Full Comprehensive Care
At Upper Avenue Dentistry, we are happy to be providing our community with comprehensive dental care. Whether you need a biannual checkup or have more serious concerns about the health of your teeth and gums, we can assist you.
General dentistry/family dentistry is offered by Dr. Sabrina Rosati. More complicated procedures including full mouth reconstructions, multiple implants and full mouth rehabilitation is offered by our specialist, Dr. Joseph Fava, prosthodontist.
A comprehensive dental exam is performed at your initial dental visit. At regular check-up exams, we always include the following:
- Examination of diagnostic x-rays (radiographs) when applicable: Radiographs are essential for detection of decay, tumors, cysts, and bone loss. They also help determine tooth and root positions.
- Oral cancer screening: Examination of the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Evaluate the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Professional Dental Cleaning:
A professional dental cleaning (dental prophylaxis) appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease! In addition, this bacteria digests sugars in our diet, producing acids that cause tooth decay (cavities).
- Polishing of teeth: Removal of stains and plaque that is not otherwise removed during tooth brushing and scaling.
Using Venus ® technology, we deliver the most efficient whitening system while minimizing post treatment sensitivity.
- Venus in office whitening with take home touch up trays
- Full take home custom whitening set using the safest and highest concentration available
Please contact us today to find out more about these options and which one is best for you.
At Upper Avenue Dentistry we use the most up-to-date and strongest tooth coloured restorations blended in flawlessly with your natural shade.
Upper Avenue Dentistry provides amalgam-free, mercury-free treatment. We provide comprehensive restorations using the most up-to-date and strongest tooth-coloured materials.
At Upper Avenue Dentistry your health is out top priority. When an amalgam ("silver filling") restoration must be removed, we aim to limit your exposure to mercury as much as possible by taking the following precautions:
- certified amalgam removal HVAC suction
- dental dam isolation to prevent silver/mercury from being ingested
- 100% oxygen with mask given to prevent micro particles of silver/mercury from being inhaled
- recommend taking 1000mg Vitamin C the night before procedure
Veneers are made of thin, durable customizable tooth-shaped porcelain that slides over the teeth. They are custom made for shape and colour by a professional dental laboratory. They are advantageous in hiding stain, masking chips, correcting slight malignments, and overall improving esthetic appearance. They are less invasive than full coverage crowns but still provide all the benefits of protection, longevity and colour stability.
Veneers can completely reshape your teeth and smile. They can often be alternatives to crowns and the ideal solution in treating many dental conditions.
Reasons for porcelain veneers:
- Cosmetically, to create a uniform, white, beautiful smile
- Crooked teeth
- Misshapen teeth
- Severely discolored or stained teeth
- Teeth that are too small or large
- Unwanted or uneven spaces
- Worn or chipped teeth
What does getting porcelain veneers involve?
Veneers usually require two visits to complete the process, with little or no anesthesia required. The teeth are prepared by lightly grazing and shaping the surface to allow for the thickness of the veneer. A mold or impression of the teeth is taken, and you chose the shade (colour) you would like for the veneer.
On the second visit the teeth will be cleansed with special liquids to achieve a durable bond. Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.
You will receive care instructions for veneers. Proper brushing, flossing and regular dental visits will aid in the life of your new veneers.
Crowns are used to provide necessary protection for a heavily restored/broken down tooth . When a tooth becomes heavily decayed, damaged or cracked, a filling does not provide adequate substance to restore the tooth. To save it from further damage and prolong its life, a crown (cap) is fitted over as a permanent cover. Crowns can be fabricated using all porcelain ceramic, gold alloy, or a combination of both. . Although there are several types of crowns, porcelain (tooth colored crowns) is the most popular, because they resemble your natural teeth. Porcelain crowns are made to match the shape, size, and color or your teeth giving you a natural, long-lasting beautiful smile. Crowns are placed using permanent cement and carry the similar esthetic benefits as veneers: long-lasting, color-stable, and protection.
Reasons for crowns:
- Broken or fractured teeth
- Cosmetic enhancement
- Decayed teeth
- Fractured fillings
- Large fillings
- Root-canal- treated teeth
What does getting a crown involve?
A crown procedure usually requires two appointments. The first appointment involves preparing the tooth and taking several highly accurate molds (impressions) that will be used to create your custom crown. A mold will also be used to create a temporary crown which will stay on your tooth for approximately one week until your new crown is fabricated by a dental laboratory.
Under local anesthetic, the tooth is prepared by removing any decay and shaping the surface to properly fit the crown. Once this is accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.
At your second appointment your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite is accurate.
You will be given care instructions and encouraged to have regular dental visits to check your new crown.
Bridges are a permanent and fixed way to replace a missing tooth or teeth. They can be fabricated using strong, natural looking tooth-coloured material.
A bridge fills the space where a tooth was removed or had fallen out. It is a false tooth that is held in place by being attached to the teeth next to it, like a bridge. The bridge preserves the integrity of your existing teeth by preventing the shifting of teeth and jaw issues.
There are several types of bridges. Porcelain fixed bridges are most popular because they resemble your natural teeth. This type of bridge consists to two crowns that go over two anchoring teeth (abutment teeth) and are attached to pontics (artificial teeth), filling the gap created by one or more missing teeth.
Dental bridges are highly durable and will last many years, however they may need replacement or need to be re-cemented due to normal wear.
Reasons for a fixed bridge:
- Fill space of missing teeth
- Maintain facial shape
- Prevent remaining teeth from drifting out of position
- Restore chewing and speaking ability
- Restore your smile
- Upgrade from a removable partial denture to a permanent dental appliance.
What does getting a fixed bridge involve?
A bridge usually requires two or more visits. Under local anesthetic, the two anchoring teeth are prepared by removing a portion to allow space for a crown. Next, an accurate impression (mold) is made which will be sent to a dental laboratory where the bridge will be fabricated. In addition, a temporary bridge will be made and worn for several weeks until your next appointment. At the second visit, your permanent bridge will be carefully checked, adjusted, and cemented to achieve a proper fit.
You will receive care instructions at the conclusion of your treatment. Proper brushing, flossing and regular dental visits will aid in the life of your new permanent bridge.
Dr. Joseph Fava is a certified prosthodontic specialist for implant placement and restoration. Whether it be single implant or multiple full mouth reconstruction, implants are a highly advanced, stable, and predictable way to restore your smile and function. Implants are anchored to the bone and an artificial customizable natural looking prosthetic tooth is then attached to the implant.
Root canal therapy is needed when the nerve of a tooth is affected by decay or infection. In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials.
A natural biocompatible material called "gutta percha" is used for the main fill of the root. This material is extracted from tropical trees native to Southeast Asia and northern Australasia. Gutta Percha is the natural latex produced from the sap of these trees, particularly from the species Palaquium gutta.
Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would have to be removed.
Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.
Signs and symptoms for possible root canal therapy:
- An abscess (or pimple) on the gums.
- Lingering sensitivity to hot and cold.
- Severe tooth pain.
- Sometimes no symptoms are present.
- Swelling and/or tenderness.
Reasons for root canal therapy:
- Decay has reached the tooth pulp (the living tissue inside the tooth)
- Infection or abscess has developed inside the tooth or at the root tip.
- Injury or trauma to the tooth
What does root canal therapy involve?
A root canal procedure requires one or more appointments. While the tooth is numb, a rubber dam (a sheet of rubber) is placed around the tooth to keep it dry and free of saliva. An opening is made on top of the tooth and a number of root canal files and low vibration rotary instruments are placed into the opening removing the pulp, nerve tissue, and bacteria. If tooth decay is present, it will also be removed. Once the tooth is thoroughly cleaned and disinfected, it is sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed. At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed. A filling will be placed to cover the opening on top of the tooth. In addition, all teeth that have root canal treatment should have a crown (cap) placed. This will protect the tooth and prevent it from breaking.
Full mouth reconstruction often requires a combination of multiple restorative and surgical procedures including crowns, bridges, implants, veneers and endodontic therapy. We offer this full range of treatments under semi-conscious sedation or conscious sedation. After a thorough examination of your needs and expectations for treatment, we will help you to decide the best course of treatment for you. Book your free smile consultation with Dr. Fava today!
An Extraction is the process of removing a single or multiple damaged or infected teeth. Extractions become necessary when: a tooth has become decayed and is beyond repair, when there is advanced bone loss, or for orthodontic purposes. Extraction is often necessary to prevent infection from spreading to other teeth or bodily tissues.
Extractions are carried out either as a surgical procedure or a less complicated procedure using forceps and local anesthesia. The type of procedure depends on your dental health and severity of problem. Sometimes it is necessary to break a tooth into several fragments to make the process of extraction easier and less painful. Once a tooth has been extracted, the gap can be easily refilled by an implant.
Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt in the mouth, generally between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat.
In most cases, inadequate space in the mouth causes the wisdom teeth to erupt in haphazard or painful ways. This is often the result of the tooth becoming impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, cysts or tumors.
First Step: Wisdom Teeth Examination
A thorough examination of the wisdom teeth and surrounding structures must be performed to assess the complexity of possible extractions. Panoramic and other types of x-rays will be taken in order to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. Early evaluation and treatment is recommended in order to identify potential problems and to improve the results is an extraction is necessary. A thorough examination also helps in determining the level of impaction and complexity attributed to each tooth.
There are several types of impaction based on the actual depth of the teeth within the jaw:
- Soft Tissue Impaction: The upper portion of the tooth has penetrated through the bone but the gingiva (gum) is covering part or all of the tooth's crown and is not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.
- Partial Bony Impaction: The tooth has partially erupted but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, infection will commonly occur.
- Complete Bony Impaction: The tooth is completely encased by jawbone. This will require more complex removal techniques.
Reasons to remove wisdom teeth
Wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future.
If impaction of one or more wisdom teeth is present, and left untreated, a number of potentially harmful outcomes can occur, including:
- Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss
- Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
- Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
- Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn't universally accepted by all dental professionals, and it has never been validated by any scientific studies.
What does the removal of wisdom teeth involve?
Depending on the level of impaction, wisdom tooth removal is performed under increasing levels of anesthesia, including local anesthesia, local anesthesia + Nitrous Oxide inhalation ("laughing gas"), or local anesthesia + semi-conscious sedation ("twilight sleep"). The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication to help manage any swelling or discomfort.
Nitrous oxide or "laughing gas" is inhaled to provide relaxation and calmness during dental procedures. It is available for all procedures.
Nitrous oxide is odorless, colourless, and does not cause irritation. It works very rapidly, reaching brain within 20 seconds, and relaxation develops after 2 or 3 minutes. The depth of sedation can be altered from moment to moment, allowing the dentist to increase or decrease its effect. Other sedation techniques don't allow for this. For example, with IV sedation, it's easy to deepen the level of sedation, but difficult to lessen it. Whereas with laughing gas, the effects are almost instant. The dentist will give incremental doses until the desired action is obtained (this is called "titration") allowing for control over the action of the drug. Nitrous Oxide has no "hangover" effect - the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don't need an escort.
Furthermore, Inhalation sedation has been found to be very effective in eliminating or at least minimizing severe gagging.
If you are especially nervous for dental procedures and need something more than laughing gas, we are happy to offer semi-conscious sedation, or "sleep dentistry". This type of sedation can only be administered by a specialist, such as an anesthesiologist, and only in clinics that have been granted privilege by the Royal College of Dental Surgeons (a "facility permit"). There are a number of different agents used in sleep dentistry. We are happy to book you a consult with our anesthesiologist Dr. Daniel Lee, and let you decide if sleep dentistry is right for you.
The temporomandibular joint is responsible for opening and closing of the jaw, mastication, balance, and many other fine and complicated functions. Temporomandibular dysfunction can present in various ways, including pain, difficulty opening, night grinding and day clenching. Treatment can be complicated and depends on a thorough and proper diagnosis. A full examination and evaluation of the problem is the first step to improving function and relieving pain.