Gum disease (gingivitis) and tooth decay are primarily caused by dental plaque. Dental plaque is a whitish, sticky film that accumulates daily along the gumline and on the surfaces of your teeth. Composed of bacteria, it is controllable through good oral hygiene habits — most importantly, effective brushing.

Controlling plaque and preventing gingivitis and tooth decay will make it more likely that you keep your teeth through your lifetime and will also improve your general health. Scientific studies have linked gum disease and diseases of the heart and circulatory system.

“I know how to brush my teeth. I've been doing it since I was a toddler,” you may be saying. But you may not be performing this daily ritual in the most effective way.

Let's take another look at tooth brushing. First, your grip: Hold the brush in your fingertips with a light pressure. Position the brush so the bristles are at a 45 degree angle to your gumline, and then brush with a gentle scrubbing motion. Don’t scrub too hard, or you may damage your sensitive gum tissue.

Some electric brushes can remove plaque more quickly than a regular hand-held brush, but if you brush well any kind of brush works. A brush will last several months. Get a new one when the bristles become worn or splayed out.

Use a toothpaste that contains fluoride. When used consistently, fluoride toothpastes make your teeth more resistant to decay. Spit out the toothpaste after brushing, but don't rinse or you will wash the fluoride away.

After brushing, complete your cleaning job by using floss to clean between your teeth where the brush does not reach. Wrap it in a “C” shape around each tooth and move it vertically up and down, removing plaque from the tooth surfaces where your teeth meet. You can also use an antibacterial mouth rinse.

Thoroughly clean your teeth at least once a day, brushing and flossing. A plaque film takes 12 to 24 hours to form itself again.

To be certain you are brushing correctly, ask our office or one of our hygienists to demonstrate brushing techniques for you in your own mouth. You can also assess the quality of your brushing technique by checking with your tongue after brushing to make sure your tooth surfaces feel smooth and slick. Your gums should not bleed after brushing. Bleeding is a sign of infection. If you have a habit of consistent brushing but your gums continue to bleed, it's time for a visit to our office.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”

Often perceived as a cancer that only affects older adults who have a history of heavy tobacco and alcohol use, oral cancer is now on the rise among younger adults as well. New research has found a link between oral cancers, and the Human Papilloma Virus (HPV), a disease that is primarily spread through oral sex.

Importance of Screening: If you're concerned about oral cancer, rest assured that our office routinely carries out a cancer screening exam on every patient. We have several ways to painlessly detect abnormal tissues in their earliest stages. In addition, please contact our office if you experience any of the following signs or symptoms:

• White and/or red patches in the mouth or on the lips
• A bleeding or ulcerated sore in the mouth
• A sore anywhere in your mouth that doesn't heal
• Persistent difficulty swallowing, chewing, speaking, or moving your jaw or tongue

Although all of these symptoms can also be signs of less serious problems, be sure to alert our office if you notice any of the above changes.

Prevention: you can take a proactive role in preventing oral cancer by:

• Conducting an oral self-exam at least once a month. Use a bright light and a mirror, look and feel your lips and front of your gums, the roof of your mouth, and the lining of your cheeks.
• Scheduling regular exams in our office. The American Cancer Society recommends oral cancer screening exams every three years for people over age 20 and annually for those over age 40.
• Refraining from smoking or using any tobacco products and drinking alcohol only in moderation.
• Eating a well balanced diet.
• Practicing safe sex.

Contact us today to schedule an appointment to discuss any questions you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Risk Factors for Oral Cancer.”

We have learned that an important part of oral health is education — but more importantly, making it fun to learn so that you retain (and apply) what you learn! For this reason, we have put together the following self-test so that you can quickly access your knowledge on the subject of mouthguards.

1. The first sport to use (and require) protective mouthguards was:
   1. football
   2. boxing
   3. baseball
   4. ice hockey
2. Research conducted by the American Dental Association (ADA) found that individuals are ___ times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise.
   1. 10
   2. 20
   3. 40
   4. 60
3. As a rule of thumb, females do not require mouthguards because they are not as physically active as their male counterparts.
   1. True
   2. False
4. The American Academy of General Dentistry (AAGD) reports that mouthguards prevent more than ______ injuries to the mouth and/or teeth each year.
   1. 200,000
   2. 300,000
   3. 400,000
   4. 500,000
5. Which of the following sports or activities does the ADA recommend that participants wear protective mouthguards:
   1. acrobatics
   2. bicycling
   3. handball
   4. all of the above
6. The US Centers for Disease Control (CDC) reports that more than ______ sports-related injuries end-up in the emergency room each year with injury or damage to the teeth and mouth.
   1. 275,000
   2. 425,000
   3. 600,000
   4. 735,000
7. Over-the-counter mouthguards are just as effective as professionally made mouthguards.
   1. True
   2. False
8. In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending ______ per tooth over a lifetime for teeth that are not properly preserved and replanted according to the National Youth Sports Foundation for Safety.
   1. $10,000 to $20,000
   2. $15,000 to $25,000
   3. $25,000 to $35,000
   4. Less than $10,000

Answers: 1) b, 2) d, 3) b, 4) a, 5) d, 6) c, 7) b, 8) a

You can learn more about the importance of mouthguards when you continue reading the Dear Doctor magazine article “Athletic Mouthguards.” And if you have already experienced a dental injury, it may not be too late. However, we need to evaluate the damage so that we can establish a plan for restoring optimal oral health. Contact us today to learn more about protecting your mouth and teeth or to schedule an appointment.