Gum disease (gingivitis) and tooth decay are primarily caused by dental plaque. Dental plaque is a whitish, sticky film that accumulates daily along the gumline and on the surfaces of your teeth. Composed of bacteria, it is controllable through good oral hygiene habits — most importantly, effective brushing.

Controlling plaque and preventing gingivitis and tooth decay will make it more likely that you keep your teeth through your lifetime and will also improve your general health. Scientific studies have linked gum disease and diseases of the heart and circulatory system.

“I know how to brush my teeth. I've been doing it since I was a toddler,” you may be saying. But you may not be performing this daily ritual in the most effective way.

Let's take another look at tooth brushing. First, your grip: Hold the brush in your fingertips with a light pressure. Position the brush so the bristles are at a 45 degree angle to your gumline, and then brush with a gentle scrubbing motion. Don’t scrub too hard, or you may damage your sensitive gum tissue.

Some electric brushes can remove plaque more quickly than a regular hand-held brush, but if you brush well any kind of brush works. A brush will last several months. Get a new one when the bristles become worn or splayed out.

Use a toothpaste that contains fluoride. When used consistently, fluoride toothpastes make your teeth more resistant to decay. Spit out the toothpaste after brushing, but don't rinse or you will wash the fluoride away.

After brushing, complete your cleaning job by using floss to clean between your teeth where the brush does not reach. Wrap it in a “C” shape around each tooth and move it vertically up and down, removing plaque from the tooth surfaces where your teeth meet. You can also use an antibacterial mouth rinse.

Thoroughly clean your teeth at least once a day, brushing and flossing. A plaque film takes 12 to 24 hours to form itself again.

To be certain you are brushing correctly, ask our office or one of our hygienists to demonstrate brushing techniques for you in your own mouth. You can also assess the quality of your brushing technique by checking with your tongue after brushing to make sure your tooth surfaces feel smooth and slick. Your gums should not bleed after brushing. Bleeding is a sign of infection. If you have a habit of consistent brushing but your gums continue to bleed, it's time for a visit to our office.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.

Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.

As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”

What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.

Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.

Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.

Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.

The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.

Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.

Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.

Contact us today to schedule an appointment to discuss your questions about dental hygiene and root planing. You can also learn more by reading the Dear Doctor magazine article “Root Planing.”

No one participates in sports or recreational activities with the goal of oral or facial injury. However, the facts reveal two things: sports injuries are the number one cause, impacting thousands of adults and children annually and many of them can be prevented or at least minimized with education and the use of a properly fitted professional mouthguard.

In addition to the obvious negative of the physical injury to the mouth and face, oral-facial injuries can also be both emotional and psychological. And while these injuries can occur due to a multitude of reasons, a recent study found that approximately 25% occur while playing sports. The following poignant facts should raise your awareness of dental injuries.

Did you know…?

• On average, 22,000 dental injuries occur annually in children under the age of 18.
• Outdoor activities and products are associated with the largest number of dental injuries to baby (primary) teeth in children aged 7 to 12 with 50% of these incidents related to bicycle accidents.
• Outdoor activities and products are also associated with the largest number of dental injuries to permanent teeth in adolescents aged 13 to 17.
• Of all sports, baseball and basketball consistently produce the largest number of dental injuries each year.
• Over 80% of all dental injuries involve the upper front teeth.
• Age, gender, condition and position of the teeth, as well as the type of sport being played are all key risk factors associated with the likelihood of experiencing a sports injury.
• Studies show that teenage boys involved in contact sports, collision sports, and high-velocity non-contact sports are at the highest risks for dental injuries.
• Young girls are starting to participate in many of these same sports, and thus their risks for injuries are climbing.
• Home furniture is the main culprit in over 50% of the dental injuries in children under the age of 7.

We encourage you to take a moment to assess your own as well as your family's risk of dental injury and to think about how you can treat and prevent them. To learn more, read the Dear Doctor article, “An Introduction To Sports Injuries & Dentistry.” Or, feel free to contact us to discuss your questions or to schedule a consultation.

Scientists don't know much about sleep even though it has been extensively studied. We do know that several hours of deep, restful sleep per night are essential for a healthy life.

Many people remain tired and unrefreshed, even after a full night's sleep. About a third of them are affected by sleep related breathing disorders (SRBD). Dentists can play a significant role in helping patients overcome these disorders, which range from frequent snoring to severe Obstructive Sleep Apnea (OSA). If you think you may have such a disorder, read on.

Under normal conditions, your upper airway is open, allowing air to flow from your nose, through your throat, and into your lungs. If you suffer from SRBD, you experience frequent reductions in the flow of air to your lungs during sleep. You may not be aware of it, but sometimes your breathing may even stop for brief periods. These reductions happen when your tongue and other soft tissues in the back of your throat collapse backwards and block your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stages of sleep your body needs.

The resulting reduced oxygen flow to your heart and to your brain can cause serious damage. You will also be tired during the day and experience a lack of energy, even if you sleep for seven or eight hours per night. This constant drowsiness puts you at greater risk for accidents.

Because dentists generally see their patients at six-month or other regular intervals, we are in a good position to screen and refer patients with suspected SRBD to physicians for diagnosis and treatment. Dentists can also treat SRBD in a number of ways.

• One of these is Oral Appliance Therapy (OAT), in which a device that looks something like an orthodontic retainer holds your lower jaw in a forward position relative to your upper jaw, preventing your tongue and soft tissue from collapsing into your airway.
• Another consists of breathing equipment called Continuous Positive Airway Pressure (CPAP). The CPAP is a mask connected to a machine that pushes air into your lungs.
• Other treatments include oral surgery or orthodontia. The goal of these techniques is to increase the volume of air passing through your upper airway by pushing your tongue forward.

Medical insurance usually covers the cost of much of these treatments.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine article “Sleep Disorders and Dentistry.”