Yesterday I discussed how new x-ray technology will make implant placement in our office more streamlined, today I want to talk about the latest in CEREC technology.

Cerec is the technology that allows us to make beautiful strong crowns by means of CAD CAM  in our office in a single appointment. (See previous blogs under New Technologies).  Currently we are using the strongest porcelain available for the technology call “e-max”.  These ceramic crowns are made by the cerec machine in a “blue” chalk-like state and then crystallized (baked in our porcelain oven much like a potter bakes his pottery in a kiln), yielding high strength and beautifully glazed crowns.  This crystallization requires an additional 40 minutes of appointment time, including the staining, glazing, baking and cooling of the restoration.  (Our patients get to relax, read, work on our WIFI network or go shopping during this time.)

Now however, there is a newer material designed to meet almost the same strength characteristics of e-max without the necessary baking in the porcelain oven.  This material called “Lava Ultimate” is made with a composite resin base with ceramic filler with a high resistance to fracture.  While this material cannot be as effectively customized for maximum aesthetics (as can be achieved with the e-max) it is milled faster and requires no baking time. As such, it is best used in areas of the mouth where aesthetics are less important such as on the back molars.

While Lava Ultimate may not meet every need, it is nice to have an alternative to the additional 40 minutes required by e-max with very little compromise in strength. This material is available immediate now in our office.

As this year comes to a close, I have chosen to reflect on what the upcoming year will bring to our practice.  One of the first items that comes to mind is the approved legislation by our provincial government and licensing body; the Royal College of Dental Surgeons, that will shortly allow qualified dentists in the province of Ontario to have Cone Beam Scanning machines in our offices.  Currently, these low dose 3D X-ray machines are only allowed in the offices of licensed Radiologists, making access this technology very difficult.  Cone Beam 3D scanning produces images similar to those of a CAT scan but with a small fraction of the radiation exposure that patients in a hospital CT machine receive. These scans are crucial to the planning and placement of dental implants in areas of the mouth where the presence of sufficient bone may be in doubt or areas where an implant might impinge on a nerve or penetrate a sinus. By reading these scans on specialized software, the dentist placing the implants is able to “see” with an almost “x-ray vision” in side the jawbones and avoid complications such as these.

In anticipation of the new regulations allowing these machines in non radiologist offices, I have already achieved the necessary educational requirements by successfully completing a univerisity level course mandated by our government and look forward to the final passing of the legislation within the next few months along with the purchasing and installation of this equipment in our office.

What this means for our patients is that they will easily be able to get the scan in our office without having to travel to a different location or wait for an appointment to determine if they are candidates for implants.   This will be extremely convenient for our patients.

Tune in for more thoughts on new technology expected in the New Year in a few days

This is the time of year when people tend to look back and assess the year that has been and start to think about the coming year and what that might hold in store.  So here is just an overview of where our practice has been in 2011 and where we plan to be in 2012.

In January we introduced the “Oravital” Periodontal System into our practice in order to help patients in the treatment of chronic bad breath and periodontal disease.  This step by step program of identifying the underlying  bacteria causing the problems and then treating this with a series of oral rinses has had a great impact on people whose lives have been hampered by living with bad breath and chronic oral infections.

In February Dr. Waldman traveled to Brazil to study the fine art of tooth bonding with the world renowned Dr. Newton Fahl .  She came back with new and exciting techniques that enable her to resurface and build up front teeth in a conservative manner, with esthetic results that rival those of porcelain, without the associated lab fees that come with porcelain work.

March saw Dr. Waldman receive her mentorship certification for the Kois Center; a world renown institute of higher learning for practising dentists. This elite program teaches other dentists the most successful, newest and advanced techniques for restoring and maintaining patients oral health. The mentorship certification allows Dr. Waldman to assist with the teaching program at the institute.

In April, Dr. Waldman was appointed to the advisory board of the Toronto Implant Institute, an organization committed to the continuing education of dentists in the field of Oral Implantology.

Dr. Liaghati provided facial cosmetic services in our office to patients interested in taking years off their appearance.  She has great skill in the use of Botox, Juvederm and other cosmetic fillers and the results and level of satisfaction has been terrific.

In June we welcomed Dr. Morris as associate dentist in our office.  With a great education at U of T, internship at Harvard Women’s College and several years of experience behind her, Dr. Morris is a great addition to our practice seeing new and existing patients.

We recently renovated our sterilization area.  Dr. Waldman is committed to staying in front of the curve not just for dental techniques, products and skills but also when it comes to the health and safety of patients and staff.  Our new sterilizer is state of the art and allows us to meet and exceed all government standards and regulations in a faster and more efficient manner to meet the demands of our growing practice.

Our hopes and dreams for 2012 is to continue to strive to better serve our patients with the best dental care available, to see continued growth in the practice and to maintain that wonderful but elusive balance between work, family, fitness and well-being.

To everyone we wish you the very best through the holiday season and a New Year of health, prosperity and happiness.

If the tooth is severely discolored or broken down, full porcelain coverage has been the standard method of treatment in the past both for the esthetic and strength characteristics.  Functionally, ceramic porcelain crowns have a proven track record as well.

Composite resins, or bonding, have also been used for decades for conservatively restoring minor, moderate and even large defects. . This form of restoration preserves more of the tooth structure and with the newest materials, and time taken by the dentist; the final esthetic result can rival that of porcelain veneers.

As is the case with most dental procedures a comprehensive exam and discussion with your dentist is the key to understanding what the best option is for your particular situation. 

Hockey, school sports, skiing, skating, basketball, football, gymnastics, soccer, rugby, whatever activity you or your kids are enjoying, you can help keep smiles safe by wearing custom fitted mouth guards. Health Canada, the Canadian Dental Association and the Canadian Academy of Sports Medicine recommend that anyone participating in a sport with a high risk of contact with other players or hard surfaces wear a mouth guard.A properly fitted mouth guard can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft tissues of the mouth.Pressure-laminated mouth guards can play a role in preventing concussions. When the upper and lower teeth slam together, the force of the impact is transmitted to the brain which can cause a concussion. A custom fitted mouth guard provides  a resilient, protective surface which can help distribute and disperse the impact reducing the chance of concussion. Mouth guards are affordable, comfortable to wear, can be worn over braces and can be customized to color coordinate with your favorite logo.  So go on, play hard, play safe, play smart.

Bite Problems

Do you suffer from frequent headaches, jaw pain, difficulty chewing, loose teeth or worn down teeth?

If you answered yes to any of these questions than you; could be suffering from a condition known as Temporomandibular Dysfunction or TMD. 

Occlusion describes how our teeth fit together, how we bite and chew, and the pressure we put on our jaw joints and muscles.  If you have a malocclusion (bad bite), it can lead to all sorts of problems as well as a lot of unnecessary pain and suffering. 

A simple exam by a well-informed dentist can identify your specific problem and then take steps to correct it.  Often a simple removable appliance can help to diagnose the problem and the treatment could be as easy as a simple bite adjustment.  The key to resolving the problem is the correct diagnosis.

Don’t suffer in silence; there is help out there for you.

Dr. Carol Waldman