Do Not Forget About Your Tongue

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Amanda Orvis, RDH

Do Not Forget About Your Tongue

There are a significant number of bacteria in our mouths. These bacteria are found in the build-up surrounding our teeth and coating our tongues. If these bacteria are left untouched they can lead to severe bad breath which is also known as halitosis. In order to keep these bacteria to a minimum we need to maintain healthy brushing and flossing habits as well as scraping or brushing our tongues daily.

Tongue Scraping

Tongue scraping should be done at least once a day and there is a specific way to remove the bacteria. When using a tongue scraper the scraper should be placed on the back of the tongue and gently scraped from the back to the front for approximately 5-10 strokes. Make sure to rinse your tongue scraper between scrapes so you do not push the bacteria back and forth on the tongue. Tongue scraping can trigger the gag reflex, so make sure to scrape gently and take a break between scrapes if needed.

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Tongue scrapers can come in various shapes and sizes and can be found in most drug stores.

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There are other causes of bad breath such as smoking, dry mouth, yeast infections and/ or medication use. Research shows that by maintaining regular tongue scraping habits most people can be effective in eliminating their bad breath even with these other causes.

Tongue Brushing

Tongue brushing can also be effective in reducing bad breath and removing bacteria; however research shows that tongue brushing is less effective than tongue scraping. The reason for this is that tooth brushes are meant to remove bacterial coating and debris from the smooth surfaces of our teeth. Our tongues have many small projections called papilla and can often have deep grooves and/or crevices. When tongue brushing with your regular toothbrush the toothbrush bristles may push the bacteria further into the grooves. So be gentle when brushing and move in the same direction as tongue scraping, rinsing between brush strokes.

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Quick Tips:

  • Start scraping or brushing from the back of your tongue moving forward.
  • Rinse your scraper between scrapes and after you are finished.
  • Scrape for at least 5-10 strokes.
  • Scrape the full top surface of your tongue.
  • If using a toothbrush or tongue brush move in the same direction as your tongue scraper from the back to the front, rinsing between each stroke.
  • Rinse your mouth out after you are done tongue scraping or tongue brushing.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources

http://www.colgate.com/en/us/oc/oral-health/conditions/bad-breath/article/sw-281474979266546

https://en.wikipedia.org/wiki/Tongue_cleaner

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Keeping Your Teeth For a Lifetime

KarenK

Karen Kelley RDH

Keeping Your Teeth For a Lifetime

Our dental practice has more over 50 year olds than under 50.  As aging adults, we need to be aware of certain things that can keep us from retaining our teeth our entire lives.

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Judith Ann Jones, DDS, a spokesman on elder care for the American Dental Association and director of The Center for Clinical Research at the Boston University Goldman School of Dental Medicine spoke about 5 things that are especially important to the over 50 crowd.

Tooth Decay:  Contrary to what many people believe, adults keep getting cavities!  I’m always surprised when people are stunned to learn they have a cavity as an adult.  Areas of the teeth that have never had a cavity can decay, but  areas  where we see more problems are where an old filling is leaking and at the base of an older crown.  The best prevention is brushing well each day along the gumline.  An electric toothbrush is very helpful in accomplishing this as well as the use of fluoride.  An over the counter fluoride rinse nightly is great and in our office we have special prescription strength fluoride that is wonderful for cavity prevention as well as help with sensitivity.
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Dry Mouth:  Keeping Your Teeth For a Lifetime We see so many people with this problem.  “Saliva protects our teeth.  The calcium and phosphate present in saliva prevent demineralization of your teeth”, Jones says.  Many drugs cause dry mouth as well as some diseases and as we get older, we are on more medications thus we see this commonly in older adults.  This is a difficult one to deal with for those affected.  The best thing is to drink lots of water, use saliva substitute and try xylitol products.  Also, if you smoke, stop, it just makes your mouth drier.

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Gum Disease:  If your gums are swollen, red, or bleed easily, you have gum disease.  If left untreated, gum disease (gingivitis) will become more serious and will cause deterioration of the bone that holds the teeth, we call this periodontitis.   If this condition continues without treatment, it can cause the loss of the teeth.  The best way to prevent gum disease is to clean your teeth well each day with brushing, flossing, and use of interdental cleaners like soft picks or go betweens. And of course, seeing your friendly dental hygienist as often as recommended.  We can remove the mineralized bacteria from your teeth that you can’t remove with brushing.

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Tooth Crowding:  “As you age, your teeth shift”, according to Lee W. Graber, D.D.S., M.S, Ph.D., Past President of the American Association of Orthodontists. And “that can be problematic, not because you’ll look different, but because it can make your teeth more difficult to clean, leading to more decay.  It’s also of concern because misaligned teeth can lead to teeth erosion and damage to the supporting tissue and bone”, Graber says.   “Add to that the tendency of older adults to have periodontal disease, and you could end up losing your teeth even faster.”   If your teeth have really shifted, and you find you are having a difficult time keeping your teeth clean and food keeps getting caught in certain areas, ask our doctors about orthodontics.  We offer Invisalign to our patients and we’ve had patients in their later years choose to straighten their teeth.  I just finished with my invisalign treatment.  I had braces when I was a teenager but my teeth had shifted and I was experiencing these problems I just mentioned.  I decided to do Invisalign.  It’s easy to do and my teeth are so much straighter.   They are now in the correct alignment and my teeth and gums will be healthier.   If you choose not to do orthodontics, more frequently exams and cleanings may be necessary.

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Oral Cancer:  According to The Oral Cancer Foundation, more than 43,000 Americans will be diagnosed with oral cancers this year, and more than 8,000 will die from it.  “Oral cancer incidence definitely increases as you get older”, Jones says, and “is very often linked to smoking and heavy alcohol use.”   Jones also said, “Only about half of people who develop oral cancer survive the disease.”   If discovered early, there is an 80 percent chance of surviving for five years.  When we do your periodic exams when you come in for your cleaning, you will be checked for oral cancer.  We also offer Velscope, Identafi, or Oral ID technologies to help in finding oral cancer earlier.

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Keep brushing, flossing and smiling!  We want to help you keep your teeth healthy your entire lives!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.huffingtonpost.com/2014/09/28/common-dental-problems-_n_5844434.html

https://aga.grandparents.com/

Electronic Cigarettes

Sharma RDH

Sharma Mulqueen, RDH

Electronic Cigarettes

E-cigarettes are electronic nicotine-delivery systems (ENDS) that consist of a cartridge containing nicotine and propylene glycol, an atomizer, and a battery (Figure 1). When a user inhales, a pressure-sensitive circuit is activated, which heats the atomizer and vaporizes the liquid as it is brought through the mouthpiece. The vapor consists of a fine mist that does not contain smoke or carbon monoxide and disperses more quickly than traditional cigarette smoke. The act of using ENDS is often called “vaping” and users are termed “vapers.”

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The nicotine cartridges used in ENDS come in a variety of flavors, including vanilla, cherry, java, piña colada, and menthol.  As the demand rises there are some ENDS stores opening with over 1000 flavors.  They are also offered in a myriad of nicotine strengths. When e-cigarettes are inhaled, light-emitting diodes are illuminated. Originally, these lights were red, but now they are often blue or another color to differentiate them from traditional cigarettes.

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There is a lot of stir about the introduction of e-cigarettes and unknown health issues that they may cause. For the mouth, e-cigarettes seem to have some positives and negatives. It is a better option than regular tobacco cigarettes, but worse than not smoking altogether. Here are a few of the effects of e-cigarettes on the mouth.

Unfortunately, research on e-cigarettes is still very minimal. Because they are a new product, research that can space several decades is still unavailable. However, there are several chemicals and clues that help determine what e-cigarettes can do to the teeth.

Just like any cigarette, the main purpose of an e-cigarette is to inhale nicotine. Studies have shown that nicotine can slow down the production of saliva in the mouth. The more nicotine you intake, the less saliva the body is able to produce. Saliva is a main deterrent to harmful bacteria and food particles in the mouth. Low saliva levels can cause quicker tooth decay, sore gums, and eventually a loosening of the teeth. One positive of smoking e-cigarettes verses normal cigarettes is that you can control the amount of nicotine the e-cigarette will release into the body. This will slow down the eventual effect of lowered saliva levels, at least.

Another effect of nicotine in an e-cigarette or a tobacco cigarette is it acts as a vasoconstrictor, which prohibits blood flow to the mouth. This results in a fewer number of white blood cells capable of fending off infections and bacteria that harm your gums. Fewer red blood cells are also sent to your mouth tissues, which lead to faster deterioration of the tissue and your teeth.

Another concern for e-cigarettes is that they contain diethylene glycol, a highly toxic substance. However, at the current point in research, scientists have not determined how much of the substance is needed to be considered harmful to the body, especially seeing e-cigarettes use a very low amount.

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Dental hygienists should continue to support tobacco cessation through evidence-based methods, such as counseling and medications. The American Dental Hygienists’ Association’s (ADHA) “Ask, Advise, Refer” program is a national tobacco intervention initiative designed to promote cessation by dental hygienists. Available at askadviserefer.org, this program follows the most successful steps to aid patients in quitting smoking, including: an in-depth presentation on the effects of tobacco and nicotine; step-by-step guide on questioning smokers; tips on advising them of why quitting is recommended; specific referrals to local quit lines; and options for Web-based cessation programs. Also, a variety of in-office handouts and reference sheets is available for immediate download or by request from the ADHA website for clinicians.

The “Ask, Advise, Refer” program recommends offering some type of smoking cessation medication in addition to a behavioral program. One option is a traditional nicotine replacement therapy, or pharmacotherapy. FDA-approved traditional nicotine replacement therapy products include gum, lozenges, transdermal patches, nasal sprays, and oral inhalers. There are several success stories of individuals sucking on hard candy day after day.  Unfortunately this may cause cavities, but if this can stop someone from using tobacco products then it is a success.  Bupropion SR and varenicline are medications used to aid in cessation.

E-cigarettes have not been evaluated by the United States Food and Drug Administration (FDA), and the levels of nicotine or other chemicals they contain are unknown. The FDA is concerned that e-cigarettes are sold to young people and do not contain “health warnings comparable to FDAapproved nicotine replacement products or conventional cigarettes.” The administration is developing a strategy to regulate this emerging class of products.

Conclusion

In response to the decreasing number of adult cigarette smokers, the tobacco industry is trying to attract young people with “healthier” tobacco products in hopes of expanding the market. None of these products is free of carcinogens, and most still contain enough nicotine to pose an addiction risk. All of them increase users’ risk of oral cancer.

The challenge for dental professionals is to identify users of these products as they may lack the typical signs of tobacco use, such as tobacco stains and odor, and the appearance of tissue changes in unusual areas, such as under the upper lip. Clinicians can play a critical role in educating patients about the nicotine content and potential harmful effects of these new tobacco products. Not only can dental professionals provide cessation support or referral for counseling, but they can also help prevent nicotine addiction in the first place.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

Polosa R, Caponnetto P, Morjaria JB, Papale G, Campagna D, Russo C. Effect of an electronic nicotine delivery device (e-cigarette) on smoking reduction and cessation: a prospective 6-moth pilot study. BMC Public Health. 2013;

American Lung Association Smoking Cessation: The Economic Benefits. Available at: lung.org/stop-smoking/tobacco-control-advocacy/reports-resources/cessation-economic-benefits/states/united-states.html. Accessed April 21, 2014

US Food and Drug Administration. FDA and Public Health Experts Warn About Electronic Cigarettes. Available at: www.fda.gov/NewsEvents/ Newsroom/PressAnnouncements/ucm173222.htm. Accessed September 1, 2013

Centers for Disease Control and Prevention. 2013 Smoking and Tobacco Use. Available at: www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm. Accessed September 1, 2013

http://www.askadviserefer.org/

Dry Socket: The Absolute Worst

AriannaM

Arianna Ritchey, RDH

DRY SOCKET: The Absolute Worst.

Last July we featured an awesome article by Becky that was all about wisdom teeth.  If you haven’t read it yet, here’s the link!  Becky touched on one of the complications following a wisdom tooth extraction, called a “dry socket.”  The technical term for a dry socket is Alveolar Osteitis, which directly translated means ‘inflammation of alveolar bone (of the jaw).’  

A dry socket is a complication which occurs after about 25% of wisdom tooth extractions, and is more common in the lower jaw than the upper jaw.  The incidence of a dry socket resulting from the extraction of any other teeth is considerably lower; only two to three percent.  The symptoms of dry socket include a bad taste in the mouth, a dry-looking socket with white-ish bone at the bottom instead of a dark red blood clot, and pain that progressively becomes more severe and can sometimes radiate to other parts of the head and neck.  Symptoms typically occur about two to three days after the extraction and are often uncontrollable with over-the-counter pain medication. If you have ever experienced a dry socket, then you already know that the pain is excrutiating.  So, what exactly is a dry socket?  Why does it happen, how can it be prevented, and most importantly, how can it be treated?

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When a tooth is pulled, what’s left behind is an empty socket site in the bone where the roots of the tooth used to be.  Following the extraction, a blot clot forms in the socket site and protects the underlying bone and nerves from exposure to the mouth.  Over time, the socket site heals and is filled in with new bone.  If this blood clot is lost prematurely, however, the underlying bone and nerves are exposed to the environment of the mouth, which is crawling with bacteria.  This exposure can lead to infection and the dreaded dry socket.  Dry socket is more prevalent in the lower jaw than the upper jaw, because the lower jaw has a poorer blood supply than the upper jaw, and food debris is more likely to become trapped in socket sites due to gravity.  

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Following an extraction, dental professionals provide post-operative instructions in the interest of preventing a dry socket.  They will advise to avoid any foods with small seeds or nuts which could get trapped in the socket site, avoid strenuous activity following surgery to prevent additional bleeding, and to avoid vigorous rinsing that could potentially dislodge the blood clot.  Instruction will be given to avoid spitting or drinking through a straw for at least two or three days.  Spitting and using a straw creates negative pressure in the mouth which could dislodge a clot.  Your dental professional will likely also tell you to avoid the use of tobacco at all costs, especially cigarette smoking.  Smoking also creates negative pressure in the mouth which could dislodge a clot, and the nicotine in the cigarette slows healing and constricts blood flow necessary for proper healing.

Besides providing helpful instructions for how a dry socket can be prevented at home, your dental health professional can also help to prevent dry socket from occurring by placing a small suture in the extraction site if necessary, and by rinsing with an antimicrobial chlorhexidine rinse immediately after the extraction.  Rinsing with chlorhexidine solution after extractions has been shown to prevent about 40% of potential dry sockets.  

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Despite dry socket being very painful, the treatment is fairly simple.  If you think you may be experiencing dry socket, call your dental provider right away.  Once they determine a dry socket is present, your dental professional will clean the socket site and apply a medicated dressing.  Your dental professional may administer a local anesthetic to the area to provide pain relief and to facilitate cleaning and medicating the site without causing further discomfort.  The medicated dressing often includes eugenol, an ingredient which is very soothing for dry socket.  Your dentist may provide a prescription for antibiotics or pain medication to assist with recovery from the dry socket.  If a dry socket is left untreated, it may resolve on its own, but the pain is likely to last for about a week.

Dry socket is a very painful complication that should be avoided with every effort.  If preventive efforts are made, and post-op instructions are adhered to, there’s a good chance you won’t experience a dry socket.  If your extraction site does start to hurt after about two or three days and over-the-counter medication isn’t controlling the pain, you may have a dry socket and should see your dentist as soon as possible!  Dry socket is easily treatable by dental professionals.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.webmd.com/oral-health/guide/dry-socket-symptoms-and-treatment

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006968.pub2/abstract;jsessionid=F0834E6C40502280912EBEE765DF99AD.f03t01?userIsAuthenticated=false&deniedAccessCustomisedMessage=

http://askthedentist.com/how-to-heal-a-dry-socket/

https://en.wikipedia.org/wiki/Alveolar_osteitis#cite_ref-Daly_2012_4-6

http://www.hayeshandpiece.com/disposable-12-cc-curved-utility-syringe-compare-to-monoject-50-box/w1/i1005997/

http://abdentalsupply.com/store/images/T/xtlchlorh.jpg

http://www.ua-dent.com/wp-content/uploads/2014/11/Alveogyl.jpg

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