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Most of us worry before we sit in the dental chair and we know the questions that are coming…”Have you been flossing and brushing regularly?” So what do we do, weCosmetic Dentist Marielaina Perrone DDS frantically brush, floss, and use a mouth rinse right before our appointment. And when we finally sit down in the chair and we get asked that dreaded question we always answer “yes, I brush and floss all the time”. You hope they believe you but deep down you know they know you are not being entirely truthful. How can they tell? What are the Signs?

Signs You Are Not Brushing and Flossing Regularly

Brushing and flossing is such an important part of maintaining not only our dental health but studies have proven our general health as well. Signs that you are not brushing and flossing properly include:

Increased Tooth Decay. There are other factors, like diet, that cause tooth decay but not brushing and flossing will definitely lead increased incidence of tooth decay over time, especially tooth decay between teeth. If you have any tooth cavities or the beginning stages of cavities, it indicates that flossing is a weak point in your home dental hygiene regimen.

Inflammation. This might be one of the most obvious tell tale signs that you are not brushing and flossing regularly. Plaque, bacteria, and food debris will sit in between the teeth when we do not brush and floss properly. This causes the body to start the inflammatory process to remove the irritant. As a result your gums will begin to appear pink, puffy, and bleed very easily.

Cuts or Abrasions on Gums. This is an indicator you are not flossing regularly or just not flossing properly. You need to be careful when flossing around teeth and do not force the floss.

Conclusion

The bottom line is you need to take the time to practice good dental hygiene to ensure a lifetime of smiles. Once it becomes a habit it will become second nature and be a seemless part of your daily routine.

The moral of the story is simple, make flossing a part of your daily regimen! The benefits to your dental health are tremendous.

At Thanksgiving we have a lot to be thankful for…great family and friends to share the holiday with, good health, and good food. Our Thanksgiving traditions center around a bountiful, hearty meal. This Thanksgiving we will all sit down to a bountiful feast but did you know not only can it be delicious but also healthy for your teeth and gums? A delicious Thanksgiving feast can include various vitamins and nutrients that are important to our oral health. These include Vitamins A, C, D, phosphorous, and calcium. Eating a nutritious meal will benefit not only your oral health but your entire health as a whole.

Best Thanksgiving Foods to Eat for Good Oral Health

-Turkey is high in phosphorous. The phosphorous is not only healthy for developing teeth but can actually help rebuild and re mineralize teeth and bones of the jaw.

-Sweet potatoes are filled with nutrients including vitamins A, C, and B6. Sweet potatoes are thought to be much healthier and nutritious than regular white potatoes as they are digested faster by the body.

-Green and winter vegetables are great sources of vitamins A and C. These vitamins are important for gum health and repair of periodontal diseases (gingivitis and periodontitis).

-Cranberries contain flavonoids. These can prevent bacteria from sticking to teeth and forming plaque. Bacteria (and their acid byproducts) are responsible tooth decay and periodontal disease. Most cranberry side dishes contain high amounts of sugar. Try sweetening with agave, stevia, or splenda.

-Pumpkin pies are loaded with vitamin C and Calcium. Vitamins that are important for gum health and developing teeth and maintenance of bones. Remember, pies have high sugar, so make sure to brush after!

Health for your entire body including your smile starts with good nutrition and prevention. We all have so much to be thankful for, so let’s hope everyone has a happy and safe Thanksgiving!!



Flossing is one of those tasks in life that we know we should do, we know the benefits of it, and we know how little time it takes but most of us, just do not do it regularly.

Flossing your teeth every night can be a hard habit to develop and maintain, but it’s one that comes with great benefits.  Simply having a cleaner feeling mouth, avoiding bad breath , preventing tooth cavities or even avoiding loss of teeth can be accomplished with flossing. Regular tooth brushing cannot reach all the areas of our mouth. Brushing supposedly is only able to clean about 60% of the mouth whereas flossing is able to get to the other 40%. Flossing is able to reach those areas if done properly. Flossing is able to remove plaque, bacteria, and food debris between teeth.

It is recommended by the American Dental Association that we floss at least once a day. Proper oral hygiene maintenance is important to stave off periodontal disease and also to keep our entire body healthy. Studies have shown less than half of Americans admit to flossing daily. In reality, that number is probably much lower.

What if there was an easier way to floss daily to maintain our teeth and gums?

 

Alternatives to Flossing

These alternatives will never be as good old fashioned flossing but they will make an improvement to your oral health versus not using them.

Flossing with Waterpik Flosser Marielaina Perrone DDS

Flossing with Waterpik

Waterpik Oral Irrigator. As the name suggests the waterpik is able to do its job by using a stream of pulsating water to remove plaque, bacteria,  and food debris between teeth and above and below the gum line, to stimulate blood flow, and to improve overall oral health. Studies have shown when used correctly that the waterpik is actually superior  in reducing bleeding of gum tissue and is as effective in reducing plaque buildup. The beauty of the waterpik is its ability to mix antibacterial rinses or a rinse like Periogen into the irrigating chamber. This adds the benefit of being an antibacterial or anti tartar rinse as well, making it doubly effective.

Oral-B Hummingbird Electric Flosser. The hummingbird flosser is an electric flossing tool that is able to gently vibrate to massage your gums while it is cleaning between your teeth. This is an excellent flossing tool for those lacking dexterity since it can be used with one hand vs two with traditional flossing.

Tooth Pick, stimudents, soft piks. Yes, a good old fashioned tooth pick can be useful for cleaning in between your teeth. While it doesn’t do the best job, it is definitely  easy to use, can remove large food particles, and stimulate blood flow. Just be careful not to poke your gums and injure yourself.

Sonicare AirFloss. This product makes it easier to keep our teeth clean between dental visits. The Sonicare AirFloss was specially

Flossing with Sonicare AirFloss Marielaina Perrone DDS

Flossing with Sonicare AirFloss

designed to give you an easy and simple, effective way to clean in between your teeth. The Sonicare AirFloss works using patented micro burst technology. This technology delivers micro droplets of air and water to remove plaque, bacteria, and food debris between teeth. Studies have proven the Sonicare Airfloss to be safe and effective as well as gentle on teeth and gum tissue.The Sonicare Airfloss is very easy to use. It features a single button and a guidance tip that allows the user to target cleaning in between teeth. Patients can complete their flossing in as little as 60 seconds. And with the narrow tip, patients are able to reach the back of their mouth very easily. This allows all the teeth in the mouth to be cleaned. The reservoir holds two teaspoons of water, mouthwash, or other oral rinse. This is enough for two uses and makes the Sonicare AirFloss doubly effective as it has an anti bacterial component as well.

Alternative Flossing Conclusion

As you can see above there are a few alternatives to flossing. Bottom line is nothing beats using a simple piece of floss and flossing like many have been for decades. But if you are unable to or unwilling, the products listed above will help improve your oral hygiene.  Use what works best for you and use it as often as you can. Keeping your teeth clean between dentist visits is very important in having your teeth last a lifetime and preventing the development and advancement of periodontal disease. So, maintain a regular schedule of complete dental examinations as well as professional cleanings along with continued at home care and you will see great results in your smile and your health.

 

 

 



The presence of bleeding gums usually when brushing or flossing is usually a sign that you have some form of periodontal disease but it can also mean a greater risk is present. Persistent gingival bleeding can be due to something far more serious. This type of bleeding has been linked to diseases such as leukemia, blood platelet disorders, and even scurvy.

Many people sometimes mistakenly believe that bleeding upon brushing or flossing is normal. They might say that their gums always bleed when brushing and so do some of their other family member’s.

Are bleeding gums normal?……NO! Healthy gums do not bleed from normal brushing and flossing.

Bleeding gums in their earliest form is a sign of ginigivits. Gingivitis is simply inflammation of the gum tissues. It is the earliest stage of periodontal disease and is reversible if treated before it progresses. Periodontal disease is a progressive disease that will advance without proper treatment. Periodontal disease is inflammation and infection that breaks down and destroys the tissues that support the teeth. This  includes the gum tissues, the periodontal ligaments (PDL), and the bone supporting the teeth.

Gingivitis comes from the long term effects of deposits of plaque on your teeth. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed protein layer,( the pellicle) on the teeth. The pellicle is like a microscopic cuticle which grows out from under the gum tissue and allows bacteria to use it as a scaffold to build upon. This pellicle layer is removed during a professional cleaning, it does not come off with a toothbrush.

Periodontal Disease - Gingivitis

Periodontal Disease – Gingivtis

The accumulated plaque bacteria and the toxins produced cause the gums to become infected, swollen, and tender. The body responds by sending blood cells ( inflammatory cells) to attack the bacteria, and the bleeding begins.

If you watch television at all, you have probably heard of gingivitis. A very big industry has been built with various types of products that are supposed to eliminate gingivitis. The problem is that most of these products do not work on their own to eliminate ginigivitis or advanced periodontal disease. They work to make your teeth “feel” clean and as a helpful aid in between visits to maintain oral hygiene. Nothing replaces visits to the dentist and hygienist for a proper examination and thorough cleaning to remove the pellicle and bacteria film.

If the plaque is not removed, eventually it will stick to a harder substance known as tartar. While the tartar is not formed directly from the plaque it is able to stick more readily to teeth because of the presence of the plaque. The tartar will be hard and will trap food particles, plaque and bacteria below the gum line.

Researchers have long recognized that there are at least 11 different strains of bacteria that can cause periodontal disease. These bacteria thrive in dark, moist areas. This includes the gingival tissues around the teeth. Our immune systems react to the problem by sending out cells to remove the bacteria. Blood to the infected area is also increased to help flush away the invading bacteria. However, if the invading bacteria do not leave, our gingival tissues become filled with blood and our gums can bleed when we brush. This makes it very difficult to maintain oral hygiene for the patient.  This will ultimately advance to more progressive forms of periodontal disease called periodontitis. Periodontal disease at this stage unfortunately is not truly reversible. Modern dentistry has newer techniques to deal with periodontal disease. These include emdogain, a gum and bone growth factor,  and arestin, a tetracyline type antibiotic.

Periogen

Periodontal Disease – Periogen

There is a new product on the market called Periogen. This product is used as an adjunct to professional cleanings to help dissolve some of the tartar, plaque and stains that builds up in the mouth. This product has shown the ability to dissolve subgingival (below the gum line) calculus through an in-home, daily irrigation regimen.  It is recommended to use this product with a waterpik ultra to allow penetration of the product below the gum line. The results of this innovative treatment include a reduction to many gum infections and the reduction of many periodontal  pockets. This product has been shown to be very helpful in the reduction of periodontal disease.

What Raises your Risk for Ginigivitis and Periodontal Disease?

Certain infections and systemic diseases. There are some very serious reasons for gums that bleed. These can include blood disorders, clotting disorders, liver problems, kidney disorders, artery or capillary diseases, and diabetes and heart problems. Vitamin C and K deficiencies can also result in bleeding gums. Fungal infections are also linked with bleeding tissues, as well as certain medications such as aspirin, high blood pressure medications, (calcium channel blockers) and blood thinners.

Maintaining poor oral hygiene. If you do not keep your teeth clean with a diligient at home oral hygiene program coupled with regular visits to the dentist you will eventually develop some form of gingivitis as well as increased posssibility of more advanced periodontal disease.

Pregnancy. Hormonal changes at this time will cause changes to your oral cavity. These changes can increase your chances of developing cavities, gingivitis, and advancement of periodontal disease.

Studies have shown that women with periodontal disease are 7X more likely to have preterm births and low birth weight babies. Preventive dental cleanings and regular dental exams during pregnancy are not only completely safe, but are highly recommended by both dentists and physicians alike.

Uncontrolled diabetes. Diabetes impairs white blood cells, which are the body’s main defense against bacterial infections.  These bacterial infections can affect everything in the mouth as well as the rest of the body. It has been noted that elevated levels of Periodontal disease also lead to complications in management of blood glucose levels. This disease tends to be more prevalent and more severe in diabetic patients than in the general population. This is mainly due to the fact that diabetics have decreased wound healing and infection fighting ability.

Misaligned, crooked teeth, rough edges of fillings, and ill-fitting or unclean mouth appliances (braces, dentures, bridges, and crowns). Crowded teeth are much more difficult to maintain and keep clean. This will pose a greater challenge for those patients and mean they need to work a little harder to avoid the pitfalls of periodontal disease.

Many people have some amount of gingivitis. It usually develops during puberty or early adulthood due to hormonal changes. It may persist or recur frequently, depending on the health of your teeth and gums.

Dental and Periodontal Examinations

The dentist will examine your mouth and teeth and make notations if soft, swollen, reddish-purple gums are present. This gum tissue is usually painless or slightly tender at this point. Plaque and tartar will more than likely be present to some degree. A periodontal probe will be used to measure around the teeth to see if your periodontal disease has progressed past just gingivitis. Remember, once bone loss has occurred you now have a more advanced form of periodontal disease.

Following examination, your dentist will recommend a course of treatment for your periodontal disease. This will include a professional cleaning along with extra home care instructions. The goal in treatment is to reduce the inflammation and not allow the periodontal disease to progress. An antibacterial rinse may also be recommended for at home use. A good example of this is Listerine. Your dentist may also recommend repair of misaligned or crooked teeth to aid you in your home care efforts. Also, most people do fine on a 6 month schedule but, everyone accumulates pellicle and plaque at different rates, your dentist may recommend a more frequent schedule for you.

Periodontal Examination

Periodontal Disease Examination

Once the plaque and tartar are removed, bleeding and tenderness of the gums should lessen within 1-2 weeks after professional cleaning and careful oral hygiene. Warm salt water or antibacterial rinses can reduce gum inflammation. Taking an over the counter anti inflammatory medication can also aid in pain and inflammation reduction.

Healthy gums should look pink and firm with no bleeding upon brushing or flossing. Strict oral hygiene must be maintained for your whole life, or periodontal disease will come back and possibly advance past the gingivitis form into advanced periodontal disease (also called periodontitis).

Home Care to prevent periodontal disease should include:

-Regular dental visits. Usually recommended every 3- 6 months for examination and professional cleaning.

Brushing after every meal and flossing at least once a day.

-Rinsing with antiseptic rinse as recommended by dentist.

Consult your physician if the bleeding is severe or chronic, gums continue to bleed even after dental treatment, or you have other unexplained symptoms along with the bleeding from your gums. These could all be the sign of a more serious condition than periodontal disease and should be checked out as soon as possible.

Periodontal disease in its earliest stages is very treatable and should be stopped in its tracks. Everybody has it in their power to keep periodontal disease from progressing to more advanced stages.

Periodontal Disease and Bleeding Gums…Linked?
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