All of us at Soho Dental wish you and your families a happy holiday season and may the New Year bring with it health, happiness, comfort and peace!
Downtown Toronto Dentist | Toronto Dentistry | Soho Dental
Contact : 416-340-SOHO (7646)
All of us at Soho Dental wish you and your families a happy holiday season and may the New Year bring with it health, happiness, comfort and peace!
Erosion is the loss of tooth enamel caused by acid attack. Enamel is the hard, protective coating of the tooth, which protects the sensitive dentine underneath. When the enamel is worn away, the dentine underneath is exposed, which may lead to pain and sensitivity.
Erosion usually shows up as hollows in the teeth and a general wearing away of the tooth surface and biting edges. This can expose the dentine underneath, which is a darker, yellower colour than the enamel. Because the dentine is sensitive, your teeth can also be more sensitive to heat and cold, or acidic foods and drinks.
Every time you eat or drink anything acidic, the enamel on your teeth becomes softer for a short while, and loses some of its mineral content. Your saliva will slowly cancel out this acidity in your mouth and get it back to its natural balance. However, if this acid attack happens too often, your mouth does not have a chance to repair itself and tiny bits of enamel can be brushed away. Over time, you start to lose the surface of your teeth.
Bulimia is a condition where patients make themselves sick so that they lose weight. Because there are high levels of acid in the vomit, this can cause damage to tooth enamel.
Acids produced by the stomach can come up into the mouth (this is called gastro-oesophageal reflux). People suffering from hiatus hernia or oesophageal problems, or who drink too much alcohol, may also find they suffer from dental erosion due to vomiting.
Acidic foods and drinks can cause erosion. Acidity is measured by its ‘pH value’, and anything that has a pH value lower than 5.5 is more acidic and can harm your teeth.
Fizzy drinks, sodas, pops and carbonated drinks can cause erosion. It is important to remember that even the ‘diet’ brands are still harmful. Even flavoured fizzy waters can have an effect if drunk in large amounts, as they contain weak acids which can harm your teeth.
Acidic foods and drinks such as fruit and fruit juices – particularly citrus ones including lemon and orange – contain natural acids which can be harmful to your teeth, especially if you have a lot of them often.
‘Alcopops’, ‘coolers’ and ‘designer drinks’ that contain acidic fruits and are fizzy can cause erosion too.
Plain, still water is the best drink for teeth. Milk is also good because it helps to cancel out the acids in your mouth.
There are a number of things you can do:
As well as using a fluoride toothpaste, your dental team may suggest you use a fluoride-containing mouthwash and have a fluoride varnish applied at least every six months. They may also prescribe a toothpaste with more fluoride in it.
Dental erosion does not always need to be treated. With regular check-ups and advice your dental team can prevent the problem getting any worse and the erosion going any further. If a tooth does need treatment, it is important to protect the enamel and the dentine underneath to prevent sensitivity. Usually, simply bonding a filling onto the tooth will be enough to repair it. However, in more severe cases the dentist may need to fit a veneer.
Costs will vary, depending on the type of treatment you need.
It is important to talk about all the treatment options with your dental team and get a written estimate of the cost before starting treatment.
Content originally appeared at: https://www.dentalhealth.org
Can decayed young teeth be saved with stem cells? Dr. Renato Silva thinks so.
When decay penetrates the nerve space in an adult’s permanent tooth—known as dental pulp—a root canal is the best solution. A dentist removes the nerve and pulp, and then cleans and seals the inside of the tooth.
But when that same problem occurs in a child or young adult, a root canal becomes much trickier, because the root of the tooth may not be fully formed. Dentists might try to clean and fill the root canal, or they might pull the tooth and replace it with an implant when the patient is older.
“We see a lot of kids come into our endodontic clinic and pediatric clinics with dental problems,” said Silva, D.D.S., Ph.D., associate professor and chair of the department of endodontics at The University of Texas Health Science Center at Houston (UTHealth). Factors that contribute to decay include not brushing and/or flossing, diet, saliva composition and genetics.
Depending on the age of the child, a permanent tooth will come in, but the root may take a few years to develop, said Ariadne Letre, D.D.S., Ph.D., director of research in the department of endodontics at UTHealth’s School of Dentistry and a member of Silva’s team.
Rather than choosing a root canal treatment or tooth extraction for young permanent teeth, Silva believes he can use stem cells to replace the damaged tissue with healthy tissue and promote root formation.
His research is in the preclinical stage, but results so far have been promising.
A microscopic image of tissue invagination into the tooth after 45 days of implantation.
Dental pulp is a complex bundle of tissue, blood vessels and nerves. The tissue dies when it is contaminated by bacteria. During a root canal, a dentist will dig out that contaminated tissue and replace it with an artificial material, Silva said, because you can’t leave an open space for bacteria to continue to grow. Even so, root canal therapy treated teeth are destined to be brittle and devitalized.
But what if there was a way to revitalize the tissue and make the tooth healthy again?
While pondering ways to promote root formation, Silva and his team came up with the idea of using stem cells retrieved from the root area deep inside the tooth called the apical papilla. Since they also needed some sort of scaffold for the cells, they devised one made of a polymer fiber impregnated with a protein called vascular endothelial growth factor (VEGF), to stimulate the growth of new blood vessels that would help with tissue and pulp regeneration.
“These stem cells of the apical papilla can turn into any type of tissue, and in our case, we need root and pulp tissue, so we thought, ‘Why not?’” Silva said.
After removing the decay from the tooth and cleaning out the root canal, Silva and his team fill in the area with stem cells and the VEGF scaffold, which will regenerate the pulp tissue, he said.
The stem cells come from extracting the third molar of the child—known as the “wisdom” tooth. Silva and his team collect the cells attached to the bottom of the tooth crown, isolate the stem cells and then use them in the decayed tooth.
Because the use of stem cells for dental treatment in humans is not yet approved in the United States, Silva and his team have been researching their theory on mice. After putting the stem cells inside the tooth, they implant the teeth on the back of mice to evaluate new tissue formation. The result has shown that the tissue and blood vessels from the mouse go inside the root and fill in the empty space, mimicking the original dental pulp tissue.
Once the use of stem cells is approved for this use, Silva and his team will move forward with isolating the stem cells of the apical papilla from third molars to deliver into the decayed tooth of the same patient.
“I believe our results are promising in light of future patient-centered approaches toward pulp and dentin regeneration therapies,” Silva said.
Article originally posted at: http://www.tmc.edu
Oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea (OSA). A custom-fit oral sleep appliance can improve your sleep, restore your alertness and revitalize your health. Here is a guide to help you get started with this life-changing treatment.
Worn only during sleep, an oral appliance fits like a sports mouth guard or an orthodontic retainer. It supports the jaw in a forward position to help maintain an open upper airway. Research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea.
If you and your doctor decide that oral appliance therapy is the best treatment option for you, then your doctor will write a prescription for you to receive a custom-made oral appliance. You also will receive a referral to a qualified dentist who can provide oral appliance therapy. More than 100 oral appliances have received FDA clearance. Your dentist will recommend the oral appliance that is best for you. Oral appliance therapy is covered by many medical insurance plans.
Oral appliance therapy is an effective, non-invasive treatment that fits easily into your lifestyle. Patients like oral appliance therapy because it is:
Dentists work closely with physicians to treat snoring and sleep apnea. At your first visit, your dentist will talk to you about the benefits of treatment. You also will receive information on the potential side effects and the cost of therapy.
Then your dentist will conduct a complete clinical evaluation. This will include an examination of your teeth, jaw, tongue and airway, and possibly a new X-ray of your mouth.
Oral appliances are customized using digital or physical impressions and models of your teeth. These models are sent to a dental lab where the appliance is made.
Once your oral appliance is ready, you will return to your dentist’s office for a fitting. Your dentist will adjust the appliance to maximize its comfort and effectiveness. You also will learn how to clean the oral appliance and maintain it. After this fitting, your sleep doctor may schedule you for a sleep study to verify treatment success.
Follow-up visits with your dentist will be needed to ensure the optimal fit of the oral appliance. Effective oral appliances are always custom fit and adjusted over time to ensure maximum effectiveness. Your dentist also will schedule you for an annual assessment. These routine visits are an important part of your long-term treatment success.
Treating snoring or obstructive sleep apnea with oral appliance therapy can help you feel like a new person. You will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use it nightly. It is likely that you will sleep better, have more energy and feel sharper throughout the day. You may find that your bed partner begins to sleep better, too!
Treating sleep apnea promotes a healthier heart, body and mind. With your dentist’s help, you can improve your sleep and your health!
Article originally appeared at: http://www.aadsm.org/
At Soho Dental, we take the sterilization of our surgical instruments very seriously.
The pictures above show what your instruments look like before your appointment at Soho Dental. All our instruments are thoroughly cleaned, placed in cassettes, wrapped and then autoclaved. The process of autoclaving sterilizes the instruments using high heat, saturated steam and pressure. Most importantly, your instruments remained sealed in the wrapping until they are ready to be used. Just before your appointment, the packages are opened as the room is prepared for your treatment.
Regular testing of the sterilizer is done to ensure instruments are in fact being sterilized and that all infectious organisms are killed. With these testing procedures we can be confident that the instruments have been completely cleaned and sterilized.
A number of items in the dental office are used on patients only once and then discarded. Disposable items include gloves, needles and syringes, protective coverings for instrument trays, and certain instruments that cannot withstand the sterilization process. Discarded needles are placed in a designated container to prevent needle-stick injuries, not in the regular waste collection. Dentists are especially concerned about needle injuries and the risk of infection they pose, so they are handled very carefully.
The area in which your treatment occurs is cleaned and disinfected after each patient, and/or disposable covers are used to protect surfaces for contamination. These covers are replaced after treating each patient.
The above highlight only a few of our infection control measures. If you have any questions regarding our sterilization procedures, please do not hesitate to ask. We would be more than happy to answer any of your questions!
This week I have been away from the office to complete a course presented by the world renowned Dr Dider Dietschi from Geneva Switzerland. The title of the course was “Excellence and Innovations in Composites: Direct Anterior Techniques and the “No-Prep” Ultra-Conservative Treatment of Tooth Wear”
Dr Dietschi is an advocate of conservative treatments for extensive and complex dental problems like tooth wear. The knowledge and skills that he has shared will enhance my ability to provide complete dental care with primary concentrations in dental occlusion, the temporomandibular joints and comprehensive esthetic restorative dentistry.
This was a wonderful journey in which I was able to meet and learn from a true master, who is a meticulous dentist and great teacher. I made new friends from around the world including Denmark, Kuwait, Lithuania as well as other fellow Canadians. It was such a joy to meet like- minded dentists who are committed to providing their patients with the very best in dental care!
-Dr Feisel Haji
Many patients are surprised to know that they can get a new cavity underneath a previous placed filling. This can occur for a number of reasons. It is very important to have your fillings checked regularly so that these cavities can be repaired before the tooth needs more extensive treatment.
The decay has been removed. The picture shows healthy dentin free of bacteria.
A new filling has been placed which is nicely sealed and integrated to the surrounding enamel. Notice the natural contours and tooth anatomy which allow cleaning with floss and proper function with the opposing tooth.
The materials that we have at our disposal in dentistry today are highly esthetic such that it is often difficult to distinguish between natural tooth structure and dental ceramics.
The patient in the photo had two old crowns on the upper front teeth that looked unnatural. The two teeth on either side of the crowns were grey from trauma and previous root canal treatment.
We replaced the two front crowns in addition to crowning the side teeth to improve the overall esthetics and her smile. Notice how the new crowns are natural looking in terms of colour and contour.
In a nutshell, cleaning around implants differs from maintenance of natural teeth for two reasons: The first is that each attaches to surrounding bone and gums in a very different way; secondly, the materials from which implants are made are very different from natural teeth.
Dental implants replace the root parts of the teeth. Artificial crowns, bridgework or removable dentures — tooth replacements that make up the visible (crown) part/s of teeth — are attached to the implants. In between the implant and the crown of a tooth there is often a connector known as an abutment. The success of the whole system is based on the implant’s attachment to bone. Titanium, the metal of which implants are made, is uniquely osteophilic — literally “bone-loving.” It fuses to bone in a process called osseointegration (“osseo” – bone; “integration” – fusion or joining).
Above the bone where the integration process ends, the abutment comes in contact with the gum tissue where it is supported by a connective (i.e. “connecting”) tissue composed of fibers made of a tough material called collagen. The fibers run beneath the surface parallel to the implant ending at the top of the bone. They hold the gum tissues against the implant surface.
At the very top of the implant assembly, the abutment and lower part of the crown attach to the gum (the surface “skin” layer) via a specialized structure known as an epithelial attachment (“epi” – on top; “thele” – nipple). The cells actually attach to the highly polished metal or ceramic, of which the implants are made, by means of microscopic suction pads.
By contrast, a tooth root is attached to the bony socket that surrounds it — by a periodontal ligament (“peri” – around; “odont” – tooth). The ligament is composed of tiny fibers that insert into the bone on one side and into the tooth root on the other. Above the bone, the fibers attach from the tooth into the gum tissue. An implant has no such attachment. Since the whole periodontal ligament has a greater blood vessel supply through which it can bring cells and nutrients, it is more readily able to resist and fight against infection.
Cleaning implant-supported tooth replacements is just as important as cleaning natural teeth, as both depend on healthy surrounding tissues for support. Bacterial biofilm (plaque) collects on implant crowns just as it does on natural teeth, and must be removed on a daily basis at home. Without daily biofilm removal, infection can develop known as peri-implantitis (“peri” – around; implant “itis” – inflammation), which can result in loss of the attachment described above. Unlike inflammation around teeth, this reaction can be quite catastrophic both in rate and amount, quickly leading to a well- or dish-shaped loss of bone around an affected implant. Bone loss can rapidly progress to loss of the implant.
The dental hygienist has an important role to play in keeping dental implants infection-free, and there are many factors to be considered in selecting the right instruments for a professional cleaning. They include: the nature of the debris, meaning whether soft (biofilm, foods) or hard (calculus or tartar, calcified material); the location of the deposits; the type of surface on which they accumulate; and the stubbornness with which they adhere.
Your hygienist must select instruments for cleaning that will not damage the crown, abutment, or the implant itself. Maintaining the highly polished, smooth surface of the abutment and crown are critical. If they are scratched they can attract and harbor bacteria. That’s why the instruments used, called scalers and curettes, are most often made of plastics and resins. Natural teeth don’t scratch in the same way, and therefore metal instruments can be used to clean them.
A number of power (ultrasonic) instruments have nylon or plastic sheaths or tips to minimize implant damage. They clean by using high-frequency vibration, which may be necessary if large quantities of debris have accumulated. They are used on a low power setting with a lot of water irrigation, and sometimes antibacterial solutions, to clean and flush material.
If any part of the implant body (root replacement portion) itself is visible, this may mean there is infection that has resulted in gum and/or bone loss. The implant surface becomes exposed following loss of its fusion to the bone. Implant surfaces are generally microscopically “roughened” to increase surface area for bone attachment. But this surface roughness makes implants difficult if not impossible to clean and disinfect. Additionally, some implants are screw-shaped and their threads just add to the cleaning dilemma.
Brushes are used to clean biofilm from exposed areas of an implant wherever possible. If calculus or dental cement (used to secure the crowns) is present on an implant surface, the hygienist needs to use instruments that are effective in removing these contaminants. In such cases the clinician must ensure no scratching or damage is caused by completing the task.
Despite these special cleaning challenges, implants are highly successful. In fact, studies indicate long-term success rates well over 95%. However, the prevention of peri-implant disease is fundamental to implant health, maintenance and function. And cleaning implants and their related components is an important part of success. Your question indicates that your hygienist is on top of it.
Here is a video demonstration of Dr. Feisel Haji from Soho Dental Toronto using the Bioclear technique to close spaces between front teeth.