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New studies are showing that poor oral health, tooth decay,  and tooth pain are putting some children at risk for falling behind in school. It is widely believed that many children, regardless of socioeconomic conditions, are not receiving routine dental care on a regular basis from a dentist or hygienist. It seems like good dental care takes a back seat at times in many families lives for various reasons.

The study recently conducted and published in the American Journal of Public Health examined close to 1,500 socioeconomically disadvantaged elementary and high school students in the Los Angeles area. They then matched their oral health to their academic achievement and attendance records. In previous studies, researchers found that about 75% of disadvantaged children in Los Angeles county area had some level of tooth decay.

In this study, children who reported having tooth pain were 4x more likely to have a low grade point average when compared to children without oral pain. The results also found that the tooth pain also resulted in a higher amount of absences, as well as more missed work for parents. This leads to lost classroom time as well as lost pay for parents and the family.

What can Parents Do to Avoid this?

Good oral hygiene must begin as soon as the child’s first teeth erupt into the mouth. Many of these tips take just a little time and patience to facilitate good oral hygiene. The following are some tips for parents to maintain their children’s teeth:

Proper brushing. Many parents leave the tooth brushing up to their kids when they are as little as 2 years old. Parents and caregivers need to brush their child’s teeth, and then monitor that their children are brushing properly using a fluoride (as soon as they are old enough to spit and not swallow) toothpaste. Toothbrushing  can remove  up to 60% of the plaque, bacteria, and food debris from mouth.

Flossing. Yes, Flossing. Children can floss and in fact when they get in the habit as a child they have that habit for life. There are children’s flossers which make it easier for them to perform themselves but again parents need to instruct, demonstrate, and monitor the job they are doing.

Use a disclosing solution. A disclosing solution is a great tool to show what areas a child might be missing. It is effective in adults as well. It simply is a dye that colors the plaque remaining in your mouth. After you brush, you rinse with the disclosing solution to see what you have missed, then remove the remaining plaque and the color from your teeth. You are able to visually inspect how effective your hygiene techniques. It is a great learning tool, and it is highly effective.

Rinse with an anti-cavity rinse. Children need fluoride more so than adults due to the developing teeth. A good example of this is ACT fluoride rinse. It comes in many flavors and is easy to use. There are also prescription fluoride rinses that are swallowed after rinsing to strengthen developing teeth. These rinses are only available through your dentist or pediatrician. DO NOT swallow over the counter fluoride rinses or toothpaste, it is harmful to both adults and children in this improper concentration.

Avoiding or moderating sugars. Let’s face it children love their sweets from fruit roll ups to gummy bears to fruit juice. To avoid tooth decay we must modify that behavior and if they are to have these items have them brush and rinse soon after so the sugars do not have time to linger in their mouths.

Conclusion

Tooth Decay and Tooth Pain can be avoided or at the very least limited with proper dental hygiene and regular visits to the dentist. Remember it is far cheaper to see your dentist regularly for routine dental examinations and professional cleanings than to show up in pain.

 

Everyone knows the basic structures of the mouth including your teeth and gums. But there is more to your mouth than just those two anatomical parts. This means

Maintain Oral Health - Marielaina Perrone DDS

Anatomical Structures of the Mouth

maintaining good oral hygiene goes beyond just your teeth and gums.  In addition to your teeth and gums, your mouth is made up oral mucosa, the upper (maxilla) and lower (mandibular) jaw, the tongue, salivary glands, the uvula, and the frenulum. All of these structures play an important role when it comes to good oral health and are regularly examined by your dentist when you receive dental care.

Anatomical Structures of the Mouth

– Oral Mucosa. When you look in your mouth everything that is not a tooth is the oral mucosa. The oral mucosa is a protective lining and includes the gum tissues. This lining is very similar to the lining in your nostrils and inner ears. The oral mucosa plays a very large and essential role in maintaining your oral health. It is also important in maintenance of your overall health by defending against germs and other irritants that come into your mouth. The oral mucosa has a tough component called keratin. Keratin (also found in fingernails and hair) helps keep the oral mucosa protected from injury.

-Gums or gingival tissue. Your gums are the pink, attached, colored tissue that envelops and supports your teeth. Also covered by oral mucosa, gums play a critical role in your oral health. Healthy gums are firm, cover the entire root of the tooth, and do not bleed when brushed, flossed, or probed. Diseased gum tissue, or Periodontal disease can ultimately progress to tooth loss. This makes it essential to take care of your gums by flossing daily and brushing regularly.

-Upper (Maxilla) and Lower (Mandible) Jaws. Your jaws are an essential structure of the mouth and face. The jaws give your face its shape and are the structures holding your teeth. They are needed for chewing and speech. The Upper jaw or Maxilla is made up of two bones fused together and then to the rest of the skull. The lower jawbone (mandible) is separate from the rest of the skull which allows it to move up and down, and side to side in your jaw joint (TMJ) when you speak and chew.

-The Tongue.  This is an extremely strong muscle covered in specialized mucosal tissue that also includes the taste buds. The tongue is unique in that it truly plays a dual role in our health. The tongue plays an integral role in the ability to speak. It does this by allowing people to shape the sounds that come from your mouth. It’s other role is being a part of the body’s digestive system. The tongue is responsible for moving food over to your teeth and following chewing, the tongue moves to the back of the throat so it can force it down to continue on its path thru swallowing. In infants the tongue and jaw work as one to allow the infant to breastfeed.

-Salivary Glands. There are three different major salivary glands in your mouth and neck. These are the parotid, sub mandibular, and the sub lingual glands. There are also smaller, or minor salivary glands in your hard palate, soft palate, and inner lip. These glands are responsible for producing saliva. Saliva is critical to maintaining good oral health. It functions in the following ways:

1) Breakdown of food. Saliva contains special enzymes that help break down food. This makes it easier for you to digest your food.

2)Lubrication. Saliva aides in swallowing food by acting as a carrier of foods out of the mouth and into the throat. Saliva also keeps gums and teeth from drying out. This constant lubrication makes it more difficult for bacteria to stick and stay, and helps keep teeth and gums clean.

3) Protection of teeth and gums. Saliva is able to offer protection of teeth and gums by rinsing away food and bacteria. It is also able to neutralize acids or acidic foods that can wear down your teeth causing tooth cavities.

-The Uvula. The uvula is the small flap of tissue which hangs down at the back of your throat. The uvula is made up of muscle fibers as well as connective and glandular tissues. The uvula is covered by oral mucosa. The uvula’s functions are not fully understood as of yet. However, it seems to play some role in speech and in keeping the mouth and throat moist.

-The Frenulum Linguae. The frenulum or frenum, is an attachment of oral mucosa that connects and pulls two areas together. There is one major frenum attachment above your two front teeth connecting your lip to the adjacent gums, another major one is under the tongue attaching it to the floor of the mouth. There can be any number of minor frenum attachments from lip to gum or cheek to gum.  Children can be born with a frenulum that is too short, or not elastic enough, keeping the tongue almost tied down. This can  affect speech as the tongue is not able to protrude as far as necessary. A short frenum can also affect swallowing and feeding in babies.

Take notice the next time you are brushing your teeth, spend a minute looking at the parts of the mouth that lie farther inside the oral cavity. Knowing what these structures do and what they look like can help you to maintain optimal oral health, and notice changes that can occur. Your self awareness can help you point changes out to your dentist, and find out why they have occurred. As always, see your dentist regularly and have an open line of communication to ensure that your mouth is it’s healthiest!

 



Who would not want to use a good mouthwash before meeting that special someone for a kiss? Or just to feel minty fresh as you go about your day?

For years there has been a discussion regarding mouthwash use. This is because people are worried about the health risks associated with the alcohol based mouthwashes.

Mouthwash manufacturers have been touting extra benefits of mouthwash besides minty fresh breath. Many tout themselves as washing plaque away, teeth whitening, as well as bacteria killers and as cavity fighters.

Are all these extra benefits possible? Is mouthwash use good for you?………

Advantages of using a Mouthwash

-Fluoride Mouthwashes. Fluoride mouthwashes do have the ability to possibly help reduce cavities. There have been many studies over the years to prove that fluoride can strengthen and reduce the breakdown of enamel thereby reducing the possibility of tooth cavities. This will not work for all but has been proven to be a benefit. Some fluorides are good antibacterials as well and help fight periodontal disease (stannous fluoride).

-Fight Periodontal Disease. Periodontal disease is caused by plaque from bacteria and food that sticks to teeth. As the bacteria feed on the food particles they release acid that will break down the bone and irritate the gum tissue. Our body responds by producing more acids to kill the bacteria. This causes bone loss and inflamed, infected gums. An antibacterial mouthwash may help prevent periodontal disease by lowering the amount of bad bacteria in the mouth.

Listerine Mouthwash - Marielaina Perrone DDS

Listerine Mouthwash

-Help during pregnancy or during a systemic disease process. It is important to maintain good oral hygiene at all times but for certain members of our population it is even more important. For pregnant women it can be critical. During pregnancy, a woman’s hormones are elevated which makes them more susceptible to developing periodontal disease if their oral hygiene is not maintained. Periodontal disease in pregnant women has been linked to pre term and low weight babies. For others it is a matter of survival. Patients with systemic diseases that make them more susceptible to infection like diabetics need to reduce the bacteria they are ingesting. It is even more critical to maintain good oral hygiene and mouthwashes are definitely recommended for those patients.

Disadvantages of using a Mouthwash

Canker Sore Irritant. This is caused when the alcohol content in your mouthwash is too high. It will irritate the canker sore and make it quite uncomfortable to use.

-Masks bad breath but does not remove the cause. Use of a mouthwash can definitely lead to fresher breath but it is usually quite short lived. Only some mouthwashes are formulated to actually neutralize odor causing chemicals, such as Closys. Not maintaining proper oral hygiene, or chemicals from your diet are usually the underlying factor in most people’s bad breath but the mouthwash will just mask it for a short time.

Alcohol based mouthwash. Studies (Listerine) have shown that rinses with alcohol, if used as directed can actually cause saliva production to be stimulated in a semi dry mouth. The alcohol in mouth rinses has historically been used as a way to cause the essential oils (the bacteria killing aspect) in the rinse to keep from separating out in the liquid, and staying mixed. No one wants to rinse with something oily feeling. There are now quite a few alternatives to alcohol to do the job, so alcohol free rinses have become more prevalent. Many people do not like the burning sensation of alcohol, and in people with little to no saliva flow, alcohol based rinses can be quite uncomfortable. The choice is based on personal preferences.

-Tartar dissolving rinse.There is a type of rinse (Periogen) that has been found to dissolve tartar, stains, and plaque. This rinse is a great way to keep your teeth from rebuilding tartar between cleanings. This is a powder that can be diluted with water in a waterpik and tends to be even more effective if a capful of your fluoride rinse is added to it.

Bottom Line on Mouthwash Use

Bottom line is mouthwashes are an aide and not a substitute for maintaining good oral hygiene. This should include proper brushing, flossing, and visiting your dentist regularly.

Mouthwash clearly offers certain advantages. But it’s important to know that not all mouthwash is the same. Saltwater rinses can be made at home with warm water and salt, whereas store-bought types contain a variety of ingredients ranging from fluoride (Act) to alcohol (Listerine) to highly specific antibacterial (Peridex).

In the end, each individual must choose the one that is right for them. For patients with periodontal disease, an antibacterial rinse like Listerine would be recommended to reduce the amount of bacteria in the mouth. For those patients who are cavity prone, a high fluoride mouthwash would be the choice. These mouthwashes only work effectively if paired with a good oral hygiene regimen. Talk to your dentist about which rinse would work best for you.

 

 

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Dental Implants were not always such a mainstream fixture in dentistry. There was a time when dental implants were for all practical purposes experiments in seeing what worked and what did not. In the last 15 years we have really entered a new age with dental implants being almost routine in their nature now. Most dentists cannot imagine a day without them anymore as a treatment for our patients.

Dental Implants are an artificial tooth root that a dentist, periodontist, or oral surgeon inserts into your jawbone to hold a replacement tooth or teeth(bridge). Dental implants are the perfect option for people with good oral health maintenance who are missing one tooth or multiple teeth due to periodontal disease, via trauma, or some other reason.

Dental Implants use the most modern materials that dentistry has to offer. Years and years of research have gone into the dental implants in use today. Dental implants are much more tooth friendly than traditional bridgework. Dental implants do not rely on neighboring teeth for support nor do the neighboring teeth need to be prepared to be part of the bridgework.

With optimal conditions and in the hands of a skilled dentist, dental implants can look as natural as your own teeth. Only you and your dentist would ever know you even have one. This gives patients the utmost in self confidence giving them the ability to broadly smile as well as eat as they choose. People missing teeth are generally self conscious about their smile and appearance. Following successful placement and restoration, dental implant patients can expect them to last a lifetime if they maintain good oral hygiene.

Modern dental implants can play a few roles in tooth or teeth replacement. These include:

-Replacement of one or more teeth without affecting the neighboring teeth.
-Act as support for a bridge. This will eliminate the need for a removable partial denture.
-Provide support and stability for a denture. Attaching a denture over dental implants make the denture more secure and comfortable. This is also called an implant supported overdenture.

Dental Implants and their advantages over Traditional Dentistry

-Cosmetics. When done properly dental implants will look and feel like your own teeth. Another plus is that since dental implants are placed directly in bone they prevent bone loss and gingival recession that happens over time in areas where teeth are missing. No one but you and your dentist will ever know you have a dental implant.

-Dental Implants allow conservation of tooth structure. Dental implants allow the dentist to save your adjacent teeth from preparations. A traditional bridge requires the preparation of neighboring teeth. Utilizing dental implants is a long term benefit to the patients dental health by saving their natural tooth structure.

-Self Confidence. The wonder of dental implants is that they allow patients to talk and eat full of self confidence. Dental implants offer security and freedom.

implant dentistry

Dental implants Diagram

-Highly Predictable. Dental implants have had a long track record of a very high success rate. Due to this they are an excellent option for tooth replacement.

Treatment

Any treatment for dental implants begins with a thorough examination to develop a proper treatment plan.  Without a good game plan the treatment will be doomed to fail.

As mentioned earlier, dental implants are ideal in the following situations:

-Single tooth replacement. Dental implants are an ideal option for patients with the quantity and quality of bone necessary to hold an implant. The dental implant will allow you to maintain the natural tooth structure of adjacent teeth while replacing a lost tooth.

-Multiple teeth replacement. Dental implants are also ideal in this situation. If you are missing several teeth, implant supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.

-Replacing all your teeth. If you are missing all of your teeth, an implant supported full bridge or full denture (also called an implant overdenture) can replace them. This renders traditional dentures to the curb as dental implants used in this fashion will be more stable allowing patients to eat and talk as if they have their own natural teeth.

In some cases, patients will need help to allow for placement of dental implants. Luckily, modern dentistry has developed a few procedures to “help” patients along. These include:

-Sinus Augmentation.  Dental implants need a good quantity of bone along with good quality of that bone to succeed. The upper jaw is known to have poorer quantity and quality bone structure as opposed to the lower jaw. The maxillary sinus also plays a role in increasing difficulty in this area. Sinus augmentation can remedy these issues by raising the sinus floor and placing bone grafts in the area to aid in dental implant placement.

Ridge Modification. When the bone is not 100% adequate for dental implant placement, dentists are able to make it perfect by performing a dental bone graft. A bone graft is the placement of bone in the jaw to to build it up. This gives an excellent platform for dental implants. Ridge modification has been shown to improve both appearance and long term success of dental implants.

Expectations of patient

Following placement of implants and restoration with crowns or dentures, patients can expect a life long restoration that will be stable and cosmetic. Just because these products are man made does not mean oral hygiene should be forgotten and neglected. Dental hygiene must be maintained at a high level if the patient wants to ensure these restorations last. Follow up dental visits are required just as if you had your own natural teeth. If dental implants are well taken care of the patient should expect them to last a lifetime!