1. UNDERSTAND YOUR OWN ORAL HEALTH NEEDS.

Changes in our overall health status often results in changes in your oral health.  Approximately 300 common drugs can reduce the amount of saliva in your mouth – resulting in dry mouth.  Women who are pregnant go through oral changes. (Inflammation of the gums = Pregnancy Gingivitis)

2. COMMIT TO A DAILY ORAL-HEALTH ROUTINE

Come up with an effective routine.  If you’re taking medication that dries your mouth, you may want to use fluoride everyday.

3. USE FLUORIDE

Fluoride strengthens developing teeth in children and also prevents decay in adults and children.

4. BRUSH AND FLOSS TO REMOVE PLAQUE.

Everyone should brush at least twice a day as well as floss once a day.  Both of these remove plaque, which is a complex mass of bacteria that constantly forms on your teeth.

5. LIMIT SNACKS, ESPECIALLY THOSE HIGH IN SIMPLE SUGARS.

Every time you eat, bits of food become lodged in and around your teeth.  This provides fuel for the bacteria in plaque.  Each time simple sugars are introduced to the teeth; these acids are exposed for 20 minutes or more.

6. IF YOU USE TOBACCO IN ANY FORM, QUIT!

Smoking or using smokeless tobacco increases your risk of oral cancer, gingivitis, Periodontitis and tooth decay. This also contributes to bad breath and stains on the teeth.

7. EXAMINE YOUR MOUTH REGULARLY.

Your dentist and hygienist only seen you a few times a year, but you should examine your mouth weekly to look for changes that might be of concern.  The changes could include:

• Swollen gums
• Chipped teeth
• Discolored teeth
• Sores or lesions on your gums, cheeks or tongue.

8. VISIT THE DENTAL OFFICE REGULARLY.

If you have a history of cavities or crown and bridge work, or are wearing braces, you should visit the dentist more often.  Diabetic patients are at a high risk for gum disease so they should also visit their dental office more often as well.

What’s wrong with sugary snacks?

They taste good-but aren’t so good for your teeth or your body.  Candies, cakes, cookies and other sugary foods that kids love to eat between meals can cause tooth decay.  Starchy snacks can also break down into sugars once they’re in your mouth.  EX: Sugary Foods

• Cookies/Chips
• Crackers/Pretzels
• Cakes/Candy
• Soft Drinks/Breakfast Cereals

How do sugars attack your teeth?

Bacteria, also classified as “invisible germs” live in your mouth all the time.  Some of this bacterium forms a sticky material known as Plaque on the surface of the teeth.  These acids are powerful enough to dissolve the hard enamel that covers your teeth.  That’s how cavities get started.

When deciding about snacks, think about:

• The number of times a day you eat sugary snacks
• How long the sugary food stays in your mouth
• The texture of the sugary food (chewy? Sticky?)

What is the right way to brush your Teeth?

Proper brushing only takes 2 minutes, 120 seconds! To properly brush your teeth, use short gentle strokes, paying EXTRA attention to the gum line, hard to reach back teeth and areas around fillings, crowns and other restorations. Clean the outer surfaces of your upper teeth, then your lower teeth. Next, clean the inner surfaces of your upper teeth, then the lower teeth. After that, clean the chewing surfaces and last, for fresher breath, be sure to brush your tongue too!

• Tilt the brush at a 45degree angle against the gum line and sweep/roll the brush away from the gum line.
• Our office recommends a soft-bristled brush because it is the best for removing plaque and debris from your teeth.

How often should I replace my toothbrush?

You should replace your toothbrush when it begins to show wear or approx. every 3 months, whichever comes first. An important thing to remember is to ALWAYS change toothbrushes after having a cold or the flu. The bristles collect germs that can lead the re-infection.

What is the correct way to floss?

1. Starting with about 18inches of floss, wind most of it around each middle finger, leaving an inch or two left to work with.
2. Holding the floss tautly between your thumbs and index fingers, slide it gently up and down between your teeth.
3. Gently curve the floss around the base of each tooth, making sure you go beneath the gum line. NEVER snap or force the floss, as this may cut/bruise delicate gum tissue.
4. Use clean sections of floss as you move from tooth to tooth.
5. To remove the floss, use the same back and forth motion to bring the floss up and away from the teeth.

What type of floss should I use?

There are 2 types of floss

1. Nylon Floss (multifilament)
2. PTFE Floss (monofilament)

• Nylon Floss)  Available waxed and un-waxed, and in a variety of flavors. Because this floss is composed of strands of Nylon, it may tear or shred-especially between tight contact points
• PTFE Floss)  Slides between teeth easily and is virtually shred-resistant

**both types of floss are excellent for removing Plaque and debris**

What are Dental Caries?

Dental caries, also known as cavities or tooth decay. It is caused by acid erosion of tooth enamel.

Areas to easily collect debris to form caries:

• Cracks, pits or grooves in the back of the teeth
• Between the teeth
•  Around dental fillings or bridgework
• Near the gum line

Damage can occur anywhere the tooth is exposed to plaque and acid. For instance, the hard outer enamel on the tooth crown or parts of the root that have been exposed because of receding gums. A cavity can penetrate the soft tooth pulp and the sensitive nerve fibers within’ it.

Theories of what causes the pain people get w/ cavities:

• Inflammation caused by bacteria
• Exposure of the root surface
• Imbalance of fluid levels in tiny openings called Tubules inside the Dentin.

SYMPTOMS OF DENTAL CARIES

Early caries have no symptoms however, when the tooth is left untreated, it becomes sensitive to sweet foods or hot and cold temperatures. -Expected Duration How long caries last is determined by the stage at which it’s found. White spots may appear in the early stage of caries. Caries that have destroyed the enamel cannot be reversed.

PREVENTION

You can prevent cavities from developing by reducing the amount of plaque and bacteria in the mouth. The best way to do this is by brushing and flossing daily and your routine dental cleanings twice-a-year. Fluoride helps strengthen your teeth also.

TREATMENT

The most common way to treat caries is to fill the tooth. Fillings are usually made of a dental amalgam, which is a silver-gray material made from silver alloyed with copper or other metals in order to improve durability. Another option for filling a tooth is with a composite Resin, which is tooth-colored for a better appearance. Amalgams are used primarily in molars and premolars. Resins are used primarily in the front teeth, but are possible to use them in all teeth. If the cavity is large with extensive erosion, then the dentist will remove the decay and cover the tooth with an artificial crown.

What are x-rays?

X-rays are a form of energy that travels in waves. X-rays can enter solid objects, where they either are absorbed or continue to pass through the object. Teeth & Bone are very dense, so they absorb x-rays. Gums & Cheeks are much less dense, so x-rays pass through more easily. Dental caries (cavities) will show up on an x-ray as a darker patch in a light tooth.

How are X-rays used?

X-ray images are among the most valuable tools a dentist has for keeping your mouth and teeth healthy.

Adult Radiographs:

• Shows areas of decay that your dentist may not be able to see with just a visual exam.
• Find decay that is developing underneath an existing filling
• Find cracks or other damage in an existing filling
• Alert the dentist to possible bone loss associated with periodontal (gum) disease
• Reveal problems in the Root Canal – such as infection or death of the nerve
• Help your dentist plan, prepare and place tooth implants, orthodontic treatments, dentures and other dental work.
• Reveal other abnormalities – such as cysts, cancer, and changes associated with metabolic and systemic diseases. (Ex: Paget’s Disease or Lymphoma)

**for children, radiographs are used to watch for decay and to monitor tooth growth and development**

How often should your teeth have X-rays?

No X-ray is considered routine however; many people require x-rays on a regular basis so that their dental condition can be monitored. Some people may need x-rays as often as every 6 months; x-rays may not be needed for as long as two years. Patients with no recent dental or gum disease and who visit the dentist regularly for check-ups, x-rays may be takes every five years or so.

Patients who need radiographs most frequently:

• Children - children are highly to develop caries. X-rays should be taken every 6 months to 1 year. They also help monitor tooth development.
• Adults with extensive restoration work - conditions that helped create caries from the beginning will continue – making it necessary to check for decay beneath existing fillings or in new locations.
• Anyone who drinks sugary sodas, choc. Milk, coffee or tea w/ sugar - anyone who drinks these beverages regularly will need to have more regular x-rays.
• People with Periodontal (gum) Disease - if there are significant or continuing signs of bone loss, Periodontal treatments may need to be stepped-up
• People who are taking Medications that lead to dry mouth (xerostomia) - medications that can decrease saliva are those prescribed for hypertension, antidepressants, anti-anxiety drugs, antihistamines, diuretics, narcotics, anticonvulsants & anticholinergics.
• Smokers - smoking increases the risk of periodontal disease.

TYPES OF X-RAYS

X-rays are divided into 2 main categories:

Intraoral: which means that the x-ray film is inside the mouth

Extraoral: which means that the film is outside the mouth

INTRAORAL RADIOGRAPHS:

Intraoral x-rays are the most common radiographs made. There are the x-rays that allow dentists to find caries, look at the tooth roots, check the health of the bony area surrounding the tooth, see the status of developing teeth and otherwise monitor good tooth health.

• Bite-wing X-rays - highlight the crowns of the teeth. Shown from the crown to about the level of the jaw
• Periapical X-rays - highlight the entire tooth. Shown from either the upper or lower jaw in one portion of the mouth
• Occlusal X-rays - larger and highlight tooth development and placement. Shown from nearly the full arch of teeth in either the upper or lower jaw.
• Digital Radiograph - the x-ray hits the pad the same way the film hits. The image can be stored on the computer or printed out. The computer can digitally compare the two images, subtract out everything that is the same and give a clear image of everything.

EXTRAORAL X-RAYS:

Extraoral Radiographs are made with the film outside the mouth. They show teeth but their main focus is on the jaw or skull. These radiographs are used for monitoring growth and development, looking at the status of impacted teeth, examining the relationships between teeth & jaws and the temporomandibular joint or other bones of the face.

• Panoramic Radiographs - show the entire mouth area – all the teeth on both upper and lower jaws – on a single x-ray. Requires a special panoramic x-ray machine.
• Tomograms - a special type of radiograph where the dentist can focus in on one particular layer, or slice, of anatomy while blurring out all other layers.
• Cephalometric Projections - x-rays taken of the entire side of the head. They are used to look at the teeth in relation to the jaw and the profile of the individual. This is a common x-ray used in an orthodontics office to plan their treatment.
• Sialography - a way of visualizing the salivary glands on a radiograph. The dentist insects a radiopaque contrast material directly into the salivary glands.
• Computer tomography - (CT Scanning) – usually performed in a hospital – not in a dentist’s office – although a dentist may request a CT Scan if needed.

X-RAY SAFETY

All types of radiation can cause damage to body cells. The X-rays used in dental and medical offices emit extremely small doses of radiation. Small doses of radiation that adds up can become damaging through-out time.

There are several ways dentists and regulatory agencies keep exposure to X-rays low:

• Reduced X-ray dose
• Improved X-ray film
• Changed to using film holders
• Required regular x-ray machine checks & licensure
• Recommended or required use of lead shields
• Recommended that radiographs be made only when necessary for diagnosis & treatment
• Developed digital radiography

What are dental crowns and tooth bridges?

Both crowns and bridges are fixed prosthetic devices. Unlike dentures, which are removable devices and you can take out to clean daily, crowns and bridges are cemented onto existing teeth or implants & can only be removed by a dentist.

How do crowns work?

A crown is used to cap a damaged tooth. It can also be used to improve its appearance, shape or alignment. A crown can be placed on top of an implant to provide a tooth-like shape and structure for function.

A crown may be recommended to:

• Replace a large filling when there isn’t enough tooth remaining
• Protect a weak tooth from fracturing
• Restore a fractured tooth
• Attach a bridge
• Cover a dental image
• Cover a discolored or poorly shaped tooth
• Cover a tooth that has had root canal treatment

How do bridges work?

A bridge is recommended usually when you’re missing a tooth/teeth.

○ TMJ: temporomandibular joint disorders  Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth (abutments), serve as anchors for the bridge. ○ Pontic: replacement tooth  Pontic is attached to the crowns that cover the abutments.

How are crowns & bridges made?

• reduce the tooth/teeth to fit properly.
• Impressions to provide an exact mold for the crown or bridge

• • if porcelain is used – your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.