Your Smile Dental Care blog


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Knocked Out Tooth

Accidents! They happen so quickly!

One of our dentists at Your Smile Dental Care  remembers the time he hit his mouth on the handle of a jet ski during summer holidays. He recalls approaching his father (a dentist) very reluctantly who was sitting with 4 other dentists whose families were also vacationing with them. While a broken or knocked out front tooth may be every parent’s nightmare, it’s horrific for a dental parent – even though they are familiar with all the treatment options and outcomes.

Dental InjuryOver the years we’ve seen many facial and dental injuries and we’re always surprised just how resilient teeth really are! Considering the degree of trauma that some teeth experience during an injury, one would think that we would see more “knocked out” (avulsed) teeth than we actually do.

A few months ago, a young boy fell while riding his scooter and his adult front tooth fell out. His parents called our after-hours emergency number and we set up an appointment for him immediately. We were able to place the tooth back into it’s socket and stabilize it. Because the tooth had fallen onto the ground and become contaminated he was sent home with  a special antiseptic oral rinse and a prescription for antibiotics.

An avulsed tooth requires immediate attention and your quick action can increase the likelihood of long-term survival. When a tooth is knocked out it’s blood and nerve supply is severed, but it can still reattach to the jawbone if it receives the proper care before you get to the dental office. Some teeth are able to reattach by way of their ligaments, whereas other teeth fuse directly to the bone. A root that is still in development may even be able to successfully continue it’s nerve and blood supply development.

Immediate Treatment (the first 15 minutes)

1. Locate the tooth, but hold it by its crown portion only (the part that you usually see in the mouth). Gently rinse it with water, milk or saline if it has become contaminated with debris, while being careful not to remove or damage any of the delicate tissue fibers that is on it’s root surface. These are the ligaments that will hopefully reattach themselves to the tooth socket.

2. Clean away any dirt or blood that is in the mouth by gently rinsing with water.

3. To help stop the bleeding and to aid in replantation, try to place the tooth back into the socket making sure that it is facing the right way, but don’t force it. Once inserted, apply gentle, sustained pressure with your hand or by biting on a damp piece of fabric if no facecloth or gauze is handy. If this is not possible, there are a few other ways to keep the tooth moist and protected as you make your way to a dentist.

– Place the tooth under the tongue or along the inside cheek area. If it is a child’s injury there is always the possibility that they may swallow the tooth if it is kept in the mouth. You will need to supervise them carefully, but only you can determine if they are old enough to do this.

– Alternatively, you can place a tooth in a clean container or baggie containing some milk, water, saline or saliva.

There is a product on the market called “Save A Tooth”  that can be placed in your emergency kit. It comes with a container that has a special solution in it that is designed to preserve an avulsed for up to 24 hour giving you the precious extra time you may need to get to a dentist. 

Dental Treatment

Avulsed tooth stabilizationOnce you arrive at the dental office they will give you and your tooth the necessary care and attention. There are no guarantees when it comes to replanting a tooth that has received such an injury, but knowing what to do immediately after the accident can increase your chances of saving the tooth, and in turn, saving you money. The mishandling of the avulsed tooth can significantly increase the failure rate of replantation.

The tooth will eventually require root canal treatment, but the alternative treatment for a lost tooth is replacement with a bridge or implant, so keeping the tooth is the best scenario.

Unfortunately, emergencies can happen at any time of day and finding a dentist that is available may be difficult. We provide our patients with 2 dental emergency telephone numbers so that immediate care is available to them ~  Call (905) 5SMILES (576-4537) after hours.

However, if you are planning a vacation, consider having the names and contact information for any nearby dental offices. Knowing what their in/after office hours and emergency policies are ahead of time may also help save you time and frustration.

Emergency Kit

Consider adding some of these dental emergency supplies to your home and car’s Emergency Kit so that you will always be prepared:

1.  A “Save A Tooth” kit
2. Protective gloves
3. Tweezers
4. Dental Floss
5. Saline solution
6. Gauze sized 2×2
7. Clean plastic baggie or small container
8. Antimicrobial skin wipes
9. Oil of Cloves (Eugenol)
10. Plastic dental mirror
11. Q-tips
12. Ibuprofen

Prevention

Accidental are not always preventable, but you can minimize your risk by wearing a sports guard. They can be purchased at pharmacies and sporting goods stores or we can make you custom-fitted sports guard which is more comfortable and fits better for added protection.

At Your Smile Dental Care we are always available to answer your questions because we believe strongly that an educated patient is a better prepared patient. If you have questions or concerns about dental emergencies please do not hesitate to call us at (905) 5SMILES (576-4537)

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Heart Attack

This could save your life……

One of our long time patients was in to see us recently and related a story to us that gave us all a moment of pause. She would like us to share her story in hopes that it will save a life.

This patient had spent the day wedding shopping with her daughter, but had been feeling a little “off” as she put it. She just didn’t feel herself and even felt a heightened level of anxiety that she attributed to wedding stress. As the day progressed,  her anxiety grew and she developed an ache in her neck and jaw area. She initially thought that maybe she had been grinding or clenching her teeth and was now feeling the effects.

She arrived at home and after about an hour or so decided that she would go to bed early as she was still not feeling well. Her husband decided to check in on her and found her in distress and sweating. Despite her protests, he decided to phone 911 and learned from the paramedics that she was actually having a heart attack. She is one of the lucky ones – she survived.

Will you recognise your heart attack?

16-06-2014 11-11-47 AMWe are accustomed to associating heart attacks with a sharp pain or squeezing feeling in the chest. Even indigestion can get a person thinking about the possibility of heart trouble. Like this woman, we rarely think of our heart when we are experiencing jaw or even tooth pain, so it is important that we all remember that not everyone experiences crushing chest pains at the onset of a heart attack. The signs can be vague or too silent for us to identify with.

Even though there are many things that can cause jaw and tooth aches, there are usually other accompanying signs that will help you identify the possibility of a heart attack. Do not hesitate to call 911 even though it is easy to ignore signs and symptoms and attribute them to other conditions.

I think over the past few years, we have become reluctant about visiting an emergency or urgent care clinic because of the long wait times. There seems to be a feeling of inconvenience about the whole process, but every second counts during a heart attack – there is no time for feeling like a nuisance or denial. Driving to the emergency takes away from the precious time you have whereas calling 911 will allow the paramedics to begin treating you immediately.

We are accustom to denial in our business and pain can be a such an annoyance! We remind our patients not to ignore pain even after it subsides because it will eventually return in one form or another,  and regretfully,  often at an inconvenient time. Thousands of Canadians die from heart attacks every year because they don’t receive medical treatment quickly enough. We invite you to visit the Heart and Stroke Foundation of Canada’s website.  It is full of the vital information everyone should be aware of.

Heart & Stroke Foundation

Yours in Better Health,

The Your Smile Dental Care Team


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Paperwork, Paperwork, Paperwork!

Why does my dentist need to know my health history.

So, you go to the dentist for a matter concerning your teeth or perhaps you’re there for your bi-annual dental check-up and cleaning and your exam begins with a bunch of questions about your overall health.

What gives?
Why does a dentist or hygienist want an update of your medical history at every visit?

This is a very legitimate question. After all, you may be coming in for just a simple visit and do not understand what the rest of your body has to do with your mouth.

We are caring for you – not just your teeth!

20140915_103718_resizedYou may have read somewhere about the “Body – Mouth” connection. There are medical conditions that significantly impact your oral health, determine the course of future dental treatment or explain why a particular problem keeps reoccurring. When we exam you we are seeing more than just your mouth. We are caring for you, not just your teeth! We are concerned with making accurate diagnoses and following up with individualized treatment.

Obviously, patients with more complicated health histories will require more attention than others. In order to maximize our patient’s time with us we routinely ask that they keep a current copy of their medication list in their wallets for quick reference and let us know in advance of their visit here if there has been any significant changes in their health. Sometimes, it is necessary to follow-up a health issue with the family doctor. Your family physician may prescribe some medication for you to take prior to your dental treatment, especially if you have recently had a new body prosthetic placed or have had a heart stent procedure. Other times, a medication may have to be temporarily discontinued before a particular dental procedure can begin.

We’re here to help!

MedsWe understand that your time is valuable and that you would like to get to your dental matter at hand rather than filling out forms. Updating your medical information may seem like an imposition to you or you may not want to disclose certain personal health issues to us, but it is important to understand that it is with your safety in mind that we must collect this information and ask any pertinent follow-up questions. What may seem like an irrelevant health issue to you may turn out to be the essential information we need when diagnosing, treatment planning, using materials in your mouth or prescribing medications. Knowing these details can save your life!

It is a strict protocol in the province of Ontario that patient health histories are clearly documented and updated regularly. We need you to be as comfortable with us as you would be with your family physician. We would like to think that our patients appreciate that we hold their health in such high regard and that we do not omit this part of your care. At Your Smile Dental Care we treat our patients as we do our own family and friends. Keeping current and accurate patient records help us deliver the very best care to you – our valuable patients.

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Bad Breath Buster

So, you’ve just spent 5 minutes of your precious time brushing your teeth and flossing. They feel great and your mouth smell minty fresh – or does it?

What about that other place in your mouth full of strands of tissue that make the perfect hiding place for all of those nasty germs that you just brushed off your teeth? Look at your tongue right now. Is there a whitish film on it? Chances are there is some degree of coating on your tongue and it’s removal should become part of your home care routine.

Yuck!

It’s easy to forget the tongue while you’re busy focusing on your teeth and gums, but bacteria, plaque, viruses, food and dead cells love to accumulate amid all the nooks and crannies on your tongue and contribute to poor oral health and bad breath. In fact, studies show that up to 80% of bad breath originates on the tongue.

I’m sure everyone is familiar with that sulphurous odour that smells like rotten eggs. Well, the reason why bad breath is such a common problem is that the germs on the tongue produce this smelly gas, yet it is an area of the mouth that is often overlooked during our home care.

And it’s not enough to just brush your tongue after you have taken care of your teeth. The toothbrush to designed for the smooth, solid surfaces of your teeth and gums whereas your tongue has a rougher, hair-like landscape. Germs must be scraped out of these deep areas not just brushed around. Mouth rinses are not effective either in removing this coating and many brands contain alcohol which “dry out” the mouth allowing the breeding of even more bacteria.

Tongue Scraper

Tongue Scrapers

Although there are tons of products on the market to clean your tongue, we advise our patients to stick to the tongue scrapers such as the one in the photo above. Used once in the morning and again during the day, these scrapers are glided along the tongue’s surface in a back to front direction bringing the white coating forward and off the tongue. This will help eliminate the bacteria and their volatile odours. Be careful not to scrape too harshly as you can irritate the tongue’s surface. It is also important to keep well hydrated during the day as a dry mouth also contributes to bad breath. Using sugar-free gums and mints during the day can assist your salvia in keeping your mouth moist. If dry mouth has been a problem for you, you may want to read our article, “Dry Mouth.” You can access it here:
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The Mouth-Body Connection

If you have persistent bad breath or you suspect that the coating on your tongue is more than just a collection of germs or food you should come in for a dental examination as soon as possible. There are other conditions/diseases of the tongue that cause discolouration, swelling or flaking of the tongue’s tissue that require more attention than just a simple cleaning. Most are easily treated with medication while others can be more serious or even life threatening.  Bad breath can result from gum disease, cavities or any number of health conditions. It is important to remember that your mouth is an area of the body where illnesses of the body often manifest themselves. We refer to this as the Mouth-Body connection and during dental examinations we see more than just your teeth and gums. Please talk to us about your concerns. We’re here to help.

Yours in better dental health,

The Your Smile Dental Care Team


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How To Choose The Right Toothbrush.

Choosing the right toothbrush for you…

You may not know this, but us dental people rarely spend time in the tooth products aisle of any given store. We’re fortunate in that dental products come to us via our dental product rep – the person we buy our dental office supplies from.

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A few summers ago, one of our staff members forgot to pack the family toothbrushes for vacation. In her 25 years in dentistry, she had never had to purchase a toothbrush and now found herself standing in front of a selection of dental products like the picture above. She realized that this is what the average person has to deal with every time they make their family’s dental purchases … Choices … Too many choices!  Since her family was vacationing for only a week, she opted for the least expensive ones.

Having choices can be a great luxury, but it can also be very overwhelming! There’s no one-size fits all toothbrush, so you should select one that meets your own individual needs and will benefit you the most.

Size
No matter how fancy the toothbrush, if you cannot reach all the hard to get to spots in your mouth then you will not be able to clean effectively. The head of the toothbrush where the bristles are should be small enough to brush all the surfaces of your teeth and gumline without causing you pain or too much gagging. Oftentimes, an adult will find that a child-sized toothbrush will fit better than a larger one. The handle of the brush should be long enough to fit in your hand and to maneuver the brush with ease and comfort in the mouth.

Bristles
It is surprisi02-06-2014 11-14-48 AMng that many people still think that a hard-bristled toothbrush will do a much better job at removing plaque than soft-bristled ones. We’ve had patients tell us they find that it hard to believe that soft bristles can do an effective job and that the bristles seem to wear out quicker than hard ones. It is important to understand that soft bristles are flexible enough to splay (spread out) and get into the nooks and crevices of each tooth and up under the gum slightly without causing damage to enamel and gum tissue.

When you use harder bristles or use too much hand pressure when brushing your teeth you can wear away enamel and gums over time and actually cause your teeth to appear darker. When you wear away enamel more of the darker dentin tissue underneath may begin to show through the outer enamel. Hard brushing action can also cause grooves or notches to appear on your tooth along the gum line which will allow bacterial plaque and food to accumulate. These grooves will have to be eventually be filled in with filling material so that a cavity will not form. When you wear away enamel or gum tissue they never grow back. Over time, this wearing away action causes the underlying dentin to wear away also and/or the tooth root to appear. These parts of the tooth are more sensitive to hot and cold and decay much more readily than enamel.

Like the way a hard-bristled tooth brush removes plaque more readily but don’t want damage your teeth and gums?

Plaque is soft and easily brushed away using a softer toothbrush if you just take your time and brush correctly. Over time, if plaque is not removed the saliva will mineralize and harden it turning it into a material we call calculus. You cannot remove this calculus with a toothbrush so there’s no sense in brushing vigorously and causing damage while trying to remove it. Your dental hygienist can remove this calculus (tartar) at your regular cleaning appointment.

You wouldn’t use hard, abrasive products that will ruin the smooth, glossy finish on your bathtub.  Treat your teeth even better!

Electric vs Manual
If you are using the correct toothbrushing technique then your hand held manual toothbrush can be just as effective as an electric one. However, time and time again, we have seen a remarkable improvement in the cleanliness of teeth and overall gum health when our patients have switched to an electric toothbrush. Perhaps people tend to spend a little more time brushing or concentrate a little harder when using one. Regardless, the price of electric toothbrushes have decreased so significantly that they are now an affordable option for many and are especially useful for people with limited hand coordination and mobility.

With electric toothbrushes, all you have to do is tilt the brush at a 45 angle and guide the brush along the gum line and in between the teeth – the bristles do all the work! The newer models even warn you if you are using too much pressure. The pulsation of the bristles are excellent for healthy gum stimulation and for getting into all the hard to reach places easier, but the strength of the vibration can take some time getting used to. Patients also find that electric toothbrushes are more effective at removing tooth stains. The good news is that most parents who have had struggles getting their children to brush are reporting that their kid seem to find electric toothbrushes “fun” and are spending more time brushing. This, of course, leads to cleaner, healthier teeth.

Sharing Toothbrushes 
For hygienic reasons and to avoid cross-contamination of bacteria, viruses and disease: Never share toothbrushes!

When to buy a new toothbrush 
If you are brushing as often as you are suppose to (2-3 times/day) you will find that after 3-4 months your toothbrush bristles will begin to appear bent and frayed. In this condition, the bristles are not as effective and it’s time to buy a new one.

Storage 
Bacteria breed in warm, dark and wet places. Never store your toothbrush in a closed container. After use, rinse your toothbrush with water and store in an upright position in a clean cup to air dry until the next time you use it. Keep your toothbrush away from the flush of the toilet, the splash of the nearby sink and other people’s toothbrushes. Some people even prefer to store their toothbrush in a safe, clean place in their bedroom.

There are many toothbrush sanitizers on the market that use ultra violet light to kill germs and help keep your toothbrush clean. The science behind these devices show that they are effective at killing most of the germs, but not 100% of them. The choice to purchase one comes down to how effective you are in keeping your toothbrush clean and you should certainly do you research before making the investment. We have found that some patients really like the sanitizing units that come with their electric toothbrushes, while others seem not to care one way or the other.

Bottom Line
A toothbrush is a small investment that can make the world of difference to the health of your mouth and your overall well being. Your teeth can last a life time and we work hard at Your Smile Dental Care to educate our patients and help them feel comfortable in asking questions about their individual dental needs. All of our patients are provided with a new toothbrush and floss at their re-care visits so that the only choice they are faced with is what colour they will choose. 🙂

Are you using the proper tooth brushing technique!  Watch our video below:

Yours in better dental health,

The Your Smile Dental Care Team