tooth loss. 

If you have dentures, or  are about to get them, here's what you need to know to keep your mouth healthy and your smile bright...

About Your Dentures

When properly fitted and cared for, dentures will enhance your appearance and can be worn with confidence as you enjoy your favorite activities. A simple, daily routine of oral care and regular visits to your oral health care professional are all that is needed to keep you on track.

It is important, however, to remember that dentures do not last forever. Even with proper cleaning and care, the average life span of dentures is only about five to seven years. The teeth and base of the dentures will eventually stain, and over time, natural changes will occur to the structure of your face and mouth that will require an adjustment to your dentures.

Like natural teeth, dentures can build up with plaque. Dentures can cause plaque to be pushed further down underneath the gum line, which may make cleaning more difficult and lead to cavities, especially on exposed root surfaces.

Wearing dentures can put extra pressure on the surrounding bone structure and gums, as well as any natural teeth that are used to support partial dentures. If these areas are not kept clean, you may experience sore, irritated gums or additional bone and tissue loss. That is why it is particularly important to see your oral health care professional regularly and follow their advice between visits.

Regular Check-Ups

Your dentures and tissue should be checked every year to prevent or reduce tissue inflammation and to minimize bone or tissue loss.

If you are already a denture wearer, or about to have denture fitted for the first time, you may wish to consult with a denturist. Denturists are denture specialists who design, construct, insert and adjust dentures.  

Sources : College of Dental Hygienists of Ontario
Please visit our website : http://scarborosmiles.com/

3rd Winner of the iPad Mini Referral Program

Congratulations Xu Lin! Enjoy the iPad mini and keep on referring! :)

http://scarborosmiles.com/index.html

Preventing And Treating Gum Disease For Overall Health

We all know that prevention is one of the keys to maintaining overall health. We exercise and watch what we eat to help reduce our risk of heart attack, stroke and certain cancers. In much the same way, we should take good care of our (dental) health now to prevent gum disease and tooth loss later.

Why is this important? The reasons are much more than cosmetic. While we once believed the worst outcome of gum disease was tooth loss, we now know that oral health matters from head to toe.

Like smoking, elevated cholesterol or obesity, periodontal (gum and bone) disease may be at risk factor for a number of serious health conditions. In recent studies, gum disease has been linked to:

• heart disease and stroke
• pneumonia and other respiratory diseases
• diabetes
• premature, low birth weight deliveries

How is this possible? For those with gum disease, the simple act of brushing the teeth or chewing can injure gum tissue, allowing bacteria to enter the bloodstream. It is believed that these bacteria may travel to other parts of the body, potentially worsening or causing other types of health problems.

How Gum Disease Develops

Gum disease begins with the formation of hard and soft deposits on the surface of the teeth. Over time, a build-up of bacteria called plaque collects at the gum line, eventually hardening on the teeth into calcium deposits called calculus (tartar). With poor oral care, those bacteria can cause inflammation of the gums (gingivitis), penetrate the gum line and finally spread into the underlying bone (periodontitis).

Gum Disease and Your Heart

Studies have suggested that bacteria from diseased gums may travel through the bloodstream, potentially contributing to the formation of artery-clogging plaques. It is also believed that gum disease may contribute to infective endocarditis, a condition in which the interior lining of the heart and heart valves become inflammed, possibly due to a bacterial infection. If left untreated, this condition could lead to a fatal infection.

Gum Disease and Your Lungs 

Scientists now believe that gum disease may also be a significant risk factor, increasing the risk of respiratory infections, and potentially worsening the severity of pneumonia, bronchitis, emphysema and Chronic Obstructive Pulmonary Disease (COPD). Preventing gum disease may help you breathe easier.

Gum Disease and Diabetes

Severe peridontal disease may increase both blood sugar levels and the amount of time the body functions with high blood sugar, putting those with diabetes at increased risk for complications. People with diabetes and gum disease should receive regular treatment from an oral health professional to reduce inflammation of the gums.

Gum Disease and Pregnancy

Research has linked gum disease in women to an increased risk of premature delivery.

What is the connection? Researchers believe that bacteria from diseased gums enter the bloodstream during eating or brushing. These bacteria may then affect the levels of prostaglandins (or PGE2), a biological fluid naturally present in a woman's body. When the level of PGE2 rises significantly, usually in the ninth month of pregnancy, labour begins. But in women with serious gum disease, the level of PGE2 may rise too soon, triggering early labour.

What Can You Do?

Visiting your Dental Hygienist on a regular basis is one of the most important steps you can take to maintain or improve your oral health.

Here are some general guidelines for maintaining good oral health at any age:

Infant Care

• Give the infant plain water instead of milk or sweet juices at naptime.
• Gently clean newly erupted teeth, gums and tongue with gauze or washcloth.

Children

• Familiarize children with oral cleaning habits.
• Parents may wish to clean the child's teeth before bedtime and allow the child to try brushing on his/her own in the morning.
• First visits to the dental hygienist are recommended at about age two.

Teenagers and Adults

• A thorough cleaning of your mouth once or twice a day is sufficient.
• BRUSHING: place your brush at a 45 degree angle to the junction between the tooth and gum, applying gentle pressure as you move the brush away from the gums. Don't forget to brush your tongue (with or without toothpaste), where bacteria build up. You should be spending about three minutes each time you brush (your dental hygienist may also recommend that you use an electric toothbrush) and NEVER forget to FLOSS!

Memories to keep! :)

A 3D hand and foot print casted model. Impression done at our office, polished and trimmed by our laboratory. Carefully packed and presented and ready to give as a gift to our patients who are newly proud parents. If interested, feel free to call our office at 416-296-0400 ext 2 for further questions.

Referral Program 2nd Winner!

Congratulations to Mr El-Hedi Maloufi for winning the iPad Mini for the quarterly Referral Program. The program is on and next raffle draw will be on April 20, 2014. Keep on referring and you might be the next winner!:)

Broken Tooth

What can I do to prevent my teeth from cracking?

While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.

- Don't chew on hard objects such as ice, unpopped popcorn kernels or pens.
- Don't clench or grind your teeth.
- If you clench or grind your teeth while you sleep, talk to your dentist about getting a retainer or other mouth guard to protect your teeth.
- Wear a mouth guard or protective mask when playing contact sports.
- See more at: http://www.aae.org/patients/symptoms/cracked-teeth.aspx#sthash.aZlaVfhh.dpuf