We all know the importance of brushing and flossing. But when it comes to other aspects of tooth care, there remains a great deal of confusion. Here are the answers to the most common questions patients have about teeth…
• How often should I have my teeth professionally cleaned?
The usual advice once every six months is rather arbitrary. Go as often as your dentist or dental hygienist says is necessary. If you have advanced gum disease, or if you’re bad about brushing, that might be as often as once a month.
• My gums bleed when I brush. Should I be worried?
Many people think a little bleeding is normal. Not true. Bleeding gums are an early sign of gum disease (gingivitis). Untreated, it can lead to serious bacterial infection. Gingivitis can usually be reversed in one to three weeks by daily flossing and by brushing after meals.
Helpful: After brushing, rinse with a mixture of one-quarter teaspoon salt and four ounces of water, to get rid of bacteria.
If bleeding persists for more than three weeks, see your dentist. You might have periodontal disease. An advanced form of gum disease, it won’t respond to self-treatment.
Other danger signs: Sensitivity to heat or cold, sugar or acidic foods sudden pain in the affected area, bleeding, the sensation that something is pressing on the root of a tooth. Over time, periodontal disease can cause bone loss in the jaw. Left untreated, it may result in tooth loss.
Warning: Periodontal disease can increase the risk of heart disease. If you suspect you have gum disease, see your dentist at once especially if you are predisposed to heart disease.
• What causes gums to recede?
The likeliest cause is gum disease, although after age 50, gums naturally begin to pull away from the teeth. Though severe recession can lead to tooth decay, most cases of receding gums are a cosmetic problem.
• What can I do to prevent gum disease?
Supplements of vitamins C, A and B-complex have been shown to help. So has eating less sugar. Sugar speeds formation of plaque (film made of food particles, bacteria and saliva), which causes decay and gum disease.
• What kind of toothbrush is best?
A teardrop-shaped model with soft bristles about one inch long. If your mouth is small, choose a “junior-size” brush.
The brush should have no more than four rows of clear (not colored) bristles. They make it easier to detect signs of bleeding from brushing. Brushes with clear plastic handles stay cleaner longer they allow bacteria-killing ultraviolet light to penetrate to the bristles.
After brushing, rinse your toothbrush in warm water. Stand it up to dry. Allowing a brush to lay flat permits the water to pool and bacteria to grow. To help control bacteria, soak brushes once a week in mouthwash.
• How often should I replace my tooth¬ brush?
Every three months sooner if the bristles become flattened or frayed. It’s also a good idea to replace your brush after each professional dental cleaning to prevent exposing clean teeth to bacteria from the old brush.
• Do electric toothbrushes do a better job?
Electric and ultrasonic brushes provide more brush strokes per second, but they’re often less effective than manual brushes at reaching the back teeth and the inner surfaces of the lower front teeth.
Instead of an electric toothbrush, you might consider buying an oral irrigating device. Such devices send a jet of water deep below the gum line, where brushes and floss can’t reach. They should be used in addition to brushing and flossing.
Best model: The Water Pik, with the Pik Pocket sub gingival irrigation tip attachment. When using an irrigator, keep the pressure low. For maximum benefit, fill the reservoir with antibacterial mouthwash or saline solution, instead of water.
• What brand of toothpaste is best?
They are all pretty much alike. It’s the brushing action that cleans the teeth and keeps the gums healthy. For adults, use the toothpaste that tastes best to you.
If you hate the taste of your toothpaste, you’re apt to avoid brushing. People who have gum problems should avoid “whitening” toothpastes, which tend to be abrasive.
Important: Don’t swallow toothpaste. Most brands contain artificial coloring, flavoring, sweeteners, etc., whose health risks aren’t frilly known.
Since children tend to swallow toothpaste when they brush, I recommend a natural toothpaste like Tom’s of Maine for them. It’s free of additives.
• What about special flosses?
Unwaxed floss, which has a rough surface, is better than waxed, thin or “friction-free” floss at removing plaque and dislodging food.
Exception: If your teeth are closely spaced, or if unwaxed floss causes pain or becomes frayed, try coated or ultrathin floss. Otherwise, you’re likely to forgo flossing altogether. Avoid colored flosses. They make it hard to detect bleeding. Flossing technique is more important than what type of floss you use.
Proper way: After inserting a 12- to 18- inch piece of floss between two teeth, press it to one side, and guide it down using a back and-forth, shimmying motion.
Caution: Pulling floss “up and out” can dislodge a filling. Instead, let go of one end of the floss and slide it through the space between the teeth. Floss at least every night after brushing but before spitting out all the toothpaste. If you have an area in which food gets trapped, floss every time you brush.
• Should I be using a fluoride or antiplaque rinse?
Yes. I recommend using these before brushing (or when you cannot brush following a meal). Fluoride is very good at fighting decay.
If your water isn’t fluoridated, children should be given fluoride drops, from age one and-a-half until age 16. Fluoride taken during that time is the best way to prevent tooth decay in adulthood.
• What’s the best way to whiten teeth?
For superficial stains caused by cola, coffee or cigarettes, try whitening toothpaste. Follow instructions carefully. Overuse can strip protective enamel from your teeth. For severe stains, ask your dentist about tooth-bleaching. Dentist-administered bleaches are faster, more effective and less likely to irritate your gums than do-it-yourself bleaches. Cost: $100 to $300 per bleaching.
• How often should I have dental X rays?
When starting with a new dentist, have a set of full-mouth, bitewing and periapical (root) X rays. After that, have bitewing X rays annually (every six months if you’re prone to decay). Depending on your checkups and your dentist’s recommendations, you can go up to five years between full-mouth and periapical X rays.
• Are amalgam (silver) fillings really dangerous?
Amalgam fillings, which contain the toxic metal mercury, can cause nausea, memory loss and neurological problems. If you’re concerned about mercury toxicity, consider replacing them. Look for a dentist who advertises mercury-free or cosmetic dentistry.