Dental Maintenance

Many people who clench also tend to grind their teeth. Grinding is when you slide your teeth over each other in a back and forth or sideways movement. Often the grinding is a subconscious behavior that is not realized by the bruxer (grinder).

Stress reduction and anxiety management are methods used to treat bruxism and reduce the symptoms, but a dental night guard is the most common treatment method. A night guard is a horseshoe-shaped, retainer-like, custom-made, plastic appliance with shallow borders that can be worn on either the top or the bottom arch.

When you have a severe toothache, it is hard to think about much else. If you have ever experienced a toothache, you will know that there are few things that are more painful. 

What can cause a toothache? | There are several things that can cause a toothache. Sometimes when you have a cavity, you can experience pain or sensitivity when you eat sugary foods or drink cold water. This is because the nerve in our tooth is inflamed. If the nerve of your tooth is inflamed for long periods of time, the nerve can die. This is when the pain can start to occur spontaneously and wake you up at night. Another cause of a toothache can be if your tooth has a crack. This will usually hurt when you chew or right after you finish chewing. Many types of dental infections can also cause oral pain.

What can I do until I see the dentist? | Usually, the only things to do until you see the dentist is to take either Advil or Tylenol or apply an ice pack to the affected area to help soothe the pain.

When should I consider seeking emergency care? | If you ever have severe swelling that interferes with your ability to breathe or swallow or if you have a severe fever, you should go to the nearest emergency room for immediate attention.

Does your bed partner complain about your snoring? Are you unusually sleepy during the day and do not know why? These are two of the most common symptoms of obstructive sleep apnea (OSA), a sleep related breathing disorder that can cause you to stop breathing dozens, or even hundreds, of times each night.

Only a physician can diagnose obstructive sleep apnea. A dentist does not diagnose OSA. However, a dentist may see patients who suspect may be at risk and will refer them to their family physicians for further diagnostic follow up.

The most effective treatment for mild or moderate sleep apnea, says The Canadian Lung Association, is continuous positive airways pressure (CPAP). With CPAP, you wear a special mask attached to a CPAP machine. A steady stream of air is blown through the mask, into your nose and down your throat. The pressure helps keep your airways open so you can breathe properly all night. Other treatments for mild sleep apnea include lifestyle changes such as losing weight, avoiding alcohol and sedatives, and sleeping on your side, not your back. Your family doctor may also recommend that you use a dental (or an oral appliance) that fits over your teeth and prevents your tongue and jaw from blocking your airway. In comparison to CPAP devices, these are sometimes regarded as a convenient, silent, and more partner-friendly bed choice, says Dr. Alan Lowe, Professor and Chair of the Division of Orthodontics, University of British Columbia’s Faculty of Dentistry.

A cautionary note: Some patients who have been diagnosed with sleep apnea may be curious about ordering prefabricated devices over the internet. Think twice! You may end up with other jaw pain or oral health problems.

We all know that prevention is one of the keys to maintaining overall health. We exercise and watch what we eat to help reduce our risk of heart attack, stroke, and certain cancers. In much the same way, we should take good care of our oral health now to prevent gum disease and tooth loss later.

Why is this important? The reasons are much more than cosmetic. While we once believed the worst outcome of gum disease was tooth loss, we now know that oral health matters from head to toe. Like smoking, elevated cholesterol, or obesity, periodontal (gum and bone) disease may be a risk factor for a number of serious health conditions. In recent studies, gum disease has been linked to:

• heart disease and stroke
• pneumonia and other respiratory diseases
• diabetes
• premature, low birth weight deliveries

How is this possible? For those with gum disease, the simple act of brushing your teeth or chewing can injure gum tissue, allowing bacteria to enter the bloodstream. It is believed that bacteria may travel to other parts of the body, potentially worsening or causing other types of health issues.

How Gum Disease Develops | Gum disease begins with the formation of hard and soft deposits on the surface of the teeth. Over time, a build-up of bacteria (plaque) collects at the gum line, eventually hardening on the teeth into calcium deposits called calculus (tartar). With poor oral care, bacteria can cause inflammation of the gums (gingivitis), penetrate the gum line, and finally spread into the underlying bone (periodontitis).

Gum Disease and Your Heart | Studies have suggested that bacteria from diseased gums may travel through the bloodstream, potentially contributing to the formation of artery-clogging plaques. It is also believed that gum disease may contribute to infective endocarditis, a condition in which the interior lining of the heart and heart valves become inflamed, possibly due to a bacterial infection. If left untreated, this condition could lead to a fatal infection.

Gum Disease and Your Lungs | Scientists now believe that gum disease may also be a significant risk factor, increasing the risk of respiratory infections, and potentially worsening the severity of pneumonia, bronchitis, emphysema, and Chronic Obstructive Pulmonary Disease (COPD). Preventing gum disease may help you breathe easier.

Gum Disease and Diabetes | Severe periodontal disease may increase both blood sugar levels and the amount of time the body functions with high blood sugar, putting those with diabetes at increased risk for complications. People with diabetes and gum disease should receive regular treatment from an oral health professional to reduce inflammation of the gums.

What Can You Do? Visiting your dental hygienist on a regular basis is one of the most important steps you can take to maintain or improve your oral health.

Here are some general guidelines for maintaining good oral health at any age:

Infant Care

• Give the infant plain water instead of milk or sweet juices at naptime
• Gently clean newly erupted teeth, gums, and tongue with gauze or washcloth

Children

• Familiarize children with oral cleaning habits
• Parents may wish to clean the child’s teeth before bedtime and allow the child to try brushing on his/her own in the morning
• First visits to the dental hygienist are recommended at about age two

Teenagers and Adults

• A thorough cleaning of your mouth once or twice a day is sufficient
• When brushing, apply gentle pressure as you move the brush away from the gums. Don’t forget to brush your tongue (with or without toothpaste). You should be spending about three minutes each time you brush (your dental hygienist may also recommend that you use an electric toothbrush) and never forget to floss

Gum disease, also known as gingivitis, is a condition in which your gums are in a state of inflammation. They can appear red, swollen, and bleed easily. This is usually caused by local irritation from plaque that is left on the teeth for a long period of time. When your gums are inflamed, the barrier between your gums and bloodstream is slightly weakened. This means it is easier for bacteria and inflammatory mediators from our mouths to enter our bloodstream. When gingivitis is left to progress, it may develop into periodontitis. Periodontitis is inflammation of the gums as well as the supporting tissues surrounding the teeth, such as the periodontal ligament and the bone surrounding your teeth. Eventually leading to tooth and bone loss.

Your best weapons for preventing gingivitis is your oral hygiene routine. This means brushing at least twice per day and flossing at least once per day. The best time of day to brush is in the morning once you have finished eating breakfast and then at night after you have eaten your last meal before bed. Brushing and flossing help to remove the plaque that builds up on our teeth throughout the day. Using a mouthwash that helps lower the bacterial levels in the mouth can also help. If you find flossing difficult, a water-flosser can be used to remove debris lodged in between your teeth. Regular professional cleanings every 3-6months can help minimize calculus buildup. Calculus provides a rough and protective environment for the plaque and bacteria that cause inflammation and calculus cannot be removed by brushing and flossing alone.

Another way to help prevent gingivitis is by eating a healthy diet and trying to avoid foods with high sugar content. Foods high in sugar act as fuel for the bacteria in your mouth. Sometimes stress can make you more prone to gingivitis. Try to minimize your stress levels as this will help improve your health overall.

If you are worried about the state of your gums or if you would like to know more about how to keep your mouth as healthy as possible, you can visit our dental office for more information and speak to one of our dentists.

We have all heard the expression “everything is connected.” This is especially true when it comes to the body and keeping the body healthy. Recent studies have shown that there is a strong correlation between gum (periodontal) disease and a host of other problems, including heart disease. You should be visiting a dentist every six months (more or less, depending on how well you take care of your teeth). We will tell you if we see any signs of gum disease and can recommend a course of treatment.

At home, you should watch out for the following signs of gum disease:

• Gums that appear to be swollen, red, or tender
• Gums that bleed when you brush or floss your teeth
• Pus that appears between the teeth and gums
• Foul smelling breath
• Brown deposits along the gum line that feel hard
• Teeth that feel loose or are moving apart
• Changes in the fit of dental appliances

Do not rely on your own assessment. If you have any concerns, book a dental appointment with us and we will be able to perform an accurate diagnosis. There are effective treatments available, and gum disease can be stopped before it causes more problems.

Remember: all the body’s systems are connected, and all need to be taken care of regularly. Good dental hygiene and regular dental visits affect more than just your teeth. They are important for your overall health as well.

Flossing your teeth should be a part of your daily oral care routine. Flossing removes food and plaque particles that are trapped between your teeth. These areas cannot be reached by brushing alone. Brushing without flossing is only doing part of the job. Flossing also helps maintain the health of your gums. If you ever wondered why your gums bleed when you floss, it is because they are trying to tell you something – they are inflamed and unhealthy. Healthy gums are a pink colour and do not bleed when you floss and brush.

Plaque that is left in the mouth for longer periods of time can calcify and form a hard substance known as calculus or tartar. This material can be discoloured and can only be removed during a professional cleaning appointment where it must be scraped off with metal instruments. Prevent this from happening with regular brushing and flossing. If done properly, once a day should be sufficient.

Just as your gums and teeth require a regular hygiene routine, maintaining the hygiene of your tongue will directly benefit your overall oral health. Bacteria often builds up on the tongue contributing to halitosis (bad breath) and may contribute to tooth decay and gum disease. This bacterial layer often discolours the surface of the tongue making it appear whiteish/yellow. Along with this bacteria, decaying food particles, fungi, and dead cells from the tongue also accumulate. So how can you improve your tongue hygiene?

• Use a tongue scraper or a toothbrush to scrape/brush your tongue
• Coat your tongue in toothpaste before scraping to neutralize the bacteria, making it easier to remove
• Rinse either with water, saline water solution, or with regular mouth wash
• Drink lots of water, dehydration can cause change of tongue colour

Do you suffer from chronic pain in your jaw, face, head, neck, or shoulders? You may have what is known as Temporomandibular Joint Disorder or TMD. TMD is a painful disorder that can drastically reduce your quality of life.

 About TMD | TMD is a term used to describe several problems that can occur associated with the temporomandibular joint (the joint that allows you to open and close your mouth). The syndrome can be characterized by pain and restricted ability to move your jaw. You may also hear noises when you move your jaw such as a popping, grinding, or a clicking sound. You may also experience jaw locking, which is when you are unable to close your jaw.

How Do You Get TMD? | TMD can be caused by a variety of factors. The correlation between the factors and the syndrome is poorly understood, and modern dentistry is still looking for a more nuanced understanding of how TMD develops and what causes the syndrome. Some of the many factors that may cause TMD include:

• Joint disease (such as arthritis)
• Jaw injuries
• Bruxism (tooth clenching and grinding)
• Ill-fitting dentures
• Stress, anxiety, and depression

How to Cure TMD | There is no magic prescription to make TMD go away, since TMD is an amalgamation of factors and symptoms. Sometimes TMD disappears with rest and care. Tips to give your jaw a break:

• Eat small pieces of food or drink liquids
• Do not move your jaw suddenly or open it wide
• Use a hot or cold compress to soothe the area that is in pain

If your TMD symptoms remain unchanged after rest, call our office. One of our dentists will be able to help you by developing a treatment plan. Possible aspects of the treatment plan include:

• Medicine for pain / inflammation or insomnia
• Relaxation techniques
• Providing you with an occlusal splint (night guard) to prevent teeth grinding
• Referral to a physiotherapist, chiropractor, or behavioral therapist (for strategies to cope with muscle pain)
• Referral to a TMD specialist
• Surgery (this option is rare and is only used in extreme cases)

TMD can be a very painful disease. If you have been suffering from the symptoms above, give us a call so we can develop a treatment plan.

We have all been there. We have woken up to somebody snoring – whether it was a friend who stayed the night, our parents in the next room, or our partner in bed next to us. Snoring occurs when the muscles in the soft palate (the roof of the mouth), throat, and tongue are relaxed to the point where they can partially obstruct the airway. The soft tissues vibrate during the air flow to make that recognizably deep and hoarse disruptive noise. And the bigger the obstruction in the airway, the louder the snoring will be as the air forces its way out. Snoring is prevalent in people who have a narrow airway due to a low, thick, soft palate or an elongated uvula. People with large tonsils also tend to snore. Other things that can cause snoring include:

• Obesity – those who are overweight or obese tend to have more fat tissue on the back of their throat that can narrow their airway
• Nasal issues – chronic congestion or allergies
• Overuse of alcohol, drugs, and tobacco – can cause the throat to relax and reduce its ability to defend itself against the obstruction of the airway

Snoring Appliances | Generally, a physician must be the one to diagnose snoring and conditions like obstructive sleep apnea. However, dentists can install devices that can open your airway to help you stop snoring and sleep better.

• Tongue re-training device – this is a splint that will hold your tongue in the right position to keep your airway open throughout the night
• Mandibular advancement device – this resembles a sports mouth guard that fits over your teeth and forces the jaw slightly forward and down to open the airway. It is one of the most widely used snoring solutions as it has a high success rate

These devices can promote healthy breathing patterns, reduce congestion, and as a result, reduce snoring. Snoring is not only a disturbance to other people but to the snorer themselves – so it is in their best interest to investigate a dental solution to ensure they and their loved ones get a good night’s rest.

What is it? | The act of grinding your upper teeth against your lower teeth, usually it is subconscious and while you sleep. Most people do not even know that they grind their teeth. You may wake up with a sore jaw or stiff and hypertrophied muscles of mastication (the muscles involved in chewing). This may also cause headaches. Stress and anxiety are implicated as possible initiators of bruxism.

How do I know if I grind my teeth? | Estimates say that from 50-96% of adults have experienced bruxism. Most people are completely unaware of their habit. If you sleep with someone, they may be able to hear you grinding your teeth at night. Your dentist will see the effects of attrition (wear to your teeth) and can examine you for muscle and jaw pain.

How do I treat it? | Wearing a night guard serves to reduce the stress to your teeth. You can have a custom fitted night guard made at our office that is specifically for your teeth. This is different from the ‘thermoplastic’ night guards you can buy at the drugstore. The drugstore ones are a softer plastic material and they can reduce the forces of bruxism but the custom night guard appliance from the dentist reduces the biteforce the most. Since they are a sturdier plastic they last much longer.

When you come in for your regular dental check up, our dentist and hygienist are also screening you for any signs of oral cancer. Every hour of every day, someone dies of oral cancer in the United States. This serious dental disease which pertains to the mouth, lips, or throat, is often highly curable if diagnosed and treated in the early stages. Visiting our office for regular check ups, and avoiding tobacco, are the key factors in preventing oral cancer.

Mouth cancer is a terrible disease. Not only is it painful, but it is also life-threatening and can be prevented. Here at Scarboro smiles, we provide you with a smile that you can be proud of. We are here to help with tips and advice for your oral health. Contact us to set up an appointment today.

Tooth sensitivity is relatively common and can present in a variety of forms. Some people experience generalized sensitivity and some only experience it in specific teeth. The sensitivity can vary in intensity and duration depending on the cause. Either way, tooth sensitivity is a nuisance and can prevent people from enjoying certain foods and or their day.

Common causes of Sensitivity | If you have recently experienced trauma to a tooth, (for example if you fell) it is normal to experience sensitivity as the nerve of your tooth may be ‘concussed’ – just like when you fall and hit your head. Depending on the severity of the trauma, the pain will either diminish on its own or possibly get worse, in which case it is recommended to have it evaluated at our dentist. If you have gum recession, the roots of your teeth become exposed. Your roots are naturally more sensitive than the crowns of your teeth. The outer layer of your crown is called enamel and it is more resistant to sensitivity than cementum (which is the outer layer of the root). Some people experience sensitivity due to compromised enamel. This can be caused by tooth wear, erosion, cavities, cracks, or a broken tooth. If you have recently had a filling or crown done, it is normal to experience sensitivity for up to a few months afterwards. If the pain does not diminish by this point or starts to get worse, consult your dentist to evaluate the status of your nerve. Teeth whitening may also cause tooth sensitivity.

Treatment | The treatment for sensitive teeth depends on what the cause is. If you have generalized sensitivity, a sensitive toothpaste such as Sensodyne or Crest Pro-Relief may help to decrease the symptoms. Your dentist can also apply a more permanent desensitizer called fluoride varnish. This type of varnish can reduce sensitivity for up to a month after application. For sensitivity due to gum recession, the treatment is to correct the cause by doing a gum surgery to bring the position of the gums back to their original position. If you have experienced a trauma or had a recent filling and are experiencing sensitivity, you can monitor the symptoms and see if they diminish on their own. If not, they should be evaluated by your dentist.

• Keep your teeth clean: plaque forms bacteria that irritates your gums and may make them recede
• Use desensitizing toothpaste and fluoridated dental products
• Use a soft-bristle toothbrush that will not scratch tooth enamel or wear away gum tissue and brush gently using a circular motion
• Use warm water when brushing your teeth to soften your toothbrush’s bristles
• Avoid tobacco in any form. In addition to its carcinogenic effects, smoking cigarettes or chewing tobacco may cause gums to recede
• Reduce your intake of acidic foods and sugary snacks and drinks

Periodontitis is a serious oral disease that is characterized by destruction of the bone that holds the teeth in the mouth. Loss of bone means tooth mobility and possible tooth loss. Unlike gingivitis, periodontitis is irreversible. Bone loss can occur at a slow rate over many years, or it can occur very rapid resulting in tooth loss. The destructiveness of periodontal disease depends on the aggressiveness of the bacteria present, as well as the patient’s health and genetic factors.

There are a few risk factors: 

• Genetics
• Smoking 
• Diabetes
• Autoimmune Diseases
• Osteoporosis and Osteonecrosis 
• Female Hormones (Pregnancy, Menstruation) 
• Medications 
• Vitamin C Deficiencies 

The American Academy of Periodontal Disease has created specific classifications for the different stages of periodontal disease. 

Case Type I: Gingivitis

• Swollen Gums 
• Gums change colour from pink to red 
• Presence of bleeding and/or pus
• Gums lose attachment to teeth and bacteria enters into the bloodstream 
• Gums lose their firmness and become soft 
• Is reversible and can be treated by regular visits to the dental office, and by following an adequate oral home care routine

Case Type II: Slight Chronic Periodontitis

• Inflammation and infection of the gums has now turned into a more serious infection 
• The bacteria and infection has now spread to the bone that holds the teeth in the mouth 
• Along with the loss of gum attachment to the teeth, there is also slight bone loss 
• Unlike inflammation of the gums, bone loss is not reversible 
• Bacteria becomes more harmful and aggressive 

Case Type III: Moderate, Chronic, or Aggressive Periodontitis

• Increased destruction of the structures that prevent bacteria from entering the blood stream, and that hold the teeth in their place 
• Noticeable bone loss that may be accompanied by tooth mobility 
• There may be spaces created between the roots of multirooted teeth where bacteria is extremely difficult to remove 
• Bacteria present is very aggressive 

Case Type IV: Advanced Chronic or Aggressive Periodontitis

• Major loss of bone support 
• Tooth mobility 
• Severe infection with very aggressive bacteria present 
• Spaces created between the roots of multirooted teeth where bacteria is extremely difficult to remove 

Case Type V: Refractory, Chronic, or Aggressive Periodontitis

• Numerous diseased locations in the mouth 
• Diseased areas do not respond even after appropriate treatment 
• Sites continue to be destroyed by the bacteria and infection present, no matter how often or thoroughly treatment is provided

When it comes to mouth-related diseases, one of the worst things that can happen to you is oral cancer. It is an extremely painful and dangerous condition that affects the tissue in the mouth. The cancerous growths can affect any area in the mouth but are normally found on the gums, tongue, or cheeks. It affects tens of thousands of people in Canada every year. Thankfully, there are ways to help avoid it. The best ways to prevent oral cancer are:

Avoiding Tobacco | According to research, smoking or using tobacco of any kind (particularly chewing tobacco) is one of the major causes of mouth cancer. One large study done in Europe showed that it was involved in 75% of cases. Quitting if you are currently a smoker or avoiding it altogether is your best bet to not getting oral cancer. This also means doing your best to avoid second-hand smoke. Of course, there are many other benefits to quitting smoking as well.

Avoiding Excessive Alcohol Consumption | This is also a good idea in your life in general, but especially when it comes to preventing mouth cancer. Alcohol can irritate the cells in your mouth, especially when taken in large quantities. In general, try to limit your consumption to a drink per day at most and avoid binge drinking.

See Our Dentist Regularly | It might seem obvious, but many people still do not follow this advice. We cannot stress to you how important it is to get regular cleanings, and to have a dentist look inside your mouth to spot any issues developing. Should there be any problems, a visit to the dentist also gives you a much better chance at catching issues before they become serious.

Fluoride is a critical ingredient in the formation of healthy teeth because it integrates into the enamel to help resist cavities and prevent tooth decay. Children who receive fluoride via their water or use fluoride toothpastes or mouth rinses may not need a supplement. As a result, it is important to inform the dentist of all the ways in which your child receives fluoride, as high doses of the element may cause tooth discoloration known as dental fluorosis.

At Scarboro Smiles, children have the option of choosing fluoride foam as opposed to traditional fluoride rinse. This foam is fun and easy to use and gives your child all the benefits of a fluoride rinse.

Sealants are a thin, clear coating made of an acrylic-like substance. They are applied to the biting surfaces of the back teeth to protect the deep grooves where cavities often begin. The back teeth are a popular site for cavities because it is a hard to reach area when cleaning. Furthermore, the deep grooves found on the back teeth are so fine, that toothbrush bristles often cannot fit into them. By bonding sealants to the back teeth, a barrier is created that prevents acid-producing bacteria and plaque from settling into the tiny crevices and causing decay.

To be a good candidate for sealants because to be applied, the tooth must be free of decay and void of previous fillings. Sealants can help to save a lot of money because they are less expensive than restorative work. The application of a dental sealant is fast and painless, and the benefits have the potential to last for years.

For children, we need to wait until the permanent teeth erupt and deep grooves develop.

Three things are needed in the mouth for cavities to form. First, there needs to be cavity-causing bacteria present in the mouth, which most people will have shortly after birth. The second necessity is to have carbohydrates in the mouth from the foods you eat. The third thing you must have to get cavity development is, teeth – we cannot get cavities if we do not have teeth.

When we eat food, the bacteria in our mouths break down carbohydrates and produce acidic by-products. When the surface of our teeth is exposed to an acidic environment, it favours demineralization of our enamel. If this happens for a long enough time, your tooth can develop holes – also known as cavities.

Knowing this recipe for what causes cavities helps us figure out the best ways to prevent their development. There are ways that we can help reduce the number of cavity-causing bacteria – basically all forms of oral hygiene. Therefore brushing, flossing, mouthwash, and professional dental cleanings all help reduce our oral bacterial load.

The other ingredients, carbohydrates, are introduced to the mouth when we eat. If we stopped eating forever, we would not develop cavities – but of course, this is impossible. So, the other way we can help prevent cavities is to keep an eye on the types of foods we eat. Foods to avoid are those with high sugar content and high acidity such as pop. Sticky foods that tend to get stuck in the teeth such as gummy candies, are also not a good idea. However, certain foods can help lower your risk of getting cavities, for example: cheese helps by raising the pH in your mouth, which makes it harder for tooth decay to begin. Sometimes we cannot avoid sugary foods, but you can brush and floss your teeth right after so the food does not sit in your mouth.

Other things that help us in the fight against cavities is our saliva. Our saliva has buffering capabilities, which can help counter the effects of acidity in our mouths. Therefore, if you have a dry mouth, you may be at higher risk for cavities. The last way to prevent cavities would be to get rid of all your teeth. But of course, this is not exactly the solution most people would be looking for.