Big Red Tooth – Dr Candice Schwartz

Where teeth and health meet

Do I need to floss my child’s teeth?

Flossing one’s teeth is probably one of the most tricky skills to master in this lifetime and that is why most people do not do it. However consider this analogy: after a day of gardening and digging in the dirt with your hands, they are covered in mud and sand. You go to the basin and wash your hands vigorously with your most potent hand soap. You rinse the soapy water off only to reveal your finger nails filled with dirt underneath. Only when you take a nail brush a scrub under your nails is all the dirt removed. Imagine if you just left all that dirt and bacteria to live and remain under your nails indefinitely…

The same applies to your mouth and especially your child’s mouth. We eat and drink all day long, bathing our teeth in sugars and carbohydrates which allows bacteria to thrive and easily attach to all the surfaces of the teeth. After a rigorous scrubbing with the toothbrush, you are only removing the plaque/food/debris from the outer surface of your teeth; you are only cleaning 60% of your tooth surfaces. This leave 40% of tooth surfaces uncleaned, covered in plaque and susceptible to breakdown by bacteria. Flossing removes the bacteria below the gums. Decay occurring between the teeth is the second most common site of tooth decay in children. Decay between the teeth of children is very difficult to detect and even more difficult to treat.

The types of cavities that develop as a result of not flossing are in my opinion “silent killers”. The hole starts directly in between two teeth and slowly burrows into the center of the tooth. You are usually completely unaware that this hole exists because you cannot feel it with your tongue and the pain is not felt because the open tooth structure is shrouded between the adjacent teeth or compacted with food (nummy!). Only once the hole has increased in size enough, does the unsupported covering of enamel fracture/cave in. This is when people decide to visit me; once it is too late and the tooth generally requires a root treatment/extraction/pulpotomy(in primary teeth).

Silent destruction that ultimately leads to abscess development

The other important reason for flossing is to prevent gum disease from occurring in the gum areas between the teeth. Brushing alone is not adequate to keep the mouth healthy and free of disease. Bad breath is often caused by masses of bacteria/plaque breeding and thriving in the areas between the teeth. Plaque matures every 24 hours, so it is imperative to break this cycle and floss every day. Bleeding gums when you floss is a sign that you need to floss more!

Example of how to floss around the gum line

To prevent these disaster cavities from developing and to prevent gum disease you need to clean away the plaque/bacteria/food that accumulates under and around the gumline in between the teeth. You do this with dental floss, every night, last thing before bedtime. Flossing must be initiated in children from the age of 2 years. Even if their molar teeth have not grown out yet, start to floss around the mouth each night and entrench this habit into their daily routine. This will set them up for a lifetime of good oral health.

You only need to floss the teeth you want to keep…

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What is a Periodontist ?

Many patients come for a routine dental visit and are then referred off to see a “periodontist“. Here I will answer what a periodontist does and you can then decide if you need one.

I am going to being with a few definitions to get us on the same page:

PERIODONTIUM: This refers to all the supporting structures that surround the teeth. The specific tissues that make up the periodontium are the alveolar bone, periodontal ligament, cementum and the gingiva (or gums).

PERIODONTICS: This is the study of the periodontium and the branch of dental specialty that treats diseases of the periodontium.

Therefore, a periodontist is a specialist dental practitioner who treats and manages diseases and conditions of the periodontium. Most often a patient requires the expertise of a periodontist when they suffer from periodontal disease. Anyone can develop periodontal disease. It is usually a slow process (but sometimes can be very acute & develop rapidly) of destruction that develops over time when the oral hygiene of the mouth is poor. Initially patients suffer with bleeding gums. People assume that this is normal and do not seek treatment. Bleeding gums then become a part of their daily life. The bleeding is caused from a chronic inflammation of the gums due to the presence of bacteria in dental plaque. This is known as gingivitis. The dental plaque present on the tooth surfaces will turn to calculus, a hard accretion that cannot be removed with a toothbrush. The gingivitis, if untreated, will turn into periodontal disease which causes the destruction of the alveolar bone that houses teeth. The result is loosening of the teeth and if untreated, eventual loss of the teeth. The primary role of a periodontist is to treat periodontal disease, by removing the calculus that has accumulated and reverse the chronic inflammatory process. The objective is to halt the destructive process of bone loss through a number of minor surgical and non surgical procedures.

In addition the treating periodontal disease, a periodontist may place dental implants, surgically extract problem teeth, place bone grafts and place gingival grafts.

In general, it is advisable to see your dentist for an assessment first before booking directly with a periodontist. An astute dentist will be able to assess the severity of any possible gum problems and refer you to a suitable periodontist if you need one.

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Do I need to visit the dentist when I am pregnant?

YES YES YES. For some reason women think that because they are pregnant they do not need to visit the dentist. It is quite the opposite. It is during this time that the most damage can be done to your teeth without you knowing it. It is very common for pregnant women to complain of bleeding gums during their pregnancy. This is the first sign that you must visit your dentist asap. Gingivitis is more prevalent while women are pregnant. The general oral hygiene of most women suffers during this time because they are concentrating on their developing baby and there is such a massive shift in their body that they tend to neglect their mouths. Bleeding gums is aggravated further by the change of hormones during pregnancy. This is known as pregnancy gingivitis. Some expecting mothers out of fear of bleeding avoid proper brushing or flossing. This further worsens the situation.

The unavoidable consequence of inadequate oral hygiene is an increase in dental plaque which leads to dental decay. Cavities will rapidly develop. Often women will come to me for a dental check up, after having their baby. I will find numerous teeth that are severely decayed and extensive restorative dental treatment is then required. It is far better to prevent this from happening. I recommend seeing your dentist at the beginning of your pregnancy and every 3 months thereafter for a scaling and polishing and a quick look over of the mouth (without xrays) till you have had your baby. 8 weeks after your baby’s birth you should come in for a full routine dental checkup with full xrays. If any fillings are required they may be completed at this appointment.

Dental treatment is possible during pregnancy however. Most dental procedures can be completed while you are pregnant. It is not in your interest, nor your baby’s interests to leave underlying infection in the mouth. Especially if you are in any sort of pain, rather see your dentist early on so the problem can be diagnosed and treated. There is a large amount of research that supports the notion that bacteria from the mouth can enter the bloodstream and affect your unborn baby. Do not neglect your mouth during your pregnancy. Visit your dentist and take responsibility for the things you have complete control over during your pregnancy. Excellent oral hygiene is the first step. Be Proactive! See your dentist today.

 

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