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What’s Brewing in your Mouth?

GERMS!

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You can’t see them, but you can sure feel, taste and even smell the hundreds of different types of germs that make their home in your mouth.

While many of these bacteria are harmless, others wreak havoc in the mouth causing tooth decay, inflammation of the gums and bad breath.

Let’s talk about bad breath. No one wants it, but everyone has it from time to time. Even though bad breath is a common condition and is oftentimes very embarrassing, it can also be an indicator of health problems in the mouth and/or rest of the body.

So what can you do to help fight bad breath as well as keep your mouth healthy?

Aside from ensuring that you are in the habit of brushing your teeth 2-3 times a day and flossing daily, you will also benefit from following these other 13 tips:

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1. Clean your tongue! Bacteria love to hide in the hair-like filaments that make up tbe upper side of the tongue, so don’t forget to also clean your tongue with a toothbrush or tongue scraper

2. Use an antiseptic mouth rinse once a day to help kill germs and fight bad breath

3. Reduce snacking in between meals. When you cut off the sugary food source that germs eat you also cut down on the number of acid attacks that occur in the mouth

4. Drink water often throughout the day to help wash away food particles and germs from the mouth and also prevent dry mouth

5. Eating a piece of sugarless candy or chewing sugarless gum will help stimulate saliva flow to wash away food debris and bacteria

6. Do not sip on sugary drinks or coffee/tea with milk, cream and/or sugar frequently or all day long

7. Consume alcohol and coffee in moderation as they also tend to dry out the mouth

8. Speak to your doctor if you suspect that you have a dry mouth condition as it can be an indicator of a health issue or be a side effect of medication

9. Ensure that other medical conditions like diabetes and heart disease is monitored by your physician regularly and is under control

10. Quit smoking or using otber tobacco products

11. Eat a healthy, nutrient-rich diet that helps to control inflammation

12. Eating crispy, fresh fruits and vegetables also increases your saliva flow to help wash away other food debris and bacteria

13. Be aware that during illness and prolonged periods of hunger or fasting from meals, acids in the stomach can build up and cause foul breath also

 

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com

 


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Medications and YOUR SMILE

  • Are Medications Ruining YOUR SMILE?

We are seeing a growing number of patients that are experiencing dryness of their mouths and a number of dental issues associated with this dryness.

In fact, some dryness of the mouth can be so severe that it is not just uncomfortable, it becomes very painful. Additionally, there are times when the throat is so parched, that a person can’t even swallow.

The Importance of Saliva

You may not have given much thought about saliva, other than the fact that the mouth is moistened by it, but the production of saliva is an important process in the mouth. It not only moistens, but it helps control the levels of  bacteria and fungi in our mouths, aids in chewing, tasting and digestion, cleans, protects and remineralizes teeth, and neutralizes our mouth after acid attacks.

Naturally, when a patient complains about a decrease in the quality and quantity of their saliva, we become concerned.

The condition of persistent dry mouth is called Xerostomia and it is a common side effect of many of the prescription and non-prescription medications we may be taking as well as a manifestation of certain diseases such as Aids, anemia, stroke, hypertension, cystic fibrosis, arthritis, Parkinson’s disease, cancer, diabetes and a condition called Sjogren’s syndrome.

Your saliva output can also be damaged by medical treatments such as radiation and chemotherapy, smoking/tobacco products, menopause and dehydration from illnesses, bulimia, excessive sweating, diarrhea, blood loss and burns.

Because our bodies are about 60% water, even a small drop in hydration can affect us immediately, let alone long term. There are over 500 medications that list dry mouth as a possible side effect.

Check out the Colgate Oral Care webpage where the classes of prescription drugs that affect the salivary glands are listed.

If you suspect that you are experiencing dry mouth, speak to your family physician and even your pharmacist as soon as possible. They can, hopefully, find a solution that is right for you.

As dentists, we can recommend that you:

  • Restore any dental issues that have arisen due to dry mouth.
  • Ensure that you are brushing at least 3 times/day and flossing before bed.
  • Limiting your meals to 3-4/day and spacing them out 4-5 hours apart
  • Reduce the amount of sugar you intake
  • Ask your doctor to suggest the vitamins supplements that are right just for you
  • Choose a product from your local pharmacy for help with dry mouth. This includes, sprays, rinses and special toothpastes. You may have to try a few until you find one that works best for you.
  • Chew sugar-less gum or suck on sugar-free lozenges
  • Drink more water
  • Using a humidifier in your bedroom at night
  • Use a fluoride rinse at bedtime
  • If you use a mouth rinse choose an alcohol/peroxide-free product
  • Avoid weather and activity that causes excessive sweating
  • Use a nasal spray if you are experiencing sinusitis
  • Avoid tobacco, alcohol, caffeine, carbonated beverages and highly acidic juices
  • Avoid dry food such as crackers and toast
  • Avoid very salty foods

Unfortunately, if dryness of the mouth persists and is left unchecked, it can lead to tooth decay, mouth sores and gum problems. If you would like more information about dry mouth, please follow the link below:

 

 

Yours in Better Dental Health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com


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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.

As such, we ask that our patients bring in a copy of their medication list when they see us for their check-ups so that we can up date our records and advise as necessary.

Never underestimate the value of your health history…

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!

Patient health histories are clearly documented and updated regularly in our office. 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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Yours in Better Dental Health,
Your Smile Dental Care Team 
(905) 576-4537
(416)783-3533
www.yoursmiledentalcare.com


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Your Stinky Floss

… and the debate continues

 

Even though it was last year that the Associated Press report suggested that flossing was overrated and unnecessary, we are still being asked by patients whether flossing is necessary or not.

 

The simplest answer seems to be answering their question with another question: “What do you suggest for cleaning plaque and food from in between teeth and under the gums?”

 

Although there are other effective interdental aids for cleaning in between teeth, flossing is the only device that can actually get into the tight area between teeth – assuming there is not already a space or gap.

 

With the toothbrush only able to reach 3 of the 5 tooth surfaces,
what does this AP report suggest people do to clean the other 2 surfaces?

 

People will have to excuse their dental care providers for getting a little defensive when the health benefits of flossing is called into question. At Your Smile Dental Care, we’ve seen the value that flossing brings to our patients’ oral care over the past 30 years and we will continue to dig in our heels on the subject.

 

We only need to use our common sense about flossing. If you have something in a body part that is causing a foul odour and inflammation that can lead to loss of surrounding tissue, infection and loss of said body part, would you not want to get it cleaned out?

 

Dental neglect is preventable and flossing is an inexpensive addition to
your
oral care routine to help you take care of your teeth and gums.

 

Practicing the best oral care you can with the tools available is important when it comes to your overall health. The link between gum disease and a number of other serious health conditions such as heart disease, diabetes, respiratory infections, and immune system disorders has been well established.

 

Most of us are already making changing in our lifestyles so that we can live healthier and longer. A daily 2 minute routine seems like one of the easier changes we could be making.

The bottom line is this: There is research and studies that both sides of this argument can cite to continue their claims. No doubt, the debate will go on and on while the plaque and tartar build up and up!

 

Note to the Associated Press: For all those people that are able to remove meat and popcorn caught between their teeth using their floss – Is that evidence enough? How about how stinky our floss is after use – Is that evidence enough?

 

Yours in Better Dental Health,
The Your Smile Dental Care  Team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com


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What is a Periodontal Screening?

Does your smile pass the Test?

No doubt, you have heard how important it is to take care of your gums for the health of your teeth, but it can also affect your overall health. Gums, also known as gingiva, is a barrier tissue that covers and protects your teeth and the bone that surround and support your teeth.

When gums become tender, swollen and begin to bleed, it is usually a sign that the body’s immune system has been triggered.

Our mouth is home to a complex ecosystem of microorganisms. While much of the bacteria is our mouth are beneficial in preventing disease, there are some that are harmful if allowed to take over. The proper balance of these germs is critical for a healthy mouth. Certain processes take place everyday to keep this balance from being disrupted so that a response from our immune system is not triggered.

Some patients become aware that something is going on when they begin to notice bleeding when they brush their teeth. Others have had progressive gum disease for a long time and are surprised to learn of it.

Periodontal Screening

Watchful Eyes

Your dentist and dental hygienist are trained to not only help you maintain healthy mouth and teeth, but they are always monitoring your mouth for signs of the onset of gum disease. By routine – usually once a year – they will perform a gum evaluation called a periodontal screening.

During this screening, they are assessing the health of your supporting gum and bone structures and evaluating the look of your gums.

Healthy gums are pink and firm. Unhealthy gums are red, swollen, spongy-looking and may bleed. They also look for signs of gum loss (recession) and use a tiny instrument called a probe to measure the depths of the pockets between the teeth and gums. The pocket is a free space located around each tooth. In between each tooth it is where your floss enters for cleaning.

In a healthy mouth, this free space becomes attached gum about 2-3 mm of the way down. When bacteria is allowed to accumulate in this space inflammation occurs that triggers the immune system to send white blood cells. Unfortunately, the WBC not only destroys bacteria but gum tissue also. When the attachment portion of the gum tissue gets destroyed, the pocket become deeper and more bacteria, dental plaque and food can accumulate.

If left untreated or unnoticed, this pocketing will lead to bone loss. Eventually, enough bone is lost that the tooth becomes loose and cannot be saved.

Early detection is key

This is why it is important to identify this pocketing early in order to prevent further gum and bone loss. There are various treatment options available for gum disease and your dentist may refer you to see a gum specialist (Periodontist) for ongoing care.

Unfortunately, gum disease is called a “silent disease” that often goes unnoticed until a significant amount of damage occurs. This is usually the case for people who do not see a dentist routinely where the health of their teeth and gums can be monitored on a regular basis.

Periodontal disease has long been the leading cause of tooth loss in adults which is why every patient should have a periodontal screening performed annually. Early detection is key and can make all the difference.

The good news is that gum disease is an easily preventable disease. By simply brushing your teeth twice a day, flossing daily, and attending to regular dental check-ups and cleanings you are already helping your mouth and teeth.

To keep them in tip-top shape you need to start looking at your other habits:

  1. Meal frequency – Reduce snacking in between meals to allow your saliva to repair damage done by acid attacks. Read here
  1. Do not sip on sugary drinks or coffee/tea with milk, cream and/or sugar frequently or all day long.
  1. Use an antiseptic mouth rinse once a day
  1. Ensure that other medical conditions like diabetes and heart disease is monitored by your physician regularly and is under control.
  1. Consider a smoking cessation program as smokers are almost three times as likely as nonsmokers to have periodontitis
  1. Eat a healthy, nutrient-rich diet that  helps to control inflammation.

Suggestions:

  • green leafy vegetables such as spinach, kale, and collards
  • fruits such as strawberries, blueberries, cherries, and oranges
  • fatty fish like salmon, mackerel, tuna, and sardines
  • nuts and legumes
  • olive oil
  1. If you suspect gum disease, never ignore the signs and see a dentist.

Signs:

  • red, swollen gums
  • tender and/or bleeding gums
  • loose gums that have pulled away from your tooth
  • sensitive teeth
  • pain when eating
  • receding gums; tooth appears longer
  • spaces between tooth and increased food impaction
  • loose fitting partial dentures
  • persistent bad breath

 

Keeping your gums healthy and strong is the simplest way to maintain your overall health and help to ensure you keep your teeth for life. If it has been a while since you have been to the dentist for a check-up or suspect you may be having problems with your gums please contact our office today at 905 – 5SMILES (905.576.4537). You’ll be glad you did!

Your in better dental health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com


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A Partial Glimpse into Dentures

Mithing some Teeth?
Here’s a Partial Solution!

24-03-2014 3-24-55 PMIt is unfortunate when you are missing several teeth and eating and smiling has become difficult – even embarrassing.

Finding a solution that is the right fit for you involves a number of considerations and your dentist will help you understand the factors involved in your specific-to-you situation.

Although implants are the most advanced tooth replacement, are cost-effective and are available for even the most complex cases, not every patient is an ideal candidate or can afford them at the time needed.

So, what are your other options then?

Perhaps, the idea of dental implants can be revisited at a later date. Until then, the spaces can be filled with bridges or dentures. Today, let’s take a look at your partial denture options:

 

Dentures are classified into 2 main categories: Full or Partial dentures.

 

Full Dentures – Are available for patients who have all of their teeth missing in the upper or lower arch or both. They are removable, but fortunately, full dentures can be secured to dental implants for added support and confidence while still being removable. They are made of acrylic and can be relined with more material as your jawbone changes in size and height due to missing roots.

 

Partial Dentures – Are designed for patients who are missing several, but not all the teeth in the upper or lower arch or both. There are several different types of partial dentures depending on design and materials used. They are supported by teeth and gum tissue, so the health of these are considered during selection. Each type of partial denture has their own set of pros and cons with some dentures using a combination of materials.

 

dnetures

 

Cast Metal:

– thin, metal alloy framework and claps

– more expensive

– metal not very aesthetically pleasing

– biocompatible metal, so hypoallergic for most people

– not usually harsh on health of gum tissues

– soft liner can be added to increase gum comfort

– preferred type of partial denture in terms of strength, durability, retention, thickness and fit.

– can have coloured plastic added that look like gums.

– more difficult to reline as gum and jaw changes unless soft liner added.

– more teeth can be added as needed.

 

Flexible

– made of nylon or another type of composite material

– moderate cost

– very aesthetically pleasing and can be colour blended to match gums

– very flexible and thin

– more comfortable in the mouth for chewing and speaking.

– hypoallergenic

– better on gum health than acrylic

– more damaging to natural teeth than a metal denture

– very good retention using clasps and undercuts

– more teeth can be added as needed, but some flexible material do not bond together well making the addition of new teeth ans relining more difficult and expensive.

 

Acrylic:

– made of a rigid plastic material

– much more affordable option as they are less expensive and easier to make.

– gum-coloured plastic is more pleasing than metal

– weaker and less durable than metal.

– plastic can pick up odours and stains

– can break more easily than Metal or Flexible

– plastic can be allergenic for some people

– more damaging to natural teeth than a metal denture

– can have more plastic material added if jaw/tissues change shape

– more teeth can be added as needed.

 

What You Should Know

In general, partial dentures:

  1. can interfere with speaking
  2. are less stable than natural teeth, bridges or dental implants
  3. may have supporting clasps that can break or bend, but they usually can be fixed readily
  4. need to be relined as jaw dimensions change
  5. need to be removed nightly to keep mouth tissues healthy
  6. prevent shifting of adjacent teeth until a more long-lasting, permanent solution is selected
  7. can wear down over time by natural teeth
  8. can be lost since they are removable
  9. need maintenance or repair of framework and components as they wear
  10. can be relined to accommodate changes to the underlying bone. Expense depends on type of material used to make partial denture.
  11. can have their fit impaired by any changes to the existing teeth because of decay, repair or loss.
  12. have artificial teeth that can be easily repaired or replaced.

 

 

Tendering in Tradeoffs

 

04-11-2014 2-04-12 PMNothing in life is as good as the real thing. There are tradeoffs that are made when we have to repair or replace our natural teeth. This is why caring for your teeth properly your whole life will increase the likelihood of “Teeth for Life!”

Every dentist has heard a patient say that they are just plain sick and tired of having to care for their teeth and think that by removing and replacing them with dentures they will become worry free of dental problems.

Wrong! They are trading one problem for another. Dentures come with their own set of issues, and, like teeth, they still require care yo prevent damage and prolong their life. Speaking, eating, comfort, mouth sores, and stability are just some of the issues you will likely face with dentures at one time or another.

How long a partial denture will last also depends on the proper care of existing teeth. There is no 100% perfect replacement for your natural teeth. The time and effort you put into caring for them is never a waste as it can make a huge difference in your dental health.

Furthermore, it is important to understand that dentures and bridges do not replace the missing tooth roots – only the visible tooth crown. Eventually, the jaw bone that once supported the roots will begin to shrink and reduce in overall size. This is an important consideration as dental implants need healthy jaw bone height and volume into which they are placed and eventually integrate into. The jawbone can be augmented using bone grafts, but this increases the complexity and cost of the dental implants.

 

Short Term vs Long Term

 

07-09-2015 6-03-36 PMEveryone knows the feeling of being faced with options. Decisions are not always easy and the more options available, the harder the decision. Your dentist is there to help you sift through all of the information, weigh all the factors and understand the tradeoffs you may have to make. Do you opt for an affordable solution that has limitations, a shorter lifespan and will require more on-going maintenance or do you invest now in the premium permanent option?

Being an informed patient who understands fully the pro and cons of each dental treatment option helps you move forward to the day when you can eat and smile with confidence.

Lastly, it’s Your Smile. Dental care is necessary for your remaining teeth. The function of chewing is meant to be distributed amongst many teeth. Expecting a few to do the job of many will result in wear and breakdown and you will run the risk of losing your remaining teeth through disease and dental collapse. If you are missing one or more teeth, see your dentist today to discuss your treatment options today. You’ll be glad you did!

 

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Your in Better dental health,
The Your Smile Dental Care team
(905) 576-4537
(416) 783-3533
www.yoursmiledentalcare.com


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Aging Well

Top 10 Aging Smile Solutions:

Aging can affect your oral health just like it can your overall health. Even if you have taken care of your teeth meticulously over the years, your teeth can show the signs of aging and can make you look older than you are or feel!

Fortunately, there are steps you can take to correct or at least minimize these changes.

1. Dark Teeth – As you get older your teeth can appear slightly darker or dull looking. This is usually because the outer, whiter enamel begins to wear as the inner yellow dentin begins to thicken. Staining foods/drinks and previous injuries to your teeth can also cause discolouration. Solution: Tooth whitening or veneers can brighten your tired smile. Avoid foods/drinks that stain which can compound the natural darkening of your teeth.

Whitening

2. Dry mouth – Some medications can reduce the amount of saliva your body produces leaving you with a drier mouth. This interferes with chewing and increases the likelihood of gum disease and cavities. Solution: There are sugarless gums and oral products that you can find at your local pharmacy which can help increase saliva stimulation and fluoride rinses to help strengthen enamel. Speak with your family physician to find out if one of your medications is causing your dry mouth. Perhaps there is an alternative medication that can be prescribed.

3. Longer teeth – Ever heard the saying, “Long in the tooth?” If you are losing gum tissue (recession) more of your tooth begins to show. If this gum disease process continues, eventually the softer, more sensitive root portion of your tooth will become exposed. Solution: Fluoride varnishes/rinse and sensitive toothpastes can be used to decrease discomfort. Avoid hard, abrasive toothbrushes and toothpastes. Use lighter force when brushing. Consult your dentist to find out if you are experiencing the effects of gum disease. Therapy can be started to slow down this gum loss.

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4. Smaller Teeth – Teeth naturally wear over time, making them appear shorter and flatter. Clenching and grinding can also cause the biting surface of your teeth to wear down. Solution: A night guard can slow down this process and prevent further tooth loss. Filling and dental crowns can be placed to repair more extensive damage.

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5. Smaller jaw – Bones change over time and forces are constantly remodeling your facial bones. As the years pass, you will eventually lose volume in the size of your jaws. Losing one or more teeth without replacing them will also cause the jaw to shrink. Solution: Replace missing teeth as soon as possible to maintain jaw strength and size. Eating a well-balanced diet will help to ensure that you are receiving the nutrition necessary for bone growth and maintenance.

6. Sagging Facial Skin – If your jaws and surrounding facial muscles are shrinking and losing definition, the overlying skin may begin to sag causing you appear older than you really are. Solution: Aside from cosmetic facial surgery, proper nutrition, chewing and replacing missing teeth sooner than later are beneficial in reducing bone loss. We now know that replacing a missing tooth with a bridge or denture will restore chewing, but will also accelerate bone loss in the jaws. A dental implant, however, takes the place of and functions like the missing root while maintaining the valuable facial bone.

7. Tooth Sensitivity – The tissue that surrounds the root of your tooth is not as naturally calcified as enamel, is more sensitive to chemical and thermal changes in the mouth and is less decay-resistant. If your gums are receeding then more of the root will begin to show increasing the likelihood of decay and discomfort. Solution: Fluoride can be applied to these areas to strengthen the root tissue and the use of sensitivity toothpastes usually provide effective relief. It is important to keep plaque away from the weaker root surfaces in order to reduce the chance of cavities. Never use a hard toothbrush, abrasive toothpastes or forceful scrubbing tooth brushing action.

Muriel8. Chipped Front Teeth – Your broad, multi-rooted molars are designed for forceful chewing and grinding not your slender, smaller front teeth. If you have had several molars removed in the past and are now using your front teeth to chew your foods, you run the risk of breaking/chipping your front teeth, fracturing your root and/or loosening these teeth. Solution: Most chipped and broken front teeth can be repaired, but a permanent solution to restore proper chewing function must be undertaken to avoid continued breakdown and eventual loss of the front teeth. High quality dentures and implants can be made to replace missing molars. Loose or ill-fitting dentures are now a thing of the past now that they can be supported by an implant.

Note: Filling do not last forever. Maintain regular dental exams so that fillings can be checked and replaced/repaired if necessary.

9. Poor Mobility – Dexterity can become a serious issue as one ages. Arthritis, strokes and Alzheimers are just a few conditions that can making tooth brushing and flossing difficult. Solution: Caregivers must be diligent in their efforts to help Seniors with their care to prevent plaque and calculus build-up that can cause cavities and gum disease. Using less toothpaste and a toothbrush with a larger grip or an electric toothbrush can make tooth care easier.

10. Nutritional Deficiency – Missing teeth, tooth sensitivity, poor-fitting dentures and impaired taste can compromise the ability and desire to eat a well-balanced diet leading to nutritional deficiencies and a decline in overall health. Solution: Food may be easier to consume if they are softer, cut into smaller pieces, and more flavourful. Ill-fitting dentures can be modified or replaced and sensitive areas of the mouth repaired or protected with dental materials.

While we may be living longer, healthier lives, we are also facing many challenges in attending to and prioritizing all of our health care needs. Unfortunately, dental issues are among one of their most common health problems experienced by the aging population. With almost over 30 years of experience, we know first hand the frustrations, challenges and barriers that can hinder a person’s access to care. Whether you are someone who is looking to obtain optimal oral health as you begin to age or are someone who is looking to bring in your elderly parent/s for a long, overdue examination, at Your Smile Dental Care we are here to team up with you and offer you support and solutions while maintaining a strong focus on prevention.

Dr. Sam Axelrod offers a wide range of dental services to make it easier for you and your family to receive the care they need. Call us today at (905) 576-4537.

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Yours in Better Health,
The Your Smile Dental Care Team