Root canals are generally successful but in a small percentage of cases a second root canal may be required.  This is called retreatment.  A tooth may not heal as expected after initial treatment because narrow or curved canals could not be accessed during the initial procedure; complicated root canal anatomy went undetected; the placement of the crown or other restoration was delayed following the endodontic treatment; the restoration did not prevent bacterial contamination to the inside of the tooth.  In other cases, a new problem can jeopardize a tooth that was successfully treated such as new decay exposing the root canal filling material to bacteria and causing a new infection in the tooth; a loose, cracked or broken down filling can expose the tooth to new infection and a tooth could sustain a fracture. The root canal filling material is taken out and the canal is recleaned, reshaped, and refilled.  In many cases, complex restorative materials such as a crown, post and core material must be disassembled to permit access to the root canals. 

Root Canal Surgery

An endodontist may do surgery when a regular root canal cannot be done or when it has not worked.  Root canal surgery involves making an incision to allow access to the tip of the root.  It is done to check the end of the root for cracks, to remove parts of the root that could not be cleaned during regular root canal treatment or to clear up an infection that did not heal after regular treatment.

Who will do the surgery or retreatment?

All dentists learn to do root canal treatment in dental school but because retreatment and surgery are more complex, your dentist may refer you to an endodontist. 

What are the alternatives to retreatment and surgery?

Most of the time, a tooth that has had a root canal can be saved.  There are unfortunately some cases where all efforts to save a tooth fail and then the tooth must be extracted.  The extracted tooth must then be replaced with a bridge, removable partial denture or implant to restore chewing function and to prevent adjacent teeth from shifting.  No matter how effective tooth replacements are- nothing is as good as your natural tooth.  The options of retreatment or root canal surgery can result in a healthy, functioning natural tooth for many years to come.

For more information please see www.rootcanals.ca and www.aae.org.

If you are suffering from a dry mouth, you are not alone.  One of the most common complaints in the dental office is that of a chronically dry mouth.  In fact, about one in every four adults experience the symptoms associated with this problem.  A dry mouth is caused by the improper function of the saliva producing glands.  Common causes of dry mouth are medications, radiation therapy, chemotherapy, stress and depression, diabetes and kidney dialysis, rheumatoid conditions and old age.  Medications known to cause dry mouth include antidepressants, antihistamines, decongestants, antihypertensives, antiparkinsonians, antipsychotics, certain cold and flu medications, sleeping medications, betablockers and diuretics.

Typical symptoms of dry mouth may include thirst, difficulty with swallowing or speaking, the need to drink frequently while eating, soreness or burning of the mouth, increased number of dental cavities and bad breath and a dry throat.  Often these symptoms can be alleviated by stimulating the flow of saliva with sugarless gum or candy or by the frequent sipping of water.  For more severe cases, there are artificial saliva formulations available which help to coat the tissues and prevent soreness of the mouth and throat.

Aside from the annoyance dry mouth usually causes, the reduced flow of saliva can have a devastating effect on the teeth.  The saliva in our mouths acts as a buffer and a cleanser to prevent cavities from forming.  When the amount of the saliva is significantly reduced, there is a greatly increased risk of severe tooth decay, especially if no additional preventive measures are taken.

Fortunately, there are several steps that we can take to prevent the formation of cavities.  Patients experiencing dry mouth should be seen at least every three months for a dental cleaning and for a fluoride treatment which will help strengthen the teeth and make them more resistant to decay.  Our office may prescribe toothpaste especially high in fluoride or toothpaste that is extra gentle on your gums.

It is also important for those people who experience the symptoms of dry mouth to take proper care of their teeth between dental visits.  Brushing at least twice daily with a fluoride containing toothpaste, flossing, and the use of a fluoride mouth rinse and gel will all help in the prevention of dental cavities.  Also, foods with high sugar content should be reduced or avoided as a frequent consumption of sweets between meals is a significant cause of tooth decay.  Talk to your doctor about alternatives to your current medications.  If you are suffering from a dry mouth, please take advantage of these excellent preventive measures.  They are painless, inexpensive, quick and effective.

If you have any further questions please call North Hill Dental Center at 905-508-2244.  We love to hear from our patients.

WHY ARE BABY TEETH SO IMPORTANT? AREN’T THEY JUST GOING TO FALL OUT ANYWAY?

Baby teeth are important for a number of reasons.  They are vital in helping your child to eat and to speak properly.  Although the first baby teeth are usually lost about six years of age, others won’t fall out until your child is twelve years old!  That is a lot of chewing.  Your child needs them for smiling!  It is important for a child to develop a good self-image.  You would not want your little one to be embarrassed about their appearance!  Baby teeth act as “space maintainers” so that the grown-up teeth will come in straight.  If a baby tooth is lost too early then the adult tooth replacing it may not be guided into the proper position and may cause adult teeth to come in crooked.  Finally, if baby teeth are allowed to rot and abscess, it can affect the grown-up teeth trying to develop in the jaw.  Baby teeth are good primers for teaching your child good oral care habits.  Baby teeth are very important and are worth caring for.

WHEN CAN I EXPECT MY BABY’S TEETH TO START COMING IN?

Most babies start teething at about six months of age… although some babies are born with teeth and others don’t start teething until almost one year of age.  It is all considered to be well within normal limits.  Most children have all their baby teeth by the time they reach two and a half years of age…. Although again, some children are done sooner and others later.  As long as the teeth are present in the jaws and are showing signs of developing, there is no need to worry.

HOW MANY BABY TEETH SHOULD THERE BE?

When your child is finished teething at about two and a half years of age, there should be 20 baby teeth; ten in the upper jaw and ten in the lower jaw.  These 20 primary teeth will be followed by 32 permanent teeth that will eventually replace them.  Your child should have all of the primary teeth until age five or six when they begin to loosen and fall out.  This process usually lasts until the child is 12 or 13.  The primary

teeth fall out because permanent teeth are pushing them and by about age 14, children should have a full set of 28 permanent teeth.  Four additional molars called wisdom teeth may grow in behind the permanent teeth in late adolescence for a total of 32 teeth.

WHAT CAN RELIEVE THE DISCOMFORT OF TEETHING FOR MY CHILD?

Between the ages of six months and three years, your child may experience sore gums and general oral discomfort as primary teeth erupt.  Signs that tooth eruption is causing discomfort in your child include crankiness, lack of appetite, excessive drooling, fever, restless behaviour, pink or red cheeks, coughing, upset stomach and chewing or sucking of fingers and toys.  A cold, wet cloth for your baby to suck on can soothe gums.  There are also teething accessories and toys that can be chilled for your child to chew on to relieve discomfort.

WHEN SHOULD I START CLEANING MY BABY’S TEETH SO THAT I CAN MAKE SURE MY BABY WON’T GET CAVITIES?

You should start cleaning your baby’s GUMS even before he/she starts teething!  Simply use a clean wet face cloth or gauze and wipe baby’s gums at bedtime.  When the first few teeth are in you can still use a washcloth or switch to a very soft babies’ toothbrush.  It is of utmost importance to clean your child’s teeth JUST BEFORE they go to bed.  Bacteria cause most of the damage to our teeth while we sleep!  Also, your child should NEVER be put to bed with a bottle containing anything but water!  If you put your child to sleep with a milk or juice bottle, their teeth can COME IN ROTTEN!  Even drinks that are good for your child contain different types of sugar that can be harmful to baby teeth.  When allowed to pool during sleep, sugary or carbohydrate –rich liquids can lead to cavities, tooth loss, infections or more serious problems.  Watch for dull white spots or lines on the teeth, particularly on the tongue side.  Dark or discoloured teeth may be a sign of a more serious problem.

HOW DO I CLEAN MY CHILD’S TEETH?

For children under three years of age, you should brush their teeth with a child-sized toothbrush and plain water.  For children over three years of age, you can start to use a pea-sized amount of toothpaste but you should ensure that your child can spit out the toothpaste rather than swallow most of it.

WHEN SHOULD MY CHILD START SEEING THE DENTIST?

Your child’s first real dental check-up should be about two and a half years of age, when all twenty baby teeth have come in.  However, we feel that you should be bringing your child along for your cleanings to watch.  We want them to get used to the dental office and feel comfortable with the people there.  A child should be introduced to the dentist before a problem develops so that positive feelings can develop with the dentist.

SHOULD BABY TEETH BE FLOSSED?

Yes! Flossing is important for baby because it enables you to clean between the teeth where the toothbrush cannot reach and where most cavities start.  Usually, you will have to floss for them until they are eight or nine years old.

WHEN SHOULD I START WORRYING ABOUT MY CHILD’S THUMB SUCKING HABITS?

Thumb sucking is an extremely innate behavior. Your baby was already thumb sucking while still in the womb. As such it can be difficult to break the habit.  Fortunately, there is no need to worry until the permanent teeth begin to erupt.  Most children, by the time they are four years old, only thumb suck at bedtime and stop immediately after they fall asleep.  If a child is older and is still thumb sucking, we have some simple techniques to help them quit the habit.  If a child is having difficulty quitting, you may want to set up a rewards program for each day that they do not suck their thumb.  Praise is always a good reward.  The dentist can place an appliance in your child’s mouth that should end the thumb sucking within days if other methods have been tried without success.

IS IT “OK” TO GIVE MY BABY A SOOTHER?

It certainly is!  As mentioned earlier, sucking is an innate behavior and is satisfying and calming.  By the time your child is approximately two years old, they will probably just be using their soother to fall asleep.  It will be simple for you to put the soother away one day and tell your child that it is gone.  Prolonged and vigorous sucking after the age of five can cause problems with dental development.  If you have concerns, talk with your dentist.

SHOULD LOOSE PRIMARY TEETH BE PULLED?

Losing primary teeth before they are ready to fall out can affect the proper positioning of the permanent teeth.  If a baby tooth is lost too early, other teeth may tip or fill in the vacant space and force the permanent teeth to come in crooked.  If the permanent tooth has started erupting and is approximately half visible then the wiggly baby tooth in front of it should be removed to allow the permanent tooth to erupt into the proper position.

HOW OFTEN SHOULD MY CHILD SEE A DENTIST?

Visit the dentist every six months to check for cavities and proper tooth development.  This way your child can be happy and relaxed rather than frightened and in discomfort.  You can discuss any dental care issues you may have at these appointments.

Remember that, as a parent, you have a vital role to play as teacher and motivator.  With your support your child can develop excellent oral health habits that will last a lifetime!

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

Your Guide to Cracked Teeth

With their more sophisticated procedures, dentists are helping patients to keep their teeth longer.  People are living longer and exposing their teeth to many more years of crack-inducing habits, such as clenching, grinding, and chewing on hard objects.  These habits make our teeth more susceptible to cracks.  Some cracks are not a problem and can exist for years without any negative consequences.  Other cracks, especially those next to fillings, can eventually cause a portion of your tooth to break away. 

Cracked teeth show a variety of symptoms which includes erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes.  A common complaint is that of a quick, sharp pain at impact, when you eat something firm.  This pain usually tells you to chew elsewhere quickly!  In many cases the pain may come and go and dentists may have the difficulty of locating which tooth is causing the discomfort.

Why does a cracked tooth hurt?

Inside the tooth, under the white enamel and a hard layer called the dentin, is the inner soft tissue called the pulp.  The pulp contains blood vessels, nerves, and connective tissue.  When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces and the pulp can become quickly irritated.  When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain.  Irritation of the dental pulp can be repeated many times by chewing.  Eventually the pulp will become damaged to a point where it can no longer heal itself.  The tooth will not only hurt when chewing but may also become sensitive to temperature extremes.  Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissues surrounding the tooth.

Types of Cracks:

Craze Lines:

Craze lines are tiny cracks that affect only the outer enamel.  These cracks are extremely common in adult teeth.  Craze lines are very shallow, cause no pain and are no concern beyond appearance.

Fractured Cusp:

When a cusp, the pointed part of the chewing surface, becomes weakened, a fracture sometimes results.  The weakened cusp may break off by itself or may have to be removed by the dentist.  When this happens, the pain will usually be relieved.  A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed.  The tooth will usually be restored by your dentist with a full crown.

Cracked Tooth:

This crack extends from the chewing surface of the tooth vertically towards the root.  Sometimes the crack may extend below the gumline and in severe cases into the root.  A cracked tooth is not completely separated into two distinct segments.  Because of the position of the crack, damage to the pulp is common.  Root canal treatment is frequently required to treat the injured pulp.  Your dentist will then restore your tooth with a full crown to bind and protect the cracked tooth.  Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack.

Split Tooth:

A split tooth is often the result of the long term progression of a cracked tooth.  The split tooth is identified by a crack with distinct segments that can be separated.  A split tooth can never be saved intact.  The position and extent of the crack, however, will determine whether any portion of the tooth can be saved.  In rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth.

Vertical Root Fracture:

Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface.  They often show minimal signs and symptoms and may therefore go unnoticed for some time.  Vertical root fractures are often discovered when the surrounding bone and gum tissue become infected.  Treatment usually involves extraction of the tooth.  However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractured root.

Treatment of Cracked Tooth Syndrome

The treatment of cracked tooth syndrome varies depending on the severity of symptoms.  We cannot determine the depth and direction of the fracture or crack below the surface.  We often have to rely on the intensity of the symptoms to indicate the progression level of the fracture or crack.  We may elect not to do treatment and to monitor the situation depending on the degree of symptoms.  We may perform a diagnostic filling removal to assess the tooth for the extent of the fracture/crack.  A full coverage crown is needed if the fracture line appears more extensive and the symptoms are more potent.  In teeth that exhibit symptoms that are characterized by long standing consistent lingering temperature sensitivity, we often elect to perform root canal treatment prior to placing the crown.

Will my tooth completely heal?

Unlike a broken bone, the fracture in a cracked tooth will never heal.  In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth.  Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.

The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen.  Once treated, most cracked teeth continue to function and provide years of comfortable chewing.  Talk to your dentist about your particular diagnosis and treatment recommendations.  They will advise you on how to keep your natural teeth and achieve optimum dental health.

If you have any further questions please call North Hill Dental Center at 905-508-2244.  We love to hear from our patients.

Dental implants are a popular option for replacing lost teeth.  If you are missing a tooth, it should be replaced in order to restore your smile, regain your chewing ability and prevent other teeth from shifting.  Your dentist may recommend replacing your lost tooth with a dental implant.  They are an alternative to bridges, partials or dentures.  Implants are comfortable, attractive and can look and feel like natural teeth.  They will preserve the level of the bone and eliminate the negative results of tooth loss. 

What is a Dental Implant?

A dental implant is an artificial tooth root inserted in the mouth usually involving a two-step procedure.  First, a small titanium screw or surgical post is placed beneath the gum into the jawbone.  This is always done under local anesthesia in the dental office.  Then a few months following the placement, an abutment or post which will hold the tooth in place is attached to the screw.  Finally, a crown, or replacement tooth is attached to the abutment after all healing is complete.  Implants can be used to replace a single tooth, support a bridge to replace several missing teeth, support a bridge when all the teeth are missing and provide secure fixation for a removable denture.

How long does the process take?

The procedure can take from four to eight months to complete; however, each patient heals differently so times will vary.  Once the healing process is completed, it will take approximately 2 weeks to fit the implant with a replacement tooth. 

What are implants made of?

Implants are made from metal called titanium.  All implant materials are compatible with body tissue and are placed in the jawbone like natural roots.  Titanium is not recognized by the body’s immune system so it is not rejected as an implant.  It integrates with the jawbone to give a firm support to the artificial replacement that it will support.  There are different types, sizes and shapes of implants used according to the needs of the patient.

Reasons for Implants

• No worrying about dentures falling out- a stable foundation
• Improves biting pressure
• Insufficient teeth or jaw structure for other types of replacements
• Restores proper chewing ability which leads to a better diet and improved overall health
• Eliminates tooth shifting
• No loose dentures
• No gooey denture adhesives
• Improves speech
• Won’t apply damaging pressure to your natural teeth because other teeth do not need to be clasped
• Comfort and fit
• Help preserve healthy vital tooth structure on adjacent teeth
• They look and feel like your natural teeth
• Increase your self-confidence when talking and smiling
• Maintain bone

How do I care for my implants?

It is important to brush and floss around the implant posts as you would with your natural teeth.  Your dentist will give you specific instructions on how to care for your new implants.  Special cleaning procedures will be necessary during your regular cleaning visits to ensure that you retain healthy gums.

Periodic inspection of the implant to bone connection must be done using x-rays.  If properly cared for , your implants can last a lifetime.  The better care you take of your implants, the more satisfied you will be with the results.

How do I know if I am a candidate for an implant?

You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place.  If you do not have enough bone, you may be able to have bone added to allow for implant placement.  People who are unable to wear complete dentures may also be good candidates.  If you suffer from chronic problems such as clenching or grinding or systemic diseases such as diabetes, the success rate for implants decreases.  People who smoke or drink heavily may also not be good candidates.  Your dentist and oral surgeon can evaluate your situation to determine if dental implants are the best option for you. 

Risks Associated with Implants

Complications are rare with implant procedures.  When infections or other complications occur, medication or surgical intervention may be used to treat it.  Oral surgery may incur damaging of the nerve that controls sensation.  Such complication is rare and may be temporary or permanent.  In addition, there is the risk of bleeding, swelling, bruising, infections, discomfort, cosmetic problems and damage to other natural teeth.  Each case is different and risks must be evaluated for each individual.

Implants and Dental Insurance

Typically implants are not covered by insurance providers.  However, the investment of a healthy smile can be priceless.  Discuss financial arrangements with your dental care provider.

If you have any further questions on dental implant choices, procedures, and care, please call our dental office in Richmond Hill, Ontario at 905-508-2244.

What is a Dental Implant?
A dental implant is an artificial tooth root inserted in the mouth usually involving a two-step procedure. First, a small titanium screw or surgical post is placed beneath the gum into the jawbone. This is always done under local anaesthesia in the dental office. Then a few months following the placement, an abutment or post which will hold the tooth in place is attached to the screw. Finally, a crown, or replacement tooth is attached to the abutment after all healing is complete. Implants can be used to replace a single tooth, support a bridge to replace several missing teeth.

Proper Care
Your dentist will give you specific instructions on how to care for your new implants. Special cleaning procedures will be necessary during your regular cleaning visits to ensure that you retain healthy gums.
Periodic inspection of the implant to bone connection must be done using x-rays. The better care you take of your implants, the more satisfied you will be with the results.

What are implants made of?
Implants are made from titanium. All implant materials are compatible with body tissue and are placed in the jawbone like natural roots. Titanium integrates with the jawbone to give a firm support to the artificial replacement that it will support. There are different types, sizes and shapes of implants used according to the needs of the patient.

How long does the process take?
The procedure can take from four to eight months to complete; however, each patient heals differently so times will vary. Once the healing process is completed, it will take approximately 2 weeks to fit the implant with a replacement tooth.

How do I know if I am a candidate for an implant?
You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. If you do not have enough bone, you may be able to have bone added to allow for implant placement. People who are unable to wear complete dentures may also be good candidates. If you suffer from chronic problems such as clenching or grinding or systemic diseases such as diabetes, the success rate for implants decreases. People who smoke or drink heavily may also not be good candidates. Your dentist and oral surgeon can evaluate your situation to determine if dental implants are the best option for you.

Risks Associated with Implants
Complications are rare with implant procedures. When infections or other complications occur, medication or surgical intervention may be performed to treat it.

If you have any questions or concerns about the fit of your implants please contact Dr. Sahar Rakhshanfar - North Hill Dental Center in Richmond Hill at 905-508-2244 and we will be pleased to help you.

Teeth Whitening and Cosmetic Dentistry

The least damaging and most conservative way of making your teeth whiter is by bleaching.  Contrary to what most of us believe, brushing your teeth harder with a more abrasive toothpaste will not make them whiter.  It will make them turn darker faster.  The intrinsic colour of your teeth or your normal tooth colour is related to the colour and thickness of the enamel and dentin as well as to the types of food you eat.  The thinner the enamel, the darker your teeth are in appearance.  Your teeth will be darker if the underlying dentin is darker.  The more coffee, tea, cola beverages and red wine you drink, the darker your teeth will become.  Smoking will also darken your teeth.  Cracks that are commonly found in the enamel of your teeth may provide a pathway for fluids to discolour the underlying dentin.  Teeth also get darker as you age.

Yellow, brown and orange staining on your teeth can be made whiter by the bleaching procedure.  Bleaching works well in removing age related darkening of your teeth.  No drilling or anesthesia is required.  Your teeth will not become weaker.  The mineralization of teeth will vary from person to person so it will take different time periods to achieve a satisfactory colour change for each individual.  It will take longer for teeth that are darker in colour.  The bleaching will also work to a lesser degree on tetracycline discolorations but it takes more time to achieve good results.

There are two types of bleaching that are available.  One is done by the patient at home and the other is done by the dental hygienist or dentist during an office visit.  Further information can be obtained on these procedures.  The colour change should last for several years.  If you drink a significant amount of coffee, tea, cola, red wine or smoke then the teeth may begin to turn darker again.  If this happens, the bleaching process can be repeated.  Do not expect to turn as white as new fallen snow.  Most people do achieve a satisfactory colour change in a short period of time.  The possible side effects include temporary white discoloration of the gum tissues if the bleaching solution comes into contact with the gum.  This goes away quickly.  The teeth may become slightly sensitive to temperature changes during the bleaching process.  There are no other long term adverse effects.

The teeth that show when you smile or speak will be shown to you by the dentist or dental hygienist.  These are the teeth that would benefit your appearance most if bleached.  The top teeth should be bleached because they are much more visible than the bottom teeth but both upper and lower teeth can be bleached successfully.  If you wish to be evaluated for tooth bleaching then please speak to the dentist or dental hygienist.

A BRIGHTER SMILE IS ALWAYS IN STYLE!

If you have any further questions please contact Dr. Sahar Rakhshanfar at North Hill Dental Center in Richmond Hill at 905-508-2244.

 What is burning mouth syndrome?

Burning mouth syndrome (called BMS, for short) is a common problem.  People with BMS often feel like they burned their mouth with hot coffee.  They may also have a dry mouth, or a bitter or metallic taste in their mouth.  Both men and women can get BMS; however, it is especially common in women during or after menopause.
 

What causes BMS?

For many years, doctors thought that psychological problems, like depression and anxiety, were the cause of BMS.  There are now thought to be numerous different underlying possible causes for BMS.  Dry mouth (xerostomia), oral thrush, psychological factors, nutritional deficiencies, irritating dentures, nerve disturbance or damage (neuropathy), allergies, tongue-thrusting, teeth-clenching, side effects of medications and endocrine disorders like diabetes or hypothyroidism have all been linked to causing BMS.  Your doctor may refer you to a specialist for screening and diagnosis and possibly treatment because BMS is associated with such a wide variety of medical conditions.  Your health care team may include a dermatologist, dentist, psychiatrist, psychologist or a doctor who specializes in ear, nose and throat problems.

How can my doctor tell if I have BMS?

There is no simple way to test for BMS.  Your doctor may look for a problem in your mouth that might be causing a burning feeling.  You may be asked to have various blood tests, complete blood cell counts, allergy tests, oral swab cultures or biopsies and you may have to take a medication regularly.

How is BMS usually treated?

You might be given a medicine that has an effect on the nerves of the tongue.  These medications include tricyclic antidepressants and benzodiazepines.  It is not exactly clear why these medications help but it may be that they change or alter the taste system.  Capsaicin (hot pepper) mouth rinses may help some people with BMS.  Burning mouth syndrome can be painful and frustrating.  In the short term, you may gain some relief by avoiding irritating substances, chewing on ice chips or sugar-free gum, keeping your dentures out at night and brushing your teeth with baking soda instead of toothpaste.  For more information please see http://www.mayoclinic.com/  and www.aafp.org under burning mouth syndrome.

If you have any further questions please call North Hill Dental Center at 905-508-2244.  We love to hear from our patients.

Bruxism:  What and Why?

Bruxism (grinding) affects millions in North America each year.  According to the American Dental Association, approximately 95% of Americans experience bruxism at some point in their lives.  However, only about 15 % of people have a regular habit of grinding their teeth or clenching their jaws. Without treatment, grinding seriously damages the tooth surface, leaving the dentition vulnerable to fractures, erosion, and even changes in facial appearance.  Most people grind or clench their teeth in their sleep, so it often goes undetected until a family member hears the grinding sound or a dentist notices symptoms.

Many patients do not realize that they have bruxism.  However, when their dentist explains the consequences of their ailment to them, most patients want to immediately begin preventive therapy.  Chair side solutions recently have been developed to meet the immediate and long-term needs of all bruxers.

There are many factors that can contribute to bruxism.  These include stress, anxiety, anger, pain and frustration.  Certain sleep disorders can trigger bruxism as well.  People who are competitive, aggressive and feel rushed may also be at greater risk.  Using alcohol and some types of medications also may worsen teeth grinding.

Bruxism can cause the following effects:

• Wear down tooth enamel
• Chip teeth
• Increase temperature sensitivity
• Erode gums and supporting bones
• Break fillings or other dental work
• Worsen temporomandibular joint dysfunction (TMJ)
• Result in cosmetic damage.

Bruxism or teeth grinding is common in children.  Three out of ten kids will grind or clench their teeth.  They may grind their teeth in response to jaw growth, losing or getting in new teeth, or the pain and discomfort of other ailments such as ear infections.  Teeth grinding is usually a passing phenomena in children and most outgrow it by the time they reach adolescence.

When bruxism is serious enough to damage the teeth or cause jaw or facial pain in adults, dentists can fit patients with plastic mouth guards to be worn at night.  These night guards are designed to prevent grinding during sleep. 

For more information please feel free to contact Dr. Sahar Rakhshanfar at North Hill Dental Center at 905-508-2244.

Any of our team members would be more than happy to show you a sample night guard or answer any questions.

Everything You Ever Wanted To Know About Bad Breath

What is bad breath?

Most of us have had bad breath some time or another.  It may be barely noticeable or strong enough to turn people off.  Bad breath can spoil your self-confidence and cause embarrassment. Halitosis or bad breath is caused by Volatile Sulphur Compounds (VSC) which are produced by bacteria that live in the mouth.

What causes bad breath?

There are many causes of bad breath.  Morning breath is a common problem most of us experience.  Foods such as garlic and onions can cause mouth odours.  Dental diseases, systemic diseases, stomach problems, hormonal changes, drugs, stress and changes in the amounts of mouth bacteria can all result in bad breath.  90% of bad breath comes from the mouth and is treatable.  Medical problems are behind a small percentage of bad breath cases.  Please visit a dentist first to treat the most common causes of halitosis.

How can I tell if I have bad breath?

The most reliable at home method is to ask a family member or friend who you know will give you an honest answer.  Bad breath changes in intensity at different times so it may be at its worst in the morning for some individuals and in the afternoon for others.  One way of assessing is to lick your wrist and then wait until it dries.  Sniffing your wrist will then inform you as to whether some odour is present on your breath. 

What can I do to treat my bad breath?

Use a tongue scraper such as Oolite to gently remove the coating of plaque from your tongue.  Take extra care not to cut your tongue.  This should be done every morning and evening.

Use a mouthwash like STEP4 that contains Xylitol.  It acts as a volatile sulfer compound oxidizer.  Mouthwashes should not contain alcohol because this further dries out your mouth and can compound the bad breath problem. 

Brush with a pea-sized amount of a chlorine dioxide containing toothpaste at least twice daily because the chlorine dioxide actually destroys sulphur compounds at the molecular level. 

Brush your teeth, gums, cheeks, palate and tongue for at least 2 minutes.  Electric or ultrasonic toothbrushes can be highly effective aids. 

Floss at least once daily and preferably in the evening.

If you wear dentures or other mouth appliances then use a very soft brush to clean you gum areas and the roof of your mouth.  Dentures and appliances should be brushed in the morning and evening.  Dentures can be soaked in a chlorine dioxide mouthwash overnight.

If you smoke then your mouth gets dried out.  It is important to stimulate your salivary flow to keep your mouth moist.  Frequent sipping on water, chewing sugarless gum and candies and avoiding acidic juices and soft drinks help to keep the saliva flowing.  Speak to your doctor regarding a saliva substitute such as Salix.

If you take medications that dry the mouth then please try to keep your mouth moist as was recommended for smokers above and also contact and speak to your physician with regards to a saliva substitute or possible modifications to your medications.

Avoid or decrease your intake of foods rich in onions, garlic or heavily spiced.  Reducing fatty food intake will also decrease mouth odours.

Use fruits and fruit juices as snacks to help control hunger odour.

Visit your dentist regularly for check-ups and cleanings to reduce the amounts of bacteria in your mouth and to treat any cavities or gum disease.

Visit your doctor for an annual check-up to help prevent serious health problems and bad breath associated with them.

Try to eat a healthy, balanced diet.

If Chronic Bad Breath Continues …
Your dentist can refer you to a Fresh Breath Clinic to assess and treat your chronic bad breath and taste with individualized treatments.  You can expect your visit to be supportive, professional and discreet.

For further information please see www.freshbreath.ca

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