Patient Fact Sheet

As a woman, you have unique oral health needs.  Changes in your body, lifestyle and medications may affect your oral health.  A well-balanced diet and regular dental check-ups are also vital to both good oral health and overall health.  There are several ways in which changes to your body can affect your oral health:

Puberty

The surge of hormones during puberty may increase blood circulation in the gums.  Your mouth may become more sensitive to irritants such as plaque, and this can lead to gingivitis.  Be sure to floss and brush regularly to ensure good oral health.  Dental check-ups are also vital at this time.

Menstruation

Your menstrual cycle does not usually cause changes in the gum tissue; however, the hormonal fluctuations associated with menstruation may cause changes in the gum tissues of some women.  These changes cause gums to swell and bleed during the days prior to menstruation.  You may experience heightened sensitivity to pain, hot and cold fluctuations and pressure in the mouth during menses.  It is important to note that most studies reveal existing gum inflammation is aggravated by menstruation rather than caused by it.

Pregnancy

Some women may experience gingivitis while pregnant; however, pregnancy does not cause gingivitis.  Due to hormonal changes while pregnant, you may be more sensitive to plaque, which results in swollen gums that bleed easily.  If you notice any changes to your oral health while pregnant, consult your dentist.

Oral Contraceptives

If you are taking oral contraceptives, you may be susceptible to the same oral conditions that affect pregnant women.  Oral contraceptives contain the hormones progesterone and/or estrogen.  If you take oral contraceptives, you may experience a heightened sensitivity to plaque, which may result in gingivitis.  You should advise your dentist if you are taking oral contraceptives as this may affect certain dental treatments.

Menopause and Post-Menopause

As you reach menopause or post-menopause you may experience discomfort, pain and sometimes burning in your mouth and gums.  You may also find that your taste perceptions may change, especially in relation to salty, peppery and/or sour foods.  Experts report that gingivostomatitis during menopause affects a small percentage of women.  Symptoms include gums that look dry or shiny, bleed easily or range in colour from abnormally pale to deep red.  If you have developed osteoporosis, xerostomia or Burning Mouth Syndrome, you may experience changes in your oral health due to these illnesses and you should discuss this with your dentist.

If you have any further questions please call North Hill Dental Center at 905-508-2244.

What is Periodontal Disease?

Periodontal disease is an advanced stage of gum disease causing damage to the gums and the bone supporting the teeth.

How does it happen?

When plaque is NOT removed by brushing and flossing it migrates below the gum tissue and calcifies into tartar.  Gums then may become red, swollen and start bleeding.  Under the gum tissue (not visible to the eye) the bone that is supporting the tooth starts to break down.

What are the signs of periodontal disease?

At the start, you may notice that your gums become red or swollen and sensitive to touch.  They may start to bleed when you eat or brush your teeth.  As periodontal disease progresses to the more advanced stages, your gums may start to recede, teeth may shift causing crowding or spacing to develop, teeth may become mobile (wiggly) and bone loss becomes apparent on x-rays.

Can you cure periodontal disease?

NO.  Once periodontal disease has started and bone loss has occurred you cannot get this bone back.  You are only able to prevent the disease from either starting in the first place or from progressing to the advanced stages.

Remember, your Dentist and Dental Hygienist are able to notice early signs of periodontal disease and inform you before it progresses to the advanced stages. If caught early, periodontal disease can be controlled, but not cured.

How do I prevent Periodontal Disease?

The first step and the most important is Proper Home Care.

1. Brushing 2-3 times a day for 2-3 minutes. Proper technique must be used to ensure your toothbrush is removing plaque at the gingival margin (where the gums meet the teeth) and a gentle touch should be used to ensure no trauma occurs to the gums.
2. Flossing. This is the ONLY way to clean between two opposing teeth and under the gums.

Know your Mouth. Be familiar with the way your gum tissues look like at a healthy state. Pay attention to redness, swelling and bleeding, as these are signs disease is present (may be gingivitis but could lead to periodontal disease).

Regular Dental Visits.  Your Dentist and Dental Hygienist are able to remove tartar build up before periodontal disease starts. They are also able to notice early warning signs and give you instructions of what you can do to stop any progression.

If you have any further questions please feel free to contact Dr. Sahar Rakhshanfar at North Hill Denal Center at 905-508-2244.

Oral cancer refers to all cancers of the oral cavity, which includes the following:  lips, tongue, teeth, gums (gingiva), lining inside the lips and cheeks (labial mucosa and buccal mucosa), floor of the mouth, roof of the mouth (palate), area behind the wisdom teeth.  Most oral cancers are located on the sides of the tongue, floor of the mouth and lips.

Incidence and Survival Rates

Oral cancer represents approximately 2.3 % of all cancers in Canada.  In 2002, these cancers accounted for more than 3000 new cases and 1000 deaths.  The 5-year survival rate for oral cancer is low, just below 50%.  However, early detection results in the survival rate increasing sharply to 80%.

Key Risk Factors

• Smoking –especially if combined with heavy alcohol consumption
• Chewing tobacco or snuff
• Heavy alcohol consumption, particularly if combined with smoking
• Excessive sun exposure to the lips, often through working in outdoor jobs like construction
• Age –oral cancer is more common in people over 50
• Gender –more men than women develop oral cancer

Symptoms

• A sore on the lip or in the mouth that does not heal
• A lump on the lip or in the mouth or throat
• A white or red patch on the gums, tongue or lining of the mouth
• Unusual bleeding, pain or numbness in the mouth
• A sore throat that does not go away, or a feeling that something is caught in the throat
• Difficulty or pain chewing or swallowing
• Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
• A change in the voice and/or pain in the ear

Diagnosis

A complete medical history is required before conducting an oral cancer assessment either as a routine exam or in cases where oral cancer may be suspected.  Any lesion that your dentist determines is unlikely to be cancerous should be observed for seven to 14 days to ensure that the healing process is ongoing.  When there is a high suspicion of cancer, an immediate biopsy will be needed to determine if the lesion is cancerous.  Your dentist may decide to remove the tissue in the office or refer you to a specialist.

Treatment

Treatment plans are developed to fit the specific needs of the patient and must consider the patient’s age and general health as well as the location, size, type and extent of the tumor and stage of the disease.

In most cases, treatment involves surgery, chemotherapy, radiation therapy or a combination of the two.  Some patients receive chemotherapy treatment with anticancer drugs.  Regular follow-up exams by the dentist and doctor are very important for anyone who has been treated for oral cancer in order to ensure that the cancer has not recurred.  Patients suffering from dry mouth due to radiation therapy should have dental exams three times per year.  Patients who continue to drink or smoke are strongly advised to quit.

Related Web Sites

Canadian Cancer Society

www.cancer.ca

Canadian Strategy for Cancer Control

www.cancercontrol.org

Cancer Care Ontario

www.cancercare.on.ca

Health Canada

www.hc-sc.gc.ca/pphb-dgspsp/dsol-smed/  (select cancer button)

National Cancer Institute of Canada (NCIC)

www.ncic.cancer.ca

MEDLINE plus

http://www.nlm.nih.gov/medlineplus/oralcancer.html

The Oral Cancer Foundation

www.oralcancerfoundation.org

You may be able to prevent two of the most common diseases of modern civilization – tooth decay and periodontal disease by improving your diet.  Decay results when the hard tissues of our teeth are destroyed by acid products from oral bacteria.  Certain foods and food combinations are linked to higher levels of cavity-causing bacteria. Although poor nutrition does not directly cause periodontal disease, many researchers believe that the disease progresses faster and is more severe in patients whose diet does not supply the necessary nutrients.  Periodontal disease affects the supporting tissues of the teeth and is the leading cause of tooth loss in adults.

Poor nutrition affects the entire immune system, thereby increasing susceptibility to many disorders.  People with lowered immune systems have been shown to be at higher risk for periodontal disease.  Today’s research is showing a link between oral health and systemic conditions such as diabetes and cardiovascular disease.  Eating a variety of foods as part of a well balanced diet may not only improve your dental health but also reduce the risk for other diseases.

How can I plan my meals and snacks to promote better oral health?

Eat a well-balanced diet characterized by moderation and variety.  Develop eating habits that follow the recommendations from reputable health organizations.  Choose foods from the basic food groups.  Avoid fad diets that limit or eliminate entire food groups, which usually results in vitamin and mineral deficiencies.  Always keep your mouth moist by drinking lots of water.  Saliva protects both hard and soft tissues.  If you have a dry mouth then supplement your diet with sugarless candy or gum to stimulate your salivary flow.

     Two important factors affecting tooth decay are:

1. How much you eat:  Malnutrition can result from too much nourishment as easily as too little.  Each time you eat, you create an environment for oral bacteria to develop.  Making a habit of eating too much of just about anything, too frequently, should be avoided.
2. How often you eat:  Foods that cling to your teeth promote tooth decay.  Every time you eat foods containing carbohydrates such as candy, cookies, breads, pastas, potatoes and even corn, acid attacks your teeth for at least 20 minutes.  Choose dentally healthy foods such as nuts, raw vegetables, plain yogurt, cheese and sugarless gum or candy.

When you eat fermentable carbohydrates such as crackers, cookies and chips, eat them with your meal instead of by themselves.  These foods do not dissolve in saliva and clear the mouth until they have been broken down into simple sugars.  The process is likely to take hours and extends the time bacteria attack the enamel of your teeth.  Combinations of foods neutralize acids in the mouth and inhibit tooth decay.  For example, enjoy cheese with your crackers.  Cheese and other dairy products can be anti-cariogenic due to their buffering effect.  They help neutralize acids in the mouth.  Your snack will be just as satisfying and better for your dental health.

Why do I need fluoride?

Fluoride is a compound of the element fluorine, which is found universally throughout nature in water, soil, air and in most foods.  Fluoride is absorbed easily into tooth enamel, especially in children’s developing teeth.  Once teeth are fully formed, fluoride makes the entire tooth structure more resistant to decay and promotes remineralization.  Remineralization aids in repairing early decay before the damage is even visible.  Drinking excessive amounts of fluoridated water can cause dental fluorosis, which is characterized by chalky white spots or lines and pitted and brown stained enamel.

When should I consult my dentist or dietician about my nutritional status?

Always ask your dentist if you’re not sure how your nutrition / diet may affect your oral health.  Conditions such as tooth loss, pain, or joint dysfunction can impair chewing and are often found in elderly people and those who are undergoing medical treatment.  People experiencing these problems may be too isolated or weakened to eat nutritionally balanced meals at a time when it is particularly critical.  Talk to your dental health professional about what you can do for yourself or someone you know in these circumstances.

The following is a list of useful Canadian Web sites that offer information on nutrition and bone health:

• Canadian Health Network  www.canadian-health-network.ca
• Dairy Farmers of Canada   www.dairyfarmers.org/engl/health/index.asp
• Dietitians of Canada  www.dietisians.ca/english/frames.html
• Health Canada  www.hc-sc.gc.ca/hppb/nutrition
• National Institute of Nutrition  www.nin.ca
• Osteoporosis Society of Canada  www.osteoporosis.ca

Many parents are surprised to learn that the nursing bottle can pose a very particular threat to young teeth.  When teeth first come in, they are not yet perfectly hardened and are very susceptible to decay. If the nursing bottle is left in an infant’s mouth for a long period of time, particularly at bedtime, and if the bottle contains anything but plain water, rapid decay can occur.  The amount of saliva produced decreases when a child is asleep.  This allows these sugars to pool around the teeth.  The mouth’s bacteria use these sugars to create acids that damage teeth.

These fluids all contain sugars and should not be given to babies or children in a bottle to take to bed:  breast milk, cow’s milk, chocolate milk, formula, fruit juice, pop, powdered drink crystals.  Do not use honey or sugar dipped pacifiers.

Sugars in these liquids turn to acid, which washes over the teeth and dissolves the enamel.  The result can be serious decay that sometimes happens so quickly that parents believe the teeth “came in that way”.

What to look for:

The first sign may be dull white spots or lines on the teeth, particularly on the tongue side.  Dark or discoloured teeth may be the sign of a more serious problem.  Your child’s teeth should be checked for brown spots, which may mark the onset of tooth decay.  Nursing bottle decay or early childhood caries can occur in children of up to four years of age.  If you suspect your infant has nursing bottle decay, your child should see a dentist immediately.  It must be treated quickly to prevent abscesses.

What to do:

If you currently give your child a nighttime bottle of anything but plain water, stopping all at once may be too upsetting for the child.  First, substitute plain water for the milk or juice.  Your child may fuss or cry until the new routine is established.  Persevere.  You will be saving your baby from discomfort and pain later on.  Regular brushing should start with the first tooth but it is also a good idea to clean your child’s gums with a washcloth after feeding even before the first tooth appears. 

Talk to Dr. Sahar Rakhshanfar at North Hill Dental Center at 905-508-2244.

• Milk or Chocolate milk                         
• Yogurt
• Apples
• Carrots & Celery sticks
• Other fruits & vegetables
• Cheese
• Nuts & Seeds
• Air popped popcorn
• Whole grain breads & cereals
• Peanut butter

UNHEALTHY SNACKS:

• Gum with sugar
• Suckers
• Hard Candy
• Soft sticky sweets that get stuck in the mouth like
  • Toffee
  • Raisins
  • Rolled – Up fruit snacks
• Pop

FOR TODDLERS:

It is not a good idea to put your child to bed with milk or juice – sugars in both will stay in the mouth and cause cavities.  If sipping juice between meals, teeth are being coated with sugar over and over again.  Water is best between meals.

                            INFORMATIVE WEBSITES

            www.nms.on.ca                                         www.mercola.com

            www.saveharry.com                                 www.kidshealth.org

            www.alegent.iqhealth.com                       www.drgreene.com

            www.smart-mouth.org                             www.go2dental.com

The first few days – You’re in good company.  More than 5 million Canadian adults (about one in four) wear dentures!  With a positive attitude and approach to denture care, wearing dentures can become as natural and easy as putting on and taking off shoes.

While you are sure to become comfortable with your dentures, wearing them for the first time may seem challenging.  It might take some time just to get used to the feel of the denture in your mouth.  You may experience some irritation or even soreness at first.  But as your mouth becomes accustomed to the dentures, these problems should gradually lessen. 

Over the first few days, you may want to wear them most of the time, including sleeping.  After this initial adjustment period, you will probably be told to remove the dentures before going to bed.  This will let your gum tissues rest and allow you to clean your dentures at night with a tablet solution.

Soon you should find that after wearing them consistently, they will begin to feel more comfortable.  With the right attitude and some practice, wearing and caring for dentures will become second nature.  Always follow your dental professional’s instructions.  Should you experience any ongoing discomfort, be sure to make an appointment to discuss your concerns.

Regular check-ups – You’ve probably seen your dental professional several times to get just the right fit.  Now it’s up to you to continue to take care of your dentures.  Regular dental check-ups are important for your general oral health, and to monitor any changes with the fit, or feel, of your dentures.

Fit and feel – Your dentures may feel odd at first.  You may even gag slightly once they are in.  They may feel slightly uncomfortable or even loose until your cheek muscles and tongue learn to keep them in place.  Take heart!  Within a few days they will begin to feel normal.  With a little practice, you will be able to adjust to this initial feeling and soon you will barely notice them.

Once you’ve been fitted with your new dentures, you may notice excess saliva (the fluid in your mouth).  Don’t worry.  This is a normal response.  For the first few days wearing your new dentures, try to swallow more frequently.  Within a few days, your mouth will become comfortable with the dentures and the flow of saliva should return to normal.

Eating – Becoming comfortable eating may take a little practice.  Start off with soft foods.  You may notice that you can’t bite down quite as hard with dentures, or chew in quite the same way.  Try taking smaller bites and chew gently to prevent dentures from becoming loose.  Soon practice and patience will get you back to eating your favourite foods again.

Speaking – You may find that it’s difficult to speak when you start wearing your new dentures.  That’s normal.   Many new denture wearers find it difficult pronouncing “s” at first.  Practice by reading or repeating a few words.  Read aloud from a book or magazine in front of a mirror so that you get used to speaking.  Try biting or swallowing before speaking to “set” your dentures in position.

Cleaning dentures – Keeping your dentures clean is an important part of complete oral hygiene.  It’s important to clean off food particles or tartar build-up on both the acrylic tooth and the plate to prevent bacteria and fungus from growing. 

1.  At night all dentures, full or partial, should soak in lukewarm water.  This takes pressure off your gums and keeps dentures from drying out and warping.  A half-and-half solution of white vinegar and water loosens bacterial deposits so they can be brushed off.  Soaking your dentures with Polident tablets, every night or during the day as directed, can clean away any food particles from spaces between the teeth that brushing can’t reach.

2.  Imagine how your feet would feel if you never took off your shoes!  Mouth tissues are extremely sensitive.  They can shrink and change under the pressure of dentures.  Give them time to rest and breathe by removing dentures overnight.  Your oral tissues need daily stimulation.  Use a soft toothbrush to massage your gums; the top, underside, and edges of your tongue; the roof and floor of your mouth.  If a brush is uncomfortable, try moistened gauze.

3.  Keep in touch with your dentist.  Your mouth changes constantly – so your dentures will need adjusting to maintain a good, comfortable fit.  Your dentures and tissues should be checked every year to prevent or reduce tissue inflammation and to minimize bone or tissue loss. While reviewing the fit, your dentist will also examine your tissues, check for oral cancer, and review your home-care routine.

Cleaning tips:

1. Fill the sink halfway with water so your dentures won’t break if you drop them.
2. Scrub dentures thoroughly.  Ask your pharmacist for a special denture brush; its short bristles clean sides and chewing surfaces, and long bristles reach the narrow spaces inside.  Soap and water work fine; baking soda removes stains.
3. If you have partial dentures, clean their metal clasps carefully.  Ask your pharmacist for a stiff, conical “clasp brush.”
4. Rinse and brush dentures and natural teeth after every meal.
5. Rinse dentures in clear water before replacing them.

Ensuring the best fit – It’s a common misconception that adhesives are only for ill-fitting dentures.  No mater how well your dentures fit at first, there may be times when a denture adhesive can help ensure denture stability.  When used sparingly as directed, Poli-Grip can provide extra comfort and confidence.  This can be particularly true during the first stages of wearing your dentures while you are relearning your eating and speaking skills.

 Any physical challenges with the supporting bone in your mouth, use of certain medications or weight loss can all affect the fit of your dentures.  You may simply want a more confident feel an adhesive like Poli-Grip can offer.  (Of course, if you find yourself using more adhesive then before, see your dental professional so that they can check the fit of your dentures.)

Remember, follow your denture professional’s advice and you will be smiling, eating, drinking and talking with comfort and confidence. Contact North Hill Dental Center in Richmond, Hill, Ontario.

Acknowledgements:

Keep Smiling:  Information for people with full or partial dentures, GlaxoSmithKline 2002, Denturist Association of Canada

Do you need fluoride?

There are a number of reasons why someone may require a fluoride treatment.  There are a number of conditions that result in increasing the probability of developing cavities.  These factors must be evaluated for each person individually to determine whether or not they would benefit from fluoride treatment.  If any of the following statements apply to you then you may benefit from a specific fluoride therapeutic program that can help you keep your teeth for life.

• No fluoride in your drinking water as a child
• No fluoride in your drinking water now
• Drink filtered or bottled water
• Have receding gums or history of gum disease
• Have multiple fillings and/or crowns
• Strong family history of dental decay
• Mouth feels dry; or take medications that cause dry mouth; or mouth breather
• Currently wear orthodontic braces
• Have sensitivity to hot, cold or touch
• Use home whitening products
• Limited hand dexterity
• Use of chewing gum, lozenges, strong breath mints or hard candy with sugar between meals
• Visit dental office irregularly
• Currently undergoing chemotherapy or radiation therapy
• Suffer from acid reflux
• Teeth that just don’t feel clean; trap food
• Dental work done in the past year
• Snack frequently between meals
• Sip on beverages throughout day (other than water)
• Use tobacco products of any type
• Grind teeth frequently
• Brush less than 2 times per day
• Floss less than once per day

Fluoride is a mineral that is found naturally in many things we eat or drink.  It is nature’s way of helping prevent cavities.  Professional strength (in-office) fluorides and low strength (home) fluorides each play important roles in helping to keep your teeth for life.  In the lifelong fight against cavities, both adults and children benefit from in-office treatment and home fluorides.  Professional in-office fluoride products are highly concentrated and can only be applied by a dental professional.

Professional in-office fluorides make teeth stronger and even heal (remineralize) weakened areas.  Over time, the high level of fluoride provided by the in-office fluoride treatment will gradually be released from the teeth.  This is where low strength, home fluorides such as toothpastes and mouth rinses play a valuable role.  These home fluorides are an important and valuable complement to the office treatment by replenishing and maintaining a beneficial level of fluoride in the teeth.  Think of office fluoride treatments and home fluorides as your aids in the lifelong fight against cavities.

Fluoride Treatments and Water Fluoridation

The Royal College of Dental Surgeons of Ontario has formally adopted a policy statement that supports the fluoridation of municipal drinking water as an important approach to oral health promotion and disease prevention.  The RCDSO joins the Canadian Dental Association in affirming its support for fluoridation of municipal water supplies as an economical and effective means of preventing cavities in all age groups. 

There has been a marked decrease in tooth decay rates- between 35% and 50% in children and 30% in adults in areas where fluoride has been added to municipal water supplies.  Children need fluoride protection while their teeth are developing.  Adults also need it since the possibility of cavities on the exposed root surfaces of teeth increases as they get older.

Nearly 100 national and international organizations and governments endorse the fluoridation of drinking water to prevent dental decay.  They include the Canadian Dental Association, the Canadian Public Health Association, the Canadian Medical Association, the Canadian Pediatric Society, Health Canada, the American Dental Association, and the International Association for Dental Research and the World Health Organization.

Opponents to water fluoridation claim that it increases the risk for a range of health problems from cancer to Down Syndrome.  The safety and effectiveness of water fluoridation have been re-evaluated frequently, and no credible evidence supports an association between fluoridation and any of these conditions.

Fluoride works in several ways.  It is incorporated into enamel during tooth development and makes the teeth more resistant to decay.  Fluoride also inhibits the demineralization of enamel.  This action requires fluoride from topical sources such as drinking water and fluoride products.  Fluoride also enhances the remineralization of enamel.  The fluoride adsorbs to the crystal surface within demineralized areas of enamel or dentin and attracts calcium ions and phosphate ions to form new mineral.  The fluoride ion also directly inhibits cavity-causing bacteria from producing organic acids that cause the breakdown of the enamel.

The Truth About Your Teeth and Fluoride

Myth:  Fluoride is only for kids.

Fact:  Fluoride helps develop strong tooth enamel on children’s growing teeth but it also helps to harden the surface enamel on adult teeth.  It is important to teens with braces and to adults with crowns and bridges.  Plaque build-up around braces and dental work can make teeth more vulnerable to cavities.  Many adults also have to protect the surface of the tooth where their gums have receded.  Fluoride prevents cavities, reverses early tooth decay, remineralizes tooth enamel and controls tooth sensitivity.

Myth:  I get enough fluoride in my toothpaste.

Fact:  Toothpaste with fluoride definitely helps to protect your teeth against cavities.  The concern is that brushing doesn’t reach all tooth surfaces especially those between the teeth and at the back of the mouth.  These are common sites for cavities.  As a result, dentists often recommend a fluoride rinse in the office or for home use.

Myth:  I can get too much fluoride from dental care products.

Fact:  Fluoride is recognized as the most effective anti-cavity ingredient available.  It is unlikely that you will get too much from using topical products such as toothpaste and mouth rinses.  The reason is that this fluoride is not swallowed.  It is either absorbed by the teeth or spit into the sink.

Myth:  I don’t have cavities so I don’t need fluoride.

Fact: Your teeth are constantly exposed to the risk of cavities and gum disease.  Plaque forms continually on tooth surfaces and along the gumline.  When you eat, the bacteria in plaque convert the sugar from foods into acid.  This acid can eat away at the calcium and phosphorous minerals in your teeth and causes your teeth to demineralize.  Fluoride actually helps to remineralize the teeth.  It bonds with the dental enamel to make it harder and more resistant to acid attack.

If you have any further questions please call Dr. Sahar Rakhshanfar at 905-508-2244.

Describe your problem with halitosis.

When did it first begin?

Have family members or friends commented about your breath?

When does your bad breath occur?

Does anything make it better?  Worse?

What do you think is the cause of your bad breath?

Are you experiencing any exceptional emotional stress at this time?

Do you feel that you have a problem with other body odours?

Do you have a bad taste in your mouth?

Does your food have an uncharacteristic taste?

Does your mouth often feel dry?

Do you have any illnesses?

Do you suffer from postnasal drip, hay fever, or other allergy-related symptoms?

Do you have any history of sinus problems?  Respiratory problems?

Do you have any history of gastrointestinal problems?

Are you currently taking any medications?

What is your typical diet like?  Colas, coffee, sweets, snacks, dairy products

How many times during the day do you drink beverages?

How much alcohol do you drink?

Do you smoke?  How much?

Please describe your oral hygiene habits.  Brushing frequency?  Flossing?  Type of toothpaste and toothbrush?  Mouthwash use?

Do your gums bleed when you brush or floss?

Have you ever had your gums measured?

Do you sleep with your mouth open?

Are you a mouth breather?

Do you suffer from canker sores?  How frequently?

What do you currently do to help your bad breath?

Have you consulted any other doctors regarding your halitosis problem?

Are you under the care of a physician?

Please copy and paste these questions into a Word document, save the document, fill it out, and then bring it to Dr. Sahar Rakhshanfar at North Hill Dental Center in Richmond Hill, Ontario. For more information, please visit the website.

Understanding Root Canals – you can save your natural teeth with endodontic therapy …Root Canal Treatment

Root canal therapy fits under the special dentistry area known as endodontics.  Endodontics literally means dentistry within the tooth itself. The procedure treats disorders of the pulp (the soft tissue inside the crown and roots made up of blood vessels, nerves and lymph vessels that keep your tooth nourished).  It restores your tooth to a comfortable state by removing the damaged tissue and replacing it with a substance that will help preserve the function of the tooth.

There are many reasons that a root canal may be needed but the most common cause is the uncontrolled process of tooth decay.  When tooth decay begins, it penetrates the outer layer of enamel and creates a cavity.  If that process is not stopped, the decay will continue toward the nerve of the tooth.  Other causes include a fracture that exposes the pulp, traumatic injury such as a blow to the tooth, a cracked or loose filling or repeated fillings in a tooth and occasionally from gum disease.  Regardless of the initial cause, the tooth pulp becomes irritated and an abscess (infection) can occur.  Bacteria from your saliva grow within the tooth pulp, causing pressure and pain.  The inflammation and infection spread down the root canal, often causing sensitivity to hot or cold foods, throbbing, aching, or pain when you chew.  Eventually the pulp dies, causing the bone around the tooth to be destroyed.  Your bone may become infected and abscessed as the bacteria escapes through the root openings.  The bone will break down and your periodontal ligaments may swell and loosen your tooth, making it feel higher than the others and quite mobile.

The Procedure

Once it has been determined that root canal treatment is necessary, you will be scheduled for one or more appointments.  Your visits may last one to two hours, and you may receive local anesthesia.  A rubber dam may be used to isolate your tooth and prevent bacteria from entering it.  The goal of the root canal therapy is to improve the health of your damaged tooth by removing the pulp from your root canals through a small opening in the crown.  Then the canals are sealed with special materials to prevent bacteria from reaching your bone.  Your dentist then restores the outside of your tooth so it will function properly and have a healthy appearance.  After root canal therapy, your tooth continues to be nourished by your surrounding gums and bones.

Stages:

A.  Cleaning and shaping your root canals

First, your dentist makes an opening in your tooth and removes any filling and decay.  Then, the unhealthy pulp is removed with tiny, flexible files.  By using delicate up and down motions, your dentist gently cleans and smooths your canals to prepare them for the canal-filling materials.

B.  Filling your root canals

After the pulp has been removed from your root canals and they have been smoothed, your dentist may fill the canals with tiny cone-shaped pieces of gutta-percha, a firm, rubber-like material, or use another dental material.  A sealer-cement is used to seal the filling material into place.

C.  Restoring your tooth

After the inside of your tooth has been treated the outside will be restored to protect your tooth’s underlying structures and to give it a healthy appearance.  If your tooth needs extra support, some of the gutta-percha may be removed and a post inserted before the filling and crown are applied.

CARE FOLLOWING TREATMENT

Once the root canal has been completed, you should be aware of discolouration and brittleness.  A root canal treated tooth may undergo a change in colour.  While this is of no great medical concern, it may be an issue especially if the tooth is located at the front and highly visible when you smile.  A non-vital, root canal treated tooth is also more brittle than a vital one and this makes it more susceptible to fracture.  Therefore, we recommend that your root canal teeth be crowned (capped) following treatment.

Occasionally, a tooth that has undergone root canal treatment fails to heal or pain continues despite therapy.  Some of the special complications that can occur include accessory canals (large side canals coming off the main canal that cannot be cleaned out), badly curved or cracked roots and narrow canals that prevent thorough cleaning and sealing of the damaged tooth.  Sometimes, for unknown reasons, tissues simply fail to heal or a tooth that initially responds to root canal therapy becomes painful or diseased months or years later.  Retreatment may be necessary in these cases.  If you would like further information please call North Hill Dental Center in Richmond Hill, Ontario at 905-508-2244.