Posts for category: Oral Health
Your family uses fluoride toothpaste and your drinking water is fluoridated too. So with the fluoride your child already takes in, is it really necessary for topical fluoride treatments during their regular dental visits?
The answer is most definitely. Fluoride has a unique ability to strengthen enamel, your teeth’s protective cover against decay and other diseases. It does this by infusing itself in the enamel structure and making it that much more resistant to acid attack and decay.
This infusion occurs in two ways. First, growing teeth obtain it through the bloodstream as they incorporate other minerals that make up the enamel structure. The very small amount of fluoride added to drinking water — as low as one part per million (ppm) — imparts sufficient fluoride to developing teeth. In the absence of fluoridated water, dietary fluoride supplements can achieve the same effect.
The second way is just after the teeth have erupted and are still quite young. In this case, fluoride coming in direct contact with the enamel surface is absorbed, resulting in changes to the enamel’s crystalline structure that will create added strength. This can occur to a limited degree through fluoride toothpaste or other dental products. The concentration of fluoride in these products, though, is relatively low (850-1500 ppm) as mandated by the U.S. Food and Drug Administration for safety.
Professional applications, on the other hand, are much higher — 12,300 to 22,600 ppm depending on their form. They’re applied, of course, under strict clinical guidelines to cleaned tooth surfaces, usually as a gel, foam or varnish. The latter form will often continue leaching fluoride into the enamel for a month or more.
These topical applications can greatly strengthen the teeth of children who don’t have the benefit of fluoridated water or may be at higher risk for dental disease because of socio-economic conditions. But they can still be helpful for children with adequate fluoride exposure and low risk factors for disease. At the very least, fluoride treatments can give your child an added boost of protection as their teeth continue to develop.
If you would like more information on topical fluoride treatments for children, 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 “Topical Fluoride.”
As a regular part of your daily hygiene you may be using a mouthrinse — or “mouthwash” — mainly to keep your mouth feeling fresh and clean. Some mouthrinses, though, do more than give you fresher breath.
While there are countless mouthrinses available, we can place all of them into two broad categories: cosmetic and therapeutic. The first refresh your mouth and breath, usually with a mentholated or minty taste and smell that masks unpleasant odors. How well they work is mainly subjective: if you feel better after using them, they’ve done their job.
Therapeutic rinses have a different role, intended to improve oral health in some way. We can divide these into anti-cariogenic (decay prevention) or anti-bacterial rinses. You can find fluoride-based anti-cariogenic rinses over-the-counter in retail or drug stores, usually containing about .05% sodium fluoride per volume. Numerous studies have shown these rinses highly effective in preventing tooth decay when used with daily brushing and flossing.
Likewise, over-the-counter antibacterial rinses have proven somewhat effective in reducing bacteria that leads to dental disease. Formulated usually with triclosan, sanguinaria extract, zinc or essential oils, they can also help reduce the incidence of gingivitis (inflammation of the gums), but only if used in conjunction with brushing and flossing.
Perhaps, though, the most widely studied and substantiated therapeutic mouthrinse is chlorhexidine, a prescription-only rinse. Chlorhexidine inhibits the formation of bacterial plaque on tooth surfaces, the main trigger for both tooth decay and periodontal (gum) disease. It’s often used as a post-surgery rinse when brushing and flossing may not be possible, but dentists will often prescribe it for patients who have a high propensity for dental disease.
Using a mouthrinse depends on your current oral health and personal preferences. Therapeutically, most people gain some added tooth strength protection from using a fluoride rinse in their daily hygiene. If fresh breath and the way your mouth feels are important to you, you should consider such a rinse that also has a pleasant taste and effect for you. We can further discuss with you whether a different type of rinse, or a prescription-strength formula, might be best for your particular needs.
If you would like more information on mouthrinses, 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 “Mouthrinses.”
Dental implants are known for their durability as well as life-like beauty. Thanks to their unique construction and ability to integrate with bone, they have a very high success rate and can last for decades.
But while they’re less problematic than other restorations, we still can’t “set them and forget them.” While the implants themselves aren’t susceptible to disease, the supporting gums, bone and adjacent teeth are. If you want them to last as long as possible, you’ll need to care for them and the rest of your mouth through daily oral hygiene and semi-annual office cleanings.
With that said, there are a few differences in how we perform hygiene tasks with implants. This is due to the way in which they attach to the jaw, as the titanium post is inserted directly into the bone. Natural teeth, on the other hand, are held in place by the periodontal ligament, a strong connective tissue that lies between the teeth and bone. The ligament holds the teeth firmly in place while also allowing minute tooth movement in response to changes in the mouth.
The ligament also has an ample blood supply that assists with fighting infection that may arise in the tooth and its supporting gums. Without this extra source of defense, infections that arise around an implant can grow quickly into a condition known as peri-implantitis and lead to rapid bone loss that could cause the implant to fail.
That’s why you and your hygienist must be ever vigilant to the buildup of plaque, the bacterial film that gives rise to dental disease, around implants and adjacent teeth. This includes removing plaque buildup from implant surfaces, although your hygienist will use tools (scalers or curettes) made of plastic or resin rather than traditional metal to avoid scratching the implant’s dental material. They’ll likewise use nylon or plastic tips with ultrasonic equipment (which uses high vibration to loosen plaque) and lower power settings with water irrigation devices.
Keeping infection at bay with effective hygiene is the number one maintenance goal with dental implants. Doing your part along with your hygienist will help you get the most of this investment in your smile.
If you would like more information on oral hygiene with dental implants, 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 “Dental Implant Maintenance.”
Although we’ve made great strides over the last century making dental visits more pleasant and comfortable, many people still feel a little apprehension about them at one time or another. For a few, though, this apprehension escalates into high anxiety — so high they may even avoid important dental treatment altogether.
If you have a significant phobia regarding dental visits and treatment, here are some things you can do to reduce your anxiety and feel more comfortable when you undergo treatment.
Let us know about your feelings of anxiety. We’re conditioned by society to regard such fears as irrational or “silly,” and so we tend to hide our negative emotions. Dentists, however, have been trained to work with fearful patients to reduce their anxiety levels. Being honest with us about your fears and nervousness is the first step to developing an anxiety-reducing strategy that will make your visits more pleasant.
Counteract bad experiences with good. For most people the fear they have during dental visits stems from earlier unpleasant experiences at the dentist. The fear can be so ingrained that simply trying to convince yourself or to be told “there’s nothing to be afraid of” will have little to no effect. Instead, build a memory collection of positive and pleasant dental visit experiences that serve to counteract the unpleasant. To do this we might first get you acclimated to routine visits and then gradually transition to more invasive procedures. This may increase the normal time for dental treatment, but the reduction in anxiety is worth the extra time.
Consider sedation therapy. In addition to modifying your experiences, you may also benefit from sedation medications that reduce anxiety, especially in the early stages of treatment. Depending on your medical history and current status, we can prescribe a sedative for you to take an hour or so before your appointment to help you relax. We can also increase the level of anesthesia (from local to intravenous or gas anesthesia, for example) if your anxiety is especially acute.
Taking proactive steps to minimize dental visit anxiety will increase the probability that you’ll obtain needed dental care. Your teeth and gums will be healthier for it.
If you would like more information on coping with dental visit anxiety, 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 “Overcoming Dental Fear & Anxiety.”
We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.
If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”
In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.
This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.
You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)
Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.
If you would like more information on treating chronic bad breath, 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 “Bad Breath: More Than Just Embarrassing.”