Charles McGee DDS

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.

When you put food in your mouth, it immediately meets the bacteria that live there.

Plaque, for example, is a sticky film of bacteria.

These bacteria love the sugars found in many foods. So, when you don’t clean your teeth after eating, the bacteria and the sugar can combine to produce acids which can destroy the enamel – the hard surface of the tooth.

In time, this can lead to tooth decay. The more often you eat and the longer foods are in your mouth, the more damage occurs.

Many foods that are nutritious and important in our diet contain sugars – such as fruits, milk, bread, cereals and even vegetables.

So the key is not to try and avoid sugar but to think before you eat.

When you eat is also important because each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

This means that foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, helping to wash foods from the mouth and reduce the effects of acids.

Here are some tips to follow when choosing your meals and snacks.
– Eat a variety of foods from different food groups
– Limit the number of snacks that you eat
– If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit

It’s also important to brush your teeth twice a day and to clean between your teeth daily with floss or interdental cleaners.

And of course regular visits to your dentist will help prevent problems from occurring and catch those that do occur while they are easier to treat.

Your dentist will do everything possible to make your visit as relaxed and comfortable as possible.

Depending on the treatment you are receiving, there are several medications available to help.

Some drugs control pain, some help you relax and others put you into a deep sleep during dental treatment.

The best approach will depend on the type of procedure being undertaken, your overall health – including any history of allergies – and the degree of anxiety you feel.

Some of the options your dentist might discuss include:

Analgesics: These are the most commonly used drugs for relief of toothache or pain following dental treatment. They includes aspirin, acetaminophen and anti-inflammatory drugs such as Ibuprofen. There is a separate category of ‘narcotic analgesics’ – such as those containing codeine – which are used for more severe pain.

Local anesthesia: Topical anesthetics are applied to mouth tissues with a swab to prevent pain on the surface level. They may also be used to soothe mouth sores. Injectable local anesthetics prevent pain in a specific area of your mouth during treatment by blocking the nerves that sense or transmit pain and numbing mouth tissues.

In other cases, your dentist many recommend sedation or general anesthesia.

Your dentist will discuss the best approach to suit your needs.

Dental plaque is a film that builds up on your teeth and, if it is not removed through good oral hygiene, it can lead to tooth decay and gum problems.

Over time it can ultimately form a hard, rough sediment known as dental tartar or calculus, which attracts further plaque buildup.

Calculus has to be removed by a trained professional such as a hygienist or dentist.

They may do this by manual tooth scaling or using an ultrasonic device.

If the buildup is light or moderate, the dentist or hygienist may use manual scaling instruments of various shapes and sizes.

If the buildup of tartar and stains is heavy, an ultrasonic cleaner may be used. This may be followed by hand scaling.

Build up of plaque can cause inflammation of the gums leading to breakdown of the connection between the teeth and the supporting structures.

Root planing is a procedure to treat gum disease by thoroughly scaling the roots of teeth to establish a smooth, calculus-free surface.

This treatment may require local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits

If conditions are more advanced, surgery may be needed for complete debridement of the roots to arrest the disease process.

Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay.

It’s therefore important to follow your hygienist’s advivce on how often to return for regular cleanings – even if your insurance only covers two a year.

If you’ve lost all of your natural teeth, whether from gum disease, tooth decay or injury, complete dentures can replace your missing teeth and your smile.

Replacing missing teeth will benefit your appearance and your health.

Without support from the denture, facial muscles sag, making a person look older. You’ll also find it harder to eat and speak – things that people often take for granted until their natural teeth are lost.

There are various types of complete dentures.

A conventional full denture is made and placed in the patient’s mouth after the remaining teeth are removed and tissues have healed which may take several months.

An immediate complete denture is inserted as soon as the remaining teeth are removed. The dentist takes measurements and makes models of the patient’s jaws during a preliminary visit. With immediate dentures, the denture wearer does not have to be without teeth during the healing period.

Even if you wear full dentures, you still must take good care of your mouth. Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures to stimulate circulation in your tissues and help remove plaque.

And even if you wear full dentures, it’s important to visit your dentist regularly to maintain your overall oral health and get early warning of serious issues such as oral cancer.

While local anesthetics are often used in dental treatment, there is sometimes a need for anti-anxiety agents – such as nitrous oxide – or sedatives to help people relax during dental visits.

Dentists may use these agents to induce “minimal or moderate sedation”.

In this case, the patient reaches a relaxed state during treatment but can respond to speech or touch.

Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce “deep sedation”.

This reduces consciousness and causes a loss of feeling which helps to reduce both pain and anxiety.

Sometimes patients undergo “general anesthesia” where the drugs lead to a temporary loss of consciousness.

A dentist may recommend deep sedation or general anesthesia for certain procedures with children or with adults who have severe anxiety or for people who have difficulty controlling their movements.

While these techniques to control pain and anxiety are used to treat tens of millions of patients safely every year, it’s important that you let your dentist know anything that might affect your ability to benefit from them for example, tell them about any illnesses or health conditions, whether you are taking any medications and if you’ve had any problems with allergic reactions to medications.

Oral cancer is not as well known as other types of cancer but it can represent a life-threatening risk if not identified early.

– It strikes an estimated 35,000 Americans each year
– More than 7,500 people (5,200 men and 2,307 women) die of these cancers each year
– More than 25% of Americans who get oral cancer will die of the disease
– On average, only half of those diagnosed with the disease will survive more than five years
– African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high

Although the use of tobacco and alcohol are risk factors in developing oral cancer, approximately 25% of oral cancer patients have no known risk factors.

There has been a nearly five-fold increase in incidence in oral cancer patients under age 40, many with no known risk factors.

The incidence of oral cancer in women has increased significantly, largely due to an increase in women smoking. In 1950 the male to female ratio was 6:1; by 2002, it was 2:1.

The best way to prevent oral cancer is to avoid tobacco and alcohol use.

Unusual red or white spots can form in and around the mouth. These are often harmless but they can be cancerous or pre-cancerous.

Identifying and removing these early enough is a major factor in reducing the incidence of cancer.

So knowing the risk factors and seeing your dentist for regular examinations can help prevent this deadly disease.

More than fifteen percent of American adults suffer from chronic facial pain.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ’s.

The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and gliding action when chewing and speaking.

Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side.

Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Often, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear.

Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding.
They’ve been successful for many and your dentist can recommend which is best for you.

If you have removable plastic dentures, it’s important to look after them carefully.

You should brush them each day to remove food deposits and plaque. This also helps prevent them from becoming permanently stained.

It’s best to use a brush that is designed for cleaning dentures as it has bristles arranged to fit the shape of the denture. But a regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles as these can damage the denture.

When you are handling a denture, hold them carefully. Try standing over a folded towel or a sink of water with them in case you accidentally drop them.

It’s advisable to use a denture cleanser which has the American Dental Association seal of acceptance. However hand soap or mild dishwashing liquid are also acceptable for cleaning dentures.

Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.

A denture can lose its proper shape if it is not kept moist. So it should be placed in soaking solution or water at night � though one with metal attachments could be tarnished if placed in soaking solution.

As you age, your mouth naturally changes, which can affect the fit of the denture so, if they no longer fit properly, they should be adjusted by your dentist.

See your dentist promptly if your denture becomes loose as this can cause sores or infections.

Don’t try to adjust or repair your denture yourself as this can damage the appliance beyond repair.

When you wear a partial denture, you need to continue brushing twice a day and cleaning between your teeth daily. This will help prevent tooth decay and gum disease.

Pay special attention to cleaning the teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Your dentist or dental hygienist can demonstrate how to properly brush and clean between teeth.

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining a healthy smile.

The Invisalign system is a series of clear, thin, mouthguards that fit over the teeth and can gradually straighten them.

These have been called “invisible braces” as they can be an effective alternative to metal braces in some circumstances.

The big advantage of Invisalign is much improved appearance and comfort.

Invisalign mouthguards can be removed during eating and when brushing and flossing. As traditional braces may trap food and plaque, this is another major benefit of Invisalign.

While the system has advantages, it also has some drawbacks.

For example, it is more expensive – costing 25-50 percent more than metal braces.

Also the fact that you remove the mouthguards more often means that you may forget to wear them and it could take longer for you to achieve the desired results.

Invisalign is better suited to some people than others – for example, it may be particularly suitable for adults who have slight to moderate spacing or crowding of their teeth.

Your dentist will be able to tell you if you might be a suitable candiate for Invisalign.

You will get more detailed advice from an orthodontist who has been certified in the Invisalign system.