Flossing is Still Important

The Associate Press recently posted an article where it revealed that the US government removed language on the value of flossing to fight gum disease and the AP asserted that studies proving the value of flossing in preventing gum disease are weak; HOWEVER, flossing still is an important part of oral health and the ADA highly recommends flossing daily. Here is a piece by Forbes on why you should keep flossing.

AP ARTICLE:   http://bigstory.ap.org/article/f7e66079d9ba4b4985d7af350619a9e3/medical-benefits-dental-floss-unproven

AMERICAN DENTAL ASSOCIATE RESPONSE:   http://www.ada.org/en/publications/ada-news/2016-archive/august/association-responds-to-news-story-challenging-benefits-of-dental-floss-use?nav=news

What Dentists have Learned about Fluoride Varnish for Your Children

by Rudolfo San Miguel

The best defense against tooth decay for your children is having your dentist or hygienist apply a fluoride varnish on their teeth. Getting this done at an early age is important. The procedure is quick and the value to your child’s teeth is remarkable. This is what many dentists have believed for years and has been confirmed by a 2006 study in UCSF School of Dentistry led by Dr. Jane Weintraub, DDS/MPH. Dr. Weintraub was quoted in an article form the UCSF News Center as expressing two important conclusions that are vital to the dental health of children: "First, the results support the use of fluoride varnish to prevent tooth decay in very young children. Second, the results support parents bringing children for their first dental visit at age one when they are getting their first teeth." Fluoride varnish is a resin of fluoride that is applied to teeth. Candy, sugar sodas, and similar treats can have erosive effects on the surface of your teeth. Fluoride varnish provides an extra layer of protection to fight these sources of erosion.

Here are some great links for more information:

• Fluoride Varnish Helps Prevent Tooth Decay in Very Young Children (UCSF News Center) 

• Fluoride Varnish - Frequently Asked Questions (New York State Department of Health)

• Fluoride Varnish: What Parents Need to Know

This is Your Mouth

by Rudolfo San Miguel

Your mouth is made of up of more than teeth and jaw bone. Good dental care isn’t just about protecting your teeth as much it is about comprehensive oral hygiene. Each portion of your mouth has a different function and design. By understanding the different portions of your mouth you can better appreciate how important its well-being is for you and your life.

The Oral Mucosa is the inner portion of your mouth, which protects you from what you put on it. Made of a protective lining called the “oral mucosa,” this inner surface of your mouth is important for your oral health along with your health in general. It consists of a tough membrane called keratin, which is also what both your fingernails and hair are made. It protects from disease, as it protects from injury.

The Gums are the pink tissue surrounding your teeth. Covering the entire roots of your teeth, the gums are important not only to your dental structure but also the health of the rest of your mouth. Gum disease may ultimately lead to both teeth decay and/or loss.

The Jaws (Upper and Lower) are the bones and structure surrounding the entrance to your mouth. They give your face its shape. They are essential for chewing and talking. Your upper jaw is attached to your skull, while the lower jawbone is separate and able to move vertically while you are chewing or speaking.

The Tongue is the organ in your mouth that you use to both taste and swallow food. Made of a powerful muscle, the tongue is covered with a special kind of mucosal tissue that harbors your taste buds. Aside from all the eating, tongues are important for speech.

The Salivary Glands are the three sets of glands located in your mouth and neck where your saliva is produced. They are called the “parotid,” “submandibular,” and “sublingual” glands. Your saliva helps protect your teeth and gums by rinsing food and bacteria. It also counteracts foods that are acidic, which can slowly wear away your teeth’s protective enamel.

The Uvula is the small flap of tissue that hangs from the back of your throat. Composed of muscle fibers and glandular tissue, the uvula is still a mystery to scientists. It does seem to play a role in both speech and maintaining moisture in your mouth and throat.

The Frenulum Linguae is the flap of mucosa connecting your tongue at the bottom of your mouth. It allows your tongue to move and assist in your ability to speak.

We may sometimes take our mouth for granted. Think of all the chewing, tasting, breathing, and swallowing you do. Through all these different elements to the structure of your mouth, these task are completed. Their health and well-being is as much part you as the rest of your body.

Periodontal Maintenance: Learning to Love Your Teeth

Sometimes it is hard loving the things that benefit you the most. Not that you don’t value them, nor that you are unaware of the value. Sometimes you may become so accustomed to their place in your life that you are oblivious of how life would be without them. A case in point would be your teeth.

Considered what your life would be like without your teeth. In other words, think about not being able to chew your food?   Not being able to smile or speak confidently.  Ever consider wearing dentures?

So learning to love your teeth is an important life lesson especially as you age. One of the possible consequences as you age is getting Periodontal Disease. This infection is caused by bacteria that live on our teeth and under our gums. In a matter of hours after a cleaning,  a film develops on the teeth.  This matrix attracts bacteria and allows it to grow and prosper. If not managed properly, it becomes a chronic infection.

What all this means is that Periodontal Disease is an infection that is managed. It is not cured. It requires daily home care that addresses the disruption of bacteria in the mouth. Finding the right oral aids and protocol with your hygienist is only part of maintenance. Your visits for professional cleanings will ensure your efforts are working and to access areas that you are unable to reach. The recommendation of a three month interval is based on research and scientific evidence.

Consider how much you spend on other portions of your well-being. How much money and time do you spend when you go to a hair stylist? How many trips to the gym do you make in 3 months’ time for weight control and fitness? Why wouldn’t this be the same with your teeth?

The pathogens that cause Periodontal Disease are persistent. You must be persistent too! The disease can become active with just a short lapse of routine brushing and flossing. We often see advancing disease when a person's immune system is challenged, as in stress, illness, or even sleeplessness.

The consequences to your teeth could be serious. This starting inflammation may seem minor, but it is the exact precursor to advancing disease and bone loss. Dismantling the maturing biofilm (bacteria) is crucial at this time to reverse early invaders from spreading throughout the mouth. It is the time when uninterrupted bacteria become destructive and the body’s immune response goes “from healing damaged cells to harming healthy ones.”

It isn’t overreacting to include your dentist and hygienist as part of your regular health regimen. Professional cleanings not only aim to control Periodontal Disease, but will lessen the burden of inflammation in general in your body. The benefits of such regular cleanings—every three months if you have Periodontal Disease—are unquantifiable!

Here are some informative links for your further reading:

• http://www.realsimple.com/health/what-causes-inflammation
• http://www.dentaleconomics.com/articles/print/volume-100/issue-12/practice/its-all-about-perio-maintenance.html

How a Dentist helped my Relationship and My Oral Health

by Rudolfo San Miguel

I really got into brushing my teeth daily when my mouth started getting sore. I figured my mouth had become irritated because I wasn’t keeping up with my daily cleaning and it was a sign of my lack of maintaining proper oral hygiene. 

I never thought it was time to go to the dentist. I didn’t like the dentist, and it was bad enough that I had to go for an annual appointment with my general practitioner. Why should I see a dentist annually as well? I stood by this attitude with the assurance that if I kept my new habit of cleaning my teeth daily, the need for an annual dental exam was unnecessary.

My girlfriend Heather was the person who got me out of this thinking when she complained that my mouth stank every time I was close to her. She always said my gums were red and swollen. Heather resisted kissing me around that time. This was enough to get me into a dentist’s office and change my thinking. 

The dentist was a nice guy by the name of Charles McDonald. He had been practicing restorative dentistry since graduating first in his class from Howard University in 1970. He was really patient with me. What I discovered really helped me realize how off was my thinking. It turns out I had the beginning stages of Periodontal Disease (PD), which is called Gingivitis. 

The bad news was I was stuck with it and I needed to deal with it or would face consequences. The good news was that I could deal with it and that PD was very treatable with the regular help of a dentist.

The first question you may have is what is Periodontal Disease? This is what the Center for Disease Control (CDC) has to say about PD:

"Periodontal disease is mainly the result of infection and inflammation of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health."

Surprisingly, it turns out that over 47% of adults over the age of 30 have some kind of PD, whether it is simply gingivitis or something more serious. And it is over 71% common for people over the age of 65. It is more common for men to have it and for people who smoke. You can follow this link for more on the CDC’s information on PD: http://www.cdc.gov/OralHealth/periodontal_disease/index.htm

 

The solution to my problem, especially since it was the early form of PD, was a lot less painful than learning about the problem. Dr. McDonald, after finishing his exam and giving me his recommendations, referred me to his hygienist, Donna Avakoff, who provided me with a professional cleaning. Both Dr. McDonald and Donna recommended that I keep up the good work and continue to brush my teeth daily along with including flossing to my daily mouth hygiene.

I ended up convincing Heather to visit Dr. McDonald after being swayed by his office’s philosophy on PD prevention, “Early diagnosis and treatment for better oral health and systemic health.” Donna stressed that PD is a chronic infection that occurs in many adults has been linked to the increased risk for heart disease and stroke. This was reason to be concerned and be proactive in my dental hygiene.

I felt reassured after finishing my cleaning and relieved of the soreness on my gums. The biggest satisfaction when Heather was more inclined to stick closer to me, especially now that my mouth was much more pleasant.

Why Fluoride Varnish?

The benefits of fluoride varnish can be realized throughout a life time.
Young children are the most vulnerable to getting cavities. As soon as the teeth erupt into the mouth they are exposed to bacteria. Those bacteria then metabolism carbohydrates that you eat and drink. The byproducts produced are acidic in nature and will demineralized  tooth structure. Fluoride varnish will not only help reverse early decay but will help prevent acid dissolution in the future.

In young adults the benefits of a fluoride treatment are geared more towards prevention. The margins surrounding existing crowns and fillings, where bacteria is often harder to remove, will be more vulnerable to the acids and can undermined a restored tooth. 

By mindful homecare and regular professional cleanings with a fluoride varnish, you can lessen the risk of recurring decay. 

In my opinion however, I feel the greatest need for fluoride varnish is when there are a multitude of challenges, often seen  in mature adults. Medications causing dry mouth contribute to the acid environment in the mouth.  With less salivation there is a decreased buffering effect from acids that are formed.  Additionally, bacterial biofilm collecting around restored teeth often at the gum line have a faster pathway into the root of the tooth. The root being less mineralized than the enamel will decay faster and comprom

ise treatment options possibly leading to root canal therapy or extraction.
To make matters worse a weakened immune response and the challenges of improving oral hygiene due to the aging body's increased needs, sets the stage for many adverse possibilities.  

Proactively practicing prevention when you are young, can give you more years of health as you age.

Donna Avakoff, RDH 

http://www.dimensionsofdentalhygiene.com/2016/02_February/Features/What_the_Evidence_Says_About_Fluoride_Varnish.aspx#.VtSQ6fDJrrw.email

Dental Biofilm

Have you ever wondered why we are so concerned about bleeding gums? Please let me explain...

The bacteria in the mouth form very complex microbial communities in between and around the teeth. They take in nutrients and they rid themselves of wastes. They transform themselves and their environment in an attempt to survive. Triggering the body's defense system, inflammatory cells are sent to the area. That is why there may be inflammation and bleeding of the gum tissue when you have your teeth cleaned.

When the gums are inflamed they will be more sensitive and can be ulcerated. This ulcerated tissue surrounding the teeth serves as a direct portal for bacteria to enter into the body's blood stream. From the mouth the bacteria circulate through the body. It is the bacteria as well as the body's inflammatory response that is being studied as to the link to heart attacks and strokes.

Research is now profound enough that we all must take this seriously. It is our goal to care for our patients in the best possible way. Understanding the importance of managing the bacteria is half the battle. We are here to help you achieve that level of care necessary to achieve oral-systemic health now and in the years to come.

Donna Avakoff, RDH

Biofilms: A microbial home 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183659/

How Plaque and Gum disease can affect your health

www.webmd.com/oral-health/plaque-on-teeth

The benefits of Air polishing

Air polishing has been scientifically shown to be an effective and efficient way of removing soft debris and stains from the tooth surfaces.

The ability to clean otherwise hard to reach areas in the mouth, the air, water and fine powder spray used with air polishing maximizes our patient's time and more thoroughly removes disease causing bacteria.

With this new generation of air polishers and powders we are now able to focus more on the removal of plaque biofilm under the gums to control disease.

Patients report they can see the difference right away in the color of their teeth.  This is because the technology allows the removal of deeper stains.  Patients are informed that after a protective fluoride varnish to wait 2 hours before consuming food or drink containing substances that could strongly color the teeth.

Start your day with a bright smile and confidence in knowing you are doing all you can to minimized the burden of inflammation on your body.

Donna Avakoff, RDH

References

http://www.dentaltown.com/dentaltown/Article.aspx?i=343&aid=4735

http://www.dentaleconomics.com/content/de/en/articles/print/volume-106/issue-1/science-tech/a-fundamental-shift-in-our-understanding-of-periodontal-disease-progression.html