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Peter Chow: No Monoclonal Antibodies in Sault Ontario – But We Have Fluvoxamine –



I asked Dr Rishi Ghosh (intensivist at SAH) and Dr Greg Berg, our pulmonologist, about COVID-19 treatment in our Sault Area Hospital.

Dr Ghosh said,  “We’ve had several COVID patients come through the ICU, some from Southern Ontario, a few local and several from Manitoba.

Our treatment has been fairly similar to what’s being offered elsewhere in Ontario which is Remdesavir and Roche’s arthritis drug Actemra (tocilizumab), a monoclonal antibody against IL-6 (not a monoclonal drug against the virus itself).

In addition Dexamethasone is given to all of our Covid patients.”

Rishi added  “It is difficult to comment on whether these actually made a difference due to our small sample size and varied degree of co-morbidities in the patients.”

I also asked Dr Greg Berg about Regeneron’s monoclonal antibodies and whether or not they were available at SAH.

Clinical trials show that Regeneron’s monoclonal antibody treatment, a cocktail of two antibodies called Casirivimab and Imdevimab, called REGEN-COV, reduces COVID-19-related hospitalization or deaths in high-risk patients by about 70%.

And when given to an exposed person  –  like someone living with an infected person  –  the monoclonal antibodies reduced their risk of developing an infection with symptoms by 85%.

When the antibodies bind to the Coronavirus spike protein, they block the virus from entering the body’s cells.

If the virus can’t enter cells, it can’t make copies of itself and continue spreading within the body.

If a person is already sick, monoclonal antibodies prevent them from having severe symptoms that lead to hospitalization, intubation, ICU admission and death.

If someone has been exposed, monoclonal antibodies can fend off the virus to prevent them from becoming sick in the first place.

Monoclonal antibodies were first authorized as an IV infusion and are most commonly given at infusion centers.

But a recent study showed they can also be given as a shot subcutaneously into the belly when an IV isn’t as accessible.

On 21 November 2020, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for REGEN-COV, Casirivimab and Imdevimab, to be administered together for the treatment of mild to moderate COVID-19 in people 12 years of age or older weighing at least 40 kilograms (88 lb) with positive results of direct SARS-CoV-2 viral testing and who are at high risk for progressing to severe COVID-19.

This includes those who are 65 years of age or older or who have certain chronic medical conditions.

On 12 January 2021, the United States government agreed to purchase 1.25 million doses of the drug for $2.625 billion, at USD$2,100 per dose.

On 14 September, another 1.4 million doses were purchased for the same price, totalling $2.94 billion.

REGEN-COV is indicated to be used only as post-exposure prophylaxis for adults and paediatric individuals (12 years of age and older weighing at least 40 kg) who are:

– at high risk for progression to severe COVID-19, including hospitalization or death, and

– not fully vaccinated or who are not expected to mount an adequate immune response to complete SARS-CoV-2 vaccination (for example, people with immunocompromising conditions, including those taking immunosuppressive medications), and

– have been exposed to an individual infected with SARS-CoV-2 consistent with close contact criteria per Centers for Disease Control and Prevention (CDC), or

– who are at high risk of exposure to an individual infected with SARS-CoV-2 because of occurrence of SARS-CoV-2 infection in other individuals in the same institutional setting, for example, nursing homes or prisons
(there is currently an outbreak of 3 cases on a medical ward in SAH)

REGEN-COV is not authorized for people who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19.

A benefit of Casirivimab and Imdevimab treatment had not been shown in people hospitalized due to COVID-19 (until the study in the UK in June).

Monoclonal antibodies, such as Casirivimab and Imdevimab, may be associated with worse clinical outcomes when administered to hospitalized people with COVID-19 requiring high flow oxygen or mechanical ventilation.

But in June, a large UK study of almost 10,000 patients, showed that REGEN-COV reduced deaths in hospitalized patients whose own immune systems had failed to produce a response.

It found that the antibody therapy reduced by 20% the 28-day mortality of people admitted to hospital with COVID-19 whose immune system had not mounted an antibody response.

Famously, Donald Trump was treated with REGEN-COV in October 2020, when he was admitted with COVID.

Trump received 8 drugs including Dexamethasone, Remdesavir, Regeneron’s monoclonal antibody cocktail, Zinc, Famotidine, Vitamin D, Melatonin and ASA.

The U.S. has purchased nearly three million doses at a cost of around USD$2,100 each and is making the treatment available to all patients for free.

In the U.S., some states have set up dedicated antibody treatment centres for REGEN-COV infusion for COVID-19 patients.

In Florida, state-run monoclonal antibody infusion clinics have been swamped with unvaccinated COVID patients seeking the free treatments.

Data showed that Regeneron’s drug has the potential to provide long-lasting immunity from COVID-19 infection, making it particularly helpful for immunocompromised people and those unresponsive to vaccines.

Regeneron Pharmaceuticals Inc said on Nov. 8 that a single dose of its antibody cocktail reduced the risk of contracting COVID-19 by 81.6%, in the two to eight months period following the drug’s administration.

The antibody therapy, REGEN-COV, is currently authorized in the United States to treat people at high risk of exposure in settings such as nursing homes or prisons.

And the World Health Organization endorsed the medication for some patients at high risk of hospitalization.

But in Canada, this and other drugs, known as monoclonal antibody treatments, are hardly being used — even though doctors say they would be an incredibly useful addition to their COVID-fighting arsenal.

“This new antibody cocktail is the one that is probably the most promising for people with mild COVID-19 and also seems to be promising for people who are hospitalized with COVID-19, who are naïve to the virus: so they haven’t been vaccinated or they haven’t been infected before,” said Dr. Amol Verma, a physician and scientist at St. Michael’s Hospital and the University of Toronto.

These drugs are a direct shot of antibodies targeting the virus that causes COVID-19, he said, designed to help people who have already been infected better fight it off, and lessening the chance that they may have to be hospitalized.

“From everything that we know so far, and we have several studies on this, it’s remarkably effective,” said Dr. Andrew Morris, an infectious diseases physician at Sinai Health and University Health Network and professor at the University of Toronto.

But although he thinks it’s useful, Dr Morris said, “In Canada, we just don’t have enough of it.”

According to the Public Health Agency of Canada, Canada has received 6,000 doses of the antibody cocktail, with another 3,000 doses due to come in October  –  far less than the U.S.’s order of 3 million doses.

Almost every province contacted reported limited supply, with some like New Brunswick saying the treatment wasn’t available at all.
There are a few reasons why these treatments aren’t broadly used in Canada, said Dr. Theresa Tam, chief public health officer of Canada, at a press conference this summer.

“It’s not really fundamentally about cost. There’s access, but also feasibility of delivery,” she said.

“For example, one of the antibody combinations used to have to be given intravenously.  And there’s new data to show that you can actually give it under the skin now, and that might then increase the viability of the use of these medications in the frontline setting.”

The logistics of actually giving the medication to people are definitely a barrier, said Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Centre.

“These antibodies, because they require an intravenous infusion, necessarily required an infusion centre,” he said.

“And infusion centres are usually done in a hospital setting where you bring people in and you have dedicated health-care personnel who put an intravenous into that person and they give them the medications and they make sure they don’t have any reactions.”

In the middle of a pandemic, there were issues finding personnel to do this, he said, and with making sure that the antibody patients  –  who have active COVID-19  –  are kept away from other people in the hospital.

“Now you’re bringing these people who are infected into a hospital setting, which is obviously not a good thing because you don’t want them exposing other people with a virus,” he said.

In the U.S., some states have set up dedicated antibody treatment centres for COVID-19 patients.

Dr Vinh is hoping to do something similar in Canada, in a dedicated area of the McGill University Health Centre in Montreal, with negative pressure rooms and specially trained staff to ensure that infections don’t spread.

Like Dr Tam, he thinks that new ways of delivering the drug subcutaneously will help solve logistical problems too.

Canada should “absolutely” use monoclonal antibody treatments more, Dr Morris said.

“I think it is problematic that we haven’t been using the therapies yet or if we have, it’s been minimal. I see it as a very, very important part of our strategy of keeping people out of hospital and out of ICUs.”

While Dr Vinh said vaccination is still the most important strategy for fighting the pandemic, antibody treatments have their place.

“These monoclonal antibodies are a welcome addition. They are not a silver bullet,” he said. But for people who get vaccinated but still get infected with COVID-19 and are at risk of complications, they are another tool, he added.

“We can’t just sit idly by and let them get infected and deteriorate. If they’ve done their part to get the vaccine, we need to do our part to make sure that we still protect them as much as we can.”

Dr Greg Berg said that REGEN-COV hasn’t been used in SAH because it has to be shipped from Toronto, it has to be used as early in the disease as possible and there’s no place in SAH to give it.

“Patients present late.

This lady that died was unvaxxed and whole family anti-vaxxer

Plus she presented really late.

So I checked on the antibody thing. We are getting them.

I know when the spring there was just a study and we had to get them from Toronto but they’ve been approved so we are getting them

But they have to be given early on often and outpatient settings.

So that is a bit of a challenge.

We don’t really have a place in the hospital to give COVID patients medication.

So I don’t know what we’re going to do plus Medical Day Care is always full.”

A 9th patient died of COVID in SAH last week.

There have been 661 confirmed cases in SSM since March 2020, with 113 active cases, and 7 hospitalised as of Nov. 12.

One patient who died of COVID this past summer was an acquaintance.

He picked up COVID on an airplane trip from Toronto and presented to SAH very early in his illness.

The obvious question is, would the outcome have been far different if he had received Regeneron’s monoclonal antibody treatment??

Breakthrough COVID-19 cases happen in people who are fully vaccinated, and they seem to happen more frequently now that the delta variant is circulating widely.

A study in Washington state gathered data from over 4 million fully vaccinated people.

The data showed a rate of about 1 in 5,000 experienced a breakthrough infection between January 17 and August 21, 2021.

More recently, some populations have shown breakthrough infection rates of approximately 1 in 100 fully vaccinated people.

In a large study in Israel of 1,497 fully vaccinated  (with 2 doses of Pfizer mRNA vaccine) health care workers, 39 SARS-CoV-2 breakthrough infections were documented, for a rate of 2.8 cases per 100 fully vaccinated patients.

Of these 39 positives, 29 had high viral loads and 7 went on to develop “Long COVID”.

Although any fully vaccinated person can experience a breakthrough infection, people with weakened immune systems caused by certain medical conditions or treatments (including organ transplants, HIV and some cancers and chemotherapy) are more likely to have breakthrough infections.

It is important to differentiate between “Breakthrough COVID Infection” and “Breakthrough COVID Disease.”

A new study from the CDC published last Friday finds that people who are vaccinated were five times less likely to develop symptoms of COVID-19, the disease..

Those who did develop symptoms were 10 times less likely to be hospitalized and die from the disease.

Around 7,000 Americans and 450 Canadians who were fully vaccinated have died from COVID-19.

Doctors note it remains rare, and that getting the vaccine is still extremely important as it protects you and others from the disease.

“When we’re hearing about some individuals who are dying who happen to have been fully vaccinated, it starts creating doubt in the minds of others about whether the vaccine is even worth it at all,” said Dr. Samir Sinha, director of geriatrics at Sinai Health and the University Health Network in Toronto.

“But we do know that those who are vaccinated have a far, far, far lower chance of potentially getting sick and even dying than those who are unvaccinated,” he said.

At least one large study suggests that being vaccinated reduces the chance that you will end up with lingering symptoms of COVID-19, sometimes referred to as “Long COVID.”

The Public Health Agency of Canada estimates that fully vaccinated individuals are 79% less likely to be hospitalized with COVID-19 and 62% less likely to die as a result of their illness.

Only 1.54% of deaths were in fully vaccinated people, their data shows.

In the US, of 759,000 COVID deaths, 7,000 were in fully vaccinated individuals  –  0.92%.

“There are a group of people who have either conditions or treatments for their conditions that compromised their immune system and prevent them from being able to even adequately respond to the vaccine to begin with,” Dr Vinh said.

Elderly people have weaker reactions to the vaccine.

“The people I’m concerned about now are the older people,” he said. “We recognize now that antibody levels do decline. And then in older people, there’s a chance that they may not be able to fight infection if they get it.”

According to data from the CDC, 85% of fully vaccinated Americans who died from COVID-19 were aged 65 or older.

I am over 65.

I have been doubly vaccinated for COVID.

If I were to acquire COVID, the chances for severe illness, intubation, ICU admission and death would be very low.

But not zero.

REGEN-COV is available at Sault Michigan’s War Memorial Hospital ER.

Would it be wise then, “out of an abundance of caution”, to cross the bridge and go to Sault Michigan’s War Memorial Hospital ER to get an infusion of monoclonal antibodies???


But there may be an easier, far less expensive alternative  –  Fluvoxamine (Luvox), an antidepressant (an SSRI  –  a Selective Serotonin Re-uptake Inhibitor) given to symptomatic COVID patients, reduces deaths by 90% and the need for ICU treatment by 67% and hospitalization by 32%.

Cost for generic 10 day course  of Fluvoxamine  –  $4.

On 0ct. 27, the prestigious medical journal, the Lancet published the results of the “TOGETHER” trial for acutely symptomatic patients with COVID-19, to assess the efficacy of Fluvoxamine versus placebo in preventing hospitalisation.

This placebo-controlled, randomised trial done among high-risk symptomatic Brazilian adults confirmed positive for SARS-CoV-2 included eligible patients from 11 clinical sites in Brazil with a known risk factor for progression to severe disease.

The study was spearheaded by principal investigator Ed Mills and other researchers associated with McMaster University in Ontario.

The team included world-renowned clinical trial experts from McMaster, including Dr. Gordon Guyatt, credited with coining the term “evidence-based medicine.”

It was part of their larger Together trial that tested a number of potential drug treatments against COVID.

The researchers looked at the rate of hospitalization among patients with test-confirmed infection.

Patients were randomly assigned (1:1) to either Fluvoxamine (100 mg twice daily for 10 days) or placebo (or other treatment groups).

The trial team, site staff, and patients were masked to treatment allocation.

The study team screened 9,803 potential participants for this trial and selected 3,323 participants.

The trial was initiated on June 2, 2020 and ran to Aug 5, 2021, when the trial arms were stopped because of the superiority of the Fluvoxamine arm.

741 patients were allocated to fluvoxamine and 756 to placebo.

1,826 patients were assigned to groups who received other drugs  –  e.g. 739 received Ivermectin, 239 Hydroxychloroquine, 215 Metformin.
The other studied drugs, including Metformin, Vitamin D, Zinc, and much-debated candidates such as Hydroxychloroquine and IVERMECTIN, showed NO DETECTABLE BENEFIT.

But the study found that 77 of the 739 subjects who were randomly selected to receive fluvoxamine ended up spending more than six hours in an emergency department or being admitted to hospital, compared to 108 of the 733 who were administered a placebo, a 32%  reduction among those receiving Fluvoxamine compared to those who did not.

Studies on Fluvoxamine were precipitated by the observation in 2020 that psychiatric patients on SSRIs in France were not getting sick with Covid-19 at the same rate or with the same severity.

A large observational study from France involved 7,230 hospitalised COVID-19 patients, and reported a reduction in intubation or death with use of SSRIs.

Studies have shown that Fluvoxamine, a Selective Serotonin Re-uptake Inhibitor (SSRI) with high affinity for the σ-1 receptor, S1R,  reduces damaging aspects of the inflammatory response during sepsis through the S1R-IRE1 pathway, and prevents cytokine storm.

Fluvoxamine was then tested by Drs. Eric Lenze and Angela Reiersen at George Washington University in St. Louis in a double-blind randomized clinical trial published in the Journal of the American Medical Association on Nov. 12, 2020

152 trial participants, diagnosed with mild COVID-19 were randomized to receive either Fluvoxamine or placebo.

Of the 80 participants who received Fluvoxamine, NONE hit the endpoint of clinical deterioration, which was defined as oxygen saturation of 92% or lower, along with difficulty breathing or hospitalization for pneumonia.

By comparison, 6 of 72 patients, or 8.3%, who took placebo tablets worsened and needed hospitalization, researchers reported in November in the Journal of the American Medical Association.

Big Pharma has come out with 2 new highly-touted  –  and expensive  –  antiviral drugs for COVID.

Merck has priced Molnupiravir (Lagevrio) at US$700 for a 5 day course.

Taken orally within 3 days of symptoms starting.

50% effective in preventing hospitalisation and death.
Pfizer’s Paxlovid, another antiviral, taken orally, was given to patients at high risk.

Paxlovid is a combination of two different drugs – the HIV drug Ritonavir and an experimental protease inhibitor.

A five day course, given within three days of symptoms starting, reduced hospitalisation by 89% and there were no deaths in the Paxlovid treatment arm.

There were 10 deaths in the untreated arm of 385 persons.

Pfizer has not yet announced pricing but they have said it will be “affordable”.


Fluvoxamine might be considered by doctors for off-label use to treat COVID-19 patients early in their disease.

Even if vaccines or other therapeutics are used as a first line of defence, Fluvoxamine may dramatically decrease the odds that someone will need to be hospitalized.

Fluvoxamine is inexpensive, it’s safe, widely available, it’s generic and it’s oral, easy to use.

Doctors can prescribe drugs approved as a treatment for one condition to treat another condition off-label, using their clinical judgment.

“Off-label” use means that a drug is being used in a way that has not been reviewed and authorized by Health Canada.

“It’s USD$2,100 for a dose for a monoclonal antibody,” Ed Mills said.

“Fluvoxamine costs $4.”

The supply chain, too, is simpler.

Fluvoxamine doesn’t need to be kept in a freezer, doesn’t expire quickly, and can be mass-manufactured cheaply.

It’s been around for decades (developed in 1983, in Canada since 1994) so its safety profile is well-known.

If it continues to show health benefits for Covid-19 patients, making it widely available in poor countries could help them weather the delta variant currently surging.

So in that sense it could be a world-wide drug.

But Fluvoxamine is generic and dirt cheap, so Big Pharma has no motivation to push it.

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Kingston MOH says COVID-19 vaccines keeping region from locking down –



As COVID-19 cases continue to rise in the region, KFL&A Public Health’s medical officer of health joined Tuesday night’s city council meeting to give an update to the region.

At this point, he says lockdown measures are not on the horizon for the area.

“Our two main goals of pandemic response in the KFL&A region is to keep schools and workplaces open and maintain health-care capacity,” Dr. Piotr Oglaza told council.

Read more:

Kingston hospitals forced to transfer patients due to high levels of COVID-19

But, with the Kingston region reaching record-high COVID-19 rates, and the news of Kingston hospitals having to offload some patients due to high COVID-19 hospitalizations, many members of the community are wondering if further restrictions to curb the spread of the virus will follow.

Oglaza has long maintained that lockdown measures that worked before just won’t pass muster in the fourth wave. He says the major difference this time around is the region’s high vaccination rate. As of Tuesday, more than 82 per cent of the five and up population have two doses.

“Some of these broad measures that were saving us in the previous waves are not applicable to a situation where vast majority of the population are immunized and are also not going to address the patterns of spread that we see,” he said.

Oglaza maintains that the driving factor for the spread of the virus is household gatherings, which now account for more than half of local transmission of COVID-19.

Click to play video: 'Community reacts as COVID-19 cases rise in the Kingston region'

Community reacts as COVID-19 cases rise in the Kingston region

Community reacts as COVID-19 cases rise in the Kingston region – Dec 1, 2021

And while there are vaccinated individuals contracting the virus, Oglaza says, for the most part, those testing positive for COVID-19 are unvaccinated.

What’s keeping the region from lockdown measures is science, Oglaza said, which has proven that vaccines work in protecting people from serious illness. He said those who are fully vaccinated are at far less risk of getting sick and transmitting the virus to others.

We have not seen a significant burden of infection and transmission coming from places where proof of vaccination is in effect,” he said.

But, despite recent moves from the health unit to limit private gatherings to 10 people and add extra screening at schools, the region is seeing unprecedented numbers.

KFL&A is currently third in the province in active cases per 100,000, behind only the Algoma and Sudbury health unit regions.

Councillors Ryan Boehme and Wayne Hill pressed the doctor on restrictions, asking if more should be done, but Oglaza maintained that widespread community lockdowns will do more harm than good.

“Are there other restrictions coming or are we basically talking about cancelling Christmas this year,” Boehme asked.

Oglaza said implementing a total lockdown like seen before, is not an option.

“Probably one of the most successful ways of of of stopping the chain of transmission is something that I don’t believe that anyone in this community is is is willing to accept. And we’ve seen that before. We’ve seen a stay at home order,” he said.

He said these orders adversely impact the most vulnerable populations in the region, and that many people with good jobs able to do remote work will still be able to work under stay-at-home orders.

“Others who rely on that in-person work cannot be working from home and they’re not going to be able to to really do well under these circumstances. They are disproportionately bearing the consequences of some of these very harsh measures,” he said.

He said any further restrictions would be tailored to target symptomatic people attending gatherings.

Click to play video: 'COVID-19: Ontario’s top doctor calls modelling projections, ICU admissions ‘disconcerting’'

COVID-19: Ontario’s top doctor calls modelling projections, ICU admissions ‘disconcerting’

COVID-19: Ontario’s top doctor calls modelling projections, ICU admissions ‘disconcerting’

“In the vast majority of all of these circumstances, there is a symptomatic person present in that social setting, that gathering, whether it’s an outbreak setting, workplace, school or household, the spread comes from an infected individual being present,” he said.

He said more information on masking and screening protocols will come in the next couple of days. But for now, the medical officer of health told those who are vaccinated to have faith in the protection associated with the vaccine, and urged those who are not to get their shots.

“Vaccines do work. They do show effectiveness and they do change the situation in this fourth wave compared to everything we’ve experienced so far,” he said.

“It is because of the vaccines that we can keep the workplaces and schools open.

Oglaza will be holding a press conference at 1:30 p.m. Wednesday to answer further questions.

© 2021 Global News, a division of Corus Entertainment Inc.

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Young adults with prior self-harm and eating disorders report mental health issues during the pandemic – News-Medical.Net



Young adults with previous self-harm or eating disorders reported higher levels of depression and anxiety during the pandemic, even when restrictions had eased, according to new research.

The study, led by the University of Bristol and funded by Elizabeth Blackwell Institute, Medical Research Council and Medical Research Foundation, has been published in the Journal of Eating Disorders. It looked at questionnaire information for 2,657 individuals from world-renowned health study Children of the 90s (also known as the Avon Longitudinal Study of Parents and Children) before and during the COVID-19 pandemic.

Researchers analyzed the relationship between previous reports of eating disorder symptoms and self-harm before the pandemic, and mental health problems (symptoms of depression and anxiety) and mental wellbeing during the COVID-19 pandemic. The study also assessed whether lifestyle changes, such as more sleep, relaxation techniques, or visiting green space, could be linked to mental health and wellbeing in young adults with and without previous eating disorder symptoms or self-harm.

Researchers studied questionnaire data from 2017, when the participants were then aged 25 years, as well as data taken during the pandemic in 2020.

At age 25, 32% of the 2,657 young adults reported at least one eating disorder symptom, 9% reported self-harm, and 5.5% reported both an eating disorder symptom and self-harm in the last year.

During the pandemic, those with previously reported eating disorder symptoms and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing, compared to individuals without previous symptoms. This remained the case after adjusting for their pre-pandemic levels of depression, anxiety and mental wellbeing.

Lifestyle changes appeared to have little effect on the increased risk for mental health problems in those with prior eating disorder symptoms or self-harm.

Eating disorders and self-harm are common and troubling mental health problems among young adults. In the UK, approximately 1.25 million people are living with an eating disorder and almost 1 in 15 adults report self-harm.

Our research has highlighted individuals with prior self-harm and eating disorder symptoms are key risk groups and further longitudinal research is needed to understand their ongoing mental health as well as risk and protective factors.

Individuals with previous eating disorder symptoms and self-harm should be considered vulnerable to depression and anxiety throughout the pandemic and beyond. Funding for rapid and responsive service provision is essential to reduce the impact of the pandemic on those with mental health problems.”

Dr Naomi Warne, Lead Author, Senior Research Associate, Centre for Academic Mental Health, University of Bristol

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5 Common Cosmetic Dental Procedures



Nothing makes a first good impression quite like a healthy and friendly smile. Radiating confidence and warmth, a smile can speak volumes about a person without them saying a word.

Unfortunately, not everyone is naturally blessed with a perfectly proportioned and straight set of pearly whites. From overbites to crookedness, discoloration to gaps, there can be a whole host of reasons why you might want to tend to your teeth.

To help you find the right treatment for you this article will highlight some of the most common cosmetic dental procedures that are available.


Orthodontics have come a long way since the days of unsightly metal braces which can add to one feeling self-conscious about their smile.

With a range of discrete alternatives on the market which are cleverly disguised to blend with your teeth, braces need no longer hold the stigma they once used to, nor be exclusively for children only.

Treatments such as ceramic braces, Six Month Smiles or Invisalign clear aligners offer you the option to straighten your teeth whilst wearing less noticeable or invisible braces.

Dental Veneers

Veneers are made from ceramic or porcelain and fit onto the front of the teeth to create a new surface. The finished result is a homogeneous looking smile.

The whole process usually takes a few weeks from consulting to fitting and  involves filing down the tooth enamel to prevent the veneers sticking out too much and to allow them to bond to the tooth effectively.

This procedure is ideal for people who have chipped or broken teeth, discoloration that can’t be resolved by bleaching, or small teeth and if well looked after, veneers can last around a decade.


A common treatment that can now be done at home, tooth bleaching or whitening,is a relatively quick and inexpensive way to achieve a glowing smile.It is ideal for people who already have healthy, aligned teeth that do not require much correction or for people who do not want to invest too much on a dental procedure.

Most dentists, such as Eastport Dental in NE Calgary, offer teeth whitening procedures and it is best to consult with them before trying an over-the-counter bleach yourself.

Dental Contouring

Dental contouring, also known as odontoplasty or enameloplasty, deals with the reshaping of the tooth’s enamel.

The procedure involves the removal of small amounts of enamel to improve misshapen, overly long or chipped teeth to create a more uniform appearance. To undergo this procedure your teeth must be healthy and strong and the enamel must be thick enough to withstand removal.  Although rare, the risk is that too much enamel is removed leaving the tooth prone to decay or breakage.


Dental bonding is a cosmetic procedure that addresses cracked, broken or stained teeth by applying a soft resin which is hardened with a special light, bonding it to the tooth.

Bonding is one of the least expensive and simplest cosmetic dental procedures and can also be used to close gaps as well increase the length of teeth.

Although bonding can last several years, the resin material used in this procedure is not as strong as a healthy tooth and can break or chip from biting or chewing on hard food.

With these five cosmetic dental procedures on the market a celebrity smile need no longer be exclusively for the rich and famous.

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