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FlossFirstorBrushFirstYouBetheJudge

Brushing and flossing are two of the best things you can do to fight dental disease and maintain healthy teeth and gums.

Or is it flossing and brushing? What we mean is, should you floss first or brush first?

There's virtually no debate among dental professionals about whether or not to perform both hygiene tasks. While brushing removes disease-causing plaque from the broad surfaces of teeth, flossing gets to deposits of this disease-causing, bacterial film lodged between the teeth that brushing can't reach. You don't want to neglect one task over the other if you want to fully minimize your risk of tooth decay or gum disease (and don't forget semi-annual dental cleanings too).

But where there is some debate—good-natured, of course—among dentists is over whether it's better hygiene-wise to brush before flossing or vice-versa. For those on Team Brush, you should pick up your toothbrush first for the best results.

By brushing before you floss, you'll remove most of the plaque that has accumulated since your last cleaning session. If you floss first, the flossing thread has to plow through a lot of the plaque that otherwise might be removed by brushing. For many, this can lead to an unpleasant sticky mess. By removing most of the plaque first via brushing, you can focus your flossing on the small amount left between teeth.

Team Floss, on the other hand, believes giving flossing first crack at loosening the plaque between teeth will make it easier for the detergent in the toothpaste to remove it out of the way during brushing. It may also better expose these in-between areas of teeth to the fluoride in your toothpaste while brushing. And because flossing is generally considered a bit more toilsome to do than brushing, tackling it first could increase the likelihood you'll actually floss and not neglect it after brushing.

So, which task should you perform first? Actually, it's up to you: Weighing both sides, it usually comes down to which way is the most comfortable for you and will give you the greatest impetus for flossing. Because no matter which “team” you're on, the important thing is this: Don't forget to floss.

If you would like more information on personal dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene.”

ThisOralApplianceCouldHelpSolveYourSleepApneaProblem

Millions of people have obstructive sleep apnea—and some don’t even realize it. That’s because even though these airway-blocking episodes can occur several times a night, they may only last a few seconds. The brain rouses the body just long enough to open the airway but not long enough to awaken the person to consciousness.

Even though a person with sleep apnea might not remember what happened to them, they can still experience the effects of sleep disturbance: drowsiness, irritability or an inability to focus. Over time, the accumulation of “bad sleep” could increase their risk for heart disease or other life-threatening conditions.

But there are effective ways to alleviate or lessen obstructive sleep apnea. The main “go-to” treatment is a method called continuous positive airway pressure (CPAP). CPAP utilizes an electric pump that supplies a constant flow of pressurized air through a mask worn by the patient while sleeping. The increased air pressure around the throat helps keep the airway open.

But although it’s effective, CPAP is unpopular with many people who have tried it. Many find the hose and other equipment cumbersome, or the mask too uncomfortable or restrictive to wear. As a result, quite a number simply avoid using it.

If you’ve had a similar experience with CPAP or would rather explore other options, we may have an alternative: an oral appliance you wear while you sleep. It can help prevent or lessen symptoms in cases of mild to moderate airway obstruction caused by the tongue or other forms of tissue.

Sleep apnea appliances come in two basic forms. One uses metal hinges to help move the lower jaw and tongue forward. The other form has a compartment that fits around the tongue and applies suction to help keep the tongue moved forward.

These appliances may not be suitable for patients with severe sleep apnea or whose cause is something other than a physical obstruction like abnormal neurological signaling patterns. But where they are appropriate, they can be an effective alternative to CPAP and the key to a better night’s sleep.

If you would like more information on this dental solution for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”

TheHowieMandelEffectAvoidDentalDiseaseThroughDailyBrushingandFlossing

Howie Mandel, one of America’s premier television personalities, rarely takes it easy. Whether performing a standup comedy gig or shooting episodes of America’s Got Talent or Deal or No Deal, Mandel gives it all he’s got. And that intense drive isn’t reserved only for his career pursuits–he also brings his A-game to boosting his dental health.

Mandel is up front about his various dental issues, including multiple root canal treatments and the crowns on his two damaged front teeth. But he’s most jazzed about keeping his teeth clean (yep, he brushes and flosses daily) and visiting his dentist regularly for cleanings and checkups.

To say Howie Mandel is keen on taking care of his teeth and gums is an understatement. And you can be, too: Just five minutes a day could keep your smile healthy and attractive for a lifetime.

You’ll be using that time—less than one percent of your 1,440 daily minutes—brushing and flossing to remove dental plaque buildup. This sticky, bacterial film is the main cause of tooth decay and gum disease. Daily hygiene drastically reduces your risk for these tooth-damaging diseases.

But just because these tasks don’t take long, that’s not saying it’s a quick once-over for your teeth: You want to be as thorough as possible. Any leftover plaque can interact with saliva and become a calcified form known as calculus (tartar). Calculus triggers infection just as much as softer plaque—and you can’t dislodge it with brushing and flossing.

When you brush, then, be sure to go over all tooth areas, including biting surfaces and the gum line. A thorough brushing should take about two minutes. And don’t forget to floss! Your toothbrush can’t adequately reach areas between teeth, but flossing can. If you find regular flossing too difficult, try using a floss threader. If that is still problematic, an oral irrigator is a device that loosens and flushes away plaque with a pressurized water stream.

To fully close the gate against plaque, see us at least every six months. Even with the most diligent efforts, you might still miss some plaque and calculus. We can remove those lingering deposits, as well as let you know how well you’re succeeding with your daily hygiene habit.

Few people could keep up with Howie Mandel and his whirlwind career schedule, but you can certainly emulate his commitment to everyday dental care—and your teeth and gums will be the healthier for it.

If you would like more information about daily dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health” and “10 Tips for Daily Oral Care at Home.”

WhatReallyHappensDuringaRootCanalTreatment

Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.

You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.

But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?

First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.

Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.

Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.

Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.

You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.

If you would like more information on root canal therapy, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”

GettingImplantsCanBeaLongProcess-ButWorthit

Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.

Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.

If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.

Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.

In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.

During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.

Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.

If you would like more information on implant restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “New Teeth in One Day.”





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