Why Floss? With all the discussion about gum disease and the consequences that it can have on your overall health, the question now becomes “What can you do about it?” Fortunately, the answers are just the basic good oral hygiene habits that we have always encouraged out patients to keep: Brush at least twice daily and floss at least once per day. Most people don’t have a problem with brushing, but flossing seems to be a much harder habit to maintain. Without flossing, it is not only more likely that you will get dental decay between your teeth, but it is impossible to keep gum disease from progressing. By not eliminating the bacterial mass that accumulates between your teeth, you are just asking for a problem to get started. Now gum disease is a slow smoldering fire, but smolder it does. While you might not notice the effects immediately, one day it will catch up to you. It always does. So if you ask yourself the question, “Why should I floss?” the answer is that you don’t really have to at all, as long as you are willing to accept the consequences.
Fluoride treatment for adults:
Have you ever wondered why children are routinely given fluoride at their check-up appointments but adults are not? The reason is that insurance companied have convinced America that there is no reason to give it to adults so it has become part of our culture; we don’t expect it so we don’t demand it. The reality is that topical fluoride treatments given to children have exactly the same benefit when given to adults. The “fluoride in the foam” serves to strengthen the outside surface tooth structure and makes it more resistant to dental decay. The fluoride has no way of telling how old the tooth is that it is being applied to. Furthermore, because the fluoride does not get incorporated into the deeper layers of the tooth, it is of no additional benefit to young developing teeth than it is to older mature teeth.
If you really think about it, fluoride can have a tremendous advantage to adults because adults typically have more expensive dental work in their mouths than do children. The tooth strengthening effect of fluoride makes it less likely that decay will creep underneath expensive dental work resulting in the need for the work to be replaced. It also can help reduce the likelihood of having as many dental emergencies. Routine fluoride treatment for adults can save you thousands of dollars over a lifetime.
Chronic Halitosis (Bad Breath):
There are some people who do suffer from what we call Super-Chronic Halitosis: chronic bad breath. For these patients, this is a real problem, because they know that they have it and can be very embarrassing. Fortunately there are some treatment options that are available that can be very helpful.
Bad breath is usually caused by bacteria living either below the gums or on the back surface of the tongue near the tonsils. Certain strains of bacteria produce volatile sulfides, or sulfur containing gasses, that are responsible for the odor. The fact that the bad breath is caused by bacteria is actually good news because it means that there is a cause that we can treat. Treatment usually involves tongue scraping at home twice daily as well as daily use of a prescription oral rinse. Most patients usually find improvement within two to three weeks.
Choose the right toothbrush:
One of the most overly gimmicked products available in stores today is the simple toothbrush. For some reason, toothbrush manufacturers believe that they have to trick you into buying one of their brushes. A common marketing tactic is to try to get you to believe that because of some revolutionary new design breakthrough, that their toothbrush is the only one that can adequately remove the plaque from your teeth. All of these claims simply cannot be true. I would like to give you some basic guidelines that should help you always choose the right toothbrush.
Choose a brush with soft bristles. Medium or firm bristles DO NOT clean your teeth any better than do soft bristles. The only advantage that medium or firm bristles have over soft is that they do more damage to your gum tissue. Second: Choose a brush that is comfortable and is one that you will use. The brush is not going to do you any good if you do not use it long enough to get the job done. 30 seconds is not long enough! If you get these two criteria right, there is very little else that matters. If you prefer electric toothbrushes, both Oral-B and Sonicare are excellent choices. There seems to be very little difference in effectiveness between the two.
Toothbrush Abrasion- Fact vs. Fiction:
In recent years, there has been some press attention about Toothbrush Abrasion and the effect that this can have on your teeth and gums. I hear questions about this topic regularly so I would like to provide some fact vs. fiction points for you.
Often patients will come into my practice with small notches in the roots of their teeth near the gum line and tell me that the have Toothbrush Abrasion. Medium or Firm bristles on your toothbrush can in fact push your gum tissue back, or cause abrasion of the gum tissue, if the toothbrush is used too aggressively (or with too much pressure). They cannot abrade away the hard tissue of your tooth. Notches in the tooth roots are called Abfractions and are cause by bruxism, or night time grinding habits.
One of the reasons toothbrush abrasion is an important issue to understand, is that once the abrasion takes place, the gum loss is permanent. The only way to recover the exposed tooth root is by placing a gum graft over the affected area.
A good friend once gave me some very valuable advice. He told me that, “…a failure to plan on my part, did not constitute an emergency on his part.” After thinking about this for a minute, I understood what he was trying to tell me. Some situations are preventable while others are not. My hope here is to give you the advice that you will need in order to help you know what to do if either condition is the case should you find yourself dealing with a dental emergency.
Broken or lost temporaries:
During the course of completing advanced dental work, it is common to place a temporary dental restoration to function as a place holder while the final restoration is being fabricated. Typically these temporary restorations function very well and cause no problems during their service. However, sometimes one of these temporary restorations can become loose, break or fall off. This constitutes a legitimate dental emergency. Here are some guidelines to follow if this has happened to you.
If the tooth does not hurt, there is usually no need to worry. Waiting until you are able to see your dentist during regular office hours should not cause any significant problems. If the tooth hurts, call your dentist.
If you cannot reach your dentist, and the temporary is not broken, most pharmacies carry dental temporary cement. Simply mix the cement according to the directions, fill the temporary, dry the tooth as well as possible and then place the temporary over the tooth. Bite your teeth together tightly for two to three minutes until the cement has set and then clean the excess cement away with a toothpick. However, do not floss! Flossing will likely just dislodge the temporary again. If you cannot find any temporary cement at your pharmacy, you can try either a denture adhesive like Polygrip® or a thin layer of petroleum jelly.
If the temporary restoration is lost or broken, call your dentist again. If you are still unable to reach your dentist do your best to avoid severe temperature changes, like drinking hot or cold liquids, and avoid chewing on the affected side. I do not recommend attempting to cover the tooth. In cases where there is severe discomfort, it may be helpful to take either Tylenol or Ibuprofen for pain relief until you can contact your dentist.
If you should happen to suffer a broken tooth and the tooth does not hurt, there is no need to see your dentist immediately. You should see your dentist as soon as possible though to prevent further damage from happening.If the tooth does hurt, call you dentist.
If you are unable to contact your dentist, do your best to avoid severe temperature changes, like drinking hot or cold liquids, and avoid chewing on the affected side. I do not recommend attempting to cover the tooth. In cases where there is severe discomfort, it may be helpful to take either Tylenol or Ibuprofen for pain relief until you can contact your dentist.If the area begins to swell and you are unable to contact your dentist, seek care at an urgent care medical facility or an emergency room.
One of the most common emergency calls I get in my office is a patient who has lost a filling. Most of the time this is an asymptomatic back tooth with a very old silver filling in it. What is surprising to most patients is that more often than not, it is actually a corner of the tooth that has fallen out rather than a piece of the filling. This happens because of the way that silver fillings weaken teeth over time. Because the weakening effect is a slowly progressing process, it usually does not cause any discomfort until the corner of the tooth actually falls off. Once this has happened though, the tooth can be sensitive to temperature changes as well as to sweets.
This usually does not constitute a crisis that requires immediate attention to avoid an infection or an abscess. It is a good idea to be gentle with the tooth and avoid severe temperature changes though. I would also recommend contacting your dentist at your first possible convenience and setting an appointment to have the tooth repaired before an extended period of sensitivity begins to cause more serious problems.
When do you need a Root Canal? This is news that nobody ever seems to be too happy to hear. For some reason, root canal treatment has earned itself a very strong reputation of being a painful experience that does not really deserve. The truth of the matter is that the pain that you can get in your tooth if you don’t have a timely root canal can be much more severe. So if you are ever told that you need to have this procedure done, don’t worry. Instead, be grateful that because of this recommendation you are going to avoid a much worse toothache.
If you are having some sensitivity and wonder what it might mean I have included a brief summary of symptoms that indicate you might need a root canal treatment and a list of those that indicate that you probably will not.
First symptoms that mean you probably do not need a root canal:
Sensitivity to cold or sweet that is non-lingering. If the sensitivity goes away as soon as the cold is removed from the tooth, the tooth is probably going to be fine without any treatment. Mild aching that requires little or no medication like Tylenol or Ibuprofen for relief will not likely need a root canal.
Symptoms that indicate you might need a root canal include:
Severe sensitivity to cold or sweet that lingers. If the sensitivity lingers longer than 30 seconds, this could be an indication that the nerve is beginning to die and that a root canal could be beneficial. Contact your dentist as soon as possible to have the tooth evaluated. Pain in a tooth that feels worse when you lie down or that makes it impossible to sleep is a strong indication that a root canal is in your near future. Sensitivity to heat is almost always a sign that you have a tooth that needs a root canal.Pain in a tooth that requires constant pain medication to manage is also a strong likelihood that you will need a root canal and means that you should contact your dentist as soon as possible for an appointment to have the tooth evaluated.
Traumatic Tooth Loss:
If you are in an accident and lose a tooth you have approximately 30 minutes to get the tooth back in the socket before it becomes probable that the tooth will not replant successfully. Whether or not you are able to find the tooth, place cotton gauze or a wet wash cloth over the injury and exert moderate biting pressure on the area to help stop the bleeding. If you can find the tooth, skim milk is the best solution to place it in to preserve the vitality of the cells on the surface of the tooth. Do not attempt to clean the surface of the tooth as this can damage these cells. If milk is not available, place the tooth in the injured person’s mouth and hold it in the saliva until you reach the dentist’s office. If a dentist is not available, seek care from your nearest urgent care center or emergency room.