by Dr. Richard J. Walicki | Mar 30, 2013 | Cavities, Dentistry, Prevention, Tooth Decay
There are a number of factors that can contribute to the formation of dental cavities. One fundamental that will apply to most everyone concerns the reduction of dental plaque. If you want fewer cavities, reduce your plaque levels.
Dental plaque can be defined as a complex microbial community, with greater than 10 to the 10th power bacteria per milligram. (That’s really a lot of bacteria.) Just to keep things simple, though, the problem is that these bacteria produce acids on your teeth – and the acids dissolve the enamel, leading to tooth decay.
After only a few years of practice, it became obvious to me that most people have difficulty identifying plaque. Even now, I’ll begin a dental exam or cleaning on a person and start removing large areas of plaque. If I casually ask the patient about their cleaning regimen, often I’m told “I brushed just before I came in here!”
Since that much plaque can’t form in an hour, the obvious conclusion is that the patient missed it or simply doesn’t see it. Just to be clear, plaque is the soft, sticky film that occurs on the surface of teeth – not the hard substance your dentist or hygienist has to pick away, which is tartar. Though it is basically mineralized plaque, virtually no amount of tooth brushing and flossing will remove tartar after the fact (dentists call it ‘calculus’). Once formed, calculus needs to be removed at your office visit.
It is useful to know that if you control your plaque well, calculus won’t be much of a problem. So let’s focus on that for a moment. What do you do if you feel you are brushing, but the dentist tells you he still sees plaque? Stain it!
Lately, I have been seeing more commercials advertising products for children that stain their teeth blue after they have rinsed with it. The child then brushes until all of the blue stain has been removed. What the liquid is staining is plaque. I think this is a great way to simplify the process of identifying the problem. Whether you are six or sixty, the principle is the same.
If you want to be certain you have gotten the plaque off, rinse with the stain after each meal and then brush (and floss) until you have removed the discolored areas. Barring other systemic or external contributory factors (such as medications leading to a dry mouth), you and your dentist should see a big improvement in the cleanliness of your mouth, and fewer cavities over time!
by Dr. Richard J. Walicki | Oct 17, 2011 | Uncategorized
As a dentist, it’s not unusual to find me browsing the dental aisle from time to time. I like to see what’s new. What I find particularly interesting, though, is watching people as they make their product choices.
My impression is that one area which seems to attract the most indecision relates to the subject of which toothbrush to buy. With manual toothbrushes people ponder over whether to get a soft bristle, a medium hardness, or an outright hard bristle. Then, the question becomes should it be angled or straight?
In my office, people also frequently ask: “How often should I replace my toothbrush?” (As often as once every other month. Don’t let it go beyond three months on average, however. Also, replace your brushes after being sick. The bristles retain germs.)
Then there is the question: is an electric toothbrush really better than a manual? If so, what kind of electric brush? Sonic, rotary, or oscillating?
It can get pretty confusing. So let me sum it up for you.
While I’m not sure every dentist will agree with me (only “three out of four” of us agree on anything anyway) 🙂 here is my opinion:
If you’re buying a manual brush, get a soft bristle. If you are deciding between a manual and electric – go for the electric. In my experience battery-powered brushes are fine, but rechargeable brushes are more convenient and eliminate the cost of frequent battery changes. Rotation-oscillation is usually preferred, but I have seen excellent results with the sonics as well.
Soft bristles are kinder to the gums, and since you should be paying attention to your gum-line when you brush, this is important. When I was in dental school I recall a lecture explaining that soft bristles were also “end-rounded,” which means that if you looked at the tips of the bristles under magnification, their ends are, well, rounded. This is in contrast to bristles that are cut off at sharp angles on the harder brushes. I guess the manufacturers figure if you’re going to buy the harder bristle, “What the heck. There is no point to rounding off these babies, let’s keep ’em really rough.” The trouble is this can be abrasive to your gums.
As for the electric brush, I think a consensus exists that — per time spent brushing — more plaque is removed. So this is worth the extra investment. If finances are tight, I believe that you still can achieve excellent results with a manual brush – if you use it correctly. This means brushing in the correct directions, with the right motions and with the appropriate amount of force. Have your dentist or hygienist demonstrate the recommended technique to you. Also, if you have all of your teeth, you should spend at least two minutes brushing them. In my observation, the trouble is that most people simply don’t brush long enough. So time your brushing. One study showed most people think they are brushing much longer than they actually are. Since human nature seems to be inclined to “rush the brush,” this is where electric brushes have an advantage over the manual variety. Many of the electrics have built-in timers. You can still cheat, but at least you will know you are doing it.
