Anomalies in Teeth – lets get weird.

Did you know that teeth can form incorrectly in ways that affect their function and appearance? Here are some of the rarest tooth anomalies seen in dentistry.

Tooth Fusion

Dental Anomalies

Tooth fusion occurs when tooth buds make contact before calcification occurs. It is the union of two or more teeth during development. Tooth fusion occurs in primary dentition 0.5-2.5% of the time and 0.1% of the time in permanent dentition.


Tooth Anomalies

Macrodontia is a condition where a tooth or group of teeth are abnormally larger than average. Macrodontia seen in permanent teeth is thought to affect around 0.03 to 1.9 percent of the worldwide population.


Tooth Anomalies

Microdontia is a type of dental anomaly in which teeth are smaller in size than normal. Microdontia of one or two teeth is common, but microdontia of all teeth is rare. The prevalence of microdontia ranges from 1.5 to 2% and occurs more frequently in females than males.


Tooth Anomalies

Hyperdontia refers to an excess number of teeth beyond the expected 20 deciduous and 32 permanent teeth. We call these teeth “supernumary” teeth. Hyperdontia, which represents about 1 – 3% of all dental anomalies, has a prevalence that ranges between 0.1-3.8% in permanent dentition and 0.35-0.6% in primary dentition.


Teeth Anomalies

Oligodontia is a rare genetic disorder which represents the congenital absence of more than six teeth in primary, permanent or both dentitions. It is a relatively rare condition affecting 0.1–0.2 % of the population.


Teeth Anomalies

 Mesiodens is a supernumerary tooth present in the midline between the two central incisors. Mesiodentes are the most common supernumerary teeth, occurring in 0.15% to 1.9%of the population.


Teeth Anomalies

Dilaceration is an abnormal bend in the root or crown of a tooth. Apical root dilaceration can affect 1 to 4.9 percent of all permanent teeth, with a higher incidence in female patients.

Oral Cancer, what you need to know.

Approximately 1 in 800 British Columbians have a precancerous area in their mouth and about 3,200 Canadians are diagnosed with oral cancer each year. Oral cancer is a disease of soft tissue not teeth, so it can also affect anyone even older adults who do not have their natural teeth.

Oral cancer generally has a high mortality rate due to late detection. Late-stage treatment of the disease can also result in disfigurement and affect daily activities such as eating. Oral cancer screening is a highly effective tool for identifying pre-cancerous lesions, and early detection may improve prognosis.

When to seek a screening.

If you have any areas of concern in your oral tissues, such as discolouration, unusual textures, lesions, or sensitivity you should contact your dentist for an exam. It is also important to have regular dental cleanings as your soft and hard oral tissues are all examined by the dentist as part of their routine examination.

What happens if my dentist finds an area of concern?

If your dentist finds a lesion or other unusual spot in your mouth they may recommend a VELscope assessment. A VELscope instrument is a system that relies on the loss of fluorescence in visible and non -visible high risk oral lesions that can be identified by applying direct fluorescence. In simpler terms, a special blue light is used to light your oral tissues that makes it easy to spot changes in the tissues.

If a lesion or other area is concerning we will perform a biopsy on the tissue and send the sample to the BC Oral Biopsy Service at Vancouver General Hospital for testing.

Who is High Risk?

People with a high risk of oral cancer may be more likely to benefit from oral cancer screening, though studies haven’t clearly proved that. Factors that can increase the risk of oral cancer include:

  • Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and snuff, among others
  • Heavy alcohol use
  • Previous oral cancer diagnosis
  • History of significant sun exposure, which increases the risk of lip cancer

Quiz Time – What do you know about teeth?

Pop Quiz – how much do you know about your teeth and how to care for them?

1 – How many teeth does the average adult have?

A) 20

B) 28

C) 32

D) 36

2 – True or False: Tooth enamel is the hardest substance in the human body

3 – How many litres of saliva can a human produce in a year?

A) 480L

B) 730L

C) 40L

D) 1,072L

4 – True or False: Teeth are the only part of the human body that can’t repair themselves

5 – How long does the average person spend each day brushing their teeth?

A) 48 seconds

B) 1 minute

C) 1 minute 16 seconds

D) 2 minutes

6 – True or False: Your adult teeth can grow back once extracted.

7 – How much of your tooth is below the gum line?

A) 1/2

B) 1/3rd

C) 1/5th

D) 1/8th

8 – True or False: Humans are born with 18 primary teeth below the gum line

9 – How often does your dentist recommend brushing and flossing your teeth?

A) Brush once daily, floss every other day

B) Brush twice daily, floss once per week

C) Brush twice daily, floss once per day

D) Brush after every meal, floss every time you brush

10 – True or False: If flossing causes your gums to bleed, you should avoid flossing.








Quiz Answer Key:

C,  The average adult has 8 incisors, 4 canines, 8 bicuspids, 8 molars, and 4 wisdom teeth

2  True, enamel is even harder than bone!

3  B, 730L  now that is a lot!

True, teeth cannot repair themselves – that’s why we do fillings, root canals, crowns, etc…

A, you should be brushing 4 minutes each day! 2 minutes in the morning and 2 minutes before bed

6  False, most mammals cannot regrow their teeth – unlike reptiles and fish

7  B, 1/3rd of your tooth, (the root) is below your gum line. When it becomes exposed due to recession it can be very painful

8  False, infants have 20 teeth below the gum line waiting to erupt during teething (ouch!)

C, everyone should be brushing twice daily and floss once

10 False, When you floss often and regularly, the gum tissue between your teeth becomes more resilient and stops bleeding when flossed

Celebrities with Unique Teeth

While celebrities are usually the image of “ideal” beauty standards, some have chosen to keep their unique dentition in tact. Here are 5 examples of stars who don’t have Hollywood smiles.

Tom Cruise

The Mission Impossible star has what fans have come to call a “middle tooth”. You can see that the space between his two front teeth does not align with the middle of his face, making his teeth asymmetrical. We know Cruise had orthodontic treatment in the early 2000’s when he wore braces to the premiere of “Minority Report”. This was a great moment in dentistry as it helped reduce the stigma around adult braces.

Lawrence Fishburne

Many celebs have diastema like Lawrence Fishburne. A diastema is a space or gap between two teeth, commonly referred to as “gap teeth”. While diastema can be corrected with braces or (in cases of small diastema) with fillings, may people choose not to “fix” their unique smiles. As long as the open space does not affect chewing or forming words, we love to see people confident and happy with their natural teeth!

Kate Moss

Kate Moss has a peg lateral, a condition where the second tooth on either side of the upper front teeth does not develop correctly and is small, often pointed, and looks like a cone. Options to make a peg lateral look more uniform with natural teeth include aesthetic fillings, veneers, and crowns.

Gary Busey

Busey had dental implants and veneers following a serious motorcycle accident in 1988. He opted for oversized veneers as part of his makeover and while not everyone can pull that off, it works for him.

Jim Carrey

I know what you’re thinking, “it’s not fair to use this picture, he’s playing a character” but did you know Carrey already had a split tooth? A fight during elementary school resulted in a chipped tooth that was eventually repaire. Looking back on how he managed to chip it for the role of Christmas, first assistant director, J.B. Rogers said: “The night before, Jim took a beer bottle… hooked the cap over the cap on his tooth, and pulled the cap off his tooth. Because he thought his character should have the split tooth. He didn’t think of it until that night.”

Bulimia, how it harms your teeth.

How Bulimia Harms your teeth

Bulimia teeth typically look worn in ways that healthy teeth do not. The back sides of the front teeth show significant wear and tear. This uncommon pattern is a major sign. It only takes 6 months to begin to see the negative effects of vomiting. Teeth can’t hold up under the damage of stomach acid forever, some may begin to yellow, become more brittle, or have a more porous texture. Chipping may also begin to occur at this stage.

This is because of your teeth’s regular exposure to stomach acids. These acids begin to corrode the protective enamel layer around your teeth. The more you purge, the more they come into contact with this delicate covering. The sugary foods that bingeing often involves can make tooth decay even worse. This can lead to tooth sensitivity to cold foods, warm foods, and sweets.

Not only does constant cycles of bingeing and purging harm your teeth, it also take a massive toll on the heart, digestive tract, and kidneys, to name a few.

Unexpected problems bulimia can cause

  • Bite problems – back teeth are especially susceptible to long-term erosion, and patients could even lose them over time. Once this happens, your bite could become painful. This stage presents about 3 years into frequent vomiting.
  • Gingivitis and periodontal disease – (almost inevitable) Stomach acid repeatedly washes against the gums, causing inflammation and damage. As the gums weaken, the teeth they hold can become loose or, in extreme cases, even fall out.
  • Sore oral tissues – the skin in your mouth and throat can experience this wear and tear as well. This is particularly hard on the roof of your mouth and your esophagus as acid moves through. Painful sores can emerge, swell, or become infected, resulting in a chronic sore throat and aching mouth.
  • Jaw pain – vomiting and binge eating put patients in a high risk category for chronic jaw pain, headaches, chewing issues, and snoring.
  • Lower saliva production – This slower flow leads to higher instances of dry mouth.Stomach acid can irritate your salivary glands, leading to difficulty swallowing. Furthermore, the presence of saliva defends your teeth from decay. Its absence can worsen cavities already caused by erosion.

Seek Help

Dental work can only repair eroding teeth and other issues. It cannot reverse or stop the effects of bulimia. Your mouth and body will continue to suffer as long as this habit continues, so opt for long-term solutions as well.

Your teeth are incredibly important, but so is your well-being. There are resources available to you that will improve your health and relationship with eating. As dentists, we play one part in the whole story of restoring you back to the healthiest version of yourself.

Dental Anxiety – How we can help

The Fear Stops Here: Techniques for Coping with Dental Anxiety

Every day, your dentist welcomes patients into their practice that are dealing with dental anxiety. While there are many degrees, the fear and anxiety associated with dental visits can sometimes prevent patients from seeking the dental care they need, resulting in more significant problems in the future.

As your partner in oral health, your dentist wants you to know that they’ll always do their best to put you at ease during visits. Here are a few ways that you can work to overcome dental anxiety and feel more comfortable during your time with your dentist.

Communication is key

One of the most effective ways to overcome dental anxiety is to communicate your fears and concerns with your dental office. They’ll help you understand the treatments you’ll undergo, the level of discomfort you can expect, and how they’ll help make the experience more comfortable for you.

Try relaxation techniques

Relaxation techniques such as deep breathing, meditation, and visuali[z]ation can help reduce anxiety and make dental visits less stressful. Before your appointment, take a few minutes to practice deep breathing exercises or visuali[z]ation techniques to help calm your nerves. During your appointment, try to focus on your breathing or visuali[z]e a calming scene to help reduce your anxiety.

Choose a distraction

Distraction techniques such as listening to music, watching TV, or reading a book can help take your mind off of the treatment.

Bring a friend or family member

Having a friend or family member with you during your visit can help provide comfort and support. Your companion can help distract you and provide reassurance throughout the visit.

Consider sedation

For patients with severe dental anxiety, sedation can be an effective option to help them relax during their dental procedure. There are different levels of sedation, from mild sedation (such as laughing gas) to deep sedation (such as general anesthesia). Your dentist is happy to offer sedation options in the practice–call them to learn more.

If you are experiencing dental anxiety, your dentist will work with you to develop a plan that allows you to feel more comfortable and confident during your time with them!

Travelling Tooth Tips

The world is opening up again and more and more people are travelling. Here’s how to keep your oral hygiene it’s best while on the road.

1. Schedule a dental appointment before your trip

If you are due for a cleaning and check up, now is the time to get it done. Your annual x-rays will find any problems that need to be sorted out before you leave – the last thing you want is to need emergency dental care on vacation! Have you had a dull or on and off tooth ache you’ve been avoiding? Travelling by air can aggravate it – get it checked before you leave.

2. Clean your travel bags

Most of us just throw our toothbrush into our toiletries bag when travelling. Can you remember the last time you cleaned the inside? Me neither. I know I don’t want my toothbrush bristles rubbing up against my spilled hair gel!

3. Dry it out!

Ideally, you shouldn’t pack your brush into a closed environment where it stays wet. The moisture will help to feed bacteria. Whenever possible, let your toothbrush dry out before it goes into a case or toothbrush holder. Since that’s not always possible, and you may need to pack it away wet, make a habit of unpacking your toothbrush, cleaning it and leaving it in an airy spot as soon as you arrive.

4. Forgot your toothpaste?

It’s easy to get toothpaste from a convenience store, but if you find yourself with a last minute missing toothpaste situation, don’t let that stop you from brushing. Use plain water and clean your teeth as you ordinarily would. Toothpaste is ideal but brushing without it is better than not brushing at all.

5. Can you trust the water?

When you’re used to clean drinking water on tap, you can forget that even brushing your teeth or rinsing your toothbrush with contaminated water could make you ill. Find out about local water quality, and if you need to drink bottled water in the country you’re visiting, be sure to brush your teeth and rinse your toothbrush with bottled water too.

6. Slow down on sugary treats

If you’re on holiday, you’re likely to spoil yourself with foods you don’t usually eat. And if you’re travelling overseas, you’ll be eager to try the local sweet treats and desserts. By all means enjoy your culinary holiday but take good care of your teeth too! Try to stick to one or two sweet treats a day and eat sugar-free gum afterwards to keep bacteria at bay.

Your teeth don’t get a holiday,  so be kind to them while you’re having a good time. A holiday may only last a few days or weeks, but your teeth must last a lot longer than that. Keep up your oral health routine, use these tips for oral health on the go, and have a great time!

Fluoride Benefits and Information

Fluoride is a mineral which is naturally found in Canada’s water, food, soil, and air.

We have used fluoride to prevent tooth decay since the 1940’s. In fact, it has been scientifically proven to:

  • strengthen tooth enamel
  • lower the amount of acid in your mouth
  • rebuild minerals that make teeth stronger

Sources of fluoride to prevent tooth decay


Brushing your teeth with fluoridated toothpaste helps prevent tooth decay.


Drinking water that contains an optimal level of fluoride helps prevent tooth decay.


Varnish prevents tooth decay in people who are at risk for the disease. Varnish should be painted on your teeth by someone who has been trained to do so.

Mouth rinses

Mouth rinses or mouthwashes prevent tooth decay in people who are at risk for the disease. Talk to your oral health professional before using them. Never give fluoridated mouth rinses or mouthwashes to children under 6 years of age. These rinses contain very high levels of fluoride, and young children are more likely to swallow them.

Gels and foams

Gels and foams are applied to the teeth to prevent tooth decay in people who are at risk for the disease. However, research shows that they do not work as well as varnish.


Fluoride supplements are drops or tablets. Only take them if an oral health professional advises you to.

Effects on health

Fluoride is good for your teeth, but having too much can cause two potential effects on health:

  • dental fluorosis
  • skeletal fluorosis

Bad Breath and Bacteria

Bad breath happens. If you’ve ever gotten that not-so-fresh feeling on a date, at a job interview or just talking with friends, you’re not alone. Studies show that 50 percent of adults have had bad breath, or halitosis, at some point in their lives. There are a number of reasons you might have breath odour. While many causes are harmless, it can sometimes be a sign of something more serious.


Bad breath can happen anytime thanks to the hundreds of types of bacteria that naturally lives in your mouth. Your mouth also acts like a natural hothouse that allows these bacteria to grow. When you eat, bacteria feed on the food left in your mouth and leaves a foul-smelling waste product behind.

Dry Mouth

Feeling parched? Your mouth might not be making enough saliva. Saliva is important because it works around the clock to wash out your mouth. If you don’t have enough, your mouth isn’t being cleaned as much as it should be. Dry mouth can be caused by certain medications, salivary gland problems or by simply breathing through your mouth.

Gum Disease

Bad breath that just won’t go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque.


Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.

Smoking and Tobacco

Smoking stains your teeth, puts you at risk for a host of health problems and contributes to mouth odour. Tobacco reduces your ability to taste foods and irritates gum tissues, tobacco users are also more likely to suffer from gum disease.

Medical Conditions

If your dentist has ruled out other causes and you brush and floss every day, your bad breath could be the result of another problem, such as a sinus condition, gastric reflux, diabetes, liver or kidney disease. In this case, see your healthcare provider.

How Can I Keep Bad Breath Away?

Brush and Floss

Brush twice daily and floss to get rid of odour causing bacteria.


Over-the-counter mouthwashes can help kill bacteria or neutralize and temporarily mask bad breath. The longer you wait to brush and floss away food in your mouth the more likely the odour will return.

Clean Your Dentures

If you wear dentures be sure to take them out at night and clean them thoroughly before using them again the next morning.

Keep That Saliva Flowing

To get more saliva moving in your mouth, try eating healthy foods that require a lot of chewing like carrots or apples. You can also try chewing sugar free gum or sucking on sugar-free candies.

Quit Smoking

Giving up smoking is good for your body in many ways. Not only will you have better breath, you’ll have a better quality of life.

Visit Your Dentist Regularly

If you’re concerned about what’s causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth and stop them before they become more serious. By determining your mouth is healthy your dentist can refer you to your primary care doctor for tests.

Piercing and Oral Health

What is an oral piercing?

Oral piercings usually consist of a barbell through the tongue or labret (the space between the lower lip and chin). Other common oral piercing locations include the lips, uvula and cheeks. The jewellery comes in different styles, including studs, barbells and rings. They can be made of stainless steel, gold, titanium, plastic or nickel.

What problems can an oral piercing cause?

It depends on the location of the piercing. If it’s through the tongue or lip, or below the tongue, there’s a risk of teeth chipping from the stud at the end of the barbell. This can happen if you don’t shorten the bar after the initial swelling goes down.

Piercings through the floor of the mouth below the tongue or through the tongue have the highest risk of developing into a serious infection. There is also a risk of nerve or muscle damage from the piercing. It is important to always go to a certified and experienced peircer. Certain labret piercings can damage gum tissue.

The jewellery can cause gums to recede and leave the tooth root more vulnerable to tooth decay and gum disease.

How can I lower the risks?

If you’re thinking about getting a piercing either close to or within the mouth, talk to your dentist first – and keep these safety measures in mind:

  • Check out the cleanliness of the place doing the piercing. Do they have an infection-control policy posted? How do they sterilize their equipment?
  • Ensure that the person performing the piercing is experienced and uses strict infection-control practices to avoid serious infections such as hepatitis B and C, and HIV. For example, do they use new needles and gloves for each customer?
  • Plastic jewellery is less damaging than metal, and nickel may cause allergic reactions and cause piercings to migrate.
  • Ask for detailed after-care instructions.
  • Disinfect your jewellery regularly and brush the jewellery the same as you would your teeth.
  • If piercings are close to the teeth, make sure the ends, or even the entire stud, are made of plastic.
  • Get immediate medical or dental attention if you experience too much bleeding, swelling or pain after a piercing, or if there is any evidence of infection (a bad odour or fluid coming from the piercing, for example).
  • Visit your dentist regularly so they can closely monitor the piercing and any potential damage to teeth and gums.
  • With clean hands, check on the tightness of your jewellery. This can prevent swallowing or choking if the jewellery comes out.
  • Don’t play with the jewellery once it’s been placed in your mouth. This increases your chances of getting an infection and can prevent healing.