How To Floss

While flossing is mostly foolproof, there are a few pointers to keep in mind. Floss is primarily used to remove plaque from the interdental space. For it to work efficiently, floss needs to contact the tooth, hug it, slide down below the gum level and be brought back up. In each space, make sure to clean both the more forward and more backward tooth. In contrast, flossing without contacting the teeth only removes stuck food and doesn't impart the full benefit. If you're short on time or juggling a busy schedule, consider keeping a pack of flossers in your car for the morning commute.  Remember to use floss daily, along with brushing twice a day with fluoride toothpaste!

For a quick refresher on all our homecare information, here's a short video our office put together: 

What do I look for in a Toothbrush?

What makes a good brush? Take a look at these five guidelines and you're sure to pick a great product!

1. Look for a toothbrush with a small brush head. Bigger brushes are hard to maneuver and tend to miss important areas.

2. Only buy soft brush heads. Stiff bristles can damage enamel and wear away at gums causing serious damage. 

3. Don't fall for gimmicks. What's more important than "cross bristles" or "massaging action" is that you use the brush for two minutes twice a day with fluoride toothpaste.

4. Remember to replace often. Older brushes harbor bacteria and don't work as efficiently. Make sure you are getting a brush that you are comfortable replacing on a regular basis.

5. Consider going electric. Electric brushes take a lot of the guesswork out of brushing your teeth. Look for products from Oral-B and Sonicare for the best battery life, easiest to find replacement heads and beneficial features. Try to find a model with a built in timer and pressure sensor to get the most out of brushing. 

Bad Habits For Your Teeth

Is kicking bad habits part of your New Years Resolution? Recently, the American Dental Association's blog released a list of some of the worst habits for your teeth. While many of these ticks may seem harmless, they can all cause permanent damage to your teeth, gums or jaw muscles. Over time, these can become very expensive problems- requiring everything from crowns to gum surgery. Take a look at some of the worst offenders and how to manage them!

1. Nail Biting- On top of being unhygienic (your fingernails harbor an entire ecosystem of bacteria), nail biting forces the teeth and jaw to function in ways that they were never designed to. Under repeated stress, the front teeth will crack and chip easily. Even crowns and fillings can become repeatedly damaged. Additionally, protruding your lower jaw to make the front teeth connect puts unneeded strain on your muscles. Consider wearing a bitter tasting nail polish or lotion to put a stop to the biting!

2. Hard/Rigorous Brushing- Many people believe that using generous force and scrubbing the teeth/gums can compensate for a shorter brush time. On the contrary, brushing your teeth too hard will wear away at the teeth and enamel prematurely. Even if you can't brush for a whole two minutes, stick to a gentle pressure. If possible, invest in an electric toothbrush that has a built in pressure sensor like certain Oral-B and Sonicare models. 

3. Grinding and Clenching- These habits typically occur subconsciously or while you are asleep, which makes them more difficult to manage. Unfortunately, our jaw muscles develop a tremendous amount of force which can erode or completely shatter enamel. The best way to manage these habits is by treating stress directly. Try meditation, exercise or any other calming techniques. If you still can't stop clenching, custom night guards will protect your teeth from fracturing while lessening tension headaches.

4. Chewing Ice Cubes- While Ice breaks easily under the force of our teeth, it is a very hard substance. Repeatedly crushing ice with your teeth will break cusps, loosen fillings and even fracture crowns. Your best bet is to chill your beverages without ice or use a straw to avoid temptation. 

5. Snacking- Tooth decay relies on three things: bacteria, sugar/carbohydrate and time. When you constantly graze on food, you are increasing the amount of time your oral bacteria can feed and cause decay. While the best option is to avoid snacking all together, you can mitigate damage by switching to non-sticky foods with low sugar content. 

6. Using Teeth as Tools- Always a bad idea. Your mouth was designed for speaking, eating and breathing, not opening plastic bags. Take some extra time and avoid using your mouth as a third hand!

No-Drill Dentistry

One of the newest "buzz words" in the dental field is no-drill dentistry. The idea behind this treatment is that if tooth decay is caught early enough it can be remineralized and "reversed" through a number of preventative measures. While these techniques sound new and exciting, they are based on established concepts that we have been using in our office for years.

Tooth decay starts in enamel and spreads towards the inner layers of dentin and pulp. The bacteria begin by removing mineral from enamel, followed by destroying the scaffolding that holds the minerals. While decay sits entirely in enamel, it can be stopped and remineralized. This relies on the use of fluoride (found in drinking water, toothpaste, etc.) along with good oral hygiene (frequent brushing/flossing, low sugar diet, infrequent snacking). However, once the underlying scaffolding is gone, there is no "regrowing" lost enamel. Furthermore, decay that extends into dentin spreads rampantly and cannot be stopped from further progression. At this point, traditional dental work must be performed to keep the cavity from growing.

Thousand Oaks Family Dentistry uses the principals of no-drill dentistry on every one of our patients. We only treat decay via traditional methods when we absolutely have to and always try to naturally remineralize first. Our younger patients all receive fluoride foam treatment with every cleaning while our adult patients are consulted and evaluated for special rinses, pastes or other preventative measures. In short, we try everything possible before touching a tooth with a drill. If you would like to know more about no-drill dentistry, preventative dentistry or any other techniques, please give our office a call! 

Dental Quesitons; Why aren't temporary crowns permanent solutions?

A typical temporary crown.

If you've ever had a crown placed in your mouth, you know the typical steps: one appointment to prepare the tooth and another to fit and deliver the final crown. In between, you were given a temporary crown as a placeholder to protect the tooth. Many patients love the look and feel of their temporary crowns and are curious as to why they can't be used as a permanent solution.

There are a few important reasons why we don't use temporary crowns as final restorations. First, they are made of a weaker material. The composites used to make temporary crowns are designed to be easy to cast and manipulate while remaining durable enough for short term use. They are not designed to stand up to years of biting, chewing and grinding. Only a permanent crown made from high strength metal, zirconia or composite can handle this task. Secondly, there is no was to adapt a temporary crown to a tooth as exacting as a lab made permanent restoration. The crown margin (where the crown meets the tooth) needs to be adapted to the tooth on the micron scale to seal out bacteria and prevent tooth decay. This level of precision can only be reached with the tools and techniques of an experienced dental lab.

You may have heard of "same day" crowns that skip the temporary crown step. While this option may sound attractive, our office feels that this technology still needs further improvement before it matches the quality of work we get from our dental labs. We only offer new procedures if we are absolutely sure they are the best options for our patients! If you would like to know more about crown procedures, temporary crowns or any other dental topics, please give our office a call.

Dental Questions: Do sensitivity toothpastes actually work?

Many of our patients complain of "sensitive teeth" and are curious if products like Sensodyne, Crest Sensi-Releif or Colgate Sensitive actually work. With all the brands of toothpaste available on the market, their skepticism is very understandable.

The short answer is yes, these toothpastes will help make your teeth less hypersensitive to hot, cold and other stimulation. They typically contain an active ingredient called potassium nitrate that helps block the nerve endings on exposed dentin. Dentin is the material between enamel and dental pulp, and is often exposed in areas of recession. This is why patients who brush vigorously at their gum lines will frequently develop sensitivity problems. The abrasion of the toothbrush causes the gum tissue to recede, revealing exposed dentin underneath. 

However, it is important to note that sensitivity toothpastes will not address other kinds of dental pain. Inflamed gums, severely cold sensitive teeth and teeth with active decay will not improve with the use of these products. Furthermore, you will need to use these toothpastes twice a day for about two weeks before you start to notice improvements. It is important to keep in mind the capabilities of these products and likewise manage your expectations. If you have any further questions about sensitivity, toothpastes or other over the counter dental products, please give our office a call or email! 

Dental Questions: What do probing numbers mean?

A periodontal probe in healthy gum tissue.

At your last dental exam, you may have heard the dentist or hygienist say numbers while scanning your teeth with an instrument. The numbers were grouped in triplets and called out after each tooth ("three-two-three, two-one-two"). These findings correspond to the space between your teeth and gums. They are typically measured using an instrument called a periodontal probe, which is pictured at the start of this article. Each color change corresponds to three millimeters, creating a sort of measuring stick for the mouth. 

The numbers you hear are the millimeters that the probe slips below the gum line. A reading from one to three millimeters is generally considered healthy. Measurements four and above indicate the presence of a periodontal pocket, where the bone has recessed away from the tooth. There are many different treatments for periodontal disease, ranging from deep cleanings to bone grafts, designed to halt or reverse increasing pocket depths. If you would like to know more about dental exams, cleanings or periodontal services, please give our office a call!

Case Presentation: Esthetic Crown Lengthening for Veneers

Today's patient came to us with complaints about the shape of their anterior (front) teeth. The teeth appeared too small or "boxy," and a large proportion of the smile was occupied by gum tissue. To correct these concerns, our office decided to utilize cosmetic veneers in conjunction with esthetic crown lengthening. 

Crown lengthening is a procedure performed by a periodontist where the gum tissue is contoured to reveal more tooth structure. Dr. Wilgus at Camarillo Periodontics worked with us to treat this patient and delivered phenomenal results. Even before veneers, the teeth have better proportions and the smile has a less "gummy" appearance. The next step will be to prepare the teeth and design a set of natural and uniform cosmetic veneers. We cant wait to see the final product!

Dental Questions: Is Dental Anesthesia Safe?

Dental anesthesia is packaged into carpules like these. The sizes and coloring is standardized to prevent any confusion between manufacturers. 

Note: In this article, we will only be discussing local anesthesia. For information on other forms of anesthesia/sedation, please contact our office.

Many patients come to our office with concerns about the safety of "Novocain" and other local anesthetics. Because these medications seem to work so quickly and powerfully, it is no wonder that they raise concerns in the general population. However, we are here to show you how and why local anesthetics are wonderful tools in dental treatment. 

First off, Novocaine is no longer used in general dentistry. Concerns of liver damage prompted pharmaceutical companies to develop a new generation of drugs. Now, we have products such as lidocaine, septocaine and carbocaine- a variety of compounds maximized for specific circumstances. They are metabolized safely and have predictable durations of numbness. Overall, these medications have very few side effects unless you are receiving large quantities (far beyond the amounts used in dentistry).

Anesthetics are frequently administered with epinephrine. This compound is made naturally by the human body and is essential to life. We use it to allow the anesthesia to better numb the intended tissue. Some patients may feel an increased heart rate or anxiety when exposed to epinephrine. However, it is impossible to have a true (medical) allergy to this substance. During exams, we take note of any contraindications or reactions you may have had with epinephrine in the past. This does a great job of minimizing unexpected side effects.

It is possible to develop an allergy to the preservatives used in dental anesthesia. However, these reactions are very rare and typically present earlier in life. By the time you are receiving dental treatment, you will most likely know if and how your body will react to these substances. As with all conditions and allergies, please inform us during your medical history/exam if you have a known problem with these substances 

In practice, most adverse reactions to anesthesia come from its method of administration. However, good technique and modern equipment (such as our wand systems) help mitigate any problems. If you would like to know more about dental anesthesia and it's safety, please give our office a call!

Sports Injuries: Basketball

Today's patient came to us with a tooth knocked in after a game of basketball. Believe it or not, basketball is one of the most oral-injury prone competitive sports (even more than football). This type of injury is called a luxation- that is, the tooth was moved but not removed from it's original location in the mouth. This is a problem that needs to be evaluated by a dentist as soon as possible. Treatment usually involves moving the tooth back into its original position, stabilizing it with minor orthodontics and monitoring it for infection. However, the long term prognosis on luxation is not great. You may find yourself needing an implant, bridge or partial denture in the future. 

Though we see numerous patients every year with injuries just like this one, they are largely preventable. Sports guards are an excellent way to minimize damage to the teeth and surrounding tissues. Our office makes custom fit guards in-house for about $55. All we need is an impression of your upper teeth and 15 minutes to fit the final product. If you would like to know more about sports guards or have questions about sports injuries, please give us a call.