Dental News

Five Tips to Make Your New Crown Last

When you started having a toothache, you knew you had a problem; but you didn’t want to face what it meant. A year later, your tooth is broken, and you’re in a lot of pain: it’s past time to get to the dentist. Even without a set of x-rays, the dentist can tell you have an infection and likely will need a root canal and a crown.

It takes a lot of effort for you to get to the dentist and get the broken tooth fixed. There are days off work, some scrimping to pay your treatment costs, not to mention overcoming the anxiety you feel about having the root canal!  Once you get the crown in your mouth, you want to know how to care for it, so you don’t have to go through that ordeal again anytime soon!

Use these five care tips and your crown may last 15 years or more.

  • Avoid hard food. Chewing on hard candies, carrots, or even your favorite holiday toffee can be damaging to a crown. Limit your exposure to these foods, especially at first. The goal is to keep your crown for as long as possible; but noshing on hard, crunchy foods put extreme pressure on the restoration and can break the bond between it and the tooth.
  • Avoid chewy food. This includes very tough foods, like overcooked meat and also sticky foods like caramel and taffy. Tough foods, like hard ones, can break cement that holds the crown to the tooth. Sticky foods can use the strength of your mouth to pull the crown (or filling) completely out. If you love the tastes of these foods and can’t avoid them, don’t chew on them. Instead, allow them to melt in your mouth and take very small bites.
  • Watch out for grinding. You may not realize you grind your teeth when you sleep, but if you wake up with a headache and jaw pain, there’s a good chance it’s caused by grinding/bruxism. Ask Dr. Cegielski for a night guard to help you stop clenching your teeth, and to relieve the pressure on your dental crown.
  • Floss carefully. Whether you use regular dental floss, a floss pick, or a proximal brush, be gentle with it. With floss in particular, make sure you move it down both sides of the space between the teeth, but when removing it, let us know if it catches on anything.

If it gets caught above the crown, don’t pull down on it, simply pull it straight out from between the teeth. Most people tend to be afraid of pulling their crown off with floss, but this rarely happens. It’s better to floss daily to prevent new decay from forming around the margins around your restoration.

  • Keep your six-month appointments: There’s no easier way to maintain your dental health than to keep your dental checkup and cleaning appointments. Six months is enough time for your dental health to show changes, but not usually enough time for those changes to become severe. A cleaning and exam at this point should be enough to keep your smile healthy and your new crown safe.

Crowns can be a great investment in your compromised tooth. With a little care, they can last 15 years or more! Contact our North Vancouver office for an appointment.


Flossing vs. Bleeding Gums: Make The Right Choice!

Dental hygiene seems to be a pretty straightforward thing. You brush twice a day, floss and rinse at night, and visit the dentist twice a year.

At least, it should be that easy. But most adults in North Vancouver either don’t brush long enough or skip the floss, so the condition of their teeth and gums starts to suffer.

Certain things happen when periodontal health is neglected:

  • Tartar buildup
  • Inflamed and bleeding gums
  • Increased risk of cavities

And that’s just the risks in your mouth, not including the impact on your overall general health!

One reason many adults don’t floss is because of the inflammation and bleeding of their gums. The logic follows that since brushing makes the gums bleed, flossing will make them worse and should be avoided. The reason this line of thought is actually false is based on what has caused the bleeding:

Bleeding Gums Are Not Caused by Brushing and Flossing!

Though it appears that a vigorous brushing or flossing causes gums to bleed, that’s far from the truth.

When you don’t floss, plaque biofilm accumulates into a permanent, hard substance called “calculus” or “tartar.”  It’s like a bio-cement on your teeth, teeming with bacteria. These tiny germs excrete toxins that seep into the gums and bone around your teeth, causing inflammation and redness. When irritated with a toothbrush, the infected gums can start to bleed.

You Can Stop Your Bleeding Gums

The real culprit of bleeding gums are the bacteria living and breeding between your teeth and under the gums.

There are three ways you can work to get rid of the plaque and buildup:

  • Use an antimicrobial rinse after brushing. This will help kill off germs and may soften the plaque some before flossing the teeth. If you’re more interested in home remedies, a salt water rinse will help with inflammation, too: Dissolve ½ tsp salt in a cup of warm water, then rinse well.
  • Flossing only works when rubbing the strand physically against the surface of the tooth and just under the gumlines. Anything loose and uncalcified can be rubbed off. However, hardened plaque (calculus) cannot be removed without a dental professional’s help.
  • Go see Drs. Cegielski & Kherani for a cleaning! The dentists and hygienists at Pier Dental Centre are used to seeing and removing calcified buildup across teeth. It can be removed with a simple cleaning or more therapeutic scaling and root planing. Manually removing the tartar from your teeth is the only way to allow your gums to heal.

Keeping your teeth and gums clean is an important part of your dental and overall health. Don’t let a little swelling or bleeding stop you from flossing; the more you floss, the less your gums will bleed! Of course, the only way to get rid of calcified buildup on your teeth is to have a professional cleaning.

Schedule your appointment with the gentle dental professionals at Pier Dental Centre today.

Three Times You Might Need A Filling – Even If Your Tooth Doesn’t Hurt!

Have you ever been surprised on a visit to the dentist?  Sometimes, even if you’ve been having your six-month cleanings and keeping up with your dental hygiene, you still get a cavity.

They don’t necessarily hurt, but cavities need to be fixed as soon as they’re found, to prevent further destruction to your teeth! Here are three examples of cavities that you might not feel, but need to be treated…quickly!

  • The cavity in the top of your molar. Your molars, the teeth toward the back of your mouth, are meant to grind food. They are creased and creviced. You may notice that certain foods get caught in them: seeds from berries, bread, pieces of meat. When this happens, you might have a very slight cavity in the biting surface of the back tooth. The more food gets stuck, the worse the cavity will get since it’s very difficult to remove food debris from an uneven crevice.


  • The cavity between your teeth. If you don’t floss well or often, and especially if your teeth are close together, you may tend to cavities between them. Food gets caught there, breeding acids and breaking down enamel, leaving a food supply for the bacteria that cause plaque. The process eats away at teeth adjacent to it too, and works its way deeper into the dentin of your tooth. Since a toothbrush cannot get into that space to clean, it’s at a higher risk. Your cavity may start in one tooth, but the bacteria and decay will spread to the next tooth, leaving you with two cavities if you don’t have the first one filled.


  • The cavity on the back of your tooth. The back of your teeth is a hard spot to clean. You have to open your mouth wider than is comfortable and reach the toothbrush around, or stick both of your hands in to floss. This spot is prone to cavities and to inflammation in your gums.

Any of these cavities are likely to go unnoticed by the naked eye; you’ll only be able to see them with a set of dental x-rays.  In fact, if you can see a cavity or feel a cavity, it’s past time to have it restored!

Fillings and Restoration in North Vancouver

Pain and sensitivity in a tooth or gum and persistent foul breath are indicators of a cavity. But by the time you’ve having these symptoms, the decay has probably gone through the outer layers and into the pulp (nerve) of the tooth, making you prone to an abscess. At this point, the root is open to infection, and is likely to be very sensitive to heat, cold, and sweetness. It’s likely at this point that you will need more than a filling, like a root canal or crown.

Don’t put off your dental appointments or fillings! Even if you don’t feel pain from a cavity, it’s working its way through your tooth. Drs. Cegielski and Kherani of Pier Dental Centre can help you enjoy better dental health. Call today!

Relaxation Options for Anxious Dental Patients

A mother with two small children. She knows the value of dental treatment, and takes her children to the dentist regularly. Their teeth are healthy and clean, and so far have had no cavities.

But her teeth are another story entirely. When she was a child, dental techniques were not so gentle as they are today. She recalls the hour spent in the chair with horrible tastes in her mouth with no way to swallow or be comfortable. She remembers sitting in agony with no anesthetic while a cavity was being prepared and filled. She remembers the smell of the antiseptic and the feeling of being trapped in a chair.  And though her teeth desperately need a dental visit and she knows modern dentistry is better, she remains reluctant to go or even schedule the time.

If this sounds familiar, you’re dealing with the realities of dental anxiety…and help is available!


Behavior Modification

As with any form of anxiety, behavior modification can provide a source of relief. When you become aware of the connection between your mental state and physical tension you may find ways to relax.

  • Yoga can train you to focus your mind, breath, and muscles together. Those who practice yoga often have a calmer, more peaceful outlook on life.
  • Breathing: Many focused breathing guides can be found online. There are several basic ones that may work for you, here. Include visualization, such as breathing in a golden light representing peace, and exhaling or releasing any anxious feelings.
  • Bring a friend of family member with you to your appointment. Having someone who can provide a calming influence may make you feel better about your time in the chair.


Sedation and Anesthetic

Aside from behavior techniques that may provide relief to your dental anxiety, you should know that the modern dental office is more comfortable and provides a wider variety of options for pain and relaxation. There is no longer any reason to perform a treatment or extraction without an anesthetic or sedation. Even standard exams and cleanings can be done under a light sedation if necessary.

  • Local anesthetic numbs nerves in a small, immediate area. Fortunately, numbing gels and newer anesthetic techniques make getting numb not so uncomfortable!
  • Nitrous oxide sedation (“Laughing Gas”) provides fast, gentle relaxation that can be reversed 100% so that you can drive yourself home afterward.
  • Oral sedatives allow you to experience more of a dream-like state, where you are semi-conscious but unlikely to remember anything about the appointment.


Don’t Be Afraid of The Dentist Anymore!

If you are like the mother of two who is afraid to go to the dentist, it’s time to get the gentle dental care you need.

At Pier Dental Centre, not only will you receive excellent dental care for long overdue issues, you’ll also have a comfortable exam with a gentle touch. Contact our North Vancouver office to schedule your appointment.

Early Cancer Screening with VELscope

When you make your six-month appointment at the dentist, you know just what to expect: dental x-rays, the hygienist using special tools to clean off plaque and check your gums, the high-powered polishing that buffs away stain, then your dentist examining your teeth and checking for new cavities.

Then he asks you something new: can you lift your tongue?  Have you noticed any sore spots in your mouth?  He feels the floor of your mouth, checks the sides of your tongue, and then feels your cheeks and neck.

He’s not examining your teeth anymore; he’s checking for signs of oral cancer. When it comes to preventative dental care, an oral cancer exam is one of the most important parts of your entire appointment.


Aren’t Oral Cancers Caused by Smoking or Driking Alcohol?

Smoking can be a cause of oral cancer, but it’s not the only one.  Any tobacco use, including “smokeless” chewing tobacco can be a trigger for pathology in the mouth, as can sun exposure or alcohol use.

Research has even shown a link to a viral cause in some cases; HPV, or human papilloma virus, a sexually transmitted disease, has been shown to be a causative agent. We now know that this virus can be spread by kissing!

Considering that most adults have an HPV strain in their system, it’s not surprising that incidences of oral cancer have been on the rise, even as cigarette use has declined. Some additional facts you might not be aware of, according to the Oral Cancer Foundation:

  • Oral Cancer is the sixth most diagnosed cancer.
  • Between 45K-55K people will be diagnosed with it in North America in this year.
  • The 5-year survival rate is 57%.
  • In North America approximately one person dies every hour, from oral cancer.

With all the strides in cancer research, prevention and treatment in the past twenty years, you might be wondering why the outlook is so bleak for cancers of the mouth. But if you think about it, you’ll figure it out.

Education for regular, early testing for skin cancer, breast cancer, and cervical cancer is everywhere. People know to wear sunscreen and check the margins and color of their moles. Most women know to check monthly for breast irregularities and have a test annually for cervical cancer.

But almost no one besides your dentist knows what to be on the lookout for when it comes to oral cancer. Additionally, while the screenings for breast cancer is visual, tactile, and mechanical using a mammogram, the screening for oral cancer is primarily visual. Oral cancer can grow and metastasize without being observed or causing pain.

By the time a person catches oral cancer on their own, it has usually reached an advanced and deadly stage.


A More Effective Way to Screen for Cancer

Luckily, advanced tools to screen for oral cancer do exist. While they aren’t a popular choice among most dentists, Dr. Cegielski places a high value on early cancer detection for his patients and uses a particular tool to screen for oral cancer: the VELscope.

VELscope oral cancer screening detects precancerous lesions on your soft tissues before they can be detected through a traditional visual or palpation exam.

The earlier cancer is detected, the more effective and successful it is to treat. This is as true for oral cancer as it is for any other form.

Schedule your next dental visit with Dr. Cegielski’s North Vancouver office for a complete oral exam including a VELscope cancer screening.

Dental insurance North Vancouver

How to Know What Your Dental Insurance Covers

Has it been a while since you last saw a dentist? At Pier Dental Centre, we’re committed to help our patients minimize the financial impact of their oral health care. We believe that you deserve to know what you need to pay for, when you’re required to pay for treatment, and how much your insurance plan really covers.

Your Treatment Plan

After your comprehensive exam and consultation, our North Vancouver dentist will discuss which types of treatment are recommended for your unique situation. In some cases, you’ll have a choice to choose between different options.

Together, we’ll create your customized treatment plan to outline:

  • Which procedures need to be completed
  • The number and length of appointments involved
  • The fees for each service
  • An estimate of what your insurance plan is expected to cover

As our treatment coordinator walks you through your care plan, you’ll have a chance to see exactly what fees are involved. Because Pier Dental Centre works with various insurance companies, we can generally provide a close estimate of what your particular carrier is expected to pay in a given circumstance.

Is Your Insurance Accepted by Your Dentist?

When you call Pier Dental Centre for the first time, or if you’ve recently changed dental insurances, our patient coordinators can let you know whether or not we take your particular type of coverage. In most cases, all dental insurance plans are welcome. There may be certain exclusions that don’t allow you to select the office where your benefits are active, so it’s always best to call us first.

When do You Pay?

How can you know when and how much you’re responsible for paying toward your dental treatment? Here are some of the most common situations when our patients may need to pay at the time of service, or following their procedure:

If a deductible is due. Deductibles are the flat dollar amount that must be paid prior to your insurance benefits being accessible. For instance, if you need $500 in treatment but have a $200 deductible, the $200 must be paid before the insurance claim is accepted by your carrier.

When there is a copay. Copays are the percentage or fixed amount that you need to pay at the time of your appointment. A common example is when a specific type of treatment is covered at a set percentage; you would pay the remaining balance at the time of service, and then the insurance claim would be filed.

When there are exclusions or the claim is rejected. Perhaps your insurance plan doesn’t take effect for 90 more days, won’t cover a particular procedure, or has rejected a claim for one reason or another. When this happens, the patient is responsible for the total fee for service.

Maximize Your Coverage

At Pier Dental Centre, our North Vancouver dentists understand that an unexpected dental expense isn’t something that anyone likes. That’s why we’re committed to helping you maximize your insurance coverage to limit any out of pocket expenses related to the care you need.

Ask us about payment plans when you call, or during your treatment plan consultation. Schedule your next appointment at Pier Dental Centre today!

5 Tips for Getting Your Kids to Take Care of Their Teeth

We all know how important good dental hygiene is, especially for our children. Even before their adult teeth come in, the health of their smile is determined by good habits and proper cleaning.  Getting your kids to take care of their teeth can be a chore, especially since brushing is usually done in the morning and before bed, which are two of the busiest times in most households.

Here are a few easy ideas to help make brushing and flossing a familiar routine and a habit that they will carry on for the rest of their lives. Since oral health is an important part of overall wellness, these habits are sure to benefit your children into adulthood.

Let Them Choose Their Own Toothbrush

Gone are the days of boring toothbrushes. Now children can find a toothbrush with just about any character on it, from cartoons to movie superheroes. There are brushes covered in glitter, brushes with cool designs, and even brushes that play music! When a child feels like the brush is her or his “own,” they will be more likely to use it. Keep the toothbrush in a special place, so that your child sees how important it is. 

But Make Sure it Fits

While you should give your child a choice in brushes, do check the label to make sure that the brush they choose is designed to fit a child’s mouth. Often children will try to use an adult-sized brush, only to find that it is uncomfortable and unpleasant. An adult-sized brush will also be unable to adequately reach all of the spots within your child’s mouth. Children’s brushes will be clearly labeled as such, so just check the label when you shop.

Watch Videos Together

Even if your child is willing to brush his or her teeth, it can be difficult to make sure that it gets done right. The dentists at Pier Dental Centre can give your child a helpful, hands-on demonstration, but once you’re home, you can reinforce these lessons by watching videos online together. These videos can make brushing and flossing cool while teaching the importance of proper technique. Best of all, your kids can watch the videos as many times as is necessary, instead of giving up when things get difficult. Here’s one to get you started:

Get Kid-Sized Dental Floss

Flossing is just as important as brushing, if not more so, but it’s often overlooked by children rushing to finish their routine. Just as they can choose an appropriate-sized toothbrush, your children can choose a fun, kid-sized dental floss. While the traditional floss will work in a pinch, kids often find it easier to use portable, one-hand, disposable dental flossers. Fortunately, these also come in smaller sizes that are perfect for fitting into little mouths. Let your child choose their favorite color and show them exactly how to work the flosser. Encourage them to floss after every day, even if they aren’t able to brush.

Sing Brushing and Flossing Songs Together

Preschool teachers and kids’ television shows agree: the easiest way to teach a child is through song. To make brushing and flossing more fun, incorporate songs along with their routine. You can find tooth-brushing tunes online, or make up your own. You can even pick a familiar favorite and just change the words to fit your theme. For example, “The Wheels on the Bus” can become “The Floss and the Brush.” Let your child help with the lyrics and have a good time with it. Not only will singing each time you brush keep things fun, it can also be used as a timer to remind your child how long they need to brush. It only takes a few weeks to establish a positive habit that will last throughout their childhood, and, hopefully, for the rest of their lives.

What Could Cosmetic Dentistry Do for You?

Visits to the dentist aren’t just about drilling and filling. Although these oral health treatments are vital, your dentist can do much more. Cosmetic dentistry is all about improving the appearance of your smile by fixing problems with your teeth, and it can leave you happier, more confident, and more relaxed in public. What treatments could you benefit from?

Although dazzlingly white smiles may be best left to Hollywood superstars, many people could benefit from having the color of their teeth lightened by removing stains that have built up over the years. Professional dental whitening is far safer and more effective than any home-based kit you can buy online, and if you’re embarrassed about your discolored teeth, it’s well worth the cost of the treatment.

Filling the Gaps

Whether they’re caused by accident or decay, missing teeth are extremely visible in a smile. Cosmetic dentists can use a range of techniques including implants, crowns, bridges, and dentures to seamlessly fill the gaps.

Damage Repair

Even if you have no missing teeth, you may have damage such as chipping and cracking that’s not only unsightly, but can lead to decay further down the line. Crowns, dental veneers, and other treatments can restore your teeth to their original shape and condition.

Teeth Reshaping

If your teeth are too large, pointed, worn down, or of noticeably different lengths, cosmetic dentistry can fix the issue. Techniques and treatments from orthodontics to veneers can give you a more even and attractive smile.

Teeth Straightening

Very few people’s teeth grow entirely straight and even, but sometimes crooked teeth are very noticeable. If this wasn’t fixed by braces in childhood, all is not lost. Modern braces are a far cry from the metal contraptions remembered from so many teenage yesteryears. Clear braces are much less visible in use, while new-style lingual braces fit almost unseen to the rear of your teeth to correct a crooked smile extremely effectively. Also, if only a few teeth are out of alignment, fitting veneers can be a quick and cost-effective solution.

If you’re unhappy with the appearance of your teeth for any reason, there’s no need to put up with being embarrassed or always covering your mouth in public. Whatever the issue that’s spoiling your smile, cosmetic dentistry can provide a solution.

We are happy to help you at Pier Dental Centre, so please feel free to reach out if you have any questions about what cosmetic dentistry can do for you. More resources available at our cosmetic dentistry page.

Why Dental Health is a Personal Investment

We all know the saying: “health is wealth” – it never gets old because we know it always rings true. Health is a treasured source of wealth because it spares you from many serious conditions and illnesses, as well as the accompanying costs that come from the required treatment. The same is also true in the case of dental health. Maintaining your dental health is an easy way to invest in your own health and well-being.

Perception of the Self

So how is dental health a personal investment? Many scientific studies suggest that self-confidence, feeling of self-competence, and importance of body investment are essential influencers of self-reported dental health status and behavior. Dental health is a personal investment because it affects how you perceive yourself – it’s a part of feeling confident, competent, and happy.

Negative Effects of Poor Dental Health

Poor dental hygiene can have adverse and far-reaching effects on your overall health, wellness, and happiness. First, poor dental health can affect your quality of life. Some people with poor dental health might also lose interest in social functions and even romantic relationships. For example, lack of oral hygiene leads to potential problems such as a severe case of bad breath or halitosis which may have serious negative effects on their romantic relationship with a significant other. Secondly, untreated tooth cavities and toothache can also reduce one’s productivity at work. For example, delaying a much-needed visit to the dentist can force someone to endure a serious pain unnecessarily.

Minimizing Risks

When we invest in our dental health, we minimize other health risks. For example, if left untreated, gum disease leads not only to the loss of teeth but also the development of more serious conditions like respiratory diseases. Bacteria build-up in the mouth can travel and spread in the lungs. Moreover, maintaining dental health also requires specific steps that also benefit the overall physical health. For example, avoiding smoking, making healthy food choices, and drinking lots of water are part of an optimal dental health regimen, and these steps are extremely beneficial to overall physical health and happiness.

In sum, maintaining dental health is a personal investment because it boosts self-esteem, prevents the negative effects of poor dental health to many aspects of our lives, and minimizes risks for the development of other diseases.

Image of woman receiving Botox treatment

BOTOX® Treatment for Teeth Grinding

BOTOX® has not traditionally been a treatment associated with dentistry, but since dentists have specialised training in the anatomy of the face and mouth, they have the perfect expertise to perform this type of delicate work. Our North Vancouver dental office has dentists who are certified to provide safe BOTOX® injections for both cosmetic treatments (softening fine lines in the forehead, around the eyes, and between eyebrows) and to treat bruxism (teeth grinding).

Bruxism is the conscious or unconscious clenching or grinding of the teeth, primarily while sleeping. This condition affects up to 40 million people in the United States, and is thought to be caused primarily by stress and muscle tension. Severe bruxism can lead to jaw pain, damaged teeth, and headaches.

BOTOX® Versus Conventional Treatment for Teeth Grinding

Bruxism is most commonly treated with a custom mouth guard that the patient wears overnight to protect the teeth from the grinding. The downside is that even a thin custom mouth guard often feels uncomfortable and unflattering. A mouth guard does not address the root cause of the problem, and only protects the teeth without necessarily stopping the other side effects.

BOTOX® treatment is not a cure for bruxism, but it can achieve better symptom control that lasts around three to four months. The treatment works by injecting a small dose of BOTOX® into the muscles that control the jaw to relax the muscle and reduce involuntary grinding. Voluntary muscle movements and facial expressions do not get affected.

How Does BOTOX® Work?

The neurotoxin in BOTOX® works by blocking out signals that control muscle contraction. When BOTOX® is injected it has a temporary partial paralyzing effect that relaxes and smooths out the muscles, and tightens the look of the skin.

Advantages of BOTOX®

BOTOX® is considered a low risk cosmetic treatment. Benefits include the following:

  • The effects are temporary. You can try it once and decide whether or not to continue.
  • The results are immediate (within a couple of hours or days) with no recovery time needed.
  • The procedure is quick (generally only 10 minutes) and non-invasive.


If you suspect you have symptoms of bruxism, discuss it with the dentist next time you’re in for a check-up. If you’re interested in cosmetic or therapeutic BOTOX® treatment, consider adding a consultation to your next appointment. Speak to your dentist to learn more and determine if BOTOX® is right for you.