We at Solly Family Dentistry are dedicated to continuing education and providing relevant information for the public. So here we have compiled monthly blogs for your enjoyment.
Do I need to take antibiotics before my dental appointment if I have an artificial joint?
I get asked this question from my patients all the time and I hope this blog post will clear things up or at least make things more clear. Current guidelines (released by the Royal College of Dental Surgeons of Ontario (RCDSO) in collaboration with the American Dental Association (ADA) and American Academy of Orthopaedic Surgeons (AAOS)) state that antibiotics should not be taken before dental procedures in patients with joint replacements (unless the patient has conditions that compromise their immune system). Before our current guidelines, it was recommended that patients with joint (hip and knee) replacements take antibiotics before dental treatment to prevent infections of their artificial joints.
Why the change in guidelines?
The ADA and AAOS systematically reviewed all the relevant scientific literature and found that taking antibiotics does not seem to prevent bacterial infections of prosthetic joints. What is worse is that a consistent exposure to antibiotics could lead to the very serious problem of antibiotic resistance, i.e. the development of bacteria that are resistant to our routine, regular and normally effective antibiotics. This will result in the use of other 2nd, 3rd and 4th line antibiotics that have many more side effects and/or are not as effective.
The rapid rise of bacterial strains resistant to multiple kinds of antibiotics is a big problem in the medical field right now and is a problem that is close to my heart. Before my life in dentistry, I co-authored a couple of scientific research articles on the topic of antibiotic resistance. Although there is active research into the development of new antibiotics to counteract these multiple drug resistant bacterial strains, this development has plateaued and we all have a duty to reduce the overuse of antibiotics.
What if my orthopaedic surgeon tells me to take antibiotics before a dental procedure?
Keep in mind that these are guidelines mentioned above are only guidelines and we always comprehensively analyse each one of our patients’ situation individually. While antibiotics are not required before dental treatment in most cases, we would consult with the orthopaedic surgeon and a decision would be made on whether antibiotics would be prescribed (taking into consideration medical conditions that compromise the immune system, overuse of antibiotics, etc.)
As always, we are happy to answer any questions you may have. Take care.
Periodontal Maintanence Therapy, 3-4 month appointments.
Though most people come in for dental hygiene appointments every 6-9 months, however, some people may benefit by coming in every 3-4 months. How often you need a hygiene visit depends on several factors. For example, the condition of your teeth can affect accumulation of plaque and calculus. Crowded teeth, fillings, missing teeth or periodontal disease are all cases which can lead to increased plaque buildup. Therefore each person will have a different dental hygiene schedule.
If you have periodontal disease, you may require scaling and root planing to remove the diseased deposits from the roots and teeth, which is the most conservative approach for treatment. Other treatment, including surgery, may also be required. After the disease process is under control, you will require special ongoing gum and bone care procedures, known as Periodontal Maintenance Therapy, to keep the disease under control and keep your mouth healthy.
When periodontal disease is first found, it is treated with scaling and root planing to remove plaque, tartar and bacteria from beneath your gum line. This treatment disrupts the growth of the bacteria; however, some bacteria remain and may settle back into the pocket where they reproduce. In fact, the number of bacteria doubles every time they reproduce, reaching destructive levels in as few as 90 days.
While there is No Cure for periodontal disease, it can be managed or controlled. A 3-4 month Periodontal Maintenance Therapy Appointment/Recare is a soft tissue management program that is a non-surgical approach to control Periodontal Disease. It is the most conservative approach to prevent more extensive and aggressive treatment. The bacterium that causes periodontal disease re-establishes 3 months after treatment. A 3 Month Periodontal Maintenance Appointment is critically timed to disable the destructive process at its critical stage. This critical stage is when the bacteria and their toxins do the most harm to the supporting structures. Waiting longer than three months for Recare may result in advanced inflammation and may require anesthesia to eliminate discomfort when treating. Your Recare interval, whether 3 or 4 months, will be determined by the hygienist and the dentist to best manage your oral health. Very rarely would it be advisable to try a 6 month Recare schedule with known periodontal problems. This would result in putting the client at risk for more breakdowns.
Therefore, we recommend that you maintain a 3-4 month Periodontal Maintenance Schedule, so the hygienist can access deeper pocket areas and disrupt the bacteria so that they do not continue to multiply and cause increases in pocket depth and additional bone loss.
Many clients ask their dental hygienists how they can best care for their dental health at home. Here are the top actions you can take at home to maintain your oral health.
Brush your teeth twice daily for 2 minutes at a time using a soft or extra soft bristled toothbrush.
Change your toothbrush every 3-6 months.
Floss daily. Cavities often begin between the teeth where both plaque and food particles can remain trapped.
In collaboration with regular dental cleanings and daily flossing, brushing our teeth is an integral part of maintaining oral health. It is an essential step in plaque removal as well as cavity prevention. Ideally, brushing should be completed twice a day for a full two minutes. As a dental hygienist, I like to stress the importance of using a soft bristled toothbrush as well as light pressure when brushing your pearly whites. Now matter how busy we are or how rushed we become, our teeth do not deserve the aggression we are all, on occasion, guilty of subjecting them to. Some habits are hard to break, but when it comes to scrub brushing your teeth, the sooner, the better.
Over continued subjection to aggressive brushing our gums will begin to recede. This will result in exposing the tooth’s root surface. Immediate results of this transformation consist of sensitivity, typically to hot, and more dominantly, cold. It is also not abnormal to experience discomfort on regular brushing.
The root surface, now exposed as a result of gum recession, is composed of softer layers than the enamel found on the crowns of our teeth. These layers, cementum (outer) and dentin (under), are subject to wear, leading to the formation of “notches” on the root surface. These notches, commonly referred to as toothbrush abrasion, can generate further sensitivity and jeopardize the integrity of the tooth. A common solution to this issue is bonding, which is placed in the grooves to help re-contour the tooth and prevent further abrasion.
This root surface exposure also leaves the tooth more vulnerable to cavities. The softer surface of the root provides less defense against oral bacteria and acids, increasing the possibility of cavity formation.
So how can we prevent this abrasion from occurring? A few small changes, is all it takes!
Replace any medium-hard bristled toothbrushes with soft. Soft toothbrushes are much less abrasive and as a result, will help to prevent further gum and tooth damage.
Change the technique used to brush your teeth. Place the head of your toothbrush with the tips of the bristles at a 45-degree-angle to the gum line. Opposed to a long sawing motion, use short strokes similar to a vibrating motion. This can be followed with a sweep, away from the gum line, to remove all disrupted plaque.
Electric toothbrushes are a great way to alter aggressive brushing habits. Allow the toothbrush to do the work. It is already doing the vibrating action for you! Some electric toothbrushes come with the added feature of warning us if we are using potentially damaging pressure. Look for pressure sensitive or pressure senor toothbrushes.
Avoid abrasive toothpastes. Studies have shown that the type of toothpaste we use can contribute to the abrasion process. Whitening agents and polyethylene microbeads (appearing as little blue dots within the toothpaste) found in various brands of toothpaste are examples of these abrasives. In addition to finding a toothpaste that is minimally abrasive, I suggest finding one with fluoride. Fluoride helps strengthen enamel and prevent cavities. Also, toothpastes, such as Sensodyne and Colgate Pro-Relief, can help create a protective coating and reduce sensitivities to hot and cold.
Lastly, slow down and take your time! Brushing is not a race; thoroughness is what is required for plaque removal, not aggressiveness. There are no added benefits to brushing hard.
Xerostomia (a.k.a dry mouth)
WHAT IS XEROSTOMIA?
Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease, but may be a symptom of various medical conditions, a side effect of head and neck radiation, or a side effect from various medications.
SIGNS & SYMPTOMS
Speaking, swallowing and wearing dentures
Difficulty eating certain foods
Tongue sticks to the roof of the mouth
Complaints of taste alterations and a painful tongue
Increased need to drink more liquids.
Dry mouth may lead to…
Increased dental cavities
Cracking and Swelling of the lips
Swelling and /or ulcers of the tongue
Salivary gland infection
MEDICATIONS THAT CAUSE XEROSTOMIA
There are tons of medications that can cause xerostomia. I have listed some of the more common medications below.
Antihistamines – helps treat for allergies
Antidepressents – help treat depression
Antipsychotics - psychiatric mediation
Antihypertensives –helps reduce high blood pressure
Anti-parkison agents – helps with Parkisons disease
Anorexiants – helps reduce appetite and food consumption
Anticholinergics – helps with asthma
Diuretics – helps with urination
Sedatives – helps calm, or aids in sleep
Things to Avoid:
Mouthwashes containing alcohol
Over the counter allergy and cold medicines
Things to start/continue:
Chew sugar free gum
Frequent sips of water
Add moisture to the air with a humidifier
Use a fluoride toothpaste and fluoride mouth rinse
Try saliva substitutes (Mouth Kote, Oasis Moisturizing Mouth Spray, Biotene Oral Balance, Optimoist)
FOODS to AVOID if you have XEROSTOMIA
Acidic Foods and drinks such as vinegar can be irritating to mouth.
Salty nuts and crackers can also be irritating to your mouth, try to sip water while eating.
Spicy Foods: such as hot sauces once again can be very irritating.
Sugary Foods and Drinks: Saliva helps with digestion by breaking down sugars. Without saliva flow your risk of cavities is increased. Try to brush or rinse your mouth with water after consuming these items.
Dry Foods: Dry foods have sharp edges likes crackers, toasted breads, cookies, and chips, try moistening foods or taking small bites.
Dried fruits, and bananas can also be difficult to swallow, once again try sipping water to help lubricate the food.
Tough Meats can be challenging, softer meats can be much easier to eat.
Alcohol: Avoid drinks containing alcohol or caffeine (for example, coffees, teas, some pops, and chocolate-containing drinks). Did you know, alcohol increases water loss by triggering frequent urination?
FOODS THAT HELP WITH XEROSTOMIA
Drink water while eating.
Use sugar free gum, or xylitol gum or lozenges to stimulate saliva flow. Good choices for flavors are: cinnamon, citrus/lemon or mint flavors as they stimulate your saliva glands.
Eat foods that are cool or room temperature and moisten with broths, soups, sauces, gravy, creams, butter or margarine.
Try teas: chamomile or ginger (non-caffeinated)
Fresh or canned Fruits and vegetables, especially oranges and peaches.
Popsicles, smoothies, slushies’ are great.
Liquid diet replacements
Cavities Happen – Even to the Dentist’s Kids
I will never forget that fateful day when I was diligently brushing my 3 year old’s teeth and I noticed it – a big dark shadow on one of her molars. How could this have happened, I thought? Dave and I brushed her teeth twice a day and yet there it was, a cavity!
So, I confess, my kids get cavities too. And like most parents whose kids receive this diagnosis, I felt terrible. Where had we gone wrong? Well here are some things that 10 years of dentistry and 3 kids have taught me about this subject.
First of all, timing is everything. It is not realistic to keep all sugary treats away from our kids but if we are selective about which treats they have and when they have them, we can minimize their risk of developing cavities. First, eliminate soft drinks and minimize juice intake from your child’s diet. Never put juice or other sugary drinks in bottles or sippy cups because children tend to walk around with them, taking small sips all day. Each time your child sips, their teeth become re-saturated with sugar which allows the bacteria in their mouth to make the acids that create cavities. Instead, put only water in sippy cups, consider diluting juice with water and encourage children to only drink sugary beverages with meals. Also, avoid giving your children sticky snacks (granola bars, fruit roll-ups, Welch’s fruit snacks, jelly beans, raisins, dried cranberries, dried blueberries) in the middle of the day, when brushing is not an option. I learned this one the hard way. When Sophia was 2, we were potty training and rewarding her with mini jelly beans. She got 1 mini jelly bean around every 4 hours, so maybe 5 candies total per day … big deal I thought. She had a nutritious diet, we brushed every morning and night and other than those few tiny jelly beans, she had no sugar. But there it was, a big cavity in her molar.
What I never considered was that the candy was sticking in the grooves of her teeth, increasing her teeth’s exposure to the sugar. So even though she was not getting a lot of sugary snacks, her teeth were still exposed to sugar for a prolonged period of time due to the snack’s sticky consistency. Does this mean that my kids don’t get raisins or the occasional jelly bean? No, but these snacks are given after dinner, when I know their teeth will be brushed readily. During the day and in school lunches I try to give muffins, popcorn or cookies instead.
Secondly, I want to stress the need to floss your child’s teeth. Many children have spacing between their baby teeth and therefore it is assumed that flossing is not required. Unfortunately, much of the decay we diagnose exists in between children’s teeth (especially the molars). Brushing alone cannot eliminate the food and plaque that accumulates between teeth, so floss your kid’s teeth and teach them how to floss their own. If these habits begin when they are young, they will carry them on into adulthood.
Thirdly, watch for those 6 year molars. At around the ages of 6-8, your child’s first permanent molars will begin to erupt behind their existing baby molars. The problem with these teeth is that they tend to have deeper grooves and take a long time to erupt to the height of the other teeth. Although most 6 years olds are capable of brushing their own teeth, these teeth are often missed by the toothbrush because they stay sunken relative to the surrounding teeth for up to a year. This means that plaque and food can accumulate in the grooves of the teeth creating a cavity in the tooth before it is even fully erupted. My 7 year old is a very diligent brusher but I often noted that her 6 year molars were still full of plaque when she was done brushing. So I recommend doing an occasional spot check of these areas. Help them brush these “hard to get to” teeth or teach them how to tip their toothbrushes to make sure it is making contact with these sunken surfaces. Also, once the teeth are fully erupted, have your dentist place sealants.
So there you have it, brushing twice a day is not enough. We need to limit how often and for how long our children’s teeth are exposed to sugary snacks, floss them regularly and watch out for those 6 year molars.
Your smile is a powerful tool. Your smile lights up a room making everyone feel better. Your smile attracts all people, young and old alike. A nice, evenly coloured and shaped smile may give you the advantage when it comes to getting employment. Do not underestimate the power of your smile!
Too many of us don't smile at all or we keep our lips shut, so as not to show our teeth. Therefore, we lose that power our smile can give us.
In Today's dental offices there are so many ways to help people get back to smiling that it is a shame not to explore your options. Often we think that "braces" are for teenagers. Not so, in todays world there are different ways to straighten your teeth, such as conventional metal brackets (or clear brackets), as well as Invisalign. Invisalign braces are clear trays worn over your teeth in a specific series that will, in a predictable amount of time, straighten your teeth.
Other methods of improving your smile would be to whiten the colour of your teeth. This is usually done by having a set of custom trays made to fit your teeth and applying gel in them and wearing them in a few hours a day for 1 or 2 weeks. We can also do an in-office laser whitening session that brings up the shade in about 1 hour.
Veneers offer a nice result. You would come in for a visit and have your front teeth prepared to accept a thin porcelain tooth shaped front (kind of like a false nail). This is then bonded to your tooth and the results are beautiful.
For missing front teeth, implants are an excellent way to "put back" those teeth. They are permanent and don't come in and out the way dentures or partial dentures do.
You never really hear anyone saying, "Gee, I with I didn't have this nice smile". So why not go to your dentist and at least explore your options of having that great smile?
Basic Oral Care During Cancer Treatment
Oral complications of cancer therapy are the most common reasons for altering or discontinuining cancer therapy. Oral complications affect comfort, nutrition and communication. Major purposes of oral care are to maintain normal function of oral tissues, to maintain comfort and reduce risk of bleeding and infection. Patients should have an oral examination before initiation of cancer therapy.
Basic Oral Care Plan
- use a small, ultra soft ,round headed bristle toothbrush
- rinse toothbrush in hot water to soften before using
- use a prescription strength fluoride toothpaste (e.g. Prevident, fluoridex, X pur)
- spit out the foam but do not rinse mouth
- use remineralizing pastes (e.g. MI paste, Oral Science)
- brush tongue gently from back to front
- rinse brush after use in hot water and allow to air dry
- change brush when bristles are not standing up straight
- if gingival tissue bleeds for more than 2 minutes, brushing may be stopped and teeth can be cleaned with clean, moist gauze or foam swab
- floss at least once daily
- waxed floss may be easier to use and minimize trauma to the gums
- if flossing causes bleeding of the gums which does not stop after 2 minutes, it should be discontinued
- patients who have not flossed routinely before cancer treatment should not begin flossing at this time
- rinsing the oral cavity helps maintain the moisture in the mouth, removes the remaining debris and toothpaste and reduces the accumulation of plaque and infection
- patients should rinse, swish and spit with a bland rinse (1 tsp salt, 1 tsp baking soda in 4 cups of water- mix daily and do not refrigerate) several times after brushing or flossing and as needed
- club soda should be avoided due to presence of carbolic acids
- commercial mouthwashes with alcohol base are not recommended
Moisturizing the oral cavity
-moisturize the mouth with water or artificial saliva products (e.g. Moi-stir Spray, Biotene products)
- avoid glycerine or lemon-glycerine swabs as they dry the mouth and do not moisturize
- apply lubricant after each cleaning , at bedtime, and as needed
- frequent rinsing as needed with bland mouth rinse
- to keep lips moist and to avoid chapping and cracking use water soluble lubricants, lanolin (wax-based) or oil based (mineral oil,coco butter) lubricants
- apply lubricant after each cleaning , at bedtime and as needed
- petroleum based products should be avoided
- do not touch any lip lesions
Good oral care is fundamental in preventing and decreasing complications and has the ability to modify the acute and long term effects of cancer therapy.
Having spent 11 years in this great profession I have been able to have seen some changes. While they don not include such things as a belt driven hand peice or beeswax fillings found in Slovenia from 6500 years ago, I continue to embrace them.
Yup, that's right, dentistry has been around for about 7000 years. Dating back to the Indus Valley Civilization. During the middle ages dentistry was not a profession in itself, and often dental procedures such as extractions to remove diseased teeth were performed by barbers and physicians.
While finishing my training in 2003 I was exposed to many restorative procedures such as gold foil, amalgam and resin to name a few. Gold foil although a great restoration when done properly, had fallen out of dentistry before I made it on the scene, most likely due to the high cost of gold and the technique sensitivity required to place a quality restoration.
Amalgam fillings have been recorded to have been around from the 1500's and are still used today. Although sometimes falling out of favour due to poor esthetics and possibly health concerns, Amalgam has remained a vital tool in maintaining teeth in the oral cavity.
Resin restorations or tooth coloured fillings have really gone through some changes in the past 20 or so years. In the early days of bonded dentistry the fillings did not match the tooth colour well and the bonding agents did not stick to the tooth well enough to keep the fillings in for too long. It is at a stage now that a dentist can place a very perdictable and esthetic filling to conserve tooth structure by having the filling bonded to the tooth.
Another area that I have really watched change has been tooth replacement. Dental implants have changed the way we look at replacing missing teeth. With the first titanium dental implant placed in 1965 by Per-Ingver Branemark, we have gained close to 50 years of information in this area.
Where we used to look at a three unit bridge to replace a missing tooth, grinding and taxing two adjacent teeth to become abutments and creating a plaque trap. We now can often replace that tooth with a single implant supported crown and not have to touch the adjacent teeth.
Likewise where a patient has been strugling with loose fitting dentures, we can get implant fixtures stabilized in the jaw bone and have the dentures either snap on the implants or be fixed to them. This allows the patient the freedom to eat the foods he/she desires and create a healthier lifestyle.
The newest area of dentistry that has touched my life has been cad/cam technology, and in particular its relation to implant dentistry.
Gone are the days where a dentist has to guess at or be surprised by the volume of bone in an area he/she plans on placing a dental implant. Now we are able to have a computed tomography or CT image done of the jaw that can give us an exact measurement of the structures and their locations in the jaw, like teeth and nerves. This image will also show us the volume that we have in certain areas we plan to place an implant.
To take it even further the information from the CT can be imported into a soft ware program that allows the dentist to plan the surgery on the computer, using digital replicas of the patients jaws. The dentist can digitally place the implants in strategic positions to create the best outcome. Now the best part. The planned out digital surgery information is sent to what is called a 3D printer.So this unit is able to print a stent or a plastic retainer like product that will fit very intimately into the patients mouth. This stent has holes positioned in it that are in the exact locations that allow the dentist to drill through and place the implant through. Using this technology the dentist can gain incredible accuracy in implant location and provide a very predictable outcome.
I love technology and I love how this great profession continues to out do itself.
I look forward to what is ahead of us in dentistry.
Overcoming dental phobia
Dental phobia and dental
anxiety can be overcome. Don’t let dental phobia stop you from seeking regular
dental care. Fear is a learned behavior and therefore it can be unlearned.
Anyone can be affected by dental phobia. It doesn’t matter if you are young or
old, a man or a woman. With proper steps and some patience, those fears can be
minimized so that you feel comfortable in the dental chair.
Dental phobia can have
wide ranging consequences on a person’s life. Not only does their dental health
suffer, dental phobia may lead to anxiety and depression. Depending on how
obvious the damage is, you may avoid meeting people, even close friends, due to
embarrassment over your teeth, or avoid jobs that involve contact with the public.
Loss of self-esteem and intense feelings of guilt over not having looked after
one’s teeth properly are also very common.
Some of the best methods
for coping with dental phobia include:
Distraction- Take control
of your mind and allow yourself to be distracted from the dental treatment.
This can be achieved by watching television during the treatment. You may want
to bring headphones in and listen to music to distract yourself while your
teeth are being worked on, this will also help to block out the dental noises
that increase the anxiety and can make the experience much more tolerable.
communication between you and your dentist can go a long way to making you feel
comfortable. Knowing what to expect, and knowing if you feel uncomfortable your
dentist will stop, can make any dental patient feel better. Establishing a
signaling system to indicate the need for a break or some other message can
also give you confidence. Raising a hand while in the dental chair is a
commonly used hand signal. Openly expressing your concerns will let them adapt
to your needs.
Remember that you are not alone in dealing with dental phobia.
If you choose the right dentist and team, they will guide you to overcome your
fears and the visits become easier and easier. You might wonder why you didn’t
do this earlier. Don’t let dental phobia prevent you from being healthy in all
aspects of your life.
‘Tooth’ Be Told
There are many
interesting facts and myths about teeth and dental care. These can often leave
you wondering what the truth really is, so I have decided to share some of
these with you and help you decipher fact from fiction.
The average person spends
approximately 48 seconds brushing their teeth per day. ‘Tooth’ be told,
dentists recommend that you should brush your teeth for at least 2 to 3
minutes. Fun fact: the average person spends approximately 38.5 days brushing
their teeth over their lifetime.
The number of people who
suffer from some form of gum disease is very high. ‘Tooth’ be told, these
diseases are not only detrimental for your mouth health but they can also cause
problems elsewhere in the body. In fact, many diseases are linked to your oral
health such as heart disease, osteoporosis, and diabetes. Regular dental cleanings
can help ensure your mouth remains healthy which can also help to prevent other
diseases in the body.
There is a myth that baby
teeth don’t matter. ‘Tooth’ be told, baby teeth can help children to speak
clearly, chew naturally, and provide a path for permanent teeth to follow.
Many people think that
you will be able to feel a cavity if and when you get one. ‘Tooth’ be told,
mild tooth decay doesn’t cause noticeable symptoms. By the time a cavity gets
to the point of pain, it usually requires a more invasive and expensive form of
treatment, like a root canal or extraction.
There is a common
misconception that if you are going to brush your teeth, you should brush them
immediately after eating. ‘Tooth’ be told, you should wait at least 30 minutes
after eating to brush your teeth. This is because many foods contain acid. As a
result, you need to allow time for your saliva to mix with the acidity and
start to dilute and neutralize it. If you brush your teeth right away, you will
be coating your teeth with acid which can weaken your enamel.
Many people believe that
you can inherit bad teeth or gums from your family members. ‘Tooth’ be told,
you do not inherit bad teeth from your parents. Your daily oral hygiene
determines the health of your teeth and gums.
Many people don’t spend
time thinking about where they should place their toothbrush in the bathroom.
‘Tooth’ be told, you should store your toothbrush approximately 6 feet away
from your toilet to avoid airborne particles from toilet flushing reaching your
It is a common
misconception that placing a cap on your toothbrush will help to keep the
bristles clean and bacteria-free. ‘Tooth’ be told, these caps can increase the
amount of bacteria on your toothbrush as bacteria favour the moist environment
which increases reproduction.
Many people probably
think that dental floss is not a strong material. ‘Tooth’ be told, when it is
braided or knotted together it can be quite strong. In fact, in 1994, a West
Virginia prison inmate braided his dental floss into a rope and was able to use
the rope to scale a wall and escape the prison. If you would like to read more
information about this prison break, click here (http://articles.latimes.com/1994-07-02/news/mn-10984_1_dental-floss)
Many people believe that
those working in the dental field must stray away from sweets. However, those
in the dental field enjoy sweet treats now and again too! ‘Tooth’ be told, the
cotton-candy making machine was actually co-invented by a dentist. This sweet
treat was originally called ‘fairy floss’.
Now that we have set the
truth straight, how about a couple jokes?
A woman and her husband
interrupted their vacation to go to the dentist. “I want the tooth pulled, and
I don’t want Novocaine because I’m in a
big hurry,” the woman said. “Just
extract the tooth as quickly as possible, and we’ll be on our way.” The dentist
was quite impressed: “You’re
certainly a courageous woman” he said. “Which
tooth is it?” The woman turned to her husband and said: “show him your tooth,
Man: “Darling, your
teeth remind me of the stars”
Woman: “Because they
gleam and sparkle?”
Man: “No, because they
come out at night”
The above information was
obtained from the sources below:
Fight, flight or floss?
Having been a dental
hygienist for 11 years, I have come to learn the importance of not only
educating children on why it is equally important to floss their teeth as it is
to brush, but also the importance of educating parents on their role in
assisting and encouraging their children with the regular use of floss.
Flossing does about 40%
of the work required to remove sticky bacteria (plaque) from your teeth. Plaque
generates acid, which can cause cavities, irritate the gums, and lead to gum
disease. Each tooth has five surfaces. If you don't floss, you are leaving at
least two of the surfaces unclean. Floss is the only thing that can truly get
into the space between the teeth and remove bacteria. It doesn't matter what
comes first, brushing or flossing. However, when floss is used prior to
brushing, it allows the toothpaste to better reach the spaces between your
teeth and this is especially beneficial when fluoride is introduced in your
child's toothpaste in the future.
Most children lack the
coordination to brush their teeth on their own until about the age of 6 or 7.
Until this time, the best way to teach children how to brush and floss their
teeth, is to lead by example. Allowing your child to watch you brush and floss your
teeth, teaches the importance of good oral hygiene. Children typically need
assistance with both of these tasks until about ages 7-9.
Many parents wonder how
early they should start flossing their child's teeth. It is recommended that
when two teeth in the mouth contact each other/sit closely together, then it is
time to introduce floss. This happens between the ages of 2-6. At this time,
parents should try to include flossing as a part of their child's daily oral
hygiene routine. As children begin to develop dexterity, parents should be
helping them learn to floss. This is also something your friendly neighbourhood
dental team can help you with. Every child is different, however most children
are able to floss independently around the age of 10.
To help stress the
importance of daily flossing, be sure to floss for your children until they are
fully capable to do it on their own. This will aid in keeping their baby teeth
clean and cavity free, as well as formulate good, lifelong, daily oral hygiene
habits in caring for permanent teeth.
Floss sticks tend to work
best for parents when flossing their toddler's teeth. They are also great for
use on young children as it makes the transition relatively smooth, from the
parent flossing for their child, to the child flossing his/her own teeth.
Encourage your child to lay their head in your lap, open wide like a crocodile
and floss away. Make it fun and tell your child floss is a toothbrush's partner
in 'sugar bug crime fighting'. Or sing a song that your child likes while
flossing. This also serves as one on one bonding time with your child, which
they will remember and appreciate. If your child objects, stay positive and use
a firm approach.
Anything your child
consumes throughout the day, is stuck between their teeth until removed using
floss. Snack favourites like raisins, gummy candies or fruit chews, fruit roll
ups, sweets, chewing gum with sugar etc, all have a time and a place, but are
better consumed when flossing can follow shortly after consumption. Also,
regular consumption of sugary drinks, such as pop and/or juice, can increase
the prevalence of decay in your little one's mouth.
Out of your busy day it will take you approximately 2-3 minutes,
twice per day for brushing, and 3-5 minutes for flossing before bed (and after
sticky snacks), to help your little one care for his/her pearly whites. This
will also most likely result in a cheaper bill upon leaving the dentist!
Do you have fluoride in
your drinking water?
The answer is.. if you
live in Simcoe County, except for Tottenham, you do not have fluoride in your
tap water. If you live in Huntsville, Bracebridge, Gravenhurst, Port Carling,
Bala, Baysville, Mac Tier and Base Borden you do have fluoride added to your
You might be wondering,
what exactly is fluoride? It is a natural element found in rocks and soil. Nature
does put some fluoride in all drinking water but in order to improve oral
health and limit tooth decay, fluoride must be added to the community's water
The benefits of drinking
fluoridated water are a significant decrease in tooth decay and improvement in
overall oral health among children, adults and seniors. This is important as
tooth pain is one of the top reasons people without a family doctor visit the
If you do not have
fluoride in your drinking water, there are other ways to get the benefits of
this decay fighting substance. For instance, from food and beverages such as
black tea, fruits, vegetables, chicken, juices and canned goods, fluoridated
toothpaste or rinses. If you visit your friendly family dentist for regular cleanings,
the hygienist offers topical fluoride treatments in a rinse, gel or a varnish.
Having said all this, can
you have too much of a good thing? Can we get too much fluoride? The answer is
yes as there are other sources for getting fluoride. If a child has too much
fluoride, it is probably because they have swallowed toothpaste which has much
more than the recommended levels. Make sure your child has no more than a smear
amount of toothpaste and spits all toothpaste out after brushing. Excessive
amounts of fluoride usually presents as "dental fluorosis", whitish
lines, mottled areas, or stained and pitted enamel.
What all this comes down to is....know if you have fluoride in
your drinking water, monitor your children when brushing to make sure they spit
and rinse, incorporate foods with fluoride into your diet and visit your
dentist on a regular basis to get optimal oral health for you and your
family.... and most importantly.... keep smiling.
Cleft Lip and Palate
As a Dental Hygienist I
have some knowledge of Cleft Lip and Palate from my formal schooling and from
working as a Dental Hygienist I have treated a number of clients who were born
with some type of cleft. Most of my knowledge comes from being the mother of a
son who was born with Bilateral Cleft Lip and Palate. I also grew up with an
older sister who had Bilateral Cleft Lip and Palate however she was ten years
older than myself so I really didn’t understand the medical / dental procedures
A Cleft is a split or
separation of parts. During early pregnancy separate areas of the face develop
individually and then join together. If some parts do not join properly then
this is a cleft. Cleft Lip and or palate occurs in about 1 in every 700 live
births. The lip forms at about seven weeks in pregnancy and the palate at
eleven weeks. The severity of the clefts varies from a slight notch in the
coloured portion of the lip to a complete separation extending up into the nose
on one side (unilateral ) or both sides (bilateral) The Palate also varies from
just an opening at the back of the soft palate to a complete separation of the
roof of the mouth.
The Cleft Lip and Palate
not only affects appearance but also it affects sucking and the ability to form
certain sounds. If the palate muscles are not attached the estation tubes in
the ears often become blocked and ear infections occur and can result in
hearing loss. Many children have ear tubes placed to relieve pressure in the
ears and prevent further ear infections.
Our first visit to the
Hospital for Sick Children was when my son was 7 days old. He had a dental
impression taken to make a feeding plate which covered the roof of his mouth to
help him to drink from a bottle. There are special bottles that have a softer
nipple and can be squeezed to assist the baby in getting enough milk.
We then met the Plastic
Surgeon and were scheduled for Lip Repair at 3 months of age. We were
instructed how to use tape and elastics to apply pressure to the tissue below
his nose to try to align it up in a favourable position for surgery. One side
of his lip was closed at 3 months and the other side 6 weeks later.
The Palate was repaired
at about 15 months of age.
Speech and Language
Pathology is also very important since it is difficult to make many sounds in
speech. We began going for Speech Therapy at around age 2 and a half and
continued until about age 10.
The Plastic Surgeon also
did further surgeries as my son grew. They did a revision to the scar tissue,
built up the tip of the nose with cartilidge, reshaped the tissues under the
lip and did bone graft surgery to allow the teeth to erupt into the cleft site.
The Orthodontist was
involved from birth with the feeding plate. Then they follow the child
throughout their growing years and try to align the arches to be ready for
braces. My son had an appliance that was called a palate expander followed by a
few years with brackets.
Most children are also
followed by a Dentist to make sure the teeth are well maintained. It is very
important to have excellent home care since teeth may be crowded and difficult
to reach. Teeth may also be malformed of missing . Healthy teeth are needed to
assist with movement of teeth with braces or appliances.
When doing Dental Hygiene on a person who has had a cleft I
realise that this is a personal space for me to work. They have had so much
work done over the years and may be more sensitive due to scar tissue and
experiences they have had to endure over the years. As a Dental Professional I
hope my knowledge will allow me to have empathy for all my patients and make
coming to the dental office a better experience for them.
I can remember, when I
was a new mom, wondering if there was something wrong with my beautiful baby.
All of my friends’ little ones seemed to have teeth coming in by 3 or 4 months
of age. All the moms talked about the excessive drooling, red cheeks, rashes,
sleepless nights, and the irritability of their children. I actually wanted to
be a part of that! It seemed to be almost a badge of honour - a rite of
passage; “My baby has four teeth already” … “Oh, mine has five“. By the time my
baby girl was 9 months old, I started to wonder if she would always have her
beautiful toothless smile.
My dentist told me not to
worry – that this was perfectly normal. In reality, there is no ideal age for a
baby's teeth to start to appear. In fact, some babies are born with one or two
teeth already visible. Typically, between the ages of 4 and 7 months, you might
notice your child's first tooth pushing through the gum. But my child, like
many, was on her own schedule. She waited until she was 11 months old to cut her
first tooth, but then within a week, she had four beautiful white teeth peeking
Before a tooth sprouts,
you might notice your baby’s overlying gums becoming red and swollen. The lower
front teeth are usually the first to appear, and by the time the child is three
years old, all 20 primary teeth will have sprouted. How the process of teething
happens is often hereditary; if the mother and father teethed early or late,
the baby may follow the same pattern. And while some babies experience almost
no discomfort while teething, for others it can be a painful and drawn-out
event. Every baby is different.
By the time my second
child came along, I didn’t focus on the teething – or lack thereof - knowing
her teeth would come in when they were ready. Sure enough, her first tooth came
in when she was 10 and a half months old, and by her first birthday, she
already had 6 pearly whites. My daughters are now in their twenties, and both
have beautiful, strong, healthy teeth.
Helpful tips for teething babies include letting your baby chew
on a cold, hard object such as a water-filled or chilled teething ring,
massaging the gums lightly with a clean finger or some ice, and frequently wipe
your baby’s face to remove drool and prevent a rash from developing. As always,
if you have any concerns about your child’s teeth, consult your dentist.
The current trend in society is becoming more holistic and
increasing its awareness of organic and natural forms to improve their overall
health. Today, I am touching base on the holistic approach to oral care
products. After researching multiple at-home remedies for toothpaste and
mouthwashes, I found that the best product is Tom’s of Maine. Tom’s is the only
oral care product with acceptance from an accredited dental association (ADA)
and with research to endorse the ingredients used in each of their products.
Tom’s has a wide variety of toothpastes and mouth rinses to accommodate adults
and children with multiple flavours/uses for each individual. Tom’s products
can be found fluoride-free or with fluoride added to suit the individuals that
are fighting cavities as well. Tom’s oral care products are made by
distinguished dentists, scientists and herbal experts making effective, and
natural products that deliver key benefits using plants and minerals for over
40 years now. So if you are an individual that is trying to go the natural way,
Tom’s of Maine is the product of choice!
Halloween Tricks and Treats
Ah yes, Halloween is finally over, all the costumes have been
packed away for another year and the candy, chips and chocolate eating has
begun. I actually look forward to Halloween night, after my kids have crashed
from all the sugar they have consumed and are tucked nicely in their beds,
Mommy's trick or treating begins. I tip toe over to their candy bags and pick
my favourites (they never miss it) and hide it where nobody knows, for those
special times when only chocolate can solve the problem. With all the candy
eating, my thoughts turn to the dreaded C word. Yes I'm talking about cavities,
but don't fear, I have some simple suggestions that may save you multiple trips
to see us. If you or your children are not remotely close to a toothbrush after
eating sugary snacks then reach for an apple, the chewing action stimulates the
salivary glands (especially under the tongue) producing more saliva which
washes sugar bugs away. Sugarless gum also does the same thing. Not crazy about
apples try cheese or yogurt, they form a protective barrier around teeth
keeping sugary acids at bay. There you go another great reason to eat more
cheese. Remember on the go, take water in tow.