How can I improve the appearance of my teeth?
Modern dentistry provides us with a multitude of options to improve the appearance and health of your teeth. Simply having your teeth professionally scaled, to remove stain and calculus, can make a significant difference to your smile. Whitening your teeth can brighten your smile to give it a bright, healthy, youthful look. We can reshape teeth to mask slightly misaligned teeth and even out chipped edges. Bonding can be done to repair larger chips, close gaps, or improve the shape and/or colour of teeth. For more extensive changes to the teeth, veneers either made of porcelain or composite resin can be made which will transform a smile. Crowns (or caps) can restore strength, function and beauty to badly worn, weak or broken teeth. Braces or Invisalign can be used reposition your teeth for a healthier and more aesthetically pleasing smile. In our office, I provide easy consultation appointments to review improvements patients may want to consider and provide options on how to achieve the results.
Which toothpaste is right for me?
There are a number of factors to consider:
Traditional toothpastes contain the following basic components; 1) an abrasive to remove stains from your teeth (i.e. one or more of calcium carbonate, dehydrated silica gels, hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates) 2) some form of mineral/s (i.e. Fluoride, Phosphate and/or Calcium) to harden softened areas of the teeth and 3) a bubbling detergent (i.e. sodium lauryl sulphate – note: this can cause gingival sloughing/irritation for some people) 4) a flavouring/sweetening agent (i.e. sorbitol) to make it taste pleasant 5) an anti-desiccant (glycerin) to keep the paste moist.
Children’s toothpastes: It is best to choose toothpaste that has no fluoride in it, until your child can spit out the toothpaste without eating it. Eating toothpaste can lead to upset stomach and, if done over a long period, permanent discolouration of the teeth called fluorosis.
MI Paste: A more recent addition to the toothpaste family. It uses a specialized formulation of calcium (RECALDENT) that is absorbed more readily by teeth. Under acidic conditions, RECALDENT (CPP-ACP) releases calcium and phosphate ions into tooth enamel. People looking for a non-fluoride toothpaste that decreases decay should consider this option. (MI Paste Plus has Fluoride in it as well).
“Natural” Toothpastes: There are a number of “natural” toothpastes that have no fluoride. While these toothpastes may clean your teeth, remove stains and freshen your breath, most will not help harden up softened teeth. The exception to this is MI paste, which has excellent evidence to back this fact. That being said, these brands may be perfectly adequate for you if you have a reasonable diet, good oral hygiene and are relatively decay resistant.
Whitening toothpastes: These will generally be more abrasive and will remove more surface stains over time, but they may also be too abrasive on your teeth if used indefinitely. They often contribute to causing sensitivity because of this abrasiveness. Some contain titanium dioxide, which has a white colour and sticks to the surface of your teeth. Over time this coating will get thick enough to make your teeth look whiter. This will be lost if you stop using a toothpaste with this product. There are some concerns over the potential health effects of titanium dioxide.
Toothpaste for sensitive teeth: Some toothpaste (like Sensodyne, Colgate Pro-Relief, etc.) also contains ingredients to decrease tooth sensitivity. These often do work well to decrease or eliminate sensitivity. It is important, however, to identify the underlying reason your teeth are sensitive and deal with the problem instead of just masking it.
I would personally select a brand that has fluoride and has a flavor that is pleasing to you, or choose a sensitivity toothpaste if you tend to have cold sensitivity in your teeth. If you experience gingival irritation or sloughing consider switching to an SLS-free product. However, if you have any questions, please just ask us at your appointment and we can help you determine what toothpaste works best for you.
What is the best way to whiten my teeth?
Dentistry started whitening teeth in the 1980’s with great results with few complications. The most common side effect has been short term tooth sensitivity. However, we have figured out how to manage this to keep it to a minimum.
Take Home Whitening: The most effective way to whiten teeth is through the use of take home whitening trays. We provide these to our whitening patients and instruct them on how to use them daily for about two weeks. These trays are important to have so you can do whitening touch ups periodically.
Over the counter whitening: These treatments are safe to use, and usually have the same active ingredients we use, however they are not as concentrated and often have limited effect, but I never discourage people from trying them. They seem to work well for some people.
In-office whitening: This process does serve to “kick-start” whitening; it typically results in an immediate, visible increase in the whiteness of teeth. You still must do take home tray whitening for several weeks afterwards to have lasting results. Studies show that after two weeks of take home trays with or without in-office whitening, there is no difference in whiteness levels. The down side is the additional cost and the increase in both frequency and intensity of tooth sensitivity from in-office whitening. For these reasons, I am not a huge fan of in-office whitening. Should you wish to try in-office whitening, we can accommodate this provided you realize the possible complications.
When should I bring my child in for their first checkup?
If you are having specific concerns about your child at any age, I am more than happy to see them. Otherwise, I follow the Canadian Dental Association Guidelines that a child’s first visit should be by their first birthday or within a few months of getting their first tooth, whichever is first.
At the first appointment, you can expect that we will evaluate the teeth and growth of your child and look for early signs of decay. We discuss the basics of homecare for your child and answer any questions you may have at this time.
The next visit is usually at about 3 years of age for healthy children. Those requiring additional care and attention may begin regular care earlier than this.
What type of fillings are the safest and best for me and my family?
I have been using tooth colored composite resins for fillings for over 20 years and I have found they are very effective, durable, and they look great. There has been much publicity regarding the question of the safety of silver fillings (amalgams) the past few years. To date, there has not been enough credible scientific evidence to support many of the claims it causes illness or disease such as autoimmune disorders. For this reason, I do not support the notion that all silver fillings should be removed and replaced.
The reality is that there is no “perfect” restorative material to replace tooth structure and function. If there were, we would not need to have any discussions about them. Each material has its pros and cons. Some look better, some last longer, some are stronger, some work better on root surfaces, some are better for small restorations, some better for larger applications. I place composite (“white”) restorations, amalgam (“silver”) restorations, porcelain restorations and gold restorations. In fact, I have placed all of these types of restorations in my family’s mouth and would do so again. The choice of which to use is based on discussions with my patients’ wants, needs and desires balanced against the limitations of any considered material. Ultimately the choice is up to you, once you are given the best scientific information about each.
Are implants a good choice to replace missing teeth?
Implants first became part of dentistry in the 1970s. They are a very effective and predictable method of replacing missing teeth. They allow us to replace a missing tooth with what amounts to another tooth without affecting the teeth beside it. They can be used to anchor dentures for greatly increased stability or replace entire arches of teeth returning normal function. Implant success rates demonstrate they last longer than other forms of tooth replacement such as bridges. Implant placement and restoration is a joint effort between myself and the surgeon placing the dental implant. Through this effort, we achieve predictable, long term success in a timely fashion. Implants are a wonderful treatment option for many patients.
How often should I brush and floss my teeth?
Brushing and flossing help control the plaque and bacteria that causes dental disease. Plaque is a sticky, complex biofilm of food debris, bacteria, and saliva. Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids. The bacteria in plaque convert food particles into acids that cause tooth decay and release toxins that damage the gums. Plaque that is not removed eventually becomes calcified to become calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing gingivitis (gum disease) and periodontitis (bone disease).
Tooth Brushing: Brush your teeth at least twice a day (especially before going to bed at night) with a CDA approved soft bristled brush and toothpaste. Electric toothbrushes are also effective. They are easy to use and can remove plaque efficiently. If you choose to use an electric brush, ensure to use it gently. Too much pressure can lead to gum recession.
Avoid rinsing as this will remove the fluoride applied to your teeth from the toothpaste which limits its anti-cavity effects. Instead, spit thoroughly to remove the toothpaste, while leaving a thin layer that will serve to harden the teeth for the next 30 minutes or so.
Flossing: Daily flossing is the best way to clean between the teeth and under the gumline. Flossing removes the biofilm that accumulates in the areas your toothbrush cannot reach. This helps to maintain gingival health and decrease tooth decay. For those who have difficulty with traditional flossing, please discuss this with us. There are many other dental aids which can be used to make flossing easier or replace flossing entirely.