Posts for: January, 2014
You've probably brushed your teeth every day since early childhood when your parents handed you your first toothbrush. But do you really know if you're doing it effectively and removing disease causing bacterial plaque or biofilm? Let's take a look at the basics of tooth brushing.
What is the goal of brushing and flossing your teeth? While it is true that brushing your teeth freshens your breath and removes stains from the surfaces of your teeth, the principal goal of tooth brushing is to remove dental bacterial plaque. This biofilm grows in the nooks and crannies of your teeth, and especially at the gum line — regardless of what you eat or drink. If left on your teeth, this bacterial film can cause gingivitis (inflammation of your gums). It can progress to periodontal disease, affecting the supporting bone of your teeth and even result in tooth loss. This means that flossing should also be an important part of your daily dental hygiene routine to remove plaque from the protected areas between your teeth.
Can you actually brush too much? More is not always better and can be damaging. We advise you to use a soft brush and to brush gently. It does not take force to remove plaque, and using a toothbrush too vigorously can damage your gums and cause them to recede (shrink away from your teeth), causing sensitivity and tooth wear. It takes between 12 and 24 hours for plaque to form on your teeth, so you don't need to brush more than twice a day and floss once a day.
How do you know when you've done a good job? A good test is that your teeth should feel like you've just had a professional cleaning. Your tongue is a great evaluator — just feel for smoothness at the gum line.
Is a powered toothbrush better than a manual one? An evidence-based study comparing all the research available found little difference between power and manual toothbrushes. The conclusion was that some powered toothbrushes with a rotation-oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushes. But as we say, “it's not the brush, it's the hand that holds it.”
Come to our office for a demonstration. Any brush, whether electric or hand-powered, requires professional demonstration and training so that you know how to remove plaque correctly. Bring your toothbrush with you on your next visit to our office, so we can see your brushing technique and make sure you are doing it correctly for the most efficient plaque removal. And don't be embarrassed — nobody really knows how to brush effectively until they're shown!
Contact us today to schedule an appointment or to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Manual vs Powered Toothbrushes.”
Tooth whitening procedures and products have become increasingly popular over the last two decades. There are two main sources of application: professional procedures performed in a dentist’s office; and over-the-counter products for performing whitening applications at home. While there are pros and cons to both approaches, neither type poses a significant health risk — that is, if you match the correct product to the type of staining you have, and it’s applied according to the manufacturer’s instructions.
Although whitening treatments may differ in formula and strength, almost all use hydrogen peroxide as the bleaching agent, usually contained in carbamide peroxide which splits into hydrogen peroxide and urea upon activation. After many studies, there’s a strong consensus that hydrogen peroxide used at the levels found in whitening products doesn’t cause any harm to the body, including as a precursor to cancer.
But as the 16th Century Swiss physician Paracelsus once noted, “All substances are poisons… The right dose differentiates a poison from a remedy.” This is true of the chemicals that make up whitening products — they’re safe unless they’re overused. Going beyond their directions for use could lead to tooth enamel damage.
Further caution is also in order for teenagers using whitening products. Although they may have their permanent teeth (although younger teens may still have some primary teeth), the enamel layer is still developing and can be more vulnerable to damage from whitening chemicals than for adults.
The best approach for both a professional or home whitening procedure is to first seek consultation from our office. If nothing else, you should at least undergo a dental examination to identify the true cause of your teeth’s staining or discoloration. If the discoloration originates within the tooth, home applications and many professional treatments will not help if they bleach the outer surface only. We can also advise you on the proper application and dosage for a chosen product.
Using the right whitening product and in an appropriate manner will reduce the risk of injury to your teeth and overall health. And, the end result can be a brighter, more vibrant smile.
If you would like more information on tooth whitening, 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 “Tooth Whitening Safety Tips.”
Many people suffer from problems with the temporomandibular joint (TMJ); this can result in chronic pain and severely limit the function of the jaw. Yet exactly what causes the problems, how best to treat them… and even the precise number of people affected (estimates range from 10 million to 36 million) are hotly debated topics.
There are, however, a few common threads that have emerged from a recent survey of people who suffer from temporomandibular joint disorders (TMJD). Some of them are surprising: For example, most sufferers are women of childbearing age. And two-thirds of those surveyed say they experienced three or more associated health problems along with TMJD; these include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, rheumatoid arthritis, chronic headaches, depression, and sleep disturbances. The links between these threads aren’t yet clear.
The survey also revealed some interesting facts about treating TMJD. One of the most conservative treatments — thermal therapy (hot or cold compresses) — was found by 91% to offer the most effective relief of symptoms. By contrast, the most invasive treatmentâ??surgeryâ??was a mixed bag: A slightly higher percentage reported that surgery actually made the condition worse compared to those who said it made them better.
So what should you do if you think you may have TMJD? For starters, it’s certainly a good idea to see a dentist to rule out other conditions with similar symptoms. If you do have TMJD, treatment should always begin with some conservative therapies: moist heat or cold packs, along with over-the-counter anti-inflammatory medications if you can tolerate them. Eating a softer diet, temporarily, may also help. If you’re considering more invasive treatments, however, be sure you understand all the pros and cons — and the alternatives — before you act. And be sure to get a second opinion before surgery.
If you would like more information about temporomandibular joint disorders (TMJD), call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Chronic Jaw Pain And Associated Conditions” and “Seeking Relief from TMD.”
You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.
This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.
We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.
Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.
The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.
Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.
If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”