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Like Parent Like Child; Good Oral Health Starts at Home

Fotolia_37296172_XS-200x300instill good oral health habits in your child. So read on for our recommendations on how to help your little one learn how good oral health starts at home!

  • Remember the best way for them to learn is to lead by example.
  • Despite what your child says they need help brushing. You should be helping brush and checking your child’s brushing until they are at least 9 years old. Most kids do not have the manual dexterity to be efficient brushers until they are older. An electric tooth brush can help with a lot of the plaque removal but you should still be checking their teeth and doing a quick brush up of their back teeth as well.
  • Get your child a toothbrush timer! Or an electric toothbrush with a timer built in. Even as an adult its hard to judge 2-3 minutes without some sort of timer.
  • Once your child starts to get their adult teeth in you should introduce child flossers. I believe that flossing with children should be done by the child. Flossers get the child used to adding flossing to their daily routine and as they grow and develop better manual dexterity they can replace the flossers with regular floss.
  • There are a myriad of dental products that are geared to every age group, in a variety of flavors and textures. Find which is your child’s favorite so the taste is not a deterrent.
  •  And lastly, DO NOT use going to the dentist as a threat, i.e.: ‘if you don’t brush your teeth then you are going to have to go to the dentist’. You want to avoid attaching negative feelings towards going to the dentist or their home care regimen.  Also, its hard as a dentist to start a child’s first dental visit with them already hating being there without ever having been. Instead focus on the positives, for example: ‘If you want to have happy, healthy teeth you have to brush them’
Focusing on prevention of cavities is incredibly important for children. By teaching our kids to be good brushers and flossers we can give them the gift of healthy teeth and gums that will last them a lifetime!]]>

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Nutrition and Dental Health: Vegetarians, What you need to maintain a healthy mouth.

With studies coming out everyday linking how important a healthy lifestyle is its no surprise to see Fotolia_35129025_XS1-211x300changes in the diet choices of the general population. Besides overall health nutrition and dental health is also an important subject that many are not aware of. Vegetarians; whether lacto-vegetarians, ova-vegetarians, semi-vegetarians or vegans; as well as people dieting or radically changing their diet,  should be more aware of the food they are eating to be sure they are including foods rich in the vitamins and minerals needed to keep your body healthy and your smile beautiful. Being a dentist we find that we see nutritional deficiencies apparent in the tissues of the mouth before you may notice them elsewhere. Some of the more important nutrients that may be neglected when changing your diet that are important for your oral and general health are:

  • Calcium: This nutrient is very important for bone health, as well as helping to maintain healthy gums and reduce your risk for cavities. Calcium is typically found in leafy green vegetables, dairy products, as well as in legumes and some shellfish.
  • Vitamin B12 and Vitamin B2: A deficiency in these two vitamins can cause mouth sores. Vitamin B2 can be found in milk and cheese, leafy green vegetables, beans, bananas, and almonds. Vitamin B12 can be found in some shellfish, cheese, and eggs.
  • Niacin or Vitamin B3: A deficiency in this vitamin can cause bad breath and sores in the mouth. Niacin can be found in eggs, tuna, salmon and halibut, avocados, dates, leaf vegetables and various nuts and legumes
  • Vitamin D: this nutrient helps with the absorption of calcium, when lacking vitamin D some may suffer from something called burning mouth syndrome which can cause and uncomfortable sensation of the tongue and mouth.
  • Iron: a decrease in Iron can present itself as a sore inflamed tongue and may cause sores inside your mouth to form as well.  Iron-rich foods are eggs, lentils and other dried beans, shrimp, cod and tuna, spinach, sweet potatoes, broccoli and peas. Accordingly foods that boost iron absorption the most are meat, a good iron supplement and foods high in vitamin C.
  • Vitamin C: this vitamin is important for healing as well as general health a deficiency can present itself as bleeding gums and loose teeth. You can find vitamin C in Citrus fruits, sweet potatoes and red peppers.
  • Some other important vitamins for oral health are Vitamins A, E and K.
In life we all strive for a healthy mind and body. But its important to be educated about our nutritional choices so whenever changing your diet be sure to consult your doctor and dentist.  ]]>

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Why Do I Need Fluoride?

Many of our patients know that we consider fluoride an amazing tool. The increased use of fluoride has Fotolia_21298027_XS1-213x300changed dentistry radically over the past forty years or so. So although you probably are familiar with fluoride, this post is really to answer the question: Why do I need fluoride?  What are the benefits? What are the risks? So lets start with the facts:

Fluoride is a naturally occurring compound found in water, soil and food.

Fortifying drinking water has been recommended by the U.S. Public Health Service to aid in the prevention of tooth decay, they recommend adjusting the naturally occurring fluoride level of existing public and private water sources to reach the optimal level of fluoride which is 0.7-1.2 parts per million or milligram per liter. Fluoride helps prevent cavities by being absorbed into the enamel of the your teeth and fortifying it, making the enamel more resistant to decay and demineralization. This can help in preventing early weakening in the tooth structure and early decay.

What are the risks of using fluoride?

The CDC has done numerous studies, the most common risk noticed is dental fluorosis if fluoride is consumed in a high amount for a long period of time during the development of the adult teeth. Dental fluorosis is pitting or mottling of the enamel of the teeth. Children 8 and younger are the most at risk for dental fluorosis. Also, There has been some speculation about a link between fluoride and osteosarcoma however over the past 60 years of fluoride use and studies no link has been established between bone health and fluoride.
  • The CDC has listed water fluoridation as one of the 10 greatest public health achievements of the 20th century
  • The first city to adjust the level of fluoride in its water supply was Grand Rapids, Michigan on January 25, 1945
  • Although not all water supply is fluoridated around 72.4% of the U.S. population receive fluoridated water.
  • Aside from fluoridated water  you can obtain fluoride from a multitude of sources. Such as, fluoride multivitamins for children, in some foods, as well as many mouth rinses and toothpastes.
  • Fluoride is endorsed and recommended by the American Dental Association as well as many other state and local dental societies.
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How To Keep My Toothbrush Clean? And other dental questions.

cavity free mouth and, all the great tools available to help you do so. Fotolia_5327278_XS-resized-600 Next comes the last part, maintenance of your repertoire of home care tools. So if you’ve ever wondered ‘How to keep my toothbrush clean?’ then read on..

Your toothbrush is the most important tool in your home care regimen so keeping it clean and up to date is very important. Here are the basics:

1. Whether using an electric toothbrush or a manual toothbrush it should be replaced every 3 months. The easiest way is to change your brush or electric toothbrush head with the change of the seasons or if the bristles begin to look splayed or frayed. 2. While brushing your teeth your brush is cleaning all the debris, plaque and bacteria that you’ve accumulated over the day. After brushing you should sanitize your toothbrush, we recommend rinsing it with Listerine then rinsing with water and letting air dry. 3. And lastly, When storing your toothbrush you want to store it head up allowing it to air dry in an area away from an open toilet. If you can store it in a medicine cabinet or something similar that is best.

Many of our patients own and use appliances at home whether they be retainers, Invisalign aligners, nightguards or sleep apnea oral appliances, these appliances need special care to maintain them and keep them clean.

1. In the morning upon removal of the appliance you should use a wet toothbrush to gently clean off the appliance, stay away from abrasive toothpastes when cleaning any appliance made of acrylic or soft rubbery material as the toothpaste may cause it to become porous and more susceptible to bacteria buildup. 2. Many of your appliances can be soaked in a chlorhexidine mouth rinse or Listerine for a period of time to help reduce bacteria build up as well. Please check with your dentist before you do so as some of these rinses may stain certain materials 3. Also, for clear retainers and Invisalign aligners, often over time the aligners may discolor due to normal wear. You can place your retainer or aligner in a small glass of water with a cap full of hydrogen peroxide, this will help clear up the stain on the aligner.]]>

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Energy Drinks and Your Teeth

Fotolia_40413702_XS-200x300The studies were spurred on by the increase in consumption of sports and energy drinks, especially by adolescents. The study warned that both sports drinks and energy drinks have pH levels that are at a level of acidity that can cause demineralization or weakening of the enamel. Also, they found that they both contain citric acid, included to help improve the taste and shelf life of the drink, which can also have an effect on enamel. The study showed, that although both sports and energy drinks are acidic enough that if  excessively consumed they can cause damage to dental enamel, energy drinks have a “significantly greater potential for enamel dissolution than sports drinks”. The study also brought to light some interesting information:

  • ” Approximately 30-50%  of adolescents and young adults in the U.S. consume energy drinks and that 51-62% of adolescents consume at least one sports drink per day”
  • Energy drinks are a fairly new and quickly growing product and there haven’t been many studies on the effects of energy drinks. One statistic showed that energy drinks are such a growing market that “200 new brands of energy drinks were launched in 2007 alone”. Also, because of new flavors and formulations are being created so frequently and the vast differences even between effects of flavors of the same brand, it is very difficult to generalize about these effects.
  • Different flavors within the same brand had different levels of acidity.
  • Of all the drinks tested “Gatorade Blue was found the highest titratable acidity” Also, Red Bull Sugar Free, Monster Assault, 5-Hour Energy, Von Dutch, and Rock Star had higher acidity than Red Bull, Rip It, Full Throttle Fury and MDX.
So what does this mean, should we stop drinking energy drinks? In my opinion that is not what this study means at all. These products when consumed excessively have the potential to create a more cavity prone mouth. So like all things they should be consumed in moderation. Also, due to the acidity of these products it is recommended by the Academy of General Dentistry to wait at least an hour to brush your teeth after consuming a sports or energy drink.    
A comparison of sports and energy drinks—Physiochemical properties and enamel dissolution; By Poonam Jain, BDS, MS, MPH; Emily Hall-May, MS; Kristi Golabek; Ma Zenia Agustin, PhD
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Worst Home Remedies For Dental Problems

Fotolia_21448390_XS-199x300Okay, I understand getting to the dentist when you have an emergency can sometimes be hard. And, yes I realize that it’s awfully tempting to try and fix the problem yourself. But, there are just some things you should not do at home. This brings us to this weeks blog post. The WORST home remedies for dental problems. Putting garlic against a sore tooth…. Besides making you smell bad, garlic is very potent and can irritate or burn soft tissues around the tooth causing even more pain and sensitivity. Shaving down a sharp tooth with tools from around the house… Besides the fact that you are putting something that has seen more dirty surfaces than I’d care to mention directly into your mouth, you are putting yourself at risk for damaging the tooth more or slipping and causing damage to your cheeks and gums. Using crazy glue to fix a broken natural tooth... Yes, I know people say the same stuff that’s in super glue is the same stuff used to seal battlefield wounds, and they’d be correct. However, the stuff used to seal battlefield wounds are made specifically to seal battlefield wounds. Using superglue to fix a tooth most likely will result in 1: You super gluing your finger to your lip, cheek, tooth or some variation of the aforementioned. Or 2: Pain from a tooth with a freshly injured dental nerve being assaulted by a brand of material that was not meant to see the inside of your mouth or to fix broken teeth. Trust me, its not pretty…. Whitening your teeth with lemon juice and baking soda… This one, although its gotten a lot of popularity throughout the years, is just not healthy for your teeth. Mixing an abrasive and an acid together and then scrubbing it on your teeth can cause abrasion to your gums while also removing and/or damaging the enamel on your teeth. And lastly, searching through your medicine cabinet and finding a left over prescription from those wisdom teeth you (or someone you know) had extracted about ten years ago… Its not a mystery that taking old, expired or another persons prescription medications is a bad idea. Taking one or two remaining capsules of an antibiotic is not only ineffective, it can also help promote bacterial resistance to antibiotics. Also, taking prescription medications that were not prescribed to you can put you right in the middle of an adverse or even allergic reaction to a drug that no one knows you are taking. So if you are having a problem call your dentist or doctor first before resorting to whats left over in the medicine cabinet. Also, whenever you are prescribed medication once you have finished the prescription if there are any tablets remaining they should be disposed of. So, I’m not saying there are not some things that you can do at home in a pinch to get you by until you can see your dentist. But, in an emergency situation, first and foremost, call your dentist and see when they can see you for an appointment and tell them your emergency. Your dentist will suggest the best way to get you comfortable and safely treated!]]>

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Link Between Bottled Water and Tooth Decay in Children

Fotolia_27127427_XS-300x199 possible link with bottled water.  Some articles have suggested that the increase in bottled water over tap water has decreased the amount of fluoride intake thereby increasing the rate of cavities in children. This statement is not entirely true. Although decreased fluoride intake can increase your susceptibility to cavities it is only one factor in a complex scenario. Also, keep in mind that many bottled water companies do offer water with fluoride in it and also many communities do not have fluoride in their tap water. Over the years dentistry has focused on preventative care with pediatric patients. We do this by recommending good home care, fluoride use, dental sealants and regular check ups. This is only one piece of the puzzle though. One portion of care that dentists do not get to address thoroughly is a child’s diet. With an increase in high sugar and carbohydrate intake, processed foods, and children with little opportunity to brush their teeth during the day, we are seeing more and more children with cavities at a young age. Bottled water is not the enemy, as the International Bottled Water Association stated in a recent article, bottled water does not have sugar in it and is a great and healthy alternative to other bottled drinks on the market. Fluoride is just one step to help our children achieve great oral health. We also have to focus on good nutrition, home care, and regular hygiene visits to help keep our kids healthy!]]>

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The Microcavity and the Early Stages of Tooth Decay

In the dental field there are many types of dentists, they can range from extremely  conservative to extremely aggressive. And depending on where your dentist falls in that range you may find that accompanying your routine dental exam your dentist will say, ‘ok lets watch that spot’, or ‘its a small cavity but I recommend filling it before it becomes something bigger’. So what exactly does that mean? dental treatment Teeth have different layers to them, the outer enamel layer, the softer inner dentin layer and the innermost layer where the nerve and blood supply to the tooth resides, the pulp chamber. When diagnosing a cavity we look at what damage has been done to these layers and from there decided what procedure needs to be done. A microcavity or incipient decay, is a cavity that is in the enamel layer but has not passed into the dentin layer. The question is, what are the risks of filling it vs. not filling it? Recent studies have shown that filling microcavities may not help in preventing further decay or breakdown of the tooth. However, treating cavities at this stage has not shown any increase of decay or damage to the tooth either. It is our belief that when a microcavity is noted while we may not recommend placing a filling immediately, we do recommend treating the area by other means. Small cavities such as microcavities often times can be abated or avoided by maintaining a good home care regimen. This includes keeping the area clean as well creating a healthy oral environment to help stop the cavity from progressing. This can be done by stabilizing the pH in the mouth as well as using fluoride to help strengthen the enamel. To learn more about how to maintain great oral health follow this link. The way it stands there are many viewpoints on how aggressive to be with decay. You as a patient may not want any decay in your mouth no matter how small. Or vice versa you may not want to begin removing tooth structure for something that may be maintained for a number or years. The best option for every patient is to find a dentist that feels the same way you do, whether it be conservative or aggressive.

Early treatment of incipient carious lesions: A two-year clinical evaluation; JAMES C. HAMILTON, D.D.S., JOSEPH B. DENNISON, D.D.S., M.S., KENNETH W. STOFFERS, D.M.D., M.S., WILLIAM A. GREGORY, D.D.S., M.S. and KATHLEEN B. WELCH, M.P.H., M.S
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Frangella Dental's Favorite Dental Products!

Fotolia_5327278_XS-resized-600Being a dentist and being surrounded by a lot of dentists, I’ve had the opportunity to try a lot of dental products over the years and learn the opinions of my friends, family and colleagues about these same products. I decided to compile a list of my absolute favorite, tried and true, dental products on the market. Of course I’m always open to try something new, so if you have any favorites, please let us know!

Toothbrush: Sonicare

This toothbrush’s sonic motion and handy timer really make a difference in your smile. It’s the best home care tool in my opinion.

Floss: Glide

Whenever I buy floss, I tend to lean towards an unwaxed tape variety rather than a rope. Glide is great b/c its easy to manuever between teeth and doesn’t shred easily.

Regular Toothpaste: Crest Original (with sodium fluoride)

Crest is a great product. I like the flavor of the paste and usually prefer sodium fluoride in my toothpaste as opposed to stannous fluoride. When I’m looking to buy a regular toothpaste I usually stick to the Crest Original.

Toothpaste for Sensitive Teeth: Sensodyne Isoactive

For patients that are long time users of toothpaste for sensitive teeth, this new product is a great change from the dull chalky tasting toothpastes that have been on the market. I tried this product about 6 months ago and use it from time to time when my teeth become hot & cold sensitive. It forms a refreshing foam that leaves you with a great taste and more comfortable teeth as well.

Whitening Toothpaste: Crest 3d White

When brushing your teeth in between whitenings to keep that beautiful fresh smile I like to use this Crest 3d White. It’s Crest, which has a great line of whitening products, and also has a great taste and is very effective in maintaining a bright smile.

Antibacterial Mouthwash: Listerine and Closys

An antibacterial mouthwash is crucial to home care. The hard part is sorting through all the options and finding whats right for you. My top two picks are: CloSys and Listerine. I love CloSys because although it has a mild flavor, it is a great tool to kill bacteria that can lead to periodontal disease and also it is less acidic than many of the rinses on the market. My other top pick is Listerine. In my opinion Listerine is hands down the most effective antibacterial rinse on the market. My morning routine usually includes a quick rinse with CloSys then a thorough brushing & flossing followed by a rinse with Listerine.

Fluoride Mouthwash: ACT Total Care

I always rinse with ACT right before bed. It has a great flavor (my favorite is the green one), probably the best tasting of all the mouthrinses I’ve tried, and is very effective in helping remineralize and strengthen enamel. Another great product worth trying.

100% Xylitol Gum: Epic (epicdental.com)

Xylitol is a great sugarfree product that is important to home care. I usually opt for 100% Zylitol chewing gum (right now I’m addicted to Epic cinnamon flavor). The only downfall is the chewing gum doesn’t keep its flavor for that long.  But on the upside, even after only chewing it for a short amount of time, my mouth feels really fresh and clean afterwards. And it’s a great way of delivering Xylitol, which is the only sugar substitute that studies have shown that has cavity fighting properties.]]>

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Xylitol: What Is It & Are You Getting Enough?

Fotolia_15738796_XS-resized-600 100% Xylitol can be consumed in many different product forms: mints, gum, lollipops, and granular just to name a few. Many commercial sugarless gums, which are not 100% Xylitol, contain approximately .5 grams of Xylitol per piece. It is recommended that 6-10 grams of Xylitol be consumed daily by children and adults. Therefore, it is recommended that a product with 100% Xylitol be consumed instead. Products with 100% Xylitol can be difficult to find at your everyday local grocery store but you can usually find 100% Xylitol at health/organic food stores and on the Internet. Xylitol is also recommended for infants and can be started with a few grams a day once the teeth begin erupting, working up to 6-10 grams as all the teeth have fully erupted. Since babies cannot chew gum/lollipop/mints, we recommend Xylitol be introduced in a granular form mixed in water. A wash cloth bathed in this solution can be used to clean the newly erupted teeth. Speak with your dentist or a pediatric dentist before introducing Xylitol.]]>

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