Should I Floss Before or After Brushing?

Did you know that taking good care of your teeth and gums can not only add years to your life, but also lowers risk for heart disease, stroke, diabetes—and even memory-robbing disorders like Alzheimer’s disease? A new study of nearly 5,000 older adults found that those who brushed their teeth less than once a day were up to 65 percent more likely to develop dementia than those who brushed daily.

And here’s even more motivation to brush and floss: A new CDC study reports that nearly 65 million Americans—one out every two adults ages 30 and older—have gum disease, a far higher rate than has previously been reported. That’s dangerous, since a 2012 American Heart Association scientific statement reports that periodontal (gum) disease is a strong, independent risk factor for cardiovascular disease (heart attacks and stroke).

A Surprising Dental Controversy

What’s the best way to keep your teeth and gums healthy? While everyone agrees that brushing at least twice a day is crucial, there’s hot debate online right now about whether it’s preferable to floss before you brush or afterwards. Here’s a look at flossing recommendations from 5 dentists:

“I’ve always advised patients to floss before they brush to break up and remove the plaque matrix between the teeth before going in with the toothbrush to sweep away the bacteria and debris they’ve dislodged with flossing.”--Mark Barry, DDS, associate dean for clinical affairs and professor, division of oral medicine, Medical University of South Carolina.

“It makes more sense, particularly for kids, to floss after brushing so you can see what you’ve missed with the toothbrush. Also, if you floss first, debris might get pushed back between the gums when you brush. It’s also important to use the right flossing technique: make a C-shape with the floss and wrap it around each tooth to clean the surface, rather than just snapping the floss up and down, which doesn’t clean the structures properly."--Mary Hayes, DDS, American Dental Association spokesperson.

“It doesn’t matter whether you floss first or brush first, because you are cleaning different surfaces of the teeth. That’s why flossing is crucial: It’s the only way to clean between the teeth, since a toothbrush can’t reach these crevices.”--Ruchi Sahala, DDS, American Dental Association spokesperson and general dentist in Freemont, CA

“The biggest thing is to remember to brush twice a day and floss once, spending several minutes removing plaque and debris between the teeth. It takes 24 to 48 hours for oral bacteria to organize into plaque, so as long as you dislodge the plaque at least once a day by flossing, you’re protecting your oral health.”--Ron Burakoff, DDM, MPH, DMD, MPH, Chair & Professor, Department of Dental Medicine, Hofstra North Shore-LIJ School of Medicine

“Either order is OK. My recommendation is to floss at night, before you go to bed. When you’re sleeping, you produce less saliva to clean your teeth and gums, so oral bacteria are free to do more damage. Therefore, it’s important to brush, floss and scrape your tongue every night to get rid of bacteria and go to bed with your mouth as clean as possible.”--Ronald M. Goodlin, DDS, President, American Academy of Cosmetic Dentistry.

What’s the Bottom Line on Flossing?

The American Dental Association reports brushing or flossing first are both fine, as long as you do a thorough job. However, the ADA adds that a benefit of flossing first is that fluoride from toothpaste is more likely to reach between your teeth when you brush, which may help reduce cavities.

As all of the dentists interviewed for this article agree, flossing once a day is crucial to avoid having the film of bacteria between the teeth harden into plaque and then tartar, a hard mineral deposit that can cause gums to become swollen and inflamed, leading to the earliest stage of gum disease: gingivitis.

www.melrosefamilydentistry.com

Study Finds Energy, Sports Drinks Damage Tooth Enamel

Energy and sports drinks can damage tooth enamel, boosting the risk of cavities, according to a new study.

"The big misconception is that energy drinks and sports drinks are healthier than soda for oral health," says researcher Poonam Jain, BDS, MPH, associate professor and director of community dentistry at the Southern Illinois University School of Dental Medicine.  "This study completely disproves that, because they erode or thin out the enamel of the teeth, leaving them more susceptible to decay and sensitivity."

Jain and her team tested 13 sports drinks and nine energy drinks for acidity. They tested six drinks for their effects on tooth enamel and found both types caused damage. Energy drinks, however, were twice as bad. Damaged tooth enamel cannot be fixed.

The study is published in the journal General Dentistry.

Sports Drinks, Energy Drinks, and Teeth: Study Details

The drinks are especially popular among teens and young adults. Up to half of U.S. teens and young adults drink energy drinks, and more than half have at least one sports drink a day, according to the researchers.

They tested the acidity levels of all 22 drinks. They found the levels of acidity in the drinks vary between brands and between flavors of the same brands.

Gatorade Blue had the highest acidity among sports drinks. Next was Hydr8.  Among the energy drinks with the highest acidity:

Red Bull Sugarfree

Monster Assault

5-hour Energy

Von Dutch

Rockstar

MDX had the lowest acidity of the energy drinks.

Energy Drinks, Sports Drinks, and Tooth Enamel

Jain's team immersed enamel samples from extracted human teeth into three sports drinks and three energy drinks.  The sports drinks tested were:

Gatorade Rain

Powerade Option

Propel Grape

The energy drinks tested were:

Monster Assault

Red Bull

5-hour Energy

The enamel samples were immersed in the drinks for 15 minutes. The researchers transferred the enamel to artificial saliva for two hours.  This cycle was repeated four times a day for five days. The beverages were replaced with fresh ones every day.  The cycle was meant to simulate real life, Jain says, as some teens and young adults drink the beverages every few hours.

Enamel loss was evident after five days of exposure, Jain says.

The average enamel lost with sports drinks was about 1.5%, while the average loss with energy drinks was more than 3%. Jain says she cannot pinpoint what percent of enamel loss would cause problems.

Susceptibility to dental problems depends on personal hygiene, lifestyle, total diet, and genetic makeup, according to the ABA.  ABA member companies agree not to offer energy drinks for sale in grades K through 12, and to offer calorie-capped sports drinks in containers of 12 ounces or less only to high schools.

Advice for Sports, Energy Drink Fans

Even one drink a day is potentially harmful, Jain says.  "If the consumer is absolutely unable to give them up, the best advice is to minimize [their use] and rinse with water afterwards," she says.  "Dilute them," she says. Do not brush immediately after drinking them, she says, as this could spread around the acid. "The mouth takes about 30 minutes to bring the pH back to normal."

Wait an hour after drinking the sports or energy drink, to be safe, then brush, Jain says.

And of course make sure to see your dentist for regular cleanings!

New Study Suggests Dental Cleaning Reduces Risk Of Cardiovascular Diseases

A study observed more than 100,000 people, none of whom had a history of heart attack or stroke at the beginning of the study, over a period of seven years in Taiwan. The study suggested that those people who got their teeth professionally cleaned at least twice or more in two years had significantly lower risk of developing cardiovascular diseases like heart attack or a stroke.

The findings which were presented at the American Heart Association's Scientific Sessions 2011 stated that people who got their teethed scaled by a dentist had 13 percent less chance of stroke and ran as much as 24 percent lower risk of heart attack, compared to people who never had had a dental cleaning done by a certified dental hygienist or dentist.
The study had included more than 51,000 adults who had undergone teeth scaling partially or fully, at least once a year. The study also included an equal number of adults who had never got their teeth cleaned professionally. The study did not make any adjustments for cardiovascular disease risk factors such as smoking, ethnicity/ race or weight factors.
As per Emily (Zu-Yin) Chen, M.D., cardiology fellow at the Veterans General Hospital in Taipei, “Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year. Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke.”
Another study conducted on approximately 8,000 participants by Dr. Holmlund, dentist researcher at the Centre for Research and Development of the County Council of Gävleborg, Sweden, showed that the type of periodontal (gum) disease is a good predictor of the degree of risk one has of heart attack and heart failure, as well as stroke.
The study went on to give very specific numbers of periodontal bad spots and the probability attached to the numbers, such as:


People having fewer than 21 teeth had an increased risk by 69 percent of having a heart attack than those who have most of their teeth.

A larger number of infected pockets in the gum 53 percent increased risk of heart attack compared to those with the fewest pockets.
 
Those with the least amount of teeth were approximately 2.5 times more at risk of developing congestive heart failure when compared to those who had the most teeth.
 
The highest incidence of gum bleeding had a 2.1 increased risk of stroke. 

Promote Oral Health with Good Nutrition

Calcium And Vitamin C Promote Oral Health

Eating a variety of nutritious food is good for your overall health, including your oral health. Some vitamins in particular have demonstrated benefits to building healthy teeth, namely calcium and vitamin C, so be sure to include foods rich in these nutrients in your diet. Calcium has been shown to help build strong teeth, and vitamin C is a powerful antioxidant that also plays an important role in collagen synthesis, by which it helps you develop and maintain healthy gums.

•Calcium: Dairy products, including milk, yogurt and cheese are good sources of calcium. Many physicians recommend 1,200 to 1,500 milligrams of calcium daily for most adults, so you may want to consider a calcium supplement, especially if dairy products aren’t a regular part of your diet. Also, try switching to low-sugar or sugar-free varieties of yogurt, since sugar (and bacteria) can promote tooth decay.

•Vitamin C: Many fruits and vegetables including berries, oranges and cantaloupe, as well as green vegetables including broccoli and spinach are excellent sources of vitamin C.

Of course, in addition to eating right, it’s important to follow a consistent dental care routine of twice-daily tooth brushing and daily flossing to promote oral health. And be sure to see your dental professional regularly and talk to them if you have questions about how your diet might affect your oral health.

Pain Free Flossing

One of the most common reasons people give for not flossing their teeth daily is that they find flossing uncomfortable and even painful. Some people experience bleeding gums after flossing, and this discourages them from continuing with this healthy habit and important element of dental hygiene.

The truth is, even if you have sensitive gums, you can enjoy pain-free flossing. Instead of the thin, string-like flosses, try a soft floss, such as Oral-B® SATINfloss®. Or try a dental tape, such as Oral-B’s Satin Tape, which is wider than standard floss. Many people with sensitive gums find that the dental tape is more comfortable, enabling them to make flossing part of their daily oral care routine.

Also, be sure that you’re using a soft-bristle brush, so your teeth and gums aren’t irritated when it's time to floss. Use a soft touch with both brushing and flossing—you don’t need to scrub hard with your toothbrush or use a lot of force when you floss to get the benefits, just be sure to brush thoroughly and floss between each tooth.

As a wise dentist once said, "You don’t have to floss all your teeth—just the ones you want to keep!"

http://www.melrosefamilydentistry.com

What is Good Oral Hygiene?

What is Good Oral Hygiene?

Good oral hygiene results in a mouth that looks and smells healthy. This means:

Your teeth are clean and free of debris
Gums are pink and do not hurt or bleed when you brush or floss
Bad breath is not a constant problem
If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.

Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.

How is Good Oral Hygiene Practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

Brushing thoroughly twice a day and flossing daily
Eating a balanced diet and limiting snacks between meals
Using dental products that contain fluoride, including toothpaste
Rinsing with a fluoride mouthrinse if your dentist tells you to
Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area

http://www.melrosefamilydentistry.com

Smokers Present Tougher Bacterial Challenge to Periodontal Treatment

Periodontal disease is difficult to successfully treat in any dental patient. One patient type that can be especially challenging is smokers. Smokers are up to 6X more likely to experience periodontal destruction compared to non-smokers And it's been long recognized that smoking impairs healing following non-surgical periodontal treatment.

A new study has found that smoking may pose yet another hurdle.

In patients with moderate-to-severe chronic periodontitis, researchers found that smokers consistently demonstrated lower levels of health-protective bacteria and significantly higher levels of disease-related bacteria below their gumlines. These included higher levels of the red complex Treponema and Tannerella species, which have been linked to more severe and refractory periodontitis.

This may help to explain why smokers are less responsive to scaling and root planing (SRP) alone, exhibiting smaller pocket depth reductions and fewer clinical gains resulting in deeper periodontal pockets.

www.melrosefamilydentistry.com

Toothbrush Advice!

Toothbrush Care and Replacement

How can I take care of my toothbrush?

To keep your toothbrush and yourself healthy, make sure you let it dry out between uses. Toothbrushes can be breeding grounds for germs, fungus and bacteria, which after a while can build up to significant levels. After using your toothbrush, shake it vigorously under tap water and store it in an upright position so that it can air out.

To prevent cold and flu viruses from being passed between brushes, try to keep your toothbrush from touching others when it is stored. A standard toothbrush holder with slots for several brushes to hang upright is a worthwhile investment in your family's health.

How often should I change my toothbrush?

Most dentists agree you should change your toothbrush every three months. Studies show that after three months of normal wear and tear, toothbrushes are much less effective at removing plaque from teeth and gums compared to new ones. The bristles break down and loose their effectiveness in getting to all those tricky corners around your teeth.

It is also important to change toothbrushes after you've had a cold, the flu, a mouth infection or a sore throat. That's because germs can hide in toothbrush bristles and lead to reinfection. Even if you haven't been sick, fungus and bacteria can develop in the bristles of your toothbrush —another reason to change your toothbrush regularly.

How can I protect my toothbrush when traveling?

A plastic toothbrush case will protect toothbrush bristles from becoming squashed or flattened in your traveling kit. After brushing, however, you should let your toothbrush dry in the open air, to help reduce the spread of germs.

Visit us at http://www.melrosefamilydentistry.com

My Enemy, The Dentist (John Whittier, 1956)

My Enemy, The Dentist
John Whittier, 1956

It isn't unusual for people to dislike going to the dentist.

The waiting in the outer office is really terrible when you try not to listen, but can't help hearing the cry of pain from the person before you. You feel like getting up and leaving, but you try to let everyone else think you're not the least bit afraid.

Everytime I am in the dentist's chair, I get the feeling that the dentist isn't telling me all the things I should know, and the words he uses to tell the nurse what has to be done are like those of a foreign language.

How I dread it when the dentist starts to go to work! Try to imagine the buzzing sound of a drill as it digs into a decayed tooth or the cracking of a tooth that was too far gone and had to be extracted; it hurts just to think of it.

I am sure you have all gone through the part when the dentist asks, "Does it hurt?" and you have so many instruments and so much cotton in your mouth that you couldn't answer him even if you wanted to.

I never take my eyes off the dentist from the time I enter up to the time I leave.

If you really stop and think for a miute, you will find out that the dentist isn't an enemy but a good friend. Think of the hours that you have suffered with a toothache. If you see the dentist, it may hurt for a few minutes, but then the pain is all over. I used to think it wasn't right to pay so much money for so much pain. Now I realize that it was worth every cent to get rid of those nights that were spent in never-ending torture with a toothache.