A: Yes.

Both regular and digital x-rays use the same type of radiation.  With repeated high dose exposures over a short period of time, this radiation dose does have the potential to be harmful.  This is why strict regulations are in place to ensure the amount of radiation being used is within the limits of what your body can absorb and dissipate without any negative side effects.

The main difference between digital and conventional x-rays is the amount of radiation required to get a similar quality image.  With direct digital x-rays the amount of radiation can be reduced by up to 90% depending on the type of x-ray taken and which type of conventional film it is being compared to.

With that said, digital x-rays are safer than conventional x-rays when used properly, but both are safe when used properly.

Although our equipment employs the latest in technology to minimize the amount of radiation required to take a high quality x-ray, there is still unwanted radiation scattered away from the intended target. Although these amounts are significantly low, and well below the levels required to do damage, it is still better to be safe than careless. Additionally, with repeated exposures these low levels can build up as it takes a while for the body to dissipate the absorbed radiation. For the patient who has a couple of x-rays taken this is not of concern as it is usually months between x-rays. However, for the dental staff, we leave the room while taking x-rays as we take many of these each day.

The American Dental Association has put forth a list of standards for when to take various types of x-rays. The Canadian Dental Association has since adopted these standards as well. According to these standards panoramic x-rays should be taken roughly every 5-6 years, and more frequently in cases where abnormalities are found. The first of these panoramic x-rays are done at approximately ages 6, 12 and 18. These are critical stages of tooth and jaw development and a panoramic x-ray can help to assess for early interceptive orthodontics (age 6), orthodontic treatment (age 12), and for wisdom tooth assessment/extractions (age 18). After these, a panoramic x-ray is done every 5-6 years to monitor bone level (assessing for gum disease), as well as monitoring for any potential developments of cysts or growths that should not be there.

Individual x-rays only show portions of the teeth and jaw. To show all the teeth it often takes up to 18 individual x-rays (our digital panoramic machine uses the same radiation as approximately 2 conventional x-rays, and costs less than 18 individual x-rays). This many x-rays show the teeth and bone level around the teeth fairly well, but can be hard to see the complete picture as it is like putting together a puzzle where the pieces don’t quite fit together properly, and some are missing. Additionally, these x-rays do not show the entire jaw, the joints for the jaw, or a complete picture of the sinus cavities. These areas are susceptible to various defects and abnormalities that will not show up on individual x-rays, and yet can be of extreme importance to know about. The bottom jaw bone is also a common place for metastatic cancer (cancer that has spread from another area). Without Panoramic x-rays, these will often be missed, which can have serious implications on appropriate treatment and timing.

You can view some of these abnormal findings on our x-ray pathology page to learn more.

The general recommendation put forth by the various dental associations is 6 months after the first teeth have come in. More practically many dentists will say age 3.

The main benefit for the earlier check up is primarily education of the parent on how to take care of your child’s teeth to prevent decay. This visit will also include a quick check of the child’s teeth to ensure decay has not already begun.

The later visits starting at age 3 will involve a more detailed exam and possibly a cleaning and x-rays. At this age most children are more cooperative and have a greater understanding of what is going on.

At our office we encourage parents to ask questions at any time. At the time of their own cleaning, parents can bring in their children under 3 for a free first time exam (just let us know so we can book extra time for your visit). For patients who are expecting their first child we will also provide them with information on how to take care of their child’s teeth.

To summarize, if you have any questions about how to take care of your child’s teeth, don’t hesitate, contact us. Sometimes these questions can be answered over the phone or via email. Other times a visit will be recommended. By age 3 your children should be on a regular recall program. Check out the next FAQ to see why.

Children’s teeth are more fragile than adult teeth and decay can progress more quickly (this is explained more in the next FAQ). Their teeth and jaws also undergo more rapid changes than in adults and require frequent monitoring to help ensure healthy teeth and proper function for when the child becomes an adult.

The other advantage for regular visits with children is to establish a “no fear” environment for them. With regular a-traumatic visits the child becomes more at ease with the dental office. This also provides us with opportunities to introduce the various instruments that would be used later if work was ever needed for the child, making that visit easier for the child.

There are multiple aspects to the answer for this question and the answer will vary from person to person. Oral hygiene, diet, and tooth anatomy are the main factors in determining cause of decay.

Many children will not have adequate manual dexterity to thoroughly clean their teeth until age 12. Unfortunately many children are left to brush their own teeth at age 2. This is something that needs to be monitored closely by parents to ensure the teeth are being adequately cleaned. A good routine is to let the child start with brushing and for the parent to finish. Once the child consistently cleans their teeth effectively, the task can be passed on to the child, but occasional monitoring should still occur.

Brushing frequency is also a factor. Brushing should occur at night before bed (no snacks or drinks other than water after this) and after breakfast in the mornings. If an extra brushing can be done after lunch, all the better.

A lack of flossing is another frequent cause for decay. By age 2 most kids will have all their baby teeth in. When the last of these teeth come in the spaces between the back teeth often closes fairly quickly. This results in a food trap that brushing alone cannot take care of. Flossing every night before brushing will help to remove the food and bacteria trapped between these teeth and reduce the risk of decay in these areas. It is also important to floss between the other teeth as well, with the focus being on the places where the teeth are touching.

Tooth anatomy impacts decay rate in a couple ways. The thickness of the outer layer of children’s teeth is a lot thinner than in adults. The inner layer is also more porous. This results in decay progressing more easily and potentially a lot quicker in children’s teeth than in adults. Additionally, many children will have deep grooves and pits in their teeth that trap food and are more prone to decay. In some cases these grooves will be sealed off by the dentist with small fillings or sealants to help prevent decay.

Diet is a huge determinate of decay which takes advantage of any and all of the above-mentioned factors. Eating foods that contain lots of sugars and acids will increase potential for decay. Soft sticky foods will also get stuck to the teeth more readily and provide a longer lasting effect. To help avoid cavities caused by diet, stick to more natural, less processed foods, in particular, ones that are harder and not sticky. Primary drinks should be milk and water. Pop and juice are very acidic and contain lots of sugars, which results in these drinks being prime sources for cavities.

Kids often have snacks throughout the day. It is very important to pick healthy snacks that won't get stuck in the teeth. Thinks like chips and fruit snacks (especially gummy candies) should be avoided and only provided as treat when tooth brushing can occur afterwards. The best snacks are cheddar cheese, carrots, and other vegetables. Cheddar cheese helps prevent cavities and things like carrots act like natural tooth brushes to help clean the teeth and contain very little for cavity causing bacteria to feed on.

As diets can be varied due to ethnicity, various life choices, etc. it is hard to go into all scenarios here. If you or your children are getting cavities, and you are following proper oral hygiene routines, you will likely need a dietary assessment done to determine the source of the problem in order to help turn things around. If you think this might be of benefit to you, contact us to set up a consult so we can work together to make a change for the better.

Pediatric dentists have extra schooling to help them deal with children that require "extra attention". Their training includes being able to do work on a child who is under general anaesthetic (put to sleep). Their practices are limited to only working on children under 18, and due to their extra training, they do use a fee guide higher than those of a general dentist (in general 30% higher than a general dentist). 

Many general dentists see children and are very good at it, even with the ones who require extra attention. Other general dentists prefer not to see children at all. If you are not sure who your child should see, check with your general dentist. If they are not comfortable seeing your child, they can recommend a pediatric dentist in your area.

In case you are asking, I do see kids and I also teach part time in the Pediatric Department in the Faculty of Dentistry at the University of Manitoba. It is very rare I ever have to refer a child to a pediatric dentist, and when I do, it is often to have the initial work done and I take over from there.

For some patients being sedated with pills, nitrous oxide, or even being put to sleep is preferred. At our office, pre-appointment sedation with pills can be provided in some cases but is not the treatment method of choice. If other forms of sedation are required, the treatment would need to be performed by another dentist in another office.

At our office we focus on other methods to help the patient relax for their appointments. The main rational for this is sedation does not improve a patient’s comfort level with the procedures and do have various adverse side effects on the body. Our goal is to improve the patient’s comfort level so other forms of sedation are not required. This is primarily done by helping the patient understand what is being done, and by providing a relaxing atmosphere for the patient. In some cases letting the patient come in for multiple visits with minimal (or no) work prior to larger procedures is all it takes to build their comfort level.

It is not uncommon for fearful patients to come for their first visit at my office terrified. And then, after a few visits, start to relax and have an easier time coming to the office. Although it is true the memories at the heart of the fears will never fully go away, and I can not promise you will enjoy having dental work done, I can promise that if you let us work with you, we can help to reduce the anxiety associated with your dental visits. So, if your fear of dentists and dental treatment are stopping you from seeing the dentist, contact us to see what we can do to help you overcome your fears.

Unfortunately nothing in dentistry lasts forever. Although crowns are very durable restorations and have the potential to last a long time, their average life span is only 8-10 years. With that said, I have seen crowns last only a couple of months and I have also seen crowns that are over 30 years old and still look as good as new.

What affects the longevity of the crown is determined by multiple factors, including the condition of the tooth being crowned, the amount and type of forces the tooth will be receiving once crowned, and how well the crown is maintained. Teeth that are in better shape, receive minimal forces, and are easy to keep clean will last a lot longer than a tooth that has been heavily restored multiple times, takes all the chewing forces, and is hard to clean.

Factors affecting the condition of the tooth:

• Root Canal Treatment: Teeth that have had root canal treatments done on them dry out and become brittle. This makes them more prone to cracking and breaking. Although crowns do a much better job at preventing the tooth from breaking than a standard filling, it is still possible for the tooth to break. Often teeth that have had root canal treatment also have a post in them due to the extent of tooth loose from previous cavities. These posts help provide support for the crown, but also increase the stress in the roots of the tooth which can result in a crack and future tooth loss.
• Remaining tooth structure: Primarily, teeth are crowned because the damage to the tooth has extended beyond what a filling can effectively restore with a good long term prognosis. Unfortunately this usually means there is not a lot of good solid tooth structure for the crown to grab hold of, and this can decrease the live span of the crown. This why dentists will often be more proactive and recommend crowns on teeth that are not having any troubles. If the crown is done before a tooth breaks, or before the filling covers all surfaces of the tooth, the crown can last longer.

Factors affecting forces:

• Surrounding teeth: The more surrounding teeth in good condition, the better the longevity of the crown. This is achieved by spreading out the forces among multiple teeth. If the tooth is on its own, it will experience greater forces, and have less lateral support (no neighboring teeth to rest against). Additionally, as teeth are lost, the bone support shrinks away in those areas. This increases the tooth structure above bone, and greater flexing can occur. The end result is increased risk of the tooth breaking.

Factors affecting cleanliness:

• Anatomy of crown: Depending on the design of the restoration, some crowns are easier to keep clean than other. In some cases, for added support, multiple teeth may be splinted together with crowns. This makes the area between the teeth much harder to keep clean. These complex areas to keep clean will collect food and bacteria, and keep it there longer. These sites are common places for recurrent decay and crown failure. Similarly, when crowns extend deep down in between teeth, the area becomes harder to keep clean as the floss needs to be extended deeper between the teeth than normal. Also, more of a gap between the teeth forms as the crown extends deeper down the side of the tooth. This creates a larger food trap that requires extra meticulous cleaning to help prevent decay.
• Patient oral hygiene: This is probably the biggest factor behind why crowns fail. As crowns blend with tooth structure right at or below the gumline, it is very important to be very thorough with cleaning these areas. This will involve brushing at least twice a day using a proper brushing technique to ensure the bristles of the tooth brush are reaching the edges of the crown. It will also involve proper flossing at least once a day. Effective oral hygiene habits will help protect the crowned tooth from decay.

• Regular cleanings and checkups, along with fluoride treatment: These visits will help keep the crowned tooth healthy, as well as allow the dentist to monitor the restoration. If problems do start, often a simple patch can be done to significantly extend the life span of the crown. Other times, the problem can not be fixed without a new crown, but if caught earlier, the damage to the tooth can be minimized. If decay under a crown is left too long, the tooth can decay enough that the tooth may not be fixable. Sometimes this process takes years, and in other cases it can happen in as little as 6 months (depends on oral hygiene, diet, and condition of the tooth under the crown). While regular visits help provide early detection, the regular fluoride treatments can help keep the tooth strong and reduce the risk of decay. And for those who choose to avoid the use of fluoride, there are alternatives that can and should be used for those with high potential for cavities.

So if you have had a lot of dental work in the past, and it has been a while since you have seen a dentist, or if you are unsure how often you should see a dentist for checkups, contact us today and let us help guide you.

A. Yes

To keep your teeth and gums healthy, you need to brush at least twice a day (after breakfast and before bed) and floss your teeth at least once a day (primarily before bed). The use of a mouth wash, like Listerine, twice a day is also beneficial. The use of a tongue scraper can also be a good idea.

• Brushing: This removes the food and bacteria from the top and side surfaces of your teeth and the gums on the sides of your teeth. This should be done 30-60 minutes after eating. If you have been eating or drinking items which are very acidic (fruits, juices, pop, etc.), drink some water and then wait 30-60 minutes before brushing. This will give the acids in your mouth a chance to be diluted and minimize damage to your teeth when brushing.
• Flossing: This gets to the surfaces of your teeth and gums where your toothbrush can not reach. This is also a very common area to find decay on children and adults, as well as the most common site for gum disease. Flossing should be done every night after your last meal of the day, and for added effect, it can also be done after every meal. If you have trouble flossing, or if there is something keeping you from flossing regularly, please let us know at your next cleaning as there are many products out there that can make flossing easier.
• Mouth washes: The best over the counter product is Listerine as it has a lasting effect of up to 12 hours. Using Listerine twice a day will help kill off bacteria that cause gum disease and cavities. The less bacteria in your mouth, the more effective brushing and flossing will be.

• Tongue scrapers: Some people have a tongue with a lot of nooks and crannies in it which can harbor bacteria. If your tongue is not a nice even pink color, this product may be for you. These are used to gently scrape the surface of the tongue, removing bacteria and food products. As the majority of bacteria in your mouth is found on the tongue, this will have a large impact on reducing the overall amount of bacteria in your mouth.