Miss Universe Canada 2014

contender
Dr. Winter is proud to be the dentist for Lavanya Hiremath, a contender for Miss Universe Canada 2014!

She writes,

Dr Sam really has an eye for what suits you, but he is also modest, kind and will never sell you products or services you don’t need. I trust him and his staff with my teeth and had him do my cleaning and fine tuning before one of the biggest undertakings of my life – Miss Universe Canada 2014! Thank you Dr Sam Winter and team!

Patient Testimonial

In addition to Dr. Winter’s professional approach to dentistry, he provides a safe and listening response to all questions you might have concerning the procedure or materials used in your visit. If I am unclear about what he is about to do, or I would like a little more peace of mind before proceeding, he makes absolutely sure you are informed and feel comfortable before he begins.

Even at my age of 73, I still feel a little scared when I first sit in the dental chair. So, his taking this time to settle me into an understanding, clearing any doubts or fears is a wonderful gift and service. I am grateful as you would be as well.

Matthew Smith

Patient testimonial

Dr. Winter is a great dentist! And I would know I have had work done by at least a dozen dentists… (I’ve moved a lot and had major major dental work done.)

When I first moved to Vancouver my husband and I selected him because of how he came across on his website as being a “gentle” dentist and being very conscious about offering great dental care.

I have needed more serious dental work done (many many crowns and root canals) so I was referred to UBC by a specialist, but I still come to Dr. Winter when I need some general dentistry.

This past weekend I had some excruciating pain in a lower molar that had an infection and it was causing problems with my bite being too high so it was suggested I get it taken out. The Dr.’s I see at UBC were not available this week and I could not wait any longer.

Dr. Winter’s staff remembered me and my husband and said they’d see what they could do and got me in right away.

I really have to thank them for saving me. I was in so much pain I could not even chew on the opposite side of my mouth there was so much inflammation and infection that caused shooting and lasting pain. I asked them if I could get the tooth extracted as it was going to be very very costly to save and it was already causing problems with my bite and proving difficult to keep a crown on. (The other work I need done is already very costly so I did not want to add to the pile.)

I was done in 30 minutes after freezing and having the tooth extracted. Dr. Winter wanted to make sure I was very numb and comfortable and gave me extra freezing when I asked.

The ladies that work with him are great too. They are very friendly and everyone works well together as a whole team.  I like that the office is small and close knit, and not a giant sprawling office with tons of dentists and dental hygienists who treat you like a number.

My husband just went last week for a cleaning and was very happy with it as well.  Dr. Winter was happy he was taking such good care of his teeth, but noticed my husband was probably over cleaning and using mouthwash more often than he should. So he gave him some suggestions to keep his teeth in good condition without overdoing it.
If I had any general dental needs I would gladly return to Dr. Winter. I will probably still see him for cleanings and checkups once my other extensive work is done at UBC, even though I’ve recently moved to Surrey.

I can’t thank him and his team enough for being so kind to me today and saving me from so much pain. It was really nice that they remembered me even though I hadn’t been in almost a year after a general consultation.

Dentist visits can sometimes be very unpleasant, but not with Dr. Winter. It’s really nice to feel taken care of and he and his team add that special personal touch with having a smaller dental practice.

Veronica D.

Dentures are not fitting well

Why don’t my dentures fit well anymore?
False teeth, whether they are complete full dentures or partial dentures, are made to fit your mouth at a specific point in time. As you age, everything about you changes, even your mouth. But the false teeth you had made years ago cannot change with you. This is why the quality of the fit slowly deteriorates.

As the years pass, the bone supporting the false teeth continues to change, usually shrinking. This rate of change is different for everyone. Many people notice a change after only two years. Others don’t notice for many years after.

Most people can tell when their dentures are getting loose or uncomfortable, but because this process is gradual it is often ignored until there is so much irritation that it can’t be ignored any more.  This irritation can be red swollen areas that bleed easily, or actual cuts into the gums, which may or may not be tender.

What if my dentures are new?
If your dentures are fairly new andwere made immediately after teeth were extracted, a reline will be required after two to six months. This will take care of the early shrinkage and healing, thus restoring proper fit again. 

I advise that you have a dentist look at your mouth every one or two years, especially at the gums under your dentures. It is best to keep your dentures fitting well so that no irritation develops, because irritation can change the shape and structure of your gums and the bone underneath. These abnormal changes will make it difficult to maintain good fitting dentures.

What does a reline do?
To keep your dentures fitting properly they may need to be relined, as the need arises. Relining is a cost effective procedure as long as you like the way your dentures look. Of course if you don’t like the way your teeth look, because of wear, shape or color, then a reline (which only affects the fit) won’t make you happy.  If you don’t like the way your dentures look or they have been relined several times already you will need new dentures.

What about denture adhesives?
When used as directed with properly fitted dentures, adhesives are a safe, effective aid for comfort and security as well as confidence for the denture wearer.  Using dentures is a skill that the muscles of the mouth, tongue cheeks and lips, must learn and develop. When you first learned to ride a bicycle, your body muscles learned to balance automatically. In a similar way, the muscles in and around your mouth must adapt to controlling the dentures. Denture adhesives are a good help in the beginning.

Like any good tool, dentures need to be kept clean and regularly maintained. Adjustments and maintenance are a fact of life for the denture user.

Should I have my abscessed tooth extracted or root canal treated?

Once you know that you have an abscessed tooth, a decision has to be made. An abscess is an active infection, so it can’t be left untreated, because it will affect the level of health for your whole body.

Unfortunately, not all infected teeth are treatable. When a tooth is rotten or broken down to or even below the surrounding bone level, it is not restorable, so needs to be removed. But what if more than enough solid tooth is left to work with? Other factors now need to be considered.

If the tooth is the last one in the row at the back of the mouth and all the other teeth are present, some patients don’t feel that this back tooth is worth the time trouble or expense to keep. Since it’s their mouth, after discussing their decision I will agree to the extraction. Also if a person is already missing many teeth, saving one doesn’t make much sense, unless it is important to make a partial denture more comfortable and stable. Other people who have already lost several teeth will say, “This has got to stop”, and go to great lengths to save every one of the few left.

Cost can be a factor in the decision process. The cost of a root canal treatment and the necessary crown on a molar is almost as much as an extraction and a permanent bridge to fill the space. The long-term success of a bridge may be more predictable than that of a root canal treated tooth. Because of the uncertainties in predicting the future, some people will opt for extraction and an implant for the replacement. This route eliminates the root canal treatment, with its approximately 90% success rate, and also removes possible complications caused by crowning two teeth to support a permanent bridge. Implant-supported teeth are not fail proof either, but you are not risking any other teeth with this treatment.

As you see, whether or not to treat or remove an abscessed tooth is not always a straightforward decision. Many factors come to play in making the decision. As with any procedure involving one’s health, the outcome and consequences are not precisely known and we can only hope to weigh them in your favour.

Will bleaching harm my teeth?

Many studies have shown that repeated bleaching, even every day for many months, causes no permanent damage to the teeth.

Dental bleaching or tooth whitening is an easily available cosmetic procedure. People whiten their teeth at all ages. Even though people under the age of 30 generally have whiter teeth than older people, they often still want their teeth whiter and brighter.

Aging darkens teeth because of the changes that occur in the mineral structure of the enamel. Of course dark-coloured foods and drink also contribute to the darkening of teeth from the outside in, over long periods of time. The kinds of staining that occur quickly can often be brushed away.

So what is dental bleach and what does it do? Most dental bleaches are carbamide peroxide, the same chemical people use to bleach their hair. This substance turns into hydrogen peroxide when exposed to the mouth. During hydrogen peroxide’s action on the teeth it turns into oxygen and water.

The hydrogen peroxide molecule is able to penetrate the tooth surface and get inside the tooth structure where it is able to bleach the whole tooth inside and out. Although this process can achieve long-term whitening, unfortunately it is also why some people experience tooth sensitivity. The nerves in the tooth can get irritated by hydrogen peroxide.

Tooth sensitivity doesn’t happen to everyone, and only lasts a short time. I advise my patients to stop bleaching for a few days if their teeth start to hurt, and then start bleaching again. It is a harmless side effect.

You shouldn’t brush your teeth or drink coffee or other coloured liquids for 20 minutes after bleaching. With every bleach application the surface enamel softens to a microscopic depth, making it more susceptible to stains from liquids consumed too early. After about 20 minutes the enamel surface returns to normal.

Quick one-hour dental office bleaching causes more sensitivity and has a higher rate of rebound. That is, the colour comes back more slowly with at-home treatments. Most people can make their teeth as white as they want in less than two weeks. using at home bleaching trays.

If you want whiter brighter teeth, first see your dentist and get your mouth checked to make sure you have no problems. Your dentist will make custom fit bleaching trays, give you the right strength bleach, and in less than two weeks you will have whiter teeth.

When to go to the dentist

Should I go to the dentist even if nothing hurts?

Yes, defnitely. Routine dental visits do for your teeth what routine maintenance does for your car. Would you leave the oil level in your car unchecked and oil not changed until your motor stopped? Of course not. Tune-ups for your car keep it running more efficiently and reliably.

The same is true for your mouth and teeth. With routine dental visits, you will be less likely to experience pain or broken teeth. Scheduled dental checkups and cleaning not only alert you to problems and wear of your teeth, but also help prevent gum disease. Gum disease or gingivitis breaks down the connection between your teeth and jaws, and also releases toxins into your blood stream, which leads to heart problems.

Broken and rotten black teeth not only cause pain but are very ugly. Most people with broken or black front teeth don’t smile or even talk to friends comfortably. Regular dental visits and small fillings will save you this embarrassment, and pain.

Everyone is reluctant to visit a dentist. Either fear of pain or fear of paying the bill could keep you away. But most people don’t let these fears stand in the way of good oral health. If you can’t overcome these fears, tell your dentist so that you can get a small anti-anxiety pill before your visit. In most cases, the type and dosage that the dentist will give you won’t make you feel drugged, but it will be enough to relieve your anxiety. This drug is the same that your doctor would give you if you told him you were afraid of flying. It will relieve your anxiety but still not interfere with your ability to deal with the airport and check in

Seeing your dentist twice a year will become a normal habit with very little stress after you have done it several times. After you’ve had your teeth scaled and cleaned once, the next six-month cleaning is much easier on you and the hygienist. And once all of your teeth are restored, very little will need to be done for many years. So after a regular cleaning and checkup you will have the satisfaction of knowing that your mouth and teeth are healthy and clean.

Dental insurance goes a long way to relieve the stress of paying the bill. Some dentists will even deal directly with the insurance company. That way you are not out of pocket, unless the insurance doesn’t cover the whole fee, in which case you have to pay the difference.

A dental visit can be as routine an experience as a visit to the hair dresser.

Mercury in metal dental fillings

What are metal dental fillings and what do they do to me?

Most metal dental fillings are an amalgam of about 50% mercury and the rest a mixture of mostly silver, with some copper, zinc and tin. Amalgam has been in common use since about 1860. In 1895 the formula was standardised, and about 1970 the formula was changed to give us what I call modern amalgam. The other metal filling material is gold which is alloyed with other metals to improve its handling and durability in the mouth.

It’s obvious that millions of people have had mercury or silver fillings over many generations. No medical problems have been directly linked to their presence in the mouth. So why change if there is no problem? Well nothing is perfect. Amalgam is ugly in the teeth because of the color contrast. It doesn’t support the tooth structure – in fact, it slowly expands over the years and actually leads to cracks in the tooth. These cracks can cause sensitivity, decay and breakage.

What about the mercury? That’s been a concern from the very beginning of its use in the mouth. Nearly all of the mercury stays bound up with the other metals used to form the amalgam. What happens to the small amount that comes out of the filling, and into your mouth? Some is excreted in the urine, some ends up in your hair and fingernails, the rest stays in your body forever. However, the amount that stays in your body is so minute that medical science tells us it would take about 7000 years to harm you. Yes, 7000 years. Some people do claim to be more sensitive to the effects of mercury on their health than others, and this is an open question.

I haven’t used amalgam to fill teeth in over 15 years. Not because I think that it may be a health hazard, but because there are without question better materials available now.

What does my toothache mean?

Pain anywhere in your body can be a warning of an abnormal situation. It is not always serious. For example, the pain of overeating or abdominal gas is real pain but is not dangerous and demanding urgent treatment. Teeth can also be painful due to temperature, usually cold, or pressure. Pressure can be applied either with or without food. In fact the pressure of clenching or grinding the teeth without anything in the mouth, especially while sleeping, is the most severe.

There are a large variety of dental pains and causes. A sharp pain occurring while biting something hard, which stops when the biting pressure is released, is often the sign of a cracked tooth which goes far below the surface. The crack needs to be cut out and the area filled, or the tooth crowned so no pressure can be put on the crack.

Pain from sweet, sour or cold may mean that some nerve endings are right on the surface, just like your eyeball. This area of the tooth needs to be covered and dentists have various methods to do this, depending on the circumstances. For example if the pain is coming from the area of an old filling, it often means that the seal between the filling and tooth has broken down, and fluids are leaking down the side of the filling. In this case you need to have a new filling. When the area of the tooth right at the gum line is tender to pressure, from a fingernail etc, or tooth brushing, toothpaste for sensitive teeth will often solve the problem.

When a tooth has a hole or is broken, even if it doesn’t hurt you need to see a dentist soon. If a broken tooth hurts it means that the nerve is either inflamed because of bacterial infection or irritation from being close to the surface, and exposed to various irritants that act through the thin bit of tooth structure still over the nerve. Your dentist will know the best treatment for the broken tooth.

When the pain is strong and starts with no obvious reason, you probably have an abcess. This is a pocket of puss at the end of as the root. It is the pressure of the pus building up that causes the pain. The pain goes away when the pus is no longer contained in the bone, but can flow out. The puss goes either into your mouth through a little opening which looks like a pimple. This is a draining fistula, a fistula can drain either into your mouth or nasal sinus, or just into the flesh of your face. Needless to say this needs urgent treatment.

If pain seems to appear in teeth in different parts of your mouth, it is often caused by clenching and grinding, due to stress. When you can’t control your stress, then a bruxism guard may help, or an occlusal adjustment may relieve the pain. When your dentist does an occlusal adjustment , the biting pressure is evened out on all the contacting teeth.

Pain with swelling, inside or outside your mouth, means you need to see a dentist or doctor very soon.

Do I have gum disease?

Gum disease occurs in varying degrees of severity. In its mildest form it is called gingivitis. The infection is on the surface of the gum tissue, and does not affect the bone, or the ligament which connects the tooth to the bone. Even though the infection is only on the surface, the gums are still red inflamed and bleed easily.

Gingivitis is caused by ineffective or insufficient tooth brushing and flossing, it is also aggravated by even a small amount of tarter at the gum line. This tarter needs to be removed and is best done in the dental office by a dental hygienist. If your gums bleed when you brush or floss, or your breath has an odour, or you have bad tasting saliva, you probably have gum disease.

When the early stages of gingivitis are left untreated, it will progress into periodontitis. At this point your gums are definitely red, swollen, tender and the bleeding and smell are worse. This is caused by tarter build up below the gum line. More important is what is going on below the gums at this point. The structures which hold your teeth attached to your jaw bones is being attacked and destroyed, by the active infection. The bone and periodontal ligament is being eaten away. You will notice some of your teeth are getting loose and tender when you eat. Again this condition needs to be treated by a dentist and hygienist. When the condition is severe with a lot of bone loss, a dental specialist is needed – the specialist is a periodontist.

Medical research has shown that the toxins that enter your blood stream as a result of gum disease may eventually lead to an early and higher incidence of heart problems. People with healthy gums generally feel better, as a whole. Good breath and a bright smile are certainly worth the effort it takes to brush and floss properly. You dentist and staff are the best place to get coaching to help you learn how.