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Early Diagnosis and Treatment is the Key to Good Health
A serious health hazard may be silently lurking in your gums. Periodontal disease is gum disease that is caused by infection. Just like high blood pressure and diabetes, the signs of periodontal disease are often not evident until it is too late. In fact, over time most adults will have some form of periodontal disease that they may not be aware of.
Your gums can serve as a reservoir for bacteria, which causes inflammation. The role of local infections in generalized disease is well established and can negatively impact your health. Medical and dental professionals have long suspected that infections in the mouth can be a risk factor for systemic illness such as heart disease, diabetes, respiratory diseases and low birth weight babies. Inflammation in the mouth can affect vital organ systems remote from the oral cavity by serving as a source of infection. As with most diseases, the key is prevention and halting the disease process in its early stages.
Periodontal disease is a “silent” infection and symptoms may include:
• Persistent bad breath
• Red, swollen or tender gums
• Blood on your toothbrush
• Gums that pull away from the teeth
• Loose or separating teeth
• Pus between the gums and the teeth
The treatment of periodontal disease includes early diagnosis, removal of bacterial deposits deep below the gum line, professional cleanings and follow-up inspection of the gum tissue. A regimen of home care, cooperation by the patient and supportive professional assistance can stop periodontal disease and preserve your teeth, gums and good health for a lifetime.
CONTINUING CARE
We believe that your oral health should continue throughout your lifetime. Ageing no longer means that you will suffer from tooth loss. Your teeth are designed to last a lifetime. Dental health is an essential component of overall physical wellness. Loss of teeth can result in changes in facial contour and create problems in the digestive tract. A continuing care program is essential to achieving and maintaining your oral health.
Frequent examinations and preventive care can help the dentist to detect dental disease in its early stages making treatment easier with less discomfort. Early detection can also help the patient to avoid the necessity of having more complex and costly procedures performed.
Tooth decay can be caused by a number of factors; the most common cause is from dental plaque that has not been removed from teeth. Plaque is a soft, sticky accumulation of bacteria and products of saliva. During a continuing care (preventive) appointment, the dentist or dental hygienist will examine the teeth and supporting structures. A dental hygienist is a dental care provider who specialises in the cleaning and maintenance of the teeth and gums. The dental hygienist will remove any tartar present. Tartar, also known as calculus, is simply hardened plaque.
The scaling process involves the crown of the tooth and below the gum line where plaque is often trapped. Following the scaling, the hygienist will polish the teeth. Children under the age of 18 will have fluoride applied to their teeth at the end of the continuing care appointment. Fluoride is one of the best preventive substances for tooth decay and has significantly reduced the amount of dental decay in school age children.
At the conclusion of a continuing care appointment, the patient will be instructed to follow proper home care and brushing techniques. The dentist will perform a final examination and the patient is escorted to the reception desk. The patient co-ordinator will ensure that your next appointment is made to keep your smile attractive and healthy.
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COSMETIC DENTISTRY
You only have one chance to make a first impression! A clean, healthy smile is attractive, sexy and a sign of self-confidence. Now you can design your own smile! Your smile says a lot about the person you are and it projects your self-image. Do you wish your teeth were a little whiter, shaped differently, not as crowded, or a space wasn’t as prominent? Take another look at your smile and talk to your dentist about how you can improve your appearance by designing the course of treatment that is best for you.
WHITENING (Bleaching)
Only a qualified dental professional can perform tooth-whitening procedures. It is your dentist who understands your dental needs and who can protect your oral health. The results of vital tooth bleaching can be quite spectacular; however, it may not be the choice of treatment for everyone. For example, if you have an anterior white filling or a crown, the bleaching process will affect the colour of the natural tooth but not the restorations. The results can then be disappointing. That is why if you are considering whitening your teeth, you should discuss this with your dentist to determine which method will suit your needs.
There are two different types of whitening procedures that may be performed. One procedure is done in the dental chair where the dentist will apply a hydrogen peroxide solution to the targeted teeth and apply a laser light to accelerate the process. This is often referred to as laser bleaching. Special care is taken to protect the gums and surrounding tissues while the procedure is in progress. This procedure may be repeated until the desired shade is achieved.
The second vital bleaching system is one that you can do at home. You will visit the dental office for the consultation and have an impression taken for a night guard. You will be supplied with a gel that is placed in the night guard that you leave in your mouth for a specific time, sometimes overnight. It is very important to follow home care instructions carefully and not exceed the time when leaving the bleach on the teeth. It is equally as important to see your dentist regularly so he or she may track your progress and assess your treatment.
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Looking for a Healthy Solution to Missing Teeth? Consider Dental Implants
Missing teeth may be cute in small children, but many adults feel extremely self-conscious about their smile if they have experienced tooth loss. People are living longer lives in a more esthetically pleasing way, which are two good reasons to consider tooth replacement options. What many people are not aware of is the impact that missing teeth may negative have on your health.
When you lose a tooth, there is a small area on your jawbone that no longer needs to provide support because the tooth and the root structure are no longer present. Your jawbone begins to lose its strength and firmness without that support. This deterioration does not happen immediately, but it is a concern for anyone who has missing teeth. Tooth loss can actually change your facial structure.
Dental implants are tooth replacement solutions that can actually protect your dental health by simulating your natural tooth and tooth root structure.
A dental implant is a manufactured post that is designed to create a stable foundation for a natural looking tooth restoration. Placed directly into the jawbone, a dental implant is the closest thing to your natural tooth.
The base of the dental implant (the post) serves as a substitute for the missing tooth root structure. Dental implant patients can be secure in the knowledge that their dental health is safe.
Dental implants are very strong because of the method of placement. There is no problem with slippage, which means that you can eat and speak with comfort and confidence. Looking at a smile with dental implants is like looking at a smile with natural teeth.
A dental implant is a restorative procedure that attaches artificial teeth to anchors that are surgically embedded in the bone. Dental implants can replace one or more teeth provide support for a partial denture, increase support and stability for a full lower denture and increase patient comfort and confidence.
Implant procedures are complex and may take up to 9 months to complete. There is some degree of risk as with any type of surgical procedure and this type of treatment will not be recommended to everyone. A good candidate for implant procedure would be one who has adequate bone structure and does not have a serious medical condition. The financial investment is greater than that for other types of restorative procedures such as bridges.
During the first stage of treatment the surgical site will be prepared. An implant cylinder is inserted into the receptor site. A sterile surgical screw is placed within the receptor. The screw is often made from titanium because it is very compatible with bone and oral tissues. The soft tissue is closed and the surgical site is allowed to heal for 10-14 days. It may take as long as 3 to 6 months for the bone to heal or integrate with the implant.
After the tissues and bone have completely healed, the second stage of the procedure consists of removing the soft tissue from the surrounding area and uncovering the sealing screw. An attachment post is screwed into the implant that now extends above the gum line. The soft tissues are again allowed to heal for 10-14 days during which time the dental prosthesis is being made. On the final appointment the dental prosthesis will be attached to the posts resulting in a strong permanent restoration that is aesthetically pleasing as well as functional.
A patient who is considering dental implant procedure should gather as much information as possible before treatment is commenced. The patient should have a realistic and informed opinion of what the expected results will be.
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VENEERS
A veneer is a layer of tooth coloured material, usually porcelain, which is cemented to the facial surface of the tooth. Veneers are also used to improve the appearance of teeth, particularly if they are discoloured; eroded or surface abrasions are evident. A veneer may be placed on one or more anterior teeth to improve the colour of the teeth or perhaps to close in a large gap between teeth. This procedure is much less invasive than a full coverage restoration and it preserves the natural structure of the tooth.
If a veneer becomes chipped or discoloured it can easily be replaced. A patient should avoid biting on hard substances such as ice, bones, and hard vegetables that could fracture the veneer. The result of cosmetically bonded veneers is aesthetically pleasing and there is no discomfort during the procedure.
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CROWNS
A crown (sometimes referred to as a cap) is a full coverage restoration that restores the anatomical surfaces of a damaged or fractured tooth to their original contour and function. The anatomical surfaces are the parts of the tooth that you can see above the gum line. Typically, this type of restoration is recommended when there is very little tooth structure left to restore. The retention of filling material is poor without adequate surface to which the material will adhere. This results in the tooth requiring both constant and frequent repair.
A crown is permanently cemented onto the prepared tooth structure. This type of restorative procedure is often a dentist’s treatment of choice because of the excellent clinical results achieved in creating a strong, permanent restoration. The aesthetic quality of these restorations enhances the overall appearance of the smile, one of our most important communicative features.
The two types of crowns that are commonly used are:
1. Porcelain fused to metal - This type of crown is often used on posterior teeth due to the strength that the semi-precious metal can provide during chewing. The veneer or facing of the tooth consists of porcelain that gives the restoration a natural looking quality.
2. Porcelain crown - This is a very thin shell covered by layers of porcelain to resemble the shading and translucency of a natural tooth. This restoration is often recommended for anterior teeth.
A patient will benefit from this procedure by having a permanently restored, functional and aesthetically pleasing tooth that blends in with the remainder of your natural teeth.
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BRIDGES
Every tooth in your mouth provides support, structure and function to the jaw. Absence of even a single tooth can cause the adjacent teeth to drift into the position of the missing tooth. Sometimes only the roots will drift causing pressure on neighbouring teeth and reducing the support of other teeth. This drifting is only evident on a dental x-ray.
A bridge is a dental prosthesis that is used to replace one or more missing teeth in the same arch. A bridge is permanently cemented into the mouth; therefore, you cannot remove it. It provides solid support to the structure of the jaw and prevents adjacent teeth from shifting.
Although a partial removal denture can also replace a missing tooth, it can compromise the health of the underlying gum tissue and cause bone loss. A permanently cemented fixed bridge will provide support to the jaw and protect the integrity of the gums. You will benefit by enjoying a permanently restored, functional and aesthetically pleasing bridge that replaces the missing tooth or teeth within the dental arch. You will never have to be concerned with ill-fitting partial dentures again.
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DENTURES
A denture is a removable, artificial replacement for all of your missing teeth in one arch. It is made of acrylic with plastic or porcelain teeth attached to it. A complete denture will replace missing teeth in either the upper or lower arch, or the entire mouth. A partial denture is a removable appliance that replaces some missing teeth. It stays in place by attachments to the remaining teeth.
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INLAYS/ONLAYS
Inlays and onlays are a natural looking alternative to silver fillings. Usually made from porcelain, they are formed to fit and fill most types of cavities and are almost impossible to distinguish from the natural tooth. They are custom designed, using a precise replica of your tooth. So only the damaged portion of your tooth needs to be removed unlike silver fillings, which require the removal of large amounts of healthy tooth. Inlay and onlay treatment will take a few appointments to complete. With regular brushing and flossing, they will last up to fifteen years.
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COMPOSITE RESIN FILLINGS (WHITE FILLINGS)
Composite restorations have a natural, tooth-like appearance and are used primarily on anterior teeth, although many patients now prefer to have composite fillings placed on posterior teeth. A major advantage of this type of restoration is that they match the tooth colour and are aesthetically pleasing. Composites are made of a mixture of plastic and acrylic materials such as polymer matrix, quartz and lithium aluminium silicate. Polymerisation is a process in which a resin material changes from a plastic state into a hardened restoration. They are also capable of bonding directly to the tooth structure reducing the possibility of leakage.
The length of time that it takes to perform a composite resin restoration depends on the size of the restoration. Some restorations will only involve one surface and may not require anaesthetic, so the appointment may only take 10 to 15 minutes. When the procedure involves more surfaces of the tooth, the procedure may take longer. A composite resin restoration will restore the tooth to its original function with an aesthetically pleasing result.
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SILVER (AMALGAM) FILLINGS
Amalgams are commonly known as silver fillings. They do contain some silver; however, they are a mixture (or alloy) of metals that are bound together, or in other words, amalgamated. Traditional amalgam fillings were bound together by using mercury; however, many of the newer amalgam materials do not use mercury. Amalgam fillings have been used for many years and are often the preferred treatment for posterior fillings.
The average biting force in the posterior jaw is approximately 170 lb. of pressure. A dental restoration must be able to withstand such forces. Amalgam fillings do not change easily under stress and are soft, pliable and easily shaped into the prepared cavity. The amalgam then hardens quickly to form a very strong dental restoration able to endure the stress associated with chewing and biting. With specialised dental bonding systems, it is possible to create a bond between the amalgam and the tooth structure. This reduces the possibility of leakage or recurrent decay forming beneath the restoration.
Metals, as those used in amalgam restorations, are excellent thermal conductors. They rapidly transmit heat and cold through the tooth. Amalgam fillings help to protect the pulp against sudden temperature changes. The retention of this type of dental restoration is excellent and can last many years within the mouth.
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ROOT CANAL TREATMENT
Root canal treatment can provide an effective means of saving a tooth that might otherwise require removal. The presence of the teeth and their root structures helps to maintain the overall structure of the jaw. Root canal treatment may be recommended if the pulp of the tooth becomes dead (non-vital). The pulp is the main source of blood supply to the tooth and it receives its nourishment from vessels that pass through the roots of the tooth (root canals). If the pulp becomes non-vital, if there is irreversible inflammation present or if the tooth has suffered trauma through an injury, root canal treatment may be warranted. A tooth that is abscessed will show a localised pus formation at the root end of the tooth. If the abscess is left untreated you may experience severe discomfort and the infection could spread to the surrounding bone.
Root canal treatment may not be recommended if the tooth has a poor prognosis (can not be saved) or if the inflammation is reversible. A pre-existing health condition may also affect the decision as to whether or not the client should undergo root canal treatment. Your dentist will discuss all available treatment options.
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PERIODONTAL (GUM) DISEASE
Periodontal disease is caused by plaque that forms on teeth. Plaque will irritate gums, causing them to become red, tender, and swollen. If not removed, plaque hardens to form tartar. Over time, the tissue that attaches the gums to the teeth is destroyed and the gums pull away form the teeth. Small pockets form between the teeth and gums and fill with more plaque. Eventually, the jawbone supporting the teeth is destroyed. Periodontal disease is usually painless so most adults are unaware they have it. But if you are diagnosed early, your teeth can be saved.
Other causes of periodontal disease are smoking, excessive consumption of alcohol, improper use of dental floss and toothpicks, an unbalanced diet, vitamin C deficiency, pregnancy and certain medications. Warning signs to look out for are gums that bleed when you brush your teeth, red, swollen or receding gums, and pus between teeth, loose teeth, bad breath, and a change in your bite or the way your dentures fit.
The type of treatment required depends on the stage of the disease. In the early stages your dentist will recommend professional cleaning followed by daily brushing and flossing. When gum disease is more serious, your dentist may have to remove the infected gum tissue. Surgery can sometimes involve reshaping the bone around the tooth or removing a portion of the bone. In the most serious cases, you may loose a tooth. Your dentist will advise you on the best way to replace it.
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BAD BREATH (HALITOSIS)
There are many reasons for bad breath. Plaque and food particles on the teeth are the most common. Practising good oral hygiene will usually help. And this doesn’t mean just brushing your teeth. It’s important to brush your tongue, cheeks and roof of your mouth. Decay-causing bacteria from food particles can develop on these areas, triggering bad breath. So, even though your teeth are cleans, harmful germs can remain in your mouth. If good oral hygiene is not practised, this could lead to another common cause of bad breath, gum disease. Your dentist will check for these signs during your visits. Your diet, prescription drugs and systemic diseases and illness such as respiratory problems and diabetes can also be at fault. So don’t be embarrassed, talk to your dentist who can probably help.
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TOOTH SENSITIVITY (DENTIN HYPERSENSITIVITY)
More than 7 million Canadians suffer from tooth sensitivity. Enamel that covers the top of your tooth, protecting the root, can wear down from brushing too hard, gum disease, tooth grinding and aging. Your dentist may suggest using desensitizing toothpaste, a soft bristle toothbrush using gentle strokes or an application of resin coating, which will seal the sensitive areas. Sometimes root canal treatment may be required to remove the infected nerve. Tooth sensitivity is often an early sing of minor or major dental problems so it’s important to ask your dentist what the most appropriate treatment would be.
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TMJ DISORDERS (TEMPOROMANDIBULAR JOINTS)
Temporomandibular joints are the muscles and jaw joints used to open and close your mouth. TMJ disorders can be caused by injury to the face and jaw regions, bite problems, grinding teeth, clenching your jaw, whiplash, and even poor posture resulting in damage to the joints or misalignment. Facial, tooth and earaches as well as “clicking” in the jaw, headaches, neck shoulder and back pain can occur. Systemic disease such as rheumatoid arthritis, which affects the joints of the body, can also affect your jaw joint, causing degeneration. Forms or treatment include physical therapy, anti-inflammatory medication, and bite guards. In more serious cases, were severe pain is persistent, surgery may be necessary.
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ORTHODONTICS
Closing spaces and straightening teeth can improve your self -image and self-confidence, no matter how old you are. An orthodontist will analyse your mouth and surrounding bone structures to determine where the teeth should be. If there is enough room, your dentist will manipulate the teeth and bone through the use of bands wires, elastics, headgear and other appliances to achieve a harmonious balance between facial muscles and teeth. If there is not enough room, teeth may have to be removed to achieve the desired results.
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X-RAY SAFETY
Dental x-rays (radiographs) are valuable diagnostic tools for the dentist. The primary reason for taking x-rays is to provide a method of detecting decay that is not visible to the naked eye. When decay is identified early, it is often easier to treat and less uncomfortable for the patient. A dentist will also use x-rays to spot changes in the supporting structures of the jaw, including the hard and soft tissues.
When a patient first visits the Dentist, he/she may choose to take a full mouth series of x-rays. The Healing Arts Radiation Protection Commission must approve all dental office personnel, who take x-rays. They are useful diagnostic tools that provide the dentist with a method of visualising the decay, or other types of dental pathology, that cannot be seen.
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BRUXISM (GRINDING OF TEETH)
Bruxism was usually attributed to stress, but authorities today believe the cause may be an unconscious effort to correct irregularities of the chewing surface of the teeth. About 1 in 20 adults and 3 in 20 children unconsciously grind their teeth at night. This is called malocclusion. If you grind your teeth, you can exert thousands of pounds of pressure per square inch on the surface of teeth, which can cause headaches, affect supporting bone, gums and the jaw joint. To correct this, your dentist may fit you with a plastic night guard to help prevent further damage.
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ANESTHETICS, ANALGESICS & SEDATION
Local Anaesthetic
Anaesthetics reduce or eliminate discomfort. Anaesthesia works to numb the area where your dentist is working. A local anaesthetic will temporarily block the generation and conduction of nerve impulses. This is commonly called freezing. An anaesthetic solution is injected into the area surrounding the nerve which blocks the action of the nerve. The action of the blood stream will eventually carry the solution away. There will be a sensation of warm water flowing to the area as the anaesthetic is reversing.
The most common type of local anaesthesia is Lidocaine mixed with a percentage of epinephrine (adrenaline). Epinephrine constricts the blood vessels causing the heart rate to increase and blood pressure to rise. If the dental patient has a history of high blood pressure or a serious heart condition, the dentist may use an anaesthetic that does not contain epinephrine. If is very important to provide your dentist with a complete and up-to-date medical history.
General Anaesthetic
General anaesthetic will render a patient unconscious during the procedure. This type of anaesthetic may be used for the removal of wisdom teeth or other more extensive surgical procedures. General anaesthetics may be administered only by qualified professionals with training in anaesthesiology. A preoperative physical examination may be necessary and postoperative visits during the recovery stage. It is important to know that the patient should not have anything to eat or drink at least 8 hours prior to the procedure. He/she can brush their teeth in the morning, but they need to spit out the water after rinsing. The patient may become nauseated during the procedure and there is a risk of aspiration during the anaesthetic. The vital signs will be monitored before, during and after the procedure. The recovering patient should not walk alone or drive an automobile. He/she should be accompanied to and from their appointment. Any unusual side effects need to be reported to the dentist immediately.
Analgesics and Sedation
Dentistry today is virtually pain free, however, client comfort in a dental office is provided by using various methods of pain control. Analgesics are drugs that dull the perception of pain. They are available in non-narcotic and narcotic forms. Commonly used analgesics are aspirin and ibuprofen. Along with relieving pain, these analgesics contain anti-inflammatory properties that will reduce swelling and help eliminate fever. Mild non-narcotic medications are used to relieve low intensity discomfort. If you are experiencing more than moderate pain, your dentist may prescribe a stronger analgesic that may contain a narcotic such as codeine. These are combination drugs like Tylenol #3 which is a mixture of acetaminophen and codeine. Occasionally a dentist may prescribe analgesics that have a longer lasting effect like Percodan or Demerol. Since these drugs carry a potential for addiction, the dentist will prescribe them in limited amounts and only in extreme circumstances.
Sedatives are sometimes used to relieve a patient’s anxiety. Sedatives can be administered orally, by injection or inhalation. Conscious sedation reduces the patient’s level of consciousness. Nitrous oxide (laughing gas) or Valium is a form of conscious sedation. Nitrous oxide and oxygen are inhaled by the patient through a face mask or nasal prong. The patient will become very relaxed yet remain conscious and there are usually no side effects. You will become very relaxed yet remain conscious. This type of sedation may be recommended for patients who have a high perception of pain sensitivity or if they have a sensitive gag reflex. This treatment is not recommended for a patient who has a respiratory condition, is a young child, has multiple sclerosis or is emotionally unstable.
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PREMEDICATIONS
If you have had a health problem that creates a risk to you during treatment your dentist may prescribe premedication. If you have a history of cardiac problems, it is likely that the dentist will prescribe a course of antibiotics to be administered before your appointment. This is to protect you, and your heart, from unnecessary bacteria entering the blood stream during the dental procedure. If you have any health problems that make dental procedures uncomfortable, such as asthma or anxiety, please inform your dentist and he/she will ensure that your visit is made as comfortable as possible while protecting your health. Your dentist may wish to consult with your family physician or specialist prior to beginning treatment. If there has been any significant change in your medical history since your last dental visit, it is important to notify your dentist. Your dentist’s goal is to protect your general health and offer you the best possible care that is specifically designed for you. That is why we will ask you for a complete confidential medical history to ensure that we have a thorough understanding of your health care needs.
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POST-OPERATIVE CARE (HOME CARE)
At the conclusion of your appointment, the dentist will provide you with post-operative care instructions. To maintain the integrity of the treatment that you receive, it is helpful to follow the instructions provided and if you have any concerns, do not hesitate to call the office. If you have had an extraction or any surgical procedure, it is important to remember to avoid foods that are too hot or difficult to eat. Do not drink out of a straw and avoid smoking. The tissues in the mouth tend to heal rapidly so the period of post-operative care will not be too long.
Home care instructions will include how to brush and floss effectively to encourage rapid healing and promote long term optimal health.
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TOOTHBRUSH TIPS
• A worn out brush is less effective removing plaque and it may harbour bacteria. Remember to replace your brush every 3 months.
• Use a brush with soft round-ended bristles. Bristles that are too hard, worn or frayed, can damage teeth.
• Spend a minimum of 2 to 3 minutes brushing your teeth, twice a day. Most people only spend about 45 second. Be gentle and hold the brush at a 45-degree angle to the gumline.
• Try to choose a toothbrush with the Canadian Dental Association Seal of Approval.
• Electric toothbrushes are helpful for patients who do not have complete manual dexterity. There are a number of useful brushes on the market that will stimulate the gums while they cleanse the tooth surfaces.
• A complete home care regimen must include flossing. Using dental floss once daily is the only way to clean plaque from the surfaces between the teeth.
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DENTAL CARE FOR CHILDREN
PRENATAL CARE FOR EXPECTANT MOTHERS
The earliest stages of dental development are found when the embryo is approximately 5 to 6 weeks old. Development of the primary teeth begins at this time. At birth there are normally 44 tooth buds present in various stages of development. Enamel formation is well under way on the primary teeth (also known as baby teeth).
Prior to birth, the mother’s body provides nutrition to the developing child. Good nutrition before pregnancy helps carry the mother and child through the first few weeks of development, which are critical. Hormonal changes can cause pregnancy gingivitis (inflammation of the gums). Maintenance of good oral hygiene and removal of any irritants helps to reduce the inflammation.
During pregnancy, fever and illness can leave marks on the developing teeth. Antibiotics, particularly tetracycline, taken during pregnancy may cause yellow-brownish stain on the primary enamel. The staining does not usually affect the integrity of the teeth and can often be treated cosmetically later in life.
Pregnancy can cause changes in the mucous of the mouth that may be a concern. Good oral hygiene and proper nutrition is essential to keep the mother and child healthy. As a precaution, dental x-rays should be avoided during pregnancy. If an x-ray can not be avoided the mother will be protected with a lead apron with an attached thyroid collar.
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YOUR CHILD’S FIRST VISIT
Your child will have all of his/her primary teeth by the time that they are 2 years of age. At this age, however, your child is in the pre-co-operative stage and too young to form a friendship with the dental caregiver. Your child is not yet sufficiently co-ordinated to obey such commands as “open your mouth.” At this age, however, you may wish to make an introductory visit to the dental office before treatment begins.
Your child’s first dental visit should occur at approximately 3 years of age. A 3-year-old is usually more co-operative and able to comprehend and obey commands. The first visit usually consists of a ride in the chair and a thorough examination. The dentist may choose to take x-rays to determine the development of the teeth and introduce the child to the dental equipment so it will be less intimidating.
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NURSING BOTTLE SYNDROME
Cavities can occur in very young children who routinely fall asleep while nursing on a bottle. The sugar in the nursing bottle (cow’s milk, juice, formula or sugary drinks) turns to acid, dissolving tooth enamel. Breast-fed babies are also susceptible if they constantly fall asleep with breast milk on their teeth. Early signs include white spots and tooth discoloration. Damage to primary (baby) teeth can jeopardise the development and proper eruption of the permanent teeth. You can protect your child by not letting your baby go to bed with a bottle unless it contains clear water. Clean your baby’s mouth regularly and don’t dip pacifiers in honey or other sweet ingredients.
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BRUSHING YOUR CHILD’S TEETH
A newborn’s gums should be massaged daily with clean, moistened gauze. When the teeth begin to show in the oral cavity a very small soft bristled brush should be used without toothpaste until the child is approximately 18 months of age. When the child is ready for toothpaste, only a tiny drop should be placed on the brush. Children have a tendency to swallow toothpaste and fluoride may be ingested in excessive quantities. Although fluoride is effective in preventing cavities, it is a toxic substance and should not be ingested. The child should be encouraged to spit out the excess and rinse their mouth with clear water.
Remember to change your child’s toothbrush every 3 months. Make sure the head of the brush fits the child’s mouth. A good way to measure is to place the head of the brush behind the lower teeth. Use light pressure with a soft bristle brush. Brushing should take approximately 3 – 4 minutes. Make tooth brushing an enjoyable activity for the child and they will want to repeat the behaviour.
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FLUORIDE
Fluoride absorbs into the enamel of the teeth making them more resistant to acid producing bacteria. It is available in various flavours and can be applied to the teeth either with a fluoride tray that gently rests in the mouth for 4 minutes or the hygienist can apply fluoride by painting it on the teeth, if the child is less co-operative.
Fluoride is also present in the drinking water of many cities across North America. Ensuring your child uses fluoride toothpaste and receives fluoride treatments will help to develop and maintain healthy teeth and bones.
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NUTRITION
Good dental health depends on an adequate supply of nutrients that are properly used by the body. The bacteria in plaque use simple sugars as their food and reacts within the mouth by producing an enzyme (or acid) that will affect the enamel of teeth.
The types of foods that cause tooth decay contains refined sugars such as are found in candy, soft drinks, and crackers. Refined sugars stay in the mouth often long enough to react to the bacteria in plaque. Natural sugars are found in fruits and vegetables but they usually clear the mouth rapidly before the sugar is converted. Dried fruits, such as raisins, contained a concentrated form of natural sugar that sticks to the teeth. If raisins are ingested with nuts or grains as in cereal, the stickiness is generally washed away from the teeth.
The child rinsing their mouth with clear water, whether they are in the form of vitamins or analgesics, should always follow children’s chewable. Aspirin and vitamin C both have an acid base and are mixed with sugar to make it more palatable for the child.
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SEALANTS (PIT & FISSURE)
The placement of pit and fissure sealants on the first set of permanent molars is an important part of a total hygiene care program for maximum protection against tooth decay. The pits of the teeth are the deep grooves on the chewing surface of the tooth and the fissures are channels that extend down the sides of the teeth, facing the cheek or tongue. This type of dental treatment is recommended for primary or permanent teeth that contain deep, narrow pits on the chewing surfaces. These pits are traps for bacteria, which will lead to decay. It is difficult, and often impossible, to reach these areas with a toothbrush during normal cleansing.
Pit and fissure sealants are of greatest benefit to children, especially when the first sets of permanent molars erupt into the dentition between the ages of 6 and 13. These are generally considered the cavity prone years. The sealant material is made of a type of liquid plastic that bond directly to the prepared tooth surface.
Sealants can be white, clear or opaque in colour and feel smooth when touched. There are no toxic effects from the use of chemical sealants and the application is painless.
Properly sealed teeth should retain their sealant material for 6-7 years or longer. During every 6 month continuing care appointment, the dentist or hygienist will re-examine the sealant to ensure that it remains in place to continue the protection. Research has shown that the placement of pit and fissure sealants has dramatically reduced the incidence of dental decay in children during their cavity prone years. They also reduce the need for more complex and costly procedures being required that could compromise the structure and integrity of the tooth.
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ATHLETIC MOUTHGUARDS
If your child is involved in sports, it is recommended that he/she wear a protective mouth guard to prevent traumatic injuries to the teeth. Athletic mouth guards are custom fitted and easily fabricated at the dental office. Talk to your dentist before involving your child in a sports activity that could increase the risk of injury.
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THUMBSUCKING
Thumb sucking can have a damaging effect on the growth of the jaw, the facial contour and even speech. It causes improper alignment of the jaw, which can be serious. Often this oral habit will disappear, but if it doesn’t and it extends beyond 4 -years of age, corrective action should be taken. It is important to encourage your child to end the habit without causing embarrassment or shame. You should ask your dentist to speak to your child while you are not present. Often children will listen to an adult whom they are less familiar with. If the child continues the habit a habit-correction appliance can be inserted in the child’s mouth as a reminder to keep the thumb out.
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DENTAL EMERGENCIES
Dental emergencies are not usually life threatening, however, a visit to the dentist will provide comfort and restore function as soon as possible. The following represents some guidelines to understand whether a dental condition is an emergency. All dental emergencies are attended to immediately. Some symptoms may be less severe and considered urgent. What this means is that, although it is important to see a dentist as soon as possible, it is not considered an emergency.
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WHEN TO CALL THE DENTIST
| Dull, continuous ache |
Non-emergency |
Schedule an appointment at your earliest convenience. |
| Sudden, severe discomfort, accompanied by swelling |
It could be an emergency |
Apply a cold compress and see your dentist immediately. |
| Abscessed tooth |
Emergency |
An abscess is a localised pus formation usually located at the root end of the tooth. If the condition is acute and there is infection present the dentist will likely prescribe antibiotics and analgesics before attempting to perform root canal therapy. |
| Knocked out tooth |
It is an emergency |
Control the bleeding by applying direct pressure with a cold compress. Do not remove or be alarmed, as there may be extensive bleeding. Transport the tooth wrapped in a wet cloth or a glass of milk. Do not rinse the tooth. |
| Broken tooth |
Emergency |
Depending on the severity of the fracture it could cause an infection which is much more difficult to treat. |
| Extruded Tooth |
Emergency |
Don’t try to force the tooth back into its socket. Gently reposition the tooth to its normal alignment. Hold the tooth in place with gauze or a tissue. You must see your dentist immediately. |
| Facial fracture |
Emergency |
Make sure the airway is open and transport the victim to medical aid as soon as possible, either a hospital emergency room or call 911. |
| Sensitivity to cold |
Non-emergency |
Your tooth could be sensitive for a number of reasons. Never apply aspirin or heat to the tooth. Call the dentist and arrange an appointment as soon as possible. |
| Sensitivity to heat |
Urgency |
Sensitivity to heat can indicate that infection is present. See your dentist as soon as possible. If swelling and/or fever are present, consider it to be an emergency. An abscess could be forming. |
| Broken Braces and Wires |
Urgency |
If the broken appliance can be removed easily, take it out carefully. If not, cover the sharp or protruding portion with gauze, cotton balls or even chewing gum. Do not remove this and see your dentist immediately. |
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