General Dentistry

A general dentistry office, such as the D Dental Office, provides dentistry services in all categories, as opposed to a dental specialist clinic. The general dentist at the D Dental Office, in Dollard-Des-Ormeaux, is Dr Karim El-Samra.

You must first consult a general dentist, who will determine, through a complete examination and a detailed interview, whether you need to be referred to a specialist.

At the D dental office, we offer a wide range of dental services under one roof. We perform a complete examination of the mouth, teeth, gums, surrounding structures, occlusion, and temporomandibular joints (TMJs or jaw joints). Then, we present you with a comprehensive treatment plan that will establish optimal long-term oral health.

This plan can consist of three phases:

Phase one :
Establish healthy teeth and gums

If the dentist finds problems like cavities, infections and problematic wisdom teeth, we would start with phase one. This phase includes repairing the teeth we can keep, extracting the ones we can’t, and getting the gums healthy. By the way, getting the gums healthy is teamwork, and you are part of the tream. But don’t worry, all you need is five minutes a day.

Phase two :
Orthodontics or tooth alignment.

When the teeth and gums are healthy but we find that the teeth are overlapped or badly positioned, we enter phase two. Orthodontics allows us to move teeth to ensure long-term aesthetics and optimal function. At the D Dental Office, we offer Invisalign orthodontics, an advanced, predictable and precise technology that allows us to align teeth faster and more comfortably than traditional braces (link to Invisalign orthodontics).

Phase three : replacement of missing teeth

Now that the teeth and gums are healthy, the teeth are well aligned and the bite is fixed, we can now replace the missing teeth. Of course, this phase is not necessary if the only teeth missing are wisdom teeth. All other teeth, central and lateral incisors, canines, premolars and molars are important. If teeth are missing, we can replace them, ideally, with implants (see dental implants section). In cases where implants are not possible, bridges or partial dentures may be a good solution. However, from time to time, the general dentist may refer you to a specialist. Specialists in maxillofacial surgery, endodontics (root canal treatments) or periodontics (gum treatments) are essential in certain more complex cases that require their attention.

Some cases will require all three phases, others will require only two, or even one of the phases. Our ultimate goal is to ensure that you are healthy, and seen for periodic check-ups only, with no dental problems for life

Complete dental exam, gum care and cleaning

This first meeting is of paramount importance. It allows us to properly assess your needs and expectations so that we can formulate the best treatment plan. It lasts an hour and a half and begins with a detailed medical and dental questionnaire.

Then, we do an interview with you, taking the time to get to know the reasons for your visit, your specific expectations and any other detail that you think is relevant to communicate to us.

X- ray examination

During this first appointment, a digital panoramic X-ray is often required. It is an extremely useful tool for getting an overview of all your teeth including wisdom teeth and surrounding structures, lower jaw, upper jaw, your sinuses, jaw joints, and a few other structures that are important to evaluate.

Small, more precise x-rays are taken to better assess certain areas of particular interest such as the spaces between the teeth to screen for cavities that do not appear to the naked eye. We also assess root canals, crown condition and existing fillings, the level of bone that supports the teeth, and many other structures of interest.

Finally, in some special cases, we take a 3D scan, to assess wisdom teeth, plan implants or visualize molars for root canal treatment.

Visual examination

Finally, the detailed clinical examination allows us to assess the condition of the teeth, gums, lips and cheeks, floor of the mouth, tongue, soft palate and hard palate.

Examination of TMJs and occlusion

We also perform an examination of TMJ (temporomandibular joints or joints of the jaw) and occlusion (the way the lower teeth close and function with the upper ones in relation to TMJ). See occlusion and TMJ section.

Gum examination

In addition, a gentle examination of the gums allows us to determine if they are healthy enough to perform a cleaning during this appointment. This examination is performed using small cylindrical interdental brushes which easily and effectively clean the spaces between the teeth and replace dental floss.

Daily gum care

In the presence of gingivitis, which is an inflammation of the gums present in 80% of the population, we do not recommend cleaning, since the gums are more fragile and more susceptible to damage. So in this case, we offer an even more important and valuable service, to establish the health of the gums, before doing the cleaning.

This stage of healing has taken a very important place in our practice, since it allows us to establish an essential basis for all the future treatments. It is also essential for your general health and quality of life. It's about taking the time to give you the information, instructions and great new tools you need to easily, quickly and naturally care for your gums at home.

By performing this daily care, the gums heal and the inflammation is gradually eliminated. You will notice a feeling of well-being in the mouth quite quickly after a few daily applications. We can then, after a few weeks, perform the cleaning in complete safety and comfort.

It's important to note that nutrition is also essential for your gum health, and whole plant based nutrition will help reduce inflammation and promote oral and general health in the short, medium, and long term. So avoiding processed foods and animal products and replacing them with whole plant foods is important for both general and oral health.


We recommend taking your child for their first visit as soon as their first tooth appears. The main goal is to introduce him to the experience of visiting the dentist from a very young age to form this good attitude more easily and to avoid the fear and irrational anxiety that it can cause. This helps to establish a good relationship by introducing him to the team through a good initial contact and shows him how easy and fun it is to visit the dental team.

We make sure that your child is treated with enthusiasm and positive energy. We pay great attention to its comfort and well-being, as for all our patients.

Plus, there are good and bad ways to prepare your child for their first visit to us. Here are some things to avoid saying : « Don't worry, it won't hurt. » « Dr Karim is very gentle, it will be fine. »

The more you try to reassure, the more the child will worry. What one should say are things that describe the event with enthusiasm and positivity. For example: "We’re going to the dentist to count your teeth!" And they will give us a surprize at the end! »With a big smile and a positive attitude.

Don't try to prepare them more than that. Children are intelligent and can sense your worry and anxiety. If this visit makes you anxious, try to find someone who is more comfortable at the dentist to accompany them.

RAMQ and Insurance

Please note that we are not registered with RAMQ. We do not use amalgam fillings, an alloy that contains mercury. The RAMQ only reimburses amalgam fillings for primary molar repairs. However, many private dental insurance plans cover children, so if you have any, we recommend that you contact your insurance company to find out if your children are covered.

As for our payment policy, our fees and services are not affected by insurance. So whether you have insurance or not, does not affect our recommendations, and will not affect your treatments.

But in the case that you have insurance, we will take care of sending estimates and making claims for you, but we are a fee-for-service office, therefor, we do not accept insurance payments. So, we ask you for the payment and you receive the refund from your insurance.

Rest assured, all charges are explained in detail, before treatment is performed and we offer payment terms and health loan services, like iFinance, to make your treatment affordable.

RAMQ et assurances

Treatment of dental caries

There are basically two ways to treat tooth decay, in cases where the tooth is repairable; a composite restoration or a ceramic crown. If the decay is not too extensive, a composite restoration (white filling) would be sufficient. Compared to a ceramic crown, a composite restoration is relatively inexpensive, takes little time to fabricate, but is not as durable or strong as a ceramic crown. It is aesthetic and presents an adequate option when the decay is relatively small, therefore, when the tooth is strong enough. It is made of a plastic material with glass particles. The composites we use do not contain BPA (Bisphenol A), a compound hazardous to health, found in certain types of plastics.

Procedure for manufacturing a composite restoration (white filling)

A desensitizing gel is applied to the gum tissue to make local anesthesia comfortable. Local anesthesia is applied to make sure you don't feel anything during the procedure. A rubber dam is placed to properly isolate the tooth, prevent contamination during the procedure, and prevent you from swallowing debris.

Then the decay is removed and the tooth is treated with special products that help to bond the composite. Then, the material is carefully inserted, layer by layer, to rebuild the tooth and restore its original shape and color. Composite restorations provide esthetic, comfortable and predictable long-term results when decay is not extensive.

However, in cases where the decay is more extensive and the tooth structure is too weak and likely to break when chewing, a composite is not strong enough to predictably restore it. In this case, a ceramic restoration is recommended. It can be a full or partial crown, also called an inlay.

At the D Dental Office, our ceramic restorations are fabricated on site using Cerec technology. For more details on this treatment, click here..


Dr. El-Samra and the team at D Dental Office are pleased to offer you advice related to your oral health. It is our mission to help you maintain a healthy smile.