So, whenever a mom ( or dad) comes it with a youngster right after a blow the mouth I warn them this may occur.  The parent just needs to watch for any "blister" or "pimple" appearing on the gums near the tooth. That would indicate an infection has started.

CSI Dentistry...

Once I have evidence I can make a diagnosis and only then can I offer treatment to resolve the problem.

So when a patient comes in, points to a tooth and says it hurts and needs a filling, I say "tell me more!"

I'm sure you have heard of plaque and tartar.  It's mentioned in all the toothpaste ads.  Plaque is the soft stuff on your teeth that can come off with a toothbrush.  Tartar ( or what we dentists call "calculus"- not the math by the way) is the hard stuff you cannot brush off.  It's found above the gum line where you can see it and below where you cannot.  Tartar...to put it indelicately... has to be scrapped off.  We dentists call this "scaling".   Now bacteria live in the plaque and tartar.  They produce among other things toxins that break down the gum tissue attachment to the teeth and cause the bone that holds the teeth to shrink away.  As it becomes more severe, your teeth become loose and you if left untreated the affected teeth will be lost.  That in a nut shell is gum disease.  It is generally painless.  Bleeding swollen red gums are often seen.  Some times you cannot tell you suffer from it to look at your gums.

gum disease © Dr Steven Rosenblat

So how do we dentists know it's there? 

I want to say thank you to may patients for trusting us with their dental health this past year and for referring friends and family for their dental care.  And I'd also like to say thank you to you, my blog readers for spending a bit of your valuable time reading my posts. 

We look forward to seeing all your familiar smiling faces again in 2012!

Dr Steven Rosenblat & Team.

Staff xmas party with with the Oakville dentist

Before we could replace missing teeth with dental implants, the most lifelike way to replace missing teeth was to make a "bridge".  Now you can only have a bridge if there are teeth on either side of the space where the lost teeth were.  These teeth have to anchor the replacement faux teeth and to do that we have to shape them as if they were to be crowned.  Now this isn't without risks - see below.   Dr Steven Rosenblat Oakville Dentst This is not to say you should avoid a crown or bridge but if you have an alternative treatment option that will give you a better result than a bridge, why involve the teeth adjacent to space from missing teeth?

So why do non removable dental bridges fail? 

This young girl is 9 years old.  Her mom was missing some upper teeth that never formed but her daughter is missing lowers!  Lots going on here and it can be confusing to look at.  There are many teeth developing underneath baby teeth. The arrows show the area where there are two adult teeth missing.  They never developed.

panoramic xray of a 9 year oldIt is important to know if all permenant teeth are present in children so we know if the baby teeth are going to be replaced by adult teeth.  If not, do we need to plan braces (orthodontics) to move teeth to close the spaces where adult teeth should have been or should we work hard to keep the baby teeth for the long haul.  I've had patients who have been able to keep baby teeth well into their 30's and 40's.  But sometimes they cannot be kept that long.  If we can keep a baby tooth until past 18 years old, if it fails we can replace it with a dental implant and crown, just as if the adult tooth had developed!  But knowledge is the key, if we know early, we can plan.

Now most of you reading this are not dentists and not use to looking at xrays so below I made an animation to show you what it would look like if this young girl had the two teeth developing properly.  Watch closely and you will see the teeth that should have formed flashing on and off.

Missing adult teeth animation

First off, I am going to discuss "white" fillings.  These are made of a composite resin, which is a high strength type of plastic.  These fillings need to be bonded to the tooth structure they touch or else oral bacteria and saliva will seep in between the filling and tooth.  Old metal fillings did not need to be bonded because we depended on corrosion to seal the "gap" between tooth and filling (really, that's true!).  But because it takes some time for the metal to start to corrode, we had to put a foul smelling varnish layer on the tooth before we placed the metal filling in to temporarily seal the tooth.

"Cindy" is a cute 5 year old with long blond hair.  She really did not want to be in my office.  Vicki, my hygenist patiently  got Cindy to let her clean her teeth.  Taking xrays were another matter.  We were not able to get the pictures we needed of her teeth. Tears flowed and she was not at all happy.  Unfortunately Cindy had four cavities that needed to be treatedand  one causing some discomfort.  

On the day we brought Cindy back for a short filling appointment she was clutching her kitty, a stuffed animal and wasn't at all happy to be here.  Her eyes welled up and she barely said a word to me.  I needed to gain her confidence and show her how easy this really could be.  I decided to give "Laughing gas" a try.  I showed her how it workded and she agreed to let me try.  In no time we had Cindy relaxed and floating and then gave her the freezing with no problems.  ( honestly, parents; giving kids freezing is really not difficult even without laughing gas).  Doing her filling was a breeze after that.  Cindy found that this dentistry stuff was easier than she thought and even let me take her xrays after the filling  (no laughing gas!).   After we were all done she was talking a mile a minute and drew me a great little picture of her appointment.  Made my day...

Broken teeth repaired immediately with composite resin by Oakville Denitst Dr Steven Rosenblat

And, he can eat right away!

A woman's dental health needs are different!

How do a woman’s hormones affect gum disease?  Well basically it starts at puberty.  An increase in female sex hormones coincides with an increase in gingivitis (mild to severe) when a girl reaches puberty.  This is due to changes in the gum tissue, the response of the oral bacteria to those hormones (oral contraceptives too!) and the reaction of the gums to the irritation of plaque and debris as a result of these changes.  This is a common theme throughout a woman’s life as natural cycles cause changes in those hormones regularly.    “Canker sores” can often occur prior to a woman’s period as well.   During pregnancy the hormone changes can be much more exaggerated.  60-75% of pregnant woman have some gingivitis, some may be severe enough to cause pain, bleeding and even need minor surgical correction.  Later in life, menopause may also cause dry mouth, oral pain with red or inflamed gums and osteoporosis may worsen bone loss around teeth due to gum disease.

A healthy diet, good oral care at home and professional dental care can help minimize and treat these issues before they can become serious enough to cause tooth loss.

Remember, great things start with a smile!