In almost any field there are basics, the fundamental facts or principles from which other truths can be derived.
Without an understanding of these basics we lack the building blocks for greater knowledge or competence. For example, before we can write we learn our ABCs. Geometry first requires an understanding of arithmetic, and so on.
Lacking these basics, we can become lost in a sea of information, lacking the correct drops of water that hold the answers to our questions or allow us to be effective.
Know the basics of automotive care and you are likely to have a car that runs well and needs few repairs. Understand the basics of grammar and you can communicate.
What, then, are the basics of dental care?
While there are several key concepts which I cover in some of my earlier articles, there is one often overlooked principle I want to briefly cover herein.
Let’s first assume you are already in good dental health or, perhaps you weren’t, but now you got things under control. You are starting off with a “clean slate.” So, what do you do now?
The simple answer is taking a look at what got you there.
You spent months and maybe hundreds, even thousands, of dollars to handle dental problems that may not even have been causing you pain. Things feel good and you have gotten the clean bill of dental health from your doctor. What now? Continue to do what fixed the problem.
Did you start brushing after meals? Good. Continue.
Did you change your diet to reduce refined carbohydrates? Good. Continue.
Do you floss every day? Good. Continue.
Do you come back for your regular visits? No?! Why not?
If that was a successful part of the formula, don’t make the mistake I see so many people commit. There is probably many a dentist who will vouch for the fact that patients come in to them and say: “Yeah, I had a bunch of dental work done somewhere about fifteen years ago and it is starting to come apart.” When asked about the time of their last dental visit: “Oh, it was around then. Since my teeth were fine, it didn’t see the point of going in for a dental visit.”
Didn’t see – that’s a key point. There are many conditions that the patient neither sees nor feels. More importantly, dental health has a direct relationship to overall health. So the fact that one doesn’t feel gum disease, bone loss, dental cavities or oral cancer – especially in the early stages is a poor excuse not to see your dentist. Regular checkups are fundamental to defending yourself against serious problems. Caught early, your treatment can be approached conservatively, saving you time in the dental chair, the potential discomfort of extensive work and, of course, money.
Why is it that patients who visit the dentist regularly seem to need less dental work? I’d like to think it also has to do with their increased care and effort – but that effort includes keeping up with regular visits. These checkups can prevent small problems from turning into big ones and help to keep your existing work in good shape. Don’t be a penny wise and a pound foolish. See your dentist at least twice a year.
Sounds like a pretty basic question for a dentist, doesn’t it? In fact, I’m not really asked that question often because “everybody knows” you should brush your teeth twice a day. But should you really?
After all, you can pick up almost any tube of toothpaste and it says right there” brush twice daily, or as directed by your dentist”.
Some time ago, I started asking patients how often they brushed their teeth when they came in for their periodic cleanings. The most common answer – by far – is “twice a day.” My next question is usually, “Yes, but when during the day do you brush?” As you read this, many of you who do brush twice daily are thinking “when I get up and again before I go to bed.”
If you have experienced dental cavities, that could be part of the problem.
When I mention this to patients I usually get this sort of silent stare. It’s kind of a cross between, “well that makes no sense at all” or, “then I might as well just give up.”
Let me explain.
It starts with an understanding of what causes dental cavities. There are a few basic elements. The most obvious is that you need to have a tooth. Additionally, you need cavity-causing bacteria. Then you also need a fermentable carbohydrate. This is an important point. Carbohydrates include sugars and starches, but the process of fermentation creates acids. Once the acids form, there is another element that comes into play: time.
If we break these factors down further, it is useful to look at what we can control in the cavity-causing process. For the sake of argument, let’s assume we are starting out with a full set of teeth, so that’s not entirely in our control. Next, there is the factor of cavity-causing bacteria. We all have both good and bad bacteria in our mouths. While I could get into a discussion of promoting the good and suppressing the bad, this is also not always easily controlled.
The next two factors, however, we have a great deal of control over.
We can control what we eat. Recognition of which foods are acid forming is also useful. But I’m a realist and understand that sometimes we are just going to eat (or drink) those things anyway.
And this is where the time factor comes in.
A little analogy may be helpful here. What would you do if you spilled a strong acid on your bare skin? Chances are you would run right over to the nearest sink and try to wash it off. But what if you had a leather jacket on and didn’t notice right away? First of all, you would end up with a hole in your jacket, but eventually – with time – it would reach your skin and start to hurt.
It’s much the same with teeth. Your enamel is a protective layer that doesn’t have any feeling because it is mostly mineral and doesn’t contain any nerves. But given enough time, the acid – even a weak one – breaks through and gets to the underlying softer and more sensitive areas. So, don’t give it time.
Change your brushing habits and do so after every meal. About a half hour after eating is ideal. If you absolutely can’t brush on occasion, chewing a sugarless gum (preferably containing xylitol) can help.
What most people do, though, is wake up and brush. Then they have breakfast and don’t brush. The acids that are formed following the meal slowly dissolve our tooth enamel. Roughly when the acids wear off, they have another meal or a snack and freshen up the acid. Few people brush after lunch, so it’s a few more hours of wearing the enamel away. Just when that acid wears off people freshen it up again with dinner. They don’t always brush after dinner either, so the acid now has even more time to work. Finally, they brush before going to bed. This cycle can, and typically does, go on for days, weeks, months and years. Given enough time, the cavity becomes large enough to require a filling.
So, if you only eat two meals a day, brushing twice a day is probably fine. But if you eat three times a day, how often should you brush? You get the idea.
The really odd thing is that I can go over this with someone thinking they get it. A couple of years later, I’ll ask: “How often do you brush your teeth?” Believe it or not, the answer is often the same as when I asked the first time. Hopefully, however, you will get it. Remember also that you can’t ignore flossing and expect to escape cavities, even if you do brush after every meal. The area between your teeth can’t be reached by the toothbrush bristles. About a third of all cavities filled by dentists occur in this location.
Nevertheless, if you follow the advice above I think you will find yourself encountering far less tooth decay over the years. Hoping it works for you as well as it has for me.
Probably one of the most common dental misconceptions revolves around the idea that in order for a tooth to have a problem it has to hurt. Certainly, if a tooth is aching, we can agree that there is most definitely something wrong. But can a tooth have a cavity and not hurt you? If so, should this still be a cause for concern?
Watch this short video to learn how this situation may have something to do with you. CAVITIES 101
Dr. Richard Walicki is a dentist practicing general and cosmetic dentistry. While we hope you find the information contained herein interesting and useful, this blog is for informational purposes and is not intended to diagnose any oral disease. Dental conditions should be evaluated by your dental health professional or a qualified specialist.
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