After months of treatment we’ve removed your braces and your new smile emerges. Upon closer view, however, you notice a number of chalky white spots on your teeth.
These pale areas are white spot lesions (WSLs), the result of mineral breakdown from the long-term contact of acid with the enamel surface. The underlying cause is built-up bacterial plaque due to inadequate oral hygiene, and as such WSLs are the beginning stages of tooth decay.
While anyone can develop WSLs, brace wearers are highly susceptible because of the extra care required to clean around orthodontic hardware. Poor dietary habits such as frequent snacking on sugary or acidic foods and beverages also increase the risk of WSLs.
To reduce the risk of developing this condition, brace wearers must give extra attention and effort to daily oral hygiene, including brushing and flossing. The extra effort required in brushing can be aided by specialized toothbrushes designed to clean around brackets and wires, along with prescription-level fluoride toothpastes for added enamel strength. Floss threaders or a water flosser, a device that uses pulsating water under high pressure, may help you maneuver around hardware to remove plaque between teeth. It's also important to maintain a healthy mouth environment by limiting intake of sugary or acidic snacks and beverages, avoiding tobacco or excessive alcohol or caffeine, and drinking plenty of water to keep your mouth from drying out.
If you’ve already developed lesions, it’s important to stop the decay process before it causes more damage. One way is to assist your body’s natural mechanism for re-mineralizing tooth enamel with fluoride pastes or gels or re-mineralizing agents, or undergoing micro-abrasion to repair a tooth’s surface.
To improve a tooth’s appearance a procedure known as “caries infiltration” involves injecting a liquid tooth-colored resin into the lesion, which is then hardened with a curing light. The spot becomes less noticeable and appears more like normal enamel. For extensive defects, conventional bonding with composite resins or porcelain veneers can be used to cosmetically cover the tooth.
Getting ahead of the problem with effective oral hygiene and good dietary and lifestyle practices will keep WSLs at bay while you undergo orthodontic treatment. If they do develop, however, there are ways to minimize their effect and restore the look of your teeth.
Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.
These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.
Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.
In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.
Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.
Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.
If you would like more information on types of toothbrushes, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Manual vs. Powered Toothbrushes.”
All children encounter sickness as they grow; thankfully most of these conditions are relatively mild and fade away in short order. But some children endure more serious, longer lasting conditions. The health of children with chronic diseases can be impacted in numerous ways, including the health of their teeth and gums.
Unfortunately, dental care is often pushed to the side as caregivers understandably focus on the primary disease. In addition, many chronic conditions involving behavior, such as autism, attention deficit and hyperactivity disorder (ADHD) or intellectual disabilities, may inhibit the child’s ability to cooperate with or even perform daily oral hygiene. Many special needs children have an acute gag reflex that makes toleration of toothpaste, spitting matter from the mouth, or keeping their mouths open more difficult. However difficult it may be, though, it’s still important to establish daily hygiene habits to reduce the risk of tooth decay and gum disease.
There are techniques for building a daily routine for children with physical and behavioral limitations. For example, using “modeling and shaping” behavior, you (or perhaps a sibling) brush your teeth with your child to demonstrate how it should be done. If there’s a problem with cooperation, you can also position the child “knee to knee” with you as you brush their teeth. In this way you’ll be able to meet their eyes at a level position and lessen the chance of a confrontation.
We encourage all children to have their first dental visit before their first birthday. This is especially true for children with chronic conditions. The Age One visit helps establish a benchmark for long-term care; it then becomes more likely with regular visits to discover and promptly treat dental disease. This is especially important for special needs children who may have congenital and developmental dental problems, like enamel hypoplasia, a condition where the teeth have not developed sufficient amounts of enamel.
Teeth are just as much at risk, if not more so, in children with chronic diseases. Establishing daily hygiene and regular checkups can reduce that risk and alleviate concern for their long-term oral health.
If you would like more information on oral healthcare for children with chronic diseases, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Managing Tooth Decay in Children With Chronic Diseases.”
Habits — both good and bad — often begin at an early age. They can be defined as recurring, mostly unconscious patterns of behavior, which are acquired by frequent repetition. Wouldn't it be nice if you could start your children off with good, healthy ones? When it comes to oral health, you can!
Practicing good oral hygiene is actually one of the easier habits to instill. The time to start is when your baby's teeth first begin to appear. To clean them, wipe gently with a clean, damp washcloth. Starting at age 2, when more teeth have appeared, you should establish a brushing routine using just a smear of fluoride toothpaste.
In the toddler years, a child-size soft toothbrush with a pea-sized dab of fluoride toothpaste will do the trick. By this time, they should have also put away their pacifiers and stopped sucking thumbs. Continual thumb-sucking past this age can lead to later problems with tooth and jaw development.
Kids soon get used to the feel of gentle brushing, and gradually begin taking over the job. However, they may need help until they're 6 or older, and have gained more manual dexterity. Don't forget to show them how to wiggle the brush back and forth along the gum line, as well as across the biting surfaces of the teeth.
You'll have to periodically confirm whether they did a good tooth-brushing job — but you can also teach them to check their own work. There are over-the-counter products that identify bacterial plaque by turning it a bright color, making it easy for you and your children to see how efficiently they have removed plaque. Another less precise way is to just have them run their tongue over their teeth: If the teeth feel nice and smooth, they're probably clean too. If not, it's back to the sink...
Eating healthy foods, getting moderate exercise, and avoiding sugary snacks between meals are a few more beneficial habits you can foster in your children. As parents, you can set a positive example by doing these things yourselves. The professionals in our office are ready to help you learn, practice and promote these healthy habits.
If you would like more information about instilling good oral health habits in your children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
Vanna White has been a household name for the last 27+ years and is best known as the first female co-host of the game show, Wheel of Fortune. She radiates a warm, friendly, down-home appeal and says when describing herself, “what you see is what you get!” While this is quite true, there is so much more to her. She has received a star on the famous Hollywood Walk Of Fame, has starred in an NBC movie and written a book. She is even featured in The Guinness Book of World Records as TV's most frequent clapper, and most recently started her own line of yarn called Vanna's Choice with half of the proceeds going to St. Jude Children's Research Hospital. And while any one of these accolades could serve as the highlight of a lifetime for most, for Vanna they fall slightly short. Her favorite job is being mother to her son, Nicholas, and daughter, Giovanna.
The following are excerpts taken from an exclusive interview in Dear Doctor magazine, the premier oral healthcare resource for patients and consumers.
What is the secret to her dazzling smile?
Vanna's oral healthcare routine is the same today as it has been since her childhood — and one everyone can follow. She brushes her teeth at least twice a day (morning and at bedtime) and flosses her teeth daily. She also has strong feelings about flossing. “I think that flossing is the most important thing. I believe that dental floss helps a lot as it keeps your gums strong and looking younger.”
What about bleaching, has she done it?
Absolutely! Vanna bleaches her teeth once or twice a year to help retain her naturally white teeth and to offset any discoloration from coffee and an occasional glass of red wine. “I have done over-the-counter and professional bleaching, but I do like the trays my dentist made because they fit perfectly.” She also states, “Anything you can do professionally is probably better because I would assume that a dentist's ingredients are stronger than over-the-counter products.”
Has she had any cosmetic dentistry?
When it comes to answering a question about cosmetic dentistry, Vanna is just as open and honest as she is about everything else — a trait for which she is known. “I had a bridge put in probably 30 years ago, where I had a tooth pulled and there was a space. And I did have a little tiny chip on one of my front teeth years ago that my dentist fixed. But that is it. Again, I feel very fortunate to have good teeth. The braces [from her childhood] straightened them out and there has been no need for any cosmetics since then.”
Does she do anything to protect her teeth?
While she admits to occasionally forgetting to use her nightguard, a protective mouthguard worn during sleep, she firmly believes in their need. “I do sleep in a nightguard because I grind my teeth. I have a filling in the back that probably has been filled five times from grinding.” She added, “Both of my children do have mouthguards that they wear for their sports.”
Want a smile like Vanna's?
Contact us today to schedule an appointment or to discuss your questions about bleaching, cosmetic dentistry or mouthguards. You can also learn more about Vanna by reading the entire interview in the Dear Doctor article, “Vanna White — The Smile Defining America's Favorite Game Show — Wheel Of Fortune.”