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Posts for: November, 2013

HowDoYouKnowIfYoureBrushingAndFlossingYourTeethCorrectly

You've probably brushed your teeth every day since early childhood when your parents handed you your first toothbrush. But do you really know if you're doing it effectively and removing disease causing bacterial plaque or biofilm? Let's take a look at the basics of tooth brushing.

What is the goal of brushing and flossing your teeth? While it is true that brushing your teeth freshens your breath and removes stains from the surfaces of your teeth, the principal goal of tooth brushing is to remove dental bacterial plaque. This biofilm grows in the nooks and crannies of your teeth, and especially at the gum line — regardless of what you eat or drink. If left on your teeth, this bacterial film can cause gingivitis (inflammation of your gums). It can progress to periodontal disease, affecting the supporting bone of your teeth and even result in tooth loss. This means that flossing should also be an important part of your daily dental hygiene routine to remove plaque from the protected areas between your teeth.

Can you actually brush too much? More is not always better and can be damaging. We advise you to use a soft brush and to brush gently. It does not take force to remove plaque, and using a toothbrush too vigorously can damage your gums and cause them to recede (shrink away from your teeth), causing sensitivity and tooth wear. It takes between 12 and 24 hours for plaque to form on your teeth, so you don't need to brush more than twice a day and floss once a day.

How do you know when you've done a good job? A good test is that your teeth should feel like you've just had a professional cleaning. Your tongue is a great evaluator — just feel for smoothness at the gum line.

Is a powered toothbrush better than a manual one? An evidence-based study comparing all the research available found little difference between power and manual toothbrushes. The conclusion was that some powered toothbrushes with a rotation-oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushes. But as we say, “it's not the brush, it's the hand that holds it.”

Come to our office for a demonstration. Any brush, whether electric or hand-powered, requires professional demonstration and training so that you know how to remove plaque correctly. Bring your toothbrush with you on your next visit to our office, so we can see your brushing technique and make sure you are doing it correctly for the most efficient plaque removal. And don't be embarrassed — nobody really knows how to brush effectively until they're shown!

Contact us today to schedule an appointment or to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Manual vs Powered Toothbrushes.”


By Tamara Simons, DDS
November 18, 2013
Category: Oral Health
Tags: antibiotic  
CertainMedicalConditionsCallforAntibioticsBeforeaDentalVisit

If you have certain health conditions, your medical doctor may prescribe an antibiotic for you to take prior to a dental visit. The reason why is a story that dates back to the mid-20th Century.

In the early part of the last century, a theory became popular that bacteria in the mouth could migrate to other parts of the body and cause systemic illness or disease. During the 1930s and 1940s evidence arose that indicated a connection between dental procedures that caused bleeding and two serious health conditions: bacteremia (the presence of bacteria in the bloodstream) and infective endocartitis. The latter is the inflammation of inner tissues of the heart (including the valves) caused by infectious agents, most notably bacteria. It became common then to prescribe antibiotics to patients susceptible to these conditions as a preventive measure. Later, patients with prosthetic joints or poor immune systems were added for this kind of treatment.

For many years, the American Heart Association (AHA) recommended pre-visit antibiotic treatment for a wide array of heart patients. After several years of research that indicated the treatment wasn't necessary for most people and might even be detrimental, they updated their guidelines in 2007 and reduced their recommendation list to just a few conditions. They now recommend the antibiotic treatment for patients with artificial heart valves, a history of infective endocartitis, heart transplant recipients with valve problems, and certain congenital (inherited) heart conditions.

If you have a condition that calls for a pre-visit antibiotic treatment, all the providers involved with your care will need to communicate. Your medical doctor will most likely prescribe two grams of amoxicillin (or a similar antibiotic if you are allergic to amoxicillin) that you would take an hour before the dental procedure. We in turn would communicate with your medical doctor concerning the dental procedures you're scheduled to undergo (including regular cleanings), in case your doctor would like to make adjustments in your medication.

Your health and well-being is of utmost importance to all your healthcare providers, medical and dental. Working together, we can ensure the dental procedures you need for oral health won't have an adverse impact your general health.

If you would like more information on antibiotic treatment before a dental visit, 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 “Antibiotics for Dental Visits.”


WhatFlorenceHendersonLearnedFromHerImpactedTeeth

Life lessons are learned in the most surprising places. This is no different for celebrities. Take, for example, Florence Henderson, an actress, singer, philanthropist, author and star of the hit television series, The Brady Bunch. As she told Dear Doctor magazine, her experience with having four impacted wisdom teeth removed — at the same time — “...only made me more aware of how important dental care is.” She continued, “This is why I have always gone every six months for a check up.”

Another important lesson we want to share is the fact that even if your impacted third molars (wisdom teeth) are not bothering you or causing any pain, you may still need to have them removed.

Why? Having a tooth submerged below the gum, pressing on the roots of other teeth is problematic; the tooth should be removed so that you can avoid major dental problems before they occur. For example, it is not uncommon for us to find an impacted third molar pressing against the roots of the adjacent second molar. Furthermore, because the enamel crown of this impacted tooth is trapped below the gum, we sometimes find an infection, gum disease or even cyst formation occurring.

Often, the best time to remove a wisdom tooth is when it is not causing any problems. This is because a painful wisdom tooth or pain in the area of the wisdom tooth may be a sign that significant damage has occurred or is occurring. It is also better to remove wisdom teeth when you are young, as young healthy people with no prior infections at the site provide the best opportunity for us to remove the tooth with no complications.

To learn more about impacted wisdom teeth, continue reading the Dear Doctor magazine article “Removing Wisdom Teeth.” Or if you suspect or already know that you have an impacted wisdom tooth, contact us today to schedule an appointment so that we can conduct a thorough examination that includes x-rays. During this private consultation, we will also address any questions you have as well as your treatment options. And if you want to read the entire article on Florence Henderson, continue reading “Florence Henderson.”


By Tamara Simons, DDS
November 06, 2013
Category: Oral Health
Tags: orthodontics   retainer  
TheTop5ReasonsWhyYouShouldWearYourOrthodonticRetainer

OK, so you've been getting orthodontic treatment for what seems like a long time, and finally, your braces are about to come off! Now you're home free, right?

Well, almost… but now comes the final part of your treatment: the retention phase. That means you'll need to wear a retainer. Most people find that a retainer is more comfortable than braces — but because it is often removable, there's the temptation to just leave it off. Don't do it! Here are the top five reasons why you should always wear your retainer as instructed:

1) A retainer helps to make your teeth stable in their new positions.

Your teeth aren't rigidly set in stone (or in bone) — instead, they are held in place by a hammock-like set of ligaments, and the bone that surrounds them is somewhat pliable. That's a good thing… because, otherwise, they would be even harder to move! But it means that it will take some time for the bone and ligament around the teeth to re-form and stabilize in its new position. A retainer holds them in position while that is happening.

2) If you don't wear it, your brand-new smile may not stay looking the way it should.

Did you know that your bone and gum tissue have some “memory?” Unfortunately, it's not the kind that could help you on a science quiz — but teeth can “remember” where they used to be located… and, if you leave them alone, they may try and go back there! A major goal of the retainer is to keep your new smile looking great! If you don't wear it, and your teeth shift back, you risk losing all the time (and money) you invested.

3) There are different types of retainers available; one of them might be just right for you.

At one time, all retainers were made of pink plastic and silvery wire, and were removable. That kind is still available, but now you may have a choice of different colors or patterns — you might even be able to customize yours! Another alternative that may be appropriate is a clear retainer that fits over your teeth, making it nearly invisible. In some cases, you can have a thin wire bonded to the inside of the teeth instead of a removable retainer. It doesn't show, and you don't have to worry about taking it out.

4) As time goes on, you'll probably need to wear your retainer less and less.

At first, you'll probably need to wear your retainer all the time, but after a while you may only have to wear it at night — a lot easier to manage! Think of it as a way of easing yourself out of orthodontic treatment — and into a brand-new smile. The retention stage also helps your teeth avoid damage by allowing the process to end slowly and gently.

5) Lots of celebrities wear them.

If we know who, we aren't telling — but let's just say that several young entertainers and a recently married British Prince have worn retainers, or are still wearing them. So, you're in good company!

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”