Patient Information

Patient Information

Your First Dental Visit
Your first dental visit promises to be a pleasant experience.

Making sound decisions about your dental care and oral health is an easy thing to do with the right

preparation beforehand:

  • Make a list of questions to ask our office, so you don’t forget anything on the day of your appointment. This includes any concerns you have, or oral problems you’ve been experiencing.
  • If you have dental insurance, remember to bring your insurance card with you.

 

Dental Emergencies
A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

Oral Cancer

Oral Cancer

Oral cancer is one of the most common cancers today and has one of the lowest survival rates, with thousands of new cases being reported each year. Fewer than half of all people diagnosed with oral cancer are ever cured.

Moreover, people with many forms of cancer can develop complications-some of them chronic and painful-from their cancer treatment. These include dry mouth and overly sensitive teeth, as well as accelerated tooth decay.

If oral cancer is not treated in time, it could spread to other facial and neck tissues, leading to disfigurement and pain.

Older adults over the age of 40 (especially men) are most susceptible to developing oral cancer, but people of all ages are at risk.

Oral cancer can occur anywhere in the mouth, but the tongue appears to be the most common location. Other oral structures could include the lips, gums and other soft palate tissues in the mouth.

Warning Signs
In general, early signs of oral cancer usually occur in the form of lumps, patchy areas and lesions, or breaks, in the tissues of the mouth. In many cases, these abnormalities are not painful in the early stages, making even self-diagnosis difficult.

Here are some additional warning signs:

  • Hoarseness or difficulty swallowing.
  • Unusual bleeding or persistent sores in the mouth that won’t heal.
  • Lumps or growths in other nearby areas, such as the throat or neck.

If a tumor is found, surgery will generally be required to remove it. Some facial disfigurement could also result.

Prevention
Prevention is the key to staving off oral cancer. One of the biggest culprits is tobacco and alcohol use. Certain kinds of foods and even overexposure to the sun have also been linked to oral cancer. Some experts believe certain oral cancer risk factors are also hereditary.

A diet rich in fruits and vegetables is one of the best defenses against oral cancer. Maintaining good oral hygiene, and regular dental checkups, are highly recommended.

Oral Piercing

Oral Piercing

While many people think this trend looks cool, it has many possible and harmful side effects.

Common symptoms after oral piercing include pain, swelling, infection, an increased flow of saliva (“spit”) and injuries to the gums:

  • Millions of bacteria (“germs”) live in your mouth, so oral piercings may become infected easily
  • Swelling of the tongue is a common side effect but it is possible for the tongue to swell large enough to block your airway and prevent breathing.

 

  • Piercing can cause uncontrollable bleeding and nerve damage. If a blood vessel was in the path of the needle during the piercing, severe and difficult-to-control bleeding can result.

 

  • Blood clots or blood poisoning can occur

 

And the jewelry itself can be hazardous or cause other problems:

  • You can choke on the studs, barbells or hoops that become loose in your mouth.
  • Teeth can chip or crack from contact with the jewelry.
  • Bacteria that breeds around the piercing can cause bad breath.
  • The jewelry can prevent you from speaking clearly or cause problems with chewing and swallowing food.
  • The metals may cause an allergic reaction.

Since oral health is important for overall health, the effects of an oral piercing may have a greater impact than one may think. Unfortunately, many people with oral piercings don’t realize that these side effects could happen to them.

Oral Health and Seniors

Oral Health and Seniors

Aging and oral health

North Americans are generally leading longer and healthier lives. Today’s seniors are also enjoying good oral health, keeping their natural teeth longer than previous generations.

The maintenance of good oral health is stressed throughout one’s life. It remains a very important corner stone to good overall health and quality of life. Neglect of teeth and gums leads to infections in the mouth. There is a growing body of medical evidence that shows that the inflammation that results due to the infection in the mouth may be closely linked to other diseases such as diabetes and heart disease, and in severe cases can even lead to respiratory infection like pneumonia. But, by simply keeping up with regular brushing and flossing as part of your daily regimen, you can maintain good oral health. Your regular dental visits are a further assurance to help screen for other serious diseases including oral cancer.

Follow the same simple rules that have supported you throughout your life including:

  • Maintain a daily regimen of brushing and flossing
  • Avoid alcohol or drink only moderately
  • Avoid tobacco
  • Eat a healthy and balanced diet that incorporates fruits, vegetables and fiber-rich foods.
  • Limit sugar-intake
  • Visit the dentist regularly. Please do ask us any questions that you may have with respect to your oral health and update us on any changes to medications that you may be taking. If you are caring for an elderly parent, ask about ways for you to support their oral health care.

With increased age, seniors can be faced with several major overall problems related to their oral health:

  • Age changes; general changes in their body physiology
  • Dealing with the effects of disease and drug therapy; seniors may become more susceptible to oral disease such as decay, gum disease and oral cancer. Additionally, increased use of medications, physical and cognitive deterioration and changes in diet may begin to impact oral health.
  • Due to an incapacity to be mobile, seniors may not be able to always receive proper and timely dental care.

Here are a few other influencing factors to consider and discuss with your dentists.

Cavities and decay – Due to the lack of fluoride when many of today’s seniors grew up, they had a higher tendency to develop decay at a younger age, and consequently had more fillings than many of today’s younger population. Today, many of these fillings, if not looked after with proper oral hygiene at home, can develop re-decay around their margins. Another factor that leads to an increased incidence of decay in seniors is due to gum recession. Over time, if one is not careful in maintaining good oral hygiene, our gums can significantly recede. As the gums recede, the roots are more exposed and therefore susceptible to decay causing acids.

Gum disease – Gum disease (gingivitis and periodontitis) are essentially caused by the bacteria found in plaque. The research evidence suggests that older patients develop plaque more quickly, but that the majority can prevent and maintain their gums and their health by focusing on good home care and regular preventive care at the dentist’s office.

Oral cancer – The incidence of oral cancer is higher among seniors. Regular dental visits can help to spot early signs of oral cancer and pre-cancerous conditions.

Dry mouth (xerostomia) – Older adults are susceptible to dry mouth, an appropriate environment for bacterial growth. Dryness of the oral cavity can result from a number of factors. Medications can influence the secretion of saliva from the salivary glands. The lack of normal saliva production leads to a very dry environment in the mouth. This dry environment results in an imbalance in the normal bacteria in the mouth and can lead to an overgrowth of microorganisms that result in increased dental decay and soft tissue infections of the mouth. Without saliva, your body losses one of its natural defenses to cleanse the mouth of harmful cavity causing bacteria.
To help combat a dry mouth, avoid caffeine and tobacco. Make sure you drink plenty of water and avoid refined sugar.

Medications – Many Seniors are prescribed medications that contain sugar and can cause dry mouth, both factors that can influence oral disease. Common causes of dry mouth include certain prescription medications (eg. Antidepressants, antihistamines, pain medications, etc.), anxiety states, certain cancer therapies that might involve irradiation of the head and neck, chemotherapy, states of anxiety, Sjogren Syndrome, HIV/AIDS, diabetes, Parkinson’s disease, and certain foods and tobacco. It’s important to tell your dentist about any medications you are taking and other possible symptoms, such as abnormal bleeding, taste alterations and soft-tissue symptoms like swelling and discoloration.

Diet – Unfortunately, many seniors may begin to experience mouth or teeth problems that make them less likely to consume a healthy diet which further leads to a negative impact on oral health. Some of the reasons for this include a decrease in appetite, physical disabilities, dementia, such as Alzheimer’s, or untreated tooth decay. All the more reason if possible to for our aging population to try and keeping their natural teeth longer in life. By virtue of being able to use their teeth, seniors make better nutrition choices, allowing them to continue to enjoy a wide variety of foods that further support ongoing oral health.

Health conditions – While diseases of the mouth and surrounding areas are a serious health risk, their relationship to overall general health is often not considered important or is simply overlooked.

Gum disease that is left untreated can lead to an increased risk of diseases of the respiratory system. This is primarily caused when the toxic bacteria that are contained in plaque make their way from the mouth to the lungs. The result is either respiratory infections or worsening of already existing cardiovascular conditions.

Seniors that are living with diabetes are a more susceptible population group to the affects of periodontal disease (i.e. gum disease that has advanced to the point of causing loss of bone and tissue attachments around existing teeth). Diabetics with uncontrolled gum disease are therefore more susceptible to tooth loss.

Seniors that may have compromised immune systems due to existing chronic ailments or medications are more susceptible to getting fungal and viral infections of the mouth.

Sensitive Teeth – A great number of people complain of tooth sensitivity, but more so amongst the senior population. The sensitivity is usually the result of a lifetime of wear and tear of the teeth and gums caused by factors such as brushing too aggressively, lack of oral hygiene leading to receded gums and overall gum disease, broken and fractured teeth, bruxism (grinding of teeth), acidic foods and complications resulting from certain dental treatments. The triggers for tooth sensitivity can be anything from thermal stimulation (hot or cold foods or drink), sugary or acidic foods, even just breathing in cold air.

Dentures – Many seniors who have lost some or all of their teeth are wearing removable dentures to replace those missing teeth. The proper care and maintenance of these partial or complete dentures is paramount to maintaining the health of the mouth. Poorly fitting dentures, and those that are not removed regularly to allow oral tissues and existing teeth to be adequately cleaned, can lead to further dental and oral tissue problems. Seniors that wear dentures are advised to continue regular dental visits to ensure proper fit and function of their dental prosthesis.

Tips for seniors and caregivers
Regular dental visits are a perfect time to speak to the dentist about concerns that you may have with regards to your oral health (or that of someone under your care) and will help to spot trouble early. It is also a time to update the dentist as to any medical issues or medications that you may be taking that could adversely affect your oral health.

Some additional tips for seniors and caregivers:

Brushing and flossing
Review the tips for proper brushing and flossing as instructed by your dentist or dental hygienist.

Always choose a soft toothbrush, run the bristles under warm water so as to further soften the brush against gum tissue, and remember to replace worn brushes every 3 to 6 months.

If your suffer from any condition that makes holding the toothbrush a challenge (e.g. arthritis or any other health conditions), speak to your dentist or dental hygienist about options

Denture Care
When cleaning or caring for your denture, in order to avoid accidental breakage should they fall, make sure to have a folded towel or a sink full water over which you handle your denture.

Avoid letting your dentures dry out. When not worn, do not simply leave them out exposed to the drying affects of air. Remember to soak them in a glass with water or a denture cleaning solution.

Never place your dentures in hot water, as that will cause the denture material to warp.

Brush, clean and rinse your dentures daily.

Message to Caregivers
If you are caring for a senior who is faced with physical or cognitive deterioration, please take note of their oral health by simple observation inside their mouth for any problems. Their oral health does impact the quality of their lives, and upon their overall systemic health. Maintain their regular dental visits in order that any problematic symptoms or troubling signs can dealt with early. If possible, attend the dental visit with the elder in your care in order to provide as much relevant medical information as possible.

Oral Hygiene Instruction

Oral Hygiene Instruction

Oral hygiene instruction is helpful and educational information meant to teach and guide our patients to prevent new cavities, and to maintain healthy teeth and gums. At your initial oral hygiene visit, your hygienist will instruct you on
the proper methods of brushing and flossing. Follow up visits will be to further assess your progress in maintaining good oral health, and to help review and reinforce techniques of cleaning at home.

The following are helpful recommendations:

    • Flossing is the foundation for healthy gums, so floss your teeth once a day. Dental floss will get into areas between your teeth and under your gums that your toothbrush cannot. Slide the floss between your teeth and wrap it into a “C” shape around the base of the tooth and gently under the gumline. Wipe the tooth from base to tip two or three times. Be sure to floss both sides of every tooth.
    • Brush your teeth twice a day, and make sure to brush your teeth after you floss, as this is a more effective method of cleaning your teeth. Use a soft bristled tooth brush (safer on your gums) and a circular motion that moves the brush bristles ‘away’* from the gums ( *on the top arch, this would mean you are brushing in a circular direction which is top-down; on the bottom arch, you would be brushing in a bottom-to-top circular motion. Use care to not speed through brushing, taking at least 2-3 minutes to do a thorough job.
    • Eat a well balanced diet, avoiding excessive snacking between meals, especially sticky, sugary foods.
    • Use either a fluoride or antiseptic rinse as directed by the dentist or hygienist.
    • Avoid smoking

Twice-daily brushings and regular flossing are excellent for maintenance between office visits, but a healthy mouth and beautiful smile require routine general and preventive care to stay that way. Our practice offers hygiene care that includes regular oral examinations and cleanings. Our preventive hygiene services include fluoride, professional breath control, and periodontal (gum disease) treatments designed to help you maintain your smile’s health and beauty. Keep your teeth and gums strong and disease-free. Contact our office today to schedule a cleaning or consultation.

Nutrition and Your Teeth

Nutrition and Your Teeth

It has long been known that good nutrition and a well-balanced diet is one of the best defenses for your oral health. Providing your body with the right amounts of vitamins and minerals helps your teeth and gums-as well as your immune system-stay strong and ward off infection, decay and disease.

Harmful acids and bacteria in your mouth are left behind from eating foods high in sugar and carbohydrates. These include carbonated beverages, some kinds of fruit juices, and many kinds of starch foods like pasta, bread and cereal.

Children’s Nutrition and Teeth

Good eating habits that begin in early childhood can go a long way to ensuring a lifetime of good oral health.

Children should eat foods rich in calcium and other kinds of minerals, as well as a healthy balance of the essential food groups like vegetables, fruits, dairy products, poultry and meat. Fluoride supplements may be helpful if you live in a community without fluoridated water, but consult with our office first. (Be aware that sugars are even found in some kinds of condiments, as well as fruits and even milk.)

Allowing your children to eat excessive amounts of junk food (starches and sugars)-including potato chips, cookies, crackers, soda, even artificial fruit rollups and granola bars-only places them at risk for serious oral health problems, including obesity, osteoporosis and diabetes. The carbonation found in soda, for example, can actually erode tooth enamel. Encourage your child to use a straw when drinking soda; this will help keep at least some of the carbonated beverage away from the teeth.

Smart Snacks for Healthy Teeth
There’s no discounting the importance of continuing a healthy balanced diet throughout your adult life.

What’s wrong with sugary snacks, anyway?
Sugary snacks taste so good — but they aren’t so good for your teeth or your body. The candies, cakes, cookies and other sugary foods that kids love to eat between meals can cause tooth decay. Some sugary foods have a lot of fat in them, too. Kids who consume sugary snacks eat many  different kinds of sugar every day, including table sugar (sucrose) and corn sweeteners (fructose). Starchy snacks can also break down into sugars once they’re in your mouth.

How do sugars attack your teeth?
Invisible germs called bacteria live in your mouth all the time. Some of these bacteria form a sticky material called plaque on the surface of the teeth. When you put sugar in your mouth, the bacteria in the plaque gobble up the sweet stuff and turn it into acids. These acids are powerful enough to dissolve the hard enamel that covers your teeth. That’s how cavities get started. If you don’t eat much sugar, the bacteria can’t produce as much of the acid that eats away enamel.

How can I “snack smart” to protect myself from tooth decay?
Before you start munching on a snack, ask yourself what’s in the food you’ve chosen. Is it loaded with sugar? If it is, think again. Another choice would be better for your teeth. And keep in mind that certain kinds of sweets can do more damage than others. Gooey or chewy sweets spend more time sticking to the surface of your teeth. Because sticky snacks stay in your mouth longer than foods that you quickly chew and swallow, they give your teeth a longer sugar bath. You should also think about when and how often you eat snacks. Do you nibble on sugary snacks many times throughout the day, or do you usually just have dessert after dinner? Damaging acids form in your mouth every time you eat a sugary snack. The acids continue to affect your teeth for at least 20 minutes before they are neutralized and can’t do any more harm. So, the more times you eat sugary snacks during the day, the more often you feed bacteria the fuel they need to cause tooth decay.

If you eat sweets, it’s best to eat them as dessert after a main meal instead of several times a day between meals. Whenever you eat sweets — in any meal or snack — brush your teeth well with a fluoride toothpaste afterward.

When you’re deciding about snacks, think about:

•    The number of times a day you eat sugary snacks
•    How long the sugary food stays in your mouth
•    The texture of the sugary food (Chewy? Sticky?)
If you snack after school, before bedtime, or other times during the day, choose something without a lot of sugar or fat. There are lots of tasty, filling snacks that are less harmful to your teeth—and the rest of your body — than foods loaded with sugars and low in nutritional value. Snack smart!

Low-fat choices like raw vegetables, fresh fruits, or whole-grain crackers or bread are smart choices. Eating the right foods can help protect you from tooth decay and other diseases. Next time you reach for a snack, pick a food from the list inside or make up your own menu of non-sugary, low-fat snack foods from the basic food groups.

How can you snack smart? Be choosy!
Pick a variety of foods from these groups:

Fresh fruits and raw vegetables

Berries
Oranges
Grapefruit
Melons
Pineapple
Pears
Tangerines
Broccoli
Celery
Carrots
Cucumbers
Tomatoes
Unsweetened fruit and vegetable juices
Canned fruits in natural juices

Grains

Bread
Plain bagels
Unsweetened cereals
Unbuttered popcorn
Tortilla chips (baked, not fried)
Pretzels (low-salt)
Pasta
Plain crackers

Milk and dairy products
Low or non-fat milk
Low or non-fat yogurt
Low or non-fat cheese
Low or non-fat cottage cheese

Meat, nuts and seeds
Chicken
Turkey
Sliced meats
Pumpkin seeds
Sunflower seeds
Nuts

Others
(these snacks combine foods from the different groups)
Pizza
Tacos

Remember to:
•    Choose sugary foods less often
•    Avoid sweets between meals
•    Eat a variety of low or non-fat foods from the basic groups
•    Brush your teeth with fluoride toothpaste after snacks and meals

Note to parents
The foods listed in this leaflet have not all been tested for their decay-causing potential. However, knowledge to date indicates that they are less likely to promote tooth decay than are some of the heavily sugared foods children often eat between meals.
Candy bars aren’t the only culprits. Foods such as pizza, breads, and hamburger buns may also contain sugars. Check the label. The new food labels identify sugars and fats on the Nutrition Facts panel on the package. Keep in mind that brown sugar, honey, molasses and syrups also react with bacteria to produce acids, just as refined table sugar does. These foods also are potentially damaging to teeth.

Your child’s meals and snacks should include a variety of foods from the basic food groups, including fruits and vegetables; grains, including breads and cereals; milk and dairy products; and meat, nuts and seeds. Some snack foods have greater nutritional value than others and will better promote your child’s growth and development. However, be aware that even some fresh fruits, if eaten in excess, may promote tooth decay. Children should brush their teeth with fluoride toothpaste after snacks and meals. (So should you!)
Please note: These general recommendations may need to be adapted for children on special diets because of diseases or conditions that interfere with normal nutrition.

Mouth Guards

Mouth Guards

In sporting activities there is a great need to protect your smile. Anyone who participates in a sport that carries a significant risk of injury to teeth, lips, cheek and tongue, should wear a mouth protector. This includes a wide range of sports like football, hockey, basketball, baseball, gymnastics, and volleyball.

A properly fitted mouth protector will stay in place while you are wearing it, making it easy for you to talk and breathe.

There are three types of mouth protectors:
1.   Stock
Stock mouth protectors are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and can make breathing and talking difficult.
2.    Boil and bite
Boil and bite mouth protectors can be purchased at many sporting goods stores and may offer a better fit than stock mouth protectors. They should be softened in water, then inserted and allowed to adapt to the shape of your mouth.  It is extremely important to follow the manufacturer’s directions in order not to end up with a poor-fitting mouth protector.
3.    Custom-fitted
Custom-fitted mouth protectors are made by your dentist for you personally. They are more expensive than the other versions, but because they are customized they can offer a better fit than anything you can buy off the shelf.  They are also designed to suit the needs of the individual athlete, with various thickness indicated for different sports.

Missing Teeth

Missing Teeth

  • Missing Teeth

Fixed bridges and implants are often used to replace missing teeth and to correct some kinds of bite problems.

Crowns and bridges are the most effective procedure for replacing missing teeth or bite problems.

    • Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can  restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semipermanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

    • Implants

The concept of implanting metal or prosthetic roots into the jaws to support
teeth is not new. Archeologists have uncovered attempts at dental implants in mummies found in ancient Egypt.

Early tooth replacement from ancient Mediterranean civilization
Over the centuries this concept has been attempted in a variety of ways, but has been unsuccessful until recently.

Dr. Per-Ingvar Branemark is credited with the discovery and development of the technique of osseointegration. Osseointegration is defined as a chemical and mechanical bonding of a titaniumimplant (essentially a titanium screw or fixture) to the surrounding bone. These implants act as artificial roots, or anchors, for the replacement of missing teeth. Implants give replacement teeth a more stable base and improve the use one can get out of bridgework and dentures.

Dental implant treatment is performed with a team.The team consists of a restorative dentist who will ultimately fabricate the prosthesis or teeth that are to be replaced; and an experienced surgeon who will place the dental implants in the jaw bone. Careful evaluation of the patient and meticulous planning is essential in providing predictable and satisfactory results.

The treatment consists of 3 phases. The first phase of treatment is the placement of the implants by the surgical specialist. The second phase of the implant treatment is performed after an appropriate period of healing. Bone heals slowly. A period of approximately 3-6 months is required for the process of osseointegration to be complete. The second phase of treatment consists of the placement of abutments or small metal posts to the implanted fixtures. The third phaseof treatment consists of the restorative phase. In this phase the new replacement teeth are fabricated and placed on the implants and abutments.

In the case where there is inadequate bone to support a removable denture, or if the length of the gap is too long between the supporting teeth for a bridge, implants are a versatile means to obtain the necessary anchorage for solid tooth replacement. Implants may be used in the following situations:

There is now over 40 years of experience with dental implants. The success
rates have been measured worldwide. Over 95% of the implants placed into the jaw have a greater than 5 years success rate. Loss of implants after 5 years is extremely rare.

Maxillofacial Surgery

Maxillofacial Surgery

When facial reconstruction, including procedures involving the oral cavity, is called for, a specialist is needed. Surgical procedures of the neck and head area are performed by a maxillofacial surgeon.

Common maxillofacial procedures include denture-related procedures and jaw surgery.

Jaw Correction
Protruding chins, crooked or buck teeth or misaligned teeth are good candidates for maxillofacial surgery.

In some people, jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.

Other kinds of maxillofacial surgery can correct problems with upper facial features such as the nose and cheek.

In addition to correcting jaw problems surgically, orthodontic appliances such as braces may be needed to restore bite relationship and ensure continued proper alignment of the jaw. In some cases, tiny wires or small rubber bands may be needed to keep the jaws in place and promote faster healing. In other cases, small “fixation” screws or plates may need to be inserted in the jaws to facilitate easy movement of the jaws following surgery.

Mouth Rinses

Mouth Rinses

There are two types of mouth rinses. These are cosmetic and therapeutic. Cosmetic mouth rinses, or mouth wash as they are sometimes referred as, mainly serve the purpose of freshening breath. The act of gargling and swishing the rinse in the mouth will remove some bacteria and debris. A therapeutic mouth rinse will do all of this but it also contains fluoride and has been proven to reduce plaque buildup, fight cavities and help to prevent gum disease (gingivitis).

It is important to note that mouth rinses, even therapeutic rinses, are only somewhat effective. This should be part of the daily routine in conjunction with flossing and brushing. Regular rinsing with water and a fluoride toothpaste is just as effective as a therapeutic mouth rinse.