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Tooth Sensitivity 101

Your dentist needs to know if your teeth are sensitive because the causes can include:
• tooth decay or damage
• gum disease and recession
• tooth grinding

Think having sensitive teeth is just an inconvenience? Think again. When ice cream or frosty drinks come with an “ouch” factor, it’s time to tell your dentist. “Tooth sensitivity may be an initial marker for something more serious,” explains Dr. Harry Höediono, Past President of the Ontario Dental Association and a dentist in Kitchener, Ont. Tooth sensitivity occurs when the protective enamel on the tooth is damaged or when receding gums or periodontal disease exposes the dentin at the roots.

Explains Dr. Höediono: “Dentin is the Tooth sensitivity is a pain and your dentist needs to know about it material that makes up the part of the tooth below the gums, the tooth root, and is found under the tooth’s enamel layer. It is a much softer material than enamel and contains tubules, tiny tubes that connect to the tooth’s pulp or nerve chamber. When this material is exposed to the air, cold, acidic drinks or infected with decay, the tooth may exhibit signs of discomfort.”

Once you’ve spoken with your dentist and the major causes have been treated and/or eliminated (see “Tooth Sensitivity 101”), there are several ways to relieve the discomfort. Brushing regularly with a desensitizing toothpaste helps because it contains ingredients that seal the tubules in the dentin, says Dr. Gillian Soskin, a dentist at London Health Sciences Centre in London, Ont. “It’s like putting a sweater on the tooth and insulating it,” she explains. (Please visit the Canadian Dental Association’s website — — and look on the CDA Seal of Recognition page for a list of recommended desensitizing products.) Using a fluoride rinse or gel may help to harden the enamel, protecting the teeth. Depending on their strength, these rinses or gels are available with or without a prescription. Talk to your dentist about whether this option is suitable for you—and how frequently it should be used.

Another option available that your dentist may recommend is a fluoride varnish, a thick paste with a high concentration of fluoride that’s applied to sensitive teeth every two or three months.

Bonding is a more permanent fix where an insulating layer of tooth-coloured composite resin is applied to exposed, sensitive roots. According to Dr. Höediono, this can provide long-lasting protection from tooth sensitivity provided you use a soft toothbrush, warm water and gentle brushing.

If grinding your teeth at night has caused tooth enamel to wear away, your dentist might suggest making you a close-fitting, thermoplastic nightguard to protect your teeth while you sleep.

Fighting the “Ouch Factor”

Here’s how to help prevent tooth sensitivity:

  • Keep your teeth clean: plaque contains bacteria that irritates your gums and may lead to gum recession.
  • Use a desensitizing toothpaste and fluoridated dental products.
  • Use a toothbrush that won’t scratch tooth enamel or wear away gum tissue and brush gently using a circular motion.
  • Use warm water when brushing your teeth to soften your toothbrush’s bristles.
  • Reduce your intake of acidic foods and sugary snacks and drinks.

You should always tell your dentist if your teeth are sensitive to hot, cold or sweet, but Dr. Höediono says you should call your dentist at once if you experience any of these symptoms:

  • Your teeth are also sensitive to pressure.
  • Your tooth sensitivity doesn’t decrease after using a desensitizing toothpaste for a few weeks.
  • The pain from tooth sensitivity lasts longer than one hour.
  • The gums around your sensitive teeth appear to be changing colour.


Does your bed partner complain about your snoring? Are you unusually sleepy during the day and don’t know why? These are two of the most common symptoms of obstructive sleep apnea (OSA), a sleep related breathing disorder that can cause you to stop breathing dozens or even hundreds of times each night.1 According to The Canadian Lung Association, these breathing episodes usually last for 10 to 30 seconds not long enough to fully wake you up but enough to prevent you from enjoying the restful sleep your body needs to recharge its batteries and stay healthy.

A Canadian Community Health Survey conducted in 2009 by the Public Health Agency of Canada found that an estimated 858,900 Canadian adults, 18 years and older, reported being told by a health professional that they have sleep apnea.2 breathe properly all night.

“Only a physician can diagnose obstructive sleep apnea,” says Dr. Deborah Saunders, a dentist practising in Sudbury, Ont. Dentists do not diagnose OSA.

However, a dentist may see patients who they suspect may be at risk and will refer them to their family physicians for further diagnostic followup.

As they do with discussing tobacco intervention or oral cancer with patients, dentists have advantages over other health-care professionals in identifying patients at risk of OSA, because dentists generally see their patients on a more frequent and consistent basis. As well, because the jaws and related structures may influence OSA, dentists play an important role in identifying patients who should be assessed [by a physician] and helping to institute treatment in selected

Treatment options

The most effective treatment for mild or moderate sleep apnea, says The Canadian Lung Association, is continuous positive airway pressure (CPAP). With CPAP you wear a special mask attached to a CPAP machine. A steady stream of air is blown though the mask, into your nose and down your throat. The pressure helps keep your airways open so you can lifestyle changes such as losing weight, avoiding alcohol and sedatives and sleeping on your side, not your back.

Your doctor may also recommend that you use a dental (or an oral appliance) that fits over your teeth and prevents your tongue and jaw from blocking your airway. In comparison to CPAP devices, these appliances are sometimes regarded as a convenient, silent and more bed partner-friendly choice, says Dr. Alan Lowe, Professor and Chair of the Division of Orthodontics, University of British Columbia’s Faculty of Dentistry.

There are more than 80 different oral appliances currently available.6 These should only be prescribed by your family physician, who may refer you directly to your dentist, says Dr. Saunders.

A cautionary note from Dr. Saunders:

Some patients who have been diagnosed with sleep apnea may be curious about ordering prefabricated devices over the Internet. “Think twice,” she says. “You may end up with jaw pain or other problems. That could be significant and serious.”

For more information on sleep apnea including a quiz to help identify the main symptom of sleep apnea, daytime sleepiness — visit The Canadian Lung Association’s website at

Other signs and symptoms of sleep apnea may include:

• high blood pressure

• irritability

• gasping or choking during sleep

• depression

• problems concentrating

• morning headaches

• memory problems/memory loss

If you have any of these symptoms and think you may have sleep apnea, you might want to discuss them with your family doctor.


Go ahead, have a piece of (sugarless) gum and make your dentist happy!

Chewing gum is thought to be the world’s oldest candy — we’ve been chomping down on it for more than 5,000 years! But what do dentists think of all that chewing? While the people who care for our teeth aren’t usually fans of candy, when it comes to sugarless gum, most dentists give it the nod.

“Chewing sugarless gum is a great way to help stimulate saliva flow in patients with dry mouth,” says Dr. Deborah Saunders, Your Oral’s Editor-in-Chief. That salivary stimulation also helps protect your teeth from decay-causing bacteria, so if you aren’t able to brush your teeth after eating, chewing sugarless gum can help.

Dr. Rick Caldwell, ODA President (2013-14), agrees. “Chewing sugarless gum can help freshen breath in the short term; although gum doesn’t bleach the teeth, it can help remove some surface stains.”

Who shouldn’t chew gum? “Patients with temporomandibular joint disorders (TMJD) shouldn’t chew gum as this may make their condition worse,” says Dr. Saunders, Medical Director of the Dental Oncology Program at Northeast Cancer Centre in Sudbury, Ont. (See TM-what? for more on TMJD.)

Adds Dr. Caldwell, a general practitioner in New Liskeard, Ont., “With TMJD problems, the joint requires rest, not extra use. Also, people with facial muscle spasms shouldn’t chew gum, and, for those with sensitive teeth, depending on the source of their sensitivity, chewing gum can be quite uncomfortable.”

One last point: If you’ve had orthodontic work done, such as implants, or if you wear a denture, you may want to talk to your dentist before opting to chew gum, since some gum will stick to orthodontic and acrylic work.

Xylitol 101

Xylitol is a naturally occurring sweetener used in many foods, including chewing gum. Unlike sugar and other sweeteners, says Dr. Saunders, xylitol cannot be digested by the plaque-causing bacteria in our mouths, which, in turn, reduces the amount of plaque on our teeth. For best results, she recommends looking for gum that contains at least one gram of xylitol per piece. But, Dr. Saunders also has a few warnings:

• Xylitol can be toxic to dogs, so keep your chewing gum away from Fido.

• When starting to chew xylitol, meeting the recommended five to 10 grams per day should be done gradually over a period of several weeks, to allow the gastrointestinal system time to adjust.

• Since it can cause diarrhea and intestinal gas, people with inflammatory bowel diseases, such as irritable bowel syndrome or Crohn’s disease, should avoid xylitol.


If you have a chipped tooth, you might not feel any tooth pain unless the chip is large enough to expose the nerves in the inner layer of the tooth. If a chipped tooth exposes the nerves inside a tooth, you might notice increased tooth sensitivity and pain when chewing or when the chipped tooth is exposed to very hot or very cold food and beverages. A chip on one of the pointed chewing surfaces of the back teeth is called a broken cusp. This type of chipped tooth is rarely painful, but it should be examined by a dental professional. You might need a crown or a dental onlay to restore the shape of the tooth and prevent further damage or decay.

Causes Of A Chipped Tooth

The possible causes of a chipped tooth include:

  • Falling and hitting your mouth
  • Biting on a hard object or food, such as a hard candy or a bone
  • Suffering trauma to the face from a sports injury or accident
  • Cavities which can weaken the teeth and predispose you to a chipped tooth

Immediate Care For A Chipped Tooth

If you have a chipped tooth, make an appointment to see your dental professional as soon as possible. Meanwhile, follow these steps:

  • Rinse: Rinse your mouth with warm water.
  • Press: If there is any bleeding in your mouth as a result of a chipped tooth, use a piece of gauze to apply pressure to the area.
  • Cover: If you can’t see a dental professional the same day that your chipped tooth occurs, cover the chipped tooth with dental cement (available at most drugstores) to protect the remaining tooth until your appointment.

Professional Care For A Chipped Tooth

Treatment of a chipped tooth depends on the size and severity of the injury:

    • Small: If the chip in your tooth is very small, your dental professional might simply smooth and polish the chipped tooth, and no additional treatment will be needed.
    • Medium: If your chipped tooth involves minor damage to the tooth enamel, your dental professional will probably place a filling, crown, or cap over the chipped tooth to restore its normal appearance and function and to protect the inner layers of the teeth from irritation and infection.
  • Large: If your chipped tooth is large enough to expose the tooth nerve, you will likely need a root canal to remove the damaged nerve, plus a crown or cap to replace the chipped tooth. (1), (2)

Your Dental Care After A Chipped Tooth Treatment

After treatment for a chipped tooth, it is important to maintain a regular oral care routine.

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Health officials in Liverpool are tackling “an alarming level” of child tooth decay in the city by publicising brands with high amounts of sugar.

A new campaign names leading brands such as Lucozade, Coca-Cola, Tropicana, Capri-Sun and Ribena – warning how many sugar cubes are in each drink.

It will target hospitals, GP surgeries, children’s centres and hospitals.

About 2,000 children in the city will have had tooth extractions by the age of five, health chiefs say.

More than a third have suffered from tooth decay and a 14-year-old recently had 15 adult teeth removed, Public Health Liverpool said.

The “Is your child’s sweet tooth harming their health?” campaign highlights that 500ml of Lucozade contains 15.5 cubes of sugar, while an equivalent bottle of Coca-Cola has 13.5 cubes.

The maximum daily allowance of sugar for children is five to seven cubes, depending upon their age.

Dentist shocked

Rotten teeth

Director of Public Health Liverpool, Dr Sandra Davies, said they are “the first local authority in the country to name how much sugar is in specific brands” to help people “make healthier choices.”

“Many of us are not in the habit of studying labels on drinks… people don’t realise how much sugar is in them.”

Hidden sugar and the frequency at which young people consume drinks are big problems, said Sondos Albadri, consultant in paediatric dentistry at the University of Liverpool.

“It is quite shocking for me as a dentist… I’ve just listed a two-and-a-half-year-old to have eight teeth removed under general anaesthetic.”


“We are increasingly seeing children aged between 12 and 16… I had to remove 15 adult teeth on a 14-year-old recently, and while that is an extreme case it is by no means a rare occurrence.”

Councillor Tim Beaumont, mayoral lead for wellbeing, said it was also “contributing to the obesity issue” in Liverpool, where “one in four children starting primary school are overweight, rising to 38% for secondary school age pupils.”

Gavin Partington, from the British Soft Drinks Association, said soft drinks companies were “taking practical steps to help consumers” including “reducing the sugar in their products”.

“If this were a genuine education campaign to reduce sugar intake then surely it would look at all sources of sugar consumption and not just target soft drinks, which is the only food category where sugar intake is actually falling year on year,” he said.

The number of sugar cubes (each containing 4g of sugar) in popular drinks, according to Public Health Liverpool:


15.5 – Lucozade (500ml)

13.5 – Coca Cola (500ml)

12.7 – Frijj chocolate milkshake (471ml)

8.25 – Capri-Sun (330ml)

7.5 – Tropicana orange juice (330ml)

7.25 – Ribena (288ml)

5.75 – Volvic flavoured water (500ml)

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Celiac disease is an autoimmune disorder according to the Celiac Disease Foundation, and affects about one out of every 100 people worldwide. Those with the disease aren’t able to digest gluten, a protein found in grains like wheat, and the disease damages their small intestine in such a way that makes it hard for the body to absorb many vital nutrients.

Although its effects on the digestive system are well known, you may be surprised to learn there are several oral manifestations of Celiac: teeth defects, dry mouth and canker sores among the most common.


Enamel quality can become a problem for those with Celiac disease, states the Celiac Disease Awareness Campaign, and can involve discoloration or poor development. Teeth with discolored enamel often have dots that appear brown, yellow or even white. Poorly formed enamel, on the other hand, looks pitted or banded, and the teeth may look translucent instead of opaque.

Unfortunately, enamel defects caused by Celiac disease are permanent, so they won’t go away if you begin a gluten-free diet. Your dentist may therefore be able to deal with this condition with veneers or bonding.


Dry mouth syndrome is exactly what it sounds like – the feeling that your mouth is frequently too dry. The condition can be caused by Sjogren’s syndrome, an autoimmune disorder that attacks your salivary glands and may occur alongside Celiac disease. According to the National Foundation for Celiac Awareness, between 4.5 and 15 percent of people with Celiac disease also have Sjogren’s syndrome.

When you’re not producing enough saliva, you often struggle to chew and swallow food. It may also make it more difficult to speak clearly. This syndrome isn’t just annoying; it’s a medical concern. Because saliva helps to keep your teeth clean, not enough of it may cause you to develop cavities more easily. Your dentist may be able to treat your symptoms with artificial saliva or prescription toothpaste.


Canker sores, also known as aphthous stomatitis, are uncomfortable oral lesions that develop on soft tissues – the insides of your cheeks or the roof of your mouth, for instance. Much like dry mouth, these lesions can make it hard for you to eat or speak. According to National Institutes of Health (NIH), studies have shown they affect between 3 and 61 percent of people with Celiac disease.

Canker sores go away by themselves, but they can recur later. If your canker sores are getting in the way of daily activities, your dentist may be able to ease your symptoms with prescription mouth rinses or topical anesthetics.

For people with Celiac, issues that influence enamel, saliva or oral tissues are a legitimate cause for concern. If you’ve got a set of Celiac teeth, make sure your condition doesn’t go ignored. Developing any of these oral manifestations is a perfect reason to see your dentist right away for diagnosis and treatment.

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dental inspection

The dental exam is critical to your ongoing oral health—and only your dentist can perform this.

The exam consists, in part, of the dentist looking inside your mouth. In the past, you may not have ever realized an exam was taking place. Perhaps you thought the dentist was checking the work the hygienist had just completed.

Not so. The dentist actually looks in your mouth for things that can affect your oral—and your overall—health. Many of these are things you can’t see on your own, but that a dentist is trained to detect. Here is some of what your dentist is looking for during a dental exam:

  • damaged, missing or decayed teeth
  • early signs of cavities
  • condition of your gums, such as periodontal pockets, inflammation or other signs of gum disease (which can lead to tooth and bone loss)
  • to see how previous dental work such as root canals, fillings and crowns are holding up
  • early signs of mouth or throat cancer, such as white lesions or blocked salivary glands
  • other suspicious growths or cysts
  • position of your teeth (e.g., spacing, bite)
  • signs that you clench or grind your teeth (a treatable problem that can cause headache or sore jaw and can, if serious, lead to hearing loss and tooth loss)
  • signs of bleeding or inflammation on your tongue and on the roof or floor of your mouth
  • the overall health and function of your temporomandibular joint (which joins the jaw to skull), checking for signs of disorders that can cause pain or tenderness
  • the general condition of the bones in your face, jaw and around your mouth

The dental exam can catch problems early—before you see or feel them—when they are much easier and less expensive to treat.

As well as the visual inspection of your mouth, the exam includes:

  • a complete medical history so the dentist knows about any health conditions that may affect the success of dental treatments or procedures or that may be associated with oral health problems.

It may also include:

  • an examination of your neck area, with the dentist feeling the glands and lymph nodes for possible signs of inflammation that could indicate general health problems; and
  • dental x-rays, if necessary. These can show such problems as cavities under existing fillings, fractures, impacted wisdom teeth, decay under your gum line and bone loss caused by gum disease.

Your dentist may explain what’s happening during the exam and give you a summary of the findings. If not, be sure to ask. As patient, you are a full partner in your oral health care.


Be Sure to Tell Your Dentist

The more your dentist knows about your overall health, the more effective they can be in addressing your oral health care needs. Be sure to mention:

  • any new medical conditions you’ve been diagnosed with since your last visit, such as diabetes or AIDS, even if they don’t seem pertinent. Your dentist needs to know to properly manage your treatment and prevention program.
  • any new medications you’re taking (side effects can often include dry mouth and overgrown gums)
  • if you’re pregnant
  • if you have any allergies
  • any changes you’ve noticed in your teeth, such as changes in colour, looseness or position
  • any changes you’ve noticed in your gums, such as bleeding when you brush or floss, or changes in appearance
  • any increased sensitivity to heat, cold or sweets
  • whether your floss catches on rough edges, causing it to shred
  • any colour changes in the skin on the inside of your mouth
  • if you smoke or chew tobacco (which increases the likelihood of oral cancer)
  • if your neck or jaw muscles are tight or if you’re aware of clenching or grinding your teeth
  • if you’re nervous about going to the dentist—new ways of doing things have made modern dentistry more comfortable for patients, and talking to your dentist may reassure you and help you feel more relaxed


What are Cavities?
“Cavities” is another way of saying tooth decay. Tooth decay is heavily influenced by lifestyle, what we eat, how well we take care of our teeth, the presence of fluoride in our water and toothpaste. Heredity also plays a role in how susceptible your teeth may be to decay.

While cavities are generally more common among children, adults are also at risk. The types of cavities include:

  • Coronal cavities—the most common type occurring in both children and adults, coronal cavities usually are located on chewing surfaces or between the teeth
  • Root cavities—as we age, our gums recede, leaving parts of the tooth root exposed. Since there is no enamel covering tooth roots, these exposed areas easily decay
  • Recurrent decay—decay can form around existing fillings and crowns. This is because these areas may have a tendency to accumulate plaque, which can ultimately lead to decay

Adults are especially at risk for cavities if they suffer from dry mouth, a condition due to a lack of saliva. Dry mouth may be caused by illness, medications, radiation therapy and chemotherapy, and may be either temporary (days to months) or permanent, depending on its cause.

Cavities are very serious. Left untreated, a cavity can destroy your tooth and kill the delicate nerves at its center, which may result in an abscess, an area of infection at the root tip. Once an abscess forms, it can only be treated with a root canal, surgery or by extracting the tooth.

How Do I Know if I Have a Cavity?
Only your dentist can tell for sure whether you have a cavity. That’s because cavities develop below the tooth’s surface, where you can’t see them. When you eat foods that contain carbohydrates (sugars and starches), these carbohydrates are eaten by the bacteria in plaque, producing acids that eat into the tooth. Over time, the tooth enamel begins to break down beneath the surface while the surface remains intact. When enough of the sub-surface enamel is eaten away, the surface collapses, forming a cavity.

Cavities are most likely to develop in pits on the chewing surfaces of the back teeth, in between teeth, and near the gumline. But regardless of where they occur, the best way to spot them and treat them before they become serious is by visiting your dentist regularly for checkups.

How Can I Help Prevent Cavities?

  • Brush at least twice a day and floss daily to remove plaque from between teeth and below the gumline
  • Have regular dental checkups. Preventive care can help stop problems from occurring and keep minor problems from becoming major ones
  • Eat a well-balanced diet that limits starchy or sugary foods. When you do eat these foods, try to eat them with your meal instead of as a snack to minimize the number of times that your teeth are exposed to acid
  • Use dental products that contain fluoride, including toothpaste
  • Make sure that your children’s drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or pediatrician may prescribe daily fluoride supplements


There are many misconceptions about what exactly Wisdom Teeth are, and why and when they may need to be extracted or worked on. In this blog post, we will explain exactly what Wisdom Teeth are, and what in what situations they would need attention from your dentist.

What Are Wisdom Teeth?

Wisdom teeth are the third and last molars on each side of the upper and lower jaws. They are also the final teeth to erupt; they usually come in when a person is in their late teens or early twenties.

When should your Wisdom Teeth be looked at by your Dentist?

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. As teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

What is the cause of the most common issue with Wisdom Teeth?

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