Friday, September 19, 2014

6 things to look out for when searching for a new dentist


1) It can be useful that your dentist is close to your place of work, school or home for convenience.  But it’s more important that you find a dentist that you trust for your treatment. It’s easy to go places because of proximity but it’s more important to search for a dentist with a high standard of care.

Unfortunately; the best way to really know who is good it to look at dental work every day. Everytime I look at a filling, a crown or orthodontic treatment I’m trained to judge it by the highest standard. But how can someone with no dental experience judge how good their dentist is?

Things to look out for:


2) The more times one spends practicing his or her craft the more skilled he or she will be. Like anything it takes time to become proficient with your hand skills as a dentist but it's just as important to become proficient with your biggest asset, your brain. What works in each clinical situation is the key to a successful outcome.

Try to find out whether your clinician is involved in continuing education.  The dental field is continuously evolving and effective new therapies are developed all the time.

Up to date Equipment

3) Just like a automobile you can get around in a 1970 chevy to get from point A to B but a newer model will have the latest in technological advancements in safety, engineering and cleanliness. It was a natural evolution that as research continued to improve that dental equipment was going to vastly improve as well. The bacteria that cause cavities haven’t changed but our tools to treat the disease have improved tremendously.

Listening Skills

4) In the 80’s going to the dentist or medical office meant sit down, don’t talk and I’ll tell you what you need. That’s no longer an acceptable way to practice dentistry. The reason for the huge shift in focus is that what a patient tells you can be integral in what your selected course of treatment may be.

Dentistry for many years was reactionary, you have a problem so now we’ll fix it. A major change in thinking has now moved to dentistry towards a preventative model. How can things be addressed so you don’t have future gum problems, cavities, enamel wear or arthritic joint concerns.

Word of Mouth

5) What do people say? The best reference is often a first hand account. Approximately 90% of our patient’s find us because they were referred by a friend, colleague or web review.


6) It’s important to remember that you have choice in deciding who you will enlist to take care of your oral health. You have to feel comfortable with that person as you will be seeing them for potentially the next 10, 20 to 30 years.

It’s amazing the number of people that come in and tell me how they disliked their old dentist but it took them years to leave the office! Just remember you can make the final decision with respect who you want to build your health relationship with and once you find the right place you'll know.

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Tuesday, September 9, 2014

Musical Instruments and a Childs Brain Development

You may have heard that studying and playing music can be beneficial to brain development. But how many parents have tried to put their son or daughter in a music class only too see the early days of excitement wane after a few weeks after the homework and long practice sessions curb the initial enthusiasm.

An interesting study by Dr’s Erika Skoe and Nina Kraus posted in the Journal of Neuroscience shed new light on how music and brain development are linked.

“… results suggest that a limited period of music lessons (~3 years) during childhood fundamentally alters the nervous system such that neural changes persist in adulthood after auditory training has ceased (~7 years later).”

This means that even if your child stops playing an instrument the benefits from the initial experience can fundamentally change their brainstem activity into adulthood.

Most studies look at the exceptional music composers and how their brains are different to the general population but the conclusions from this paper were unique because it showed the how the benefits of music can apply to all children.

In another study from the Journal of Neuroscience from Jan 2013 by Dr's Steel, Bailey, Zatorre and Penhune researchers found that white matter changes in the brain before the age of 7 from playing music generated a scaffold that stayed with children throughout their lifetime.

The moral of the story - have your kids play musical instruments and start them early.  Even if they don't stay with it the benefits for future development are tremendous!

Friday, September 5, 2014

Oral Cancer - Part 2: Treatment and Dental Care

Because cancer treatment can affect the oral tissues it’s important to know about the various side effects and how these conditions can be managed. Often preexisting conditions can complicate treatment and will require an organized and systematic approach to therapy.

Oral complications from radiation to the neck and head areas can compromise quality of life and sometimes can be so debilitating that treatment is postponed, moderated at lower doses or even cancelled all together.

There are some things that can be accomplished prior to chemotherapy that will help to increase the success and comfort level of treatment but first it’s important to understand how chemotherapy and radiation work.

Chemotherapy works by stopping or slowing the growth of cancer cells which grow and divide quickly. But it also affects the other cells of the human body that divide quickly: blood producing cells, hair cells, cells of the mucous membranes of the mouth area and of the digestive system. These can have short term effects like hair loss, anemia, nausea, vomiting, diarrhea and infections in the mouth. The severity of chemotherapy will vary individual to individual and sometimes can be less severe. The most important thing to realize is that hair, mucous membranes, and blood production will all repair themselves after treatment. The adverse effects of chemotherapy can present themselves later on, particularly for younger people. Because sperm and eggs can be damaged from treatment it’s important to practice oral contraceptive use.

Radiation therapy will work in two ways
  • It will stop or slow the growth of a tumour
  • It will shrink the size of the tumour, reduce some symptoms and relieve pain.

Doctors want to provide the right amount of radiation while protecting the healthy cells around the area so the size of the beam and the strength is determined on a case by case basis.

Oral complications that are common to both chemotherapy and radiation:

  • Infection: These can include bacterial, fungal and viral infections resulting from xerostomia (dry mouth), myelosuppression and damage to the mucosa.
  • Xerostomia and salivary gland dysfunction: Dryness can effect chewing, speaking and swallowing. Saliva can cleansing and anti-microbial properties and if it’s effect is diminished the number of dental caries can increase rapidly for those succeptible.
  • Taste Alteration: The changes in taste can cause food to be anywhere from tasteless to unpleasant
  • Nutritional Compromise: Because of the difficulty eating food, loss of taste the quality of nutrition can become compromised
  • Oral mucositis: Inflammation, tissue sloughing and increased sensitivity
  • Abnormal dental development: If younger than the age of 9 then this becomes a major concern in jaw bone development and tooth development.
  • Radiation caries: cavities that result because of changes in either the quantity or quality of saliva
  • Trismus and tissue fibrosis: When the muscles of the masticatory system restrict the normal ability to open the mouth.
  • Osteonecrosis: Blood vessel compromise and necrosis of the bone

Proper planning and preventative measures will increase the likelihood that a patient will complete their treatment and decrease the severity of oral complications while minimizing pain.

The role of Pretreatment dental care:
  • Identify and treat existing infections, both periodontal and tooth related. Including a cleaning and treating tooth decay.
  • Remove teeth that have excessive bone loss associated with deep pockets around the gums to prevent future related bone necrosis from tooth removal at least 2 weeks prior to treatment.
  • Conduct a prosthodontic evaluation of any removable appliances and make sure they are well fitting to prevent “tissue burn” from the prosthesis rubbing aggressively. Ideally the prosthesis should not be worn at all.
  • Remove orthodontic bands and brackets
  • Supplemental fluoride using custom made trays and a daily 10 minute application of 1.1% neutral fluoride gel.
  • Obviously the cessation of alcohol and tobacco products will reduce the chance or current and future complications
  • Use an extrasoft toothbrush and avoid brushing aggressively
  • Avoid mouthwashes containing alcohol
  • Avoid candy and gum unless they are sugar free
  • The use of an appliance, like the therabite, will help to prevent the stiffening of jaw muscles
  • Avoid spicy foods
  • Sip water frequently
  • Suck ice chips or sugar-free candy
  • Use a saliva substitute rinse or spray if needed