Preventing Gum Disease
Your are most likely to avoid chronic periodontal disease through a combination of regular professional treatment and conscientious home care. At home, essentially the same techniques serve to protect both your teeth and gums. Periodontal disease is especially likely to begin in areas between the teeth, so it is crucial to clean these areas thoroughly. With age, the gums often recede, exposing larger spaces between the roots of the teeth. To clean these spaces, you may find it helpful to use an interdental stimulator, a mechanical irrigator or a small brush designed for this purpose.
Brushing your gums along with your teeth tends to make them firmer. Although this promotes oral health, it does not eliminate the risk of periodontal disease. Improper or overdone massage can even damage the gums. If your gums are healthy, but brushing causes them to bleed, you may be using too much pressure or too stiff a toothbrush. See Dr. Patenaude for individualized facts on what is best for your mouth.
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Bad Breath
The old joke about bad breath being better than no breath at all is certainly true. For those affected, however, there are times when they're not too sure about the truth of that statement. Bad breath dominates any personal relationship and leaves the owner feeling like a social outcast. It changes the way you act, the way you talk, and generally the way you conduct yourself.
To get rid of bad breath, you have to eliminate the cause-not just mask it. This may require some help from your dentist or physician. It usually comes from excessive alcohol, smoking, or food retention around the teeth. I can also occur from gas producing bacteria from anywhere in the digestive system, a coated tongue, or infections of the tonsils, sinuses, and lungs. Even indigestion and certainly chronic gum infections can cause bad breath. Diabetes produces an acetone or sweet breath, and certain foods such as onions and garlic can be offensive. Your first step! Identify the cause.
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Beginning of Gum Disease
By now, most people are aware of the seriousness and impact of gum disease the leading cause of tooth loss in adults but how many people know how it begins and what causes it?
There is a space between the gum lining and tooth called the SULCUS. Bacteria fill this space and unless it is removed by brushing and flossing, it can irritate the gum lining. The cells in the lining swell and separate. Gradually the material inside the lining cells, or the cementing substances which hold the cells together, are destroyed. As the sulcus becomes diseased, a pocket forms.
At this point, tooth brushing or eating hard foods might cause your gums to bleed. THIS BLEEDING IS NOT NORMAL. Unless steps are taken to correct the situation and it is reversible it may lead to the destruction of more gum tissue and bone, and eventually the loss of the teeth themselves.
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Care For Restored Teeth
Restored, as well as natural teeth need good home care to keep them healthy. Talk with your dentist about the right dental cleaning aids for your restored teeth, and learn how to use them. The extra effort you make to keep your restored teeth healthy means they're likely to last longer, look good and feel good, too.
The best way to keep your teeth and gums in good shape is to brush and floss them each day, to remove germs that cause decay. Thoroughly clean your crown, fixed bridge or partial denture just as your would your natural teeth, preferably after eating.
Because it's removable, the partial denture takes special care. Once removed, it is possible to the top surface as well as the inside of the denture. Since the partial denture may be made of different materials, ask Dr. Patenaude about the best toothpaste, tooth powder or cleaning agent to use. Soak your dentures in water or a denture cleaner to keep them from distorting.
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Cavity- Tooth Loss Myth
Are cavities the greatest threat to dental health? Far from it. Untreated decay takes its greatest toll in children and young people, but the largest single cause of tooth loss in adults is pyorrhea or gum disease (dentists call it periodontal disease).
Gum disease not only attacks the gums, actually detach from the tooth and the tooth becomes loose and falls out.
Irritating deposits formed from substances normally found in the mouth, cling tenaciously to the teeth, and if they aren't removed by careful and frequent cleaning at home, they can lead to gum disease. Eventually this plaque hardens (calculus) and can then be removed only by regular cleaning by your dentist or dental hygienist. The sooner treatment begins, the better your chances of stopping gum disease and tooth loss.
Whether it is either of the anti-tooth villains, gum disease or dental decay, they can both be combated by a combination of good home dental care and regular visits to Dr. Patenaude. It's up to you!
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Child with Periodontal Disease
If you've noticed that your child has swollen gums that tend to bleed when he's brushing, this could be an early sign of periodontal disease and should be treated without delay.
Periodontal disease is an infection of the gums and other tissues that support the teeth. This is much more common in adults but no less serious when it happens to children. It is caused by plaque or bacteria that forms along the gum line, making the gums swollen and tender. Left untreated, the plaque will harden into calculus or tartar, increasing the decay area and infection. This causes the gums to separate from the teeth, leaving pockets for the further spread of decay and infection. Eventually periodontal disease attacks and destroys the bones that support the teeth, causing the affected teeth to loosen and fall out.
Protect your child's health with regular dental checkups and seek treatment whenever a sign of dental health problems, such as bleeding gums, appears.
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Detecting Gum Problems
Red, bleeding, puffy, or swollen gums may alert the individual to a problem, but the diagnosis of periodontitis requires professional evaluation to determine if true periodontal pocketing is present.
Long-standing periodontal disease or rapid destruction of bone may be recorded without necessarily indicating that any teeth will be lost. When the pocket approaches the entire length of the root, which may be 8-10 millimeters, or extends between the roots of a molar crown, risk of tooth loss is much greater. Treatment has so improved that many of these previously hopeless teeth can now be saved. Some teeth, however, are beyond the help of dentistry's best efforts.
Loss of a few teeth from advanced disease does not mean that all the teeth will be lost. Some people insist that all their teeth be removed even though only a few require extraction. It is their mistaken belief that periodontitis will inevitably destroy the remaining teeth anyway. Not true! Get the facts from Dr. Patenaude.
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First Sign of Peridontitis
If your gums bleed easily when you brush your teeth, this may indicate you have a serious form of gum disease know as periodontitis. Periodical disease is the number one cause of tooth loss in adults. This disease attacks the gum tissue and supporting bone structure. As the gum and supporting bone gradually deteriorate, this causes the teeth to become loose and eventually fall out.
Dental plaque, an accumulation of harmful bacteria that is constantly forming on teeth, is believed to be the chief cause of inflammation of the gums and tooth decay. Gum disease in its early stages (gingivitis) is an easier problem for Dr. Patenaude to treat. When treatment is neglected or put off, however, early gum disease progresses to periodontal disease, and, eventually loss of teeth.
Prevention is the best way to keep this from happening to you. This should include good oral hygiene habits at home as well as regular professional cleaning.
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Gum Boils or Abscess
Maybe you've heard an abscess described as a gum boil or pimple, but whatever it's called, this infection of the gum may cause severe pain until it is treated by Dr. Patenaude. Usually when someone has a gum abscess there will be swelling caused by the inflammation as well as pain and soreness. The cause of the abscess may not be as obvious as the results. This type of mouth infection may originate in the gum or in the tooth. More certain is the discomfort this condition can cause and the need for immediate dental treatment to prevent infection from spreading.
One method of treatment is to open up the abscess and drain it. This will result in immediate and grateful relief. Then the cause of the abscess must be treated. An abscessed tooth can often be saved from extraction if there is enough bone remaining around the root of the tooth to give it good support.
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Gum Disease and Bad Breath
When you look at your teeth in the mirror, they may look strong and healthy with no signs of decay. Yet you may be troubles by mouth odor or bad breath. The decay must be there somewhere, but you don't have the instruments or expertise to detect it, especially if it is lurking below the gumline.
Bad breath in an otherwise healthy person is often caused by decomposing food particles and the bacteria that feed on them. It is
Also caused by decaying or diseased teeth and gums. Even the most strenuous and regular brushing and flossing at home can not reverse these problems without your dentists help. Any incidence of bleeding gums when you brush or floss could be a sign that you have gum disease. You may not feel any discomfort in your gums, but the disease is there and may get worse, causing loose teeth and other problems, as well as bad breath.
If you have a mouth odor problem, see Dr. Patenaude for a check up. He can restore any decayed teeth and treat the gum disease so your teeth can be saved and your breath can smell fresh and pleasant again.
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How Teeth Are Scaled
The most commonly used instruments are hand scalers, whose heads are shaped like little sickles, curved spoons, hoes, or files. This of course depends on the teeth to be scaled and the preference of Dr. Patenaude. The scaler is placed on the tooth and gently inserted beneath the gum and beyond the tartar. Firm pressure is then applied toward the crown to dislodge it. The scaled material does not always come off conveniently or in one piece, so the process may have to be repeated a few times. Then it may be necessary to smooth the surface of the tooth. Most scaling does not hurt at all because it is against enamel, which has no sensitivity. However, it must be accomplished slowly and carefully to insure comfort. It helps a great deal if the scaling process can be done at regular intervals.
To relieve any minor discomfort, a topical anesthetic can be applied to the gum tissue in the form of a gel. It numbs the tissue enough to eliminate even minor pressure sensations.
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Inherited Gum Disease
If one of your children's gums bleed occasionally, this may be an indication of gum disease. If this happens in spite of good oral hygiene, it may suggest that he or she had inherited a tendency to gum disease.
Juvenile periodontitis or gum disease can advance rapidly if left untreated. It can also result in loss of permanent teeth in children and teenagers who are otherwise healthy. If the tendency is inherited, it may be traced to an x-linked gene present in the mother's chromosomes. Both boys and girls can inherit this trait, though it is more common among girls.
In one case, the history was traced to a great-grandmother on the mother's side of the family and several other female family members. In the present generation there were four girls and one boy in the family. Three of the daughters showed evidence of gum disease before they reached their teens. Whether there is a history of gum disease in your family or not, prompt treatment of this condition is needed to prevent soft tissue involvement and loosening of permanent teeth.
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Partial Denture Hygiene
People who wear partial dentures should pay particular attention to home hygiene. They have two kinds of teeth to take care of; their natural teeth and their artificial teeth. The natural teeth can be cleaned in the usual way (brushing and flossing); partial dentures can be cleaned with special denture brushes available in drugstores. Their contoured bristles make it possible to clean under the clasps between the teeth and in other recesses of the dentures that are hard to reach with a regular toothbrush. Wearers of partial dentures should remove them and soak them once or twice a week in a solution made for that purpose. These products should be used only according to the manufacturer's recommendation, and any special advice which Dr. Patenaude may have included. Since tartar collects as readily, or more readily, on dentures than natural teeth, periodic professional cleaning may also be required.
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Periodontal Conditions
Periodontal disease (gum disease) is bad enough in its dental effects it is the leading cause of tooth loss in adults but there is also evidence that it leads to complications in other areas of the body.
Pyorrhea is the more common name for advances periodontal disease. Its literal meaning "a continuous discharge of pus" describes the condition perfectly. This purulent material along with its disease-producing by-products, can enter the system by two routes from the periodontal pocket. One is through the digestive tract and the other route is direct entry to the bloodstream byway of veins and lymph vessels that drain the periodontal tissues.
It has been claimed that many diseases result from infection around the teeth. Among them are disease of the eyes, ears, joints, cardiovascular system, digestive system, other internal organs, and the skin. So not only do you risk tooth-loss by neglecting infected gums, but other diseases as well.
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Pregnancy Gingivitis
One factor which the expectant mother must consider if she wants to keep her teeth healthy during pregnancy is the phenomenon of PREGNANCY GINGIVITIS, which increases the expectant mother's susceptibility to tooth decay.
Because the baby has to be nourished in the womb, the mother's body undergoes certain hormonal changes that have the function of increasing the blood supply to the mucous lining of the womb. Sometimes, however, the hormonal activity becomes excessive and increases the blood supply to the mucous membrane of the mouth. The extra, unwanted blood causes inflamed and bleeding gums, creating a comfortable habitat for certain decay bacteria.
Teeth are lost, it turns out, not because of surrendering calcium to the fetus, but for the usual reason decay from bacteria and acids. That's why expectant mothers should take extra care with oral hygiene, and not neglect periodic dental examinations.
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Pressure and Periodontal Disease
There are other causes of periodontal disease (gum disease) besides poor oral hygiene and the build-up of calculus (tartar) around the necks of teeth.
How does this happen? For one thing, crooked teeth tend to cause such pressure. A tooth that is out of line in the dental arch is frequently subjected to abnormal pressures during chewing of food or grinding of teeth. This condition is called traumatic occlusion. Over a number of years the excessive burden may result in chronic inflammation, as well as loss of bone and supporting tissue.
Improperly placed fillings, crowns, or dentures may also exert abnormal pressures. Although Dr. Patenaude makes every effort to contour the restoration so that it will conform with the contour of adjacent and opposing teeth, only by using the restoration can the patient tell whether or not this goal has been achieved.
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Professional Cleaning - How Often?
How often should you have a professional cleaning? This depends on your own personal thoroughness with daily brushing, with the foods you eat, with any medications you may take, and of course, smoking. Thorough cleaning is much more than simply cosmetic, although that is very important.
If you think you are the exceptional person who doesn't need a periodic professional cleaning, buy some disclosing tablets at your pharmacy. A red dye is released when they are chewed which attaches itself to stain and plaque. Look in the mirror. The red stains show the areas that need scaling to prevent gum disease and cavities.
We are all subject to the formation of tartar, although the amount that precipitates out of saliva varies with each individual. If you accumulate little, then your teeth must be scaled infrequently. Usually twice a year is sufficient. However, if you accumulate a lot-it must be more frequent of the irritation will cause pocket formation, bone loss and eventually possible loss of your teeth.
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Receeding Gums
If you have abnormal spacing between your teeth, this may indicate that your gums have receded because of chronic gum disease. Take a look at the gum directly in front of a tooth. Do you see the full crown of the enamel or do you see more than just the crown? On close inspection, if you can see a darker, yellowish-gray portion of the tooth, you may be looking at part of an exposed root. Receding gums may have caused this.
The shape of your gums is another indicator of gum disease. Normal, healthy gums have a pyramid or cone shape. When your gums become irritated because of gum disease, however, they may look flat, thickened or puffed out. The tips may also have become enlarged. Your gum has reacted to bacterial invasion and irritation by overgrowing and enlarging.
Gum disease should be treated as soon as possible to protect your teeth and you dental health. If you have any signs of receding gums or other gum problems, see Dr. Patenaude for treatment.
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Replacing Old Bridgework
You probably realize the importance of replacing missing teeth with bridgework for your appearance's sake as well as to help keep your teeth in proper alignment. Even the best-made bridgework, however, will show signs of wear in time. This wearing may also lead to irritation of your gums because the bridgework no longer fits as well in your mouth as it did initially.
If you have bridgework that shows signs of wear or if you notice your gums have receded or look red and puffy, ask Dr. Patenaude if he would recommend replacing the old bridgework with a new appliance. In checking your mouth and your old bridgework he may also study signs of wear on the artificial teeth as well as opposing natural teeth.
Before the new bridgework is fitted into your mouth, Dr. Patenaude will want to make sure your gums are healthy. Any infection that is causing irritation, redness, or puffiness will be treated before you begin wearing the new bridgework. In addition to a good fit, he will make the bridgework as natural-looking as possible to it will blend in well with your other teeth.
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Seeing The Invisible
Dental plaque is invisible to the human eye. In order to remove plaque, we have to see it. We can make invisible visible with a disclosing agent, usually red dye, that stains bacteria. You can buy it at any pharmacy. Apply it with a Q-tip (after you brush and floss). Paint the edge of your gum where it meets the teeth. Move the Q-tip along, up and down, following the gumline. Now rinse and look to see where the stain is. Then brush and floss again. You'll notice that although brushing removes some of the stain at the direct edge of the gum, it did not get it all BETWEEN the teeth. Only dental floss will get into these areas to remove bacteria. Brushing won't. That's why flossing is so important.
Do this disclosing daily at first until you really know your mouth, and later three times a week. You really won't know if you've effectively removed plaque if you don't disclose. It's like trying to lose weight without checking yourself on a scale.
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Smokeless Tobacco Problem
If you've given up smoking cigarettes but are now chewing tobacco, you can still have dental problems that have been found to be tobacco related. According to researchers, prolonged or excessive use of smokeless tobacco can produce irritants that have an unhealthy effect on gum and bone tissue. If damaged tissue isn't treated in time, this can lead to permanent damage, loosening of the teeth, and eventually loss teeth.
Another condition that users of smokeless tobacco should be aware of is hyperkeratosis. This is the formation of a whitish, callous-like thickening in the mouth. It usually occurs in the area where the tobacco is placed for chewing, sometimes called the "snuff pouch".
Whether you smoke or chew tobacco, and even if you do neither, regular dental checkups are the only way you can protect the health of your teeth and mouth. If there is the beginning of any kind of dental-related problem, the earlier the treatment, the better chance you have of keeping your teeth and mouth healthy.
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Stopping The Chain Reaction
If you want to save your teeth, you'll need Dr. Patenaude's help to stop the chain reaction that often begins with gum disease. The disease can be deceptive, because you may feel hardly any discomfort at all in its early stages. By the time you're aware of occasional bleeding of the gums, this disease may already have become well established. Left untreated, bleeding gums may ultimately lead to destruction of the underlying bone. This may cause your teeth to loosen or abscess and eventually lead to tooth loss. Gum disease should never be ignored or left untreated. When bacteria invade your mouth and are allowed to thrive uncontrolled, they quickly multiply and intensify their efforts in destroying gum tissue. Once they have achieved a firm hold in your mouth, routine dental care at home may not be able to stop the destruction. That's why regular dental checkups are recommended. If your want to save your teeth, seek the professional help available from your dentist.
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Take The Brushing Test
So you think you're really good at tooth brushing? Why not take the test? No one needs to know your test score except you and your mirror. After you identify the areas your toothbrush is missing you can modify your brushing technique to improve your results. When you eliminate plaque, you're on your way to better oral health.
Plaque disclosing tablets, available at your pharmacy, contain a red vegetable dye that stains any plaque that remains on the teeth after brushing and flossing. The wafer is chewed and mixed with saliva and then swished to bathe all teeth with the solution. It is also available as a liquid. By exposing the remaining plaque to view, you can learn where brushing and flossing need improvement.
Disclosing tablets are not recommended for daily use but only as an occasional checkup on brushing efficiency. Since we all need an occasional boost in our brushing anyway, the best advice is to take a little more time and work conscientiously at being thorough.
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About Flossing
To fight plaque, floss is considered to be our most important weapon. Perhaps even more important than the toothbrush. Have Dr. Patenaude or his hygienist instruct you properly at your next visit. Even those of us who know and understand the importance of brushing and flossing don't spend enough time doing it. Once-a-day brushing and flossing is the absolute minimum and it should be done twice or more to have a real shot at being effective. For those who accumulate tartar rapidly- even twice a day is not enough.
Dental floss comes in many forms-waxed and unwaxed-flavored and unflavored-wide and regular. Dental tape is just floss that is wider and stronger, but may be harder to get between the teeth. You may prefer a prethreaded flosser or holder, which are great for people with limited dexterity. A good flossing takes 2-5 min to be effective. It just can't be done in less time because each tooth surface needs individual attention. One firm rule. Be Gentle!
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Choosing Dental Floss
Dental Floss is a nylon string that comes in various forms and has a variety of other properties. It can be thick or thin, round or flat, waxed or unwaxed, flavored or unflavored. Each type has its advantages and its supporters. Originally, all floss was waxed to permit easy passage between the teeth, but advocates of unwaxed floss claim that waxed floss does not remove plaque. All competent studies show, however, that waxed floss cleans as well as unwaxed. And both can be beneficial if used properly-and harmful if abused,
A waxed dental floss has the advantage of slipping between the teeth more easily and is less likely to fray and tear. When floss breaks, it sometimes gets stuck between the teeth. This happens much more frequently with unwaxed floss than with waxed. If your choice is unwaxed, have waxed floss available in case an unwaxed piece gets stuck; sometimes they can be tough to get out. If this happens, wait and try again. The contact may open slightly.
How to Floss
The function of dental floss is to clean the surfaces of teeth that cannot be reached by the toothbrush. The floss is stretched between the fingers, which are placed inside and out side the teeth. It is then gently slipped between the teeth-not snapped through. Snapping can injure the gum tissue, so it is important to ease rather than force the floss through. The floss should then be worked, three, or four times up and sown in a scraping motion, without rubbing gum. It should not be pulled back and forth. This sawing Acton causes undue wear.
Flossing is a skill that takes some practice. Eventually ones finger's get a feel for what they are doing. Floss holders can make it easier, but they are not necessary for anyone with normal dexterity. As long as you can hold the floss taut, you can learn. Even a skilled flosser has difficulty where contacts between the teeth are very tight or fray the nylon. If this occurs these problems may be eliminated by scaling the teeth or by smoothing or replacing defective fillings.
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Diabetes and Gum Disease
Some general, or systemic diseases, especially DIABETES MELLITUS and fat-storage diseases, make the supporting tissues and bone around the teeth susceptible to chronic inflammation, infection, abscesses, and other periodontal disorders.
When diabetes is successfully controlled with insulin and/or other drugs and the patient is diligent in the following the advice of his physician and his dentist, dental complications may be controlled so as to preserve teeth for many, many years. However, in most cases of uncontrolled diabetesand even in some cases that are controlled loss of teeth from periodontal disease seem to be inevitable, no matter how hard the patient and his dentist try.
The best hope for people in this situation is in research that is being done in the area. New types of treatments are constantly being developed and tested.
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Getting Children to Brush
It is very important to start children off with good dental habits. It is better that they pick up these habits naturally and early than having it forced upon them later on.
Children are great imitators. If they see you brush and floss, they will want to do the same for themselves. By all means encourage it. Regardless of how young they are. Just as children may want to drive a car or have many years before they are ready, they will want to "play" at brushing and flossing.
Ask Dr. Patenaude about a brush suitable for your children. It will be the same design as yours, only smaller. Floss should also be available to them, even if they can't manage it too well. They will enjoy the use of the water pik, which flushes their mouths very effectively. They may also brush longer and more often if they have access to an electric toothbrush.
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Healthy Gum and Bone
You probably care about your dental health or you wouldn't be reading this column. One of the keys to good health is to have healthy gum and bone and do what ever you can to protect them. This is not as easy to achieve as you might think; also appearances can be deceiving. For example, when you look into your mouth you may think your teeth and gums look healthy. You may see no sighs of decay in your teeth, and your gums dont seem to be giving you any problems, they may not be as healthy as they look, however, if bacteria have already started to work to destroy your teeth and gums.
If you have a dental problem, it usually starts on a tiny, microscopic level. Tooth decay, for instance, usually begins when bacteria produce acids that dissolve the crystalline portion of a small area of enamel. When bacteria attacks your gums, they cause tiny ulcers to form in your gum lining. A lot of damage may already have been done before your gums begin to bleed.
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Need For Professional Cleaning
If you want to keep your teeth and gums healthy so you can escape the threats of gum disease and tooth loss, it is extremely important to keep your teeth and gums clear. Good oral hygiene at home, faithfully performed, ca help achieve this goal. You will also need to have your teeth professionally cleaned and get regular dental checkups.
Some people are more prone to gum disease and tooth decay that others, and for that reason they may have to have their teeth cleaned and checked more often. Some patients need to have their teeth cleaned every three months. It all depends on your individual condition and the best one to make that decision is your dentist.
Dr. Patenaude or his hygienist can also give you good tips on how to properly clean your teeth at home, between checkups. You will be shown how to do this without damaging your gums and making them more vulnerable to disease. Healthy gums are important if your aim is to keep your teeth for a lifetime.
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Stuck Food Particles
Sometimes a bit of food becomes stuck or impacted between adjacent teeth. It can be very annoying and just won't be removed by your tongue. If it is fibrous and remains there for a prolonged period it can actually move teeth out of position and start a pocket area in your gum which will collect other food and may eventually lead to some periodontal involvements. This food may have gotten stuck because of beginning decay, a broken filling, tartar formation, lack of contact points between adjacent teeth,-or maybe it just happened.
Try getting this impacted food loose by gently flossing between your teeth. If the are is wider it may be helpful to tie a small knot in the floss. This is particularly helpful if the food is trapped under a fixed bridge. If this doesn't work, try to remove it with the soft, pointed end of an interdental stimulator. The use of a water irrigator can also be very helpful. If you can't dislodge it without damaging the gum, go to Dr. Patenaude. Don't count on it working itself out.
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Take The Brushing Test
So you think you're really good at tooth brushing? Why not take the test? No one needs to know your test score except you and your mirror. After you identify the areas your toothbrush is missing you can modify your brushing technique to improve your results. When you eliminate plaque, you're on your way to better oral health.
Plaque disclosing tablets, available at your pharmacy, contain a red vegetable dye that stains any plaque that remains on the teeth after brushing and flossing. The wafer is chewed and mixed with saliva and then swished to bathe all teeth with the solution. It is also available as a liquid. By exposing the remaining plaque to view, you can learn where brushing and flossing need improvement.
Disclosing tablets are not recommended for daily use but only as an occasional checkup on brushing efficiency. Since we all need an occasional boost in our brushing anyway, the best advice is to take a little more time and work conscientiously at being thorough.
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The Best Tools For You
Two of the best tools you can use to maintain good oral hygiene are a toothbrush and dental floss. There are many varieties of these on the market.
You can buy dental floss either waxed or unwaxed. Which is better? Most dentists recommend unwaxed floss because it's more efficient in removing bacteria from teeth. But people whose teeth are very tightly spaced may find it better to use the waxed floss because it will penetrate more easily.
There's a lot of variety in toothbrushes. They come in different shapes and with bristles that are soft, medium, or hard. Among the most recommended is a brush with soft, multi-tufted, round-end bristles. There are also narrow periodontal toothbrushes with two rows of soft bristled for better gum care.
Some people prefer an electric toothbrush, especially those whose hands are handicapped by arthritis. Whether you use manual toothbrush or electric, the best advice as to style and design will come from Dr. Patenaude.
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The Cause of Dental Decay
Dental decay is a microbial plaque disease. Bacteria require a special protected environment-dental plaque-to do their dirty work. Plaque is a sticky gelatinous substance, which is nearly invisible until it has picked up stain. It is deposited on the teeth by bacteria and their products in combination with dietary and salivary components. Plaque takes only about a day to reach a sufficient thickness for bacteria to colonize. There is a wide variety of bacteria present as the plaque builds, and some of them are especially effective is using dietary sugars to form acids. The plaque concentrates these acids against the tooth surface, resulting in a demineralization of enamel. This is the beginning of cavity formation. Until recently, it was believed that demineralization was irreversible. It is now known that teeth can remineralize under certain conditions and that many very early cavities can heal spontaneously- a process aided by the presence of fluoride and the absence of plaque.
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The Quiet Disease
Are dental checkups really necessary when your teeth are not bothering you? Absolutely! Even though the incidence of tooth decay has dropped over recent years, periodontal (gum) disease has not. It actually accounts for over 60 percent of teeth being lost. It starts without your knowledge, causes no pain in the early stages, and at that time is usually easy to treat. Catching it early saves not only the teeth, but time and money. Sound teeth which are supported by bone and gums involved with periodontal disease will eventually be lost.
Early intervention in gum disease generally means cleaning off tartar from the root surfaces. Only a dentist or hygienist can remove this material. When root surfaces are involved, home oral hygiene alone won't solve the problem. Bone will be lost and teeth will loosen. Periodontitis is a quiet and destructive disease which can usually be detected only by your dentist. By getting routine, periodic checkups, you will not allow this to sneak up on you.
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The Shape of Your Gums
One of the things Dr. Patenaude will look for in the detection of gum disease is the shape of your gums. If your gums are healthy, the gum contour will rise up and down between the teeth, forming a "V" or cone shape. This pyramid of gum is called the papilla. However, if your gums have been damaged by disease, they will be rounded or blunt where the top of the pyramid should be. This indicates a recession of the gum and possible loss of structure. There are other signs of gum disease. For instance, diseased gums usually look as though somebody had removed some of the tissue between the teeth as well as at the gum tip. Other signs are enlarged, swollen and reddish-looking gums, rather than the normal pink colour. Inflamed and reddened gums with occasional bleeding are early signs of gum disease that should be treated by Dr. Patenaude if your want to save your teeth. Don't delay treatment because this condition usually gets progressively worse, causing teeth to loosen and abscess. At the first signs of gum disease, have this condition treated by Dr. Patenaude.
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The Silent Disease
Gum disease, gingivitis or the more serious periodontal disease, in which tooth-supporting bone is attacked, knows no age barriers. Children and adults alike can be threatened.
Gingivitis and periodontal disease usually develop slowly and may not cause any pain or discomfort until an abscess develops. Unfortunately, it is much too easy for gingivitis to progress to periodontal disease without your being aware of it. It's not like a toothache that quickly lets you know when something is wrong. When the gums begin to recede and teeth begin to loosen, however, major work will be needed to save them.
Don't wait for that to happen you. Get regular dental checkups. At the first sign of gum problems, have the condition treated by Dr. Patenaude so your teeth will last as long as you do.
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Tooth Picks Etc.
Toothpicks have been used throughout the ages to pick food out from between the teeth. They come in all shapes. They are round and flat, narrow and thick, mostly pointed but some blunt, and can even be elaborately made out of ivory with gold handles. Toothpicks can be dangerous by actually creating pockets, which can house bacteria and become areas of food impaction. They are not as effective as floss, and certainly don't begin to clean the bacterial plaque as floss does. Specially designed toothpicks made out of soft orangewood are available, however, and can actually do a good job of cleaning and massaging the gums as well as cleaning the side surfaces of the teeth.
If you decide to occasionally use toothpicks, remember that chewing on toothpicks can traumatize and loosen teeth. Also remember that excessive pressure on the gums always worsens the condition. Toothpicks can really become more of an oral habit than a tooth-cleaning device. Generally speaking, they should be avoided.
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Treating Gum Disease
If you have a gum disease problem that is serious enough to threaten loss of teeth, Dr. Patenaude may recommend one of several options in treating this problem. If the teeth are beyond saving, there may be no alternative but to extract them and remove diseased gum tissue so the condition will not spread to other teeth.
When the gum disease is in its early stages, however, your dentist may recommend more conservative treatment, such as subgingival curettage. In this procedure, concentration will be on cleaning the root surface of the teeth and scraping the inside of the soft tissue next to the teeth. By doing this, Dr. Patenaude may be able to restore your gums and teeth to a healthy condition.
Another treatment that may be recommended is called the modified Windman-flap surgery. This involves separating the diseased gum tissue from the teeth and cleaning it as thoroughly as possible. Then the gum tissue is sutured back to the teeth and allowed to heal.
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Treating Inflamed Gums
If you have inflamed gums, an early sign of gum disease, your dentist will probably initiate treatment by removing the bacteria and other bacterial byproducts that have been irritating your gums. As your gums are restored to health, they will tend to shrink toward the bone. They will also begin to lose their puffiness and redness as the inflammation diminishes. You will also note spaces forming between your teeth as the gum shrinks back to normal. More of your teeth will begin to show as the gum tightens and moves toward its junction with the bone. If more of a tooth shows than is normal, however, this may indicate that you have lost some of your gum. Loss of gum and loss of bone often result when gum disease is not treated in time. When treatment is not given soon enough, this can also cause tooth loss.
Don't take chances with your dental health by ignoring the symptoms and discomfort of inflamed gums; not if you want to save your teeth. Have this condition treated promptly by Dr. Patenaude.
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Treatment For Non-Support
Even if you use the best oral hygiene techniques at home, it may be difficult to keep harmful bacteria from attacking two of its favorite targets: your teeth and your gums. Tooth decay gum disease are the result, and, if left untreated, may threaten loss of teeth.
In a healthy mouth, each tooth sits firmly in its socket, separated by a thin membrane or ligament composed of millions of fibers as well as blood vessels, nerves, lymphatics, and cells. The purpose of the ligament is to prevent the tooth from being too tightly compressed in its socket. If your gums are healthy, they attach to your teeth just above the bone crest. This is where the uppermost portion of the root emerges from the bone.
Even in healthy gums and teeth there is a space between gum and tooth. If this space should be attacked by bacteria, both tooth and gum as well as supporting bone may be threatened. That's why prompt treatment of any signs of gum disease is recommended.
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Vincents Infection (Trench Mouth)
Vincent's infection is a disease of the gums, and is contagious; it acquired its more common name, Trench Mouth, from the high incidence occurring in the trenches during World War 1. As with most communicable diseases, a health, resistant host will not be susceptible. Vincent's infection is a common occurrence in our colleges. It should be promptly treated by your dentist.
The symptoms are:
" An especially foul mouth odor
" Chopping off the tips of the gums between the teeth.
" A layer of Grey , infected tissue covering raw undersurface in one or all four quadrants of the mouth.
" Possible general malaise.
" Fever in more serious cases.
" Progressive destruction of gum tissue which can never be regrown.
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What is Plaque?
If you're looking for a villain in the continuous saga of dental problems-start with plaque. Plaque is the primary cause of tooth decay and periodontal (gum) disease.
Plaque is a soft, sticky, colorless film of bacteria that is constantly forming on your teeth. The bacteria are most harmful when they become organized into colonies-about every 24 hours.
When they become organized into colonies-about every 24 hours. When you eat sugar, it combines with the plaque and produces acids, which attack the tooth enamel. The sticky plaque holds these acids on the teeth, prolonging the attack and allowing decay to begin.
The irritants in plaque inflame the gums making them tender and likely to bleed. If not removed by daily cleaning, plaque builds up, eventually pulling the gums away from the teeth causing pockets that become filled with bacteria and infection. If not treated, health teeth may become loose and may be lost.
You can prevent dental disease by controlling plaque, How?
Brush and floss thoroughly at least once a day. Avoid sugary foods. See Dr. Patenaude for regular checkups and professional cleanings.
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What You Should Know About Plaque
We hear a great deal about plaque these days in dental product advertising. Since its' elimination is so important in controlling dental decay and periodontal disease, there are a few things you should know.
Your mouth normally contains large amounts of bacteria. Many of these bacteria digest sugar. Among the byproducts of digested sugars are acids, -particularly lactic acid. If these bacteria remain undisturbed on your teeth, they combine with food debris and their own digestive products to form a sticky film called plaque.
Plaque hold the acids released by bacteria in firm, prolonged contact with the tooth. These acids react chemically with the minerals in the enamel and dissolve them. Decay usually begins with a tiny pit on the surface, which enlarges to become a cone shaped soft spot of partially dissolved enamel. When more sugar is fed to the bacteria, more acid will be produced, and the decay progresses faster. Untreated, it will eventually destroy the tooth.
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When Gum Pockets Form
Does toothbrushing or eating hard foods make your gums bleed? If so, you can be sure that some inflamation is going on. Pockets of bacteria may have developed around some of your teeth.
Gum Tissue has two parts. The lining of surface tissue is called the epithelium, The dense supportive tissue that lies under it is called the connective tissue. In the early destruction phase, called gingivitis, bacteria attack the gum lining and connective tissue, Your body sends cells to fight the bacteria, but some of them are destroyed in the process. When these cells die, enzymes and other substances are released that contribute to the destruction of gum tissue and bone. As the disease progresses you may notice that your gum tissue looks red and shiny. It may also look slightly puffy or swollen and bleed more easily.
Fortunately, gum disease, even at this stage, is reversible if you get the treatment you need from Dr. Patenaude. The longer you delay treatment, however the greater your chances of losing teeth.
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Why Floss?
Flossing your teeth should be painless. If flossing hurts, it means that too much pressure is being applied the wrong way. When you begin to regularly floss your gums may bleed. This occurs because bacterial plaque, which your toothbrush has been unable to remove, has irritated and inflamed the gum tissues. As plaque is removed and prevented from re-forming by repeated flossing, the tissues become healthy and bleeding ceases. Don't stop when you see some blood on the floss. Continued flossing will help end the bleeding eliminating the inflammation that causes it.
Flossing may cause an unpleasant taste and smell as food debris that have decomposed are removed. No matter how thoroughly you brush, only flossing or water irrigation can clean these inaccessible surfaces and reduce unpleasant mouth odors. Since many bacteria thrive on the same food we eat, removal of bacterial plaque prevents not only gingivitis and periodontal disease but also dental decay.
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Checklist for a Healthy Mouth
The regular examination of your lips, gums, teeth, tongue and mouth lining should be a periodic routine. A self-examination every couple of weeks could be vitally important to your overall health. Here's how to do it:
Look into a mirror in a good light, take out all removable dental devices and look for the following signs of a healthy mouth.
-firm, pink gums will well-defined edges
-smooth, glistening, reddish-pink mouth tissue surfaces
-off-white/yellowish teeth, free from stains, deposits or cavities
-a rough-surfaced tongue of even colour - - occasional small fissures
Since the mouth is an area where the health of the entire body is revealed, it presents us with an ideal indicator of our overall health. Consult Dr. Patenaude if you see anything unusual, have any tooth pain or have extreme sensitivity to hot or cold.
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Dental Splints
By far, the most common cause for teeth to become loose and mobile is advanced periodontal disease which erodes the supporting bone. If the mobility is not too severe and the teeth are otherwise sound, they may be stabilized with a splint which binds them to healthy adjacent teeth and to each other. This distributes the chewing pressures among them. A very simple splint may connect a single tooth to a single firm tooth, or it may connect a group of mobile teeth to teeth on either side. One type of splint is created by cutting continuous channels into the involved teeth. Wire or nylon filaments are laid in these grooves. The dentist then fills the channels with a tooth-coloured material which holds the wire and binds the teeth together. These splints are inconspicuous and can be inserted easily.
Another more elaborate splinting device is the Maryland bridge. Although it is beautiful and strong, it must usually be redone if one of the splinted teeth becomes loose.
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Fighting Tartar
If you keep plaque under control, you'll have less reason to worry about tartar. Tartar is calcified plaque, made rock-hard by the minerals in saliva. If plaque is not removed by flossing and brushing, it can start to harden in a day. Tartar is mainly a cosmetic problem when it first starts to form above the gum line. But then it acts as a matrix on which other tartar can grow and develop below the gum line where it can create a periodontal problem.
After tartar forms it can no longer be brushed away. It must be scaled off. About 10% of people accumulate tartar at a rate much faster than normal. For these people, no brushing will completely control tartar. An anti-tartar toothpaste can be truly effective by slowing the buildup of tartar by as much as 40%. When brushing, special attention should be given to the areas behind the lower front teeth and on the cheek side of the upper back teeth where saliva comes into the mouth and increases tartar formation.
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