Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B6J3
At no other time in a person’s life will their teeth and mouth change as rapidly as it will between infancy and adolescence. In this short span an entire set of teeth will emerge and then gradually disappear as a second permanent set takes its place.
While the process may seem chaotic, there is a natural order to it. Knowing what to expect will help ease any undue concerns you may have about your child's experience.
The first primary teeth begin to appear (erupt) in sequence depending on their type. The first are usually the lower central incisors in the very front that erupt around 6-10 months, followed then by the rest of the incisors, first molars and canines (the “eye” teeth). The last to erupt are the primary second molars in the very back of the mouth just before age 3. A similar sequence occurs when they’re lost — the central incisors loosen and fall out around 6-7 years; the second molars are the last to go at 10-12 years.
A little “chaos” is normal — but only a little. Because of the tremendous changes in the mouth, primary teeth may appear to be going in every direction with noticeable spaces between front teeth. While this is usually not a great concern, it’s still possible future malocclusions (bad bites) may be developing. To monitor this effectively you should begin regular checkups around the child’s first birthday — our trained professional eye can determine if an issue has arisen that should be treated.
Protecting primary teeth from tooth decay is another high priority. There’s a temptation to discount the damage decay may do to these teeth because “they’re going to be lost anyway.” But besides their functional role, primary teeth also help guide the developing permanent teeth to erupt in the right position. Losing a primary tooth prematurely might then cause the permanent one to come in misaligned. Preventing tooth decay with daily oral hygiene and regular office visits and cleanings (with possible sealant protection) is a priority. And should decay occur, it’s equally important to preserve the tooth for as long as possible for the sake of the succeeding tooth.
Your child’s rapid dental development is part of their journey into adulthood. Keeping a watchful eye on the process and practicing good dental care will ensure this part of the journey is uneventful.
If you would like more information on the process of dental development 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 “Dentistry & Oral Health for Children.”
Witnessing or being involved in a sports-related dental injury can be a scary event not only for the player, but also for onlookers even if the injuries turn out to be minor. However, knowing what to do — and more importantly — how quickly to react can make a radical difference to the outcome. This is just one reason why we want to share the following easy-to-remember guidelines for what, how and when you need to respond to various types of dental injuries.
There are several ways you can learn more about sports-related dental injuries.
As a parent, the task of guiding your children through their physical, mental and social development can sometimes seem overwhelming. That doesn’t have to be the case with their dental development — that’s because we’re one of your most reliable support partners for oral health. We’re available not only to treat problems as they arise, but to also offer expertise and resources that can help you help your children establish life-long oral health.
Here are just a few ways we can help guide you along the path to a brighter dental future for your children:
Age One Dental Visit. A healthy life is built on healthy habits — and there’s no better habit for great dental health than regular checkups. We recommend your child’s first visit with us around their first birthday. Beginning this early not only helps us identify any emerging dental problems, it can also help the child — and you — become more comfortable with visiting the dentist. As they grow older they’ll think nothing of their regular visits in the dentist’s chair.
Help! While your child’s first teeth coming in are exciting milestones, the teething process can be extremely frustrating. And, when those same primary teeth give way to their permanent versions, you’ll develop a new set of concerns about their development. By establishing a long-term trust relationship with us, we can offer a wealth of knowledge and tips (as well as needed reassurance) concerning the various stages of your child’s dental development.
“Do as I Do.” Dental visits are important — but the greatest contribution to long-term dental care is a daily habit of proper brushing and flossing, which should start as soon as your child’s first teeth begin to appear. “Modeling” is the best approach for instilling this habit in your child — performing hygiene tasks together and allowing them to learn how to do it from you. To be sure you’re passing on the proper technique, we’ll be glad to provide you with instruction on brushing and flossing — for your sake as well as theirs.
Although rewarding, raising a child is a tough job. When it comes to their oral health, though, we can help make that job a little easier.
If you would like more information on building the right foundation for your child's dental health, 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 “Dentistry & Oral Health for Children.”
Considering all the intensive conditioning, practice and training they do, most people would expect elite athletes to be… well… healthy. And that’s generally true — except when it comes to their oral health. A major study of Olympic contenders in the 2012 London games showed that the oral health of athletes is far worse than that of the general population.
Or to put it more succinctly: “They have bodies of Adonis and a garbage mouth.”
That comment, from Dr. Paul Piccininni, a practicing dentist and member of the International Olympic Committee’s medical commission, sums up the study’s findings. In terms of the numbers, the report estimates that about one in five athletes fared worse in competition because of poor oral health, and almost half had not seen a dentist in the past year. It also found that 55 percent had cavities, 45 percent suffered from dental erosion (excessive tooth wear), and about 15 percent had moderate to severe periodontal (gum) disease.
Yet, according to Professor Ian Needleman of University College, London, lead author of the study, “Oral health could be an easy win for athletes, as the oral conditions that can affect performance are all easily preventable.”
Many of the factors that had a negative impact on the athletes are the same ones that can degrade your own oral health. A follow-up paper recently published in the British Journal of Sports Medicine identified several of these issues. One is a poor diet: The consumption of excessive carbohydrates and acidic foods and beverages (including sports drinks) can cause tooth decay and erosion of the protective enamel. Another is dehydration: Not drinking enough water can reduce the flow of healthy saliva, which can add to the damage caused by carbohydrates and acids. The effects of eating disorders (which are more commonly seen in certain sports, such as gymnastics) can also dramatically worsen an individual’s oral health.
Sound familiar? Maybe it’s because this brings up some issues that dentists have been talking about all along. While we don’t mean to nag, this study does point out that even world-class competitors have room for improvement with their oral hygiene. How about you? Whether you’re a triathlete in training, a weekend warrior or an armchair aficionado, good oral health can have a major effect on your well-being.
If you have additional questions about oral health, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Tooth decay is a primary cause of tooth damage and loss, with annual treatment costs in the billions of dollars. It arises mainly from oral bacteria, which proliferates in the absence of effective oral hygiene. There are, however, other risk factors besides poor hygiene that could make you more susceptible to this disease.
Many people, for example, have genetically inherited deeper grooves (fissures) and depressions (pits) than the average tooth anatomy. These may be harder to reach with a toothbrush and can become havens for bacterial plaque. Others may have health conditions that indirectly affect the mouth: bulimia or anorexia, psychological conditions that involve self-induced vomiting, or GERD, gastro-esophageal reflux disease, in which stomach acid could regurgitate into the mouth. These conditions could result in a highly acidic mouth environment.
Some medical and — ironically — dental treatments could also increase your tooth decay risk. Some medications can reduce saliva flow, which inhibits acid neutralization and re-mineralization of enamel. Retainers, braces, bite guards or other dental appliances may also reduce the saliva wash over teeth, and can make brushing and flossing more difficult.
There are also risk factors that result from our lifestyle choices. Eating a lot of foods rich in sugars and other carbohydrates, for example, or acidic beverages like soda, energy or sports drinks contributes to the rise of bacteria in our mouths.
There are ways to reduce the effects of these risk factors. In addition to a daily habit of effective brushing and flossing, you should also include semi-annual cleanings and checkups at our office a part of your routine. If you have genetic, medical or dental issues that are out of your control, we can discuss solutions, such as alternatives to medications or different techniques for cleaning around dental appliances. For lifestyle-related factors, you should consider removing the habit or modifying it: for example, snacking at specific times or drinking acidic beverages only at mealtime.
While tooth decay is a serious, destructive disease, it is highly preventable. Addressing all your risk factors, not just hygiene, will reduce your chances of having it.
If you would like more information on tooth decay prevention, 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 “Tooth Decay: How to Assess Your Risk.”
Being “in the pink” is a good thing; it means you're healthy. Being “in the red” is not so good; it means your health is questionable (financially, anyway). Though they weren't coined for dentistry per se, these colorful expressions are helpful reminders when it comes to taking care of your gums: Pink is their natural, healthy color; that's what you want to see every time you look in the mirror. Red is generally a warning that something's amiss.
If your gums, or “gingiva,” appear slightly swollen and reddened at the margins and/or they bleed when lightly prodded by brushing or flossing, it's likely that you have gingivitis. This is an immune response to the buildup of bacterial plaque (biofilm) at your gum line. It is also an early red flag for periodontal disease (peri – around, odont – tooth), a degenerative process that affects not only the gums, but the periodontal ligament that attaches each tooth in its bony socket, and the underlying supporting bone.
Attentive home dental hygiene practices prevent most plaque buildup from occurring. Brushing correctly at the gum line is a good start. But even a deftly handled brush can't reach everywhere, so it's important to use dental floss or specially designed mini-brushes to get in between teeth and other hard-to-reach areas. Our office can instruct you on optimal home care techniques. We also encourage you to visit at regular intervals for professional cleanings so you are assured of addressing anything home care might miss.
In the absence of good oral hygiene, dental plaque can build and become increasingly difficult to remove as it calcifies, becoming tartar. It becomes a breeding ground for disease-causing microbes that normally wouldn't have the chance to gain a foothold. When caught early, gingivitis can be treated before any harm is done. Sometimes a thorough professional cleaning is sufficient. If the problem is ignored, however, the disease will most certainly progress to destruction of the surrounding, supporting tissues — the periodontal ligament and the underlying bone. If this happens, tooth loss could eventually result.
That said, there can be other causes for bleeding gums. These include:
Whatever the reason, red is not normal when it comes to your gums. The sooner you discover the underlying reason(s) for inflammation or bleeding and take appropriate action, you and your smile will be back in the pink and you'll have no reason to be blue!
If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”
There are dozens of brands of mouthwashes and rinses on drugstore shelves that American consumers buy each year for clean breath and oral health. But the question is do they really work?
To properly answer that, you should first know that mouth rinses fall into two general categories: cosmetic and therapeutic. A cosmetic rinse can give you a temporary “clean” feeling in the mouth (usually masking bad breath with a more pleasant smell) but in the long run doesn't contribute to better oral health. On the other hand, therapeutic rinses do enhance oral health; they contain one or more ingredients that can help prevent the development of tooth decay and/or inhibit bacterial growth.
Although some therapeutic rinses are prescribed by dentists, many are available over-the-counter (OTC). Decay-fighting rinses usually contain sodium fluoride, which has been amply demonstrated to strengthen the surface of teeth and thus inhibit tooth decay and the likelihood of new cavity development — but only when used in combination with good hygiene practices. Anti-bacterial rinses contain ingredients such as triclosan, zinc or essential oils like menthol that reduce the level of bacteria in plaque (when also coupled with good oral hygiene). This also helps reduce the growth of decay.
For some patients a prescription rinse may be in order, especially during recuperation from oral surgery or where normal plaque control is difficult. The most common rinse contains chlorhexidine, a chemical that prevents bacteria from sticking to the teeth. The effectiveness of chlorhexidine, especially in helping to control gingivitis (inflammation of the gums) and preventing tooth decay, is well-documented after many years of research and use. While it may cause teeth staining in some patients, the staining can be alleviated by ultrasonic scaling or polishing.
So then, should you incorporate a mouth rinse into your daily hygiene regimen, and if so, what kind? That will depend on your own individual oral health needs, which we can advise you on. Knowing what your own needs are and the different kinds of mouth rinses and what they are designed to do, you can make an informed choice.
If you would like more information on the use of mouthwashes or rinses, 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 “Mouthrinses.”
Tooth decay (dental caries) is one of the world’s most common infectious diseases. Left untreated, it can lead to tooth loss. The best treatment strategy, of course, is to prevent it from occurring in the first place with a long-term approach that begins in early childhood and continues throughout our lifetime.
Here are some basic components for just such a prevention strategy.
Know your risk. We each don’t share the same level of risk for tooth decay, so it’s important to come to terms with any factors that raise your personal risk for the disease — your dental history, inadequate oral hygiene, absence of fluoride use, and lifestyle habits like smoking. Coming to terms with these and other factors — and altering those you can change — can lower your risk.
Reduce acid-producing bacteria in your mouth. Tooth decay usually arises from elevated acidic levels in the mouth caused by certain strains of oral bacteria. You can reduce these bacteria by removing plaque, a thin film of food particles that collect on tooth surfaces, with daily oral hygiene and regular cleanings in our office. In some cases, we may also recommend antibacterial mouthrinses like chlorhexidine to further lower the bacterial population.
Apply protective measures to teeth. Fluoride, a naturally occurring chemical, has been proven effective in strengthening tooth enamel and reducing tooth decay. In addition to fluoride found in many oral hygiene products and public water systems, children can also benefit from a direct application of fluoride to the enamel surface just after the teeth have erupted in the mouth. Many clinical studies have shown 99% cavity free results in over a thousand teeth receiving a fluoride application with sealants.
Control your diet. Bacteria ferment leftover sugars and other carbohydrates in the mouth; this creates acid, which can soften tooth enamel and lead to decay. You can limit this effect by eating more fresh fruits and vegetables and reducing your consumption of refined sugar. You should also limit between meal snacking — constant snacking prevents saliva, the mouth’s natural acid neutralizer, from effectively restoring the mouth’s pH balance.
A prevention strategy for tooth decay will help you avoid unnecessary pain and problems — physically and financially. You’ll also reap the rewards that come from a lifetime of good dental health.
If you would like more information on preventing tooth decay, 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 “Tooth Decay.”