Dental FAQs – Your Questions Answered by MI Dental in Kitchener, ON

Dentistry is the art and science of restoring and maintaining the natural, healthy and functional state of the oral environment.

Finding the right dentist is not just about credentials, it is about trust, experience and sincerity of purpose. While technical expertise is essential, a truly great dentist understands that dentistry is about more than just teeth. It is about treating the person, prioritizing your comfort, confidence and overall well-being.

For those who experience dental anxiety or have avoided dental visits for years, it is crucial to find a team that values patience, understanding and clear communication. At MI Dental, Dr. Manzoor and our team take the time to walk you through every step of your care, ensuring you feel informed, respected and never rushed. We believe that your dental experience should be stress-free and empowering.

A compassionate dentist listens, informs and supports you in achieving long-term oral health. The teeth are just one part of the equation, it is the person behind the smile that truly matters. Patients deserve to feel respected not judged. They should have ample time to ease into the process and receive all the information they need to make confident decisions about their care. Understanding the steps involved, both for individual appointments and the overall treatment plan can alleviate anxiety and foster trust.

Choose a dentist who sees and treats you as a whole person. At MI Dental, we are committed to creating a supportive environment where your health and comfort come first.

I do enjoy very much the human aspect of my profession. In dental school we are trained to be excellent clinicians however bringing the teeth and the oral environment to optimal health is a small part of what we do. In essence we are treating a person in an attempt to improve the quality of their life within our prescribed role. I enjoy meeting new people, having conversations with my patients on a varying range of topics and learning from them in the process. The day is full of interesting interactions and conversations.

Braces are a great investment in your smile, but they also create extra challenges for oral hygiene. The brackets and wires can trap food particles and plaque, making it harder to brush and floss effectively. If not properly cleaned, this buildup can lead to gum disease, cavities and staining even while your teeth are being straightened.

That is why regular dental checkups and cleanings are essential during orthodontic treatment. Dentists typically recommend cleanings every three months to prevent plaque buildup and keep your gums healthy. Daily care is just as important, brushing after every meal and using special flossing tools help maintain a clean and healthy smile throughout your treatment.

Seeing your dentist regularly ensures that your teeth stay in top shape, not just during orthodontic treatment but long after your braces come off!

Basic procedures such as cleanings, X-Rays and fillings are typically covered by most insurance plans as per the specifics of the plan for that particular subscriber. Quite a number of plans cover major dental work as well such as crowns, bridges and implants.

Restoring a tooth that has lost part of the natural tooth structure due to any given reason is more like art to me. Bringing it back to its full form and esthetics, it seems like the work of a sculptor who is patiently chiseling away to reveal a perfect form.

Our consultation fee is drafted to accommodate most individuals who do not have dental benefits. We realize that there is a financial barrier to seeking dental treatment for a vast majority of individuals and therefore we do offer consultations at a lower fee.

Our process is detailed in that regard. At the time of the consultation, we go over the X-Rays that we may have taken in addition to colored photos. I indicate to patients of any areas of concern, explain to them what is happening to a particular tooth for example and why and offer my recommendations in terms of treatment options. If I feel that patient needs further clarification, I go over certain animations/videos of a recommended procedure for example. The only time we would treat a condition is when the patient fully understands what is being proposed and is able to appreciate the the benefit of the recommended procedure. If the patient is still not clear, no treatment is rendered and we offer to email the patient their X-Rays/photos and recommend that they seek a second opinion.

With three decades of experience, I have come to identify the needle as one of the main deterrents to individuals seeking dental care. We use heaters for our anesthetic cartridges that warm them up to human body temperature and thereby reducing the discomfort that the individuals experience. The slower we go the lesser the individual experiences the discomfort. I always walk my patients through the steps during a procedure hence there are no surprises and the individual is prepared every step of the way with awareness of the next steps. This also helps reduces anxiety and there is no element of surprise. We use ultrasonic scalers for teeth cleaning that are gentle and more efficient in removing the hard and soft deposits from the surface of teeth. Our handpieces are electric motor driven in comparison to traditional pneumatic ones they produces less vibration and less noise. For quite a few individuals the sound of the *dental drill* is an anxiety causing factor and with electric motors this is reduced to quite and extent. Most individuals find it difficult to stay open for an extended period of time and we have what we call tooth pillows for that which help the individual stay open so they are not straining their jaw joint and jaw muscles.

High quality dental work with predictable results is one aspect of our profession and most dentists are good at it however what patients remember is how they were treated, what their experience was at the facility is what matters more to them. Did they feel valued? Were they heard? Did the dental team pay attention to their particular concerns?  Were their anxieties and phobias met with empathy and kindness? In regards to their oral health, were they judged? Did the dentist speak to them as an equal human being? Were they given the time that they had expected or did they feel rushed?

Was the condition explained to them with clarity? Were their questions answered to their satisfaction? Were the treatment options presented to them in a simple manner? Did they feel that it is their choice to accept a treatment option? Did they feel that denying any treatment was acceptable? Were they offered to seek a second opinion?

These are the intangibles that constitute an experience for the individual that is beyond ordinary. As professionals in the field, we should strive to understand that dentistry is a major part of our being however for our patients it is not. They have other priorities and we should respect the fact that they will have their dental concerns addressed when they can.

For as long as I can remember! It has been 30 years since I have been in the field however I am not a hunched over older person wearing a white coat and using technology from the 70s. I am fascinated by every emerging technology in the field and continue to incorporate newer methodologies and techniques that make the treatment more predictable and the process more efficient. Patients want to be in and out fast, they do not wish to sit in the chair for any longer than they have to and we bear the responsibility of providing higher quality work in a relatively shorter time span.

I maintain memberships of dental organizations that offer courses and seminars to keep us up to date with what’s at the cutting edge of technology. I am a member of American Dental Association, College of Oral Implantologists, Ontario Dental Association and Academy of General Dentistry among others. I am also certified in use of LASERS for soft tissue treatments.

We realize our scope of work and stick to what we are good at. There are instances when it would be in the best interest of the patient to seek specialized care. We have a network of specialists in the area that we can refer to. We also do get patients referred to us from other dental offices.

The most common emergencies that we come across are, broken fillings, broken teeth, nerve damage, infection in mouth, swollen gums or swelling in face or jaw. We also see injuries due to trauma, contact sports for example, slip and falls, playground accidents in children.

We make it a point to see all emergencies the same day, our front desk is tuned to accommodate emergency appointments in the schedule. Over the years working in many dental offices in various locations, I have noticed a pattern, most emergency appointments calls are received on Mondays and Tuesdays and we in anticipation leave time slots open in these two days to see such cases.

Veneers can be considered as a very thin slice of Porcelain, meticulously crafted to an ideal tooth form and shade matched to adjacent teeth. They are placed on only the front surface of the tooth.

There are many variables that play a role in determining the longevity of veneers however properly maintained veneers can last over 10 years.

Maintaining good oral hygiene, having regular professional cleanings can reasonably ensure their longer lifespan.

It is a relatively simple process. The front surface of the tooth is polished and prepped, an impression is taken which is sent to the lab. The lab fabricates the veneer, it comes back to us, we try it on, let the patient take a look and approve before it is cemented.

They would be recommended to someone who is looking for the absolute best in terms of esthetics and form. They want their teeth to look perfect. Veneers would not be recommended for minor chips and surface fracture lines in a tooth that can easily be restored with a cosmetic filling.

A crown can be thought of as a cap for the tooth or a helmet for a rider. It protects the tooth from forces from all directions.

When a filling is placed in the tooth, we want the size of that filling to be small, we want to retain as much natural tooth structure as we possibly can. With larger sized fillings, there is an increased risk or breakage of those fillings and that is why a crown is recommended. After a tooth is root canal treated, it tends to become brittle over the years and can break easily. A crown would again protect it and increase its lifespan.

We prep the tooth, take an impression which is a guide for the lab to fabricate a crown and place a temporary crown until the permanent crown is back.

We use metal free crown and bridge materials, mostly Lithium DiSilicate or E.Max. They are durable, have the strength needed to withstand chewing forces and excellent esthetics.

Maintaining good oral hygiene and coming in for regular maintenance appointments.

We offer cosmetic restorations that are tooth colored fillings in varying shades to match the natural shade of the teeth or in case the individual is looking to improve the shade then a lighter shade can be placed to mask the discolored natural tooth structure.

Crowns can be placed on teeth that are compromised structurally meaning there is very little remaining natural tooth structure. Crowns have excellent esthetics and work for many years.

Veneers can be placed over just the front surface of the teeth, they are very conservative and look fabulous.

There is a wide range of conditions that can be addressed. Discolored teeth, deeply stained enamel, chipped tooth surface, stained teeth due to Tetracycline use and more.

That would be cosmetic restorations as they are relatively lower cost while still delivering excellent esthetics.

It is the fact that we are creating an esthetically pleasing smile line. Planning it meticulously and executing it to take a certain form.

If a tooth is missing and we have one adjacent teeth on each side of the missing tooth space then a bridge can be considered as a fixed, missing tooth replacement option. The adjacent teeth are capped and the missing tooth is replaced.

An implant is a stand alone replacement of a missing tooth, whereas a bridge needs two teeth to rest upon. Both are fixed replacement options. An implant could be considered a better choice as it does not involve the presence of two other teeth in order for it to work.

The adjacent teeth are prepped and an impression is taken. Temporary crowns are placed. The lab fabricates the bridge, we try it on, let the patient check and approve and then it is placed.

There is no special consideration, just good oral hygiene at home and regular cleaning appointments at your dental office which would be the case even if there was no bridge in place.

For the esthetic zone, which is the smile line, the teeth that show when an individual smiles we use E.Max for its superior esthetics and for the back teeth that take the brunt of the chewing forces, we use stronger Zirconia material. Both options are metal free.

Many individuals experience anxiety visiting a dental office and many more stay away for the same reason. Any teeth related problem is easier to treat at its initial stage, the appointments are shorter, the treatment is simpler and the cost is less. When we postpone, we end up with a more complex clinical condition in which often times there is infection and the tooth cannot be saved. My recommendation for individuals that experience anxiety is that they do go to speak to their dental team and they would try their best to make the experience as comfortable as possible for the individual.

That would be Nitrous Oxide gas also known as laughing gas. With its use the individual is not asleep however it takes the edge off. The individual is not as concerned about the process underway.

For Nitrous Oxide, we recommend having a light meal two hours prior to the appointment. There is no after effect, we give 100% Oxygen at the end of the procedure which removed any residual effects of the Nitrous. The individual is able to drive afterwards.

One of the main anxiety causing factors in dentistry is the fear of the unknown, patients anticipate the worse and hence feel nervous being in the dental chair. We take our time to explain to the patients before starting, what we are planning to go, why are we taking this course of action, how long will it take and what are the steps. During the procedure the patient is informed of what to expect from the next step, that way they are part of the process and know exactly what is going to happen next. The element of surprise is eliminated which helps patients feel more in control.

We would not. It is a personal choice, esthetics is all about perspective. What looks beautiful to us may not look as appealing to another and vice versa.

They don’t have to. If they feel that the shade of their teeth should be improved then we can evaluate if the person is a good candidate for Zoom Whitening. It is not suitable for everyone.

Not exactly a danger but It can cause some sensitivity during the process and for a few days after.

We have the well recognized, industry leading Zoom Whitening system that can improve the shade of teeth within an hour to a remarkable degree.

Teeth are isolated, gums are protected, The Zoom Whitening gel is applied and exposed to whitening light. Maintenance instructions are given.

Because we do not recommend whitening unless the patient wants it done and in that case we evaluate if the patient would benefit from whitening without any unwanted effects. In this way the ones that do end up getting whitening at our office, see the best results. Offices that recommend whitening to patients, may come across situations where the result is less than ideal and the individual experiences significant unfavorable effects. Due to our non promotion of whitening and case selection, the process has a higher success rate.

TMJ also known as the jaw joint is the most complex joint in the human body. It can move along multiple planes. TMD is a disorder of this joint.

Many factors come into play for TMD to occur. Any deviation from the normal environment of TMJ can lead to discomfort, pain or diminished function; A few notable causes are degeneration of the joint itself, inflammation of the joint, restricted movement due to a pathology, atrophy of the joint muscles and trauma.

Pain upon movement, unable to open wide, clicking sound from the joint, popping of the joint upon movement, inability to chew, pain in general.

The first step is determining the cause i-e diagnosis. Second step is management of the cause and the third step is alleviating the symptoms while the cause is being treated.
Typically we start with conservative measures such as balancing the bite if it is due to irregularities in the way top and bottom teeth contact each other during chewing movements. In case the individual grinds their teeth at night, then fabricating a Night Guard. Jaw muscle relaxation exercises and massage.

After eating or drinking anything there is food reside left on the teeth. Our mouth has a natural population of bacteria, they feed on this residue and acid is produced as a by product. This acid starts dissolving the enamel of the teeth. This is the process of tooth decay. With regular brushing and flossing we are removing most of the food residue, thereby reducing the amount of acid that would eventually be produced. In addition the food residue causes redness and ultimately swelling of the gums. The gums start to bleed upon brushing, this is not normal. Unhealthy gums begin to sag, moving away from the teeth. The teeth are supported by the jaw bone and the gums, once the gums start receding, the bone around the roots of the teeth start to disappear as well. The tooth will slowly become loose as it would not have enough foundation in the jaw bone. The tooth becomes longer and longer until it is no longer.

At least twice a day, ideally after every meal.

With regular tooth brush one has to be good with the technique, one has to be able to take it to all surfaces of the teeth and use it there for a proper amount of time. With electric tooth brushes, they are more forgiving, due to their head movement, they are able to clean more effectively. If someone is good with their technique and spends a proper amount of time brushing, for them the electric toothbrush may not be very advantageous.

We show them the technique on a model for brushing and flossing, let them try it with us and then they practice more at home.

No matter how meticulous we are with our brushing and flossing, we are still not able to remove all of the residue. The remaining soft residue becomes hard over time that is called Tartar or Calculus which cannot be removed with a tooth brush. Cleanings at a dental offices are preformed by trained professionals and they are able to effectively remove all the soft and hard deposits which leaves a more healthy environment for the gums.

Mostly fruits and vegetables, less processed food and even less sugar.

Hard candy, as one tends to keep it in the mouth for an extended period of time prolonging the detrimental effects of sugar on teeth and gums. In general sweet food items as less as possible. Carbonated beverages, citric fruit juices as they create an acidic environment in the mouth.

Among services, cleaning, polishing/stain removal, oral hygiene instructions and demonstration. We also give our patients various oral hygiene devices more suited for their individual condition.

Mouth Guard also known as Sports Guards are recommended for any individual engaged in contact sports. They protect the teeth and the supporting bone from traumatic injury.

Night Guard is for individuals that grind their teeth at night also known as Bruxism. When we grind our teeth at night we generate excessive forces that can damage the teeth as these forces are more than what we use to chew our food. The enamel of the teeth is not designed to withstand such extreme stress and can fracture resulting in extensive dental treatment to repair or in case the tooth is beyond repair then removal of the tooth itself.

The main idea is to keep it clean just as we would like to keep our teeth clean. Brushing with toothpaste after use should be sufficient. Once clean leave it in the open to dry and then store in its protective case.

If a Night Guard is not kept clean, it develops a thin film of bacteria that harbor in its porous surface producing an odor and when placed back in mouth in this condition, we are transferring that bacteria laden debris in our oral environment.

Dental offices have been flourishing in the GTA for the past several years. Currently there is an oversupply of dental professionals and offices which is beneficial for the consumers as it offers them plenty of choice. This abundance of dental offices puts them in competition with each other for a particular geographical location. Healthy competition is good as it motivates each entity to improve in several ways. Unfortunately, the trend that I am witnessing among dental offices is to veer towards commercialism. They have begun to offer free whitening with exam and cleanings for example, I have also seen offers for free cleanings with exam and X-Rays. There is increased social media presence with dental offices frequently posting pictures and videos on their Instagram and Facebook pages of their engagements which may or may not be of value in creating awareness about oral health.
but then dentistry is a health care profession and if more focus is placed upon advertising, free whitening offers and such then there may be a deviation from our core which is to be medical professionals that uphold the highest standards of the profession.
It seems we as professionals are trying to utilize any modalities at our disposal to make ourselves prominent and to be seen. This in turn has created an image of dental offices as commercial entities and not as health care facilities. I believe our profession should carry respect in the eyes of the public for who we are, knowledgeable, ethical, compassionate, highly skilled and capable professionals who can uphold the trust that a patient puts in them.
If I am excellent at what I do and am caring for the individuals that come to me and trust me with their oral health then their word of mouth is the best advertisement for me. We as a dental office do not offer free whitening or cleanings or any other services for that matter because we take pride in what we do and feel that our services are valuable. In turn our patients are individuals that are concerned about their oral health, they are able to see what we stand for and appreciate us for what we do for them. It is a matter of prioritizing what is important, an office that truly cares for their patients’ well being or one that someone would go to because they offer free electric toothbrush and whitening.

That would be tooth decay and gum disease.

There are stages of gum disease. In the initial stage the gums look red, puffy and tend to bleed upon brushing. If the process goes unchecked, the gums begin to move away from the teeth, they become loose around the teeth that they are supposed to support. In later stages, they continue to retract and the jaw bone in which the teeth are anchored begins to disappear around the roots of the teeth. The teeth begin to move and as the gums and bone regress, they get to a point where they need to be extracted or fall out on their own.

Food residue on teeth and gums that is not removed effectively. Bacteria in mouth interact with it producing by products that initiate gum disease.

At the initial stage gum health can be restored by conservative means. Once the gums start receding, beyond a certain point they cannot regenerate and coverage of the exposed root surfaces may be considered with gums grafts and some other modalities.

Not being able to maintain good oral health with home care, not being able to get periodic professional cleanings.

Maintaining good oral hygiene and going for regular professional cleanings.

Typically it is four teeth, two in the upper jaw and two in the lower jaw that show up quite late in comparison to other teeth in the mouth. Usually all adult teeth are in by age 13 and these four wisdom teeth come in around age 17. It is technically a molar tooth.

If they are causing pain, swelling, infection or pushing on other teeth adjacent to them and compromising their health in the process.

Once it has been determined that removal of these teeth is the best option, the details of the treatment, what to expect during the process and what to expect after are discussed with the patient. Some patients choose to have the laughing gas during the process. Local anesthetic is administered and we wait for it to take effect. There are signs that we look for to ensure its effectiveness. Once it has become effective, then the tooth is removed.

After the extraction, most precautions given are for a 24 hour time period. No spitting, no exercise, no alcohol, no smoking and no hot liquids.

For the sake of simplicity, a tooth has two main parts, the one that we can see in the mouth is called the crown and the part that is hidden in the jaw bone and gums are the roots. Tooth decay usually starts in the crown part of the tooth and with time invades the deeper layers. Each tooth root has a canal running through it, a hollow chamber that contains nerves and blood vessels. Once the decay has extended deep enough, then in our treatment process, we have to clean the canals in the root as well to restore the health of the entire tooth, both crown and root parts.

Lingering pain, throbbing sensation in the tooth, pain getting worse upon laying down are among some of the signs.

We remove all decay from crown portion of the tooth and then clean and shape the canals. They are disinfected and finally filled.