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With the myriad of options on the market today, it is getting harder and harder to choose the right toothpaste for your dental needs. Toothpaste used to be sold as aCosmetic Dentist Marielaina Perrone DDS one size fits all but with sensitivity, enamel recalcifying, gum issues, dry mouth, or for teeth whitening it has become much more customized to each individual.

The primary function of toothpaste is to clean teeth and prevent tooth decay. Fluoride is a main ingredient in almost every toothpaste on the  market today. Fluoride has the ability to enhance remineralization of the tooth’s enamel  which can allow for reversal of very small tooth decay.

Different Types Of Toothpaste

Whitening. This has become quite popular to the general public. These teeth whitening toothpastes contain hydrogen peroxide, baking soda, or some other custom ingredient. These toothpastes work in a variety of ways to whiten your teeth. Some work through the mechanical action of brushing while others work chemically to whiten our teeth. Some are even able to remove staining present on our teeth from our daily eating activities.

Sensitivity. Tooth sensitivity is a very common issue for many of us. Luckily, there are many good sensitivity toothpastes on the market today including crest pro health line of toothpastes. Many of these toothpastes contain potassium nitrate. The potassium nitrate is able to plug the holes in our dentin layer of our tooth to form a protective layer, protecting the nerve, thus relieving sensitivity.

Remineralizing. These types of toothpastes allow for tooth enamel to repair itself and remineralize. This is only effective in small areas of decay and will not work for very large tooth decay. A good example of this is colgate prevident or GC MI paste with recaldent.

Cosmetic Dentist Marielaina Perrone DDSXylitol. This is a commonly used as a sugar substitute but it also has the added properties of not allowing bacteria to adhere to tooth enamel. This gives it the ability to lower a person’s risk for tooth decay. It has also been found that xylitol when combined with fluoride (fluoride concentration greater than 0.8 ppm) it can provide additional remineralization benefits.

SLS free toothpaste. SLS or sodium lauryl sulfate is the bubbling agent in toothpaste. For some people, SLS causes irritation to oral tissue, apthous ulcers (canker sores), peeling or red gums.

Mouthrinse in toothpaste. Many toothpastes contain mouth rinse, supposedly to help gums, and give fresher breath.

Fluoride free. Some people prefer natural toothpaste without fluoride.

Specialty toothpaste for children. It is important to choose a toothpaste specifically for children because a toothpaste with fluoride when they are too young to swish and spit will be swallowed. The level of fluoride in toothpaste is much higher than in the water supply, fluoride if swallowed often, can be harmful. As a child gets older, you can use children’s toothpaste with fluoride, but only a pea size amount.

Toothpaste Conclusion

With the multitude of toothpaste choices comes the responsibility of choosing the right toothpaste for you and your family. It is important to use the toothpaste that suits your needs. Brush at least twice a day to stave off tooth decay as well periodontal disease. Luckily, for dentists and patient, with all these choices a toothpaste can be custom selected for each individuals needs.

 




Dental Implants have changed the way we all look at tooth replacement and dentistry. Dental implants are not just for single tooth or multiple teeth replacement. They can also be used in support and stabilization of removable dentures. Long time denture wearers will tell you that over time the bone remodels and resorbs resulting in loose and ill fitting dentures. When this happens patients used to be forced to grin and bear it using various denture adhesives. Now with the development of dental implant supported dentures those days can be a relic left in the past for many patients.

Dental Implant Overdenture – What is it?

A dental implant supported denture is also called an overdenture. A traditional removable denture rests directly on the gums, and is not supported by dental implants. This is because the denture sits over the dental implants. The dental implants give support and stability to the denture.

A dental implant supported denture is recommended when a person is missing all the teeth in the jaw. The patient needs to have enough bone in the jaw to support the dental implants. The denture is able to stay in place using special attachments that allow the denture to “snap” into place over the dental implants.

Implant supported removable dentures usually are fabricated for the lower jaw. This is because regular dentures tend to be less stable on the lower arch due to tongue and musculature present. Usually, a regular denture made to fit an upper jaw is much more stable and tolerable on its own and doesn’t need the extra support offered by dental implants. If the patient chooses they can receive a dental implant supported denture in either the upper or lower jaw.

Dental implant supported denture should be removed daily to clean the denture and gum area just like traditional dentures. Also, you should not sleep with the dental implant supported dentures at night. Some people prefer to have fixed (permanent) crown and bridgework in their mouths that can’t be removed but this is not always possible in every patient’s case. Your dentist will consider your particular needs and preferences when suggesting fixed or removable options.

Dental Implants with bar supporting denture

Dental Implants with Bar Supporting Denture

Types of Dental Implant Supported Dentures

 

There are two types of dental implant supported dentures:

1) Bar-retained dentures. Your dentist will have a thin metal bar custom fabricated for your mouth. This bar will follow the curve of your jaw and is attached to 2-5 dental implants that have been placed directly into your jawbone. Clips or other types of attachments are fitted to the bar, the denture or both. The denture is then designed to fit directly over the bar stabilized by the attachments. The dental implants along with the bar and attachments gives the denture support and stability.

2) Ball-retained dentures. The dental implants in the jawbone hold a metal attachment(ball) that fits into another attachment(socket) on the

Dental implant supported denture - Ball retained

Dental Implants – Ball Retained Denture

denture. In most cases, the attachments on the implants are ball-shaped (“male” attachments), and they fit into sockets (“female” attachments)

on the denture. In some cases, the situation is reversed and the male attachment is in the denture and female attachment is on the dental implant. This also gives the denture wearer increased stability and retention over the traditional removable denture without dental implants.

In both scenarios, the removable denture will be made of a custom fabricated acrylic base that will look like gingival tissue. The teeth can be made of porcelain or acrylic. These teeth will look very natural. Either type of denture needs a minimum of 2 dental implants to work properly over the long term.

Placement of Dental Implants

The prime location for placement of the dental implants is in the front of the mouth. The reason for this is due to the fact that there is

supporting denture with dental implants

Visualization of dental implants supporting dentures

generally more bone present in this area for the dental implants. This is the case even if the teeth have been missing for a long period of time. When teeth are lost, bone is lost in that surrounding area.  Anatomy plays a role as well. In the front of the mouth there are less nerves orother important structures that could interfere with he placement of the dental implants.

The time schedule to complete the dental implants can be complicated. The general time frame is approximately 5 months for the lower jaw and approximately 7 months in the upper jaw. The process can take much longer if the case is more complicated. Complications can include the need for bone grafting or even sinus lifts.

The procedure generally requires two surgeries. The first surgery is for placement of the dental implants in the jawbone under your gingival tissue. The second surgery is to remove the gingival tissue that has now covered the dental implants. The second procedure comes 3-6 after the first.

There has been increased use of a one stage procedure.

A one-stage procedure is now used sometimes. In this procedure, your dentist places the implants and the supporting bar all at same visit.  The success rate of this procedure is high. if properly treatment planned.

Dental Implant Supported Denture Care

The dentures need to be removed at at night and to clean them. The attachments and/or bar need to be cleaned as well. Your dentist will give you instructions on how to clean these as they can be delicate.

Your dentist will periodically check the parts of your new denture to ensure they are secure and in proper place. Your denture may seem stable but over time these attachments can loosen. If they loosen even slightly it will cause the denture to move when chewing. This movement of the denture can cause sore spots as the denture rubs against your gums. Your dentist will also check to make sure your bite is correct and make any adjustments as needed.

The clip or other attachments on the bar retained denture usually will need to be replaced every 6-12 months. They are made of a plastic material (nylon) and will wear after continued use.

Complications that may Arise From Dental Implants

The actual dental implant surgery carries its own risks but so does a bar retained denture. The fabrication of a bar retained denture needs extra space inside the denture to allow for the bar to fit inside. This means there is less support for the teeth in the denture. Due to this, the teeth sometimes come loose. This is an easy fix but an inconvenience for the patient.

Another important item is that the denture fits on the bar passively. This means that the bar is evenly balanced across all implants. If the fit is not passive, the extra strain can cause the screws holding the bar down to loosen. A special note for teeth grinders or clenchers is that their parts are more likely to break due to the excessive force they are placing on the components and dental implants.

Dental Implant Overdenture Expectations

A denture supported by dental implants will be far more stable than a traditional removable denture. Patients will find everyday tasks easier. They will find speaking easier. They will also not be concerned that their denture may fall out or become loose. Patients report being able to eat foods they have not been able to eat in years. A word of caution is to avoid sticky or very hard foods as you can damage the denture with these types of food.

A big advantage to having dental implants support the upper denture is the dentist can make your denture much less bulky. A traditional denture covers your entire palate whereas a dental implant supported denture does not need that extra material for support.

A whole new world has opened up with dental implants for both patient and dentist. The old compromise and limitations are slowly being worn away. We are entering a new world of dentistry and dental implants are leading the way!

 

Benefits of Dental Implants with Removable Dentures
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Dental Hygiene Top 10:

1) Brush Properly. Believe it or not there is a wrong way to brush for proper dental hygiene.. It is important to brush after breakfast in the morning to remove plaque and bacteria that have accumulated over night (and from your morning meal) and to brush last thing at night because saliva (which helps to wash the cavity-causing plaque off teeth) dries up as we sleep. Toothbrushes should come with a small head and very soft bristles. Your dental hygiene all starts with proper brushing.

2) Floss your teeth at least once a day if not more. This will keep plaque from building up. Use dental floss to clean in between the teeth where plaque collects. Floss before you brush to remove any plaque or food particles. It is important to floss regularly because about 90% of cavities occur between teeth. Hold floss tightly between your thumbs and forefingers and guide it between your teeth using a gentle sliding action. When the floss reaches where the tooth meets the gum, curve it into a V shape against the tooth and gently slide it up and down between the gum and the tooth, Do Not” Shoeshine” (rubbing floss side to side ) as this motion can cause notching in the root. Repeat for the other side and every tooth. An inter dental brush can be used for larger gaps.

3) Rinse your mouth with antiseptic mouthwash twice a day. Make sure you do not swallow it. Discuss with your dentist which rinse is best for your oral condition and dental hygiene maintenance. Listerine is a great product with many combinations to suit almost every need. It is also one of the only rinses backed by years of scientific research.  The benefits of a mouthwash are that they can reach areas not touched by brushing alone. Rinse twice a day. Once in the morning and last thing at night and always after brushing.

4) Limit your sugary foods to avoid getting tooth cavities. Think about what you are eating. Do you want the best or worst foods for your dental and overall health? If you do choose a sugary or high acid food, chew a sugar free gum or xylitol gum. This will increase salivary flow in your mouth which will get rid of lingering sugar and neutralize acids faster. The bacteria will not cause decay in a clean neutral environment.

Dental hygiene

Dental Hygiene – Fluoride Toothpaste

5) Use a fluoride toothpaste. A fluoride tooth paste will help strengthen your enamel, making it tougher for bacterial acids to break down. Toothpaste also helps control plaque build up and keeps your teeth white and healthy!

6) Electric Toothbrushes. These are recommended by most dentists for their superior performance when compared to old fashioned manual brushing. Electric toothbrushes tend to have small brush heads that cup around the tooth and are faster and more efficient in cleaning areas of the mouth where bacteria and plaque collect. They are great for people who brush aggressively, as they brush for you. They are also easier if you have limited manual dexterity. Many also have a timer so you know you are brushing for the correct amount of time. Using an electric toothbrush will make all your dental hygiene efforts even easier to attain.

7) Eat your vitamins. Maintain a healthy diet to give your teeth and oral tissues (bone and gum tissues) the nutrients they need. Make sure you have enough B vitamins and calcium to keep your teeth strong! This is often overlooked in most dental hygiene programs.

Dry Mouth

Dental Hygiene – Biotene

8) Avoid Dry Mouth. Saliva provides an essential defense against tooth decay and periodontal disease by washing and rinsing the bacteria in the mouth. Patients who experience decreased salivary flow generally have increased dental health problems. Chronic dry mouth or xerostomia could be a side effect to certain medications or a symptom of a systemic disease. Your dentist can recommend several products to combat this problem. The leader in this category is Biotene. Without proper salivary flow or moistness in oral cavity your dental hygiene will suffer.

9) Clean Your Tongue. A major cause of bad breath can actually come from bacteria building up on your tongue with a high percentage of it accumulating at the back, making it hard to reach. Use a proper tongue scraper every morning to remove tongue plaque and freshen your breath.

dental hygiene - orabrush

dental hygiene – orabrush

A daily tongue scraping will help remove harmful bacteria. The use of a tongue scraper is more effective than brushing your tongue with a toothbrush. A good example of a tongue scraper for dental hygiene is the orabrush.

10) Change your toothbrush out regularly. Did you know you should change your toothbrush every two to three months for good dental hygiene? If you do not then bacteria will collect on the bristles and you will transfer them back into your mouth. Also over time the bristles will become worn and ineffective. The same rules apply for electric toothbrushes. If your toothbrushes are wearing out before two months then you are probably brushing too harshly. Ask your dentist or dental hygienist to show you the proper way of brushing to maintain proper dental hygiene. Always chose a toothbrush with soft not hard bristles as hard bristles can cause damage to the teeth and your gums.

Follow the steps above along with regular visits to your dentist and you will be on your way to having great dental hygiene.

dental hygiene

Dental Hygiene – Listerine



Halitosis is the medical term used to define bad breath. The word halitosis was first introduced to the world in the 1870’s but made popular in the 1920’s by the Listerine company. The correct scientific term for bad breath is oral malodor. Halitosis can be a very embarrassing problem to have. Americans spend approximately $500 million attempting to treat halitosis every year. It’s no surprise then that store shelves are stocked full with gum, mints, mouthwashes and other products designed to counteract bad breath. But many of these products are merely temporary measures and do nothing to treat the condition in the long term. The makers of these products have made a lot of money out of the general population’s desire for fresh breath. These products promise that your breath can be minty fresh. However, it is only temporarily beneficial at best in controlling breath malodors. Actually, many often contain sugar and alcohol, which may lead to tooth decay and may aggravate certain mouth conditions.

The irony of halitosis is that most people have no awareness that they even have halitosis. This is because the cells in the nose that are responsible for the sense of smell actually become unresponsive to the constant flow of bad odor emanating from your mouth. If you have bad breath, you may need to be told, or you may begin to pick up the facial expressions of other people when you’re just too close!

Most halitosis originates from something in your mouth. Food can stick in between your teeth, around the gums and on your tongue. This food will breakdown and combine with bacteria to form plaque.  If not cleaned off properly thru proper brushing and flossing, the plaque will cause a foul smell in your mouth. Plaque and the bacteria which feed off of it can cause periodontal disease (gingivitis and periodontitis). Periodontal disease definitely causes a distinctive type of bad breath we call “perio breath”. Other dental causes of halitosis include ill fitting dentures, yeast infections of the mouth, tooth cavities, and tobacco use. Smoking actually causes your mouth to dry out and creates its own unpleasant mouth odor. Tobacco users are also more likely to have periodontal disease(about 50% of all smokers have some form of periodontal disease).

Halitosis can also be made worse by the types of foods you eat. Many foods may cause bad breath which can include onions, garlic, cheese, certain spices, orange juice and soda. Once these foods become digested, their oils are absorbed into your bloodstream and carried into the lungs. The odor is given off in your breath until all of the food is out of your body. If you eat foods with strong odors, brushing and flossing, even mouthwash simply is a temporary cover up. The odor will linger with you until the foods have passed through your body completely.

Dry mouth or xerostomia can also cause halitosis. Saliva is needed to wet and cleanse the mouth by neutralizing acids produced by plaque and washing away dead cells that accumulate on the tongue, gums, and cheeks. If they are not removed, these cells decompose and can cause bad breath. Dry mouth may be caused by the side effects of various medications (for example, some antidepressants, anti psychotics, antihistamines, decongestants, and medications to reduce high blood pressure), salivary gland problems, snoring, sleep apnea, or continuous breathing through the mouth. A lack of saliva at night deprives the mouth of oxygen, which can promote the spread  of anaerobic germs. This is why most everyone suffers from what’s commonly  referred to as “morning breath”.

The bad odors do not come from the mouth in approximately 10% of the cases. Many other diseases and illnesses may cause halitosis. They include, respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, gastroesophageal reflux disease (GERD), and liver or kidney disease. Some of these conditions can have their diagnosis confirmed (along with other medical tests) by the presence of their halitosis. Diseases, such as some cancers and metabolic disorders, can cause a breath odor that is distinctive as a result of the chemicals they produce. Diabetics with uncontrolled glucose levels can have a fruity breath odor from chemicals called ketones. And chronic reflux of stomach acids has also been associated with halitosis.

Treatment and Prevention of Halitosis

Closys Halitosis spray

Closys Halitosis Spray

The most effective way to treat halitosis is thru maintenance of proper oral hygiene along with regular appointments with the dentist. Regular brushing, flossing, rinsing, and scraping of your tongue can also help keep halitosis at bay. There is one product that will not just cover and mask the odor by actually neutralizing the chemicals at the back of your throat. This product is called Closys.

Helpful hints for getting rid of Halitosis:

Halitosis

Halitosis – Tongue Scraper

-Tooth brushing 2-3 times per day. Change tooth brush as recommended.

-Before bedtime, clean your tongue with toothbrush or use a special tongue scraper. This will remove any particles and bacteria lodged in folds of the tongue. A good example of this is the GUM dual action tongue cleaner.

-Use an electric toothbrush, such as the Rotadent, to be more effective in your brushing.

-Keep your nose and sinuses clean.

Halitosis-Stimulate salivary flow by chewing sugarless gum during the day. This will keep the mouth awash with saliva. This can include Trident white among others.

-Drink lots of water daily to keep your mouth wet and to help rinse away odor forming bacteria and food particles.

-Lower coffee and alcohol drinking.

-Ask your doctor or pharmacist whether your medications are causing problems of dry mouth that may be leading to bad breath.

-Schedule and maintain regular visits to your dentist.