Dr. Raed Kamal D.M.D

Dental Care For The Whole Family

Winnipeg Family Dentist | Dr. Raed Kamal

Listed below are many of the questions that we are commonly asked. As well as this main FAQ page, we have a number of FAQ sub-pages (see the drop down menu for their titles).

If you have a question that is not answered here, feel free to send us an email at myfamilydentist@shaw.ca.

Both regular and digital x-rays use the same type of radiation. With repeated high dose exposures over a short period of time, this radiation dose does have the potential to be harmful. This is why strict regulations are in place to ensure the amount of radiation being used is within the limits of what your body can absorb and dissipate without any negative side effects.

The main difference between digital and conventional x-rays is the amount of radiation required to get a similar quality image. With direct digital x-rays the amount of radiation can be reduced by up to 90% depending on the type of x-ray taken and which type of conventional film it is being compared to.

For more information about x-ray technology, please see our page: http://www.myfamilydentist.ca/frequently-ask-question/digital-x-ray-comparison/

Although our office employs the latest technology to minimize the amount of radiation in each high quality x-ray, it remains that unwanted radiation gets scattered away from the intended target. Although this amount of radiation is significantly low, we believe it is always better act with utmost caution. With repeated exposure, even these low levels can build up, as it takes a while for the body to dissipate the absorbed radiation. For the patient who has been given a couple of x-rays over a few months, this is not of concern. However, for the dental staff, we leave the room while taking x-rays as we take many of these each day.

For more information about x-ray technology, please see our page: http://www.myfamilydentist.ca/frequently-ask-question/digital-x-ray-comparison/

The American Dental Association has put forth a list of standards on dental x-rays, and the Canadian Dental Association has since adopted these standards as well. According to these standards, panoramic x-rays should be taken roughly every 5-6 years, and more frequently in cases where abnormalities are found. The first of these panoramic x-rays are taken at approximately ages 6, 12 and 18. These are critical stages of tooth and jaw development and a panoramic x-ray can help to assess a patient for early interceptive orthodontics (age 6), orthodontic treatment (age 12), and for wisdom tooth assessment/extractions (age 18). After a person reaches adulthood, a panoramic x-ray is taken every 5-6 years to monitor bone level (assessing for gum disease), as well as monitoring for any potential developments of cysts or unusual growths.

Individual x-rays only show distinct portions of the teeth and jaw. To show all the teeth one would need up to 18 individual x-rays (our digital panoramic machine uses the same radiation as approximately 2 conventional x-rays, and costs less than 18 individual x-rays). This many x-rays show the teeth and bone level around the teeth fairly well, but can be hard to see the complete picture as it is like putting together a puzzle. Additionally, these x-rays do not show the entire jaw, the joints for the jaw, or a complete picture of the sinus cavities. These areas are susceptible to various defects and abnormalities, and can be of extreme importance for your continued dental care. The bottom jaw bone is also a common place to find metastatic cancer (cancer that has spread from another area). Without panoramic x-rays, these concerns can often be missed. And missing them can have serious implications on appropriate timely treatment.

You can view some of these abnormal findings on our x-ray pathology page to learn more: http://www.myfamilydentist.ca/services/cleaning-and-prevention/oral-cancer-screening/x-ray-pathology/

The general recommendation put forth by North American dental associations is that children should make their first visit to the dentist 6 months after their first teeth have come in. Many dentists claim that children should come in at least by their 3rd birthday. Visiting the dentist while your child is still young is primarily encouraged in order to educate the parents on how to take care of their child’s teeth. This first visit will also include a quick check of the child’s teeth to ensure decay has not already begun.

Starting at age 3 visits to the dentist will involve a more detailed exam and possibly cleaning and x-rays. At this age most children are more cooperative and have a greater understanding of what is going on.

At our office we encourage parents to ask questions at any time. At the time of their own cleaning, parents can bring in their children under 3 for a free first time exam (just let us know so we can book extra time for your visit). For patients who are expecting their first child we will also provide them with information on how to take care of their child’s teeth.

If you have any questions about how to take care of your child’s teeth, don’t hesitate, contact us. Sometimes these questions can be answered over the phone or via email. Other times a visit will be recommended. By age 3 your children should be on a regular recall program. Check out the next FAQ to see why.

A child’s teeth are more fragile than those of an adult, and decay can progress more quickly (this is explained more in the next FAQ). Children’s teeth and jaws also undergo more rapid changes than adults’ and require frequent monitoring to help ensure healthy teeth and proper function for adulthood.

The other advantage of regular visits with children is to establish a “no fear” environment for them. With regular a-traumatic visits to the dentist, the child becomes more at ease with the dental office. This also provides us with opportunities to introduce the various instruments that would be used later if work was ever needed for the child, making that visit easier for the child.

The answer will vary from person to person. Oral hygiene, diet, and tooth anatomy are the main factors in determining cause of decay.

Many children will not have adequate manual dexterity to thoroughly clean their teeth until age 12. Unfortunately many children are left to brush their own teeth from age 2. Daily brushing needs to be monitored closely by parents to ensure the teeth are being adequately cleaned. A good routine is to let the child start with brushing and to have the parent finish. Once the child consistently cleans their teeth effectively, the task can be passed on to the child (with occasional monitoring).
Brushing frequency is also a factor. Brushing should occur at night before bed (no snacks or drinks other than water after this) and after breakfast in the mornings. If an extra brushing can be done after lunch, all the better.

Lack of flossing is another frequent cause for tooth decay. By age 2 most kids will have all their baby teeth in. When the last of these teeth come in, the space between the back teeth often closes fairly quickly. This results in a food trap that brushing alone cannot take care of. Flossing every night, before brushing, will help to remove the food and bacteria trapped between these teeth and reduce the risk of decay. It is also important to floss between all the other teeth as well, focusing on the place where the teeth are touching.

Tooth anatomy impacts decay rate in a couple ways. The thickness of the outer layer of children’s teeth is a lot thinner than that of adults’ teeth. The inner layer is also more porous. This results in decay progressing more easily, and potentially a lot quicker in children’s teeth than in adults. Additionally, many children have deep grooves and pits in their teeth that trap food, and are thus more prone to decay. In some cases these grooves will be sealed off by the dentist with small fillings or sealants to help prevent decay.

Diet is a huge determinant of tooth decay. Eating foods that contain a lot of sugars and acids will increase potential for decay. Soft sticky foods will also get stuck to the teeth more readily and provide a longer lasting effect. To help avoid diet-related cavities, have your children stick to a more natural diet, with less processed foods. The primary drinks for children should be milk and water. Pop and juice are very acidic and contain lots of sugars, which make it no surprise to hear that these drinks are prime sources of concern for cavities.

Kids often have snacks throughout the day. It is very important to pick healthy snacks that won’t get stuck in their teeth. Chips and sugary ‘fruit’ snacks (especially gummy candies) should be avoided as much as possible. The best snacks for small children are cheese, carrots, and other vegetables. Cheese helps prevent cavities and vegetables like carrots act as natural tooth brushes. These snacks also contain very little for cavity causing bacteria to feed on.

If you are following proper oral hygiene routines,and you or your children are getting cavities, you may want to conduct a dietary assessment. We can help you determine the source of the problem, in order to turn things around and keep your children’s teeth strong. If you think this might be of benefit to you, contact us. We can set up a consult, and we can work together to make a change for the better.

Certified pediatric dentists have completed additional schooling to help them treat children that require special attention. This training includes working on a child who is under general anaesthetic (put to sleep). Pediatric dentistry practices are limited to working on children under 18, and, due to their extra training, these dentists use a fee guide that is higher than those of a general dentist (generally 30% higher than a general dentist).

Many general dentists see children and are very good at it, even with the children who require extra attention. Some general dentists prefer not to see children at all. If you are not sure who your child should see, check with your dentist. If they are not comfortable seeing children, they should be able to recommend a pediatric dentist in your area.

For some patients the thought of being sedated with pills, nitrous oxide, or even being put to sleep sounds like the perfect visit to the dentist. At our office, we occasionally provide pre-appointment sedation with pills, but this is not the treatment method of our choice. If you require other forms of sedation, your treatment would need to be performed by another dentist in another office.

At My Family Dentist we focus on other methods to help the patient relax for their appointments. The rationale is that sedation does not improve a patient’s comfort level with the procedures, but it can have various adverse side effects on the body. Our goal is to improve the patient’s comfort level so sedation is not required. We improve our patients’ comfort by helping them understand their upcoming procedure(s), and by providing a relaxing in-office atmosphere. In some cases letting the patient come in for multiple visits with minimal work prior to large procedures is all it takes to build their comfort level.

It is not uncommon for fearful patients to visit my office for the first time completely terrified. And then, after a few visits, the patients start to relax, and have an easier time coming to the office. It is true the memories at the heart of the fear will never fully go away (and I can not promise you will enjoy having dental work done). However, I can promise that if you let us work with you, we can help to reduce the anxiety associated with your dental visits. So, if your fear of dentists and dental treatment is stopping you from seeing the dentist, contact us to see what we can do to help you overcome your fear.

Unfortunately nothing in dentistry lasts forever. Although crowns are very durable restorations and have the potential to last a long time, the average lifespan for a crown is only 8-10 years. That said, we have have seen crowns that are over 30 years old and still look as good as new.

What affects the longevity of the crown is determined by multiple factors. These factors include the condition of the tooth being crowned, the types of force the tooth will be regularly experiencing, and how well the crown is maintained. Teeth that are in better shape, receive minimal forces, and are easy to keep clean will last much longer than a tooth that has been heavily restored multiple times, takes all the chewing forces, and is hard to clean.

Factors affecting the condition of the tooth:

  • Root Canal Treatment: Teeth that have had root canal treatments dry out and become brittle. This makes them more prone to cracking and breaking. Although crowns do a much better job than a standard filling at preventing a tooth from breaking, it is still possible for that tooth to break. Often teeth that have had root canal treatment also have a post in them, to make up for the extent of tooth loose from previous cavities. These posts help provide support for the crown, but also increase the stress in the roots of the tooth. This stress can eventually result in cracks and more tooth loss.
  • Remaining tooth structure: A tooth tends to be crowned because the damage to the tooth has extended beyond what a filling can effectively restore with a good long term prognosis. Unfortunately this usually means there is not a lot of good solid tooth structure to which the crown can adhere. This why dentists are often proactive and recommend crowns on teeth that are not having any serious troubles. If a crown is added before a tooth breaks, or before the filling covers all surfaces of the tooth, the crown can last longer.

Factors affecting forces:

  • Surrounding teeth: The more surrounding teeth that are in good condition, the better the longevity of the crown. This is because the biting force is spread across multiple teeth. If the tooth is on its own, it will experience greater forces, and have less lateral support (no neighboring teeth to rest against). Additionally, as teeth are lost, the bone support shrinks away in those areas. This increases the tooth structure above bone, and greater flexing can occur. The end result is increased risk of the tooth breaking.

Factors affecting cleanliness:

  • Anatomy of crown: Depending on the design of the restoration, some crowns are easier to keep clean than others. In some cases, for added support, multiple teeth may be splinted together with crowns. This makes the area between the teeth much harder to keep clean. These sites are common places for recurrent decay and crown failure. Similarly, when crowns extend deep down in between teeth, the area becomes harder to keep clean as the floss needs to be extended deeper between the teeth than normal. Also, more of a gap between the teeth forms as the crown extends deeper down the side of the tooth. This creates a larger food trap that requires extra meticulous cleaning to help prevent decay.
  • Patient oral hygiene: This is probably the biggest factor behind why crowns fail. As crowns blend with tooth structure right at or below the gumline, it is very important to be very thorough with cleaning these areas. This will involve brushing at least twice a day using a proper brushing technique to ensure the bristles of the tooth brush are reaching the edges of the crown. It will also involve proper flossing at least once a day. Effective oral hygiene habits will help protect the crowned tooth from decay.
  • Regular cleanings and checkups, along with fluoride treatment: These visits will help keep the crowned tooth healthy, as well as allow the dentist to monitor the restoration. If problems do start, often a simple patch can be done to significantly extend the life span of the crown. Other times, the problem can not be fixed without a new crown, but if caught earlier, the damage to the tooth can be minimized. If decay under a crown is left too long, the tooth can decay enough that the tooth may not be fixable. Sometimes this process takes years, and in other cases it can happen in as little as 6 months (depends on oral hygiene, diet, and condition of the tooth under the crown). While regular visits help provide early detection, the regular fluoride treatments can help keep the tooth strong and reduce the risk of decay. And for those who choose to avoid the use of fluoride, there are alternatives that can and should be used for those with high potential for cavities.

So if you have had a lot of dental work in the past, and it has been a while since you have seen a dentist, or if you are unsure how often you should see a dentist for checkups, contact us today and let us help guide you.

Answer: Yes.

To keep your teeth and gums healthy, you need to brush at least twice a day, preferably after breakfast and before bed.  You also must floss your teeth at least once a day (before bed). Twice a day use use of a tongue scraper and mouthwash is also beneficial.

  • Brushing removes the food and bacteria from the top and side surfaces of your teeth and gums. This should be done 30-60 minutes after eating. If you have been eating or drinking items which are very acidic (fruits, juices, pop, etc.), drink some water and then wait 30-60 minutes before brushing. This will give the acids in your mouth a chance to be diluted and minimize damage to your teeth when brushing.
  • Flossing gets to the surfaces of your teeth and gums where your toothbrush cannot reach. It is very common to find decay on children and adults between the teeth, and it is also the most common site for gum disease. Flossing should be done every night after your last meal of the day. For added effect, you can also floss after every meal. If you have trouble flossing, please let us know at your next cleaning, as there are many products that can make flossing easier.
  • Mouthwashes: The best over-the-counter mouthwash is Listerine, which has a lasting effect of up to 12 hours. Using Listerine twice a day will help kill off bacteria that cause gum disease and cavities. The less bacteria in your mouth, the more effective brushing and flossing will be.
  • Tongue scrapers: Some people have a tongue with a lot of nooks and crannies in it, and those spaces can harbor bacteria. If your tongue is not a nice even pink color, you may benefit from using a tongue scraper. These are used to gently scrape the surface of the tongue, removing bacteria and food products. As the majority of bacteria in your mouth is found on the tongue, this will have a large impact on reducing the overall amount of bacteria in your mouth.
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