Bentall Dental Centre
General Dentistry Vancouver

General Dentistry Vancouver Dentist Bentall Dental

What is General Dentistry?

General Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body.

We offer general dentistry, dental exams and treatments for overall dental care at our downtown Vancouver Dental Clinic. We conduct a dental examination to identify how healthy your teeth and gums are and any problem areas within your mouth. We will then discuss the options that are available to you and decide which treatment is most suitable.

All of our procedures may be considered cosmetic in nature; we strive to restore tooth functionality while making the teeth look natural. In the past, dental fillings and other tooth restorations were made of gold, amalgam and other metals – some of which were veneered with porcelain. Now, dental work can be made entirely of porcelain or composite materials that more closely mimic the appearance of natural tooth structure. These tooth colored materials are bonded to the underlying tooth structure with resin adhesives. Unlike silver fillings (amalgams) they are entirely free of mercury.

Dental Hygiene is one easy way to keep your oral health in beautiful shape.

On This Page

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Hygiene & Prevention

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Proper Flossing

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Proper Toothbrushing

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Procedures Overview

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Crowns & Caps

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Onlays

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Inlays

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Fillings

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Bridges

Dental Hygiene and Preventative Dentistry

Besides the decay that bacteria can cause if left on your teeth for a length of time, it can start to move into your gums causing inflammation and all sorts of other dental nightmares can occur.

Swollen, tender, inflamed or bleeding gums characterize periodontal disease. Gingivitis is the mildest form of periodontal disease. Both early and advanced periodontal disease can be treated with both surgical and non-surgical therapy.

Preventative dentistry is a four-step process:

  1. Eat a balanced diet
  2. Brush your teeth at least twice a day
  3. Floss daily
  4. Visit your hygienist as often as determined by your dental team. In general, you should have your teeth cleaned at least twice a year

The best way to prevent tooth and gum disease is with proper home care. One of the facts of life and teeth is the build-up of plaque. Plaque is the word used for dental bacteria. You can imagine the damage it does to your teeth if it is not removed. The good news is that by visiting your dental hygienist on a regular basis the plaque is removed and cannot cause damage.

Our Hygiene Examination will proceed like this:

  • Greeting
  • Review of past charting
  • Talk about any issues
  • Digital Xrays are taken if you have not had images done for a while
  • Dental probing is done to check for pockets/recession, gum disease, and bone depths
  • We then clean your teeth using hand tools and the ultrasonic scaler to remove tartar build-up
  • Your teeth are polished and fluoride treatment is provided
  • We also examine your tissues using the VELscope. This is considered a standard of care in our practice

What Is Periodontal (Gum) Disease?

Periodontal (gum) disease is an infection in which bacteria attack the tissues that surround and support teeth. Simply put, it is an infection that can result in tooth loss if not treated. Because it is often painless, you may not be aware that you have a problem until your gums and bone are seriously affected. The good news is that periodontal diseases often can be prevented or treated in the early stages with a treatment call scaling and root planing.

Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means “around the tooth.” Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

There are many forms of periodontitis. The most common ones include the following.

  • Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
  • Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment, and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
  • Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
  • Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament, and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition, and immunosuppression.

What are the warning signs of periodontal disease?

See your dentist and hygienist if you notice any of the following warning signs:

  • gums that bleed easily
  • red, swollen or tender gums
  • gums that have pulled away from the teeth
  • pus between the teeth and gums when the gums are pressed
  • persistent bad breath or bad taste
  • permanent teeth that are loose or spreading
  • any changes in the way your teeth fit together when you bite
  • any changes in the fit of partial dentures

What Is Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body, in essence, turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

What Is Plaque? Calculus?

Plaque is a sticky film of bacteria that clings to teeth and gums. Even if you brush and clean between your teeth every day, you may not completely remove plaque, especially around the gum line. The bacteria in plaque create toxins that injure the gums and underlying bone. Over time, these toxins can destroy gum and bone tissue. Plaque that is not removed completely every 24 to 48 hours hardens into a rough, porous deposit called tartar or calculus. Once tartar develops, the only way to remove it is by having your teeth cleaned at a dental office. Tartar that builds up below (under) the gum line makes it more difficult to remove the film of plaque. This can lead to chronic inflammation and infection. Periodontal (gum) diseases are progressive – if left untreated, the condition will worsen.

Why Do I Need X-rays?

Radiographic, or X-ray, examinations provide us with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays help us determine the presence or degree of periodontal (gum) disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted and un-erupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination.
Our office has been using digital x-rays for the past five years.

What Is the Ultrasonic Scaler?

This is a tool we use to aid in removing tartar build-up from your teeth. The sclera vibrates and shoots out water to flush out the pockets under the gum line. This flushing action is known as “lavage” and helps to flush away the bacterial plaque from under the gums. This helps reduce the incidents of gingivitis and helps keep pockets clean and will even help reduce the size of pockets created by gum disease.

The sclera will also remove larger pieces of calculus build up. This allows Niki to go in with a hand scaler and remove the little pieces that are left behind. The whole process leaves a cleaner fresher feeling in the mouth when the hygiene is completed.

Why Fluoride?

Fluoride is a mineral that helps prevent tooth decay. Fluoride occurs naturally in all water sources. Studies show that fluoride reduces cavities and is effective and safe. The use of fluoride can dramatically reduce tooth decay and help to prevent tooth sensitivities.

Proper Flossing Techniques

What is the Right Way to Floss?

Proper flossing removes plaque and food particles in places where a
toothbrush cannot easily reach — under the gumline and between your
teeth. Because plaque build-up can lead to tooth decay and gum disease,
daily flossing is highly recommended.

To receive maximum benefits from flossing, use the following proper technique:

  • Starting with about 18 inches of floss, wind most of the floss
    around each middle finger, leaving an inch or two of floss to work with.
  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
  • Gently curve the floss around the base of each tooth, making sure
    you go beneath the gum line. Never snap or force the floss, as this may
    cut or bruise delicate gum tissue
  • Use clean sections of floss as you move from tooth to tooth
  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth
Proper Flossing

What Type of Floss Should I Use?

There are two types of floss from which to choose:

  • Nylon (or multifilament) floss
  • PTFE (monofilament) floss
  • Nylon floss is available waxed and unwaxed, and in a variety of
    flavors. Because this type of floss is composed of many strands of
    nylon, it may sometimes tear or shred, especially between teeth with
    tight contact points. While more expensive, single filament (PTFE)
    floss slides easily between teeth, even those with tight spaces between
    teeth, and is virtually shred-resistant. When used properly, both types
    of floss are excellent at removing plaque and debris

Proper Toothbrushing

Proper brushing is essential for cleaning teeth and gums effectively. Use a toothbrush with soft, nylon, round-ended bristles that will not scratch and irritate teeth or damage gums. An electric toothbrush will help you to brush in the manner outlined below and is less irritating on the gums.

Place bristles along the gum line at a 45-degree angle. Bristles should contact both the tooth surface and the gum line.

Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back & forth rolling motion.

Move brush to the next group of 2-3 teeth and repeat.

Gently brush using back, forth, and rolling motion along all of the inner tooth surfaces. Tilt brush vertically behind the front teeth.
Make several up & down strokes using the front half of the brush.

Place the brush against the biting surface of the teeth and use a gentle back and forth scrubbing motion. Brush the tongue from back to front to remove odor-producing bacteria.

Remember to replace your toothbrush every three to four months. Researchers have established that thousands of microbes grow on toothbrush bristles and handles. Most are harmless, but others can cause cold and flu viruses, the herpes virus that causes cold sores, and bacteria that can cause periodontal infections.

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Dental Procedures

There are a variety of dental procedures that may be necessary to do depending on what is going on with your oral health and the state of your teeth. The following is a brief description of dental health issues that fall under the heading of general dentistry. and ones for which Bentall Dental offers treatment.
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Crowns/Caps

When a tooth is severely damaged or decayed, dental crowns act as a protective cover to strengthen the tooth. Read more

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Onlays

Made of a strong, natural-looking material, such as porcelain, onlays are larger restorations, extending over one or more sides of your tooth, and can be used similar to a crown or cap. Read More

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Inlays

If you have a failing metal filling, and the decay is inside the cusp of the tooth, an inlay can be used to restore the tooth to health. Read more

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Fillings

Composite “white” fillings are used to restore teeth that have small cavities. They are called “white” fillings because of the natural, tooth color of the material. Read More

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Dental Bridges

For one or more missing teeth, dental bridges literally “bridge the gap” between the missing tooth and the tooth on either side. Read More

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Root Canal

When someone has infected tissues in the tooth pulp it can cause severe pain and eventually lead to tooth loss. Root canal therapy is designed to remove infected tissue with the goal of saving the tooth.

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TMJ Disorders

TMJ disorders can be the source of a variety of painful symptoms, from headaches to ear and neck pain. A misaligned bite, bruxism (teeth grinding), and other factors can put stress on the temporomandibular joint (TMJ).

We are confident in our treatment of complex cases; however, we do consult with specialists and refer our patients when we see the need.

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Endodontic Dentistry

Is the area of dentistry that deals with the tooth pulp and the tissues surrounding the root of a tooth. We refer all our endodontic work to a specialist.

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Extractions

This 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 also routinely performed, as are extractions of some permanent teeth to make space for orthodontic treatment.

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Orthodontic Dentistry

Is a specialty of dentistry that is concerned with the study and treatment of improper bites, which may be a result of tooth irregularity, disproportionate jaw relationships, or both. Orthodontic treatment can be carried out for purely aesthetic reasons—improving the general appearance of patients’ teeth and face for cosmetic reasons—but treatment is often prescribed for practical reasons, providing the patient with a functionally improved bite (occlusion).

Dental Crowns and Caps

A dental crown that has been cemented into place essentially becomes the new outer surface for the tooth, it is easy to imagine how the placement of a crown can restore a tooth to its original shape. It’s also easy to see how a dental crown can help to strengthen a tooth by way of being a hard outer shell that encases the tooth structure that lies within it. For both of these reasons, dental crowns are routinely made for teeth that have broken, worn excessively, or else have had large portions destroyed by tooth decay.

When a dental crown is made the dental laboratory technician can visualize and examine all aspects of your bite and jaw movements, from a variety of angles, and then sculpt your dental crown so it has the perfect anatomy.

Since a dental crown serves to cup over and encase the visible portion of a tooth, any dental crown that has a porcelain surface can be used as a means to idealize the cosmetic appearance of a tooth. Possibly you have heard it rumored (especially in past decades) that certain movie stars have had their teeth “capped.” This simply means that the person has obtained their “Hollywood smile” by way of having dental crowns placed.

Actually, getting your teeth “capped” just to improve their cosmetic appearance can at times be a very poor choice. Dental crowns are best utilized as a way to improve the cosmetic appearance of a tooth when the crown simultaneously serves other purposes also, such as restoring a tooth to its original shape (repairing a broken tooth) or strengthening a tooth (covering over a tooth that has a very large filling).

In general, a dental crown probably should not be used as a means to improve the appearance of a tooth if there is any other alternative dental treatment that could equally satisfactorily achieve the same cosmetic results. This is because we must grind a significant portion of a tooth away when a dental crown is made. If a more conservative dental procedure could equally well improve the tooth’s appearance, such as a porcelain veneer, dental bonding, or even just teeth whitening, then it is usually best to consider that treatment option first.

Dental Crowns and Caps

Dental Crowns and Caps

Dental Crowns and Caps

Dental Onlays

Onlays To Treat Tooth Decay

Onlays are used to treat decay that extends to one or more of the cusps. Onlays are created from tooth-coloured material, which makes them virtually undetectable to the naked eye. Onlays also help to conserve more tooth structure because their use requires minimal removal of a tooth’s surface. Perhaps their most important benefit, however, is that, in saving damaged teeth, onlays help patients avoid the eventual need for more extensive treatment with dental crowns, dental bridges, or dental implants.

First Appointment

  • We begin the procedure by numbing the area first with a topical cream followed by a local anesthetic.
  • The decay or damage is removed using a drill, preparing the tooth for its new surface.
  • An impression is made of the prepared tooth so the onlay material can be cast in a form that will fit the tooth exactly.
  • A temporary restoration is placed on the tooth to protect it until the laboratory makes the new structure and it can be bonded to the tooth. This can take about ten days.

Second Appointment (After 10 Days)

  • The temporary restoration is removed and the surface is cleaned to prepare for the new structure.
  • Try the new restoration to ensure that there is a correct fit.
  • If the fit is good, using special cement or bonding, the onlay is permanently attached to the tooth. Some minor adjustment may need to be made to the restoration if there are interferences.
  • To finish the procedure, we polish the cemented or bonded onlay and tooth to restore lustre.

 

Dental Onlays

 

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Dental Inlays

Dental inlays are used to treat teeth that have decay or damage lying within their indented top surfaces. They can also be used to replace old or damaged metal fillings. Inlay placement is usually carried out over two appointments. Since dental inlays are made from durable materials like tooth-colored porcelain, they offer much more enduring and natural-looking results than gold inlays or metal fillings. In addition, their customized nature allows us to securely bond them to the tooth surface, adding structural integrity and preventing bacteria from entering and forming cavities.

First Appointment

  • We begin the procedure by numbing the area using a local anesthetic.
  • The decay or damage is removed using a drill, preparing the tooth for its new surface.
  • An impression is made of the prepared tooth so the inlay material can be cast in a form that will fit the tooth exactly.
  • A temporary restoration is placed on the tooth to protect it until the laboratory makes the new structure and it can be bonded to the tooth. This can take about ten days.

Second Appointment (After 10 Days)

  • The temporary restoration is removed and the surface is cleaned to prepare for the new structure.
  • Try the new restoration to ensure that there is a correct fit that doesn’t interfere with your bite.
  • If the fit is good, using special cement or bonding, the inlay is permanently attached to the tooth. Some minor adjustments may need to be made to the restoration if there are interferences.
  • To finish the procedure, we polish the cemented or bonded structure and tooth.

 

Dental Inlays

Fillings and Tooth Repair

What Are Composite Fillings?

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth coloured filling and thus are often referred to as ‘tooth coloured filling’. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when we prepare the tooth, and this may result in a smaller filling than that of an amalgam.

What Is A Cavity And What Causes One?

Plaque – that whitish film on teeth that results when bacteria from eating, drinking and smoking – is the principal cause for tooth cavities. Plaque that doesn’t get washed away by saliva, brushed away by your toothbrush or removed by flossing, produces an acid that dissolves the mineral salts in your saliva help add to the hardness of your teeth but are vulnerable to attack by acids that cause them to break down. Tooth enamel is very hard, mainly because it contains durable mineral salts, like calcium, but when teeth are not professionally cleaned frequently enough, plaque builds up and eats tiny holes in tooth enamel until the enamel surface of the tooth becomes porous surface. After a while, the acid from plaque makes the tiny holes in the enamel bigger until one large hole appears. This hole is a cavity, and unless it is professionally cleaned out and filled, the tooth will eventually decay completely

Cavities: What is our Process?

To treat a cavity we remove the decayed portion of the tooth and then “fill” the area on the tooth where the decayed material once lived.

Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).

What Steps Are Involved in Filling a Tooth?

  • First, we numb the area around the tooth to be worked on with a local anesthetic.
  • Next, we remove the decay and test the area where the decay was living to determine if all decay has been removed.
  • We then prepare the space for the filling by cleaning the cavity of bacteria and debris.
  • If the decay was near the root we may first put in a liner made of glass ionomer, composite resin or other material to protect the nerve.
  • Because we only use composite filings in our office, we go through a layering process with the composite material.
  • The composite is applied in layers and cured with a light in between each layer.
  • Once we have finished the layering process, we shape the composite material to the desired result and polish the final restoration.

Unlike inlays and onlays that are crafted in an outside lab, composite fillings can be made on-site and completed in only one office visit. It is conceivable that a dental filling, as an alternative, could be used as a means to restore a tooth’s shape.

Dental Fillings

Fillings

Dental Bridges To Fix Teeth

A dental bridge is a false tooth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth. A fixed bridge is when the false tooth is attached to the two crowns on either side of the false tooth. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.

Dental Bridges