What happens if you don't remove all the plaque and have regular examinations

Yesterday I received a phone call from a patient saying that she bit into something soft and her upper left "eye tooth" broke off at the gum-line. There was no pain, but she was embarrassed to smile and was worried about what would have to be done to give her a tooth so that she could smile and function in a social setting. Why did this happen? She had gotten busy and neglected to appear for a hygiene visit for about 4 years. During that time (a stressful time for her) she developed extensive tooth decay on about 6 teeth. A few of these will need to have root canal treatment because the decay has eaten it's way into the nerves of those teeth. The tooth that I looked at today may not need the root canal treatment. ... but the decay was so extensive, it had eaten into the tooth like a beaver chews into a tree, that the tooth could no longer support itself and it fractured. It was very tricky to restore, and it challenged me and forced me to be creative, but after about 1 1/2 hours I was finished repairing the tooth. This was a temporary repair and the options for final treatment are rather complex. This patient will need extraction and implant replacement of the tooth, extraction and a bridge, or root canal treatment followed by gum surgery and a crown. Had she been more consistent with her dental hygiene appointments I would have been able to catch the decay sooner and avoid this unfortunate situation. It seems from my experience that if we go longer than 2 years between x-rays that it is possible for tooth decay that may have been too small to be detected at first, to grow into a full blown area of tooth decay on the tooth. It's good to have x-rays taken at least every 2 years to catch decay before root canal treatment is needed. Dr. Marty Frankel 416-770-8526 drmartyfrankel@rogers.com

Dental Tips

Greetings from Toronto. Today I am resuming my blog posts. I will be posting to this space approximately once a week and will be talking about topics of dental interest. I will also submit information that is currently available from other sources on dentistry and related topics. Today I would like to talk about a few things related to cleaning teeth. I had a patient who came into the office last week for a hygiene visit. It had been a little over a year since she had last had her teeth cleaned. Although she has excellent homecare, she brushes and flosses regularly, she was surprised to find that she had a lot of build up of bacteria and debris under the gum line. She didn't realize how important her office visits were. Cleaning of teeth is a job that is best shared. There are things that we can do in the dental office and things that people must do at home. Plaque, which is basically bacteria, builds up around the teeth. It is soft and can be removed at home with a tooth brush and floss. It only takes 24 hours to build up on the tooth surface. If it's not removed at home daily, it can grow down around the tooth and get under the gum where it can destroy the bone that supports the tooth roots, and it can also enter the blood stream where it can cause or contribute to health problems such as heart issues, stroke, diabetes, respiratory issues, and the list goes on. Over time that bacteria along with mineral deposits on the teeth, (know as calculus or tartar) can adhere to the tooth. These deposits are hard, and must be removed professionally. Different people will build up deposits at different rates. This is what we do at the office, we remove the hard deposits, and help to set up an appropriate interval for maintenance visits. Look out for more "Dental Tips" as we move forward over the next while. Sincerely, Dr. Marty Frankel 5775 Yonge Street, Suite 1000 Toronto, Ontario, M4M 2J1 416-770-8526

While building and transitioning into my new practice, I am practicing a few days a week at my friend Dr. Alex Koranyi's office in North York. The address is 5775 Yonge Street, suite 1000. To make an appointment please call Arlene at 416-770-8526. We can still be reached at 416-224-8087, and drmartyfrankel@rogers.com