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Dental anxiety affects a large portion of the population. While many have such anxiety, some are so fearful that they can not even get themselves through the dentist’s front door.Statistics show that  15-20% of all Americans avoid the dentist due to fears or anxiety about the dentist. The reasons for anxiety are different for everyone. These can include fear about feeling rushed by the dentist, possible pain, or even just the smells and sounds of the dental office. Dental anxiety and dental phobia, when stopping someone from receiving dental care,  lead to unnecessary oral and general health problems.

Tips To Calm Dental Anxiety

-Finding The Right Dentist And Dental Team. That’s right, it is not just about the dentist. The dental team is just as important in maintaining a calm, soothing atmosphere. A well trained dentist and team can make you feel at ease throughout your dental treatment and actually make it an enjoyable experience. Ask friends or relatives for recommendations. A good review about a dentist from someone you trust can significantly reduce anxiety. Also, in the internet age read online reviews. These can let you get a better understanding of the dentist and how they treat their patients. Last, make an appointment for a consultation so that you can meet the dentist and staff to see if they make you feel comfortable enough to schedule an exam and cleaning.

-Communication. One of the most important factors in overcoming dental anxiety is a good, open line of communication between dentist and patient. You must always feel comfortable expressing your feelings, fears, and concerns before, during, and after treatment is rendered. You must also feel that the dental team is listening to you and making adjustments as needed. Communication should never be compromised for any patient but it is even more important for a patient with dental anxiety. This will allow you to feel a sense of comfort that you may have never felt in a dental office before.

-Feeling Of Being In Control. This comes from the confidence to stop or start treatment whenever you need to. You should always feel comfortable controlling your treatment.  Making treatment decisions based upon options, how long your appointments should be, and how often you are comfortable coming in for treatment. Another aspect to being in control is to give yourself the power of knowledge about your dental care. This will give you the ability to understand the steps of treatment, and why it is important for you to follow through. Being in control will allow you to properly express your feelings about how much treatment you can handle.

-Own Your Emotions. For many who have neglected their dental care due to fear there can be a sense of embarrassment. Express your feelings and allow your dentist to understand your feelings so they can be addressed properly. Panic, tears, needing your hand held, etc. are coping mechanisms to fear. It is ok to get emotional at the dental office. You can and should be able to express your emotions without embarrassment.

-Utilize Relaxation Techniques.  These can include:

1. Proper Breathing. Focus on breathing regularly and slowly during dental work. When people are feeling anxiety or nervousness we tend to hold our breaths, or breathe in short rapid breaths. This decreases oxygen levels in the body, or hyperventilation, further increasing our feelings of panic.

2. Wear Headphones. For many, the sound of the dental office is a trigger for dental anxiety. Using an ipod or mp3 player with headphones can drown out the noises and relax you.

3. Avoid Caffeine. Caffeine can raise your heart rate and blood pressure, This can trigger panic attacks, make you feel dizzy, lightheaded, or give you the feeling of a fast beating heart. Caffeine before a dental appointment should be avoided.

4. Choose Pre Dental Meals Carefully. Eating high-protein foods have the ability to produce a calming effect.

5. Timing Is Everything. The time of day for your dental appointment can be critical. Try to choose a time for your dental visit when you’ re least  likely to be rushed or feel under pressure.

-Repetition. The simple process of repeat appointments, will make you feel more comfortable and at ease. As you learn what to expect, and realize that you are in control of the appointment, you will be able to manage more time in the chair. Remember not to wait too long between appointments or to reschedule unless an emergency arises. Merely coming to the office and not having treatment that day is better than canceling.

-Predictable Pain Control. Every individual is slightly different. What may work for one may not work for another. Let your dentist know if you have a history of difficulty getting numb. Be sure to let your dentist know whether or not you still feel sensitivity, or lack of complete numbness. When you can trust that your comfort will be a priority, you will find that your anxiety rapidly diminishes.

Dental Anxiety Conclusion

Overcoming dental anxiety can be a trying experience. It is important to find the right dentist and dental team so that you can move forward and free yourself from dental anxiety once and for all. Know what you are looking for in a dentist, and be prepared with questions for your meeting. Remember, it is ok to shop around, you will know when you have found the right dentist for you!



Many believe that periodontal disease is a disease that is solely based on genetics. My grandparents had dentures, my parents had dentures, so will I. The truth is, that genetics plays a role, but is not a sentence for dentures. There are risks and limitations in the progression of periodontal disease… Can each patient limit the risks of developing full blown progressive periodontal disease?….The answer is a resounding…YES! It takes a good oral hygiene regimen, knowledge of the current state of your condition, and frequent professional cleaning to keep our mouths in a healthy, disease-free state.

Risk Factors Of Periodontal Disease

Patient Caused Risk Factors

-Poor Oral Hygiene – This is an obvious one that each individual can control. Brushing, flossing, rinsing, and seeking regular dental care are essential steps to remain periodontal disease free and avoid progression beyond gingivitis.

-Age - Research has shown that older people have the highest rates of periodontal disease. The research shows that over 70% of Americans 65 and older have periodontitis.

-Smoking Or Tobacco UseTobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

-Poor nutrition- Eating an unhealthy diet will not supply you with the essential vitamins and minerals necessary for tissue healing and repair.

-Anatomy - The local anatomic risk factors for periodontal disease include:,

1. Furcation anatomy. These are the spaces between roots of molars.  In many instances, the entrance of  such furcations are restricted enough to limit access for proper hygiene maintenance. Risk factors for periodontal disease are classified according to their involvement in tooth furcations. A Grade I CEP presents with minimal projection of enamel toward the entrance of the furaction. A Grade II CEP approximates the entrance of the furcation, and the tip of a Grade Ill CEP is well within the furcation.

2. Common anatomic deformities. These interfere with a patient’s ability to effectively remove plaque biofilm which are one of the risk factors for periodontal disease. An example are Cervical enamel projections (CEP). CEPs are tooth developmental deformities of the CEJ found on molars.

4. Palato-gingival grooves (PGG). POGs are tooth developmental deformities of maxillary central and lateral incisors. They begin in lingual pits and extend vertically onto root surfaces. PGGs could, on rare occasions, extend to the root apex. PGGs are commonly associated risk factors for periodontal disease with increased gingival inflammation, plaque accumulation, and probing depth.

5. Open contacts, loss of interdental papilla, and food impaction. Open contacts between teeth may allow for easy food impaction. Food impaction is defined as the forceful wedging of food between teeth. Loss of the pointed papilla between teeth leaves another area for food impaction.

-Medications - Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can have an affect on your oral health, causing dry mouth, inflammation and gum tissue overgrowth. It is important to tell your dentist the medications you might be on so they can tailor a treatment schedule for your needs.

-Other Disease - These include cardiovascular disease, diabetes, and rheumatoid arthritis.  These diseases can interfere with the inflammatory process, causing healing problems, and may worsen the condition of the gums.

-Poor Nutrition – A diet without all the essential nutrients for our bodies to function can compromise our immune systems, decrease healing ability, and make tissue weaker and easier to breakdown. This will make it harder to fight off infection. Since, periodontal disease essentially begins as an infection, this lack of nutrition can make the periodontal disease develop and progress faster than it normally would. Studies have also linked obesity with an increased risk of periodontal disease.

Dentist Caused Risk Factors

-Overhanging dental restorations – A poorly completed dental restoration typically has dental material overhanging the tooth. This creates an issue keeping the area clean and also creates an area for food and bacteria to build up. These overhangs can be irritating to the tissues and retain plaque and food more easily.

-Violation of the “biologic width” –  is the height between the deepest point of the gum pocket and the bone. This distance is important to consider when fabricating any dental restorations, because they must respect the natural architecture of the gingival attachment if harmful consequences are to be avoided. These consequences include bone and tissue recession.

-Open contacts and food impaction - If a dentist places a new dental restoration and does not create the proper tight contact between adjacent teeth, that area becomes a food and plaque trap. It will necessitate improved dental hygiene in that area to keep it clean. More often than not, food and debris will accumulate creating a localized area of periodontal disease.

-Occlusal trauma – If a new restoration is not properly set in alignment with the other teeth, a patient can create damage to the tooth as well as the surrounding tissue just from the act of chewing. The bite should always be checked and adjusted after dental work to prevent trauma to an individual tooth.

Periodontal Disease Conclusion

Luckily, with the exception of the anatomy we are born with, all of these periodontal disease risk factors can be overcome. The first step is to practice good oral hygiene by brushing, flossing, and using an antibacterial mouthrinse. The second step is to choose a well qualified dentist and keep a regular schedule to help give you the best fighting chance at preventing,  treating and stabilizing periodontal disease.

Bad breath or halitosis, results from poor maintenance of dental hygiene, chemical breakdown of food, and may be a sign of other health problems. Bad breath can also be made worse by  unhealthy lifestyle habits. We all know how bad our breath is after eating onions or garlic for lunch, but did you know that your tongue can be a major cause of your bad breath?

Importance of Regularly Cleaning Your Tongue

Did you know that your tongue’s surface is the main breeding ground for harmful bacteria? These are the same bacteria that attack your teeth and gums causing tooth cavities and periodontal disease.  Bacteria  give off toxins in your mouth that in turn produce foul smelling gases.

Most people are aware of the importance of brushing and flossing but a simple “scraping” of your tongue twice a day can reduce bad breath odors. Studies have shown this can reach as high as a 75% reduction in odors emanating from the mouth.

A dental myth widely believed is that the stomach is the root cause of bad breath. Bad breath directly caused from the stomach is so rare that of a thousand people treated for bad breath not a single case was caused by underlying stomach issues.

Tooth brushing and most mouthwashes do nothing to remove oral debris and dead cells on the tongue, the root cause of bad breath. The most you can hope for from them, is to mask the bad breath for a short while. A combination of methods works best and this should include brushing, flossing, and tongue cleaning. Tongue cleaning can show a huge improvement in one’s breath almost immediately.

Orabrush Marielaina Perrone DDS

Orabrush for a Cleaner Tongue

Tongue Cleaning: Did You Know?

-Combination of teeth brushing and tongue cleaning can reduce bad breath by as much as 85% Vs. tooth brushing alone.

-Tongue cleaning alone can reduce mouth odor by as much as 75%.

-Brushing alone, reduces mouth odor by as much as 25%.

-Tongue cleaning reduces the amount of bacteria, plaque, and dead cells on the tongue by as much as 40%

-Tongue cleaning will cut down the bacteria stored in the mouth by Tenfold.

-Tongue cleaning reduces halitosis including smoker‘s breath by as much as 85 %

How to Clean Your Tongue Effectively

There are lots of products on the market now strictly for tongue cleaning. There are many types of apparatus available to clean your tongue, it is strictly a matter of preference. The old fashioned manual toothbrush does quite an effective job as well.

1.  Apply a pea sized amount of toothpaste to a wet toothbrush, not the same one that you use for your teeth, because the tongue holds significantly more debris and different bacteria than your tongue. The tongue cleaning toothbrush should be rinsed in antibacterial mouth rinse and stored separately so as not to contaminate your regular toothbrush.

2. Open your mouth wide and stick your tongue out at yourself in front of the mirror. Reach in with the toothbrush and gently touch the back of your tongue, near your throat. If you gag, pull the toothbrush a bit farther out of your mouth and try again. Repeat this step until you find a starting point that does not cause you to gag. Don’t worry if you can’t get very far back, your gag reflex will relax over time.

3. Press down on the toothbrush and pull it forward. Drag it across the entire length of your tongue until you reach the tip.

4. Repeat Step 2, moving the brush off to one side slightly so you drag across a new section of tongue. Spit out excess toothpaste if necessary, but don’t swallow it.

5. Continue doing this until you have scraped the entire top of your tongue. Rinse the toothbrush. Lighten the pressure, and repeat the process on the underside. If the procedure is painful, you’re pushing too hard.

6. Rinse your mouth thoroughly for at least one minute with an anti bacterial mouthwash. Spit when you’re finished.

Tongue Cleaning Conclusion

Maintaining good oral hygiene may seem like a daunting task but it is really quite simple once it becomes a part of your daily routine. Not only will you experience better breath, and less dental issues, but you will feel better and more confident about yourself as you go about your daily activities. Research has shown time and again how important a smile is to our self esteem. Give yourself peace of mind and follow your dental hygiene instructions for a happier, healthier you!