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Preventive Dentistry

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Types of Sports Mouthguards
©Suzanne Tucker/Shutterstock.com

Did you know that a recent survey by the American Association of Orthodontics found that “70 percent of parents said their biggest fear is that their child will get hurt while playing organized sports, yet 67 percent admitted that their child does not wear a mouth guard during organized sports including football, basketball, soccer and lacrosse.”

I’m guessing that the survey asked parents about their biggest fear relating to their child and sports, not just their biggest fear in general.  If the latter were asked, I’m pretty sure that most parents would’ve said that their biggest fear has something to do with pythons, getting stuck in an elevator, or getting stuck in an elevator with a dentist and his drill.

Back to mouth guards.

While there are a variety of mouth guards out there, they can all be categorized into three basic groups.

The Three Types of Sports Mouth Guards: Which is Best?

In this section, I’ll go over the three main types of sports mouth guards.  If you’re impatient and you need to know which one is best, jump down to the next section where I provide the answer.

1 – Pre-formed or Stock Mouth Guards

Shock Doctor Brand Stock Sports MouthguardThe mouth guard pictured to the left is a Shock Doctor brand sports mouth guard.  It is a typical pre-formed or stock sports mouth guard.

The biggest advantage of stock sports mouth guards is that they are usually fairly cheap — they can usually be purchased for $10 or less.

The biggest draw back of stock sports mouth guards is that they are a “one size fits all” type of mouth guard.  Sure, they have different sizes for children and adults, but they don’t take into account the fact that jaws are all shaped differently.

Stock mouth guards are also usually rather bulky and make it more difficult to speak versus the other two types of mouth guards.

2 – Boil/Heat & Bite Mouth Guards

Boil and Bite Mouth Guard - Brain Pad Pro PlusPictured to the right is a Brain-Pad Pro Plus brand boil & bite mouth guard.  The name may be a bit misleading as it’s still not clear whether or not mouth guards prevent brain injuries.  These mouth guards are generally considered to be a step above the one-size-fits-all stock sports mouth guards.

When you open up a boil and bite mouth guard, it’s not ready to use.  You need to heat it up and bite down on it so that your teeth make an imprint on the inside.  They are usually heated up in hot water, hence the term boil & bite mouth guard.

Boil & bite mouth guards are usually fairly inexpensive.  They can be found in the $20 to $50 range. This particular brand retails for right around $20.

3 – Custom Fit Mouth Guards

Custom Sports Dental Mouth GuardA custom fit mouth guard is pictured to the left.  These types of mouth guards are usually the least bulky (only a few millimeters thick) and they are custom-made, usually by a dentist, to fit your teeth.  My dental school charges $75 for a custom sports mouth guard, but most dental practices seem to charge $100 to $200.

While looking around on Amazon, I did find that both Shock Doctor and Sporting Smiles sell a kit that will allow you to get a custom mouth guard made without setting foot in a dental office.  They are slightly cheaper, but if the fit is poor then you are out of luck.  If your dentist makes a custom fit mouth guard and the fit is poor, he or she can make adjustments (usually at no extra charge to you) if needed.

The Best Mouth Guard for Protection Against Sports Injuries

You may wonder which type of mouth guard is superior in terms of the protection it provides.

One of the main problems with mouth guards is that they’re not “cool” to wear.  Many kids give up wearing their over-the-counter mouth guard because it’s too bulky or it makes it harder for them to breathe.

This study by Bass determined that athletes were much more likely to wear a mouth guard if it fit well and was comfortable.  Interestingly, studies have shown that custom made mouth guards fit better, are more comfortable, are less likely to affect speech, and are less likely to come loose.

Pinkham’s Pediatric Dentistry textbook states the following about the high cost of custom-made sports mouth guards: “Even though the actual cost is higher than that of other types of mouth guards that are available, the relative cost is low compared with other equipment such as athletic shoes.  Furthermore, the actual cost is far more conservative than the fees associated with emergency and long-term management of a traumatic athletic injury.”

While that is true, many parents choose the least expensive option when it comes to mouth guards.  Although any mouth guard is better than no mouth guard, it’s important to get a mouth guard that fits well enough that your child will actually wear it during sports activities.  A well-fitting, comfortable custom-made mouth guard can be a good investment for your child if they plan on playing lots of sports throughout their childhood.

Want to know why mouth guards are important?  Read Six Reasons Why You Should Wear a Protective Mouth Guard.

Do you have any questions, concerns, or comments about which sports mouth guard is best for your child?  Write them below in the comments section.  Thanks for reading!

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Comprehensive Dental Exam
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Have you ever wondered how thorough your routine dental exams are?

A dentist that I shadowed prior to dental school told me that he used to rush through patient exams trying to get as much done as he could.  Eventually, he got tired of this because he really wanted to spend more time with his patients.  He doubled the price of his exams and spent twice as much time with each patient, being as thorough as he could.  Rather than losing patients, he said that he gained many more patients because his exams were complete and his patients felt they were getting a quality exam at each visit.

What Is a Dental Exam?

At my dental school, we do our exams by-the-book — we’re pretty thorough!  We examine just about every possible thing that a dentist can.  I thought I’d write a post about what our comprehensive dental examination includes, so you can gauge thorough your dentist’s exams are.

What Is a Dental Exam?

A dental exam consists of several different parts.  Each part helps to ensure that you and your dentist understand what is going on with your oral health.  In order to better describe a routine dental exam, I’ve simply written what I do when I see a new patient at the dental school.

I’ve divided it into 10 parts.  You can read over them all to see what we do, or simply jump to the sections that interest you.  If you have any questions when you’re done, scroll to the bottom to leave a comment, and I’ll get back with you.

1 – Introduction

I meet the patient in the waiting area, introduce myself and then ask them a little bit about themselves to get to know them better and put them at ease with me as their student-dentist.

2 – What Does the Patient Want?

I ask the patient why they came to the school for treatment.  I also ask what they expect from their treatment and what kind of dental work they want to have done.

3 – Medical History

I next obtain a very detailed health history, including which medications they are taking and any past or current medical conditions.  I then take a blood pressure and pulse.  It’s important to get the patient’s health history because certain things, like joint replacements and certain heart conditions can affect your dental treatment.  Also, there are over 300 medications that can cause dry mouth, affecting dental health.  Finally, an accurate health history is important because the dentist needs to ensure that there are no systemic problems that will affect the dental treatment that will be provided.

4 – Dietary Survey

We then complete a dietary form that indicates whether their diet places them at a high risk of getting cavities.  Although there are many things that can influence your risk of getting cavities, (here’s 25 things that increase your risk of cavities), diet is one of the most important factors.

5 – Risk Factors

We complete a “risk factors” form that tells us the patient’s risk for developing certain diseases, such as periodontal disease and oral cancer.  This form also gives us a general idea about the patient’s risk for fracturing or knocking out a tooth.

Another part of the form discusses the patient’s dental phobia.  We ask what kinds of things make the patient anxious about their dental treatment.  If you want to pinpoint your dental phobia, take a look at 15 common reasons why people are scared of the dentist.

The “risk factors” form also discusses other risk factors.  For example, this is the form I talked about in a previous article about how wearing your seat belt affects your dental health.

6 – Head and Neck Exam

6 – After that, we perform what we call a head and neck exam.  We feel the neck to note any enlarged lymph nodes or any suspicious lumps or bumps that could be cancerous.  We also feel the TMJ to evaluate whether or not the patient has any joint problems.  We note any popping or clicking in the jaw, which is fairly normal but which can cause problems.

7 – Oral Soft Tissue Exam

Next, we move on to the intraoral soft tissue exam.  The soft tissue exam consists of looking at every area in your mouth.  We look at the lips, the cheeks, the gums, the roof of the mouth, every side of the tongue, under the tongue, in the back of the mouth, the throat and the tonsil area.  Your tonsils can tell us if your body is fighting off a disease and sometimes your tonsils can cause bad breath if there is a tonsillolith present.

It is necessary to perform a very thorough soft tissue exam because this is where dentists check for oral cancer.  If your dentist isn’t very attentive during the soft tissue exam, he or she may miss the beginning stages of oral cancer.  It is important to catch cancer early because it improves your chances of beating it.  If something looks suspicious, your dentist may biopsy the area and/or refer you to an oral pathologist, one of the nine types of dental specialists.

8 – Periodontal (Gum) Health

Another part of the dental exam is periodontal probing.  This consists of sticking a little instrument between your teeth and your gums to see how healthy your gums are.  We measure the space between the top of the gums and where your gums attach to your teeth.  If it’s too deep, you won’t be able to clean it out well and it could indicate that you have periodontal disease, which is a leading cause of tooth loss in people over age 30.  If you do have periodontal disease, your dentist may recommend getting a deep dental cleaning, which is technically known as scaling and root planing.

9 – Hard Tissue Exam: We Finally Check Your Teeth

Next we perform a hard tissue (teeth) exam where we look at every side of your teeth and note any existing fillings, crowns, implants, root canals, cavities, fractures, or if there are any problems with your bite.  We also look at all of your dental work to make sure that it is still in good shape.  Depending on the health of your teeth, we may order x-rays to better diagnose any problems with the teeth and the area around the tooth.  Want to know if you need x-rays?  Read the article How Often Should You Get Dental X-Rays Taken?

During the hard tissue exam, we will also evaluate the patient’s bite.  If we will be making any crowns or dentures for the patient, we usually take dental impressions as part of the dental exam so that we can evaluate the patient’s bite and make sure we don’t cause any problems with the way that their teeth come together when we place crowns.

 10 – Treatment Planning

After gathering all of the above information, we create a treatment plan with all of the dental work that we recommend having done.   Sometimes this is as simple as getting a regular cleaning and providing instructions on how to maintain better oral hygiene or it can be as complex as getting dentures, crowns, bridges, root canals, implants, veneers, braces, and other dental treatment.

Conclusion

This is the comprehensive dental exam that each patient receives initially at my dental school.  Your dentist may choose to do things differently.  For example, some patients hate the “risk assessment” form and the dietary questionnaire.  At my dental school, we are required to complete these forms with the patient.  If you don’t seem interested in those things, then your dentist may choose to omit those parts of the exam.

Remember, all dentists are different, and most dentists want what’s best for their patients and will try to provide you with optimal dental treatment.  However, some dentists aren’t thorough, and hopefully this list will help you evaluate what you want your dentist to address during a dental exam.

If you have any questions, comments, or concerns about your dental exams, feel free to leave a comment below.  Thanks for reading!

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Flossing Mistakes
©Prod-Akszyn/Shutterstock.com

It seems so simple to just slide some string between your teeth to clean those hard-to-reach areas.  While the idea is simple, there are a few techniques that you need to master in order to maximize the return on the time you spend flossing.

Here are ten common mistakes that people make when they floss:

10 Common Flossing Mistakes

1 – Not Flossing the Sides of Both Teeth

Flossing MistakesIf you just slide the floss down, and then pull it up, you are only getting 50% of the job done.  When you move the floss up between two teeth, you need to make sure that you are cleaning the side of both teeth.  One of the favorite places for plaque to hide is between teeth. If you’re only removing plaque from the side of one of the teeth, you could easily get a cavity on the tooth that you’re not flossing.

Find out about six common places where you are most likely to get cavities.

2 – Using the Same Section of Floss Between All of Your Teeth

When you floss you are removing bacteria from between your teeth and below the gum-line.  If you use the same section of floss for all of the teeth in your mouth, you are spreading around a lot of bacteria.  Of course you still are loosening the plaque, which has its benefits, but if you use a new section of floss each time you floss between two teeth, you will be loosening the plaque without putting plaque that you’ve already removed back in between your teeth.

3 – Snapping the Floss Down Hard Between Your Teeth

To get the floss to go between a tight contact between two adjacent teeth, try working the floss back and forth applying a firm but controlled downward pressure.

Snapping the floss down between the teeth can not only injure your gums in the short-term, but the trauma can cause your gums to recede.  Do it enough, and you’ll cause gum disease.

4 – Not Flossing Behind the Very Back Teeth

Even though there isn’t a tooth next to it, it is still important to clean behind the four teeth that are all the way in the back of your mouth (two teeth on each side in the upper and lower jaws.)  This can help remove bacteria that has made its way  between your tooth and gums.

5 – Flossing Aimlessly Without a Plan

When you floss, you need to have a road-map of what order you are going to floss your teeth in, or you can quickly become confused and miss some teeth or even a quadrant of your mouth.  It may be easiest to start in the upper right and go to the upper left, then come down to the lower teeth in the bottom left and move across to the bottom right.

However, as long as you have a plan, it really doesn’t matter which teeth you floss first.  Personally, I start right in the middle of my upper teeth and work my way back on one side and then on the other.  Then I do the same thing on the lower teeth.  Just find a “floss order” that works for you and stick to it so that you don’t forget to floss any teeth.

Dental Floss

6 – Not Flossing Around Dental Appliances

Many people don’t know that if they have fixed dental appliances in their mouth, they need to floss around them.  For example, if you have a bridge, it is necessary to use a floss threader, or get something similar to Oral-B Superfloss.

I had braces on my lower teeth when I was a teenager.  After I had them removed, the orthodontist cemented a wire that connects to each of my six lower front teeth.  This stabilizes them, but also makes it impossible to use conventional floss due to the wire.  Because of this, I have to use Superfloss or floss threaders to get under the wire so I can floss and maintain my gum health.

7 – Quitting When Your Gums Bleed

Blood may scare some people when they floss because they think that they are hurting their gums if they bleed.  You are not hurting them as long as you’re not flossing too hard (see mistake #3.)

Most likely, the reason they bleed is because they haven’t been flossed in a while and the gum tissue has become red and inflamed.  This is a condition known as gingivitis and it occurs because the body is sending more blood to the gum.  This is to help the tissue fight all of the plaque that is accumulating.  When you floss, you are removing that plaque, and since the tissue is inflamed and engorged with blood, you are causing some of the blood to leak out.  After a few days, your gums should return to health and you can floss normally without any bleeding.

8 – Not Spending Enough Time With Your Floss

Most people have 28 teeth if they’ve had their wisdom teeth extracted.  When you floss, you need to get both sides of the teeth (even the most posterior teeth – see mistake #4.)  That means that there are 56 sides that you need to get.  You should be spending a couple of seconds with each side, scraping up and down against the tooth a few times before moving onto the next surface.  That means that it will probably take you around two minutes to floss your entire mouth if you have a full set of teeth.

9 – Not Applying Pressure to the Tooth Surface

When you floss, you want to be careful to avoid using too much downward pressure so you don’t damage your gums.  However, when you are flossing against the side of a tooth, you want to make sure that you are pushing the floss against the tooth surface enough to be able to remove the plaque.

10 – Only Using Floss to Remove Food

Unfortunately, lots of people think that the only reason for flossing is to remove food that has gotten wedged between their teeth. I think many people end up doing this because they can see the food between their teeth — they can’t see the plaque.  An easy solution to this problem is to use a plaque disclosing tablet/solution to visualize the plaque on your teeth.

When you floss, your primary goal should be to scrape against each tooth to remove as much plaque as you can.  As long as you are doing this, you should be getting rid of the food between your teeth without even thinking about it.

Floss Correctly and Keep Your Teeth For Your Whole Life

By avoiding these ten common mistakes, you will be able floss more efficiently which will lead to greater oral health.  Since many cavities start out between two teeth, you will be able to prevent many cavities by regularly flossing and avoiding these ten flossing mistakes.

Do you have any questions or comments about flossing?  I’d love to hear them!  Just leave them below in the comments section.

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New Year's Resolutions for Oral Health
©Becky Stares/Shutterstock.com

Dental New Years ResolutionsYou’ve probably made a lot of New Year’s resolutions in your life — but I’m willing to bet that you’ve never made a New Year’s resolution for your teeth!  Here are a few goals that will improve your oral health, as well as your overall health:

1 – Eat Healthier

I’ve written about food and drink more than 20 times on this blog.  Fresh fruits and vegetables are generally not harmful to your teeth whereas sugary, processed foods will probably cause you problems with your teeth if eaten frequently.  A healthy, well-balanced diet will not only help your teeth and gums, it will also improve your overall health by providing your body with vital nutrients and keeping your weight in a healthy range.

2 – Floss Every Day

As people age, the main reason that they lose their teeth isn’t because of cavities, it’s due to periodontal disease.  Flossing removes the plaque between your teeth that you simply can’t remove by brushing your teeth alone.  One of the most common reasons that my patients tell me they don’t floss is because it’s difficult.  Fortunately, there are many simple devices that can make flossing easier.  Here are a few products that have 5-star reviews on Amazon:

3 – Lose Weight

If you have some extra pounds to lose, you’re in good company — according to a recent poll, about 63% of American adults are either overweight or obese.  Unfortunately, being overweight puts you at risk for many diseases, including type II diabetes.  Type II diabetes has been shown to increase the risk of getting periodontal disease.

You can learn more about the link between diabetes and oral health at this oral health portal from the American Diabetes Association.

4 – Go to the Dentist

There are many reasons that people avoid going to the dentist.  The key is to figure out the reason that you’re not going.  Once you know why, it is easier to make a plan to get in for your dental checkup.

If you’re already going to the dentist every six months, then you are not only having regular cleanings and getting existing problems taken care of — your dentist will also be able to tell you if new problems are starting so you can prevent them.  Many people are unaware that they have dental problems until they become painful.  By that time, there if often little the dentist can do other than removing or filling the problem tooth.  By going in for regular checkups, you will be able to have these problems diagnosed early and treated.

What Do You Think?

Can you think of any other new years resolutions that will benefit your teeth?  If you have any questions or comments, please leave them below in the comments section.  Thanks for reading!

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Children's Medicine Sugar Teeth
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A quick walk down the aisle at your local pharmacy will reveal an alarming amount of sugar.  Most medicine that we give our children is combined with a thick syrup made up of sugar and corn syrup.  For more information on the different sugars that hurt your teeth, read my article about the five sugars that damage your teeth.

Sugar in Children's MedicineWhen you give your child syrupy medicine, the sugary syrup clings to your child’s teeth.  Because the medicine is so thick, it can stay around in your child’s mouth for a lot longer than sugary drinks such as soda pop that are more easily washed away by saliva.

It’s unlikely that you’re giving your child medicine just for fun — you’re likely giving them something that they need to return to full health or to be more comfortable.  So, the most important concern you have is to get a sick child to take their medicine at all!  But since you need to give your so or daughter medicine in syrup form to get them healthy again, here’s how you can do it without causing harm to their teeth.

How to Give Children Cough Syrup Without Hurting Their Teeth

Here’s a few suggestions that you can try when giving your child medicine in syrup form:

1 – Dilute the syrup with water.  By diluting the syrup you are doing two things: you are making it less sticky, so it’s easier to get rinsed away by your child’s saliva.  You are also decreasing the concentration of the sugar in the medicine, which will provide less sugar to feed the plaque that live on your child’s teeth.  One caution: your child will still need to drink the entire amount of liquid you have diluted the medicine in to get its intended effects, so don’t dilute it too much – sick kids often have decreased appetites and once you have diluted the medicine, it will be difficult to guess how much medicine they have actually ingested.  So don’t overdo it!  Also, don’t dilute their medicine if they are having a hard time keeping other food or liquids down – in this case, just get them to take the medicine as is and try to rinse their mouth out after, as described below.

2 – Try having them drink it through a small straw.  When we drink anything through a straw, it bypasses our teeth and gets whisked to the back of the mouth and swallowed almost immediately.  By avoiding contact with most of the mouth, the syrup doesn’t have much of an opportunity to damage your child’s teeth.  Some medicines will be too thick to do this with, so use your judgment or dilute it slightly first, as mentioned above.

3 – Have your child drink water afterwards, or at least rinse out their mouth after having the medicine.  This suggestion is probably the most important and most easily done.  If your child can drink some water, or rinse out their mouths and spit it out, it will remove most of the sugar that hangs out in their mouth waiting to get turned into acid by the plaque.

4 – Avoid giving the medicine right before bedtime if possible.  If you give your child a syrupy medicine and then send him or her right off to bed, your child will fall asleep with sugar-coated teeth.  When we sleep, our saliva production decreases dramatically.  Without the saliva there to wash away the syrup, it can stay on your child’s teeth all night.  This is the main reason why toddlers get lots of cavities; they drink sugary drinks right before they fall asleep, or even worse,  their parents give them a bottle when putting them to bed.

If you need to give your child a bottle to get them to fall asleep, the best thing to give them is pure water.

Conclusion

Cold medicine may seem like an insignificant source of sugar in the grand scheme of things but every bit of sugar your child ingests adds up.  By following these four suggestions, you can reduce the potential damage caused by these cold medicines.  Of course, the most important thing when your child is sick is to get he or she feeling better; but if your child is able to take their medicine in one of these ways it will prevent the medicines they need to take from harming their teeth.

Do you have any comments or questions about giving medicine to children and its effects on the teeth?  Leave them below in the comments section!

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