Prevention

PROFESSIONAL DENTAL CLEANING

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:

• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

DIGITLA X-RAYS

Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.

Dental x-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.

Dental x-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and your teeth!

Are dental x-rays safe?

We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.

Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.

How often should dental x-rays be taken?

The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.

A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

FLOURIDE TREATMENT

Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.

Fluoride works in two ways:

Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.

Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.

Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:

• Deep pits and fissures on the chewing surfaces of teeth.
• Exposed and sensitive root surfaces.
• Fair to poor oral hygiene habits.
• Frequent sugar and carbohydrate intake.
• Inadequate exposure to fluorides.
• Inadequate saliva flow due to medical conditions, medical treatments or medications.
• Recent history of dental decay.

Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.

PROPER BRUSHING & FLOSSING

Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.

Reasons why proper brushing and flossing are essential:

• Prevention of tooth decay– Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
• Prevention of periodontal disease– Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
• Prevention of halitosis– Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
• Prevention of staining– Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.

The Proper Way to Brush

The teeth should be brushed at least twice a day; ideally in the morning and before bed. The perfect toothbrush is small in size with soft, rounded-end bristles and no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue. The American Dental Association (ADA) has given electric toothbrushes their seal of approval; stating that those with rotating or oscillating heads are more effective than other toothbrushes.

Here is a basic guide to proper brushing:

1. Place the toothbrush at a 45-degree angle where the gums and teeth meet.
2. Use small circular motions to gently brush the gumline and teeth.
3. Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
4. Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
5. Use back and forth strokes to brush the chewing surfaces.
6. Brush the tongue to remove fungi, food and debris.

The Proper Way to Floss

Flossing is a great way to remove plaque from the interdental regions (between the teeth). Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets. The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis. The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.

Here is a basic guide to proper flossing:

1. Cut a piece of floss to around 18 inches long.
2. Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
3. Work the floss gently between the teeth toward the gum line.
4. Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
5. Carefully move the floss up and down several times to remove interdental plaque and debris.
6. Do not pop the floss in and out between the teeth as this will inflame and cut the gums.

If you have any questions about the correct way to brush or floss, please ask your dentist or dental hygienist.

ORAL HYGIENE AIDS

Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.

Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.

There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.

Here are some of the most common oral hygiene aids for homecare:

Dental Flosses

Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.

Interdental Cleaners

Many hygienist & periodontists recommend interdental brushes in addition to dental floss. These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.

Mouth Rinses

There are two basic types of mouth rinse available: Cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription. Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.

Oral Irrigators

Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.

Rubber Tip Stimulators

The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.

Tongue Cleaners

Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.

Toothbrushes

There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.

Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.

If you have any questions about oral hygiene aids, please ask your dentist or dental hygienist.

SEALANTS

A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.

Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.

Reasons for sealants:

• Children and teenagers– As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
• Adults– Tooth surfaces without decay that have deep grooves or depressions.
• Baby teeth– Occasionally done if teeth have deep grooves or depressions and child is cavity prone.

What do sealants involve?

Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.

The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.

Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.

EXAM & HYGIENE VISIT

What can I expect on my visit with the Hygienist?

During your visit, your Dentist or Hygienist will review your complete medical and dental history with you. It is very important for your Dentist or Hygienist to know if you are taking any medications or are being treated for any condition that can affect your Periodontal care. The more they know, the better.

A complete oral and periodontal exam will be given. Your Dentist and Hygienist will examine your gums, and check for any gum recession or loose teeth. Also, an examination of your soft tissues will be given, including your tongue, lips, the inside of your cheeks, and the floor of your mouth to evaluate any lumps or bumps that might look unusual or suspicious.

What is a periodontal probe and Why do they use it?

Your dental hygienist will also take a small measuring device called a perio probe and will place it gently between your teeth and gums to record the measurement of gum tissue around each tooth and determine the depth of the pockets surrounding your teeth. Periodontal probing is necessary in determining the health of your gums.

How do they clean my teeth?

A routine procedure of root scaling and planing can be performed to remove any plaque or calculus (tartar) from below the gumline. This is a non-surgical procedure, where the surface of the tooth root are cleaned and smoothed.

Once this is completed, your hygienist will evaluate your teeth for any stain or plaque that might remain on the teeth and can remove them with a rubber cup polish, followed by a professional fluoride application.

Your hygienist will also give you any advice you could want for maintaining your own personal oral health, including diet counseling and promotion of general health.

What about x-rays?

Radiographs (x-rays) may be taken, as determined by your Dentist, which show the bone levels between your teeth so that he/she can check for bone loss or any other pathology that may be present (like cysts or tumors) and assess any tooth decay.

At the end of your hygiene visit, your Dentist will review your periodontal records and discuss any general dentistry concerns and make any further treatment recommendations at that time

MOUTHGUARD

What is a Mouthguard?

A properly fitted mouthguard is an important appliance you wear to prevent facial and head injuries while playing sports. They do a lot more than just protect your teeth. A mouthguard not only protects your smile it will prevent injuries to:

• your lips
• cheeks
• tongue
• neck
• brain
• lower jawbone
• Temporomandibular Joint

Mouthguards help to cushion potential blows during physical sports that might otherwise cause these injuries.

Who should wear a Mouthguard?

You don’t have to be on the hockey rink or football field to benefit from a well fitted mouthguard. It is recommended that everyone, from children to adults, wear a mouthguard during any recreational activity that could possibly be a risk of injury to the mouth.

If you’re athletic, you should consider getting a mouthguard.

What is a Nightguard?

A nightguard is an appliance you wear while you sleep to prevent you from damaging your teeth by grinding or clenching.

How is the nightguard effective?

A nightguard can help to reduce your grinding problems by:

• Relaxing your jaw muscles (which will reduce your headaches and sore jaws and balance the forces in your mouth).
• The nightguard appliance substitutes as the wearing material so that your teeth and jaw muscles don’t suffer the consequences: Better to grind the nightguard than your own tooth enamel!

Who should wear a nightguard?

If you grind your teeth at night, you should consider wearing a nightguard appliance.

Can children wear nightguards?

Special considerations for child toothginding should be taken. Child toothgrinding is common and may subside as your child ages and develops more permanent teeth. Consult your Dentist regarding treatment for children, as an appliance worn continually may interfere with their growth and development.

Where can I get a mouthguard or nightguard?

There are several different types of (sport) mouthguards available.

• stock mouthguard
• mouth-formed
• custom-fit

Nightguards are available from your dentist! They are made on models taken of your upper and lower teeth and can be made using hard or soft material. Discuss with your Dentist which is best for your situation.

How do I care for my mouthguard or nightguard?

There are several things you can do to make your guard last longer:

• Never bite your guard in place; biting on the guard when it’s out of position can possibly damage the guard, your teeth and gums.
• Rinse your guard, with cool water, after every use.
• Becareful not to use hot water as it may distort the appliance. A gentle, soft toothbrush may be used to clean, depending on the guard.
• Keep your guard in a safe carrying case while storing. This will protect it against breakage, household pets and also keep it clean.
• Make sure to schedule regular dental check-ups and your Dentist will look over the guard and review the amount of wear and its fit! (Bring your mouthguard or nightguard to each dental visit).

PERIODONTAL DISEASE

Periodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.

Some factors increase the risk of developing periodontal disease:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy or use of oral contraceptives

There are several warning signs that can signal a problem:

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy teeth.