What is considered a beautiful appealing smile?

You would think a beautiful smile is subjective, but the truth is, it’s largely objective! What makes a smile beautiful is the harmonious relationships that exist within the patient’s face, lips, teeth, gingiva (gums) which all need to be evaluated and sometimes to create the harmony that may be lacking for a given patient when they present. When we can manage/correct all of those relationships, (science), we can predictably create a beautiful smile that the patient will be happy. In other words an appealing smile is dependent on the harmony of the entire facial features, not just the individual set of teeth.

What is the best treatment available to whiten your teeth?

We still continue to recommend home bleaching techniques alone or in combination with the Boost technique, a technique that usually takes about 2 to 3 hours in-office to ‘jump- start’ the process followed by continued use of over-night trays for several days to complete the process. An immediate 3 to 5 shades improvement is typical. The result continues to improve with the use of over-night trays.

What is a 'gummy smile' and how do you correct it?

A gummy smile is used to describe a patient’s smile that displays too much gingiva (gum) when they laugh or smile. There are 7 different reasons why a patient may have a gummy smile. When necessary it can be treated orthodontically (braces) or surgically depending on the circumstances. A proper diagnosis is critical to determine which technique is ideally suited for each individual case.

And what age groups usually have them?

The age of patients presenting for implant dentistry ranges from young adults (16-17 years of age) to elders over 80. Again diagnosis is critical especially for the very young who may be congenitally (from birth) missing teeth. In these cases we have to plan their treatment and manage them until they complete the majority of their growth (usually15-17 for females and 17-18 years old for males).

Are implants permanent?

There is often confusion surrounding dental terminology. Implant dentistry like conventional dentistry can be designed as fixed or removable. Permanent is erroneously used to describe fixed restorations. The patient cannot remove a fixed restoration. In contrast, permanent is used to imply ‘forever’. Nothing in dentistry lasts forever.

What is new in Dental Implants?

Extraction of hopeless tooth and immediate implant placement is the most significant advancement in implantology. The use of 3D imaging software and virtual surgery has allowed for more precise and easier implant placement which usually results in less time and more accuracy.

What is TMJ and how do you diagnose it?

TMJ stands for the temporo-mandibular joint. This is an anatomical term. Literally it is where the lower jaw (mandible) inserts into the skull base. The exact area of the skull is anatomically described as the temporal bone. The coming together of these two bones is referred as a joint, thus the term temporo-mandibular joint (TMJ).

Usually when people they say “I have TMJ”, they are either talking about a muscle imbalance or a joint imbalance. Again a diagnosis must be made to distinguish between the two. Treatment can then be directed towards the specific problem. This usually is accomplished with a combination of splint therapy (there are many different splints that can be used depending on the problem), physical therapy, medications, behavior modification and even minor arthroscopic surgery.

An exciting new development is the relationship between airway obstruction and TMJ dysfunction.

To maintain healthy teeth how often should you have a check up and teeth cleaning?

When we’re young, the immune system can overcome much of our deficiencies in oral hygiene. Unfortunately as we age our ability to overcome biological challenges decreases. Our recommendation for children up to 18 years of age is twice per year and up to four times per year if they are undergoing orthodontics or have demonstrated high risks for caries (cavities). Adults should be scheduled two to three times per year to maintain the best dental health.

How often we should brush our teeth?

Plaque takes 24 hours to form so if you can brush all the plaques off the surfaces of all your teeth with one pass the answer is once a day. If I can’t do that with 10 brushes a day then the answer is more than 10, it really depends on how well you brush and floss your teeth. Assuming normal conditions, brushing twice a day and flossing once per day is usually adequate.

How long can I go between visits before I have to worry about it?”

Once the hygienist has removed all that tarter and plaque from all of the surfaces of your teeth and assuming you have a normal immune system, most people can withstand new accumulation within 3 to 4 months without serious consequences. However, how much time can elapse with new deposits on the teeth again depends on general health status of the patient, the amount of accumulation and the amount and condition of the dentistry that exists in the patient’s mouth. Therefore, 3 to 6 months is typical.

Is there any connection between poor oral health and poor general health?

There is growing evidence that good oral health is a requisite for good overall health. This is especially true in cases such as diabetes and respiratory diseases. Untreated oral diseases can be painful and can lead to serious infections. Studies are also currently examining whether there is a link between poor oral health and heart disease and between poor oral health and pre-term, low birth rate (PLBW) babies!

What is plaque? How does plaque differ from tarter or calculus?

Plaque is a combination of food debris and bacteria found in all mouths. It cannot be prevented. It is of soft consistency and loosely at attached to the tooth surface as a biofilm. It can lead to oral problems such as caries and periodontal disease and therefore needs to be removed daily. Calculus or tarter is a mineralized form of plaque. It cannot be removed with a toothbrush or floss and needs to be removed professional by a dentist or hygienist.

What are dental implants?

Dental implants are medical devices used in dentistry to replace missing teeth. They are made of pure titanium and are inserted under sterile conditions after careful planning often using sophisticated 3D imaging and imaging software. They can be used to replace one or more teeth and can be used for removable or fixed prostheses.

Special training is required to safely place dental implants and there are RCDSO minimum training requirements for dentists who use them.


Why do I grind my teeth?

There is no one recognized reason for why some patients grind their teeth. Some of the reasons theorized include stress, bite imbalances, habit, side effect of medications etc… one recent and interesting theory includes sleep-breathing disturbances. This is a rapidly developing area in medicine and holds promise for future understanding and treatment.

Can I use an OTC night guard?

This depends on the reason for the guard. OTC guards can be of some help if the only symptom is worn teeth. If there are joint pains or sore muscles an OTC can make the symptoms worse!!!

What is TMJ disease?

This is a combination of ‘illnesses’. Technically it is a chronic condition, which affects some anatomical structure contained within the TMJ. This includes any or all of the following; muscle, ligaments, capsule, retro-discal tissue, bone. the cause is not clear but involves hyper-active muscles which lead to breakdown of joint structures. The breakdown leads to inflammation which gives rise to pain.

Does grinding of teeth lead to TMJ problems?

Under most circumstances, the answer is no. In the short-term it will always lead to tooth wear most and sometimes sore muscles. Long-term it may lead to problems with the TMJ’s.

If I have recession and my roots are sensitive, what is the best way to treat them?

Usually by various desensitizing solutions provided the recession is not severe. If the recession were severe a better solution would involve a gum graft. Your dentist can diagnose this for you.

My tooth hurts when I bite down. Does that mean I have gum disease?

Pain on biting could mean you have gum disease but it would have to be very advanced gum disease. Usually pain on biting is an indication of a crack in a tooth. Your dentist can diagnose this.

How often should I have x-rays?

It all depends on your risk to caries (cavities) and bone disease. Your dentist can diagnose your risk and make an appropriate recommendation.

When should I have a crown? Why can’t I just have a filling?

A crown is necessary when a tooth or teeth have structural compromises such that the remaining tooth structure is at risk for fracture. Occasionally a large ‘filling’ may work but remaining tooth structure may still be at risk. Pain on biting is usually a sign of a tooth needing a crown. Molar and premolar teeth that have had root canal treatment usually require a crown to reduce the risk of fracture.

Is amalgam dangerous?

The scientific answer is NO!!! There are many situations where I is not advisable such as in patients who have known heavy metal allergies, the very young, pregnant women or in highly esthetic regions of the mouth.

What are my options if I choose not to have amalgam?

Depending on the size of the restoration, a composite resin may be used. When larger restorations are required, ceramic, gold and combinations of cramics and gold can be used. A relatively new application of an older material, zirconia, may be the material of choice in the future since it resembles porcelain but has strength approaching gold.

Should I have a root canal or an implant?

There is no absolute answer to this question. Again it depends on the circumstances. If the tooth is structurally sound and can be restored adequately after root canal treatment, then the tooth should be treated with root canal therapy over implant placement. A proper assessment by both the general dentist and the endodontist should be carried out. Retreatment endodontics is becoming less common because the long-term prognosis is not as predictable as implant treatment.

Are mouth rinses effective and what do you recommend?

Many mouth rinses are effective but not all. Listerine products are very effective in helping to reduce gingivitis and tooth sensitivity. Colgate and Crest also have good products. Check with your dentist and hygienist.

Do teeth get yellower as I get older and if so, why?

Teeth do get more yellow as we get older. The reason is that teeth have yellow dentin layer below the enamel and this dentin layer gets thicker as we age. As this layer gets thicker so too does its color. This is not all bad. As this layer of dentin thickens it insulates the tooth and the tooth become less sensitive especially to cold.

Stain is another reason why teeth get yellower as we age. Both are well treated with bleaching treatments.

Is bleaching safe?

Generally yes. But studies on its safety have only tested bleaching for periods of up to 3 months. One should ask how long a patient has bleached their teeth for and if they’re still bleaching before further bleaching should carried out.

I understand most offices use a fee guide to determine their rates. Is this true? How do you set your fees?

There is a fee guide for dentists in Ontario, which helps dentists set their fees. This is only a guide and is often modified to some degree by dental offices to reflect the level of training, experience and the degree of risk inherent in different procedures. Our fees are set in a similar fashion.

Do you charge for missed appointments?

Yes. Unfortunately the dentist’s time is all dentists have to earn a living with. If the time is not respected a dental office would not be able to carry on business. Of course there are always situations that can arise and force a patient to miss an appointment. Special allowances are made for these circumstances. However if the pattern of missed appointments continues a charge will usually apply. Often this can be remedied with strategic scheduling. This can be discussed with an office staff.