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. 

Sincerely,

Mark Librach D.D.S.  

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

Dentistry on Dundas

Whitby, Ontario

For further information, please consult the website of the Canadian Dental Association

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

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. Michelle Lanys

Dentist

Dr. Dana Levy                                                             Connie

Periodontist                                                                  Treatment Coordinator

Jonathan Mursic RDT

5 Axis Lab



Dentistry on Dundas 

Free Ice Time up for Grabs!!

 

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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.

 



 

After

Before

 

 

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. 

 

 

Before

 

 

After

 

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. Mark Librach

Dentist



Dr. Jon Rapp                                                           Dr. Dana Levy

Endodontist                                                               Periodontist



Jonathan Mursic                                                        Connie

5 Axis Lab                                                                 Treatment
                                                                                  Coordinator                                                  

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
 

A Career in Dentistry?....

One of our patients is a grade 12 student at Donald A. Wilson Secondary School.  As part of a French project she is required to research a profession in which she is interested in, as you might have guessed the profession she chose is dentistry.  She presented us with few questions regarding our profession for her dentist, Dr. Librach, to answer. Here is what he said...

1.      What is the most difficult part of your career? Explain.

The most difficult part of dentistry is keeping up with technology.  The practice of dentistry has changed so much since I graduated in 1987.  Although the principles of good dentistry have not changed, the methodology advances have changed dramatically and will do so exponentially in the coming years.  At Dentistry on Dundas we continue to invest in the latest technology that gives our patients the highest quality dentistry.  With that commitment comes a responsibility to stay on top of the latest developments and to chose for our patients those technologies that will offer them the greatest benefit.   It can be a daunting task but, on the other hand, it continues to make dentistry an exciting profession.

2.      What is the best part of your career? Explain.

Working with great people. Firstly, our staff at Dentistry on Dundas are some of the best people I have ever met.  They are compassionate, competent and fun to work with.  They are as important to my practice as having the best equipment and knowledge.  They are an integral part of what attracts patients to our practice.  Secondly, our patients, many who have been with us since our start in 1989, make this career second to none.  There isn’t a day that goes by that I do not feel blessed that these people have put their confidence in me and our staff.  The interactions with our patients makes me excited to come to work every day.

3.      How competitive was the job market when you started working versus today? 

Quite a change has occurred over the last 27 years.  There are definitely more options for patients when it comes to who they see for their dental care.  When I graduated dental offices were fewer especially in the Durham region.  In addition, denturists (those that only make dental prosthesis like false teeth) are licensed to practice in Ontario.  Finally, Dental Hygienists  are now able to practice independent of the supervision of a licensed dentist.   That being said, I welcome the competition.  It keeps your business sharp and challenges you to be the best in your field.  At Dentistry on Dundas we continue to be successful in a very competitive market by offering our patients great dentistry in a comforting atmosphere.

4.      What advice would you give to someone starting out in orthodontics?

There are so many facets of dentistry that you should keep an open mind when entering dental school.  Orthodontics is a great profession but so is Endodontics (root canal therapy), Oral and Maxillofacial Surgery ( jaw surgery and complicated extractions), Oral Radiology, Periodontics (implants, gum surgery & care), Paedodontics (oral care for children), Oral Anaesthesiology (dentistry while asleep) and Prosthodontics (the restoration of complicated oral cavity collapse).

And lets not forget General Dentistry that allows you to perform any, some or all of these disciplines as you expand your knowledge in these fields. In addition, comprehensive treatment planning requires multiple disciplines.  At Dentistry on Dundas we have specialists in most of these fields that work as a team “quarterbacked” by a treatment plan set out by the General Practitioner.  Having said that, Orthodontics is a great specialty in dentistry and I would only encourage some one to continue to follow that path if that is where their interests lie.  Any path you chose you should always keep in mind that you serve the patient.  The rewards of this profession will come on its own if you treat your patients with respect, compassion, empathy and keep their best interests a focal point.

Mark Librach D.D.S.