MY TOOTH HURTS BUT MY DENTIST CAN'T FIND THE PROBLEM

 This is a repost of a blog I wrote in 2012.  I am reposting this because it happens so often I just want to refresh your memories or to just sharpen the point. So please have a good read:

A patient comes into the office and says that he is having discomfort on one side. He has hasn't eaten on that side for months if not years.  The culprit tooth has a small filling in it or no filling at all.  In the x-ray the tooth looks perfectly normal.

I am most definetly starting to think CRACKED TOOTH!!

I place pressure on each cusp separately.  On one of the cusps, as the patient opens from pressing, then the tooth starts to hurt.  Yes it is a cracked tooth.

Can you see it on the x-ray?  No you can't since the tooth is fractured and not broken.  When it is fractured the two sides are close together and an X-ray will not pick up the fracture.

Why is it hurting if the sides are still together?  This is because, as you bite down on the tooth, the sides of the tooth are flexing.  At that point fluid moves in and out of the tooth causing pain.

So how do you fix it?  This is the easy or hard part.  It all depends where and how far down the root the tooth is fractured.  To fix this problem you need a crown on the tooth.  By shaving the tooth down and then covering it with a crown (or cap) all the forces of biting will be directed internally and the fractured parts will be held together thus stopping the pain.  To test this, we place a temporary crown on the tooth first.  If the symptoms disappear then we can go ahead with the permanent crown and have reasonable confidence in the outcome.  If the fracture goes further down the root and beyond the crown then the symptoms may persist.  We may need to do a root canal and the symptoms may then disappear.  But overall the prognosis is now guarded.  When the crown does not encompass the entire fracture the tooth may still be flexing and the long term prognosis is questionable.

Does this happen a lot?  Actually it happens quite a bit, even teeth that have never had a filling in them get fractures.  This is called wear and tear.  If you never use your teeth this will never happen to you.  Since most people use their teeth quite a bit and of course many of us also grind our teeth which makes this worse, quite a few of us will experience this throughout our lifetimes.

If you have any questions, you can always send me a note.

All the best

Dr. Ron Barzilay
Hamilton Ontario

www.rondentist.com

Oral appliance therapy - your dentist may save your life!!

What is oral appliance therapy and can my dentist really save my life?

Obstructive sleep apnea is a sleep related breathing disorder that involves a decrease or complete stop in airflow despite an ongoing effort to breath.  It occurs when the muscles relax during sleep, causing  soft tissues at the back of the throat to collapse and block the upper airway.

Well let's think about it, air flow stop, that sounds like suffocation.  For people with OSA this can happen a few times an hour to 40, 50, 60, or more times an hour while you sleep and it can be pretty serious.

If left untreated will have impact on your cardiovascular system, increase chance of motor vehicle accidents, psychiatric and behavioral issues, quality of life and productivity issues, endocrine and and neurocognitive issues.

A cpap (continuous positive airway pressure) machine can treat this but this machine is strapped onto you and the compliance is not great, perhaps around 50%.  If you can wear this machine then  your success is close to 100%.  If you can't get used to wearing this then you need to find another solution.

This brings us to the dentist, your dentist can fabricate an appliance (mandibular advancement device) for you that stops your tongue and jaw from falling backwards as you sleep and opens your airway to help you breath.  Many people can tolerate this much better and it again lets you breath while you sleep and perhaps saves your life.

Any questions you have don't hesitate to leave a reply on the blog.

Regards and all the best

Dr. Ron Barzilay

Hamilton Ontario Canada

www.rondentist.com

Another LOST TOOTH After a Root Canal Treatment

 So today I had to take out another tooth after the patient had a root canal treatment.

So many times patients come in and tell me how they had a root canal treatment and later had to have the tooth extracted as if this was caused by the root canal.  Sometimes root canals do fail and the tooth is lost but most of the time this is not the case.   The overwhelming amount of teeth that I extract after root canal treatment is because after the treatment the tooth was not restored properly.  That means that after the root canal a proper filling was not placed in the tooth and a crown was not placed on the tooth.

After root canal treatment the teeth are weakened and are prone to breakage and this happens a lot.  Unfortunately when this happens many times there is nothing left for us to do but extract the tooth.

So a little bit of friendly dental advice, get the crown after the root canal and protect your investment.

Doing dentistry in Hamilton Ontario

All the best

Dr. Ron Barzilay

https://thehamiltondentist.com/

www.rondentist.com

 Back in 2022 - Another Broken Tooth

HI Everyone,

Well I took a long break from writing this blog over Covid but it is time to get back to writing.  

Covid is still raging on and I haven't gone skiing in two years but we definitely have been doing dentistry for the last two years.  It has been done with a few more precautions than before but basically people are having the same problems and at the end of the day need treatment.

So the latest emergency I had was a patient who had broken a tooth.  I had told this patient that they needed a crown on this tooth for a number of years.  Not because this tooth had already had a root canal treatment  but because this tooth was a back tooth that the patient had been grinding on for years and now I could see the fracture areas starting to become visible.  I had warned the patient but you know how it is, if it doesn't hurt then why do I need the crown. or if it isn't broken why fix it.  Well at the end of the day you have to believe and trust the person who is telling you these things or else you may suffer the consequences.  The consequence here was minor.  We were able to fix the tooth and then put on a crown so it wouldn't break any further.  Of course it could have been worse and the tooth could have been lost.

Moral of the story, do what needs to be done and if you are not sure get a second opinion but don't wait for bad things to happen.

All the best

Still doing dentistry in Hamilton Ontario Canada

Dr. Ron Barzilay

www.rondentist.com

Do I need a Crown after Root Canal Treatment

Do I need a Crown after Root Canal Treatment

This is not the first time I have written on this subject and I keep getting asked this same question.
I understand the question.  People have had their root canal treatment and their tooth no longer hurts so why should they have this expensive treatment called a crown.  I mean they have just paid enough for the root canal. and the filling.
Well, this past week, another patient of mine came in who had his root canal done a few months ago and the tooth was cracked.  Nothing I could do and I had to extract the tooth.  Only problem was that this tooth was his last molar on one side and it held his partial denture.  Now that the tooth is gone he has a real issue holding that denture.  We have repaired the denture to have it hold better but a solution that will let him hold the denture at least the way it was is going to be expensive.
Yes you need the crown after the root canal treatment.  It will save you money in the long run.

Enjoying dentistry in Hamilton Ontario Canada

All the best

Dr Ron Barzilay

www.rondentist.com

PS. any questions, just send them as a comment

My Insurance! My Insurance! My Insurance! - Do you know anything about your insurance?

This is a true story.
A patient of ours was in the other day.  We had just made  new dentures for him and his wife.
We said we would send it to his insurance company to see if they would pay but he right away knew that they would not pay since he didn't have coverage for dentures.  Of course, shortly after that we heard from the insurance company that he has no coverage for dentures (major coverage).
He did tell us that he pays $170 dollars a month for only dental insurance for himself and his wife.
$2040 dollars a year for him and his wife and there was no major coverage.
My staff were flabbergasted.  They almost never have fillings to do and their cleanings amount to about 2 months of their premiums
So they pay their premiums faithfully every month but never get value.  In other words, in their case, it is not worth it to get insurance. Pay your dental bills out of pocket and they would be left with a larger sum of money in their pockets.
   Is this the case for everyone?  Of course not but it was the case for them.  Many people when they come to see me, say that they haven't been to the dentist for years because they didn't have dental insurance so they couldn't afford it.  I always explain to them that dental insurance costs money and that if they put that same money aside to go to the dentist they would be surprised by what value they get.
    The morals of the story?
 1. Check what you are actually getting when you buy dental insurance.  How much does it cost and is it really worth it.
2.  You can still go to the dentist even if you don't have insurance.

All the best

Dr. Ron Barzilay

Having fun practising dentistry in Hamilton Ontario Canada

www.rondentist.com

PS. If you have any questions just send a reply to the post.

Sometimes a small change can make a big difference

This patient came in and nothing really bothered her.  I suggested that we could make her smile look a little more aesthetic especially where she had some discoloration and old fillings on the roots on her upper left side.  They were visible in the smile.

I took out the old fillings and placed some white fillings.  We also covered up some of her discolored roots and then we got this....

She was very happy with the result.  It didn't take us very long to do and a much nicer smile.

Doing this is really a lot of fun.

Having fun doing dentistry in Hamilton Ontario Canada

If you have any questions don't hesitate to ask.

All the best

Dr. Ron Barzilay

www.rondentist.com

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

www.rondentist.com

MY SMILE LOOKS TERRIBLE BUT I CAN'T AFFORD THE DENTISTRY - WHAT CAN I DO?

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
www.rondentist.com

enjoying dentistry in Hamilton Ontario

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

I DON'T GRIND MY TEETH AT NIGHT!! WHY DOES MY DENTIST SAY I NEED A NIGHT GUARD?

     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

www.rondentist.com

enjoying dentistry in Hamilton Ontario!!

YOU CAN STILL GO TO THE DENTIST EVEN IF YOU DON'T HAVE DENTAL INSURANCE

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

www.rondentist.com

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

www.rondentist.com

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

www.rondentist.com

SO HOW DO YOU GET YOUR KIDS TO BRUSH THEIR TEETH???

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

www.rondentist.com

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
www.rondentist.com

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.
www.rondentist.com

Temporary Crowns -Why? and How long will they last?

I just received a question on the blog by someone who had just had a temporary crown placed and they wondered how long it would last as they were nervous because they were going on vacation. 
The purpose of a temporary is to protect the underlying vital tooth (if vital) from sensitivity and prevent the teeth around the prepared tooth/teeth from moving. The temporary must be strong enough to resist breakage for a short period while flexible enough to be easily removed.
I do many crowns and place many temporary crowns and if the permanent crown is to be placed in the next few weeks, my temporary crowns almost never come off or break.  This is when they are cemented with the weakest cement.  Sometimes I have temporary crowns on for a number of months for various reasons.  I can still say that we have a fairly high success rate but you must remember that they will not last more than a few months because they will loosen as the temporary cement leaches out and the tooth is subjected to the forces of chewing.  

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

My Dentist gave me 12 needles, is something wrong?

I have been asked many times about the number of injections given and whether it is OK or not?
Let us start with the basics, it is not the number of times that you have been"given the needle" but for safety it is the the quantity (in cc) of local anesthetic that you are actually being given.  Every dentist can calculate how much of a certain material he/her can give you before you reach unsafe levels (toxic levels).  The amounts that can be given depending on the size and weight of the patient, also whether a child or adult and your general health situation.  Your dentist will know how much he can give you in order to keep you safe.  As to how many injections, that is another story.  Some dentist go in quite aggressively and in 1 "shot" freeze you up. This gets you frozen quickly but sometimes you might be seeing stars.   When I "freeze" a child I can take up to 4 "shots".  The first one a quick short prick, generally not felt, but it freezes the area.  Then another one slightly deeper placing more material and so on.  Throughout we have only used one cartridge or less of material.  I think you get the idea.  Also the number of injections may be related to technique, the length of the procedure and the size of the area being worked on, also whether the area is "frozen" enough or perhaps some extra needs to be added.
In general, your dentist will always do his best to make you comfortable during any procedure he is doing.  Sometimes this may involve 1 " shot" and sometimes multiple "shots".  Don't bother counting, it will not be helpful to you.  If you do have a question, always feel comfortable to ask your dentist.  I am sure he/she will be more than happy to explain to you any questions that you may have.

All the best

Dr. Ron Barzilay

enjoying dentistry in Hamilton Ontario

www.rondentist.com

Toothpaste

We were sitting around the table in the staff room one afternoon and the discussion came around to TOOTHPASTE!
We started to discuss the different uses of toothpaste and this is what we came up with.

1.  To clean your teeth with.  Toothpaste is an abrasive and you place it on your toothbrush to help clean your teeth.
2.  If you get a burn, you place toothpaste on the burn and it will take away the sting.  (Of course we are talking about small burns not 3rd degree to 90% of your body.)
3.  Bee stings and mosquito bites feel much better after placing toothpaste.
4.  Cleaning your silverware.  Toothpaste does a great job taking off that tarnish.
5.  If your dog gets sprayed by a skunk place toothpaste. (one of our staff members swears by it!)
6.  Drying out acne zits.

If you have any others please let us know.

Toothpaste is really an all purpose product.

All the best
from the all of us in Hamilton Ontario

Dr.Ron Barzilay
www.rondentist.com

My tooth is dark at the tip and it is worse since I whitened them!

My tooth is dark at the tip and it is worse since I whitened them!
 Can I fix them?

A patient came in and asked me this today.
What I told her was that her teeth were not really dark that it was just at the tip of the tooth.  What she was actually seeing was the translucency of the tooth through the thinnest area of the tooth.  This is normal.  The enamel is translucent and where it is thin even more so.  In the thicker part of the tooth there is more dentin so the light does not go through as much.  That is why you see the mid tooth as white while the tip will be gray as you see the darkness of the mouth through it.  After you have whitened it may be more noticeable because the whiter tooth contrasts more with the grayness of the translucency.  I assured her it was quite normal and her teeth actually look very nice.  Is there anything that can be done?  Sure, you can have crowns or veneers placed but I though her teeth looked great and didn't need those drastic measures.
You decide:

Enjoying Dentistry in Hamilton Ontario

All the best

Dr.Ron Barzilay

www.rondentist.com