News & Updates
March 26, 2021
March 2021 - The Dental Mercury and Antibiotics Resistant Bacteria Connection
Studies have shown that laboratory animals (monkeys) who receive mercury amalgam fillings significantly increase their percentage of gut bacteria able to produce volatile mercury.
Despite never being exposed to any antibiotics over 80% of these mercury transforming bacteria were also resistant to several antibiotics. Scientists have discovered that mercury transformation genes in primate gut bacteria are often located in the same genetic area as antibiotic resistance - they are genetically linked. Studies in humans have found similar, but less clear results. However, there is strong evidence of an association between antibiotic resistance and mercury transformation in gut bacteria when mercury amalgam fillings are present.
For the last two decades, government and health care organizations everywhere have been attempting to decrease the use of antibiotics to minimize the development of bacteria resistance to an antibiotics. The EEU has taken severe steps to keep antibiotics out of the food supply. However, a time when antibiotics can no longer kill harmful bacteria may be on the horizon. Despite decreased use antibiotics resistance continues to spread. A possible candidate for why resistance continues to escalate is mercury amalgam fillings. This is still especially pertinent in developing countries where mercury amalgam is the dominant restorative material.
Perhaps it's time to consider banning mercury fillings which (in addition to their deleterious direct effects) seem to foster the spread of antibiotic resistant bacteria.
Nov. 22nd, 2020
COVID-19 update from Dr. Mark Cloth
Just a quick note to let everyone know that we remain open for all your dental needs during this next phase of the pandemic.
There have been no known transmissions of COVID to patients in any dental office in Canada.
Dentistry on Sheppard surpasses the infection control standards set out by the governing bodies.
We welcome any inquiries you may have.
Spring 2020 Update
COVID-19 Dental Facts
From the Ontario Dental Association
Emergency dental care is considered an essential service and the Ontario Dental Association (ODA) wants you to know what treatments you can expect during this time of social distancing in response to the COVID-19 Pandemic. Dentists have been directed not to do check-ups, non-emergency or cosmetic procedures so if you have an upcoming dental appointment, call your dentist to reschedule.
What's a dental emergency?
- A severe injury to the teeth, mouth and face
- Severe infection, like an abscess or swelling
- Bleeding that doesn't stop
- Dental pain that can't be managed by medications like acetaminophen and ibuprofen
Not all dentists can treat emergencies or guard against COVID-19 but your dentist will have an emergency contact number so they can either help you over the phone or direct you where to go.
If you don't have a dentist, the Royal College of Dental Surgeons of Ontario has a list of emergency clinics. Please do not go to a hospital emergency room for a dental problem. Our health-care system is focused on treating COVID-19 patients and other medical emergencies. You could also run the risk of infecting someone or becoming infected by going to the hospital.
Brush and floss!
Dental health is a key part of maintaining overall health and well-being so it's especially important during this time to keep up with good dental care routines like brushing twice a day and flossing daily. It prevents bacteria build-up and inflammation which can affect your immune system.
Personal Protective Equipment (PPE) Donations
The ODA is working with its local dental branches and other organizations to coordinate PPE donations for emergency dental clinics, hospitals, long-term care homes and public health units. There's a lot of interest in the dental community to help out and we're keeping dentists updated on how they can. For more COVID-19 dental facts and information on other dental issues, go to www.oda.ca
About the Ontario Dental Association
The ODA has been the voluntary professional association for dentists in Ontario since 1867. Today, the ODA represents more than 9,000, or nine in 10, dentists across the province. The ODA is Ontario's primary source of information on oral health and the dental profession. The ODA advocates for accessible and sustainable optimal oral health for all Ontarians by working with health-care professionals, governments, the private sector and the public. For helpful dental care tips, visit www.YourOralHealth.ca
For more information, please visit the Ontario Dental Association
Fall 2019 Update
TMJ, TMD, Temporomandibular Dysfunction, Jaw Joint Disease
TMJ (temporomandibular joint), or more accurately TMD (temporomandibular dysfunction) is a common musculoskeletal condition of the head and neck. The TMJ connects the jaw to the temporal bone in the skull, right in front of each ear, and allows you to move your jaw up, down and side to side. TMD occurs when the joint and/or muscles that control the joint have problems.
TMD's cause is not clearly understood, but we believe it is often caused by excessive forces on the jaw joints or muscles. An injury (eg. Whiplash), tooth grinding and clenching habits, exaggerated movements of the soft tissue disc between the jaw and temporal bone, arthritis and stress are all thought to be etiologies.
When a patient has TMD, they may have all or some of the following symptoms:
Pain at the side of the face, over the jaw joints (in front of your ears), in
- Neck or shoulder
- Limited mouth opening
- Locked jaw
- Noisy jaw joint (popping, grating, noises)
- Difficulty chewing
- Tired face
- Bite that feels "off"
- Tooth pain
- Neck pain
How to manage the symptoms of TMJ, TMD, Temporomandibular Dysfunction, Jaw Joint Disease
The most successful treatments for TMD involve managing the symptoms. Surgery is often not the best option. Medications to reduce the inflammation and pain can be helpful (eg. ibuprofen). Moist heat and cold packs can help relieve symptoms. Ice to side of face for 10 minutes followed by a few gentle jaw stretches and then moist, warm heat for 5 minutes. Soft, non-chewy, food to decrease the stress on the joint and its accompanying muscles is imperative.
Minimize yawning (opening wide), talking, nail biting, slouching and gum chewing as these can stress the joint and/or muscles. Consider physiotherapy, massage and possibly destressing using yoga or meditation. A professionally made bite plate fit to your teeth is often an excellent tool. Custom made bite plates are usually worn at night and act to relax facial muscles and limit the forces compressing your TMJ by keeping your teeth apart at rest. Managing TMD often requires multiple modalities to help control the symptoms.
June 2019 Update
OZONE! Ozone Dentistry / Oxygen Dental Therapy
We are really excited to now be offering this cutting edge all-natural treatment.
We use both ozone gas and ozonated water.
Ozone gas is used to fumigate and disinfect periodontal pockets (gum disease); decrease sensitive exposed roots; disinfect root canal systems after they are cleaned out; disinfect diseased tooth sockets; decrease cavity sensitivity and decrease drilling when preparing areas of decay.
Ozonated water is used to irrigate infected periodontal pockets (gum disease), sterilize infected extraction sockets (infected teeth) and sterilize dental equipment and water lines for a safer dental experience.
What is Ozone? How is it used in Dentistry?
Read more about Ozone Dentistry and how we use use ozone gas and ozonated water as natural disinfectant in our dental procedures …
Fall 2018 Update
Those grey fillings are more accurately called mercury amalgam not silver amalgam. They contain 50% mercury, (only 25% silver) and in chemistry you name compounds with the element in the highest concentration first.
Mercury is the most poisonous, non-radioactive, naturally occuring substance on earth. Because mercury is very highly concentrated at 4 trillion atoms per ounce its vapour is very concentrated and toxic, especially to the nervous system. The mercury vapour released is what we are concerned about, when mercury amalgam fillings are removed without safety precautions.
Mercury amalgam in banned in Norway, Sweden, Denmark, Germany and U.K. For the above reasons Dentistry on Sheppard has instituted several precautions to safeguard our patients and staff. Dr. Cloth was trained in these precautions by The International Academy of Oral Medicine and Toxicology (IAOMT), the recognized body in the safe removal of mercury fillings.
- Rubber dam placed over tooth/teeth, keeping filling particles from being swallowed.
- Fillings kept cool with cold water flow during filling removal to minimized mercury vapour.
- Fillings "chunked out" to decrease particulate.
- High volume suction adjacent to tooth to capture particulate and mercury vapour.
- High volume, high capacity vacuum in front of patient's mouth to remove particles and mercury vapour.
- Patient breathes pure oxygen, staff have specially treated North masks which filter out mercury.
- Treatment room air filtered continuously to capture any residual mercury vapour and contaminents.
- Mercury separator used to keep mercury filling remnants entering assistants high volume suction out of the municipal water system
Mercury exposure can be especially harmful to those people with certain genetic variants — people with reduced levels of superoxide dismutase 2 (SOD2), which is an enzyme in cells responsible for clearing metabolic waste. SOD2 protects the body from free radical damage. Mercury preferentially bonds to SOD2 (and other enzymes), in this way mercury lowers the body's antioxidant defence systems.
There are many published studies showing mercury from amalgam fillings enters the blood stream and raises the level of mercury in our blood, urine and brains. Amalgam proponents say the levels are "slight" while other studies show the rise in mercury levels in blood and urine are "significant".
A study published in 2011 in Journal of Oral Rehabilitation tried to research the long term subjective effect of mercury amalgam removal. They hypothesized that the control group and the group getting their mercury fillings removed would show no difference. In fact, what they found was in the group treated, there were "significant reductions" in intra-oral and general health subjective complaints. The treated group's blood mercury levels dropped by greater than one half and urine levels were V4 what they were with amalgam fillings.
Mercury Amalgam, White Filling and BPA
As public support for mercury amalgam fillings grows weaker over time, one may notice that proponents of amalgam have changed tactics. Proponents often dismiss the toxic mercury in amalgam and praise amalgam's longevity, low cost and ease of use. They say the mercury in amalgam isn't the "toxic" methylmercury- when in fact the vapour released from amalgam fillings upon chewing, brushing teeth, grinding, drinking hot liquids becomes methylated in the mouth and body.
Proponents of amalgam point out the dangers of bisphenol A (BPA) which most "white fillings" are based upon. However, health concerns with one product ("white fillings") cannot be used to justify the continued use of another product (mercury amalgam). A scientific paper in Paediatrics journal confirmed BPA is released from some dental materials. BPA is an estrogen mimicker in the body. When it is taken in and begun to be used by the body, the body cannot use it properly since it is not really estrogen. BPA has been found to be especially harmful in pregnant women, menopausal women and children. Some studies show a link between BPA in dental materials and behavioural issues in children.
BPA is something I believe we should be concerned about eventhough the release from most white filling is very small. Therefore Dentistry on Sheppard uses composite white filling material without any BPA. One cannot avoid mercury in amalgams, but one can avoid BPA in white fillings.
What to do if one already has white fillings? Don't panic, the amount released, like most environmental toxins, is very small. However, BPA does accumulate in our organs and is a body burden. White fillings wear out and need replacement over time. If the white filling is serviceable and not causing any immediate health concerns, it is probably best to leave the restoration until it requires replacement since any replacement cause some tooth trauma and possible complications.
For more info, please read "How to Reduce Your Exposure to BPA"- an excellent general summary.
Dr. Cloth, Dentistry on Sheppard
January 2018 Update
The Impact of Restrictive Diets on Oral Health
One's diet may be altered for several reasons - ethical, religious or medical. A restrictive diet can have a deleterious effects on one's oral health.
Vegetarian, Vegan Diet
A diet free of animal products could contribute to increased acid enamel erosion as acidic foods (fruits) will likely be consumed in greater quantity. Solutions to decreasing "the irreversible loss of tooth structure and enamel due to ongoing exposure to an acidic environment" include:
- drinking water after acidic foods to dilute the acidity
- using a toothpaste high in calcium and phosphate to remineralize your teeth.
- keeping an impeccable oral hygiene routine before bed as protective salivary flow decreases significantly while sleeping.
Vitamins B12 and B2 are often lacking in vegetarian diets as they are most prevalent in animal products. Deficiencies can cause canker sores, burning mouth and inflammation of tongue.
Lactose Intolerant Diet
In people who cannot easily digest lactose sugar a deficiency in calcium or vitamin D may occur. Vitamin D and calcium are needed for developing and maintaining bones and teeth. Food sources and not supplements are best.
Non-dairy sources of calcium include dark leafy green vegetables (rapini, spinach, kale) beans and salmon. Vitamin D is naturally present in few foods so the best way of getting the optimal amount of vitamin D is to expose ones bare skin to the ultraviolet rays of the sun allowing our skin (our largest "organ") to create vitamin D.
Optimally one should be in the sun half as long as it takes for your skin to start to burn. Because of reduced winter sunlight in northern latitudes vitamin D supplements may be advised.
Gluten Free Diet
Celiac disease is an autoimmune disease whereby certain proteins (gluten) cause a reaction. Some dental effects of the disease include canker sores, dry mouth and enamel defects. Processed gluten-free foods are often high in sugar and low in fiber, so read labels and try and eat lots of fruits and vegetables, meats and dairy products. High sugar diets may cause rapid cavity development. Glutenfree grains like millet and quinoa are great for gluten free diets.
In summary, for those on restrictive diets, it is especially important to stick to the perimeter of the grocery store and eat lots of fresh, whole foods. Simpler, shorter ingredient lists are better.
June 2017 Update
The Mouth-Body Connection
Your mouth acts as both a mirror and a getaway to your body. There is a bidirectional relationship between the health of your mouth and your body. Traditional Chinese medicine has long understood this. Your mouth appears to have a profound impact on the rest of your body.
Chronic low grade disease in your mouth - primarily gum disease- is a major source of inflammation in your body. Thirty percent of North American adults have significant gum disease. This inflammation can contribute to serious systemic diseases such as cardiovascular disease, non insulin dependent diabetes, weight problems and premature labour in pregnant females.
Inside the average person's mouth are approximately 20 billion (!) micro organisms divided into about 600 different types of bacteria, protozoans, fungi, etc. It sounds unhealthy and disgusting, but the key to oral health, (and by extension oral health which promotes overall body health) is keeping these micro-organisms in balance. We do not want to sterilize the mouth. Once in balance, inflammation is minimized and health is promoted. The oral environment can be balanced by the correct diet, supplements, a good exercise program and minimizing stress.
- Diet - An alkaline, small portion diet full of whole, natural foods; organic meats, dairy, eggs; filtered water, lots of nuts and seeds.
- Supplements - Anti-oxidants such as Vit C, E, Beta Carotene are some of the most important.
- Exercise - Bi-weekly 15 minute high intensity interval training is all that is needed.
- Stress reduction - Include some type of meditation, yoga and practice being in the moment.
In the last ten years, much new medical science research has focused on the microbial ecosystems in the human body, which includes the oral microbiome. Scientists are learning just how important the microbiome is to our health with disease causes and treatments being rethought.
For more details please read, "The Mouth-Body Connection" by Dr. G. Curatola
February 2017 Update
Perio Protect - Periodontal (gum) Pocket Reduction Tray System
In our effort to stay at the forefront of dental care while respecting one's whole body, we have initiated the Perio Protect Program at Dentistry on Sheppard.
Half of North Americans have a chronic, low grade, silent infection in their mouths - gum disease. Gum disease is the number one cause of tooth loss but more importantly research has linked oral bacteria to diabetes, heart disease, Alzheimer's disease and other chronic diseases.
Gum disease is caused when a biofilm (grouping) of bacteria developes in the pocket between the tooth and gums. Bleeding gums, bad breath, swollen gums, receding gums, and loose teeth develop as part of the body's response to the infection.
Professional dental scalings (cleanings) are an excellent way to control the biofilm. However, between dental appointments the Perio Protect method of delivering daily medication to the depth of the pocket is very effective. Perio Protect uses specially designed custom sealing trays into which a specially formulated hydrogen peroxide is placed. The peroxide dissociates into water and oxygen. The oxygen is toxic to the bacteria in the pocket helping reduce gum disease and inflammation in the body. Fifteen minutes a day of tray wear can translate into a noticeable decrease in inflammation within days. Even the side effects are positive- whiter teeth and fresher breath. "Research shows the Perio tray therapy and scalings deliver better results than professional cleanings alone."
By using the power of oxygen we can decrease inflammation in one's mouth and body helping control gum disease and possibly decreasing the incidence of other chronic disease.
November 2016 Update
New at Dentistry on Sheppard:
1. Opalescence GO Tooth Whitener
Opalescence Go is a faster, cheaper, more effective, more natural way to whiten your teeth. Go uses hydrogen peroxide to bleach your teeth in convenient ready made trays. Hydrogen peroxide is a natural powerful oxidant found in everything from rainwater to natural wound disinfectants.
2. iTero tooth scanner.
Digital tooth scanning makes the crown, bridge, implant or onlay appointment much easier. The scanner is an electronic device that generates a digital representation (picture) of an object (your tooth) for data input into a computer. From the computer, we can then fabricate precise teeth. The scanner is a more biocompatible method (compared to using impression materials) and is virtually radiation free. No more biting into mushy pastes and materials.
October 2016 Update
One of the most common products we put in our bodies has a significant number of controversial ingredients. We use toothpaste twice a day. Even if we don't swallow it, the oral tissues are very absorbent giving toothpaste components a direct path into our blood stream.
One of the most controversial ingredients is Triclosan-a common ingredient in over the counter toothpaste (Colgate Total especially). Triclosan has been banned by the FDA in soaps, but not in toothpastes. The FDA and European Union are worried about it seeping into the groundwater, but not into our bodies! It is thought that triclosan causes cancer, possibly causes antibiotic resistance and can be an "endocrine disruptor" (hormone production interference).
It takes some skill to read a toothpaste label. Even "natural" pastes may contain questionable ingredients.
Check your toothpastes for:
- Artificial Colours: Many toothpastes contain colouring agents considered too toxic for food! Red #30, Red #33, Blue#1. Children's toothpastes are the worst. The artificial colours are often contaminated with harmful heavy metals.
- Carrageenan: This additive is linked to intestinal inflammation and cancer.
- Diethanolamine (DEA): A foaming agent which is a precursor to nitrosamines (linked to human cancer).
- Formaldehyde releasing preservatives: Formaldehyde is a carcinogen which can be easily absorbed through the oral mucosa.
- GMO ingredients: Glycerin, citric acid, Xanthan Gum are just some possible GMO ingredients in your toothpaste.
- Paragens: Estrogen hormone mimicer which is used as a preservative in some toothpastes.
- Polyethylene Glycols, Propylene Glycol
- Sodium Lauryl Sulfate (SLS): Foaming agent which has been shown to break down the protective mucosa in your mouth. SLS is also often contaminated with carcinogens.
Keep in mind the above components are often found in minute amounts, but why expose our bodies to these toxins? Buy a good natural toothpaste which lists all its components. Check Cornucopia.org for their report, "Behind the Dazzling Smile", to get some ideas on the best natural toothpastes.
Gum Disease and Anti Inflammatory Supplements and Medications
Studies have shown that anti inflammatory medications and supplements help reduced gum disease. Gingivitis and periodontitis are chronic low grade inflammation of the gums and supporting structures of our teeth caused by the host's destructive response to bacterial plaque. Medications such as corticosteriods, aspirin, ibuprofen, statins (anti cholesterol medications) and even simple omega3 fatty acid supplements help decrease inflammation in our mouths.
For the past several years academics have shown prostaglandin and other arachidonic acid metabolites are important proinflamatory mediators in bone resorption and various forms of periodontal disease. Non-steroidal anti inflammatory drugs inhibit the synthesis of metabolites of the cyclooxygenase pathway, thereby blocking production of prostaglandins, thromboxane and prostacyclin. Inhibiting prostaglandin synthesis has been shown in animal and human studies to be beneficial in treating periodontal disease.
Most interesting of all are studies showing that intake of Omega-3 fatty acids, particularly DHA and EPA, are inversely associated with periodontitis. These fatty acids increase production of good factors and decrease production of pronflammatory cytokine and interleukin. Given that Omega-3, have a proven role in other chronic inflammatory conditions it is possible that treating periodontitis with Omega-3 could have added benefit of preventing other diseases, especially cardiovascular disease.
Medications (steriods, NSADS, statins) and Omega-3 supplements are a pharmacological intervention in the inflammatory pathways. Development is now focussing on development of daily, topical forms to be used as rinses, gels, and toothpastes.
Click on the dental video below to view more about Family Dentistry: Gum & Periodontal Disease
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Clifford Materials Reactivity Testing
In modern society we come in contact with many substances every day. They exist in every facet of our lives, including the foods we eat, the products we use and the treatments we receive.
Because each of us possesses a unique biochemistry, these substances affect each of us differently and in varying degrees. For some, the effects of certain substance (and their corrosion byproducts) can be toxic and even hazardous. A substance which causes little or no reaction in one individual can prove harmful in another.
Because biochemical effects vary in each of us, it is vital that these factors be considered when choosing dental and other materials for use in the body. This is especially true with patients having special or unique health concerns. Clifford Materials Reactivity Testing provides dentists with extensive information about their patient's individual sensitivities. The Doctor can then select least offensive materials for use in individual treatment planning.
Holistic Dentistry Update
New evidence and ideas have recently come to light showing an even stronger relationship between overall health and oral health than previously believed . Both of the two main oral disease - gum disease and cavities – have been shown to correlate to overall health.
Periodontal disease has for many years been linked to systemic diseases such as heart disease and diabetes through the common factor of uncontrolled inflammation. Periodontal disease occurs when the body's normal controlled inflammatory response (gingivitis) progresses to an uncontrolled level of inflammation leading to destruction of the gums and bone by the body's own enzymes. Plaque and tartar (toxins) trigger this inflammatory process.
Cavities (decay, caries) now have been shown to follow a similar pattern. Traditionally, cavities have been viewed as specific oral bacteria taking sugars and producing acid which breaks down the tooth. Now it has been shown that in addition to the above localized events one usually needs a host tooth with uncontrolled inflammation in the dentine of the tooth to form a cavity.
New research shows the brain is involved. A tooth is designed to with stand the harsh oral environment with an outward flow of fluids to nourish it. However, a high carbohydrate diet increases blood sugar levels causing the hypothalamus (a part of the brain) to release chemicals causing a reversal of the protective fluids. A healthy tooth "sweats" and an unhealthy tooth acts like a "sponge". The signalling for this process starts in the brain and is sent to the parotid glands which control fluid flow through tooth dentine. A vulnerable sponge like tooth absorbs the acids produced by certain oral bacteria demineralizing the enamel and irritating the dentine. If there is enough irritation the enzymes in the tooth cause destruction and ultimately a hole (similar to the gum disease). This new systemic paradigm is enlightening and offers hope for a systemic solution to decay.
Here is the good news. The key signaling factor in the hypothalamus are free radicals. Antioxidants in fruits, vegetables, green tea, and in some vitamins mop up these free radicals thereby maintaining a tooth's "sweating" ability and decreasing the likelihood of decay.
Therefore by thinking systemically about decay, we can expand beyond prevention of demineralization (the symptom) and focus on treating the cause by eating a diet high on fruits, vegetables and antioxidants.