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By Eric Romano DDS
November 13, 2021
Category: Oral Health
Tags: oral hygiene  
DentalHygieneandCareCriticalDuringCancerTreatment

After months or even years of radiation or chemotherapy, the words "cancer-free" is music to your ears. Your joy and relief, though, may be tempered by the toll these treatments can take on the rest of your body—including your mouth.

Both of these treatments can destroy healthy tissue along with targeted cancer cells. If the focus has been on the head and neck regions, they could damage the salivary glands to the point that they won't produce adequate saliva flow.

A lack of saliva can have a detrimental effect on your oral health. Saliva buffers and helps lower oral acid levels that soften and erode enamel and increase the likelihood of tooth decay. Saliva also supplies antibodies that fight disease-causing bacteria. Otherwise, bacteria—and the risk for disease—can rapidly grow.

If these or other scenarios occur, you may experience dental damage, even tooth loss. Fortunately, we can restore an injured smile in various ways, including dentures, bridges or dental implants. But we should also attempt to limit the potential damage by taking steps to prevent dental disease during cancer treatment.

The most important of these is to brush and floss daily. Everyone should practice these hygiene tasks to remove disease-causing dental plaque, regardless of their health status. But because some natural disease-fighting mechanisms in the mouth may be disrupted during either radiation or chemotherapy, it's even more important if you're a cancer patient.

It's equally important to maintain as much as possible regular dental visits during cancer treatment. Dental cleanings provided during these visits remove any residual plaque and tartar (hardened plaque), which further lowers your disease risk.

Your dentist can better monitor your overall dental condition during frequent visits and provide as much treatment as you can tolerate. They can also enhance your protection against disease by prescribing antibacterial mouthrinses, fluoride applications or products to boost saliva production.

Some teeth and gum problems may be unavoidable; in that case, you may need post-treatment dental care to restore your oral health as needed. But caring as much for your dental health as you're able during cancer treatment could help you realize a better outcome.

If you would like more information on dental care during cancer treatment, please contact us or schedule an appointment for a consultation.

ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “HIV-AIDS & Oral Health.”

PracticeDailyOralHygienetoPreventCalcifiedPlaqueFormation

If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.

Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.

Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush.  Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.

Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.

In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.

If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.

Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.

If you would like more information on reducing plaque buildup, please contact us or schedule an appointment for a consultation.

BuffaloBillsStefonDiggsKnowsTheresNeveraBadPlacetoFloss

Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!

The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”

We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.

Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.

We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.

The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.

If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.

If you would like more information about keeping in the best dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By Eric Romano DDS
February 15, 2021
Category: Oral Health
Tags: oral hygiene  
4TipsforImprovingDailyBrushingandFlossing

Two important practices boost your protection from dental disease: twice-a-year dental visits; and daily brushing and flossing. Of the two, that second one could be the most important.

Personal oral hygiene cleans the teeth of dental plaque, a thin film of bacteria and food particles that accumulates on them each day. This plaque buildup is the number one cause for both tooth decay and periodontal (gum) disease, so removing it reduces your risk of an infection.

But it's not just a matter of doing these tasks—it's also doing them well. A quick once-over isn't going to have the same preventive power as a more thorough job.

Here then are 4 tips for improving your daily oral hygiene efforts.

Time yourself brushing. It usually takes about two minutes to thoroughly brush all tooth surfaces. So, set a timer for two minutes, focusing on methodically brushing the front, back and biting surfaces of each tooth.

Easy does it. Brushing teeth requires only a gentle bit of manual force as the mild abrasives and detergents in your toothpaste provide most of the action of loosening plaque. In fact, aggressive brushing can lead to enamel and gum damage. Practice gentle scrubbing action when you brush.

Don't neglect flossing. While brushing gets most of the hygienic attention, it can't effectively get to areas between teeth where over half of built-up plaque can accumulate. Be sure then to floss at least once a day to remove plaque between teeth that brushing can miss.

Test yourself. Your dentist may be the ultimate judge for the quality of your hygiene, but you can check your effectiveness between visits. For instance, run your tongue across your teeth—it should feel smooth, not rough or gritty. Using a plaque disclosing agent periodically can also reveal missed plaque.

And don't forget to keep up your regular dental visits, which are necessary for removing plaque you might have missed or tartar that may have formed. They're also a great time to get advice from your dentist or dental hygienist on how you can further improve your own efforts in daily dental care.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”