Dental Health Tips

It's something nobody likes to discuss, but something we all get on occasion. Bad breath isn't nice, but the good news is, it's usually easy to cure by simply practicing oral hygiene.

Plaque or food particles on the teeth are the primary sources of bad breath, which is also known as "halitosis'. The solution is simple; brush and floss your teeth regularly.

Gum disease can also cause bad breath. There are two types; gingivitis is the name for gum disease that causes the tissues around the necks of the teeth to become red and swollen; periodontist is the name for the gum disease which involves gum tissues and the bone of the jaw, casing teeth to become loose. Your dentist checks for both of these diseases during each checkup.

There is another famous form of bad breath which we sometimes have when we wake up; 'morning breath', that bad taste accompanied by bad breath.

It too, is caused by a combination of such things as food residue and cigarette smoke that have been in your mouth overnight. Brushing and flossing should dispatch the problem quickly.

And, don't forget to brush your tongue as well. Everything in your mouth can potentially trap bacteria and can be a source of bad breath. The whitish coating that develops on your tongue may also be a contributor.

If your wear dentures, good oral hygiene is especially important since food particles and plaque can get trapped in and around dentures and odours can develop. Dentures should be carefully cleaned and soaked overnight in a cleansing solution.

Bad breath can also be caused by a variety of problems other than oral hygiene. Fad diets and prescription drugs have been known to cause bad breath by altering the chemistry of the body. And halitosis can also be a sign of a systemic disease. If you get a case of bad breath which persists despite good oral hygiene, consult your dentist or physician.

We've all admired people with perfect, sparkling smiles. These days more people are not simply admiring those pearly whites - they're going to their dentist to get their own. In an age of designer everything - from clothing to interiors - it's not surprising that designer smiles are beaming from more and more faces. The most popular dental options to brighter, whiter teeth are bonding, veneers and crowns.

Bonding: Since the 1970's, dentists have been using special adhesive plastic materials to repair fractured teeth and to seal the crevasses of teeth to prevent decay.

In recent years, bonding has become more popular as new age materials have been developed to advance the technique. Dentists can now mix plastic into a paste, tint the mixture to match (or whiten) teeth, and then use the paste to coat discolored, stained or naturally yellowed teeth. Broken teeth can also be repaired with bonding techniques.

Veneers: Veneers are a type of bonding, but instead of a plastic paste which is applied and shaped onto the tooth, a prefabricated thin acrylic material is used. These veneers are then 'bonded' to the front of teeth to mask chips, gaps or discoloration's. Veneers take only about an hour per tooth to apply. Bonded veneers do, however, have their limitations. Habits such as smoking, nail biting, chewing gum, eating hard candies, and drinking coffee or tea can have a negative effect on the lifespan of veneers.

Crowns: A crown fits over a tooth to restore its normal shape, colour or size. Crowns are used most commonly when a tooth has been damaged by decay, extensive filling or by injury. Crowns are usually made of gold alloy, other metal alloys or porcelain. Gold or metal alloys, of course, contrast in appearance to the existing teeth, so are often used for back teeth only. Porcelain crowns can be colour-matched to your existing teeth, providing a natural look.

Traditionally, dental bridges and dentures have been used to replace the gaps caused by missing teeth. And for cost and ease of insertion, they are still the first choice for tooth replacement. A bridge is an appliance attached to natural teeth, with a false tooth filling the gap between them. A partial denture is a removable partial set of false teeth, attached to existing teeth by clasps. A full denture is used when all teeth in a jaw are missing. Dentures are designed to replace missing teeth. Both bridges and partial dentures rely on the strength of remaining teeth, since they are attached to them.

These days, more dentists are turning to implants, especially when bridges and dentures are not suitable. Some people, for instance, are not happy with removable dentures; others have inadequate gum surface to support the denture. Often called the next best thing to natural teeth, dental implants offer wearers almost total restoration of chewing power and the ability to enjoy a variety of foods.

Implants permanently anchor man-made teeth below the gum surface by means of artificial roots. They can be implanted into either the upper or lower jaw, and at the front or the back of the mouth. There must be enough healthy gum tissue, and sufficiently dense jawbone, to support implants. A three-step oral surgery process is used.

In the first step, the gums are cut and small holes are drilled into the exposed jawbone to accept the 'anchors' or implants. These implants are special metal surgical 'screws' or 'posts', which are permanently anchored into the jawbone. They become the 'artificial root' for the new teeth.

The most common type of implant is the screw type, which is cylindrical in shape and threaded so that it can be attached to the jawbone. The implants are pressed tightly into a conical hole that is drilled into the jawbone. The implants have porous surfaces that bone tissue can grow into them, forming a strong bond.

In the second step, 'abutments' are attached to the implants. They hold the new teeth in place. In the final step, an artificial tooth is attached to the abutments. It is important for patients with implants to develop good oral hygiene habits to ensure that food does not lodge around the new teeth and cause infection.

Brace yourself for the good news - today's braces are less conspicuous and more comfortable than ever before.

The application of braces, called orthodontics, is the area of dentistry primarily concerned with moving or repositioning teeth. Dentists specializing in this area of dentistry are known as orthodontists. They adjust relationships between teeth and facial bones by either applying, stimulating or redirecting natural 'forces' within the skull and face. Braces, applied to the surface of the teeth and attached to each other with wires, help achieve such corrections. The wires are periodically adjusted to stimulate the movement of the teeth in the desired direction.

At one time, all braces were made with metal and were attached to the tooth with a metal band. Modern braces are often bonded directly to the tooth, and may be made with clear plastic or porcelain, although the connecting wires are still metal. Braces can sometimes be installed on the inside of the teeth. These are known as lingual braces. Not all cases can be treated with lingual braces, but it's worth asking your orthodontist.

While wearing braces is not painful, some patients feel pressure when they are first applied. This is because it is necessary to apply pressure to the teeth in order to move them. The types of corrections achieved by braces can vary. Simple 'tooth uprighting' is for tilted or 'drifted' teeth. These are aligned and uprighted with springs and elastics. If one or more of the teeth are biting in reverse to the others, it created a condition called a crossbite. A cross-bite is the abnormal orientation of tooth to tooth arrangements. It can be corrected with a removable appliance that has a spring, which pushes the tooth back into alignment.

For mild crowding of teeth, selective filing may open up the space necessary. A removable appliance worn for a year or so will achieve the correction. With excessive crowding, it is sometimes necessary to remove teeth and orthodontically guide the other teeth into their proper positions.

In the case of an upper or lower jaw that is structurally out of alignment, creating either a protruding or receding chin, surgical correction is sometimes necessary of adults. For children, the correction is often accomplished by influencing the growth of the misaligned jaw by means of braces.

The importance of maintaining a healthy mouth over a lifetime cannot be overstated. A bad bite can contribute to health and digestion problems, and can also set the conditions for people to feel self-conscious. It is therefore recommended that children have an orthodontic assessment by a dentist before age seven, so that early treatment can reduce time spent wearing braces.

More and more adults are also seeking orthodontic care, even into their sixties!

Teeth can be replaced in many ways - by placing a bridge, a denture or an implant - but these are replacements, not substitutes, for a lost natural tooth. Saving a tooth that would otherwise be lost and replaced by a prosthetic device is still the first choice of most dentists. Besides, retaining a natural tooth is generally a less expensive procedure than trying to replace it.

If one of your teeth becomes infected and abscessed, check with your dentist to see if that tooth can be saved. The type of treatment your dentist may use to do this is known as endodontic treatment or root canal therapy.

Root canal infections are caused by a variety of contributors, such as deep cavities or accidents that internally damage or externally fracture the tooth. Germs can then enter into the root canal of the tooth, infecting the pulp (nerve) of the tooth, and can spread to the bone around the tooth to produce a dental abscess. Infections in the root canal or bone, like infections in the skin (boils) may or may not be painful. The more serious ones are generally painful, gut the absence of pain does not necessarily mean that an infection is not present. Usually, tests and x-rays done by the dentist can reveal the presence or absence of a root canal infection.

If an infection is discovered, the dentist can open the centre of the tooth, remove the infected nerve, clean and medicate and then fill the root canal, to allow the injured bone around the infected root to heal. Sometimes the treatment is conducted over a series of two or three appointments; sometimes it can be done in one. This decision is made once the dentist has assessed the severity of the root canal infection. With proper diagnosis and treatment, more that 85 per cent of teeth receiving root canal therapy respond favorably. These teeth can be restored (filled or crowned) in a manner that allows them to look lifelike, and function comfortably, for many years.

Another aspect of root canal therapy is its role in the retention of teeth that have been accidentally knocked out and replanted. Studies have shown that retention of such teeth is aided, and in some cases made possible, by treating the tooth endodontically. This treatment can be undertaken before or after the "knocked out" tooth is replanted into its original socket. Again, the dentist will assess the injury before making the decision as to when the tooth should be treated.

Root canal therapy (endodontic treatment) has come a long way since its inception. Most family dentists perform root canal therapy for their patients. For those who do not wish to do so, or for the treatment of more complicated cases, there are endodontic specialists, called endodontists, who work with family dentists to service the endodontic needs of their patients.

It's a startling statistic, but experts claim that 95 percent of adults will grind, gnash, or clench their teeth or jaws at some point in their lives. Although it may occur for a number of reasons, tooth grinding, also called bruxism, can often be attributed to the amount of daytime stress we experience. Relaxing and taking control of stress factors may help to reduce the habit of tooth grinding.

However, bruxism may in fact be an important indicator of our overall well-being. Just like the canary in the coal mine, bruxism can be an early signal that all is not right in general. As we know, excessive stress can be a serious contributor to poor health.

If you catch yourself grinding, it may be time to rethink your lifestyle. Exercise more, consider behavioral counseling, or take up a hobby to help manage the stress. In dental terms, grinding can also damage your teeth by wearing down precious enamel. It can also damage your fillings and crowns.

While grinding may be more of a medical or psychological problem because of its stress overtones, your dentist may be able to offer some relief. Your dentist may recommend a bite plate - a mouthpiece that helps to reduce or prevent grinding. Be sure to consult a physician or stress specialist if grinding continues.

Tooth Talk

Q: How do X-rays detect tooth decay?

A: X-rays are particles of ionizing radiation projected from an X-ray machine. These particles are sent at various energy levels, in the form of an X-ray beam. Only the higher energy levels have sufficient penetrating power to pass through human tissue, expose the X-ray film and produce a black and white X-ray picture. The more particles reaching the film, the blacker the picture. Dense tissue, such as teeth and bone, absorb most of the particles and only a few of the very high energy particles reach the film, producing a lighter image. Less dense tissue, such as skin and muscle, allow more particles to pass through and reach the film, producing a darker image. Cavities, which are holes in the teeth, are less dense, and appear as dark spots on the lighter image of the tooth.

Q: What type of toothbrush should I use ?

A: There are toothbrushes with straight handles and toothbrushes with handles that slope and curve. There are toothbrush heads with tufted ends designed to clean the inside surface of lower front teeth. There are toothbrush heads with bristles; and brushes with head designs that are wedge-shaped, boat-shaped, or with some bristles recessed. Bristles are available in variety of hardnesses too. Many brands offer soft, medium or hard bristles.

Most dentists agree no one type of brush is better than another at removing dental plaque. However, it is important to select a toothbrush with a brush head small enough to reach all areas of the mouth easily. Small children should have brushes one-quarter to one-third smaller than those used for adults. Select a simple type of brush with a straight, flat handle and polished, well-rounded, soft bristles. Avoid brushes with natural bristles as they have hollow cores, and irregular and tend to break. As well, natural bristles are more likely to collect bacteria. Power-operated toothbrushes are useful aids for people with handicaps, but there is no conclusive evidence that they clean teeth better than manual brushes. In toothbrushes, motivation still beats technology.

Q: I've heard of TMJ disorder and understand about 20% of North Americans suffer from it. What is it ?

A: TMJ stands for temporomandibular joint. Basically, the disorder is a disturbance in the joints of the jaw located near the ear. Muscles and joints not working properly in this area can cause pain, tenderness and eventually tissue damage. While it may not be strictly a dental problem, your dentist is often alerted to this disorder because it affects the mouth. Your dentist may recommend a bite plate - a mouthpiece that helps to realign the jaw, correct your bite or prevent grinding. Other methods of treatment may be recommended by your dentist. Counseling to reduce stress, heat applied to the area and massage may also help to relieve the problem.

Baby's First Visit - Make it fun

Training your baby for a lifetime of healthy gums and teeth starts early, in the cradle in fact. But your child may get a real boost when it's time for his or her first visit to the dentist's office. You can avoid many dental problems for your child by following the recommended schedule of early visits set out by your dentist. The most important thing is that the first visit be a positive experience. That way your child will have a positive outlook on dental health and hygiene which, hopefully, will persist throughout his or her life.

There are several things you can do to prepare for the visit. For instance, try playing 'dentist'; count your toddler's teeth, then switch roles and let him or her count yours. Make the exercise fun and explain that this is essentially what the dentist will do.

Explain other things that may happen at the dentist's office, using non-technical language. Don't try to explain X-rays, for instance. Simply say, "the dentist might take some pictures of your teeth with a special camera."

You might also find that taking your child along with an older brother, sister or friend when they go for a routine check-up or cleaning, is a good way to familiarize your little one with the dentist's office. Some children may associate dental offices with the doctor's office and, if they've had a bad experience at the doctor's - a needle which hurt, for example - they may be uncomfortable. But if they see their slightly older playmate handle the experience with a smile, they'll be more inclined to do the same.

Try to treat the appointment as routine. Don't build it up as something out of the ordinary. And be sure to advise your dentist about any special needs or medical problems, such as allergies or bleeding disorders.

There's also nothing wrong with letting your child bring his or her favorite stuffed toy along. Everyone appreciates a little moral support.

Straight Talk about Crooked Teeth

Crooked and crowded teeth can cause more than just dental problems - they can affect your overall health and even your moods.

How? Crooked and crowded teeth at the front - the ones everyone sees when you smile - can set the conditions for people (children especially) to feel self-conscious, and this can lead to feelings of insecurity, low self-esteem and even depression.

Bite and chewing problems may also be responsible for such things as headaches and indigestion because teeth don't meet properly and food does not get fully chewed. Also, people with teeth that are out of line may choose foods that are easy to chew and thereby miss out on the crunchy or hard foods necessary for good health.

Irregular alignment of teeth is called malocclusion and can be inherited or caused by habits, such as mouth-breathing, thumb-sucking, pushing the tongue against the teeth, or biting the lips, which interfere with normal dental and jaw development.

In strict dental terms, irregular teeth are more difficult to clean and therefore more likely to develop cavities and gum disease.

Modern dentistry has a variety of methods for repositioning teeth. Speak to your dentist if you are concerned.

Anaesthesia & Dentistry

While there is no recognized dental specialty for anaesthesia, many dentists have recieved extensive training in the use of anaesthesia. All dental offices involved in the use of deep sedation techniques must have a certificate from the regulatory body (the Royal College of Dental Surgeons of Ontario) permitting the dentist to use this type of anaesthetic. Apprehensive patients, and patients requiring complicated or extensive dental treatment in as few appointments as possible, are excellent candidates for these advanced procedures.

A variety of dental anaesthesia techniques are available to relieve pain and apprehension in patients undergoing dental treatment. Local anaesthesia or "freezing" is the most common method used by dentists to provide comfortable dental treatment to their patients. Unfortunately, some patients are so apprehensive that they cannot tolerate dental treatment with local anaesthesia alone. These patients are ideal candidates for the use of advanced techniques in pain control.

Nitrous oxide or "laughing gas" is a form of sedation which is administered to patients through a mask that is placed over their nose. Nitrous oxide can provide patients with a mild, relaxed feeling to eliminate discomfort. Although not used as a substitute for local anaesthesia, nitrous oxide does allow some patients to receive dental procedures comfortably.

Oral medications can be used to provide a limited degree of sedation to patients. When used in combination with local anaesthetics, oral sedation may relieve enough apprehension in patients to comfortably undergo dental procedures.

The use of intravenous sedatives and general anaesthesia are effective means of providing dentistry to apprehensive patients. The use of these procedures can be tailored to individual patient needs to help make high quality dental care available to all patients.

Your Dentist - Dr. Clean

One of the first things you may notice when you step into your dentist's work area is how clean it looks. It's no illusion, and it's not by accident - your dentist's office is one of the cleanest places you will find. And for very good reason.

Germs, and the infection they can cause, are visitors your dentist does not welcome. In fact, dentists and their staff go to extreme lengths to give germs one clear message: keep out.

The main reason for this is, of course, the well-being of patients and the dental team. Dentists deal with the public all day long, and because of the possibility of exposure to infection, rigorous procedures for infection control are at the top of the dentist's list of concerns.

The Canadian Dental Association has established a list of recommendations for dentists to follow, regarding proper infection control procedures. The Ontario Dental Association endorses these recommendations and encourages every practitioner to adhere to them.

The simple essentials for "universal precautions" are:

1. Provide personal protection for the patient, staff and dentist

2. Everything that goes in the patient's mouth must be sterilized or made so that it can be thrown away afterwards.

3. Everything else must be disinfected. Personal protection precautions for the dentist:

a) Maintain an up-to-date immunization status for hepatitis B, measles, mumps, rubella and influenza.
b) Thoroughly wash hands before and after wearing gloves.
c) Wear gloves for all procedures when contact with blood, saliva and body fluid is anticipated.
d) Wear face masks.
e) Wear eye protection.

Sterilization: Sterilization is the process whereby all bacteria, viruses and other organisms are killed. There are two types of sterilizing methods: heat sterilizing and chemical sterilizing.

Disinfection: All instruments or surfaces that cannot be sterilized must be cleaned and disinfected with a suitable, proven disinfectant. The Ontario Dental Association believes that all practitioners should use safe, efficient and effective infection control procedures in their offices. Be sure to look for Dr. Clean the next time you visit you dentist's office.

Preventative Dentistry In The 90s: How To Make Your Smile Last
Gum Disease: When you were a kid, taking care of your dental health was pretty easy. You brushed regularly, gave your baby teeth to the tooth fairy and visited your dentist every six months. But adult dental problems aren't the same as kid's dental problems. Here are some of the most common dental problems with some tips to help prevent them.
Symptoms of gum disease may include, shiny, red, puffy or sore gums, a change in gum colour, gums that bleed every time you brush, chronic bad breath, a metallic taste in your mouth, gums that are red around the base of teeth. The good news is that gum disease is almost always preventable.
Home prevention should include twice-a-day gentle brushing and flossing between the teeth and gumline. For best results floss first, then brush. Pay attention to the areas where your teeth and gums meet. Clean every surface of every tooth -- the chewing surface, the cheek side and the tongue side.
Brush at a 45 degree angle to your teeth. Direct the bristles to where your gums and teeth meet. Use a gentle, circular, massaging motion, up and down. Don't "rush your brush." A thorough brushing should take at least two or three minutes.
Daily flossing removes plaque from areas your toothbrush can't reach, preventing the build-up of tartar along and under your gums.
The Ontario Dental Association recommends that frequency of dental visits be based on individual patient needs. It advises, however, that a minimum of twice yearly visits are in the best interest of the oral health of the majority of patients in Ontario. Your dentist can spot gum disease in the early stages, even before you notice any symptoms. Your dental team will help clean your teeth to remove built-up tartar before it causes gum disease.
Tooth Decay: Two cavity problems are unique to adults: root cavities and cavities at the edges of fillings. You can help prevent cavities in three easy steps: brush and floss regularly; eat a balanced diet and avoid sweets. Use a fluoride toothpaste recognized by the Canadian Dental Association, and ask your dentist if a fluoride treatment would be a good idea.
Smoking: If you smoke, you may be causing trouble for your teeth and gums. Smoking kills cells inside your mouth. Smoking can make your mouth more susceptible to infections and is one of the leading causes of oral cancer. Smoking can also discolour teeth and composite restorations. Smokers should be on the lookout for early signs of trouble such as white or red patches in your mouth, unexplainable bleeding, soreness or numbness. See your dentist if any of these signs occurs.
Tension and Grinding: Many people clench or grind their teeth, especially during sleep -- this is called bruxism. Over a long period of time, bruxism can wear down tooth surfaces. The main cause is muscle tension brought on by stress. To help prevent grinding, simply try and relax. Become more conscious of when you clench your jaw and avoid biting on pencils and pens. Your dentist may be able to help you with a custom-fitted mouthguard or can recommend relaxation exercises to help you deal with stress.
Food for Thought ... and Healthier Teeth
A balanced, nutritious diet is good for your general health as well as your dental health. Without the right nutrients, your teeth and gums can become more susceptible to decay and gum disease. Sugar is one of the main causes of dental problems. The average Canadian eats the equivalent of 40 kg (88 lb) of sugar each year. Here are a few ways to reduce your sugar intake, and help your teeth at the same time.
Try to choose sugar-free snacks such as milk, fruit, vegetables, nuts, plain yogurt, sunflower or pumpkin seeds, cheese, melba toast, juice and salads. Add less sugar to your coffee or tea or try sugar substitutes. Try to avoid sugar-sweetened soft drinks and look for fruit juices and drinks with no added sugar.
Pay attention to the list of ingredients when you are grocery shopping. Honey, molasses, liquid invert sugar, glucose, and fructose are all types of sugar.
When you do eat sweets, there are things you can do to avoid harming your teeth: avoid sticky sweets that cling to your teeth and are harder to brush away; eat sweets with a meal, not as a snack, to improve the flow of saliva which helps wash away and dilute sugar; and carry a travel-size toothbrush and use it after eating sweets.
If you can't brush, at least rinse your mouth out with water or eat a fibrous fruit such as an apple or raw vegetables. Or chew a piece of sugarless gum.
Why Should I Visit The Dentist?
Regular check-ups are important for cleaning, the detection of cavities and periodontal examination. Plaque and tartar can build up in areas that are not easily reached through home maintenance. These can be removed during a dental check-up to prevent cavities and gum disease.
While semi-annual visits are sufficient for cleaning and detection of cavities, patients needs do vary and patients should discuss the frequency of visits with their dentist.
Patients should also contact their dentist immediately, if their gums bleed, teeth become hypersensitive to temperature or pressure, or in the event of tooth pain or abscess.
New Treatment Options
New materials enable less invasive and less expensive treatment for cosmetic defects, replacement of teeth and improved chewing ability.
New techniques for veneering for aesthetic purposes are also available, as well as implants to replace missing teeth.
Some dental offices are also starting to offer technologies such as Electronic Dental Anaesthesia (EDA) and Virtual Reality Vision to make patients feel more comfortable during their dental visits.
Ask your dentist about any alternatives to the recommended treatment options.

Dental Amalgam:Questions & Answers

Q. Who is responsible for the safety of medical devices and materials?

A. In Canada, medical devices and materials require approval of the Health Protection Branch of Health Canada. For several years, the Canadian Dental Association has encouraged the federal government to fund increased research on dental amalgam. The dental profession recognizes an obligation to use approved devices and materials in the best interests of patients.

Q. Is dental amalgam approved for use in Canada and is it safe? Have recent studies proven that dental amalgam releases mercury vapour and that it should not be used?

A. Yes, dental amalgam is approved for use in Canada by Health Protection Branch (HPB). Scientific studies have not verified that dental amalgam causes any specific problems. It has been known for some time that amalgam in fillings releases minute amounts of mercury vapour, especially with chewing, and that mercury can reach body organs and cross the placenta. Scientific literature on the topic, as a whole, supports the position that amounts released are less than mercury picked up from natural sources.

Q. As a dental patient with many dental amalgams, what should Ido now? Is my health in jeopardy if I don't have them removed?

A. There is no need to have your dental amalgams replaced. In fact, the process of removing dental amalgams actually releases mercury vapour so that overall exposure can be increased.

We are not aware of any new scientific evidence showing that there are any health risks associated with dental amalgam, except for the small segment of the population which may be sensitive to mercury. If there were substantial risks involved with the use of dental amalgam, evidence of this would have been apparent during the 150 years the material has been used. Nonetheless, the Canadian Dental Association, and the Ontario Dental Association, have encouraged the Federal Government to support definitive research in the area of dental amalgam. The safety and efficacy of any medical device must be judged on the current level of accepted scientific knowledge. Dentists want their patients to be informed, and are concerned with patient interests above all else. The dental profession considers carefully any new information pertaining to dental amalgam and would look at altering its recommendations concerning amalgam, if it was warranted. If you have strong personal concerns about dental amalgam, discuss alternatives with your dentist, (including gold, composites, and ceramic) but keep in mind that all materials have their own advantages and disadvantages. Many of these materials have not been subjected to the same level of scientific scrutiny as has dental amalgam.

Q. Is the mercury which is released from fillings absorbed into the body?

A. Yes, but in extremely small amounts, ie, in MILLIONTHS of a gram (this is a very small amount, 0.000001 gram). Mercury found in the body can also be related to the number of biting surfaces of amalgam. The amounts in the body are in BILLIONTHS of a gram per gram of body tissue, (a billionth of a gram is an extremely small amount, 0.000000001 gram). Some researchers claim to detect higher mercury in the blood of people with amalgams than in those without amalgams. However, other researchers could not detect mercury in the blood of patients even with new amalgam restorations, and could find mercury in the blood of people with no amalgam restorations.

Q. Can dental amalgam be used safely with every patient?

A. No. There are patients who are sensitive to the components of amalgam, just as there are individuals who are sensitive or allergic to other chemical substances or even foods, such as milk or bread. It has been estimated that the prevalence of mercury sensitivity in the general population is approximately 3% (Journal of the American Dental Association, Vol. 122, Aug. 1991, pg. 54). In addition, dentists may consider the use of composite fillings or other restorative materials in individual cases. Dentists routinely take a number of considerations into account in selecting a restorative material, including cavity size, location, the individual's condition, patient preference and dental history.

Q. Is the dental profession suppressing information on the dangers of
amalgam?

A. No. The dental profession believes in patient interest above any other consideration. Dental amalgam is still the restorative material of choice in most instances and because of its excellent qualities as a restorative material the risk/benefit ratio is in the patient's interest. Use of composite, gold, or ceramic restorative materials would actually be in the interest of the dental profession as overall patient visits would be increased to the economic benefit of the profession. Of course, if dental amalgam posed a health hazard, dentists would be most at risk since they are exposed to amalgam daily. If you have any questions about the use of any restorative material, talk to your dentist.

Q. Why does the dental profession support the continued use of amalgam when questions are being raised, even if dangers are unproven?

A. Every time a foreign substance is used in the human body for therapeutic purposes, there are benefits and drawbacks. Health professionals constantly must weigh the known risk of a particular intervention against known benefits. In the case of dental amalgam, evidence indicates that no dramatic risks are involved or they would have been clearly observed during the 150 years the material has been used. The risks appear limited, and the benefits to patients large. Dental amalgam is much stronger and more durable than many alternative restorative materials, and amalgam restorations can be completed at a reasonable cost. Recent advances, such as the development of amalgam bonding techniques, have made amalgam even more advantageous as a restorative material. Gold alloy inlay castings would be a reasonable substitute if the material and required procedures were not so costly. It is also possible that alternative materials, subjected to the same level of scrutiny as dental amalgam, will prove to have other advantages and disadvantages. The dental profession is aware of research to find more durable alternatives to amalgam, and these may be available in the foreseeable future.

Q. Do I have the option of asking for alternative restorative materials
rather than dental amalgam when I need a dental restoration?

A. Yes. Dentists attempt to recognize patient concerns with respect to choice of restorative materials. You should note, however, that the dentist may be concerned about the retention, durability or strength of alternative restorations in particular applications and advise you to choose amalgam.

Q. Where does all this leave me as a dental patient? What sort of attitude should I take to dental amalgam?

A. Take a common sense approach to the use of dental amalgam. Discuss your situation with your dentist and determine if there are special reasons to be cautious about filling materials in your case. Your dentist wants you to be aware of conclusions from the range of scientific studies on dental amalgam. Don't have your amalgam fillings removed in response to media reports focusing on selected scientific studies. If you have strong personal concerns, ask for alternative materials (such as composite fillings, ceramic inlays or onlays or gold castings) as your fillings are replaced.
Bonding: Can Bonding Improve The Appearance Of My Teeth?
Afraid to smile because your teeth are chipped, uneven or discoloured? Why not try bonding -- a treatment that is used to repair chipped or stained teeth and that may be used to reduce gaps between teeth. By "bonding" you can perk up your appearance and self-image.

Dentists mix composite resin (plastic) into a paste, tint the mixture to whiten or match the colour of your teeth and apply several layers to a tooth. Each layer is hardened under a special light and final steps include shaping and polishing the resin material so the finished tooth looks natural and smooth.

Bonding can also be used to build up older teeth to make them appear younger. Anyone can have their teeth bonded, including a child, as the resin can be replaced as teeth grow.
Good Dental Habits: Do I Need To Brush Up On My Dental Hygiene?
If you give your teeth the "brush off", you may suffer in the future from gum disease and painful tooth loss. By following a few simple steps, you will ensure you keep your teeth for a lifetime. Here's how:
Floss daily to remove bacteria and reduce tooth decay.
Brush twice a day, holding the brush at a 45-degree angle, and brushing for at least two minutes.
Change your toothbrush every three months (Quick tip: New season ? New toothbrush).
Avoid eating sticky foods.
Choose sugar-free snacks, fruits and vegetables whenever possible.
Don't chew foods like ice or hard candies which can damage tooth enamel.
Never use your teeth as a tool to open bags, nuts, bottle caps or to cut thread.
If you play sports, always use mouth protection to prevent injury.
Taking care of your teeth and gums is easier than you think when you form good dental habits.

Sterilization: How Clean Is My Dentist's Office?
Sterilization kills harmful bacteria and viruses. The Ontario Dental Association (ODA) recommends sterilization guidelines for dentists to follow to protect their patients from infectious diseases, including AIDS. There is no evidence that AIDS (a virus usually transmitted through sexual activity or by sharing needles) or any other virus can be transmitted during dental treatment if proper preventative measures, called universal precautions, are used.

Today, dental professionals wear masks, protective eye glasses and latex gloves when performing procedures. They also sterilize dental instruments, operatory centres and equipment before each patient. There is even a sterilizer monitoring service to help dentists ensure their sterilization systems are operating properly. Also, nowadays, dental teams use disposable items such as needles, paper towels, plastic wrap, aluminum foil or pre-made covers and gloves to protect patients.

Still have concerns? See your dentist for more information.
TMJ Disorders: What Are TMJ Disorders?
Temporomandibular joints (TMJ), that is your jaw joints and muscles, are used to open and close your mouth when talking, chewing, singing and swallowing. Temporomandibular disorders (TMDs) are a group of conditions which can affect the jaw joint or muscle causing facial, tooth and ear aches as well as "clicking" in the jaw, "tension headaches" and even neck, shoulder or back pain. You may experience pain (ranging from minimal to severely debilitating) especially when chewing and opening your mouth wide, or your jaw may lock or be prevented from opening fully.

TMDs can be caused by injuries to the face and jaw regions, whiplash, poor posture, bite problems, badly fitted dentures, grinding teeth, and clenching your jaw resulting in damage to the joints or misalignment. Systemic diseases which effect the joints of the body (like rheumatoid arthritis, lupus, etc.) can also affect your jaw joint, causing degeneration.

Ask your dentist about examining your TMJ, if you are experiencing any of these symptoms. Special tests, including x-rays or MRI scans of the joints, are sometimes carried out. Most patients benefit from simple forms of treatment, including physical therapy, dental bite guards, and anti-inflammatory medication. Patients with persisting, severe pain may require surgery and may be referred to an oral and maxillofacial surgeon for consultation. See your dentist for more information.
Nursing Caries: Is A Toddler's Toothless Grin Charming?
Not always. Nursing caries in baby's first teeth occurs when babies habitually fall asleep sucking on a bottle. The sugar in whatever they're drinking (cow's milk, juice, formula or sugary drinks) turns to acid, dissolving tooth enamel. Breast-fed babies are also susceptible if they constantly fall asleep with breast milk on their teeth. Early signs of nursing caries include white spots/tooth discolouration. If the process continues, rampant decay and discomfort to the child results.

Children need their baby teeth to chew and to learn to speak properly. Fortunately, you can protect your baby from nursing caries. Don't let your baby go to bed with a bottle unless it contains plain water. Never let your child use a bottle as a daytime pacifier because all-day sucking is as bad as night-time nipping. Clean baby's mouth and teeth after meals and breast-feeding. Finally, if you suspect your child has nursing caries, contact your dentist immediately.

The Designer Smile: Cosmetic Dentistry

Implants - Filling in the Gaps

Brace Yourself - Adult and Children's Orthodontics

Root Canals: A Real Tooth Saver

Life's Grind Can Be Harmful to Your Teeth