Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B6J3
One of the top concerns in healthcare is the interactions and side effects of medications. Drugs taken for separate conditions can interact with each other or have an effect on some other aspect of health. It's important then that all your health providers know the various medications you are taking, along with other lifestyle habits. That includes your dental team.
Calcium channel blockers (CCBs) are one type of medication that can have an effect on your oral health. CCBs are used primarily to control hypertension (high blood pressure), and to treat other cardiovascular conditions like angina or abnormal heart rhythm. They work by dilating blood vessels, which makes it easier for the heart to pump.
CCBs are now recognized as a contributing factor in the development of a condition known as gingival hyperplasia in which the gum tissues “overgrow,” extending in some cases abnormally over the teeth. This abnormal growth can be painful and uncomfortable, and can make oral hygiene more difficult to perform. The overgrowth of tissue can also be socially embarrassing.
There's also a secondary factor that can increase the risk for tissue overgrowth in patients taking a CCB — poor oral hygiene. In the absence of a good hygiene routine, a layer of bacterial plaque known as biofilm can build up on tooth surfaces and lead to various forms of gum disease, including hyperplasia. The overgrown tissue contributes in turn to this disease process by inhibiting effective oral hygiene.
If you've already developed gingival hyperplasia or some other form of gum disease, it's important for you to receive periodontal treatment for the disease as soon as possible. Once we have the condition under control, it's then a matter of regular dental checkups and cleanings to reduce the risk of disease, including gingival hyperplasia. We can also help you develop effective hygiene practices that inhibit this condition while you are taking a CCB.
If you would like more information on the effects of medication on oral 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 “Blood Pressure Medications.”
That “squeaky clean” feeling on your teeth might be the most noticeable result of a professional cleaning performed by a dental hygienist. Rest assured, though, there's more to it — regular professional cleanings yield long-term benefits to your oral health.
A basic procedure known as coronal cleaning removes plaque (bacteria and leftover food deposits) on the crowns, the visible portion of the teeth. If you are showing signs or are at risk for gum disease (a bacterial infection of the gum tissue) your hygienist may also initiate cleaning below the gum line with a procedure called scaling. This common technique removes plaque and tartar (hard deposits) above and below the gum line using either a traditional set of hand instruments (known as curettes) or an ultrasonic scaler, a device that uses vibrations from ultrasonic frequencies and water to remove plaque and tartar.
Root planing takes the cleaning even deeper, using curettes to remove plaque and tartar adhering to tooth roots. This is typically necessary for patients with advanced gum disease, and may need to be repeated over a number of visits as inflammation subsides.
Polishing is another common hygienic procedure performed both above and below the gum line. It's the procedure you most associate with that feeling of smoothness after a cleaning. The hygienist will typically apply to the teeth polishing paste held in a small rubber cup attached to a motorized device. As the motor rapidly rotates the rubber cup, the paste works into the teeth to remove surface stains and bacterial plaque. While it's considered a cosmetic procedure, it's more accurately defined as a prophylaxis, a dental term derived from the Greek meaning to guard or prevent beforehand.
Professional cleaning performed by a dental hygienist is only one half of an overall hygiene plan; the other half is your own daily habit of brushing and flossing. Both your daily hygiene and regular dental checkups and cleanings will go a long way toward preserving your teeth as they were meant to be — for a lifetime.
If you would like more information on teeth polishing, 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 “Teeth Polishing.”
If you have to ask why anybody would voluntarily endure the pain of receiving a tongue piercing — then maybe you're just too old to understand. But seriously: no matter where you stand on the aesthetics of the issue, you shouldn't ignore the real health risks that go along with the installation of oral piercings.
According to the Journal of the American Dental Association, the most common sites for intraoral piercing are the tongue and the lip. In the case of the so-called “tongue bolt,” several significant short-term and long-term risks have been identified; most also apply to other types of oral piercings as well.
The tongue is primarily composed of muscle tissue, along with a rich supply of associated blood vessels and nerves. This explains why accidentally biting your tongue can be so painful — and bloody. Installing a tongue bolt involves piercing a small hole through the tongue, and attaching the ornament through the hole.
In rare instances — such as the case of a teenager who experienced severe pain and the sensation of electrical shocks — nerve irritation and damage may occur soon after a tongue bolt is installed. (Fortunately, her symptoms cleared up shortly after the bolt was removed.) More often, the symptoms are less severe, but the health issues are chronic.
Tongue bolts are known to cause problems with the teeth, including increased sensitivity and pain. Teeth are also prone to chipping due to contact with the ornament. These are among the reasons why you are likely to need more frequent dental checkups if you have an oral piercing.
Additionally, periodontal (gum) problems can develop in individuals with oral piercings. These frequently appear as gum recession, inflammation and infection. Eventually, bone loss may occur as well.
The good news: removing an oral piercing is generally easy, and the area is quick to heal. If it doesn't seal up by itself, the hole left behind can be closed with only minor surgery. And removing the piercing immediately reduces your health risk — thus instantly improving your overall oral health.
Thinking of getting — or removing — an oral piercing? Talk to us. No matter what you decide to do, you owe it to your health to become informed about the issues surrounding these body ornaments.
If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”
Ninety percent of people have noticed bleeding from their gums when they brush or floss their teeth at some time or other. You may wonder if this is a result of brushing too hard — but that's not usually the case.
If your gums don't hurt — even if they bleed easily — you may think the bleeding is normal, nothing to worry about, or you're brushing too hard.
Bleeding from your gums is not normal!
It is an early warning sign of gum disease. In fact ten percent of those who start with bleeding gums go on to develop serious periodontal disease affecting the support for the teeth leading to tooth loss.
The way you brush your teeth is indeed a factor! Bacteria that normally reside in the mouth (in fact you need them to stay healthy) collect along the gum line in a biofilm. When the biofilm is not removed effectively on a daily basis, over time the gums become inflamed and bleed when touched. Other signs of inflamed gums — gingivitis — are redness and swelling, and even recession.
SO — the problem is not that you are brushing too hard, but that you are not brushing and/or flossing effectively. Both are important.
Contact us today to schedule an appointment or to discuss your questions about bleeding gums. Bring your toothbrush and floss with you to our office and ask us to demonstrate proper oral hygiene techniques. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums: A very important warning sign of gum disease.”
Dental plaque (a film of bacteria that forms on your teeth) is known to be the main cause of periodontal (gum) disease. When the bacteria settle on your teeth they form a whitish film called biofilm. Those that are not removed cause formation of “pockets,” areas of separation between the teeth and their surrounding gums, in which plaque hardens into deposits known as calculus or tartar. The purpose of having your teeth cleaned regularly by a trained professional hygienist is to remove deposits of plaque and calculus. Removal of hard deposits on your teeth is called “scaling.” This can be done either by using hand-held scalers or by newer technology: ultrasonic power scalers.
Let's take a look at the strengths and weaknesses of both types of instruments.
How they work: These instruments use the energy of ultrasonic vibration to crush and remove hard, calcified deposits of calculus. They also create shockwaves that disrupt bacterial cells. Use of these tools includes washing and flushing the pockets and any exposed root surfaces with water.
Pros: They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. They are very effective in removing calculus from root surfaces and from within periodontal pockets. Their small tips can penetrate deeper into periodontal pockets than manual instruments and are more comfortable to experience, and they are more effective for cleaning difficult nooks and crannies. Coolant sprays flush the area and remove bacteria and their by-products. They require less time than manual instruments.
Cons: A contaminated mist may form so that the hygienist needs to wear protective equipment. The vibration of the ultrasonic instruments may make it difficult to feel if the root surface is completely smooth and free of calculus. Power scalers affect some heart pacemakers.
How they work: These depend on the skill and knowledge of the hygienist to manipulate them and scrape away calculus (tartar) from teeth and within pockets.
Pros: They are equally effective for plaque and calculus removal from shallow gum pockets. They do not interfere with electronic equipment like heart pacemakers. They can be used more easily on teeth in which there are areas of demineralization (areas where minerals have been removed from the tooth's enamel, making it more vulnerable to decay). They are easier on the tooth's surface and are thus better for use with porcelain or composite restoration, or sensitive teeth.
Cons: They take longer to complete a cleaning. Sometimes they cause more discomfort than ultrasonic scalers.
In most cases the choice of scalers is not really an either/or situation. Most experts say that the best results come through using both types of instruments. As a result, cleanings can be done with effective and efficient outcomes and greater patient comfort.
Contact us today to schedule an appointment to discuss your questions about dental cleanings. You can also learn more by reading the Dear Doctor magazine article, “Dental Cleanings Using Ultrasonic Scalers.”
Root planing is a procedure that allows us to achieve your — and our — basic goal in dentistry: healthy, clean gums and teeth.
At a level in between scaling by your hygienist and periodontal (from peri, around and odont, tooth) surgery, root planing is a conservative treatment that attempts to eliminate the need for gum surgery.
Plaque is a film of bacteria (a biofilm) that adheres to your teeth at the gumline. This is what you try to remove with daily brushing and flossing. Plaque that is not removed can form a hard coating called calculus or tartar. These substances irritate your gums and cause inflammation, which in turn causes your gum tissues to lose their attachment to your teeth. The resulting gaps between the teeth and gums are called pockets, and they act just like pockets in your clothing.
Your teeth are fastened in your jaws by a combination of bone and soft tissue including the gums and the periodontal ligament, tissues that holds each tooth in place. When pockets form and bacteria move into them, the bacteria and the toxins they emit can become ingrained into the surface of the roots of your teeth (the bottom parts that are below the gumline) and cause further inflammation and infection. This can lead to loss of attachment of the gum tissues and bone that anchor your teeth. In the worst cases you can lose the teeth.
1. The first level of defense is your own daily brushing and flossing. Ask us to check your technique to make sure you are effectively removing plaque.
2. Second, your dental hygienist can remove superficial collections of calculus by scaling, using hand tools or a sonic scaler.
3. Third, root planing actually planes the surface of the roots of your teeth, in the same way as a carpenter planes a piece of wood. It removes calculus, bacteria and toxins ingrained into the root surfaces so that the infected gum tissues can heal.
Root planing is usually done using local anesthesia to numb the teeth and surrounding soft tissues. The planing may be done first with an ultrasonic device that cleans by vibrating particles off the root surfaces and simultaneously flushes the pockets with water. The root planing is finished with delicate hand instruments called curettes. The area may then be flushed with antibacterial medication to fight infection.
The response to root planing is usually evaluated three to four weeks later. The gum tissues are checked for healing, and probing measurements of the pockets are retaken. Depending on the results, additional root planing may be needed.
4. Finally, in cases of the worst periodontal infections, you may need periodontal surgery. Each person's situation is unique and should be based on an examination and evaluation.
If you have ever had tooth decay, you should know:
Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay – The World's Oldest & Most Widespread Disease.”
Oral cancer accounts for approximately 3% of cancers in men and 2% in women. That may not sound like a lot, but the disease often isn't detected until it has progressed to its later stages when it's harder to treat and the outlook for survival is significantly diminished.
The main areas where oral carcinomas (cancers) occur are:
Even if you can't change these risks, awareness helps raise your vigilance in order to catch potential problems early when treatment options and positive outcomes are greatest.
One way you can address these risk factors is to have a diet rich in fruits/vegetables, which are high in antioxidants because they been found to have a protective effect against a variety of cancers, including oral.
As part of your routine oral hygiene, you should be closely monitoring any non-healing changes in your mouth (e.g., ulcers or sores, white or red patches on the tongue). And rest assured that as part of your regular check-ups, our office performs a comprehensive visual screening for signs of oral cancer.
If you would like more information about oral cancer prevention and detection, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”