Atkins......The Zone.......Ketogenic........Mediterranean........Paleo There are so many fad diets out there! A couple of weeks ago I was walking to the gym when I passed a new hipster "Paleo Cafe", which prompted me to giggle and post what I thought was a witty remark about humans catching their food with spears....and of course, some people chimed in how they think Paleo is awesome. Is it? What is the paleolithic diet? There is a belief that our digestive systems stopped evolving way back when we were hunters and gatherers, so the modern human body is not designed to consume foods such as grains, dairy and processed sugars and added salt. Instead, we should only be eating what was readily available to early man (people-kind) prior to the introduction of, you know, farming. This concept has many assumptions. There is no proof that hunter/gatherers were actually obtaining the nutrients they needed to be healthy, and we surely do know that they did not have the life expectancy that we have today. Furthermore, it assumes that the human body does not have the capacity to adapt to foods that are acquired through farming or that are processed. Ignoring the logical fallacies involved in the diet, is there evidence that it works? What does the science say? There is a surprisingly high number of research studies looking at the paleo diet and various outcome variables, and there are some very promising results. In the short term, a strict paleo diet can result in weight loss, body fat loss, improved glucose and fat metabolism. Long term data, however, is not very plentiful, and most of the studies are done on obese people, or people with diabetes or metabolic syndrome, so the results may not reflect the "healthy" population. One of the main risks of the paleo diet, just like many unbalanced fad meal plans, is that because you are avoiding certain food sources, you may find yourself deficient in certain important nutrients, such as Calcium in the case of the paleo diet, I guess unless you are eating the bones of your prey. Not the best for your teeth IMO lol. But....do not take my word on things.....check out what researchers have published on the topic: Paleo diet and the older adult Evidence for the paleo diet and even better here is a review of ALL the fad diets: Fad diet systematic review You may need to find them on Google Scholar or Pubmed for full text....... Keep safe from the Sabre-tooth Tigers!!!! Dr. Dave #diet #nutrition #paleo #food

Porcelain has been used in dentistry for centuries for everything from dentures in the 1700's, to the temporary "Hollywood smile" veneers of the 1920's. It was not until the 1960's, however, that dental porcelain technology advanced enough to allow for the predictable repair of broken teeth with porcelain fused to metal crowns. Nowadays dentists have various dental porcelains to choose from depending on the clinical scenario and personal preference, many strong enough to be used without a metal substructure. The way I look at porcelain is that it is like pottery clay; we have a mass of earth based compounds that are shaped and then baked at a very high temperature. This causes parts of the mixture to melt and fuse together and other parts to crystallize. In dentistry, this crystalline phase is very important because it affects various properties of the porcelain. This topic is way too extensive to discuss in one post, so I will put together a series of short videos on all of the important types of dental porcelain and their properties. It is honestly pretty nerdy and boring......but it is very important! Every dentist should know these things inside and out! Check out this introductory video for more information: Thanks for reading! Dr. Dave #dentalceramic #porcelain #Prosthodontics #biomaterials #nerdy #veneers #crowns #emax #zirconia

Do you know when you should take your child to the dentist for the first time? Many dentists recommend that you take your child to the dentist within 6 months of the first teeth showing up in the baby's mouth. But did you know that how healthy a parent's mouths is can affect how healthy the child's teeth are? Yes! Obviously, we want parents to develop healthy dental habits so they can have healthy mouths and teeth themselves, but it also sets an example for the kids! And..... there is further evidence that improving parental dental health is not just about habits. Tooth decay is caused by bacteria in a process we call dental caries. This is transmissible from parent to child, so the cleaner and healthier that moms and dads keep their mouths, the lower the threat of transmission of these bad bugs to their kids (try to avoid sharing stuff like spoons). We do see kids at our office, but.......mostly older children that have experience at the dentist and are big enough for our grown up dental equipment. We will gladly see the little ones, but once it is time for x-rays, or if we see any dental work that needs to be done, we refer our littlest patients to Certified Specialists in Pediatric dentistry. Taking care of children with advanced dental needs is not everyday dentistry; even a couple of fillings can be a challenging task if a child is fussy. Dental specialists in pediatric dentistry have spent an extra 2-3 years in residency taking care of children with very compromised dental and general health conditions, often in hospital based settings, and their offices are set up with the pediatric patient in mind. This is why I refer my young patients to these specialists. Once the kids are a little bit bigger and things are clean and healthy....well, then they can come back to our office if they wish. We do not have any cool prizes though........but we do have a pretty sweet lego collection. Please let me know if you have any questions about pediatric dental specialists in your area! Check out my video for more information: Dr. Dave #toothdecay #Cavities #fillings #dentalresidency #pediatricdentistry #dentistryforkids

What is the deal with metal fillings? Are they bad for you? What about plastic ones? Do they not last as long as metal fillings? These questions are often asked by dentists and patients alike, and to be honest, the information that we have available to us is quite difficult to analyze. To understand the data, we need to first know a bit of background. First of all tooth decay has to be diagnosed for a tooth, which is what most people call a "cavity". The dentist then drills away the decayed parts of the tooth, and places a filling in the cavity that is left. But.......what type? Well, there are metal fillings and a couple of different types of plastic fillings and they all have advantages and disadvantages. Amalgam (metal) fillings have been around for over 150 years and are still in use today. The filling material is composed of a mix of silver, tin, copper and other trace metals. In order to make the material malleable, mercury is shaken in to the metal mixture. This semi-liquid metal mush is then crammed in to the cavity and hardens over the next 24 hours. Yes, there is mercury, but much of this mercury is removed during the filling process as it is compressed out and removed via the suction wands as the dentist shapes the restoration. These fillings do not stick to the teeth so the dentist has to cut the tooth into a shape that allows for the restoration to lock in place after it sets. Composite (plastic) fillings have only really been around since the 1980's. The material itself does not stick to the tooth, but an adhesive can be applied to the cavity which allows for the plastic to be bonded in place. The dentist therefore often only has to remove the decay, and does not need to cut the tooth in to a specific shape to lock the plastic filling in place. The material is placed in as a paste and then is hardened with a blue light, which can cause the material to shrink a bit. It is much more technique sensitive in comparison to amalgam, and the quality of the filling is affected by many more variables. Many people come in asking to have their metal fillings taken out because of the mercury, but guess what? Plastic isn't necessarily the best either. So what to do???? There is too much information to go over in one post so I will be putting up a series of articles and videos. Check out these vids for more information: Dental Amalgam: Dental Composites: Thanks for following along! Dr. Dave #fillings #toothdecay #Cavities #drdave #amalgam #Composite

I always encourage people to get second opinions when it comes to dentistry, and people often contact our office for this reason. Sometimes......we get phone calls where they want to send in some radiographs (x-rays) for me to look at....... without coming in for an exam. But....we do insist on a proper consultation appointment at my office along with a comprehensive dental examination because "cavities" are much more complicated than they seem. What is a cavity and what causes them? "Cavity" is a common term for the tooth decay that happens as part of dental caries, but it only describes the later stages of the process. As everyone knows, the mouth is full of bacteria, and there are a couple of types that cause tooth decay, streptococcus mutans in particular. These "sugar bugs" (as we tell the kids) metabolize carbohydrates and create acid as a byproduct. This acid then attacks the teeth, leeching out the minerals within them, making them weaker. If frequently exposed to acid, the tooth begins to demineralize and decay, eventually getting weak enough that the outer layer, the enamel, gets a hole in it; a "cavity". Teeth can have tooth decay before there is actually a "cavity"! How do dentists detect tooth decay? It is actually not that easy! Many people think that we can just check some radiographs (x-rays) and can tell if there is tooth decay right away. Radiographs, however, only give us some of the information we need, particularly about the areas where the neighbouring teeth contact each other. They are not so good at showing tooth decay on the biting surfaces of the teeth. Furthermore, the tooth has to have quite a bit of demineralization for the tooth decay to show up on a radiograph, so we may not be able to see smaller "cavities". X-rays can be deceiving! Dentists therefore have to perform a clinical examination, including a dietary, dental, and medical history in order to properly evaluate someones "caries risk". This includes evaluating symptoms, assessing old dental work, visual and tactile inspection of the teeth, and also the use of many other tools including special lights and dyes that can help point out areas of decay. This takes time to be properly completed. How do I decrease my dental caries risk? Since sugar is the main culprit, cut back on the frequency of simple sugars. It is not bad to have a sweet treat from time to time, but if you are sipping on a sugary coffee all day, that is a recipe for tooth decay. Then there is home care. You need to keep things spotless or else the bacteria make themselves a lovely home in the plaque and calculus that covers your teeth. Brush with a FLUORIDATED TOOTHPASTE! Those two are pretty obvious, but, one thing that many people do not realize is that there are hundreds of medications that cause dry mouth, and this significantly increases dental caries risk. As we live longer, more of us are taking medications for chronic conditions, and as a result, are getting more cavities. It is a serious problem that I deal with every day at the office. Obviously we cannot ask people to stop taking these medications, but, there are many conditions that can be improved with diet and lifestyle changes, with resultant decreases and sometimes even the elimination of the need for these drugs. Oral health and general health are one and the same. We need to look beyond x-rays and teeth to properly take care of our patients! Check out this quick video about dental caries: Thanks for reading! Dr. Dave #Cavities #oralhealth #dentalexamination #toothdecay #fillings #medications #generalhealth

I am sure that many of you have looked up reviews for a dentist or doctor at some point and have found that somewhere in the mass of glowing and amazing reviews that everyone seems to have (not fishy at all, right?), there will be some bitter comment......with no reply from the practice owner. Or maybe you have read a news article that is looking into a dental or medical practice for some reason, and that doctor refuses to answer questions. But.....why do they not reply? It makes us dentists look pretty bad! It simply comes down to patient privacy regulations. In BC we have the Personal Information Protection Act (PIPA), which protects patients from having their personal information made public. As dentists, we are legally required to ensure that any patient data we obtain is kept private---even if they are complaining about us on the internet. Restaurants and other types of commercial entities have the opportunity to respond to reviews because they do not have these legal privacy expectations. This allows readers to see that the business owners care about their customers and to hear the other side of the story. Health professionals, on the other hand, do lose the opportunity to turn a negative in to a positive. So if you ever see a negative review on Google or Yelp that is not responded to, or read an article where a dentist "refused to comment", understand that we simply cannot. Reporters KNOW this, but it is obviously less intriguing to the reader if they say, "due to PIPA regulations the dentist was unable to comment on this specific case". "Fake news! Fake news!" LOL. Thanks for reading! Dr. Dave #PatientPrivacy #Reviews #NewsReports

"A prosthowhat????" Story of my life. Very few people know what a prosthodontist is, but most people will have a dental problem that could warrant a visit to one at some point in their lives. Prosthodontists are dental specialists who focus on the repair and replacement of damaged teeth and oral structures. After the completion of dental school, Prosthodontists spend another 3 entire years in a university or hospital setting, learning the history and evidence behind complex dentistry, performing research, and taking care of patients that need very challenging dental care. This is thousands of hours of very structured continuing education; it would take over a decade to obtain this amount of training via courses and lectures as a general dentist. Then there is a very challenging licensing exam at the end of it. It is a lot of work to earn the title of "Certified Specialist" in BC....and that is why there are so few of us! Prosthodontists treat patients that need anything from simple fillings and cleanings, all the way to full mouth reconstructions, cosmetic dentistry, and implant dentistry, and have focused their educations and built their practices to offer these kind of treatments. Why wouldn't you see a prosthodontist if you had a dental problem? This kind of care requires time and attention, so at my office, I see patients one at a time, including those who need more basic treatments such as crowns or fillings. Doesn't your smile, and more importantly, your oral health, deserve that attention? I think so!!!! For more information, check out my latest video: Thanks for reading! Dr. Dave #Prosthodontics #DentalTraining #drdave #dentalresidency

Have you seen videos or read articles where people claim that they have been able to "fix their cavities" at home with some sort of DIY fix? Well....this is highly unlikely..... A "cavity" is a hole in the outer layer of the tooth; the enamel. Quite often, even without a visible hole in the tooth, when we open it up, we find extensive tooth decay, which is areas of dead tooth. The outer layer of the tooth, the enamel, is made by cells (ameloblasts) which are only present during tooth development. If a hole develops in the enamel, it can therefore never be repaired by the body, no mater how much coconut oil you swish. The middle layer of the tooth, the dentin, is formed by cells (odontoblasts) that are still alive inside the dental pulp. These cells can be activated to create new dentin by various stimuli, including the chemicals in some of these home remedies. But.....this does not seal the the hole in the enamel, leaving a highway for bacteria to enter the tooth. So yes....the tooth can repair itself somewhat, but it will never be able to seal a "cavity" on its own. For more information check out my latest video! Please like and share if you learned something today! Thanks for reading, Dr. Dave #DIYDentistry #Cavities #Fillings

Have you ever experienced those traditional paste and tray dental impressions? If you ever have, you will know that it is not a very pleasant experience. I clearly remember the day that we were learning how to take alginate impressions on each other in dental school, and my partner had to try over, and over, and over again, until he nailed the perfect impression. It was not fun. Well those days are in the past! Dentists can now take dental impressions without the mess and fuss! Digital impression technology has been around since the early 1980's, but has made HUGE strides over the last couple of years. We now have intraoral camera systems that are able to take impressions faster, and for many systems, more accurately than with the traditional pastes. We take virtually all of our impressions with our Trios 3 scanner by 3Shape, and our patients are always blown away when they see the 3D full colour image of their teeth appearing on the screen in seconds. The scanner let's us take impressions for virtually everything, including: nightguards, Invisalign®, sportsguards, crowns, bridges and implant dentistry. It is so versatile. I had the opportunity to study digital impression technology extensively during my master's project so it is kind of a passion of mine. If you are interested in seeing the technology in action, come on by! We also regularly hold study club sessions at the office so if you are a dentist interested in learning more, please give us a call for more information on the next session. If you want more information about digital impressions, check out my video on the 5 pros and cons of digital impression technology. Thanks for reading and watching! Please like and share if you have found it to be educational! Dr. Dave #DentalImpressions #DigitalImpressions

Soo......I bet many of you guys have noticed that I am not really keeping up my blog that much anymore. The truth is....videos seem to be more effective at reaching out to people, so now I am using my blog to supplement those clips. In my most recent video I chatted about a couple of websites that I use to when I am trying to keep a healthy diet and exercise plan. If you are considering watching what you eat, a great website is http://nutritiondata.self.com/. You can register for free and then quickly start adding recipes. It has a crazy list of foods and you can add them to a recipe in virtually any quantity. So if, for example, you are making smoothies for breakfast, you can add all of those ingredients individually to the recipe and see what you are actually consuming. It will show you simple things like calorie breakdown and fibre and stuff, but you can really get down to specifics, including minerals and vitamins. It does get a bit addicting! For those who are looking interested in research on exercise and healthy active living, I like to refer to the Amercian College of Sports Medicine website: http://www.acsm.org/. This website is a bit more cumbersome to navigate because it is geared towards health professionals and also has a general public section, but there is a whole bunch of information out there, and a lot if it is very applicable to the every day athlete! There is a whole section on "position stands" and a "brochures" section, which is a good place to start if you want a quick summary on a specific topic. I don't know about you guys, but I am battling the winter belly, so I am back on the healthy diet and exercise bandwagon......during the week.....I have cheat meals on the weekend but still workout....I am only human :) Thanks for reading! Dr. Dave drdave@alfaropros.com #DrDave #DietandExercise

Whenever I meet someone new and they ask me what I do for work and I tell them that I am a prosthodontist, almost everyone asks me what that is. Then...when I explain that prosthodontics is a speciality that focuses on prosthetic dental rehabilitation using crowns, bridges, implants etc. for complex problems, people often respond....."well....isn't that what my dentist does?" Part of my role as a Prosthodontist is helping raise awareness of what we do and what differentiates us from general dentists. This is tricky to do because no matter how things are worded, some people can interpret what I am saying as either me being conceited and arrogant, or demeaning to non-specialist dentists. Obviously that is not the goal.....I want people to know more about my specialty. But..... there are differences between dentists and specialists that people should be aware of. Let us talk about Prosthodontics.....again. How does one become a dentist? My path to dental school was not easy; all of my friends know that. I was a band geek and studied music for 5 years and then went back to SFU after I decided, well, that I needed a reliable career. And that was tough. After a half decade of jazz studies, where making music was my homework, getting back in the flow of real academia took some time. So my grades weren't so hot the first year back. It didn't really sink in that my poor first year would hurt me until I got rejected by UBC Dentistry ......twice. I mean, I aced my DAT, but my 3.55 GPA just wasn't up to their standards, and I guess I was not a good interviewee. But Columbia University took me with open arms, and as I find so often in life, things happen for a reason: I became a dental specialist because of it. Dental school in Canada and the US is 4 years long at pretty much every program, but they are all quite different. Columbia has an extremely challenging curriculum, one where we had to complete the first 2 years of medical school at the same time as our basic dental training. Once in the clinic, we were required to complete credits in various specialty programs, had extensive hospital training, and were encouraged to do externships at other schools in their specialty programs, to help us understand that complex dentistry is hard. Historically, over 95% of Columbia Dental students enter a residency after graduation, with most of my classmates having become specialists. Not every school is like this. Some programs are not even associated with a medical school, and traditionally, very few students complete a residency (at least locally). I have said it many times, but a dental residency is imperative to really start to understand complex dentistry. The reality of dental school is that it is a quick 18 months of clinical training where you get to learn how to do basic dentistry; fillings, a couple crowns, maybe a bridge, no implants, simple surgery, simple root canals, basic orthodontics......stuff for the entry level general dentist. And believe me......dentistry can get way harder than that. So how do dentists learn complex dentistry? This is one of the major differences between a specialist and a general dentist; how complex technical and didactic skills are acquired. A general dentist can perform whatever treatment they feel competent performing, and many dentists are very skilled at complex dentistry. But they didn't get there overnight. It takes years and years of continuing education courses, and trial and error in the practice, to learn advanced techniques. It is really a lifetime process. Dental specialists, on the other hand, dedicate a full 3 years (after completing dental school) to the acquisition of these complex skills. A typical residency program has thousands and thousands of hours of clinic time, with direct supervision from specialists. And then there is the reading. So much reading. Specialists have to understand how treatments and philosophies have developed, and the evidence (or often lack of evidence) behind them. This type of training is above and beyond even the best of continuing education courses, and it would take a decade to acquire that training while in private practice as a general dentist. In Canada, most specialty programs require the completion of a Masters thesis, and then in order to be registered as a specialist, there is a crazy hard two part board examination. I completed my specialty program at UBC, and my Masters thesis focused on digital impression technology. So....there are differences in how dental specialists and general dentists learn to perform and manage complex dental care. What does a prosthodontist do? There is also a big distinction between how dental specialists practise and how general dentists practise. Most of you probably go to a general dental practice where the main focus of the office is hygiene and prevention. You get called in every 6 months, the hygienist cleans your teeth, checks your gums and looks for tooth decay, and then the dentist comes in and does a "hygiene check", and if they find something, you get scheduled for the treatment. The dentist spends his or her time going between many rooms, checking on patients, and performing routine treatments such as fillings. This has long been a successful way to provide good, efficient dental care to patients. But....what happens when something complicated pops up? Can a dentist continue to perform hygiene checks, and be working "two columns" (or more), when a patient requires a treatment that deserves undivided attention for a long time? When something challenging must be completed, like crown and bridge dentistry or implant dentistry, modifications to the usual patient flow are then imperative, which complicates scheduling, and leaves resources underutilized....that is if the dentist chooses to give his or her undivided attention to the more complicated treatments in the first place. This is often a debate in practice management: do you disturb your usual patient flow to take on more complex treatments in order to retain the potential revenue, or do you maintain your practice efficiency and refer out complicated dental work that will disrupt workflow? Nowadays it feels that everyone is keeping things in house. Is that really the best way to provide complex care? As a specialist, I spend most of my days performing complex dentistry, and I have set up my office to operate in a manner that allows me to provide my patients with one on one care throughout their whole procedure. Yes, I have a small handful of patients who come to my office for cleanings and basic dentistry, but most of the time my day involves complex crown and bridge dental work, managing broken down dentitions, working with dental implants, and lots of surgery. Lots. These are long appointments that require my undivided attention. Furthermore, patients are often nervous when it comes to any dentistry, let alone complicated dentistry. It really helps calm people down if the office is quiet, and they know that they are my team's sole focus, and that I am not running around distracted, coming in and out of the room while checking on other people. As you can see, there are various differences between how dental specialists and general dentists practise dentistry, and it has nothing to do with who is better or who is worse, but more so to do with the type of dental cases that are the norm in their practices. Yes, general dentists can do what I do, and what other specialists can do, but specialists have focused their training and have designed their offices around the provision of complex dental care, and we spend our days doing hard stuff. This is very different from the average dental office, where the majority of patients just need a cleaning and a filling from time to time, and tougher cases may only come around a couple of times a month. I hope that in reading this, you get a better understanding of what make me a dental specialist and what makes my practice is different than a general dental practice.....and that you don't consider it bragging about specialty dentistry or putting down non-specialists. If you ever have any questions about dental crowns, bridges, implants, veneers, surgery etc.....please feel free to come and have a consultation. I often work together with general dentists, so they shouldn't be offended if you want a second opinion. Being well informed before beginning any treatment is the smart thing to do! Thanks for reading! Dr. Dave Prosthodontist #prosthodontics

We listen to 102.7 The Peak all day at the office, and I happen to be good buds with a couple of the on air personalities. They like to ask questions to their listeners, and there I was, literally in the middle of performing a gum examination on someone before doing a cleaning, when Casey-Jo started talking about little harmless lies that people tell. Her little lie was that she lies to her dentist about how much she flosses. So.....one of her listeners messaged back and told her about an article that explains that maybe flossing isn't that important..... Let us talk about flossing. First of all let's go over this article. This is the second article that has come out in the New York Times by someone with absolutely no formal education in dentistry talking about how dental treatments are unnecessary. The first article was about dental x-rays, and it was totally bunk. This one here on flossing also demonstrates how information can be very misleading. http://www.nytimes.com/2016/08/03/health/flossing-teeth-cavities.html?_r=0 Basically, the writer is saying that you do not need to floss because the evidence is not that strong. Let me tell you, as a dentist who does gum examinations and cleanings myself (most dentists pass these tasks off to dental hygienists nowadays), I can absolutely tell when someone is not flossing. When someone doesn't not floss, and please put your lunch down before reading this next bit, I can fish the nastiest crap out of between peoples teeth. For example, I can be like, "hey bud, when did you last have mango?"....."um last week?".....so that stuff has just been sitting there impacted between the teeth forever, getting all funky and gross. Sick. Ok, so that may be more for someone who doesn't floss. But for people who floss irregularly, it can still be clear that they aren't, when we do a gum examination. Part of a thorough evaluation is to jab the gums a bunch of times with a blunt metal instrument......super scientific!!!! But as crude of a test it is, if the gums are healthy, they actually don't bleed, and the gums are not swollen. When people have not been brushing or flossing properly, the bacteria on the plaque that collects on the teeth irritate the gums, causing them to swell and to be easily damaged. That's why gums bleed easily in people that do not floss.....the gums have a chronic level of infection (gingivitis). When this progresses further, the underlying bone gets injured too and shrinks away from the plaque (periodontitis). So when someone has bleeding points and swollen gums between the teeth, but nowhere else, it is a clear indicator that that person brushes, but is not flossing well. What about the research? Really it comes down to ethics. The best kind of study is a "randomized control study", where we get a random sampling of the general population, and split them up in groups, also randomly. Then one group gets an intervention, and the other doesn't. Where ethics comes in is when we ask, can we really deny a group a treatment that is helpful for the sake of science? For flossing, ok it may not be the most important thing in the world, but there has been a long history of unethical research where people were denied important treatments. Ever heard of Tuskegee? To get around this, researchers perform "retrospective" studies, where they look at a group of people who already self admittedly are poor flossers, and then compare them to those who floss well, again self admittedly. The problem with this is that there can be multiple uncontrolled variables, so "causation" is hard to prove. These studies allow for the inference of a "correlation". Another challenge is in how gum inflammation is actually measured. The measuring tool (blunt probe) is not the most precise instrument, meaning that the readings can be highly variable. I don't really care too much whether a pocket is a "2 mm" or "3 mm". I do care when pockets are bigger than that. We are therefore talking large increments....so a study that says that there was a 0.25 mm improvement....well that may not be very clinically relevant. For flossing in particular, it is pretty obvious that it is only going to make an impact on the health of the gums in between the teeth, but brushing affects almost all surfaces of the teeth. Gum inflammation studies look at the health of the gums all the way around the teeth, so flossing really can only make a small impact because it only cleans a small area. But it does not mean that it does not help. Realistically, the studies would have to compare the inflammation of the gums in between the teeth only, to really measure the impact of flossing in the area it is intended to work on, which very few articles do. What is the take home? Well, it is up to you obviously. If you are not motivated enough to remove the smelly, disgusting food debris that is wedged in between your teeth, which is away from the reach of your toothbrush and mouthwash, because some guy in the New York Times said that it may not be that important.....go for it! You should know, however,.......gum disease is one of the few health conditions that is actually on the rise in Canada. Thanks for reading! Dr. Dave #Flossing #ThePeak #DrDave