What Exactly is Biofilm?

May 18, 2011 | Posted Education

Some of you might have seen certain toothpaste commercials on television talking about what appears to be the latest threat to your oral health…biofilm!

If so, you might have wondered what biofilm is.

The first thing to be aware of is that biofilm is not a new oral health issue! In fact, most of you are probably familiar with another term for biofilm as it relates to your oral health…namely, plaque!

The reality is that the plaque that forms on your teeth is a form of biofilm. As such, there is no need to feel that biofilm is some brand new form of mutated superbug that did not previously exist. It was always there! We simply did not have the technology to recognize it! More importantly, we did not understand how it develops and grows.

The good news is that today, we have that understanding. And that means we are better able to control and eliminate it!

Now that you know that biofilm on the teeth is essentially plaque, you may still be wondering what is biofilm?

Biofilm is a complex community of bacteria that has adhered to some sort of surface, such as a tooth. It is protected by an exterior surface of, for want of a better word, slime.

Believe it or not, beneath this slime is a well organized community of bacteria. As part of that organization, it is interesting to note that different types of bacteria will thrive in different locations within the biofilm.

For instance, deep within the biofilm, where it is harder for air to reach, you will find bacteria that survive better with less oxygen. Conversely, as you move to the exterior surface, the bacteria you find there need higher levels of oxygen to thrive. These different types of bacteria have found a way to meet their individual needs while surviving together in the same colony.

The colony also has an elaborate system for eliminating its own waste products. From our standpoint as dentists, the exterior slimy surface as well as the ability of these bacteria to adhere to teeth makes them difficult to remove. Antibiotics are ineffective at killing them while rinses cannot eliminate them.

Fortunately, biofilm bacteria can be wiped off the surface of your teeth. And that means regular brushing and flossing. Brushing has to be for at least two minutes each time in order to be effective at removing biofilm. It is such a sticky substance that casually wiping the surface is not enough to remove it from your teeth.

And even if you maintain good brushing and flossing habits, biofilm will grow underneath the gums where the brush and floss cannot reach. Regular trips to the dentist are essential to clean the biofilm from the area of the teeth beneath the gum line.

So there you have it. Next time you see that commercial, you will know that biofilm is nothing new. However, we now understand it better. That means we are in a better position to know how to eliminate it. Because understanding how to remove biofilm is a healthy habit…and healthy habits lead to healthy lives!

Dr. Wayne Perron

Dental Surgeon

Nobody likes to have braces to correct an overbite or a crossbite. So often, the age when people have braces is right in the middle of those awkward teenage years. Already feeling self-conscious about their appearance, most teenagers dread the thought of having braces.

But if a crossbite or overbite develops, it really is in their best interest to have the issue addressed. And the earlier it is looked after the better. That means if you see the signs of developing bite problems in your child, the sooner you have them looked after, the quicker they can be corrected.

There is no one single cause for a child to develop problems with his/her bite. It may be a hereditary issue. Sometimes, adult permanent teeth erupt before the baby teeth have fallen out. The jaw may respond by slipping in a different direction to accommodate the extra row of teeth.  The longer this situation is allowed to persist, the greater the likelihood of your child developing a crossbite or overbite.

Children who are mouth breathers are more likely to develop problems with their bite. Normal breathing through the nose allows the tongue to rest in its normal position along the roof of the mouth. When mouth breathing occurs, the tongue falls away from this position and the lateral development of the jaw is adversely affected.

Often, enlarged tonsils can be the cause of mouth breathing. If that is a problem for your child, you may need to have it addressed before treating the bite. In fact, you may have to consider removing the tonsils before treating the bite.

A similar problem occurs in children who suck their thumbs. Thumbsucking also affects the lateral development of the jaw and can result in problems with a child’s bite. Many children find thumb sucking to be comforting and a difficult habit to break. But if you can find a way to break your child’s habit, they will thank you down the road!

Bite problems usually do require orthodontic treatment. The severity of the problem will determine the nature of the treatment. Minor problems may be dealt with far more easily than you might expect!

Regardless, we strongly recommend that you obtain whatever treatment you require. Not only are there the obvious cosmetic concerns about crossbites and overbites. There are very real health issues as well.

People with a poor bite may find it difficult to chew some of the more nutritious, whole foods, such as fruits and vegetables. As a result, they may elect not to eat these foods, thereby denying themselves of the health benefits they provide. Bite problems can also lead to serious TMJ problems, with persistent headaches.

So if you notice your child’s teeth are not coming together the way you think they should, mention it to your dentist. The sooner you address bite problems, the easier they are to correct. And maintaining a proper bite is a healthy habit…and healthier habits lead to healthier lives.

Dr. Bao Nguyen

Dental Surgeon



We all know how unpredictable life can be. The best laid oral health care plans and practices can seemingly be undone by an accident or trauma that leads to a dental emergency.

Dental emergencies can come in many forms. Accidents can result in people biting their tongues or lips. They may lead to broken or chipped teeth, or even to teeth being knocked out.

Prompt action in all these circumstances can be highly beneficial. In fact, you might be surprised to discover that it can even save a tooth you might otherwise have given up on!

If some form of trauma leads to you biting either your tongue or your lip, you will want to keep the area as clean as possible while controlling the bleeding. Use a cloth to try to clean the area, and then apply a cold compress to control the bleeding.

This will usually be sufficient to deal with minor cuts. However, if the bleeding proves difficult to control, you may require medical attention. You should get to an emergency clinic, hospital or dentist as soon as possible as you may require stitches to close the wound.

A cracked or chipped tooth can also benefit from prompt attention. Again, you will want to ensure that the area is kept clean and that a cold compress is applied to deal with any swelling. Once you have dealt with those immediate needs, get to your dentist right away!

Treatment options will vary depending upon the severity of the crack. Minor ones may be sealed quite easily. More serious cracks may result in the need for a root canal and crown to protect the pulp or living portion of the tooth. Let your dentist make the assessment and discuss the treatment options with you.

If a tooth is knocked out, you might be surprised to know that you still might be able to save it! The first ten minutes from the time it is knocked out are crucial. If you can replace the tooth into the socket within ten minutes, there is a good chance it will take root again. The more time passes, the less likely you will succeed in saving the tooth.

When handling a knocked out tooth, try to touch only the crown. Do not touch the roots. If the tooth is dirty, rinse it in water to clean it. You can then try to replace the tooth into the socket.

If you are unable to do this yourself, or you are concerned that the tooth might be swallowed, place the tooth in a glass of milk. You then need to seek the help of a dentist immediately.

Of course, sometimes we have to accept that an accident does mean the end of that tooth. However, it does not mean the end of an attractive smile or a healthy mouth. With options such as implants, crowns and bridges, nobody needs to ever know that you have had a tooth replaced.

Regardless of the outcome, the best way to protect your oral health in the face of an emergency is to make sure you take quick action and get to your dentist. Because acting quickly in an emergency is a healthy habit…and healthier habits lead to healthier lives.

Dr. Peter Georgopoulos

Dental Surgeon



It may be hard to realize that you may have a health issue when you are as healthy as almost everyone else. However, the truth is that sometimes, you do not want to be just as healthy as the next person. You want to be healthier!

That is definitely the case when it comes to your oral health. You may not want to be part of the majority of the population. The reason is simple. It is estimated that 80% of Americans suffer from some form of periodontal disease.

While we can appreciate that these are American statistics, it is highly likely that the Canadian numbers may be similar. From the standpoint of a dentist, we certainly would take little comfort in knowing that one person’s oral health is no worse than the next person’s when so many people are suffering from a potentially serious condition.

And why is periodontal disease such a serious health issue? First of all, there is a growing body of evidence that links periodontal disease to poor cardiovascular health. Bacteria associated with periodontal disease are often found in people suffering from heart or lung disease. And when we are talking about heart disease, we are talking about one of the number one killers of North American men and women.

For those already suffering from diabetes, periodontal disease can prove to be a serious complication. Studies have shown that diabetics with gum disease have more difficulty controlling their blood sugar. If you have been diagnosed with diabetes, it is imperative that you follow a strict oral health routine that includes regular visits to the dentist, to be certain that your condition is not exacerbated by poor oral health.

Pregnant women should be aware that the health of your baby could be compromised by periodontal disease.  This condition in the mother increases the risk of a premature birth. Premature babies are less developed and have a lower birth weight, making them more susceptible to various other health risks.

So these are just some of the health risks you may expose yourself to if you are content to be part of the majority who suffers from periodontal disease. When you think of it in those terms, you realize it is not just your gums and teeth that suffer!

The best way to protect yourself is to make sure you brush your teeth at least twice each day, for two minutes each time! And feel free to brush more often! You should also floss at least once per day.

But do not assume that is sufficient. Visit your dentist regularly to be certain that your oral health care routine is having the desired effect. Your dentist can conduct the thorough examination you need to make sure you either get a clean bill of oral health or the treatment you need!

So don’t settle for an oral health condition that is just as good as the majority. Because avoiding periodontal disease is a healthy habit…and healthy habits lead to healthy lives!

Dr.  Martin LaBoissonniere

Dental Surgeon

If you celebrate Christmas, you know how excited your kids can get as the time for Santa’s visit draws near! We will soon be seeing a similar excitement for many children as the prospect of the Easter Bunny and all those Easter chocolates approaches!

Well, many kids get just as excited about a visit from the Tooth Fairy – particularly that first visit! It can be quite fun to share in your child’s excitement as you move from having that wiggly tooth right up to the moment when it finally comes out. It is such a special milestone in the growth of a child, it is no wonder that many people save their child’s first tooth!

But with all the magic associated with losing that first tooth, it is easy to forget that you need to make sure that you treat it, and lose it, in the right way! That means you should resist the temptation to pull it out.

To understand why you should avoid this, you need to understand how the tooth loosens in the first place. A baby tooth becomes loose as its root dissolves. Once the root is sufficiently dissolved, there will really be nothing holding it in and it can be removed simply by wiggling it back and forth.

If you were to pull it prematurely, that would mean the root has not sufficiently dissolved. The pulling action will create a larger wound. A larger wound means easier access for bacteria and a greater risk of your child developing an infection.

It is important to keep in mind that even when the tooth is allowed to come out naturally, you are leaving behind a space that bacteria can use to access your child’s bloodstream. Therefore, it is important to emphasize good oral health care practices as the new, permanent tooth grows in!

This means you should continue to brush and floss around the area of the lost tooth. You may need to be more gentle immediately after the tooth has fallen out as your child may find the area to be more sensitive. Teaching your child to rinse properly can also help to keep the area clean. The key is, do NOT assume that, because there is no tooth, there is no need for oral health care!

And as the new tooth takes its place, do not be concerned if it looks disproportionately large compared to what you were used to. The adult teeth usually grow in at full size. Unlike your child’s jaw, they do not continue to grow. Over time, your child’s new tooth will likely settle into place and look perfectly natural in doing so.

The key is to make sure you bring your child to the dentist regularly to monitor the development of his/her teeth in relation to the jaw. If there is an issue with crowding, your dentist can discuss treatment options with you as your child grows.

In the meantime, enjoy the magic of watching a child lose a tooth…and the excitement of a visit from the tooth fairy. It is a wonderful experience that all kids look forward to, as they should! You will be surprised how much fun it can be for you too…because sharing your child’s excitement is a healthy habit…and healthy habits lead to healthy lives!

Dr.  Bao Nguyen

Dental Surgeon

We have just turned the calendar into April. As we head into spring, many of us think of the promise of spring and all it has to offer. April is a great time to come out of our winter hibernation and get ready for a wonderful summer.

April also brings about Daffodil Days for the Canadian Cancer Society where fundraising and cancer awareness find an important meeting place. Cancer awareness is, increasingly, becoming an area of greater concern for all health care practitioners, including your dentist.

It is with this thought in mind that we believe April is an ideal time to raise awareness of oral cancer. Oral cancer does not receive the same amount of attention as other forms of cancer, perhaps due to the fact that it is not as prevalent.

However, with that lower awareness comes a greater danger. Compared to cancers such as breast or prostate cancer, oral cancer has a much higher mortality rate. It is estimated that 35,000 Americans will be diagnosed with oral cancer this year. Approximately half of them will not survive the next five years.

The reason for this is the lack of early detection. And early detection usually requires a visit to your dentist for a thorough examination. Simply visiting your doctor for a routine physical usually will not be sufficient. A complete oral cancer check will involve a visual examination of the entire mouth, both top and bottom, gently moving the tongue to the side to examine underneath and using fingers to search for lesions on the gums.

When was the last time anyone other than your dentist conducted such a thorough examination of your mouth?

This is the type of examination you should receive from your dentist at least every six months…perhaps more frequently if you are a smoker or otherwise at higher risk to develop oral cancer. The good news is that, like most other cancers, oral cancer is highly treatable when detected early.

Unfortunately, with at least one-third of North Americans failing to visit their dentist on a regular basis, early detection is what is missing for so many people. Since the mouth provides such an easy access to so many other areas of the body, it is easy for oral cancer to metastasize and spread. Once that occurs, treatment becomes more debilitating and, sadly, less likely to succeed.

So we urge you to use April to help in the fight against cancer. If a volunteer for the Canadian Cancer Society offers you a daffodil, buy it! Consider it an investment in your health! And after you do so, call your dentist and schedule an appointment so that you can be screened for oral cancer.

Because early detection of oral cancer is a healthy habit…and healthy habits lead to healthy lives!

Dr.  George Parry

Dental Surgeon

Did you know that some studies have shown that the average person only brushes his/her teeth for 37 seconds at a time? If you are one of those people, we have to ask you to think about how clean you can get your teeth in 37 seconds?

Odds are, anything you clean around the house, you spend more than 37 seconds doing it. Certainly many people will spend more time than that cleaning their kitchen sinks and counters. Of course, we know it is important to make sure you do not allow bacteria to build up in those very areas you will be preparing your food.

So based on that logic, you should also be just as concerned about removing bacteria from the area of that mouth the food enters  into your body. In fact, we recommend nothing less than two minutes should be spent brushing your teeth.

Then you need to remember that brushing, no matter how thoroughly, is simply not sufficient to ensure that you have properly cleaned your teeth. In fact, the best job you can do brushing your teeth will only succeed in cleaning, at most, 65% of the surface area of your teeth.

The reason for this is simply. Approximately 35% of the surface area of your teeth is found in the spaces between your teeth. Your toothbrush simply cannot access these areas effectively. To make sure you get at this 35% of the tooth, you need to make sure you take the time to floss every day!

Think about it…you need not feel good preparing your meals on counters that were only 65% clean. Imagine all the potential bacteria that could get into your food that way.

Now think about the bacteria that will build up on your teeth if you leave 35% of the surface area unclean. No matter how effectively you clean the rest of the tooth, bacteria will build up between them. The longer it is allowed to remain, the more damage it will do.

Plaque will develop and it will spread.  Bacteria will attack the gums, likely leading to gum disease which is a leading cause of tooth loss amongst adults. You might even develop more serious health complications, including infections in the bloodstream, asthma, or even heart disease.

The simple act of adding flossing to your regular oral health care routine, combined with brushing for at least two minutes, is all that you need to do in order to reduce the risks of these serious health complications. We understand that we are asking you to commit more than 37 seconds to your routine. But you have to ask yourself…isn’t your health worth it!

We believe it is! We believe YOU are worth the investment! You deserve the best in oral health care for yourself! That means proper brushing and flossing. It also means regular visits to the dentist to confirm your oral health in being properly maintained.

So invest the time in yourself! Because recognizing you deserve the best in oral health care is a healthy habit…and healthy habits lead to healthy lives.

Dr. Bao Nguyen

Dental Surgeon

Many of you might have heard of the concept of an “abscessed” tooth. However, you may not really be sure as to what that means.

In its simplest terms, an abscess of the tooth is an infection. Like any infection, it can be so mild that you may not even be aware it is there. On the other hand, it can become quite painful as puss may accumulate around the pulp of the tooth, resulting in pressure on the nerve.

Also like any other form of an infection, it can spread to other parts of the mouth or throughout the body. Given the potential health consequences associated with a spreading infection, an abscessed tooth is not something to be taken lightly even if it is not causing you any discomfort.

Aside from pain around a tooth, other potential signs of an abscess include fever, pain when chewing, bad breath, bitter taste in the mouth, swelling in the gums or neck and an open sore.

If your dentist concludes you have an abscess, the first thing that must be done is that the infection must be drained. The most common way to achieve this is through the process known as a root canal.

Given an infection was involved, your dentist may prescribe anti-biotics to prevent it from spreading. In addition, pain medication, such as ibuprofen, may be needed to alleviate any pain that you may still be experiencing.

In addition to dealing with the infection itself, you may also have to deal with the tooth. As a result of the infection, the pulp of the tooth may actually have died off. If that is the case, you will have to consider different treatment options. It may be that the best option for you is an implant. For some patients, crowns are best. This is a matter that you will need to discuss with your dentist before making any final decision.

Like most other dental conditions, the best way to treat an abscess is through prevention! The two primary causes of an abscess are decay and trauma.

Preventing decay means following a good oral health regime. This means brushing at least twice per day for a minimum of two minutes each time. It also means flossing at least once per day. Adhering to a healthy diet is also recommended, as are regular visits to your dentist.

Following such a plan can reduce the likelihood of your enamel being compromised. If the enamel is in good shape, it is harder for bacteria to penetrate the tooth and start an infection.

Even healthy teeth are susceptible to infections after some form of trauma. If your teeth have experienced such a trauma, you should consult your dentist to make sure that they are not cracked. Just because YOU cannot see a crack does not mean there is not one there! Let your dentist take a closer look to make sure there are no small fissures that bacteria might be able to slip through.

It is never pleasant to have an abscess. An abscess is an infection and infections can have troubling consequences. That is why prevention is the best solution. Because preventing an infection is a healthy habit…and healthy habits lead to healthy lives.

Dr. Peter Georgopoulous

Dental Surgeon

As anyone who visits their dentist on a regular basis is likely aware, one of the number one goals we have is to ensure you keep your natural teeth for as long as possible…all of them! There can be one exception. Wisdom teeth.

Wisdom teeth are the third and last set of molars that will develop for most of us. They usually come in during the teenage years. However, it is quite common for them to first erupt in people as late as the mid-twenties.

When wisdom teeth erupt fully and are properly aligned, there is no reason to remove them. Unfortunately, many people find their wisdom teeth are not so well aligned or that they fail to fully erupt from the gum line.

Poorly aligned wisdom teeth can cause many problems. First and foremost, they can result in crowding. This can affect the bite and may result in uneven wear and tear on teeth throughout the mouth. Some people will experience strain in the muscles around the mouth which, in turn, may result in frequent headaches or general pain in the jaw joint.

Even chewing with misaligned teeth can prove difficult, sometimes painful, and this can have an impact on nutrition. Nutritious foods, such as raw fruits and vegetables, that are hard to chew may be passed over for less healthy, but easier to chew, alternatives.

Crowding also makes all teeth harder to clean. It makes it more difficult to get at trapped food particles with conventional brushing and flossing. Consequently, plaque may accumulate on both the wisdom teeth and the adjacent teeth that are affected by the crowding. With increased plaque build-up, the risk of decay is increased.

Crowding may still be a problem even if your wisdom teeth have not erupted. They may be under the surface of the gum line, still putting pressure on the adjacent teeth.

Moreover, partially erupted wisdom teeth provide an opening that makes it easier for bacteria to make its way to the bloodstream. This can lead to serious health complications, including infections or even heart disease.

Your best bet is to have your dentist monitor the development of your wisdom teeth. By using x-rays, your dentist can usually determine if your wisdom teeth are likely to make a proper and beneficial appearance or if problems are likely to be just around the corner.

If you are the parent of a university student who will soon be returning home after another school year, now may be the perfect time to schedule an appointment to check out how those wisdom teeth are doing.

Talk to your dentist if you are concerned about your wisdom teeth. S/he will recommend keeping them if it is possible. However, if keeping them is not in the best interests of your oral health, it is usually easier to remove them sooner than later…because ensuring the proper development of ALL of your teeth is a healthy habit…and healthy habits lead to healthy lives.

Dr. David Lui

Dental Surgeon

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January 03, 2011 | Posted Welcome | Be the first one to comment.

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