Restorative Dentistry

What is a dental implant? | Dental implants are an excellent way to replace lost teeth, leaving your smile looking natural and healthy. Implants function, look, and feel like real teeth. They provide stability, maintain jaw-bone density, and keep the natural contours of your face. The implant itself is a titanium post inserted into the jawbone, mimicking the root of your tooth. This provides a base for a prosthetic tooth, whether it is a crown, bridge, or denture.

Why would I get a dental implant? | Did you know that in areas of missing teeth, the bone resorbs, and in some cases causes wrinkles to form around your mouth? By placing dental implants into the area of the missing teeth, the bone becomes stimulated from the implant post and therefore will not resorb. Long term, this will prevent those early age wrinkles.

Can my dental implant get a cavity? | Implants are made of a different material than natural teeth, which makes them resistant to tooth decay. This does not mean that you do not have to brush and floss. Dental implants can still experience inflammation of the tissues surrounding them and even bone loss. This is called peri-implantitis. Your implants should be maintained with diligent home care (brushing and flossing) and hygiene visits, to have them professionally cleaned along with the rest of your teeth.

Benefits of dental implants | Life can get messy sometimes. Through one mishap or another, teeth can become knocked loose or even knocked out completely. At one point in time, this may have meant being without a tooth for the rest of your life. Now? We have the technology to make your smile whole again. There are many reasons to consider having dental implants put in – here are some of the best:

• Natural Appearance | Gone are the days of metallic coloured teeth. Dental implants from Scarboro Smiles are bright, and as white as your smile. These implants can bite, chew, and function exactly as your natural teeth. They keep the natural shape and contour of your face, blending in as naturally as if you had grown it yourself
• Safe and Secure | The methods of installing a dental implant are similar to the way the human body grows teeth on its own. Using a titanium post implanted in the jawbone, the implant mimics the natural root of your tooth. This titanium post also provides a base for different kinds of prosthetic teeth, like crowns, bridges, and dentures. This post will never compromise the bone density of your jaw. Your new tooth will be secure and solidly anchored in your jawbone, allowing you to have some peace of mind, and a great smile

There is no need to be ashamed after losing a tooth. Everyone’s physiology is different, along with the events in everyone’s lives. Things happen – and the professionals at Scarboro Smiles are here to help you fix them.

How Do Dental Implants Work? | A post made from titanium is surgically screwed into your jawbone. During a 4-6-month period, this post will osseointegrate (fuse) with your natural bone. During this time, your dentist will create an artificial tooth matching your needs, color, and function. Once the healing process has completed, an abutment (connector) is placed on the implant post, and the artificial tooth, or teeth, will be attached. The result will look completely natural.

How Long Will My Dental Implants Last? | With good care, your implants can last you a lifetime. Like your original teeth, your implants need to be regularly monitored by a dentist and cleaned by a hygienist. You also need to ensure that you clean and floss them daily, like you would with natural teeth. If you treat them well, your new implants should last you an exceptionally long time.

If you have dentures and never want to worry about them wiggling or falling out, mini implants are an excellent solution. Mini implants, as the name suggests, are just thinner and less invasive versions of traditional implants. Also, they can be finished in one appointment and require much less healing time than normal implants because with mini implants, there is no need to make an incision in the gums. This means that the amount of trauma to your mouth is minimal. The mini implant works as a solid post that keeps your dentures firm and in place because implants mimic the function of natural teeth (the way they grow deep into the bone for support). The dentures attach to these posts and then remain firm and in place in your mouth.

Endodontics is the branch of dentistry that deals with diseases of the tooth’s pulp. The pulp is found in the center of the tooth and in canals (called root canals) inside the root of each tooth. Pulp includes connective tissue, nerves, and blood vessels. Pulp nourishes the tooth when it first emerges through the gums. Once the tooth matures, the pulp can be removed without destroying the tooth. That is because each tooth is nourished by a blood supply in the gums. Removing the pulp is called endodontic treatment, but it is often referred to as root canal treatment or root canal therapy. Root canal treatments are quite common.

When is a root canal needed? | Root canal treatment is needed for two main reasons. The first is infection. An untreated cavity is a common cause of pulp infection. The decay erodes the enamel of the tooth until it reaches the tooth’s roots. This allows bacteria to infect the pulp. Antibiotics cannot get to infections inside teeth. The inflammation caused by the infection reduces the blood supply to the tooth. The reduced blood supply also keeps the pulp from healing.

The second reason for a root canal is damage to the pulp that cannot be fixed. Trauma or a fractured tooth can damage the pulp, as can a restoration, such as several fillings placed in the same tooth over a short period of time. Sometimes, common dental procedures, such as preparing a tooth for a crown, can hurt the pulp.

An infection in the pulp can affect the bone around the tooth. This can cause an abscess to form if the infected pulp is not removed. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, to treat the infection, and to full the empty root canals with a material called gutta percha.

If root canal treatment is not done, an infected tooth may have to be extracted. It is better to keep your natural teeth if you can. If a tooth is missing, neighboring teeth can drift out of line. They also can be overstressed from chewing. Keeping your natural teeth also helps you to avoid other treatments, such as implants or bridges. Also, if you ignore an infected or injured tooth, the infection can spread to other parts of your body. Once a tooth is treated, it almost always will last the rest of your life.

Your tooth might need a root canal if:

• Your tooth hurts when you touch it
• Your tooth is sensitive to heat
• Your tooth is sensitive to cold for more than a couple of seconds
• There is swelling around your tooth
• Your tooth is discolored (whether it hurts or not)
• Your tooth is broken

What Is BOTOX®?

BOTOX® has been approved by the FDA as an effective treatment for managing Temporomandibular Joint (TMJ) disorder, a condition causing discomfort and dysfunction in the jaw joint and surrounding muscles. Unlike its cosmetic applications, BOTOX® exhibits promise in relieving the symptoms associated with TMJ disorder. TMJ disorder stems from various factors such as teeth grinding, stress, or jaw misalignment, leading to muscle strain, resulting in pain, stiffness, and difficulty in jaw movement.

BOTOX® injections, derived from botulinum toxin, work by temporarily relaxing the injected muscles, reducing their ability to contract forcefully. This relaxation can alleviate the symptoms of TMJ disorder, providing relief from pain and restoring ease in jaw movement. One of the notable advantages of using BOTOX® for TMJ disorder is its minimal downtime, allowing patients to resume regular activities promptly after the procedure. Results typically start to become noticeable within 48-72-hours, reaching their full effect within 30-days and potentially lasting up to 4-months.

Moreover, BOTOX® treatments for TMJ disorder are suitable for both men and women, offering a viable option for patients seeking relief from TMJ-related discomfort. Treatment plans may vary depending on factors such as age and specific treatment goals. Patients trust BOTOX® for TMJ disorder due to its established reputation and track record. Supported by extensive research spanning over several years, BOTOX® employs a unique manufacturing process, ensuring its potency and effectiveness in managing TMJ disorder symptoms.

How Does BOTOX® Work?

BOTOX® for TMJ works by injecting botulinum toxin into the affected jaw muscles, inhibiting their excessive contraction. This blocks nerve signals that cause muscle tightening, relaxing the jaw muscles. By reducing muscle activity, BOTOX® eases strain on the temporomandibular joint (TMJ), alleviating pain, tension, and improving jaw mobility. This intervention provides temporary relief from TMJ-related symptoms, diminishing discomfort and allowing for better jaw function.

What is a dental crown? | A crown is a type of dental restoration which is used to fully cover the portion of tooth that lies above the gum line. Like most other dental restorations, crowns often require more than one visit to the dentist. However, with CEREC Crown technology, we can manufacture your crown right in our office, allowing us to completely restore your tooth in a single appointment, start to finish.

What is a dental crown made of? | Traditionally, metal was used for crowns due to its strength. Then the use of porcelain fused to metal crowns became the material of choice because of their esthetics and strength. The inner layer of a crown is metal with the outer being a tooth-coloured porcelain to match the other teeth in the mouth. However, porcelain fused to metal crowns can sometimes have a small gray rim of metal at their base. The newest crowns are made with a ceramic base which is white in colour. Introduced in the last decade, Zirconia has mechanical properties which are the highest reported for any dental ceramic. Zirconia bases can be used with a porcelain outer layer to deliver great esthetic outcomes. In our office, we have CEREC crowns. These ceramic crowns can be finished in a single appointment.

Dentures are prosthetic teeth, made mostly of plastic, that replace missing or lost teeth. Dentures are usually a solution of last resort. Many people assume that they will need dentures as they age, but losing teeth is not a normal part of the aging process. If you care for your teeth and guard them against gum disease, you should be able to keep your teeth for a lifetime.

How do dentures work? | Saving even a few natural teeth is often better than losing them all. Natural teeth, or even parts of natural teeth, can help you retain your jawbone. Natural teeth act as stable supports for bridges, overdentures, or removable partial dentures. Complete dentures are made for patients who have lost all their teeth. Partial dentures are used to replace only a few teeth, similar to a dental bridge.

The good news is that dentures are not what they used to be. Newer materials and technology have allowed great improvements. Dentures are now made to fit comfortably and look natural. However, problems such as clicking, slipping, frequent gum irritation, and odor, may be signs that your dentures do not fit well. They may need to be adjusted, relined, or remade.

Although dentures may look like your natural teeth, but they take time to get used to. This may take months, but soon enough, you will be talking and eating like you use to. Just like real teeth, plaque can build up on dentures too. Therefore, your denture should be removed at night and placed in a denture cleaning liquid. This liquid loosens the plaque. Dentures should also be brushed before being reinserted in your mouth the next day. Here at Scarboro Smiles, we provide our patients with a complementary Ultrasonic Denture Cleaner. This cleaner vibrates as it cleans, working even harder to rid your dentures of plaque. This will leave your dentures looking clean and new.

Nickel-Free Dentures | Scarboro Smiles offers nickel-free dentures made from an alloy safe for individuals allergic to nickel. In addition, this alloy is also more accurate and requires less extension than plastic-based dentures, allowing for a more comfortable and precise fit.

Complete Dentures | Complete dentures cover your entire jaw, either upper or lower, and sit comfortably on your gumline. Complete dentures are custom-made for you. The size, shape, and color of the artificial teeth are made to look and feel as natural as possible. On occasion, one or more natural teeth are kept when a denture is made. These teeth usually have root canal treatment and are shortened to fit under the denture. This type of denture is known as an overdenture. This has several advantages:

• Your natural teeth help preserve your jawbone.
• Your natural teeth bear some of the chewing pressure. This reduces pressure on other areas of your jaw
• Your remaining teeth make the denture more stable and less likely to shift in your mouth
• You may find it easier to accept wearing dentures if you keep some of your teeth

Lower dentures tend to be more difficult to keep in your mouth than upper dentures. Therefore, an overdenture can be particularly helpful for the lower jaw. The teeth will have to be shaped to fit the denture. Shaping may expose the tooth’s living pulp. For this reason, the teeth usually need root canal treatment. This removes the pulp (the nerve of the tooth) and replaces it with filling material. Overdentures can also fit over implants instead of natural teeth. In fact, implants originally were developed to give people “artificial roots” for bridges or dentures in the lower jaw. The denture can fit onto the implants directly, or onto a metal bar between implants.

Partial Dentures | Partial dentures consist of a metal framework. The framework includes metal clasps or other attachments to hold the denture in place by attaching to other teeth. The dentures can be removed easily for cleaning. Metal clasps are C-shaped, I-shaped, and Y-shaped parts of the denture framework and they fit around neighboring natural teeth. These teeth may require shaping to help hold the clasps and keep the denture securely in place.

Fixed partial dentures, which most people call bridges, are cemented in place, therefore, cannot be removed. Bridges are more expensive than removable partial dentures. They also must be supported by nearby healthy teeth.

If you wear partial or complete dentures, it is especially important to take good care of your gums and any natural teeth, and to keep your dentures clean and properly fitted. When gums, dentures, and remaining teeth are not cleaned properly, you are likely to experience a build-up of plaque, a type of bacteria that collects at the gumline and can harden on teeth into deposits called calculus. Too much plaque can lead to bad breath, cavities, gum disease, and further tooth loss. If you are about to get dentures, here is what you need to know to keep your mouth healthy and your smile bright:

• When properly fitted and cared for, dentures will enhance your appearance and can be worn with confidence as you enjoy your favorite activities. A simple, daily routine of oral care and regular visits to our dental office are all that is needed to keep you on track
• It is important to remember that dentures do not last forever. Even with proper cleaning and care, the average life span of dentures is only about five to seven years. The teeth and base of the dentures will eventually stain, and over time, natural changes will occur to the structure of your face and mouth that will require an adjustment to your dentures
• Like natural teeth, dentures can build up with plaque. Dentures can cause plaque to be pushed further down underneath the gumline, which may make cleaning more difficult and lead to cavities, especially on exposed root surfaces
• Wearing dentures can put extra pressure on the surrounding bone structure and gums, as well as any natural teeth that are used to support partial dentures. If these areas are not kept clean, you may experience sore, irritated gums or additional bone and tissue loss. That is why it is particularly important to come to our office regularly and follow our dental advice between visits

You might know or have met somebody with a “gummy smile” – a person who shows more than two millimeters of gum when they smile. This can be due to several reasons, including:

• They may have smaller than average teeth
• They may have a shorter or raised upper lip
• They may have excessive gum tissue covering part of the tooth
• They may have a larger maxilla (the upper jawbone)

Many people feel fine about having a little extra gum in their smile, but in certain cases, people might find it unaesthetic. Depending on the reason for the gummy smile, different treatments exist. Corrective gum surgery is an option for those with extra gum tissue covering up parts of their teeth. If the problem is in the upper jawbone, surgery may be required.

What to expect from the procedure? | Corrective gum surgery is performed using modern tools such as lasers and scalpels. A typical surgery begins with your dentist marking where the gum line will be cut. A local anesthetic is applied to the affected area and then the excess tissue is removed and recontoured for an ideal aesthetic outcome. There are very few risks involved, but like any procedure, it is always good to know what to look out for. In some cases, a relapse of the gum tissue, post-surgery, is possible, but this is generally considered to be a rare occurrence.

After surgery | Like any surgery, a corrective gum procedure will take some time to heal. Eating soft foods helps to aid the process of healing. If pain persists, you can take over-the-counter pain medications to help. It can take up to a few weeks to completely heal. Caring for your gums is crucial post-surgery. Brushing softly and rinsing with salt water can make sure germs and plaque stay away from the healing area.

A toothache usually means that the nerve of your tooth is inflamed. In dental terms, this is called ‘pulpitis’. The inflammation can be caused by several factors: trauma, bacterial ingression from cavities, biting pressure (clenching and grinding), or anything that irritates the nerve of your tooth. There are two types of pulpitis – reversible or irreversible. With reversible pulpitis, the nerve can become healthy again and remain vital. With irreversible pulpitis, the nerve is doomed to die.

Death of The Nerve | So, what if the nerve dies, is there no more feeling? If the nerve dies, it is a great environment for the growth of bacteria. If left alone, bacteria can collect at the apex (end of the root) and cause a granuloma or a cyst. This can flare up and cause a toothache that can be more painful than the one felt with the pulpitis while the nerve was still vital.

What is the treatment? | The typical treatment for a severe toothache is a root canal. A root canal is a procedure in which the entire nerve is removed from the tooth. The canal is cleaned out to remove as much bacteria as possible and then the canal is sealed with a material. Antibiotics can help calm the infection down but only to a certain extent, eventually the canal must be physically cleaned out. Also, the tooth can be extracted to remove the infection, this is usually the option if the tooth is broken and there is not enough structure left to place a crown or filling.

We offer a wide variety of surgical procedures to aid in your oral health. With Dr. Cumandra’s years of dental experience, you can rest assured that you are in good hands.

Bone Grafting | The success of a dental implant is dependent on how much bone is available on the implant site. Although bone loss is not uncommon, it must be replaced if an implant is to be placed. The process in which bone is replaced is called a bone graft. There are many ways in which bone grafting can be done. Sometimes it is as simple as collecting bone when preparing an implant site and then reusing the bone for grafting purposes. Whenever we use a patient’s own bone for repairs or additions, we get the best results. An alternative technique is called “bone in a bottle.” This bone is created by synthetic materials and is used to stimulate a patient’s own bone formation in graft areas.

Corrective Gum Surgery | Corrective gum surgery is when excess gum and bone within the mouth are reduced in size to create a balanced and beautiful smile. Although this surgery can be undertaken purely for esthetic purposes, it can also be used to correct damage caused by gum disease or to fix jaw related issues that arise due to jaw misalignment. Such problems include:

• Trouble biting, chewing, or swallowing
• Pain and sensitivity in the jaw
• Protruding jaw
• Asymmetrical or crooked jaw
• Problems speaking or breathing 

Root Coverage Gum Grafting | When gums recede, teeth become more vulnerable to bacterial penetration. This is because recession exposes the root surfaces of teeth. Not only can this leave you vulnerable to disease, it may also cause heightened sensitivity. Potential problems associated with gum recession can be solved with a gum graft. In this procedure, a thin piece of tissue is taken from the mouth. Although it is usually from the roof of the mouth, it can also be taken from adjacent areas. This tissue is then placed around the bottom of the tooth to cover the exposed root.

Sinus Lift Implants | The human skull has several sinuses. Defined as air spaces, sinuses often prohibit implant placement due to their location over the upper jaw. If an implant were to enter the sinus area, nothing would hold it into place because of the lack of bone anchorage. The good news is that when we encounter this problem, we can place bone, or bone stimulating material, into the sinus by opening the side of the gum or removing gum tissue and injecting bone from below. These processes increase the height of the bone and thus, lift the floor of the sinus allowing for implant placement.