Posts for: March, 2014
Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.
These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.
Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.
In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.
Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.
Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.
If you would like more information on types of toothbrushes, 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 “Manual vs. Powered Toothbrushes.”
Thumb or finger sucking is a normal activity for babies and young children — they begin the habit while still in the womb and may continue it well into the toddler stage. Problems with tooth development and alignment could arise, however, if the habit persists for too long.
It’s a good idea, then, to monitor your child’s sucking habits during their early development years. There are also a few things you can do to wean them off the habit before it can cause problems down the road.
- Eliminate your child’s use of pacifiers by eighteen months of age. Studies have shown that the sucking action generated through pacifiers could adversely affect a child’s bite if they are used after the age of 2. Weaning your child off pacifiers by the time they are a year and a half old will reduce the likelihood of that occurring.
- Encourage your child to stop thumb or finger sucking by age 3. Most children tend to stop thumb or finger sucking on their own between the ages of 2 and 4. As with pacifiers, if this habit continues into later childhood it could cause the upper front teeth to erupt out of position and tip toward the lip. The upper jaw also may not develop normally.
- Replace your child’s baby bottle with a training cup around one year of age. Our swallowing mechanism changes as we grow; introducing your child to a training cup at around a year old will encourage them to transition from “sucking” to “sipping,” and make it easier to end the thumb or finger sucking habit.
- Begin regular dental visits for your child by their first birthday. The Age One visit will help you establish a regular habit of long-term dental care. It’s also a great opportunity to evaluate your child’s sucking habits and receive helpful advice on reducing it in time.
While your child’s thumb or finger sucking isn’t something to panic over, it does bear watching. Following these guidelines will help your child leave the habit behind before it causes any problems.
If you would like more information on children’s thumb-sucking and its effect on dental development, 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 “Thumb Sucking in Children.”
Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.
This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.
We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”
Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.
We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.
Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.
If you would like more information on furcations, 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 “What are Furcations?”
Participating in athletic activities offers numerous well-documented health benefits — not to mention instilling the intangible values of discipline, teamwork and goal-setting. Of course, in nearly every sport, the possibility of injury exists as well. But don't let that stop you or someone you love from playing! Instead, you can learn about the potential hazards of dental injury, and take some practical steps to minimize the risk.
It should come as no surprise that injury to the mouth is an ever-present possibility in so-called “collision” sports like football and ice hockey. But did you know that the greatest number of dental injuries result from the games of baseball and basketball, which are often played informally? Even non-contact sports like skiing, bicycling and skateboarding carry a real risk of injury.
Who suffers dental injury? Men are slightly more likely than women — but only by a small percentage. Injury peaks in the teenage years, and seems to decrease afterward — but older athletes tend to have more severe problems. In short, most anyone who participates in sports is subject to possible dental injury.
Besides the obvious aesthetic imperfections, a damaged or missing tooth can also result in functional problems with the bite — a potentially serious condition. If a tooth can't be immediately replanted, restoring it can be expensive: The total cost of each tooth replacement is estimated at $10,000-$20,000 over a lifetime. So tooth damage or loss can cause a multitude of troubles.
The American Dental Association (ADA) has recommended that participants in all of the sports mentioned above — as well as two dozen others — should wear a custom-fitted mouthguard. Why? Because when it comes to dental injury, an ounce of prevention really is worth a pound of cure.
Numerous studies have shown that wearing a custom-fitted mouthguard is an effective way to prevent dental injury. According to the Academy of General Dentistry, mouthguards prevent some 200,000 injuries each year. And the ADA says that athletes who don't wear mouthguards are 60 times more likely to sustain harm to the teeth than those who do wear them.
Off-the-shelf mouthguards in a limited range of sizes are available at many sporting-goods stores. But these can't compare to the superior protection and durability offered by a mouthguard that's custom-made just for you. Using an exact model of your teeth, we can individually fabricate a piece of protective gear that fits correctly and feels comfortable in your mouth. A custom mouthguard may be more economical than you think — yet its real payoff comes in preventing dental injury.
If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”