Our Dental Blog - Helpful Information & Fun Tips

People ask me all the time “What is the best toothbrush I should use? Soft? Medium? Firm? Manual or electric?”, and my answer used to be “The one you use on your teeth and gums.” But that changed as I noticed more and more patients getting gum recession, especially when they felt like their toothbrush was giving them the best cleaning ever. The answer is “True Soft.”

Most people don’t know just how soft their toothbrush (TB) needs to be in order to clean their teeth efficiently and safely. Some people are happy with “Firm” or even “Medium” TB. Unfortunately, in my experience, patients who use these types of TB always have moderate to advanced gum recession. So what about the store bought TB that says soft? If you look real closely at the front, back, side, top, and bottom of the TB package, you most likely won’t find an expiration date, which means you have no idea how long that TB has been on the shelf. It could’ve just been put up that day or have been there for years. Who knows? When using such a TB, the “Soft” label may be misleading, and feel harder than soft.

Solutions: Unfortunately the TB you need may not be the one you want, which is what I call “True Soft”, because soft is relative to the TB you were using last. You may be use to using a “Firm” TB, which means “Medium” will feel soft to you, etc… If you want to know what a true soft TB feels like, you can either look for a TB that says “Ultra Soft” or “Sensitive,” or order one online. A TB I always recommend is called Nimbus, from nimbusdental.com. Whether you’re using a manual or electric TB, if your toothbrush isn’t at least close to the softness of this one, then it may be too hard.

Patients will sometimes say “Every time I use a soft TB I still feel like there is stuff there.” That’s ok, really, that’s allowed. Even the most ardent Hygienist will miss some stuff from time to time when brushing their teeth. Simply put a little toothpaste on your TB and brush those areas again, and it will most likely come off. If it doesn’t, take note because there may be external reasons why. For one, you may not be brushing enough, such as only once a day, so brush 2-3x a day. Second, you may be experiencing dry mouth throughout the day, so drink more water to hydrate yourself. I recommend cucumber water, since your body will absorb it better than just straight water which usually goes straight through you.

Most of use look for the easiest method of cleaning between our teeth and for good reason, it's very tedious. Nobody wants to do anything so tedious just before bed, since all we want to do just before bed is just that, go to bed. So we con ourselves into either doing what we think is good enough or just nothing at all. Trust me, its a mind game we play with ourselves and for our teeth's sake, its a game we need to win more than lose. But what's the best way and products to do the job? Here we'll discuss the top 3 types of products used from best to worst and how to use them.

Floss picks: Worst

Floss picks are small strands of floss attached to what looks like a U-shaped frame with a pick at the end. Floss picks are designed to easily slide in between teeth quickly with the pick part used to remove anything left behind. Patients tend to love them due to their ease of use such as you only need one hand to use them, and the fact they can get the job done quickly. But just how effective and safe are they? Unfortunately most people don't use them both safely and effectively. First, the problems with floss picks in general. Floss picks are designed only to go between the contact points of the teeth, and with such a small section of floss, it becomes very difficult to push the floss up against side of the tooth (hugging the tooth/c-shape flossing), which would allow the floss to go beneath the gum line safely, and due to the U-shaped frame, you're also limited on how deep you can go.

The pick part is also a problem, since you should NEVER PICK AT YOUR TEETH OR GUMS!!! What happens in many cases is that over time, as you pick at your teeth and gums, digging out whatever peace of meat or popcorn kernel is stuck there, you inadvertently loosen up the attached part of the gums to the tooth, making your gum pocket deeper. Now, is there conclusive evidence of this in any peer review science journals? Nope. It's just my theory from my experience with patience who use the pick part of the floss pick a lot. They mostly have deep pockets of 5-7 mm. Another problem is the fact that most people who use floss picks use only 1-3 picks for the whole mouth. This creates a bacteria problem as they transfer bacteria from tooth to tooth. Patients will say "But I rinse my pick with water every few teeth." Um okay, if you only rinsed your hands with water after doing a number 2 in the bathroom, would that take care of the bacteria? But seriously there are those who need to use them due to having either a physical or mental handicap issue or they are just dead set on using them no matter what. If that's you then you must switch out your pick every 2-3 teeth, try hard to hug the side of each tooth, and only use the pick part as an absolutely last resort.

Traditional flossing: Best

Without getting into the million and one types of floss out there, lets keep it simple and just talk about the traditional stringy floss. Whether its waxed or non waxed, flat, thin, rope, etc...whatever is comfortable to you is good enough.You may be wondering what could be said about traditional floss since it seems pretty straight forward but trust me when I say there is more to it in how its used and why it works. First, how to really use it. There are many ways one can floss their teeth and every time I think I've seen it all, there's always another patient that introduces me to a new method. Unfortunately, of all the methods one could use, there is only one method that is the right method. It's called "C-shape" flossing or what I like call "The hug and rub." To keep it short, all you do is push the floss up against the side of the tooth and go up and down. Down as deep as you can that is comfortable and back up to the contact of the teeth. Repeat for the other side and make sure you are going up and down at least 3-4 times. Sometimes your teeth can have really tight contacts and in this case, you can go back and forth like a saw to slide past that tight contact.

Second, why it works. Without getting too "scientifically" correct I'll try and keep it short and simple. Bacteria have what you can call a protective matrix (like a bubble) that protects the bacteria from outside factors like chemicals, cold, heat, oxygen, white blood cells, etc... Simply throwing mouth rinse on it won't do anything more than have the bacteria thank you for giving it a bath. So to break this matrix you need to use something physical, like floss, and now the bacteria is susceptible to whatever you throw at it. This is why I recommend flossing first, then brush, then tongue scrap (well discuss later), then mouth rinse. Finally, this bacteria reproduces itself every 12-24 hrs, which is why your mouth rinse bottle will be labeled as saying to use it 2 times daily.

Proxy Brush: Best

A good product that can be somewhat of an "in between" (pun intended) of floss and floss picks are proxy brushes, otherwise known as inter proximal brushes. They look like miniature bottle cleaners with there tiny bristles. Proxy brushes (PB) are somewhat tricky to use because they're not a one size fits all kind of brush. They are designed to go between the larger spaces of your teeth where flossing or floss picks wont do much good. Many people who have spaces between their teeth will find PB's to be very helpful in removing the plaque in those areas even your toothbrush can't get to. The trick to using a PB is to find the right size. A good brand to look into is Type, which have a variety of sizes and types, such as PBS on a toothbrush handle. Your PB should fit snugly between your teeth without having to really force it through. Having too much space between the tooth and the brush will prove ineffective. Aloha

With so many dental products out there, who knows whats good and whats not, even for dental professionals. Well one things for sure, the dental product you don't know about is definitely one you won't be using, which may be the one you really need. In this set of blogs I'm going to help you become aware of what I consider the best and worst products on the market that either do what they say do, or not and possibly worse.

1st product: The Waterpik

The product is by far the one I recommend the most. It does what its supposed to do and then some, but there's one catch, you have to read the the instructions. You think I'm kidding but I'm not. Most patients who use this haven't really ready the instructions and therefore miss out on the best thing about it. So what does it do? It's basically a glorified water gun, but for teeth. The hard part about getting one is deciding which one to get. Well, to narrow it down you really only have 3 options, small, medium, and large. Of the three I highly recommend medium, and maybe small, but never large. Why? Small is too small for general consistent use and may only be good for traveling. Small has too small a reservoir. The water will run out before you know it and will get frustrating in time. Small also only comes with 2 basic tips and only has two basic power setting, high and low. Large waterpiks are simply that, too large. Having this giant monstrosity may take up more counter space than you want, and it isn't necessary to do get the job done.

Finally we come to my personal favorite, the medium. First off, medium has a reservoir size that more than adequately can finish you mouth 2 times over, and then some. 2nd, it has multiple power settings so you can easily find your comfort level while getting the job done. Third, it comes with multiple tips galore. You have a tip literally for every occasion such as brushing, braces, bridges, implants, plaque removal, and even one for implants. My personal favorite tip is the "gum irrigator." This is the rubberized tip that is very narrow, very comfortable, and in my opinion, the only one you'll every really need, except if you have braces of course. This tip specializes in flushing out those deep pockets between the gum and the tooth, just below the gum line.

Now the how. So how does one use a waterpik effectively without waterpiking the entire bathroom? Your going to need one of those small mirrors that can flip up or down, which usually have 2 sides to it. Place the small mirror in front of you next to the sink faucet. Make sure the small mirror is facing up at you so you can see into your mouth as you look downward at it. Now fill the waterpik reservoir as much as desired making sure you don't just use water, but use 50% water and 50% of your favorite antiseptic mouth rinse (always keep ratio 50/50 which is allowed per the instructions). Place the waterpik in your mouth 1st before turning it on, since the pause button doesn't always work. Once on, proceed to waterpik your gums and teeth, making sure you are aiming the tip downward along the gum line, flushing out the gums and blasting away plaque on the teeth. Have your mouth open enough to see what you are doing but closed enough not to allow water to squirt out. You'll notice that since you are looking downward at the small mirror, the water will fall out of your mouth and into the sink (somewhat of an organized mess), granted you are leaning over the sink in the first place.

Pros & Cons:

Pros: Reaches areas not reached by brushing and flossing. Gives more of a complete oral health care than brushing and flossing alone. Cons: Can be a bit messy. Adds more time to your oral home care. So if you haven't guessed it, this product definitely fits in the "Best Products" category. Aloha

Please limit the amount of sports and energy drinks that you consume. Unfortunately, The largest consumers of these beverages are children and adolescents, who are often unaware of the damaging effects of these products. They are designed to re-hydrate and energize the body, but they also contribute to demineralization and tooth decay.

Sports and energy drinks contain large amounts of sugar and are highly acidic. Taken over time, the sugar and acid work to weaken and break down the enamel on the teeth, which can lead to tooth decay. If you consume these products, please use fluoridated toothpaste and rinse, and products containing calcium phosphate, which can work to remineralize the teeth.

Your dental professional can check for any detrimental effects caused by sports and energy drinks during your routine check up.

In the past, whitening teeth have always been done in a dental office setting. However, with new OTC delivery techniques and whitening materials, the industry realized it could address consumers directly. The material used are typically Carbomide peroxide, or hydroden peroxide. As with any whitening product, their is a chance of getting dentinal hypersensitivity and/or demineralization.

The use of a flouride product such as toothpaste or rinse, can help address this problem. Toothpastes that contain calcium phosphate have also been suggested as a desensitizer and remineralizer. Others include casein phosphopeptide-ACP, arginine calcium carbonate,

Tri-calcium phosphate, and amorphous calcium phosphate. To find out if you are a candidate for successful tooth whitening and bleaching, please check with your dental professional.

Did you know that untreated periodontal disease in a pregnant mother can adversely affect the health of her unborn baby?

Periodontal disease has been associated with early labor, gestational diabetes, pre-eclampsia, and low birth weight babies. To help prevent this, please see your dentist for a check up and cleaning. please make sure to brush and floss twice daily and use a mouthwash of your choice.

Make sure to keep up to date on your regular check up schedule. Let us help you, to help you and your new baby.

Did you know diabetes directly afffects the health of your mouth, and the health of your mouth directly affects diabetes? Diabetes and periodontal disease each cause inflammation, and if both are present, the inflammatory burden is increased.

Currently about 387 million people have diabetes, half of which are undiagnosed. Over 80% of our population has gum disease and don't even know it. Please see your dentist for a check up and keep to regular recalls to help prevent the detrimental and damaging effects these conditions can cause.

Did you know that your hygienist can provide dietary counseling? studies have shown certain foods increase inflammation in the body. Inflammation is directly related to certain systemic diseases which include diabetes, cardiovascular disease, rheumatoid arthritis, and Alzheimer's disease. 1-3 These systemic diseases in turn, can affect chronic periodontitis, since inflammation is the primary cause of periodontitis. 2. One solution for reducing systemic inflammation is to consume anti-inflammatory foods.

Anti-inflammatory foods contain vitamins A, C, D, and E. Fruits and vegetables are healthy food choices. These include root vegetables and green leafy ones as well. Any fruit that is not juice, non-fatty fish, poultry and nuts are beneficial. Always try to limit the consumption of sugar, red meat and pork. The anti-inflammatory diet closely mimics the Healthy Mediterranean diet.

The Healthy Style of eating includes a variety of fruits and vegetables. Also, whole grains, fat-free dairy, a variety of seafood, lean meat, poultry, eggs, legumes, nuts, seeds and soy. 21 It also recommends limiting saturated fats, trans-fats, added sugars and sodium. 21

Try to avoid our Western diet. It is rich in whole milk dairy, fatty meats, processed grains, sugars, fats and oils. Unfortunately, these foods have all been linked to systemic inflammation. If you have any questions about your diet, Please talk to your dental hygienist. We are here for you, and will help to guide you on your journey to excellent oral, and total body, systemic health.

1. Cordain L, Eaton S, Sebastian A, et al. Origins and Evolution of the Western Diet: Health implications for the 21st Century. American Journal of Clinical Nutrition. 2005;81:341-354 2. Varela-Lopez A, Giampieri F, Bullon P, Battno M, Quiles JL. A systematic review on the implication of minerals in the onset , severity, and treatment of periodontal disease. Molecules. 2016;21:1183 3. Ly V, Bottelier M, Hoekstra P, Vasquez A, Buitelaar J, Rommelse N. Elimination diet's efficacy and mechanisms in attention deficit hyperacitivity disorer and autism spectrum disorder. European Child Adolescent Psychiatry. 2017;26:1067-1079 21. US Department of Health and Human Servies and Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. Available at: health.gov/dietaryguidelines/. Accessed December27,2017