Video Blog on Home Hygiene

Greetings, my name is Dr. Kari Ann Hong, and I have a family dentistry practice where I see patients from all age groups.  In my practice, I help educate my patients about what they can do at home to help care for their teeth.  

The first topic of discussion is what patients eat and drink and how frequently they do so.  Our mouths all naturally harbor a certain amount of bacteria.  A specific strain called streptococcous mutans is responsible for eating the foods and beverages we ingest and creating acid.  This acid causes a breakdown in the calcium phosphate structure of our teeth, leading to tooth decay.  Certain foods will stick to the teeth longer than others and make the teeth more susceptible to decay.  Examples of cavity provoking foods and beverages are pretzels, crackers, cereals, sodas, energy drinks, and juices.  Natural foods that come from a tree or are picked from the ground will naturally wash of the teeth much quicker after we eat it.

Every time we eat or drink something other than water, our mouth will become more acidic for at least fifteen minutes after we ingest it.  So the more frequently we eat, the more acid that accumulates in our mouths.

In order to counteract the bacteria in our mouths and the foods that stick to our teeth, it is important that we brush twice a day and floss once a day.  I generally recommend an electric rechargeable toothbrush like a Sonicare or an Oral B to all of my patients.  These electric toothbrushes are great because they help remove plaque build up better that we can with a manual toothbrush.  Also, they have timers on them to encourage us to brush for a full two minutes.  I recommend that my patient split their mouth up into four quadrants, and spend 30 seconds on each quadrant.  If you choose to use a manual toothbrush, then I recommend a soft tooth brush.  A harder tooth brush can adversely abrade the gum tissue or the tooth surface with extended use.  Place the tooth brush at a 45 degree angle to the tooth surface.  Make sure to gently massage the tooth and focus on where the teeth meet the gums, because this is where the plaque likes to collect.  

I recommend flossing or using a hygiene tool to clean below the contact of the teeth at least once a day. The idea behind flossing is that you want to get the floss between the gum and the tooth, by wrapping each tooth you have just flossed between in a C-motion.  For the butler soft pic, you just need to get it below the contact area.

In terms of what toothpastes or mouthwashes to use, I have a couple of suggestions.  Any fluoridated toothpaste will be sufficient to clean the teeth.  In patients that have a high risk of tooth decay, I will often recommend an additional  tooth paste to be brushed on with a dry toothbrush, after regular tooth brushing.  CariFree gel and MI paste are two of my favorite products for tooth remineralization.  Both products have calcium, phosphate, and fluoride that help to rebuild tooth structure.  

For mouth washes, I like over the counter ACT Fluoride rinse for those prone to tooth decay.  For those that are prone to gum disease, I recommend Listerine, which is anti-bacterial.  CariFree also makes a mouth wash that is pH neutral and has the same calcium and phosphate as the gel.

Finally, if you like to chew gum, then you can also fight your bacteria at the same time, by finiding a gum with xylitol. Xylitol is a plant derived sugar that prohibits the bacteria in our mouths from producing acid.  Studies have shown that 5-8mg of xylitol a day in a chewable form helps protect our teeth.  

If you would like more information about what you can do to prevent tooth decay and make your teeth healthier, contact us for a new patient exam, where we will go into your specific needs in detail!

Video Blog on Periodontal Services

Greetings, my name is Dr. Kari Ann Hong, and I have a family dentistry practice, where I see patients from all age groups.  Approximately ⅓ to ½ of the population at large is affected by periodontal disease.  Periodontal disease is when the bacteria in the mouth causes loss of the bone surrounding the teeth.  From a patient’s perspective, gum disease can be characterized by bleeding gums, loose teeth, bad breath, and a feeling of deposits stuck to the teeth.

As a dentist, I determine if someone has periodontal disease by a combination of evaluating the bone levels and build up on a dental x-ray, measuring the gum health with something called periodontal probing depths, and by a visual inspection of the quality of the gum tissue.  Periodontal probing depths are a measurement of the height of the gum tissue to where the tissue is attaching to the tooth.  In health these measurements are 1-3mm.  Periodontal disease is diagnosed as mild, moderate, or severe and this is primarily based on the amount of bone loss present.

I diagnose a service called scaling and root planing when the probing depths are 4mm or more, the gum tissue bleeds when touched, bone loss is present, and there is tartar build up under the gum tissue.  Scaling and root planing is done with local anesthesia and is usually billed by quadrant and/or the number of appointments required to adequately remove all of the build up. In severe cases, scaling and root planing can take as many as four separate appointments.  

There are some practices that will recommend procedures called irrigation,  localized antibiotic placement (Arrestin), or laser treatment to help with the treatment of periodontal disease.  Irrigation involves squirting an antibacterial prescription mouth wash called Chlorhexidine or Peridex around the teeth.  Arrestin is an antibiotic called doxycline that is injected directly into the deeper pocket depth areas.  Laser treatment involves shining a specific wavelength of light in the pocket area to kill the bacteria.  In my opinion, the irrigation and Arrestin treatment are helpful at the time of treatment, but do not have enough long term benefits to justify doing the procedure.  Laser treatment is an effective way at killing bacteria and has longer acting benefits than the irrigation and Arrestin, but is not a cure all for periodontal disease.  Those with periodontal disease need to adhere to a consistent professional periodontal maintenance routine in order to maintain their dental health.

If you are interested in periodontal services, please fill out the contact us information at the bottom of this page.

Video Blog on Dental Emergencies

What constitutes a dental emergency?  If your face is swollen and you are in pain, that is the number one reason to call a dentist today.  Swelling of the face is the sign of a serious infection called an abscess.  It is necessary to seek treatment immediately to prevent the spread of the infection.  If it is after hours, then it is recommended you seek treatment at an urgent care or emergency room.  

The second biggest emergency is when an adult  tooth is knocked out of its socket.  This can happen from running and falling, falling off a bike, getting hit by a car, playing sports and getting hit in the face. It might be possible to replant the "avulsed" tooth, but it needs to be done in the first 30 minutes to one hour after it falls out, in order for the replantation to have a chance at being successful. To transport the lost tooth, it is best to either place it in a cup of milk or store it in your mouth until you are able to see a dentist.

The first two emergencies I mentioned are relatively rare occurrences.  The most common emergency I see is when a patient is having tooth pain.  And the second most common is when someone chips a front tooth or breaks a back molar.  

If you are having a dental emergency, please call my office and we will do our best to see you as soon as possible.

Video Blog on TMJ Pain and Night Guards

Greetings, my name is Dr. Kari Ann Hong and I have a family dentistry practice where I see patients from all age groups. In my practice, I see a number of patients that clench or grind their teeth at night.  This extra function at night can cause headaches, morning muscle pain when chewing, temporomandibular joint (TMJ) pain, tooth pain, and breakage of teeth.  The number one way to protect the teeth and muscle groups from the clenching and grinding is to wear a custom fitted night guard.

The first step in making a night guard is to take impressions of your teeth and to take an impression of how your teeth come together when your jaw is slightly open.  From the impressions, we make stone models that are used to fabricate a custom fitted acrylic night guard.  Usually we make the appliance for the lower arch.  During the one hour fitting appointment, we adjust the surface of the acrylic so that when the upper teeth touch the appliance, they all hit evenly.  Also, when you grind side to side or forward, the appliance is adjusted so that the majority of the force happens on the front off the appliance. This helps protect the facial muscle groups and the TMJ.

Due to concerns about the cost of a custom fitted night guard, sometimes patients will buy over the counter boil and bite type appliances.  The disadvantage of these boil and bite appliances, is that the opposing teeth don’t have freedom of movement, thereby potentially causing additional interferences for the TMJ and increased firing of the muscle groups that help our jaw open and close.  Depending on your medical and/or dental insurance plan, there usually is some coverage for a custom fitted night guard to treat TMJ pain.  If you would like to find out if a custom fitted night guard is right for you, and what your cost would be, please fill out the contact us page.