Dental Blog

New Way to Floss Your Teeth

admin — Wed, 01 Feb 2012 20:25:32 +0000

Most of us will admit that flossing is one of the least favorite things to do. It takes patience, concentration and a lot of awkward hand movement. Sometimes we wrap the floss around our fingers so tight that the fingertips turn blue. The truth is that many patients consistently floss 1 to 2x per week. There are also patients who don’t floss at all.

Philips Sonicare recently came to the rescue with the Airfloss. It is a device about the size of a electric toothbrush that is supposed make it more convenient to floss and replace the need for the string floss. I recently received mine and have been using it for about a week. The unit works by gently sending a puff of air and water between the teeth which in theory is supposed to disrupt the film of plaque collected on the surface of the teeth. This is repeated between all the teeth and both inside and outside surface.

Initially, I was skeptical of the device, however after using it for a week I became a fan. The process of flossing with this device is comfortable, quick, and simple. The unit has to be held upright to work properly therefore flossing between the lower anterior teeth around the tongue can be awkward. I must admit that the unit is not perfect. After flossing with the unit and then flossing with conventional string floss, certain areas had a small amount of remaining plaque. However, if used everyday I feel comfortable with the plaque control obtained with this device. At the same time my technique might not be perfected yet. As quick as the process takes you could floss the teeth twice with this unit in less time than using conventional string floss once.

This unit should not be confused with a water pick. A water pick sends a stream of water between the teeth which in not very effective at plaque removal. The Airfloss uses a concentrated burst of air and water droplets that forces the plaque and bacteria of the teeth. I would recommend it to my patients.

Click here to watch a demonstration video.

You can also download the clinical study here.

Buy the Airfloss here:

Why Do We Get Cavities?

admin — Sun, 29 Jan 2012 13:43:29 +0000

Often patients feel disappointed when they find out that they have a cavity during their periodic dental visit. This occurs despite what they claim as good oral hygiene practice.

So is it possible to get a cavity even if someone practices excellent oral hygiene?

The answer is yes and no. Let’s go over some basics before we explore the answers.
A cavity forms when bacteria present on the surface of a tooth consumes sugar and produces acid as a byproduct. The acid erodes the tooth surface creating a cavitation. This in turn allows more colonization and more acid production and eventual growth of the cavity. Let’s examine in more detail why a cavity develops.

For a cavity to develop we need three things. The host site which in this case would be a tooth, bacteria, and sugar. If we eliminate one of these a cavity will not develop. Realistically, it is impossible to eliminate even a single one of these. We would like to keep our teeth for life which provides a host site for the bacteria. Our mouth cannot be sterilized, and even if you could sterilize them, constant consumption of food and exposure to the environment will reintroduce microorganisms. The third factor is the presence of sugar. In this case, sugar means any form of simple carbohydrate that are easily digested by bacteria. This includes a wide range of products available at the supermarket today. Bacteria like simple sugars because they are easier to digest. These are commonly found in soda drinks, cereal, baked goods, and anything else we to which we add sugar.

To reduce the number of cavities that we get we need to reduce one or more of the three factors needed for a cavitation to develop. This translates to good oral hygiene (to reduce the number of bacteria present), and reduced sugar intake. Consumption of less processed foods can also be of benefit. Complex carbohydrates take more energy and time to digest, which means less exposure to simple sugars in the oral cavity.

Sometimes even with excellent oral hygiene we can still get cavities. This can be due to the anatomy of teeth. Deep grooves, irregularities in the structure of teeth, large gaps between teeth that collect food, and microscopic cracks in the surface of a tooth can lead to collection of bacteria and formation of a cavitation. This is why regular dental visits are very important. Usually these small cavities can be monitored for further growth and dealt with when necessary.

To summarize, cavities can occur in different situations. There are certain steps we can take to reduce the chances of getting cavitations. These include regular dental prophylaxis (cleaning), regular checkups, good oral hygiene,
reduced sugar intake and any other aids that will protect teeth.

Toothpaste; Which One Is Best

admin — Mon, 26 Dec 2011 05:34:12 +0000

As a dentist, questions about toothpaste are very common. One of the most frequent is “which toothpaste is best?” Patients are usually surprised to hear that for the most part all toothpaste is the same. Yes it is true. No matter what it says on the box or tube the variety of products on the market will do the same thing. Let’s discuss some major differences between various brands of toothpaste.
The main distinction between between toothpaste is whether it contains fluoride or is fluoride free. Brushing with fluoridated toothpaste can help prevent cavities. The fluoride ion incorporates itself into the surface of the affected (decalcified) tooth and actually makes that surface more resistant to tooth decay. Using non-fluoridated does not have the regenerating properties of fluoridated toothpaste but works just as good with removal of plaque.
Another difference between toothpaste is the variety of things that toothpaste will accomplish. From tooth whitening to tartar control, what really works? You would be surprised to know that there is no toothpaste on the market that will eliminate internal stains of teeth. Whitening toothpaste usually contains some form of abrasive which at best will eliminate the external stains present on teeth. No matter how much or how hard you brush you will not eliminate the internal stains. As for tartar control, brushing properly eliminates all the dental plaque which in turn does not allow any tarter to form.
This leaves two more important factors to consider in choosing good toothpaste. The first would be the taste and consistency. If you find toothpaste that has a pleasant taste and consistency you will enjoy brushing more than if you don’t like what you brush with. The other factor to consider is the cost of toothpaste. How much are you willing to spend on toothpaste? Is it worth spending two to three dollars more just for a name brand? That is something you have to decide for yourself. With the same core benefits offered with both products, is it really worth spending more money?
Bottom line is that flossing and brushing will eliminate the plaque, which in turn will prevent cavities. The technique used is more important than the type of toothpaste that is used.

Colgate Total Whitening Paste, Anticavity Fluoride and Antigingivitis Toothpaste

AquaFresh Fluoride Toothpaste, Triple Protection

Electric Toothbrush For Children

admin — Thu, 15 Dec 2011 05:45:42 +0000

As electric toothbrushes have become more popular among adults, it was just a matter of time before electric toothbrush specifically designed for kids would appear on the market. Kids usually love them. They make noise, they vibrate, and best of all they are brushing their teeth in a similar fashion as their parents. Kids electric toothbrushes on average cost anywhere between 6 and 30 dollars and are usually disposable. They are made by different companies, some well known in the dental market such as Crest or Oral B and others that I have never heard of. They are usually covered with graphics that are appealing to children. Whether it be a cartoon character or a superhero.
With all the hype about electric toothbrushes for kids, how do they perform during brushing? With my own kids (ages 3-6) recently started using electric toothbrushes I was curious to see the result. I have found that kids get distracted by the noise and vibrations and get a false sense of belief that they are efficiently brushing their teeth. On several occasions my 5 year old daughter would literally move the toothbrush to three different spots and claim that she was done brushing her teeth. She brushed very well with a manual toothbrush before the change to electric. Because of all the movement and noise produced by the brush kids feel that things are getting done. Many times I have to go back and brush their teeth manually to take care of what the electric toothbrush missed.
Another issue I have with an electric toothbrush is that kids at a young age should be practicing their brushing technique so that they understand when teeth are properly brushed. They can judge their own performance. This would be difficult with the use of an electric toothbrush.
As for cleaning efficiency, bristle head design appear cheap as compared to an adult electric toothbrush. The bristles are also much less efficient than the more expensive counterparts. Taking into account the design and the poor brushing technique when kids use the electric toothbrush, an electric toothbrush is not a good investment.
I do understand that kids like toys and brushing with an electric toothbrush make it fun for them. However, they should have a good understanding as to what the goal of brushing is and have developed good brushing habits before we introduce them to a new toy. Good habits developed early in life will stick with us for a lifetime.

Electric Toothbrush Comparison; Oral B and Sonicare

admin — Wed, 16 Nov 2011 07:11:37 +0000

More and more patients today ask about electric toothbrushes. Many dental professionals also recommend electric toothbrushes for their patients. One of the main reasons is to reduce damage to the teeth caused by brushing with excessive pressure. Toothbrush abrasion as it is commonly known is trauma induced recession of the gums that leads to exposure of the root surface of the tooth. This can lead to severe sensitivity. An electric toothbrush can help prevent toothbrush abrasion by eliminating the poor brushing technique. An electric toothbrush is also recommended for patients with poor manual dexterity.
As we mentioned before the two most popular brands of electric toothbrushes are Oral B and Sonicare. Having tried them both I would like to discuss the major things I like and dislike about each. This will strictly be a comparison between the two brands.

Oral B Electric Toothbrush:

The head of an Oral B toothbrush is round and rotates in a circular motion clockwise and counterclockwise. Dental plaque is removed mechanically just like a manual toothbrush. They are well designed, looks sharp, have a good battery life, and if used properly, do a great job eliminating plaque. The only disadvantage is that they are a bit noisy. Overall it is a quality product that I would recommend to everyone.

Purchase Professional Care Oral B Toothbrush

Sonicare Electric Toothbrush:

The head of a Sonicare toothbrush is rectangular and oscillates at a very fast rate back and forth. Plaque is removed through the motion of the brush as well as the sonic wave created by the brush. These toothbrushes are also well made. They function just as well as the Oral B and if used properly do a great job with plaque removal. The only disadvantage I encountered was that after using it for about two years, the battery failed. There is no way to replace the battery, which means that a new unit has to be purchased. I am trying out the new ones to see if there is improvement in that category.

Purchase a Philips Sonicare Toothbrush

In summary, no matter which brand you choose you will be happy with the result. If you were never educated on proper technique of brushing, the electric toothbrush will help you keep things simple and eliminate plaque in the process.

Manual or an Electric Toothbrush; which one is best

admin — Sat, 12 Nov 2011 18:08:38 +0000

With so many toothbrushes available on the market how do you know which one to choose? Manual or electric toothbrush? Soft or hard bristle? Brand or generic? I love the commercials that say “nine out of ten dentist recommend… .” The truth is that dentist will use either what is provided for them or what they use at their office. With that said lets review what is available on the market?
Lets first review the benefits and drawbacks of electric and manual toothbrushes.

Electric Toothbrush:
Electric toothbrushes are great. They allow you to brush your teeth thoroughly without having to do much manipulation. The instructions usually indicate to hold the toothbrush in a certain position and move it around your mouth slowly. Not much to it. These are especially great for individuals who have manual dexterity issues. The disadvantage of these toothbrushes is the cost, size, and the fact that they need to be plugged in. The electric toothbrushes cost can range from about $15 for a generic toothbrush to $150 for either the oral B or Sonicare electric toothbrush. These toothbrushes also don’t last forever. The useful life of an electric toothbrush is 2 to 3 years.

Purchase a Philips Sonicare Toothbrush

Purchase Professional Care Oral B Toothbrush

Manual toothbrush:
If you use a manual toothbrush, brushing technique is important for proper removal of plaque (the white build-up that collects on your teeth). You have to do all the work as opposed to the electric toothbrush that does most of the work for you. The advantage of a manual toothbrush is that they are inexpensive, small, and do not require electricity. The disadvantage of a manual toothbrush is that good brushing technique is required to maintain good oral health and reduce the chance of toothbrush trauma. If a proper technique is practiced the manual toothbrush works just as good as an electric toothbrush.
You might ask, is one brand better than another? It is all about personal preference. I would definitively stick to either a soft or extra soft bristle toothbrush. As for the brush itself, there really is no difference between a generic or a well known brand brush. You will definitively pay a lot less for a generic. It is all about the technique.

Purchase a Manual Toothbrush

Check back in the near future as I will evaluate the two most popular brands of electric toothbrushes.

When should I bring in my child for their first dental visit?

admin — Sun, 28 Aug 2011 20:53:20 +0000

Children usually start getting their first baby teeth at about the age of six months. This can vary depending upon different factors. So the question that is often asked is when should an infant have their first dental visit. There is no one specific answer to this question. Usually it is good to bring the child in when the first teeth start erupting. This can be at five months for some kids and 8 months for others. During this visit the dentist can check to make sure the teeth are coming in properly as well as check the soft tissues for any abnormalities. The dentist will usually go through oral hygiene instructions with the parent to make sure that the baby teeth stay healthy. Diet recommendations are also made.
Education is the best way to prevent tooth decay. The parents need to be educated on the causes of tooth decay and how the disease can be prevented. At an early age rampant tooth decay is common. Usually the cause is consumption of milk or juice which contain high amounts of sugar. This condition is referred to as baby bottle tooth decay. Usually parents will give the baby a bottle with milk or juice to calm them before bed. As the baby drinks from the bottle the upper teeth are bathed in the high sugar liquid. This provides tooth decay causing bacteria with energy. The byproduct of the sugar metabolism by bacteria is acid. The acid causes dissolution of the tooth structure which we see as tooth decay. If the problem is not dealt with the teeth can be completely dissolved. This can sometimes cause pain and discomfort. However, the bigger issue is the lack of tooth surface for chewing food, affected aesthetic appearance and potential for future spacing issues.
The best way to deal with this problem is by eliminating liquids with high sugar content during the day and before or during bedtime and good oral hygiene (eliminating the plaque, or the soft white substance, which collects on our teeth.

Teeth whitening safer than orange juice

admin — Thu, 10 Feb 2011 06:36:29 +0000

Concentrations of hydrogen peroxide used in professional and over the counter teeth whitening processes don’t cause significant changes to tooth enamel, according to US researchers.

Conversely the researchers found that an everyday practice such as drinking acidic fruit juices can have significant negative effects on the hardness and the roughness of tooth enamel.

The scientists, led by YanFang Ren at the Eastman Institute for Oral Health at the University of Rochester, investigated the effects of hydrogen peroxide 6 percent on tooth enamel.

According to the team, when compared to orange juice the hydrogen peroxide did not lead to any significant changes in the hardness of surface enamel.

After 20 minutes of daily exposure for five days to eBright Tooth Whitening Accelerator (6 percent hydrogen peroxide) provided by Beyond Dental Health which part funded the study, surface hardness was reduced by 5.6 percent.

Insignificant when compared to orange juice

However, compared to 20 minutes exposure to orange juice which reduced surface enamel by 84.4 percent, the researchers concluded the teeth whitening was insignificant.

“Enamel surface becomes significantly softer and rougher after the orange juice challenge,” wrote the authors.

“The acid is so strong that the tooth is literally washed away,” said lead author Ren.

Furthermore, softened and roughened enamel surfaces may predispose the tooth to the development of dental caries and non-carious lesions such as abrasion and attrition, according to the study.

The authors discussed the potential of fluoride to protect against the assault of acidic soft drinks on the teeth as it has been shown to help harden the enamel surface after whitening treatments; however, they were unsure as to fluoride’s potential to fight against the dangers of acidic soft drinks.

“In contrast, the effectiveness of fluoride treatments on erosion caused by soft drinks has not been firmly established. Some studies have indicated that fluoride treatment had limited effect_but others have show that higher concentrations of fluoride could indeed reduce the erosive effects of soft drinks on surface enamel.”

The researchers conclude that the results provide dentists with a unique perspective on the relative impact of tooth whitening on dental hard tissues.

Katie Bird, Cosmeticsdesign.com

“Why You Want to Avoid Root Canals” by Dr. Mercola

admin — Tue, 08 Feb 2011 21:27:09 +0000

Has anyone seen the video posted by Dr. Mercola on youtube. Here is the video:

In the video he clearly states that root canal treatment is bad for your health. He recommended extracting the tooth and placing a bridge, which he said was the best and most expensive option.

As a dentist I completely disagree.

The root canal treatment does two things.
1. Sterilize the inside of the tooth, as much as possible.
2. Seal anything that we are unable to neutralize inside the tooth.

Link Found Between Periodontal Disease And Pancreatic Cancer

admin — Mon, 31 Jan 2011 22:03:15 +0000

Pancreatic cancer is the fourth leading cause of cancer death in the U.S.; more than 30,000 Americans are expected to die from the disease this year. It is an extremely difficult cancer to treat and little is known about what causes it. One established risk factor in pancreatic cancer is cigarette smoking; other links have been made to obesity, diabetes type 2 and insulin resistance. In a new study, researchers at the Harvard School of Public Health (HSPH) and Dana-Farber Cancer Institute found that periodontal disease was associated with an increased risk of cancer of the pancreas. The study will appear in the January 17, 2007 issue of the Journal of the National Cancer Institute. “Our study provides the first strong evidence that periodontal disease may increase the risk of pancreatic cancer. This finding is of significance as it may provide some new insights into the mechanism of this highly fatal disease,” said lead author Dominique Michaud, assistant professor of epidemiology at HSPH.

Periodontal disease is caused by bacterial infection and inflammation of the gums that over time causes loss of bone that supports the teeth; tooth loss is a consequence of severe periodontal disease. Two previous studies had found a link between tooth loss or periodontitis and pancreatic cancer, but one consisted of all smokers and the other did not control for smoking in the analysis, and therefore no firm conclusions could be drawn from these studies.

Data for the new study came from the Health Professionals Follow-Up Study, which began in 1986 and includes 51,529 U.S. men working in the health professions. Participants respond to questionnaires about their health every two years. After analyzing the data, the researchers confirmed 216 cases of pancreatic cancer between 1986 and 2002; of those, 67 reported periodontal disease.

The results showed that, after adjusting for age, smoking, diabetes, body mass index and a number of other factors, men with periodontal disease had a 63% higher risk of developing pancreatic cancer compared to those reporting no periodontal disease. “Most convincing was our finding that never-smokers had a two-fold increase in risk of pancreatic cancer,” said Michaud.

One possible explanation for the results is that inflammation from periodontal disease may promote cancer of the pancreas. “Individuals with periodontal disease have elevated serum biomarkers of systemic inflammation, such as C-reactive protein, and these may somehow contribute to the promotion of cancer cells,” she said.

Another explanation, according to Michaud, is that periodontal disease could lead to increased pancreatic carcinogenesis because individuals with periodontal disease have higher levels of oral bacteria and higher levels of nitrosamines, which are carcinogens, in their oral cavity. Prior studies have shown that nitrosamines and gastric acidity may play a role in pancreatic cancer.

Michaud, senior author Charles Fuchs, a gastrointestinal oncologist at Dana-Farber, and their colleagues believe that further studies should be done to investigate the role of inflammation from periodontal disease in pancreatic cancer. However, Michaud notes that the underlying mechanisms for this association are speculative at this point. “More research is needed both to confirm this finding in other populations and also to explore the role of inflammation in this particular cancer,” she said.

This study was supported by grants from the National Cancer Institute.

Citation: “A Prospective Study of Periodontal Disease and Pancreatic Cancer in U.S. Male Health Professionals,” Dominique S. Michaud, Kaumudi Joshipura, Edward Giovannucci, Charles S. Fuchs, JNCI, 2007; 99:1-5