At night, generally, saliva flow reduces up to 10 times than during the day. Since saliva carries factors which balances the pH in your mouth, a significant lack of this will allow more bacteria to grow and also create a more acidic environment than during the day. If any mouth breathing occurs either in episodes or constantly, it will worsen the situation further.
Now you know why you may have bad breath in the morning.
Brushing and flossing thoroughly at night before going to bed significantly helps reduce bacterial growth over night which can improve bad breath and help prevent dental diseases. And don't forget to gently brush your tongue in the morning!
Oral pH Post 3: Toothbrush + Softened Teeth = Teeth Exfoliation
When you have just eaten, or just drank an acidic drink like soda, juice, or Gatorade, you have just contributed to softening the outer surface of your teeth/enamel. Many people brush directly after this. But when doing so, you are essentially exfoliating a very thin layer of your teeth off, or possibly roughening up the surface.
My advice to my patients is to brush a while after the natural factors, bicarbonate in your saliva, in your mouth has taken its course to bring the acidic environment back to neutral and has given your teeth time to un-soften. Xylitol containing lozenge can promote salivary flow especially after a meal or snack. Xylitol gums have become popular over the years as well, but chewing gum can be contraindicated for people with TMJ issues. You can consult your Dentist on whether you have TMJ problems or not.
Now that we covered eating, then what about the mouth at night?
Oral pH Post 2: Frequent Snacking and Oral pH
Did you know that your mouth goes through a change in pH or acidity throughout the day and night?
Not only does an acidic pH create a friendly environment for bacteria to grow and expand in number, it also softens the outer surface of your tooth called enamel.
When you eat something, the pH in your mouth drops from neutral to an acidic pH. This is normal and natural. The saliva in our mouth contains factors, called bicarbonate, which can bring this pH back to neutral, but it takes up to a few hours. So eating often keeps the mouth an acidic environment without giving it a chance to come back to neutral. Therefore, your Dentist will recommend you to limit the frequency of snacking to help prevent dental diseases like cavities and gum disease.
Frequently snacking also can overwork your digestive system. Just like the rest of the body, rest time in between meals helps to keep your gut healthy!
Now this brings us to a very important fact about brushing your teeth.
Oral pH Post 1 : Things in Your Body Which Love Acidity
First, let's go over things that can cause acidity in your body. I listed some common things which all of us know whether we are health practitioners or not.
Saturated/Trans fats:
red meat, overcooked vegetable oils, dairy products
Sugar:
table sugar, other unhealthy "white" carbs like white bread, white rice, white pasta, we all know sweets are not good for teeth!
Drinks:
fully pasteurized juices, sodas, high dose of caffeine, Gatorade type drinks, alcohol
Lack of Oxygen:
improper breathing, lack of exercise, lack of fresh air
Lack of Water Consumption:
water helps with balance, promotes circulation, and just washing/dumping out impurities from within, promotes healthy amount of salivary flow
Lack of Sunlight
the body needs its vitamin D - D for Depression ;), sunlight is also bactericidal
Unnecessary Stress:
an unhealthy amount of stress inhibits proper bodily functions
Lack of Rest
the body cannot regenerate or repair damaged cells without proper rest/sleep
Lack of Application
so you have all this knowledge, will you do something about it? :)
Now, we can talk about things which love and flourish in this acidic environment that you've created in your body and oral cavity.
Harmful Bacteria
Tumor/Cancer Cells
I would say that the above two things are enough reasons to strive for a healthy life style which include healthy eating habits, proper exercise, fresh air, adequate amount of water intake, rest, temperance, and good oral hygiene.
Let's always remember, your mouth is a part of your body! Having a healthy lifestyle will also promote a healthy mouth; a healthy mouth can contribute to a healthy rest of the body. It's become more common knowledge that oral diseases are contributing to systemic diseases like Diabetes, Heart Diseases, Alzheimers, Low birth weight babies, etc. A Neutral-Alkaline pH-environment is highly encouraged!
Tuesday, June 11, 2013
Fillings Post 1: Silver Amalgam vs. White Tooth-colored Composite and others
Simply put, I am pro-composite. Why?
First let me define the different materials to be discussed.
Amalgam: silver colored metal material used to do fillings
Composite: white or tooth-colored resin material used to do fillings
Glass-Ionomer: also white, but more opaque than composite.
Now that you know what it is, I will go into why I'm against Amalgam.
material itself stains teeth
is a conductor, a metal, and can cause
a degree of hot/cold sensitivity
shrinking and expanding from conducting temperature
weakening and eventually cracking of teeth due to pressure from this thermal expansion
need to cut out more of the healthy part of the tooth
need to make sharp angles on the intaglio of the tooth which becomes stress points - again aiding in possible cracking and dentinal sensitivity
it's inert, but it does contain mercury
looks bad, simply put
Why do I like Composite for my patients?
the composite itself does not stain the tooth
composites I choose for my patients are BPA-free
is not a conductor, so you can rule out the problems that comes from a conductor
can remove just the bad parts of the tooth for the most part and save more of the healthy parts of the tooth
internal design of the tooth can be rounded, which is much more friendly to the rounded anatomy of the tooth and the pulp (nerve)
not a heavy metal - more biocompatible
esthetic! multiple shades which can match all kinds of different teeth colors!
There are times, though, when it is impossible to get saliva under control when composites just cannot be used. This is one disadvantage of composite. In this case, I use a resin-based glass-ionomer material. Glass-Ionomers
can stick to teeth pretty easily even if there is some saliva around
releases fluoride at a slow and steady rate to compensate for some saliva contamination
more flexible than composite for specific types of restorations but will not last as long as a composite
it works great as a temporary stop gap until a composite resin can be placed
So if someone tells you amalgam is the best filling material because it is highly durable, you are now much more educated in the subject. This may have been true a long ago when composites were not so advanced, but things are different now.
Laser Post 1: A Myth?
People tend to want magic. Some verbal command, or a magic wand that can make everything better. We grow up hearing of fairy tales but eventually grow out of it...or not.
In my practice, I have realized we, as adults, are still looking for this magic to happen...in the dental chair.
Laser has been debated by many. Although widely used in medicine, it seems its evolution in dentistry is quite slow. There seems to be a bit of a lack of organized research despite the practitioners seeing positive results which have helped their patients throughout their practice. As a trained certified laser provider, I can tell you that laser is no magic wand. It is an instrument that allows the body to do what it normally does better, for better treatment outcome, and more patient comfort.
In my practice, I mainly use the soft tissue diode laser. I will list some simple but enormous benefits of this laser.
reduced inflammation/swelling in the soft tissues - instantly.
patients with gum pain come in, get laser therapy with no injections, and leave without pain - also experience pain subsiding as the laser is being administered.
disinfects the area where laser is exposed.
promotes the body to produce more healing cells - better quicker healing.
all of the above results in zero to highly reduced pain in my patients who receive laser assisted surgery. typical response from patients on followup "I never had to take any pain meds" "I took one before I went to bed, but woke up and felt nothing"
in the same way, laser assisted perio treatment - deep cleaning and others - also leave my patients with no to minimal pain and less post-operative complications.
laser, in hypersensitive individuals, helps to reduce the sensitivity, allowing deep cleanings and certain gum treatments with less or no anesthetic.
if you receive deep cleaning, the treatment irritate the gums in order to reduce the irritation from the infection. laser helps reduce both at the time of treatment, allowing your body to heal with less effort.
can debride infectious tissues arouund implants without disturbing the implant (unlike metal instruments)
can debride infectious tissues more thoroughly than using only metal instruments, while it promotes healing cell production, unlike metal instruments.
I don't see the need to undermine an instrument which helps my patients feel a lot less pain and experience better healing. Where is this controversy coming from then? Probably from blown up marketing and unrealistic expectations. Well, this is life, not just an issue in the field of laser dentistry.
Newborn Post 4: Tongue Thrust and Breastfeeding
Tongue thrusting is a habit which can end up in abnormal bone development leading to an open bite and crooked teeth. There are many speculations as to what causes it such as breathing problems, large tongue, genetics, etc. But one theory which I found interesting and wanted to share as food for thought was the 'gushing milk from baby bottle' theory - I gave it this name after attending a seminar on the benefits of breastfeeding related to Orthodontics.
Babies when fed through a bottle, in order to prevent the 'gushing milk' from the nipple of the bottle, will start to push back with their little tongues. This eventually becomes a habit. Some babies overcome this once they grow up. Some babies don't.
Breastfeeding has more benefits than the contents which give babies necessary immune-related antibodies. The act of suckling on mommy's breast takes a greater amount of effort to obtain breast-milk for the baby compared to the nipple of a bottle. Therefore, the baby won't have the problem of having to push back the 'gushing milk' with their tongue. This not only gives the baby's musculature, the needed normal level of exercise for proper/natural development of the muscles and bone, teeth positioning, and speech, but also promotes better circulation to the head and neck region.
Proper development to the head and neck may even aid in preventing certain breathing disorders such as Obstructive Sleep Apnea which is becoming more and more prevalent. Proper teeth positioning may reduce the need for complex orthodontic treatment for your child.
So working moms who choose to use pumps for bottles, this is a great choice for when you are not with your baby. But if time allows, I encourage you to try breastfeeding directly for your baby.
Newborn Post 3: Thumb Sucking
A very common habit babies have is thumb sucking. The first year or so, your baby may be prone to thumb sucking as a comforting mechanism. But if this habit continues on past the age of 4-5, it can contribute to an open bite. To encourage your child to help stop this habit, compliment your child whenever they are not sucking their thumb. A bandage on the thumb or a mit over the hand can remind them whenever they attempt to bring the thumb to the mouth to stop.
Newborn Post 2: Bottle for Bedtime
Although breastfeeding is the best way to promote growth and development in your newborn, for many moms, it is not easy due to their busy work schedules.
If your child needs a bottle as a comforter at bedtime, only water should be used for the bottle. Milk, breastmilk, formula, juice, all contain sugar and having it for a long period of time make it easier for bacteria to cause cavities. This habit can lead to a serious problem called “Baby Bottle Decay” where your child will suffer from cavities in a lot of their baby teeth.
I have seen young babies with bottle decay who have needed sedation in order to treat all their little blackened teeth or even those who developed infections/abscesses and needed emergency care. This always breaks the heart of the parents but first and foremost is not something we want our children to have to experience. If followed the water-only-in-bottle advice, it will help in preventing such a situation.
Newborn Post 1: Baby Teething
Teething happens when the baby's teeth are starting to grow out of the gums. Your baby can be irritable due to the soreness from it. Using a clean moist washcloth or gauze to wipe your baby's gums clean once a day can help alleviate some of the soreness that occurs from the teething. This method is recommended for daily oral hygiene of infants as well. Teething is not known to cause fever.
Child Post 4: Riding a Bike Unsupervised
"I told you you need to brush your teeth." My disappointed mom is telling her child after hearing their 5-year-old has cavities. Then the mom tells me,"I told them to brush but they don't listen." or
"They brush so quickly."
At times I get the 'hush-hush version' where the parents whisper to me "Can you really tell them to brush their teeth?" It always makes me smile. All these comments and more gave me insight on how parents are struggling at home to get their children to brush.
Most parents are not aware that just like walking as a toddler and riding a bike, a 5-year-old needs guidance when it comes to brushing and flossing. If you have been faithful about brushing and flossing your child's teeth till now, you are already on the right track.
I encourage parents to help children brush and floss even up to age 12. Slowly ease your 5-year-old into brushing on their own. Use positive reinforcement and praises! Check to make sure all is clean and brush once again for them as routine. Introduce them to flossing the same way. Soon, your child will become an expert.
Some parents, though, struggle with the children with a more independent nature who just don't like the idea they are being supervised. Then how about turning it into a fun parent-child activity? Brush together side by side! Time each other a good two minutes and see who persists! After checking your child's performance, maybe even allow your child to check if you did a good job.
If you need advice on how to improve your techniques, your dentist can help you during your regular visits for exams and cleanings. These visits to your dentist will play an important role in maintaining and improving good habits and skills.
Child Post 3: Your Baby's First Tooth to Toddler
As soon as you see your child’s first baby tooth appear (usually 8-12months), they should be seen by a dentist. This visit is not just a checkup for the child, but also to educate the young parents on how to take care of their child’s oral health.
It is quite simple. Take a clean moist washcloth or a piece of gauze and wipe the gums of your baby once daily. As soon as your child gets a tooth, it can be subject to getting a cavity. You can use a finger brush or a soft baby toothbrush to lightly brush it and continue with wiping the gums with a washcloth or gauze, also once daily.
Once your baby is older and now is a toddler, you should continue to brush their teeth but also start flossing in between teeth. They will have most or all of their teeth by the age of three. I recommend the flossers on a plastic handle with the fun colors and alligator shapes made for children. There are other types of floss available as well. If you have questions on how to use it, bring your child in for a checkup and cleaning. The dentist can demonstrate how to use the flosser better.
Child Post 2: A Gift that can last a Lifetime
Good oral hygiene and habits is a great gift parents can give their children. But doing so is not always easy. If the routine can be started early on in the child's life, even before your child's first tooth appears during the teething stages, it may increase the chances your child will retain these habits as they grow up. This routine includes bringing your child to see the Dentist in a timely regular manner along with consistent home care.
Child Post 1: Baby Teeth Don't Matter: A Common Misconception
Cavities on baby teeth are often thought to be ‘ok’ since they will ‘fall off anyway’. This is not true. Baby teeth are vital to your child’s development such as muscle and bone development, speech, and facial profile; they provide a guiding path for the adult teeth to grow in.
A small cavity on a baby tooth can eventually grow into a tooth infection and affect the adult tooth under it and/or your child's overall health. Regular checkups and cleanings and parents actively involved in children's daily home care can help prevent this. It is a gift you can give your children that can last a lifetime.
Hygiene Post 2: Brushing, Flossing and the Secret to Oral Health
"I know I have to, but it's too much work."
"But I brush really well every day, 3 times a day. So do I have to?"
"Yes I floss! I floss when food gets stuck in between, only."
"I can't get to my back teeth so I don't floss those."
These are some common responses my patients give me when I ask "so do you floss daily?"
Only brush the teeth you want to keep - is the wise saying of old times. But really, you must brush and floss the teeth you want to keep. This may be news to some, so I invite you to unlock the secret behind it all by continuing to read.
Plaque, as we all know, the white fuzzy stuff that grows on your teeth, especially when you eat, is basically bacteria. To be more precise, it is 95%-98% bacteria, the rest being minerals. This plaque sticks to the surfaces of your teeth including the surfaces you don't see, like in between your teeth and under your gum pockets. But not all bacteria is bad.
Bacteria seems to gain power to cause damage as it gets older. We naturally have an endless supply of bacteria living in our mouth. So it's ok to have bacteria. Just don't let it stay on your teeth and tongue for a prolonged period of time. Clean it, and keep your bacteria supply fresh.
The yellow-brown surrounding the tooth along the gums is old plaque turned into hard calculus or tartar. This could have easily been prevented, at least minimized, with daily correct brushing and flossing.
A good portion of my patients claim brushing very well but gums still bleeding. This is either because they need a deep cleaning due to existing periodontal disease, and/or lack of flossing - which cleans in between teeth and under the gums.
Think of it as vacuuming your home. Some corners will remain dusty because your vacuum head is simply too large to get in between the nooks and crannies, or under the rugs. So you need a smaller tip or attachment to clean those areas. Floss to your teeth and gums is like the specialized smaller attachments for your vacuum.
Your floss will fit under your gums to however deep it is. Once
you get it in carefully, just scoop out the bad boys with the floss.
We need to floss out the bacteria from in between our teeth and under the gums which surround every tooth in our mouths.
So what is the big secret in maintaining good oral hygiene? It is 24 hours. Once bacteria lives past 24hours, it cultures a sticky matrix on your teeth called the biofilm. It makes it easier for more harmful bacteria to grow, and eventually cause cavities and severe cases of gum disease. This is how you get gum swelling/bleeding - or inflammation - and research shows it contributes to Coronary Artery Disease, Alzheimers, Low Birth Weight Babies, Diabetes, and more.
The basic requirement to a beautiful smile, crisp breath, and healthy lifestyle? Good 24hr-daily oral hygiene routine. Happy Brushing and Flossing!
Hygiene Post 1: Controversy: Floss first? or Brush first?
I have taken into consideration both approaches and here is my take on this highly debated topic.
If you floss first, you're dealing with a larger amount of plaque. You'll see a lot more plaque being removed than if you floss after brushing. Flossing gets the plaque out from under the gums and in between teeth. But I also see flossing as 'fine-tuning' after getting the big stuff out of the way with the brush. Once the big load is removed, the fine-tuning can be more effective.
In conclusion, I floss after I brush with the Sonicare, and rinse thoroughly.
Happy flossing!