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Undergoing orthodontic treatment can be a trying time for maintaining good dental hygiene, but the end result makes it all worth it. Creating a straight, attractive smile that one can be proud of is the goal of most orthodontic treatment.  However, orthodontic treatment can disrupt your daily routine. The orthodontic brackets and wires, and chewy, sticky foods can make dental hygiene more challenging and difficult. Poor hygiene, while wearing braces, can put your teeth and gums at risk for periodontal disease and decay. Luckily, there are ways to maintain great hygiene even with orthodontic brackets and wires attached to your teeth.

Tooth Decay Prevention Tips

Even without braces, maintaining dental hygiene can be very challenging. The main task in any dental hygiene program is to control the buildup of dental plaque and tartar. This dental plaque contains oral bacteria that releases acid that can destroy the out layers (enamel) of your tooth. Tartar is an irritant that can cause swollen or receded gums, and bone loss. The following are some key tips to help keep your teeth and gums in top shape while wearing orthodontic braces (or even without them!):

Flossing And Brushing Tips - To floss teeth if you have braces, feed the end of the floss threader or all in one floss through the space between the main arch wire and the upper portion of the tooth closest to the gum. Use a gentle sawing motion to work the floss on each side of the two teeth the floss is between. Be careful not to pull with too much force around the arch wire. Brush teeth by using a rotary toothbrush or a regular soft toothbrush. Brush down from the top and then up from the bottom on each tooth with braces. Next, brush your teeth with a proxabrush or “Christmas tree” brush. This brush is specially designed for cleaning between two braces. Insert the brush down from the top and then up from the bottom between two braces. Use several strokes in each direction before moving on to the next space between two braces. A Waterpik with Periogen and purple listerine works very well to flush out plaque, tartar, and stain to keep your brackets and elastics clean. Continue with cleaning until all metal surfaces shine and there is no plaque left behind.

Dental hygiene appointments should occur more frequently (every 3-4 months). Fluoride treatments and dental sealants are also helpful to keep teeth strong and decay free.

Foods to Avoid While Wearing Braces – While going through orthodontic treatment there are several types of foods that shouldn’t be eaten. It helps if the pieces are smaller so they can be easily chewed and lessen risk of breaking any brackets or wires. Items and habits that should be avoided include:

-Hard or difficult to bite foods. These include apples, bagels, pizza crust, beef jerky.

-Chewy and sticky foods. This includes taffy, bubble gum, or caramels.

-Corn on the cob. Remove the kernels and eat them individually vs biting them off the cob.

-Hard pretzels, popcorn, nuts, and carrots.

-Do not chew ice, fingernails, or pencils.

-Do not open things (bottles, chip bags, etc.) with your teeth.

Conclusion

The last thing anyone wants, is to complete orthodontic treatment with beautifully straight teeth loaded with cavities and bleeding gums. Luckily, with diligent work in maintaining dental hygiene tooth issues can be prevented. This should also include regular dental visits for examinations and professional cleanings.

Dental implants are widely spread throughout dentistry and have become mainstream for many patients. In the past, patients were presented other options…go without a tooth or teeth, wear a removable denture, or have a cementable bridge made. Dental implants have allowed for a great additional option which does not cut down existing teeth, and is strong and unmovable. Unfortunately, many of us forget that dental implants need to be cared for and maintained just like  natural teeth.

What Are Dental Implants?

Dental implants are an artificial tooth root (usually made of titanium) that a periodontist or oral surgeon places into your jaw to support restorations that resemble a tooth or group of teeth. Dental implants can replace a single tooth, support  a bridge, or support a denture (making it more comfortable and secure).

Dental implants are an ideal option for people in generally good oral health who have lost a tooth or teeth due to periodontal disease, injury, fracture or decay. Dental implants are actually more tooth saving than traditional crowns and bridges, since dental implants do not cut down healthy teeth or rely on adjacent teeth for support.

Sufficient bone, and good overall health will give you the best prognosis for ideal oseointegration, (the way bone fills in around the implant for strength). Dental implants are intimately connected with the underlying bone and gum tissues in the mouth. So, proper fit, good occlusion, and excellent oral hygiene are necessary for long term success. With technique and material advances, dental bone grafts are now more successful than ever and can be used to augment your natural bone. Periodontal disease, diabetes, bleeding problems, etc. can cause difficulty in placement, healing and longevity of the dental implants. Be upfront with your dentist regarding health issues so that the proper steps can be taken to give you the highest chance of success. There is an increased risk of failure in patients who are smokers. For this reason, dental implants are frequently placed only after a patient has stopped smoking.

Top Tips For Caring For Your Dental Implants

-Toothbrushing. Usual toothbrushing applies. It is recommended that you brush twice a day but it is even more beneficial to brush after every meal if that is possible.

-Flossing. Yes, flossing is important even with dental implants. Flossing is able to clean around the dental implants along the gum line. Just because the dental implants cannot get tooth decay it does not mean you cannot lose them. Bone loss is still possible around the dental implants which can lead to their loss.

-Maintain Regular Dental Visits.  Dental implants should be cleaned with different types of dental instruments as not to scratch the surface. They should again not be cleaned with ultrasonic or vibrating dental instruments of any kind. It is important to examine the dental implants at least once per year along with your regular professional cleaning schedule. Your dentist will evaluate the bone levels along with the soft tissues and occlusion. The important takeaway here is to have frequent examinations to catch any issues that might arise early enough so proper corrections can take place.

-Use A WaterPik. A great way to clean around dental implants is to use WaterPik.  The WaterPik is a water spray that cleans in between and around the teeth. But keep in mind again too much pressure may cause damage to the pocket so keep it at the lowest level possible. Recent studies have shown the WaterPik to remove up to 145% more debris than regular dental floss alone. Periogen in the waterpik can help remove tartar buildup around implants making it easier to keep them clean.

-Do Not Smoke. Smoking has been known to decrease oxygen flow to the gum tissues. This results in delayed healing, deterioration of the oral tissues, and bone loss. Bone loss and inflammation will cause your implant to loosen and fall out. If you want to protect your investment, do not smoke.

-Avoid Extremely Hot Liquids. Dental implants are made of metal and metal has ability to retain heat more readily than our oral tissues. If you drink extremely hot liquids, the metal of the dental implant  may heat up from the liquid and stay hot. The heat may cause a burning of a thin layer of cells around the implant. With repeated small damages this may cause inflammation around the implant. This is not backed by research, but is worth mentioning.

Caring For Dental Implants Conclusion

Just like your natural teeth, dental implants should be maintained if you wish to keep them. With proper maintenance, both at home and in the dental office, dental implants can last a lifetime. Dental implants can strengthen, and enhance your smile for years to come.

Periodontal disease can be very difficult to manage once it begins to progress past its initial stage of gingivitis. The treatment requires diligence on the part of the patient to

Periogen Marielaina Perrone DDS

Periogen + Waterpik = Healthier Mouth!

maintain regular hygiene appointments and meticulous home care. Professional cleanings go a long way to preserving your teeth and gums, but once patients leave the office they need to maintain their oral hygiene so it does not progress further. Many patients just need to get into a routine of brushing, flossing, and rinsing regularly. So, how can we make it more effective and efficient for the patient?

How to Improve Dental Hygiene?

Let’s face it, most patients do not like to floss. So what do we do to get patients to maintain their dental hygiene? One of the most effective and most popular products on the market today is the waterpik flosser. The waterpik flosser works by delivering a combination of water pressure and pulsation. This allows the waterpik to remove debris and bacteria lodged between the teeth and below the gum line. It is also able to massage and stimulate the gums to improve blood circulation and help promote healthy gums.

The waterpik has also been extensively studied in clinical trials and shown that it is clinically proven 50% more effective than traditional dental floss.

SO…what can make the waterpik even better? The answer is in a new rinse called Periogen. Periogen is a patented oral rinse that has been proven capable of dissolving tartar buildup between professional cleanings and dentist visits. Periogen works by exploiting a weakness (discovered by the research team at the Periogen Company) in the fundamental structure  of oral tartar, and the way it sticks to our teeth.

Tartar (or calculus as it is sometimes called) can be found above and below the gum line. Tartar above the gum line is referred to as supra gingival tartar and tartar below the gum line is referred to as sub gingival tartar. Dental Tartar is comprised almost entirely of Calcium Phosphate Salt. Calcium Phosphate is also the basic component of tooth material.

Periogen Marielaina Perrone DDS

Periogen Oral Rinse

Calcium phosphate salt differs from calcium phosphate in its electron structure. The calcium phosphate salt has two less electrons than the calcium phosphate which makes it electrically unstable. This process of losing electrons happens in nature all the time. The best comparison is the buildup of lime deposits in water pipes and faucets. Microscopically, tartar is layer upon layer (can be in the tens of thousands layers) of  calcium salts and bacterial debris.

The tartar is a main cause of periodontal disease. Breakdown of gum and bone tissue is caused by toxins released by bacteria in plaque and tartar, and by the body. The toxins cause the body to react by starting the inflammatory process thereby destroying healthy gum tissue and supporting bone structures. Periodontal disease is progressive. Without proper treatment, periodontal disease will lead to tooth loss and infections throughout the mouth.

Periogen is used as an oral rinse 1-2 times per day between professional cleanings to reduce the level of tartar buildup and stain. This will in turn, make for an easier dental visit. It also maintains a healthier state in your mouth for your teeth and gums to heal. Periogen should in no way replace brushing and flossing, or visits to the dentist but just works as an accessory between professional dental cleanings to give you a more effective way to reduce tartar and fight periodontal disease .

Periodontal Disease- is a group of diseases that affect the tissues that support and anchor the teeth. If untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where the teeth arise), and the outer layer of the tooth root. The earliest form of periodontal disease is called gingivitis. Gingivitis is reversible with proper treatment.

Once a patient is diagnosed with advanced periodontal disease (also called periodontitis), their dentist will recommend procedures above and beyond that of a normal professional cleaning to properly treat and manage the periodontal disease. In the initial stages, most treatment revolves around non surgical intervention but as the periodontal disease progresses surgical treatment is often recommended and required.

Periodontal Disease Treatment

Non Surgical Procedures

-Scaling and root planing. This procedure is a special type of cleaning that removes plaque and tartar from under the gum line and makes the root surfaces smooth. The smoother root surface is thought to promote reattachment of the gum tissue and promote healing. This type of cleaning is the only way to remove tartar from below the gum line. This is usually completed in multiple visits utilizing a numbing anesthetic to make the procedure more comfortable..

-Drug Therapy. In some cases, antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early periodontal disease, scaling and root planing in addition to continued daily cleaning at home (flossing, brushing , and rinsing) will achieve a satisfactory result of reversing periodontal disease.  A wide array of antibacterial rinses such as Peridex, antibiotics taken in pill form such as  Periostat, or localized placement directly into the affected pockets with an antibiotic such as Arestin, can aide in, and promote healing of the affected gum tissue.

-Periodontal maintenance or supportive periodontal therapy: Following a scaling and root planing, routine specialized  cleanings (every 3-4 months)  to target your periodontal problem area, can minimize the recurrence or progression of periodontal disease.

Surgical Procedures

-Pocket depth reduction procedures: Your dentist or periodontist will open up the affected gum tissue so that periodontal disease causing bacteria and calculus build up can be easily seen and removed. Some cases may require contouring and smoothing of the damaged bone and root surfaces to allow the gum tissue to reattach to healthy bone during the healing phase. The procedure also repositions the gum tissue so that it is easier to keep clean going forward.

-Perioscope cleaning: A deep cleaning requiring a microscope to be placed below the gum line to remove tartar, cement, or other debris.

-Regeneration. Your dentist will treat the affected gum tissue in the same way as in pocket depth reduction procedures, with the additional procedure of using membranes, bone grafts or tissue-stimulating proteins to stimulate the body’s natural ability to regenerate healthy bone and gum tissue. A good example of this is a bone and tissue growth factor called Emdogain.

-Soft tissue grafts. Your dentist will take synthetic tissue such as Alloderm, or healthy gum tissue from the roof of the mouth (palate) or other areas of the mouth and use it to repair receding gums and cover exposed root surfaces.

-Hard Tissue Bone Grafts.  This procedure is needed when periodontal disease has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone. The dentist can use your bone, cadaver bone, cow bone, or a lab created calcium based bone matrix material.

Conclusion

If you have been diagnosed with periodontal disease please take the news very seriously. Periodontal disease is a progressive disease that will continue to get worse without treatment. Periodontal disease  leads to tooth loss and oral infections. Your dentist can help you with diagnosis, prevention, better oral hygiene methods and instruction, and proper treatment for your particular needs.  Studies have shown time and again that there is a link between oral health and your general health. Keeping your mouth healthy will lead to better overall health. As always visit your dentist regularly for dental examinations and regular professional cleanings to stave off the onset of periodontal disease.