Gum Health and Cleanings
The teeth are supported by gum tissue and bone. As we eat carbohydrates, bacteria take some of these nutrients we eat and multiply in our mouth. In order to make a home out of your mouth, bacteria secrete a biofilm or glue substance also known as plaque to help them hook onto the teeth and shelter them. This allows them to live near a replenishing food supply as we generally eat several times a day. Our immune system does not like the presence of bacteria or their secretions. Immune cells cannot reach the mouth bacteria because they stay within the body tissues. The presence of the bacteria, however, makes the gum tissue inflamed due to the presence of bacterial secretions on the gums. Inflammation of the gums is called gingivitis. The immune system then tries to fight what it thinks in an infection inside the gum tissue when the bacteria are really just on the surface. Over a long period of time the attack of the white blood cells trying to kill bacteria they cannot reach begins to do collateral damage to the gums and bone surrounding the tooth. This can lead to bleeding swelling and loss of gums and bone. The goal of daily brushing and flossing is to routinely remove the bacteria and biofilm from the teeth so that the gums are not chronically inflamed. Brushing removes the plaque and bacteria from the chewing and side surfaces of the teeth. The bristles of the brush do not reach well in between the teeth. Floss is what we use to brush the surface between the teeth and remove plaque.
When plaque is not effectively removed from the mouth and remains there for some time, calcium that is in the saliva begins to collect onto the plaque and harden it. This calcified hard plaque is known as tarter or calculus. Prophylactic cleanings are routine cleanings meant to remove plaque and tartar build up periodically before things get out of hand. Tater makes a great surface for more bacteria to stick to. The more bacteria that begin to live in the area, the more collateral damage you will get and possible loss of gums and bone as they are destroyed over time. This loss of gum and bone support to the tooth is known as periodontal disease. When the gums become so damaged that they start to lose their connection to the tooth, pockets or spaces form between the tooth and gums. When these pockets get to a certain depth, more harmful bacteria begin to colonize these deep spaces and periodontal loss of gums and bone can become accelerated. Normal surface cleanings will not adequately remove these deep infestations of bacteria. Scaling and root planning is a type of deep cleaning designed to flush out all the bacterial colonies on the surface of the tooth and in the deep pockets in the gums. Scaling in the presence of gingivitis is a cleaning between the scaling and root planning and prophylactic cleaning. This is done when there isn’t deep pocketing but there are still large tarter deposits. If it has been a very long time since you have had a cleaning. There may be too much tarter buildup for the hygienist to measure your gum and bone loss and how deep your pockets are. In these cases a debridement cleaning is done to remove enough of this build up to measure your periodontal loss and determine if you need the deep cleanings or just a scaling in the presence of gingivitis.
Generally if you lose gums and bone the goal of regular cleanings and proper brushing and flossing is to stop the gum and bone loss from continuing. People do not generally grow the bone or gums back. There are some periodontal surgeries that can be done in certain situations to help get some gum coverage back. You can discuss your situation and options for this with a periodontist.
What is the best floss?
The goal of flossing is to brush the area between the teeth that the tooth brush bristles cannot reach. With this goal in mind the rough style of floss is more aggressive at removing bacterial glue otherwise known as plaque from between the teeth. Very smooth floss has a higher risk of just cutting through the plaque instead of grabbing it and removing it with flossing motion. Many people ask about using flossing sticks. These are not quite as good as regular floss as they have a hard time wrapping around the tooth when scraping. They are however very superior in use than not flossing at all. I like and use the two string floss sticks myself as I feel like it grabs the plaque better when removing than the single string ones. Triple string is too much and does not allow me to conform to the tooth shape when I am scraping it. Water floss equipment is good but not a replacement for floss. I recommend using both. Be careful not to damage the gums by turning the settings too high.
Why do I have bad breath?
In general bad breath comes from the presence of bacteria. Tooth infections, gum infections, things getting stuck in the tonsils all contribute to bad breath. Plaque is bacteria glue that helps germ to adhere to the teeth and eat the food you eat to grow and reproduce. Tartar is plaque that has been in the mouth long enough to calcify and get hard. The presence of these bacterial colonies is the first source to look at when you have bad breath. Getting a cleaning and then focusing on correct brushing and flossing can improve this issue. Sour taste and putrid smell could be a sign of a dead tooth leaking pus into the mouth. This will need to be treated asap with a dentist as infections can be dangerous. Some individuals have naturally large tonsils. Tonsils can easily get food stuck in them chronically and allow bacteria to multiply and cause a smell to emanate. Try gargling and swishing water if you suspect something is stuck in you tonsils. Diabetic patients and those on ketogenic diets are also susceptible to having the ketone smell. This is preventable in diabetics by keeping sugar levels within range. Those on ketogenic diets will have to change diets or spread carbohydrate intake more evenly across the day to avoid it. Dentures must be cleaned properly or they can become bacteria hotels. Denture cleaner is designed to keep bacteria and fungus at bay.
How do I get my toddler to brush?
Brushing a toddler’s teeth can be challenging. Especially when they are teething and it is sore to get brushed. It is still important though as not brushing their teeth or doing so inadequately can lead to bottle rot. This must be avoided because when it occurs the toddler will likely have to have general anesthesia to fix the teeth.
So things to try. There are many strategies that can help.
1. You can try to sing a song to the toddler while brushing I have used the ABC song. it allows them to concentrate on something other than the brushing and becomes a ritual that they know exactly how long it will last and when they are done. to brush well sometimes you have to sing it twice.
2. You can get two tooth brushes, give one to your toddler and they can brush while you brush. that way they get to “help“ and you get to get the job done.
3. You can try using a handy device such as the AutoBrush® that helps you to brush quickly
