The Importance of Dental Care
Everybody knows that dental care is what helps keep our smiles white and our teeth bright. But the reasons why proper dental care is so important go much deeper than that. Proper dental care is crucial if you want to keep your teeth from decaying and possibly even falling out for good.
That may sound drastic but it is true. A cavity results from tooth decay and dentures or dental implants are the end result of teeth that have decayed beyond repair. Poor nutrition and lifestyle habits such as cigarette smoking can both contribute to tooth decay, but by far the most common reason these types of tooth problems develop is improper dental care. Teeth that aren’t cared for properly can also cause the dreaded ‘bad breath’, a foul odor that others shun.
It’s never too early to start learning about dental care. In fact, it’s a habit that should be taught very early in life. Teaching children to brush and floss their teeth regularly and to visit the dentist twice a year is something they’ll remember throughout life. It’s also what’s going to help them take better care of and protect the teeth they have been given.
There is much more to a tooth than meets the eye. The part that is visible is referred to as the crown. Every tooth has another part called the root. A tooth’s root is below the gum line and extends into the jaw bone. The area where the crown meets the root is called the neck. These parts – the crown, the root and the neck – are the 3 basic parts of every tooth.
The crown consists of 3 layers: the enamel, the dentin and the pulp. The enamel is the outer layer of the tooth, the part we brush, and it is actually translucent, not white. Enamel is what gives a tooth its strength but it is also the part of the tooth that will decay when not properly cared for. Below the enamel is a layer called the dentin. The majority of each tooth consists of this bone-like hard material that extends into the crown and below the gum line. Dentin is what’s responsible for a tooth’s coloring.
Within the dentin is a pulp cavity. This area contains pulp which is actually made up of connective tissues, nerves and blood vessels. The blood vessels carry important nutrients to the teeth and the nerves trigger hot and cold sensations.
What we refer to as our gums is actually called gingiva. Gingiva is the pink area that fits around each tooth and covers the jawbones.
Just as enamel surrounds the dentin in the crown area, cementum is a material that surrounds the roots. A layer of dentin also covers the cementum. Periodontal ligaments are what attach each tooth to the jaw. Craters, or more appropriately, alveolar sockets, form within the gum as each tooth pushes up through the gum. These sockets along with the alveolar process (the walls of the crater) also help keep teeth in place.
Food and Your Teeth
Eating sweets is bad for your teeth, but do you know why? Do you know that even eating ‘good’ foods can be bad for your teeth or that eating at certain times during the day is better than others? If you don’t understand that when and what you eat can affect your teeth, then read on.
The problems all revolve around plaque, that sticky, whitish substance that covers your teeth after you eat. As you probably already know, carbohydrates break down into sugars, the fructose, maltose, glucose and lactose that fuel our bodies. We think this process happens after food leaves our mouths, while en route to our digestive tracts.
That’s true for many foods, but some foods begin breaking down right in our mouths. These foods are referred to as fermentable carbohydrates. Bacteria living on your teeth use the sugars found in fermentable carbohydrates like cookies, crackers, cake, soft drinks, cereal, even bananas to produce very strong acids.
These acids can cause demineralization, a process by which the minerals inside a tooth’s enamel begin to dissolve. Damaging acids are continually produced as long as these foods remain in contact with the tooth bacteria.
That’s why sipping soda all afternoon is more damaging than drinking an entire can during your meal and why sticky foods (potato chips, raisins) and foods that get stuck in the crevices of molars can do more damage than foods that don’t stick. Those who snack on sugary foods throughout the day also have a higher incidence of tooth decay.
Fortunately, the body can combat demineralization with a process called remineralization. Saliva facilitates the remineralization process by helping to neutralize damaging acids. Therefore, foods and sugar-free gum that help increase saliva are good choices for combating tooth decay. However, when remineralization takes place more slowly than demineralization, in other words when the process is out of balance, tooth decay may still result.
Eating disorders such as binge eating where an individual consumes large quantities of food only to purge them shortly afterwards also causes serious mineral loss because of all the stomach acids that come into the mouth during a purging session. That’s why those suffering from eating disorders often experience tooth decay and demineralization.
When it comes to the teeth and your overall state of health, it’s a good idea to stick with the food categories and amounts advised by the US government in its updated Food Pyramid. The ‘good’ foods to choose include whole grains rather than refined grains, non-citrus fruits (citrus contains a lot of acid), dark green leafy vegetables, lean proteins and calcium-rich foods and beverages.
Cheese is a good food to eat for counteracting acids and so are chicken and nuts. Milk contains lots of minerals that can enhance the remineralization process. Fruits with high water content are also good because they promote saliva. Sugar-free gum that contains xylitol is a good choice as are sugar-free hard candies.
You should limit your intake of processed foods, sugary snacks, beverages containing or mixed with sugar and alcoholic beverages. Limit in-between meal snacking, too.
What You Need to Know About Cavities
The pain definitely tells us when we have cavities, but few of us understand why we get them. You likely know that poor dental hygiene causes cavities, but do you understand why not brushing or flossing causes cavities?
In order to understand all that’s involved in the making of a cavity, you’ve got to first understand the key players. Those players include saliva, pellicle, plaque and calculus and each resides in the mouth.
Saliva is really important when it comes to protecting teeth and keeping our mouths healthy. Saliva keeps teeth, gums and other tissues inside the mouth lubricated and moist. Saliva helps break food down while eating, and afterwards it washes away some of the bits of food that get stuck on teeth. Saliva also can neutralize acids which lowers the amount present in the mouth. Interestingly, it can even help protect us against certain viruses and bacteria.
If you’ve ever noticed a slippery feeling on your teeth right after you brush, that’s the result of proteins in saliva called pellicle. Pellicle coat teeth after brushing by absorbing into the surface. The pellicle gives teeth an extra layer of protection against decay-causing acids. Unfortunately, bacteria and microorganisms can easily attach to the pellicle and this is actually the stage during which plaque begins to develop.
If you were to look at the white sticky substance on your teeth through a microscope, you’d realize that plaque consists of yeast, microorganisms, bacteria, protozoa, mycoplasmas, white blood cells, food particles, body tissues and viruses.
If people realized that, surely they’d do a better job brushing and flossing! Several hours after brushing is when plaque starts to develop and in just one hour, a good amount will accumulate. If left untouched other microorganisms join the mix, thickening the plaque and turning on its destructive powers.
Bacteria are in the mouth too and they’re always present in both good and bad form. The good bacteria help us fight colds and other illnesses. The bad intensify the tooth decaying process. Streptococcus mutans is the worst, producing acid while attaching to teeth. Lactobacillus only can attach to plaque so it doesn’t do quite as much damage. Several other bacteria located inside the mouth contribute to tooth decay and periodontal disease.
To summarize, decay begins when bacteria start attaching themselves to the pellicle. Six or so hours later, plaque begins to form. The bacteria present in your mouth produce acids, and these acids, by throwing the pH balance of your mouth out of balance, cause tooth decay. In the case of tooth decay, a process called demineralization begins when the pH level inside the mouth drops below 5.5.
Remember, this chain reaction begins the moment you finish brushing your teeth. But brushing is what continually returns the pH level in your mouth back into the range of 6.2 and 7.0, which is considered neutral. That’s why brushing and flossing are so important in fighting tooth decay.
pH Balance and Cavity Formation
You’d never have to worry about tooth decay if you didn’t eat. Of course, you wouldn’t have to worry about much because you would die. But eat we do, every day, and the foods we choose aren’t always the best.
When we eat carbohydrates, the body breaks them down into sugars including sucrose, fructose, maltose, dextrose and glucose. Fermentable carbohydrates actually begin breaking down in the mouth (as opposed to the digestive tract where other foods begin the process). If you eat cookies, cake, chips, crackers, candy, sugary drinks and cereal you are eating fermentable carbohydrates.
When the sugars in these foods interact with the bacteria in the mouth, acids are produced. Acids are what cause a drop in pH level. When pH drops to 5.5 or lower, the drop causes the minerals inside the teeth to start dissolving. This is demineralization.
This loss of minerals weakens teeth. The damage will continue for as long as pH is at or lower than 5.5. Remember brushing teeth returns pH to a neutral level, between 6.2 and 7.0 which is why brushing is so important in preventing tooth decay. Some of the bacteria inside your mouth love sugar so as long as sugar is present, these bacteria keep producing more and more acid.
Tooth decay begins inside the tooth, as demineralization takes hold. Remineralization from fluoride and saliva can defend against decay at this early stage. If left untreated though, the spot where the decay began grows. Once the decay spreads through to the enamel, the damage cannot be reversed. You’ve now got a cavity.
With a break in the enamel, food particles can get inside the tooth and cause pain. That’s when you’ll show up at the dentist begging for help. The dentist will clear away the debris and decay and fill the cavity. If you don’t get the cavity filled, the decay can spread into the dentin and even to the pulp and the nerves.
Acute caries (the proper term for cavity) develop quickly, in just a few months. Children whose enamel tends to be weaker and young adults are more prone to acute carries. Chronic carries take longer to progress, and sometimes don’t progress much at all. Older individuals are more prone to this type of cavity. When decay forms in the roots, root caries develop and they too are more common in older individuals. When decay continues to form even after a cavity has been filled or a crown has been put into place, that is called recurring decay.
Only you can prevent cavities and it’s not that hard if you brush and floss regularly to remove bacteria, drink fluorinated water, seal the teeth that are most vulnerable, and limit your intake of fermentable carbohydrates.
When you have a cavity in a tooth, the most common treatment option is a filling. Fillings are also placed on teeth that have been damaged in other ways including those that have been worn down due to nail biting or grinding, or those that have been chipped.
Your dentist will evaluate your need for a filling. Once it’s determined that a filling is the best treatment option, the dentist will discuss with you the various filling options that make sense for the damaged tooth. A number of filling options are available, and their differences center on the types of material used for each. Some are made with combinations of metals that can withstand a lot of chewing action. Others aren’t as strong and are good choices for small-sized cavities or cavities that appear in between teeth.
The most common type of dental filling and the type that’s been in use the longest is the amalgam filling. Its combination of metal elements including tin, silver, mercury, copper and others creates a dental amalgam that’s inexpensive to produce, extremely durable and easy to work with. It’s usually the perfect choice for filling cavities in molars because its silver color is not very noticeable and because it can withstand much chewing.
A composite filling is the color of a tooth therefore, it’s less noticeable. Made by mixing quartz or glass filler into a resin medium, this filling is perfect for smaller cavities and those cavities located in frontal teeth. The material is less durable than an amalgam filling, but it can withstand moderate chewing. Composite fillings cost more and they can be bonded onto the tooth.
An ionomer filling is a good choice when a cavity is located on a root surface. Made with glass powders and acrylic acids, the end result is a translucent filling that can also release fluoride.
What we dread most about the filling procedure is a toss-up between the shot of local anesthesia and the high-pitched telltale whine of the drill that is used to clean out and shape the cavity. Both can make a person shrink with fear and unfortunately, both are necessary. The various types of fillings each require a unique preparation process including use of different tools. When the filling is in place and properly affixed to the affected tooth, the final step is to polish the material.
It’s common to feel sensitivity in the area of the filling for a week or two after the procedure. Temperature, pressure, sweets and air can all cause the area to feel sensitive and avoiding these can be challenging, but try. If these feelings don’t go away, you should make another appointment with your dentist. If you can, pay attention to the discomfort you’re experiencing so you can accurately describe it to the dentist. The description will help the dentist decide how to proceed.
Most fillings will need to be replaced at some point because they will either fall out, or weaken, or discolor or crack. When one is ready to be replaced, talk with the dentist to learn the best option for replacing that filling.
Like the name implies, a crown is designed to sit atop a tooth that is too damaged to be fixed with a filling. This type of extensive damage can be caused by tooth decay, but it can also result from a tooth that has been cracked or chipped. There are other reasons people put crowns on their teeth. For example, if a bridge is needed, a crown helps hold it into place.
Crowns can also be created for reasons that are purely cosmetic. Severely discolored teeth and/or teeth that are misshapen can be topped with crowns to create a look that is more visually pleasing. And today, some people cap perfectly healthy teeth in gold as a status symbol.
A lot of preparation is required before a crown can be properly affixed to a tooth. The tooth typically has to be made smaller to ensure a proper fit. This is accomplished by filing the tooth. Sometimes, not much of the tooth remains and it must first be built up.
When damage or decay is extensive, the patient may first need a root canal – a procedure which remedies pulp that has been infected or inflamed. If this procedure isn’t done, there’s an increased chance of losing the tooth.
After the tooth’s size and underlying root and pulp issues have been addressed, the next step is to create an impression. That’s an important step because the crown must be the correct size or it will be useless. An impression is basically a mold of the tooth from which the crown will be created. To ensure the crowned tooth won’t in any way affect the bite, impressions of surrounding teeth are also made.
After the impressions are made, they are sent to the laboratory where the permanent crown will be crafted. Crowns can be produced using a number of different materials including ceramic, metal or a combination of metal and porcelain. A temporary crown, which you’ll wear until your permanent crown is fitted, can be made out of stainless steel or plastic right there in the dentist’s office.
When the permanent crown is ready, you’ll return to the dentist where the crown will be fitted and adjusted as necessary. When all is perfect, the crown is permanently attached to the tooth using cement. After the crown is put into place, you may still experience some problems such as sensitivity or discomfort. If so, return to the dentist and discuss the feelings. The crown may require repositioning. And if there still is a nerve under the crown, it may be reacting to hot and cold causing sensitivity.
A crown is a very durable dental treatment and it’s not uncommon for one to last decades. But during that time you could experience problems with the crown. It might chip, especially if it is porcelain. Or the cement might begin to wash away partially or completely. If any of these problems arise, you’ll need to return to the dentist. Bacteria and acids can leak onto the tooth when crowns are loose or they fall out and this can lead to tooth decay.
Gingivitis is a mild form of periodontal disease. Its presence is indicated by a redness and/or swelling of the gum area. Those who have gingivitis usually have gums that bleed easily, too. Gums generally bleed when slight pressure is applied such as after brushing or flossing. A change in the color of the gums is another indication that gingivitis may be present.
What makes gingivitis tricky to self-diagnose is that typically not much pain accompanies these symptoms. What also makes the problem go unnoticed by many is the fact that millions of Americans have some degree of gingivitis, especially those who are over age 35. Most don’t realize it isn’t ‘normal’ for their gums to bleed.
The most common cause of gingivitis is poor dental hygiene. When plaque is not completely removed from the teeth, it will begin to release toxins. These toxins irritate the gums. In just a few days, plaque that is not removed from the teeth will turn into calculus, more commonly referred to as tartar.
These hardened deposits of plaque cannot be removed at home. A dentist must use a special tool to scrape away the tartar build-up. Because tartar cannot be easily removed, its presence will also irritate the gums. Tartar compounds the problem by giving bacteria one more location where it can grow.
Gingivitis is caused by other factors including genetics, certain medications, fluctuating hormones and certain diseases such as leukemia and diabetes. Fungal and viral infections such as oral thrush and herpes also negatively impact the gums. A weakened immune system can also trigger gingivitis because the body has a more difficult time fighting off the bacteria that develop along with plaque.
A diet lacking in Vitamins B and C and calcium contributes to the onset of periodontal disease, too. Therefore poor nutrition is also a cause.
Effective treatment of gingivitis takes effort on behalf of the dentist and the patient. If you think you have gingivitis, it’s important to make an appointment with your dentist as soon as possible. The dentist will give your teeth a thorough cleaning that will include scraping the tartar off your teeth. The dentist uses a special scraping tool and the procedure might cause discomfort, but it’s absolutely necessary.
After completing the dental visit, the second step in treating and preventing future incidences of gingivitis is the development of a better at-home routine for tooth brushing and flossing. Brush at least twice daily, in the morning and in the evening, using a new toothbrush after every 3 months. If possible, brush once more after lunch. Daily flossing is important, too. And be sure to floss all teeth, not just the ones in front.
Both of these steps are equally important because when gingivitis isn’t treated by the dentist and properly addressed by the individual, the condition can become much worse. It can turn into periodontis, a more serious form of periodontal disease. At that stage, there is a real possibility that the tooth or teeth in the affected area might fall out – permanently.
Periodontal disease is the category given to those infections that occur in and around the teeth, specifically, the gums. Periodontal disease typically begins as gingivitis and will progress to periodontis if left untreated.
Periodontal disease can develop around any tooth. When plaque starts growing along the gum line, over time it can spread below the gums. As the bacteria that are part of plaque begin releasing toxins, the gums become irritated. In response to the irritation, the body initiates an immune response and attacks itself.
Specifically, the body begins destroying the tissues and bones that provide the underlying support for the teeth. With the support structure compromised, gums and teeth can separate, creating pockets which then start getting infected. Those pockets will keep growing deeper as long as the condition isn’t treated. Once teeth start loosening, there’s nothing else that can be done except to extract the affected teeth.
As mentioned above, periodontal disease is most often caused by poor dental hygiene. However, there is another bad habit that can lead to gum disease – cigarette smoking. The relationship between cigarette smoking and periodontal disease has been studied extensively and the relationship is real: those who smoke greatly increase their risks of developing periodontal disease.
Genetics has been shown to play a role in its development, too. If periodontal disease is known to run in the family, early intervention can mean the difference between keeping teeth intact and losing teeth.
Wildly fluctuating hormones during puberty and pregnancy have been shown to increase the risks of developing periodontal disease, and so has stress. When you’re stressed, your body has a more difficult time fighting infection, including that which forms in the gums. Certain medications might negatively impact your oral health which is why it’s important that your dentist know all that you are taking, along with the dosage. Tooth clenching or grinding can accelerate the rate that the tissues that support your teeth weaken, which can lead to periodontal disease.
Diabetes and certain disorders of the immune system can contribute to problems with the gums as can poor nutrition.
Periodontal disease treatment begins with an effort to scrape away the plaque and tartar that have built up in the root surfaces. This process helps remove the irritating toxins, too. Once the deep pockets have been thoroughly cleaned, surgery usually can be avoided if ongoing, regular maintenance is performed.
When surgery is necessary, the type will depend on the severity of the periodontal disease. Pocket depth reduction reduces the size of the pockets that have developed, making it easer to keep plaque out. The pockets are cleaned and then surgically tightened around the tooth. Regenerative procedures attempt to regenerate the tissues and bone that have been lost. Crown lengthening involves surgically removing and reshaping gums so that more of the tooth is visible. Soft tissue grafts can cover up exposed tooth roots, reducing sensitivity. This procedure can also build up gum tissues that have been lost.
Root Canal Treatments
When tooth decay progress deep inside the innermost layer of a tooth, the pulp can become infected. Sometimes the infection becomes so severe that an abscess forms. Other times infection doesn’t happen, but still the pulp becomes inflamed. Decay isn’t the only reason that pulp can become inflamed or infected. It can also result from a serious mouth injury or trauma. Regardless of the cause, the only way to remedy the situation, and save the tooth, is by undergoing a dental treatment called a root canal.
If a root canal is needed but not performed, it’s likely that the infection, if there is one, will spread. An even more significant consequence is that the tooth might have to be extracted. Some people decide to skip this dental treatment, thinking that a tooth that has undergone a root canal will ultimately have to be extracted anyway. But this isn’t true. It may be weaker but it will function again, either because it’ll be covered with a crown or filled with a composite material. If cared for properly, the procedure can result in lifelong success. Therefore, it’s always better to undergo the root canal procedure. No matter how much a root canal costs, it will be less expensive than a dental implant or bridge.
A root canal is a major procedure involving several steps. The first step is the most important one – delivery of a local anesthesia. If determined necessary, the patient may be sedated. Once the patient is prepared, the dentist uses a special tool to cut through the crown. The cut that is made has to extend down to the pulp chamber. The dentist will take an x-ray to help measure the canals. The dentist will next clean out the affected pulp and the infection using a tool called an endodontic file. An antiseptic is also delivered to help with the infection.
After the dentist has completed the canal cleaning stage, the canal is filled with a substance called gutta-percha. This filling will be permanent and will help ensure that the canals do not become reinfected or contaminated again. With the canals clean and filled, work to repair the hole that was cut through the tooth begins. The hole is filled temporarily and that filling remains in place while a crown is created for the affected tooth. When the crown is ready, it is fitted, adjusted and then permanently attached to the tooth.
There will be some amount of pain after the procedure, but that should go away once the infection has cleared. Pain medication will help during this time.
Unfortunately, sometimes the infection is not completely removed during a root canal. When this happens it’s necessary to repeat the procedure. Other issues can also cause reinfection. Besides repeating the treatment steps, extra time and effort is needed because all of the restorative work must first be removed. This makes the procedure more expensive and time-consuming the second time around, but it must happen or the patient risks losing the tooth permanently.
If you’re missing teeth, you may want to consider getting dental implants. A dental implant is designed to look, feel and act like a real tooth, which can help boost your self-confidence, help you chew your foods more efficiently and can help avoid bone atrophy, a process whereby the jawbone begins to shrink over time. Dental implants may even improve your speech.
Dental implants are made from titanium. The bottom of an implant is shaped like a screw or nail and it is designed to mimic the root of a tooth. This part of the implant is surgically inserted into the jawbone. An incision deep enough and wide enough to support the implant is made into the jaw bone, and then it’s inserted.
Osseointegration, a process in which the bone surrounding the titanium implant grows around the implant, takes place during the following months, helping to ensure the implants remain in place.
Titanium is the preferred material for dental implants because of its durability, its non-corrosive and non-magnetic properties and because of its ability to resist among other things acid, oxygen and salt solutions. Most importantly, the body does not reject titanium. After the implants have been put into place, the next step involves placement of crowns, dentures or bridge.
The Root-Form implant is the most popular. It’s perfect for individuals with a sufficient quantity of bone remaining in the jaw. Those who have lost a considerable amount of bone in the jaw will benefit from a Ramus-Frame implant. Only two implants are imbedded into the jawbone, near the wisdom teeth. A wire bracket runs along the gum line onto which dentures are placed.
A Blade Form implant is similar to the Root Form, except two blades will protrude above the gum line. The bridge or crown is then attached to the two blades. A Transosseous implant is another option, but it’s not very popular because of the extensive amount of surgery involved.
Although dental implants initially cost considerably more than crowns, bridges or dentures, they are designed to last for life. When the costs are spread over the long-term, the price becomes much more reasonable. Patients who have chosen implants prefer them over dentures because with implants, there no longer is a thick layer of plastic covering the roof of their mouths. With the plastic out of the way, taste is greatly enhanced.
Also, with dentures certain foods like apples and popcorn must be avoided, but with implants, there are no food restrictions. Dentures must be secured into place with denture adhesive, which can be messy and sticky. There’s no need for adhesives with implants.
Those whose health is poor, or who smoke or drink alcohol excessively, or who take certain medications, or who are pregnant, or whose jawbones have not yet fully developed and others may not be good candidates for dental implants. If you’re interested in dental implants, discuss this option with your dentist.
Dental Insurance in the United States
In the United States, dental care is not something that the government offers to all of its citizens. There is government assistance available to those who qualify such as those whose income falls below a certain level and the elderly.
But aside from those few programs, an individual’s dental care is either partially or fully covered by an insurance plan. Or, if the individual has no insurance coverage, the individual assumes the responsibility for paying all dental care costs as well as any costs assumed by his or her family.
Available dental care options vary widely and depend on the individual’s personal situation. If employed, the employer might offer some type of dental coverage plan. Unfortunately, the cost of providing dental insurance to employees is high and many employers are finding it difficult financially to offer dental coverage as a benefit.
When employers do offer their employees dental coverage, costs typically are shared between employee and employer. Those Americans who are self-employed or whose employers do not offer dental coverage can purchase a dental insurance plan on their own, for which there is generally an associated monthly fee. Or they can forgo the purchase of a dental plan and instead pay all costs for dental services as they are incurred.
There is no general answer to what is covered by a dental plan. What is covered by one dental plan may or may not be covered by another. And while one dental plan might cover 100% of the costs of a particular service, another might only cover 70% with the remaining 30% to be paid for by the patient.
Most dental plans will offer some level of coverage for preventative dental services such as 2 check-ups per year. Services covered at a twice-yearly dental exam typically include cleaning, examination, x-rays and a fluoride treatment.
Under the terms of most dental plans offered in the US, any follow-up work that may be needed as a result of such examination will only partially be covered by the plan. Examples of those services include but are not limited to fillings, crowns, root canals, anesthesia and sealants.
As far as what is not covered by dental plans in the United States, most will not cover any type of service considered cosmetic. That includes such services as teeth whitening, orthodontic work, dental implants and, unless they’re deemed medically necessary, crowns.
If an employer is offering dental coverage, the employee will complete the application form at the place of employment. After completing the application the employee will have coverage according to the company’s enrollment policy.
If an individual is purchasing his or her own dental plan, the Internet is a good place to start the search. There it’s easy to compare the costs and coverage of the various dental plans offered to individuals. Application typically can happen online, or the individual can call a special number to apply. After paying the applicable fees and upon approval, that individual can begin making appointments for dental services.
Maintaining Good Teeth and Gums – Flossing
Brushing your teeth properly is an effective way of removing plaque, that sticky white substance that grows in between and along the bottom of teeth and along the gum line. But rarely will tooth brushing alone remove all plaque, no matter how good a job you do.
To ensure you remove every bit of plaque from your teeth, you’ve got to remember to floss. While most people will make the effort to brush in the morning and at night, few take that extra step of flossing. Rather than flossing daily, they’ll floss weekly or worse, they just don’t floss at all.
Flossing takes a bit of time and a lot of coordination which probably is why so many choose to skip this step. But like any habit, if you’re willing to practice and repeat the process, in a few weeks you’ll be flossing daily like a pro.
As you chew your food, some of it gets trapped in the spaces between teeth. The closer the space, the more difficult those particles are to remove with the bristles of a toothbrush. And when it comes to the molars, it’s difficult to position the toothbrush so that it adequately gets between them.
When you floss, you wrap what looks like a length of thread around one or more fingers on both hands, and then work the thread up into the crevices between teeth. You don’t use normal sewing thread as that could damage the gums. Instead you use floss, which can either be uncoated or coated with a wax. To add a bit of excitement to the task, floss now comes in a variety of flavors and some brands even resist shredding!
As you move the floss back and forth, up and down the space between teeth, that action loosens the plaque from those hard-to-get-at spaces that toothbrush bristles can’t reach.
Some people wrap floss around their fingers while others just hold it between their fingers. How it’s held doesn’t matter as long as you have a firm grip and a segment that you can work with. With a back and forth motion, gently work the floss in between two teeth. This protects gums. Then wrap floss around an inside edge of a tooth by making a ‘c’ shape with the floss. Moving gently from base of tooth to gum line, use the floss to scrape the plaque from the tooth. Repeat for all teeth and don’t forget the molars. Flossing those teeth can be awkward at first, but it’s absolutely necessary.
You need only floss once a day, so choose morning or evening and stick with that time. You may wish to floss more often, especially after eating popcorn or other foods that tend to stick between teeth. Floss isn’t expensive so use as much as you need, as often as you need.
Never rush your flossing session and never floss aggressively. Both can cause gums to bleed or become damaged. You actually want to avoid coming into contact with the gums as much as possible.
Maintaining Good Teeth and Gums – Tooth Brushing
Removing plaque from your teeth and gums is what proper dental care is all about. Daily, you can handle this task on your own by brushing right and flossing. Twice a year, however, you should let a professional take a look inside your mouth.
When it comes to brushing your teeth, you’re probably going through the motions, but not actually brushing efficiently. In fact, you could be damaging your gums and/or leaving plaque behind. And if you’re not flossing to remove the plaque you missed while brushing, your teeth may slowly be decaying.
There are several ways you can brush your teeth and the one you choose should be based on your mouth and your age. The best place to turn when deciding on a tooth brushing method is your dentist. In addition to advising you on the right method for your mouth, he or she can demonstrate proper brushing technique and answer any questions you may have.
Most people load up a toothbrush with toothpaste, stick the toothbrush inside the mouth, and aggressively brush the front teeth with a quick back and forth motion. They’ll do a bit of brushing on those hard to reach back teeth, spit, rinse and consider the job done, all in about 30 seconds. Is this what you do?
If so then realize that there are two problems with this method. First, harsh brushing back and forth along the gum line will damage this sensitive area. Such brushing can cause gums to begin receding and/or wear down over time. It might also cause root surfaces to become exposed. Second, this isn’t long enough! A thorough tooth brushing session should last 2 – 3 minutes!
There is a better way to brush teeth and gums. Brush using a circular or elliptical motion and brush just a few teeth at a time, on the outside and the inside surfaces. This technique will protect against gum damage and will ensure that all teeth get brushed. It’s also important to brush the surfaces of the teeth, especially your molars to remove trapped food particles. And don’t forget to brush your tongue! Bacteria live there too and when not brushed from the tongue, bacteria cause bad breath.
Use a toothbrush with soft bristles made from nylon. It’ll be gentler on teeth and gums. The head of the brush should be about an inch long and the bristles should have rounded edges. And don’t use the same toothbrush for longer than 3 months. By that time, the bristles will begin to flare, making tooth brushing less efficient.
Brush morning and night and if possible, after eating lunch. But don’t brush more than this! Also, develop a tooth brushing routine. By repeating the same motions in the same order each time you brush, you’ll have a better chance of removing all plaque.
The brand or type of toothpaste doesn’t matter. What’s important is that it contains fluoride and that the package bears the seal of approval of the American Dental Association (ADA).
Fluoride and Your Teeth
Fluoride plays an important role in keeping teeth healthy by helping to prevent tooth decay. That’s why fluoride is added to many toothpastes and why fluoride treatment has become a routine part of dental cleanings. Fluoride is actually derived from fluorine, a prevalent element found within the Earth’s crust. Fortunately, most people get the fluoride their teeth need from their drinking water.
How can fluoride help prevent tooth decay? It does so two ways. First, part of the fluoride that enters the bloodstream travels to the teeth and once there, helps strengthen enamel. The enamel is the translucent material that covers your teeth. Stronger enamel helps minimize the effects of demineralization – the loss of minerals caused by the damaging acids the bacteria in plaque produce. Demineralization will weaken a tooth’s enamel over time, making it more susceptible to decay. As the enamel decays, it’s more susceptible to dental cavities.
The other way fluoride benefits teeth is during the remineralization process. Remineralization is the body’s natural way of replenishing the minerals that have been lost via the demineralization process. Each time you drink milk, for example, a portion of the minerals contained in milk head to the teeth to assist with remineralization.
Fluoride works the same way. As it enters the body, either via drinking water, mouthwash, toothpaste or topical application, it helps enamel replenish its supply of fluoride. While remineralization is taking place, it has the added benefit of slowing down plaque’s ability to produce damaging acids.
To supplement or not? That’s a controversial question and the bottom line is this. If your drinking water supply is not fluorinated, you should inquire about receiving fluoride supplements. Children between the ages of 6 months and 16 years especially need fluoride as it’s the most effective way there is so far to keep dental decay under control. A dentist or your child’s doctor can prescribe fluoride in liquid or tablet form when deemed necessary.
Most people who get their drinking water from a ground water supply or from a water processing plant get an adequate amount of fluoride. However, those who purchase bottled water may have a problem because fluorine is not added to many brands. While bottled water may have other benefits, its lack of fluoride may outweigh those benefits. If you drink bottled water and you’re unsure whether it contains fluoride, check the ingredients listed on the label.
The controversy surrounding fluoride centers on the possibility of getting too much into your system. Like other vitamins and minerals, too much may cause problems. The most common result of excess fluoride is fluorosis, which may be unsightly, but isn’t harmful. Fluorosis is a condition in which the enamel becomes discolored or mottled.
Fluoride toxicity is more serious and occurs when a large amount of fluoride is ingested in a short time. Its symptoms include nausea, vomiting and diarrhea, pain in the abdomen and abnormal thirst. Since this occurs most frequently in small children, it’s important to keep toothpaste out of children’s reach and to supervise children while they brush their teeth.
Caring for, Cleaning and Replacing Your Toothbrush
How long has it been since you started using that toothbrush you used this morning? Is it fairly new? Is it a month old? Two? Three? Is it older than that? If you’re still using the same toothbrush you were using three months ago or worse, even longer, then get yourself to the store and purchase a new one as soon as possible!
You need to regularly replace your toothbrush because over time, the bristles are going to start breaking down. You’ll know when this is happening because they’ll start looking frayed and they’ll flare outwards. Once this breakdown starts to happen, it’s not going to be possible for your toothbrush to work as effectively or efficiently as one with bristles that are standing straight up.
If your toothbrush is relatively new but you’ve just gotten over a cold or the flu, or if you’ve had a cold sore, an infection in your mouth, or a sore throat, it’s a good idea to throw out the toothbrush you used during that sickness or infection. Bacteria can live among a toothbrush’s bristles and using that toothbrush may cause reinfection.
Bacteria can also grow on toothbrush bristles when you haven’t been sick, especially if bristles aren’t thoroughly rinsed after each use. Food particles can remain on bristles and that can lead to the development of bacteria, another reason why frequently changing your toothbrush is a good idea.
After you’ve finished brushing your teeth, it takes only a moment to ensure that your toothbrush is clean. Remember, its job is to remove food particles and plaque from your teeth, which it does, but sometimes those particles that have been removed will stick between the bristles of your toothbrush. While you are rinsing the excess toothpaste and foam from the toothbrush, be sure to rinse away any food particles too. When you’re done rinsing, take a close look at the bristles. If needed, rinse again.
Some people think that sticking their toothbrush in the dishwasher or the microwave oven is an effective way to clean/sanitize it. The truth is, these environments are too harsh for most toothbrushes and will only cause them to become damaged.
After you’ve rinsed your toothbrush, it needs to air dry to inhibit the growth of bacteria. Always store your toothbrush upright in an open container. Don’t lie it down inside a drawer and don’t enclose your toothbrush inside a case or other type of airtight container. With no air circulation, the moisture will create an environment ripe for bacteria growth.
To prevent cross-contamination, you never want the head of your toothbrush to touch the head of another toothbrush either. It’s also not a good idea to share your toothbrush with others. To date, there’s not been any solid proof that toothbrush sanitizers or mouth rinses with antibacterial agents offer any better protection than good cleaning habits so read the product’s claims carefully before making any purchases.
And always remember – when in doubt, throw it out!
Dental Care for Babies
There is this belief among some people that dental care for babies isn’t an important issue because those ‘baby’ teeth will be replaced by permanent teeth. They believe that because baby teeth fall out, the focus should be on the child’s permanent teeth.
It’s true that primary teeth fall out and are replaced by permanent teeth. But one of the most important reasons to teach proper dental care to children is so that the habits they learn early will stick with them throughout the rest of their lives. If good dental habits aren’t in place by the time permanent teeth begin appearing, which is around 6 years of age, developing good habits will be more difficult later on.
Most babies start getting teeth when they are 6 months old. The bottom row central incisors typically are the first to appear, followed by the top row central incisors. All together there are 20 primary teeth and they usually erupt according to a ‘schedule’ that most infants follow. The last primary teeth to erupt are the second molars and they’ll appear between the ages of 2 and 3.
If not properly cared for, an infant’s teeth can begin to decay from the moment they first erupt. Infant dental decay is painful and should be avoided. Of course, at only 6 months old, an infant does not have the physical or mental skills needed to brush his teeth. At this stage of life, it’s up to the caregiver to clean a baby’s teeth using either a toothbrush designed for an infant or a very soft washcloth. Just gently brush or rub the tooth (teeth) once a day, before bed.
Pediatric dentists advise that the first dental visit take place when the baby turns 1. That first visit is important and the dentist will want to ensure your baby is getting fluoride from his drinking water. If not, the dentist can write a prescription for fluoride which will help protect the child’s developing teeth from dental decay. If a baby’s teeth are showing signs of spotting or staining and the baby has not yet turned one, it’s a good idea to visit the dentist sooner.
To keep decay under control, don’t give infants sugary drinks, especially at night from a bottle. During the day, don’t fill a baby bottle with sweet drinks to use as a pacifier. Keep in mind that most milk and formula and even fruit drinks contain sugar. Doing any of the above can cause baby bottle tooth decay. It’s not a good idea to coat a pacifier with sugar either as that can also lead to decay.
At age 2, children can begin daily brushing using a small dab of fluoride toothpaste. Be sure to supervise the tooth brushing.
At meal and snack time, steer clear of sugary drinks, foods and snacks. Teaching your child early on to eat vegetables and healthy snacks will limit tooth decay and is an excellent way to instill good eating habits.
No matter what anyone tells you, your wisdom teeth do not make you smarter! Wisdom teeth are the last of the permanent teeth to erupt. The late teen years and into early adulthood is when wisdom teeth typically begin to erupt. Located behind the molars, these teeth are sometimes referred to as the third molars.
Oftentimes wisdom teeth don’t actually erupt because they are extracted before they have a chance. Since they are the last to make their appearance in a mouth that’s fairly full already, there sometimes isn’t enough room in the mouth for the wisdom teeth to take their place.
When there is no room for these teeth to emerge, they are considered impacted. Sometimes, when wisdom teeth try to erupt even though there isn’t enough room, they end up in a sideways position, still unable to erupt.
There may or may not be pain when wisdom teeth are impacted. If these teeth do make an attempt at erupting, the gum might begin to feel swollen and possibly even painful. These attempts sometimes cause pain in the jaw or the surrounding teeth which is another reason why these teeth are extracted.
Infections and tooth decay can form when a wisdom tooth only partially erupts which is why extraction typically is the preferred alternative in this case. And when wisdom teeth look for routes through which they can erupt, their search can cause other teeth to move out of place in response.
Problems with chewing can arise when teeth don’t line up properly, and that’s yet one more reason why extracting wisdom teeth may be necessary.
To date there is no procedure available that can move a wisdom tooth into the correct position so that it erupts where and how it should. Therefore, when it comes to the wisdom teeth, there usually is just one decision to make – to extract or not to extract.
An x-ray of the area is the most reliable way of determining whether extraction of the wisdom teeth is necessary. The x-ray can see below the gums where the naked eye cannot. The x-ray will show the location and positioning of the wisdom tooth and will also show whether or not there is enough room for the wisdom teeth to properly erupt.
If it is decided that extraction is required, when and were the procedure takes place will depend on the number of teeth to be extracted and how far below the gum line they are located. The person’s overall tolerance to pain and his or her degree of anxiety will also be evaluated.
Sometimes the procedure can take place in the dentist’s office in about a half an hour or less. Other times, however, it makes more sense to visit a surgeon so that all wisdom teeth can be removed. In this case, the person will be sedated and given a local anesthesia. There likely will be pain after surgery, but it should go away in a few days.
Tooth whitening is all the rage, with teeth looking whiter and brighter than ever before. Strictly cosmetic, this dental treatment improves the appearance of teeth by lightening stains and other discolorations. There are many reasons why teeth stain and turn yellowish in color, but the biggest culprits are the things people do every day – drinking coffee, tea and non-clear soda and smoking cigarettes. The pores on the enamel take hold of these stains which is why regular brushing can’t remove them.
Age is also a factor in tooth staining and discoloration. And sometimes, teeth stain from the inside rather than from the out. Excess fluoride and certain medications can cause these intrinsic stains. Tooth whitening, a process that needs to be repeated regularly, works on the stains on the outside of the teeth.
Teeth whitening can be done while at the dentist’s office or it can be done while at home. At home, you can use whitening products available at your local pharmacy or you can use custom-made trays and solutions that are prepared by your dentist. Each requires a series of whitening procedures of varying lengths. If you’re interested in having your teeth whitened, it’s a good idea to discuss with your dentist the benefits and disadvantages of each method.
Before teeth whitening can begin, teeth must be cleaned by a dentist or dental hygienist and all cavities will need to be filled. Receding gum can cause a problem if it has receded so much that the roots are exposed. Because there’s no enamel on roots, whitening won’t take hold. Whitening also won’t work on teeth that have crowns or veneers.
How teeth whitening woks
To whiten teeth, trays are loaded with a solution made with hydrogen peroxide. The trays are similar in look and shape to a mouth or night guard. The solution-filled trays are positioned over the top and bottom rows of teeth and they remain in place for one to two hours. Or if the whitening is done at home, overnight.
Sessions can be shorter when done at the dentist’s office, but the patient needs to return for several visits. When done in the office, the dentist is right there to monitor the process. If done at home, care must be taken when inserting and wearing the mouth guards. If any of the solution leaks, it may irritate the gums.
In theory, the longer you keep the solution on your teeth, the whiter they’ll become. However, some types of discoloration are difficult to remove. There are some whitening products that are only activated when they come into contact with a light or heat. Those are best used under the supervision of your dentist.
Whitened teeth can last just one month or 6 months or longer. The more you avoid the substances that cause staining, the longer the process should last. The only side effects of teeth whitening are possible gum irritation and temporary sensitivity. Overall the process is very safe however those who are pregnant should avoid teeth whitening. To date, studies on how or if whitening agents affect a developing fetus have not been conducted.
Dental Checkup and Examination
The dental visit – most people enjoy it but others dread it. Here’s an overview of the two most common types of dental visits: a dental checkup and a comprehensive dental examination.
As a preventative measure, twice a year you should schedule an appointment for a routine check-up. During this visit, the dentist will examine your teeth for signs of decay and other potential dental issues. That way, if problems are discovered, the dentist can take measures before those problems become worse.
During your check-up your teeth will get a deep cleaning and the dentist will use a special tool to remove tartar build-up. Your teeth will also get a polishing and an extra strength fluoride treatment. The dentist might also take a few x-rays.
If you’ve never been to the dentist before or if you are visiting a new dentist for the first time, the dentist likely will perform a comprehensive dental exam. Such an examination is a good way for the dentist to get to know you, your overall state of health and the particulars of your dental health.
During this visit, a thorough examination will take place. The dentist will take a set of full mouth x-rays. These will stay on file and will also help identify abnormalities. In addition to a comprehensive evaluation of your teeth the dentist will look closely at your gums and other soft tissue inside your mouth. Redness or puffiness might indicate gum disease.
The dentist will also look at your face, neck and chin for swelling and other abnormalities. He or she will also feel your saliva glands and lymph nodes for the same purpose. You’ll be asked to open and close your mouth and to move it from one side to another. The reason for this is to make sure the temporomandibular joint is properly gliding your jaw as you move your mouth. The dentist will check your bite to ensure your teeth are in proper alignment.
The dentist will also want to know about any prescription medications you currently are taking. Either bring your bottles along or write everything down, including the dosage so your dentist can record this in your file. The dentist also will want to make note of any illnesses or diseases you have as some will have an impact on your teeth.
After either type of appointment, the dentist or dental hygienist will discuss with you ways you can improve your dental hygiene routine. He or she will also discuss any further treatments deemed necessary as a result of the examination.
Overcoming Your Fear of Dental Visits
Why is it that so many people become scared at the thought of going to the dentist? Some degree of fear is understandable, but when that fear turns into dread, a person might actually have a phobia.
When people put off going to the dentist because they are so afraid of what may or may not happen their teeth are at significantly increased risk of developing decay. Left untreated, tooth decay can damage not only the tooth but the underlying roots and gums. If gingivitis develops and isn’t treated, it can develop into periodontis, gum disease that can become so bad that the gums and underlying bone structure are no longer capable of holding teeth in place.
If you feel stressed or tense before your dental appointment, worrying excessively and even losing sleep, or if you become sick to your stomach while waiting in the dentist’s office or while looking at the assortment of instruments or the staff in their white lab coats, you might benefit from knowing how to overcome this type of fear.
Fear is a common emotion and almost everyone fears something whether it’s spiders or flying or standing before a large crowd. Therefore, understand that fear isn’t something to hide or feel embarrassed about. Instead, admit you’re afraid because there are tools that can help alleviate this fear.
Communication is one of the best tools there is for overcoming your fear of the dental visit. Modern dentistry has advanced to the point where many of the procedures are performed without pain. This is important to know and your dentist can explain what’s going to happen inside your mouth in precise detail, if your dentist realizes that such communication will help alleviate your fears.
Knowing what’s happening may make you feel more in control of the situation. Another way to feel more in control is to agree upon a hand signal you can give the moment you want the dentist to stop. Communicating with someone else’s hands inside your mouth is difficult so a hand signal can definitely help.
Also available at the dentist’s office are different pain medications and numbing creams that you can be given. The options range from localized topical numbing creams to anesthesia to sedation. If you can’t relax because you’re worried about feeling pain, then let the dentist do something so that you won’t feel it.
There are also various techniques to help you relax that you can employ. You can distract yourself by listening to music, watching television or daydreaming. A technique called guided imagery helps you create in great detail an image of a more pleasant environment. A dental assistant can help you create this image by suggesting situations which you then visualize. You’ll be so busy creating the perfect mental image that you might even forget that your teeth are being worked on!
For intense dental phobia, consider finding a dentist that practices hypnosis or acupuncture. And if your fear is so bad that you can’t even make a dental appointment, you might benefit from therapy or participation in a support group.