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Dr. Archer Provides Expert Opinion on Global News

Dr. Natalie Archer discusses Best Practices for Good Dentistry

In October 2017, Dr Natalie Archer appeared on Global News to discuss how and why dental clinics should regularly be tested for infectious diseases HIV, and Hepatitis B, and C.

Dr. Archer was the guest expert that Global News consulted with when a major oral health story broke in 2017. After a routine dental check-up, a Guelph mom and her two young sons were forced to undergo an array of scary medical tests to determine whether or not they had contracted any infectious diseases.  Health officials warned them that they needed to be tested for HIV and Hepatitis after a complaint about their dental clinic resulted in a public health inspection.

You can watch Dr. Archer discuss the need for regular health inspections below and read the original Global News article here.

The Catalyst

The mom and her family were among the 3,600 patients of the Guelph Dental Associates clinic who were advised to get tested for Hepatitis B, C, and HIV in response to concerns about the sterilization practices of the equipment at the dental office.

The WDG (Wellington-Dufferin-Guelph) Public Health advised all patients who had visited the Guelph dental office anytime between January 21st 2015 and June 21st 2017 to get tested because they might have been at risk of contamination. Luckily, there haven’t been any reported infections thus far but the original warning came as a result from formal complaints from the public to health inspectors.

After the complaints were received and the office was inspected, the location was temporarily closed due to concerns of improperly sterilized dental instruments and equipment.

dental tools

The Problem is More Wide Spread than just One Clinic

The problem is bigger than just one dental clinic. In fact, a number of clinics across Ontario have been investigated after concerns of health and safety violations.

Global interviewed Dr. Archer to get her take on the situation and to hear her thoughts on what changes need to be made to the dental industry to ensure situations like this never happen again.

Dr. Archer said that while most dental clinics and offices do follow health and safety protocols and ensure their equipment and tools are safe and sterilized, there should be a move towards bi-annual or annual inspections from the province. As the system currently functions, inspections only occur if a complaint is made by a member of the public.

Dr. Archer said that she, “think[s] an annual check or some sort of system is a really great idea,” and that she knows, “there are guidelines available to dental offices … working together with the ministry, working together with our members to ensure the public feels safe.”

Dr. Archer believes that the recent HIV and Hepatitis scares have been just as troubling for dentists as they have been for the general public and are a wake-up call for the Ontario dental industry as a whole.

dental chair

What Changes Are Being Proposed?

After this latest health scare, it’s clear that something major needs to change. Kevin Marsh of the Royal College of Dental Surgeons of Ontario (RCDSO) says that the college has its own guidelines and its own process for handling complaints but that it does work with the healthcare agencies in the province to follow up with dental clinic complaints from the public.

He believes there would need to be a change in how the law currently works to allow the college to inspect all dental offices in the province. At the moment, the Ontario Ministry of Health says they have not received a formal regulation proposal from the RCDSO but are open to discussing any possibility that could improve patient safety.

Currently, the RCDSO operates inspection programs for clinics that use dental CT scanners or who provide sedation and general anesthesia. They are looking for different ways to implement mandatory or random dental clinic inspections.

Most dentists are rigorous about preventing the spread of infectious diseases but there are always a handful of dental offices that prove the exception to the rule and make regular inspections necessary.

So You’re Getting a Tooth Implant

Whether you’ve recently lost a tooth or are only just coming around to the idea of getting a replacement, the tooth implant process can seem a bit scary for most patients.

We’re here to help demystify the process and to help you understand exactly what goes into getting a tooth implant.

Single tooth implants have three parts: the implant itself (which is made of titanium and placed directly into the jawbone), the abutment (which is made of titanium, gold, or porcelain and is attached to the implant/connects the implant to the new tooth), and the restoration (the ‘tooth’ itself, also called a crown).

The crown is the part of the implant that’s visible in your mouth and is typically made of porcelain fused to metal alloy. Once it’s been placed in the mouth, the screw hole will be covered with a tooth-coloured filling material called composite.


The bone of your jaw must be strong enough to hold the implant, and the surrounding oral health structures (teeth, gums etc) must be healthy enough to withstand the process.


There is no set time for how long it will take your dentist to complete the tooth implant process,  as it depends entirely on the patient. That being said, the shortest time frame for a complete implant using the traditional method is about five or six months, though it can take up to a year or more – especially if the jaw is weak and the bone needs to be built up first.


In the traditional method,  your dentist will perform two procedures: One to make a small incision in the gum and bone/place the implant, and the second to make a new incision to place a collar (or healing cap) on top of the implant to help the surrounding tissue heal. The cap is removed after a few weeks and the abutment is screwed into the implant, followed by the crown.



Your dentist may choose to place the healing cap and implant at the same time, or may do everything in one procedure with the implant, abutment, and a temporary crown or bridge placed all in one visit.


You’ll visit your dentist for an initial consultation before any actual dental work is done. You will be given a comprehensive examination and your dentist will take X-Rays and create impressions of your teeth and gums to make models. A CT scan may also occur to help determine if your jawbone is strong enough to hold the implants in place. If the jawbone is not strong enough, your dentist will suggest options for building up the bone ranging from bone grafts to distraction, a process in which more bone is grown.


Your dentist will place the implant into your jaw. The implant will essentially serve as the root of your new ‘tooth’ in your jawbone. During the time between your first and second surgery (often four or five months), the implant and your jawbone will fuse together.


This surgery is less tricky than the initial surgery as one new incision is made to expose the top of the implant. A healing cap is then placed on top of the exposed implant to guide the healing of the gum tissue. The healing cap (or collar) is removed after the gum tissue has healed and the abutment is screwed into the implant.



A temporary crown is then placed on the implant and will remain in your mouth for the next four to six weeks so the gums can heal around it and look natural. The temporary crown is intended to cushion and protect the implant while giving your jawbone time to get stronger. The material of the temporary crown is softer than that of the permanent crown.


Last but not least, it’s time for the dentist to place the permanent crown (which is created while you are wearing your temporary crown). It is created from a model of your teeth and gums (including the abutment) and is either cemented or screwed into place.


The Dangers of Avoiding the Dentist

“The only thing we have to fear is fear itself.”

It’s a phrase we’ve all heard before. It also happens to be a phrase that feels completely useless when we’re forced to actually confront the thing making us afraid in the first place. Like, for example, someone with a fear of the dentist waiting to be called in for their appointment.

Sure, the dentist may not be as outwardly intimidating as skydiving or swimming with sharks, but studies say that anywhere between 9 and 15% of the population in the United States avoids going to the dentist because of their fear. That’s over 30 million people! In the UK, 36% of the people who avoided going to a dentist said it was a direct result of their fear.

Whether you call it a fear, a phobia, or anxiety, dreading visits to the dentist can cause patients a number of problems – both in the short and long term.

Aside from the gradual and inevitable build-up of plaque and tartar that only a dentist can remove, patients who avoid the dentist drastically increase their chances of developing a number of oral health issues (ranging from cavities and gum disease to tooth decay and eventual tooth loss). In addition, patients lose the ability to pro-actively take control of their dental health and are far less likely to spot developing health issues issues (like oral cancer, for instance) than a dental professional.


Why Do People Fear the Dentist?

So what causes the kind of extreme fear that keeps people away from the dentist? And more importantly, what can patients do to overcome their fear?

Here are some of the most common reasons patients avoid the dentist:

Negative Previous Experiences

If a patient had a terrible or traumatic experience at the dentist in the past, it’s not particularly surprising that they would want to avoid any chance of history repeating itself.

Shame or Embarrassment

In some cases, a patient’s fear may have morphed into shame over the state of their teeth after years of avoiding the dentist. At this point, a patient who previously avoided the dentist out of fear now continues to put off making an appointment because they’re unhappy with the current state of their oral hygiene and are too embarrassed to meet with their dentist.

Aversion to Pain and Discomfort

Depending on a patient’s background, they may have been through a number of painful or uncomfortable dental procedures and want to avoid having to sit through them again. Even a routine cleaning can trigger those same feelings of anxiety a patient has experienced in the past.


How Can You Overcome Fear?

Talk to your Dentist

Set up an appointment with your dentist and make sure they know that it’s purely to discuss the possibility of treatment. This way, you can go through the motions of booking the appointment and showing up to the dental office without actually having to sit through an appointment you’re not ready for yet.

Talk to your dentist about your fear and listen to what they have to say. Most dental practices offer specialized services (like laughing gas) to help a patient stay as relaxed as possible during their appointment. Here at Archer Dental, we offer a number of anti-anxiety options ranging from laughing gas to lavender scented neck pillows and netflix. Dental work can even be performed when you’re asleep if that’s an option that appeals to you.

Actually booking and following through on an appointment will be much less anxiety-inducing if you’ve had a chance to speak with your dentist one-on-one and know that they understand where you’re coming from and what your needs are.

Consider Therapy and/or CBT

Sometimes your fear of the dentist can be part of a larger problem. This is when looking into a therapist might be the most helpful option for you. In addition to listening to you and helping you develop coping mechanisms that work best for your personal situation, a therapist is an objective third party. You can be honest and open with them without judgement.

Your therapist might also suggest something called CBT (Cognitive Behavioural Therapy). CBT is a great way to re-train the neural pathways in your brain using a mixture of psychotherapy and behaviour therapy so you can overcome your fear of the dentist in a relatively short period of time (often within 5 to 10 months)


Happy Halloween from Archer Dental!

Scaler (plaque attackers!)

Used to carefully scrape away any hardened plaque above the gum line.


Burnisher (aka The ‘Pretty Maker’)

Used at the end of a procedure or restoration to smooth, polish, and remove any scratches.


Curette (the cure for the common plaque)

Curettes are plaque – removers, but they’re specially shaped to work below the gum line without damaging the gums.  


Suction Device (it sucks. Literally.)

Used to suck away any saliva or fluids that pool in your mouth during a procedure.


Cotton Pliers (give your dentist a hand)

Used to place and remove cotton from your mouth so your dentist doesn’t have to get in there with their fingers.


Dentist Tools. They only LOOK scary…

Dental Drill (noisy, but effective)

Removes decay from the tooth before fillings, then smoothes and polishes the tooth after.


Mouth Mirror (nothing to see here)

Gives your dentist a good view of all the nooks and crannies in your mouth.


Spoon Excavator (no drill? No problem!)

Used to remove softer tooth decay that doesn’t quite require the firepower of the drill.


Anaesthetic (*sings* I can’t feel my face when I’m with you…)

A numbing agent to protect the sensitive enamel on your teeth.


Dental Probes (hide and seek champions)

The sickle probe is used to find cavities and other oral issues.

The periodontal probe is used to find oral issues and measure the periodontal pockets.


Dental Syringe (a little pinch for a big smile)

Used to administer your anaesthesia to numb teeth and gums before a procedure.


So, you’re getting a tooth pulled

No one wants to hear their dentist say that they’ll need a tooth pulled, but there are things you can do to prepare yourself so the process goes as smoothly as possible.

The first thing you need to do is figure out what kind of extraction it is. Most of the time, when you get a tooth pulled, it’s something called a simple extraction. This is a non-invasive procedure in which your dentist is able to remove your tooth with nothing more than a numbing agent, a tool called an elevator, and forceps.

When a tooth has not come into the mouth yet or has broken in the gum line, your dentist may need to perform a surgical extraction (in which you will receive a local – and possibly an intravenous – anesthetic).


Your dentist will numb the area prior to the procedure with a local anesthetic delivered via injection. While you may feel pressure during the procedure, the anesthetic should ensure that you don’t feel any pain at the site of the extraction.


Your dentist will rely on two main tools to extract your tooth: an ‘elevator’ and a pair of forceps. Your dentist can’t just yank your tooth out of your jawbone without first expanding the tooth socket. An elevator is used to jiggle the tooth around in the socket and loosen the connection between your tooth and your jaw.


Once the tooth has been sufficiently loosened from the socket, your dentist will use a pair of forceps to remove the tooth from the mouth completely.


Once the tooth and root have been completely removed, your dentist will gently scrape along the walls of the empty socket to remove any residual tissue. This process is done to help prevent the formation of cysts. Your dentist will then wash out the socket with saline solution and trim down any sharp bone edges that may remain. In the case of a surgical extraction or the extraction of several teeth in a row, your dentist will also likely place stitches in your mouth. The last step of the extraction process occurs when your dentist places folded gauze over the site of the extracted tooth and asks you to apply pressure by biting down on it.


Your dentist will tell you how to keep the extraction site clean, safe from harm, and free from infection. They will also advise you on which foods and drinks to avoid immediately after the extraction and which medications are best to manage any post-procedure pain.

If your extraction was surgical or you were placed on an IV, you should also be prepared to have someone else take you home as you will likely not be in the position to drive yourself.


Is this covered?

In Ontario, OHIP covers many major healthcare related costs, but there are some notable exceptions. One of the main among them? Dental care.

If you have private health insurance (either through your job or through a plan you’ve purchased yourself), then your coverage is more expansive and typically includes both eye and oral care.

But that doesn’t mean it covers everything. Here are some questions you should ask your insurance provider about your insurance coverage before your next appointment.

It’s also important to remember that your dental plan and treatment plan are not the same thing. A dental plan is what your benefits will cover when you go to pay the bill after your appointment. A treatment plan is something you and your dentist agree upon regarding the future of your oral health that might not necessarily be covered by your insurance.


What Procedures and Services are Fully Covered?

Whether you’re going in for a routine cleaning or a root canal, you need to know whether your insurance company will foot the entire bill or if you’ll be required to pay for part of it.


Is There a Deductible?

Some insurance companies require that you pay a specified amount of money out of pocket towards the total cost before they pay the rest of what’s owed. The deductible may only apply towards certain procedures but it’s good to know what to expect beforehand.


What is the Maximum amount of Money I can Claim on Dental Procedures each Year?

It’s important to know how much money your insurance company will allow you to claim back on a yearly basis. This way you can plan out your appointments and review your dentist’s treatment plan with the peace of mind that comes with knowing you’ll be covered.


Can I Choose my own Dentist or am I Restricted to Dentists Endorsed by my Insurance Company?

Some insurance companies require you to choose one of the dentists they’ve selected or else they will deny coverage. This is definitely something you need to know before finding yourself stuck footing the cost for an expensive dental bill not covered by your benefits.


What is my Co-Payment Amount?

Much like a deductible, a co-payment is the part of the bill that you’re on the hook for and that the insurance company will not reimburse you for.


Why is my doctor always late?!

While you’d expect a place called ‘the waiting room’ to be fairly self-explanatory, a lot of us are still surprised by how often we’re stuck waiting for our doctor or dentist 10, 20, or even 30 minutes after our scheduled appointment time. So why does it happen? And more importantly, what can you do about it?


Other Patients are Late

Even one patient showing up 10 to 15 minutes late for their appointment can throw everything off schedule and push all subsequent appointment back anywhere from 15 minutes to half an hour.


Previous Appointments Run Over Time

You might be scheduled for a simple oral cleaning, but the patient ahead of you could have come in for something far more complex. It can be hard for the receptionist to predict just how long each appointment is actually going to take ahead of time (especially if a new medical problem is discovered and diagnosed during the appointment) which means they might book you for an appointment time that’s earlier than your dentist will actually be prepared to see you.


Unforeseen Complications with other Patients

Your dentist may have a bunch of cleanings scheduled back to back but if the hygienist doing the cleaning spots something troublesome during the oral exam, it will likely cause the appointment to run longer than initially anticipated.


A Member of the Staff Could have Called in Sick

Being short staffed is a problem in every field but especially so in medical professions. A dental hygienist calling in sick can throw off the flow of the entire practice and can inadvertently increase wait times for the patients.

So what can you do to deal with longer than expected waiting times?


Modify and Manage your Expectations

Rather than going into your appointment expecting to be seen at 3pm on the dot, realize there’s every chance that you’ll be waiting at least another 15 minutes before you’re called in and plan accordingly. If you’re taking time off work or hiring someone to babysit your child/children, make sure you book enough time to cover any extra waiting you may have to do.


Bring a Book

Yes, most dental and doctor’s offices have a selection of magazines but are they really enough to keep you occupied while you wait? Bring a good book or newspaper with you to your next appointment so your waiting time feels less like wasted time. Playing a game on your phone is another good option (so long as the sound is turned off so you don’t annoy the other patients waiting alongside you).


Book early

The earlier in the day you book your appointment, the lower the chances are of there being a wait time. If you can manage it, try to get the first appointment of the day.


So, you’re getting a cleaning and check-up

You might have heard the terms ‘polish’ and ‘scaling’ thrown around by your dentist or dental hygienist, but what do they even mean? And what is your dentist actually doing when they’re poking around inside your mouth anyhow?

We’ve come up with a simple step by step guide to a dental cleaning and check-up to help you understand exactly what’s going on when your dentist asks you to open wide.


Your dentist or dental hygienist will give your entire mouth a solid once over to ensure there are no problems that immediately stand out to them. This includes looking at your teeth, gums, the sides of your mouth, and your tongue with a mirror. If everything is okay to proceed and no major problems are spotted, your dentist or dental hygienist will proceed to the next step.


If you look at your teeth closely, you’ll likely see a build up of a hard white or grey substance around your gums and in between your teeth. What you’re seeing is a combination of plaque and tartar.  Plaque forms first and is something you can manage through diligent flossing and brushing, but once it hardens into tartar, only your dentist or hygienist can remove it. When your dentist or hygienist scales your teeth, they use an instrument called a scaler to remove any plaque or tartar in order to keep your gums and teeth healthy and to prevent gingivitis.


This is the part of the cleaning process that makes the most noise (and therefore tends to inspire the most anxiety in patients). But there’s no need to fret! All your dentist or hygienist is doing during this step is brushing your teeth with a high powered electric toothbrush. This step is necessary to ensure that any plaque or tartar that might have been left behind during the scaling process is removed.


Yes, we all floss at home (or we’re supposed to anyway) but nothing beats a good thorough flossing from a professional. Your dentist or hygienist has a better view of your mouth and can deep clean spots that you might not be able to reach yourself. This expert flossing also ensures that any final missed bits of plaque, tartar, or toothpaste from the polish are completely removed.


Depending on your dentist or hygienist, there’s a good chance this step has already occurred at some point during your cleaning. Rinsing is essential to ensure that any potential bits of debris that might still be lingering in your mouth are flushed out.


This step isn’t always a requirement but it’s definitely one of the most memorable parts of your treatment. After choosing a flavour (typically mint or bubblegum), your dentist or hygienist will place a tray filled with either a foamy gel or a sticky paste-like substance over your teeth for about one minute. While it might feel a bit awkward, this fluoride treatment ensures your teeth are well protected against cavities for the next few months.


If your cleaning was performed by a hygienist, this is typically when your dentist will come in to give your mouth and teeth a final look over before giving you the okay to leave. In addition to examining your teeth, your dentist will also take a close look at and under your tongue to ensure there are no signs of oral cancer.