Dental decay around gumline in a persistent coffee sipper

As long as humans have roamed the earth, we have suffered from dental decay. From time immemorial, teeth and their associated issues have been a conversation piece for humans and they are a hot topic today as well. Ancient Egyptian mummies still show the ravages of tooth decay and the feeble attempts of ancient practitioners to stem the rot. Success was not always guaranteed in ancient days, and many such failed attempts were followed by painful extractions done by primitive instruments; often with a few relatives holding the patient down forcefully. Why? Well, dental anesthesia was not discovered till just about a 100 years ago!

If this discussion causes you revulsion and an image with a rotten tooth and a squiggly worm snaking through the hole comes to your mind, then you are not alone. Most people think of dental decay as a hole in the tooth. As simple as that. A hole in the tooth that the dentist will clean out and fill with something magical and that is the end of that problem! Unfortunately, tooth decay is not so simple. Not meaning to say that dental decay is a complex mystery, it is just that the process is a complex one with many variables that influence it. Those who can understand the why and how, can take steps to prevent it or limit the damage done by cavities, the most common infection on the planet. Yes, tooth decay is an infection, like the flu or pneumonia, and it is the most common one prevalent today.

To understand dental decay, understand that a tooth has four main tissues, the white hard enamel that covers the outermost layer of the visible tooth in the mouth, an inner dentine, which forms the bulk of the tooth and is sensitive in the mouth when exposed to cold air and cold water, a soft tissue that fills the inside of the tooth called ‘pulp’, aka ‘the nerve’ which brings nourishment and blood supply to the tooth besides having the nerves in it as well. The last tissue is the cementum which covers the root surface, which is soft and helps anchor the tooth in the jawbone.

Although enamel is the hardest substance in the body, it weakens down when exposed to acidic liquids and food. You can easily chew hard almonds but when soaked in pop or cola or apple juice, your teeth don’t stand a chance! Acid is also produced by microscopic bacteria that use up sugars (carbohydrates) in the mouth and actually cause decay. Patients that continuously sip acidic beverages like pop and energy drinks and fruit juices and coffee also show a peculiar type of gumline decay of lower teeth, especially lower back teeth where the liquid stays pooled in the mouth and causes the enamel to break down in curved half-moon crescent shaped areas of demineralisation. See the photo for an example. Typically seen in teenagers who constantly sip pop or juice or energy drinks, this type of decay is also common in truck drivers who have a large double-double next to the gearshift all day long. Apparently the coffee helps them stay alert on long drives, but their teeth pay the price. Another group is hockey players and athletes who sip drinks like Gatorade and Powerade all the time they are training. These athletes seem to show a high rate of decay which can be explained by the high acidity and high sugar content of these popular energy drinks. Acid wear of teeth seems to be a common problem in Mississauga, and we have successfully treated all types of damaged teeth in our office, Applewood Village Dentistry.

Call us today! Click here for our location, phone number and map.

-Dr. Vipul G Shukla January 2012.

We have many reasons for this, and the extreme toxicity of elemental mercury is just one of them.

While silver-mercury fillings were the staple for dental restorations in the 20th century and were the only way to predictably fill a cavity, today we know that they were not the best materials or the safest either. There is long-standing research in the dental literature from the last 20+ years that shows that minute amounts of mercury are released as the patient chews on these fillings, and that most of it is ingested. Moreover, the use of mercury fillings over a period of years has shown that it does not bond to the surrounding tooth in which it is placed. On the contrary, there is a definite gap present between the silver filling and the tooth. This micro-gap quickly fills up with plaque and bacteria and leads to ‘recurrent decay’ , or filling failure. Many times, the filling is lost along with a major chunk of tooth along with it. Most times this ‘recurrent decay’ is detected by the dentist during a dental exam and patients are unaware that they have an old mercury filling that is doing more harm than good. Take a look at the photos below that show the failure of silver amalgams around the margins, and it’s subsequent replacement with a composite filling.

Old failing silver mercury filling

New composite filling in an hour!

A tooth is a hard live tissue and as such has a living pulp within it, that is the tender soft part of the tooth, aka ‘the nerve’ of the tooth.. The nerve is to be protected at all costs, as any irritation leads to severe pain or an impending root canal treatment. The mercury fillings pose a constant toxic leak of mercury oxides and sulphides that slowly irritate the dental pulp, sometimes leading to the death of the nerve, and with no immediate symptoms or indications. Often these old silver fillings cause the back teeth in which they are placed to develop cracks and fracture lines, along which teeth shatter unexpectedly under routine chewing pressure. Old silver fillings also cause the tooth to look grey and unsightly, a result of recurrent decay or oxidation of the material itself.

Mercury free dentistry or mercury safe dentistry is not a fad or a fashion statement. It is a set of protocol set forth by many national and international bodies for dentists who do not place any mercury in their patients’ mouths, but routinely have to get these removed and replaced with more safer options, including composites.  Replacing old silver mercury fillings must be done by adequately trained dentists and under special care and precautions so as there is minimal if any swallowing or breathing in of mercury vapor. We use a very high power suction machine to make sure you do not swallow any particles nor breathe in any mercury vapors. We remove the old fillings in chunks rather than grind it down. We always keep the area cool using a powerful water spray. Often, we will use a rubber dam to isolate teeth for the process, that further enhances isolation of the toxic materials. Usually, we take ‘Before-and-after’ photos to show you our work as well. And since we are an environmentally conscious office, this silver amalgam powder is collected from our suction lines by a special machine that prevents it from going down the drain, from where it would eventually enter Lake Ontario. It is collected safely and disposed according to Environment Canada guidelines.  Hence, we are doing our part in reducing mercury levels in our Great Lakes.

In my opinion the days of silver-mercury fillings in teeth have passed, and like Sweden, Finland, Switzerland and other European countries, we should put a permanent ban on placing of these restorations that ultimately cause more harm than good. Whether silver mercury fillings cause Multiple sclerosis, Alzheimer’s disease, ‘mercury poisoning syndrome’ or other serious problems in the patient is debatable; what is certain is that mercury is a potent neurotoxin and I wouldn’t want it in my mouth, when the alternatives are so much better. -Vipul G Shukla, DDS. June 2011.

A toothache is not to be neglected

A cry for you, as parent, to take action. A child cannot pick up the phone and dial the nearest dentist that accepts children; it has to be you. A child does not understand why the tooth hurts or why he cannot chew on a particular side. Why the side of the face is swollen. Moreover, a child can rarely accurately locate the tooth that is causing the pain, it usually needs a dental X-ray to locate the offending tooth. It is usually a back tooth, a molar, that is the culprit.

How do we know? We are dentists in Mississauga that routinely provide emergency dental care in Mississauga and Oakville, Etobicoke and Brampton as well as visiting tourists. When you have a child (or an adult) in need of a dentist, call Applewood Village Dentistry in south Mississauga to schedule an appointment. We provide all aspects of childrens’ dentistry, including childrens’ root canals, that can save severely decayed back teeth. If a tooth cannot be saved, we can even make a replacement so that the child’s teeth do not drift into the open space and cause crooked or crowded teeth in adult life. This simple appliance is called a space maintainer and can literally save you hundreds or thousands of dollars in later life in orthodontic fees! (see photo)

Band and loop type space maintainer to hold the room for adult premolar

The youngest child we have worked on is 2 years old; and if your child will cooperate, we can have a lot of work completed per sitting. We have a children’s play zone in our reception, all of us are kid-friendly and we have a lot of children who routinely come in and get a cleaning with our hygienist, Linda. She is great with children and everyone loves her for her gentle hand and thorough technique. Every room is further equipped with a TV with more than 70 channels, so a child can watch Dora the Explorer or Spongebob Squarepants while we work in their mouths. The TV screen can be tilted at any angle that is needed, so a child is always kept occupied visually, while we work at peace.

The more a child visits a dentist, the more comfortable he or she gets and more likely to get a regular cleaning and checkup. We are more likely to catch decay in its early stages and treat it before it causes pain or swelling or an abscess. A child that grows up fearing the dentist is more likely to avoid going to the dentist in later life as well, causing dental problems to build up and be serious. Good habits begin early in life. If you are going to the dentist yourself, say, for a routine cleaning, then make it a point to take your young one with you too. This is called behaviour modelling and the child understands that the dental professional is actually helping mommy to get a clean and white smile and not hurting by poking around the mouth. This is positive reinforcement of watched actions and goes a long way to alleviate dental fears in a child. Similarly, at home, a child watches mom or dad brush and floss at bedtime, and will eventually follow suit without much effort.

Whatever your child needs done, either we will do it ourself, or refer you to an appropriate pediatric dentist so that dental problems do not get out of hand. The most important decision you will make is to pick up the phone and call. The rest is up to us.

A smile can say it all!

 Applewood Village Dentistry is your one-stop destination for family and cosmetic dentistry in Mississauga. What is cosmetic dentistry? Is it expensive? Is it permanent? Do porcelain veneers last a lifetime? Is teeth whitening safe?

People are living longer and fuller lives, and your smile is an important aspect of your overall health and appearance. A clean, bright smile can mean more confidence in public and overall better prospects. Cosmetic Dentistry is that branch of dentistry which focuses on the appearance of teeth in the smile zone, along with their overall health. From porcelain veneers to metal-free zirconia crowns, cosmetic dentistry encompasses a wide assortment of procedures to suit every need and budget. Cosmetic dentistry need not be expensive, and we incorporate it into pretty much every thing we do; from a simple composite filling to a complex smile makeover. And yes, today’s modern materials and techniques make it virtually impossible to detect a natural smile form a fabricated one. Even up close!

If you are contemplating a smile alteration, or are wondering about that crooked front tooth, then cosmetic dentistry can be the answer you are looking for. Book your complimentary initial consult today. You will be amazed at all the options available today that we didn’t have before.

Pain. Swelling. Bleeding. Loose cap or bridge. Broken denture. Split tooth.

If you have any of the above in your mouth, then it is classified as a dental emergency, and we can help. Usually on the same day. Even if you are not a registered patient of our office. We provide emergency dental care during office hours to patients from Mississauga, Oakville, Etobicoke, Brampton and even visiting tourists during the summer months.

Call us on 905 279 1818 to schedule an emergency appointment.

Amalgam replacement (before)

Amalgam replacement (after)

What can you do to help avoid a dental emergecy?

Be regular. Regular in brushing and flossing. Regular in wearing your mouthguards when on the ice or other contact sports. Regular in caring for your teeth and your childrens’ teeth. Most importantly, regular in your dental appointments; usually every 6 months (or earlier). Being regular helps us to keep dental problems to a minimum. We routinely examine mouths for problems that need urgent attention, and tell you about them. A simple filling in time keeps a dental abscess away!

• Avoid chewing ice cubes. One of the main causes of cracks and fractures in teeth.
• Use teeth for eating food, nothing else. Buy a corkscrew or a bottlecap-opener to open beer bottles.
• Do not use teeth to pry open cans or lobster claws or oyster shells. Use appropriate tools.
• Avoid using your mouth to hold roofing nails (roofers) or such is an invitation to visit the ER with serious puncture injuries.
• Avoid tongue and lip piercings. A tongue piercing of metal is called a ‘dumb bell’ for a reason.
• If you have been informed of a dental problem, get it fixed; waiting till it pains is not a smart idea.
• If you ignore a mild toothache, it will get back at you eventually; on a long weekend or after hours, when no dentist is around.
• When your child complains of a toothache, don’t ignore it or postpone calling the dental office.
• If you play hockey or football (or kickboxing or judo, etc), wear a dentist-made mouthguard that fits well.
• Use a fluoride-containing toothpaste regularly.
• Do not constantly chew gum. Humans, unlike cows and goats, are not meant to ruminate all day.
• If you grind your teeth in sleep(or the Hwy-401 during rush hour), get a custom nightguard made. And yes, reduce stress in your life.
• ‘You don’t have to floss all your teeth; only the ones you want to keep.’
• Remove your dentures before you take a swim. Fibreglass acrylic dentures, that we usually make, are strong, but will sink to the bottom of the lake.
• Learn to care for your mouth and teeth early on in life. We are all living long lives due to modern medical science. Chewing your favorite foods with strong and healthy teeth is one of the few free pleasures of life.
• Keep our phone number in your speed dial. Or pick up a fridge magnet.

Bon appetit!

A smile can say it all!

Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth.  The most popular method is using a home tooth whitening system that will whiten teeth dramatically.  Since tooth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc.  Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Tooth whitening gives a long-standing effect, yet not permanent.  A touch-up maybe needed every several years, and more often if you smoke, drink coffee, tea, or wine.

Reasons for tooth whitening:

• Fluorosis (excessive fluoridation during tooth development).
• Normal wear of outer tooth layer.
• Stained teeth due to medications (tetracycline, etc.).
• Yellow, brown stained teeth.

What does tooth whitening involve?

This type of tooth whitening usually requires two visits.  At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary.  The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening.  It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.

Family Dentistry – Cosmetic and Family Dentist in Mississauga

Front tooth severe decay	Front tooth filling with composites!
Amalgam replacement (Before)	Amalgam replacement (After)

Drs. Sherin and Vipul Shukla would like to warmly welcome you and your family to our state-of-the-art dental office in the heart of south Mississauga, also serving south Etobicoke and Oakville area. Applewood Village Dentistry also provides emergency dental care in Mississauga, Oakville, Etobicoke and Brampton, and even visiting tourists.

When you visit our Mississauga office, your smile is our top priority.  Dr. Shukla and his entire team is dedicated to providing you with the personalized, gentle care that you deserve. Our dental clinic is designed in a soothing, stress-free design to help patients who are anxious around dentists.

Part of our commitment to serving our patients includes providing information that helps them to make more informed decisions about their oral health needs.  This website is a resource we hope you’ll find both useful and interesting.

We genuinely hope this site is helpful to you in learning more about our Mississauga dentistry practice, dental conditions and treatments, dental recommendations, and more.

Please browse through our website and be sure to give us a call if you have any questions or would like to schedule an appointment.

We hope to hear from you soon! Click here for our location, phone number and e-mail.

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