The most important thing you can do for good oral health is brush and floss your teeth daily. But we’re not born knowing how to do either — they’re skills we must learn and practice to be effective in removing disease-causing bacterial plaque.
It helps then to have a good understanding about technique, implements or problem situations you may run into. So then, here are answers to 4 typical hygiene questions that can help you improve your brushing and flossing.
How often should I brush and floss? You should brush and floss at least once a day to prevent a buildup of plaque, the cause for both tooth decay and periodontal (gum) disease; if you have some form of dental disease, we may advise a different frequency. Be sure to use a gentle technique — it doesn’t take much pressure to remove plaque and being too aggressive can harm your gums and tooth enamel.
When should I change my toothbrush? If you use it correctly (gentle vs. aggressive), your toothbrush should last several months. When you begin to notice the bristles becoming worn or splayed, it’s time to get a new, soft bristle brush.
What kind of toothpaste should I use? You may have a preference among the dozens available when it comes to flavor and texture. But from a hygiene standpoint you should choose one that contains fluoride to strengthen enamel and an anti-tartar agent to inhibit the formation of hardened plaque deposits (calculus). While we’re on the subject, don’t rinse out the toothpaste right after brushing — you may be washing away fluoride too early, which takes time to work in contact with tooth enamel. Just spit it out.
What if my teeth are sensitive when I brush? If you encounter problems when you brush, visit us to find out the cause. The most common cause for sensitivity is gum recession, usually due to gum disease, which has exposed the roots. This can cause discomfort when you encounter hot or cold foods, or pressure on the teeth when you brush. You should then receive treatment for the underlying condition; we may also recommend toothpaste that reduces tooth sensitivity. And, of course, be gentle when you brush.
If you would like more information on brushing, flossing and other aspects of oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”
One of the top concerns in public health today is exposure to the metallic element mercury within the environment. At abnormal levels, mercury can have a toxic effect on our nervous systems and cause other health problems.
These concerns over mercury have also increased attention on one material in dentistry that has included the metal in its makeup for over a century — dental amalgam for filling teeth. Amalgam is a metal alloy that can include, in addition to mercury, silver, tin, and copper. When first mixed dental amalgam is a moldable material used for fillings in prepared teeth. It then hardens into a durable restoration that can withstand biting forces.
While the use of amalgam has declined with the introduction of life-like colored fillings, it's still used for teeth like molars subject to high biting forces. With what we now know about the ill effects of mercury (which can make up to half of an amalgam mixture) is it safe to continue its use?
The American Dental Association has performed extensive research into amalgam safety. They've found that mercury is stabilized by the other metals in the amalgam. This prevents "free" molecules of mercury, the real source of harm to health, from escaping into the blood stream in the form of vapor. Although trace amounts of mercury vapor from the amalgam are released as a person chews, those levels are well below the threshold that could cause harm.
From a patient standpoint, the biggest drawback to dental amalgam isn't safety — it's the appearance of teeth it's used on. Silver fillings aren't considered attractive. And now there are viable filling alternatives that not only look like natural teeth but can withstand biting forces almost as well as amalgam. These materials include composite resins, mixtures of glass or quartz within resin, or glass and resin ionomers. Each of these has advantages and disadvantages depending on how and where they're applied.
After a thorough dental examination, we'll be able to advise you on what filling material will work best to produce the best result. And if we do suggest dental amalgam you can rest assured it will be a safe choice.
If you would like more information on the safety of dental amalgam, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Silver Fillings — Safe or Unsafe?”
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
’Tis the season for holiday joy with sweet treats at every turn. Don’t let it be the season for dental woes as well. You've heard that sugar causes cavities. That’s because bacteria in your mouth feed on sugar and release acid as a by-product. The acid eats away at tooth enamel, resulting in tooth decay if not checked. To protect your smile during the December onslaught of cookies, candies and other goodies, follow these tips:
Seek balance. Foods that stick to your teeth like candy canes, chewy candies or potato chips provide more opportunity for cavities to develop. To help keep your smile sparkling for the New Year, mix it up with healthy options. Chances are you will come across tooth-healthy offerings like raw vegetables, a cheese plate or mixed nuts. Vegetables scrub your teeth while you chew and stimulate the production of saliva, which helps neutralize acid and rebuild tooth enamel. Cheese also neutralizes acid in the mouth and has minerals that strengthen teeth, while nuts stimulate saliva production and provide vitamins and minerals that keep teeth strong and healthy.
Consider your timing. There’s a higher risk of developing tooth decay when sweets are consumed as standalone snacks, so when you do eat sugary treats, try to have them at mealtime. Repeated snacking between meals exposes teeth to food particles throughout the day, and the acids produced can continue to act on your teeth for 20 minutes after a treat is consumed. During meals, however, other foods present help balance out the sugar and stimulate saliva production, which helps neutralize acid and wash away food particles, sugar and acid from your teeth.
Watch what you drink. Sipping sweet drinks over time can have ill effects on your teeth because of prolonged contact with sugar. If you consume sugary beverages, try to do so in moderation and preferably along with a meal. Sipping your drink through a straw can help keep the beverage away from direct contact with your teeth. Consider opting for water—there are plenty of other opportunities for extra sugar and calories! Besides, water washes away food bits and dilutes acidity. After eating the sweet stuff, it’s a good idea to drink water or at the very least swish a little water around in your mouth.
Keep up good oral hygiene. With all the holiday busyness—shopping, gatherings with friends and family, school functions—you may find yourself exhausted at the end of the day. Still, this is an especially important time to keep up your oral hygiene routine. Brushing your teeth with fluoride toothpaste morning and night and flossing every day are key to keeping your teeth for the long haul.
Finally, if you are due for a dental checkup or cleaning, give us a call to make sure you start the New Year with a healthy smile. If you have a flexible spending account that will expire with the calendar year, make it a priority to fit in an end-of-year dental appointment. Please contact us or schedule an appointment for a consultation if you would like more information about keeping in the best oral health. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”
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