Mouthwashes - Should I Use One?

Mouthwashes are used as an adjunct to brushing & flossing. Most mouthwashes are effective oral antiseptics that freshen & reduce bad breath; however, other mouthwashes are targeted to specific needs.

The type of mouthwash one should use depends on their specific needs which can include the following:

Anticavity/Fluoride - These mouthwashes contain fluoride. This is a simple, effective, and clinically proven way to prevent tooth decay. Anticavity/fluoride rinses on the market include:

• ACT
• Fluorigard
• Tom's of Maine
• Listerine Total Care

Antiplaque - These are designed to be used as a pre-brushing rinse to help loosen plaque. Studies show only a 20-25% effectiveness in plaque reduction. However, if rinsing, along with brushing & flossing, make you more diligent about your home care, then by all means, rinse away. Plax & Viadent are two OTC pre brushing rinses.

Antimicrobial - Listerine products reduce the bacteria found in plaque, therefore, they help combat gingivitis. Peridex is a prescription strength antimicrobial rinse often prescribed by periodontists and oral surgeons post surgery.

CoQ10 rinses - Helps to prevent and recerse the beginning symptoms of gum disease. One brand name is JASON and can be found online, in health food stores and at Wegmans.

Fun Facts!

Did you know that tooth enamel is the hardest substance in the body?

Snacking on carrots, celery and apples helps clean away food debris!!

Toothbrushes should be changed every 2-3 months and after an illness such as a cold or flu.

(Source- American Dental Hygiene Association)

The above information is for general education purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Which toothpaste is right for you?

Just take a walk down the toothpaste aisle in the supermarket and you are presented with numerous choices. The following information will answer some questions you may have. Characteristics of today's toothpaste include:

• Fluoride- Fluoride can help in the prevention of cavities. Most toothpaste contains fluoride. Studies show that the most effective concentration of fluoride is around .1%.
• Treatment of sensitivity- Sensodyne is the brand widely recognized for the relief of sensitivity. The main ingredients are Strontium Chloride, found in original Sensodyne, and Potassium Nitrate.
• Abrasiveness- We do not recommend a highly abrasive toothpaste.
• Ph level- Toothpastes are mainly base and that is what you want.
• Whitening formulas- These contain tiny mildly abrasive particles that help to remove stain, thus making your teeth look whiter.
• Flavor- Use any that appeals to you.
• Plaque prevention- Colgate Total contains Triclosan to help fight plaque buildup.
• Pronamel- This toothpaste fights sensitivity and erosion or recession. Erosion can be caused by acidic foods. Recession can be caused by over aggressive brushing or periodontal disease. Pronamel helps to strengthen the enamel. It contains Potassium Nitrate and fluoride.

The most important thing to remember is that frequent and effective brushing and flossing along with your toothpaste will help you to maintain good oral health.

The above information is for general education purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Remineralization

Demineralization occurs when acid from bacteria, food, drinks, and our body dissolves the tooth enamel & reduces important minerals from the tooth surface. Remineralization is when important minerals are added back into the teeth where the acid has eroded.

Over the past 10-20 years, there has definitely been a shift in our understanding and management of cavities. Now, rather than focusing on the end result (the cavity), the focus has started to shift to the status of the bacterial plaque and its effects on the demineralization-remineralization process at the tooth surface and subsurface.

What we know for sure is that the tooth can be remineralized. While our body helps to remineralize teeth, there are products available to aid the natural processes. Currently, there are a number of calcium-phosphate-based remineralizing toothpastes, mouth rinses, foams, gels, gum, and more. These products will help patients fight cavities and reverse others that have not progressed beyond the enamel.

There are other ways to treat and prevent tooth decay:

• Increase more arginine in the diet. Eat more spinach, soy, seafood, and nuts.
• Brush with baking soda, or apply your regular toothpaste and then dip it in baking soda.
• Xylitol is a great preventive aid. Look for gum that has xylitol in it.
• Combat dry mouth with hydration and an at home fluoride rinse or gel
  
  

If you have any additional questions or concerns regarding this suject, please feel free to contact us. Our email address is dentalinfo@drdaviddersh.com.

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Teeth Bleaching (Whitening)

A child's baby teeth are generally whiter than the adult teeth that follow. As a person ages, the adult teeth often become darker due to changes in the mineral structure of the tooth and the enamel becoming less porous. Teeth can become stained from bacteria, tobacco, and foods and drinks, i.e. red wine, tea, coffee, soda, and berries. Certain antibiotic medications (esp. tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel. Excessive fluoride can also cause tooth discoloration or mottled enamel.

There are several methods to whiten teeth.

• Bleaching Strips
  
• Bleaching Pens
  
• Bleaching Gels
• Laser bleaching

The degree of whiteness will vary from patient to patient, depending on the individual, the shade and type of staining. Intrinsic staining (stain within the the tooth) is much harder to bleach, and may not achieve the results one is expecting. Tooth mottling from excessive fluoride is also tricky when it comes to whitening because sometimes the mottled spots only become whiter.

Bleaching can be done with over-the-counter (OTC) products or in office at a dental office.

If you're thinking about (OTC) bleaching, we would advise sticking with a reputable brand of a bleaching product, such as Crest, Colgate, or Rembrandt. We advise staying with these companies because they have been around for years and have a long standing reputation to maintain. Therefore, their bleaching products are safe to use. We cannot be sure of the efficacy and side effects of the many other brands that are available.

If you're thinking of using an OTC bleaching product, do not use more than once in a 6 month period. Also, generally, we do not recommend bleaching, whether OTC or in office, for individuals under 18 years of age. It depends on the bone growth completion of the adolescent. This is due to eruption not fully completed or additional jaw growth not yet completed. If done too early, an area not bleached could show up later,on the exposed tooth , making it difficult to match.

Professional dental whitening is performed in a dental office and monitored by a licensed dentist. In office bleaching can be done two ways:

• Gel in trays performed at home (monitored by a dentist)
• Gel and light combination performed at the dental office
  

When performed under the supervision of a dentist, whitening is safe.

The side effects of any bleaching procedure, at home or in office, may include sensitivity and minor tingling sensations. These side effects always dissipate.

If you have any additional questions regarding dental whitening or are thinking about having your teeth whitened, please feel free to discuss it with us at your next visit or call us at (908)-232-8455!

We hope you found this information helpful!

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

Gingival Recession

Receding gums is a condition found most common in adults over the age of 40. Therefore, we felt it would be a topic well received by many of our patients. We hope you find this article beneficial.

Recession refers to the roots of the teeth being exposed caused by a loss of gum tissue or retraction of the gingival margin from the crown of the teeth. Although it is a common problem in adults over the age of 40, it can occur starting in the teens.


There are several possible causes of gingival recession:
* Abnormal tooth position
* Thin, fragile or insufficient gingival tissue
* Overaggressive brushing
* Periodontal disease
* Inadequate brushing or flossing (allows bacteria to build up between the teeth)
* Eating disorders (self inducing vomiting)
* Dipping tobacco (it affects the mucus membrane lining in the mouth and cause receding
gums over time)
* Adult orthodontic movement of teeth
* Piercings in the lip or tongue (wears away the gum by rubbing against it)
* Sensitivity to Sodium Lauryl Sulfate (SLS), an ingredient in most commercial toothpastes

The following signs and symptoms may indicate gum recession:

* Sensitive teeth
* Teeth may appear longer than normal (if gums are receded, a larger part of the crown in visible)
* The roots of the teeth are exposed and visible
* The tooth feels notched at the gumline
* Change in the tooth's color (color difference between enamel and the root)
* Larger spaces between teeth (gums don't fill in between anymore)
* Cavities below the gum line (roots are more susceptible to decay due to the softness of the
root surface)

If gum recession is caused by gingivitis, the following symptoms may also be present:

* Puffy, red, or inflamed gums
* Gums bleeding while brushing or flossing
* Bad breath (halitosis)

The first step to treatment is the address the problem which has caused the recession.

Some advice to arrest the recession or prevent it is:

* Use a soft toothbrush
* Gentle brushing technique
* Improved oral hygiene
* Regular dental check ups and cleanings

For more advanced cases, treatment may include:
* Soft tissue graft surgery which uses tissue from another site in the patients' mouth to replace receded gums
* New research is focusing on using stem cells to culture the patients' own gums to replace receded gums

Most cases of recession can be monitored, coupled with changes in technique or hygiene, and may never require invasive treatment. If you have any questions regarding recession, please feel free to talk to us about it on your next visit, or email us at dentalinfo@drdaviddersh.com.

- Dr. David A. Dersh, Tracy, & Phyllis

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.

The Truth About Thumb-Sucking

Many children have a habit of sucking their thumb. Parents need to be aware of the complications of thumb sucking and when it should be addressed.

Two questions are most frequently asked regarding thumb sucking:

* Does thumb sucking interfere with dental development?
* Does my child need to stop thumb/finger sucking?

Many dentists are satisfied to wait until the child is ready to be seen by an orthodontist; they let the orthodontist "deal" with it.

Preventative dentists would like to see the thumb sucking cease early as to not interfere with the normal processes of orofacial growth and development, but usually not until permanent teeth begin to erupt. Many times as the child starts school , peer pressure can stop the habit.

Most orthodontists feel it is crucial to address the thumb/finger sucking habit by the time the adult incisors (front teeth) begin to erupt.

Dental Complications

If a thumb or finger exerts a force for hours per day against anterior (front) teeth, positional changes of the teeth can occur. The most common changes to the teeth that can occur include the development of posterior crossbites, anterior teeth that overjet, and an open bite of the anterior teeth. The direction of jaw growth may also be affected. Constant pressure of the thumb or finger against the roof of the mouth can also contribute to the development of a narrow, high arched palate.

Other Complications

Thumb sucking can also lead to :

* Abnormal tongue rest and functional patterns
* Altered respiration
* Open rest posture of the lips
* Skin, cuticle infections or calluses

The American Dental Association and the American Academy of Pediatrics agree and believe that until the age of 6, thumb sucking usually does little or no damage to the teeth or the orofacial structure. After age 6, however, chronic thumb sucking may begin to do damage and should be addressed.

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist or physician to determine an individualized treatment plan.

Beware of Acid and the Effects It Has on Your Teeth

We all have our vices. It might be soft drinks, coffee with sugar, wine, fruit and juices, energy drinks, or sucking on hard candies. But are you aware of the harmful effects these can have on your teeth?

The acid in food and liquids can cause irreversible erosion of tooth enamel. The results of the erosion can include, pain, sensitivity, higher incidence of decay, and a darker appearance in your teeth because the layer below the white enamel is a darker shade.

Generally, teeth affected by this type of damage cannot always be fixed with fillings; more often the treatment consists of veneers or crowns.

The following are ways to minimize the damage:

* Limit consumption of high-acid foods and drinks
* Use a straw for soda or juice - it helps minimize contact with the teeth
* Eating acidic foods as part of a meal will help neutralize and eliminate acids. The worst time to consume these foods is just before bedtime (saliva production decreases during sleep)
* Neutralize acid consumption by eating cheese or swishing with water or a fluoride rinse
* Brush your teeth with a fluoride toothpaste 30 minutes before consuming acidic food or drinks is most beneficial
* Chewing sugar-free gum can help stimulate saliva, therefore, neutralizing the acid in your mouth

People who suck on lemon or orange slices, as well as runners who suck on hard candies while they run, are "bathing their teeth in acid". That's not a good idea.

In addition to acidic foods and drinks, people with eating disorders, such as bulimia, are at a high risk of enamel erosion due to the vomiting. Many people have acid relux who are also at risk because of the acid that may be coming into their mouths from their digestive systems.

If you suspect you or a family member may be suffering from any of the above conditions, you should be evalulated by a medical doctor for a diagnosis.

The above information is for general educational purposes only and does not constitute health or medical advice. Consult a qualified dentist to determine an individualized treatment plan.