Author Archives: Dentistry Done Differently

Oral Piercings

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Lindsay Whitlock RDH

ORAL PIERCINGS THROUGH THE AGES:

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  • Body art or oral piercings originally began as a sign of distinction, religious acts and sacrifice.
  • This culture is traced back to the Mayans who pierced their tongues to demonstrate courage and virility.
  • In purification rituals Eskimos, pierced the lips of infants.
  • As passage into puberty Aleuts pierced the mandibular lips of boys.
  • In Southern India, the tongue was pierced with a skewer to take a vow of silence.
  • In history, oral jewelry such as stones, bones, ivory, and adorned wooden disks are used as tribal influence for those in Ethiopia and Brazil (The Perils).
  • In several third world countries body art is still a practiced custom.
  • Today, body art and oral jewelry have become a huge phenomenon in the western culture as a compulsive tendency to be different.

EFFECTS OF ORAL PIERCINGS:

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  • Infection, Swelling, Pain: The oral cavity is a damp, warm environment, which houses millions of bacteria. An infection can quickly become life threatening; it’s a possibility for the piercing to cause the tongue to swell, potentially blocking one’s airway.
  • Damage To Gums, Teeth, Fillings: A common habit of biting the oral piercing can injure one’s gums, chip or injure teeth or a filling.
  • Nerve Damage: Following a piercing, one may experience a numb tongue, which is caused by temporary or permanent never damage. The injured nerve may affect how one moves their mouth, and sense of taste. Damage to the tongue’s blood vessels can cause serious loss of blood.
  • Hypersensitivity To Metals: Allergic reactions at the piercing location is common.
  • Excessive Drooling: Oral piercing can greatly increase saliva production
  • Dental Appointment Difficulties: Oral piercings/jewelry can interfere with dental care by blocking X-rays.

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WHAT YOU SHOULD DO IF YOU ALREADY HAVE AN ORAL PIERCING?:

  • Contact your dentist or physician immediately if you have any signs of infection—swelling, pain, fever, chills, shaking or a red-streaked appearance around the site of the piercing.
  • Keep the piercing site clean and free of any matter that may collect on the jewelry by using a mouth rinse after every meal.
  • Try to avoid clicking the jewelry against teeth and avoid stress on the piercing. Be gentle and aware of the jewelry’s movement when talking and chewing.
  • Check the tightness of your jewelry periodically (with clean hands). This can help prevent you from swallowing or choking if the jewelry becomes dislodged.
  • When taking part in sports, remove the jewelry and protect your mouth with a mouthguard.
  • See your dentist regularly, and remember to brush twice a day and floss daily.

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Works Cited

American Dental Association. Oral Health Topics: Tongue Piercing and Tongue Splitting. Amended. October 2004. Retrieved 30 April 2013. http://www.ada.org/2750.aspx?currentTab=2 Body piercing Statistics. (2012). Retrieved from http://www.statisticbrain.com/body-piercingstatistics Chimenos-Küstner.E. (2003). Appearance and culture: oral pathology associated with certain “fashions” (tattoos, piercings, etc.). retrieved from  http://www.ncbi.nlm.nih.gov/pubmed/12730654

Ford CA, Bearman PS, Moody J JAMA. Foregone health care among adolescents.1999 Dec 15; 282(23):2227-34. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360944/

Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D.             Inchingolo, Antonio Palladino,Angelo M. Inchingolo, and Gianna Dipalma. Oral            Piercing and Oral Diseases: A Short Time Retrospective Study. Published 2011 October    18. Retrieved 30 April 2013. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204433/

Kelly Soderlund, ADA News staff. Fewer adults visiting the dentist. Updated 13 March 2013.     Retrieved 30 April 2013. http://www.ada.org/news/8366.aspx

Oral Piercings. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360944/

The Perils of Oral Piercing Retrieved from http://www.rdhmag.com/articles/print/volume- 26/issue-3/feature/the-perils-of-oral-piercing.html

Wilkins, E. M. 2011. Clinical Practice of the Dental Hygienist. Philidelphia: Lippincott Williams & Wilkins.

Image Sources:

Spheno Palatine Gangleonerualgia

Kim McCrady

Kim McCrady RDH BA

Spheno Palatine Gangleonerualgia

Spheno Palatine Gangleoneuralgia!  Now that’s a mouthful.  But believe it or not, most everyone has experienced spheno patlatine gangleoneuralgia at one time or another.  In fact, as scary as the condition sounds, its uncomfortable but harmless.

So, what causes spheno palatine gangleoneuralgia?  It is the rapid release of blood back to the brain back from the palate after something very cold has been present in the mouth and contacted the roof of the mouth.  This results in a sharp uncomfortable headache.  Fortunately, the headache does not last long.  Have you figured it out yet?  What is spheno palatine gangleoneuralgia?  If you guessed a good old fashioned brain freeze, you are correct.

The roof of our mouths are made up of a hard area, referred to as the hard palate.  Your hard palate is located toward the front of the mouth and extends to the about the middle of the second molars.  It is hard because there are three bones that fused together as you grew to create the hard palate.  The soft palate is located just behind the hard palate and continues down into the throat area.  It is soft because there are no bones present.  The brain freeze according to recent studies is caused by an intense and sudden increase in blood flow through the brain’s anterior cerebral artery due to dilation of the artery.  When the artery constricted, the brain-freeze pain sensation wears off.

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Of course, allowing your cold treat a moment to warm up before it contacts your palate is a start to preventing brain freeze.  But, if your brain freeze is underway the quicker you can warm your palate the quicker the headache will recede.  Cupping you hand like a mask around your mouth and breathing in and out into your cupped hand helps to warm the palate.  As well has pressing your tongue or thumb on the roof of the mouth can shorten that headache. The goal is to prevent the blood vessels in your palate from constricting and dilating due to extreme changes in temperature.

Next time you are in need of a conversation starter, consider asking your friends if they have ever experienced spheno palatine gangleoneuralgia.

Medical News Today:  http://www.medicalnewstoday.com/articles/244458.php

Discovery Fit and Health: http://www.medicalnewstoday.com/articles/244458.php

Photo: http://robjundt.hubpages.com/hub/Brain-Freeze-Adventures

STOP IT!! These habits can harm your teeth!

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Ann Clark RDH

Enamel is the toughest substance of the body.  But teeth can still be vulnerable when it comes to neglect, abuse or misuse.

1) Chewing on ice, pencils- Harmless? think again.  This habit can chip or crack your tooth.  It can also irritate the inside of the tooth causing toothaches or sensitivity.

ice chewing

2)Sports without mouthguards-Many sports require a mouthguard, a molded piece of plastic protecting your teeth.  Without one you an chip or even knock one out.  Get a custom fit one from your friendly dentist.

3)Bedtime bottles-Giving baby juice, milk or formula at bed can lead to decay.  The remnants bathe the teeth in sugars over night.

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4)Tongue piercing-Biting on a stud can crack a tooth.  Metal rubbing against gums can cause damage that may lead to tooth loss.  The mouth  is a haven for bacteria increasing the risk of infection.  Over time the metal can also wear down the enamel changing its shape.

piercing

5)Drinking coffee-The dark color and acidity can cause yellowing over time.  Fortunately, it’s one of the easiest to treat with a little whitening.

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6)Smoking/tobacco products-These stain the teeth and lead the way to periodontal disease.  Tobacco can also cause cancer of the mouth, lips and tongue.

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7)Drinking wine-The acids in wines eat at the enamel creating rough spots.  A stained tooth is like sandpaper attracting more bacteria.  Red wine contains chromogen and tannins which help the color to stick…rinse with water, alcohol dries out your mouth.

8)Constant snacking- This produces less saliva than when eating a meal, leaving food bits in the teeth longer.  Snacks should be low in sugar/starch…try carrots.

9)Binge eating-Binging and purging(Bulemia) can do damage from acids found in vomit that erode enamel, leaving them brittle and weak.  Acids also cause bad breath.

10)Whitening too often- Chronic whitening or not following directions acn lead to gum irritation and increased sensitivity.

11) Bottled water- Most have little to no Fluoride as do home filtration units.  Fluoride remineralizes and strengthens tooth structure.

12)Grinding/Clenching-Bruxism wears the tooth down over a period of time.  If worn to the  inner dentin your teeth become sensitive.  Stress, boredom, and sleeping habits make it hard to control. Worn down teeth make you look older and cause pressure to fracture the teeth.

13)Medications-Oral contraceptives can change your hormones and lead to periodontal disease.  Cough drops are high in sugar content leading to decay.  Antihistamines asue dry mouth as do many meds.  We need our saliva to protect our teeth!

14)Drug Abuse(Meth)- Crystal Meth, an illegal and addictive drug can destroy your teeth.  Users crave sugary drinks and foods, clench and have dry mouth.  They notoriously lack in taking care of themselves.

15)Gummy candy-Sticky foods keep sugars and resulting acids in contact with your enamel for hours.  Eat them with a meal as more saliva is produced helping to rinse your mouth.

gummy bear

16)Sodas/Sports drinks/Fruit juice-Sodas have 11teas. of sugar per serving.  They also contain phosphorus and citric acids which eat at enamel.  Diet skips the sugar but adds more acid (artificial sweetners).  Don’t sip these beverages keeping the teeth bathed, chug them and rinse with water

17)Potato chips-Bacteria in plaque will break down starchy foods into acid.  This acid can attack teeth for 20+ minutes if stuck between the teeth…floss!

18)Using your teeth as a tool-It’s convenient to open a bottle or package this way but it canlad to a chip or crack and nail biting is full of germs and bacterias, don’t chew on them.

tooth tool

19) Brushing too much, too hard or with a hard bristle brush-This can erode enamel. Toothpaste can be abrasive, technique is important so as not to take away enamel.  Skipping check ups and not flossing will, of course, cause problems as well.

Being informed is your best defense!

Ann Clark RDH

 
Photo cited:
 
Cigarette  www.webmd.com
Baby bottle www.webmd.com
Gummy Bear www.markmatters.com
Tooth Tool www.webmd.com
Ice Chewing. www.personal.psu.edu

Tooth Brushes!!

Karen

Karen Kelly RDH

As a dental hygienist, one of my most frequently asked questions is, ‘There are so many toothbrushes, which one should I use or should I just switch to an electric toothbrush?’.  My response is, first, always use a SOFT name brand toothbrush (I know stores sell medium and even hard toothbrushes but don’t buy them!!) and second to make sure you are brushing correctly at least 2 times daily and brushing for at least 2 minutes.  When I say correctly, I mean to aim the toothbrush up into the gums at a 45 degree angle.

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 Properly angled brushing

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Unhealthy vs. healthy gum tissue

I see lots of people who do brush their teeth, but since they don’t actually brush along the gumline, their gums are red and puffy.  So, brush the gums like you are giving them a massage; use little back and forth or circular motions.  Don’t use long scrubbing strokes, it is abrasive!  Then floss and/or use an interdental cleaner of some kind each and every day.  No matter how good a toothbrush is and how good someone brushes, it’s impossible to get in between the teeth clean with just a brush.  Also, change your brush often!  When the bristles begin to flare out or it’s been 3 months, change it, it makes a difference to use a new brush.

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                        If your brush looks like this, throw it out!                

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 A brand new SOFT toothbrush

If you brush really well with a manual toothbrush, you probably won’t see that much of a difference if you were to switch to an electric toothbrush.  The problem is, many people don’t clean their teeth that well with a manual toothbrush so that’s where the electric toothbrush can really help.  We recommend 2 brands of the electric brushes, the Sonicare and the Oral-B Braun.  These are not the battery powered toothbrushes, these brushes plug into the wall and have a rechargeable battery.  They just have so much more brushing action than a manual toothbrush that even if you aren’t that great of a brusher, you can do an excellent job if you use one of these brushes daily.  In a recent study conducted by the National Institute of Health, they stated, “The subject group using the powered toothbrush demonstrated clinical and statistical improvement in overall plaque scores. Powered toothbrushes offer an individual the ability to brush the teeth in a way that is optimal in terms of removing plaque and improving gingival health, conferring good brushing technique on all who use them, irrespective of manual dexterity or training.”(1)  In another study, “the Sonicare DiamondClean toothbrush was found to be safe and significantly superior to a manual toothbrush in reducing gingivitis, sites of gingival bleeding and plaque over time.  DiamondClean reduced gingivitis and gingival bleeding sites up to two times more and removed up to four times more plaque than a manual toothbrush after four weeks of use.”(2)   Sonicare also states that their ‘DiamondClean toothbrush effectively removed extrinsic tooth stain within one and two weeks of use, and it was significantly superior to a manual toothbrush at both one and two week checks.'(3)  On the Oral B website, they state that their Professional Precision 5000 toothbrush has produced these results:  34% less gingival bleeding at 6 months vs. a regular manual toothbrush and 29% lower gingival bleeding scores at 3 months vs. Sonicare® FlexCare (4)

It is still important to use the powered toothbrush 2 times daily for at least 2 minutes and allow the toothbrush to clean along the gumline.  If you have an electric toothbrush but it mostly sits on your counter, that doesn’t count when we ask if you use an electric toothbrush!

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Philips Sonicare DiamondClean

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                                                     Oral-B® Professional Precision 5000

Electric toothbrushes come in many different models and prices.  Take a look at a store like Target or Walgreens, they have lots of choices so you can find one that will fit your budget and taste.  We carry our favorite electric brushes and replacement brush heads in our office as well, and we are happy to answer any questions you might have about toothbrushes.  I like to answer questions about brushes so much that I go to Target and walk up and down the dental isle just so I can give advice to shoppers!!

So, remember what I tell my younger patients:  2 times a day for 2 minutes.  It’s easy to do and easy to remember!

Karen Kelley  R.D.H.

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 Just some fun photos to make you smile!

 

1.  http://222.ncbi.nlm.nih.gov/pubmed/23674927

2.  http://sonicare.com/professional/en_AU/pdf/Gingival_DC_2011_Milleman.pdf

3.  http://staging1.microsites.ce.philips.com/DP_AU_EN_3_3_Orc2/pdf/Stain_DC_2010_Colgan.pdf

4.   http://www.dentalcare.com/en-US/oral-b-crest-professional-products/category/electric-toothbrushes/oralb-5000-professional-trial.aspx

Image Sources

http://www1.macys.com/shop/product/sonicare-hx9332-diamondclean-rechargeable-electric-toothbrush?ID=827710

http://www.webmd.com/oral-health/proper-angle-for-brushing-your-teeth

http://www.impledent.com/patient-services/teeth-dental-cleanings/

http://blog.sciencemuseum.org.uk/talkscience/2011/10/27/wonderful-things-more-than-meets-the-eye/

http://www.oralb.com/products/pro-health-gentle-clean/

http://www.oralb.com/products/professional-care-smart-series-5000/?utm_source=google&utm_medium=cpc&utm_term=%2Boralb%20%2B5000&utm_campaign=Oral-B_Search_Desktop_Brand+Awareness_Power|ProfessionalCare+SmartSeries+5000&utm_content=sGVAVXD2P|dc_21461550775_b_%2Boralb%20%2B5000

www.pinterest.com

Waterpiks

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Lora Cook RDH

A question I am often asked of my patients is, “what do you think about a waterpik?” Waterpiks are great, but they DO NOT replace flossing with string floss. Once a person hears that they still have to floss, a look of discouragement or disgust comes across their face.  However, before you completely write off the thought of investing time and money into to a water pick, let me give you some information.

Waterpiks force oxygenated water underneath the gum tissue where plaque and bacteria like to hide.  This bacteria that lives under the tissue is anaerobic, it thrives under the gum tissue in that non-oxygenated environment. The oxygenated water works to not only flush out plaque and food, but also kills bacteria.  Also adding a few ounces of a quality, over the counter mouth rinse\antiseptic to the water reservoir is effective in reducing the bacterial load in the mouth.

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Who can benefit the most from the adding a waterpik to their daily oral hygiene routine?  I recommend water picks to patients who have bridges, implants, braces, or have been diagnosed with periodontal disease. The waterpik can reach places that string floss can miss.  Studies show that it is 50% more effective then just dental floss alone.  With a 3 second application it is 99.9% effective in the removal of plaque.

Some patients ask if waterpiks are so effective, why do I still need to use my string floss?  The string floss will scrap and mechanically remove the sticky plaque that likes to stick to the tooth surface. A waterpik will just rinse it.

There are different types of waterpiks out on the market.  A counter top water pik with a seperate resevoir and a cordless waterpik.  The cordless waterpic is rechargeable, no batteries needed. The water reservoir will hold 45 seconds of water supply.  All waterpics have different pressure settings, the water pressure will be 45 to 75 psi.

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Another type of waterpik is called shower floss.  Many people have never heard of this type, and do not know that it is available.  This unit is attached to your shower head, it comes with a rechargeable battery pack. This unit will supply a  continues flow of water without having to stop and refill.  With this nifty unit you also do not have to worry about making a mess of your bathroom mirror!

 

shower flosser

Another type of waterpik is a shower floss.  Many people have never heard of this type, and do not know that it is available.  This unit is attached to your shower head, it comes with a rechargeable battery pack. This unit will supply a  continues flow of water without having to stop and refill.  With this nifty unit you also do not have to worry about making a mess of your bathroom mirror!

 

 

http://www.waterpik.com/oral-health/products/dental-water-flosser/WP-480/

http://www.waterpik-store.com/?trk_src_ss=WATFGS49WEBPAYPC

Dental Sealants

Kara

Kara Johansen BSRDH

No one likes cavities right? Is there something that can prevent decay in just one short dental visit! YES! Here it is folks, SEALANTS!

No matter how amazing we are at flossing and brushing our mouth is filled with bacteria. Plaque is the home for bacteria. As we go throughout our day we have breakfast, mid morning snack, lunch..etc. Bacteria also enjoy snacks. Bacteria especially like fermentable carbohydrates, and sugary treats. After they have processed the food it excretes acid onto our teeth and that causes a cavity.

Permanent damage to the tooth is nothing to mess with. There are small grooves in the top biting surface of our teeth that are too small for our tooth brush bristles to fit in. Often children are benefiting from dental sealants. However, adults have the same risk of decay but are not receiving the same tooth saving service.

sealants

Sealants are a plastic covering for the pits and fissures that are applied by your dentist or hygienist. The tooth is first cleaned; the sealant material is placed, and then hardened with a curing light. The sealant can last for a very long time before they may need to be redone. Your dentist will check them at each maintenance appointment.

A sealant is one of the best ways to prevent decay. They are cost effective, easy to keep clean, and will protect the integrity of your teeth. If you have any more questions I am sure your dentist, hygienist, or dental assistant would love to answer them.

Image source:polkadotdental.com

ADA Division of Communications in cooperation with The Journal of American Dental Association(2003). For the Dental Patient…Dental Sealants Protecting Your Teeth.JADA, volume 134, pages. doi:http://www.ada.org/sections/professionalResources/pdfs/patient_28.pdf

 

Mouth Breathing

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Julie West BS RDH

Parents take heed; if your child breathes through his mouth instead of his nose, he can have more problems than bad breath!

     Mouth-breathing contributes to: sleep disorders, changes in posture, jaw deformity, lowered immune function, gum disease, and tooth decay.

Mouth-breathing causes the jaws to grow in an altered fashion, resulting in long faces, tooth crowding, and an altered head posture. The lower jaw remains too far behind in its growth, producing a small chin, an abnormal bite, and a distorted profile.

Sleep disorders can be caused by the lower jaw and tongue being positioned too far back, constricting the upper airway.  Enlarged tonsils and adenoids due to chronic allergies may also constrict the airway to such an extent that normal nasal breathing becomes impossible.

Nasal breathing produces a hormone that regulates normal blood circulation. It also filters, warms and moisturizes the air. The lack of oxygen in mouth breathers, who usually snore at night and struggle for air, weakens the immune system, disrupts deep sleep cycles, and interferes with growth hormone production.  Children may be fatigued and less attentive in school due to this disruption in sleep.

Saliva helps to naturally cleanse the tissues of the mouth.  Salivary flow is disrupted by mouth-breathing, leaving a dry environment that irritates tissues and leaves them susceptible to infection such as tooth decay, gingivitis, and periodontal disease, as well as contributing to bad breath.

If you notice that your child breathes through his mouth, you can get help before these problems arise.

     Typical treatment options include myofunctional therapy to help retrain your child to breathe through their nose and the use of orthodontic appliances to help move the lower jaw forward.   The earlier mouth-breathing is addressed, the better the outcomes of treatment will be.

Below is a picture of a patient before and after treatment for mouth-breathing.

http://mcgannfacialdesign.com/before-after/

http://www.asha.org/public/speech/disorders/OMD.htm

PLEASE, Stick Your Tongue Out at Your Dentist

Kim McCrady

Kim McCrady RDH, BA

Dedicated to Phil Swanson and his courageous family

     Come on, you know you have always wanted to stick your tongue out at your dentist and or your hygienist. Honestly, we invite you to be as impolite as possible. During the oral cancer-screening portion of your dental check up we need and want to see as much of your tongue, tissues, lips, and throat as we can.

Oral Cancer Risk Factors

     Unfortunately, according to The Oral Cancer Foundation, cancers of the tongue, lips, cheeks, throat and floor of the mouth are on the rise and have been for the last five years.   In fact, one person passes away every hour from oral cancer.  Those at the highest risk for oral cancer are people with past or current tobacco use habits.  Patients with a family history of oral cancer and men are at a greater risk for oral cancer than women.  The latest consideration as a causative factor for oral cancer is the human papilloma virus (warts) in the oral cavity.  Other listed risk factors include heavy alcohol consumption and over-exposure to the sun.  However, there are many people with oral cancer who will have none of the major known risks factors.

Signs and Symptoms

     There are some signs and symptoms of oral cancer, but most are not detectable until the later stages of development. The National Cancer Institute lists a few of the symptoms of possible oral cancer.  They are patches of tissue that become white or red or a combination of white and red.  Sores on the inside or outside of the lips, mobile teeth, difficulty or pain when swallowing.  If you wear dentures, pain while wearing your dentures can be a warning sign.  Lumps in your neck, along your jawline, behind your ears, pain in your ear that does not subside and lumps in the floor of the mouth are also possible symptoms of oral cancer. 

Oral Caner Screening

     Your dentist and hygienist will check your tissues by having you stick out your tongue.  We catch your tongue with a piece of gauze and will pull it from side to side. We will ask you if you have noticed any sores in your mouth that have been present for more than two weeks.  We will have you touch the roof of your mouth with the tip of your tongue so we can easily view the underside of your tongue.  We also evaluate the inside of your cheeks, lips, floor of the mouth and the back of your throat is also examined. Even the lymph nodes in your neck and along your jawbone need to be checked regularly for abnormalities.  We also check your face, neck and lips for abnormal changes.

     Luckily, new technology is available for oral cancer screenings.  Our office uses a piece of equipment called, the VELscope.  The VeELcope allows the doctor to see changes in the tissue using fluorescence.    This technology allows the doctor to detect changes in the tissue earlier than he can with the naked eye.   Like most technology, we are confident these tools will continue to evolve in accuracy and be used more and more in dental offices.  It is our office philosophy to stay aware of these changes in technology and make them available to you.

Diagnosis and Treatment

     If a suspicious area is detected during your oral cancer screening, your dentist will refer you to an oral surgeon, ear nose and throat specialist or a dermatologist for evaluation and probable biopsy of the area in question.  If you are diagnosed with an oral cancer, treatment will likely vary depending upon the stage of the cancer.  Surgery, radiation, targeted therapy and chemotherapy are often used in combination as treatments.  Early detection and immediate treatment is critical to survival.  Prognosis in a latter stage of development is poor because oral cancers spread (metastasize) quickly to the lymph nodes and other parts of the body as they grow. 

Prevention

     Decrease your risk of oral cancer by reducing your alcohol intake, commit to tobacco cessation.  If you need help quitting, contact your doctor or contact a support program like Ashline.  Be proactive, check your tongue and tissues at home regularly and report to your dentist immediately if you find any concerning areas in your mouth.  The ADA estimates 60% of the US population will see a dentist each year.  This means dental professionals are your partner providers in early detection.  When you see your dentist and your hygienist at your regular visit, insist on an oral cancer screening.  Our office takes oral cancer screening seriously and we invite you to, “PLEASE, stick your tongue out at your dentist!”

 

The Oral Cancer Foundation:  http://oralcancerfoundation.org

National Cancer Institute:  http://www.cancer.gov/cancertopics/wyntk/oral/page1

Ashline: http://www.ashline.org

Oral Surgeons and the VELscope system:  Partners in Early Detection and Diagnosis:  http://www.velscope.com/upload/VELscopeVX_Oral_Surgeons.pdf

Embracing Fluoride

 

Peggy 

 

 

 

 

 

Peggy Stoor BSRDH

As a hygienist with many years of experience, I’m starting to notice an alarming trend.  I began to be suspicious, when my own children who I fanatically watched the diet and toothbrushing habits of, werefound to have cavities. A small number of cavities, but still! My kids! How could this happen?

According to the Centers for Disease Control, the caries rates (cavities) in children ages 2 thru 5, is onthe rise. This is a trend we have not seen in over 40 years. Many dental professionals are beginning tosuspect that this is, at least in part, due to drinking bottled or filtered water, without fluoride. Fluoride isoften found naturally and may be added to our community water supplies. But, a recent study found thatabout 45 % of parents give their children only or almost exclusively bottled water. The Journal of Pediatric Dentistry reports that figure closer to nearly 70%.  While the correlation between the increase in caries and the decline in fluoridated water consumption hasn’t been sufficiently linked, many are beginning to believe that this is a contributing factor.

Obviously, the eating habits of American children also play a huge role and every time a child has a sweet snack, their mouth becomes acidic.  The number and frequency of these acidic attacks is important in causing tooth decay.  Sweetened juices, high sugar, and high carbohydrate snacks coupled with parents’ reluctance to brush their children’s teeth with fluoride toothpaste also play a large role.

Interestingly, a study by The National Center for Health Statistics found that boys in higher income families had the greatest prevalence of decay.  Is it because parents in higher income families can afford to provide more beverages such as juice, sports drinks, and bottled water believing that they are doing better for their children? Parents trying to promote health may potentially help to harm as these drinks don’t protect from cavities and are often high in sugars.  Just as we need to be aware of the amount of sugar in our fruit and sports drinks, we should also be informed of the amount of fluoride in our bottled and filtered water.

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It has been nearly 70 years since the discovery of the decay preventing effects of fluoride. The CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century. “The health and economic benefits of water fluoridation accrue to individuals of all ages and socioeconomic groups, especially to poor children”  (Review of Fluoride: Benefits and Risks, 1991, US Public Health Service)

Despite numerous studies from experts in many fields, including the medical establishment, which have proven the safety and efficacy of fluoride, controversy and fears continue among many.  The debate has a very lengthy history and is far too much to detail in these few paragraphs.  Communism, socialism, cancer, mental retardation, and bone fractures are some of the concerns expressed by anti-fluoridationists.  However, in a report on the benefits and risks of fluoride, the U.S. Public Health Service Department states that optimal fluoridation of water does not pose a cancer risk to humans. This is evidenced by extensive human epidemiological data from studies over the past 75 years. While its true that fluoride is found in sources other than water (foods, toothpastes, mouthwashes, and fluoride supplements), the conclusions were that no trends in cancer risk were seen between populations of fluoridated and non-fluoridated communities. These findings were duplicated by the National Cancer Institute in a review of studies and an additional 16 years of research.

Concerned parents have often asked me about the pros and cons of fluoride.  While excessive fluoride consumption is obviously something to guard against, spotty consumption of fluoride poses a great risk for decay.  As in all things, finding a balance is the key. I now advise my patients to find out about their water. Reverse osmosis filtration removes the fluoride as well as the contaminants. While some bottled water contains fluoride, the majority does not. Contact your city’s water supplier and/or research your bottled or filtered water online. This information is readily available and as wise consumers and parents we should be knowledgeable about what our children and we are ingesting.

For young children, ages 2 to 6, please skip the sugar sticky snacks and that bottle of milk or juice at bedtime, drink a little tap water daily, and brush your child’s teeth with a pea size amount of fluoridated toothpaste twice a day. If the child cries or complains, think about how much more difficult and potentially traumatizing decay, pain, and possible tooth loss might be.

 

 

 

Aleccia, J. (2012, March 21). Bottled water may boost kids’ tooth decay, dentists say. NBC News Health. Retrieved July 04, 2013, from http://www.nbcnews.com/health/bottledwater.

Ellwood, R. P., & Cury, J. A. (n.d.). How much toothpaste should a child under the age of 6 years use? 168-74. Abstract obtained from Eur Archives Paediatric Dentistry, 2009 168-74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed.

Garrison, G. M., MD, & Loven, B., MLIS. (2007). Can Infants/Toddlers Get Enough Fluoride Through Brushing.Journal of Family Practice, 56`(9). Retrieved from http://link.springer.com/article/10.

Hobson, W. L., Knochel, M. L., Byington, C. L., Young, P. C., Hoff, C. J., & Buchi, K. F. (2007). Bottled, Filtered,and Tap Water Use in Latino and Non-Latino Children. Archives of Pediatrics and Adolescent Medicine, 161(5), 457-461.

Kliff, S. (2013, May 21). The Ongoing Fluoride Wars- Once Again Portland Votes Against Fluoridation of … The Washington Post. Retrieved July 4, 2013.

McNeil, D. R. (1985). America’s Longest War: The Fight Over Fluoridation. The Wilson Quarterly, Summer, 140-153.

Sriraman, N. K., Patrick, P. A., Hutton, K., & Edwards, K. S. (2009). Children’s drinking water: Parental preferencesand implications for fluoride exposure. Pediatric Dentistry, 310-5. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed.

United States Public Health Service, Department of Health and Human Services (February 1991), Report of The AdHoc Subcommittee on Fluoride. (n.d.). Review of Fluoride: Benefits and Risks.

Which Mouth Rinse Should I Use?

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Julie West BS RDH

As you stroll down the dental product aisle in your local grocery store, have you ever taken the time to fully acknowledge the amount of dental products that are out there?  While we are fortunate to have options available to us, it can also make the process of selecting the product right for you more challenging.   When it comes to oral rinses, one size does not fit all.  Taking time to examine the labels of the mouth rinses on the shelf can help you make the best choice for your specific needs.

There are two categories of oral rinses: therapeutic rinses and cosmetic rinses.  Cosmetic rinses mask bad breath and leave you with a “fresh” feeling; however the results are short in duration. Therapeutic rinses will do a variety of things such as: reducing halitosis (bad breath), aiding in the reduction plaque levels and inflammation by killing oral bacteria, and providing additional anti-cavity protection.  To ensure you are getting a mouth rinse that will be therapeutic and not just cover odor, look for a seal from the ADA and words such as “antigingivitis” and “anticavity”. Now that you’ve narrowed down the contenders, let’s discuss ingredients.

Rinses that are antiseptic and kill oral bacteria have active ingredients of essential oils such a menthol and thymol.  These rinses also usually include a high percentage of alcohol.  You may notice a “sting” or burning sensation when using these types of rinses.  For those who have xerostomia (dry mouth) naturally or from medication may want to stay away from these rinses as alcohol will dry out the tissues even more. Other types of rinses act as anticavity rinses by providing more fluoride to the teeth.  The active ingredient in these rinses will often be sodium fluoride.  Many rinses today will combine these two types of rinses into an anticavity/antigingivitis rinse containing all of the above ingredients.

Some rinses may stain teeth after prolonged use. A third type of oral rinse that is not usually discussed contains the active ingredient stabilized chlorine dioxide.  Several studies have been conducted on the CloSYS stabilized chlorine dioxide product line.  This ingredient has been shown to kill oral bacteria that cause gingivitis and periodontal disease with results similar to the prescription oral rinse, chlorhexidine, dispensed at your dentist’s office, as well as reduces volatile sulfur compounds which cause halitosis.

CloSYS is available over-the-counter and allows patients to leave the rinse unflavored or add in the amount of mint flavoring they want.  The rinse does not contain alcohol that will burn or dry tissues and does not stain teeth as chlorhexidine does. Using this information, you are prepared to walk down the dental product aisle with the ability to appropriately choose the rinse that will provide you with the specific results you need.

 

American Dental Association. (2013). Mouthrinses. Retrieved from http://www.ada.org/1319.aspx

Rowpar Pharmaceuticals, Inc.. (2013). CloSYS Research. Retrieved from http://www.closys.com/pros/research.html

David Drake, MS, PhD. Alissa L. Villhauer, BS, Dows Institute for Dental Research, College of

Dentistry, University of Iowa An In Vitro Comparative Study Determining Bactericidal Activity

of Stabilized Chlorine Dioxide and Other Oral Rinses Journal Clin Dent 2011;22:1-

M. Robert Wirthlin, DDS, Brand J AHN, DDS, Belma Enriquez, BS, and M. Zamirul Hussain,

PhD. Effects of stabilized chlorine dioxide and chlorhexidine mouthrinses in in vitro cells

involved in periodontal healing. Periodontal Abstracts, The Journal of the Western Society of

Periodontology, vol. 54, no. 3, 2006.