Q1. How often should I have my teeth cleaned?
Most people like to have their teeth cleaned once or twice a year. Research shows that regular professional cleaning may reduce the risk of dental caries (cavities) and periodontal (gum) diseases. Some dental conditions require more frequent monitoring and intervention; some require less. Discuss your personal dental health needs with your dentist.
Q2. What type of dental floss should I use — waxed or un-waxed?
Research comparing waxed and un-waxed floss shows it doesn’t matter which is used, it’s not the floss, its proper flossing techniques that makes the difference in dental health. We have a tendency to floss on the backside of a tooth better than the front side; we floss the front teeth better than the back, and we are better at flossing near the chewing surface of the tooth than at the gum line. So, use either waxed or un-waxed floss, but be meticulous, practice technique and floss at least once a day. Proper flossing removes plaque and food particles from areas not reached by a toothbrush.
Q3. How often should I brush my teeth? What kind of toothbrush should I use?
Regular brushing is vital to maintaining optimal oral health. Dentists recommend brushing with fluoride toothpaste after every meal and before bedtime because carbohydrates in food and drinks feed oral bacteria and produce acids that can lead to cavities. One caution for patients who eat several small meals daily rather than the traditional three meals — brushing more than five or six times a day may increase the risk of damage to the tooth enamel.
With so many shapes, sizes and styles of toothbrushes on the market, choosing the right one can be confusing. Be sure to use a toothbrush with round, soft nylon bristles; toothbrushes with medium to hard bristles can be abrasive to the tooth enamel. Research suggests that no particular configuration of bristles is better than another for removing plaque and food particles. So, go ahead and clip the store coupon and get the best buy on your favourite style and colour.
Q4. Are electric toothbrushes better than manual brushes?
Manual and power toothbrushes are effective, but studies show electric and sonic toothbrushes, if used properly, can perform better than manual toothbrushes. The key is to use the toothbrush that best meets your needs. For example, people with arthritis or limited dexterity may find an electric toothbrush especially helpful. People with orthodontic braces may find it easier to brush effectively with an electric toothbrush; and since the rotating head of a powered toothbrush requires less force and manipulation than a manual toothbrush, the risk of dislodging orthodontic appliances might be reduced.
Q5. What is a good toothpaste? Do I need fluoride, baking soda, whiteners and flavours?
There are five categories of toothpastes: “anti-cavity,” “anti-cavity & tartar control,” “anti-cavity & desensitizing,” “anti-cavity, anti-plaque/anti-gingivitis & tartar control” and “whitening.” Toothpaste formulations and chemistry are very complex, and each manufacturer has its own variations, but the primary ingredients remain the same. A very important ingredient is fluoride to prevent dental caries.
More than 95% of toothpastes sold contain an fluoride formulation. So, in addition to the name brands most store brands are effective anti-cavity products. In spite of its gritty texture, baking soda is actually an extremely mild abrasive — very kind to tooth structure — that also exhibits some anti-bacterial properties. Toothpastes that advertise improved stain removal (“smokers’ toothpastes,” etc.) usually contain harsher abrasives and if overused can damage the tooth enamel.
Flavouring agents are important for marketing — people want a product with a pleasant flavour. Whitening toothpastes, a category that received ADA acceptance only within the past two years, work by removing surface stains. The “whitening” agents are special abrasives, detergents, or enzymes. Currently, only six products have received the ADA seal as whitening toothpastes. Each contains fluoride as an anti-cavity agent, and five are accepted for tartar control. As for the whitening properties, there hasn’t been much independent research published yet.
These products are safe, however they will not change the overall colour of teeth and they don’t claim to deliver the “Hollywood smile.” These products should not be confused with bleaching agents (usually peroxide compounds) that work by breaking down pigment to remove colour from teeth.
Q6. Do bleaching products really work?
Yes, but consult your dentist first, because the procedure isn’t always as simple as many people believe. Tooth colour is influenced by many factors, including previous trauma to the teeth, exposure to certain medications, drinking tea or coffee, smoking and the natural aging process. Not all teeth respond equally well to bleaching.
In general, bleaching is more successful on lighter (yellow) colorations than darker (grey/brown); and bleaching will not lighten existing dental restorations, such as tooth-coloured fillings, bonding, crowns or bridges. Before bleaching, it is important to consider how much of your existing dental work will have to be replaced to achieve the desired results. Your dentist can determine if you are a good candidate for bleaching.
Q7. Is there fluoride in the water?
If you want to know the local fluoride content contact the local water company. They can tell you the required fluoridation level and provide details on the high, low and average levels for the year, the month and the day.
Depending on the geographic area, the level of naturally occurring fluoride in the water supply can range from 0 to >5 parts per million (ppm). The ADA recommends one part per million. Keep in mind that not all communities have fluoridated water or adjust their water to optimal fluoride levels. Well water, in particular, can be quite variable even within the same geographic location.
Q8. Does bottled water contain fluoride?
There is concern that drinking bottled water instead of fluoridated tap water may result in insufficient fluoride exposure, which could increase the risk of dental caries. The fluoride content in bottled water and beverages (everything from soft drinks to fruit juices) can vary from <0.01 ppm to 4-5 ppm, and will mirror the level of fluoride in the water at the place of manufacture.
Remember, we get fluoride from many sources, including foods and beverages, professional fluoride applications during dental visits and, most importantly, toothpaste and drinking water.
Q9. Does my home water filter remove fluoride from the water?
This tends to be brand-specific; however, studies have shown that the more heavy duty the filter, the more likely fluoride could be filtered out. One study compared five filters in cities with low fluoride, optimal fluoride or naturally fluoridated water, and there was no noticeable change in water fluoride levels. Another study showed that a water softener and water conditioner did not alter the fluoride content, but the water filter studied reduced fluoride content by 90 percent. The small activated charcoal filters that screw to the faucet probably don’t remove fluoride, but, without testing, this isn’t certain.
Q10. My 15-year-old son wants to pierce his tongue. Should I be concerned?
Your son needs to be aware of several risks associated with oral piercing. First, the tongue is highly vascular and bleeds when cut, so there is a risk of hemorrhage. There is also a risk of nerve damage, swelling, localized infection and systemic infection (tetanus, hepatitis, HIV), particularly if the piercing establishment doesn’t follow strict infection control procedures.
After the piercing, he must be committed to removing and cleaning the appliance at least once a day to prevent bad breath, swelling and infection from an overgrowth of bacteria and fungi. He must also realize that when the appliance is removed, the opening will start to heal and close in a matter of hours, so the appliance may be difficult to reinsert. Most importantly, he must be aware of the substantial risks of cracked and broken teeth, gingival (gums) recession, impaired speech and the possibility that he could swallow or aspirate the appliance. If all this fails to discourage him, remind him that the piercing will probably be done without anesthesia.