Good Health Starts in Your Mouth

Charmaine Gooden learns that putting your money where your mouth is pays off with good health.

It started around midnight. The ailing tooth I hoped wasn’t really so bad was now erupting like Mount Etna in the back of my mouth. The pain was making me see stars as I drove to a 24-hour pharmacy and made a beeline for the Orajel before I lost my mind. It numbed the pain, but I knew this was the end game for procrastination. For the past few months, I could only eat food on the left side of my mouth because of sharp, jabbing pains when chewing on the right side with its broken and partly dislodged filling. I must confess that I hadn’t seen a dentist in more than two years. Hard to believe I had let things slip so much.

I’m not alone. A study by researchers at St. Michael’s Hospital, Women’s College Hospital and the Institute for Clinical Evaluative Sciences (ICES) reports nearly half (45 per cent) of Ontario’s Zoomers 65 years and older did not visit a dentist last year, which could increase their chances of chronic diseases and a reduced quality of life. Statistics for the rest of the country reflect a similar situation nationally.

Oral health is like the canary in the coal mine. There is a direct link between oral health and overall health, and many diseases have their first manifestation in the mouth. Your dentist can detect the early signs of many systematic diseases through a routine oral examination.

Plaque and tooth decay, gum disease and gingivitis affect the health of your mouth and point to health problems in other parts of the body. These seemingly innocuous oral complications can actually increase your susceptibility to opportunistic infections of the heart, lungs and other parts of the body. They exacerbate existing medical conditions such as diabetes, arthritis and hypertension. Despite a recent statement from the American Heart Association declaring insufficient evidence to prove gum disease causes atherosclerotic heart disease or stroke, the bottom line is that periodontal care reduces your overall systemic inflammation, which is great for the body and could very well turn out to be great for your heart. Better safe than sorry.

Dr. Jordan Soll of Toronto’s Central Dental Group, responsible for some of the most notable smiles in town, will undertake my dental restoration. No scrubs and clogs for the sartorial Soll, who favours well-made shoes and stylish ties. I warn him before I open my mouth that it’s a mess in there, but he’s unfazed.

“You’re very typical of your generation who had really good dentistry done 20 years ago and thinks it will last till you’re in the box,” he says.

My first one-hour appointment starts with Soll doing a comprehensive examination of the inside of my cheeks and lips, back of the throat, the floor and roof of the mouth, tongue, lymph nodes in the neck, thyroid and glands behind the neck for any abnormalities and signs of oral cancer. Statistics from the Canadian Cancer Society show that nearly 3,400 Canadians develop oral cancer annually. Early detection increases the chances of successful treatment.

After checking for gum disease, a tooth-by-tooth analysis and X-rays follow. “See this?” Soll asks, pointing to a dark area on a digital X-ray of my mouth. “I think you’ll need to see a root canal specialist.”

And that’s just the beginning. The extensive treatment plan would also include three crowns, eight new fillings, new upper and lower retainer wires, whitening, strategic cosmetic bonding and a bite plate to help ease teeth grinding. He’ll work on the right side first, then the left, so I’ll always be able to chew comfortably. Accustomed as he is to clients on the social scene, Soll assures me my treatment will “never leave you socially challenged.”

Soll numbs my gums, and it’s a revelation. Instead of using a huge speargun of a needle, he uses a fine gauge needle and a controlled slow drip, so there’s no ramming of a harpoon into your jaw and pumping novocain in under high pressure. Later, when the numbness wears off my jaw isn’t sore for days. Old ceramic fillings are replaced with new plastic-based coloured fillings. Using what looks like a miniature sander, he pares down some teeth at certain angles so they’ll become anchors for the permanent crowns.

A high-tech image scanner takes a 3-D image of the teeth to be crowned. Trays of a goopy purple mixture are placed over the teeth, making an impression into the stuff. I’m spared walking around with stumps of teeth, as Soll creates my temporaries in-office.  Once everyone’s happy with the fit, Soll tells master ceramist Trevor Laingchild to go ahead and make the permanent crowns.

Days later, I’m at Laingchild’s Yorkville dental studio ( as he customizes the colour by hand. Out comes a paintbrush and artist palette of colours, which he uses to personalize the shade to a perfect match.

Root canal. The very words conjure images of the torture scene in Marathon Man (1976), where actor Dustin Hoffman screams as Laurence Olivier, who plays a sadistic dentist, drills into his teeth. But the truth is, as I discovered, root canals are no more uncomfortable than having a filling done.

Endodontic specialist Dr. Gary Glassman ( reviews my X-rays, which Soll has emailed. After freezing, Glassman works to remove the top surface of the decayed tooth, drilling down into the pulp to remove diseased nerves and tissue inside the tooth. The now-hollow tooth is sterilized and filled with what looks like tiny rubber toothpicks, then sealed at the top. Soll will later cap this tooth with a permanent crown.

I’ve started using an at-home bleaching system, and we take things up a notch with an in-office Zoom bleaching appointment. The hygienist applies a protective balm to the lips and gums, then a 30 per cent hydrogen peroxide gel on the teeth. A special light, pointed at the teeth and gel, activates the hydrogen peroxide to penetrate and whiten the tooth surface. The hygienist can’t believe how much whiter my teeth are after just a one-hour session.

Soll now works on the left side of my mouth, removing decades-old cracked ceramic fillings and replacing them with new plastic-based tooth-coloured fillings. Once the new fillings harden, they are shaped to adjust the bite and polished to a silky glass finish. He places the permanent crowns and replaces my old permanent retaining wires.

I have some gum recession, which has left unsightly black triangles around my front teeth  “It’s a very tedious process to close up those spaces,” Soll explains, working slowly and painstakingly to shape and curve the bonding material to reduce the appearance of these triangles and make the teeth rounder at the gum line. There was no pain or discomfort. I not only felt comfortable, I felt cared for. The effect is immediate and dazzling.

While a complete renovation like I undertook could cost as much as $9,000 (about $1,250 root canal; $7,500 to $8,000 for comprehensive examination, crowns, whitening and restorative work), you can avoid most of these expenses with regular quarterly visits to your dentist. Insurance plans cover basic services such as examinations, X-rays, cleanings and fillings, but advanced treatment like crowns and veneers are a function of individual policies.

Six weeks and 20 dental appointments later, my oral health has been restored, and I’ve got plenty to smile about. My at-home maintenance plan includes a night mouthguard appliance to help alleviate the discomfort of grinding during sleep.

Soll’s parting instruction is, “Rinse and gargle with warm salt water once a day because bacteria that cause gum disease can’t live in a salty environment.”