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! 

Happy Holidays and 2015 Office Closure Reminder

Everyone had a great time at our office holiday party this weekend! A special thank you to Dr. Kari Ann Hong and her husband Erik for hosting our staff and their loved ones. So you can better plan your own festivities: please note that the office will be closed from Saturday, December 19th to Sunday, December 27th. Merry Christmas and happy holidays!

Case Presentation: Anterior Veneer Replacement

Today's patient came to us with a set of porcelain veneers on their two front teeth, where one had become cracked along the gum line. Defects in this location are particularly problematic, as they create an easy place for bacteria to enter the tooth and are cosmetically unpleasing. After discussing options with the patient, we decided to replace both veneers with new Emax lithium disilicate units. Lithium disilicate is an engineered dental material that is about five or six times stronger than porcelain, along with having more "natural" cosmetic properties. By replacing both veneers, we were able to repair the defect, add length to the teeth (the original veneers were short of optimal) and create overall more natural contours. The result is a beautiful and more youthful smile. If you are interested in veneers or any other cosmetic dental procedures, 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.

Jonathan's First Birthday

What a time to celebrate! Our office manager Michael's son Jonathan turned one this week. Michael and his wife Katie definitely had their hands full with planning and preparing for the event, but it all payed off. Happy birthday Jonathan, we hope you got everything you wished for!

Case Presentation: Polishing an Existing Filling

Over time, dental fillings tend to pick up stains from the foods and beverages we consume. This isn't a big concern with the posterior teeth, where restorations are generally hidden during daily activities. However, discoloration can become a  genuine cosmetic concern in fillings on anterior teeth.

This patient had a filling placed years ago by a different dentist to correct for abfraction, or the loss of enamel near the gum line due to stress and clenching. This type of restoration is very common and usually affects the canines and premolars (both visible in a typical smile). They were dissatisfied with the dark line around the filling that drew the eye towards that tooth. With a 10 minute appointment to polish and recontour, the filling looked brand new! 

It is important to note that we checked the seal and fit of the filling first, to make sure we weren't just polishing a defective restoration. Many times, discoloration is a sign of recurrent decay, where the entire fillings needs to be replaced. If you would like to know more about fillings, their lifespans and how to care for them, 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!