Toothbrushes (Part II)

In my previous blog, I discussed head size and bristle stiffness of toothbrushes. Toothbrushes can come in a variety of shapes. It can be helpful to have the type that has rounded bristles. Most bristles are made of nylon so they don’t soften when they gets wet like the natural bristles do. Mom always told us to go into the bathroom and scrub our teeth real hard and thorough. Brushing thoroughly is important. Brushing hard was fine for the old days when the natural bristles would soften in saliva, but since the nylon bristles don’t soften, we must be very judicious in the amount of pressure that we use. Only the tips of the bristles do the cleaning work, so a toothbrush whose bristles are all bent and frayed is ready for the trash can or the household cleaning bucket. Another important aspect of choosing a toothbrush is to look for the American Dental Association seal of approval. The ADA puts dental products through stringent, independent testing to make sure that a manufacturer’s claims are valid. This way, you can be sure that whatever it says on the packaging has been verified and is safe for you and your family to use.

Toothbrushes

Soft Bristle Toothbrush

Toothbrushing is a vital part of daily oral hygiene to help prevent cavities and gum disease. Choosing the toothbrush that is right for you is an important part of the process. Toothbrushes come in a variety of shapes, sizes, and styles. Head size is important to make sure that all areas of the mouth are accessible. The larger the head of a toothbrush, the more efficient it will be in cleaning the teeth. However, trying to get the sides of the upper molars can be a challenge for some. When you open your mouth wide, the coronoid process of the jaw bone will drop down right next to the upper molars making it a very tight fit. By closing the mouth halfway and moving the jaw to the side will many times allow enough room to get a brush with a bigger head all of the way back into the mouth. The bristles should be no firmer than the “soft” variety. Plaque is actually not that difficult to remove, so a medium or hard brush is not necessary. Use of too stiff a brush can cause damage to the tooth enamel and the gums which can necessitate fillings and gum grafts.

Floss (Part II)

Flossing you teeth on a daily basis is just as important as toothbrushing. To floss, you need to saw the strand of floss between the teeth, then scrub the tooth surfaces to remove the sticky dental plaque. To manipulate the floss, for the upper teeth, I like to wrap the floss around my index fingers then use my thumbs to do the scrubbing. For the lower, again I like to wrap the floss around my index fingers, but I will manipulate the the floss with my middle fingers. It is important to keep the thumbs (for the upper) and middle fingers (for the lower) very close to the teeth that you are cleaning. That way, the proper pressure can be applied in the correct direction in order to do an efficient job of plaque removal. If the fingers aren’t close enough to the teeth, then you will move a lot of floss and do very little work. As far as type of floss, either waxed or unwaxed are fine. It is just a matter of personal preference. If properly used, both do an adequate job. For those who have difficulty reaching their hands into the back of the mouth, there are little floss picks that are readily available at grocery stores and pharmacies that make it much easier to access and clean the molar teeth.

Floss

Floss is an important part of a daily oral hygiene program. A toothbrush will reach the sides and chewing surfaces of the teeth, it can not fit in between the teeth. This is where floss comes into play. Just imagine floss as being a bristle from a toothbrush and with it you scrub the plaque off from between the teeth. Dental plaque is a collection of sticky bacteria that is essentially invisible. It takes the sugar that you eat and produces acids which leaches the calcium from your teeth causing cavities and produces exotoxins which causes an inflammatory response leading to gum disease. This layer of plaque requires about 24 hours to organize and do its dirty work. By getting the floss cleaning between the teeth daily, cavities and gum disease can be greatly reduced. The key to flossing is to make sure that the floss is wrapped around the tooth and then the tooth is scrubbed along its side. It’s a common misperception that the floss merely needs too be placed in between the teeth to be effective, however, floss has no magical properties and must be properly manipulated in order to remove the layer of bacterial dental plaque.

Drug Addiction in Dentistry

Dentists deal with patients in pain every working day. It is our goal to alleviate as much suffering as possible. As part of the process, many times a pain reliever must be prescribed. Although there are some extremely effective anti-inflammatories available for mild to moderate pain, many times, a narcotic pain reliever may be the only type strong enough to relieve the dental pain. Unfortunately, overuse of narcotic pain relievers can lead to addiction. In addition to the pain relieving aspects of narcotics, they also produce euphoria. This can lead to a learned reward experience and can cause a craving to relive the same feeling even after the need for pain control is gone. As more doses are taken, a tolerance is progressively built up, meaning that higher doses are required to achieve the same effect. Dentists need to be aware of patients who experience “pain” with visible source and require heavy doses of narcotics to relieve that “pain”. With the advent of computer networks, dentists now have the ability to check online to see if a particular patient is a “drug seeker”. This allows a dentist to have the piece of mind in prescribing narcotics to provide his patients with proper and adequate pain control.

Preparing the Gums for Dentures

Constructing a new set of dentures is not always as straight forward as taking a quick impression of one’s mouth. First, the dentist must check the tissues for any pathology. It is certainly not a good idea to build a denture over a tumor or cancer. The next thing to check is the condition of the ridges of the gums themselves. If there is inadequate bone to allow for good retention and stability of a denture, then a bone graft may need to be considered. Artificial bone substitutes, cadaver bone, or pieces of the patient’s own bone can be placed under the gums surgically to add enough bulk to comfortably wear a denture. If there are bumps of bone called tori or severe bony undercuts that rigid plastic could not snap around, then they need to be surgically removed. The dentist peels a flap of gum tissue that is over the bony prominence and grinds the offending piece of bone off and smooth the area. In other cases, there could be flabby, moveable tissue or even extra folds of gums which would make a denture unstable. This would also have to be surgically removed. By properly preparing a good gum foundation, a very well fitting set of dentures can be constructed.

Snap-On Smile (Part II)

In my previous blog, I discussed the indications and contraindications of a Snap-On Smile. A Snap-On Smile is a custom made piece of acrylic plastic that covers the front teeth. It is a temporary, lower cost alternative to permanent cosmetic dental treatment. In order to construct a Snap-On Smile, the dentist will fill all cavities and remove any hopelessly loose teeth. At that point, the dentist will make a custom mold of the teeth with an extremely accurate impression material called polyvinylsiloxane. A model of the teeth that will oppose the Snap-On Smile is made from another mold and a bite impression is taken in order to relate the two models together. Pictures are taken to make sure that the lab has the ability to build the smile in the proper alignment with the face. And, last, but not least, a color is selected. All of this material is sent to a lab where they construct the Snap-On Smile prosthesis. Then the big day comes when the Snap-On Smile is ready for insertion. The new prosthesis is tried in for proper fit and function. With good technique in the preliminary stage, usually adjustments are minimal. And it sure makes for a happy patient to have their smile instantly restored! If you are interested in seeing our video of Snap-On Smile, please follow this link: http://youtu.be/8N4BE9PEgOs

Snap-On Smile

Snap-On Smile has been a welcome addition to the dentists bag of cosmetic tools. The name says it all – it’s a smile that simply snaps on. Before one considers a Snap-On Smile, they must understand the indications and limitations. Snap-On Smile is not meant to cover cavities or hopelessly loose teeth. All cavities must be filled ahead of time. Also teeth that have too much bone loss that makes them to shaky to withstand the snapping forces must be removed. Snap-On Smile is not meant to be a permanent solution to a cosmetic dental problem. It is not meant to replace lost function from chewing forces due to lost teeth. What Snap-On Smile is is a lower cost alternative to what can be expensive cosmetic dental procedures. It can cover discolored teeth. It can cover mismatched spacing between the front teeth. It cannot be used where the teeth are too far forward already such as “buck” teeth since a thin layer of plastic will be snapped on over the front teeth. Snap-On Smile allows people to go out in public and feel confident with a big, wide smile and showing off their pearly whites.

A Child’s First Trip to the Dentist

A good experience at a child’s first trip to the dentist is vitally important in shaping their future behavior at dental visits. When a child’s first time at a dental office is to relieve the pain of a toothache, that can greatly affect their future perceptions of the dentist and produce fear and behavior management issues. Therefore, it is important to make the first appointment for a cleaning and checkup around the child’s third birthday. The days leading up to the first visit should be filled with stories about the fun, exciting trip to the dentist that is coming up. If a parent has a fear of the dentist, they should be careful to not project that fear on to the child. Kids are more perceptive than you think. The parents need to make sure that big brother doesn’t fill the patient with needless horror stories. And they shouldn’t ever say things like “If you don’t behave, I’m going to take you to the dentist.” At our office, we try to make every trip to the dentist a fun adventure with cartoons playing on TV’s in the ceiling, good tasting toothpastes and fluorides, and trips to the treasure chest afterwards. Having a pleasant experience at the first dental will help alleviate apprehension at future dental appointments.

Children’s Fear of the Dentist

Many factors can contribute to a child’s fear of the dentist. On top of that list is a bad experience at a previous dental appointment. The younger the age, the higher likelihood that a child will have a fear of the dentist. It has even been shown that parents can pass along their own fear of the dentist. Children are very perceptive and can sense that a parent is stressed when talking about a dental visit. I employ a number of techniques to help allay a child’s fear. We have TV’s in the ceiling with cartoons playing which helps distract the child. Just something as simple as using a gentle, friendly voice and a smile can also put the child at ease. The “tell-show-do” technique works great. I tell them about the “water sprayer” that will flush out all of the “cavity bugs”, then I will take the dental hand piece and spray water on their hand so that they can see that there is nothing to fear. Then, for the “do”, I touch the anesthetized tooth which produces a gentle vibration so that they can see that there is no pain. And speaking of the numbing process, they are never shown the needle. They just get a little “pinch” to put the tooth to sleep. By employing just a few simple techniques can greatly reduce a child’s fear of the dentist and make it a pleasant experience.