Sealants are placed in the natural grooves and pits of posterior permanent teeth to prevent decay.  They are usually placed soon after these teeth erupt into the mouth and so near age 6 and again at age 12, as soon as the second molar erupts, into the mouth.  The material used to seal these grooves and pits has evolved over time and is now very effective at its work.

With the newer sealant materials, we are now able to gain a chemical bond between tooth and sealant, so as not to allow bacteria to find their way into this minute space and go to work destroying tooth structure.  Chemical bonds are not prone to detachment and do not leak at the juncture (or we use the term margin) of tooth and sealant.  Glass ionomer sealants are state of the art.  They also have a fluoride release characteristic.  And there is a difference between a product that has fluoride in it and one that releases fluoride from it into the tooth.

Glass ionomer sealants wear more quickly than the old school sealant material.  But even if they are worn on the surface, the material remains intact down in the depths of the pits and grooves of the teeth.  So the tooth is still very well protected and the sealant does not need to be replaced.  They can be placed in a wet environment and are self- curing ( as opposed to needing to be cured with an ultraviolet light).

The "old school" resin sealant will not adhere well to aprismatic enamel, which is the primary type of enamel in  the pits and fissures.  Glass ionomer sealants do adhere to aprismatic enamel.  The "new school" glass ionomer sealants actually recharge each time it comes into contact with an external fluoride source.  So with each brushing where fluoride toothpaste is used and with each sip of fluoridated water as well as when fluoride mouthrinse is used, the fluoride level of the sealant is back to the level at initial placement.

My vote for my teeth and for the teeth of my children and friends is for glass ionomer sealants!!!!!

Do I Really Need to Floss?

Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces and controls bad breath. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal (gum) disease and tooth decay.

Flossing is the single most important weapon against plaque, perhaps more important than the toothbrush. A toothbrush cleans the tops and sides of your teeth. Dental floss cleans between them. Some people use waterpicks, but floss is the best choice.  Many people just don't spend enough time flossing and many have never been taught to floss properly. When you visit your dentist or hygienist, ask to be shown.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridge work. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side to side as if you're shining shoes. Bring the floss up and down several times, forming a "C" shape around the tooth and being sure to go below the gumline.

The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline and forming a "C" on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss or for caretakers who are flossing someone else's teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. When you use a toothpick, don't press too hard, as you can break off the end and lodge it in your gums.

Do I need a waterpick (irrigating device)?

Don't use waterpicks as a substitute for brushing and flossing. But they are effective around orthodontic braces, which retain food in areas where a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended by dentists for persons with gum disease; solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir in these cases.

Common Oral Problems

Whenever you browse through any oral health article/blog you might encounter the words Plaque, Tartar and Calculus with a brief definition that hardly renders any understanding.

You might have also been told by your dentist that you have calculus or tartar deposits and need to get them removed. Often people misuse the words either mistaking one for the other or lacking any understanding on them. So let me throw some light on this issue and the appropriate measures to remove them.

Successful build up of plaque leads to Tartar formation

Plaque:

This is a thin film of clear sticky bacteria that forms on your teeth, gums and tongue.

Plaque contains various types of bacteria and is a sticky layer. Hence, mechanical cleansing by toothbrush is essential to remove plaque.

Plaque begins forming 12 hours after brushing and thus brushing twice a day is very important to control it.

Mucoid Plaque(or simply Plaque) is harmful as it contains infective bacteria which can cause tooth decay and gingivitis.

Removal of Plaque

• Mechanical removal by tooth brush is necessary.

Calculus (Tartar)

If Plaque is not removed, it hardens to mineralized visible mass which is called Calculus or Tartar.

It forms hard yellowish deposits above or below the gums, on the inner or outer surface of teeth and can only be removed by your Dentist or Oral hygienist.

Different people exhibit varied susceptibility to calculus formation. Some are quite resistant where as others experience frequent calculus formations.

Removal of Tartar

• People who have susceptibility to Tartar formations should use Tartar control toothpaste. Previously, Hand scalers were used by dentist to remove the deposits which was very tedious, time consuming and tiring procedure both for the patient and the dentist.
• The process has been made much simpler now by the advent of automatic machines and you can simply get your calculus deposits removed by asking the dentist to scale or clean your teeth.

Heart Disease

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries.

Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

I just wanted to share a little bit about one of my favorite at-home tools for my patients.  The tool is called the "Reach Access Flosser".  It is a hand held flosser on a long handle.  I have been a dental hygienist for 12 years and out of all the adjuncts that I have recommended over the years, this tool is my patients favorite.  Not only do my patients say they are going to try it---they actually use it!! 

The great thing about the "Reach Access" is that it is strong and it reaches to even the back of the back teeth.  Most people have a very hard time flossing their back teeth, the molars.  I hear complaints mostly from men trying to get their hands and fingers that far back.  The posterior teeth need to be flossed the most because they are wider and can trap more food and bacteria around them.  The posterior teeth are usually the ones first involved with periodontal disease.  Can you see the correlation?  The teeth flossed less get in more trouble.   Being a proactive person and flossing contributes not only to dental health, but to better health in general.

The important part of flossing is that the floss actually slides under the gumline around each side of each tooth.  The floss will disturb the bacteria/plaque in this area that a toothbrush will never reach.  When the plaque hangs out too long under the gumline it can cause distruction of the bone that actually hold our teeth in our mouth.  Also, the plaque will calcify from the minerals in our saliva and form calculus, better known as "tartar".  All of this happens under the gumline and you might not ever know it, feel it or see it.  The best time to floss is before bedtime because while we sleep the bacteria just goes crazy in the warm and still environment in our mouths. 

The "Reach Access Flosser" can be purchased almost anywhere they sell dental floss.  The flosser is reusable and you can just buy little replacement tips.