Unique Way To Prevent Cavities - Sealants

Patients often ask me how they can prevent cavities.  Next to brushing and flossing, sealants are a great way to prevent tooth decay. I am a big believer in sealants!

 

A sealant is a plastic material that is painlessly applied to the chewing surfaces of the back teeth--the molars and premolars. Most tooth decay begins on these chewing surfaces because they have many small grooves where germs and food can hide, and toothbrush bristles cannot reach to clean. This plastic resin bonds into these grooves and acts as a barrier to protect these surfaces from food, plaque, and acids. Prevention is better than treatment. Preventing decay by sealing out the bacteria and acids that contribute to caries/cavities is much easier and much less expensive that the trauma and cost of dental treatment, such as fillings, extractions, or crowns!

There are no shots and almost no drilling when applying sealants! The tooth is first cleaned, a chemical etchant is applied, a liquid plastic material is painted on, and then "cured" (made hard) with a special light. It takes only minutes, and is easy for both the clinician and the patient! The hardest part about the entire procedure is keeping the tooth dry so that the sealant will stick.

Ideally sealants are applied upon the eruption of the first permanent molars, usually at age 6 years, and upon the eruption the second permanent molars, usually at age 12 years. Although traditionally sealants are applied to children of these ages, they are effective preventative measures for adults as well, especially if your teeth have deep grooves, or if you are prone to decay.

Just like tires on cars and roofs on houses, sealants don't last forever, and they tend to wear out over time due to normal chewing and eating.  For this reason, sealants need to be evaluated every 6 months and replaced when they wear out.  The average life of a sealant is 3-5 years, and most insurance companies will cover the cost of replacement within certain restrictions.


By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental

A Child's First Visit to the Dentist

New parents often ask me what age is appropriate for their child's first dental visit. The American Academy of Pediatrics (AAP) recommends that all infants receive an oral health risk assessment by six months of age by either a dentist or pediatrician. Infants at a higher risk of early tooth decay should be referred directly to a dentist as early as six months of age.  Otherwise, infants should see a dentist for that first visit no later than six months after the first tooth erupts or by age one (whichever comes first).

Dental problems often start early, so the sooner the visit occurs, the better. To protect against problems such as baby bottle tooth decay, teething irritations, gum disease, and prolonged thumb-sucking, the dentist can provide or recommend special preventive care. Children, like adults, should see the dentist every six months.  Some dentists may schedule interim visits for every three months when the child is very young to build up a comfort and confidence level, or to treat a developing problem.

According to the Academy of General Dentistry (AGD), many general dentists treating children are designing their offices to be more child-friendly by providing their young patients with age-appropriate books, video games and movies.  Dentists recognize that they can make a child’s (and the parent’s) dental experience more positive by providing a fun environment so that the child is excited about coming to the dentist’s office.

The AGD offers the following recommendations on how to prepare for the visit and on how to keep your child from being anxious about seeing the dentist:

Parents should ask the dentist about the procedures of the first appointment so there are no surprises. The first visit usually includes a gentle but thorough examination of the teeth, jaw, bite, gums and oral tissues to monitor growth and development and observe any problem areas. The dentist may also have your child’s teeth cleaned, particularly if your child's teeth have a stain that commonly appears in infants.

Very young children may be fussy and not sit still. Talking to the dentist beforehand about the best way to communicate with your child about dental visits is often helpful. It is important that parents are reassuring and calm when communicating with their child about the dental visit. Be positive when speaking with your child about what to expect and build excitement about the visit.

For parents who feel their child will be anxious about the visit, ask the dentist if he/she will schedule a pre-visit. Ask the dentist to take your child on a tour of the office, explain the equipment and tools, allow them to sit in the chair and even demonstrate on a family member to help them become comfortable. Ask if the dentist what his/her policy is on allowing a relative to accompany the child in the treatment room. 

Be sure to bring to the child's complete medical history records to the appointment. 

In addition to the overall dental examination, the first dental visit is about establishing a relationship with a dental team you feel comfortable with for you and your child.

By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregonhttp://www.facebook.com/TenderCareDental

Flossing, How often? Which ones? Is it necessary?

I often get asked questions such as how often should I floss, is flossing necessary, and what teeth should I floss? My response is the cliché used by dentists the world over. You should only floss the teeth you want to keep! Besides brushing, flossing is the most important thing that you can do to ensure good oral health. 

The purpose of both brushing and flossing is to reduce the number of bacteria which inhabit our mouths. Normally, millions of these microscopic bacteria call your mouth home,  feeding on food particles left on our teeth.


These bacteria produce acid as a result of their feasting, and it is this acid which eats into tooth enamel creating cavities.  If this wasn't bad enough, the bacteria also pour out volatile sulfur compounds creating embarrassing bad breath.


Normally bacteria are found within a mesh of mucus and debris known as plaque. Regular brushing removes the plaque and the bacteria plaque contains. Unfortunately, many people only brush, forgetting that flossing is a key component to any good oral hygiene program.


Flossing removes the bacteria that escape the toothbrush by hiding in the tiny spaces in between teeth. Brushing without flossing is like washing only 65% of your body. The other 35% remains dirty! The American Dental Association recommends that you floss at least once a day.

If you do not floss and allow plaque to remain in between teeth it eventually hardens into a substance known as tartar. Unlike plaque which can be easily removed by brushing and  flossing, tartar can only be removed by your dentist. 


Over time, levels of more dangerous types of bacteria build up within tartar. These bacteria produce toxins which irritate and inflame the gums. This condition is known as gingivitis. If gingivitis is left untreated it can progress to periodontal disease - a condition where bacteria and their toxins invade not only the gums but also the bones and the structures supporting the teeth. This can lead to bone loss, loose teeth, and teeth which fall out.


I recommend Glide or any other coated dental floss because they slide easily between teeth. However, any floss that you can get between your teeth and which does not fray or break easily is good. 
Alternatively, if you don't like using dental floss, consider an interdental cleaner (electric flosser) which makes flossing easy and convenient.


If you haven't flossed in a while, you may see a little red tinge of blood on the floss after you use it. This indicates that your gums are slightly inflamed and vastly in need of flossing to remove bacteria. With a regular regimen of flossing this red tinge should go away.


By brushing and flossing we help to eliminate the bacteria which can lead to bad breath, gingivitis, and periodontal disease thus creating smiles which last a lifetime.


By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregonhttp://www.facebook.com/TenderCareDental

Pregnancy, Periodontal Disease and Gingivitis. What you need to know...

When I was in dental school back in 1998, I was taught that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight.

Now evidence is mounting that suggests a new risk factor – periodontal disease. Periodontal disease is bacterial infection of the bone and gums that support teeth. Gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.

Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

More research is needed to confirm how periodontal disease may affect pregnancy outcomes. It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. I recommend that women considering pregnancy see their dentist every 6 months for a comprehensive dental exam that includes necessary x-rays and a periodontal evaluation in order maintain good oral health and prevent the onset of periodontal disease.

By Dr. Andrew Thompson
TenderCare Dental - Portland, Oregon
http://www.facebook.com/TenderCareDental