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Wednesday, May 30, 2018


     Many times we tell people that they are grinding their teeth at night and they really don't believe us.  Many times they will outright say that " they are not grinding their teeth!"  I think they would like to ad that "by the way Doc.. I think you are nuts!"
     I understand where they are coming from.  I would think it is a little weird too.  Nothing bothers me and nobody has ever mentioned it to me so how could I be grinding?  I mean, I would know!!!
     Well here is the thing, when your dentist looks at your teeth we see things that you don't.   When we look at your back teeth and we see that these teeth are flat when they should have hills and valleys, we know you are grinding.  When we can see the yellow dentin layer of your teeth and there is no more outer white enamel layer then we know you have ground away the enamel of your teeth.
    From regular eating, it would take about 100 years to grind away 1 mm of tooth structure.  In patients who grind we see mm's of tooth structure missing.  Patients who grind their teeth can be any age.  From children to teenagers to the elderly.  Even in young teenagers we can see a large amount of tooth structure missing.  Sometimes people hear us grinding, sometimes no one hears us.  All this grinding is done while we sleep.  This tooth grinding is called Bruxism.
    Why do we grind?  There are a number of theories but I haven't seen a definitive answer that I can give you yet.
    By the way, many people do know that they grind because in the morning they wake up and their jaw is sore or perhaps they have pain in their joint or perhaps their teeth are tender or perhaps they wake with headaches.
   So what do we do for people who grind their teeth?  In general, we fabricate a Nightguard.  This is a plastic guard that you wear at night so that you grind on the plastic and not on your teeth.  This will preserve your tooth structure and relieve the pressure on your muscles of mastication and your temporomandibular joint (jaw joint)!  This usually gives relief  from sore muscles of the jaw and headaches that occur as a result of the grinding.
     If any of this sounds familiar and you have some questions then discuss it with your dentist. or leave a comment on the blog and I will answer any question you may have.

All the best

Dr. Ron Barzilay

enjoying dentistry in Hamilton Ontario!!

Tuesday, October 31, 2017


I had two emergency patients come in this past week and both said the same thing, "Doc, I haven't been to the dentist for years because I don't have insurance."
I wrote a similar blog about 5 years ago but I felt that I need to say a number of things regarding not having dental insurance.  I wrote similar things in my blog back then but because this happens so often I felt that I need to write again on this subject so that if someone is not going to see the dentist because they don't have dental insurance, maybe they will read this and change their minds.

This is exactly what I told those patients when they said they couldn't go to the dentist because they didn't have insurance.
1.  Here you are and you don't have insurance.  So actually when you want to go you can go.
2.  You will pay more now than if you had regular dental care since now, things will be more complicated.
3.  When you haven't taken care of your teeth for years and you finally get insurance, don't think that it will cover the cost of large amounts of dentistry.  Remember, most plans have maximums after which you are paying out of pocket.  Not all plans cover major work such as crowns which you now may need since your mouth is falling apart.  Again, this will be out of pocket.
4.  Regular dental care is much cheaper than emergency dental care.  Regular care will allow you to do a small filling in a tooth versus a root canal, buildup and crown at 10 times the cost because you waited.  We all understand that we need to change the oil in our cars from time to time.  We all understand that it is cheaper to change the oil than the engine.
5.  If you think you couldn't afford the regular care then take a little more time between appointments to help you financially. ( But still go from time to time!)
6.  Don't forget that you pay for your dental benefits!  Your employer removes a certain amount monthly for your benefits from your paycheck.  So even when you get benefits you are still paying for them.  If you don't have benefits then perhaps put aside the amount you think your employer would remove monthly and then you are saving for your own dental benefit.

I never tell someone what they can or cannot afford, since I can never put myself in their shoes.  What I do try to do is to help people look at this problem from a different perspective which I hope will help them in the long run save their teeth.

Having fun in Hamilton Ontario Canada

All the best

Dr. Ron Barzilay

Monday, August 21, 2017

I had a Root Canal, I had a Crown and the Tooth still hurts! Why?

I had a root canal treatment.  They put the crown on afterwards and now the tooth is still sensitive.
Why does this happen?
Well let us start off by saying that root canal treatment is highly successful but highly successful does mean that there are failures.  Even with a success rate in the 90 percentile and above, if you are one of the few where it doesn't work, it is very unpleasant.
Why can a root canal treatment fail?  There may be an extra canal or 2 which we did not see and accordingly did not clean and therefore bacteria was left in the tooth.  As good as we get, and we are always getting better with greater magnification and better techniques, we still miss canals. Sometimes there maybe a fracture in the tooth which causes ingress of bacteria and dooms the tooth.
These things can happen and even with our best efforts a root canal may fail.  Keep in mind, our success rates are always improving and at 90 plus success rate we are not doing to bad.

All the best

Dr Ron Barzilay

enjoying doing Dentistry in Hamilton Ontario

Monday, July 24, 2017

My Child is grinding his teeth at night and it is driving us crazy! What should we do?

I have had patients come in and ask me this question.  In the past I would have said that there is nothing you can do and they will grow out of it.  Today, I would ask them if the child is also snoring. I would ask a whole range of questions to see if possibly they have a number of different issues.  Depending on the results of our screening I may now refer the child to their family doctor to possibly send the child for a sleep assessment.  We would be concerned regarding the possibility of sleep apnea.  Today we understand that bruxism (teeth grinding) maybe the brains' way of trying to wake someone because the brain may not be getting enough oxygen. There is no question that as the child grows the airway will get larger and the problem of bruxing usually fades.  But you need to ask yourself is it worth waiting if it is an airway problem and your child is not getting enough oxygen to their developing brain.  How many nights without oxygen for a child brain is enough?   For this reason there are pediatric sleep studies and if the child has sleep apnea the treatment usually involves  removal of tonsils and adenoids and possibly orthodontic expansion of the maxilla.  The airway is openned and the child usually does better at school, stops snoring and bruximg and a whole range of other problems tend to improve.
All the best
Having fun doing dentistry in Hamilton Ontario

Dr Ron Barzilay

Friday, June 9, 2017


I get this question many times from parents.  Many times I get children and adults coming into the office and it is clear that they are not brushing their teeth.  When I ask if they brushed their teeth today, they answer "yes".  It is perfectly clear to me that they have not brushed their teeth but I move on because I don't want to embarrass anyone by confronting them.  How do I know they didn't brush?  It is quite clear by the amount of debris on the teeth.  Even if they did the worst job possible, you wouldn't have this much debris on the teeth.
I recently had a young man of 13 in the office.  He had just had his braces removed perhaps a month or two earlier and his gums were inflamed, fiery red.  I ran a probe over his teeth and huge amounts of white gunk (plaque) came off with the probe.  I asked him if he brushed his teeth today and he answered "yes he did".  The amount of plaque and the redness of his gums really worried me because this was a fork in the road for this young man.  Either a life of cavities and gum disease and eventually tooth loss or a beautiful smile with minimal tooth issues.  I asked him how long he had brushed his teeth today and he said a half hour.
I gave him a new tooth brush in the office and asked him to brush his teeth the way he does at home.
He brushed a little here and a little there and told me he was done.  I asked him how long he thinks that he brushed his teeth for and he answered, 1 minute!  I told him that he had brushed for 20 seconds.  I then took the tooth brush and systematically brushed his teeth so that I reached every area in his mouth in a systematic fashion..  I brushed his teeth this way for 2 minutes then I asked him to repeat what I had done.  He tried, didn't quite do it that well but he started to get the idea.  I guided him to  the the system that would let him clean every area and to how long it should take.  I told him he needs to do this morning and evening.  I had him back in two days and we repeated the same process with him brushing then with my repeating  and then with him brushing again.  I brought him in a week later and his oral hygiene had improved tremendously.  The red was almost gone and the teeth were clean.  We repeated again what we had done previously and I am bringing him in again in a month from now.
So how do you get them to brush?  You need to be involved, you need to work with your kids.  You need to let them understand that you are going to keep working with them until they brush their  teeth regularly and the way you show them.  The actual technique of brushing is not as important as the regularity of brushing and the time spent each time they brush They will come to the realization that it will be better for them if they just put a little effort into it themselves.  Eventually this will become a habit and they will brush for life.  You have to think of yourself as their personal trainer in the brushing department except that you are not getting paid.  Remember, spend the time with them!!!!

All the best
Dr. Ron Barzilay
Having fun doing dentistry in Hamilton Ontario

Sunday, September 18, 2016

Should Teeth Always be so White?

I received an anonymous letter in the mail this week with an advertising which we posted.
The person who sent us the advertising  made the comment that in one area of the advertising the person's teeth were white, in another area of the advertising the person's teeth were not as white and we should get our money back from the printer as they did a bad job with our print.  This was very interesting to me and I am only sorry that the person sent this anonymously.  What I would have told him is this.  Not everyone has white teeth and believe it or not, as a dentist, I strive to give people what they want and to make people look natural.  We have all seen those cosmetic surgery cases that go wrong because the surgeon just needed to say to the patient that it will not look good and I am not going to do it.  We have seen those people that have had dental work and  the second they smile you are almost blinded by the "light".  In this particular case we had a gentleman who had terrible teeth and they all needed to come out.  We gave him new dentures which were appropriate for his age and complexion.  He also did not want his smile to be overwhelming to those who knew him as until now he hardly smiled and he wanted his smile to look natural.  I was very proud of the job we did and how we helped change this gentlemans' life.
Today, in general, we actually do go for slightly whiter teeth since everyone is whitening their teeth and have whiter smiles. But!! I will always do what is appropriate for my patient and tell him or her if this is what is right for them or maybe we have to go for a color that is less conspicuous.
As to the advertising, I guess we could have posted a case that had a whiter end product but I am really proud of this case and it is a truly realistic case and result.
The marketing people and this particular person may not like it that much but I really like honesty in my marketing.
All the best
Dr. Ron Barzilay
Having fun in Hamilton Ontario

Should I go to the Dentist if I am Pregnant and what can I have done?

Should I go to the dentist if I am pregnant and what can I have done?

This question comes up often.  Unfortunately it mostly comes up when the pregnant patient is in pain.
In this situation the answer is quite simple,  of course you can go to the dentist.  There is no question here.  If you broke your arm while pregnant would you not go to the hospital?  Of course you would and you know that they would take the xrays needed and give you medication as required.
If you had a tooth ache, we would take xrays as required and do treatment as required.  We would also give you any medication required.  Having said this, a shield always covers the fetal area when giving you x-rays (dental xrays are minimal amounts to begin with).  Also most professionals will do their best to give medications which have the least affect on the fetus.
If you are planning on getting pregnant, it is a good idea to have your teeth checked first and to make sure that you do not have dental problems that could lead to pain or infection during pregnancy.  If you have fillings to do we generally try to do them in the second trimester.  Small fillings can wait but anything that is quite large can become painful and infected if not treated early.  If that happens then that can involve a lot more things for the unborn child than the filling would have.
Also we do recommend extra cleanings during pregnancy as the hormonal change in a women's body during pregnancy causes a more exagerated response of the gums to the bacteria in the mouth resulting in a greater amount of inflammation of the gums.  This inflammation can manifest as swollen and bleeding gums which may be uncomfortable.
The short is you can and should go to your dentist during pregnancy and don't hesistate to ask your dentist regarding any concerns which you may have.
All the best
Dr. Ron Barzilay
Having fun in Hamilton Ontario.