What are the benefits of straight teeth?

Society tells us that straight teeth are pretty and desirable.  But that is not the only reason to have your teeth straightened.  In fact, that is only one benefit of straight teeth.  Let’s discuss some of the benefits to straight teeth.

Straight teeth have minimal overlaps with their neighbouring teeth which makes them easier to clean.  Teeth that are easier to clean tend to get less plaque built up on them which in turn helps prevent cavities and gingivitis from forming.  By being easier to clean, this means that with less effort from you, you will have less dental problems over your lifetime.  And who wouldn’t want less dental work done.

Another reason that dentists recommend having teeth straightened is to realign the bite forces.  Teeth are made to bite together in a certain way and when they are tipped, rotated or crowded, they cannot bite together properly.  This causes unnecessary chipping, breaking and wearing of those teeth over time.  This can then lead to increased sensitivity, shorter teeth or the need for fillings or crowns to repair the lost tooth structure.  By realigning the teeth so that they bite together properly, you decrease the wearing of your teeth which helps keep them strong and healthy.

Finally we come to the cosmetic benefits.  This is the obvious one.  Our society values straight teeth as esthetically pleasing.  Unfortunately for some, the societal pressures placed on us can be detrimental to our self esteem.  We do not believe that everyone needs perfectly straight teeth to be healthy.  There are a lot of mouths that we see that do not have perfectly straight teeth but are functional and healthy.  We only recommend orthodontic treatments to straighten teeth when we see a problem that is developing or when the patient themselves expresses a concern about the look of their smile.  If a patient let’s us know that they would like to have their teeth straightened, we are more than happy to help get them there.  But if they don’t mention it and we do not foresee any damage happening, we will leave well enough alone too.  Every situation is unique and that is why we treat all of our patients based upon what they need.

Why should you fill your cavity?

Your dentist told you you have a cavity in your tooth.  And that you need to have a filling done to fix it.  So now what?  Do you have to have it fixed?  Will it go away?  What will happen if you don’t fix it?  Let’s discuss those questions a bit more since they are common and logical questions many patients have.

Kid's Cavity

Cavity on a lower right primary molar in a child.

Do you have to have it fixed?

The short answer?  No.  No one is going to make you do anything.  All patients have the right to make their own decisions about their oral health.  Your dentists, hygienists and dental assistants are here to educate you on your diagnosis as well as your options.  We can answer questions about risks and benefits of your options and help you make an educated decision on what you would like to do, but ultimately, the decision is yours.

Will it go away?  What will happen if you don’t fix it?

Also no.  Unfortunately, once the bacteria that cause cavities have created a hole in your tooth (the cavity), the only way to fix that hole is to have a filling done.  If a filling is not done, the bacteria will continue to grow the cavity and it will get larger.  As the cavity gets larger, it breaks down the structure of your tooth and can move closer to the nerve of the tooth.  

The structural breakdown of the tooth puts you at greater risk of the tooth breaking on you.  When a tooth breaks, there are a couple scenarios that you could be met with.  Often times, the break just leads to you needing a larger filling than originally thought.  Sometimes it leads to a structural issue that requires a crown to repair it.  In rare but unfortunate circumstances though, the fracture can go under the gums and bone and require the tooth to be extracted.

If the cavity moves towards the nerve of your tooth, the bacteria causing the cavity can get into the nerve of your tooth and cause an infection.  This infection causes a toothache.  Once the tooth is infected, there are only two options to heal the infection.  You can have a root canal done to remove the nerve of the tooth and the infection, or you can have the tooth extracted.  Most teeth that need root canals will also need a crown placed afterwards.

root canal

Root canaled and crowned tooth on upper left.

If the cavity grows too close to the bone, then the tooth may need to be extracted.  There is a limit as to how close a filling can be placed to the bone.  If the cavity is too close to the bone, any filling material placed there will cause the body to react to the filling material leading to the eventual downfall of the tooth so it would be recommended to extract it instead.

This is why we recommend fixing cavities with fillings.  The earlier we can repair a tooth, the less likely it is to have any of these unfortunate outcomes, especially an extraction.  By finding cavities when they are small and repairing them early, we can help you keep your teeth.  If you have questions about your cavity, make sure you ask your oral health team about what they would recommend to fix it.  After all, you chose them as your oral health care providers because you trust their education and opinions.  Use their knowledge to help you make an informed and educated decision about your oral health.

Perfect Smile

Botox & Dysport – The Cosmetic Injectables

Cosmetic Injectables, like Botox and Dysport, have become one of the most common cosmetic procedures done in North America today.  Something that used to be considered taboo or only for the rich and famous a few years ago is now quite common.  The idea of aging gracefully is leading the shift in our society.  Botox and Dysport treatments can now be performed by doctors, dentists, nurses and naturopaths in British Columbia. 

Dr. Moreau was trained at the Pacific Training Institute for Facial Aesthetics and Theraputics (PTIFA), one of the most comprehensive training courses for Cosmetic Injectables in North America, and now offers treatment in the office.

We all know about Botox for the treatment of wrinkles.  But how much do you really know about what it does?  And about the therapeutic uses for Botox or Dysport?  

The theory behind cosmetic injectables is that if you stop the muscle from crinkling the skin over and over again, you stop the wrinkle from forming.  This is how Botox and Dysport help with wrinkles.  The injection of Botox or Dysport, purified Botulinum Toxin-A proteins, into a wrinkle-forming muscle paralyzes the muscle.  This prevents the muscle from folding the skin for 3-4 months until the effects wear off.  Long term treatment will prevent the muscle from making these movements and wrinkling the skin.  If the wrinkle is already there, treatment can help to soften the appearance of the wrinkle and help prevent it from worsening.  

pain emergency patient

Therapeutic Botox and Dysport is used to treat pain, such as headaches and jaw pain.  By relaxing the muscles causing tension in the face, the Botox or Dysport helps lessen the pain that these muscles are causing.  Many of our patients notice a decrease in their headaches when they have treatment done on their upper face.  Our jaw pain patients, the clenchers and grinders, often notice great improvement after receiving treatment to their overactive jaw muscles.  Therapeutic Botox or Dysport is part of an overall treatment plan for managing these symptoms.  

Interested in learning more?  Schedule a consult with Dr. Moreau to discuss your options.  


Prevention: Nightguards

I talk to my patients all the time about grinding and clenching their teeth, but do they really know what that is and why it is bad?  Do they understand why the need a nightguard?  Sometimes I think they do but other times I wonder. So, I thought I would take a moment to explain it here.

First of all, what is the difference between grinding and clenching?  Well, grinding is when a person rubs their teeth together over and over wearing them down over time.  Clenching is when a person holds their teeth together very tightly over a period of time.  Grinding causes excessive wear on the teeth and sore muscles and headaches.  Clenching causes sensitive teeth, tooth chips and fractures, sore muscles and headaches.  Clenching and grinding are grouped together under the term ‘bruxism.’

What causes it?  Well, that is a great question.  Most of us who grind or clench do so when we are sleeping.  We are unconscious so we aren’t aware of what is causing us to do this.  There are many theories out there but it remains to be seen if we have an overactive muscle, a bite discrepancy, a sleep-breath disorder or just a subconscious habit.  I personally think it is likely a combination of a lot of factors.  One thing I know for sure about clenching and grinding is that stress exacerbates it. I cannot tell you how many of my patients come in during or after periods of stress in their lives (global pandemic anyone?) and tell me that their teeth are sore, their jaw is sore or that they have been having more headaches.  These are classic symptoms of grinding or clenching!

So what do we do about it?  Since we don’t know what truly causes it, we cannot stop you from doing it.  But we can manage it.  My favourite treatment option is a night guard because it is a non-permanent option that protects your teeth.  They are simple to use and last for years depending on the extent of your grinding or clenching.  Most patients find them quite comfortable, once they get used to wearing them.  Some other treatment options are eliminating stress from your life (if you figure out how, please let me know!), physiotherapy, massage therapy, orthodontics to realign your teeth and Botulinum Toxin-A therapy (better known as Botox or Dysport).  

What is a night guard?  It is a custom acrylic appliance made to fit around your teeth on one arch (usually the top teeth) that you wear while you are sleeping.  The hard acrylic helps to distribute your clenching or grinding forces throughout your mouth so that you cannot take your stress out on specific teeth.  It won’t stop you from doing it, but it will help protect your teeth.  Most people find that it helps with their sensitivity, jaw soreness and headaches as well. For those that it doesn’t, we then look into adding other treatment modalities in to help with that like sensitivity toothpastes, massage, orthodontics or Botox therapy.

Night guardNot sure if you grind or clench?  Take note over the next few days if you are waking up with tight or sore jaw muscles, sensitive teeth or headaches.  Look at your teeth.  Do they look worn?  Are your canine teeth pointy or flat?  They should be pointy.  If they are flat, you have likely ground them down over the years.  Still not sure?  Ask us the next time you are in for a check up and we can help you determine if you are clenching and grinding and if a night guard would be a good prevention idea for your teeth.  Remember, these are the last set of teeth you grow so you want to protect them as best you can for as long as you can!


Dr. Robyn’s 2020 Observations

2020 is almost over!  

What a year it has been for everyone.  I won’t go into details as I am sure we are all more than well aware of the dramatic events of this year.  What I did want to touch on though are some observations I have on the effects of the stress of this year on our patients’ mouths.  We all know that stress can effect us in a number of ways.  Let me tell you about a few of them that we have seen in your mouths.

Now, please keep in mind, there is no research backing up this post.  This is purely based on my observations in our dental clinic in Kelowna, British Columbia, Canada.  I recognize that this is not a science-based conclusion, nor may it represent the patient populations of other clinics.  I just thought it was interesting so I thought I would share for those interested as well.

I would say the number one call I received during our COVID-19 shutdown this Spring was about broken teeth.  Most of these patients were not in pain, but had broken part of their tooth off.  These patients were able to manage their broken tooth at home with some TLC and in some cases, the application of some sensitivity toothpaste to the sensitive spot.  Once we were able to reopen and see them, we were able to diagnose many fractured teeth.  More than I have ever seen!  And in talking to colleagues across Canada, they were seeing the same thing – an increased number of broken teeth.  I can only assume that the increased stress people have been under caused them to grind or clench more, leading to these fractures.  

I have also noticed an increase in the number of our patients coming in with jaw pain or Temporomandibular Disorder (TMD).  The stress that we are under is often taken out on our mouths by grinding and/or clenching, and often while we are sleeping so we cannot control it.  These increased forces in our jaws puts extra strain on the muscles, joints and bones that make up our jaw joint or Temporomandibular Joint (TMJ).  Some of the patients we are seeing have long standing jaw issues that are being aggravated by the current situation but many of these patients are having jaw pain for the first time.  It can be alarming but so far we have been able to manage these cases relatively easily.  

My hygienists have also noticed that our patients have more buildup or calculus on their teeth.  Now, that is to be expected with the patients who had to cancel their cleaning appointments due to our COVID shutdown.  But they are also seeing it with our patients who are not overdue.  The ones who were in just before the shutdown and then returned right on schedule. I can only assume that the increase in stress has affected the buildup somehow. Now, your guess is as good as mine as to why:

  • Did they slack on their brushing and flossing while they were on lockdown or working extra helping their kids with homeschooling?
  • Did the stress cause the chemistry of their saliva to change making it easier for the plaque to calcify?
  • Did the stress cause the amount of their saliva to decrease making it easier for the plaque to calcify?

Was it a combination of the above?  We will never know.  And it may be different for every patient.  What we do know, is the need for our patients to get in for their regular dental hygiene appointments has not decreased.  If anything, there are some patients who we will need to see more during this stressful time to keep their mouths as healthy as we can.

What can we learn from this?

Stress can do surprising things to our bodies and our mouths.  This global pandemic has sure shown us that.  It will be important to keep this in mind when our patients are going through stressful times in the future.  We can be aware of these things and maybe even counsel them on it before they happen to try to prevent some of these stress-related dental events from happening.  

The other thing we can learn from this year is that our community is strong and resourceful. We came together through this nightmare of a year and for the most part helped support each other.  Our patients and team members seem to be coping with all the stresses they are under as best they can and that’s all we can truly hope for.

Here’s to us coming out the other side of this with a smile on our faces.

Happy New Year!

Dr. Robyn Moreau

What to do After a Tooth Extraction?

Having a tooth extracted is not something any of us look forward to.  But sometimes, for some teeth, it is the only option.  In these instances, we take the utmost care in making you feel comfortable throughout the procedure.  And after the tooth is out, special care needs to be taken to care for the area so it heals well.  

pain emergency patient

Instructions to Patients following Oral Surgery

  1. Bite on gauze for ½ hour.
  2. Brush your teeth and tongue tonight, avoiding the affected area(s) for 48 hours.
  3. Do not rinse your mouth vigorously for 24 hours. Do not drink through a straw, spit or smoke for 24 hours.
  4. Starting tomorrow, rinse your mouth frequently with a solution of ½ teaspoon of salt in a glass of warm water. Continue the rinses for a few days.
  5. If you have any discomfort, take whatever you normally take for a headache, as directed on the bottle. If necessary, a stronger medication will be prescribed for you.
  6. Diet – cold or lukewarm liquids may be taken for the first 4-6 hours. After this, eat soft foods.  Avoid small foods like rice, quinoa or seeds that can get stuck in the surgical site.
  7. Bleeding – it is normal for the saliva in your mouth to be streaked with blood for a day or two. If frank bleeding is present, fold a sterile gauze into a firm wad and place it directly on the bleeding area.  Maintain firm pressure by biting for 20 minutes.  You can also bite on a damp tea bag.
  8. Swelling & Discolouration – it is to be expected in certain areas, usually reaching its maximum 2 days after surgery. It will disappear gradually and is no cause for concern.  Ice pads should be applied for the first 4-6 hours only, alternating 20 minutes on and 20 minutes off.
  9. Place an old towel on your pillow tonight in case you drool some blood so that you don’t stain your pillow.
  10. Sutures (Stitches) – if required, they will dissolve on their own over the next week.
  11. Do not hesitate to call the office if you are in doubt or have any questions.