Should you visit the dentist while pregnant?

montreal dentist pregnan


Being pregnant can be a very exciting, but also stressful time, for many reasons. Physical and hormonal changes, often accompanied by nausea and fatigue, are only some of aforementioned reasons that can make pregnancy a sometimes trying time. Many patients ask if it is safe to visit the dentist while pregnant. The answer is a resounding yes, not only is it safe but it is recommended.

During pregnancy, several problems of the mouth can be more common. These include:


Can result from hormonal changes that exaggerate the response of the gums to bacteria. Many women will report that their gums bleed more during pregnancy, even if they are still brushing and flossing as usual. It can be distressing to see bleeding when there wasn’t any before. Maintain your healthy dental habits and your gums will eventually return to normal.


Dryness of the mouth or increased acidity due to vomiting, as well as changes to the diet such as increased snacking, can all lead to increases in the rate of dental cavities. Many people have heard the tale of how a mother had great teeth until she got pregnant and that her baby took all her calcium. Although the reason isn’t correct (a developing fetus can’t soften a mother’s teeth by removing calcium), the increase in dental problems can occur for the reasons above.

Swelling in the gums:

Also known as pyogenic granuloma, a round growth on the gums that can develop in response to hormonal changes. Its appearance can be concerning to patients, because it may resemble an abscess or tumour. It is however, benign.

Erosion of teeth:

Again, potentially caused by acidity from vomiting.


Because of this, regular checkups and cleanings are recommended as per the patient’s usual schedule. But what about dental work and emergencies? Many pregnant women are reluctant to proceed with x-rays and anesthetic out of a fear it will harm their developing baby. However the American Dental Associations and the American College of Obstetricians and Gynecologists both agree that in appropriate situations they are completely safe. Elective treatments and routine x-rays can be postponed until after delivery. But any emergencies or repair of cavities or broken teeth can and should  be treated. No single x-ray,  if necessary for diagnosing an emergency problem and taken with correct shielding of the body, can cause harm to the developing baby. And our dental anesthetic, lidocaine, is a Category B drug – safe for use during pregnancy. Ideally, the most appropriate time for dental work would be the second trimester but if you are in pain or have a broken tooth, do not delay! The risk of infection and stress of a painful or abscessed tooth is far worse for both mother and baby.

To help make the experience more comfortable, be sure to tell us that you are expecting. Let us know if lying too far back in the dental chair is a problem, or if you require an extra pillow or more frequent breaks. Making our patients comfortable in any situation is always on the top of our minds. Below are a few more links with more information. Have a great pregnancy!



Pregnancy and Dental Work

Sugar-Free Chewing Gum Can Boost Your Oral Health


dentist downtown montreal chewing gum


Chewing gum isn’t only about freshening your breath. While that certainly is one benefit, especially depending on what you’ve had for lunch, did you know chewing sugarless gum can also prevent cavities and improve your oral health?

Chewing Gum Increases Saliva Flow and Prevents Cavities

According to the American Dental Association (ADA), studies show that chewing sugar-free gum for 20 minutes after a meal can prevent tooth decay. The act of chewing increases saliva flow in your mouth. The saliva then washes away food and neutralizes acids, cleaning and protecting your teeth from cavity-causing bacteria.

You’ll want to make sure your gum is sugar-free. While gum that contains sugar also increases saliva flow, the sugar actually feeds the bacteria in your mouth, putting you at greater risk of decay. We definitely don’t want that!

Most sugar free gum is sweetened with Xylitol. Unlike artificial sweeteners such as Aspartame, xylitol is a naturally occurring product. And what’s more, xylitol can help decrease the amount of cavity causing bacteria sticking to your teeth.

Chewing Gum Helps Strengthen Tooth Enamel

Saliva contains necessary calcium and phosphate that strengthens tooth enamel. After a meal, reinforcing your enamel can be especially beneficial in fighting off bacteria and decay. Chewing gum can also be extremely beneficial in stimulating saliva flow in people who have dry mouth due to side effect of their medications or other reasons.

Look for Sugarless Gum with the ADA Seal

The ADA seal indicates that the gum has been tested and proven to do at least one or all of these three things: reduce plaque acids and cavities, promote remineralization of tooth enamel, and reduce gingivitis. If you want a sugarless gum you can trust to boost your oral health, look for the ADA seal. Here is a link to their website Mouthhealthy.org that shows all the recommended chewing gum brands.

Don’t Stop Brushing and Flossing

Even though chewing sugar-free gum can aid in keeping your mouth healthy, it should never serve as a substitute for regular brushing and flossing. Your best defence against decay and dental disease is to brush teeth twice a day using a fluoride toothpaste as well as floss once daily!

Five Tips for Maintaining your Toothbrush

Taking care of your toothbrush is an important part of maintaining proper oral health. An old tooth brush won’t be able to do its job if its worn out and broken. At Downtown Montreal Dentistry in Montreal, we encourage patients to practice excellent oral hygiene habits at home to help prevent complex dental issues from developing. Dr Seminara and his team of dental hygienists, Laurie, Kim and Tara, believe in educating patients on healthy practices to help improve the health of their smile. Part of practicing proper oral hygiene is keeping your tooth brush in tip top shape. Our Montreal dentist office have listed a few tips and tricks to help keep your tooth brush in pristine conditions.

Maintaining Your Toothbrush

Tip #1: Carefully rinse out your toothbrush after each time you brush your teeth. Food particles and debris can cling to your toothbrush and become a platform for bacteria.

Tip #2: Try to keep your brush away from your toilet. Every time you flush with the lid open, it can cause certain bacteria to become airborne and cling to your toothbrush. If you can not keep your toothbrush away from your toilet, try to keep it covered.

Tip #3: Replace your toothbrush every 3-4 months. After a few months of use, the bristles can get worn out and your toothbrush will not be able to properly clean your teeth and tongue. You will notice the time to change when the bristles start to look flattened and frayed.

Tip #4: Do your best to keep the bristles dry after use. Keep your tooth brush in a position where it can properly dry after brushing your teeth. An upright positions is best.

Tip #5: Don’t share your toothbrush with anyone, not even your child. Sharing means that you are also sharing germs, food particles, and debris with another person. Get a new tooth brush for each member of the family, or ask us to give you an extra on your next visit!

Bonus Tip #6: For those using an electric brush, don’t let it sit on the charger when not in use. Instead, let it completely discharge before recharging it entirely overnight. This will help prolong the life of the battery.

Healthy Snacks That Are Surprisingly Bad For Your Teeth

Healthy snacks, like popcorn, that are surprisingly bad for your teeth


Eating healthier is a goal many of us have, but there are a number of foods that, while good for our bodies, are surprisingly bad for our teeth. Here are some foods that are surprisingly harmful to your oral health (along with some tips to help minimize damage).

Oranges and Grapefruits

Citrus fruits are supposed to be some of the healthiest fruits out there; they are packed with Vitamin C and make for a great well-rounded snack. On the flip side, they are also  full of acid which results in the harmful demineralization of your enamel. The same applies to lemons and limes (even more so when you add sugar [like with lemonade] into the equation). The key is to minimize direct and long term contact citrus fruits have with your teeth. Eat oranges, grapefruits, and other citruses sparingly, and if you’re a big fan of adding lemon to your beverages, try to use a straw as often as possible.

Almonds (and other hard nuts)

Almonds are packed with vitamin E and healthy fats that are great for your body, but not so much for your teeth. Almonds can be difficult to chew as they break or splinter in your mouth (potentially causing your teeth to crack or fracture). Chew very carefully and don’t exert too much pressure when snacking on whole almonds and hard nuts. If you can, opt for sliced almonds instead (which are considerably kinder to your teeth). Aside from this, many nuts come salted, and excessive salt can have it’s own negative effect on health.

Fruit Juices

Fruit juices are another surprisingly high source of acidity which is harmful to teeth. In addition, juices tend to be made from concentrated fruit and very high in sugar. (many actually have sugar added – as if they weren’t sweet enough!) Drinking juice sparingly or with a straw is a good idea, as is drinking some water right after the juice. The key is to avoid prolonged exposure of your teeth to the sugars and acid. You can brush your teeth after drinking juice, but be sure to wait a half hour first or you might do more damage by rubbing away the acid-effected enamel.

Dried Fruits

Dried fruits can make for a great portable snack, but they are also a perfect breeding ground for cavities. Dried fruit has had all the water removed, so the fruit that remains is full of sugar that will stick in between and to the surface of your teeth. It is a good idea to take sips of water in between snacking and to thoroughly brush and floss at least twenty minutes or so after you’re done.

Peanut Butter

Many of us have been in the uncomfortable situation where the peanut butter has gotten stuck to the roof of your mouth. It’s for this sticky reason that peanut butter is such a danger to your dental health (and increases your chances of developing a cavity). Try to buy peanut butter brands without added sugar if you don’t mind the taste. Otherwise, keep floss or floss sticks with you and take the time to clean your teeth after eating.


Popcorn is considered by many dentists to be the enemy of teeth! The kernel husks can easily get lodged under your gums and cause an uncomfortable situation. A good number of patient come to see us with painful swollen gums, only to surprised when we floss out pieces of popcorn. In addition, there is a big risk of biting into an un-popped kernel and breaking a tooth or filling. The take home lesson is to be careful when eating popcorn!



Effective Flossing—The What, Why, and How


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Have any of our hygienists told you that your gums looks inflamed and you have plaque between your teeth?

Have you ever wondered how you managed to get dental plaque in spite of brushing twice a day? If yes, then you might be missing an essential oral hygiene habit, flossing!
Flossing is one of the most important yet most neglected dental health practices. You may brush your teeth religiously twice a day, but if you’re not flossing then you’re allowing plaque to settle in between your teeth.
Plaque is a sticky bacterial film that covers your teeth every day. When you brush your teeth in the morning, this film is removed. But, your brush cannot reach in between your teeth and that’s where plaque starts building up. It then transforms into stubborn tartar, which can only be cleaned professionally. Tartar buildup can lead to tooth decay, cavities, and gum diseases and if you want to avoid all of that, it’s time you started flossing!


What is Floss?

Dental floss is a thin cord that is used to remove tartar stuck between your teeth. It was first made commercially available in 1882 and was originally made of silk thread. Your typical floss dispenser will contain 10 to 100 meters of dental floss. It comes in different varieties like waxed, unwaxed, mint flavored, and fluoride floss. Waxed floss slides in more easily than the unwaxed ones and mint flavored floss leaves a fresh feeling in your mouth.
You can buy a floss pick that holds the floss for you and you can just use it to clean the gaps between your teeth. On the other hand, you can also buy an oral irrigator that uses a spray of water to remove plaque and food particle from your teeth. But, remember that no matter what kind of flossing device you buy, it will only be helpful if you use it regularly.

Why Should You Floss?

As mentioned earlier, tartar can be really stubborn and will not come off by regular brushing and flossing. Over time, this tartar will give rise to gum problems like gingivitis and periodontitis. Brushing is not enough to remove plaque from tight spaces between your teeth and you have to floss if you don’t want bleeding gums.
Weak and bleeding gums will ultimately result in loss of teeth. And apart from that, gum diseases have also been related to chronic health problems like diabetes, cardiac arrest, and heart diseases. If you want to live a healthy life, it’s time you started giving flossing some serious thought.

How do you Floss?

Pull out around 18 inches of floss from the dispenser and wrap it around the your index fingers. You can look into a mirror to see if your teeth are getting cleaned. If you floss regularly, you don’t have to exert too much pressure to clear debris from your teeth. You can floss before you brush so that the fluoride present in your toothpaste reaches between your teeth too.
You may face some difficulty and awkwardness if you’re flossing for the first time. However, with practice, you will be able to master the technique in no time at all. Visit us for a cleaning appointment and one of our talented hygienists, Laurie, Kim or Tara, can give you a crash course in flossing.

If you want to keep your pearly whites healthy and your gums pink, then you should floss at least once in a day. Make it an everyday ritual and save yourself from a myriad of health problems.

What is Periodontitis?

What is Periodontitis?

Periodontitis, or gum disease, is an infection of the gums that surround your teeth. It is one of the most common causes of tooth loss in adults.  Because the disease can occur without any pain or obvious signs, it is not always easy for a person to tell if they are affected. At each recall visit, we can check for it by examining your gums and bone surrounding your teeth and x-rays.

What causes it?

Plaque and tarter is a cause of gum disease

Gum disease is caused by a buildup of plaque, a sticky form of bacteria that forms on the teeth. If the plaque is not removed by flossing, brushing, and regular dental checkups, it will continue to build up and create toxins that can damage the gums.

Periodontal disease forms just below the gums and creates small pockets that separate the gums from the teeth. It has two stages: gingivitis and periodontitis.

  • Gingivitis — This is the early stage of gum disease, when the gums become red and swollen, and bleed easily. At this stage, the disease is treatable and can usually be eliminated by daily brushing and flossing.
  • Periodontitis — If left untreated, gingivitis will advance into periodontitis. The gums and bone that support the teeth will become seriously and irreversibly damaged. Gums infected with periodontitis can cause teeth to become loose, fall out, or require removal by a dentist.

    Stages of Gum Disease

Certain factors can increase a patient’s risk of developing periodontal disease, including:

  • Smoking or using chewing tobacco
  • Diabetes
  • Certain types of medication such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers, and oral contraceptives
  • Bridges that no longer fit properly
  • Crooked teeth
  • Old fillings
  • Pregnancy

While it is possible to have periodontal disease and not know it, some symptoms can include:

  • Gums that bleed easily
  • Red, swollen, tender gums
  • Gums that have pulled away from the teeth
  • Persistent bad breath or unpleasant taste in the mouth
  • Pus between your teeth and gums
  • Loose or separating permanent teeth
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

Treating Gum Disease

Treatments for gum disease can vary, depending on the severity of each individual case. Typical treatments include:

  • Non-surgical treatments such as scaling and root planing (deep cleaning)
  • Periodontal surgery 
  • Dental implants

Preventing Gum Disease

Regular dental checkups and periodontal examinations are important for maintaining your health and the health of your smile. You don’t have to lose teeth to periodontal disease. By practicing good oral hygiene at home, you can significantly reduce your chances of ever getting gum disease. Remember to brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits to help keep your smile healthy.


How often should you go to the dentist for a teeth cleaning and exam?

How often should you go to the dentist for a teeth cleaning and exam? This is a question that our patients frequently ask. The short answer is that it depends on a patient’s individual needs and risk of oral diseases. The long answer requires a bit of information about why we recommend the exams and why we clean teeth at all.

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A dental examination is first and foremost a screening tool. Diagnosing dental problems such as cavities when they are small can help prevent the need for larger, more costly procedures down the road. And cavities are only one of the potential problems we look out for. Oral cancers, diseases of the mouth, tongue, lips and throat, jaw problem (TMD), misaligned teeth, infections, cracked teeth and gum disease are some of the more common things that are evaluated at each dental exam. The exam also gives patients the opportunity to ask questions about their health and to seek referrals to medical and dental specialists as needed.


Another aspect of the dental exam is the radiographic exam, or x-rays. You can read a great summary of x-rays in dentistry and their safety in our post: http://downtownmontrealdentistry.com/dental-x-rays-really-need/ . Suffice it to say, we take as few x-rays as necessary to ensure that we don’t miss any potential problem without overdoing it.


Teeth cleaning is done regularly to remove any buildup of plaque and tartar on teeth and to lower the amount of bacteria present in your mouth. That smooth clean teeth feeling you get after the hygienist is finished her work isn’t just because she polished your teeth. She in fact removed a layer of bacteria-filled plaque that coats teeth. This layer is what can lead to cavities, gum disease, bad breath and bleeding gums. Removing it early can also help prevent it from hardening into tartar, which can look very unsightly and also lead to periodontal disease (gum disease)


So to answer the question: How often should you go to the dentist for a recall exam and teeth cleaning? We have patients who come in from as often as every 3 months or 4 month, to the most common 6 month intervals. Lower risk patients may be seen every 9 or 12 months.  Although some insurance companies have decided that all their clients have the same needs and will only provide minimal benefits, the fact is that they are more interested in their bottom line than your health. The appropriate frequency of care can and must only be determined by the dentist and the patient together, and must only be based on the specific needs of the individual.



How to Manage a Dental Accident

How to Manage a Dental Accident

A dental accident or trauma involving a front tooth can be a stressful thing to happen to anyone. These types of injuries can take on many forms and are surprisingly common. Some studies suggest that up to 1/3 of adults and children will have an incident in their lifetime. In this article we will discuss some of the more common types of traumas that we see and how to best manage them. It cannot be overstated that in all cases, seeing a dentist for an assessment as soon as possible will increase the success rate of any treatment and help preserve your tooth.

We will discuss tooth fractures, luxations (movements of the tooth out of position but still in the mouth) and avulsions (tooth completely knocked out of the mouth). We can further differentiate into primary teeth and adult teeth.

Primary (baby) teeth

The treatment options for primary teeth that are fractured will depend on the extent of the fracture. Small chips or breaks in the enamel are often just smoothed off, and any discomfort in the tooth usually will go away in a couple of days. Any deeper fractures may require a filling to cover up the sensitive inner part of the tooth, if it is exposed. Sometimes a deep fracture may even require a root canal on the baby tooth, particularly if you notice that the tooth itself is bleeding from the broken part. However, in a lot of cases, it is often a better choice to extract the tooth at that stage. Usually your child won’t miss it, and the adult tooth will eventually take its place.

A luxation is when a tooth has moved out of its original position. It can be pushed deeper into the gums, to the left or right, or even further out of the gums. In most cases, no treatment is required other than monitoring the situation. The tooth may correct itself on its own, but even if it doesn’t it should still fall out when the adult tooth is ready to come in. The exception is when it is pushed deeper into the gums, or intruded, in a manner that puts the adult tooth at risk. In this case, we would extract the luxated tooth.

An avulsion is when a tooth has been completely knocked out of the socket. For primary teeth is it not recommended to try and put it back into place. Of course you must be sure that it is in fact a baby tooth and not an adult one, so be sure to see the dentist quickly after any accident.


A graphic representation of some of the different kinds of effects a trauma can have on a tooth

Permanent teeth

With permanent teeth, the treatments are a bit different and sometimes depend on the age of the patient. Since permanent teeth are not easily replaced, the goal is to try and preserve them as much as possible. In the case of a fractured tooth, that may mean a filling, it may mean a crown, and it may sometimes mean a root canal and post as well. It is up to the dentist to assess the specific situation and then for both of you to come to a decision on the best course of action for you. Sometimes the tooth may not be salvageable, and then extraction and replacement may enter into the discussion.

For a luxated permanent tooth, the ideal treatment is to try and reposition the tooth back into its usual position. This is best done as soon as possible after the accident. Usually a splint wire is then attached to the front teeth to hold the injured one in position for 1 to 2 weeks. After the wire is removed, care must still be taken as the tooth may be tender for a number of days. An exception to this treatment is if the tooth is intruded, pushed into the gums, a significant amount. In these cases it is often required to reposition the tooth surgically or orthodontically.

An avulsion of a permanent tooth requires fast action. The chance of being able to re-implant the tooth decrease substantially after the first hour. Should you be involved in an accident and have a tooth knocked out, try your best to clean off the tooth gently, touching only the crown part of the tooth, not the root. If possible, try and put the tooth back into its place yourself. If that is not possible, you can place it in a cup of milk, or in your mouth, and in either case go to the dentist immediately. There a splint will be made to hold the tooth in place until it heals.

An example of a splint wire holding a tooth in position

An example of a splint wire holding a tooth in position









It is important to realize that with avulsions, even if treatment is carried out quickly and correctly, the long term prognosis of the tooth is guarded. It may discolour, or need a root canal, or be lost eventually and need to be replaced. Unfortunately it is one of the most serious dental injuries and does not always have a predictable outcome.

If you have had a dental accident, please call our office immediately for assistance. After hours, our emergency contact information can be found on our voicemail.

For more information on this topic, you can link to the following resources:




Five Common Questions And Answers About Dental Crowns

Five Common Questions And Answers About Dental Crowns


Since crowns are one of the more common restorations that people need on their teeth, we are regularly asked the question, “Do I really need a crown?” It is a completely fair question that we encourage you to ask. We strongly feel that with any dental or medical treatment, you should be fully aware of the reasons for treatment, different options, and consequences of proceeding with treatment or not. In this article I will answer some of the more common questions about dental crowns that I frequently hear from patients. I also encourage you to send me an email at info@downtownmontrealdentistry.com or call the office if you have any other questions that are not answered here.

1. Why do I need a crown?

There are a variety of situations that may require a tooth to be restored with a dental crown. The following are the most common:
a. Large filling: When a tooth has a cavity or a fracture that involves half the width of the tooth or more, it may need to be covered with a crown. This is because the remaining tooth around the large filling is so weak that it is prone to fracture.
b. Root canal: Root canal treatment leaves the tooth hollowed out and predisposes the remaining tooth to cracking. So, a tooth that has had a root canal should be restored with a crown immediately to prevent it from fracturing. This is especially important when it is a back tooth.
c. Broken cusps: Sometimes a cusp (the pointy part) of a tooth will fracture due to trauma. These are the parts of the tooth that take on a lot of the chewing stress, and typically simple fillings are not strong enough to replace them for the long term.
d. Undesirable appearance of teeth: Teeth that have an unacceptable appearance due to colour, shape, or spaces between teeth can be made to look very natural and beautiful with crowns. This is a different reason than the previous three since it is more based on esthetics than function, but it can still be a very valid reason depending on the situation.

Figure 1. The procedure for a dental crown

Figure 1. The procedure for a dental crown

2. What are my options?

In some cases, while a crown is one option, there can be others. You might opt for a filling instead. Keep in mind, however, that a filling does not prevent you from needing a crown later on. Also, if a substantial portion of your tooth needs filling it may not give you the same kind of protection as crowns do. If the filling is extremely large, it can cause the tooth to break, making it irreparable.

3. What if I wait or do nothing?

A few different scenarios can occur if you choose to not proceed with treatment:
a. Nothing may happen, the tooth could remain as is for many years
b. The tooth could chip or crack and may require a repair.
c. In more rare cases, it may break in a way that would require a root canal
d. The tooth may fracture in a way that renders it not repairable and it would have to be extracted.

4. Is a root canal needed?

Most teeth that have root canals should have crowns, but not all teeth that need crowns require root canals. The need for a root canal depends on whether the tooth is infected or inflamed and painful, or if a very significant portion of the tooth is missing.

How long does the crown last?

The research on dental crowns indicate that most will last an average of 10 to 15 years. However, there are factors that influence this figure. A person who has a high risk of cavities (someone who has to have a couple of fillings each year for example), or grinds their teeth, or has poor oral hygiene habits may find that their crown lasts less than the average. On the other hand, we have some patients who have had the same crowns for 30+ years. The point is that the average lifespan is just that, an average. It should be taken as a guideline, but cannot be considered a guarantee. The mouth can be a very hard environment for the teeth, with chewing pressure and repetitive stresses from the muscles of the jaw. Add to that some of the negative factors listed above and you have the reasons why some crowns fail early. But with a well designed crown and some effort to improve oral care, we can maximize the lifespan of any restoration.

Attention: Technology Update at Dr. Seminara’s office

  • A downtown dentist's tools

I am pleased to announce a technology update that we hope will improve the patient experience at our office. Starting this week we will be using email and text messages to send out automated confirmations and reminders for our patient’s appointments. It is my job to be sure that all of our patient’s contact information is correct, so that they can quickly and easily confirm their appointments with the click of a button. In addition, the emails will come with a feature to automatically add the appointment into your digital calendar, and other useful information for patients. My goal is to provide patients with a more convenient way to maintain contact with us, and via text or email which they can answer any time of day, even after office hours, and it will be reflected in our schedule immediately. This should lead to less instances of “phone tag”, and less having to respond to voice mails. Of course, any patient who prefers to be contacted by telephone will absolutely still be! And we can always be reached by phone at our office number, 5148443112.

We have more plans for our technology updates in the future, and are constantly working to improve what we do and how we communicate with our patients. Eventually we would like to have the ability for patients to book their own appointments directly into our schedule online. We are also looking at methods of asking for feedback from our patients, so we can tailor any changes we make to what you find most important. Ultimately our goal is to make the administrative side of the patient experience as simple as possible. So please, whether by phone or by email, or whenever you are in the office, let me know how we are doing. Your input and suggestions are very appreciated!!!


Thanks, and looking forward to hearing from you,
Secretary to Dr. Seminara

Elizabeth, secretary to Dr. Seminara, is in charge of office administration and patient communication

Elizabeth, secretary to Dr. Seminara, is in charge of office administration and patient communication