Many times a patient comes in with a front tooth that is dark in comparison to the tooth beside it. It may be grey or black or dark yellow. The patient has usually had this tooth discoloration for many years, some from childhood. They were used to it and it never bothered them until someone said something and now they are asking me.
Generally the discolorations that we are talking about are intrinsic. That means they come from inside the tooth.
A tooth that is yellower than the front tooth beside it is usually a result of a blow received to the tooth. The cells around the nerve of the tooth perceive some sort of challenge and reply by laying down new dentin. The dentin is the yellower inside of the tooth between the transparent enamel and the pulp of the tooth. Once you have a lot more of that yellow dentin there, we see the tooth as being yellower than the tooth beside it.
How do we treat this? We bleach just the one individual tooth and the results are quite good.
A tooth that is grey or black in color has usually had a root canal treatment done to the tooth. Sometimes some of the root canal filling materials are left in the top part of the tooth, the crown. It results in discoloration of the crown giving a grey or black color.
The treatment here is an internal bleach of the tooth. The root canal chamber is openned and any excess rootcanal material is removed. The tooth still has to be bleached as color has generally leached into the dentin. A bleach consisting of sodium perborate and hydrogen peroxide is placed in the tooth for a number of days and if the color is not quite right it is repeated. After the bleaching the tooth is closed with a new white filling.
In both situations these are both relatively simple solutions and work quite nicely, however not all situations are alike and depending on the situation other solutions, such as veneers or crowns, may be required.
I have touched on only two specific types of discoloration. There are many other reasons for discoloration and best that you consult with your dentist to see why your tooth has discolored and how it can be made to look more aesthetic.
If you have any question, just send me an e-mail and I will reply.
You can also follow my blog at your leisure.
All the best
Dr. Ron Barzilay
A denitist having fun doing dentistry in Hamilton Ontario.
http://www.rondentist.com/
Sunday, November 20, 2011
Thursday, September 29, 2011
Front baby tooth is now black!
The parents call up and say "my child's front tooth is black. What should I do?"
Well the first thing we tell them is they should come in so we can have a look.
The history of this situation is that the child had received a blow to this front tooth at some point in time and now the tooth had turned dark. This tooth is no longer vital (alive). The nerve inside the tooth has died. The tooth darkens.
If there is no sign of infection, no swelling of the gum, no pain, we leave this tooth alone. It will most likely fall out by itself when the permanent tooth comes in. The permanent tooth will come in without any problems. If there are signs of infection we will extract this tooth so that the infection will not affect the developing permanent tooth.
This is what happenned to my daughter when she was about 3. She fell, hit her front tooth and it turned dark. The gums were fine, no sign of infection so we just left it alone and today she has a beautiful smile. (14 years later)
Just another day for a Hamilton Dentist!
www.rondentist.com
If this was helpful to you join the followers of this blog.
All the best
Dr. Ron
Well the first thing we tell them is they should come in so we can have a look.
The history of this situation is that the child had received a blow to this front tooth at some point in time and now the tooth had turned dark. This tooth is no longer vital (alive). The nerve inside the tooth has died. The tooth darkens.
If there is no sign of infection, no swelling of the gum, no pain, we leave this tooth alone. It will most likely fall out by itself when the permanent tooth comes in. The permanent tooth will come in without any problems. If there are signs of infection we will extract this tooth so that the infection will not affect the developing permanent tooth.
This is what happenned to my daughter when she was about 3. She fell, hit her front tooth and it turned dark. The gums were fine, no sign of infection so we just left it alone and today she has a beautiful smile. (14 years later)
Just another day for a Hamilton Dentist!
www.rondentist.com
If this was helpful to you join the followers of this blog.
All the best
Dr. Ron
Friday, September 16, 2011
Composite or Amalgam, White Fillings or Silver Fillings
I am still getting those questions regarding fillings.
Which is better, white or silver? Are silver fillings safe? Should I remove all my silver fillings and replace them with white?
First let me say that in my office we do 99% of our fillngs in white. I believe that most dental offices today do most of their fillings in white. What has driven this change is the aesthetics of these fillings. Who would not rather have white fillings in their mouth versus the dark fillings that may become visible as we smile or talk.
Having said that, when I graduated dental school, white fillings in the back teeth were available but they weren't that good. They leaked alot around their edges which resulted in alot of sensitivity after the filling and alot of recurrent decay. Due to these facts, many dentists were reluctant to place them but with the years and the advancement in materials and techniques these problems have been resolved. Today most dentists are very comfortable placing them.
So what about silver fillings? Are they bad fillings? Are they dangerous to your health? Should they be replaced? Are dentists still placing them?
Silver fillings are good fillings that have been around for over 100 years. Their safety has been proven over the years with numerous studies. I have many of these in my mouth and if I thought there was a problem with them, I would be the first to change them.
Many patients do ask me if they should replace the old ones or if they can replace them with the white ones? I tell my patients that just because the filling is old does not mean it has to be replaced. If there is no breakage of the filling or decay underneath it then there is no reason to replace it. If it is not broken don't fix it. If the darkness of the filling bothers the patient from an aesthetic perspective then yes we can go ahead and replace them. I do warn my patients who want them replaced that they should know that when a filling is replaced we usually must make the hole the filling was in slightly deeper in order to get the old filling out. In the really deep fillings where the filling is close to the nerve this may necessitate root canal treatment if there is pain after the filling.
Do we still use silver fillings? Yes we do. The white fillings are more technique sensitive fillings. (that is also why they are a little more expensive than silver fillings) When we place the white filling, the area must be perfectly dry. If it is not dry then we may get leakage of the filling and subsequent sensitivity and recurrent decay. As you know the mouth is a wet place and for some people in certain areas of the mouth it is almost impossible to keep the area dry. For these people we still use silver fillings as it is not so technique sensitive and it can successfully be place in areas that still have some wetness.
We still use silver fillings in children as these fillings can be placed faster than white fillings and in a child whose attention span is limited and where you need to get the job done quickly, silver fillings are a valuable tool.
Some insurance providers only pay the cost of silver fillings in the posterior teeth and then it is up to the patient wether they would like silver fillings or pay the difference for white fillings.
White fillings and silver fillings, both are good. White is more aesthetic but don't rush out to have the silver replaced unless it bothers you aesthetically.
All the best from this dentist in Hamilton Ontario on this beautiful summer day. (yes it is still summer but not for much longer)
http://www.rondentist.com/
PS. If you like the info on this blog, join this site as a follower.
Which is better, white or silver? Are silver fillings safe? Should I remove all my silver fillings and replace them with white?
First let me say that in my office we do 99% of our fillngs in white. I believe that most dental offices today do most of their fillings in white. What has driven this change is the aesthetics of these fillings. Who would not rather have white fillings in their mouth versus the dark fillings that may become visible as we smile or talk.
Having said that, when I graduated dental school, white fillings in the back teeth were available but they weren't that good. They leaked alot around their edges which resulted in alot of sensitivity after the filling and alot of recurrent decay. Due to these facts, many dentists were reluctant to place them but with the years and the advancement in materials and techniques these problems have been resolved. Today most dentists are very comfortable placing them.
So what about silver fillings? Are they bad fillings? Are they dangerous to your health? Should they be replaced? Are dentists still placing them?
Silver fillings are good fillings that have been around for over 100 years. Their safety has been proven over the years with numerous studies. I have many of these in my mouth and if I thought there was a problem with them, I would be the first to change them.
Many patients do ask me if they should replace the old ones or if they can replace them with the white ones? I tell my patients that just because the filling is old does not mean it has to be replaced. If there is no breakage of the filling or decay underneath it then there is no reason to replace it. If it is not broken don't fix it. If the darkness of the filling bothers the patient from an aesthetic perspective then yes we can go ahead and replace them. I do warn my patients who want them replaced that they should know that when a filling is replaced we usually must make the hole the filling was in slightly deeper in order to get the old filling out. In the really deep fillings where the filling is close to the nerve this may necessitate root canal treatment if there is pain after the filling.
Do we still use silver fillings? Yes we do. The white fillings are more technique sensitive fillings. (that is also why they are a little more expensive than silver fillings) When we place the white filling, the area must be perfectly dry. If it is not dry then we may get leakage of the filling and subsequent sensitivity and recurrent decay. As you know the mouth is a wet place and for some people in certain areas of the mouth it is almost impossible to keep the area dry. For these people we still use silver fillings as it is not so technique sensitive and it can successfully be place in areas that still have some wetness.
We still use silver fillings in children as these fillings can be placed faster than white fillings and in a child whose attention span is limited and where you need to get the job done quickly, silver fillings are a valuable tool.
Some insurance providers only pay the cost of silver fillings in the posterior teeth and then it is up to the patient wether they would like silver fillings or pay the difference for white fillings.
White fillings and silver fillings, both are good. White is more aesthetic but don't rush out to have the silver replaced unless it bothers you aesthetically.
All the best from this dentist in Hamilton Ontario on this beautiful summer day. (yes it is still summer but not for much longer)
http://www.rondentist.com/
PS. If you like the info on this blog, join this site as a follower.
Monday, July 18, 2011
Alpha Omega Sailing Day
I went sailing last week with Alpha Omega Dental Fraternity. They hold this event every summer and I have gone for the last number of years and every year I enjoy the day. The event is held at the Toronto Island Yacht Club.
This year I brought my daughter with me. She just finished first year at York University in sciences and is working this summer on a concurrent Bachelor of Education. We played tennis in the morning then went swimming before lunch. After lunch we spent 4 and a half hours on Lake Ontario on just a glorious sailing day. The sun was shining, but it was cool out on the lake and it was just a beautiful relaxing day.
Throughout the day many discussions ensued regarding all kinds of topics, of course mainly dental, but as my daughter and I sat with 3 sailors(dentists), UofT class of 52, 56 and 62. An interesting discussion took place. One of the gentleman (our skipper later that day) at his 55th class reunion was asked to speak on the major changes that have occurred in the 55 years since they graduated. He asked the other two what they thought was the single greatest change or innovation they had experienced in dentistry since they had graduated. They both replied "the air rotor." To those non dental people, the air rotor is the high speed drill that we use to drill teeth. When these gentleman graduated, they were trained on the low speed drill , the same drill that had been powered by a footpedal for so many years. (theirs had been electric but still very slow.)
He asked me what was the greatest change that I had seen since I had graduated (class of 86). I said that it was the advent of the dental implant to general practise. The implant has changed so much in terms of the way we do dentistry and the solutions that we can now give our patients.
Well as I sat there with my daughter, I reflected on the passage of time and the work and contribution to the profession of so many who have come before us. I remembered that when I attended my first Ontario Dental Association meeting as a student in 1982, I had met a retired dentist who liked to still attend the meetings. He had graduated in 1923 and he spoke to me about what he had seen in his lifetime as a dentist. Unfortunately, I don't remember his name but I do remember this meeting with him. So as I sat there with my daughter, who is considering going to dental school, I reflected on this gathering of generations and the passing of collective wisdom and knowledge from one generation to another in our profession. I think my daughter also felt that there was something special in this moment. I wondered wether in 20 or 40 or 60 years from now my daugher will be sitting on a sailboat telling some young dentist or dental student of all the glorious changes she had seen in her life as a dentist.
I wonder?
http://www.rondentist.com/
This year I brought my daughter with me. She just finished first year at York University in sciences and is working this summer on a concurrent Bachelor of Education. We played tennis in the morning then went swimming before lunch. After lunch we spent 4 and a half hours on Lake Ontario on just a glorious sailing day. The sun was shining, but it was cool out on the lake and it was just a beautiful relaxing day.
Throughout the day many discussions ensued regarding all kinds of topics, of course mainly dental, but as my daughter and I sat with 3 sailors(dentists), UofT class of 52, 56 and 62. An interesting discussion took place. One of the gentleman (our skipper later that day) at his 55th class reunion was asked to speak on the major changes that have occurred in the 55 years since they graduated. He asked the other two what they thought was the single greatest change or innovation they had experienced in dentistry since they had graduated. They both replied "the air rotor." To those non dental people, the air rotor is the high speed drill that we use to drill teeth. When these gentleman graduated, they were trained on the low speed drill , the same drill that had been powered by a footpedal for so many years. (theirs had been electric but still very slow.)
He asked me what was the greatest change that I had seen since I had graduated (class of 86). I said that it was the advent of the dental implant to general practise. The implant has changed so much in terms of the way we do dentistry and the solutions that we can now give our patients.
Well as I sat there with my daughter, I reflected on the passage of time and the work and contribution to the profession of so many who have come before us. I remembered that when I attended my first Ontario Dental Association meeting as a student in 1982, I had met a retired dentist who liked to still attend the meetings. He had graduated in 1923 and he spoke to me about what he had seen in his lifetime as a dentist. Unfortunately, I don't remember his name but I do remember this meeting with him. So as I sat there with my daughter, who is considering going to dental school, I reflected on this gathering of generations and the passing of collective wisdom and knowledge from one generation to another in our profession. I think my daughter also felt that there was something special in this moment. I wondered wether in 20 or 40 or 60 years from now my daugher will be sitting on a sailboat telling some young dentist or dental student of all the glorious changes she had seen in her life as a dentist.
I wonder?
http://www.rondentist.com/
Monday, July 4, 2011
What a great country we live in! Happy Canada Day!
I spent Canada Day at Sibald Point Provincial Park with my family. It was a glorious day! The sun shone all day and it was just one of those beautiful summer days. I have been to Sibald Point many times but I don't think that I had ever seen it quite so full. Everyone had something on a barbecue somewhere. This is Canada, people from all over the world, working hard , trying to make a better life for themselves and their children. Here we all were just having a great time together. The really interesting thing was that you could walk down the beach or through the grass and you heard just about every language on Earth being spoken but when you went close to the water and watched all the little kids playing with each other, they were just speaking English. I said to myself, here is the future of this country and it looks pretty promising. I enjoyed a great Canada Day with my family and am very proud to be living in this great country of ours!
www.rondentist.com
www.rondentist.com
Thursday, June 30, 2011
Tongue Tied - what does it mean? What do you do?
Today a patient brought in her 4 year old son for the first time. The child was great, no problems except we noticed that the tip of his tongue was tied to tissue attached to the floor of his mouth and rising up to the back of his lower front teeth.
This is called Ankyloglossia or Tongue Tie.
This attachment can interfere with the baby or child's eating or speech. Often it is snipped by the paedatrician when the child is just a baby. Often it is just left so they can see if it does interfere with speech and eating. If it does interfere then it is removed. What the paedatricians often forget is that because it is attached to the gingiva behind the lower front teeth it tends to pull the gingiva down and create gum problems which will affect the long term health of the lower front teeth. In these cases the attachments must be removed.
In addition to consultation with your family doctor you should consult with your family dentist. It is a quick procedure but important to do before you develop any associated problems. The best people to do these procedures are the dentists, periodontists or the oral surgeon.
http://www.rondentist.com/
PS. If you like the info on this blog, become a follower of this blog.
This is called Ankyloglossia or Tongue Tie.
This attachment can interfere with the baby or child's eating or speech. Often it is snipped by the paedatrician when the child is just a baby. Often it is just left so they can see if it does interfere with speech and eating. If it does interfere then it is removed. What the paedatricians often forget is that because it is attached to the gingiva behind the lower front teeth it tends to pull the gingiva down and create gum problems which will affect the long term health of the lower front teeth. In these cases the attachments must be removed.
In addition to consultation with your family doctor you should consult with your family dentist. It is a quick procedure but important to do before you develop any associated problems. The best people to do these procedures are the dentists, periodontists or the oral surgeon.
http://www.rondentist.com/
PS. If you like the info on this blog, become a follower of this blog.
Wednesday, June 22, 2011
What about those Wisdom Teeth?
Every week I see a number of new patients and many times I end up recommending the extraction of wisdom teeth.
Inevitably I get some very similar questions:
Why do I need them out? They aren't bothering me!
Why now, my last dentist didn't say anything?
Well for most people it is pretty straight forward, if the wisdom teeth are hurting and there isn't enough space for them to come in, they need to be extracted. Pretty straightforward!
But what about those people whose wisdom teeth aren't hurting, why do they need to come out?
The answer to that always depends on the specific case.
Of course if there is enough room in the jaws and the teeth come in properly then wisdom teeth are normal teeth and can stay.
What does come in properly mean?
The gums around the teeth must sit low around the tooth like any other tooth so that the tooth can be cleaned properly. Also there must be enough room around the tooth so that it can be cleaned by a tooth brush and if need be, the dentist able to do a filling back there. If not, the tooth will either eventually decay or get recurrent gum infections. Since the tooth can not be cleaned or filled properly then the tooth will need to be extracted. Accordingly, as a dentist, our first thoughts are always, will this be a normal tooth or will it have to eventually be extracted.
That brings us to the question of why now if it is not hurting me?
Wisdom teeth when taken out when you are young, up till about age 24 get very good healing of the bone in the socket, after that not as much. This is very important for the future health of the tooth in front of the wisdom tooth. Also, wisdom teeth are easier to extract when you are younger as the bone is more pliable and the tooth will move easier.
In addition, as my dad always said to me, you do any surgeries while you are young and healthy. People don't often think ahead but if you have to do even a minor surgery when you are older and your health is in decline and you are on multiple medications, sometimes a simple procedure can become complicated.
Of course we can't forget Murphy's Law, it may not hurt now but when you want to go on vacation or any event of significance in your life you can bet your bottom dollar that it will start to hurt.
This is really a simple overview and not meant to be a textbook on the subject. If you have a question on the subject you can always e-mail me. If you have a dentist, discuss it with your dentist as every case is different with it's unique set of circumstances which require a dentist or oral surgeon to give their expert opinion.
All the best
Dr. Ron Barzilay
A Dentist in Hamilton Ontario
http://www.rondentist.com/
Inevitably I get some very similar questions:
Why do I need them out? They aren't bothering me!
Why now, my last dentist didn't say anything?
Well for most people it is pretty straight forward, if the wisdom teeth are hurting and there isn't enough space for them to come in, they need to be extracted. Pretty straightforward!
But what about those people whose wisdom teeth aren't hurting, why do they need to come out?
The answer to that always depends on the specific case.
Of course if there is enough room in the jaws and the teeth come in properly then wisdom teeth are normal teeth and can stay.
What does come in properly mean?
The gums around the teeth must sit low around the tooth like any other tooth so that the tooth can be cleaned properly. Also there must be enough room around the tooth so that it can be cleaned by a tooth brush and if need be, the dentist able to do a filling back there. If not, the tooth will either eventually decay or get recurrent gum infections. Since the tooth can not be cleaned or filled properly then the tooth will need to be extracted. Accordingly, as a dentist, our first thoughts are always, will this be a normal tooth or will it have to eventually be extracted.
That brings us to the question of why now if it is not hurting me?
Wisdom teeth when taken out when you are young, up till about age 24 get very good healing of the bone in the socket, after that not as much. This is very important for the future health of the tooth in front of the wisdom tooth. Also, wisdom teeth are easier to extract when you are younger as the bone is more pliable and the tooth will move easier.
In addition, as my dad always said to me, you do any surgeries while you are young and healthy. People don't often think ahead but if you have to do even a minor surgery when you are older and your health is in decline and you are on multiple medications, sometimes a simple procedure can become complicated.
Of course we can't forget Murphy's Law, it may not hurt now but when you want to go on vacation or any event of significance in your life you can bet your bottom dollar that it will start to hurt.
This is really a simple overview and not meant to be a textbook on the subject. If you have a question on the subject you can always e-mail me. If you have a dentist, discuss it with your dentist as every case is different with it's unique set of circumstances which require a dentist or oral surgeon to give their expert opinion.
All the best
Dr. Ron Barzilay
A Dentist in Hamilton Ontario
http://www.rondentist.com/
Tuesday, June 7, 2011
Dr. Ron comments on Dr. Oz's show regarding thyroid collars
I received the following letter from a patient.
" I am sure you are already up to date."
Next part printed, most likely from an e-mail.
Precautions re: Mammograms and Dental Xrays/ A Useful Warning
On Wednesday, Dr. Oz had a show on the fastest growing cancer in women, thyroid cancer. It was a very interesting program and he mentioned that the increase could possibly be related to the use of dental x-rays and mammograms. He demonstrated that on the apron the dentist puts on you for your dental x-ray there is a little flap that can be lifted up and wrapped around your neck. Many dentist don't bother to use it. Also, there is something called a "thyroid guard' for use during mammograms. By coincidence, I had my yearly mammogram yesterday. I felt a little silly, but I asked about the guard and sure enough, the technician had one in a drawer. I asked why it wasn't routinely used. Answer "I don't know. You have to ask for it." Well, if I hadn't seen the show, how would I have known to ask?
" Since I have had breast cancer and many, many, many dental xrays and mammograms; I thought I would make you aware."
I received this letter from a patient who was concerned regarding dental x-rays. She had had breast cancer and was now obviously concerned regarding thyroid cancer because Dr. Oz had suggested that a rise in thyroid cancer was related to dental x-rays and mammograms.
First thing I assured my patient that in our office it is standard practise to use a thyroid collar to cut down any radiation to the thyroid area. Of course patients have x-rays done on a routine basis and may not even be aware that a thyroid shield is being placed along with the regular shield.
Relating back to the show, I do feel that Dr. Oz's comments regarding the rise in thyroid cancer among women being related to mammograms and dental x-rays was a bit more of a "wow" factor than substance. If you watch the video he did not say that it was related but that it may be related to dental x-rays and mammograms. I quite understand the regular individual watching this, his jaw dropping and as their jaw drops him or her saying "wow!" The next thing that happens is that e-mails start to fly, if you know 10 people then have them send it to 10 people and you know how it goes. This is what keeps TV shows on the air but to Dr. Oz's credit he did run another show with experts giving rebuttal.
The comments in rebuttal were:
1) The increase in thyroid cancer is also occurring in men and since men are not having routine mammograms then there would be no connection between mammograms and an increase in thyroid cancer. The comment was also made that thyroid collars are not given to women during a mammogram unless they ask for one because the shield may distort the image taken and may result in doing the mammogram a second time thereby doubling the actual dose of radiation.
2) In dentistry we do place thyroid collars for protection. Also I can tell you, as was stated on the show, that in dentistry, in the last decades, we are using faster speed film and digital x-rays which have reduced the radiation drastically so that we would expect to see actually less thyroid cancer if dental x-radiation was the cause.
So my feeling on Dr. Oz's comments is that there is a lot more hype than substance here. When you have a daily show, you need a lot of the wow to maintain interest and there was a lot of that here. I have links to his videos here and you can decide for yourself. Bear in mind that these are not the full shows but this is what was available on their website and the time for a meaningful discussion is always limited by the length of the show.
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-1
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-2
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-3
When I said I would be writing comments on Dr. Oz, my wife said "ooooh, are you sure?' I said "yes!" She then said to me "just so you should know. There are 3 people that you just don't mess with. One is Oprah, two is Dr. Phil and Three is Dr. Oz."
Accordingly, I humbly submit this blog and Dr. Oz does do a good job bringing health issues forward.
wwww.rondentist.com
" I am sure you are already up to date."
Next part printed, most likely from an e-mail.
Precautions re: Mammograms and Dental Xrays/ A Useful Warning
On Wednesday, Dr. Oz had a show on the fastest growing cancer in women, thyroid cancer. It was a very interesting program and he mentioned that the increase could possibly be related to the use of dental x-rays and mammograms. He demonstrated that on the apron the dentist puts on you for your dental x-ray there is a little flap that can be lifted up and wrapped around your neck. Many dentist don't bother to use it. Also, there is something called a "thyroid guard' for use during mammograms. By coincidence, I had my yearly mammogram yesterday. I felt a little silly, but I asked about the guard and sure enough, the technician had one in a drawer. I asked why it wasn't routinely used. Answer "I don't know. You have to ask for it." Well, if I hadn't seen the show, how would I have known to ask?
" Since I have had breast cancer and many, many, many dental xrays and mammograms; I thought I would make you aware."
I received this letter from a patient who was concerned regarding dental x-rays. She had had breast cancer and was now obviously concerned regarding thyroid cancer because Dr. Oz had suggested that a rise in thyroid cancer was related to dental x-rays and mammograms.
First thing I assured my patient that in our office it is standard practise to use a thyroid collar to cut down any radiation to the thyroid area. Of course patients have x-rays done on a routine basis and may not even be aware that a thyroid shield is being placed along with the regular shield.
Relating back to the show, I do feel that Dr. Oz's comments regarding the rise in thyroid cancer among women being related to mammograms and dental x-rays was a bit more of a "wow" factor than substance. If you watch the video he did not say that it was related but that it may be related to dental x-rays and mammograms. I quite understand the regular individual watching this, his jaw dropping and as their jaw drops him or her saying "wow!" The next thing that happens is that e-mails start to fly, if you know 10 people then have them send it to 10 people and you know how it goes. This is what keeps TV shows on the air but to Dr. Oz's credit he did run another show with experts giving rebuttal.
The comments in rebuttal were:
1) The increase in thyroid cancer is also occurring in men and since men are not having routine mammograms then there would be no connection between mammograms and an increase in thyroid cancer. The comment was also made that thyroid collars are not given to women during a mammogram unless they ask for one because the shield may distort the image taken and may result in doing the mammogram a second time thereby doubling the actual dose of radiation.
2) In dentistry we do place thyroid collars for protection. Also I can tell you, as was stated on the show, that in dentistry, in the last decades, we are using faster speed film and digital x-rays which have reduced the radiation drastically so that we would expect to see actually less thyroid cancer if dental x-radiation was the cause.
So my feeling on Dr. Oz's comments is that there is a lot more hype than substance here. When you have a daily show, you need a lot of the wow to maintain interest and there was a lot of that here. I have links to his videos here and you can decide for yourself. Bear in mind that these are not the full shows but this is what was available on their website and the time for a meaningful discussion is always limited by the length of the show.
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-1
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-2
http://www.doctoroz.com/videos/thyroid-guards-do-you-need-one-pt-3
When I said I would be writing comments on Dr. Oz, my wife said "ooooh, are you sure?' I said "yes!" She then said to me "just so you should know. There are 3 people that you just don't mess with. One is Oprah, two is Dr. Phil and Three is Dr. Oz."
Accordingly, I humbly submit this blog and Dr. Oz does do a good job bringing health issues forward.
wwww.rondentist.com
Monday, May 30, 2011
We had a visit from the Ticats last week
Hi everyone,
We had a visit from the Ticats last week.
What do you think?
Well we had some fun as you can tell.
See everyone at Ivor Wynne.
click on this link to watch the Ticats at our office
http://www.ticats.ca/video/index/id/17463
We had a visit from the Ticats last week.
What do you think?
Well we had some fun as you can tell.
See everyone at Ivor Wynne.
click on this link to watch the Ticats at our office
http://www.ticats.ca/video/index/id/17463
Sunday, May 29, 2011
Teeth don't start moving after having your teeth cleaned
A little while back a patient came in whom we had been treating his kids for sometime. He had a loose tooth that was giving him some trouble. We took the tooth out and brought this gentleman back for a new patient exam to check all of his teeth. He had a number of loose teeth which we would have to remove and some teeth that we could save. The patient then said to me, "Dr., whatever you do I don't want you to clean my teeth. My teeth were fine but from the moment they started to be cleaned by a hygenist they started to move!"
Well where do I start. Of course this is nonsense. Teeth move because there is a loss of underlying support structure which is the bone and gums. The underlying bone is destroyed by toxins that come from bacteria sitting in pockets around the teeth. These pockets can be cleaned with the resultant loss of these toxins and the preservation of the tooth but if this cleaning is not done then there will be continual destruction of the tooth support with the tooth eventually starting to move and then falling out. This patient may have associated the movement of his teeth with his first cleaning but it is most likely that this cleaning was the first time he had really noticed what was going on in his mouth.
I can't drive it home any more clearly than the next example. This past week a gentleman, 65 years old came to the office. Believe it or not, this was the first time in his life he had been to a dental office. I didn't believe it so I asked him how he had lost four teeth on the bottom, assuming they had been extracted by a dentist. He told me that they started to move and then just fell out. I checked out the rest of his mouth and sure enough he had a lot of calculus (hard buildup on the teeth) and plaque everywhere. His upper front six teeth were extremely mobile and would have to be extracted. (If he would leave them a little longer they would fall out on their own.) I bring this example ( and I could bring many more) to show that this man never had his teeth cleaned by a dentist or hygenist and this is the result. Teeth do not move because of dental cleaning, they move because of the lack of professional cleaning. In other words when the build up and plaque is left on the teeth the underlying support structures will be destroyed, the teeth will start to move and eventually fall out.
I have to ad that the first gentleman did have all his upper teeth out and a complete upper denture made. The question is how long will the remaining lower teeth last without professional cleaning? The answer, not that long.
http://www.rondentist.com/
Well where do I start. Of course this is nonsense. Teeth move because there is a loss of underlying support structure which is the bone and gums. The underlying bone is destroyed by toxins that come from bacteria sitting in pockets around the teeth. These pockets can be cleaned with the resultant loss of these toxins and the preservation of the tooth but if this cleaning is not done then there will be continual destruction of the tooth support with the tooth eventually starting to move and then falling out. This patient may have associated the movement of his teeth with his first cleaning but it is most likely that this cleaning was the first time he had really noticed what was going on in his mouth.
I can't drive it home any more clearly than the next example. This past week a gentleman, 65 years old came to the office. Believe it or not, this was the first time in his life he had been to a dental office. I didn't believe it so I asked him how he had lost four teeth on the bottom, assuming they had been extracted by a dentist. He told me that they started to move and then just fell out. I checked out the rest of his mouth and sure enough he had a lot of calculus (hard buildup on the teeth) and plaque everywhere. His upper front six teeth were extremely mobile and would have to be extracted. (If he would leave them a little longer they would fall out on their own.) I bring this example ( and I could bring many more) to show that this man never had his teeth cleaned by a dentist or hygenist and this is the result. Teeth do not move because of dental cleaning, they move because of the lack of professional cleaning. In other words when the build up and plaque is left on the teeth the underlying support structures will be destroyed, the teeth will start to move and eventually fall out.
I have to ad that the first gentleman did have all his upper teeth out and a complete upper denture made. The question is how long will the remaining lower teeth last without professional cleaning? The answer, not that long.
http://www.rondentist.com/
Monday, May 16, 2011
Spent the day with Dr. McIsaac, Pediatric Dentist
I had a lot of fun today at Dr. McIsaac's pediatric dental office.
We refer children to Dr. McIsaac that I feel we can not treat in our office. I wanted to go to their office to see what a day in a pediatric dental office looks like. Hopefully I would pick up some pointers and some new perspectives as I love working with kids.
Dr. McIsaac is a pedodontist who has been around for some time and has a wealth of experience. It was a pleasure to speak to him and to see him in action. Remember, he gets the toughest cases. From the youngest to the loudest (screamers that is) not to mention the special needs patients. He and his staff remain calm throughout, just going about their normal day. I give Dr. McIsaac a lot of credit because he truly has a tough job and yet does a great job and enjoys doing it.
I was very satisfied at the end of the day as on a day like this you always pick up pointers that you can bring home to your practise and do an even better job for your patients. Does this mean I will no longer refer to a pedodontist. No it does not. We as professionals always try to improve what we do but as professionals we must always respect our boundaries. I am lucky that I have many great dental specialists in the city of Hamilton to refer to if the need arises.
Thank you to Dr. McIsaac and staff for a great day.
We refer children to Dr. McIsaac that I feel we can not treat in our office. I wanted to go to their office to see what a day in a pediatric dental office looks like. Hopefully I would pick up some pointers and some new perspectives as I love working with kids.
Dr. McIsaac is a pedodontist who has been around for some time and has a wealth of experience. It was a pleasure to speak to him and to see him in action. Remember, he gets the toughest cases. From the youngest to the loudest (screamers that is) not to mention the special needs patients. He and his staff remain calm throughout, just going about their normal day. I give Dr. McIsaac a lot of credit because he truly has a tough job and yet does a great job and enjoys doing it.
I was very satisfied at the end of the day as on a day like this you always pick up pointers that you can bring home to your practise and do an even better job for your patients. Does this mean I will no longer refer to a pedodontist. No it does not. We as professionals always try to improve what we do but as professionals we must always respect our boundaries. I am lucky that I have many great dental specialists in the city of Hamilton to refer to if the need arises.
Thank you to Dr. McIsaac and staff for a great day.
Thursday, May 5, 2011
Don't you just hate it when the dentist is late? The Dentist hates being late even more!!!
I remember as a kid waiting in my dentist's office at least 45 minutes to an hour before I would be seen. BOY DID I HATE IT!!! I always assumed that maybe because I was a kid they thought it was OK. I got a little older and they were still just as late. Then I realized that they were just late for everyone.
When I became a dentist, the one thing I promised myself that I would do better, was to be on time for my patients appointments. It is my feeling that everyone tries to plan their day based on the appointments and commitments that they have made with others. If people are making the effort to be ontime for me, it is not fair for me to make them late to their appointments with others. Taking into account the nature of what we do I feel that my track record has been pretty good. I am usually but not always ontime. If I am late I have my staff notify my patients so they will at least know where we stand.
This past Tuesday I have to admit, I think I was behind for just about every patient. A number of emergencies (my staff know that emergencies must be seen the same day) and one scheduling error and boom the whole day we were playing catch up. At the end of the day we sat down at our end of the day meeting (which was now half an hour late). We were all pretty tired and we just talked about the day. We had gotten everything done but it just didn't get done the way we wanted to do it. We looked at our day and we realized that so many unforseen factors had taken place. We all sat there and immediately the ideas started to pour out on how to do our best that this should not happen in the future. We are making changes to try and improve, but does this mean that we will never be late again? No, because as they say "stuff happens!" What I can tell you is that we are always trying to do better and learn from the "stuff".
I will always believe that being on time matters.
Just another fun day doing Dentistry in Hamilton for a Hamilton Dentist.
When I became a dentist, the one thing I promised myself that I would do better, was to be on time for my patients appointments. It is my feeling that everyone tries to plan their day based on the appointments and commitments that they have made with others. If people are making the effort to be ontime for me, it is not fair for me to make them late to their appointments with others. Taking into account the nature of what we do I feel that my track record has been pretty good. I am usually but not always ontime. If I am late I have my staff notify my patients so they will at least know where we stand.
This past Tuesday I have to admit, I think I was behind for just about every patient. A number of emergencies (my staff know that emergencies must be seen the same day) and one scheduling error and boom the whole day we were playing catch up. At the end of the day we sat down at our end of the day meeting (which was now half an hour late). We were all pretty tired and we just talked about the day. We had gotten everything done but it just didn't get done the way we wanted to do it. We looked at our day and we realized that so many unforseen factors had taken place. We all sat there and immediately the ideas started to pour out on how to do our best that this should not happen in the future. We are making changes to try and improve, but does this mean that we will never be late again? No, because as they say "stuff happens!" What I can tell you is that we are always trying to do better and learn from the "stuff".
I will always believe that being on time matters.
Just another fun day doing Dentistry in Hamilton for a Hamilton Dentist.
Monday, May 2, 2011
Good times at the Ontario Dental Association annual convention
This past Thursday and Friday, my staff and I spent 2 full days at the Ontario Dental Association (ODA) Annual Convention.
The line up of international lecturers was truly excellent. The exhibit floor was really quite large with dental suppliers bring to us the latest in innovations. It is really quite an impressive affair and I really enjoy going every year. By the end of the day Friday I was exhausted. There was another full day of speakers on Saturday (my brother among them) but a previous commitment did not allow me to attend.
At the end of these convention days I am usually more tired than a hard day at the office. We are on our feet going from booth to booth on the convention floor trying not to miss anything that might be important. (not to mention any convention specials) The speaker lectures are intense. On Thursday I spent time listening to lectures on paedatric dentistry. On Friday I spent the day listening to Dr. Joe Massad speak on complete dentures.( joemassad.com ) In December I spent a full day in Tulsa Oaklahoma with Dr. Massad at his teaching facility there and it was a pleasure seeing him again.
All in all it was a great meeting for myself and my staff. It is at these meetings that we charge our batteries, find out what is new, find out how to do things better and get excited about the innovations that we anticipate taking to our practise.
The line up of international lecturers was truly excellent. The exhibit floor was really quite large with dental suppliers bring to us the latest in innovations. It is really quite an impressive affair and I really enjoy going every year. By the end of the day Friday I was exhausted. There was another full day of speakers on Saturday (my brother among them) but a previous commitment did not allow me to attend.
At the end of these convention days I am usually more tired than a hard day at the office. We are on our feet going from booth to booth on the convention floor trying not to miss anything that might be important. (not to mention any convention specials) The speaker lectures are intense. On Thursday I spent time listening to lectures on paedatric dentistry. On Friday I spent the day listening to Dr. Joe Massad speak on complete dentures.( joemassad.com ) In December I spent a full day in Tulsa Oaklahoma with Dr. Massad at his teaching facility there and it was a pleasure seeing him again.
All in all it was a great meeting for myself and my staff. It is at these meetings that we charge our batteries, find out what is new, find out how to do things better and get excited about the innovations that we anticipate taking to our practise.
Tuesday, April 26, 2011
YOUR CHILD COMES HOME WITH A NOTE SAYING CAVITIES HAVE BEEN DETECTED! WHAT DOES THIS REALLY MEAN?
Living in Ontario, ( we live in Hamilton) one day your child comes home with a letter from school saying that cavities have been found and you need to have them looked after. Parents, please do not take this lightly. Go to your dentist immediately and have the proper treatment done. You will be given a form that has to be signed by your dentist at the beginning of treatment and more importantly at the end of treatment. Here is the important part. If the proper authorities do not get that form signed off for dental treatment completed then your case may be referred to Children's Aid and they may start an investigation for neglect. Once that ball starts rolling it is definetly not a pleasurable situation that your familty may find itself in.
One more small note, if you never receive a letter from your children's school regarding your child's teeth do not assume that they have been checked and that everything is OK. The exams at school are superficial and do not include x-rays. They will only catch the largest gaping cavities. Cavities that would be seen in a more comprehensive exam with x-rays would not be picked up and your child could still have many cavities waiting to give them pain.
This post is in red because I think this information is really important and many parents don't understand the gravity of that innocuous letter they received from school. Having said that, parents must also understand that not checking for and treating dental decay in their children's teeth is neglect.
I am adding the following link so any of you can clarify any questions you may have regarding child abuse and/or neglect. http://www.oacas.org/
One more small note, if you never receive a letter from your children's school regarding your child's teeth do not assume that they have been checked and that everything is OK. The exams at school are superficial and do not include x-rays. They will only catch the largest gaping cavities. Cavities that would be seen in a more comprehensive exam with x-rays would not be picked up and your child could still have many cavities waiting to give them pain.
This post is in red because I think this information is really important and many parents don't understand the gravity of that innocuous letter they received from school. Having said that, parents must also understand that not checking for and treating dental decay in their children's teeth is neglect.
I am adding the following link so any of you can clarify any questions you may have regarding child abuse and/or neglect. http://www.oacas.org/
Saturday, April 16, 2011
PARENTS -DON'T LIE TO YOUR CHILDREN!
Yesterday was a fun day at the dental office in Hamilton.
I had to do a simple extraction of a baby tooth for a 12 yr. old. My assistant had placed topical anesthetic which we let sit for 5 minutes before we place the local anesthetic (the shot). I do this quite well. I mean, if you can give a shot to a 3 yr. old without them feeling anything you can just about do it for anyone. Anyways, I was about to give this little girl the shot and she started to look at what I was doing. Before I could even get close to her or touch her she jumped out of the chair, ran out of the office and as she ran out of the office yelled at her caregiver "YOU LIED TO ME!"
I just sat there asking myself "what the (censored) just happened?"
Afterwards I spoke to my staff and they had told me that the caregiver had told the child emphatically in the reception area that the child was not going to get a needle. (Are lightbulbs starting to go off in your head?) The caregiver came into the operatory with the child and the child again asked wether she would be getting a needle? The caregiver again responded "no".
Oviously the child was phobic regarding needles. The rest is history and you already know what happened.
The moral of the story.......don't lie to your children. You can't tell them one thing and then bring them to the dental office and the dentist is going to do the exact opposite. Don't expect a good outcocme when you have told them they are not going to get a needle and then the dentist says they are. There won't be any miracles as if we just waved a magic wand and then everything goes along beautifully. The outcome will always be poor and at that point you have made our job next to impossible.
Please remember, we require the cooperation and trust of our patients. Adult or child, it doesn't matter, they need to believe what we tell them because it is the truth and we will back up our words with our deeds. We are experts at doing these procedures painlessly. Let us do our jobs. To all those parents out there not knowing what to tell their apprehensive child, just tell them that you are going to meet the dentist and he will explain everything and answer all your questions. Let us do the talking and most important, just don't lie to them.
I had to do a simple extraction of a baby tooth for a 12 yr. old. My assistant had placed topical anesthetic which we let sit for 5 minutes before we place the local anesthetic (the shot). I do this quite well. I mean, if you can give a shot to a 3 yr. old without them feeling anything you can just about do it for anyone. Anyways, I was about to give this little girl the shot and she started to look at what I was doing. Before I could even get close to her or touch her she jumped out of the chair, ran out of the office and as she ran out of the office yelled at her caregiver "YOU LIED TO ME!"
I just sat there asking myself "what the (censored) just happened?"
Afterwards I spoke to my staff and they had told me that the caregiver had told the child emphatically in the reception area that the child was not going to get a needle. (Are lightbulbs starting to go off in your head?) The caregiver came into the operatory with the child and the child again asked wether she would be getting a needle? The caregiver again responded "no".
Oviously the child was phobic regarding needles. The rest is history and you already know what happened.
The moral of the story.......don't lie to your children. You can't tell them one thing and then bring them to the dental office and the dentist is going to do the exact opposite. Don't expect a good outcocme when you have told them they are not going to get a needle and then the dentist says they are. There won't be any miracles as if we just waved a magic wand and then everything goes along beautifully. The outcome will always be poor and at that point you have made our job next to impossible.
Please remember, we require the cooperation and trust of our patients. Adult or child, it doesn't matter, they need to believe what we tell them because it is the truth and we will back up our words with our deeds. We are experts at doing these procedures painlessly. Let us do our jobs. To all those parents out there not knowing what to tell their apprehensive child, just tell them that you are going to meet the dentist and he will explain everything and answer all your questions. Let us do the talking and most important, just don't lie to them.
Friday, April 8, 2011
Teeth Don't Fall Out After Root Canal Treatment
All kinds of interesting questions come me almost on a daily basis and it is amazing how many repeat themselves over the years. I guess that is why they are called frequently asked questions. A little while ago a patient came in and required a root canal. When I told her she required a root canal treatment she asked me "my friend had a root canal treatment and she said that after the treatment the tooth just fell out. Is that what happens?" I smiled at the patient ( I have heard this question before) and told her that this was not true. I had a root canal in a front tooth of mine when I was about 9 or 10 and it is still there almost 40 years later (yes now you can figure out how old I am). Many times people do not realize that a tooth that has had a root canal must have a filling and crown placed on this tooth. This is because teeth that have root canals are usually broken down or have large fillings to begin with. When the root canal is done even more tooth structure is taken away to do the root canal. So what you are left with is a severely weakened tooth. You must first restore the tooth with a filling and possibly posts and pins, then the tooth must be crowned to hold it all together. This is the case for posterior teeth, front teeth may be different due to the function of these teeth. In any case a tooth that is not properly restored after the rootcanal is in danger of breaking and eventually being extracted. I have seen it happen literally within a week of completing the root canal and we didn't have enough time to place the crown. Those are really sad cases because the patient did not neglect the treatment but just didn't have enough time to finish it. In other cases this may not occur for years but many times a patient will come in saying they have broken a tooth and of course it is a rootcanal tooth that did not have the crown that we recommended. I always tell my patients having root canals on their back teeth that they will need crowns after the root canal treatment.
In short I assured my patient that teeth that have root canals do not just fall out after the treatment!
http://www.rondentist.com/
In short I assured my patient that teeth that have root canals do not just fall out after the treatment!
http://www.rondentist.com/
Tuesday, April 5, 2011
Happy Patients make your day
Today I saw a patient whom we completed their treatment 6 months ago. For a dentist there is nothing more satisfying than a happy patient. When this patient originally came into my dental office here in Hamilton, she was not a happy person. Her teeth were falling apart due to decay, gum disease and years of neglect. She could not smile at anyone because of the way her teeth looked. After much discussion we took out her upper teeth and placed an immediate denture. She left the office that day with tears of joy. She returned a few times for adjustments and I hadn't seen her in about 5 months. She came in today and was beaming. She spoke about how her new dentures had changed her life. How before she was always sore and in pain, how embarassed she was to smile and she didn't go out for that reason. Today she is happy and we are going to start her lower denture. These are the moments that make you proud to be a dentist.
Monday, March 14, 2011
Every day has it's moments!
Every day has it's moments, the good and the bad.
There was one moment today that was uplifting and just made my day. One of our patients had all of his teeth extracted and today he received his new teeth. He is really just a young man whose natural teeth were in bad shape. Needless to say he could not smile as all of his front teeth were rotten. His self esteem, you can only imagine.
We inserted the new teeth and the change was instant. This man smiled from ear to ear and the thank you that I heard was overwhelming. These are the moments that eclipse all others in your day and I said to myself " I just made a difference in that guys life and it feels great."
The dental treatment was full mouth clearance with immediate dentures. I will post some pictures shortly.
It was a good day for dentistry in Hamilton.
There was one moment today that was uplifting and just made my day. One of our patients had all of his teeth extracted and today he received his new teeth. He is really just a young man whose natural teeth were in bad shape. Needless to say he could not smile as all of his front teeth were rotten. His self esteem, you can only imagine.
We inserted the new teeth and the change was instant. This man smiled from ear to ear and the thank you that I heard was overwhelming. These are the moments that eclipse all others in your day and I said to myself " I just made a difference in that guys life and it feels great."
The dental treatment was full mouth clearance with immediate dentures. I will post some pictures shortly.
It was a good day for dentistry in Hamilton.
Sunday, March 13, 2011
My First Post
Hi to my friends, patients and anyone else who happens across my blog. It is 11:30 at night and tomorrow starts a new week.
As I write my first blog I just wanted to set out my goals in writing this blog.
I want to write about the questions that I receive on a daily basis from patients in my practise. They are very interesting and informative as to what people think and know about dentistry. I will answer those questions and try to inform and enlighten.
I want to write about changes and important things going on in the profession and the world of dentistry.
I want to write about some of the humorous things and sometimes touching events that occur in the day of a dentist.
Thanks to new technologies and social media, I am going to take the oppurtunity to be creative and have a little fun with you my friends, patients and people out there in the world of blogs.
Let me know how I am doing. Hope to hear from you soon
P. S. Visit our office website at http://www.rondentist.com/ to view our newsletter, past and present, and current events with our dental team.
As I write my first blog I just wanted to set out my goals in writing this blog.
I want to write about the questions that I receive on a daily basis from patients in my practise. They are very interesting and informative as to what people think and know about dentistry. I will answer those questions and try to inform and enlighten.
I want to write about changes and important things going on in the profession and the world of dentistry.
I want to write about some of the humorous things and sometimes touching events that occur in the day of a dentist.
Thanks to new technologies and social media, I am going to take the oppurtunity to be creative and have a little fun with you my friends, patients and people out there in the world of blogs.
Let me know how I am doing. Hope to hear from you soon
P. S. Visit our office website at http://www.rondentist.com/ to view our newsletter, past and present, and current events with our dental team.
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