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What is Tooth Decay?

Plaque is an insidious substance-a colorless, sticky film that blankets your teeth and creating an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.

Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.

Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.

Plaque is one of the biggest causes for tooth decay. It also causes your gums to become irritated, inflamed, and in some cases, bleed. Over time, the decay process may cause your gums to pull away from your teeth, a condition called receding gums. In addition, the long-term decay process can lead to infections in your gums and can eat away at the bone structures under the teeth.

Inside your teeth, decay can gradually destroy the inner layer, or dentin, the pulp, which contains blood vessels, nerves and other tissues, and the root.

Periodontal disease is advanced gum disease. This serious condition occurs when the structures that support your teeth-the gums, the bone, break down from the infection. Pain, hypersensitivity and bleeding are some of the signs of periodontal disease.

Simple Preventative Measures

The two best defenses against tooth decay and gum disease are a healthy, well-balanced diet and good oral hygiene, including daily brushing with fluoride toothpaste, flossing and rinsing. Most public drinking water contains fluoride, but if you are unsure of your water supply, then use a good quality mouth rinse containing fluoride.

A good way to help your oral health between brushing is chewing sugarless gum; this stimulates your body's production of saliva, a powerful chemical that actually neutralizes plaque formation and rinses decay-causing food particles and debris from your mouth.

In some cases, our office can prescribe anti-cavity rinses or apply special anti-cavity varnishes or sealants to help fight decay.

Brushing

Brushing is the best way to remove cavity-causing plaque and other debris from your teeth.

Plaque, a colorless, sticky substance, reacts with the bacteria and decaying food particles in your mouth and when left on the teeth long enough, begins to erode the enamel.

It is recommended that you brush your teeth three times a day, usually after meals and before bedtime.

Techniques

How long you spend brushing your teeth is as critical as how often you brush your teeth.

Here are some technique tips for brushing:

  • Many people simply brush for a few seconds, spit, and place the toothbrush back in the cup. It is very important to spend at least 2-3 minutes brushing your teeth. This helps to ensure that the brush doesn't miss hard-to-reach or often neglected surfaces.
  • Use short, circular motions and brush at a 45-degree angle.
  • Brush all surfaces of your teeth-the sides and chewing surfaces-as well as the lower portions near the gum line.
  • Gently brush other areas of your mouth, including your gums, tongue and "roof" of your mouth. These can be prime areas for bacteria to hide.
  • Choose toothbrushes with soft, round-headed bristles Avoid big-headed toothbrushes. Dental associations recommend that you buy a toothbrush with a compact head-1" by 1/2"-so you can easily reach the small areas of your mouth.
  • Some toothbrushes today have wide handles. This helps you control the toothbrush better. So, choose a toothbrush with a handle that is long enough and wide enough for you to handle.
  • You should replace your toothbrush at least four times a year - more often if you have been sick.
Flossing

What Is Flossing?

Floss comes in a variety of materials and colors, but essentially, it is a very thin cord you hold between fingers of each hand and insert between adjoining teeth. The cord, or floss, helps loosen debris by gently moving it up and down and back and forth between the teeth.

Flossing is a proven method for loosening debris from hard-to-reach surfaces of your teeth and gum lines. Next to brushing, flossing is a highly effective method for removing plaque on tooth surfaces your brush can't reach very well.

Another benefit of flossing is increasing blood circulation in your gums. Gum stimulation is a necessary means of keeping your gum tissues healthy; strong gums are the foundation of your teeth.

How Often To Floss

Our office recommends that you practice flossing once a day. Many people find that flossing at night is an easy bedtime routine; moreover, nighttime flossing helps to protect your teeth during sleep, when harmful plaque can do a lot of damage.

Types of Floss

Dental floss comes in a variety of materials, colors, and even flavors. Waxed varieties are slipperier, allowing people with extremely tight spaces between their teeth to floss more easily. Popular flavors of floss include wintergreen and cinnamon. Waxed floss does tend to fray more than unwaxed floss.

A type of material called wide floss can be effective for people with large spaces between their teeth, or for people with delicate bridge work.

Floss can be purchased in small self-dispensing boxes. Floss can also be purchased in special, single-use holders, a useful invention people who have a hard time wrapping floss around their fingers, including those with dexterity problems or arthritis.

Flossing Techniques

Most people who floss wrap 1-2 inches of floss around a finger on each hand, and use the floss in between on their teeth. The important thing is that you leave plenty of floss in between to allow you to maneuver inside your mouth.

One effective way is to break off about a foot of floss. Wrap one end of the floss a few times around the middle finger of each hand. You can use your forefinger and thumbs to maneuver the floss inside your mouth.

Press the floss in between two teeth and gently press downward (or upward if doing an upper set of teeth). Next, glide the floss up and down a few times against the surfaces of both teeth, carefully doing so at and below the gum line as well. Repeat this procedure for each tooth, taking up the slack when floss becomes worn or frayed.

Don't be alarmed if your gums slightly bleed the first time you floss. This is normal and will cease when your gums become used to flossing.

For Those with Special Needs

Those who have a hard time holding on to a piece of floss or a toothbrush can try supplementing the toothbrush handle with a rubber handle grip or ball, or even lengthening the handle with a stick or piece of plastic.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

Flossing Alternatives

There are several alternatives to flossing for those who find it too difficult, too painful (sensitive gums or gum disease) or ineffective (those people with braces or delicate bridge work). But remember one thing: Never use a toothpick as a substitute for flossing. Toothpicks can tear delicate gum tissue and may damage existing dental restorations.

One popular flossing alternative is called a water pick, or irrigator.

Water picks use powerful tiny bursts of water to blast away food particles and other debris in hard-to-reach areas of your mouth. Dentists use professional-grade water picks when preparing a tooth for restoration, or in general cleaning and exams.

People with painful gum disease or highly sensitive gums may find water picks useful for supplementing their brushing regimen. And people with orthodontia, including braces, have found water picks quite useful because toothbrush bristles often get stuck.

Antibacterial rinses (over-the-counter and by prescription) are somewhat effective.

Fluoride Facts

For decades, fluoride has been held in high regard by the dental community as an important mineral that is absorbed into and strengthens tooth enamel, thereby helping to prevent decay of tooth structures.

In nearly every U.S. community, public drinking supplies are supplemented with sodium fluoride because the practice is acknowledged as safe and effective in fighting cavities.

Some private wells may contain naturally fluoridated water.

What Is Fluoride?

Fluoride is a safe compound found throughout nature-from the water we drink and air we breathe, to many kinds of foods.

Why Is Fluoride Important To Teeth?

Fluoride is absorbed into structures, such as bones and teeth, making them stronger and more resistant to fractures and decay. A process in your body called "remineralization" uses fluoride to repair damage caused by decay.

How Do I Get Fluoride?

Just drinking public water will provide a certain measure of fluoride protection. But for years, health professionals have endorsed the practice of supplementing our intake with certain dietary products, and topical fluorides in many toothpastes and some kinds of rinses. Certain beverages such as tea and soda may also contain fluoride. Certain kinds of dental varnishes and gels may also be applied directly to teeth to boost fluoride intake.

Fluoride Safety

It is generally NOT safe to swallow toothpastes, rinses, or other products containing topical fluoride. In rare cases, some people may be overexposed to high concentrations of fluoride, resulting in a relatively harmless condition called fluorosis, which leaves dark enamel stains on teeth.

Mouth Rinses

Mouth rinses can have therapeutic benefits; others are only cosmetic in nature. Some have both attributes. The Food and Drug Administration even classifies mouth rinses this way.

In general, some therapeutic rinses with fluoride have been shown to actually fight cavities, plaque and gingivitis formation.

On the other hand, cosmetic rinses merely treat breath odor, reduce bacteria and/or remove food particles in the mouth. They do nothing to treat periodontal disease or prevent gingivitis.

In any case, make sure and look for indication on the label of a mouth rinse that is accepted by the American Dental Association.

Surgery or oral disease sometimes leads to complications for which a good quality therapeutic rinse is indicated. Even people who have difficulty brushing (because of physical difficulties such as arthritis) can benefit from a good therapeutic mouth rinse.

Caution: Even rinses that are indicated to treat plaque or cavities are only moderately effective. In fact, regular rinsing with water and use of good quality fluoride toothpaste are actually just as or more effective. Some rinses have even been known to causes severe irritation of the soft tissues in the mouth and other problems such as fluoride toxicity, discoloration or overly-sensitive teeth and gums (due in part to high fluoride and alcohol content).

Sealants

Sealants are liquid coatings that harden on to the chewing surfaces of teeth and are showing a great deal of effectiveness in preventing cavities-even on teeth where decay has begun.

The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses these intricate structures on the chewing surfaces of your teeth.

The sealants are applied to the chewing surfaces and are designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of teeth.

Sealants actually were developed about 50 years ago, but didn't become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants (especially on molars) because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Application

Sealants are applied by first cleaning the tooth surface. The procedure is followed by "etching" the tooth with a chemical substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.

X-Rays

X-rays, also called radiography, provide an important tool that shows the condition of your teeth, roots, jaw, and overall facial bone composition. X-rays can reveal the advanced nature of periodontal disease, as well as tumors and abscesses.

There are three basic kinds of X-rays:

  • Bitewings are the most conventional kind of dental X-rays and are used to spot cavities and decay.
  • Periapical X-rays are broad pictures of an entire tooth structure and are used to spot deep tooth problems, such as impacted teeth, bone loss, and abscesses.
  • Panoramic X-rays are designed to capture an entire mouth, and have been used to spot tumors and cysts, as well as wisdom teeth.
  • Radiation Concerns

Patients have little reason to be concerned about the health effects of dental X-rays; chances are you receive more radiation from sunlight in one day than one sitting involving dental X-rays.

Exposure to radiation is extremely brief and minimal. Safety precautions such as high-speed film minimize exposure time, and lead aprons prevent exposure to surrounding areas of the body such as the head, neck and upper chest.

Denture Care

Dentures today are made from very advanced materials designed to give you a natural appearance.

However, keep in mind that just like your teeth, dentures should be cared for with the same diligence. This means daily brushing and regular visits to your dentist.

Regular visits to your dentist are critical. Your dentist also can make minor adjustments that ensure that your dentures continue fitting naturally and comfortably.

Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.

Cleaning Techniques

Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

  • People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
  • Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
  • Hold your dentures gently to avoid loosening a tooth.
  • Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn't damaged if it falls.
  • Soak your dentures overnight in any commercially available product like Efferdent or Polident, and remember to rinse your dentures before placing them back in your mouth.
  • Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.

Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.

Emergency Care

A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

Temporary or Permanent Crown Came Off/Knocked Off

If ther is no post in it, try to place it back on the tooth and bring it with you to your appointment if you cannot.

Broken, Knocked Out, Fractured, or Displaced Tooth

A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.

If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.

First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown - not the root. Next, place it in a container of warm milk, saline or the victim's own saliva and keep it in the solution until you arrive at the emergency room or dentist's office.

For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.

Women and Tooth Care

Women have special needs when it comes to their oral health. That's because the physical changes they undergo through life-things like menstruation, pregnancy and childbirth, breast-feeding and menopause-cause many changes in the body, some harmful to teeth and gums.

Lesions and ulcers, dry sockets, as well as swollen gums, can sometimes occur during surges in a woman's hormone levels. These periods would be a prime time to visit the dentist. Birth control pills have been shown to increase the risk of gingivitis, and hormone replacement therapy has been shown to cause bleeding and swollen gums. Gum disease can also present a higher risk for premature births.

Some research has shown that women may be more likely to develop dry mouth, eating disorders, jaw problems such as temporomandibular joint disorders, and facial pain-all of which can be difficult from a physical and emotional standpoint.

Taking care of your oral health is essential, and can go a long way to helping you face the physical changes in your body over the years.

Seniors and Oral Health

Good Oral Hygiene

More and more people today are avoiding the need for dentures as they grow older, bucking the notion that false teeth are a normal part of growing older.

In fact, there's usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.

Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body.

And just because you're getting older doesn't mean you can relax on your daily routine. This means brushing twice a day, flossing, and rinsing.

Dexterity and Arthritis

People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.

Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.

You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

One popular flossing alternative is called a water pick, or irrigator.

Water picks use powerful tiny bursts of water to blast away food particles and other debris in hard-to-reach areas of your mouth. Dentists use professional-grade water picks when preparing a tooth for restoration, or in general cleaning and exams.

Risks

Having to wear dentures is one of the risks of poor oral hygiene. Older adults also may be at risk for such oral problems as:

  • Gingivitis - a condition that occurs when bacteria and plaque invade below the gum line, causing inflammation of the soft tissues and, sometimes, bleeding. Advanced gingivitis can lead to formation of a substance called tartar (also called calculus), which is a hard and crusty coating that can usually only be removed by scraping.
    Periodontal (gum) disease - Usually the advanced stages of gingivitis, gum disease begins with infections in the gums that can spread to the teeth and bones. Advanced forms of gum disease can lead to a host or problems that can only be treated by extreme measures such as extraction.
  • Dry mouth - Older adults sometimes experience diminished production of saliva and a condition called dry mouth, which leads to problems such as swallowing or speech difficulty. Certain kinds of medications and even cancer treatment can cause dry mouth. One of the more serious consequences of dry mouth is greater susceptibility to cavities and other oral problems because saliva acts as a natural rinsing agent in the mouth.
  • Oral cancer - Older adults are more prone to certain kinds of oral cancer. There are risks factors such as tobacco use and alcohol, and even heredity. But avoiding use of cigarettes, chewing tobacco and minimizing your intake of alcohol can go a long way ion defending against some kinds of oral cancer. Early signs of oral cancer are unusual lumps, patches or lesions, as well as unexplained or chronic bleeding.
Nutrition and Your Teeth

It has long been known that good nutrition and a well-balanced diet is one of the best defenses for your oral health. Providing your body with the right amounts of vitamins and minerals helps your teeth and gums-as well as your immune system-stay strong and ward off infection, decay and disease.

Harmful acids and bacteria in your mouth are left behind from eating foods high in sugar and carbohydrates. These include carbonated beverages, some kinds of fruit juices, and many kinds of starch foods like pasta, bread and cereal. While no links have been actually made between gum disease and a poor diet, nutrition problems (including obesity and overeating) can create conditions that make gum disease easier to contract.

Children's Nutrition and Teeth

Good eating habits that begin in early childhood can go a long way to ensuring a lifetime of good oral health.

Children should eat foods rich in calcium and other kinds of minerals, as well as a healthy balance of the essential food groups like vegetables, fruits, dairy products, poultry and meat. Fluoride supplements may be helpful if you live in a community without fluoridated water, but consult with our office first. (Be aware that sugars are even found in some kinds of condiments, as well as fruits and even milk.)

Allowing your children to eat excessive amounts of junk food (starches and sugars)-including potato chips, cookies, crackers, soda, even artificial fruit rollups and granola bars-only places them at risk for serious oral health problems down the road, including obesity, osteoporosis and diabetes. The carbonation found in soda, for example, can actually erode tooth enamel. Encourage your child to use a straw when drinking soda; this will help keep at least some of the carbonated beverage away from the teeth.

Adult Nutrition and Teeth

There's no discounting the importance of continuing a healthy balanced diet throughout your adult life.

If you develop a weight problem, change your diet and get regular exercise. Be aware that some so-called fad diets have been known to cause serious deficiencies in recommended levels of minerals and vitamins.

Of course, good oral hygiene helps ensure that harmful bacteria and plaque-the sticky substance that coats your teeth during sleep and after meals-are effectively minimized. Adults also are encouraged to avoid eating "sticky" foods such as caramels and dried fruits because they leave behind stubborn substances on teeth and only encourage needless plaque formation.