Richmond Hill Sleep Dentistry

Richmond Hill Sleep Dentistry Richmond Hill Sleep Dentistry Our dental anaesthesia facility is built with patient's safety and comfort in mind. Check out our website for more detail.

We provide full range of dental care while asleep, eliminating any struggle or discomfort, to the very young, the young @ heart, the sensitive, the compromised and the special ones.

In 2022 - There is update of American Heart Association's 2007 Recommendation for Prevention of Infective Endocarditis -...

In 2022 - There is update of American Heart Association's 2007 Recommendation for Prevention of Infective Endocarditis - related to select Dental Procedure.

The following procedures and events DO NOT need prophylaxis for high risk patients:
/ routine anesthetic injection through noninfected soft tissue
dental radiographs
/ placement of removable prosthodontic or orthodontic appliances
/ adjustment of orthodontic appliances
/ placement of orthodontic brackets
/ shedding of deciduous teeth
/ bleeding from trauma to the lips or mucosa
** For clarity, the AHA guidelines state that prophylactic antibiotics, which were previously routinely administered to certain patients, are no longer needed for such patients.

Antibiotic prophylaxis is reasonable before select dental procedures (^procedures that involve manipulation of gingival (gum) tissue or the periapical region -area around the roots - of teeth, or perforation of the oral mucosa.^) for people with heart valve disease who have any of the following:
/ Prosthetic cardiac valves, including transcatheter-implanted
/ prostheses and homografts.
/ Prosthetic material used for heart valve repair, such as annuloplasty rings, chords or clips.
/ Previous IE.
/ Unrepaired cyanotic congenital heart defect (birth defects with oxygen levels lower than normal) or repaired congenital heart defect, with residual shunts or valvular regurgitation at the site adjacent to the site of a prosthetic patch or prosthetic device.
/ Cardiac transplant with valve regurgitation due to a structurally abnormal valve.
Except for the conditions listed above, antibiotic prophylaxis before dental procedures is NOT RECOMMENDED for any other types of congenital heart disease.

In addition, antibiotic prophylaxis is NOT RECOMMENDED for patients with valvular heart disease who are at high risk of IE for nondental procedures (e.g., TEE, esophagogastroduodenoscopy, colonoscopy, or cystoscopy) in the absence of active infection.

Good oral health and infection prevention is the ULTIMATE GOAL - Patient can reduce the risk of IE by maintaining good oral health through regular professional dental care and the use of dental products such as manual, powered and ultrasonic toothbrushes; dental floss; and other plaque-removal devices.

1) Canadian Dental Association Position 2021-
2) American Heart Association topics on infective endocarditis -

A good read for dental colleagues with patients in mixed dentition. Our clinic frequent see patient with rampant decay c...

A good read for dental colleagues with patients in mixed dentition.
Our clinic frequent see patient with rampant decay complex with malocclusion, we routinely explain to family about staged dental care that follows. There is no magic bullet, but constant practice & reminder about importance of daily habit, home care and knowledge accumulation.
With sleep dentistry, one main goal is prompt control of dental caries, infection and pain control for the very young, very scared and the special population; which is considered essential and at times - urgent. But there-after, the very young/the growing children definitely require long-term rehabilitation of oral health.... which frequently includes diet pattern change and daily oral hygiene routine improvement plus regular follow up with professionals …. Parental dental knowledge is critical (for motivation, which will hopefully translate to action).
Then Stage II - growth and space management - which will take months-to-years. But good daily oral hygiene and routine are fundamental for long term prognosis.

A 9-year-old female patient visited the orthodontic office for an initial consultation. She presented with a Class II malocclusion...

Welcome 2023!  We thanks everyone for your diligence and compliance with Dental College and Public Health Ontario's guid...

Welcome 2023!

We thanks everyone for your diligence and compliance with Dental College and Public Health Ontario's guidance for Managing infection risks during in-person dental care, especially during in this Tridemic (the combination of three virals infection - Flu, Covid-19 and RSV).

Health and Safety is an critical aspect for everyone in our facility - We continue to ask patient-family to be screened for COVID-19 prior to entering the office using the COVID-19 self-assessment tool ( This screening tool is regularly updated and an excellent guidance for patient/ family who has question about health-status prior to appointments.

We will re-open Wed Jan 4, 2023.

May Health and Peace be always presence.

Dental College updated Patient Care Guidance as of Jun 29, 2022.   --> All patients and visitors must be screened for CO...

Dental College updated Patient Care Guidance as of Jun 29, 2022.
--> All patients and visitors must be screened for COVID-19 prior to entering the office using the COVID-19 self-assessment tool.

Big Thank you for all family and patients for following this guidance and being diligence during 7th Wave of this COVID pandemic.

Take this self-assessment if you think you have coronavirus (COVID-19) or have been in close contact with someone who has it.

Ref: Patel A, Aghababaie S, Parekh S. Hypomineralisation or hypoplasia?. Br Dent J. 2019;227(8):683-686. Developmental d...

Ref: Patel A, Aghababaie S, Parekh S. Hypomineralisation or hypoplasia?. Br Dent J. 2019;227(8):683-686.

Developmental defects of enamel are not uncommon, both in the primary and permanent dentitions. Environmental and/or genetic factors that interfere with tooth formation are thought to be responsible for both hypomineralisation and hypoplasia. If a disturbance occurs during the secretion phase, the enamel defect is called hypoplasia. If it occurs during the mineralisation or maturation phase, it is called hypomineralisation. Often the cause is difficult to determine.
Enamel hypomineralisation is a qualitative defect, with reduced mineralisation resulting in discoloured enamel in a tooth of normal shape and size. Because the enamel is weaker, teeth can undergo post eruptive breakdown, resulting in missing enamel. Enamel hypoplasia is a quantitative defect of the enamel presenting as pits, grooves, missing enamel or smaller teeth. It can sometimes be difficult to differentiate between the two.
Preventative measures including fluoride treatments and fissure sealants can reduce sensitivity, and minimally invasive treatment options should be used where possible to preserve tooth structure.

Ref: Patel A, Aghababaie S, Parekh S. Hypomineralisation or hypoplasia?. Br Dent J. 2019;227(8):683-686. doi:10.1038/s41415-019-0782-9, 10.1038/s41415-019-0782-9

Warmest Greeting to all patients, families, friends...   in this changing pandemic era.   Our office is now closed and w...

Warmest Greeting to all patients, families, friends... in this changing pandemic era. Our office is now closed and will re-open Wed Jan 5, 2022. Wish everyone a great and safe holiday seasons.

Gratitude to all patients and families for your continuous cooperation and understanding on measures adapted in dental s...

Gratitude to all patients and families for your continuous cooperation and understanding on measures adapted in dental settings! Big Thumbs Up to everyone's effort!

"Oral Ecology" cartoon by Martin P-M.      : illustrating importance of proper daily oral hygiene, detrimental effect of...

"Oral Ecology" cartoon by Martin P-M.
: illustrating importance of proper daily oral hygiene, detrimental effect of sugary snacks etc...
Our clinician strive to explain the importance of good daily oral hygiene to better patient's oral health (the very young, the young at heart and the special ones).
Thank you Canadian Dental Association's publication with translation to English.
ref: CDA essentials 2021/issue 2/ 28.

Take a look at the common-behaviour-risk-factors -- perhaps there is something everyone can all do NOW to welcome a heal...

Take a look at the common-behaviour-risk-factors
-- perhaps there is something everyone can all do NOW to welcome a healthier and better Quality-of-Life as we age....


How Not to See Your Dentist    (more than necessary)As the pandemic linger on, it is critical daily best practice for op...

How Not to See Your Dentist (more than necessary)

As the pandemic linger on, it is critical daily best practice for optimal oral health be followed - sharing great resource from Canadian Dental Association with everyone (adult and children alike)...

Good preventive oral care at home can save you money—it can also save your teeth, freshen your breath, and improve your oral and overall health.

The Six Steps of Preventive Care

1. Brush at least twice a day.
2. Floss once a day.
3. Limit sugary snacks and drinks (including fruit juices).
4. Don't smoke or use any to***co products.
5. Have an examination as often as is recommended by your dentist. The frequency will be based on your individual needs and the risk of oral diseases.
6. Have your teeth cleaned and polished as per the schedule recommended by your dentist.

Examinations—Once, Twice or More per Year?

Examinations are an important part of maintaining healthy teeth and gums and the frequency should be determined in consultation with your dentist. Some people need more frequent examinations while others can have a yearly exam.

Back to the Basics—A Refresher on Brushing and Flossing

Brushing and flossing remove the bacteria that promote tooth decay and the plaque that can cause gum disease. A reminder of what works best:

:Ideally, brush after every meal—but at least twice a day including just before bed.
:Use a soft-bristle brush with rounded bristles, small enough to reach your back teeth.
:Use a toothpaste with fluoride—look for the CDA Seal.
:Brush for at least two minutes.
:Don't forget to gently brush your tongue.
:Get a new toothbrush if yours looks worn, is more than three months old, or if you've had a cold (bristles can harbour germs that may re-infect you).
:Flossing is a must—otherwise more than a third of your tooth surface is not getting cleaned. After flossing, roll it up in a tiny ball and put it in the garbage. Never flush floss down the toilet.
:Consider an interdental cleaner or proximal brush for cleaning between your teeth instead of floss if you have wide spaces between your teeth, wear braces, or have had gum surgery.
:Brushing and flossing aren't complicated, but technique does matter. Ask your dentist or click here for a visual guide.
Watch Your Mouth!

Preventive care also means being alert for signs of tooth decay, gum disease, and oral cancer. If you see any of the warning signs listed below, contact your dentist right away.

Tooth decay

sensitivity to heat, cold, sweetness, or pressure
Periodontal disease (gum disease)

red, shiny, puffy, sore, or sensitive gums
bleeding when you brush or floss
persistent bad breath

Oral cancer

bleeding that you can't explain
open sores that don't heal within 7 to 10 days
white or red patches
numbness or tingling
small lumps or thickening on your gums, the sides or bottom of your tongue, the floor or roof of your mouth, or the inside of your cheeks

You and Your Dental Team—Working Together

By practising good preventive care at home, you are working together with your dentist to safeguard and improve your oral health.


Seasonal Greetings to our friends and family.
Our office will be closing for holiday Dec 24-Jan 3, 2021 inclusive. We'll be back Jan 4, 2021 in great spirit, welcoming a new year!

2020 has been a memorable year to say the least! Since we re-opened in June, we have been managing countless cases with pain, abscess, facial swelling etc... Gratitude to our team of Nurses, Dental Assistants and Admin officers for your continuous presence, positive energy and great team-work (it's really something adapting to the new health-n-safety protocol, keeping physical distance, talking through layers of mask and face shield. Sweating under the PPEs). The procurement for PPE continue to be a fun task in face of global pandemic! Best wishes to all, including this beautiful globe we called Earth.


“an ounce of prevention is worth a pound of cure” -Benjamin Franklin
Information for all new parent, grandparent - Early Childhood Caries is PREVENTABLE.

:Discipline Baby/child's feeding/meal time.
:Breast-feeding on-demand or baby-bottle all-night-long, or snacking-on-demand, is detrimental to child's teeth/oral health.
:Baby teeth do not come out yellow or brown on it's own.
:Brush and floss for them at least twice daily, coach them at adequate age. Supervise their brush/floss until they can do it properly for themselves.
Develop good habit early on. There is no restoration/filling that's as good as your/anyone's own teeth.


Common Dental Anoamlies (Double Teeth):
Gemination and Fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite.
Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. reference 1) Contemp Clin Dent. 2012 Apr; 3(Suppl1): S92–S95. 2) Bilateral fusion in primary mandibular teeth: A report of two cases 2011 | Volume : 29 | Issue : 1 | Page : 50-52 jisppd.

N Tewari, RK Pandey

Dental Care Slowly Resumes But Not Like Usual

We are very excited to announce our practice will be opening as of Jun 10, 2020 to care for referred patient. Our new scheduling options are designed to address individual oral health needs and maintain a safe and sterile environment. We look forward to seeing you again.

Ref: Ontario Dental Association's Media Release Jun 1, 2020

"All patients will be asked COVID-19 screening questions before their appointment. If they clear the screening, they can receive treatments. Just keep in mind, dentists are prioritizing patients making sure those with the most pressing dental care needs are treated first.
:If a patient screens positive, the dentist will determine if they require emergency and urgent care and if not, will be asked to wait until their health improves. If they do meet emergency or urgent criteria, treatment will happen in a closed room with the dental team in full personal protective equipment (PPE), and there will be up to a three-hour wait time until a dentist can see the next patient (the amount of time depends on the air filtration system in the office).
:At the time of your appointment you may also:
:Have to wait outside the office and be called in
:Be asked screening questions again
:Have to sanitize your hands when you enter and leave the office
:Wear a mask (except during treatment)

Since 1867, the Ontario Dental Association has been the voluntary professional association representing the dentists of Ontario. Today, there are more than 9,000 ODA dentists, which is more than nine in 10 dentists in the province. The ODA is Ontario’s primary source of information on oral health ...


Happy Mother's Day!
Sharing reference and info for a Q commonly asked by many moms....



A Silent Tragedy In How We Are Raising Our Children - Mums Advice

Some life-style improvement strategies that'll not only improve your family member (child)'s oral health, but overall well being too!!

"What to do?

If we want our children to be happy and healthy individuals, we have to wake up and get back to basics. It is still possible! Many families see immediate improvements after weeks of implementing the following recommendations:

• Set limits and remember that you are the captain of the ship. Your children will feel more confident knowing that you have control of the helm.

• Offer children a balanced lifestyle full of what children NEED, not just what they WANT. Don’t be afraid to say “no” to your children if what they want is not what they need.

• Provide nutritious food and limit junk food.

• Spend at least one hour a day outdoors doing activities such as cycling, walking, fishing, bird/insect watching

• Enjoy a daily family dinner without smartphones or distracting technology, let everyone feel valued

• Play board games as a family or if children are very small for board games, just let the pretend to play it

• Involve your children in some homework or household chores according to their age (folding clothes, hanging clothes, unpacking food, setting the table, feeding the dog, etc.)

• Implement a consistent sleep routine to ensure your child gets enough sleep. The schedules will be even more important for school-age children.

• Teach responsibility and independence. Do not overprotect them against all frustration or mistakes. Misunderstanding will help them build resilience and learn to overcome life’s challenges,

• Do not carry your children’s backpack, do not carry the homework they forgot, do not peel bananas or peel oranges if they can do it on their own (4-5 years). Instead of giving them the fish, teach them to fish.

• Teach them to wait and delay gratification.

• Provide opportunities for “boredom”, since boredom is the moment when creativity awakens. Do not feel responsible for always keeping children entertained.

• Do not use technology as a cure for boredom, nor offer it at the first second of inactivity.

• Avoid using technology during meals, in cars, restaurants, shopping centers. Use these moments as opportunities to socialize by training the brains to know how to work when they are in mode: “boredom”

• Help them create a “bottle of boredom” with activity ideas for when they are bored.

• Be emotionally available to connect with children and teach them self-regulation and social skills:

• Turn off the phones at night when children have to go to bed to avoid digital distractions.

• Become a regulator or emotional trainer for your children. Teach them to recognize and manage their own frustrations and anger.

• Teach them to greet, to take turns, to share without running out of anything, to say thank you and please, to acknowledge the error and apologize (do not force them), be a model of all those values you instill.

• Connect emotionally – smile, hug, kiss, tickle, read, dance, jump, play or crawl with them
reference: .

A SILENT TRAGEDY There is a silent tragedy that is unfolding today in our homes and concerns our most precious


Wish everyone a great Christmas and Holiday Seasons.
RHSD office will be closed Dec 23-Jan 3, 2020 inclusive.
We'll be all ready for a new decades start Jan 4, 2020!


15 things you can do now to reduce your risk of Dementia
Great life style choice and routine will improve your oral health as well as overall well being!

What is dementia?
Dementia is an overall term for a set of symptoms that are caused by disorders affecting the brain. Symptoms may include memory loss and difficulties with thinking, problem-solving or language, severe enough to reduce a person's ability to perform everyday activities. A person with dementia may also experience changes in mood or behaviour.

Dementia is progressive, which means the symptoms will gradually get worse as more brain cells become damaged and eventually die.

Dementia is not a specific disease. Many diseases can cause dementia, including Alzheimer's disease, vascular dementia (due to strokes), Lewy Body disease, head trauma, fronto-temporal dementia, Creutzfeldt-Jakob disease, Parkinson’s disease, and Huntington’s disease. These conditions can have similar and overlapping symptoms.----------------------------

Alzheimer's disease
Alzheimer's disease is irreversible and destroys brain cells, causing thinking ability and memory to deteriorate. Alzheimer's disease is not a normal part of aging.

Ref: BrainMatters Fall/Winter 2019


One major cause of Toothache - is Pulpitis.

When patient presence with toothache - clinician will ask various questions and perform various clinical exam; with a goal to form a proper diagnosis.

Is the ache of -- Tooth origin or Gum tissue origin?
If Tooth Origin - is the pulpitis reversible or irreversible?

Recommended treatment varies according to each patient's situation.

Don't delay care if you have toothache or discomfort --- Seek proper diagnosis; and proper treatment early on.


Mouth Breathing in Children- by Patrick McKeown

Do you know the benefit of Nose-Breathing & the Risk of Mouth Breathing to your Children?
An innocent habit might have drastic consequences!! Knowledge and knowledge sharing with you.

Mouth Breathing in Children Buteyko Educator Patrick McKeown The physiologic breathing mode in the human being is nasal, regardless of age. Any factor leadin...

How to Floss Your Teeth

Could FLOSSING DAILY be your new year resolution in 2019?
Start now, its never too late....and here is a video showing the correct and most efficient way to floss for yourself or your children. PLUS a tips on how not to worry....even if there is bleeding!
Reference: Ottawa Public Health.

Learn the proper technique on how to floss daily to keep your teeth and gums healthy.


We're now closed for Christmas and New Year Holiday. Clinic will resume normal hour as of Jan 4, 2019. Wish all our patients, friends and families a Wonderful Holiday Seasons.


Silver Diamine Fluoride - FYI
(SDF) is a revolutionary treatment option for the management of dental cavities. It is an antimicrobial liquid that’s able to treat cavities in a non-invasive, fast, affordable, and painless manner.
Although the treatment permanently stains caries lesions black, this treatment option is simple, painless, non-invasive, and low-cost. It is well accepted by many clinicians and patients and therefore appears to be a promising strategy for caries control, particularly for young children, the elderly, and patients with severe caries risk or special needs.


Although Sleep Dentistry is quite different than Sleep Apnea, Patient with OSA (Obstructive Sleep Apnea) are at increased risk of complication with sedation, on top of health consequence associated with OSA when left un-treated.

Highly recommend this ~1hr video if you or your loved one are diagnosed with OSA and/or snoring heavily everynight....

WATCH Youtube video :

What do you know about Huntington disease?

Huntingtong Disease (HD) - What do you know about it?
1) A rare neurodegenerative disorder that affects 5-7 per 100,000 individuals.
2) Presents with symptoms of Chorea, dystonia, coordination, cognitive decline, or behavioural difficulties between the 3rd and 4th decade of life.
3) HD has an autosomal dominant inheritance that is caused by an expansion of the CAG repetition in the IT15 gene, resulting in increased production of a mutant protein, huntingtin. This protein initially leads to cell loss and atrophy, mainly of GABAergic striatal medium spinal output neurons of the caudate, putamen, and cortex.
4) Degeneration throughout the cortex and abnormalities of the dopaminergic substantia nigra pars compacta can occur. Widespread dysregulation of glutamatergic and dopaminergic signaling systems results.
5) As the disease progresses, patients develop worsening atasia resulting in falls and trauma, pharyngeal dysfunction and poor nutrition requiring feeding tube placement, and poor oral hygiene requiring dental procedures, all of which may result in the need for procedures that require anesthesia.
Ref: "Anesthetic Management of Patients with Huntington's Disease" J.E. Kivela et all Feb 2010.
Videos: Huntington Society Canada

For more information about Huntington disease or to donate, visit Video courtesy of Shared. Visit them at


Seasonal Greetings to all!
While we said Goodbye to our long term teammate Ms Thamara this October; we are honored to have Ms Baydaa joining RHSD family with loads of experience.
HAVE a wonderful 2018!!
Clinic Closure Dec 23, 17 to Jan 2, 2018 inclusive.


Tooth Decay is PREVENTABLE
: quoting Bruce Lee — 'Knowing is not enough, we must apply. Willing is not enough, we must do.'
: Check out this fun poster from Spear-Education for various wisdom to help prevent tooth decay (caries/ cavities) in everyone's mouth. Just Do it!


What you should know about Dental Injury of Baby and Permanent Teeth.

I - How to prevent dental trauma in primary teeth?
:Do not use baby walkers.
: Do not let children use roller skates without protection.
: Teach your children to:
- Look after their teeth as well as that of their friends’ teeth when playing by not knocking their teeth with heavy objects.
- Watch out for possible obstructions that they can trip themselves up on.
- Do not push when playing.
- Stay seated on the swing and do not jump off when the swing is in motion.
- Use the stairs when getting out of the swimming pool.

If the child participates in sports such as rugby, hockey, karate, riding on a bike, wintersports (i.e. skiing) a skate board or any activity that involves potential trauma to the facial area, make sure that the child uses a helmet or mouth protector

II - What to do in case of a fall that affects a permanent teeth?
First, you must consult a dentist immediately after the accident has occurred. This measure has many advantages:
1) There is more possibility of conserving the tooth's vitality.
2) A conservation treatment will be applied.
3) There is a better prognosis.
4) Future complications and high cost treatments are prevented.
It is of vital importance that all traumatic injuries are diagnosed, treated, and controlled in time (at least within five years).

III - What to do if a permanent tooth is broken or knocked out?
1) Find the tooth. Hold the tooth by the crown (the white part), not by the root (the yellow part).
2) Replant immediately, if possible.
3) If contaminated, rinse shortly with cold tap water and put the tooth back in its place. This can be done by the child or an adult.
4) Hold the tooth in place. Bite on a handkerchief to hold it in position and go to the dentist immediately.
5) If you can not put the tooth back in, place it in a cup of milk or saline. When milk or saline are not available, place the tooth in the child's mouth (between the cheeks and gums)
6) Seek immediately specialized dental treatment
Children between 7 and 10 years of age are more exposed to suffer avulsion due to the elasticity of the bone at this age.
Good oral hygiene is absolutely necessary in the healing period


Why is periodontal disease so difficult to Treat?
What can be done to Prevent it? control it?
- Periodontal tissue is delicate and complex; its health is also extremely important for dental longevity.
- Reason for Teeth loss include not only dental decay (aka caries) but also periodontal disease, as well as trauma.
- Sharing the figures from an interesting Read titled:
Defining periodontal health
From Prevention in practice - making it happen
Mariotti and Hefti BMC Oral Health 2015, 15(Suppl 1):S6

Full article available

How to Properly Floss Your Teeth by Hermosa Beach Dentist Dr. Mondavi

Do floss everyday (once at least every 24 hours) to avoid gum disease and cavities - children and adult alike! Sharing some instructional videos
1) (Dr Mondavi)
2) (Jenny &Nicole)
3) by Dr Berdy

You can use regular floss or Floss handle!

In order to properly maintain your dental health a patient should floss once daily. This video describes the proper way to floss your teeth to prevent decay ...


406/250 Harding Boulevard W
Richmond Hill, ON

Opening Hours

Monday 8am - 4pm
Tuesday 8am - 4pm
Wednesday 8am - 4pm
Friday 8am - 4pm




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