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Supporting Your Practice

What is the safest way to clean up the cement found inside a porcelain crown?

This question was submitted by a general dentist: A patient comes in with a full porcelain crown which has come off. The tooth is sound and there is resin cement inside the crown. What’s the safest way to clean up the cement from inside that crown?   Dr. Alan Kilistoff, from the  University of Alberta, provided the following initial response in an interview recorded with Dr. John. O’Keefe. A summary of the interview is provided followed by the complete audio interview (7 minutes)       Historically, the safest way would have been to sandblast out the interior of the crown; ...

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What are some indications for replacing old amalgam fillings?

This question was submitted by a general dentist: What are some indications for replacing old amalgam fillings? Dr. Anuradha Prakki, Restorative Dentistry Assistant Professor, in the Faculty of Dentistry at the University of Toronto, has provided this quick initial response Drafted by Alexandra Rabalski, JCDA Oasis Summer Intern Oftentimes, patients do consider changing their old amalgam fillings to the latest white composites. It is important to note that although an amalgam filling may be “old,” it does not necessarily indicate a need for replacement. As a restorative material amalgam has some properties that improve over time. For example, the corrosion products ...

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Opening the conversation: What is the best restorative material still in existence and use?

This question was submitted by a general dentist and is a conversation opener on the best restorative materials based on your experience.  Related questions include:  Is cast gold a long lost art? How many of us are still able to offer it to our patients? What would we as dentists put in our own mouths ? Dr. John Miner provided the following response:  Yes…fabricating well-fitting/occluding Gold Restorations is a lost art; I offer Gold Restorations to my patients; I would definitely advocate the use of Gold Restorations in my mouth. Let us know what you think. You can reply to ...

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Should amalgam fillings be changed to the latest white composites?

This question was submitted by a general dentist: As a practicing dentist I am often asked whether it is recommended to change amalgam fillings to the latest white composites. What information should I be giving patients in order for them to make a well-informed decision? Dr. Anuradha Prakki, Restorative Dentistry Assistant Professor, in the Faculty of Dentistry at the University of Toronto, has provided this quick initial response. Drafted by Alexandra Rabalski, JCDA Oasis Summer Intern It is important to inform patients about the benefits and drawbacks of both restorative materials. Amalgam generally tends to have a longer lifespan when compared ...

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Why are furcation areas important and how can they be treated?

This question was submitted by a general dentist: Why are furcation areas important and how can they be treated? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response: The primary etiologic factor in periodontal disease is plaque. The outcome of periodontal therapy is in general good and predictable, if the clinician and the patient can adequately access root surfaces to remove the bacterial plaque. Access to the molars furcation areas is especially difficult for the patient and clinician alike due to the posterior location of molars, the dimension and position of furcation entrances, and the ...

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What is the significance of bleeding on probing?

This question was submitted to us by a general dentist: What is the significance of bleeding on probing? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response: The classical signs of gingival inflammation associated with gingivitis are: Bleeding from the gingival sulcus upon gentle probing, Increased gingival fluid flow rate, and Swelling, and discolouration of the gingival units. Bleeding from the sulcus is the earliest clinical symptom of gingivitis and precedes discolouration and swelling (1). Therefore, since gingival colour changes are less obvious during the early stages of gingivitis and are most often overlooked, bleeding ...

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What is the significance of periodontal-probing depth measurement?

This question was submitted by a general dentist: What is the significance of periodontal-probing depth measurement? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response: Probing depth measurement is an essential part of any complete periodontal examination. Probing-depth measurement provides the clinician with an accurate estimate of the size of the denuded root surface. Periodontal probe in a healthy shallow pocket approaches the anatomic sulcus, which is in contrast to cases involving gingivitis or periodontitis. The difference between probing-depth measurement and anatomic measurement of the sulcus, or pocket depth, appears to be due to the ...

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What are the main components of a comprehensive periodontal examination?

This question was submitted by a general dentist: What are the main components of a comprehensive periodontal examination? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response: The primary objective of periodontics is to help patients maintain the form, function, and esthetics of their teeth for as long as possible. In essence, a complete periodontal examination is carried out to determine a treatment plan that will aid with the aforementioned objective of periodontal therapy. The initial patient assessment should include the following: Measurement of probing depths, Measurement of attachment levels and corresponding loss of attachment, ...

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