Dental disease, tooth decay (cavities) and gum disease, is caused by microorganisms known as bacteria (germs) that can stick to your teeth and form a layer known as dental plaque. As these bacteria multiply, this plaque layer germs gets larger and covers more of the tooth surface. It is this layer of microorganisms that cause both tooth decay (cavities) and gum disease.
Probably the most common dental disease we encounter is tooth decay and it is caused by bacterial plaque. Plaque organism love to consume what you eat but since they're so tiny, they don't have mouths. They can only absorb their nutrients from your diet so they rely on things that can dissolve in your saliva. They love to be fed something that happens to be in most everyone's diet; something that tastes great and has lots of energy...SUGAR!!! When sugar is eaten, the bacteria get lots of energy and multiply rapidly causing a growth of plaque organisms. And, when they're done metabolizing the sugar, they secrete their metabolic end product right onto the tooth surface where they're sticking. This end product is ACID. As you can imagine, this acid will eat into the surface of the teeth wherever the bacteria are collecting. The more sugar that is eaten, the more the organisms will multiply and the more acid will be secreted onto the tooth.
Any form of sugar will cause plaque growth and acid formation on your teeth. However, some forms of sugar are worse. Sticky dried fruits, for example, remain on your teeth and dissolve more slowly. Most sweet beverages including juices are not only sugary, but are acidic and make the bacterial acid more destructive. Can you think of a beverage that's sweeter and more acidic than orange juice? Lemonade? Believe it or not, the most destructive beverage is actually Gatorade and related types of sports drinks. They have a lot of sugar and they're very acidic. As one can see, sugar can go from bad to worse. Eaten with moderation and control, sugar can be enjoyed without concern.
Gum disease is caused by the presence of bacteria like tooth decay, but the action of bacteria are not the cause. Just the presence of the plaque next to gum tissue and under the gums (where the pocorn goes) causes the gums to become inflamed. Just as a cut becomes red and inflamed from the bacteria that get into the cut, gum tissues respond with redness, swelling and discomfort. This redness is called gingivitis (we call gums "gingiva" and "itis" means inflamed, etc...). If the bacteria are removed regularly, the gums aren't inflamed so there's no gingivitis. If not, the gums will gradually break down due to persistant, chronic, inflammation. Gums become diseased when the gum which is attached to the teeth (like your nail attached to your finger) looses its attachment. Pockets form around the gum space and are harder to clean leading to a worsening of the pocketing and the loss of bone which supports the tooth. When the pockets become very deep, there is very little attachment of gum and lots of bone loss. The teeth become loose and infected and need to be removed.
Adults over 35 lose more teeth to gum diseases (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily.
Periodontal disease and decay are both caused by bacterial plaque. Plaque is a bacterial film, which sticks to your teeth at the gumline and in between teeth. Plaque microrganisms (germs) constantly reproduce so the plaque layer grows on your teeth. By thorough daily flossing and brushing you can remove these germs and help prevent periodontal disease.
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gumline then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefingers of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office at 415 456-5402.
Dr. Herschleb recommends using a soft to medium tooth brush. Position the brush at a 45 degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes brushing the outside surfaces of your teeth. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.
When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.
Next you will clean the biting surfaces of your teeth by using short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.
There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes called Rotadent and Interplak.
Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.
Fluoride toothpastes and mouth rinses, if used in conjunction with brushing and flossing, can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gumline so these products have not been proven to reduce the early stage of gum disease.
Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.
Teeth Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive consult with your doctor. They may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.
Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Your visit to our office is an important part of your program to prevent gum disease. Keep your teeth for your lifetime.