Flossing…Do I have to?

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Wendy Parker RDH
 
Absolutely! In some shape or form, flossing is essential in keeping the mouth and the rest of your body healthy!
As a hygienist, I have heard almost every excuse as to why people don’t floss, and trust me, I understand! From the “I’m too tired at night” to the “I just don’t have time” or the “I just forget to,” my job today is to try and make it a little simpler for you to want to floss and to help you understand why we should floss.
 
As a mother of 4 little ones, I understand that flossing isn’t a priority somedays….getting showered is. But with that, let me just say, flossing really is something that you don’t see the immediate results from, but in 20 years when you have your teeth still and you are smiling at their graduation with all your pearly whites, you will thank me.
 
So, let’s start with answering the basic questions about flossing….WHY should I floss? I brush really well!Brushing is a wonderful thing, and we are encouraged to do it twice a day, for two minutes with a fluoride toothpaste. What most people don’t realize is that brushing only reaches that tops, outside and inside surfaces of the teeth. But how to get inbetween? There really isn’t a substitute for flossing, sorry to be the bearer of bad news. Rinsing with mouthrinse or using an electric toothbrush will definitely help with keeping the mouth cleaner however, it is NOT a substitute for flossing. Plaque and bacteria form on every surface in the mouth, including the tongue and inbetween the teeth, therefore, you have to clean every surface of the teeth, not just the ones you can see. The tongue, saliva, and brushing take care of the plaque on most surfaces of the teeth, but floss truly is the only way to get the sticky plaque off the sides.The idea behind flossing is that as long as you disrupt the bacteria in the mouth once every 24 hours, you prevent it from hardening and becoming tartar. Flossing is MOST effective just before or after brushing at bedtime but really….you can do it any time of the day! Stuck in traffic? Floss. Waiting to pick the kids up? Floss. Going for a walk? Floss. Any time is a great time to floss! When you floss, it prevents Gingivitis (inflammation of the gum tissues), bleeding gums, bad breath, and will make easier dental appointments! The more you floss, the easier it becomes and the less your gums will bleed. It’s kind of like riding a bike. The first time you get one, you’re a little shaky but with practice you’ll be jumping off curbs in no time!
A lot of times people don’t floss because their gums bleed. That is because the gum tissue in that area is unhealthy so the body sends more blood to that area to help it heal. When your gums bleed, and the bacteria from the plaque and tartar are present, that bacteria gets into your bloodstream it is carried throughout the body increasing your chances of heart disease, compromising your immune system, and possibly causing an infection in the lining of your heart, which can be deadly! So, the more you floss, the healthier your gums are and the less they bleed!
 
So now that we know why, let’s focus on HOW to properly floss….

  • Starting with about 18 inches of floss, wind most of the floss around each middle finger, leaving an inch or two of floss to work with
  • Holding the floss tautly between your thumbs and index fingers, slide it gently up-and-down between your teeth
  • Gently curve the floss around the base of each tooth, making sure you go beneath the gumline. Never snap or force the floss, as this may cut or bruise delicate gum tissue
  • Use clean sections of floss as you move from tooth to tooth
  • To remove the floss, use the same back-and-forth motion to bring the floss up and away from the teeth
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The type of floss you choose is up to you. My personal favorites are Glide floss and Oral-B Satin floss. You may need to try a few different types to find the one that’s right for you. But don’t give up! It does get easier. Flossing looks simple, right? But what if you don’t have the perfect and easiest mouth to floss? Or you hate how the floss cuts off your circulation in your fingers every time? When you walk down the dental isle in any store there are so many aides to assist you, so which one is right for you? Hopefully you have already asked your hygienist this question but if not, here are a few things for you to check out the next time you are perusing the dental isle.
 
Several of my patients enjoy using floss picks. These are a great way to start your day. They don’t cut off your circulation and are totally disposable. These are great to keep a pack in your car or purse when you’re out and about.
And you can find all kinds of cute designs for your kids! Kids don’t usually become proficient at flossing until 10 or 11 years old. It’s never too young to start them on flossing. They’ll thank you later!
 

For those with braces, bridges, or large gaps between their teeth you may want to try Oral-B’s superfloss. It is a piece of floss that has one stiff end, a thicker, yarn-like middle section, and regular floss at the end. It’s hand to floss your thread through those brackets, bridges, permanent retainers, and then use the floss width that fits the area. This is a favorite of mine.
Also for places that have a little bit of a space, braces or bridges, is the interproximal brush. Some are disposable, some are reusable, just check them out and decide which one you would like. But these are great for teens who get something stuck in their teeth at school and don’t want to carry a toothbrush with them. Or for men just before business meetings.
 
And of course, there are the rubber tips toothpicks. You can go back to old school and use a regular wooden toothpick if that’s your preference but these are great. They are small, disposable, and awesome for on the go. They have a flexible rubber tip you can get inbetween tight spaces, permanent retainers, and brackets. Check them out, you may like them.
 
I know that there are several other gadgets out there but these are just a few of my personal favorites. If you see one you like, ask us about it and we’ll do the research for you to see if it’s the best one for you! But no matter what you do, just be sure that you do your best and remember what Dory from Finding Nemo says, “Just keep flossing, just keep flossing, flossing, flossing…..” Or was is swimming?

Oral Cancer Detection

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Lora Cook RDH

Your Dentist can play vital role in detecting cancerous cells in the mouth at stage 0 to stage 1.

“According to the National Cancer Institute, most mouth cancers start as small flat cells that are in the lining of the mouth.” These area’s include lips, inside lining of the cheeks, roof or floor of the mouth. Also area’s of the tongue, sides of the tongue and under the tongue. The back of the throat is another area in the mouth that cancer can form. When oral cancer is caught early before it grows deeper into the tissue and progresses into the lymph nodes the outcome for the patient is good.

  • Stage 0 – Is the precancerous stage, this is where cells are identified to be abnormal. They have the potential to develop into tumor.
  • Stage 1 – Is when the primary tumor is 2 centimeters or smaller. In this early stage there are no cancer cells present in the nearby oral tissues or lymph nodes.

So what can the dentist do to catch oral cancer in the precancerous and primary stage of development? Its is called the Velscope! This is a tool used by the dentist to help detect precancerous and cancerous cells in small and early stages not easily seen by the naked eye. This type of exam is more thorough. This scope helps the doctor check for abnormalities just under the tissue surface. It can show where abnormal cells are, months and even years before they become easily visible to just the naked eye.

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http://www.leddental.com

 

Frequently asked questions:

What does the doctor look for?

The scope will direct fluorescence light to find abnormal cells. When looking through the scope healthy tissue will fluoresce, any tissue that is abnormal will appear dark. So the doctor is looking for any dark spots or areas. The dentist and your hygienist will also do a manual exam shown below feeling for lumps or bumps, and unilateral abnormalities.

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http://therightsmile.files.wordpress.com/2013/04/oral-cancer-screening.jpg?w=611&h=611

 

Is radiation involved when using the Velscope?

This exam is very safe, and there is no radiation involved. However the doctor will have you where some orange safety glasses to protect your eyes from the blue LED light from the scope.

How long does the exam take?

This exam takes all of one to two minutes to complete. Just long enough for the doctor to look at all the oral tissue in the mouth looking through the scope.

How often should I have this type of exam?

The doctor recommends thorough oral cancer screenings done at least once yearly.

American Cancer society recommends for people age 20 and older yearly screenings and exams for oral cancer.

 

Want to learn more? Visit us at http://www.alamedadentalaz.com

 

Sources:

http://www.livestrong.com/article/22882-early-stages-mouth-cancer/

http://www.webmd.com/oral-health/guide/oral-cancer

http://www.ddsgadget.com/ddsgadgetwp/velscop-early-detection-of-oral-cancer/

http://www.leddental.com

Oral Cancer Monthly Self Exam

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Amanda Orvis RDH

The prevalence of oral cancer is on the rise; in fact one person dies per hour from oral cancer. In the early stages oral cancer can often times go unnoticed. It can be painless and not obvious to the naked eye. The most common areas for oral cancer are the floor of the mouth & sides of the tongue. That being said, oral cancer can be found in various locations as well as a variety of shapes, colors and sizes. It is important that you perform monthly oral self-exams. If you notice any suspicious areas that do not go away within seven to fourteen days make an appointment with your dentist to have them checked. Remember early detection saves lives.

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How to perform a monthly self-exam:

Supplies: Flash light and a mirror

Steps:

  • Take a moment to look at the skin on your face and neck in the mirror. Look for any changes in the color of your skin, any changes in moles or beauty marks, any swelling, lumps or sores.
  • Use both hands to gently feel along the outside of your cheeks, your lower jaw bone, your jaw joint, in front of and behind both ears. Checking for any areas that do not feel uniform on both sides, any lumps and/or any areas that are swollen or tender.
  • Gently use both hands to feel down the sides of your neck, follow the path along the neck muscles. Gently place your fingertips around your “Adam’s Apple” and swallow. Try to notice if it moves up and down normally or if there is any deviation.
  • Gently use both hands to feel the tissue above and around your clavicles for any swollen or tender areas, or areas that do not feel uniform on both sides.
  • Remove any removable dentures or appliances from your mouth.
  • Use the flashlight to check the roof of your mouth for changes in color or texture. Use your index finger to lightly sweep the roof of your mouth to feel for any lumps or swellings.
  • Pull out your upper lip and then your lower lip looking for any changes in color, size and/or texture. Gently squeeze each lip and cheek with your thumb and index finger feeling for any lumps or tender areas.
  • Using your fingers gently pull your tongue forward and check the back of your throat. Also check all the surfaces of the tongue and the floor of your mouth looking for any changes in color, size and/or texture in the tissue.
  • Lift your tongue to the roof of your mouth. Using both of your index fingers gently place one index finger on the floor of your mouth and the other index finger under your chin and press your fingers towards each other feeling for any swellings or tenderness along the floor of the mouth.
  • Look at your gums for any change in color and/or texture. Run a finger around all the surfaces of your gums feeling for any swollen or tender areas. \

What to look for specifically:

  • White patches
  • Red patches
  • Sores that fail to heal
  • Lumps, bumps or masses
  • Any areas that are differ from one side to another

 

oral-cancer

 Want to learn more? Visit us at http://www.alamedadentalaz.com

 

Sources:

http://myoms.org/procedures/head-neck-and-oral-cancer

http://fightoralcancer.org/information/images/

http://www.sixstepscreening.org/wp-content/uploads/SixStepScreening.pdf

http://oralcancerfoundation.org/

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=lh3dem7gJGMA5M&tbnid=lSyDf2Zx6tGb8M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.ocfstore.org%2Foral_cancer_wristbands_p%2Focf_wristband.htm&ei=73M9U_K4DuO0yAGh6IDABA&bvm=bv.63934634,d.aWc&psig=AFQjCNE7TOClwAu96v2KHsbn1XlrAdQ49w&ust=1396622626125563

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=osKRQqBu-J5qcM&tbnid=o3zZpWEozQnX-M:&ved=0CAUQjRw&url=https%3A%2F%2Fstjamesdentalgroupcudahy.wordpress.com%2Ftag%2Foral-cancer-self-exam%2F&ei=YXQ9U6uJBaKQyAGt9oHQDw&bvm=bv.63934634,d.aWc&psig=AFQjCNFoFpa18hNHhvzAAzKxqgandu3-2Q&ust=1396622812272438

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=JWvDkHxnv4okFM&tbnid=VRZ3RjtVWC5AKM:&ved=0CAUQjRw&url=http%3A%2F%2Flaneendsdental.wordpress.com%2F2013%2F06%2F15%2Fmouth-oral-cancer-in-the-news%2F&ei=zHU9U_XoB6_lygHGu4HQDA&psig=AFQjCNEyDetzw_20EKBCjYSVXCnqHqZW5A&ust=1396623042961165

 

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

 

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.

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/

Wonders of Whitening

There are so many different types of teeth whitening out on the market now-a-days, ever wonder if they all work? Which ones are the best for you? Do they last long? Are they good for your teeth and gums? Do they damage your tooth structure? Often, people whiten their teeth with different products without really knowing what it is, the effectiveness, and do they have that long-term effect that everyone wants. If you’re anything like me, you strive for whiter teeth every day. I have been obsessed with whitening my teeth ever since I got my braces off 6 years ago. I have tried every method under the sun and have found positives and negatives about each one.

The first method I started out with were the whitening strips. I found these to be most convenient and affordable at a young age. I purchased the 60 pack of Crest White Strips at Costco for around 100 dollars. I started using them as soon as I got home! I found they were a little odd at first. Teeth whitening strips are clear, flimsy plastic that you place on your teeth and hope that they don’t slide or fall off so you won’t have to taste the yucky bleach. They are coated on one side with a film of hydrogen peroxide bleaching agent. You open a bottom strip, and a top strip and place them on your teeth. I found them to be a bit awkward because I felt like I had to keep my mouth open, and smiling the whole time so I wouldn’t swallow the bleach, or get it on anything but my teeth. The strips definitely made a difference, it just took a while. If you’re an impatient person like I am, this is not the route to go.

Another option I tried was ordering trays online that you boil and then shape them to your teeth. Let me tell you one thing before I continue, DO NOT WASTE YOUR MONEY ON THIS. They do not work, and are the most frustrating things on the planet. Trying to boil something, and put it into your mouth right after, HURTS! They didn’t mold correctly, and they were uncomfortable. I had a hard time having them in my mouth for an hour each day. I just couldn’t do it anymore. After about 2 weeks of no difference in my teeth what-so-ever. Definitely recommend steering clear of an online order for bleach trays.

I am an aspiring Dental Hygienist. I have a passion for teeth, and have had that passion ever since I would beg my friends to allow me pull their teeth out when I was 5 years old. Teeth are a big deal in my life. I started working in a dental office about 7 months ago while I go to school for Dental Hygiene. While working there, I have been introduced to a whole new world of whitening. I have learned more about whitening then I have ever hoped. The first week of working, I purchased the custom trays. Let me just say this before I continue, this has been the best decision I have ever made (next to some other life altering choices). The trays are affordable and range depending on the office, mine were obviously at a discounted price being an employee of the practice. These trays are custom, like I said. Getting set up does take the most time by far, but the results are more than worth the time invested. First you come in for impressions, usually later that day we have the trays ready for you. The material we use comes in a prefilled syringe like tube which makes it easier to apply in the bleach trays. The syringes contain 16% hydrogen peroxide which is more than enough to remove those stubborn stains, or even effects of tetracycline use (see previous blog). I have a bonded tooth that can sometimes get a little discolored, and what I love most about this bleach is that it makes a huge difference even on my bonded tooth. The best thing about custom trays is that they are comfortable, and you only have to use a little bit of gel, so when you put the trays in, they aren’t over flowing with bleach making it awkward to close your mouth. I wore my trays consistently for one hour every night for 7 days and saw a huge difference. The trays are a good choice if you’re the type of person that wants results fast and loves convenience at a reasonable cost. The only downside to this method of whitening is that when you put too much bleach in your trays and it makes contact with your gums, it may cause a little bit of discomfort or a little bit of pain. But other than that, this is my go to whitening!

My office, as well as many other dentist offices offer in office whitening. It is a one day office visit, pain-free, short chair time procedure, with lasting results. This is by far the most popular procedure. It is popular because of the long-lasting effects. You have one visit, and your teeth are up to 7 shades lighter. A lot of people are very hesitant of in office whitening due to the fact that they are afraid their teeth may become sensitive. With the in office procedure, 4 separate tubes of whitening are applied to your teeth over an hour period in 15 minutes intervals there is little to no sensitivity.

All of this talk about whitening leads me to my most exciting discovery. In talking about my pursuit for excellence in whitening around the office, I discovered that my office participates in an annual Zoom Whitening campaign called Smiles for Life. Smiles for Life is a whitening campaign partnered with the Crown Council that whitens teeth on a donation basis. During March – June of every year my office joined with Philips Oral Health makers of ZOOM whiten teeth and all the proceeds go directly to charity, 50% of proceeds benefit national children’s charities, 50% benefit a charity of our choice – Hope Arising, visit http://www.smilesforlife.org for more details. Hope Arising is a sustainable organization that helps people of Ethiopia, we work very closely with Hope Arising , even traveling to Africa twice a year to aid in their stabilization efforts. While in Ethiopia we provide dental services to those in need as well as aid in other efforts to stabilize agriculture and water delivery systems to local villages, visit http://www.hopearising.org for more details or information on how you can help. In the 2012 Smiles for Life campaign we raised over $10,000 and donated approximately $5,000 to Hope Arising, were hoping for an even more successful 2013.

Different whitening methods apply to different people. You may love the strips, and hate the trays. You may love the in office whitening and hate everything else. These are just some of Cassie’s (me) tips to whiter teeth! And for a good cause, too  If you need any more information on whitening, please feel free to email me at appt@shalimarfamilydentistry.com or call me at (480)838-3355. I am very reachable by both.teeth-whiteningpress_release_distribution_0301198_57938