Dental Procedures

Guard Your Teeth to Get the Most Out of Your Smile

You only get one set of permanent teeth. Are you doing everything you can to keep them healthy and strong?

Sure, you brush and floss. Maybe you even use a great antimicrobial mouthwash. You never miss a six-month appointment with your North Vancouver dentist, either.  So, what more can you do? Well answer this question, if you can. Have you ever noticed yourself clenching or grinding your teeth? If you have, there is one more big thing you can do to help your teeth stay healthy: Get a night guard.

Wearing a night guard can help your oral health in several ways. Not only does it protect your teeth, but also your jaw and if you have migraines, it could provide some relief from a common musculo-skeletal headache trigger!


Grinding Down Through Your Enamel Over Time


Your teeth can show age just like the rest of your facial features. But instead of getting fine lines like your eyes and mouth, your teeth will discolor, shift alignment, and show wear through the enamel. Perhaps they even look flat or jagged.

But if you have bruxism and grind your teeth when you sleep, the wear and tear will look much worse. After a lifetime of grinding, your regularly shaped teeth will be very short. A night guard can help protect your teeth from excessive wear from grinding and clenching, keeping your pearly white enamel intact.


Cavity Prone?


When you wear away all the enamel due to grinding your teeth, you open them up for extra cavities. Additionally, during the wear, your teeth may flatten out, which makes it more difficult for you to bite and chew.

When you start wearing a night guard early enough, you can prevent the wear before opportunistic cavities start to form.  Our North Vancouver dentist at Pier Dental Centre will make sure your night guard fits your teeth and bite effectively, to protect them from the bite forces that come with bruxism.


Have TMJ Disorder? About that Sore Jaw


Do you wake up in the morning with a tired, aching jaw? How about waking up with a headache that radiates from your temple into your eyes or ears?  That kind of wakeup call is not the way to start your day, but if you have bruxism, you’re probably used to this kind of morning.

Now imagine not grinding your teeth through the night. How would your jaw feel if it were unable to tighten down as hard? A night guard will help keep your jaw from locking down and clenching your teeth together (or fully engaging your TMJ.) Additionally, if you have migraines that are triggered by your bruxing, a night guard may help decrease or completely stop the trigger, lessening the instance of your migraines.

If you’re looking for a solution for your night grinding or potential tooth wear, schedule a consultation with to Dr. Robert Cegielski.  Not only will you find a sympathetic listener, but it’s likely, you’ll find help and hope for better oral health.  Contact our North Vancouver dentist office to schedule your appointment!

Four Things to Know About Porcelain and Composite Fillings

When you’re faced with a choice of fillings, the chances are you want ones that will look natural in your mouth and also last for a long time.  At Pier Dental Centre, you have a few choices available. We want you to have the information necessary to make the best decision for your health and your smile!


Here’s what you need to know:

Match Your Teeth

The older type of filling material, amalgam, is a blend of different metals. While this is an effective and strong material, it leaves your teeth looking grey. Even metal fillings like gold and silver can be very obvious in the teeth. With the (wrongful) stigma that goes along with obvious dental restorations, there’s no that wonder metal fillings often have the effect of making patients self-conscious, and hesitant about smiling. The good news is that both porcelain and composite fillings are great choices for fillings and they match your teeth! You’ll feel confident smiling and laughing!


Not All Cavities Are the Same!

Surface cavities can be repaired in a single visit under local anaesthesia. For this type, one that is between your teeth or very small, a composite filling is the best choice.  Not only does it match your teeth, but it is installed with and bonds quickly to your tooth!

The repair for a deeper cavity may be more extensive. Depending on the structure of the tooth, Dr. Cegielski and Dr. Kherani may decide that a porcelain filling is better. If you have to choose one or the other to make up the majority of your tooth, porcelain is a better aesthetic and minimally-invasive choice.  Large porcelain fillings, however, are usually put in as an inlay or an only.  What this means is that an impression of the cavity area is taken, and a lab-made filling is designed to fill and/or cover the space. It requires more than one appointment and a temporary filling in between.


Choose for Tooth Size!

The larger the tooth, the more pressure it has to withstand while you are chewing hundreds of times during the day.  So, a smaller tooth, like one of your front teeth or canines, may have a cavity that is easily corrected with composite filling, the same size cavity in a bicuspid or molar may need the stability of a lab-designed porcelain inlay.

Cavities are nothing to wait on. They can cause sensitivity, infection, bad breath, and abscessed roots.  Food can get caught in them. They can spread to other surrounding teeth if not treated early on.

If you think you might have a cavity in one tooth, don’t delay: it’s time to call Pier Dental Centre for a dental exam and X-ray.  Restoring your smile to health is one of our primary goals. Make an appointment with Dr. Cegielski or Dr. Kherani for a complete checkup to have all of your questions answered. Not only will we diagnose your dental decay, we will also help you understand all your treatment options available!

Common Causes of Tooth Sensitivity – Is It Normal?

Whether you’re celebrating with ice cream or having a Halloween candy snack, the pain in your teeth from the cold and sweet makes enjoying them a difficult task. You’re left sucking on your teeth, trying to get the sensation to subside. But why is it happening at all?

There are a few different reasons why you could be suffering from sensitive teeth, and not all of them indicate a problem! Dr. Cegielski of Pier Dental Centre can help you figure out why.

Recent Fillings? New Crown?

If you’ve had recent work done to your teeth, they may still be adjusting to the new material. It takes some time, maybe as long as a couple weeks for your teeth to really adjust to the amalgam or composite fillings. Sensitivity is possible, especially with the metal style fillings that conduct heat so well.

Crowns are also a likely culprit. Though a newer style crown will not have a metal component, many caps are still made with silver, gold, or white gold at the base. Like an amalgam filling, the metallic crown will conduct heat remarkably well. If you’ve had a root canal, you might not feel the sensitivity in the tooth with the crown, but rather in the surrounding teeth. Then again, a crown can be placed on a tooth with an extra-large cavity, without a root canal, so the root and nerve may still be present, and more sensitive to the heat and cold.

Watch Out for Whitening!

Getting your teeth whitened once could leave you with a small amount of sensitivity. Getting your teeth whitened regularly may increase that hyperactive sensation. Whitening your teeth too much or using aggressive products may even cause severe pain. Be on the alert for commercial bleaching products that you find online or at the mall. They may promise amazing whitening, but the tradeoff of oversensitivity and weakened enamel is not worth it!

Tooth Decay and Cavities

A cavity, even a small one, can affect how sensitive your teeth are to cold, heat, and sweet. If you notice a newly sensitive tooth, don’t ignore it! At Pier Dental Centre, we are more than happy to check your smile and screen for any signs of decay. You might not see them: they could be between the teeth or in a narrow crack. But as that sensitivity grows worse, you can be sure the cavity is growing larger. Don’t wait to get it treated!

Solutions for Sensitive Teeth at Pier Dental Centre

With professional memberships across Canada and in the US, Dr. Cegielski is committed to the best outcomes for his patients and their smiles. If you’re having tooth sensitivity in North Vancouver, make your appointment at Pier Dental Centre. Sensitivity can turn to toothache and pain overnight if it’s not treated right. Dr. Cegielski can give you options that treat the problem and help you get back to the life you had before you suffered from tooth sensitivity.


Is Cosmetic Bonding Right for You?

As you get older, you start to see and feel the signs of age on your body. First your hair, then your skin, perhaps your joints get a little achy in the damp weather. Then one day you smile in the mirror and realize your teeth are also showing age too, and it’s not so graceful!  They’ve started to yellow, and some of them show signs of wear, like tiny chips or grooves on the biting surface.

Further, they’ve started to show some movement – gaps that have gotten bigger, teeth that are crooked when they never used to be. You keep your dental appointments for cleanings and exams, so you know you don’t need fillings to correct any of these issues, but what can you do?

It’s possible that you’re a candidate for cosmetic bonding. There are several situations when bonding may work for you. At Pier Dental Centre, we are happy to examine your teeth and discuss which ones you are concerned about, then determine what treatments are available.


Bonding May Work If…

…You have gaps that are slightly too wide: If your teeth are widening a bit as the years go on, it could be due to a missing tooth in the back of your mouth, even your wisdom teeth.  That little bit of room in your jaw gives the teeth enough space to move under normal bite forces. It takes time, but after 15 years or so, you may start to see spaces where they never were before. Cosmetic bonding can close that small gap, or the one between your front teeth if you have it!

…Your teeth are worn from grinding. A sore jaw in the morning, a headache that radiates from your temples, teeth that are worn and yellowed along the gumlines. They all mean one thing: Bruxism. Grinding your teeth wears down enamel, allowing the yellow dentin underneath to show through along the gumlines or even causing wedge-shaped notches in your teeth. Dental bonding can cover the dentin, allowing your teeth to be their whitest again! (Aside from the wear on your teeth, bruxism can be a symptom of oral sleep apnea, so it’s best to get that checked out!) If the biting edges of your teeth are worn too, you may need a crown.

 …You have small chips or cracks on prominent teeth. These could be from biting on hard foods or using your teeth as a tool.  Bonding can fill and cover these minor imperfections up to a point, however if a tooth is broken, it will need different sort of repair.


Bonding Won’t Fix Everything

Though there are several minor cosmetic problems bonding works well for, it can’t fix large gaps, severe fractures, alignment, or poorly shaped teeth. But Drs. Cegielski and Kherani can create a treatment plan that will work for your teeth, whatever their condition. Regardless of whether you have your teeth bonded or use another cosmetic procedure, you should continue caring for them with excellent dental hygiene including brushing twice daily, flossing, and visiting your dentist at Pier Dental Centre every six months for a checkup and cleaning.

Contact our North Vancouver office to schedule your appointment!


Is Whitening Safe for Your Teeth?

Whitening is the most frequently requested cosmetic dental treatment available. It’s simple, relatively inexpensive, and offers results with a relatively high impact on your appearance.

But there is a certain caution that should be observed with undergoing whitening treatments, especially when using systems that are not overseen by a dentist. Over bleaching can have far reaching effects on your dental and overall health.

There are three basic ways to whiten your teeth and what you should know about each.

  1. At Home Whitening: Products available at your local pharmacy that promise tooth whitening are generally pretty safe when used as the packaging directs.  They may be useful for lightening your teeth temporarily or if you have generally mild staining and tooth discoloration. They are usually made with a low concentration of peroxide that is safe for your teeth if a dentist hasn’t screened you.
  2. Shopping Center Whitening: The dental bleaching offered in shopping centers or what can be found for purchase online often boasts superior results. Even the before and after pictures look amazing. But as a patient and consumer, you need to be very careful. These treatments may be very harsh. And if they are not overseen by a dental professional your teeth can be at risk.  Dental bleaching slowly changes the enamel of your teeth. This is okay if you only have it done every now and then. Some people, however, develop a body dysmorphic problem that has been dubbed “bleachorexia,” which makes them believe their teeth are never quite white enough. They continue to pursue excessive whitening treatments even when their teeth cannot be any whiter. With no dental or medical professional to keep the products in check, these patients wear their enamel thin, leaving the exposed to plaque, bacteria, heat and cold. Not only that, but the dentin underneath the enamel is a yellow color, with no possibility of becoming white. People who get this far usually have to turn to crowns or veneers to cover their natural teeth.
  3. Dental Office Whitening: Most dentists offer whitening in their offices. This is by far the safest route for getting a whiter, brighter smile. You can rely on Dr. Cegielski and Dr. Kherani to keep a careful watch over your teeth, looking out for the enamel as well as dental concerns like plaque build up, gum irritation, or swelling. And when your treatment is done, you’ll be able to do touch ups with a custom fitted at-home kit.

At Pier Dental Centre, we are committed to providing excellent care to our patients whether you come in for a check up, a root canal, whitening, or any other treatment. We know you have many options for dental whitening in North Vancouver; we seek to honor your trust in us with a higher standard of care than you might receive elsewhere.

If you’re looking for a whitening treatment or need help restoring teeth affected by bleachorexia, contact our office to schedule an appointment!

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.


Preparing for Your Wisdom Teeth Removal

Medically speaking, a wisdom teeth extraction procedure is not a major surgery. It’s typically completed in an hour or less and involves no vital organs or arteries. But, as the saying goes, the only “minor operation” is one that’s not on you or your family. Still, as long as you are prepared, there is no reason why your teen can’t be comfortable and have a quick recovery time for this common dental procedure.


Here are some ways you can prepare:


Coming Home: Wisdom tooth extractions typically involve a general anesthetic. Your teen won’t be able to drive home, so you must come with him or make transportation arrangements. Make sure you have a couple plastic bags and perhaps some anti-bacterial wipes with you. Some patients have a rough time coming out of anesthesia, and nausea and vomiting could occur as the medication wears off.


Foods: Once your teen wakes up enough, he’ll be hungry (when are teens NOT?) Choices should only include soft, easily chewed and swallowed foods like yogurt, cottage cheese, applesauce, or ice cream. Soups with soft vegetables may be well tolerated, but only at lukewarm temperatures. Flat, non-carbonated drinks are best for the first couple of days.


A Cozy Nest: Maybe it’s common sense, but you want to make sure there is a convenient, cozy place for your teen to rest when he returns home. He probably won’t want to do much for the first day or two, so now is the time to indulge in a Netflix binge! Have enough pillows to prop him up as he sleeps to help decrease any risk of swelling.


Ice, Ice Baby: Get a flexible ice pack before the surgery. One you’re home, fill it up with ice, wrap a clean towel around it, and have your teen hold it to their jaw. The coldness will numb the area, reduce any throbbing ache, and also help reduce swelling.


Watch Out: The biggest detriment to recovery is a “dry socket.” After an extraction, the body forms a clot in the socket where the tooth was. This clot is essential to closing the wound and healing. Occasionally, the clot will come out, leaving the socket exposed. Not only is this painful, but it increases the risk of infection and may double the recovery time.


To avoid dry socket:


  • No straws! The suction from using a straw could remove the clot.
  • Avoid foods that get caught like tough meats, berries, popcorn. Cleaning them out of the extraction area can irritate it.
  • Fizzy Drinks: Avoid carbonation and alcoholic drinks after having a tooth extracted.
  • Eat soft foods. Crispy or harder foods could put pressure on the surgical area and irritate it.
  • No tobacco products. Items such as cigarettes can cause atrophy to blood vessels, slowing down recovery.


Without dry socket, you can expect the gums to heal over the wounds in about two weeks, but your teen should feel recovered long before then.


If you suspect that your child’s wisdom teeth need to be removed, contact Pier Dental Centre of North Vancouver.  Dr. Cegielski can assess and if necessary, remove the painful problem teeth leaving your teen with a naturally beautiful smile!

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.

Seven FAQs about Dental Fillings

Your dentist says that you have a cavity that needs to be filled. In 36 years you’ve never once had to have actual “dental work,” so you have some questions. At Pier Dental Centre, these are the most frequent questions we get asked about new and replacement fillings.

What Are Fillings Made Of?

There are a variety of materials that teeth can be filled with — gold, silver, porcelain, but the most common filling materials are amalgam (silver) and composite resin (metal-free.)

Amalgam is a blend of metals, including mercury, tin, silver, and zinc. While it was once the most used filling material and is certainly the most economical, many people believe the very low level of mercury are a cause for concern. Composite resin is made of ground glass and acrylic resin, allowing us to match them to your tooth.

How Do They Work? 

Fillings do just what they say: fill a hole in your tooth that has been created by decay. Composite fillings bond with your teeth best, allowing them to be less invasive than another material.

How Long Do They Last?

Fillings are not as strong as your natural teeth, but with proper care they can last for many years. Most reports indicate that a composite filling will last for as long as 8-10 years, while an amalgam filling can last 12 years or longer. One study even shows that amalgams can last more than 20 years in some cases.

Does Getting A Filling Hurt? 

While you might experience some discomfort in your tooth before discovering your cavity, getting a filling shouldn’t cause you major pain. At Pier Dental Centre, we use a topical anesthetic applied to the gum and/or the roof of the mouth near the cavity and a small injection of local anesthetic to completely numb the area being worked on. If even the thought of a filling makes you anxious, we can even provide a sedative for you during your procedure to keep you comfortable and relaxed.

What Happens Next?

After your tooth is numbed and isolated, we use a micro file, laser, or an air tool to remove all of the decayed structures. Finally, our dentist will apply the filling and set it with a UV light. The procedure takes about 30-45 minutes to complete.

Won’t My Teeth Be Sensitive After?

You may have some sensitivity as the anesthetic wears off, but within a day, maybe two, you shouldn’t feel anything different than your normal teeth.  If you do have sensitivity, you’ll need to speak with Dr. Kherani or Dr. Cegielski to reassess the tooth.

What Happens If I Don’t Get A Filling?

If your dentist says you need a filling, get it. Your teeth will not heal by themselves! Decay and bacteria will continue to eat away at your tooth well into the nerve, causing infection, inflammation, and a great deal of pain.

Fillings are a relatively simple procedure, one that is performed on a daily basis by Drs. Kherani and Cegielski. You can have confidence that the team at Pier Dental Centre will take superior care of you and your teeth!