Overbrushing: Watch Out for Too Much of a Good Thing

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Toothbrush Abrasion Leads to Sensitive Teeth and Gums

Brushing regularly is considered vital for healthy teeth and gums, but dental experts warn that you can overdo a good thing. Known as “toothbrush abrasion,” overbrushing can lead to sensitive teeth and receding gums.

Vigorous brushing can wear down the enamel on the teeth as well as damage and push back the gums, exposing the sensitive root area. Receding gums can also lead to other dental problems such as periodontal disease and cavities on the roots of the teeth and may lead to the need for treatments such as fillings, root canals and tooth extraction. According to the Wall Street Journal, dentists estimate that between 10 to 20 percent of the population have damaged their teeth or gums as a result of overbrushing.

The people most at risk for tooth or gum damage from overbrushing are those who are particularly diligent about their oral care and those who use medium- or hard-bristled toothbrushes. Other factors, such as a genetic predisposition to receding gums, clenching or grinding your teeth or having had your teeth straightened with braces, can increase your risk for damage from overbrushing.

Brushing vigorously isn’t necessary to remove plaque. “Plaque is so soft that you could remove it with a rag if you could reach all the surfaces where it hides,” says Dr. Kevin Sheu, managing dental consultant for Delta Dental. “Thoroughness is what is required for plaque removal, not aggressive brushing. You’re not going to achieve any extra benefit by brushing hard.”

Changing brushing habits can usually stop the problem from getting worse. In cases of severe toothbrush abrasion, dentists can fill in the grooves with bonding material.

Proper brushing technique

What’s important when brushing your teeth is not how hard you scrub, but that you use the proper technique and that you do a thorough job. And that takes time. Dentists recommend that you brush your teeth for two to three minutes to get the most thorough cleaning. The following are some other tips for brushing your teeth correctly:

·        Use a soft-bristled toothbrush to prevent gum damage and wear on the soft tooth dentin (the less mineralized layer of tooth found just under the enamel) and in the root area. If you are accustomed to a hard-bristled toothbrush, even using a toothbrush that is softer than you are accustomed to will help.

·        Place the head of your toothbrush with the tips of the bristles at a 45-degree-angle to the gumline when brushing.

·        Move the toothbrush with short strokes and a scrubbing motion, several times in each spot – don’t saw back and forth across the teeth with your toothbrush.

·        Apply just enough pressure to feel the bristles against the gums. If you are squashing the bristles, you're brushing too hard.

 

Worn Brush Bristles

The smoothness of your toothbrush’s bristles (which are rounded in the factory when they are made) also gets worn away back to its original jaggedness via brushing, which is why you may have heard that dentists recommend you replace your toothbrush often. The key is to throw away your toothbrush before the bristles splay, because by that point, it’s too late. Splayed bristles mean you’ve been using a worn toothbrush that is too abrasive and has been wearing away your tooth structure. Replace your toothbrush every four weeks for people who brush twice a day

 

Sources: DeltaDental.com, AskTheDentist.com

 

9 Ways Medicine Can Affect Your Smile

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Many Medications Have Side Effects on Your Oral Health

Generally speaking, medicines are designed to make you feel better. But all drugs, whether taken by mouth or injected, come with a risk of side effects, and hundreds of drugs are known to cause oral issues. Medicines used to treat cancer, high blood pressure, severe pain, depression, allergies and even the common cold can have a negative impact on your dental health.

Some of the most common mouth-related (oral) side effects of medications are listed below.

 

Dry Mouth

Some drugs can reduce the amount of saliva in your mouth, causing an uncomfortably dry mouth. Without enough saliva, the tissues in the mouth can become irritated and inflamed. This increases your risk for infection and gum disease. Antihistamines and other drugs can cause a decrease in saliva, leaving your mouth prone to soft tissue inflammation, pain and infection.

Dry mouth can be a bothersome problem. However, many times, the benefits of using a medicine outweigh the risks and discomfort of dry mouth.Alleviate dry mouth by drinking more water or using sugarless lozenges or gum to stimulate the flow of saliva. Artificial saliva or, in some cases, medication may be recommended by your dentist or physician.

More than 400 medications are known to cause dry mouth. Dry mouth is also a side effect of certain chemotherapy medicines.

 

Gum Swelling

Some medications can cause a buildup of gum tissue, a condition called "gingival overgrowth." Gum tissue becomes so swollen that it begins to grow over the teeth. Gingival overgrowth increases your risk of periodontal disease. Swollen gum tissue creates a favorable environment for bacteria, which can damage surrounding tooth structures.

Gum tissue overgrowth is associated with anti-seizure medications, immunosupressant drugs such as those taken by organ transplant patients, and calcium channel blockers taken by heart patients. Studies suggest that gum tissue overgrowth can be controlled if meticulous oral hygiene is started at the same time or before medication is taken. Tissue overgrowth can complicate oral hygiene. Sometimes, a gingivectomy (a procedure used to remove excess tissue) may be necessary.

 

Fungal Infection

Certain inhaler medications used for asthma may lead to a yeast infection in the mouth called oral candidiasis. Rinsing your mouth out with water after using an inhaler can help prevent this side effect.

 

 

Inflammation of the Lining Inside of the Mouth

Mucositis is inflammation of the moist tissue lining the mouth and digestive tract. This tissue is called the mucous membrane. Mucositis is a common side effect of chemotherapy treatment. Doctors think that certain chemotherapy drugs, including methotrexate and 5-fluorouracil, trigger a complex pattern of biological changes that damage the cells that make up the mucous membranes. Mucositis causes painful swelling of the mouth and tongue and can lead to bleeding, pain, and mouth ulcers. The condition can make it difficult to eat.

 

Mouth Sores

A mouth ulcer refers to an open (ulcerated) sore that occurs inside the mouth or on the tongue. Mouth ulcers are often compared to "craters" because they have a hole in the middle. This hole is actually a break in the moist tissue (mucous membrane) that lines the mouth. Mouth sores may also be called canker sores.

 

Taste Changes, Including Metallic Taste

Sometimes, a medication can alter your sense of taste. A change in the body's ability to sense tastes is called dysgeusia. Some drugs can make food taste different, or they can cause a metallic, salty, or bitter taste in your mouth. Taste changes are especially common among elderly patients who take multiple medications.

Usually the taste changes are temporary and go away when you stop taking the medicine.

Chemotherapy drugs, including methotrexate and doxorubicin, are a common cause of taste changes.

 

Abnormal Bleeding

Reduced blood clotting is a result of aspirin and prescribed anticoagulants, like heparin or warfarin. These medications are prescribed to treat strokes or heart disease, but can cause bleeding problems during oral surgery or periodontal treatment. If you're having dental treatment, talk to your dentist about these medications, especially if the dental procedure involves bleeding.

 

Tooth Decay

Long-term use of sweetened medications can lead to tooth decay. Sugar is an added ingredient in many types of drug products, from vitamins and cough drops to antacids and syrup-based medications. Rinse your mouth out after using such products, or ask your doctor or pharmacist if there is a sugar-free alternative.

 

Tooth Discoloration

In the 1950s, doctors discovered that the use of tetracycline antibiotics during pregnancy led to brownish-colored teeth in children. When a person takes tetracycline, some of the medicine settles into the calcium that the body uses to build teeth. When the teeth grow in, they are a yellowish-color, and they gradually turn brown when exposed to sunlight.

Tetracycline, however, does not cause tooth discoloration if taken after all teeth are formed. It only causes a change in tooth color if you take the medicine before the primary or secondary teeth come in.

Today, tetracycline and related antibiotics are not recommended during pregnancy or in young children (under age 8) whose teeth are still forming.

Cosmetic dentistry techniques like veneers, crowns, bonding procedures, or, in some cases, bleaching may be used to lighten teeth with tetracycline stains.

 

Talk Medications with Your Dentist

Your dentist, not just your doctor, should always know about all the medications you are taking, including over-the-counter products, vitamins and supplements.

 

Sources: American Dental Association, WebMD

 

 

Is There a Link Between Oral Health and Heart Disease?

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Help Your Heart by Taking Care of Your Gums

Paying attention to your dental hygiene and health - especially your gums - may pay you back with more than a gleaming, healthy smile and manageable dental bills. It may keep your heart healthy too.

Did you know that the plaque that develops on your teeth is the same plaque that causes heart attacks? The most common type of bacteria in dental plaque can escape into the bloodstream, travel through the arteries, and result in blood clots that can cause fatal heart attacks.

The Heart and Mouth Connection

The American Heart Association published a Statement in April 2012 supporting an association between gum disease and heart disease. The article noted that current scientific data do not indicate if regular brushing and flossing or treatment of gum disease will decrease the incidence, rate or severity of the narrowing of the arteries (called atherosclerosis) that can lead to heart attacks and strokes. However, many studies show an as-yet-unexplained association between gum disease and several serious health conditions, including heart disease, even after adjusting for common risk factors.

There are two different connections between heart disease and your oral health:

1.      Studies have shown that people with moderate or advanced gum (periodontal) disease are more likely to have heart disease than those with healthy gums.

2.      Oral health holds clues to overall health. Studies have shown that oral health can provide warning signs for other diseases or conditions, including heart disease.

“The mouth can be a good warning signpost,” said Ann Bolger, M.D., William Watt Kerr Professor of Clinical Medicine at the University of California, San Francisco. “People with periodontitis often have risk factors that not only put their mouth at risk, but their heart and blood vessels, too. But whether one causes the other has not actually been shown.”

Common Association

Periodontitis and heart disease share risk factors such as smoking, age and diabetes, and both contribute to inflammation in the body. Although these shared risk factors may explain why diseases of the blood vessels and mouth can occur simultaneously, some evidence suggests that there may be an independent association between the two diseases.

People with periodontal (gum) disease are nearly twice as likely to suffer from heart disease, according to the American Academy of Periodontology. The following diseases have been linked to plaque:

·        Bacterial endocarditis - a condition in which the lining of the heart and heart valves become enlarged

·        COPD (chronic obstructive pulmonary disease)

Overall, people who have chronic gum disease are at higher risk for a heart attack, according to the Academy of General Dentistry (AGD). Gum disease (called gingivitis in its early stages and periodontal disease in the late stages) is caused by plaque buildup along and below the gum line. It has been suggested that inflammation caused by gum disease may also trigger clot formation. Clots decrease blood flow to the heart, thereby causing an elevation in blood pressure and increasing the risk of a heart attack.

Dentists can help patients who have a history of heart disease by examining them for any signs of oral pain, infection or inflammation. According to the AGD, proper diagnosis and treatment of tooth and gum infections in some of these patients have led to a decrease in blood pressure medications and improved overall health. If you currently have heart disease, make sure to tell your dentist about your condition as well as any medications you are currently taking. Remember to carefully follow your physician’s and dentist’s instructions about health care, and use any prescription medications, such as antibiotics, as directed.

Warning Signs

Gum disease affects 80% of American adults and often the condition goes undiagnosed. Warning signs that you may have gum disease include:

·        Red, tender or swollen gums

·        Bleeding gums while brushing or flossing

·        Gums that seem to be pulling away from your teeth

·        Chronic bad breath or a bad taste in your mouth

·        Teeth that are loose or separating from each other

The best way to be proactive in maintaining your oral and overall health is scheduling regular dental checkups, getting professional cleanings and regular brushing and flossing.

 

Sources: Heart.org (American Heart Association), MouthHealthy.org (American Dental Association, DeltaDentalIns.com

 

 

Patient Spotlight: Bobby Gunther Walsh

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A Prince of  A Grandpa

You may know Bobby Gunther Walsh as the morning voice of 790 WAEB radio, but when he’s not on the air he’s really a prince… of sorts. Gunther just had a vacation in late August and spent his days off with two of his favorite people - his two granddaughters, who are 7 years old and 5 years old.

“We went to several amusement parks,” says Gunther with a smile. “Knoebels, Sesame Place and Dorney.” As for parks, he also likes to take his two princesses to The Bethlehem Rose Garden. “The girls like to play make-believe. They’ll touch a flower and pretend to fall under a sleep enchantment,” he explains. “I have to go carry them off to rescue them and they wake up.”

Evelynn and Lilah spend a lot of their time with their princely grandpa playing mini-golf and having water gun fights. “I see them several times a week. I’m an usher at my church and the girls help me take collection every Sunday.  They also come to my races,” says Gunther, who drives on a NASCAR modified circuit.

Gunther endorses Lehigh Valley Smile Designs and notes their friendly, relaxed approach. One of his greatest testimonies came when one of his granddaughters had a dental emergency and lost a tooth. “Linda Petrillo from Dental South was the first person I called. She responded immediately and referred us to a pediatric dentist,” he recalls. “It turned out to be no big deal, but that’s how much I trust them.”

Overcoming Dental Fear and Anxiety

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Tips for Taking Control of your Dental Anxiety

Fear and severe anxiety are the reactions of as many as a third of all Americans when they think about going to the dentist. Many will never go at all, and a lot of others will go to the dentist only when absolutely necessary.

However, good oral health is important to your overall health and quality of life. So if you suffer from dental anxiety of fear, here are some tips and ideas that may help you overcome those obstacles and see one of our dentists at Lehigh Valley Smile Designs.

 

How to Overcome Common Reasons for Dental Anxiety

1. Fear of the Unknown

Schedule a meeting time with your dentist to just talk over the procedures and help you better understand what is going to be done and how long it should take. Having knowledge of the process and what to expect can help calm anxiety.

2. Fear of Dental Equipment

Sometimes, the scariest part of the dental visit is having those strange, sharp, metal tools stuck into your mouth. What can help ease this fear is to ask to hold the tools first, just so they don't seem so foreign.

3. Sensitive Gag Reflex

People with a sensitive gag reflex may loathe the part of the dentist's visit where those tabs are put in the mouth for the dental X-ray. These days, newer dentist offices offer digital X-rays.

4. Fear of Loud Noises

Those dental tools can be really loud, and the noise can stir up fear in some people. So, consider wearing earplugs or noise-canceling headphones to block out the sound.

5. Feeling Uncomfortable Lying Back In a Dentist's Chair

Some people may be uncomfortable with something as simple as lying back in the dentist's chair, due to a bad back or some control issues. A simple remedy may be for the dentist to only put the patient half-back so that it's more comfortable. Or, a dentist could provide positioning pillows for people who feel aches and pains for being in a laid-back position.

6. Unable To Breathe Through the Nose

Are you a mouth-breather, who feels like you're being stifled if you can only breathe through your nose? That could be an issue at a dentist visit, where the dentist must work in the mouth, which can make mouth-breathing hard. 

Nasal strips can help patients to help them breathe through their nose. Or, nitrous oxide can help you relax and breathe better - all depending on the situation.

 

Taking Charge

Tell your dentist you are afraid, even when setting up an appointment and make sure the dentist is prepared to listen. If you can't talk about it you can't get over it.

Chances are, visiting a dentist won't be nearly as painful as you expect. Surveys of patients before and after the most dreaded procedures - such as a root canal or wisdom tooth extraction - have found that they anticipated much more discomfort than they actually experienced.

Here are a few tips that may help you overcome your fear of the dentist:

Go to that first visit with someone you trust, such as a close relative or friend who has no fear of dentists.

Seek distraction while in the dentist's chair. Listen to your own music on headphones.

Try relaxation techniques like controlled breathing -- taking a big breath, holding it, and letting it out very slowly, like you are a leaky tire. This will slow your heartbeat and relax your muscles. Another technique is progressive muscle relaxation, which involves tensing and relaxing different muscle groups in turn.

Review with your dentist which sedatives are available or appropriate. Options can include local anesthetic, nitrous oxide ("laughing gas"), oral sedatives, and intravenous sedation.

The best dentists use simple methods to enhance that feeling of control:

They gently explain what the patient will soon feel, and for about how long.

They frequently ask the patient for permission to continue.

They give the patient the opportunity to stop the procedure at any time the patient feels uncomfortable.

They make time for breaks as requested.

Give us a call at Lehigh Valley Smile Designs and make an appointment to meet with one of our dentists to discuss your dental fear and anxiety and how our practice can help you reduce or overcome your fear and get your oral health issues effectively resolved.

 

Sources: WebMD, Huffington Post

 

 

 

Comfort is King When Choosing a Toothbrush

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Americans Invest Nearly 1,000 Hours Each, Brushing Their Teeth over a Lifetime

 Never before has there been such a dizzying array of toothbrushes on the market. Consumers are inundated with new designs, materials, attachments, and colors. How do you choose your toothbrush? Perhaps you have a steady fave bought out of habit, or maybe you’re always on the lookout for a sale, jumping from toothbrush to toothbrush when the price is right. You might spend extra money for style, considering the handle’s shape or color before any other attributes. All of these strategies will get you a toothbrush, but none gets you the best one for the job. Let’s brush up on some history for perspective.

The Toothbrush through Time

Toothbrush design and materials have come a long way and, fortunately, we now have a far better selection than our ancestors did. Early forms of the toothbrush have existed for nearly 5000 years.

Circa 3,000 BC: Ancient civilizations used a “chew stick,” a thin twig with a frayed end. The sticks were rubbed against the teeth to remove food.

500 (or so) Years Ago: Toothbrushes were crafted with bone, wood or ivory handles that held the stiff bristle hair of hogs, boars or other animals.

The 20th Century: The nylon-bristled toothbrush as we know it today was invented in 1938.

 

When to Buy a New Toothbrush

Buy a new toothbrush as soon as the bristles begin to look worn or frayed (usually every three months). A worn toothbrush won’t do a good job of cleaning your teeth.

  • Always replace your toothbrush after an illness. Germs can linger and make you sick again.
  • If you can’t remember the last time you changed your toothbrush, it’s probably time for a new one.

 

Components of a Toothbrush

Bristles: Soft is Safe

Most dentists agree on using a toothbrush with soft bristles. Go gently, too. You may have a penchant for scrubbing your teeth with a stiff-bristle toothbrush; however, this habit can damage teeth and gums. A survey of 700 dentists found that brushing teeth too hard was a leading cause of sensitive teeth.

Hard bristles may cause:

  • Gum tissue to pull back from teeth, which can expose the tooth root and lead to increased sensitivity to heat, cold or certain foods and drinks.
  • Damage to enamel on teeth, which can leave them exposed to cavity-causing plaque.

Head: Size Matters

Consider the toothbrush’s head shape when selecting your tool of choice. Some toothbrush shapes will suit some mouths better than others.

  • Make sure the head allows your toothbrush bristles to comfortably reach your back molars, as some brush heads may be too large or wide.
  • Brush in front of the mirror to make sure you cover every tooth. If it doesn’t, swap your toothbrush for one that does.

Handle: Get a Grip

The handle of the brush should be long enough to hold comfortably. It should neither be too thick nor too thin to hold.

  • Some toothbrushes today have wide handles. This helps you control the toothbrush better. So, choose a toothbrush with a handle that is long enough and wide enough for you to use.
  • A lightweight, plastic handle is very comfortable to use. It helps you to easily maneuver and clean from all directions.  

 

Don’t Buy Dollar-Store Toothbrushes

Five no-name toothbrushes in a package may seem like a steal at a handful of pennies each, but consider the risks. Seeing as you put a toothbrush in your mouth two or more times per day, it’s worth going with a reputable manufacturer.

Leave the Cheap Ones on the Shelf:

  • The product could be from a manufacturer who doesn't care about safety or efficacy.
  • The toothbrushes could be made of inferior or unsafe materials
  • They’re better suited for cleaning grout than oral hygiene.

 

Get the Right-Size Toothbrush for Children

Babies need baby toothbrushes because of their tiny mouths, so it also stands to reason that small children need toothbrushes with smaller heads than adult versions.

Tips for a Toddler Toothbrush:

  • Instead of promising a small toy or sugary treat to reward good behavior at the supermarket or drugstore, let kids choose a new toothbrush with fun colors and graphics from the oral hygiene aisle.
  • Don’t forget to replace a child’s toothbrushes every three months when you replace your own, or possibly more often if they are hard on their brushes.

 

The ADA Way

The American Dental Association (ADA) recommends that you buy the one that you will use and one that displays the ADA Seal of Acceptance. A company earns the ADA Seal for its product by producing scientific evidence that the product is safe and effective. The ADA Council on Scientific Affairs carefully evaluates the evidence according to objective guidelines for toothbrushes.

To Qualify for the Seal of Acceptance, the Company Must Show That:

  • All of the toothbrush components are safe for use in the mouth.
  • Bristles are free of sharp or jagged edges and endpoints.
  • The handle material is manufacturer-tested to show durability under normal use.
  • The bristles won’t fall out with normal use.
  • The toothbrush can be used without supervision by the average adult to provide a significant decrease in mild gum disease and plaque.

 

Toothbrush Selection Bottom Line

At the end of the day, the best toothbrush is the one you’ll actually use. That means the toothbrush handle should fit comfortably in your hand and the toothbrush head should feel comfortable in your mouth and be able to reach every tooth surface. Look for the ADA Seal, your assurance that the product has been objectively evaluated for safety and effectiveness.

 

Sources: The American Dental Association (ADA), Best Health Magazine, Dentalsolutionscreatingsmiles.com