Brushing and flossing every day are important for preventing dental disease. The object is to remove as much bacterial plaque, the thin biofilm most responsible for disease, from your teeth and gums as possible.
But how do you know your hygiene efforts are that effective? You can of course do the “tongue test” â?? feel your teeth with your tongue after brushing and flossing and see if they feel smooth and “squeaky” clean. We can also give you a “report card” at your regular cleaning appointment. There is, however, a more precise way you can find out at home by using a plaque disclosing agent.
A plaque disclosing agent is a formulation that when applied to the teeth will temporarily dye any bacterial plaque present a distinct color. While dental hygienists occasionally apply them, they’re also available over the counter for use at home. They’re usually found in a solution, tablet or swab form in various flavors.
To use the product you first brush and floss, then swish the disclosing liquid around in your mouth for about 30 seconds before spitting it out (or chew the tablet or apply the swab as directed). The agent will react with any remaining plaque and dye it a bright color. There are even two-tone agents available that can differentiate between old and new plaque and dye them different colors.
Examining your teeth in a mirror will give you a good idea where you need to concentrate your attention when brushing and flossing. If, for example, you see dyed plaque more along the gum line and less in other places, then that’s where you should focus your hygiene efforts.
While the dye will eventually wear off on its own, you should take the opportunity to brush and floss again to remove any remaining dyed plaque. Not only does this provide a more thorough cleaning at that moment, you’ll also get a better sense of how “thoroughness” feels for future brushing and flossing.
It’s always good to know how well you’re doing with your dental hygiene efforts. A plaque disclosing agent can give you just the right feedback to help you improve.
If you would like more information on proper oral hygiene habits, 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 “Plaque Disclosing Agents.”
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.
Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.
It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.
Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.
Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.
The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.
If you would like more information on the effect of eating disorders on oral health, 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 “Bulimia, Anorexia & Oral Health.”
More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.
E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.
The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.
According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.
Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.
These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.
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