Question 1

Brushing

Accepted Answer

Brushing

What is Dental Decay?
Simply, dental decay is a bacterial infection of the tooth. Everyone's mouth is full of bacteria - both good and bad. In a healthy individual, with a healthy diet, a balance occurs which keeps the bacteria and the decay process in check.

As far as the su

rface of the teeth are concerned: demineralization (loss of minerals) and remineralization (gain of minerals) is constantly occurring based on features of the surrounding environment of the mouth.

When acidity of the mouth increases (pH below 5.5) the teeth lose minerals faster than they can gain them. This weakens the teeth and they become more prone to the bacterial invasion. This is dental decay.

Is brushing enough?
A tooth has five sides. Even if you brush perfectly you are only removing the bacteria from 3 sides. Bacteria which form in between the teeth can only be removed by flossing.

*Reminder: water pics and tooth pics do not remove bacteria.

Question 2

Diet

Accepted Answer

How Important is diet?
Your diet is very important. Actually dental decay can be controlled by diet alone. By controlling the types of food and drinks you buy, you can prevent 90% of the decay we see in children.

Soda and Sports Drinks
Drinking pop is double trouble. A 12 oz. can of soda contains 10 sugar cubes and has the acidity of pH 2.3. Sports drinks have an acidity of pH 2.7. To put the pH levels in perspective: water, which is neutral, has a pH of 7 and the acid in you car battery has a pH of 1. Diet sodas also have phosphoric acid added to them.

The sugars in the soda feed the bacteria around the teeth creating a highly acidic environment. The sugars also multiply the number of bacteria in the mouth. In addition, the acids themselves weaken the tooth surface enabling additional bacteria to invade the tooth surface.

Fluoride
There are two main types of fluoride used in dentistry. Digestible fluoride which is distributed through drops or tablets and surface fluoride which is placed directly on the teeth through toothpaste, swish-swash programs and topical treatments in the dental office.

Digestible fluoride works on the developing tooth. Fluoride ions are absorbed into the body and bond to the developing tooth making the "entire" tooth harder and not just the surface of the tooth.

Do medications cause dental decay?
Yes, but they do so indirectly. Remember a healthy mouth contains many types of bacteria which remain in balance. Your saliva is essential to maintaining this balance. Decreased saliva flow is a common side effect of many medications. With decreased saliva flow or xerostomia, the acid loving and acid producing bacteria take over resulting in active uncontrolled decay.

What types of medications cause decreased saliva flow?(https://scotterler.com/files/2014/09/Medicine_DryMouth_DrErler_ForWeb.pdf)
Actually, over 400 prescription drugs and many over OTC (over the counter) drugs cause xerostomia. Some of the more common are: antidepressants, antihypertensives, antihistamines, diuretics, antipsycotics, decongestants, and opiads. Illicit drugs like metamphetamines and cannabis also cause "dry mouth".

In addition, systemic disorders like Sjorgen's Syndrome, TB, HIV, and uncontrolled diabetes can cause "dry mouth" symptoms. Habits like tobacco and alcohol use also contribute to the problem.

Question 3

Grinding

Accepted Answer

Grinding or "Bruxism" and clenching of ones teeth is a fairly common malody in our modern stress driven society. In fact, Bruxism affects 30-40 million children and adults in America.

Most people do not know they are bruxers because it occurs in the deepest levels of sleep and only for short periods of time. Since people can generate 300-400 lbs. of pressure on their teeth when they brux the results can be very destructive.

Headaches, earaches, cracked and broken teeth, and hypersensitivity of teeth to hot and cold are some of the the more common symptoms of bruxers. In addition, broken crowns and bridges, jaw pain, and worn teeth enamel can occur exposing deeper more sensitive areas of the tooth.

Bruxism seems to be common in personality types who tend to internalize anger and coping with stress.

Custom fitted nightguards protect the teeth and restorations and help "remind" the brain not to brux.

Pictured on right is a 43 year old female with severe bruxing habit as evidenced by extreme wear on the gold crown.

Question 4

Dental Hygiene

Accepted Answer

Proper Dental Hygiene is the cornerstone of successful dentistry and long-term retention of natural teeth.

The naturally occurring bacteria of the mouth form a "film" on the surface of the teeth every 6-8 hours. Every 24 hours these bacteria organize into colonies and begin producing acids and toxins.

The toxins invade the gum tissue resulting in a low grade infection called "gingivitis". This is a precursor of periodontal disease or Pyorrhea which is responsible for 90% of adult tooth loss.

In addition, other bacteria invade the teeth themselves. This process is called dental decay or dental carries.

As people age, and if they have not followed up with regular cleanings or dental prophylaxis, the film calcifies forming a hard, crusty substance called tartar.

The tartar or calculus is 90% bacteria. The surface of the tartar is active bacteria and removing this layer can only be done with a professional dental cleaning.

Our hygienists use "state of the art" techniques to remove tartar in the most efficient and comfortable way possible.

Question 5

How often is enough?

Accepted Answer

For most people, twice a year should keep tartar formation to a minimum. As people age, and depending on their home care, tartar may accumulate more often requiring more frequent cleanings. Also patients with active periodontal disease require more frequent treatment.

The good news is that insurance companies recognize the importance of regular sixth-month cleanings. They often pay at 100% for this preventative service.

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Question 6

What causes bad breath?

Accepted Answer

For 90% of people with bad breath the cause is not brushing or flossing correctly on a consistent schedule. The bacteria in dental plaque (which forms every 6-8 hours) produce gases which are the main culprit in "bad breath". Its important to remember these bacteria originate on the tongue. Brushing the tongue helps in reducing their numbers.

Other factors include smoking, stress, eating certain foods, and various systemic disorders like diabetes, alcoholism, and certain types of cancers. Medications leading to "dry mouth" also contribute to "bad breath".

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Question 7

Should kids get cleanings?

Accepted Answer

Even though children do not collect a lot of tartar, regular dental cleanings are important. They give us a chance to evaluate and remind the child of the importance of their home care. The application of topical fluoride helps to harden the teeth and make them more decay resistant.

Caries (cavities) tend to progress quickly in children. Their enamel, large pulps, questionable flossing habits and sugary diets work against children as they try to prevent dental decay.

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Question 8

What is "deep cleaning"?

Accepted Answer

This is a term meant to describe periodontal scaling. Individuals who have had a more advanced form of gum disease "periodontitis", require a more technical cleaning. Periodontal disease results in the loss of supportive bone around the teeth. Pockets which harbor bacteria then form. These areas cannot be cleaned with normal brushing and flossing.

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