Is It Time for New Dentures Yet?

"Doctor, I had these dentures made 30 years ago, do you think it is time for new dentures?"
" I mean, they still feel pretty good!"


Well, my response to the patient is "let me have a look!"


My gut feeling tells me what I am going to find but never be so arrogant as to assume that you are correct without even investigating.


The patient takes out their denture and the biting surface is completely flat and worn down.  No wander their chin looks like it is approaching their nose, the teeth are so worn that the vertical dimension of their face has decreased.  When I look at the dentures the inside is full of plaque and food.  A signal that the denture is not fitting properly.  I put the dentures back into the mouth to see how much movement there is in the denture especially the upper and yes the denture moves all over her upper jaw.  Another sign the denture is not fitting properly.  I ask the patient to smile to check the aesthetics and you can hardly see the teeth as they are so worn down.


I address the patient, "yes Mrs. Jones, I think it is time for a new denture!"


New dentures every 5 years or so is a good rule of thumb.  You can go a little longer but they have to still fit well and not be worn on the surfaces.  Have your dentist advise you.


All the best


Dr. Ron Barzilay
www.rondentist.com

DO I NEED TOOTH WHITENING?

Do I need tooth whitening?
I have been asked this question so many times.  I can tell you that my answers have changed over the years.  First of all we have to ask some precursor questions.
What is white?  We look at someone's teeth and you see white, yellow and gray.  (Sometimes you also see black but this is usually due to decay so whitening won't help that problem.)  People have different shades of these colors in their teeth.  Some people have yellower teeth, some have grey teeth.  Children can have especially white teeth.  There really is no such thing as true white when it comes to your natural tooth.  It is made up of a combination of colors, brightness, intensities that give us the color of the tooth that we see.
The next question is what should the color of ones teeth be?  Well when we couldn't do anything about it, as you grew older, your teeth yellowed with the years.  Before whitening we would say to people that it looks natural for someone your age to have yellow teeth.  If they really objected to the color of their teeth then we would place porcelain crowns on all of their teeth.  Today, with whitening and so many people who have already whitened their teeth, we see more and more people of all ages with very white teeth.  As we have gotten used to this, a new norm has been created.
Taking all of this into account, my answer to the original question is No you do not need whitening.  Nothing will happen to you or your teeth if they are not white but if you want whitening I will be very happy to do it for you as more and more people today have whiter teeth.


All the best
Dr. Ron Barzilay


Having fun doing Dentistry in Hamilton Ontario
www.rondentist.com

I HAD A ROOT CANAL - WHY DOES MY TOOTH STILL HURT?

I HAD A ROOT CANAL - WHY DOES MY TOOTH STILL HURT?

I have heard this question many times from new patients coming into the practise or from emergency patients having problems with a tooth.  Of course the answer is never simple and always depends on the circumstances.
When someone has had a root canal treatment the tooth is now altered and may not feel exactly the way it did before.  The questions we must ask:  Is the tooth functional?  Can you eat on it without discomfort?  If you answer yes to both then there is no problem.  If the answer is no then there is a problem and that is what we will deal with in this blog.
Lets start with the simple.  If you just had a root canal yesterday and your tooth is hurting it is most likely some post op discomfort and it will most likely resolve shortly.  You can even get some swelling after the treatment which may need an antibiotic but then will resolve.
What we really want to discuss here is the tooth that had root canal treatment a while ago and you still can't eat on it.  General success of root canal treatment is in the very high range.  If a root canal treatment does not succeed there can be a number of reasons which in general amounts to bacteria still being in the root canal system.  This can happen because there may be an extra canal (or two) which we didn't find.  It can also be because the root canal system is so convoluted that we couldn't clean out the entire root canal system well enough.  Another reason that a root canal may fail is due to a fracture in the tooth which may never have been noticed.
So probably the more important question in all this is what can be done?
This question usually involves a discussion with your dentist because the answer is not always black and white.  If the root canal looks like it was done poorly then you would consider redoing it.  The results could be very good.  If the root canal looks like it was done well then you have to consider the cost benefit of redoing the root canal or apical surgery (all in an attempt to stop bacterial leakage into the surrounding tissues) versus extraction and implant placement. I have simplified things but as I said earlier this will involve a discussion between you and your dentist as to the proper course of action depending on your individual circumstances.

Having fun doing Dentistry in Hamilton Ontario

All the best
Dr. Ron Barzilay
www.rondentist.com

PS you are welcome to follow the blog and leave comments

How to make your Dentist HAPPY!

Dentists are just ordinary people and like ordinary people something's make them sad and something's make them happy.  Something's make them angry and something's make them smile.
Why is it important to make your dentist happy?  Well I guess I could tell you that he is the guy holding the needle so it is not a bad idea to make him happy (just kidding) but that is not true.  Your dentist is a professional and even if he is angry he will never hurt you and he will always act for you benefit.  Then why even worry about whether you dentist is happy or not.  I guess it is the same reason we try to make anyone happy.  Because it is the right thing to do!!  But here is a little secret that many people don't know.  If you treat people well then they will treat you well.  If you are nice to your dentist he will be nice to you.  If you don't miss appointments or cancel at the last second he will be more inclined to stay late for your emergency.  If you are just plain nice then the whole office will always bend over backwards for you in just about everything.  No this is not a secret but for some reason (and it is so simple) most people don't know this. 

So what makes a dentist happy you may ask?  Well here are a few things:

Remember your appointments especially if you just booked it yesterday.  Don't be a habitual appointment no show.
Remember to shut off your cellphone when going into treatment.  Nothing worse than the cell phone buzzing throughout treatment.
Brush your teeth!  Next time your dentist asks you why you are not brushing don't say "It's a time thing!"  We know that anyone can find two minutes in the morning and two minutes in the evening, which is much less time than you spend watching TV or checking your Facebook everyday.
Remember to do the treatment that has to get done.  Nothing worse than you showing up a year later with a toothache and now we have to extract the tooth which we told you then was just a small filling.
Nothing is worse than this happening to your child because you didn't book the appointment, better it should happen to you.
Remind your children we have coloring books for coloring and the reception carpet is not part of the coloring book.  Yes we do love children and see so many of them but we just ask them and you to respect our home as you would respect your own.
Oh yes, remember to pay your bill. 

There are more things but I think you get the general idea.
"Remember to treat your dentist, or anyone, as you would like to be treated yourself."

Having fun doing Dentistry in Hamilton Ontario
All the best to everyone.
Dr. Ron Barzilay
www.rondentist.com

If you have a comment let me know and you are more than welcome to follow this blog.

Discussions while Ziplining in West Virginia

While on vacation in West Virginia  I was zip lining and the guy beside me happenned to be a dentist from Manasus Virginia.  We started to talk and he asked me "what piece of equipment could you not do without?"  I answered, my air compressor since it powers my drills.  I thought about it later and then I realized that there is no one thing.  How can I practise without my gloves?  How can I practise without my magnifying glasses and the list goes on and on.......
Dentistry is complicated and multifaceted and doesn't fit into a small bag.
This is a good thing because we do so much today on so many different levels.
I guess you never know who you will run into or what you will talk about while ziplining!

All the best!
Dr. Ron Barzilay
www.rondentist.com

My Insurance pays for a cleaning every 9 months. Do I need a cleaning more often?

My Insurance pays for a cleaning every 9 months.  Do I really need a cleaning more often?

I have heard this question many times.  The answer is quite simple.  Insurance plans are financial arrangements between the employer/patient and the insurance company.  One insurance plan allows cleanings every 9 months, one plan allows every 6 months, one plan every 3 months.  Other plans allow a certain amount of cleaning per year.  Yet other plans allow unlimited cleanings.  This variation occurs across the broad spectrum of treamtments done by dentists among the thousands of dental insurance plans that exist.

We as dentists treat patients and your needs as patients.  The dictates of insurance companies are really between the patient and that company.  What the patient needs to remember is that if you go the route of "I only want what is covered" then you have to be prepared for the consequences.  For those people with naturally "good" teeth there may be no consequences as they never really need much in the way of cleanings and dental work.  Most of us are generally not that lucky and if we don't maintain our teeth then we suffer.

So, yes the answer is quite simple, if your dentist says you need it then you need it!  You have to ask yourself, "How important are my teeth to me and what am I willing to do to keep them?" 

All the best

Dr. Ron Barzilay

www.rondentist.com

A Hamilton Dentist having fun in Hamilton, Ontario.

Sometime a Single Tooth Goes Dark

Here is an exchange regarding a single tooth going dark.  I hope it is useful to anyone out there with a similar question.

Dear Dr Barzilay, I live in PA, so I am not inquiring to be a new patient. I have been searching the internet looking for treatments for teeth whitening options, specifically one tooth. One of my front teeth seems to be getting darker than all the rest. I have not had any damage to the tooth or root, no root canal, just darker than the rest. I have never had white teeth, so I am not looking for magic, just suggestions. I am 56 years old and in good health. If you can give me any kind of suggestions or if you have anything in Canada that we do not have in the US, I would greatly appreciate if you can tell me. Thank you very much. Sincerely, C

HI C,

Whitening of the one tooth really depends on the reason it has darkened and how dark is it?  There is always a reason it has darkened relative to the other teeth.

Sometimes you will have received a blow to the tooth and you will not even remember it.  The nerve has been damaged and the nerve as a defense mechanism lays down more internal tooth structure which makes the tooth appear yellower than the other teeth.   In some cases as a result of a blow the nerve dies and the tooth darkens and a root canal treatment is required before any whitening.  You really need to see a dentist to tell you why the tooth has darkened.  That will dictate the treatment.  Sometimes we can bleach the individual tooth from the outside.  Sometimes if there has been a root canal (which you may or may not need) we can bleach it from the inside.  Sometimes you need a veneer or a crown on the tooth.  It really depends on the reason the tooth has darkened so my main suggestion is to see your dentist and find out why the tooth has darkened and he/she will tell you what can be done.

 

All the best

Dr. Ron Barzilay

 

 

Dr.Barzilay,

I had my teeth professionally whitened a few years back, but to tell you the truth I don't think it made much of a difference. I have not had a root canal on the tooth in question.  It just seems a bit darker.  My dentist says it is just age.

Thanks again for your help!
C

 

 

Hi C,

On a single tooth that has darkened I have done bleaching on just that tooth.  Bleaching trays but you only place a drop of material on the tooth that has darkened.  I have had good results.  If you use trays and place material in the whole tray then all the teeth will whiten and the tooth that was dark will whiten but will always look darker than the others since they have also whitened.  Try placing a single drop of whitener on that specific tooth in the tray. (otherwise it is a veneer or crown which if it is a front tooth then they are always hard to match and then you are most likely going to be doing a  good number of  teeth to insure color match).

All the best

Dr. Ron Barzilay

www.rondentist.com

Thank you! I am going to try bleaching just the one tooth rather than all of them. I will keep you updated!

C