Qualicum Beach Dental Services

Dental amalgam is a commonly used dental restorative material used for dental fillings. First introduced in France in the early 19th century, it contains a mixture of mercury with at least one other metal. Amalgam has been the restorative method of choice for many years due to its low cost, ease of application, strength, durability, and bacteriostatic effects.

Factors that have led to recent decline in use are concerns about aesthetics; because the metallic colour does not blend with the natural tooth colour and environmental concerns regarding mercury emissions during preparation or removal of restorations.

Amalgam is widely used for direct fillings, mainly for posterior teeth, and completed in a single appointment. While concerns have been raised of leaching, there is currently no evidence that any of this mercury remains in the body nor that dangerous levels are ever reached.

If you choose not to have amalgam fillings as part of your treatment, we are happy to work with you. Composite filling options for posterior teeth should be discussed with your dentist. We will help make you aware of the durability and cost differences or responsibilities. It is not common practice to automatically remove amalgam fillings to change to composite fillings unless it is in need of replacement and the situation is suitable.

White or Composite Restorations: Tooth coloured fillings primarily used in front teeth to match individual shade colours. Made up of a composite of plastic resins which, once set with curing light will produce a filling of natural appearance. Although they are aesthetically ideal, composite filling material is bonded to the tooth structure and studies show they tend to debond or breakdown sooner than amalgam fillings.

Certain criterias define the use of composite filling material in posterior teeth (bicuspids and molars). They are technique-sensitive meaning that without meticulous placement they may fail prematurely. They take up to 50% longer to place than amalgam fillings and are thus more expensive. You should discuss the applicable uses and pros & cons of composite restorations verses amalgam restorations as per your dental treatment with your dentist.

A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant. Crowns are often needed when a large cavity threatens the ongoing health of a tooth. They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods. Crowns are often used to improve the strength, longevity or appearance of teeth.

Your dentist prepares the tooth by removing the outermost layer of tooth and/or filling material into a short flattened pylon shape and takes an impression which is sent to a lab to fabricate the crown outside of the mouth. Your dentist will also make a provisional crown for your use while the lab does its work. The permanent crown is then inserted at a later dental appointment.

Using this indirect method of tooth restoration allows use of strong restorative materials requiring time consuming fabrication methods requiring intense heat, such as casting metal or firing porcelain which would not be possible to complete inside the mouth. Many patients choose to have their crown fabricated with gold because of the similar expansin properties of natural teeth.

A bridge, also known as a fixed partial denture, is a dental restoration used to replace a missing tooth by permanently joining to adjacent teeth or dental implants.

A bridge is made by reducing the teeth on either side of the missing tooth or teeth. An impression is taken for the lab, and a temporary bridge is made for your use while the lab makes the permanent bridge. Then you return for the cementation appointment.

The teeth supporting the bridge on either side are called the “abutments” and the replaced missing teeth are called “pontics”. A bridge cannot connect from a natural tooth abutment to a dental implant abutment. Two dental implants are required for a bridge where this function is required.

The materials used for the bridges include gold, porcelain fused to metal, or in the correct situation porcelain alone. The amount and type of reduction done to the abutment teeth varies slightly with the different materials used. Patients are instructed how to and must be careful to clean the abutment teeth and gums well under the bridge.

A veneer is a thin layer of restorative material placed over the front of a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. There are two main types of material used to fabricate a veneer, composite and dental porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth. A porcelain veneer may only be indirectly fabricated in the same way a crown is made.

Today, with improved cements and bonding agents, they typically last 10 or more years. They may have to be replaced in time due to cracking, leaking, chipping, discoloration, decay, shrinkage of the gum line and damage from injury or tooth grinding.

*There are two fees associated with crowns, bridges, porcelain veneers, dentures and other oral appliances. The dentist’s fee and a lab fee for their materials and services.

Once a tooth has under gone RCT it no longer has a blood supply and becomes brittle, therefore prone to fracture. It is usually recommended to get a crown to surround the tooth and prevent it from splitting like firewood, vertically into the gums/bone. If this happens, the tooth is now non-restorable and usually has to be extracted.

The general public has the notion that Root Canal Therapy is experiencing pain; but in most cases the patient falls asleep during the procedure.

A dental implant is a titanium “root” used in dentistry to support restorations that resemble a tooth or group of teeth to replace missing teeth.

Virtually all dental implants placed today are root-form endosseous implants, i.e., they appear similar to an actual tooth root (and thus possess a “root-form”) and are placed within the bone (end- being the Greek prefix for “in” and osseous referring to “bone”). The bone of the jaw accepts and forms more bone to attach around the titanium post.

Dental implants can be used to support a number of dental prostheses, including crowns, implant-supported bridges or dentures. They can also be used as anchorage for orthodontic tooth movement. The use of dental implants permits tooth movement without reciprocal action.

The implant placement itself is done at the oral surgeon office. Your dentist at Qualicum Dental works closely with the oral surgeon to ensure you will be a successful candidate and designing placement of the implant. Your dentist then works directly with you through the healing stages, and the making of the crown, bridge or dentures on top of the implant.

A successful candidate for an implant must have adequate bone level or consider bone grafting. Hygiene should be good and be a patient patient. It takes about 2-6 months of time for bone to adhere firmly around the implant prior to making the crown, bridge or denture; as until then it cannot support the load of chewing. Also most dental plans do not cover the fees of the implant but may cover or a percentage of the implant supported crown, bridge or denture fees.

A dental extraction (also referred to as exodontia) is the removal of a tooth from the mouth. Extractions are performed for a wide variety of reasons, including tooth decay that has destroyed enough tooth structure to prevent restoration. Extractions of impacted or problematic wisdom teeth are routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment. Usually, the dentist will require an x-ray to view the roots of the tooth to be extracted.

Other dental surgeries include gum grafting, frenectomy (incision of the midline tissue attachment to the lip), apicoectomy (removal to the root tip of a failing root canal treated tooth), a crown lengthening (removal of bone around a tooth to facilitate the better success of crowning), and gum recontouring.

Dentures (more commonly known as false teeth) are arificial devices constructed of acrylic and sometimes with porcelain teeth to replace a full arch of missing teeth. The denture is supported by the surrounding soft and hard tissues of the oral cavity. Maxillary (or upper) dentures are held in place by suction on the palate. Mandibular (or lower) dentures fit like a horseshoe saddle over the boney ridge left where there was once teeth. Conventional dentures are removable, however there are many different denture designs now with some attaching to implanted posts with magnets or bars.

Partial Dentures are usually made from a cast metal framework with acrylic teeth and gums. Some smaller temporary partials are made of acrylic alone and are used in the process of having an implant procedure. Partial Dentures rely on clasping onto existing teeth or precision attachments to existing crowned teeth.

Procedures for both Complete and Partial Dentures requires multiple appointments for recording of impressions, cast frame try in, bite registration, try in with teeth in wax prior to acrylic processing and insertion with adjustments if necessary. Sometimes it takes multiple appointments again after insertion to adjust any sore spots that develop as the denture settles in. Please call our office to arrange these appointments asap.

Night guards (also called bite splints, bite planes, or occlusal splints) are removable dental appliances carefully molded to fit the upper or lower arches of teeth.

They are used to protect tooth and restoration surfaces, manage mandibular (jaw) dysfunction, and stabilize occlusion or create space prior to restoration procedures. People prone to nocturnal bruxism, or nighttime clenching or grinding, should routinely wear occlusal splints at night.

Night guards are typically made of a heat-cured acrylic resin. Soft acrylic or light cured composite, or vinyl splints may be made more quickly and cheaply, but are not as durable, and are more commonly made for short-term use. Soft splints are also used for children, because normal growth changes the fit of hard splints. Some guards require heating under warm running water prior to insertion and improve fit as they cool.

They generally cover all the teeth of the upper or lower arch, but partial coverage is sometimes used.  Maxillary (upper) splints are more common, although various situations favor mandibular (lower) splints.

Orthodontics (from Greek orthos “straight or proper”; and odous “tooth”) is the first specialty of dentistry that is concerned with the study and treatment of malocclusions (improper bites), which may be a result of tooth irregularity, disproportionate jaw relationships, or both.

Orthodontic treatment can focus on dental displacement only, or can deal with the control and modification of facial growth. Orthodontic treatment can be carried out for purely aesthetic reasons with regards to improving the general appearance of patients’ teeth.

Dr. Verne McShane has been practicing orthodontics for many years and presently Dr. Jo McShane treats less complicated cases as she continues her Orthodontic Study Club.

Pediatric Dentistry This area of dentistry focuses on pediatric/adolescent growth and development, disease causality and prevention, child psychology and management, and all pediatric restorative techniques.  All services from cleanings, oral hygiene instruction, pit and fissure sealants, restorations or extractions and orthodontics for children are provided.

We are a family friendly office and cater to all ages and development. Most children are introduced with their parents to the office and do quite well. They are encouraged to learn about and see the operatory tools and the how and why to care for their teeth. Usually explanations prior to the dental procedure can build trust.  If the child is still unable to cooperate the appointment may be rescheduled within the office or referred to a pedodontic dental practice which specializes in treating children through this age period.

It is recommended that you bring your young child to the office at 2 – 3 years of age for his/her first time with another caretaker while you get your teeth cleaned and examined. This will reinforce the need for dental exams/cleanings as Mom or Dad also get their teeth cleaned and examined. The child may allow the dentist to take a look in the mouth at this visit but do not be disappointed if they do not co-operate. If you have any concerns about your child’s teeth at an earlier age, please do not hesitate to call our office for an appointment.

Home dental care for childen starts in infancy. A clean gauze or soft terry face cloth should be wrapped on your finger and used to wipe the gums on a daily basis. Once teeth erupt (generally at approximately 6 months) a small soft brush should be used to brush the teeth and gums at least twice daily now. Use a minimal amount of toothpaste, less than a baby pea size or smear across the brush. Children’s toothpastes are available which are less spicy, but do be careful that your child is not eating it. Fluoride is a huge benefit for tooth enamel but may upset a child’s stomach if ingested.

Flossing can begin as soon as teeth are present. Lay your child along the couch/bed with his/her head in your lap so you can look down into the mouth and floss. Your should encourage your child to brush and floss by them selves occasionally but ensure you do it more often until they are more proficient at these life skills.

Should your child need specialized orthodontic care (braces), we are able to provide these services at Qualicum Dental from 2 dentists.

Periodontal diseases (also called gingivitis and periodontitis) are those diseases that affect one or more of the periodontal tissues (the bone and gums which support the teeth):

While many different diseases affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the huge majority of periodontal diseases which are divided into two categories, gingivitis (infected, bleeding gums) and periodontitis (involving progressive loss of the bone around the teeth, and if left untreated, can lead to the loosening and eventual loss of teeth). Gingivitis can be controlled by proper daily cleaning of the oral cavity which includes brushing and flossing. Controlling periodontitis requires more extensive home treatment routines combined with more frequent dental hygiene visits.

Qualicum Dental has two hygienists to ensure patients recieve the extra dental care to help keep the periodontal tissues healthy in our patients. Once deep pockets have started to form around teeth it is that much more difficult to keep clean at home. Your dentist and hygienist can help prolong how long you will keep your teeth….

“Hopefully, one more day than you will need them!”

Plaque is a mixture of bacteria, minerals and some food leftovers. It irritates the gums, or gingiva and causes inflammation over time (gingivitis). The bacteria make it stick, the minerals make it hard, and the longer plaque is left on the teeth, the harder it gets. After 24 hours, some plaque hardens into calculus, otherwise known as tartar. The difference between plaque and calculus is that calculus does not come off with the brush and floss anymore. This causes an ongoing state of inflammation of the gingiva.

Because the bone is alive, it has cells in it that build bone, and cells that break down bone. Usually these work at the same speed, and keep each other in balance. The chemical by-products of ongoing inflammation stimulate the cells that break down bone, which now start working faster than the cells that build bone. The result is that you lose bone, and the loss of bone and attachment tissues is called periodontal disease.

Injury to the dental pulp (nerve) can lead to pulp infection and/or its death. Root Canal Therapy must be performed in order to avoid the spread of infection to the surrounding root tissues and avoid the loss of the tooth. The treatment involves removing the nerve, filing the canals to a uniform shape and then completed by filling the canals with a material called gutta percha. This is usually a two-appointment procedure but can require more if canals are difficult to find or re-infection occurs. If the pulp dies without infection, your dentist may decide that the entire procedure be completed in one appointment.
Once a tooth has undergone RCT it no longer has a blood supply and becomes brittle, therefore prone to fracture. It is usually recommended to get a crown to surround the tooth and prevent it from splitting like firewood, vertically into the gums/bone. If this happens, the tooth is now non-restorable and usually has to be extracted.

The general public has the notion that Root Canal Therapy is experiencing pain; but in most cases the patient falls asleep during the procedure.