If you’re seeing your dentist regularly, that’s great. But if that’s all you’re doing to stay ahead of dental disease, it’s not enough. In fact, what you do daily to care for your teeth is often the primary factor in whether or not you’ll maintain a healthy mouth.
Top of your oral care to-do list, of course, is removing daily plaque buildup from teeth and gums. This sticky film of bacteria and food particles can cause both tooth decay and periodontal (gum) disease. You do that with effective daily brushing and flossing.
Effective brushing starts with the right toothbrush—for most people a soft-bristled, multi-tufted brush—and fluoride toothpaste. As to technique, you should first avoid brushing too hard or too often (more than twice a day). This can damage your gums and cause them to recede, exposing the tooth roots to disease. Instead, use a gentle, scrubbing motion, being sure to thoroughly brush all tooth surfaces from the gumline to the top of the teeth, which usually takes about two minutes.
The other essential hygiene task, flossing, isn’t high on many people’s “favorite things to do list” due to frequent difficulties manipulating the floss. Your dentist can help you with technique, but if it still proves too difficult try some different tools: a floss threader to make it easier to pull floss through your teeth; or a water flosser, a handheld device that directs a pressurized water stream on tooth and gum surfaces to loosen and flush away plaque.
And don’t forget other tooth-friendly practices like avoiding sugary snacks between meals, drinking plenty of water to avoid dry mouth, and even waiting to brush or floss about an hour after eating. The latter is important because acid levels rise during eating and can temporarily soften enamel. The enzymes in saliva, though, can neutralize the acid and re-mineralize the enamel in about thirty minutes to an hour. Waiting to brush gives saliva a chance to do its job.
Lastly, keep alert for anything out of the ordinary: sores, lumps, spots on the teeth or reddened, swollen, bleeding gums. All these are potential signs of disease. The sooner you have them checked the better your chances of maintaining a healthy mouth.
If you would like more information on caring for your teeth at home, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
There is much to contend with as we grow older, including a higher risk for dental disease. One possible contributing factor: dry mouth from a lack of saliva.
Also known as xerostomia, dry mouth occurs when the salivary glands secrete less than the normal two to four pints a day. Saliva performs a number of functions, but perhaps the most important for dental health is as an acid neutralizer. Within a half hour to hour after eating, saliva can restore the mouth's normal pH level to prevent acid from softening tooth enamel. When there isn't enough saliva, acid levels stay high leading to erosion of the enamel. This vastly increases the chances for tooth decay.
Although there are several causes for dry mouth, one of the more common is as a side effect from certain medications. It's estimated over 500 drugs — many taken by seniors — can cause dry mouth, including diuretics for high blood pressure and heart failure, antidepressants, and antihistamines. Some diseases like diabetes or Parkinson's may also reduce saliva flow, as well as radiation and chemotherapy.
If you've developed chronic dry mouth, there are some things that may help restore adequate saliva flow. If medication is the cause you can talk to your doctor about an alternative medication or add a few sips of water before swallowing the pills and a full glass afterwards. You should also drink plenty of non-caffeinated beverages (water is the best) during the day and cut back on sugary or acidic foods. And a cool-air humidifier running while you sleep may also help keep your mouth moist.
We may further recommend an over-the-counter or prescription stimulant for saliva. For example, xylitol, a natural alcohol sugar that's found in many gums and mints, has been found to stimulate saliva and reduce the risk of tooth decay as an added benefit.
Last but not least, be sure to brush and floss daily to remove disease-causing plaque and see us at least twice a year for cleanings and checkups (if your mouth is very dry, three to four times a year is a better prevention program). Managing chronic dry mouth along with proper oral hygiene will help ensure your mouth continues to stay healthy as you grow older.
If you would like more information on the causes and treatment for dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Mouth.”
Maybe you don’t like to be without teeth — ever. Or maybe you get a little forgetful sometimes. Whatever the reason, if you’re wearing your dentures to bed at night, we have one message for you: Please stop!
Sleeping in dentures can have serious health consequences. A recent study published in the Journal of Dental Research found that nursing home residents who wore their dentures to sleep were 2.3 times more likely to be hospitalized or even die of pneumonia as those who did not sleep in dentures. But how can wearing dentures at night more than double your chances of getting a lung infection?
As the study noted, pneumonia-causing bacteria can readily be moved from the mouth to the lungs simply by breathing. And dentures that are not removed at night can become breeding grounds for all kind of bacteria and fungi (such as yeast). That’s what makes them potentially dangerous.
Another condition often seen in people who wear upper dentures continually is called denture stomatitis, which is characterized by a red, inflamed palate (roof of the mouth) that has been infected with yeast. The yeast microorganisms can also infect cracked corners of the mouth, a condition known as angular cheilitis. Moreover, it has also been shown that people who sleep in dentures have higher blood levels of a protein called interleukin 6, which indicates that the body is fighting an infection. Need we go on?
Wearing dentures is supposed to improve your quality of life, not reduce it. So promote good health by taking your dentures out at night, and sticking to a good daily oral hygiene routine:
- Remove and rinse your dentures after every meal.
- Brush your dentures at least once a day with a soft toothbrush or denture brush and dish soap, liquid antibacterial soap, or denture cleanser (but don’t use toothpaste — it is too abrasive).
- Store your dentures in water or a solution made for this purpose.
- Brush your gums and tongue every day with a soft toothbrush (not the same one you clean your dentures with).
- Rinse your dentures in clean water before you put them back in your mouth.
Unlike other tooth replacement options, dental implants require a surgical procedure. But don't let your imagination run wild — the procedure is relatively minor and easy for most people to undergo.
Implants are unique among restorations because they replace a tooth's root. A metal titanium post, substituting for the root, must be surgically placed into the jawbone. While the procedure itself is simple and no more involved than a tooth extraction, it does require careful attention to detail before, during and afterward.
Our first step is to examine the target site with x-rays (often CT scanning) to pinpoint the best location for placement. This is critical because where we place the implant will have a huge bearing on how attractive and natural the implant finally appears. From this evaluation we frequently create a surgical guide.
Surgery begins with a local anesthesia to completely numb the site. You will feel no pain during the procedure and only minimal discomfort for a few days afterward. We then make small incisions in the gums to access the bone and create a small channel or hole.
Using the surgical guide, we then initiate a drilling sequence that gradually increases the size of the channel until it's the size and shape of the implant post. One thing we must do at this point is take our time: we use gentle pressure and water-cooling to avoid overheating and damaging the bone.
Once we're finished with drilling we remove the implant from its sterile packaging and imbed it directly into the prepared channel. It's then a matter of verifying the location with x-rays and then closing the gum tissue with self-absorbing sutures if necessary.
Most patients only need mild pain medication like aspirin or ibuprofen to manage discomfort afterwards. You won't even notice it in a week or less. After several weeks in which the bone grows and adheres to the implant (a process called osseointegration), you'll be ready for the final step, attaching the life-like porcelain crown to the implant.
Although the process can take several weeks to months, your discomfort should be minimal at any stage. In the end, your patience will be rewarded with a new, more attractive smile.
If you would like more information on the process of obtaining dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Surgery.”
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