You've been brushing your teeth since you were big enough to look over the bathroom sink: now you brush and floss every day. You do it because you know it's important — but do you know why?
It's because your teeth and gums have enemies: oral bacteria in particular, the major cause for tooth decay and periodontal (gum) disease. The vehicle for these infections is a thin-film of food particles on tooth surfaces called plaque.
Daily brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth. If you don't brush or floss every day — or you aren't effective enough — then plaque becomes a haven for bacteria which then produce high levels of acid that soften and erode enamel. Bacterial plaque can also trigger gum disease: gingivitis (inflamed gum tissues) can begin in just a few days of not brushing and flossing.
You could avoid these diseases and their high treatment costs with an effective, daily hygiene regimen. There are things you can start doing right now to improve your efforts: be sure to hold your toothbrush (soft, multi-tufted is best for most people) at a 45-degree angle to the gum line and gently scrub or wiggle the bristles across the teeth; cover all tooth surfaces on both sides of the teeth — about two minutes of brushing. Be sure to use a fluoride toothpaste to boost enamel strength and don't apply too much pressure when you brush to avoid damaging your gums.
With flossing it's best to hold a small amount of string between fingers from each hand and work it gently between the gaps of each tooth. You then wrap the floss around each tooth in the form of a “C” and gently move up and down three or four times.
You can check to see if you're performing these tasks adequately by running your tongue across your teeth — they should feel smooth and a little squeaky. The real test, though, is during your next checkup. Hopefully we'll find the hygiene habits you've been practicing your whole life are helping you keep your teeth healthy and disease-free.
Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!
Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.
Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.
Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.
It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
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.”
Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.
The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.
Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.
Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.
All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.
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