Frequently Asked Questions

Yes, absolutely. We are always happy to welcome new patients and families to the clinic. You can book using the Book Now button at the top of any page, or simply call us.

Your first visit is about getting to know you. We review your dental and medical history, take digital X-rays if they are needed, and complete a comprehensive exam of your teeth, gums, bite and soft tissues — including an oral cancer screening. Dr. Radomsky then walks you through exactly what we found and builds a treatment plan with you. Plan on roughly 60–90 minutes.

Bring your insurance card or policy details, a list of any medications and supplements you take (including blood thinners and bone medications), and the name of your family doctor. If you have had X-rays taken elsewhere within the last year, ask that office to forward them so we do not repeat them unnecessarily.

Yes. Your dental records belong to you, and your previous office is required to release copies on request. Just tell us who to contact and we will handle the request. Recent radiographs are especially worth transferring — it saves you a repeat exposure and gives us a baseline to compare against.

Yes — free parking within the building, plus ample paid parking in the building's parkade and street parking along Broadway and the surrounding streets. We are also conveniently located near major transit lines.

Yes. The building and our operatories are accessible. Let us know in advance if you use a wheelchair, scooter or walker, or if you need extra help transferring, and we will set aside a suitable room and extra time.

Yes, and we welcome it. Bring any treatment plans, X-rays or photos you have. We will do our own exam, explain what we see, and tell you plainly where we agree or disagree — including when the honest answer is that no treatment is needed yet.

Our team speaks several languages. Call the office and let us know what you would prefer — we will book you with someone who can help, or arrange an interpreter where that is needed.

Call us immediately at (604) 263-1701. If you are in severe pain, have knocked out a tooth, or have facial swelling, we prioritise emergency cases and will do our best to see you the same day. Go to the emergency room instead if you have swelling spreading toward your eye or under your jaw, difficulty breathing or swallowing, or a fever with facial swelling — that is a medical emergency, not just a dental one.

Time matters enormously here. Pick the tooth up by the crown, never the root. If it is dirty, rinse it gently in milk or saline for no more than 10 seconds — do not scrub it. Try to reinsert it into the socket and bite gently on a clean cloth. If you cannot, store it in cold milk or the patient's own saliva (not water) and get to us immediately. Replanted teeth have the best prognosis within the first 30–60 minutes, and a tooth left dry for over an hour rarely survives. Never reimplant a baby tooth — it can damage the developing adult tooth underneath.

We recommend booking your next hygiene visit before you leave the office — usually six months ahead. The popular slots (early mornings, after school and Fridays) fill first, so booking ahead is how you get the appointment you actually want.

We ask for at least 48 business hours' notice so we can offer the time to someone waiting. Short-notice cancellations and missed appointments may be subject to a fee. Life happens — call us and talk to us, we are reasonable.

Yes, and you are far from alone — dental anxiety affects a large share of adults, and avoidance reliably makes both the dentistry and the fear worse over time. Tell us when you book. We can schedule longer, unrushed appointments, explain everything before we do it, agree on a stop signal you can raise at any moment, use strong topical numbing before any injection, and discuss sedation options. Starting with a simple no-treatment visit just to meet us and talk is completely acceptable.

It should not. We apply topical anaesthetic gel first, warm the anaesthetic, and inject slowly — injection discomfort is driven far more by speed of delivery than by the needle itself. If you have had painful freezing in the past, tell us; that is usually a technique problem, not something about you.

Most local anaesthetics keep the tooth numb for 1–3 hours, with soft-tissue numbness of the lip, tongue and cheek lasting longer — often 3–5 hours. Wait until sensation fully returns before chewing, because it is very easy to bite your lip or tongue without feeling it. This matters especially with children, who may chew a numb lip out of curiosity.

You are welcome to, but where possible we would suggest arranging care for treatment appointments so you can actually relax. For your child's own appointments we encourage you to come along — familiarity with the office helps a great deal.

Yes. A virtual consult is a good way to have a problem looked at, get a preliminary opinion on cosmetic options, or work out how urgently you need to be seen. It does not replace an in-person exam and X-rays for a firm diagnosis, but it can save you a trip.

Yes, we offer direct billing to most major insurance providers, including Pacific Blue Cross, Sun Life, Manulife and Canada Life. You only pay the portion your plan does not cover, at the time of your visit.

Costs depend on the complexity of the treatment. Before any major procedure we can send a pre-determination to your insurer — a written estimate of what they will cover and what your out-of-pocket portion will be. You will always receive a written treatment plan with fees before we start anything.

Visa, MasterCard, Debit and cash. Payment is due at the time of service for any amount not covered by insurance.

No. Insurance plans are contracts between you and your employer's insurer, with annual maximums and exclusions set by that contract — they are not clinical judgments about your mouth. A plan may decline to pay for something you genuinely need, and may happily pay for something optional. We will tell you what we think you need and why; what your plan covers is a separate question.

It is a request we send to your insurer describing the proposed treatment, so they respond in writing with what they will pay. It is worth doing for crowns, bridges, implants, dentures, gum treatment and anything else substantial. It typically takes 2–4 weeks, so we build it into planning rather than delaying urgent care for it.

We have a dedicated CDCP page covering eligibility, what is included, and how billing works at our office. The short version: CDCP covers a defined list of services at established rates, and some treatments require pre-authorisation. Bring your Sun Life CDCP member card and we will go through it with you.

Two common reasons. First, most plans reimburse a percentage — often 80% for basic services and 50% for major work. Second, many plans reimburse against an older or provincial fee guide rather than current fees, so a gap remains. We show you the numbers before treatment so nothing is a surprise.

If the treatment is not urgent, we can often stage it across two benefit years so you get the benefit of two annual maximums. If it is urgent, we will say so — deferring an active infection or a cracked tooth to save on insurance usually costs more in the end. We will lay out both paths honestly.

Short-notice cancellations and no-shows may be subject to a fee, since that time was reserved specifically for you. Give us 48 business hours' notice and there is no issue.

Not necessarily — but the comparison has to be honest. A large filling costs less than a crown today, and for a tooth with enough remaining structure it is the right call. For a heavily broken or root-canal-treated back tooth, that same filling is far more likely to fail and take the tooth with it. We will tell you which situation you are actually in rather than defaulting to the bigger treatment.

For most adults, every six months. But recall intervals should be risk-based, not automatic. If you have active gum disease, a high cavity rate, diabetes, dry mouth, or you smoke, intervals of 3–4 months meaningfully improve outcomes. If you have a stable, low-risk mouth, longer intervals can be entirely appropriate. We set your interval based on your actual risk and revisit it as things change.

Yes. Brushing and flossing remove plaque — the soft biofilm. Once plaque mineralises into calculus (tartar), typically within a couple of days, it bonds to the tooth and cannot be removed by brushing at any pressure. That calculus then acts as a rough, retentive surface holding more plaque against the gum. Only instrumentation removes it.

No — bleeding is a sign of inflammation, not of brushing too hard. Healthy gums do not bleed when cleaned properly. Bleeding usually means gingivitis, which is fully reversible with thorough daily plaque removal and a professional cleaning. The instinct to brush that area less is exactly backwards; it is the plaque you are leaving behind that is causing it. If bleeding persists beyond 10–14 days of good technique, come and see us.

Gingivitis is inflammation of the gum only — red, swollen, bleeding gums — and it is fully reversible. Periodontitis is what happens when that inflammation extends to the bone and ligament holding the tooth in, causing irreversible attachment and bone loss. Bone that is lost does not grow back on its own. The goal of periodontal treatment is to arrest the process and keep what you have, which is exactly why catching it at the gingivitis stage matters so much.

Periodontitis is consistently associated with cardiovascular disease, poorly controlled diabetes, adverse pregnancy outcomes and respiratory conditions. The link with diabetes is the best established and runs in both directions: high blood sugar worsens gum disease, and periodontal inflammation makes glycemic control harder — treating gum disease produces measurable improvements in HbA1c. For most of the other associations the evidence shows a real link but does not yet prove that gum treatment prevents those diseases. Managing your gums is well worth doing on its own merits.

It is the non-surgical treatment for periodontitis: cleaning plaque and calculus from the root surfaces below the gumline, usually with freezing, often over more than one visit. It is the standard first-line treatment and works well for most patients. Afterwards gums often shrink slightly as inflammation resolves — that is healing, not damage, though it can leave teeth feeling more sensitive or looking longer for a while.

The evidence favours it. Powered brushes — oscillating-rotating ones in particular — remove modestly more plaque and reduce gingivitis more than manual brushing, and the difference holds up over months. Much of the benefit comes from the built-in timer and reduced reliance on technique. That said, a manual brush used well beats an electric brush used badly.

Toothbrush bristles do not reach between teeth, and that is where a large share of cavities and gum disease begin. What matters is that you clean between your teeth daily — floss, interdental brushes or a water flosser. For anyone with gaps, bridges or implants, interdental brushes are often more effective and easier than string floss. The best tool is the one you will actually use every day.

No. Mouthwash does not mechanically disrupt the biofilm. A fluoride rinse can add caries protection, and chlorhexidine is a genuinely effective short-term antiseptic we sometimes prescribe after surgery — but chlorhexidine causes staining and taste changes with long-term use, so it is not a daily-forever product.

The large majority of persistent bad breath originates in the mouth — most commonly from bacteria on the back of the tongue, and from gum disease or decay. Tongue cleaning, treating gum disease and staying hydrated address most cases. If your mouth is healthy and it persists, the cause may be sinus, reflux, tonsil stones, medication-related dry mouth or, rarely, a systemic condition — and we will help you work out where to look.

It uses a controlled spray of warm water, air and a fine erythritol or glycine powder to remove biofilm and stain from teeth, restorations and implant surfaces. It is comfortable, quicker than scraping stain away, and gentle around implants and orthodontic brackets. It supplements instrumentation for hard calculus rather than replacing it.

Quite a lot. Saliva buffers acid, clears food, and delivers the calcium and phosphate that repair early enamel damage. Reduced saliva — from medications, radiation therapy, Sjögren's syndrome or mouth-breathing — sharply raises cavity risk, often producing rapid decay at the gumline in people who never previously had problems. Hundreds of common medications reduce saliva. Tell us what you take and we will set you up with high-fluoride toothpaste, saliva substitutes and shorter recall intervals.

Yes, at the doses used in dentistry. Topical fluoride works by making enamel more resistant to acid and by promoting remineralisation of early lesions. The main risk of excess is dental fluorosis, which is cosmetic and only arises from swallowing too much fluoride while the adult teeth are still forming, before roughly age 8. That is precisely why children should use a rice-grain smear under age 3, a pea-sized amount from 3–6, and be supervised while brushing.

Frequency matters more. Every sugar exposure drops the pH in your mouth into the range where enamel dissolves, for roughly 20–40 minutes afterwards. One dessert eaten in one sitting is far less damaging than the same sugar sipped across an afternoon. Sipping sweetened coffee, juice or soda through the day keeps your teeth under near-continuous acid attack — that is the pattern that produces widespread decay.

Wait about 30 minutes after acidic things — citrus, wine, sports drinks, or after vomiting. Acid temporarily softens the enamel surface, and brushing immediately can abrade that softened layer. Rinse with water straight away instead, then brush later.

Yes, considerably. Smoking is the strongest modifiable risk factor for periodontitis, roughly doubling to tripling risk, and it suppresses gum bleeding — meaning gum disease progresses more silently. It substantially increases oral cancer risk, impairs healing after extractions (a leading cause of dry socket), and raises implant failure rates. Vaping is not harmless either: the evidence is younger, but it shows increased gum inflammation, dry mouth and biofilm changes. Quitting measurably improves periodontal treatment outcomes.

Yes — the doses are extremely small. A set of digital bitewings is on the order of a few microsieverts, and a panoramic image averages around 20 µSv. For context, natural background radiation gives everyone roughly 2,400 µSv per year, so a panoramic image is comparable to a couple of days of simply being alive. Digital sensors cut the dose substantially versus old film, and we use lead aprons and thyroid collars and only take images that will actually change what we do.

There is no fixed schedule — it depends on your risk. Someone with a history of decay may need bitewings every 6–12 months; someone with a stable, low-risk mouth may go 24–36 months. A panoramic image is taken far less often. We follow the ALARA principle — as low as reasonably achievable — prescribing images for a reason, not by routine.

Dental X-rays are considered safe during pregnancy: the beam is directed at your head, the dose is minute, and the fetal dose is effectively negligible, particularly with an apron. Both dental and obstetric bodies agree that necessary dental radiographs and necessary dental treatment should not be deferred during pregnancy, because untreated infection is the greater risk. That said, we generally postpone purely routine screening images until after delivery. Always tell us if you are or might be pregnant.

Because a large share of dental disease is invisible to the eye. Cavities between teeth, bone loss from gum disease, infections at root tips, cysts, impacted teeth and many tumours simply do not show on a visual exam until they are advanced. X-rays let us find problems while they are still small and inexpensive to fix.

It is a systematic examination of your lips, tongue (including the sides and underside), floor of mouth, palate, cheeks, throat and neck lymph nodes, looking for lesions, colour changes or lumps. It takes a couple of minutes and we do it at your checkups. It matters because oral cancer found early has a far better survival rate than oral cancer found late — and early lesions are typically painless, which is exactly why people do not notice them.

Tobacco in any form and heavy alcohol use are the classic risks, and they multiply each other. HPV (particularly HPV-16) is now a major cause of oropharyngeal cancer, and it affects people with no tobacco or alcohol history at all — often younger patients. Sun exposure raises lip cancer risk. Anything unusual that does not heal within two weeks — an ulcer, a red or white patch, a lump, numbness, persistent hoarseness or difficulty swallowing — should be looked at, not waited out.

Where it is appropriate, yes. Digital intraoral scanning is far more comfortable than trays of impression material, avoids gag-reflex problems, and lets you see your own scan on screen. For some cases conventional impressions still give the better result, and we will tell you which we are using and why.

With modern composite (white) fillings the material is fully set before you leave, so you can eat as soon as the freezing wears off. Wait for sensation to return so you do not bite your lip or cheek. If you had an amalgam filling placed, avoid heavy chewing on it for about 24 hours.

Composite bonds to tooth structure, so we can remove less healthy tooth to place it, and it matches your tooth. Amalgam requires undercuts for mechanical retention, meaning more sound tooth has to be cut away, and over years it can wedge the cusps apart and contribute to cracks. To be straightforward about the evidence: amalgam is durable — systematic reviews give it a median survival above 16 years versus about 11 for composite in back teeth — but that gap has narrowed with modern materials and technique, and the conservation of tooth structure plus aesthetics is why composite is our default.

Health Canada, the FDA and the WHO all conclude that amalgam is safe for the general population, and there is no evidence that removing sound amalgam fillings improves health. In fact, drilling out an intact amalgam creates a short spike in mercury vapour exposure and sacrifices tooth structure for no benefit. Extra caution is advised in pregnancy and in young children when placing new amalgams — but that is not a reason to remove existing ones.

Only if there is a clinical reason — recurrent decay underneath, a fracture in the filling or the tooth, an open margin, or a genuine wish to change the appearance. “It is old” is not a reason. Every replacement removes a little more tooth and moves that tooth one step closer to needing a crown.

Well-placed composite restorations have annual failure rates of about 1–3%, so a large majority are still serving after 10 years. Longevity depends far more on you than on the material: your cavity risk, your hygiene, whether you grind, and how large the filling is relative to the tooth that remains.

Some sensitivity to cold and pressure for a few days to a few weeks is normal — the nerve responds to being drilled and restored — and it should trend downward. What is not normal: sensitivity that worsens over time, lingering pain for more than 30 seconds after cold, spontaneous or night pain, or pain on biting that persists past a couple of weeks. Any of those, call us. It may simply be a high bite needing a five-minute adjustment, or it may mean the nerve is inflamed.

Early ones, yes. A lesion confined to enamel that has not cavitated can remineralise with high-fluoride toothpaste, fluoride varnish, dietary change and good plaque control — and we will often monitor rather than drill. Once the lesion breaks through into dentine and cavitates, the surface can no longer be cleaned or remineralised, and it needs restoring.

It grows — and the cost curve is steep. A small filling becomes a large filling, then a crown, then a root canal and crown, then an extraction and implant. Decay also accelerates once it reaches dentine, which is softer than enamel. And a tooth that reaches the nerve can go from painless to abscessed with very little warning.

Most do. Restorations have finite lifespans, and each replacement is slightly larger than the last — that is the restorative cycle. The way to slow it is to not need the first filling, and after that to keep the margins clean so the failure mode is not new decay.

Call the office to book an appointment to have the temporary crown recemented. This should be done as soon as possible. Teeth move slightly when there is nothing adjacent holding the space, so the temporary crown needs to be recemented promptly to prevent tooth movement — even slight drifting of the neighbouring or opposing teeth can mean the permanent crown no longer seats properly when it arrives, which means remaking it. Keep the temporary and bring it with you. In the meantime, keep the area clean and avoid chewing on that side.

A crown covers and splints the whole tooth, where a filling sits inside it. Once a tooth has lost enough structure — a large old restoration, a fracture, a broken cusp, or root canal treatment — a filling leaves the remaining walls unsupported, and they flex and split under chewing load. A vertical root fracture usually cannot be repaired and the tooth is lost. The crown is what prevents that.

Modern all-ceramic materials — lithium disilicate and contemporary zirconia — are translucent and layered in a way that matches surrounding teeth closely. We match shade against your adjacent teeth in natural light, and where the aesthetic demand is highest, on front teeth, we can involve the laboratory more directly.

Contemporary ceramic crowns show survival rates commonly above 90% at 10 years. What ends a crown's life is rarely the crown itself — it is usually decay at the margin where crown meets tooth, or fracture of the underlying tooth. Cleaning that margin every day is the single highest-value thing you can do.

The appointment is done under local anaesthetic and should not be painful. Afterwards, mild sensitivity for a few days to a couple of weeks is common while the tooth settles.

Sometimes, and it is worth knowing upfront. Crown preparation removes tooth structure close to the nerve, and studies of pulp survival after full-coverage preparation report the need for root canal treatment in a meaningful minority of cases — the figures vary considerably with how compromised the tooth already was, with intact teeth faring much better than heavily broken or previously deeply restored ones. It is usually the accumulated history of the tooth, not the crown appointment, that decides this. If a tooth does become symptomatic later, root canal treatment can usually be done through the crown without replacing it.

Avoid sticky and hard foods on that side — caramel, gum, nuts, ice. When you floss, do not pull the floss up out of the contact; slide it out sideways so you do not lift the temporary off. It is cemented with deliberately weak cement so it can be removed later, so it is normal for it to feel less solid than the final crown.

Brush and floss it exactly like a natural tooth, with particular attention at the gumline where the crown margin sits. The crown material cannot decay, but the tooth underneath it absolutely can. Avoid using it to open packaging or crunch ice, and wear a night guard if you grind.

It is urgent but not usually an emergency. Keep the crown, do not try to glue it back with household adhesive, avoid chewing on that side, and call us. Often the crown can simply be recemented if the underlying tooth is sound. If there is decay under it or the tooth has fractured, we need to address that first.

If a tooth has broken or decayed at or below the gumline, there is not enough sound tooth above the gum for a crown to grip, and no restoration can be sealed reliably against the biological attachment. Crown lengthening reshapes gum and a small amount of bone to expose more tooth. It is what makes an otherwise unrestorable tooth restorable.

Conventional bridges commonly serve 10–15 years or longer. The most frequent reasons for failure are decay in an abutment (supporting) tooth and loss of the cement seal — both of which come down largely to how well the margins are cleaned.

It takes a different tool, not more effort. Because the bridge is joined, ordinary floss cannot pass between the units — you use a floss threader or superfloss to pass under the pontic (the replacement tooth), or an interdental brush. Skipping this is the main way bridges fail, because plaque then sits against the abutment margins undisturbed.

An implant does not touch the neighbouring teeth, which is a significant advantage when they are healthy and unrestored: a bridge requires cutting them down for crowns. Implants also preserve the bone that resorbs under a bridge pontic. A bridge is faster (weeks rather than months), requires no surgery or bone volume, and may be the better choice if the adjacent teeth already need crowns anyway, or if you smoke heavily, have uncontrolled diabetes, or cannot have surgery. It genuinely depends on your specific mouth.

Teeth are not fixed in place. The teeth beside a gap drift into it and the opposing tooth over-erupts down into it, over months to years. That creates food traps, uneven bite forces, and makes replacing the tooth later harder and more expensive — sometimes requiring orthodontics first. Front gaps also affect speech. Leaving a gap can be a legitimate decision, particularly for a last molar, but it should be a decision, not a default.

Sometimes a chipped porcelain surface can be smoothed or repaired with composite. But if an abutment tooth decays or the framework fractures, the whole bridge usually has to come off — and removing it can damage the abutment teeth. That is part of why maintenance matters so much.

Placement is done under local anaesthetic, and most patients report it as more comfortable than expected — often comparable to or easier than an extraction. Afterwards, expect swelling and soreness for a few days, generally well managed with over-the-counter anti-inflammatories.

The evidence is strong: meta-analyses put 10-year implant survival at around 96%. That figure is for the implant fixture itself — the crown attached to it is a separate component and typically needs replacing at some point, commonly in the 10–15 year range. Neither is a guarantee: survival depends heavily on smoking, diabetes control, gum disease history and maintenance.

Usually 3–6 months from placement to the final crown, because the implant must osseointegrate — bone has to grow into direct contact with its surface. If a graft is needed first, add several more months. Some cases allow immediate placement or an immediate temporary tooth, but that depends on bone quality and stability at placement, not on preference.

Most adults are, provided there is enough bone volume, healthy gums, and reasonably controlled general health. Uncontrolled diabetes, heavy smoking and active periodontitis all raise failure risk substantially and are usually addressed first. Certain medications — high-dose intravenous bone medications in particular — change the calculus. Growth must also be complete, so implants are normally deferred in adolescents.

Yes, they can. Peri-implantitis is inflammation around an implant with progressive bone loss — essentially gum disease around an implant. It is not rare: systematic reviews report it in roughly 20% of implant patients, with the milder, reversible form (peri-implant mucositis) affecting a substantially higher share. The key risks are a history of periodontitis, smoking, diabetes and poor maintenance. Implants cannot get cavities, but they are not maintenance-free — arguably they need more attention than natural teeth, not less.

Functionally, very close — you can eat normally and it does not move. The one real difference is that an implant fuses directly to bone without a periodontal ligament, so you get less fine pressure feedback than from a natural tooth. Most people stop noticing within weeks.

When a tooth is removed, the bone that supported it loses its purpose and resorbs — most rapidly in the first 3–6 months, with the greatest loss on the outer (facial) plate. If there is not enough bone height or width left to fully house an implant, grafting rebuilds it. Grafting at the time of extraction (socket preservation) is often easier and more predictable than rebuilding later.

It is a well-established, routine procedure. Graft material may be your own bone, processed human donor bone, bovine-derived mineral, or fully synthetic material — all rigorously processed and regulated, with an extremely strong safety record. We will tell you which we are using and why, and we are happy to use synthetic material if you would prefer.

Soft tissue closes within a couple of weeks, but the graft needs roughly 4–9 months to mature into bone capable of holding an implant, depending on the size and the site. Rushing that step is a common cause of implant failure.

You can, but you should know the numbers are not in your favour — smoking significantly increases both early failure and later peri-implantitis, and it impairs graft healing in particular. We will not refuse to treat you, but we will be honest that stopping even just for the healing period materially improves your odds.

Expect a genuine adjustment period — commonly a few weeks to a few months for full dentures. Early on, increased saliva, a feeling of bulk, and difficulty with certain sounds are all normal. Practise reading aloud, start with soft foods cut small, and chew on both sides at once to keep the denture stable. It does get better, but it takes deliberate practice.

No — take them out overnight. Your gum tissues need relief from constant pressure, and wearing dentures 24/7 is strongly associated with denture stomatitis, a Candida-driven inflammation of the palate. Clean them and store them in water or a denture solution so they do not dry out and warp.

Brush them daily with a denture brush and mild soap or denture cleaner — not regular toothpaste, which is abrasive enough to scratch the acrylic and create plaque-retentive surfaces. Rinse after meals. Clean them over a sink of water or a folded towel, because acrylic fractures easily on a hard surface. And still brush your gums, tongue and palate to remove biofilm and stimulate the tissue.

They should not. Modern denture teeth come in a wide range of shapes, shades and translucencies, and a well-made denture is set up to match your face, lip line and age — including deliberate slight irregularity, because perfectly uniform teeth are exactly what reads as false. If you have photographs of your own teeth from before, bring them.

Because the ridge underneath them keeps resorbing. Without tooth roots to stimulate it, the jawbone slowly shrinks for the rest of your life, so a denture that fitted perfectly will not fit the same ridge in five years. That is why relines exist — and why lower dentures, with far less surface area to grip, become loose sooner than uppers.

A reline resurfaces the fitting side of your existing denture to match your current ridge. Most people need one every few years. It is far cheaper than a remake, and continuing to wear a poorly fitting denture causes sore spots, accelerated bone loss and sometimes tissue overgrowth.

A small amount can add confidence and stability, particularly on a lower denture. But adhesive is not a fix for a badly fitting denture. If you need steadily more adhesive to get through the day, that is a signal to have the fit assessed, not to buy a bigger tube.

Yes — and this is one of the highest-impact things in dentistry for quality of life. Two implants in the lower jaw with attachments can convert an unstable lower denture into one that snaps in and stays put, dramatically improving chewing ability and confidence. It is far less involved and less expensive than replacing every tooth with an implant.

Yes. We check the fit of the denture, look for sore spots and tissue changes, assess bone loss and — importantly — screen for oral cancer. Denture wearers are often older and may have tobacco or alcohol histories, and a denture can hide a lesion from view. An annual check is well worth keeping.

With local anaesthetic only, yes — you are numb, not impaired. If you have any form of sedation (oral, nitrous with a sedative, or IV), you must have someone drive you and ideally stay with you afterwards.

Bite firmly on gauze for 30–45 minutes to form a clot, then leave the site alone. For the first 24 hours: no rinsing or spitting, no straws, no smoking, no hot liquids, no vigorous exercise, and no poking at the socket. That clot is the foundation of healing, and dislodging it is what causes dry socket. Use ice on the outside of the face 20 minutes on and off for the first day, keep your head slightly elevated, and take pain relief before the freezing wears off rather than after.

Dry socket (alveolar osteitis) is loss or breakdown of the blood clot, leaving bone exposed. It typically appears 2–4 days after the extraction as severe, throbbing pain radiating to the ear, often with a bad taste — and it is disproportionately painful relative to how it looks. It follows roughly 3% of routine extractions, but is dramatically more common after impacted lower wisdom teeth, where reported rates reach 20–30%. Smoking, oral contraceptives and a previous dry socket all raise the risk. It is very treatable — we irrigate the socket and place a medicated dressing, and relief is usually rapid — so call us rather than enduring it.

Brush your other teeth normally the same evening — a clean mouth heals better. Just avoid the extraction site itself for the first few days, and start gentle warm salt-water rinses after the first 24 hours, not before.

Swelling typically peaks around 48–72 hours and then subsides; some bruising is normal, particularly in older patients. Pain should peak in the first day or two and steadily improve. Call us if pain increases after day three, if swelling worsens after day three, if you develop a fever, if you cannot open your mouth, or if bleeding is heavy and will not stop with 30 minutes of firm gauze pressure.

Not automatically. Wisdom teeth that are fully erupted, functional, cleanable and free of disease can be left alone and monitored. Removal is indicated for recurrent pericoronitis (infection of the gum flap over a partly erupted tooth), decay in the wisdom tooth or the molar in front of it, cysts, or damage to the adjacent tooth. Prophylactic removal of genuinely asymptomatic, disease-free impacted teeth is debated in the literature. That said, surgery is generally easier with faster healing in the late teens and early twenties, when roots are less developed and bone is less dense — so timing is a real consideration.

The main ones are dry socket, infection and — specific to lower wisdom teeth — injury to the inferior alveolar nerve or lingual nerve, causing numbness or altered sensation of the lip, chin or tongue. Temporary nerve disturbance is reported across a wide range in the literature, while permanent alteration is uncommon, generally under 1%. Upper wisdom teeth carry a small risk of communication with the sinus. Risk depends heavily on how close the roots sit to the nerve canal — which is exactly what we assess on your imaging beforehand, and why a 3D scan is sometimes recommended in higher-risk cases.

Usually not. Routine antibiotics after a straightforward extraction do not improve outcomes and contribute to resistance and side effects. We prescribe them when there is a genuine indication — spreading infection, systemic signs, or specific medical conditions. Pain after an extraction is usually inflammatory and responds far better to anti-inflammatories than to antibiotics.

In most cases yes — and removing the source is often the definitive treatment. Very acutely inflamed tissue can be harder to freeze fully, so occasionally we will drain the infection and start antibiotics first to get you comfortable, then extract. We will not leave you in pain waiting.

Do not stop any blood thinner on your own. Current guidance is that most routine dental extractions can be performed without interrupting anticoagulant or antiplatelet therapy, because the bleeding is manageable with local measures while stopping the medication carries a real risk of stroke or clot. We will coordinate with your physician where needed. Tell us exactly what you take and when you take it.

It is important that you tell us. Bisphosphonates and denosumab, which reduce fracture risk, are associated with medication-related osteonecrosis of the jaw (MRONJ) after extractions. For patients taking oral bisphosphonates for osteoporosis the risk is low — best current estimates sit in the region of 0.5% after extraction — while it is substantially higher for patients on high-dose intravenous therapy for cancer. This does not mean you cannot have treatment; it means we plan carefully, take a preventive approach, and where possible complete any needed extractions before such therapy begins.

Professionally supervised whitening does not cause clinically meaningful enamel damage. Peroxide can produce small, transient changes in surface hardness, which saliva remineralises over the following days — systematic reviews find the effect small and of uncertain clinical relevance. The real risks come from unsupervised misuse: excessive concentration, excessive duration and acidic DIY methods.

Often, and temporarily. Transient sensitivity is the most common side effect, reported across studies in a wide range — from roughly 15% up to two-thirds of users, depending on concentration and protocol. It typically starts within the first few days and resolves within days of finishing. Potassium nitrate and fluoride desensitising gels, shorter wear times, and taking a day off between sessions all help. It is not a sign of damage.

Typically 1–3 years, but it varies enormously with habits. Coffee, tea, red wine, dark berries, curry and tobacco all re-stain teeth. Most people maintain results with occasional top-up trays, which is exactly why custom trays are valuable — you keep them.

No. Peroxide only whitens natural tooth structure; ceramic and composite do not change shade. This matters for planning: if you have visible restorations on your front teeth and you want everything to match, whiten first, wait about two weeks for the shade to stabilise and bond strength to recover, then replace the restorations to the new shade. Doing it the other way round means redoing the work.

They reach comparable end results; they differ in the path. In-office is faster and fully supervised, so it is good if you have a deadline. Custom take-home trays use lower concentrations over a longer period, generally with less sensitivity, and leave you with trays for future top-ups. Many people do a combination of both.

Strips from reputable manufacturers do work, though more slowly and less evenly than custom trays — a one-size tray cannot match your arch, so the gel contacts gums and misses edges. Charcoal is a different matter: there is no good evidence it whitens, and it is abrasive. Abrading enamel exposes the yellower dentine underneath, so the long-run effect can be darker teeth, not whiter. Kits sold online with unregulated peroxide concentrations are worth avoiding entirely.

Not all discolouration responds to peroxide. Surface stain and age-related yellowing respond well. Intrinsic discolouration — tetracycline staining, fluorosis, a trauma-darkened non-vital tooth, or simply thin enamel showing dark dentine — responds poorly or not at all, and those cases are better served by bonding or veneers. A single dark tooth after trauma may need internal bleaching following root canal treatment instead.

There is no evidence of harm, but there is also no good safety data — so the conventional and sensible advice is to postpone elective whitening until after pregnancy and nursing. It is cosmetic, and it can wait.

We prefer to wait until the permanent teeth are fully erupted and mature, generally mid-teens at the earliest, because younger teeth have larger pulp chambers and are more prone to sensitivity. In this age group it should always be dentist-supervised.

Well, when properly bonded. A systematic review of 25 studies covering around 6,500 porcelain laminate veneers reported a 10-year cumulative survival of about 95.5%. The single most important factor is bonding to enamel rather than dentine — veneers bonded predominantly to enamel perform markedly better, which is a strong argument for minimal preparation.

Conventional porcelain veneers are not. They require removing a layer of enamel, and enamel does not regenerate — from that point the tooth will always need something covering it. “No-prep” or minimal-prep veneers exist and are genuinely conservative in suitable cases, but they do not suit every situation, particularly teeth that are already prominent or dark. Anyone presenting veneers as freely reversible is overselling them.

Bonding is composite applied and sculpted directly in a single visit: less expensive, little or no tooth removal, and repairable. Its trade-offs are that it stains over time and chips more readily, with a typical lifespan of around 5–8 years. Veneers are lab-made porcelain: more expensive, requiring at least two visits and irreversible preparation, but far more stain-resistant and longer lasting. For one small chip, bonding. For eight front teeth being reshaped and rebrightened, usually veneers.

Bonding on an unprepared surface often needs no freezing at all. Veneer preparation is done under local anaesthetic and is comfortable; expect some temporary sensitivity between preparation and cementation, while the teeth are in temporaries.

Absolutely — arguably more carefully. The porcelain cannot decay, but the tooth behind and beneath it can, and the margin at the gumline is the vulnerable point. Veneers fail at the margins, from decay and gum inflammation, far more often than they fail as porcelain.

No — composite and porcelain do not respond to peroxide. If the surrounding natural teeth whiten, the restoration will begin to look darker by comparison, and matching it again means replacing it. So whiten before cosmetic work, not after.

It is usually a straightforward repair — composite bonds to composite, so we can often add material and repolish in one short visit. That repairability is one of bonding's real advantages over porcelain.

It depends on how much is missing and whether the nerve is involved. A small enamel chip can be smoothed or bonded the same day. A larger fracture into dentine needs bonding or a veneer and may be sensitive. A fracture exposing the pink pulp needs urgent treatment to try to keep the nerve alive. If you still have the broken fragment, bring it in cold milk or water — in some cases it can be bonded back on, which gives an outstanding aesthetic result because it is your own enamel.

A chip that does not hurt still leaves a rough surface that collects plaque and an unsupported edge that tends to keep fracturing — often at a worse angle next time. A painless chip is also not proof the nerve is fine: trauma can cause the pulp to die slowly and silently, showing up months later as a darkening tooth or an abscess. Worth having looked at even when it is comfortable.

They only look fake when they are made to. Natural teeth vary slightly in shape, have translucent edges, and are not blindingly uniform white. A good result is planned in advance — with photographs, digital design and often a trial mock-up you wear temporarily, so you can see and approve the shape before anything irreversible happens. If you want to see it before committing, ask; that is an entirely reasonable request.

You can, but grinding is the leading cause of porcelain fracture and it must be managed as part of the plan — normally with a night guard worn from the day the veneers are placed. Placing veneers on an untreated grinder without protection is a predictable route to broken porcelain.

It is reshaping the gum line — typically for a gummy smile, where a lot of gum shows when you smile, or for an uneven gum line that makes teeth look mismatched in length. Because a smile reads as much through gum symmetry as through the teeth themselves, small changes here have an outsized effect.

When tissue is removed with adequate bone contouring and biologic width respected, the result is stable. Some rebound is normal in the first weeks as the tissue matures. If gum was removed without addressing the underlying bone, tissue does tend to grow back — which is why the assessment beforehand matters more than the procedure itself.

Not always. The same technique (crown lengthening) is used to expose enough sound tooth for a crown or filling when a tooth has broken near the gumline, and to remove overgrown tissue that traps plaque. Some gum overgrowth is caused by medications — certain calcium channel blockers, anticonvulsants and immunosuppressants — and in those cases we may liaise with your physician too.

Mild soreness for a few days, managed with over-the-counter pain relief, and soft foods for a short period. Surface tissue looks settled within one to two weeks, though full maturation of the gum line takes a few months — which is why we do not finalise front-tooth veneers or crowns immediately after contouring.

Recession is the opposite problem, and it is not corrected by contouring. Causes include aggressive horizontal brushing with a hard brush, gum disease, a thin tissue biotype, grinding and tooth position. Mild recession is often simply monitored with the cause removed. Where there is sensitivity, ongoing progression or an aesthetic concern, a gum graft can cover the exposed root. The first step is always identifying why it is happening — otherwise a graft recedes too.

Common signs are waking with jaw soreness or headaches at the temples, teeth that are flattened or shortened with matching wear on opposing teeth, hairline cracks in enamel, increased cold sensitivity, scalloped indentations along the edge of the tongue, and a partner who hears grinding. Many people grind without ever hearing themselves — the wear pattern tells us.

That is the right question, and it deserves an honest answer: a night guard does not cure bruxism, which is centrally driven and linked to sleep arousal, stress and certain medications. What it does is redistribute the load and give the force somewhere to go — the guard wears down instead of your enamel, your restorations and your veneers. Many patients also report less morning jaw and muscle soreness. Protection, not cure.

Usually the upper arch, which most people find more retentive and comfortable, but a lower guard is preferable for some — particularly if you have a strong gag reflex. Either can work; what matters far more is that it is custom-made to fit and correctly adjusted to your bite.

They are better than nothing for short-term use, but they have real drawbacks. They are bulkier, they fit imprecisely, they can allow teeth to shift over months of wear, and being softer they can actually encourage more clenching in some people. A poorly fitting guard that changes your bite is a genuine risk, not a theoretical one.

Rinse it and brush it with a soft brush and cool water — never hot water, which distorts the acrylic — as soon as you take it out. Let it dry fully before storing it in its ventilated case; storing it damp and sealed grows bacteria and fungi. Bring it to your checkups and we will check the fit and clean it properly.

Many plans cover a portion, often under major services and sometimes with a frequency limit (such as one every 3–5 years). We can send a pre-determination so you know before you commit.

They are built for opposite jobs. A night guard is a hard, thin appliance designed to resist slow, sustained grinding forces; a sports guard is thicker and resilient, designed to absorb and disperse a sudden impact. A night guard worn during contact sport can fracture, and can concentrate force rather than dispersing it.

The risk is higher than people assume in basketball, skateboarding, cycling and soccer, where most dental injuries come from collisions with elbows, the ground or equipment rather than from tackles. A custom guard fits better than a boil-and-bite, stays in place, and does not interfere with speech and breathing — which is the real reason kids stop wearing store-bought ones.

A sealant is a thin resin flowed into the deep grooves of back teeth, where the fissures are narrower than a toothbrush bristle and cannot be cleaned. Cochrane reviews consistently find that sealed molars develop significantly less decay than unsealed ones in children and adolescents. They are quick and painless, and require no drilling or freezing.

They typically last several years. We check them at each recall and top them up when they wear — a partially lost sealant should be repaired rather than left. They are tooth-coloured or clear, and essentially invisible in normal conversation.

Not over an established, cavitated lesion — that would trap active decay. Sealants are for sound or very early, non-cavitated surfaces. We assess each tooth first, and where there is any doubt we would rather investigate than seal over a problem.

They are most valuable in children, applied soon after the permanent molars erupt around ages 6 and 12, when those teeth are most vulnerable. But adults with deep, stain-catching grooves and a history of decay can benefit too.

The standard recommendation is by the first birthday, or within six months of the first tooth appearing — whichever comes first. The point is not a full exam on a one-year-old; it is establishing a dental home, checking development, and coaching you on brushing, feeding and habits before problems start. Early positive visits also prevent dental fear from forming.

They matter a great deal. Baby teeth hold space for the permanent teeth (losing one early lets neighbours drift in and cause crowding), and they are essential for eating, speech development and confidence. Decay in a baby tooth can also infect the developing permanent tooth beneath it. Untreated dental decay is one of the most common reasons children miss school and require treatment under general anaesthetic.

Brush from behind them, with their head resting back against you or in your lap, so you can see and reach properly and they cannot twist away — this is a two-minute care task, not a negotiation. Use a rice-grain smear of fluoride toothpaste under age 3 and a pea-sized amount from 3–6. Songs, timers, letting them have a turn first, and brushing your own teeth alongside them all help. Children need an adult brushing or closely supervising until roughly age 7–8, when manual dexterity catches up.

It is normal and usually self-limiting in early childhood. It becomes a concern if it continues past about age 4, or once the permanent front teeth start erupting, because sustained pressure can produce an anterior open bite and a narrowed upper arch. Most of these changes correct themselves if the habit stops early enough. Positive reinforcement works far better than shaming.

Milk, formula and juice all contain fermentable sugars, and saliva flow drops sharply during sleep — so a bottle in bed pools sugar against the upper front teeth for hours. This causes early childhood caries, a rapid and destructive pattern of decay. Water only after brushing at bedtime, and work toward an open cup around age one.

An orthodontic assessment around age 7 is recommended — not because most children need braces then, but because that is when the first permanent molars and incisors are in and we can spot crossbites, severe crowding, impacted teeth or jaw growth discrepancies while growth can still be used to advantage. Most actual treatment still starts later.

Handle it by the crown, not the root; rinse briefly in milk if it is dirty; reinsert it into the socket if you can and have them bite on a clean cloth; if you cannot, store it in milk — and get to us immediately. Prognosis drops sharply with time out of the socket. If it is a baby tooth, do not reimplant it, because doing so can damage the permanent tooth developing above — but still bring them in.

Because it genuinely changes what we do. Blood thinners affect bleeding management, bone medications affect extraction planning, diabetes affects healing and gum disease, certain heart conditions may require antibiotic premedication, and hundreds of common drugs cause dry mouth or gum overgrowth. A quick update each visit takes seconds and prevents entirely avoidable problems.

Yes — and you should. Preventive care, cleanings and necessary treatment are safe throughout pregnancy, and untreated infection poses a greater risk to you and the pregnancy than treating it does. The second trimester is generally the most comfortable for elective work. Pregnancy gingivitis is very common due to hormonal changes, so cleanings matter more, not less. Tell us that you are pregnant and how far along, and we will adjust positioning, medications and imaging accordingly.

Two things. First, diabetes raises your risk of gum disease and slows healing, especially when blood sugar is poorly controlled. Second, it runs both ways — periodontal inflammation makes glycemic control harder, and treating gum disease produces a measurable improvement in HbA1c. Practically: keep us informed of your control, aim for more frequent hygiene visits, eat normally before your appointment, and bring your glucose monitoring supplies.

Far fewer people need this than used to. Current cardiology guidance restricts antibiotic prophylaxis to a small group of high-risk cardiac conditions — such as prosthetic valves, previous infective endocarditis and certain congenital heart disease. For prosthetic joints, current dental and orthopaedic guidance no longer recommends routine prophylaxis for most patients. If you were told years ago that you need it, it is worth rechecking with us and your physician rather than assuming.

Yes — ideally before treatment begins. A dental assessment before head and neck radiation, chemotherapy, or the start of high-dose bone-modifying therapy lets us deal with infections and extractions while healing is still normal, which substantially reduces the risk of serious complications later, including osteonecrosis and osteoradionecrosis. During treatment we focus on managing mucositis, dry mouth and the sharply increased cavity risk that follows salivary damage.

Tell us and we will note it prominently in your chart. We can work latex-free, and we will check materials, gloves and local anaesthetic components against your history. Genuine allergy to local anaesthetic is rare — most reactions people remember are to epinephrine or are anxiety-related — but if you have had a reaction, we want the details so we can choose appropriately.

They can. Bruxism and TMJ disorders commonly produce temple headaches, jaw fatigue and pain that refers to the ear, and upper molar problems can also refer pain toward the ear and sinus. Conversely, sinus infections often mimic upper toothache. Because referred pain is genuinely confusing, we test the teeth specifically rather than guessing from where it hurts.

Yes. Dental X-rays do not affect breast milk, and local anaesthetics along with most commonly used dental antibiotics and analgesics are compatible with breastfeeding. Let us know so we can choose medications with that in mind.

For most dental pain, which is inflammatory, an anti-inflammatory such as ibuprofen is more effective than an opioid — and combining ibuprofen with acetaminophen at appropriate doses outperforms either alone, and outperforms common opioid combinations for post-extraction pain. That is well supported in the evidence. We will give you a specific regimen suited to your medical history — and if you cannot take NSAIDs, tell us.