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By contactus@drjrobb.com
November 22, 2020
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Did you know dental floss had its own day? I didn't until recently--but it is on November 23rd.

Flossing is still the best way to reach plaque that is in between your teeth in areas where your toothbrush can't reach. "String" floss is still the standard. It is the one that can best be wrapped around the tooth. Flossing correctly is important, so ask your dentist or dental hygienist to review the correct way to floss with you. You can also read about it here: How To Floss

String flosses come in several varieties:

  • Unwaxed: tends to be thinner and has not coating on it. Some like it because it doesn't leave a residue behind and it squeaks when the teeth are clean. Some don't like it because it is harder to slide it between the teeth and it tends to shred or break more easily.
  • Waxed: has a waxy coating on it to make it easier to slide between your teeth. Some versions are flavored and some are not. Some people say they get a residue from the wax on their teeth.
  • Teflon Coated/Easy Slide Varieties: these have a coating on them that makes them easier to slide between the teeth--some say it's even easier than the waxed flosses. Other experts say the slick coating on this type of floss also makes it easier for the floss to slide over plaque rather than removing it as it is intended to do. We do recommend making a few extra up and down passes with this type of floss compared to the others.

For those with physical dexterity problems who cannot hold string floss, there are floss handles available. Some still require you to load the string floss onto the holder (with new floss each day) and others have prefilled cartridges that are inserted, used for one pass through the mouth, and then the cartridge is discarded. 

Other people who don't like to use string floss will use a preloaded floss pick. these do work, but often times the floss is not able to wrap as much around the tooth due to the construction of the floss pick itself, so make sure you are pushing it against the tooth to wrap it around it as much as possible with the device you use. Again, these should be used for one pass through your mouth and then discarded. 

For those people who have had gum recession or who have wider spaces or "triangles" between their teeth, proxybrushes are an option. These come in a variety of styles and are basically a small brush that fits between the teeth. Be careful to never force these into a space. They should only be used in areas where the slide in easily. Most of the time, these brushes can be rinsed and reused, just like your toothbrush. (They should be replaced on a regular basis. Some types just the brush needs to be replaced and you can reuse the handle, and others are a one piece construction.) 

You can also learn more about interdental cleaners here: Interdental Cleaning Devices

If you have a fixed partial denture (or "bridge") you will need to use either a floss threader or a 3-in-one floss or some other type of floss device that has a stiffer end at one side to allow you to thread the floss under the welded portion of the bridge to clean the sides of the teeth and the underside of the bridge.

There are also some fancier devices that help with flossing:

  • Oral Irrigators (WaterPik and others) use a concentrated stream of water to remove plaque from between your teeth.
  • SonicFusion (WaterPik) combines a sonic toothbrush with a water flosser. Theoretically you could brush and floss in the same 2 minute cycle
  • Hummingbird flosser (Oral B) vibrates the floss to help insert the floss between your teeth and move the dental plaque around.
  • Air Flosser (Phillips Sonicare) uses a blast of air to move plaque off your teeth
  • There was also a flosser that had a thin fiber that you positioned correctly between your teeth then turned it on and the fiber vibrated/rotated to clean the area between your teeth. 

Hopefully, you are now ready to celebrate National Floss Day!

*Note: Information in this article is not meant to replace the clinical judgement of your healthcare professionals.

Jennifer G. Robb, DMD is a general dentist with an office at
1320 Cooper Foster Park Rd. W
Lorain, OH 44053
440-960-1940
www.drjrobb.com

You can also find us on Facebook at www.facebook.com/DrJenniferRobb

By contactus@drjrobb.com
November 18, 2020
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Both sealants and Preventive Resin Restorations (PRRs) are proven effective at reducing cavities on the chewing surface of your teeth. Please note, these do not protect all areas of your tooth, so brushing and flossing are still needed!

 

A sealant is used when the tooth has deep pits or grooves but no cavity. It is a surface coating that is painted on to a prepared tooth to fill in the pits and grooves that collect food and bacteria (leading to decay). A PRR is used when a small cavity has already started in your tooth’s pits or grooves. The soft tooth structure in the decayed area is removed and then a tooth colored material is placed into the area. Like the sealant, the goal is to fill in the pits and grooves that can collect food and bacteria.

 

If you let the cavity get larger, then a filling is needed, rather than a sealant or PRR.  Fillings can be composite resin (tooth colored) or amalgam (silver or gray colored).

 

Local Anesthetic, commonly called Novocain, is not needed for sealants. In most cases, it is not needed for PRRs. It is often needed for fillings.

 

A few years ago, a concern about a monomer (bisGMA) used in many sealant and PRR materials surfaced. Studies have found no significant or statistical associations and indicate that sealing teeth should continue since it has shown proven benefits.

 

Sealants are usually done on children as the molars come in to their mouths. They can be done on premolars as well. Most insurances only provide benefits for sealants  up to a certain age and only on molars. PRRs have been done for many years but are a relatively new separate dental code, so it remains to be seen if the insurance companies will place age or tooth limits on this procedure.

 

You can learn more about sealants, PRRs, and fillings from Dear Doctor in the Patient Education section of my website, www.drjrobb.com

Sealants

 

This advice is not intended to replace the clinical judgement of your healthcare providers.

 

Dr. Jennifer Robb is a general dentist who does sealants, PRRs, and fillings in her office located at 1320 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940.

www.drjrobb.com   www.Facebook.com/DrJenniferRobb

By contactus@drjrobb.com
October 31, 2020
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November 1st is X-ray Day! In honor of that, I thought I'd answer some questions about dental radiographs.

Q: Why did you call them radiographs instead of x-rays?

A: Good question! Most of the time, in casual conversation, we call them x-rays. The technical answer is that the x-rays are what comes out of the x-ray machine that create the image. The image that we see is called a radiograph. (But, as I said, in casual conversation, most of us just call them x-rays.)

Q: Why are dental x-rays important?

A. They help us to see areas of your mouth that we can't see just by looking in your mouth. If you've flossed your teeth, you've probably noticed that there's a spot where it's hard to get the floss between the teeth. We call that a contact point. When teeth are close together like that, we can't see in between them to see if decay has started. We also can't get our cavity detecting instruments into the contact point to see if decay has started. An x-ray helps us see that area.

Gums cover your jaw bone. The dental x-rays also let us "see" that bone so we can check for bone loss, abscesses or other pathologies in the bone. Some x-rays also let us see bones of the skull and bones that make up the tempromandibular joint (jaw joint).

Q: You said only some x-rays let you see certain bones. What are the types of dental x-rays and what are they used for?

A: There are several types of x-rays that your dentist may take:

Bitewing x-rays: usually 1-4 films though vertical bitewings may involve up to 7-8 films. The traditional method for these is to put the film or sensor into the mouth and you bite down on a tab or plastic bite block. These show both top and bottom teeth from about the gumline to the biting surface. They're most helpful for seeing cavities in between your teeth though for those with healthy bone levels around the teeth, we can sometimes see that as well. Newer panoramic type machines can also take bitewing x-rays with only a bitestick in between your front teeth. These give us a bit more information than the traditional bitewings since there is more bone repressented and we can see the ends of the roots of your teeth. (It's kind of a combination of bitewing x-rays and periapical x-rays which I'll discuss next. The panoramic machine's bitewings do not always show your front teeth, so if you're having a problem with front teeth, a different type of x-ray might be needed.) 

Periapical x-rays: traditionally a film or sensor was placed in the mouth near the tooth in question and you'd bite down on a plastic holder. This type of film shows teeth from the biting surface of the tooth to the end of the root. (The end of the root is called its apex.) It is most often used to see if there is a dark circle around the apex of the root (which indicates an abscess) or to see if there is other pathology around the tooth. It can also be used to check the height of bone around a tooth. With the traditional method usually 1-3 teeth (possibly more for lower front teeth) are shown on the x-ray. Newer panoramic machines can take this type of x-ray too, again with only a bitestick between your front teeth. Depending on the settings, we may see more teeth per film than we would with the traditional method of taking them. If you have a root canal, this type of x-ray is used to check that the instruments have reached the end of the tooth root.

Full Mouth Series: This is a set of approximately 18 films or images. The full mouth series includes both bitewing and periapical views of each tooth you have. In the traditional method, films or a sensor would be inserted into your mouth and a series of images taken. They're used for the same reasons as described under each individual type of film. Periodontists like this type of x-ray because it shows them bone levels around teeth. Some offices skip areas of the mouth that don't have teeth, while others will still try to take a film there just to check for pathology. 

Panoramic x-ray: the panoramic x-ray is taken in a machine where part of the machine rotates around your head to produce the image. In most cases, there is only a bite stick between your front teeth. (Many people find this more comfortable than having the film or sensors inside their mouth.) It's similar to a full mouth series in that we see all your teeth, but it also shows areas where you don't have teeth, as well as the jaw bones and the bony aspects of the tempromandibular joint area (jaw joint). It is useful for detecting pathology and seeing changes in the bone. It's not as accurate for detecting decay that is just starting (incipient decay) but larger areas of decay can often be seen on this type of x-ray. It's also helpful for checking on unerupted permanent teeth in children and unerupted wisdom teeth.

Cephalometric x-ray: this type of x-ray always reminds me of a profile (only it's showing the bones, not the facial features). Orthodontists use this view most often but there are other times it is useful as well.

Occlusal x-ray: Traditionally, this type of x-ray involved a larger film size and it was set in the mouth almost like you were biting into a sandwich. It was often used to check for unerupted front teeth. I'm not sure if digital platforms make a sensor in that size. CBCT units might be needed to render this view. 

CBCT (Cone Beam): This is a specialized machine that's often used for surgical planning (dental implants, orthognatic surgeries etc.) and to detect fractures in teeth. It kind of reminds me of a medical tomography scan. The software and machine take a series of images which the software then compiles into an image, but the operator can look through the various "slices" or images that the machine took to see various levels and to see the position of anatomic structures. 

 

I hope this helps you to understand why your dentist takes dental x-rays. If you're curious to see what a specific type of x-ray looks like, ask your dentist to show you at your next dental visit. 

*Note: The information in this post article is not meant to replace the clinical judgement of your healthcare professionals. 

Jennifer G. Robb, DMD is a general dentist. Her office is located at 1320 Cooper Foster Park Rd. W, Lorain, OH 44053.
Call 440-960-1940.
Website: www.drjrobb.com
Facebook: www.facebook.com/DrJenniferRobb

By contactus@drjrobb.com
October 24, 2020
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Most people ration out the Halloween candy haul for weeks, but is that wise? After you eat sweets, bacteria feed on the sugars and starches left on your teeth and form plaque. Eventually, the acids in the plaque begin to wear away the enamel coating on your teeth, forming tiny holes (cavities) that grow larger and larger over time.

 

Eating all of your candy at once and then brushing your teeth after is actually  less cavity-causing than parceling out your candy a little at a time each day (unless you plan to thoroughly brush your teeth after each daily treat—something that’s unrealistic for most of us.)  From a cavity-causing perspective, the bacteria have a limit to how fast they can make acids—at some point there’s a threshold where they can’t make any more—whether you have one piece of candy or five.

 

In school, they used to have me state that each sugar exposure causes 20 minutes of acid production in your mouth. So eating one Lifesaver until it is gone is 20 minutes. If you then put a second one in, it’s another 20 minutes, and so on, totaling quite a few hours of acid production. But if you put the whole roll of Lifesavers in your mouth all at once, it would only be 20 minutes of acid production.

 

What may surprise you is that the treats that are most tooth friendly are those made of chocolate. Chocolate-based candy melts quickly in the mouth. Hard candies, gummies, candy corn and other sticky candies tend to last longer and/or stick to teeth where they are more likely to cause cavities.

 

*This advice is not intended to replace the clinical judgement of your healthcare providers.

 

Dr. Jennifer Robb is a general dentist who treats both children and adults at her dental office located at 1320 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940.

www.drjrobb.com www.facebook.com/DrJenniferRobb

By contactus@drjrobb.com
October 16, 2020
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If you’ve been to the dentist, you may have heard the words “your gums are inflamed”, but do you really understand what that means or why it’s important?

 

Inflammation is a localized, protective reaction to injury or infection. Signals of inflammation include: redness; swelling; pain; heat and, for your gums, bleeding. In response to inflammation, your body produces chemicals to try to ward off or destroy the irritating agent. If your inflammation continues for a long time, these chemicals can cause damage to both the surrounding area and your entire body.

 

The most common spot for oral inflammation is your gums. In this case, the irritants are plaque and calculus. Plaque is a mix of saliva, food and oral bacteria. Calculus, which is also called tartar, is plaque that has hardened. If the inflammation only affects your gums it is called gingivitis. Gingivitis can be reversed if the irritants are removed. Plaque can be removed with a toothbrush or dental floss. Tartar or calculus need to be removed by a dentist, dental hygienist, or dental specialist.

 

When gingivitis is present for a long time, the chemicals begin to break down the bone around your teeth. Once your bone is gone, it’s gone. There’s no way to replace it. When enough bone is lost, your tooth will loosen and need to be taken out.  Once your jaw bone is involved, the process is called periodontitis or periodontal disease.

 

Inflammation chemicals and other disease-causing agents can enter your bloodstream when your inflamed gums bleed. Many scientific studies link inflammation to disease:

  • Heart disease and gum disease seem to share some of the same agents. The common factor seems to be inflammation.
  • Diabetes and gum disease have a complex interaction where both diseases affect each other.
  • Pregnant women who have oral inflammation are more likely to have premature labor and babies with low birth weights.
  • Some respiratory diseases show oral bacteria in the airways.
  • Rheumatoid arthritis symptoms seem to worsen when oral inflammation is also present.

 

In addition, scientists are currently studying whether inflammation in the brain might be a cause of Alzheimer’s disease.

 

Because oral inflammation is often not painful in its early stages and is not life-threatening, you may think “it’s no big deal” and feel that it  doesn’t need to be treated. It is important to remember that your oral health and your overall health are closely related, and making dental care part of your regular schedule is the best way to maintain your health.

 

If you have any of the symptoms of gum inflammation and do not have a dentist, please call my office at 440-960-1940. We’d love to help you. We are also online at www.drjrobb.com

*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.