Category: Dental Education

Dental Education posts include case studies, etc.

Veneers

Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance. These shells are bonded to the front of the teeth changing their color, shape, size, or length. Dental veneers can be made from porcelain or from resin composite materials. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of less of the tooth surface before placement. You will need to discuss the best choice of veneer material for you with your dentist.

What Types of Problems Do Dental Veneers Fix?

Veneers are routinely used to fix:

  • Teeth that are discolored — either because of root canal treatment; stains from tetracycline or other drugs, excessive fluoride or other causes; or the presence of large resin fillings that have discolored the tooth
  • Teeth that are worn down
  • Teeth that are chipped or broken
  • Teeth that are misaligned, uneven, or irregularly shaped (for example, have craters or bulges in them)
  • Teeth with gaps between them (to close the space between these teeth)

What’s the Procedure for Getting a Dental Veneer?

Getting a dental veneer usually requires three trips to the dentist – one for a consultation and two to make and apply the veneers. One tooth or many teeth can simultaneously undergo the veneering process described below.
  • Diagnosis and treatment planning. This first step involves your active participation. Explain to your dentist the result that you are trying to achieve. During this appointment, your dentist will examine your teeth to make sure dental veneers are appropriate for you and discuss what the procedure will involve and some of its limitations. He or she also may take x-ray and possibly make impressions of your mouth and teeth.
  • Preparation. To prepare a tooth for a veneer, your dentist will remove about 1/2 millimeter of enamel from the tooth surface, which is an amount nearly equal to the thickness of the veneer to be added to the tooth surface. Before trimming off the enamel, you and your dentist will decide the need for a local anesthetic to numb the area. Next, your dentist will make a model or impression of your tooth. This model is sent out to a dental laboratory, which in turn constructs your veneer. It usually takes 1-2 weeks for your dentist to receive the veneers back from the laboratory. For very unsightly teeth, temporary dental veneers can be placed for an additional cost.
  • Bonding: Before the dental veneer is permanently cemented to your tooth, your dentist will temporarily place it on your tooth to examine its fit and color. He or she will repeatedly remove and trim the veneer as needed to achieve the proper fit; the veneer color can be adjusted with the shade of cement to be used. Next, to prepare your tooth to receive the veneer, your tooth will be cleaned, polished, and etched — which roughens the tooth to allow for a strong bonding process. A special cement is applied to the veneer and the veneer is then placed on your tooth. Once properly position on the tooth, your dentist will apply a special light beam to the dental veneer, which activates chemicals in the cement, causing it to harden or cure very quickly. The final steps involve removing any excess cement, evaluating your bite and making any final adjustments in the veneer as necessary. Your dentist may ask you to return for a follow-up visit in a couple of weeks to check how your gums are responding to the presence of your veneer and to once again examine the veneer’s placement.

Dental Hygiene Cleaning

What are dental cleanings and why should you have them?

Dental cleanings involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time. Your teeth are continually bathed in saliva which contains calcium and other substances which help strengthen and protect the teeth. While this is a good thing, it also means that we tend to get a build-up of calcium deposits on the teeth. This chalky substance will eventually build up over time, like limescale in a pipe or kettle. Usually it is tooth coloured and can easily be mistaken as part of the teeth, but it also can vary from brown to black in colour. Bacteria are present in all of our mouths, on our teeth and tongues. The bacterial biofilm continuously multiplies and soaks up calcium and other minerals from your saliva, hardening into tartar and calculus deposits.

If the scale, or calculus (tartar, as dentists like to call it) is allowed to accumulate on the teeth it will unfortunately provide the right conditions for bacteria to thrive next to the gums. The purpose of the cleaning and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them and you have a better chance of keeping the teeth clean during your regular home care.

Dental cleaning also leaves your teeth feeling lovely and smooth and clean, which is nice when you run your tongue around them. Actually, come to think of it, there’s nothing worse than someone you fancy running their tongue around your teeth and finding a piece of spinach or something!

The professional cleaning of teeth is sometimes referred to as prophylaxis (or prophy for short). It’s a Greek word which means “to prevent beforehand”; in this case, it helps prevent gum disease.

How are dental cleanings done?

The dental hygienist or dentist uses specialized instruments to gently remove these deposits without harming the teeth. The instruments which may be used during your cleaning, and what they feel like, are described below.

Commonly used first is an ultrasonic instrument which uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris and keep the area at a proper temperature. The device typically emits a humming or high pitched whistling sound. This may seem louder than it actually is because the sound may get amplified inside your head, just like when you put an electric toothbrush into your mouth.

The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. They are by no means sharp since their purpose is to knock tartar loose and not to cut into the teeth. It is best to inform the operator if the sensations are too strong or ticklish so that they can adjust the setting appropriately on the device or modify the pressure applied.

With larger deposits that have hardened on, it can take some time to remove these, just like trying to remove baked-on grime on a stove that has been left over a long time. So your cleaning may take longer or require further cleanings. Imagine not cleaning a house for six months versus cleaning it every week. The six-month job is going to take longer than doing smaller weekly jobs.

Once the larger pieces of tartar are gone, the dental hygienist will switch to finer hand tools (called scalers and curettes in dental-speak) to remove smaller deposits and smooth the tooth surfaces. These tools are curved and shaped to match the curves of the teeth. They allow smaller tartar deposits to be removed by carefully scraping them off with a gentle to moderate amount of pressure. Just like taking a scrubbing brush to a soiled pot, the dental hygienist has to get the areas clean and smooth.

Once all the surfaces are smooth, polishing your teeth is next. Polishing is done using a slow speed handpiece with a soft rubber cup that spins on the end. Prophylaxis (short for prophy) paste – a special gritty toothpaste-like material – is scooped up like ice cream into the cup and spun around on the teeth to make them shiny smooth.

Your dentist may also apply fluoride. This is the final – and my favorite – part of the dental cleaning! Fluoride comes in many different flavours such as chocolate, mint, strawberry, cherry, watermelon, pina colada and can be mixed and matched just like ice cream at a parlour for a great taste sensation! Make no mistake though, this in-office fluoride treatment is meant for topical use only on the surfaces of the teeth and swallowing excessive amounts can give a person a tummy ache as it is not meant to be ingested.

Fluoride foam or gel is placed into small, flexible foam trays and placed over the teeth for 30 seconds. Afterwards the patient is directed to spit as much out as possible into a saliva ejector. The fluoride helps to strengthen the teeth since the acids from bacteria in dental tartar and plaque will have weakened the surfaces. It is best not to eat, drink or rinse for 30 minutes after the fluoride has been applied. Is it going to be painful?

Most people find that cleanings are painless, and find the sensations described above – tickling vibrations, the cooling mist of water, and the feeling of pressure during “scraping” – do not cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards! There may be odd zingy sensations, but many people don’t mind as they only last a nanosecond.

Be sure to let your dentist or hygienist know if you find things are getting too uncomfortable for your liking. They can recommend various options to make the cleaning more enjoyable.

Emergency Dental Treatment

If you have a dental emergency please call 24-Hours 416-223-4000

Regardless of the nature of your dental emergency, you have our commitment to giving you the treatment you need as quickly as possible. That’s why when you call for emergency treatment our first question is: “How Quickly Can You Get Here?”

Same day treatment whenever possible:
  • we will arrange for you to have the first available appointment time
  • we will adjust schedules to accommodate your emergency
  • we will do everything in our power to relieve you of pain and make you comfortable as soon as possible!

Dental Bridges

Dental bridges literally bridge the gap created by one or more missing teeth.

A bridge is made up of two crowns for the teeth on either side of the gap. These two anchoring teeth are called ‘abutment’ teeth, with a false tooth (or teeth) in between. These false teeth are called ‘pontics’, and can be made from gold, alloys, porcelain, or a combination of these materials. Dental bridges are supported by natural teeth or implants.

What Are the Benefits of Dental Bridges?

Bridges may be suggested by your dentist for several reasons, which might include:

  • Restoring your smile
  • Restoring the ability to properly chew and speak
  • Maintain the shape of your face
  • Distributing the forces in your bite properly by replacing missing teeth
  • Prevent remaining teeth from drifting out of position
What Types of Dental Bridges Are Available?

Traditional or conventional cast bridges involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Conventional bridges are the most common type of bridge and are made of either porcelain fused to metal or ceramics. Sometimes full coverage crowns may not be required to help retain a bridge. If this is the case, a Maryland Bridge may suffice. Occasionally a patients own tooth may be used as a temporary bridge by bonding to the adjacent teeth.

Crowns

What are Crowns?

A Crown – also known as a “CAP” – is a type of dental restoration which completely encircles a tooth or dental implant. Crowns are often used to improve the strength or appearance of teeth. Crowns are often needed when a large cavity or filling threatens the ongoing health and strength of a tooth. Similarly, they are often required after endodontic (root canal) therapy on a tooth.

Crowns are typically bonded to the tooth using a dental cement, though they can be made from many materials, and are usually fabricated using indirect methods. While inarguably beneficial to dental health, there may sometimes be alternative methods available, such as inlays and onlays.

How are Crowns made?

The most common method of manufacturing a crown involves first preparing the tooth, reducing the circumference by the thickness required for the material to be used. An impression of the prepared tooth is then obtained and sent to a dental laboratory where the crown is fabricated. The crown can then be inserted at a subsequent dental appointment.

Using this indirect method of tooth restoration allows use of strong and extremely cosmetic restorative materials. The use of porcelain with gold alloys, or extremely strong porcelain by itself, allows the restoration of a tooth to a size, shape and appearance often better than the original. Crowns can also be used to support and retain fixed bridges and removable dentures.

Conscious Sedation

What is Conscious Sedation?

Dr. Raskin & his associates are pleased to offer a valuable service which you can take advantage of when having treatment in our Finchurst Dental office. Conscious sedation allows you to have dental work done in the utmost comfort.

In contrast to general sedation, where patients are completely unconscious, conscious sedation allows you to remain conscious but places you in a state of deep relaxation. You are still able to talk and communicate with the doctor but will remember nothing of the appointment afterwards.

Conscious sedation can benefit not only more fearful patients, but any patient who is having a longer appointment, which some patients find to be stressful. With conscious sedation, medications and the use of Nitrous Oxide Inhalation, help make the appointments easy, comfortable, and easy tolerated.