Wednesday, November 26, 2014

Martin's Dental Makeover

Martin underwent dental treatment to achieve his new smile, which included orthodontics, 6 anterior crowns and bonding of his lower anterior teeth.

What were Martin's initial concerns, and what was your plan for addressing them?

Martin's teeth were badly broken down.  Through many years of wear and tear from grinding, Martin's teeth were now wider than they were long.
Martin hated his smile or the lack of it.  He had to really try hard to show any teeth at all and what he could show were not aesthetically pleasing.
Since Martin's teeth were edge to edge with no overlap, just placing new crowns or veneers were impossible.  Something had to be done to get some space between his incisors.

What procedures did you perform and why?
In order to get some space we had to use orthodontics to move teeth.
Instead of standard braces we used invisalign to open the bite to accommodate the crowns he would need from canine to canine.  This took about two years to accomplish.
We used bonding along the way to mock up his teeth to a comfortable bite and aesthetically pleasing position.  Once Martin was comfortable, his final crowns were placed.
The results are spectacular!!

  Dr. Mark Librach - Dentist

Thursday, November 13, 2014

Diane's Dental Makeover

Diane underwent several months of dental treatment to achieve her new smile. This included periodontal therapy, dental implants to support an anterior implant bridge and additional crowns on her upper teeth.


1. Why was Diane a good candidate for these procedures?
This patient presented with an advanced chronic Periodontal infection which required many steps in order to achieve healthy tissues and improve her overall health.
The fundamental basis of implant treatment is to make sure that the overall condition of the patients mouth is absolutely healthy. Otherwise, we can compromise the health and longevity of implant and prosthetic treatment. After treating the Periodontal disease and achieving a stable and healthy condition of the patients gums,then we proceeded with planning for the replacement and rehabilitation of the missing teeth.
2. How did you develop a plan for treating Diane's concerns?
The front teeth required removal as they were too compromised to keep them and treat them periodontally. The patient knew this from the outset and she also knew that the ultimate replacement will be done with an implant supported fixed prosthesis.
Once her teeth were extracted in the upper front, a bone graft was placed in order to maintain and regenerate her jaw bone which would provide an adequate anatomical area to place two implants. We allowed a period of 6 months of healing from the time of tooth extraction, bone grafting and implant placement.
A cone beam CT scan was done at the 6 month period and a virtual implant surgery was done in order to make a custom surgical guide. This guide was used during surgery I. Order to place the implants in he exact position required for this particular case.


3. Was her treatment out of the ordinary?
Her treatment consisted of first bringing back health to her gums and teeth, making sure that a stable periodontal condition was present in order to continue with her implant treatment plan. It's a very detailed plank which requires many steps in order to prepare the mouth for dental implant surgery.

4. How long did Diane's transformation take?
The treatment time was 16 months (?) I don't have marks notes so not sure when re placed the final bridge.
5. Is there an ideal candidate for these procedures?
The ideal candidate is always one which is healthy, complies with all appointments and instructions, and of course protects the final prosthesis with wearing a night guard and keeping all maintenance dental visits.


Jonathan Mursic                                                        Connie
 5 Axis Lab                                                                Treatment Coordinator


Wednesday, September 10, 2014

Ice Bucket Challenge raises $2026.00!!

In the spirit of education, awareness and donations for ALS, Dr. Steven Millman nominated Dr. Mark Librach to an ice bucket fundraising duel. In an effort to raise more donations we switched it up a little and collected donations over the past three weeks and the challenge was for one doctor to raise more than the other to be spared the ice bucket dumping.
We are pleased to announce we raised in total $2026.00 for ALS research and our fundraising duel was very close. Dr. Millman did raise $23.00 more in donations and therefore Dr. Librach accepted the ice bucket challenge.

To our video Click Here
As it turned out, Dr. Millman not only dumped the icy water on Dr. Librach, but accepted a splash himself too. We would like to thank all of our friends, families and patients for supporting our fundraising contest for ALS, often referred to as "Lou Gehrig's Disease", a progressive neurodegenerative disease that affects so many.

Dentistry on Dundas #icebucketchallenge

Tuesday, August 19, 2014

Thursday, June 12, 2014

Thomas's Dental Makeover!

Thomas underwent a few procedures to achieve his new smile. This included two Dental Implants and an Implant retained bridge to replace his 4 anterior missing teeth.

Why was Thomas a good candidate for these procedures? 

Thomas was the ideal candidate for this procedure as he was missing multiple front teeth, was in good general and oral health, and had been wearing a removable prosthesis for years. 

How did you develop a plan for treating Thomas's concerns? 
The chief complaint was his desire to have his teeth look and feel just like his own. His current removable denture relied on support from his adjacent natural teeth, and did not preserve the underlying jawbone. Dental Implants are able to preserve the underlying bone and improve comfort, aesthetics, and function without compromising the adjacent teeth. 

Was his treatment out of the ordinary? 

The treatment is ordinary, but requires a multidisciplinary approach. Since dental implants are closely connected with gum tissues and the underlying bone in the mouth, Dr. Levy, our periodontist was an expert in this area. It was important that we worked together to ensure the best results. 

How long did Thomas transformation take?  

The total transformation took one year.  

What steps do these procedures involve? 

1) Examination and evaluation of patients X-rays, oral health and overall health.
2) First stage surgery with Dr. Levy to place two dental implants into the jawbone beneath the gum tissue allowing the implant to bond with the bone and attach to the gums. 
3) Second stage surgery with Dr. Levy to expose the implants once the gum tissues had healed
4) Dr. Lindsay attached an abutments (post) to the implants and took a digital impression (itero scan)
5) A fixed bridge with artificial teeth was made by our lab 5-axis to fit the implant posts
6) Dr. Lindsay restored the missing teeth by cementing the fixed bridge to the implant posts. 


Is there an ideal candidate for these procedures? 

The ideal candidate for a dental implant is someone in good overall health, with healthy gum tissues and with adequate bone in their jaw to support an implant. 

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

It is important to care for your dental implants like you would your natural teeth. Regular home care with toothbrush and floss is advised as well as regular dental checkups to ensure the bite is correct and that the implants are not loose. A nightguard may be recommended for patients who clench or grind their teeth.

Periodontist & Implantology

Treatment Coordinator at Dentistry on Dundas

Wednesday, May 7, 2014

Dentistry on Dundas Celebrates 25 years in the Durham Region!

Dentistry on Dundas Celebrates 25 years in the Durham Region

Dentistry on Dundas: A Pictures Chronicle of the Past 25 Years! As a way to celebrate our anniversary we've compiled some of our favourite photos throughout the years to share with all of you. Want to see more photos? Head to our website!
Please note that our office will be closed from May 15th at 1:30pm to May 20th, 2014.
Regular hours will resume 7:30am Wednesday May 21st. 

Dentistry on Dundas is Celebrating our 25th Anniversary. We have always been proud to serve the Durham Region and pride ourselves in being able to offer high quality services to all of our patients. 

Even after 25 years we continue to grow. This is mostly due to the trust and confidence our patients have placed in us. As we move forward we have decided to revitalize and energize our team to serve you even better. As a result, we are closing our doors for 5 days in May. In celebration of this milestone and to further foster strong teamwork, we are all heading to Paris, France. We will be posting our progress on Facebook, so please follow us. 

Our celebration will not stop there. Stay tuned for further announcements as the year progresses. Thank you to all of our wonderful patients! We look forward to serving you everyday. 

Wishing you and your family countless reasons to smile, 

Dr. Millman and Dr. Librach

Monday, March 3, 2014

3 things everyone needs to know about tooth decay!

I know it can be frustrating when you feel like you have done everything to prevent tooth decay, but still get cavities and others never get them. The cards just are not the same way for everyone.  We are all genetically different and that can play a major factor on how our bodies react to our environment.  I do believe that we all have a chance to achieve great oral health no matter what cards we are dealt, but some have it harder than others to achieve those same results.  There are still many things that can be done that can help aid you in your quest for a cavity free check up. 
First of all, diet plays a major role.  But sometimes it’s not what you eat, it’s when you eat it.  Acid levels increase in your mouth every time you eat regardless of what you are eating.  Peaks in acidity are usually not the problem.  It’s the number of peaks or the time you stay in that high acid zone that is the problem.  For example, if you pour yourself a coffee at 9 am that has sugar and milk in it and nurse that coffee until 11:00am taking sips throughout the morning, the potential to do harm to your teeth is greater than if you finished that coffee with breakfast. The goal is to keep yourself in that low acid zone as much as you can throughout the day so your teeth have a chance to recover (i.e. remineralize) from the peaked high acid levels. 
Secondly, technology rocks.  If you are not using an electric toothbrush already get one.  Regardless of the brand or quality of a manual toothbrush, its effectiveness cannot compare to that of the excellent quality electric toothbrushes that are out there.  I always recommend one that is rechargeable.  Typically the brush heads are smaller and they are always charged and ready to go.  Remember to change the head every three months, as they will wear out the same as a manual toothbrush. 
Thirdly, it’s not one toothpaste fits all.  If you’re constantly getting cavities, than a boost in the fluoride content of your toothpaste can help and some toothpastes can help remineralze teeth that have developed small cavities that have not progressed beyond the enamel (i.e. the outer layer of the tooth).  These toothpastes are not amoungst the dental product section of your pharmacy or supermarket.  Instead they are behind the counter and must requested from the pharmacist.  In some cases they have to be specially ordered by the pharmacist. 
Finally, there are three parts to the equation when it comes to cavities.  It takes acid production and a carbohydrate to cause cavities but it also takes acid producing bacteria.  So it stands-to-reason, that a reduction in the levels of bacteria or a disruption in the types of bacteria in the mouth could effectively decrease your risk of getting cavities. Hence, antibiotic intervention should be considered. 
So that is four years of dental school, twenty-nine years of practice and countless number of continuing dental education courses in a nutshell.  I hope it helps.  Please feel free to contact me at Dentistry on Dundas for further insight into cavity prevention and selection of the appropriate toothbrush and toothpaste. 

Tuesday, February 25, 2014

Your Child, Their Teeth and YOU!

The complete health of a child includes healthy teeth and gums.  As a parent, it is imperative that you understand the important role you play in getting your child started on the road to good oral health.  Parental knowledge of how to prevent Early Childhood Decay, nutrition, brushing, dental safety and regular visits to the dentist all play important roles in the developing dentition of a child.
Early Childhood Decay, sometimes called “Baby Bottle Syndrome” is completely preventable.  It is caused by a parents lack of knowledge and not due to child’s susceptibility to decay. All edible liquids, other than water, contain sugars that can cause tooth decay. For example, any milk (both cow’s and mother’s), juice and formula have the potential to cause tooth decay. So sending a child to bed with a bottle or sippy cup with anything but water can lead to severe dental and health issues.  Simply put, NEVER SEND YOUR CHILD TO BED WITH A BOTTLE.
It is recognized that babies have a natural tendency to suck. A soother is preferred to a thumb as a soother can be taken away eventually when the child reaches the appropriate age. I hope for obvious reasons, NEVER PLACE HONEY, SUGAR OR CORN SYRUP ON A SOOTHER.  At age three or four (at the latest), the need for the sucking action is diminished and the use of a soother should be terminated. Extended use of a soother can lead to unfavorable jaw growth and crowding. My advice is to have the soother go missing. The first night might not go without incident but the next nights should be much easier.

Good nutrition goes a long way in preventing tooth decay. The sugars in drinks and foods we give our children can contribute to poor dental health.  Consider soda pop and some sports drinks: These liquids contain high levels of sugar and acid with little or no nutritional value.  Even fruit drinks such as orange and apple juice have high concentrated amounts of sugar.  In addition, sticky foods such as fruit rolls are  “wolves in a sheep’s clothing”, as far as tooth decay is considered.  They are sticky and full of sugar, a deadly combination as far as tooth decay is considered. Starchy foods such as teething cookies also are sticky.  It is when these sticky carbohydrates mix with acid producing bacteria that decay begins. They attack the enamel and cause the holes we call cavities.
So now that I’ve scared you I have some good news.  Cavities can be prevented by following some easy steps and prevention techniques.  First, Read the labels of what is in the prepared foods you feed your kids.  Keep the sticky sugary foods to a minimum and if you have to include them, do so at mealtime.  Constant snacking keeps acid levels in your child’s mouth at persistent high levels without allowing a breather from high acid levels to allow their teeth to remineralize.  Help your child brush and floss their teeth.  Let them brush first and then you take over to finish the job.  The older they get, their ability should improve and so should their responsibility for their own dental care. Flossing should become routine as well with the parent taking the lead roll as the child’s dexterity improves. The two most important times to brush a child’s teeth is just before bed and right after breakfast in the morning. Once a child has brushed before bedtime only water should be considered if the child requests something or else the teeth must be brushed again.  Additional brushing should be considered for kids at higher risk. Previous cavities and constant snacking place children in a high risk category.
So when should a child see a dentist?  The first visit should happen at the first sign of a baby tooth erupting (around 6 months) and no later than one year of age.  This visit should help get the child and the parent off on the right foot when it comes to taking care of the child’s teeth.  Then at age 3 the child should begin regular checkups at about a 6 month interval.
Finally, dental safety starts at a young age.  From the day the child comes home from the hospital till the day the child can sit safely in the front seat of a car, an age and weight appropriate car seat should be used.  If the child is involved in contact sports a helmet and mouthguard should be worn. In combination, both can help prevent serious trauma to the head and teeth in the event of hard contact with other players, the playing field or ice and surrounding structures. Toddlers tend to fall a lot so dental trauma is common during this stage but dental trauma can happen at any age.  Your dentist is ready to assist so see your dental practitioner as soon as possible following the trauma.
So simply put, your child’s dental health requires a team effort.  Cooperation by the child, parent and dental practitioners (dentists and dental hygienists) can go a long way to ensuring oral health.
Mark Librach DDS
Whitby, Ontario
For further information, please consult the website of the Canadian Dental Association

Wednesday, February 19, 2014

Eleanor's Dental Makeover!

 Eleanor underwent a few procedures to achieve his new smile. This included dental implant on extruded anterior tooth with new implant crown and veneer on adjacent front tooth.

Why was this patient a good candidate for this procedure?

Eleanor's chief complaint was the "drop" of her tooth below the line of the adjacent teeth, which created a very unfavorable aesthetic situation. Also, the tooth already had a very old crown on it which had a poor match of color to her front teeth. Upon clinical and x-ray examination, it was evident that the tooth wasn't healthy and also had a very short root, most probably as a cause of the roots being resorbed.

How did you develop a plan to treat her concerns?
We decided after completing a through clinical, radiographic and aesthetic examination, that Eleanor would benefit from having the tooth removed, a dental implant to be placed to replace the missing tooth and a veneer to cover the adjacent tooth for perfect color match.

Was her treatment out of the ordinary?
Although treatment was not out of the ordinary, it is a very challenging and complicated treatment. Every effort needs to be made during the surgical and dental procedures to obtain perfect position of the implant with the final objective of achieving the most aesthetic outcome (and of course functional as well).

How long did this transformation take?
Eleanor's treatment took just under one year to complete to achieve optimal healing. During the
healing phase she had a transitional crown positioned for immediate aesthetic improvement.

What Steps do these procedures involve?
First, the tooth had to be removed and a bone replacement graft was placed in order to preserve the bone and maintain a proper future " housing" for the root implant. During this time, a temporary and provisional denture (or bonded bridge) is done, which is quite esthetic. It's main goal is to allow for the bone underneath to heal and have a nice temporary replacement while healing occurs. Once this healing period is done (usually anywhere between 4-6 months), a titanium dental implant is placed with a surgical procedure. This implant is allowed to heal for 4 months, during which time it "integrates" or becomes part of your jaw. Once this is completed, a minor procedure to uncover the implant is done and the crown or "cap" is done, at the same time as the veneer on the adjacent tooth, maximizing a " color match" for the two porcelain teeth.

    Dr. Michelle Lanys                                                   Dr. Dana Levy
                                    Dentist                                            Periodontology & Implant Dentistry

Jonathan Mursic                                                        Connie
 5 Axis Lab                                                                Treatment Coordinator

Tuesday, February 18, 2014

Harry's Dental Makeover

Harry underwent a few procedures to achieve his new smile. This included crown lengthening of upper anteriors, new fillings and crowns on upper teeth.

Why was the patient a good candidate for the procedure?
This patient was a good candidate for the procedure because the anterior teeth that were involved, were constantly chipping and cracking for many years.
It was a long time goal to prevent and protect these teeth from further damage.
The restoration of crowns or caps were indicated.
The patint also followed a good oral hygiene regiment and was eager and compliant with respect to treatment.
Was his treatment ordinary?
Crowning vulnerable teeth is a typical practice in dentistry.
How long did the patient's transformation take?
There were a few preliminary procedures that were necessary prior to the actual placement of the crowns that involved a few extra appointments. The actually crowns took two appointments, two weeks apart, to complete.

What steps do these procedures involve?
Good oral hygiene must be a priority before any major restorations are placed. Tooth decay must also be eliminated with no symptoms present. One of the involved teeth required some gum reshaping and and root canal therapy in order to accept a crown.Subsequently, the crowns were prepared at one visit, and the crowns were permanently placed two weeks later.

Are there any homesteps patients should follow after procedures like this?
Continuous good oral hygiene is essential to maintain teeth and especially crowns
This includes regular checkups to the dentist.
A night guard is also recommended for certain procedures such as Harry's.
This is a guard that is worn during the night to protect the new crowns and prevent wear on the opposing teeth.

Dr. Dana Levy                                                             Connie
Periodontist                                                                  Treatment Coordinator

Jonathan Mursic RDT

Monday, January 20, 2014

Barbara's Dental Makeover!


Barbara underwent several procedures to achieve her new smile. This included root canal therapy, surgical crown lengthening of upper anteriors and full crown and bridgework on upper teeth.

What was her chief concern about her teeth?
Barbara's previous bridgework was failing. One of the teeth that supported her bridge were breaking down and needed adjunctive gum surgery to make them candidates for support for the new prosthesis. Her case presented some challenges as she had also lost some posterior support. She would require restoration of her bite to complete her treatment. Ideally implants would be the best option but she opted at this time for partial dentures until implants could be considered.

Why are implants the better option in many cases?
implants are now the treatment of choice in most cases when it comes to the replacement of lost teeth. Although they are biologically different from teeth, they act like teeth in many ways. Aesthetically they are usually the best way to mimic what nature originally gave us. They can stand alone as individual teeth, something a bridge or partial denture can't.  Implants do not affect the adjacent teeth, unlike other alternatives that rely on adjacent teeth for fixation or support. However, implants do come at a higher cost but that is only in the short term. Over the long haul, properly integrated and maintained implants can be a bargain when you consider the costs associated with maintaining and replacing the other alternatives. 

What further treatment will Barbara need as she moves forward?
Post treatment care is always the key to a successful restoration. maintenance at home as well as frequent visits to the dentist for examination and cleaning of the restoration and all of her teeth will help ensure many years of smiles.  in addition, the sooner implants are placed in the posterior dentition the better.  for it's the posterior teeth that protect the anterior teeth and the smile.

Treatment was possible through a team effort!


Dr. Jon Rapp                                                           Dr. Dana Levy
Endodontist                                                               Periodontist

Jonathan Mursic                                                        Connie
5 Axis Lab                                                                 Treatment

To view other dental makeover click on the following:
Laurie's Dental Makeover
Carol's Dental Makeover
Martine's Dental Makeover
To learn more about implant click the following:
Dental Implants