Come visit us at

Come visit us at

Monday, November 12, 2018

What can I do with my Peg Lateral?

What is a peg lateral?  A peg lateral is an incisor that has not developed properly.  It is the tooth beside the central incisor and it usually is small and pointy, hence the name peg lateral.
Aesthetically it just doesn't look right.  So what can be done?
    There are a few options.
1)   extract the tooth and move the teeth behind forward.  This is done many times when a child is having orthodontics.  The only problem is the tooth behind is usually a larger size than the tooth it is replacing and sometimes it doesn't come out that great.  Sometimes it comes out just fine.
2)  extract the peg lateral then replace it with an implant.
3)  leave the peg lateral in place and just build it up to look like a normal tooth.

I like option 3 although it is not always easy but when done well can give a very nice result.

All the best
Dr Ron Barzilay

Wednesday, November 7, 2018


My smile looks terrible, so I don't smile any more.  I can't afford the dentistry.  What can I do?

How many times do I get asked this question!  Usually it is from a new patient who I have never seen before and they have come in to see what we can do about their smile.
So many people assume that it is just to expensive so they never come in and even ask the question.  That is the worst situation because for many people the fix really isn't that bad or that expensive.  You really need to ask the question so that you can get an answer.
Many people assume that things are terrible when the solutions are often small and simple.
There are of course cases that are more complicated and more expensive but let's go over some cases and see some solutions.  Of course I can in no way cover all the possible scenarios but here are just a few easy ones.
"My teeth are yellow and they embarrass me".  The solution is teeth whitening!  From in office to buying whited strips at Walmart.  Both work well and you can keep your cost low.
"Crooked teeth".  I always wanted straight teeth but couldn't afford it.  I refer to the orthodontist.  The typical case is $6-7,000 dollars (CDN).  The people I work with ask for a deposit then they put you on a payment plan for about 2 years so it works out to about $200 dollars a month after the deposit.  Sometimes, if patients are hard up for the deposit then I will speak to the Orthodontist and sometimes I can get the deposit  waved and get them more payments.
Now comes the tricky stuff where it is more difficult to give you an idea of cost without seeing the case.
Sometimes a patient needs all their teeth out and new dentures made.  The cost of the extractions will depend on how many teeth are left and how difficult the extractions.  Then the cost of new dentures.  There are some extra costs, not really hidden as your dentist will discuss these with you before you start.  No dentist likes to get into a situation of  "I didn't know" or " you didn't tell me".  These costs include things such as immediate denture cost (denture going in at time of extraction) and reline costs (to make the denture fit the gums after a few months).  Also a possible remake of the denture if it still doesn't fit well because the gums need time to settle to their final shape after the extractions.  If you can wait two to three months after the extraction to make the dentures you can save yourself a lot of these costs.

These are before and after dentures. Not bad!

Of course not everyone needs dentures. Some people just need to replace there existing fillings and make them look good.
Here we just cleaned the gums and so you can see the red line around the gums disappear and now look pink. We replaced the fillings in her four front teeth and just did a better job.  The result was great.  The cost including the cleaning was about $1200.
   Of course I am cherry picking here.  There are cases which are a lot more expensive but if you don't ask you won't know.  Perhaps your solution is not as complicated as you thought it would be.

All the best
Dr. Ron Barzilay

enjoying dentistry in Hamilton Ontario

If you have any questions, just send them as a comment to the blog and I will reply.

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