Ask the Experts - Smiles By Design
 


We are located in Peace River across from ATB and beside YL Country / KIX FM at 9811-100th Ave. Our team of dedicated professionals provide quality dentistry in a relaxed friendly environment. We offer professional cleanings, white restorations (fillings), crowns, bridges orthodontics (braces) and implants. Phone 780-624-3355.  www.drblench.com.


       
 



I am experiencing receding gum lines and I wear a partial plate on the bottom. I have worn this for a very long time. With few remaining (natural teeth) I was wondering what the cost of dentures would be and what is all involved in the procedure. Any advice would be appreciated thanks.

I would like to ask the age of the patient. Please bear in mind that once a complete lower denture (CLD) is placed; the jawbone will continue to deteriorate until it is next to impossible to wear the CLD with any degree of success. I do realize some people do quite well with a CLD, but that is about 1% of the people that have them. What this person might consider is an implant supported lower denture, which can be worn with a much better retention. However, the patient has to be a good candidate for the implants.

As well, is there a complete upper denture?

I cannot give costs of dentures as we do not do them in our practice unless absolutely necessary. Typically we refer to one of the local denture clinics. The best thing for this patient to do is to make an appointment with a dental office for an examination and consultation so all options can be explained properly so they can then make an informed decision.

I understand that I may have mercury fillings, should I get them replaced or just leave them alone?

In MY opinion, unless the older amalgam fillings are breaking down and are actually in need of replacement, there is no need to have them removed and replaced with something that does not have Mercury in it.

There are many websites and dentists that will easily convince you to have mercury fillings replaced. I have a book in my waiting room that would impress upon you to have mercury fillings removed ASAP. As well, here is a website that will make you want to have your mercury fillings removed yesterday! http://www.hugginsappliedhealing.com/I even know a dentist that wears a GAS MASK when he is removing the old mercury fillings.

Amalgam fillings are essentially 50% Silver and 50% Mercury. Please note that it is ONLY in certain forms is mercury bad for you. The earth's crust gives off many metric tonnes of mercury every year (this is called background mercury). Pollution and other problems - give off mercury. The mercury in your fillings is "bad" when you eat - the abrasion exposes a fresh surface that gives off some mercury vapor that you might inhale. Some medicines including eye drops have mercury in them. You can actually drink mercury and it will pass directly through your system.

Mercury fillings have been around for 200 years and have saved millions of teeth. If anyone is at a high risk from mercury vapors - it is the dental personnel themselves, yet on average, they are healthier than the average population.

Personally I cannot say that mercury fillings are that bad for you. Of course, the Canadian and American Dental Boards still claim mercury fillings to be completely safe.

In my office, I have not used mercury filings for over ten years. I did not change because of the health controversies, I changed because there are better materials that give strength back to the tooth and are also more aesthetic.

So - the answer to the question, in MY opinion, is to replace "mercury fillings" only if there are good reasons for the filling to be replaced. Of course, you can have them replaced if you choose to do so if you are concerned about having mercury fillings, or if you simply just don't like the poor aesthetics of the Amalgam fillings.

Is an electric toothbrush any better than a standard one Water Pik versus an electric toothbrush..any suggestion? Soft or hard bristles?

In most cases, brushing your teeth is all about technique. A regular toothbrush in the right hands can do a wonderful job. Many people however, have trouble spots and that is where an electric toothbrush can excel. Oral-B makes an oscillating/rotating brush with a small round head that is very effective in reaching those hard to access areas. The best thing to do is ask your Dentist/Hygienist at your next appointment if they think the brush you are using and your technique are adequate. Waterpik products are designed to provide oral irrigation to the gums surrounding the tooth. Harmful bacteria and their byproducts get wedged down between the teeth and the gums. Waterpik products are an effective way of washing these irritants out with pulsating water. A Waterpik should be viewed as an additional means of maintaining oral health NOT as a replacement for either flossing or brushing. A SOFT bristle toothbrush should be used at all times (electric & regular). Plaque is generally soft and can be easily removed with a soft toothbrush. If plaque starts to harden and becomes Tartar/Calculus, it must be professionally removed. Hard bristle toothbrushes can be damaging to the tooth structure and irritating to the gums. Save the medium/hard toothbrushes for cleaning inside pipes or car parts!

At one of the anti nuclear meetings, the guest speaker said dental x-rays are toxic and should be avoided at all costs. Should I be concerned. Can denistry be done without x-rays?

The amount of radiation for a Full Mouth Series of x-rays (approximately 14 – 18 xrays) is less than you would receive from one month's of normal living given off as natural environmental sources (known as background radiation). Other x rays such as panoramic films are even less. The advent of digital x rays further reduces the amount of radiation than conventional film type x rays. So in general, dental xrays are considered normal routine and safe. As well, they are considered essential medical - legally. However, some people still do not want to take any risk and decline xrays. This seriously limits the dentist's ability to accurately diagnose many conditions that may exist - bone loss; dental decay; cysts;odontomas; abscesses; supernumary or missing teeth. As well, we absolutely need xrays when doing root canals, implants and all restorations should be checked at finish with an x ray. I have done dentistry on patients and not used x rays if that is what they truly request, but I still inform the patient I am being limited in my treatment of them by their decision, and I would rather they would allow me to do my job as I see fit.
Here is a link to a pretty good Q & A website about dental radiation:
http://www.hps.org/publicinformation/ate/faqs/dentalpatientissuesq&a.html

I have been told I may need a root canal. What exactly is this procedure?

Inside each tooth, there is a root canal system made up of the nerve and blood supply (aka. pulp) of the tooth. Once decay reaches this space, it must be 'cleaned out' and filled with a material called gutta percha to prevent re-infection. If a root canal treatment is not performed, the infection within the tooth can progress to the surrounding bone and tissue, and may cause facial swelling and other serious consequences.

I just got my braces off and I now have a retainer to wear-for the first few week all the time, and then after just at night. How long am I going to have to wear it at night? Will my teeth stop moving after a while?

This is really a question for whoever did your braces. However, this is what I tell my patients so there is no misunderstanding from the get go. And, it is in writing.

Relapse of teeth is contributed to by various factors. In my opinion. the closer a person ends up at what is termed their "physiologic rest position"; which means the
facial muscles are in harmony, the less the amount of relapse.

There is a relapse "graph" so to speak. Most people will exhibit mild relapse after a few years, but SOME people can relapse to WORSE than their original condition (this is without wearing retainers).

So, this is what I tell every orthodontic patient - retention is lifetime. I usually have a lingual bonded upper and lower retainer and a removable retainer for night wear. If any serious problems arise from wearing the retainers, well, we just quit and hope for the best.

Every patient is different. I have seen patients 15 years later and they look great - and when I ask if they are still wearing their retainer, they inform me they never wore it ONCE!. Yet a few months ago I removed a lingual bonded retainer on a patient in whom the retainer had been present for 25 years. Her teeth started shifting within a week and we had to redo the retainer.

Some pateints are told they have to keep the retainers in until the wisdom teeth are removed, but there is no scinetific literature to suggest this is a fact.
Teeth are NOT locked into the jaw. They have some degree of mobility and they are able to shift if a force is applied to them.
So, please take this up with whomever did your braces, and see what their take on it is.
Hopefully this is of help to you.
  
I have a brown spec on one of my teeth, its not big and doesn't bother me but I'm just wondering if it's something to worry about? Thanks.

A brown spec may simply just be that - a discoloration of the enamel. However, it could also be the small entry into the enamel and further - the dentin of the tooth and could actually be a very large cavity underneath.

The ONLY way to tell is to have a dentist give his or her opinion, this is best done with an x ray or a density reading laser called a Diagnodent.

Is the spot on the front of a front tooth or the biting surface of a back tooth? How long has it been there? Is there an indentation into the tooth or is the enamel just a little bit discolored?

Without actually seeing the spec/spot, it is very difficult to give a diagnosis. I do not want to say "it is probably nothing" and you later discover it was indeed far from nothing. I think if it has been some time since you have seen a dentist, then you would be best off having a check up and cleaning and specifically pointing out the area of concern to the dentist.

Is it true that eating acidic fruits, such as lemons, oranges, grapefruits and limes can cause you to lose the enamel on your teeth?

There is a considerable following of this theory, and it likely is true to some degree.

Some experts attribute enamel erosion and pitting of teeth to acidic diets. As well, they attribute worn off areas of tooth at the gum line to theses acids and vigorous use of the toothbrush.
However, people grind and clench their teeth - sometimes they are aware of it and at other times it is at night only. This grinding and or clenching is the main cause of loss of tooth structure at the gum line.

It stands to reason that a very aggressive acidic diet might contribute to enamel erosion, but personally, I find this theory hard to support. The shape of teeth are such that they are self cleaning and most people I have seen over the past thirty years with "erosion of enamel: claim to NOT have an acidic diet. EXCEPT for people with acid reflux - this truly can cause extensive erosion of teeth. As well, the teeth would have to be "bathed" in the acid for a considerable time. I would say that, as in most diseases, some people are far more susceptible to the problem than others are.

What is the real answer? Have your teeth checked by a dentist for his or her opinion(s).

I have been getting flouride with my six month checks. Considering the chemical is in our water, am I overdoing it by getting the treatment with my semi annual checkups?

Regarding Fluoride with your six month checks.- and it is in the water. Fluoride is not just in our drinking water, it turns out it is in a LOT of liquids (foods). However, Fluoride that is consumed in water only affects the developing teeth, prior to their eruption. You may notice some people have quite obvious white patches on their teeth- this is fluorosis - from too much fluoride intake when the teeth were developing.

At any rate, once the tooth is developed, the fluoride in the water has no effect on the teeth and therefore we add flouride to the outside surface of the enamel.
Fluoride ions will replace calcium ions in the enamel structure and it is proven that teeth with fluoride ions are more resistant to decay than just the "normal " tooth structure.
I hope this short answer is helpful.

 When you get your wisdom teeth taken out, I've heard of people getting dry sockets...what are those? and how can you prevent them?

In reality, a "dry socket" means everything looks Ok but it hurts like heck. So all we can do is medicate ( analgesics / antibiotics) and WAIT it out.

It seems to stem from a delay in the normal healing process. The blood clot doesn't seem to form and there is exposed bone ( now visible) - hence "dry socket".

Sometimes a dentist will place a "medicated dressing" - a goop of mixture that looks like tobacco and has the texture of moss. It has oil of cloves and every other medicament known to help alleviate toothaches since the Egyptians. However, it seems to be of little value. Also mixture is usually not well tolerated in terms of taste and inconvenience.

The good thing is to know that this is why they make pain killers and the problem will always heal with time. There is not a prevention as it cannot be predetermined who will and who will not get one. They fortunately are not that common.     

I have heard that continual issue of over the counter teeth whitening products will have harmful effects. I like the results, but am I damaging my teeth?

Over-the-counter (OTC) products , as a rule, cannot damage your teeth. However, some people do experience an increased sensitivity to temperatures. This usually is decreased and / or eliminated by ceasing the use of the product.

There is a remote possibility of root resorption and even the development of carcinoma, but this is extremely rare. Meantime, it is the current position of the Canadian Dental Association that all forms of tooth whitiening are safe. Keep in mind that existing restorations, or decay, will not bleach. As well, discolorations caused by medications or flourosis may produce an uneven result and require other means of treatment ( crowns or veneers).

I have extremely sensitive teeth to hot and cold, I don't whiten them, I go to the dentist regularly and I've tried all the sensitivity tooth pastes, nothing works. Do you know what could be causing this problem and what I could do to help it?

Generalized tooth sensitivity:

Hot and cold sensitivity can occur when the dentin (middle layer) of a tooth is exposed, due to lose of enamel layer. Dentin is made up of tiny openings called tubules. Inside each tubule lies  nerves that comes from the tooth's pulp (the nerve center of the tooth). When the dentin is exposed, cold and hot temperature can affect these nerves. This causes sensitivity. Some causes of dentin exposure include:

-Brushing your teeth too hard, wears away the enamel 
-Poor oral hygiene, calculus build up at the gum line
-Long-term tooth wear(grinding,clenching)
-Untreated cavities
-Old fillings with a crack or leak
-Receding gums that expose the tooth's roots
-Teeth whitening agents
-Eating acidic foods or drinking acidic beverage

Suggested treatments:

-Dental exam with xrays, check for decay, leaky or cracked fillings and repair 
-Have regular dental cleanings with fluoride(can reduce sensitivity
-Good oral hygiene, brushing with soft or ultra soft toothbrush 
-Use a fluoride toothpaste and fluoride mouth rinse 
-Getting treatment for grinding or clenching your teeth (bruxism) 
-Dentist or hygenist may apply a dental varnish to exposed dentin

Sensitive teeth can be caused by many factors, have your dentist/hygenist check your personal situation.

How often should I visit the dentist?

We recommend children every six months and an adult at least once a year. The best way to maintain good oral health is to visit your dentist on a regular basis.

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