How do I know which Toothpaste to pick?

Sharma Mulqueen, RDH

How do I know which Toothpaste to pick?

When it comes to choosing toothpaste, sometimes it seems like your options are endless. On the drugstore shelves you’ll see dozens of varieties that claim to whiten your teeth, decrease tooth sensitivity, prevent cavities, heal your gums, protect against tartar—even all of the above! But toothpaste doesn’t just polish teeth; it also removes the bacteria that cause dental plaque and bad breath, so it’s important select a brand that is approved by the American Dental Association. Since everyone has different needs, here are some tips that will help you choose a toothpaste to meet your individual needs.

Types of Toothpaste

  • Anti-cavity: This type of toothpaste contains fluoride. Fluoride not only helps to prevent decay, it also actively strengthens tooth enamel.
  • Anti-gingivitis: If have tender, swollen gums that bleed when you irritate them, this is probably an early sign of gingivitis, a mild form of gum disease. Anti-gingivitis toothpaste helps fight oral bacteria and restore gum health, preventing more serious gum disease.
  • Desensitizing: If your teeth hurt when you consume things like ice cream or cold drinks, this toothpaste can help you. It will provide relief by blocking the tooth’s pain signal to the nerve so that sharp changes in temperature aren’t so painful.
  • Tartar-control: This toothpaste will help control tartar. However, the best way to remove tartar is by scheduling a professional dental cleaning with your Dental Hygienist.
  • Whitening: This toothpaste contains chemicals that are able to help whiten and brighten tooth enamel, thus maintaining the natural color of your teeth. If your teeth are sensitive this is a toothpaste you want to avoid.
  • Children’s: Fluoride or Fluoride free?  When making this decision it is important that you are aware if your child is swallowing the toothpaste.  If they have not learned to spit it out, stick with a non Fluoride toothpaste.  Fluoride is a great benefit for children as it helps remineralize teeth and prevent tooth decay.

It is recommended that everyone brush their teeth twice daily for two minutes and floss daily.  You only need a pea size amount of toothpaste. Today there is toothpaste to meet the oral needs of everyone. But while all of the products on the shelf might seem the same, with a little help from your Dentist or Dental Hygienist, you can determine which is right for you. It is important to schedule dental checkups and professional cleanings twice a year to prevent tooth sensitivity, gum disease, tartar buildup, and tooth decay. We hope to see you soon in one of your dental offices.

Sources:

www.colgate.com

www.ada.com

What are those white spots on my teeth?

AnnC

Ann Clark, RDH

                                                                                                      What are those white spots on my teeth?

Dental fluorosis is not a disease but a permanent cosmetic condition affecting the way the teeth look.  It occurs when baby and permanent teeth are forming under the gums.  Once erupted, teeth cannot develop enamel fluorosis.  This condition is caused by overexposure to fluoride during the development stage of the tooth.  After their eruption into the mouth, teeth may appear discolored;  such as: lacy white markings, yellow to brown stains, surface irregularities, or pitting into the enamel.

Causes
A major cause is inappropriate use of fluoride products such as toothpaste and rinses.  Children are offered products with some fun flavors.  They are known to eat and swallow them so remind them to spit out.  Taking a higher than recommended supplement can also cause fluorosis.  The perfect amount is already regulated into the water where it occurs naturally.  Symptoms of fluorosis range from small white specks or streaks to dark brown stains and rough, pitted enamel.  A normal healthy tooth is smooth and glossy and a pale creamy white.

Treatment
Most cases are mild not requiring treatment.  White spots are considered moderate if more than 50% of the surface is affected  and severe if pitting occurs.  The appearance can be improved by various technique options aimed to mask stains.  Such techniques may include:
Teeth Whitening and other procedures to remove the surface staining.  Initially whitening can temporarily worsen the appearance.
Bonding: a coating over the enamel bonded with a hard resin.
Crowns
Veneers: custom-made facings that cover the front of teeth.
MI Paste: a calcium phosphate product sometimes combined with a micro abrasion procedure to minimize discolorations.

Prevention
Parental care is the key to preventing fluorosis.  If you drink well water, which is not regulated, or bottled water,your public health department or local laboratory can analyze the fluoride content.
Fluoride is also in some fruit juices and sodas, so knowing the water content will help you decide whether or not a supplement is needed.  Also, keeping fluoride containing products, like toothpaste, rinses and supplements out of children’s reach is recommended.  Ingesting a large amount of fluoride in a short period of time may result in nausea, vomiting, diarrhea or abdominal pain.  Only a small pea-sized amount of toothpaste is needed for each time you brush.
Encourage your child to spit out and not swallow.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

 

Sources:

webmd.com Fluorosis:Symptoms, causes, and treatments

American Academy of pediatric Dentistry:”Enamel Fluorosis”
Kidshealth.org: “Fluoride in Water”
Reuters Health:”U.S. Lowers Limits for Fluoride in Water”
National Institute of Dental and Craniofacial Research:”The Story of Fuloridation”
SimpleStepsToBetterDentalHealth.com:”Fluorosis”
CDC:”Prevalence and Severity of Dental Fluorosis in the United States, 1999-2004″

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/

Tooth Sensitivity

KatieM

Katie Moynihan RDH

Tooth Sensitivity

Sensitive teeth is one of the most common concerns among dental patients. Tooth sensitivity occurs due to enamel loss or gum recession which exposes the underlying dentin structure of the tooth. The dentin layer of your tooth is found underneath the enamel and contains several tiny tubes which run from the nerve to the outside of the tooth. When exposed, these tubes are highly sensitive to temperature changes, sweets, or mechanical forces. Not to mention very painful!

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Tooth sensitivity can be caused by several factors. Aggressive brushing can wear away your enamel at the gumline leading to gum recession and exposed tooth root. Another cause of sensitivity can be from continuous grinding of the teeth to the point that the enamel is completely worn down to the dentin layer. Cracked teeth or worn fillings can create passageways to the nerve of the tooth. Periodontal disease, or severe gum disease, can contribute to sensitivity because the gums around the teeth break down and lead to gum loss and bone loss.

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There are several ways to help reduce tooth sensitivity either at home or at the dental office. The type of treatment will depend of what is causing the sensitivity.

At home treatments include:

  • using a soft or extra-soft toothbrush while brushing gently in order to avoid toothbrush abrasion at the gumline (take a good look at your toothbrush…if the bristles are pointing in multiple directions, you’re brushing too hard!)
  • using a toothpaste that contains potassium nitrate, which penetrates the exposed dentin and soothes the nerve endings
  • using a fluoride toothpaste to help strengthen the tooth and exposed dentin
  • using MI Paste (available at your dental office) to block dentin tubule openings
  • limit acidic foods and drinks because they can remove small amounts of enamel over time

In office treatments include:

  • application of a fluoride varnish – helps seal the tubules and rebuild exposed dentin
  • application of a fluoride foam – provides a high dose of fluoride to help strengthen teeth
  • bonding agents can be placed at the gumline if necessary to seal exposed dentin and reduce sensitivity
  • restorative treatment if needed to correct the tooth that is causing the sensitivity
  • periodontal treatment if needed to keep gums healthy around the teeth

A mix of potassium nitrate and fluoride is your best solution for desensitization. Some products which include these active ingredients include Sensodyne, Pronamel, Colgate Sensitive Pro Relief, and Colgate Prevident 5000 Sensitive. These products must be used on a regular basis for at least 30 days before any therapeutic benefit will take place. Whitening and tartar control toothpastes contain abrasive ingredients that can damage tooth enamel and may be too harsh for those with sensitive teeth. The application of a fluoride varnish is always available in-office at your request. If you suffer from tooth sensitivity, feel free to ask us which desensitizing agents will work best for you!

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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.ada.org/~/media/ADA/Publications/Files/patient_33.ashx

https://us.sensodyne.com/faq.aspx

http://www.colgate.com/en/us/oc/oral-health/conditions/tooth-sensitivity/article/treatment-options-for-tooth-sensitivity

http://www.mouthhealthy.org/en/az-topics/s/sensitive-teeth

Black Line Stain

AriannaM

Arianna Ritchey, RDH

BLACK LINE STAIN

During the regular prophylaxis cleaning for a recent patient, she inquired as to the black stain on her teeth.  She had excellent brushing and  flossing habits, saw us every six months for her professional cleanings, and has only one filling on her permanent teeth.  This patient does not participate in any behaviours that normally result in staining; she does not drink coffee, tea, wine, and she does not use any tobacco products.  She was also concerned, because this same type of stain is also present on her infant’s teeth, who is strictly breastfed.  So, where was this stain coming from?!

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It was explained to this patient that the stain she was experiencing was most likely a type of stain called “Black Line Stain,” or sometimes simply “Black Stain”.  Black Line Stain is more common in women than men, and can occur in patients with excellent oral hygiene.  It appears as a thin black line, which is firmly attached to the tooth surface, and most commonly near the gumline of the facial and lingual surfaces of a tooth.  This type of stain is associated with a low incidence of cavities in children and adults, and is caused by a type of Gram-positive bacteria that produces a certain colour, or chroma, which makes it identifiable. It is possible that this patient’s child has the same type of Gram-positive chromogenic bacteria on his teeth, creating the same type of Black Line Stain.  This is especially likely if the child has good oral hygiene and a low incidence of cavities.

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This non-metallic type of stain is absorbed onto the tooth surface deposits, such as tartar, plaque, or even the acquired pellicle.  The acquired pellicle is a thin film made up of proteins in our saliva, that forms almost instantly after a tooth is cleaned.  Because this type of bacteria is able to attach to the acquired pellicle,  this condition is not related to oral cleanliness or the presence of periodontal disease.

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To prevent this stain from building up as quickly, patients can use a toothbrush to effectively clean the teeth twice a day, while using a toothpaste that helps to prevent staining.  Powered toothbrushes can often clean the teeth most effectively without causing trauma to the gums.  Once the stain has settled onto the teeth,  the most effective way to remove this Black Line Stain is by a professional cleaning with a dental hygienist.  The hygienist may professionally remove the stain with an ultrasonic scaler, coronal polishing using an abrasive prophy paste, or by using an air-jet polisher with an abrasive powder.

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The only real downside to removing the Black Line Stain from the teeth, is that repeated stain removal using an abrasive paste or powder removes micro-millimeters of enamel from the tooth surface.  The top layer of the teeth which is partially removed during polishing, is the most fluoride-rich part of the tooth, so if frequent polishing is utilized to remove Black Line Stain, it is advisable to have a professional fluoride treatment administered after the polishing to replenish the depleted fluoride from the teeth.  Fluoride is available in a few different forms, the most effective of which are a fluoride varnish or a fluoride foam.

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There are some other types of dark stain that are caused by other sources, including dietary components, beverages, tobacco, mouthrinses and other medicaments. These types of stain have a different source than Black Line Stain, but are removed in a very similar fashion.  If you have any questions or further concerns about staining on your teeth, feel free to ask your dental hygienist!

 

 

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://jairjp.com/JANUARY%202013/02%20SRUTHY%20PRATHAP.pdf

http://www.sammyboy.com/showthread.php?154192-Black-stain-in-teeth-by-chromogenic-bacteria

http://medical-dictionary.thefreedictionary.com/black+line+dental+stain

http://www.carolinasdentist.com/wp-content/uploads/2013/06/toothpaste.jpg

http://www.youngdental.com/wp-content/uploads/2013/09/dlishezpak4.jpg

http://www.sanclementeperiodontist.com/portals/165/images/fluoride.jpeg

 

Dental “Myth Busters”

KO6A3321-Edit

Becky Larson, RDH

Dental “Myth Busters”

There are a lot of dental myths out there that are sometimes mistaken for dental truths.  Here are a few facts to help clear up some of the confusion.

Myth #1: You don’t need to brush baby teeth because they will fall out eventually anyway. 

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Absolutely not!  Baby teeth can still get cavities, which can spread to other teeth and cause pain.  Some baby teeth may even fall out too soon and cause problems with bite or improper development of a child’s permanent teeth.  It’s also important to establish good oral hygiene habits early on.  Children’s teeth should be brushed twice daily (just like adult teeth).

Myth #2: Fluoride is poisonous and should be avoided. 

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Wrong!  Each day the enamel layers of our teeth lose minerals (demineralization) due to the acidity of plaque and sugars in the mouth.  The enamel is remineralized from food and water consumption.  Too much demineralization without enough remineralization leads to tooth decay.  Fluoride helps strengthen enamel, thus making it more resistant to acidic demineralization.  Fluoride can sometimes reverse early tooth decay.  According to the American Dental Association, community water fluoridation is the single more effective public health measure to prevent tooth decay.  Many dental offices also offer in office fluoride treatments that can help both children and adults.

Myth #3:  You lose one tooth each time you have a child.

Missing Tooth

Now that’s just silly.  Some women think that when they are pregnant the baby leeches a lot of their calcium supply.  That may be, but it doesn’t mean she will lose any teeth.  However, pregnant women are prone to cavities or having other dental problems.  This is due to morning sickness and vomiting, dry mouth, and a desire/craving for more sugary or starchy foods.  Pregnant women in these circumstances should be sure to continue their regular dental check-ups and try to maintain pristine oral home care.

Myth #4:  If your gums are bleeding you should avoid brushing your teeth and flossing.

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I can’t even begin to stress how wrong this one is!  If your gums are bleeding it means there is active inflammation and infection present.  That means you need to improve on oral hygiene by brushing more frequently or more effectively.  Bleeding gums is a sign of periodontal disease.  If caught early (in the gingivitis stage) it can be reversed.  Brushing should be done twice daily with a soft-bristled toothbrush.  Flossing should be done at least once daily.

Myth #5:  Placing a tablet of aspirin beside an aching tooth can ease the pain.

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Wrong again.  In order to ease the pain caused by a toothache, aspirin must be fully swallowed.  Placing aspirin on gum tissue for long periods of time can actually damage the tissue and possibly cause an abscess.

Myth #6:  You don’t need to see the dentist if there is no visible problem with your teeth.

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Unfortunately not all dental problems will be visible or obvious.  You should continue to visit the dentist for regular check-ups at least twice per year, in conjunction with your cleanings.  Dental radiographs or other instruments can detect cavities or other problems that might not be causing any symptoms yet.  It’s best to catch things early to minimize the treatment needed.

Myth #7:  After a tooth has been treated for decay it will not decay again.

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There are no guarantees in dentistry!  While the dentist will do their best to restore teeth to last for as long as possible, there is no way of knowing when or if a tooth will get recurrent decay.  Proper oral home care can prolong the life of dental restorations.

Don’t always believe what you hear!  If you have questions or concerns about your dental health be sure to ask your dentist, hygienist, or other dental professional.

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.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation

http://www.webmd.com/oral-health/guide/fluoride-treatment

http://www.livescience.com/22463-gain-a-child-lose-a-tooth-myth-or-reality.html

http://tips4dentalcare.com/2008/06/21/popular-myths-about-dentistry/

“They are just baby teeth. So what does it matter”?

Peggy

 

Peggy Storr BSRDH

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Many people think that dental care of baby (primary) teeth isn’t really necessary. They aren’t permanent teeth and they will be lost eventually. The truth is that as soon as those little teeth appear, they should be cleaned daily. A tiny smear of toothpaste should start about the age of 1, as should the first visit to the dentist. Many of the baby teeth will be in your child’s mouth until he or she is 13 years old.

Look in your child’s mouth. White spots or lesions are early signs of demineralization or decay of the teeth. These lesions can be reversed with proper homecare and administration of fluoride and or MI Paste.

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www.recaldent.com

Early-Childhood-Caries1

http://www.babyorganics.co.id/general/dental-caries-on-children/

Decay (cavities or caries) in baby teeth is a serious health concern that is now known to be contagious. Dental decay is five times more common than asthma and seven times more common than hay fever in children. While decay in permanent teeth has declined, decay in baby teeth is increasing. Left untreated, cavities can lead to dental pain that can affect a child’s eating, speaking, and learning. It can lead to expensive treatment, malnourishment, disruption of growth and development, and may even cause life threatening infections. If the dentist simply pulls the decayed tooth, it can affect how the permanent teeth grow in. The space from the baby tooth must be preserved or the permanent teeth may erupt in a crowded and incorrect position.

Most people are surprised to learn that cavities are contagious. But bacteria, particularly Mutans Streptococci, are responsible for tooth decay and bacteria can be transmitted from one person to another. If mom cleans the baby’s pacifier by putting it in her own mouth, or shares a spoon, she can transfer bacteria to the baby. Being mindful of diet is a first step in prevention of tooth decay. Dipping a pacifier in honey or sugar is a bad idea, as is letting a child go to bed with a bottle of milk, juice, or anything other than water.

Chewy, sticky foods (such as dried fruit or candy) are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugary drinks or frequent sucking on candy and mints. The sticky sour candies kids love so much are the worst as they stay in the mouth longer and cause significant increases in the acid that cause tooth decay.

Dental sealants can prevent some cavities. Sealants are thin plastic-like coatings applied to the chewing surfaces of the molars. This coating prevents the buildup of plaque in the deep grooves on these surfaces. Sealants are often applied on the teeth of children, shortly after the molars come in.

Fluoride is also recommended to protect against dental caries. People who get fluoride in their drinking water or by taking fluoride supplements have less tooth decay. Numerous studies report that products containing Xylitol decrease tooth decay. Gum or mints for children who are beyond the choking stage are recommended. Xylitol needs to be among the first three ingredients.

Dental disease can impact the total well-being of a child and is largely preventable.  So while they are “JUST BABY TEETH”, they are a vital consideration in the health of your child.  A healthy mouth contributes to the overall health every child.

Sources:

1. Ezer, Michelle, S, DDS, Swoboda, Natalie A DDS and Farkouh, David DMD, MS; Early Childhood Caries: The Dental Disease of Infants

2. Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.

3. Sleeper, Laura J, RDH, MA and Gronski Ashley; The Benefits of Xylitol; http://Dimensionsofdentalhygiene.com/June 2014

4. http://www.thedentalleif.net

5. http:// twoothtimer.com

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

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

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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.

baby toothbrushing.jpg

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.

Kids and Dentistry

I have to say that my favorite appointments are the ones with patients who are 18 and younger. No offense to the rest of the adult world, however, kids are the best. They are like little sponges soaking up all the dental knowledge I can share. Being a future parent I want to know all the information I can get to help my children have smooth transition into new experiences. Here are some kid tips for in office and at home to help our children have a great time at the dentist.

Office Tips:

When should my child first come to the dentist?

According to the American Academy of Pediatric Dentistry (AAPD) children should come no later than 12 months of age. That may sound early to most people. However, this helps create a dental home for the child. We can also answer questions that the parents may have. Your dentist and hygienist will give advice on snacking habits, teach oral hygiene tips and make sure your child’s teeth are coming in on schedule.

The first visit is called a “Happy Visit”, we show them the instruments and the dentist checks their teeth. Cleanings are dependent on the temperament of the child. Whatever they are comfortable with. We want a happy, calm visit.

Regular Check ups

Cleanings are to be 2 times per year. The dentist checks for dental decay, orthodontic needs, discuss sports guards and if sealants should be placed. Hygiene cleanings are performed. Fluoride treatments are given and oral hygiene instruction is tailored to the child’s needs.

What if my child has a cavity?

Then you are at the perfect place. At our offices we have wonderful doctors and staff who help each and every patient have a great experience. Start off by setting a good example to your child by being calm. The child will always be well-informed on what is going on during the appointment. Believe it or not we have had better experiences with not having the parent in the room during the procedures. This helps the child develop trust with the doctor and the child will more likely communicate with the dentist about his or her needs rather than the parent.

Nitrous Oxide or laughing gas is very effective for children. It is fast acting, calms the patient quickly, it is safe, reversible, and is affordable for most patients. Kids respond well to the nitrous. Just like adults your child will always have localized anesthesia to make the procedure virtually painless.

We may refer some patients to a pediatric dentist. This is decided by the child’s temperament, if there is a large amount of dental work to be done, or they need to be sedated. However, most of the time we can take care of all dental needs presented.

Home Tips:

Oral Hygiene Habits
Brush 2 times per day for 2 minutes. Make sure the brush has soft bristles. An electric toothbrush helps kids brush for longer and it is more fun.

It is recommended for parents to help children brush and floss until the age of 8.

Floss at least 1 time per day if not more.

Sequence-

  1. Rinse with mouthwash
  2. Floss
  3. Brush, spit in the sink and do not rinse afterwards. We want the fluoride to stay on the teeth.

Infants should have their oral cavity wiped with a clean damp cloth before bed at night.

Tooth brushing charts are a great motivator for kids who have a hard time brushing.You can find many online to print out.

Fluoride

Under 2 yrs smear fluoride toothpaste onto the brush. 2 yrs and above a small pea size should suffice. According to the AAPD.

Parents should dispense toothpaste to prevent from too much being digested.

Further questions about fluoride and its benefits consult your dentist or hygienist.

Diet

Have a balanced diet of veggies, fruit, meat and beans, dairy, and whole grains. Limit amounts of starchy and sugary foods.

Significantly decrease amounts of soda and fruit juices

Limit frequency of snacking.

Xylitol

Xylitol is a sugar substitute that also helps prevent cavities. It is put in gums such at Ice Breaker Ice Cubes, Trident and others. It also can be bought to be used in baking. Xylitol is a great way to keep sweets in our lives with benefit of not getting cavities.

Dental Caries is the number one disease that affects children. The good thing is that cavities are preventable. Health in the oral cavity affects our entire bodies. With these tips and many others our children are on their way to a life of happy, healthy, smiles.

-Kara Johansen BSRDH

American Academy of Pediatric Dentistry (2011). Ask Your Dentist About Dental Care For Your Baby. Retrieved from http://www.aapd.org/publications/brochures/

American Academy of Pediatric Dentistry (2011). Ask Your Dentist About Nitrous Oxide. Retrieved from http://www.aapd.org/publications/brochures/

American Academy of Pediatric Dentistry (2011). Ask your Dentist About Diet and Snacking. Retrieved from http://www.aapd.org/publications/brochures/

American Academy of Pediatric Dentistry (2011). Ask Your Dentist About Regular Dental Visits. Retrieved from http://www.aapd.org/publications/brochures/