A Guide to Nighttime Oral Care

• By Jen Laskey

There are three basic steps to nighttime hygiene: brushing, flossing, and rinsing with mouthwash. Dr. Zak says the order doesn't matter, as long as the food particles and plaque are removed. However, she adds, "My preference is for brushing, flossing, and then mouthwash because I feel that brushing first makes it easier to floss."

Steps for Basic Nighttime Oral Hygiene:

Brushing

Brushing your teeth helps protect them from plaque buildup and tooth decay. Using a soft-bristled brush and toothpaste that contains fluoride, start brushing your teeth at a 45-degree angle to the gums. The correct method, according to the American Dental Association, is to brush back and forth gently in short (tooth-wide) strokes. The ADA suggests brushing the outer tooth surfaces first, then working your way through the inner tooth surfaces and the chewing surfaces of your teeth. The association also recommends using the "toe" of the brush to clean the backs of your front teeth with gentle up-and-down strokes.

Whether you should brush right after dinner, before bed, or both depends on your susceptibility to dental disease. Because recent studies have shown that the risk for dental disease varies from person to person, dentists are now following medical models of dental disease to determine their patients' susceptibility and the type of care they need. "People who are at a low risk for cavities and gum disease can certainly wait until bedtime to brush (though the timing isn't as crucial for them). Higher-risk patients would benefit from both an after-dinner and a bedtime brushing," says Dr. Zak.

Flossing

Cleaning between your teeth with floss allows you to reach plaque that you can't remove with a toothbrush. Flossing at least once a day will also help prevent periodontal (gum) disease. To floss properly, the ADA recommends using an 18-inch-long strand, winding most of it around your middle fingers (to manage the floss as it gets dirty), and then holding the remaining floss tightly between your thumbs and forefingers. Next, use a gentle rubbing motion to guide the floss between your teeth. As you move toward the gum line, curve the floss into a C shape against each tooth, rubbing back and forth against the tooth as you go. When you get to the root of the tooth, slide the floss into the space between the gum and the tooth and keep rubbing gently. Then slowly move the floss away from the gum with an up-and-down motion, and repeat for the rest of your teeth, including the backsides of your last teeth on the top and bottom.

Dr. Zak says that flossing is important because it enables you to remove plaque while it's still soft: "Once the plaque hardens and forms tartar, only a professional cleaning by a hygienist or dentist can remove it. Patients who are very susceptible to gum disease or tartar buildup may want to consider flossing twice a day."

Rinsing With Mouthwash

Rinsing with a therapeutic mouthwash will help keep your breath fresh, your teeth plaque- and cavity-free, and your gums safe from gingivitis. Most mouthwashes are sold over the counter, though some require prescriptions. Follow the instructions on the packaging for best results.

10 Biggest Causes of Tooth Sensitivity

• By Beth W. Orenstein | Medically reviewed by Lindsey Marcellin, MD, MPH

Are your teeth tender? From acidic foods to certain toothpastes, a number of culprits could be to blame.

Does eating frozen yogurt make you say “ouch” — or do you find yourself wincing when you brush or floss? You could have what’s known as tooth sensitivity.

But you don’t have to put up with the pain. In fact, there are things you can do to lessen tooth sensitivity and improve your oral health says Leslie Seldin, DDS, a dentist in New York City and a spokesman for the American Dental Association.

Here’s why you could be experiencing this mouth malady — and what steps you should take to ease the ouch:

• You brush with too much gusto. Sometimes tooth sensitivity comes from brushing with too much force or with too hard-bristled a toothbrush. Over time, you can wear down the protective layers of your teeth and expose the microscopic hollow tubes or canals that lead to your dental nerves. When these tubules are exposed to hot or cold or to acidic or sticky foods, tooth sensitivity and discomfort can be the result. The simplest solution is to switch to a toothbrush with softer bristles and to be gentler when brushing.
• You eat acidic foods. If the pathways to your nerves are exposed, acidic foods such as tomato sauce, lemon, grapefruit, kiwi, and pickles can cause pain. Use common sense: Stick to foods that won’t cause you pain.
• You’re a tooth-grinder. Grinding your teeth can wear down the enamel, even though it’s the strongest substance in your body. By doing so, you expose the dentin, the middle layer of the tooth, which contains the hollow tubes that lead to your nerves. Talk to your dentist about finding a mouth guard that can stop you from grinding. The best guards are custom made to fit your bite, Dr. Seldin says.
• You choose tooth-whitening toothpaste. Many manufacturers add tooth-whitening chemicals to their toothpaste formulas, and some people are more sensitive to them than others. If your toothpaste could be to blame for tooth sensitivity, consider switching toothpastes.
• You’re a mouthwash junkie. Like whitening toothpaste, some over-the-counter mouthwashes and rinses contain alcohol and other chemicals that can make your teeth more sensitive — especially if your dentin’s exposed. Solution: Try neutral fluoride rinses — or simply skip the rinse and be more diligent about flossing and brushing.
• You’ve got gum disease. Receding gums, which are increasingly common with age (especially if you haven't kept up with your dental health), can cause tooth sensitivity. If gum disease or gingivitis is the problem, your dentist may suggest a procedure to seal your teeth along with treating the gum disease itself.
• You have excessive plaque. The purpose of flossing and brushing is to remove plaque that forms after you eat. An excessive build-up of plaque can cause your enamel to wear away. Again, your teeth can become more sensitive as they lose their enamel protection. The solution is to practice good daily dental care and visit your dentist for cleanings every six months — or more frequently if necessary.
• You’ve had a dental procedure. Teeth often become more sensitive after you’ve been in the dentist’s chair. It’s common to have some sensitivity after a root canal, an extraction, or the placement of a crown. If your sensitivity doesn’t disappear after a short time, another visit to your dentist is in order — it could be an infection.
• Your tooth is cracked. A chipped or cracked tooth can cause pain that goes beyond tooth sensitivity. Your dentist will need to evaluate your tooth and decide the right course of treatment, such as a cap or an extraction.
• There is decay around the edges of fillings. As you get older, fillings can weaken and fracture or leak around the edges. It’s easy for bacteria to accumulate in these tiny crevices, which causes acid build-up and enamel breakdown. See your dentist if you notice this type of tooth sensitivity between visits; in most cases, fillings can be easily replaced.

Tooth sensitivity is treatable. In fact, you might find that using toothpaste specifically made for sensitive teeth helps, Seldin says. However, these formulas don’t work for everyone. “I have a lot of patients with sensitivity that could not be resolved by toothpaste,” he says.

If your sensitivity is extreme and persists no matter what you do, see your dentist for an evaluation. Among other possible treatments, he or she may be able to apply a fluoride gel to areas of the teeth where you have the most sensitivity, to strengthen your tooth enamel and reduce the sensations you feel. And, of course, only an office visit can determine the most likely cause of your tooth sensitivity and the best solution for your particular situation.

Tobacco Use and Your Oral Health

• By Connie Brichford | Medically reviewed by Niya Jones, MD, MPH

It's no secret that smoking is bad for your overall health but using tobacco products can have serious consequences on your oral health, too.

 

In addition to affecting your overall health, tobacco use and smoking can cause a number of oral health issues, ranging from oral cancer to discolored teeth.

“You can get yellow teeth [and] a yellow tongue," says Thomas Kilgore, DMD, professor of oral and maxillofacial surgery and associate dean at the Boston University Henry M. Goldman School of Dental Medicine. "You see a lot of staining on the tongue.”

Smoking and tobacco use can lead to more serious oral health complications as well, including gum disease and oral cancer.

Smoking and Oral Cancer

“The most serious issue is mouth cancer,” Dr. Kilgore says. “It’s hard to say what percentage of people who smoke will get mouth cancer, but the death rate of those who do get it is high — between 40 and 50 percent of all cases, and that hasn’t changed over the last few decades.”

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The American Cancer Society estimates that 90 percent of people with oral cancer (cancer affecting the lips, tongue, throat, and mouth) have used tobacco in some form. Likewise, the risk of oral cancer is six times higher among smokers relative to non-smokers. Your individual risk of oral cancer depends on how long you’ve been using tobacco — the longer you use it, the greater your risk.

Smoking and Periodontal Disease

“Smoking cigarettes doesn’t cause dental decay, but it does cause periodontal, or gum, disease,” Kilgore explains. “Bone loss is part of periodontal disease. It starts out as inflammation of the gums. In the natural and unfortunate progression, the bone supporting the roots of your teeth becomes inflamed,” and then the underlying bone can deteriorate, he adds.

“There are surgical and nonsurgical therapies to reverse or slow the progression of periodontal disease,” Kilgore says, but without proper treatment, gum disease does eventually lead to tooth loss and jawbone damage. One study found that smoking was associated with more than 50 percent of periodontal disease cases.

For Oral Health, No Tobacco Is Safe

People often think that different forms of tobacco are "safer" than others. However, says Kilgore, “Tobacco in any form has risks. It’s hard to figure out which is worse” — when tobacco is chewed, smoked, or inhaled.

The bottom line is that regular exposure to tobacco in any form can compromise your health. Kilgore points out that “pipe smokers may not smoke very often, but they can [still] get cancer of the lips, as they’re always holding the pipe in the same place on the lip.” Additionally, “there’s a myth that chewing tobacco has less risk, but it’s been shown pretty clearly that this isn’t true.”

And people who use smokeless (chewing) tobacco are at a four to six time greater risk of oral cancer than people who don't use tobacco at all. People who use smokeless tobacco are also at higher risk of tooth decay and cavities because some varieties of chewing tobacco contain sugar for a sweeter taste, and sugar is a primary cause of tooth decay.

Protecting Your Oral Heath

The following three principles can help to ensure good oral health throughout the years:

• Quit smoking. After you’ve quit smoking, your risk of oral health problems decreases significantly. And the longer you remain a non-smoker, the lower your risk becomes. A decade after you’ve quit, your risk for periodontal disease is similar to that of a person who never smoked at all. “A lot of dentists now are taking the initiative to ask patients about their smoking habits, and are talking about the [nicotine] patch” and other ways to help people quit, Kilgore says.
• Get regular dental checkups. As with most cancers, early detection can improve your outcome. “The good news is that regular checkups by a dentist are a good way to catch oral cancer early,” advises Kilgore. “Any mouth ulcers can be checked out with a biopsy, and you can get a diagnosis.” The sooner you start treatment, the better your odds of survival.
• Brush properly. “Most people who have periodontal disease develop it from not brushing and flossing properly,” Kilgore notes. The heat and carcinogens found in cigarettes and tobacco are also damaging to your mouth and gums. So people who use tobacco need to be doubly careful about brushing and flossing correctly and doing so as often as recommended. Ask your dentist or dental hygienist to watch you brush and floss to make sure you’re doing a thorough job.

Having Trouble Quitting? Visit the Dentist Regularly

If you do use tobacco, cutting back and eventually quitting are some of the most important actions you can take to improve both your oral health and your overall health.

Tobacco use “is a tremendously addictive habit, so in the meantime, regular dental visits can help with early detection” of gum disease and precancerous mouth sores, Kilgore says. He adds that the people at greatest risk for oral cancer are chronic smokers who don’t visit their dentists regularly. “By the time oral cancer is detected, it’s hard to treat," he says. Plus, the treatments can be more challenging at later stages. Surgery and radiation treatments are often disfiguring and can affect your ability to speak and eat.

Talk to your dentist or general doctor about what can help you to kick your smoking and other tobacco habits today.

How to Brush Your Teeth and Floss With Braces

  

If you or someone in your family wears braces, take heart. Before you know it, you’ll be flashing a confident smile if you keep these few things in mind.

Don’t Let Plaque Win  

Once teeth are straightened by braces, it is easier to reach plaque on and between your teeth. But while wearing braces, plaque and food particles have additional places to accumulate and become trapped. Use an Oral-B® Electric Toothbrush with an Ortho® brush head that’s specially designed to effectively and gently clean around braces.

Treat Your Gums Kindly  

While wearing braces, you might consider using the sensitive mode of your Oral-B Electric Toothbrush. The sensitive mode oscillates at a lower speed for extra care and comfort along the gum line—and around the brackets and orthodontic wires.

Brush and Floss Like a Pro

Using an Oral-B Electric Toothbrush makes this routine easy.

• Get started. Remove elastics, bands, or removable parts of orthodontic appliances.
• Clean your braces. Carefully clean around wires and pins.
• Brush each wire. Move top to bottom, and all the way around upper and lower teeth.
• Brush your teeth. Dental professionals recommend brushing your teeth for two minutes, twice daily. That means each quadrant of your mouth gets 30 seconds. Oral-B Electric Toothbrushes have a built-in timer that pulses every 30 seconds to let you know when to switch areas of the mouth. As you’re brushing, make sure to clean all areas of the tooth. Some people find they get the best clean going tooth by tooth.
• Floss once a day. Use waxed floss and thread it carefully under the main wire before passing between two teeth. Don’t snap it—simply move up and down gently, remove, and move on to the next pair of teeth. Use Oral-B Superfloss®, which is self-threading or regular floss with a floss threader to place above and below the orthodontic wire.
• Rinse, and then check your teeth. Rinse thoroughly. Examine teeth and braces in the mirror, and remember to look for any remaining food particles.

Plan Regular Check-ups

Seeing your orthodontist for checkups and adjustments is essential. He or she can repair broken pieces, answer general questions, and address any irregularities such as cavities or gingivitis. Your dental professional may recommend a fluoride treatment as a precaution.

Baby Teeth Grinding - Sounds Horrible, but is it Harmful?

Baby Teeth Grinding - Sounds Horrible, but is it Harmful?

We’ve all heard the harm that kids sleeping with a baby bottle or sippy cup can do, and we know the dangers that thumb-sucking can pose for kids’ dental health, but one thing you never think about is baby teeth grinding…until you hear it for the first time!

Should you Worry about Your Baby Damaging Their Teeth?

For the most part, parents don’t mind what their kids are doing when they sleep, so long as they’re sleeping -- but is teeth grinding (or “bruxism”) bad for them? Since babies lead a relatively carefree existence, we assume this sometimes stress-related habit is uncommon for kids, but in fact more than 30% of kids do grind their teeth at night. So, while teeth grinding is real, is it more or less dangerous than the boogey man under the bed?

The Causes of Bruxism in Children

While experts aren’t sure what causes babies to grind their teeth at night, the majority believes it to be an attempt to soothe sore gums during teething. Another theory holds that kids are simply testing out their new chompers, which usually come in between 8 and 12 months -- to get a feel for having teeth at all. Other common theories include babies grinding their teeth to soothe the pain of an earache or the discomfort of an allergy. One thing everyone agrees on is that such intermittent grinding at this age is harmless and won’t cause any damage.

 

In older children, bruxism can be a sign of worry or anxiety, and when teeth grinding is a more long-term habit, it can be harmful causing problems such as tooth damage, headaches or even TMJ, (temporomandibular joint disease). 

Usually teeth grinding will naturally cease as your baby gets used to having their teeth, but if it continues, be sure to alert your dentist so that they can help your child prevent excessive long-term wear and damage. In the meantime, providing a cool teething ring (and earplugs for the parents) can help make your baby – and you -- more comfortable.

 

Back to News Europe

According to the British Dental Health Foundation, constant eating of sugary foods over Christmas can make the holiday period a miserable time for teeth. (DTI/Photo courtesy of ER_09/shutterstock)

Dec 23, 2011 | News Europe

Christmas: a miserable time for teeth

by Dental Tribune Interational

RUGBY, UK: Constant snacking, drinking and eating sugary foods and liquids over Christmas can make the holiday period a miserable time for teeth, the British Dental Health Foundation warns. The consumption of tempting treats means that teeth are likely to be under a constant risk of attack from tooth decay and tooth erosion over the festive period.

The Foundation stated that sugar-filled mince pies, chocolate selection boxes, fizzy drinks and acidic alcoholic drinks like red wine that make up a traditional festive diet are all likely to pose a hazard to teeth during the holidays. 

“It is important to be extra vigilant with your oral health over the Christmas period,” said Chief Executive of the British Dental Health Foundation, Dr Nigel Carter. “Your teeth are under attack for up to one hour after eating or drinking, and if you think about how much is consumed, and how often, particularly over Christmas and Boxing Day, your teeth don't really get the chance to recover.”

According to Carter, brushing teeth just before going to bed will ensure that you have removed acid-forming plaque before sleep – as your saliva flow slows down overnight – while brushing first thing in the morning is a simple way to limit damage caused to your teeth. 

To ensure you fully enjoy this time of year without having to compromise on what you eat and drink, the Foundation recommends that everyone bear in mind it is not how much sugary food and drink one has, but rather how often one has these that causes a perilous situation for oral health.

The Foundation reports that traditional foods like cranberries – the perfect accompaniment to one’s turkey – are scientifically proven to benefit overall health, and scientists have also shown they may have the capacity to help prevent both gum disease and tooth decay. However, moderation is important, as cranberries are acidic and it is a good idea not to have them too often throughout the day to avoid erosion of teeth enamel.

Other things, like passing a tin of sweets around throughout the day, selection boxes and even Bucks Fizz, have the potential to damage teeth if consumed too often. For this reason, it is best to try and restrict such food and drink to mealtimes. Mince pies, Christmas cake and Christmas pudding are all laden with dried fruit, which is high in sugar and sticks to the teeth where it can cause the most damage.

To accommodate these treats, it is a good idea to offer a cheese board after mealtimes, as a small piece of cheese will help to return the mouth to its natural acid balance and thereby help to reduce the chances of tooth decay. Chewing on sugar-free gum for around ten minutes can also have the same effect.

To accommodate children’s sweet tooth without damaging their teeth, Carter suggested some novel yet practical ways of getting the balance right between having a sweet tooth and healthy teeth. “Children will inevitably get sweets, so try and get them to eat them straight after mealtimes rather than grazing on them all day. New research even suggests ice cream containing probiotics could reduce levels of tooth decay so in the future this could become a healthier option. Any fruit juice they have should be diluted 10 parts water to one part juice as most are acidic and many contain added sugar.”

How to Clean Braces

Braces Do A Lot Braces do a lot more than improve your smile. They also play an active role in correcting overcrowded and misaligned teeth. This is important because an abnormal bite (also known as “malocclusion”) may cause other problems, such as impaired plaque removal around misaligned teeth, which can lead to gum inflammation and cavities. Taking good care of braces can help prevent damage to the braces themselves and the teeth underneath as well as make the braces more comfortable to wear. Learning the basics of orthodontic care will help you follow your dental professional's recommendations to keep your teeth and gums healthy during the time you’re wearing braces. The Basics: Brushing And Flossing Careful cleaning is required with braces, because plaque bacteria are easily trapped inside and around them. The following procedure will make daily brushing and flossing both simple and effective. Prepare to brush. Take off elastics and any other removable parts of your orthodontic appliance. Clean your braces. Hold your brush at a 45-degree angle to clean around the wires and pins of your braces. Brush from the top of each wire down to the bottom. Take your time to ensure that all plaque and debris are removed, and that you work all the way around upper and lower teeth. Brush your teeth. Clean each tooth individually. First, place your brush at a 45-degree angle the gum line, then apply gentle pressure as you move in a circular motion. Do this for about 10 seconds. Use the same brushing action on all outer and inner tooth surfaces, tilting the brush as needed to better reach the insides of smaller front teeth. Floss once a day. Have your dental professional show you the best way to floss, or follow the instructions on the product package. You may also want to use a flossing product designed for braces and orthodontic work, like a floss threader. Rinse and check your teeth. Rinse thoroughly with water or mouth rinse, and examine your teeth and braces in the mirror. Professional Care: Dentist And Orthodontist Visits During the time that you have braces on your teeth, you will need to visit the orthodontist regularly for adjustments to your appliance. After a routine orthodontic adjustment, you may experience some tightness or even a slight amount of pain. If this discomfort or pain does not quickly dissipate, or becomes extreme, you should consult your orthodontist. Concerns about your appliances, and any problems with broken parts, should also be brought to your orthodontist's attention immediately. It’s also important that you continue with regular visits to your general dentist while undergoing orthodontic treatment. Routine checkups are necessary to spot cavities and signs of gum disease. Your dentist or hygienist may also perform frequent fluoride treatments to provide additional protection to tooth surfaces from decay while you’re wearing braces. Your home oral care techniques will be monitored by your dental professional and changes will be recommended as necessary. As always, be sure to follow their instructions.