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Posts for category: Oral Health

By Paul E. Marcuz, DDS, PC
September 09, 2021
Category: Oral Health
Tags: oral hygiene  
BrushorFlossFirstHeresWhatYouNeedtoKnowtoDecide

If you like conundrums like "Which came first? The chicken or the egg?", then you may enjoy this one: "Which should you do first, brush or floss?"

Both of these oral hygiene tasks are equally important for removing dental plaque, a thin bacterial film that forms on teeth after eating. Removing plaque on a daily basis minimizes your risk for developing tooth decay or periodontal (gum) disease, the top causes for tooth loss. Brushing removes plaque from broad tooth surfaces, while flossing removes it from between teeth where brushing can't reach.

There is wide consensus that you need both brushing and flossing to thoroughly remove plaque. But there is a debate over which of these two tasks you should do first for the most effective outcome. Those debates are more or less good-natured, but there are proponents on both sides on which task should come first.

Those on the "Brush First" side say brushing initially gets the bulk of accumulated plaque out of the way. If you floss first, you may be plowing through a lot of soft plaque, which can quickly turn your floss into a gunky mess. More importantly, you may only be moving plaque around with the floss, not actually removing it. By brushing first, there's less plaque to deal with when flossing.

"Floss First" folks, though, say flossing before you brush loosens plaque stuck between teeth that can be more easily brushed away. But perhaps a more important reason is psychological: People don't really like flossing as much as brushing. Because of this, putting it off to the end may mean it doesn't happen; doing it first will help ensure it actually gets done.

In the end, though, the order you perform these tasks comes down to personal preference. You can try both ways to see which one suits you best. The important thing, however, is that you do both tasks—if you do, you can greatly lower your risk of dental disease that could rob you of your teeth.

If you would like more information on effective oral hygiene, 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 “Brushing and flossing: Which Should Be Done First?

By Paul E. Marcuz, DDS, PC
August 30, 2021
Category: Oral Health
Tags: oral hygiene  
SeeHowWellYoureRemovingPlaqueWithaDisclosingAgent

You've just finished your daily brushing and flossing. How did you do? Swiping your tongue across your teeth can generally tell you: It's a good sign if it glides smoothly; but if it feels rough and gritty, you better take another run at it.

This "tongue test," however, only gives you a rough idea of how well you're removing plaque, that thin bacterial film on teeth most responsible for dental disease. Plaque, though, can be sneaky, "hiding" in the nooks and crannies on the biting surfaces of teeth, around the gum line and in between teeth.

So, how do you know if you're clearing out any plaque holdouts? An effective way is to use a plaque disclosing agent. This over-the-counter dental product consists of a swab, tablet or solution, which contains a dye that's reactive to plaque.

After brushing and flossing as usual, you apply the solution to your teeth for about 30 seconds. You then take a look in the mirror: Any remaining plaque will be stained a bright color that makes it stand out. There are also agents with two colors of dye, one that stains older plaque and one for newer plaque.

The plaque staining not only helps you see how well you've been brushing and flossing, it can also show you areas in need of improved hygiene. For example, if you notice a scalloped pattern around the gum line, that may mean your brush isn't getting into that area effectively. In this way, you can use a disclosing agent to fine-tune your hygiene.

Repeated use of a disclosing agent is safe, but just remember the dye color can be vivid. It does wear off in a few hours, though, so perhaps schedule it for a day off around the house. You should also avoid swallowing any solution or getting any of it on clothing.

The ultimate test, though, is a thorough dental cleaning with your dentist at least every six months. They can verify whether you've been fairly successful with your brushing and flossing, or if you have room for improvement. If you do use a disclosing agent, you can also discuss that with them in working out better strategies to protect your teeth from tooth decay and gum disease.

If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”

WhytheBottledVarietyMightnotbeYourBestChoiceforCleanDrinkingWater

In recent decades civilization's millennia-long search for clean, safe drinking water has become much easier with modern purification methods. Today, there are few places in the United States without adequate access to potable water. And about three-fourths of the nation's tap water systems add fluoride, credited with helping to reduce tooth decay over the past half century.

But in recent years some have voiced concerns about the safety of tap water and popularizing an alternative: bottled water. Manufacturers of bottled water routinely market their products as safer and healthier than what comes out of your faucet.

But is that true? A few years ago a non-profit consumer organization called the Environmental Working Group (EWG) performed a detailed, comprehensive study of bottled water. Here's some of what they found.

Lack of transparency. It's not always easy to uncover bottled water sources (in some cases, it might actually begin as tap water), how it's processed, or what's in it. That's because unlike water utilities, which are rigorously monitored by the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA) oversees bottled water production with less strenuous guidelines on labeling. Eight out of the top 10 selling brands were less than forthcoming about their water's contents in EWG's investigation.

Higher cost. According to the EPA, the average consumer cost in the last decade for tap water was $2.00 per 1,000 gallons (0.2 cents per gallon). The retail cost for even bulk bottled water is exponentially higher. It can be a costly expenditure for a family to obtain most of their potable water by way of bottled—while still paying for tap water for bathing and other necessities.

Environmental impact. Bottled water is often marketed as the better environmental choice. But bottled water production, packaging and distribution can pose a significant environmental impact. EWG estimated the total production and distribution of bottled water consumes more than 30 million barrels of oil each year. And disposable plastic water bottles have become one of the fastest growing solid waste items at about 4 billion pounds annually.

While there are credible concerns about tap water contaminants, consumers can usually take matters into their own hands with an affordable and effective household filtering system.  EWG therefore recommends filtered tap water instead of bottled water for household use.

If you would like more information on drinking water options, 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 “Bottled Water: Health or Hype?

CraftaCustomCarePlanbyIdentifyingYourIndividualRiskforToothDecay

Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.

Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.

Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.

Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.

Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.

Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.

Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.

If you would like more information on tooth decay, please contact us or schedule an appointment for a consultation.

By Paul E. Marcuz, DDS, PC
July 21, 2021
Category: Oral Health
Tags: tooth decay  
StayAheadofDecay-SpreadingRootCavities

Finding out you have a cavity isn't the best of news. But finding out it's a root cavity is even worse: if not treated, the decay can spread more rapidly than a cavity occurring in the tooth's crown surfaces.

Our teeth are basically composed of two parts: the crown, the visible tooth above the gum line, and the roots, the hidden portion beneath the gums. The root in turn fits into a bony socket within the jaw to help hold the tooth in place (along with attached gum ligaments).

A tooth crown is covered by an ultra-hard layer of enamel, which ordinarily protects it from harmful bacteria. But when acid produced by bacteria comes into prolonged contact with enamel, it can soften and erode its mineral content and lead to a cavity.

In contrast to enamel, the roots have a thin layer of material called cementum. Although it offers some protection, it's not at the same performance level as enamel. But roots are also normally covered by the gums, which rounds out their protection.

But what happens when the gums shrink back or recede? This often occurs with gum disease and is more prevalent in older people (and why root cavities are also more common among seniors). The exposed area of the roots with only cementum standing in the way of bacteria and acid becomes more susceptible to cavity formation.

Root cavities can be treated in much the same way as those that occur in the crown. We first remove any decayed tooth structure with a drill and then place a filling. But there's also a scenario in which the cavity is below the gum line: In that case, we may need to gain access to the cavity surgically through the gums.

If you have exposed root areas, we can also treat these with fluoride to strengthen the area against cavity formation. And, as always, prevention is the best treatment: maintain a daily schedule of brushing and flossing and regular dental cleanings to remove bacterial plaque.

Because decay can spread within a tooth, dealing with a root cavity should be done as promptly as possible. But if we diagnose and initiate treatment early, your chances of a good outcome are high.

If you would like more information on treating root cavities and other forms of tooth decay, 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 “Root Cavities.”