Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B6J3
Sports are an important element in human society — besides providing enjoyment they also build discipline, teamwork and character.
But sports activities, especially for children and teenagers, also carry the risk of physical injury — and your teeth and mouth aren’t immune. About 22,000 mouth injuries occur annually in individuals under the age of 18. As the degree of contact within the sport rises, so does the risk of dental injuries.
To reduce this risk, it’s important to adopt a comprehensive approach to dental injuries, beginning with protection. For any sport that involves a ball, stick, puck or physical contact with another player, athletes should incorporate two pieces of equipment to fully protect against mouth injury: headgear and a mouthguard. Both help to evenly distribute the forces generated during an impact and thus reduce the chance or severity of injury.
The design of headgear will depend on other factors involving a particular sport. Mouthguards are more singular in their purpose, and so what works in one sport should work in another. While there are a number of types like stock or “boil and bite,” the highest level of protection is a custom-fitted mouthguard created by a dentist to specifically fit the individual’s bite. Although more costly than other options, it can better reduce the chances of an even more costly mouth injury.
Because we can only reduce the risk of injury but never eliminate it, protection is only part of the approach. Individuals, parents and sports officials should have plans in place for treating dental injuries should they occur. Depending on the level of trauma, individuals should have access to a dentist as soon as possible. It’s also important to know what to do when specific injuries occur, whether they require an immediate, urgent or less urgent response. The Dear Doctor magazine article, “The Field Guide to Dental Injuries” is an excellent primer on dental injury treatment.
Sports can have a positive effect on physical, emotional and social development. Adopting a well-rounded approach to dental injury prevention and treatment will help keep the focus on those benefits.
If you would like more information on protection and treatment from sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “An Introduction to Sports Injuries & Dentistry.”
Teeth are composed of layers of different types of tissue. The main inner layers — the pulp and dentin — help the teeth respond and adapt to external forces. But they’re vulnerable to decay and quite sensitive to environmental extremes. They are protected from all these by a coating of enamel, made of the hardest material found in the human body.
But while enamel is strong, it’s not invincible — it can soften and dissolve (de-mineralize) if the mouth environment becomes too acidic. While de-mineralization occurs normally whenever the mouth becomes too acidic after eating or drinking, saliva helps neutralize the acid (buffering); in fact, saliva can restore to the enamel some of the calcium and other minerals it has lost (a process called re-mineralization).
If the acidic level remains too high for too long it can overwhelm saliva’s buffering ability and cause permanent mineral loss to the enamel. This erosion leaves teeth more susceptible to decay and disease and could lead to tooth loss. With this in mind, here’s some ways you can help preserve your enamel:
Following these tips, along with effective oral hygiene, will go a long way in protecting your teeth’s enamel coating — and preserving your teeth in the long run.
If you would like more information on enamel erosion and how to prevent it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
Local anesthesia has emerged over the last half century as one of the most effective tools in dentistry. Its use has literally revolutionized pain control and led to a new description of care known as comfortable dentistry.
The term “local” indicates that the numbing agent is applied only to the area affected by the procedure to temporarily block nerve sensation while the patient remains conscious. Some topical anesthetics are applied to the surface of the lining tissues of the mouth with a cotton swab, adhesive patch or spray to immediately numb the area. While topical anesthetics are sometimes used to increase comfort during teeth cleaning, they’re most often used to block the feeling of the needle prick of an injectable “local” anesthetic. Injectable “local” anesthetics provide a deeper numbing of the teeth, gums and bones.
Along with other calming or sedative techniques, local anesthesia is especially helpful in lowering a patient’s anxiety and stress levels during treatment. It’s a necessity during treatments like decay removal, deep root cleaning, fillings, tooth extractions or gum surgery because the nerve-rich tissues of the mouth are especially sensitive to pain. There are some treatments, however, that don’t call for anesthesia such as enamel removal or shaping (unless the more sensitive dentin below the enamel layers has been exposed).
One common complaint about local anesthesia is the lingering numbness a patient may continue to feel even a few hours after their visit. This inconvenience can be reduced by using different types of anesthetics, and there are now agents that can be applied after a procedure to reverse the effects of an anesthetic.
Local anesthesia benefits both you the patient and your dental professional — you’re more comfortable and less stressful during your visit, and your dentist or hygienist can work more effectively knowing you’re at ease. A pain-free, anxiety-free treatment atmosphere contributes greatly to your long-term dental health.
If you would like more information on the use and benefits of local anesthesia for dental procedures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Local Anesthesia for Pain-Free Dentistry.”
Oral cancer is not as uncommon as people think. In 2008 an estimated 34,000 cancers of the mouth and throat were diagnosed. In order to minimize your risk of developing oral cancer, be aware of habits that increase your risk.
Early signs of oral cancer can mimic harmless sores that occur in the mouth such as canker sores, minor infections, or irritations that occur from biting or eating certain foods. Cancers in the lip area can easily be mistaken for harmless sores.
It is important to have regular oral examinations to detect signs of oral cancer. Although 90 percent of oral cancers occur in people who are over 40, it is becoming more prevalent in younger people, particularly those who adopt risky behaviors: smoking, drinking and oral sex.
It is important not to let a suspicious sore go unchecked. If detected and treated early, while a lesion or growth is small, survival rates can exceed 80 percent. Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”
Young children are like sponges, soaking up patterns of behavior they will later apply in many circumstances throughout life. In this learning process, they often look to family members for guidance. Some good habits, like saying “please” and “thank you,” can be taught verbally. Others are best learned by example.
Developing good habits early will benefit your children for a lifetime — especially where their health is concerned. Fortunately, it isn't hard to instill good oral hygiene behavior in a young child; for example, most all children are successfully taught to brush their teeth at an early age. What follows are some tips that might not be as obvious, but will help your children build healthy routines for maintaining optimum oral hygiene.
1) Teach your children how to check the cleanliness of their own teeth.
How? By running their tongue over the tooth surfaces! If the teeth feel nice and smooth, they're likely to be clean, too. Remember to give kids a soft brush, and tell them to use gentle strokes in brushing.
2) Avoid transferring your own oral bacteria to your children.
Children aren't born with decay-producing bacteria — they get them from others! That's why sharing baby's spoon or licking a pacifier clean aren't really good ideas. (Neither is pre-chewing a baby's food, despite what some birds and celebrities do. Trust us on this.)
3) Set an example of healthy eating habits for your children.
Follow common-sense guidelines (like those in www.choosemyplate.gov) for maintaining a balanced diet, eating plenty of vegetables and whole grains, drinking lots of water and getting moderate exercise.
4) Limit sugary treats to mealtimes, not snack times — if you allow them at all.
Oral bacteria utilize sugar for energy and when they metabolize it, they produce harmful acids. These acids attack the teeth and cause decay. The more sugar, the higher potential for stronger acids. Saliva helps neutralize these acids — but not if sugar is constantly present in the mouth. Try to limit sugary treats to mealtimes, and serve a healthier snack between meals.
5) Encourage your children to stop sucking thumbs and pacifiers by age 3.
Thumb sucking is a normal, comforting habit that may begin in the womb. Most kids stop on their own between ages 2 and 4. But long-term sucking on fingers or a pacifier can lead to tooth and jaw-development problems. We can help you find ways to gently encourage children to stop when it's time.
If you would like more information about instilling good oral hygiene habits in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
Periodontal (gum) disease is sometimes called a “silent” malady — meaning that its symptoms don’t generally announce themselves with great fanfare (or pain, as conditions like tooth decay and root canal issues often do). Yet this disease is estimated to affect almost half of the adult population in the United States, causing deterioration of the gums and the bone surrounding the teeth… and possibly leading to bacterial infections, loss of teeth, and even systemic (whole-body) problems.
So what exactly is periodontal disease? Actually, it’s the broad name for a group of related diseases which attack the soft tissue of the gums and the tooth-supporting bone. Most periodontal diseases are caused by the buildup of harmful bacteria in a biofilm (thin, sticky layer), which coats teeth in the absence of effective oral hygiene. And yes, that means if you don’t brush and floss daily, you’re much more likely to develop gum disease.
Even the most attractive smile could have gum disease lurking beneath it. How do you know if you may be affected? Some early warning signs include redness or inflammation of the edges of the gums, a bad taste in your mouth or bad breath, plus any degree of bleeding when you brush your teeth (brushing should never cause gums to bleed). As the disease progresses, you may develop painful inflammation or a pus-filled abscess, bone loss, loose teeth… and eventually tooth loss.
But don’t wait until then to seek treatment! If you see your general dentist regularly, and if he or she notices signs of gum disease, you may be referred to a periodontist. But you don’t need a referral — you can simply make an appointment and come in for a check-up. That may be wise if you have noticed any warning signs — especially if it has been a while since you’ve had an exam. Periodontal disease may be a silent malady, but that doesn’t mean you have to let it affect your oral health.
If you would like more information about periodontal disease, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “When To See A Periodontist” and “Warning Signs of Periodontal (Gum) Disease.”
Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.
Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.
Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.
If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.
Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.
Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.
If you would like more information on treatments for “gummy” smiles, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”
You may be suffering from an uncomfortable cracking of the skin at the corners of the mouth. This condition is known as perleche (or angular cheilitis). From the French word “lecher” (“to lick”), it derives its name from the tendency of sufferers to lick the affected areas.
There are a number of causes for perleche. It’s found most often in children who drool during sleep, or in teenagers or young adults wearing braces. Older adults develop perleche due to the wrinkling of skin caused by aging; and anyone can develop the condition from environmental factors like cold, dry weather. Conditions from within the mouth may also be a cause: inadequate saliva flow; inflammation caused by dentures; or tooth loss that diminishes facial support and puts pressure on the skin at the corners of the mouth. Systemic conditions such as anemia, diabetes or cancer can dry out oral tissues and membranes, which may lead to perleche.
Our first priority is to treat any underlying infection. Cracked mouth corners are easily infected, most commonly from yeast called candida albicans. The infection may range from minor discomfort localized in the affected area to painful infections that involve the entire mouth and possibly the throat. Any of these can be treated with an oral or topical anti-fungal medication, including anti-fungal ointments applied directly to the corners of the mouth until the infection clears up. Chlorhexidine mouth rinses can also be used to treat minor yeast infections.
As for healing the cracked skin, a steroid ointment for control of inflammation combined with a zinc oxide paste or ointment will serve as an antifungal barrier while the tissues heal. If the condition is related to missing teeth or dentures, we can take steps to replace those teeth or ensure the dentures are fitting properly. Good oral health also goes a long way in preventing further reoccurrence of perleche, as well as dermatological techniques to remove deep wrinkles due to aging.
If you would like more information on perleche and other mouth sore issues, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cracked Corners of the Mouth.”