Your dentist

Your dentist is your oral health care expert and knows how the health of your teeth, gums and mouth relates to your general health. Only your dentist has the training, skill and expertise to:

• Examine and diagnose your oral health condition.
• Recommend and carry out treatment.
• Inform you about the general oral health care you need after treatment or surgery.
• Meet all your oral health care needs.

The dental hygienist

The dental hygienist works together with your dentist to prevent dental disease and keep your mouth healthy. The dental hygienist is registered and certified to clean your teeth and discuss with you the importance of caring for your teeth and gums at home.

The dental hygienist may do a basic examination of your teeth and gums, and will inform your dentist about the result. In some dental offices, the dentist alone performs the examination and may also provide dental hygiene care. Your dental hygienist may clean, polish and apply fluoride to your teeth, take x-rays and make dental impressions.

The dental assistant

The dental assistant helps the dentist during patient examinations and treatment procedures. The dental assistant prepares patients for treatment, passes dental instruments and materials to the dentist and keeps the mouth dry using suction during treatment procedures. The dental assistant sterilizes dental instruments and may polish and apply fluoride to your teeth, take x-rays and make dental impressions.

The dental office staff

Your dentist may have a receptionist or several dental office staff depending on the size of the practice. The office staff, including the receptionist, is often your first point of contact with a dental office. The office staff manages the flow of patients through the office by booking and scheduling appointments, taking care of billings and payments, as well as day-to-day office administrative duties.

Dental specialties

If your treatment requires specialized dental procedures, you or your dentist may be more comfortable if you see a dental specialist. Your dentist will arrange for you to consult with the specialist best suited to your needs.

In Canada, there are 9 specialty areas of dentistry:

• Endodontics.
• Oral and maxillofacial surgery.
• Oral medicine and pathology.
• Oral radiology.
• Orthodontics and dentofacial orthopedics.
• Pediatric dentistry.
• Periodontology.
• Prosthodontics.
• Public health dentistry.

A number of different bleaching techniques and products are available to patients. Your dentist will use one of these two methods to whiten your teeth:

• Vital bleaching is done on “living” teeth and can be used to whiten your teeth if they have become stained by food or tobacco, or if they have become dark with age.
• Non-vital bleaching is bleaching done on teeth that are no longer “alive.” If your tooth has changed colour because of a root canal, non-vital bleaching can lighten your tooth from the inside out.

There are three methods for bleaching teeth. The method that will work best for you depends on the number of teeth that need to be bleached, and on how badly they are stained (or discoloured).

Your dentist may suggest:

1. Putting a special bleach on your stained teeth and using heat (or heat and light) to start the bleaching action; or
2. Wearing a custom-made mouthguard filled with a special bleach for part of each day; or
3. Brushing with a special bleach mixed in toothpaste.

Bleaching should be done only under a dentist’s care. Tooth-bleaching under controlled dental office conditions may be safe and effective, but the new in-office vital tooth-bleaching techniques, particularly those using laser and lights, have undergone little scientific assessment.

Home-use tooth-bleaching systems are available to the general public, either from a dentist or from various retail outlets. Clinical studies support the safety and effectiveness of home-use bleaching gels when used appropriately. Tooth sensitivity and irritation to soft tissues can occur during bleaching treatment, but these effects are transient. Yet the effects of long-term tooth-bleaching are unknown and need to be researched, especially since the effect is not permanent and many individuals end up undergoing periodic bleaching treatments.

Ask yourself the following questions:

• Do I floss every day?
• Do I brush twice a day with a fluoride toothpaste and follow my dentist’s instructions on how to brush properly?
• Do I eat a well-balanced diet, including food from all food groups, and limit sweets and sticky foods?
• Do I smoke?
• Do I have a history of cavities or gum disease?
• Is my overall health good?

The answers to these questions are all factors that affect your oral health. They will help you and your dentist decide how often you need to visit for dental exams. It’s worth noting that you should not determine your need for dental care on what your dental plan covers.

Do I need x-rays at each visit?

How often you need to have x-rays also depends on your oral health. A healthy adult who has not had cavities or other problems for a couple of years probably won’t need x-rays at every appointment. If your dental situation is less stable and your dentist is monitoring your progress, you may require more frequent x-rays.

If you are not sure why a particular x-ray is being taken, ask your dentist. Remember that dental x-rays deliver very little radiation; they are a vital tool for your dentist to ensure that small problems don’t develop into bigger ones.

The damage that sugars do depends on how much sugar goes into the mouth and how long it stays in the mouth.

Any kind of sugar will mix with germs in the mouth. Natural sugars can have the same effect on teeth as white (or refined) sugar out of the bag! Many healthy foods contain natural sugars. Milk contains natural sugar.

If you put your child to bed with a bottle of milk, the milk stays in the mouth for a long time. This may cause cavities. Unsweetened fruit juice may have no added sugar, but fruit juice has natural sugars in it. If your child is always sipping juice between meals, the teeth are being coated in sugars over and over again.

Water is the best drink to have between meals. Starchy foods, like teething biscuits, break down to make sugars. If these kinds of food stay in your child’s mouth long enough, they will make the acid that can cause cavities. Your job is to clean your child’s teeth, not to stop your child from having milk, juice, bread or noodles. Your child needs these foods to stay healthy.

Read the labels of the packaged food you buy. By law, everything ingredient in packaged food is listed by weight. So if a sugar is listed first, you know that there is more sugar than anything else.

These are sugars you can look for on labels: corn sweeteners; corn syrup; dextrose; fructose; glucose; honey; maple syrup; molasses and sucrose.

Also, check to see if liquid medicines (such as cough syrup) have sugars. Ask your doctor or pharmacist to give you medicines that are sugar-free.

Snacks

Growing children need and like snacks. Here are some smart ways to give snacks:

Limit the number of times a day your child eats or drinks sugars. If your child sips juice or pop while playing, he or she will have sugars in the mouth over and over again. Water is the best drink to have between meals.

Do not give your child sugar-rich foods that stay in the mouth for a long time like gum with sugar in it, suckers (or lollipops) and other hard candy. Stay away from soft, sticky sweets that get stuck in the mouth such as toffee, raisins and rolled-up fruit snacks or fruit leather.

Keep good snacks handy where your child can get them. Have carrot sticks or cheese cubes on the bottom shelf of the fridge. Children like small things like small boxes of cereal, small fruits and vegetables, and small packs of nuts or seeds (provided they are safe for your child). Keep them in a low cupboard.

To keep your child from asking for sweets, do not buy them. If they are not in the house, you can’t give them out. If you do serve sweets, limit them to meals. When your child is eating a meal, there is more saliva in the mouth. This helps to wash away the sugars.

Step 1
Take a piece of floss about as long as your child’s arm. Wrap it around your middle fingers, leaving about 2 inches between the hands. Use your index fingers to guide the floss between the teeth.

Step 2
Slide the floss between the teeth and wrap it into a “C” shape. It should wrap around the base of the tooth, where the tooth meets the gum.

Step 3
Wipe the tooth from bottom to top 2 or 3 times or more, until it is squeaky clean.
Be sure you floss both sides of each tooth, and don’t forget the backs of the last molars.
Move to a new part of the floss as you move from tooth to tooth.

Step 2
Use gentle circles. Do not scrub. Clean every surface of every tooth. For the front teeth, use the “toe” or front part of the brush. The key word is gentle. You can hurt the gums by brushing too hard.

Toothbrushes

The best kind of brush is soft, with rounded bristles. It should be the right size for your child’s mouth. You will need to buy a new toothbrush at least every 3 or 4 months.

Children can be hard on toothbrushes. If the bristles get bent or worn down, they will not do a good job, and may hurt your child’s gums.

Toothpaste

Make sure the toothpaste has fluoride. Check the box or tube for the symbol of the Canadian Dental Association. This symbol means the toothpaste has fluoride. Use only a bit of toothpaste and make sure your child spits it out.

As excessive swallowing of toothpaste by young children may result in dental fluorosis, children under 6 years of age should be supervised during brushing and only use a small amount of toothpaste.

Children under 3 years of age should have their teeth brushed by an adult. The use of fluoridated toothpaste in this age group is determined by the level of risk. Parents should consult a health professional to determine whether a child up to 3 years of age is at risk of developing tooth decay. If such a risk exists, the child’s teeth should be brushed by an adult using a minimal amount (a portion the size of a grain of rice) of fluoridated toothpaste. Use of fluoridated toothpaste in a small amount has been determined to achieve a balance between the benefits of fluoride and the risk of developing fluorosis. If the child is not considered to be at risk, the teeth should be brushed by an adult using a toothbrush moistened only with water.

Children from 3 to 6 years of age should be assisted by an adult in brushing their teeth. Only a small amount (a portion the size of a green pea) of fluoridated toothpaste should be used.

It may be your own dentist or one who specializes in treating children (called a pediatric dentist). Once you have selected a dentist, call the office to find out at what age he or she prefers to see child patients for the first time. CDA encourages the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age.

It’s important to make the first visit a positive experience for your child – one reason why it’s best to visit before a problem develops. If you think there is a problem, however, take your child to the dentist right away, no matter what age.

If you are a nervous dental patient, ask your spouse or another family member to take the child for the appointment. If your child senses that you are nervous, he or she may feel nervous too. When you talk to your child about going to the dentist, explain what will happen without adding things like “it won’t hurt” or “don’t be scared.”

Be sure to get an early start on regular dental care at home. Start cleaning your child’s mouth with a soft damp cloth before teeth come in and continue with a soft toothbrush once he or she has a first tooth. Limit the number of sugary treats you give your child, and focus on healthy food choices from the very beginning.

Ask yourself the following questions:

- Do I floss every day?
- Do I brush twice a day with a fluoride toothpaste and follow my dentist’s instructions on how to brush properly?
- Do I eat a well-balanced diet, including food from all food groups, and limit sweets and sticky foods?
- Do I smoke?
- Do I have a history of cavities or gum disease?
- Is my overall health good?

The answers to these questions are all factors that affect your oral health. They will help you and your dentist decide how often you need to visit for dental exams. It’s worth noting that you should not determine your need for dental care on what your dental plan covers.

Do I need x-rays at each visit?

How often you need to have x-rays also depends on your oral health. A healthy adult who has not had cavities or other problems for a couple of years probably won’t need x-rays at every appointment. If your dental situation is less stable and your dentist is monitoring your progress, you may require more frequent x-rays.

If you are not sure why a particular x-ray is being taken, ask your dentist. Remember that dental x-rays deliver very little radiation; they are a vital tool for your dentist to ensure that small problems don’t develop into bigger ones.

Dental hygiene services are provided to individuals across the age spectrum. Dental hygienists work with patients ranging from parents in pre-natal classes to the elderly in long-term care centres. A work day could involve assessment, planning, implementing and evaluating oral health data and include:

- teaching an elementary class about oral health care

- counseling a family about oral health

- providing fluoride treatments to patients during a dental visit

- administering local anaesthetic for dental hygiene or dental treatment

- teaching long-term care staff about mouthcare for their clients

- working with nurses to prevent sports and playground injuries

- screening seniors for signs of oral cancer

- performing head, neck and oral examinations

- applying pit and fissure sealants to teeth

- reviewing literature and conducting research

- scaling and rootplaning, and so on…

The dental hygiene profession focuses on preventive health care. As a result, many dental hygienists deliver health promotion programs in their community to parent and special needs groups, schools, day cares and long-term seniors’ care facilities. Among the programs provided are:

- Tobacco Cessation

- Sports/Mouthguard Clinics

- Well Baby Seminars