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What is a Comprehensive Dental Exam?

At Soho Dental, we encourage all our new patients to have a Comprehensive Dental Exam.  This is an important assessment that identifies potential problems and health risks, which in turn allow the dentist and hygienist to give you the best possible dental care. It is the most thorough kind of examination you can have not only for your teeth and gums but the jaw joint, chewing muscles as well as other important areas around the head and neck.

Comprehensive Dental Exams Include:

  1. Medical History: recorded at your first visit. Any aspects that could impact your dental treatment are identified.
  1. Full Set of Digital Radiographs (X-rays): Shows multiple angles of each tooth, allowing us to assess everything below the gums, underneath fillings, in between teeth, as well as levels of supporting bone structure.
  1. Glands and lymph nodes surrounding the head and neck are checked for tenderness or inflammation.
  1. The chewing muscles: examined for any signs of pain or tenderness that could be related to clenching and grinding.
  1. Jaw Joint: Clicking and popping may indicate a TMJ disorder.
  1. The bite of the jaw is tested to see how the upper and lower teeth fit together and to make sure the bite is in harmony for optimal comfort and function.
  1. The inside of the mouth, including the lips, cheeks, tongue, palate are checked for health. Abnormalities are ruled out at this time; screening for oral cancer.
  1. All teeth and existing fillings are checked for signs of decay and damage, ensuring all is functioning well.
  1. A complete and thorough assessment of the gums: measurements are taken around all the teeth and areas of recession are documented. This is important in the early detection of gum disease.
  1. Any other concerns that you may have regarding your dental health and well being are addressed and discussed with the dentist during this exam.

A comprehensive dental exam is much more than a mere check-up.  It is an important component to receiving the very best dental care.  Please do not hesitate to ask us any questions regarding the benefits of a comprehensive dental exam.

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Filling replacement

Amalgam or silver fillings have been used in dentistry for many years. They tend to last a long time but like any restoration, they do have a life span. How long they last depends on how well they were originally placed, whether or not tooth clenching or grinding occurs, susceptibility to dental decay and a variety of other factors. We often find old silver fillings have decay underneath or are fractured. It is at this point that they would need to be replaced. If not, the decay under the filling or the compromised filling itself may lead to more serious problems.

Very often we replace worn silver fillings with composite resin; a tooth coloured filling material. Composites resins are virtually undetectable to the naked eye, very strong and are chemically-bonded to tooth structure-a significant advantage over silver fillings. They are technique sensitive: if placed in a moisture free environment they can serve the patient well for many years.

The first photo shows a fractured silver filling that needs replacement. The middle photo is typical of what we see when we remove a silver filling. There is decay under the filling and some staining as well. The final photo shows the tooth restored with composite resin.

If you have any questions regarding replacement of your worn silver fillings, please do not hesitate to ask us at your next visit!

fillings1 fillings2
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Welcome Dr. Monica Ramirez

drramirezWe are very pleased to announce that  Dr. Monica Ramirez has joined Soho Dental as an associate dentist.

Dr. Ramirez grew up and went to school in Santo Domingo, Dominican Republic. She obtained her Doctor of Dental Surgery degree in 2002 at Iberoamerican University.  After many years working in private and hospital practice in her hometown, she went through the qualification process to obtain her license in Canada in 2014.

Dr. Ramirez has embraced Toronto as her new home and she is excited about serving this community. She is very passionate about dentistry, constantly trying to provide the highest level of care for her patients. For this she is eagerly committed to continuing education and training.

What she enjoys the most is developing lifelong relationships with her patients and helping them gain a healthy smile in a caring and compassionate atmosphere.

She is a member of the Ontario Dental Association, Canadian Dental Association, and Dominican Dental Association.

On a personal level, she enjoys cooking, swimming, traveling, and salsa dancing.

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Bonding is the application of a tooth colored filling material (composite resin) to repair chipped, fractured or decayed teeth.  Bonding, when used on the front teeth, can be a non-invasive treatment modality to solve many simple esthetic issues.  Worn teeth can be made longer,  spaces between the teeth can be closed, fractured teeth can be repaired, slightly misaligned teeth can be made to look more pleasing, in addition to many other applications.

Often, bonding does not involve local anesthetic.  The preparation is very conservative and only involves lightly abrading the tooth surface involved in order to get the bonding to adhere.  The tooth colored filling material is then applied and “bonded” to the tooth.  Once it has adhered to the tooth, it is shaped and polished to match the surrounding tooth structure. The procedure usually takes only one appointment.

The material does have a life span of about 5-10 years and it can discolor or chip overtime. Replacing the filling material is simple, especially since the tooth preparation is minimal.  Please do not hesitate to ask us more about bonding and to see if you may be a candidate for this simple procedure to improve your smile.

bonding1 bonding-2

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Dental erosion


Dental erosion is defined as the dissolution or wearing away of tooth structure due to acidic solutions.  These acid solutions can be from foods or beverages that we consume or from stomach acids.  Today we will discuss dental erosion from acidic foods and beverages.

Common sources of acidic solutions from our diets include citrus fruits, soft drinks, fruit juices, and sour candies. Often these substances also contain sugar which amounts to a “double hit” to the teeth.  The acid softens the tooth structure and the sugar feeds the bacteria, which creates a more acidic environment. This leaves the teeth more prone to developing cavities.

Sometimes beverages which may seem healthy are often very harmful to the tooth structure.  For example, “liquid cleanses” are quite common these days and some regimes advocate frequent intake of lemon juice in water.  The problem is that lemon juice is highly acidic (pH 1.8) and this daily regimen is enough to cause tooth sensitivity in the short term and possible dental erosion in the long term.  Once tooth structure dissolves, it is lost for good.

Prevention is the key and it is advisable to limit the intake of citrus fruits to no more than twice daily and reducing or eliminating the use of soft drinks and fruit juices. If you do have something highly acidic, then wait 30 minutes before brushing your teeth.  This will allow the enamel to re-harden so that you do not brush away any softened tooth structure.  It also helps to have acid neutralizing foods such as cheese (which is a why wine and cheese make such a great pairing!).

You can also use toothpaste formulated for acid erosion.  Sensodyne Pronamel is one such toothpaste that I recommended. It is very non-abrasive and helps with tooth sensitivity.  Please let us know at your next dental visit if you are concerned about dental erosion.  We will check for any early signs and we can make appropriate recommendations to prevent further loss of tooth structure.

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Canker Sores

Canker sores or apthous ulcers occur quite commonly.  These are very painful ulcers that occur in the mouth specifically in areas that are not bound firmly to the underlying tissues.  As a result, we see them on the cheeks, the soft palate, underneath the tongue, the floor of the mouth and on the gums. They appear suddenly as white or pink ulcers surrounded by a halo of red, inflamed tissue that will generally heal on their own in about 14 days.

The cause for these ulcers is unknown.  It is thought that they are a result of an exaggerated immune response to a local irritant.

There can be many triggers to this reaction and if you are prone to getting them, it may be difficult to pinpoint the cause.  Citrus fruits such as oranges and lemons, physical trauma, stress, lack of sleep, sudden weight loss, hormonal changes, food allergies (e.g. dairy, glutens, chocolate, nuts, cinnamon, spices, and preservatives) and disorders that depress the immune system are thought to contribute to aphthous formation.  Deficiencies in iron, vitamin B12, folic acid, and possibly zinc appear to be associated with chronic aphthous ulcers.

Minor injuries to the mouth can also trigger these ulcers. Examples include a burn from hot coffee or pizza or a cut from hard crusty breads.

The key to controlling the occurrence of ulcers is to recognize what your particular trigger might be.  This may involve keeping track of what you eat on a daily basis and eliminating foods that are commonly triggers.

Once you have an ulcer, the treatment is primarily to treat the symptoms until the ulcer heals. Your dentist or physician can prescribe a corticosteroid cream that is formulated to be used in the mouth, which can reduce the pain and help the ulcer heal quicker.

If you tend to get very large ulcers on a very frequent basis this could be indicative of an underlying condition such as an immune problem, or an underlying chronic illness such as Behçet’s, Crohn’s or celiac disease. If this is the case, then a consult with your physician is highly recommended.

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Halitosis or bad breath is a common condition affecting about half of the adult population.  Most causes of bad breath can be attributed to coming directly from the mouth. There are actions that one can take to minimize the problem.

The tongue is one of the most common sources of bad breath.  This is evident when one has bad breath even after brushing and flossing well.  The surface area of the tongue is immense and bacterial breakdown of food on the tongue is the cause of this odour.  The solution is a tongue scraper.  Using a tongue scraper once a day will minimize the build-up and aid in controlling odours from this cause. There are many different styles of tongue scrapers and I have found one that is very effective and simple to use. Please ask us for one if you think you would benefit from its use.

Of course there are other causes of bad breath.  Dry mouth is another common condition that can contribute to bad breath.  Dry mouth may be due to an autoimmune disorder, medications that are commonly prescribed or simply not keeping hydrated.  Drink plenty of water to stay hydrated.  Remember when you feel thirsty, you are already dehydrated.

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Happy Holidays!

We wish all of you the very best for the Holiday Season! May the New Year bring to you and your families much joy and happiness and life. We look forward to continuing to provide you with the very best in dental care.

To your good health,

The Team at Soho Dental

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