Dr Rosenblat's Blog

Dental Implants & Crowns can improve a smile...

2010-07-23T20:54:54Z

I've written before about dark gumlines and tooth roots and I see quite a few patients with this problem. It has also been a popular topic here on this site too so I thought I would post another case.four new all ceramic crowns and one dental implantold failed crowns

Cindy ( not her real name of course) wanted to improve her smile by replacing four crowns on her upper front teeth. You can see the two on your left have darkness showing through her gums. The tooth indicated by the red arrow had to be removed. I replaced this tooth with a dental implant and porcelain crown. This helped esthetically as the roots of the two center teeth on the left were black from old failed dentistry and replacing one with an implant helped remove some of the darkness, allowing for pinker gums. Due to the blackness of the root under the gums I couldn't make much improvement in the tooth on the far left. See the after image. With a small bit of trimming we could have perfected the length of her left implant tooth but Cindy was happy with the teeth as you see them and the smile she now has.

( If you want to see what the teeth looked like after I removed the old crowns, just click on the left image.)

How long after my filling do I have to wait until I can eat?

2010-07-23T18:38:09Z

This is a question I hear every day. The white fillings that you get today are composite resins (very hard and wear resistant “plastic / ceramic” mixtures). You may notice that when these fillings are made in your mouth, we use a use a special light to cure (set) the composite. This makes the fillings as hard as they are going to be, right away.

When the old silver amalgam fillings are placed (not often these days), they are soft for at least one hour. So, we use to have to tell patients to wait one hour before chewing as the fillings were soft and would fracture if used too soon. This does not happen with today’s composite resins- you can chew immediately. The real question is, do you want to? While the fillings are ready to go, you are most probably still anaesthetized ( ie frozen) and may not be able to feel your lips and tongue. Eating while you are frozen can cause injury or burns if you like hot coffee.

So a word of advice, if your dental appointment is at lunchtime, maybe a light meal before will keep you from having to worry about when you can eat.

Summer holidays....

2010-07-07T22:25:35Z

Well the scorching hot summer days we've all been waiting for have arrived in this neck of the woods. Time to plan time away from dentistry and being with family and friends instead.

So to that end, I'll be off from July 23 until August 9th. Duing these two weeks one of our team will be available for calls to book appointments or answer questions from 9 am until 1pm.

Hope you all have time to enjoy some time off this summer too, it doesn't last long.

Great things start with a smile! ( including summer vacation)

Dr. Rosenblat

Sterilization and Infection control in a dental office.

2010-06-21T13:54:11Z

This past year has been another busy year for continuing education. Most programs start to wind down for the summer until next September the new "school year" starts again.

The final formal lecture I attended for this season was last Friday, the subject was Infection control and Steriliztion standards in the dental office. This is something that goes on behind the scenes in every dental office. Most patients are more aware of it these days because they see us wearing masks and gloves as well as wrapping various items in plastic. This lecture reviewed the latest standards in care. Most of you might already know that we use sterilizers ( we call them "autoclaves" ) in the office to sterilize everything we can. But how do dentists know they actually work and kill the bacteria and virus's that could infect a patient or staff memeber? Along with chemical strips that tell us that the sterilizing conditions have occured in the autoclave, we place live harmless bacterial cultures inside and expose them to the sterilizing conditions. We then culture them for 24 hours and see if they grow. If not, we've been successful. If not, action is taken! Today,these spore tests are done each and every day that the office sees patients.

Being a great summer day and a Friday as well, it was great to see the lecture room at the Mississauga Convention Center was packed!

In the morning I often have sore jaws and sometimes a headache...

2010-06-02T14:43:05Z

Headaches and muscle soreness are conditions that are often related to how your teeth and jaws work together. 85% of people show signs of tooth grinding (bruxism) or clenching. These are non functional uses of your teeth and jaws (that overstress you chewing muscles) and often happen only at night. In today’s world there is a great deal of stress and anxiety and this, as well as caffeine use and some medications can all lead to these destructive and painful muscle activities ( dentists call this ``parafunction`` ). The result is tension, headaches and excessive wear and destruction of your teeth. This may show up as flattening of your teeth or chipping as well as grooves or notches in the side of your teeth near the gums ( ``abfraction``).

The most common way to treat muscle pain caused by clenching or grinding is to have a “nightguard” made. This is a custom fitted acrylic appliance usually worn at night that takes the stress off your jaw joints and will safely prevent tooth wear. There are different types of Nightguards for different purposes and which one I recommend depends on a patient’s particular problem and tolerances. They are designed specifically for the way your teeth fit together.

Every persons teeth fit together and function in unique ways and this is why the simple grinding appliance available at drugstores cannot accomplish the same protection and pain relief.

I have found that this kind of conservative therapy has helped many of my patients reduce or eliminate their muscle and headache pain.

Replace a missing tooth with a Dental Implant and a Porcelain Crown

2010-05-01T20:44:10Z

One of the most common uses for dental implants in my practice is to replace a single missing tooth, especially in the part of a patients mouth that shows when smiling.

I find this type of treatment as one of the most rewarding parts of my practice. Being able to replace a missing tooth without attaching the new replacement tooth to any nearby teeth, nor having to resort to an old fashioned removable denture. This allows people to smile and use their teeth as nature intended. No worries about it moving when eating or speaking. If planned properly, we can often get results that look like nature intended.

This is Fred. He had been without a tooth for quite a few years and used a removable plastic denture with just one tooth to replace the missing one. Now his very young kids miss his "party trick"- being able to flip his tooth in and out of his mouth, but Fred doesn't miss it!

dental implant and Porcelain crown

Cosmetic Dentistry... how will it look when it's done?

2010-04-28T21:45:06Z

One of the most frequent cosmetic concerns patients ask me to correct for them are pointy "fang" (canine) teeth. What I often hear is "can't you just file down the tooth?" The solution is usually not taking away tooth material but actually adding more to the tooth, either with composite resin (white filling material) or porcelain veneers. When I suggest adding instead of taking away, it can be hard for patients to visualize what I am recommending (well, they are patients and not dentists, right?) Let's therefore go over one of the best ways to show what cosmetic enhancements can be accomplished by cosmetic dentistry today.

Yesterday I had a young woman with an attractive smile in the office who wanted this very type of esthetic improvement. Now I can show her on a computer what it may look like but seeing is believing. So using composite resin (the white filling material we use) I added to her teeth to show her the different types of improvements I can offer. I didn't bond the material nor spend a lot of time matching colours or polishing the composite as I was performing what we dentists call a "Cosmetic Mock Up".

Oral Cancer.

2010-03-22T01:20:06Z

I am not writing this post to tell you how bad smoking is. Today, it's not possible to avoid hearing that important health message. I just wanted to relate a story about a patient. And I'm not going to show any pictures or his x-rays.

About two weeks ago I met a new patient in a great deal of pain. He was 45 years old. It was severe pain and when I met him the pain was etched across his face. With him was his young teenage daughter. He smoked a pack a day and he didn't like going to doctors and hadn't been to a dentist since his teenage years. The pain made him do something he didn't want to do, see me.

The cancer I found in his mouth was something a general dentist only sees occasionally, usually only in a pathology text book.

I arranged for him to see my Oral Surgeon immediately who called me back an hour later to advise me of his findings. He arranged the patient to see an oncologist. The cancer had spread quite a bit and the prognosis is not good.

I couldn't stop thinking about that patient all day. And his daughter. I probably won't ever see him again but I still think of him. He is only 45.

If he routinely went to a dentist this could have been detected early. We could have been sure we could save his life.

If only he didn't smoke.

We always believe it won't happen to us.

If you smoke...quit.

Are Denture Adhesive Creams Safe?

2010-03-03T22:25:11Z

Maybe. These denture adhesives are regulated in Canada as medical devices. They have chemical formulations that may contain Zinc as an ingredient. Chronic ingestion of Zinc can lead to Copper deficiency and this in an “established and increasingly recognized cause of neurologic disease”, such as weakness and numbness or the extremities. This is from the March 2010 issue of the Ontario Dentist Journal where it sites cases of patients that have experienced numbness and pain in extremities linked to excessive use of these adhesives and numerous references.

So why use them at all? Well, for a person who has lost all their teeth, an initially well fitting denture will loosen over time as the bone and gums continually shrink due to lack of teeth. The adhesives will provide some stability (and are messy to use). But they can only provide temporary help and a refitted denture (relined or a new denture) is really needed to get the best fit. Sometimes this is can be required fairly frequently. Sometimes the bone shrinks away so much a regular denture cannot be made to be worn comfortably even with denture adhesive.

Today the best way to avoid all of the problems associated with dentures and their stability and potential risks from denture adhesives is to have dental implants placed to hold a denture in place so that a person can chew with comfort and confidence.

Wondering about dental X-Rays?

2010-02-18T17:08:14Z

I just put up a page with some interesting ( at least to dentists) information on dental X-Rays with some images taken in my office. Look under the "Services" menu drop down.

Dr. R.