Preventive Services
Brushing
Brushing Your Teeth
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Proper tooth brushing involves four things: a toothbrush with soft bristles, toothpaste with fluoride, the correct angle of brushing, and brushing in a pattern. Here are some tips that will help you get the most out of your brushing sessions.
- Whether you use a manual toothbrush or an electric toothbrush, it's important to brush at least twice a day, after breakfast and before bed.
- We recommend the use of a toothbrush with soft bristles. Soft bristles with rounded tips are kinder to your teeth and gums, and they also make it easier to remove plaque below the gumline, where periodontal disease starts.
- Use a pea-sized amount of toothpaste that contains fluoride. Fluoride hardens the outer enamel layer of the teeth. It might stop a cavity in its tracks and give you more resistance to future cavities.
- Angle the bristles of the brush along the gumline at a 45-degree angle and apply firm pressure so the bristles slide under the gum line.
- Vibrate the brush while you move it in short back and forth strokes and in small circular motions. Brush two or three teeth at a time and then move to the next teeth, allowing some overlap.
- Tilt the brush and use the tip to brush the backs of the front teeth.
- It's fine to brush in any regular pattern you choose, but since the insides of the teeth tend to get less attention, you might start with the insides of the upper teeth, then go to the insides of the lower teeth. Switch to the outsides of the upper teeth, and then the outsides of the lower teeth. Brush the chewing surfaces of the upper teeth, then the lower teeth. Complete your routine by gently brushing your tongue and the roof of your mouth. This removes germs and keeps your breath fresh.
- Change your toothbrush when the bristles are worn or bent, at least every three months. Old bristles don't clean well under the gum line, and they host more plaque and disease-causing bacteria.
What Are Cavities?
How cavities form
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Plaque, a sticky film of food and bacteria that is constantly forming on your teeth, is the culprit when it comes to tooth decay. Bacteria that naturally exist in plaque break down the starches and sugars in the food you eat. A chemical reaction occurs, and as a result, an acid is produced. Like all acids, the acid produced in your mouth is corrosive, which means that it dissolves other materials. Your teeth are the victims of this corrosive action; the acid dissolves their protective outer enamel layer, eventually creating holes in your teeth (cavities).
Regular checkups are a must
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Cavities first form in the hard, protective enamel layer of your teeth. Beneath the enamel is a softer layer called dentin. If a cavity wears through the enamel and reaches the dentin, it can grow much more quickly and threaten the inner layer of the tooth, containing its nerves and blood vessels. This part of your tooth is called the pulp chamber.
If the decay is allowed to penetrate the enamel and dentin and gets into the pulp chamber, it's likely that we'll need to perform root canal treatment. That's why regular checkups and professional cleanings are so important; they allow us to restore your tooth while the cavity is still small and confined to the outer enamel layer.
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Diagnosing cavities
Sometimes, we can detect cavities just by looking at your teeth, but to find cavities in their early stages when they are very small, we use a dental explorer and X-rays. A dental explorer finds cavities on the surfaces of your teeth; the explorer catches or sticks in the tiny pits created by cavities. X-rays locate cavities between teeth where the explorer can't reach.
Repairing and preventing cavities
To repair a tooth with a cavity, we usually remove the decayed portion of the tooth and replace it with a filling, provided the damage is not extensive and there is still plenty of healthy tooth structure remaining. However, preventing decay in the first place is the preferred solution! We'll be happy to work with you so you'll learn to keep your teeth free of plaque and decay.
How Teeth Decay
Our goal is to help you prevent tooth decay and keep your natural teeth for a lifetime. That's why we want you to understand the process of tooth decay, from start to finish. Armed with this knowledge, you can take steps to stop tooth decay in its tracks.
Bacteria and sugar are the culprits
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Thousands of bacteria exist in everyone's mouth. Most of these bacteria are beneficial. But there are two types of bacteria, mutans streptococcus and lactobacillus, that are the primary culprits in the tooth decay process. If you're not brushing and flossing regularly, or if your oral environment is out of its natural balance, these bacteria reproduce quickly in your mouth, establishing huge colonies whenever they're given the opportunity to feast on foods that contain sugar.
Sugars, which are the building blocks of starchy foods like pasta, crackers, bread, and sweets, can build up on your teeth if you don’t brush regularly. This sugar buildup is one component of plaque, a sticky film of saliva, food debris, and bacteria that’s constantly forming on your teeth. If ifs not removed, plaque mineralizes and can turn into rock-hard tartar in as little as 24 hours.
To survive and multiply in your mouth, the decay-causing bacteria feed off of the simple sugars that are produced from the starches you eat. This causes a chemical reaction in which the sugars are broken down into simpler elements. One of these elements is an acid. As you probably know, acid breaks down many things, including your tooth enamel. Every time you eat a starchy food, your teeth are bathed in this acid for 20 minutes or more.
The process of decay
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The acid slowly dissolves the hard, protective enamel layer on your teeth, forming a demineralized area that appears as a white or brown spot on your tooth. That spot is the first visible sign of tooth decay. If the area does not remineralize, it will progress until a hole, also known as a cavity, develops on the surface of your tooth. It’s vital that we treat your tooth decay early, before it can penetrate the surface of your tooth. Once a cavity has entered the softer dentin layer of your teeth, it can grow more quickly and may lead to a much more complicated and expensive set of problems.
How to avoid decay
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The good news? You can cut down on the frequency of acid production in your mouth by limiting the number of times you eat each day. Also, when you brush and floss properly and regularly, there's very little plaque on your teeth. Consequently, the number of decay-causing bacteria on the surfaces of your teeth will be dramatically reduced, and in turn, they won’t be producing the enamel-destroying acid. You should also use toothpaste that contains fluoride, which will strengthen your tooth enamel so it's more resistant to decay. And what about the times when you can't brush? You'll need to use other methods, like rinsing with water or a fluoride mouthrinse or chewing sugarless gum, to minimize the acid attacks and protect your teeth.
Flossing
Why flossing is important
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Brushing is a good way to prevent cavities, but it s only half the battle; flossing is just as important! Most cavities start between your teeth, where the bristles of your toothbrush simply can t reach. To keep your gums and teeth healthy, you must use dental floss to remove the plaque between your teeth at least once a day.
How to use dental floss
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First, take about eighteen inches of floss and wind the two ends of it around your middle fingers, leaving about five inches between your hands. Pinch the floss between your thumbs and index fingers, and leave about one inch in between to work with. Gently guide the floss between the first two teeth using a side-to-side motion.
Pull the floss tightly in a C shape around the side of one tooth and slide it under the gum line. Clean the surface of the tooth by using an up-and-down motion, not the side-to-side motion you used to guide the floss between the teeth. Repeat on the adjacent tooth. Then remove the floss, wind it to a fresh section, and repeat the process to clean both sides of every tooth.
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What to Expect
If you re just beginning to floss, your gums will probably bleed a little. The bleeding should stop after about a week of regular flossing. If you have trouble getting the floss between your teeth, or if it catches or tears, let us know as soon as possible. It could indicate a problem that needs to be corrected.
Fluoride
Why do I need fluoride?
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 Fluoride strengthens enamel |
The widespread use of fluoride to fight cavities has been the greatest breakthrough in the past fifty years of preventive dentistry. Fluoride can help prevent cavities by actually hardening the outer enamel layer of teeth, and it can even stop or slow down the growth of pre-existing cavities.
Fluoride in your water supply
Most water naturally contains some fluoride, but many cities add additional fluoride to their water supplies to prevent tooth decay in their residents, especially children. When children are young and their teeth are forming, fluoride hardens the protective outer enamel layer, making it more resistant to decay. The use of fluoride in drinking water alone has dramatically decreased the incidence of cavities among school children.
Adults also benefit from the presence of fluoride in drinking water, as well as in oral hygiene products such as toothpaste and mouth rinses. Fluoride can rebuild the enamel layer of teeth to repair early cavities before they're even visible, and it can help to solve the problem of root sensitivity in older adults. Also, we sometimes prescribe fluoride rinses or gels to help eliminate germs that can cause gum disease.
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Other Sources of Fluoride
We recommend fluoride toothpaste for all of our patients. We may also recommend supplemental sources of fluoride for increased protection, including fluoride drops, tablets, gels, or prescription toothpaste. We frequently administer topical fluoride treatments following cleanings in our office, especially for our young patients.
Fluoride is an important part of every prevention program. When combined with good brushing and flossing habits, fluoride can dramatically reduce the number of cavities in both children and adults.
What is Gingivitis?
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Gingivitis is the earliest, most common form of gum disease. There is usually no pain or discomfort associated with it; in fact, 75 percent of adults in the U.S. have gingivitis, and many aren't even aware of it.
Luckily, the effects of gingivitis are reversible, but this isn't the case if it goes untreated. Gingivitis can be the gateway to periodontal disease, a much more serious condition that can lead to irreversible bone loss and ultimately, tooth loss.
Plaque is the culprit
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The main cause of both gingivitis and periodontal disease is the accumulation of plaque, the sticky film of food and bacteria that forms constantly on your teeth. You must remove all of the plaque each day, or it builds up and mineralizes to become tartar. Bacteria that thrive in tartar produce toxins; it's these toxins, combined with your body's reaction to them that destroy bone around your teeth. Once bone has been lost, it never grows back.
When too much bone is lost, there's little support for the teeth. They get loose and have to be removed. That's why it's vital that we treat gingivitis early, before it can progress and cause irreversible damage.
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The symptoms of gingivitis
Though most people aren't aware that they have gingivitis, the warning signs are redness where the gums meet the teeth, swollen gums, bleeding when brushing and flossing, and persistent bad breath.
To determine whether or not you have gingivitis, we'll perform a thorough examination. We'll look for any changes in the shape, color or contour of your gums, and we'll determine if any bleeding occurs when we gently probe them.
Treating gingivitis
If we determine that you do have gingivitis, treatment will always include a professional cleaning, which removes plaque from teeth. We’ll also get you started on an effective, consistent homecare regime, and a revisit schedule.
In some cases, additional steps are required, which could include using a disclosing solution to determine where the plaque is, a review of the proper use of floss as well as a manual or electric toothbrush, and using an antibacterial rinse to help kill destructive bacteria.
