Activated Charcoal Toothpaste or Powder

Maria Iavarone, RDH

Activated Charcoal Toothpaste or Powder

Activated charcoal toothpaste and powders have been gaining popularity the past few years. Ads have been flooding social media. You may have seen the YouTube videos and the Pinterest before and after photos. It has become a true dental fad. Charcoal is not only a trend right now, but historically ancient Romans used charcoal, amongst other products to clean teeth. As a dental hygienist, I get questions about charcoal toothpaste often. Does the toothpaste actually whiten the teeth? Does it help prevent gingivitis? Is charcoal toothpaste effective and safe to use? 

Unfortunately, the answer is unclear on the effectiveness and safety of using activated charcoal toothpastes or powders. The Journal of the American Dental Association did a literature review of 118 articles and smaller studies done on charcoal and charcoal-based toothpastes. The conclusion was that there was insufficient clinical and laboratory data to substantiate the safety and efficacy of charcoal and charcoal-based toothpastes. Larger-scale and well-designed studies are needed to establish conclusive evidence (Brooks, Bashirelahi, & Reynolds, 2017). The Pharmaceutical Journal states, there have been no scientific studies published that support the effectiveness of charcoal toothpastes in tooth whitening, oral hygiene and any claimed preventative effects (Greenwall & Wilson, 2017).  

From information I have gathered from journal articles written on the subject, activated charcoal toothpastes are seemingly effective in removing surface stains from coffee, tea, red wine,etc. This is most likely due to the abrasive nature of activated charcoal. There has not been enough evidence to show that activated charcoal toothpaste has an effect on whitening yellow teeth. Activated charcoal is characteristically absorbent,however in the form of a toothpaste, it may be the abrasiveness that is contributing to the removal of the stain. The abrasive nature of activated charcoal can be seen as a potential concern as well. Activated carbon is more grainy than traditional pastes and can potentially cause damage to the teeth (Potts, 2018). There was not much information supporting gum health, however some reviews claimed that a side effect was gum irritation. There are a lot of positive claims and a lot of negative claims, yet no claim is supported by enough clinical evidence to be deemed as true.

In conclusion, we have to take this information lightly because there is not enough substantial evidence to support these claims. Because activated charcoal toothpastes and powders have grown in popularity, there are a lot of companies making this type product right now and some may be putting harmful ingredients into the mix. RDH magazine claims that some foreign brands of toothpaste may contain toxic ingredients. We must exercise caution when buying a product like this. Several charcoal toothpastes or powders on the market right now do not contain Fluoride, which is the key ingredient for cavity prevention. If you’re using a charcoal toothpaste without Fluoride, your dental professional may recommend supplementing with a Fluoride mouth rinse. My recommendation would be to read the ingredients carefully when purchasing toothpaste, especially if it is not from a reputable company.  Be cautious if using activated charcoal toothpaste or powder and do not use it long-term until more research has been published to support the safety and efficacy of the product.

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Brooks, J. K., Bashirelahi, N., & Reynolds, M. A. (2017). Charcoal and Charcoal-Based Dentifrices. The Journal of the American Dental Association, 148(9), 661-670.

Greenwall, L., & Wilson, N. H. (2017, July 13). Charcoal toothpastes: what we know so far. Retrieved February 16, 2019, from The Pharmaceutical Journal:

Potts, K. (2018, July 1). Marketing Ingenuity or Beneficial Dentifrice? Retrieved Februrary 16, 2019, from RDH Magazine:

Do I need to take antibiotics before my dental visit?

Lacee Hogle, RDH

Do I need to take antibiotics before my dental visit?

Physicians and dentists may recommend that a patient takesantibiotics prior to certain dental procedures. This is called “antibiotic prophylaxis”. But why do physicians and dentists at times recommend antibiotic prophylaxis?

All of us have bacteria in our mouths, and many dental procedures allow bacteria to enter the bloodstream. This is known as bacteremia. For most of us, this does not pose a problem. A healthy immune system typically prevents the bacteria from causing any harm. There is a concern, however, that for some people, bacteremia could potentially cause an infection elsewhere in the body. 

Who is at risk? 

Antibiotic prophylaxis is recommended for people who have specific heart conditions. In 2008, the American Heart Association released new guidelines identifying people who need to take antibiotics prior to dental care. Antibiotic prophylaxis should be considered for people with:

Artificial heart Valves

A history of endocarditis

A heart transplant with abnormal heart valve function

Certain congenital heart defects including:

Unrepaired cyanotic congenital heart disease, including people with palliative shunts and conduit

Defects repaired with prosthetic material or a device for the first six months after the repair procedure

Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device


The guidelines prior to 2008 suggested use of antibiotics for many additional conditions. Conditions for which antibiotic prophylaxis is no longer recommended include:

Mitral valve prolapse or heart murmur

Rheumatic heart disease 

Bicuspid valve disease

Calcified aortic stenosis

Any heart condition present from birth that is not listed above


Antibiotic prophylaxis guidelines were also developed for those who have orthopedic implants, such as artificial joints. In the past, antibiotics were recommended for two years post artificial joint placement. And in rare occasions, more than two years. In 2012, the American Dental Association and the American Association of Orthopedic Surgeons updated these recommendations.

The new guidelines do not recommend routinely prescribing antibiotics for people with artificial joints. Due to these changes, dentists and physicians rely more on case-by-case assessments and consultation with patients to determine when antibiotics are appropriate with orthopedic implants. For example, antibiotic prophylaxis might be used for the patients that also have a compromised immune system which might increase the risk of orthopedic implant infection.

If you have a heart condition or an orthopedic implant, talk with your dentist or physician about whether antibiotic prophylaxis is necessary. 

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Sources: ED Page Antibiotics 2.ashx

“My teeth are sensitive.”


Amy Smith, RDH

“My teeth are sensitive.”

One of the most common concerns voiced in the dental office; here are a couple solutions. First we need to differentiate between gum and tooth sensitivity. If you have symptoms of sore, bleeding, or red gums, this would indicate gum sensitivity. If you drink cold or hot foods/drinks and begin to feel a “ZING” feeling to the tooth and nerves, this would indicate tooth sensitivity. First and foremost, the easiest method of gum sensitivity prevention it to brush, floss, and remain consistent with your dental re-care visits. In addition, there are different toothpastes and fluoride treatment that can help with tooth sensitivity.  

#1- Home Care: By staying on top of a great home care routine of brushing twice per day for two minutes and integrating a method of flossing, there with be less plaque retention around the gums. This plaque can be causing irritation, inflammation, and in some cases bleeding. By improving your home care regimen, gum pain can reduce and furthermore protect your teeth from decay.

#2- Desensitizing Toothpaste: Sensodyne toothpaste, MI Paste, and PreviDent are created specifically for remineralization of the tooth but also help with sensitivity. Sensodyne is available over the counter while MI Paste and PreviDent are stronger strength and can be dispensed at the dental office. Remember when using these toothpastes to brush, spit, but do NOT rinse. It is important to allow the ingredients to sit on the teeth rather than rinse away with water.

#3- Fluoride Treatment: There are a few different methods of fluoride treatment available for patients. One in specific that has an easy and swift application would be a fluoride varnish. These vitamins are tooth-colored and painted onto the teeth after a cleaning. It is designed to assist with tooth sensitivity and promote remineralization of the tooth. Fluoride varnish is great for all ages and it comes in various flavors.

One size does not fit all to meet our patient’s needs for treatment of sensitivity. Ask your hygienist if you have any other questions regarding sensitivity to chose a possible treatment that is best for you.

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Four Ways to Clean Between Teeth

Ruth Mickelson, RDH

Four Ways to Clean Between Teeth

When thinking about cleaning between teeth, floss will probably come to mind. This is a great way to clean between teeth, but it is not the only way! There are other oral hygiene aids that are available and it’s not one size fits all. Below are options with the benefits and uses for each one. 

1. String dental floss. With proper technique, this is effective in removing plaque and reducing gingivitis and risk for non-reversible periodontal disease. There are many types of string floss and between waxed, tape and spongey floss, there is an option suitable for everyone. Waxed floss is great for the average person but may rip or tear. For those with tight contacts, a smooth floss like the Glide Oral B is useful. It’s easier to get into the tooth contact without breaking. Spongey floss like the Glide Super Floss is useful for people with bridge restorations, spacious contacts, or those wearing braces. The Super floss has a stiff end that allows for directing the floss under the bridge or orthodontic appliance. The spongey part of the floss is great for attaching to plaque and removing it from the teeth and gums. Another great point about sting floss is that it is generally inexpensive. For some, sting floss can be difficult to use. It does take practice to feel comfortable using it but after learning, can be done in just a few minutes. 
2. Mounted Floss Picks. Many people love floss picks for their convivence! There are even floss picks called platypus flosser specifically made for patients with braces. These are a great option for people with limited dexterity such as children. Because there is only a small amount of floss being used, it is instructed to rinse off plaque as needed between teeth and then dispose of pick.
3. Water floss. This is great for gum stimulation and removing large pieces of plaque or food that it stuck. This is a good option for those with limited dexterity, those with tight contacts, and those who have a hard time using other flossing aids.
4. Proxabrushes. This come in a variety of sizes and different handle. They are used to clean between wide contacts, around orthodontic braces and in some cases be useful under bridge restorations. 

One person could benefit from using more than one type of interdental aid, depending on the area od the mouth. No matter what oral hygiene aids are used to clean between teeth, it is important to use proper technique in order for them to be effective. Speak with a dental professional for instructions on how to use any oral hygiene aids. 

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How to Clean Your Denture/Partial Denture 

Lindsay Olsen, RDH BSDH

How to Clean Your Denture/Partial Denture 

 Rinse your dentures before brushing to remove any loose food or debris. 
 Use a soft bristle toothbrush and a non-abrasive cleanser to gently brush all the surfaces of the dentures so they don’t get scratched.
 When brushing, clean your mouth thoroughly—including your gums, cheeks, roof of your mouth and tongue to remove any plaque. This can help reduce the risk of oral irritation and bad breath. 
 When you’re not wearing your dentures, put them in a safe place covered in water to keep them from warping.
 Do not sleep with your dentures. Your tissues need to breath overnight. If you do not take out your dentures at night, you are at risk of developing oral fungal infections. 
 Occasionally, denture wearers may use adhesives. Adhesives come in many forms: creams, powders, pads/wafers, strips or liquids. If you use one of these products, read the instructions, and use them exactly as directed. Your dentist can recommend appropriate cleansers and adhesives.
 Visit your dentist once every 6 months for a complimentary oral cancer screening, and to have the fit of your denture evaluated. 


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How To Care For Your Infants Teeth

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Lora Cook, RDH

How to care for your infants teeth.

When to start cleaning your baby’s teeth.

You can start before your baby even has teeth, it is best to incorporate mouth cleaning at bath time.  This routine will help your baby get used to you cleaning their mouth, which can allow a smoother transition when you do begin to brushing their teeth. This will also help you to know when your babies teeth first start to push through their gum tissue.

The bacteria that lives in the mouth is not harmful to the gum tissue, but can be harmful to the teeth.  The enamel on baby teeth are 50% thinner than adult teeth.  Therefore baby teeth are more susceptible to the bacteria that causes cavities.

How to clean your infants teeth.

To clean your babies mouth before tooth eruption use a clean wet wash cloth.  Wrap wash cloth around your finger then rub it gently around your babies gums.

When to transition to a tooth brush.

When the teeth have started to erupt, this will be time to transition from a wash cloth to a baby tooth brush.  Look for a tooth brush specifically made for infants. This will usually start around six months old.  This will also be the time to change from bath time mouth cleaning to brushing two times daily.

It is fine to just dry brush with just tap water, or a fluoridated tooth paste can be used. When using toothpaste, use the tiniest smear.  It is never too early to help create a good brushing routine for your child.

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Why Do I Always Have Bad Breath?

Becky Larson, RDH

Why Do I Always Have Bad Breath?

As a Dental Hygienist, I frequently get asked about bad breath.  Many patients suffer from chronic bad breath, or halitosis, and are constantly seeking a cure!  Here’s the deal with halitosis:

  • Halitosis is chronic bad breath
  • Not cured by mints, mouth wash, or brushing
  • Remains for an extended period of time
  • May be a symptom of something more serious

Possible underlying issues that result in halitosis:

  • Cavities
  • Periodontal disease
  • Mouth, nose, or throat infections
  • Poor oral health
  • Certain foods and beverages
  • Dry mouth
  • Smoking/tobacco use
  • Other chronic conditions

Cavities and periodontal disease are both caused by different types of bacteria.  Infections are also caused by bacteria that feed on mucus produced by the body.  Left untreated, all of these bacteria can cause odors in the mouth that contribute to bad breath.  Poor oral hygiene can leave plaque and calculus on the teeth, also contributing to bad odors.  An obvious cause of bad breath would be a diet of potent foods such as garlic and onions.  Usually odors from these foods can be eliminated after brushing/flossing/rinsing, so if the odors persist, there is most likely a more pressing underlying issue.   Saliva helps rinse the mouth and remove debris after eating.  When saliva flow is decreased the removal of debris is also decreased and leftover food in the mouth could be one cause of bad breath.   Smoking and/or tobacco use come with their own associated odors but can also contribute to periodontal disease, which can be a major cause of halitosis.  Chronic conditions such as gastric reflux, diabetes, liver disease, kidney disease, etc. may also contribute to halitosis.  Our mouths are connected to our bodies and chronic diseases may present with signs or symptoms in the mouth.

How to treat and prevent halitosis:

  • Perform frequent and proper oral hygiene at home including brushing, flossing, and mouth wash
  • Visit your dentist and dental hygienist regularly for cleanings and necessary restorative work
  • Avoid smoking or tobacco use of any kind
  • Drink more water to stimulate saliva flow
  • Keep track or change what you eat, eliminating more potent foods like garlic and onions
  • Visit your primary care physician regularly

For specific questions or concerns about halitosis, ask your Dentist or Dental Hygienist.


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Why does my Dental Hygienist or Dentist “Poke at my Gums” Every Oral Hygiene Visit?

Morgan Johnson, RDH

Why does my Dental Hygienist or Dentist “Poke at my Gums” Every Oral Hygiene Visit?

Have you ever wondered why your dental professional “pokes your gums?” Or why they call out numbers such as “2-3-3, 4-2-3” and what those numbers mean? This “poking” is actually a vital step in assessing your gum health and is called periodontal probing. Between each of your teeth and the surrounding gum tissue is a space, or gum pocket. Our instrument, called a periodontal probe, measures the depth of that pocket in millimeters (mm).

What do the pocket numbers mean?

Generally, a healthy pocket depth will range from 1-3 mm. This usually indicates healthy tissue, with no signs of inflammation or disease. Pockets of 4mm or greater can indicate potential areas of concern, including the presence of periodontal (or gum) disease. Unhealthy pocket depths can be the result of poor oral home care, which can cause inflammation, and even bone loss. Periodontal disease is also liked to various systemic diseases including diabetes and cardiovascular disease, which is an additional reason to maintain a healthy mouth.

What can I do about my pockets?

After assessing your pockets, your hygienist will have recommendations on what type of cleaning would most benefit you, to either maintain your periodontal health, or help restore it if it is lost. Sometimes a “deep cleaning” may be necessary to reduce pocket depths. To maintain healthy pocket depths, or lower unhealthy ones, it is essential to be brushing for a full two minutes everyday, and flossing at least once a day. Your hygienist will also offer specific, individualized recommendations for your mouth. If you have any questions, make sure to ask your hygienist at your next check up!

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Why would a Dental Hygienist need to know your blood pressure?

Amy Smith, RDH

Why would a Dental Hygienist need to know your blood pressure?

At that first lengthy appointment in a new dental office where all of the x-rays, pictures,
and probe recordings are taken, a blood pressure reading is recommended as well. Some might
question, “what does this have to do with my teeth?” It’s simple, awareness and safety.
As licensed health care providers, it is our responsibility to discuss any medical
conditions, current medications, drug allergies, and chief concerns with our patients. This
knowledge contributes to our understanding of any present infections or symptoms in which
they may be experiencing. In some cases, patients might not be aware of their reading or risks
associated with higher numbers (hypertension). According to the American Dental Association,
the updated 2017 classifications are listed below:


When presenting for a procedure where local anesthetic (or numbing) is administered,
such as a deep cleaning, a blood pressure reading is mandatorily taken. When injecting an
anesthetic containing epinephrine, there is potential for a person’s blood pressure to rise from
their initial reading due to the vasoconstriction of blood vessels. To prevent a medical
emergency from occurring, hygienists obtain a reading. In some cases, it is safer for the patient
to reschedule their appointment if their reading is too high and refer them to see their
physician for further evaluation.

Having high blood pressure threatens your health and quality of life. When left
undetected or uncontrolled, hypertension can lead to heart failure, stroke, vision loss, angina, heart attack, and kidney disease, to name a few. Not only is high blood pressure awareness
important for your health, but the reading is a preventative measure we take as dental professionals to ensure quality and safety of care to our patients.

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Don’t Lose Your Benefits before the End of the Year

Sharma Mulqueen RDH

Don’t Lose Your Benefits before the End of the Year

Many people do not realize if they do not use their benefits they will be gone! While the majority of dental plans run on a calendar year, there are some that run fiscally dependent on different situation. Please call one of our offices and we can help you with any of your Insurance questions.  We have compiled 4 different reasons why using your benefits before the end of the calendar year will save you time and money.

  1. Yearly Maximum

Your dental insurance plan likely has a yearly maximum, this amount is what your dental insurance plan has agreed to pay up to for the year. Most people have an average of $1,000 per year, per person, but this can vary by insurance company. Some insurance plans have Orthodontic (braces) benefits that have a onetime maximum, than amount can vary by Insurance Company.  If you have any unused benefits, they do not rollover to the next year so it is wise to plan ahead before your calendar or fiscal year ends.

  1. Deductible

Most insurance companies requires a deductible to be paid out of pocket to your dentist, before your insurance company will pay for any services. Depending on your plan and the dentist you choose, your deductible can vary in amount, however average deductibles are around $50 per year. When plans roll over to a new year, your deductible will also be reset.  If you have met your deductible for the year and you have pending treatment. It is a good idea to have that treatment completed.

  1. Premiums

You are paying dental premiums each and every month and you should be taking full advantage of them. If you don’t think you require dental treatment, coming in every six months for a cleaning is great for maintaining your oral health and preventing future dental problems. At your cleaning appointment, x-rays are taken and a dental exam is performed.  Any treatment that is needed will be discussed at this appointment.

  1. Dental Problems Can Worsen

If you still have benefits available before the end of the year, book yourself in for an appointment. Delaying treatment can mean that you will encounter more expensive and extensive treatment in the future. Call one of our Dental offices and schedule an appointment now, so that cavities and other minor issues can be treated rather than them turning into larger.  

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