Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!
Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.
Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.
Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.
It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”
Besides attractively showcasing your teeth, your gums protect your teeth and underlying bone from bacteria and abrasive food particles. Sometimes, though, the gums can pull back or recede from the teeth, leaving them exposed and vulnerable to damage and disease.
Here are 4 things that could contribute to gum recession—and what you can do about them.
Periodontal (gum) disease. This family of aggressive gum infections is by far the most common cause for recession. Triggered mainly by bacterial plaque, gum disease can cause the gums to detach and then recede from the teeth. To prevent gum disease, you should practice daily brushing and flossing and see your dentist at least twice a year to thoroughly remove plaque. And see your dentist as soon as possible for diagnosis and treatment at the first sign of red, swollen or bleeding gums.
Tooth position. While a tooth normally erupts surrounded by bone, sometimes it erupts out of correct alignment and is therefore outside the bony housing and protective gum tissue. Orthodontic treatment to move teeth to better positions can correct this problem, as well as stimulate the gum tissues around the involved teeth to thicken and become more resistant to recession.
Thin gum tissues. Thin gum tissues, a quality you inherit from your parents, are more susceptible to wear and tear and so more likely to recede. If you have thin gum tissues you'll need to stay on high alert for any signs of disease or problems. And you should also be mindful of our next common cause, which is….
Overaggressive hygiene. While it seems counterintuitive, brushing doesn't require a lot of "elbow grease" to remove plaque. A gentle scrubbing motion over all your tooth surfaces is usually sufficient. On the other hand, applying too much force (or brushing too often) can damage your gums over time and cause them to recede. And as we alluded to before, this is especially problematic for people with thinner gum tissues. So brush gently but thoroughly to protect your gums.
If you would like more information on treating gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gum Recession.”
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Hygiene for Fixed Bridgework.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
As permanent teeth gradually replace primary (“baby”) teeth, most will come in by early adolescence. But the back third molars—the wisdom teeth—are often the last to the party, usually erupting between ages 18 and 24, and the source of possible problems.
This is because the wisdom teeth often erupt on an already crowded jaw populated by other teeth. As a result, they can be impacted, meaning they may erupt partially or not at all and remain largely below the gum surface.
An impacted tooth can impinge on its neighboring teeth and damage their roots or disrupt their protective gum attachment, all of which makes them more susceptible to tooth decay or periodontal (gum) disease. Impacted teeth can also foster the formation of infected cysts that create areas of bone loss or painful infections in the gums of other teeth.
Even when symptoms like these aren’t present, many dentists recommend removing the wisdom teeth as a preemptive measure against future problems or disease. This often requires a surgical extraction: in fact, wisdom teeth removal is the most common oral surgical procedure.
But now there’s a growing consensus among dentists that removing or not removing wisdom teeth should depend on an individual’s unique circumstances. Patients who are having adverse oral health effects from impacted wisdom teeth should consider removing them, especially if they’ve already encountered dental disease. But the extraction decision isn’t as easy for patients with no current signs of either impaction or disease. That doesn’t mean their situation won’t change in the future.
One way to manage all these potentialities is a strategy called active surveillance. With this approach, patient and dentist keep a close eye on wisdom teeth development and possible signs of impaction or disease. Most dentists recommend carefully examining the wisdom teeth (including diagnostic x-rays and other imaging) every 24 months.
Following this strategy doesn’t mean the patient won’t eventually have their wisdom teeth removed, but not until there are clearer signs of trouble. But whatever the outcome might be, dealing properly with wisdom teeth is a high priority for preventing future oral health problems.
If you would like more information on wisdom teeth and their potential impact on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth: Coming of Age May Come with a Dilemma.”
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