Ally Kassam

Although there are various methods for whitening, one option includes in-office whitening, which can be completed at your dental office in one visit. Your dentist will want to ensure that you are a good candidate for the procedure, meaning that your gums are healthy and that you are cavity free. The procedure is often approximately two hours long, but your dental team will keep you comfortable with a cozy blanket and headphones. Your teeth will first be polished and then a small bite block will be placed for the appointment so that you can relax your jaw. A liquid rubber dam will be painted on the gums and any sensitive areas (worn parts of teeth or recession areas) to protect from any sensitivity. The in-office whitening solution will then be applied to your teeth, often with three applications of twenty minutes each. Upon completion, photographs with your new shade will be compared to the shade before the procedure. Although results will vary, one can expect 1-8 shades of color difference/brightness. Often, the teeth will continue to whiten at home for a day or two following the procedure. Your dentist may also speak to you about an option to supplement the bleaching at home with take home trays. Be sure to ask your dentist if you are a good candidate.

Great Question. The procedure itself is the same for front or back teeth. In fact, often it will be quicker and easier as there is less canals in the front teeth to treat, depending on your tooth anatomy. Molars often have multiple roots and can have 3-4 canals to treat but front teeth almost always have a single root and 1 or maybe 2 canals. The treatment is done from the back side of the tooth so does not affect the tooth cosmetically during the procedure. Sometimes the tooth may darken over time and if that is the case your dentist will talk to you about any cosmetic options such as a veneer or crown at that time. If the tooth is mostly filling or heavily worn or decay, your dentist may recommend a crown as well. If there is an infection present your dentist may also talk to you about being on antibiotics as well to help settle the tooth prior to the root canal so that you are comfortable and everything heals well.

It sounds like you are doing a lot of things right. There are still a few things that could be causing your bad breath. It could be as simple as brushing your tongue as well, as the tongue harbours bacteria and this could be one of the causes. There are tongue scrapers/cleaners available and your dentist may have a sample or they are available at most drug stores. Additionally, it could be your technique of brushing or flossing. If you are missing some of the door causing bacteria near the gum line or between your teeth, this can be one of the causes. Cavities also may cause bad breath due to the bacteria. Gum disease or deep pockets around the gums also traps bacteria (ie. tartar hardened underneath the gum line) leading to halitosis or bad breath. Check with your dentist to ensure that you don’t have any of these causes, and if you do, they can discuss possible solutions with you. If you know you are completely healthy, start with the first few items listed.

Regular professional cleanings will help you keep your teeth and gums healthy. During the polishing (prophy or prophylaxis) any stains on the surface of the enamel will be removed. Such stains could be from the foods we eat, such as chocolate and wine or even from certain mouthrinses or from smoking. However, should the stains be engrained into the teeth or in the deeper layers, these spots will likely not come out. Have your dental professional team assess and advise you as there is always options in making your smile beautiful for you.

Has your dentist discussed with you why this may happen in your case or warned you of this possibility based on your bite/occlusion? Sometimes, if the bite forces are too high or the teeth are extremely worn, this may cause an issue with retention. If a reasonable explanation was provided or your dentist showed you a photograph of your situation, it may explain what/why this is happening. If you are not satisfied with the answers you are getting, consider getting a second opinion so that you can have peace of mind.

There could be several possible reasons for your bottom front teeth sensitivity. Causes will range from wear of your enamel (possibly from your occlusion/bite or grinding), cavities, gum recession, an infection, etc.; the solution will be linked with the cause. Your dentist may recommend a night guard or fillings or a sensitivity toothpaste or possibly even gum grafting depending on the cause. Start with using sensitivity toothpaste and arrange to see your dentist for a thorough exam and likely an X-ray or two to help determine the cause and possible options for you.

Sharp shooting pain should certainly be assessed by your dentist. Your dentist will usually take a couple of dental X-rays and do a thorough exam and diagnostics tests. Based on the the above information, your dentist can assess for cavities, infections, etc. (which would be the likely situation) and provide you with your treatment options.

There is always treatment options available for chipped teeth along with pros and cons. If the chip is extremely minor, your dentist may be possibly able to smooth or polish the chipped area. Alternatively, a small composite resin (tooth coloured/bonding) filling may be another economical option. Depending on the size of the chip and your cosmetic expectations, this may serve as a good short or perhaps medium to long term option. If the chip is directly on the biting edge, there is a risk of fracturing the filling even with the best possible dentistry, and the color match will be close but not perfect. Your dentist may also discuss the option of porcelain veneer/veneers with you for the best color match and longevity but this will come with a higher cost. Ultimately, you will need to decide what is most important to you and make the best decision for you.

Great question. Typically the peak of bruising, swelling and discomfort is 3-5 days and in most people, they feel quite good after the first week although this can vary. Each wisdom tooth case is unique depending on whether the teeth are already fully erupted vs fully or partially impacted, with impactions taking longer to heal. Your medical history also makes a difference as healthy and younger individuals generally heal quicker vs people with medical conditions such as diabetes will experience delayed healing. Generally teeth with less fully developed roots will also heal more quickly. In other words, there is a lot of variables and your dentist can best advise you based on your age, medical condition and extent of your impactions. In general, I tell my patients to expect the worst of it over the first 3-5 days and generally improving over the first week and to consider having that period off work.

Yes, do not be concerned as this is absolutely normal. Each child and boys and girls develop differently. Similarly, some children start to crawl or speak earlier or a little delayed. Rest assured, wait for Mother Nature to do her part and everything will be ok over time.

Ask your friends/family/coworkers to refer you to a dentist that they trust. Do your own research and research reviews on local dentists. As you have not been in some time, you will want to feel comfortable that you are in great hands. Your dental team will review a medical and dental questionnaire with you to review any medical and dental history and concerns. You should expect that your dentist will do a thorough dental examination including a head and neck exam and oral cancer screening. Following this, your dentist will prescribe specifically based on your needs a set of records which will likely include necessary X-rays and likely a full set of diagnostic digital photographs. The photographs are an excellent tool to have as a baseline and also to communicate anything going on with you. The X-rays will be useful to look for cavities, infections, bone loss, excess tartar, etc. Based on the findings, your dentist will review with you your treatment options and pros and cons so that ultimately you can make the best choices for yourself. You can expect that there may be an excess of tartar build-up and that you may require at least a few (or more) sessions of professional cleanings to catch up with the years of missed cleanings and to bring your teeth and gums back to health. Only once all the records are collected and the exam is complete can your dentist have a better picture of what is going on and advise you further.

An abscess is basically an infection resulting from bacteria. It is generally coming from the gums or from the teeth or from a combination of both. An abscess will only go away if the cause of the infection is treated. In other words, even if it seems to go away on its own, the abscess will return until the cause of the problem is corrected. Your dentist will need to do an exam of your gums and teeth in that area and take the appropriate radiographs (X-rays), and likely even a few measurements around your gum. Once the cause of the abscess is discovered, your dentist can review appropriate treatment options with pros and cons with you so that you can make the best decision for your health.

There is certainly things that can be done to address sensitive teeth. First your dentist will need to determine the exact cause of the sensitivity by doing an exam and likely taking the appropriate X-rays. Causes may range from minor gum recession exposing the root to more severe recession with minimal gum tissue adapting around the tooth. Other causes may include decay, orthodontic (Invisalign or braces) tooth movement, bone loss and tooth mobility, infection, etc. Depending on the exact cause treatment may vary widely from sensitivity toothpastes, fillings, gum grafts, root canal or extraction. Only once your dentist has done a thorough clinical exam with X-rays can the cause and options be determined for your exact situation. Make an appointment with your dentist soon to determine how to get you the best possible treatment.

Erosion of teeth is generally caused by something acidic, either in the diet or some sort of systemic condition. The acids can cause this breakdown or erosion of the enamel on your teeth. Dietary factors could be acidic beverages in high consumption such as Cola soft drink, or acidic fruit drinks due to the content of phosphoric and citric acids in these beverages . Other causes may be included gastro intestinal problems such as acid reflux causing acid to re enter the mouth. Frequent vomiting in conditions such as bulimia or alcoholism may also contribute to erosion of the dental enamel. Dry mouth and certain medications causing more dry mouth may further exacerbate the condition as the saliva helps to protect the dental enamel. See if any of these listed factors may be contributing to the erosion on your enamel, and discuss with your dentist any solutions to help you achieve a healthy smile.

There are so many different options for tooth whitening and the length that the treatment will last varies accordingly. Options range from whitening toothpastes which really only remove surface stain to take home whitening strips which also have varied results as they are a one size fits all option. In office options will include take home custom whitening trays, in office whitening or a combination of the two. There is no predictable way to predict exactly how many shades your teeth will whiten so expectations will also need to be realistic and set by your dental team who can guide you better. Take home trays give you the flexibility to do it at home anytime at a cost savings however not a great option for patients (such as myself) who do not like to do on their own at home. In office whitening may be a good option for those who have any sensitivite teeth or gum recession, crowns, etc as the dental team can apply a coating on these sensitive areas during the whitening process. In addition, in office whitening will allow your dental team to protect any crowns from the bleach solution and causing any damage to the crowns as they will not whiten. Although the combination of in office and take home custom trays may be the most costly, it usually will provide you with the best value as it will allow you to have the best of both worlds....the advantage of having it done in one in office session of 2 hours and then touching it up at home as needed. Although it can vary, the in in office whitening can generally last approximately 1 year and to manage costs you can touch it up at home with the take home trays every 6 months. Speak to your dental team about the options that may be suitable for you and the time that it may realistically last for you...this way you can make the best decision for you.

General Dentists are trained to do root canals, and it is up to each individual practitioner to decide which cases/teeth he feels comfortable doing for you. In my experience and based on science, upper molars often have an extra canal which can often be difficult to locate and treat. In my hands/opinion, I prefer to refer to specialists for any teeth that I am not comfortable treating including upper molars, calcified teeth, odd shaped canals, etc, and I prefer to do more straightforward root canals myself. Ultimately, you need to feel comfortable, and you will make the best decision for yourself after discussing with your dentist.

Some dentists, such as myself, are trained to treat sleep apnea. It is done in conjunction with a physician as well as a sleep study/sleep clinic study. It will be important to determine how severe the sleep apnea is first and to see if you are a candidate for an oral appliance. An Oral Appliance, such as a the Res Med, can be used to slightly move your lower jaw forward, and allowing more opening of your airway resulting in greater oxygen. The compliance in wearing the appliance is much higher but can really only be used in Mild Sleep Apnea Cases. In more moderate to severe cases, a CPAP machine (oxygen mask) is more necessary to allow adequate oxygen saturation. Unfortunately, patients have only been found to wear these appliances 50% of the time after 1 year as they do not find them comfortable although they are life saving. Talk to dentist about a Referal to a sleep clinic, as a first step, for a sleep study first if you suspect you have sleep apnea. Often the signs are gasping for breath, snoring, and waking up fatigued.

Check with your dentist to see if you have adequate room in your mouth for the wisdom tooth to come through and erupt. If you have adequate room for the entire tooth to erupt and you can keep it clean, an extraction is not necessarily recommended. However, if the tooth will only have room to partially erupt, it will be more at risk of infection and decay. This is because of more likelihood of food trapping under the gum, difficulty in cleaning or risk of decay. Your dentist will do a clinical exam and also likely take a panoramic X-ray to check for the eruption of your wisdom teeth and give you advice based on the findings. Often the best age for extraction of wisdom teeth is ages 18-25 as the body generally heals the quickest at this younger ages, but this can vary based on your needs.

Thanks for your question.

Smoking can certainly leave a lot of staining. Much of it is superficial but some also gets deeply engrained into the tooth. Superficial staining can be removed during your professional
cleaning by your dental hygienist with the polishing and professional cleaning. Certain home care tools can certainly help as well such as a high quality electric toothbrush and flossing. At the very least these great home care tools can help prevent further staining or allow longer before the stain builds up. You may also be a candidate after the
professional cleaning for in office or at home whitening options. In addition to all this, your dental office will need to work with you to evaluate with an examination of the gums and the bone and dental X-rays to see the health of the bone and gums. Smoking is known to cause periodontal disease or bone loss; so in addition to the stain, it would be important to
know the overall health of the teeth and gums. Smoking cessation would ultimately be the healthiest option; if that is not possible, the above pointers will help keep your smile whiter and brighter.

I am a big fan of a high quality electric toothbrush. As with anything else, there is a variety of models to choose from from disposable models costing approximately $10 to higher end models costing closer to $200. Consider speaking to your dental professionals for specific advice on which models you should consider. However, generally the higher quality toothbrushes are less abrasive on the teeth and gums. All the motions are taken care and you simply need to move/hold the toothbrush in the appropriate areas. As a result brushing is less technique sensitive. I have seen a difference in my own gums and teeth (as well as for several patients) once the switch was made to a high quality electric toothbrush.