My Blog

Posts for tag: oral hygiene

By John P. Ducar, DDS, Inc
June 12, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”

By John P. Ducar, DDS, Inc
March 14, 2021
Category: Oral Health
Tags: oral hygiene  
FlossinganImplant-SupportedBridgecanPreventaDamagingGumInfection

In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.

Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.

But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.

To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.

A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.

With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.

You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.

If you would like more information on oral hygiene practices with dental work, 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 Hygiene for Fixed Bridgework.”

By John P. Ducar, DDS, Inc
October 03, 2020
Category: Oral Health
Tags: gum disease   oral hygiene  
PreventingGumDiseaseCouldHelpMoreThanYourTeethandGums

The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.

But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.

The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.

But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.

You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:

  • Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
  • See your dentist regularly for more thorough dental cleanings and checkups;
  • See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
  • Stop smoking to lower your risk for both gum disease and tooth decay;
  • Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
  • Manage other inflammatory conditions to lessen their effect on your gum disease risk.

Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.

If you would like more information on prevention and treatment of gum disease, 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 “Gum Disease & Systemic Health.”

By John P. Ducar, DDS, Inc
September 23, 2020
Category: Oral Health
Tags: oral hygiene   oral health  
KeepTheseTopFactorsinMindWhenBuyingYourNextToothbrush

Search online for “right tool for the job” and you'll get over a billion results related to everything from baking cakes to repairing cars. It's also just as applicable to oral hygiene.

One of those “right” tools is the humble toothbrush. Most of us use the manual variety whose basic components—a long narrow handle and a bristled head—haven't changed much in a couple of centuries. That hasn't stopped competing manufacturers, however, from striving to produce the latest and greatest toothbrush. It's a wonderful testament to the free market, but it might leave you dizzy with indecision about which product is right for you.

You can avoid this paralysis if you remember why you're using a toothbrush in the first place—to remove the daily buildup of dental plaque, a thin bacterial film that causes tooth decay and gum disease. With that in mind, here are the top things to consider when picking out your next toothbrush.

Bristle texture. Although you might think a stiff-bristled brush would be better at removing plaque, most dental professionals recommend soft bristles. Stiffer bristles can damage your gums and lead to recession; on the other hand, coupled with the mild abrasives and detergents in toothpaste, soft bristled-brushes are just as effective in removing plaque.

Comfortable size and shape. Toothbrushes come in various lengths and handle widths, so choose one that's comfortable in your hand. If you have issues with manual dexterity, consider one with a wider and thicker handle that's easier to hold. You'll be acquainted for at least six months (that's how often you should change out your current brush for a new one), so get a toothbrush that feels right to you.

The ADA Seal of Acceptance. Like toothpaste, the American Dental Association also tests toothbrushes. Those that meet the ADA's high dental product standards can include the ADA Seal of Acceptance on their packaging. When you see it, it's a good indication that particular toothbrush will perform well. You can also get advice from your dentist or hygienist on what type of brush you should use.

Every time you brush, you're potentially improving your dental health and avoiding disease. Make sure it counts with a toothbrush that's right for you.

If you would like more information on toothbrushes, 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 “Sizing Up Toothbrushes.”

By John P. Ducar, DDS, Inc
September 03, 2020
Category: Oral Health
Tags: oral hygiene   oral health  
UseAppropriateHygieneProductsforMaximumSmileProtection

After years of research, we're confident in saying that brushing and flossing daily are essential for maintaining a healthy mouth. A mere five minutes a day performing these tasks will significantly lower your risk of dental disease.

We're also sure about the essentials you'll need to perform these tasks: a soft-bristled toothbrush using fluoride toothpaste, and a roll (or picks) of dental floss. The only deviation might be a water flosser appliance instead of flossing thread.

Unfortunately, some folks deviate even more from the norm for both of these tasks. One of the strangest is a social media trend substituting regular toothpaste with substances containing activated charcoal. The proponents of brushing with charcoal claim it will help whiten teeth and kill harmful microorganisms. People brushing with a black, tarry substance also seem to make for good “gross-out” videos.

There's no substantial evidence to support these claims. Perhaps proponents of charcoal's whitening ability are assuming it can remove stains based on its natural abrasiveness. It could, however, remove more than that: Used over time, charcoal could wear down the protective enamel coating on your teeth. If that happens, your teeth will be more yellow and at much greater risk for tooth decay.

When it comes to flossing (or more precisely, removing food material from between teeth), people can be highly inventive, substituting what might be at hand for dental floss. In a recent survey, a thousand adults were asked if they had ever used household items to clean between their teeth and what kind. Eighty percent said they had, using among other things twigs, nails (the finger or toe variety) and screwdrivers.

Such items aren't meant for dental use and can harm tooth surfaces and gum tissues. Those around you, especially at the dinner table, might also find their use off-putting. Instead, use items approved by the American Dental Association like floss, floss picks or toothpicks. Some of these items are small enough to carry with you for the occasional social “emergency.”

Brushing and flossing can absolutely make a difference keeping your teeth and gums healthy. But the real benefit comes when you perform these tasks correctly—and use the right products for the job.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.