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.
Thursday, June 30, 2011
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.
Subscribe to:
Posts (Atom)