Why is oral hygiene so important? Adults over 35 lose more teeth to gum diseases, (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily.
Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film, which sticks to your teeth at the gum line. Plaque constantly forms on your teeth. By thorough daily brushing and flossing you can remove these germs and help prevent periodontal disease.
While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth and gums in the pocket, but not so much pressure that you feel any discomfort.
When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside (tongue side) of the back teeth.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth.
Next you will clean the biting surfaces of your teeth by using short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.
Frequently electric brushes can be very effective. For most patients a better result can be achieved with less effort. Sonicare, Oral B and Braun make very effective electric brushes.
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed, or woven, is easier and more effective) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the backside of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long let us know if sensitivity persists after dental treatment as a more serious condition may be present.
Often sensitivity can occur because of tooth brush abrasion, gum recession, chemical erosion from acidic diets, abfraction (chipping at the gum line from tooth clenching), or wear from tooth grinding. These above cause the reduction of enamel on the teeth and less protection from cold temperatures and sweets.
Today there are many antidotes for this type of sensitivity. Tooth pastes, fluoride treatments, rinses, or varnishes that contain high concentration of fluorides potassium nitrates and other protective compounds can be used to soothe and in some cases reverse this kind of sensitivity. In more severe cases physical bonded barriers can be placed, gum graphs or restorations preformed to provide a more significant and permanent solution. We are learning more about the benefit of ph balancing treatment rinses from CariFree and would be happy to discuss the benefits with you.
There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with Sonicare and Oral-B electric toothbrushes. Some toothbrushes have a rubber tip on the handle; this is used to massage the gums and clean in the pocket of the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth
Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.
Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control.
Unique and specialized aids can be useful adjuncts for some patients. The best prevention we find is a routine that is simple and can be maintained every day. Using the electric toothbrush and flossing effectively has shown the best results over time.
Our goal is to help you develop an effective technique that you can implement every day. This virtually can eliminate your need to spend a lot of money and time on professional therapies.
Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Your visit to our office is an important part of your program to prevent gum disease but it is our philosophy to recommend cleanings in intervals that are suited to your specific chemistry and health condition rather than insurance metrics. We want you to have a routine that is easy low cost and effective that assists you in keeping your teeth for your lifetime.
Good nutrition plays a large role in your dental health. Brushing and flossing help to keep your teeth and gums healthy and strong however a balanced diet will help to boost your bodies immune system, leaving you less vulnerable to oral disease and inflammation that we are finding has wide spread implications.
How often and what you eat have been found to affect your dental health.
Starchy foods: Eating starchy foods such as crackers, bread, cookies and candy causes the bacteria in your mouth feed on it, they then produce acids, which attack your teeth for up to 20 minutes or more.
Sticky foods: Also foods that stick to your teeth such as raisins or fruit rolls or are slow to dissolve give the acids more time to work on destroying your tooth enamel.
Acidic foods: As people are keeping their teeth longer, we are seeing a huge rise in chemical erosions from acidic beverages especially colas. The sugars in these drinks are very high and destructive.
Sugary foods: If sugary foods are introduced to the teeth repeatedly throughout the day the teeth are constantly bathed in sugar and the acids remain extremely high, breaking down the teeth. Saliva is a natural buffer so it is less destructive to have one dessert and drink water and chew sugar free gum than to sip on coffee with sugar in it or have a sugary juice beverage throughout the day. Certainly brushing with tooth paste after a meal is preferable.
Hard crunchy foods: Extremely hard foods such as corn nuts, hard candies and ice can break natural teeth and dental work. Especially vulnerable are teeth with very large old silver fillings. We see a high correlation between tooth fracture and, for example, ice chewing.
Staining foods: Certain tannic foods and very concentrated foods such as red wine and tea can stain teeth, dental restorations and can expedite natural staining of enamel.
Foods such as nuts, cheese, onions, and some teas have been shown to slow growth of decay- causing bacteria in the mouth.
Vitamins have been shown to be more necessary than ever as even the most wholesome organic foods are grown in our world where soil nutrients are depleted and ground water is more contaminated.
Periodontal diseases are infections of the gums, which gradually destroy the support of your natural teeth. There are numerous disease entities and bacterial strains requiring different treatment approaches. Dental plaque is the primary cause of gum disease in genetically susceptible individuals. Daily brushing and flossing will prevent most periodontal conditions. In some cases bacterial cultures can be taken and specific antibiotic protocols can be prescribed in addition to traditional periodontal therapies preformed in the office.
Why is oral hygiene so important? Adults over 35 lose more teeth to gum diseases, (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily.
Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film, which sticks to your teeth at the gum line. Plaque constantly forms on your teeth. By thorough daily brushing and flossing you can remove these germs and help prevent periodontal disease.
Periodontal diseases can be accelerated by a number of different factors. However, it is mainly caused by the bacteria found in dental plaque, a sticky colorless film that constantly forms on your teeth. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar).
Bacteria found in plaque produces toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gum tissue houses persistent inflammation and there is a breakdown in the attachment of the gum to the teeth and a breakdown of the bone supporting the teeth. When the gums separate from the teeth, pockets, or spaces, form that are difficult to access and harbor more and more bacterial plaque and calculus. The breakdown continues. The pockets are diagnosed by measuring the depth of the pockets. Typically pockets that measure 1-3 mm and have no redness, inflammation or bleeding are considered healthy. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. The pockets get deeper and can have progressively larger measurements. If left untreated, this leads to lack of support for the teeth, mobility and tooth loss.
The best way to prevent gum disease is effective daily brushing and flossing as most diligent home dental care, most people still can develop some form of periodontal disease and build up of calculus over time. Once this disease starts, professional intervention is necessary to prevent its progress.
Other important factors affecting the health of your gums include:
Prophy: this is the term for a routine cleaning where pockets measure 1-4 mm and there may be few but some areas of redness inflammation or slight bleeding. Typically hand instruments, possibly the ultrasonic, floss, and polishers are used during this appointment.
Periodontal Debridement: this is a term for an initial removal of large deposits on the teeth and major stain. It is indicated when a patient has not seen a dentist for a long time or has medical compromise and has generalized moderate to heavy calculus build up. It is not in itself curative but prepared the mouth for a finer more therapeutic scaling. This can be effective when the pockets may or may not be deep and more time is required to do an effective treatment due to the amount or tenacity of deposits.
Root Planning: This is a term for a treatment that is under the basic services and is indicted when pockets are over 4 mm. Basically the same technique is preformed just on more of the root surface under the gums in the pockets. There are more specifically shaped instruments used and most often anesthesia is administered for maximum patient comfort. The mouth can be divided into 2-6 sections and an hour visit can be allowed for each section in some cases to be thorough.
Arestin: This is a new technology where an antibiotic pellet is placed in the pocket after scaling and has shown to stay in place in a adhesive gel state for a prolonged period of time and disinfect and promote a higher level of healing.
Gum Surgery: There are times when the best and most predictable therapy can be surgical where we need to:
Some of these procedures are performed in our office and often we work in conjunction with a Periodontist, a gum surgeon specialist. Close follow up is indicated and can be by alternating subsequent cleanings in the specialist’s office.
Whenever we are providing a treatment it is most important that our patients are comfortable. Communication is the key. Everyone has unique situations and can have particularly sensitive teeth or gums. We have topical gum desensitizers, we have teeth and root desensitizers and there are new technologies that Oraquix solution can be placed into the pocket topically to relieve discomfort. Often we will numb the entire tooth and gum in the region to obtain comfort if necessary to provide a pleasant experience. If patients have had severely traumatic experiences in the past a whole half mouth can be given anesthesia and a second visit scheduled for the other half even if no pockets or root planning are indicated.
Cynthia Stephenson DDS your Walnut Creek Dentist provides Dental Implants, Porcelain Veneers, Dental Bonding, Teeth Whitening, Dental Sealants,
Mercury-Free Fillings, Preventative Dentistry, Children's Dentistry, Elder Care.
Address: 1981 North Broadway • Suite 212 • Walnut Creek, CA 94596 • Telephone: 925-938-6000 • Fax: 925-938-6001
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Dr. Cynthia Stephenson provides Family Dentistry & Cosmetic Dentistry to patients in the San Francisco East Bay,
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