Answering your questions

What is periodontal disease or gum disease?


Half of the North Americans have some form of periodontal disease. Periodontal disease, or gum disease, is a chronic bacterial infection of the gums and bone supporting the teeth. It is usually painless and silent, until its advanced stage. That is why periodontal disease is the number one reason for tooth loss in the adult population.

According to the World Health Organization (WHO), 10-15% of the world population or 600-900 million people are suffering from severe periodontal disease.

In recent years, studies have shown that moderate to severe periodontal disease increases the risk of developing the following health problems. This is because the oral bacteria travel throughout the body to major organs and begin new infections and damage the major organs.

  • Stroke: 2 times more likely to develop stroke
  • Respiratory Disease: 2-5 times more likely to develop respiratory disease
  • Coronary artery disease: 2 times more likely to develop coronary artery disease
  • Adverse Pregnancy outcomes: 4-7 times more likely to develop adverse pregnancy outcomes (premature birth weight baby)
  • Diabetes:2-4 times more likely to develop diabetes.


The mildest form of periodontal disease is gingivitis, which causes the gums to become red, swollen and bleed easily. It is reversible with dental professional cleaning and proper oral hygiene.

The more advanced form of periodontal disease requires a dental professional who performs a root planing and scaling procedure to remove the plaque and calculus accumulated below the gum line, and in hard to reach areas.

When periodontal disease is in the most advanced stage, surgery may be required to treat the infection properly and help the patients to clean those problem areas better.

How do I care for my child′s teeth?

There can be large variations in when your baby’s teeth come in, but by 2-3 years old, they should have a total of 20 baby teeth. Daily oral hygiene is important to keep your baby’s teeth clean. Before the baby teeth erupt, you can wipe their gums with clean gauzes after their feeding. After baby teeth erupt, use a small soft bristled toothbrush appropriate to their age to clean the plaque off their teeth. Flossing once a day should also be introduced at age 3. A well balanced diet is also important to keep the baby teeth healthy. Avoid sugary snacks and starchy food, especially the sticky kind.

Accidents can also happen to your child’s baby teeth. A proper car seat and child proofing your house are important. Wearing a mouth guard during any contact sports is also beneficial to protect your child’s teeth.

My daughter sucks her thumb. Is it OK?

Thumbs sucking or the use of pacifier is one of the most common kinds of oral habits. If this habit is carried on beyond age four, it can lead to an open bite, crooked permanent teeth and problems with the normal jaw development. Therefore, it would be the most ideal to wean off thumb sucking by age four or five. Thumb sucking tends to be harder to wean off in girls. The effect of thumb sucking is worse than the use of a pacifier.

My dentist told me I would need some crowns. Why do I need crowns?

Crowns are used to restore structure, function and esthetics of teeth. If your tooth has cracked, broken or has been damaged by decay to a large extent, you should have a crown. If your tooth is over-filled and there is not enough tooth structure left to support the filling material, a crown is also indicated.

If you tooth has had root canal treatment, the internal structure of the tooth is changed, and it is mostly hollowed out. This kind of tooth tends to split or break under stress. Your dentist usually would recommend a crown for a tooth that has had root canal treatment, especially if they are bicuspids or molars. Also, if you have a badly discolored or badly shaped tooth, your dentist may also want to put a crown on that tooth.

The average lifetime of a crown is around 10 years. Good home care and regular professional cleaning are necessary to prolong the life span of your crowns.

How much does a crown cost?

Crowns typically cost between $900-1000 dollars each. The high cost of a crown is due to the number and duration of dental visits, as well as the laboratory cost. Lab costs make up approximately 40%-50% of the total cost of a crown.

Why do I need a dental check up by my dentist?

There are many problems that are associated with your oral health, which your dentist checks for, and you cannot see. The following are some of the things that your dentist will be able to detect in the check up exam: the deterioration of the restorations in your mouth (old fillings, crowns and bridges), root cavities, the presence and progression of periodontal disease (gum disease), cavities under the gum line, presence of any impacted wisdom tooth, early signs of dental pathology (abscess, infection, etc), and oral cancer.

Why do I need a regular cleaning every 6 months?

Here is what the registered dental hygienists do on a daily basis:

They remove extrinsic stain and discoloration on your teeth so that you can maintain a youthful smile;

They remove the hard deposits (calculus) in your mouth, including the hard-to-reach areas, keeping the gums and the hard tissues (bone support) healthy;

They prevent and monitor the progression of gum disease, which at an advanced stage can lead to tooth loss or other serious health problems;

The dental hygienists will teach you effective ways to keep your teeth clean and healthy. They may also recommend fluoride treatment to individuals that are cavity prone.

They can check and monitor the conditions of your dental problems (gum recession, how loose some teeth are, etc).

How often you go for a dental cleaning or check up depends on many factors: how diligent and how effective you are about brushing and flossing, how fast calculus builds up in your mouth, whether you smoke, whether you have underlying medical issues or you are on medications that cause dry mouth or gums to overgrow. According to the Canadian Dental Association, most people need a cleaning every six months. Your dentist may recommend that you visit more or less frequently depending on your needs.

Why do I need to have my old fillings replaced?

Old fillings may need to be replaced when they start to fail or develop recurrent decay. No matter how good today’s technology is, the seal between the tooth and the filling material is not perfect. Over time, this seal breaks down because of attrition, erosion, grinding and chewing, etc. The filling material starts to pull away from the tooth, leaving gaps at the filling edges and creating an entry point for food particles and decay-causing bacteria. When decay develops along the edges of a filling or underneath a filling, it is called “recurrent decay”.

Why do my teeth stain?

Teeth stain because of two reasons. The extrinsic stain is superficial and affects only the enamel surface. It is associated with the use of tea, coffee, chewing tobacco or smoking. A dental cleaning and polishing can remove the extrinsic stain to a certain degree, and tooth whitening will remove the extrinsic stain too.

The intrinsic kind of stain is much harder to treat with tooth whitening or bleaching, because they discolor the inner structure of the tooth. The intrinsic stain can be related to fluorosis (too much fluoride when the permanent teeth are being formed), or the use of tetracycline (a kind of antibiotic) at an earlier age.

There are so many kinds of whitening or bleaching out there. How do I choose?

There has been phenomenal growth in consumer awareness since tooth whitening became a concept. Many different kinds of whitening products or systems are in the market.

Whitening toothpastes have polishing or chemical agents that help remove surface stains, even though they do not contain any tooth bleaching agent.

The over the counter whitening products such as Crest White strips contain the peroxide bleaching agent. They also need a certain degree of compliance and need to have touch-up’s after the results are stable.

The third kind of whitening is done at home, but the bleaching gel has to be dispensed professionally by a dentist. We will fabricate a whitening tray that adapts to your teeth precisely without irritating your gums.  Bleaching gel will then be applied on these trays and each product’s usage regimen varies. Compliance is also needed to achieve good results.

The last kind of whitening is called in-office whitening, and it works best for those who desire an instant result and for those who need close monitoring of their gums or tooth sensitivity. The highest concentration of the bleaching agent is used, and lasers/light/heat are often used to activate the bleaching agent.

Please note that bleaching is not for everyone. If you have bonding or tooth-colored fillings placed in your front teeth, they will stand out after you bleach, and may therefore need to be replaced. In some cases, you may want to investigate other options like porcelain veneers or cosmetic crowns if you want to change the positions and shapes of your front teeth in addition to changing their color.