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Downtown Toronto Dentist | Toronto Dentistry | Soho Dental

  Contact : 416-340-SOHO (7646)

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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Cracked Teeth

A cracked tooth is a challenge both to diagnose and to treat. Patients will often present with a sharp pain on biting but they are unable to localize it to a specific tooth. Sometimes the problem tooth

is obvious. It may have a large filling in it, or cracks may be visible on the surface of the tooth. We sometimes have the patient bite down on an instrument that isolates the bite force on just one part of the tooth in order to localize not just the tooth but the cusp that is affected. Once the problem tooth is identified the next step is to determine how to treat the tooth.

The difficulty is that we cannot visualize the extent of the crack on radiographs (x-rays) or clinically and yet treatment success depends entirely how far the cracks have progressed. These cracks can travel down the root, below the gum or even into the nerve of the tooth.

Cracks that are above the gum line can usually be treated successfully. The fractured segment is removed and the tooth is crowned to prevent further fractures of tooth or filling. If the crack involves the nerve of the tooth, a root canal in addition to a crown will be required.

Any crack that extends below the gum line and travels down the root is more difficult to treat and thus the treatment has a poor prognosis. Even if the tooth can be saved (usually with root canal treatment, a small gum surgery to expose the crack and then a crown) the prognosis is poor and it advisable to discuss other treatment options that may have better prognosis. The photo above shows just such a crack. I had to extract the tooth because the crack extends well onto the root surface and into the nerve of the tooth causing the patient significant discomfort.

If you have a cracked tooth it is important to discuss all you treatment options with your dentist and realize that despite our best efforts to save the tooth, it may be lost eventually in the future.

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Which toothpaste should I use?

There are many varieties of toothpaste available for purchase. There are those for dental caries prevention, for the prevention of periodontal disease, for  treatment of sensitive teeth,  for whitening and bleaching,  and others that claim to have a specific purpose.  It is no wonder that our patients frequently ask us for advice concerning which toothpaste they should be using.

Anticavity or anticaries toothpaste will typically contain 1000-1500 ppm of fluoride in order to inhibit the development of cavities, as fluoride helps to re-mineralize enamel surfaces.

Gingivitis and periodontitis are caused by the bacteria in dental plaque, which is removed by our daily brushing and flossing. Some toothpastes contain various antiseptic and antibacterial agents, such as triclosan, hydrogen peroxide, chlorhexidine, and baking soda in order to prevent bacterial growth.

Sensitivity toothpastes usually have an analgesic or numbing effect in order to treat sensitive teeth. These toothpastes tend to contain various fluoride compounds, silicates, arginine, and/or strontium salts, which help to block dentin tubules in our teeth, reducing or inhibiting the transmission of impulses to the pulps (nerve-containing centres) of our teeth.

Whitening toothpastes contain abrasive particles that are harder than stain molecules, and therefore stains are removed when we brush our teeth with these toothpastes.  A significant side effect is enamel and dentin abrasion, which in turn leads to increased tooth sensitivity. The abrasiveness of toothpaste is indicated by its RDA (Relative Dental Abrasivity). The larger the number, the more abrasive a toothpaste is. For example, Sensodyne Pro-Enamel has an RDA value of around 32 to 37, and Colgate Total has an RDA value of 70, while Colgate Total Whitening has an RDA value of around 120 to 150.

Your choice of toothpaste should be based on your own personal dental needs and preferences. If you experience sensitivity on a daily basis, it’s best to use a sensitive toothpaste such as Sensodyne Pro-Enamel or Colgate Sensitive Pro-Relief, and whitening toothpastes should be avoided. If you are prone to developing surface staining on your teeth and sensitivity is not an issue, you can consider using a whitening toothpaste from time to time to help prevent stain accumulation in between dental cleanings. There are also many toothpastes out there that serve more than one purpose. For example, Colgate Total contains fluoride in order to fight cavities, as well as triclosan which acts as an antibacterial.

It should be noted that most of the common toothpaste brands contain fluoride (Sensodyne, Crest, Colgate, etc), and these brands have all been approved by the Canadian Dental Association.

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Dental Operating Microscope

D7K_9321At Soho Dental we have always taken great pride in providing our patients with the highest level of dental care utilizing the latest technologies.  We are pleased to include a dental operating microscope as one of our newest technologies for the benefit of our patients.

With the use of a microscope, we are able to diagnose dental problems at an earlier stage before they become difficult and more costly to treat.  As a practitioner, I am able to see dental conditions far better than with the naked eye or magnification loupes. It allows me to provide treatment more comfortably and with more precision than ever before.

One of the biggest advantages of increased visualization is more conservative treatment. Modern dentistry keeps moving to more conservative treatments and I have already noticed how the microscope allows me to keep cavity preparations as small as possible. This results in a smaller filling which is always better for the overall health of the tooth.

Please do not hesitate to ask us any questions that you may have regarding the dental microscope and its benefits in helping us provide you with the best possible dental care!


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