Patient FAQs

• How should I choose toothpaste and mouth rinses?
• I'm over 55 — Will I get periodontal disease?
• Is it normal for my gums to bleed when I brush?
• Oral Cancer - Help Your Dentist Help You
• Ways to Get Your Kids to Brush
• TMD: What is It? What Causes It?
• Tooth Decay & Children
• What are periodontal diseases?
• What are the advantages of dental implants?
• What kinds of oral care products should I use?

How should I choose toothpaste and mouth rinses?

Fluoride toothpaste and mouth rinse used in conjunction with brushing and flossing can reduce tooth decay as much as 40 percent. So, using products with fluoride is a good idea. However, mouth rinses are not recommended for children under six. Children should use only a pea-size dab of fluoride toothpaste on the brush to avoid fluoride overdosing. Tartar control toothpaste will reduce tartar (a buildup of hardened plaque) above the gum line. Anti-plaque rinses approved by the American Dental Association contain chemical agents that may help bring early gum disease under control. These rinses can be a helpful addition to brushing and flossing.

I'm over 55—Will I get periodontal disease?

Your chances of developing periodontal disease increase considerably as you get older. More than half of people aged 55 and older have periodontitis. The good news is that research suggests that these higher rates may be related to risk factors other than age. So, periodontal disease is not an inevitable part of aging. Risk factors that may make older people more susceptible include general health status, diminished immune status, medications, depression, worsening memory, diminished salivary flow, functional impairments, and change in financial status.

Is it normal for my gums to bleed when I brush?

Bleeding gums are one of the signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something was wrong. There are a number of other warning signs of gum disease. Contact you dentist.

Oral Cancer – Help Your Dentist Help You

Each time your dentist examines your teeth, he or she also checks your mouth for signs of oral cancer. As part of your routine home care, you should do the same.

• Pay particular attention to sores in the mouth that don't heal quickly (within two weeks) or that bleed easily.
• Check the floor of your mouth, the front and sides of your tongue, and the roof of your mouth for white or red patches that don't go away.
• Watch for soreness, thickening, or lumps anywhere in your mouth or throat, or on your tongue.
• Watch for leukoplakia—a white or gray, hardened, slightly raised, or thickened lesion inside the mouth. These lesions can become cancerous; if you find one, schedule an exam with your dentist.
• Don't think you're off the hook if a mouth sore doesn't hurt; most pre-cancerous or cancerous lesions are painless.

Unlike other forms of cancer, the overall survival rate for cancers of the mouth and throat (called "pharyngeal" cancers) has not improved over the past two decades. In fact, researchers have noticed a marked decrease in the oral cancer survival rates for minorities. Early detection of oral cancer can greatly increase your chances for beating the disease.

About 75 percent of oral cancers can be linked to elective behaviors — tobacco use, including cigars, cigarettes, pipes, and smokeless tobaccos, and excessive alcohol usage.

What to do? Don't use tobacco products; if you already use them, quit. See your dentist at least once, but preferably twice, each year. Make sure he checks your mouth for signs of oral cancer.

Practice good dental home care, including oral cancer self-exams.

Sources: The National Cancer Institute's "Screening and Prevention" The American Cancer Society

Ways to Get Your Kids to Brush

Start with a visit to your dentist. Here, a dental professional will teach your child the proper way to brush, using kid-friendly words. Let your child pick out her own toothbrush and toothpaste. There are many colorful child-sized toothbrushes on the market, as well as toothpastes in flavors that appeal to kids. Just make sure that the toothbrush has soft or very soft, rounded bristles so they don't damage your child's gums or tooth enamel. Be sure your child uses only a pea-sized amount of toothpaste on her brush. Kids tend to swallow toothpaste, and it's important that they not get too much fluoride. If your child doesn't like toothpaste, don't sweat it! You don't want dental hygiene sessions to turn into a battle.

If you have more than one bathroom, keep a toothbrush and toothpaste for her in each one, to make brushing more convenient.

Using stickers or some other artwork, make little signs to put on your child's plate at mealtime, or on her pillow before bed, reminding her to brush.

Brush your pet's teeth, and let your child help — or at least watch. Not only does this reinforce the idea that clean teeth are important, it's also good for your pet. Praise their brushing efforts and the results they're producing. Try saying, "Your teeth are so sparkly!" or "Your breath smells so good!" They'll be delighted that you noticed, and the positive effects of brushing will be reinforced.

And finally, because children learn by example, be sure your child sees you brushing and flossing your own teeth every single day. It's good for them, and good for you!

TMD: What is It? What Causes It?

TMD, or temporomandibular disorder, is not one condition, but a group of conditions that affect the temporomandibular joint (the TMJ). The symptoms arise when there is a conflict between the biting surfaces of the teeth, the muscles in the jaw, and the jaw joint. TMD symptoms can range from a mild jaw clicking and minor discomfort to searing pain in the temple, ear, jaws and teeth. Some people with TMD can't open their mouths all the way; others' mouths "lock" wide open, or dislocate.

Researchers don't know specifically how many people suffer from TMJ disorders, but the statistics they have seem to indicate that about twice as many women as men suffer from the condition as men. However, for most people suffering with TMD symptoms, the discomfort is temporary and does not indicate the development of a serious problem. Only a small percentage of people suffer from chronic, significant TMD symptoms.

What is the temporomandibular joint? The TMJ is the joint that joins the lower jaw with the temporal bone of the skull. It is located just to the front of your ear, on each side of your head. The joint is lined with a rubbery, slippery tissue called cartilage, which allows the joint to glide smoothly as it works.

To feel your TMJ at work, put your index finger on the hard triangular tissue next to the front of your ear opening. Press down as you open and close your mouth. The motion you feel is the TMJ doing its job, and it shouldn't hurt. If it does, chances are you have a TMD; you should see your dentist or your physician for a diagnosis.

What causes TMD? Jaw joint pain occurs when the cartilaginous tissue wears down to the nerve endings. Many things can cause the cartilage to wear away, but the scientific community is in disagreement as to what these causes are. Currently, most experts agree that it's a combination of behavioral, psychological and physical factors that bring on the symptoms associated with TMD. However, dental professionals are in agreement that severe injury to the jaw is a definite cause of TMD.

What can you do to prevent TMD? Although the specific causes of TMD, other than jaw injury, have not yet been clearly identified, many dentists recommend taking the following steps to put as little stress on the TMJ area as possible:

Pay attention to how you chew. Have you gotten into the habit of chewing only on one side of your mouth? If so, is there an uneven or uncomfortable area on your teeth or gums that is causing you to favor one side over the other? If that's the case, you need to have the problem corrected by your dentist. If it's just a habit to chew on one side only, you need to make a conscious effort to chew on both sides of your mouth. No matter what the cause of the lopsided chewing, it inflicts too much wear on the jaw joint on that side of your mouth. Do you clench or grind your teeth, either during the day or at night while you sleep? Ask your spouse or roommate to let you know if you grind your teeth when you're sleeping. This is a condition called "bruxism," and many people have it but don't realize it. Bruxism is not only damaging to your jaw joint, but to your teeth, as well. If you have bruxism, your dentist can fit you with a night guard that will prevent your teeth from grinding together.

Clenching or grinding during the day is usually a subconscious response to stress. Pay attention to your body's reaction to stress; is clenching your teeth one of them? If so, you will have to consciously "tell" your jaw to relax. Try to always keep your teeth a little bit apart; resting your tongue between your teeth often helps. Give your jaw frequent rests from chewing, and avoid gum and hard, chewy food.

Sources: The National Institute of Dental Research; The American Academy of Orofacial Pain

Tooth Decay & Children

What is tooth decay?

Tooth decay is a destruction of the tooth enamel. It occurs when foods containing carbohydrates (sugars and starches) such as milk, pop, raisins, cakes, or candy are frequently left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

How Do I Prevent Tooth Decay?

You can help prevent tooth decay by following these tips:

• Brush twice a day with a fluoride toothpaste.
• Clean between your teeth daily with floss or interdental cleaner.
• Eat nutritious and balanced meals and limit snacking.
• Check with your dentist about use of supplemental fluoride, which strengthens your teeth, and about use of dental sealants (a plastic protective coating) applied to the chewing surfaces of the back teeth to protect them from decay.
• Visit your dentist regularly for professional cleanings and oral examination.

Aren't Cavities Just Kid's Stuff?

No. Changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges, or margins, of fillings is also common to older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

This information is provided by the American Dental Association.

What are periodontal diseases?

The word "periodontal" literally means "around the tooth." Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. Left untreated, these diseases can lead to tooth loss. There are many forms of periodontal disease.

What are the advantages of dental implants?

Dental implants look and feel like your own teeth. They can help prevent the bone loss and gum recession that often accompany bridgework or dentures. In addition, they don't sacrifice the quality of your adjacent teeth like a bridge because neighboring teeth are not altered to support the implant. Implants are secure and offer freedom from the clicks and wobbles of dentures. The success rate of implants is highly predictable.

What kinds of oral care products should I use?

Here are some guidelines for choosing dental care products — what works for most patients most of the time. To find out what is best for your particular needs, talk to your dentist.

• Begin with the right equipment: a soft bristled toothbrush that allows you to reach every surface of each tooth. If the bristles on your toothbrush are bent or frayed, but a new one. A worn-out brush will not clean your teeth properly.

• In addition to manual toothbrushes, your choices include automatic toothbrushes and "high tech" electronic toothbrushes. These are safe and effective for the majority of patients.

• Oral irrigators (water spraying devices) will not remove plaque from your teeth unless used in conjunction with brushing and flossing.

• Another aid is the rubber tip, often found on the handle end of a toothbrush used to massage the gums after brushing and flossing.

• Other options include interproximal toothbrushes (tiny brushes that clean plaque between teeth) and interdental cleaners (small sticks or picks that remove plaque between teeth). If used, it is important to discuss proper use with your dentist.