Wednesday, July 18, 2018

Dental Makeover! Cheryl's before and after

Fixing gaps and wear on Cheryl's upper teeth gave her a bright new youthful smile! 

Procedure: Dental Crowns
Dentist by: Dr. Mark Librach

1. Why was Cheryl a good candidate for these procedures?
Cheryl was very motivated and considered all treatment alternatives.  She wanted to correct her smile but when presented with the treatment plan that was based on the protection of her front teeth by building strong back teeth, she took to the idea.

2. How did you develop a plan for treating Cheryl's concerns?
Records are always critical to the creation of a treatment plan that is customized to our patients needs.  Comprehensive photos, models and X-rays are critical in presentation to the patient, other adjunctive professionals and our lab technicians.  A temporary mock up was also used on this case that gave us and the patient a clear picture of what the final outcome would feel and look like.

The above shows the extensive wear on the inside of Cheryl's upper teeth.
 The above shows the post-treatment crowns.

3. Was her treatment out of the ordinary?
There really is no such thing as “ordinary treatment”. Every case presents with complexities that are unique to that case.  In this case, the posterior teeth were in rough shape due to erosion and bruxism( grinding).

4. How long did (Patient’s) transformation take?
A few months and approximately 5-6 appointments.

Anterior view of Cheryl's front upper teeth prior to crown placement.
Anterior view of Cheryl's front upper teeth post-treatment with porcelain crowns.

5. Are there any at-home steps patients should follow after procedures like these? 
For most patients with extensive dental care we recommend the use of a night guard to protect the teeth and the dental work at night time. This decreases wear and tear and protects her teeth while the patient sleeps. 

Read what Cheryl had to say!

1.     What made you decide to undergo these procedures?
Due to years of erosion and night grinding I was told that I was going to start losing my teeth. I had so many spaces between my front teeth that I was self conscious about smiling.

2.     Why did you choose Dentistry on Dundas/Dr. Librach?
I had been told that he was really good.

3.     What were your procedures like?
I am very nervous about going to the dentist to have anything done. I gag easily and feel claustrophobic when things are put in my mouth. A couple of the procedures were very long appointments. Dr. Librach and Joan were awesome, gentle and understanding. The procedures were basically pain free. Dr. Librach did his best to ensure that things were removed from my mouth as quickly as possible and was always checking to see if I was comfortable. Both were willing to answer any questions I had too which I appreciated.

4.     How do you feel about your results?
Great!! I have had many positive comments and now I can smile again!!

Tuesday, April 17, 2018

Dental Implants

Dr. Mark Librach has been published! Though there are a number of ways to replace missing teeth, dental implants are considered state of the art. "For the appropriate candidate, they can be a smile-changing and a life-changing experience," says Dr. Mark Librach of Dentistry on Dundas in Downtown Whitby. 

Tuesday, April 3, 2018

Meagan's Myofunctional Orthodontic Transformation

Meagan is an excellent example of how myofunctional orthodontics can transform a patients bite and profile. Meagan's bite is what we consider a class III malocclusion. In simple terms a class III malocclusion is an underbite where the bottom teeth overlap the top teeth. Megan had seen several dentists who had recommended to her that this problem could only be corrected through orthognathic surgery. This type of surgery is very invasive and requires a hospital stay of two days followed by a recovery time of several weeks where her mouth would need to be wired shut. Megan‘s parents were hesitant to go forward with the surgery. I offered them a treatment plan that would require her to wear and appliance every evening while she slept plus 2 hours per day. 

This type of treatment known as myofunctional orthodontics and works by retraining muscles of the face and jaws to reposition her maxilla and mandible to the correct relationship. Megan’s transformation was completed in one year of treatment. As you can see in the photos her teeth are now in a very good class one relationship and her profile has improved dramatically. 
Megan will need to continue to wear her appliance for two years while sleeping. This will prevent her teeth and jaw from relaxing to the original position.

We asked Meagan's Mom how she felt the treatment went....

1.     What made you decide to undergo orthodontic treatment for Maegan?

Maegan had a class 3 malocclusion. Which is a pronounced overbite. Before coming to Dr. Millman, we were told the only way to correct this overbite was surgery.

2.     Why did you choose Dentistry on Dundas, Dr. Millman, for this treatment plan for Meagan?

Dr. Millman was the only dentist we met that offered us a non surgical procedure for her overbite.  The Myobrace Dr Millman fitted Maegan has successfully corrected her overbite without surgery 

3.     How did Meagan tolerate her orthodontic treatment?

The myobrace treatment was painless and easy for a young girl to manage on her own. What was really important to my teenage daughter is this treatment was done at home. She didn't have to wear it in public.

4.     How do you and her feel about the results?

We are extremely pleased with the results. Maegan's overbite has been corrected without painful surgery or the use of braces. The Myobrace was the perfect treatment for my daughter.                   

Wednesday, March 7, 2018

Michelle's Dental Makeover!

Dr. Steven Millman explains Michelle's treatment plan....

Michelle's case is an excellent example of how we can use porcelain veneers to correct a person smile instantly without orthodontic treatment. 

The patient was very concerned with the symmetry of her smile and her mid-line being off. She also did not like the anatomical shape of her teeth.

                                                       Michelle before

A treatment plan was developed with the help of our lab technician Jonathan Murisac and our periodontist Dr. Dana Levy. Prior to treatment we created a wax mock-up of her smile in order to correct her concerns. Once the patient was able to visualize the changes we could  make to her smile, she accepted going ahead with this treatment.

The transformation was completed over a month of treatment. We started off by placing temporary veneers to correct the position of the gingival tissue and to create a symmetric smile. Once the patient was satisfied with the cosmetic result we then replaced the temporaries was permanent veneers. 

                                                           Michelle after

There are many potential patients that could benefit from this type of treatment. This is a relatively non-invasive treatment that can correct crooked misaligned teeth without orthodontic treatment. As you can see by the photos the cosmetic result was excellent. Both myself and the patient extremely pleased with the final results. 

The beautiful porcelain veneers can be easily maintained with routine brushing and flossing. We also highly recommend six month cleaning at the dental office with a skilled hygienist. 

From the Michelle....

1.     What made you decide to undergo these procedures?  Saw an orthodontist and due to the crowding of my teeth and the extended years of work that needed to be done they didn’t feel it was an good option for me at my age and I would not get the result I was looking for since I was missing the canine tooth. 

2.     Why did you choose Dentistry on Dundas/Dr. Millman?  He is my family dentist so didn’t feel the need to look elsewhere.

3.     What were your procedures like?  It was definitely time consuming, however this was due to my specific case as we were turning another tooth to appear to be a canine. Other than that, there was nothing intolerable. 

4.     How do you feel about your results?  Anyone who sees them think they look perfect and have had comments on how perfect they look from people who don’t know I had them done.  

                                                    Dr. Steven Millman

Thursday, February 15, 2018

Meagan's orthodontic before and after photos!

Meagan went through orthodontic therapy with Dr. Librach to create her new beautiful and functional smile!

1. Why was Meagan a good candidate for orhtodontics?

Meagan was keen to have her straight teeth. She is a great listener and followed instructions well.  Her Oral hygiene was also good.

2. How did you develop a plan for treating Meagan?

Starting with all the appropriate records, including photos, x-rays, and models, a thorough exam is done. We can then devise a treatment plan that would correct both tooth position issues and underling skeletal problems. We then consult with the patient and her parents, taking into account all of their concerns. 


3. Was her treatment out of the ordinary?

There really isn't any "ordinary" cases.  They all are special and treatment plans are tailored to each patient.  Some are complex and others, like this one are less so.

4. How long did Meagan's transformation take?

Her treatment plan was completed in 18 months.

5. What steps do these procedures involve?

She had six months of appliance therapy and twelve months of braces.

6. Is there an ideal candidate for these procedures?

A patient who is a good listener and follows instructions can vastly reduce the length of treatment.  Children who accept the responsibility for part of their treatment can accelerate the process and finish early. Good listeners who take responsibility for their own treatment and don't rely on their parents for day-to-day maintenance make the idea patients.


7. Are there any at-home steps patients should follow after procedures like these? 

Retention and oral hygiene are key to the long term success of any orthodontic treatment.  Retention is a lifelong endeavour as teeth are subject to changing forces as we age, any of which can affect the position of a tooth or many teeth.  Depending on the treatment done, full time retention (usually for one year) is required followed by night time wear there after.  Oral Hygiene is also key for the oral health of the patient.

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Tuesday, March 14, 2017

Children's dental cavities are preventable

Dr. Mark Librach on Daytime Durham March 9, 2017

                                                    click here to see the full program

What does decay look like?
Although decay may appear as a discolouration or a pitted appearance on a tooth, it is actually diagnosed by feel using a sharp instrument called an explorer.  Decay will present itself as a “sticky” pit on a tooth when examined with a dental explorer.  In addition, dental x-rays can help diagnose decay in areas our instruments can’t reach, specifically the surfaces between teeth.

What is preventive dental care for children?
Preventative dental care in children includes brushing at least twice a day. The most important time for brushing is right before bed.  The second most important time is right after breakfast in the morning.  This applies to adults as well. Flossing 2-3 times a week is also important.  Parents should be active participants in their child’s oral health.  They should promote the child’s attempt to brush their own teeth and fill in the gaps for a thorough cleaning.  When it comes to flossing, the duty will fall to the parents.  Parents should also lead by example by taking care of their own oral health in front of their children.

At what age should I first take my child to the dentist? 
An infant should be seen by a dentist when their first tooth erupts and no later than one year of age.  The rational behind this early approach is to get the child’s oral health off to good start and to educate parents as to the best methods of keeping their children healthy with respect to their teeth.  

Is it necessary for me to clean or brush my baby's teeth?
Absolutely!  Tooth decay can start immediately after a tooth erupts in the mouth so oral hygiene must start immediately.  At first, baby teeth can be cleaned with a clean damp terry cloth. As the child matures, a specifically designed baby toothbrush can be used.

What is "Baby Bottle Tooth Decay"?
Baby bottle tooth decay is a completely preventable tragedy that is brought on by lack of oral health education.  It is most commonly caused by infants being put to sleep with baby bottles that contain milk or juice.  As the child pacifies itself with the nipple on the bottle, the acidity form the juice or milk bathes the teeth breaking down the enamel and causing rampant decay.

What is fluoride and does my child need fluoride treatments?
Fluoride is a natural mineral that is derived from the earths crust. It is sometimes naturally found in water supplies but many jurisdictions have added fluoride to drinking water as a matter of public health to help prevent tooth decay. It is also found in foods and is the main cavity-preventing ingredient in toothpastes.  In addition, your dentist may include topical fluoride treatments as part routine oral care appointments for children.  Fluorides in all these forms help decrease the incidence of cavities.

What are sealants and should my child have them?

Sealants are plastic coatings applied to teeth to help prevent cavities.  If required, they are usually applied to the first adult molars that erupt at age six, but can also be applied to molars that erupt at age 12 also. The determination of whether to place sealants takes into consideration the cavity history of the child and the “grooviness” of the teeth.  A child that has a history of several cavities in their baby teeth and has “groovy” teeth is a prime candidate for sealants.

Dr. Mark Librach Dentistry on Dundas

Thursday, May 26, 2016

JP's Dental Makeover

JP underwent dental treatment at Dentistry on Dundas to achieve his new smile, which included dental bleaching, anterior bonding and porcelain crowns.
1. Why was JP a good candidate for these procedures? JP was a great candidate because he had healthy gum tissues free of periodontal disease, specific treatment goals and excellent home care and compliance. 
2. How did you develop a plan for treating JP's concerns?
Understanding the specific concerns of JP was essential to a positive outcome. JP was unhappy with the appearance his existing teeth restorations (an older crown on one lateral incisor and a large composite resin restoration on the other). JP wanted to enhance his smile without appearing unnatural.

3. Was his treatment out of the ordinary?
JP’s treatment was not out of the ordinary. Our goal was to be as conservative and cost effective as possible. Multiple treatment options were recommended but together we came up with a plan that met his specific functional and esthetic concerns after evaluating the advantages and disadvantages of all treatment options.
4. How long did JP's transformation take?
The total transformation took under 2 months. 
5. What steps do these procedures involve? Our first step was the assessment of JP’s overall and oral health; because he attends his regular check up and hygiene appointments there were no unexpected complications. The next step was to fabricate customized home bleaching trays to improve the shade of JP’s teeth and smile. After the optimal shade was achieved we gently removed his previously existing restorations, digitally scanned the tooth preparations and produced lab fabricated restorations. This helped restore JP’s teeth to their natural shape and size, strengthen his teeth and enhance his overall appearance. 


6. Is there an ideal candidate for these procedures?
The ideal candidate is someone who is engaged in preventative dentistry and regular maintenance visits. Minimizing risks and complications are enhanced when a patient presents with no active disease such as caries and inflammation. 
7. Are there any at-home steps patients should follow after procedures like these? Based on JP’s functional habits a night guard was recommended to reinforce home care and prevent future breakdown of his natural teeth and tooth restorations. In addition proper brushing and flossing techniques are always recommended.

Treatment Completed by Dr. Cara Lindsay