When you’re buying a tool or appliance, you compare brands for the best quality you can afford. There’s another important item that deserves the same level of scrutiny: your toothbrush. Choosing the right one for you can make a huge difference in your oral hygiene effectiveness.
But a visit to your store’s dental care aisle can dim your enthusiasm. You have plenty of options involving all manner of shapes, sizes and features. Perhaps too many: After a while, the sheer number of choices can paralyze your decision-making process.
You can streamline this selection process by concentrating on a few important toothbrush basics. First up for consideration: the bristles. While you may think a good stiff brush would be best, it’s actually the opposite—most dental professionals recommend softer bristles. That’s because hard bristles can potentially damage your teeth and gums over time.
Softer bristles are gentler on your teeth and just as effective for removing plaque, if you use the right technique and thoroughly brush all tooth surfaces. And look for rounded bristles, which are friendlier to your gums.
Next, look for a brush that feels right in your hand. If you have problems with manual dexterity, look for one with an oversized handle. Some brushes come with angled necks and tapered heads, which you may find effective in reaching less accessible back teeth. This might mean trying different brushes until you get one that’s right for you. Don’t worry, though, you’re not buying a brush for life—in fact, you should change out your brush every three to six months.
You’ll also rarely go wrong buying a toothbrush with the American Dental Association Seal of Acceptance on the packaging. This seal signifies the toothbrush has undergone testing and met the ADA’s standards for hygiene effectiveness. While some manufacturers of effective brushes don’t pursue this seal, you can be sure one with it has passed the test of quality.
It makes all the difference in the world having the right tool for the job. Be sure your toothbrush is the right one for you.
If you would like more information on toothbrushes and other dental care products, 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 “Sizing up Toothbrushes: How to Choose the Right Brush for Optimal Oral Health.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
If your tooth sustains damage that compromises its structure — typically through decay or trauma — you have several options depending on the extent of the damage: One of them is a crown. This method saves the tooth and its root and completely conceals the visible portion of the tooth, or crown, under a natural-looking cap made to mimic as closely as possible the size, shape and color of the original tooth.
Crowns also hide imperfections in the original tooth like discoloration, chipping, fractures, excessive wear (from bruxism, or tooth grinding, for example), or abnormalities in the way the tooth formed. And they’re used following root canal treatments, which treat infected pulp at the center (canal) of a tooth root by removing the pulp and replacing it with an inert, rubber-like material.
Saving the natural tooth has long been the goal of dentistry because normal micromovements of the tooth root, which is suspended in its jawbone socket by elastic ligaments, stimulate the surrounding bone to rejuvenate. Without that stimulation, the bone continues to lose old cells, but no longer replaces them. Crowns are also designed to restore tooth function.
The function and location of the damaged tooth can determine what material the crown will be made of. If the damaged tooth is clearly visible when you smile, porcelain, the most realistic-looking material, is almost always used. If the tooth receives significant bite force, a stronger material is considered — either, a gold/porcelain combination, or a high-strength ceramic. If you are restoring a second molar, an all-gold crown may be considered.
With the advent of dental implants, saving a damaged tooth is no longer the only option for preserving the health of the bone surrounding the tooth root. The implant — a tiny biocompatible, titanium screw-like artificial root — is placed in the jawbone and is then capped with a natural-looking crown of course!
If you would like more information about dental crowns, 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 “Crowns & Bridgework.”
Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.
One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.
That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.
The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.
To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.
But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.
You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.
If you would like more information on the prevention and treatment of tooth decay, 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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”
Periodontal (gum) disease is a serious infection that can damage more than periodontal tissues — supporting bone structure is also at risk. Any bone loss could eventually lead to tooth loss.
To stop it from causing this kind of damage, we must match this disease's aggressiveness with equally aggressive treatment. The various treatment techniques all have the same goal: to remove bacterial plaque, the source of the infection, from all oral surfaces, including below the gum line. Buildup of plaque, a thin film of food particles, after only a few days without adequate brushing and flossing is enough time to trigger gum disease.
The basic removal technique is called scaling, using hand instruments called scalers to manually remove plaque and calculus (hardened plaque deposits) above or just below the gum line. If the disease or infection has advanced to the roots, we may use another technique called root planing in which we shave or “plane” plaque and tartar from the root surfaces.
Advancing gum disease also causes a number of complex problems like abscesses (localized infections in certain areas of gum tissue) or periodontal pockets. In the latter circumstance the slight normal gap between tooth and gums becomes deeper as the tissues weaken and pull away. This forms a void or pocket that fills with inflammation or infection that must be removed. Plaque buildup can also occur around furcations, the places where a tooth's roots divide off from one another.
It may be necessary in these more complex situations to perform a procedure known as flap surgery to gain access to these infected areas. As the name implies, we create an opening in the gums with a hinge, much like the flap of a paper envelope. Once the accessed area has been cleansed of plaque and infected tissues (and often treated with antibiotics to stop further infection), the flapped tissue is closed back in place and sutured.
To avoid these advanced stages it's important for you to see us at the first sign of problems: swollen, red or bleeding gums. Even more important is to reduce your risk for gum disease in the first place with dedicated daily brushing and flossing to remove plaque and regular dental visits for more thorough cleaning.
Gum disease can be devastating to your long-term dental health. But with diligent hygiene and early aggressive treatment you can stop this destructive disease in its tracks.
If you would like more information on treating gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”
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