BOTOX® is the most popular, non-surgical cosmetic treatment in North America, for women and men seeking wrinkle reduction.  It is most commonly used to reduce or eliminates frown lines, forehead creases, crow’s feet near the eyes, lines on the upper lip and thick bands in the neck.  It temporarily blocks nerve impulses that activate muscle contractions and cause wrinkles.  This gives the skin a smooth, relaxed, and refreshed appearance.

Dos and dont’s

• Do wear a mouth guard at all times when playing sports.
• Do inform yourself about the most common oral injuries.
• Do wear a mouth guard custom-fitted by your dentist, especially if you wear fixed dental appliances such as braces or bridgework.

• Do not wear removable appliances (retainers, bridge, or complete or partial dentures) when playing sports.

What are your choices

There are three types of mouth guards: custom-made, mouth-formed and ready-made.

• Custom-made mouth guards are professionally designed by your dentist from a cast model of your teeth. Because they are designed to cover all back teeth and cushion the entire jaw, they can prevent concussions caused by blows to the chin. Custom guards may be slightly more expensive than commercially produced mouthpieces, but they offer the best possible fit and protection. They are more secure in the mouth and do not interfere with speech or breathing. Calling plays or formations, for instance, will not be impeded by custom guards.
• Mouth-formed guards, also called “boil and bite,” should also be fitted by your dentist. This is generally done by shaping a soft pre-formed guard to the contours of the teeth and allowing it to harden. However, these devices are difficult to design for athletes who wear braces and can become brittle after prolonged use.
• Ready-made, commercial mouth guards can be purchased at most sporting goods stores and are made of rubber or polyvinyl. They are the least expensive but also the least effective. Keep your mouth guard in top shape by rinsing it in water. Do not use denture cleaners. Keep it in a strong rigid box for protection.

Remember, your mouthguard will protect one of your vital assets.

Post Op information for restorative procedures

Following a procedure to restore your tooth - whether it be a filling, crown or bridge - you should realize that there is a certain amount of trauma/irritation that your nerve may encounter. This is usually a factor of the amount of decay and the size of the previous filling material. If you started with a cold sensitive tooth, post operative sensitivity may be more common. Following restoration of your tooth/teeth, you may experience some of the following:

• Thermal sensitivity either cold and/or hot. This is not of much concern if the sensitivity only last for a few seconds.
• Biting sensitivity. The most common cause of this is when the bite is a bit high. Sometimes it can be hard to duplicate the correct bite when you are still frozen.
• Jaw pain and headaches. This is usually a sign that the bite is high and you are grinding/clenching on the new restoration(s)
• Prolonged thermal sensitivity and/or throbbing pain. This may be a sign that the insult to the nerve was more than it could endure.

After a procedure, if you feel that the bite is not correct, we ask that you let us know within a week. If you ignore this sign, then you risk further trauma to your tooth as well as possible fracture of the new restoration.

Post Op information for root canal procedures

Following your root canal procedure, you should expect all thermal sensitivity for that tooth to disappear. For 95% of all root canal treated teeth, all symptoms should begin to disappear and subside within three days. 5% of root canal treated teeth will show postoperative sensitivity resulting in pain on biting as well as possible swelling. This may occur even in the event that the root canal procedure was entirely successful. We recommend you take a basic anti-inflammatory agent (we recommend advil/ibuprofin; 400mg every six hours) for up to two days, in order to greatly reduce postoperative discomfort. In the event that you are experiencing rapidly progressing pain and swelling after a root canal procedure, we recommend that you call your dentist as soon as possible. It is very likely that antibiotic therapy will be required at this point. Please have the phone number of your local pharmacy handy as the dentist will need this in order to phone in your prescription. Also, in the event that your call is after hours and your dentist is away from the office, please remind the dentist if you have any antibiotic allergies. Usually, the pharmacist will have this information on hand anyways.

It is important to note, that root canal treatment has a 98% success rate on the first treatment. Approximately 0.5% of root canal treated teeth will require extraction at some point. This is an inescapable statistic as with all other medical treatments.

Post OP information for extractions

After teeth have been extracted, you will be directed to place pressure over the extraction socket(s) with rolled gauzes provided to you. You must keep this pressure applied until bleeding stops. In the event, it continues, please place pressure on the socket using more gauze. If necessary, you may use tissue or a tea bag. During the healing process please note the following:

• Avoid and sucking or spitting actions as the negative pressure can dislodge the newly formed clot. This is usually critical for the first three days.
• Avoid carbonated drinks. Again, this is most useful for the first three to four days.
• Listen to your body. Avoid the site as long as it is uncomfortable.
• Clean the area by brushing the extraction site. As soon as you can, please remove all plaque and debris from the extraction site.

In the event that you experience discomfort, prolonged bleeding or swelling, it is important that you call our office (604.431.0431) as soon as possible.

1. Fixed braces - the teeth have small attachments glued to them. Fixed braces fitted to upper and lower teeth look a bit like railway lines, so some people call them “train-track braces”. Fixed braces are very good for correcting complex problems. These are commonly made of stainless steel, when used for children as they are easier to keep clean. Tooth coloured ceramic or acrylic appliances are also available, and are most often used for adults. They are much more aesthetic. We are investigating the use of lingual fixed appliances. this is where the attachments are glued to the back of the teeth, very helpful for straightening teeth for people in prominent positions.
2. Removable braces - can obviously be removed, but they must be worn full-time, apart from when they have to be cleaned. Removable braces are good for correcting simple problems, such as moving a single tooth.
3. Functional braces - These are also removable but have to be worn full-time, except for cleaning. They are used to correct the growth pattern of the jaws. They can be used when one jaw is bigger than the other, to correct asymmetry. They can be used in conjunction with headgear to help jaws to grow correctly.

What happens on the first appointment?

An initial short examination appointment is to discuss the possibilities of orthodontic treatment. This is followed by a full examination. A full examination is made which will include X-ray pictures and moulds of the teeth. You will not have a brace fitted, or any other treatment, on this visit. You will get a full report on the treatment to be undertaken, as well as a full schedule of the fees payable. Particular attention is paid to how well you brush your teeth! It is important to know that you are capable of keeping your teeth clean before a brace is fitted since it is very much more difficult to clean them with a brace on. We insist that all patients are seen regularly by a hygienist to ensure that their teeth are kept in the best condition possible. If you are ready for treatment, your next appointment will be to fit the appliances.

What is it like having a brace fitted?

A removable brace is fitted very easily by clipping it onto several teeth. There is no discomfort involved. Fixed braces are simply “glued” onto the teeth. There is no need for an anaesthetic injection.   Teeth can become a bit sore a few hours after a brace is fitted or adjusted and this can last for two or three days. Simple painkillers will help a lot. We also recommend a soft diet for the first few days.

What happens after the brace is fitted?

Your brace has to be adjusted regularly. Removable braces are adjusted every 4-8 weeks and fixed braces every 4 weeks.

How long will the treatment take?

This depends on how much work there is to do. Fixed brace treatment can take between 12 and 24 months, but longer if the problem is particularly severe. If braces are broken frequently this can add a lot of time to the total. Combination treatment for difficult cases can take as long as 48 months.

Retainer braces

It is important to realise that once a brace is removed the teeth can drift back towards their original positions. They must, therefore, be held in their new positions for a long time with retainer braces until they have settled. Retainers are either removable appliances or thin wires stuck onto the tongue side of the teeth.

Do braces mark the teeth?

The brace will not mark the teeth. If dental plaque is allowed to become thick around the brace the plaque itself may damage the teeth. Instruction will be given on the use of special brushes. A daily fluoride mouthrinse can be used to harden areas that are very difficult to clean. Care must be taken to choose an alcohol-free, pH-balanced rinse. Certain foods and drinks may also lead to damage. You should avoid drinking lots of fizzy drinks and keep in-between-meal snacks to a minimum.

Foods to avoid during treatment

Very crunchy and sticky foods can break your brace. Toffee and chewing gum must be avoided. Really enjoyable hard foods can be chopped up and chewed gently!

Your dental hygienist is specifically trained and responsible for the delivery of these important services. Their roles will include:

• Removing all debris (plaque, calculus and stain) from your teeth.
• Providing you with the tools and skills necessary to keep the debris to a minimum.
• Constantly evaluate both your gum health as well as home care efficiency.
• Evaluate your specific susceptibility to dental disease.
• Suggest hygiene appointment frequency and intervals (maintenance program).

Consider that not all people are equally susceptible to dental disease. While some have absolutely no dental disease, others will display susceptibility to either dental (tooth), periodontal (gum) or both disease processes.

Our first order of business is to advise you on any health recommendations such as smoking cessation.

Second order of treatment will be to mechanically remove as much calculus and plaque as possible. This will be limited by the extent of the gum disease as well as any areas which are difficult to access. Examples of this would be retained wisdom teeth or severely crowded teeth where access in between the teeth is difficult or impossible. Once we have removed as much of the bacteria from your mouth as possible, there will be an immediate healing process that takes place. This will continue for as long as the bacteria are kept away from the gums.

Our third order of treatment, and probably the single most important aspect of your oral health will be home care instruction. Simply put, much of your oral health and the ability to reduce your future dental treatments lies directly in your hands. Your hygienist will be carefully monitoring your home care techniques and will be encouraging you to do them on a daily basis. This is not as easy as you may think. First, we try to make this a daily habit. Even when this occurs, it may still not be dequate. Not to worry, once you have the habit, it simply becomes a matter of perfecting your technique. Home care techniques require a fair bit of manual skill and you cannot expect them to be perfect right off the mark. In many instances, with both hygiene treatments and home care, we will see continued healing and improvement for up to two years!

Consider that your dental health is not just about your situation today but about your ongoing dental health, especially as it relates to time and the ageing process. Certainly, not a very sexy subject, however, all of us are trying to limit the effects of ageing through various means. The mouth is no different and we continually see the effects of ageing. When we evaluate your dental health and create a treatment plan for you, we are looking at both your current situation as well as the future. Although you may be in good dental health today, we may notice factors such as progressing gum recessions which we will expect to continue and become a potential problem in the future. For this reason, we will be drawing your attention to these factors so that you/we can reduce the progression as much as possible and, if necessary, apply corrective treatments.

Our goal, currently, is to provide you with good dental health into your mid 90’s. This sounds rather astounding, but we have already found that an active lifestyle into the late 80’s is really nothing of note anymore. It is expected that within two generations, the majority of people will be surviving into their second century. What does this mean for those patients? It means that more time will be spent visiting all manor of health specialists (eyes, hearing, feet, spine, etc) including dentists. This means that we, in dentistry, have to become more proactive in the earlier years of our patient’s lives. If we consider that it is now unacceptable to lose one’s teeth at any time of life, we need to start the process during childhood.
It is now becoming clear to us that we need to prevent more disease in order to provide you with less treatment during your lifetime in order to avoid excessive treatments as you get older.

Its an obvious fact that the more disease that your teeth experience, the more treatments they receive and the more they become compromised. Also, the earlier in life that your teeth become diseased, the harder it will be to maintain them. The sooner we all realize this concept, the better your dental health will remain. For this reason, your dentist and hygienist will be constantly monitoring your gum health through pocket probing as well as recession values.

Whether we have completed your treatment plan or not, this maintenance process will be vital to your dental health. Needless to say that when patients fail to carry our their home care or to continue their professional visits with us, we will expect more dental breakdown than when the program had been followed

Remember, your hygienist is specially trained to provide you with the expertise to maintain your teeth and gums. Please contact us or let us know if you have any questions.

Clean teeth and gums

Having a clean mouth is important. In addition to being healthier, it gives you fresh breath and a nicer smile. When you eat, bits of food, some too small for you to see, remain in your mouth. They feed bacteria that grow in a sticky film on your teeth. This film, called plaque, is the main cause of tooth decay and gum disease.

Having a clean mouth is important. In addition to being healthier, it gives you fresh breath and a nicer smile. When you eat, bits of food, some too small for you to see, remain in your mouth. They feed bacteria that grow in a sticky film on your teeth. This film, called plaque, is the main cause of tooth decay and gum disease.

Why brush?

Brushing your teeth after meals and between-meal snacks not only gets rid of the food particles that you can see, it removes plaque from your teeth. Using a fluoride toothpaste is important because the fluoride can help kill bacteria, as well as make your teeth stronger. Ask us to recommend the best toothbrush for you. Generally, a brush with soft, end-rounded or polished bristles is less likely to injure gum tissue. The size and shape of the brush should allow you to reach every tooth. Children may need smaller brushes than those designed for adults. Remember: worn-out toothbrushes can not properly clean your teeth and may injure your gums. Toothbrushes should be replaced every three or four months.

Why floss?

Flossing removes plaque and food particles from between teeth and under the gumline, areas your toothbrush can not reach. Because tooth decay and periodontal disease often start in these areas, it is important to clean them thoroughly on a daily basis. Flossing is a skill that needs to be learned. Do not be discouraged if you find it difficult at first. With practice, you will find that flossing takes only a few minutes of your time each day.

What about mouthrinses and mouthwashes?

If used as directed, in addition to brushing and flossing, mouthrinses and mouthwashes can help to prevent tooth decay.