There are two main factors that determine when to change your toothbrush. The first and most important is effectiveness. Worn out bristles simply do not do a decent job of removing plaque and bacterial biofilm from your teeth. We’re sure you’ve seen a toothbrush with bristles bent over from use. If you’ve let a toothbrush go that far, you waited too long to buy a new one.

The other factor is contaminant build-up. Everyone knows that a mouth contains bacteria and some of these microorganisms, and others, inevitably end up on your brush. Rinsing your toothbrush with antibacterial mouthwash before and after brushing will limit the number of bacteria present, but studies have shown that there are no known adverse health effects from simply rinsing your toothbrush and letting it dry out after use. Nevertheless, starting with a new toothbrush is always advised, after a cold, flu or similar illness, to avoid any reinfection.

So how long does a toothbrush last? The American Dental Association recommends changing your toothbrush every three to four months, more often if you tend to wear them out faster. For electric toothbrushes, follow the manufacturers instructions, as their bristles tend to be longer-lasting. Remember to always use soft bristles to ensure healthy gums.

Of course, if you want to change your brush even more often just because you like the fresh, new feeling on your teeth and gums, the dentists at Sacramento Dentistry won’t argue with you!

The electric toothbrush is not a new invention. Introduced into the United States in the 1950s, it’s been a part of the domestic life of many families. Since an electric toothbrush represents a bigger investment than your typical fluoride applicator, it’s fair to ask if a technological toothbrush really improves your oral health.

Our clients at Sacramento Dentistry may be interested in the results of a review study completed by the Cochrane Oral Health Group in 2005. Based in the United Kingdom, researchers for this organization examined 29 different studies on this very subject, involving over 2500 patients. What they found demonstrated two things:

• Electric toothbrushes do provide a modest benefit in plaque reduction (between six to seventeen percent, depending on the study or system of measurement) and the associated health of the gums.
• These oral health benefits were seen with models that used a rotation oscillation action.

Most electric toothbrushes use either a simple oscillation that mimics human toothbrushing technique or the preferred rotation oscillation, where the brushes spin in circles, sometimes with additional action thrown in. This spinning motion is the type of action that garnered positive results in multiple studies.

While a specific type of machine may do the best job of cleaning your teeth, even the most expensive toothbrush is worthless if it doesn’t reach your teeth on a regular basis. Whether you use a regular toothbrush, or one that needs an electrical outlet, if you don’t brush at least twice daily, your oral health will suffer. So learn to love your toothbrush, no matter what it’s variety, and your dental health will be better.

Feel free to ask the doctors at our Sacramento Dentistry offices for their opinion on preferred models of electric toothbrush, but remember that what we’re really after is that you brush and clean between your teeth every single day!

Interdental brushes are the tiny brushes made of straight wire and bristles affixed to a small handle that you can use to clean in-between your teeth. Many people now use these mini brushes instead of dental floss for cleaning between their teeth. Studies support the use of interdental brushes (or IDBs). They are not for everyone, however, and are probably best used as an addition to dental floss.

First, using an IDB is simple. This is probably the main reason why many people prefer them over floss. You insert the brush between your teeth and simply move it back and forth a few times for each pair of teeth. Be careful to never force the brush between the teeth, as you risk damaging the enamel or the gums. Always be careful not to puncture the gum tissue as you insert the brush. Brushes come in many different sizes, so make certain to use the size that fits between all of your teeth.

For our Sacramento Dentistry clients with dental appliances, such as braces, bridges or implants, we may even suggest specific IDBs to assist in cleaning. They are very useful for reaching spaces where a toothbrush cannot complete your daily oral hygiene. Our staff would be happy to demonstrate the proper use and suggest an ideal brush size for your situation.

There are some things, however, that an IDB cannot handle. Consider the patient with little space between their teeth. For them, flossing is generally the easiest way to clean their teeth. Also, think about your last molars – how do you fit an IDB between those teeth and the surrounding gums? You can’t, which again points to dental floss as the best tool for that job.

To conclude, numerous studies have demonstrated that, when combined with toothbrushing, IDBs do a better job than floss at reducing plaque, pockets in the gums and bleeding gums. Sacramento Dentistry, however, wants you to have, not just better dental health, but maximal dental health. So don’t stop buying dental floss just yet! Consider the ease of IDBs and the usefulness of floss as an oral hygiene combo, complementary methods of keeping your beautiful smile!

To quote directly from the American Dental Association: “If you use dental floss before you brush, the fluoride from the toothpaste has a better chance of reaching between teeth.” Every day your teeth get covered in a sticky biofilm created by oral bacteria. While brushing does a pretty good job of removing this material on the exposed surfaces of the teeth, it’s hard for a toothbrush to completely clean the enamel hidden between the teeth. That’s a job for dental floss or interdental brushes.

If you floss after your brush, however, any biofilm that’s not removed can prevent fluoride from making contact with your enamel. Making contact is essential if fluoride is going to do its best work as a catalyst for strengthening your teeth. So if you floss first, the biofilm is removed, your toothbrush applies fluoride even into the crevices between your teeth, and the likelihood of getting cavities decreases.

So it may take an adjustment for our patients to “floss first,” but the long-term benefits for preventing tooth decay are likely worth it! In a future article we’ll talk about those little interdental brushes. Many patients prefer them for cleaning between teeth. How do they compare to dental floss?

Enter the simple toothbrush. While it’s extremely important for removing food from the fissures and wrinkles in the crowns of your teeth, a quality toothbrush also reaches inside the crevices between teeth. As it removes food particles, plaque, and bacterial biofilm, it also applies fluoride to the surface of your tooth enamel. This repairs and protects your teeth from active and future attacks from bacteria and acidic foods.

This doesn’t mean that you should get overzealous with the toothbrush — patients can and do brush so much that they damage gums and teeth through abrasion. Gentle brushing with soft bristles and fluoride toothpaste is sufficient. It’s best to brush after every meal, but brushing at least twice a day is the recommended minimum. Your enamel needs fluoride and your toothbrush is the applicator!

Our next article will look at the question of flossing — is it better to floss before or after you brush your teeth? Our knowledge of how fluoride works to protect your teeth plays a part in our answer.

The first of these sites are the natural grooves of the grinding surface of the teeth. Food is easily caught in these formations in the enamel. With particularly deep fissures or pits, decay is almost inevitable. Dental sealants or pre-emptive treatment with composite fillings are methods for preventing serious destruction of the enamel by opportunistic bacteria.

Another common location for caries is between the teeth. Flossing is the primary way to remove food particles and bacterial biofilm from these tight gaps. Some patients also report good success by cleaning these areas with interdental brushes, small brushes that fit between the teeth. Crowded teeth are especially susceptible to tooth decay since it can be difficult to fit either floss or brushes between them. This problem is best resolved by orthodontics.

The gum line is a third location where caries are often found. Developing caries in this zone is extremely hazardous to dental health, since it is more likely that the disease will progress into the root. While it’s important to brush this area regularly, use caution to not brush too aggressively, or you may damage the very gum line you’re trying to protect. Bleeding gums are a sign of serious problems and should be brought to the Sacramento Dentistry Group for examination.

Gaps between fillings and your tooth are the final “trouble spot” for caries. Unfortunately, this is an area where most people assume they are immune from decay, since they have already been treated once before. The point must be made that there is no place in the mouth safe from tooth decay. Replacing amalgam fillings with composite materials wherever possible lessens the likelihood of this type of dental caries, since composites are much more form-fitting as a dental restoration.

We encourage our patients to make daily use of fluoride toothpastes in the battle against caries. Fluoride encourages remineralization of damaged enamel and dentin. Taking this step, along with others that can be discussed in our Sacramento offices, goes a long way towards keeping your teeth healthy and whole.

The root surface is primarily made out of dentin. Compared to enamel, dentin has significantly less mineral content (chiefly calcium and phosphorus) and is far more porous. While approximately half the root is made out of minerals, the other half is formed from collagen. This fibrous tissue offers little defense against acids, so as dentin is rapidly demineralized by acids from our foods, drinks and oral bacteria, the collagen is destroyed too. This breakdown of minerals and destruction of collagen leads to root caries.

The best cure for root caries is prevention! Avoiding gum recession is essential. Regular oral hygiene is key. Visiting the Sacramento Dentistry Group at the first sign of root exposure is ideal.

Remineralization of the root surface will occur and some regrowth of dentin is possible. Both are encouraged with the use of fluoride, applied topically by our dentists to the exposure site or with rinses, gels and toothpastes at home. When brushing your teeth, remember to use only soft toothbrushes so you don’t further degrade your gums or exposed roots!

Where remineralization is no longer possible, shallow lesions can be filled, much like caries in the enamel. Deeper cavities in the root may require root canal therapy or even extraction. The best way to avoid this worst-case scenario is to avoid gum recession. If your gums have receded already, modifying your diet to avoid highly acidic substances, like sodas and sweet teas, while practicing regular oral hygiene is essential. Otherwise, we may end up discussing dental implant therapy!

Perhaps you’ve seen a school science fair experiment where a student takes a pulled tooth and soaks it in soda pop to see what happens. Over a number of days, the tooth will completely wear away due to acids in the beverage. All of the popular sweetened beverages are extremely acidic, but some people think that teas or diet drinks do not subject a patient to caries.

To figure out which drinks are the greatest enemies to your enamel, a pair of researchers put a large variety of drinks to the test in a carefully controlled scientific experiment published in Operative Dentistry. What they discovered about soft drinks and enamel wear is important for our patients at the Sacramento Dentistry Group. First, while acid damages your teeth, a drink with higher acid content does not necessarily break down your teeth faster. Second, diet drinks may not feed bacteria with sugar, but they still destroy your teeth. Third, sweet teas are not a dentally safe substitute for sodas, since they are just as hazardous to enamel as the worst offenders in the world of soda pop.

The popular belief that Mountain Dew is the most destructive drink for your teeth was demonstrated to be true. Over fourteen days of constant exposure (considered the equivalent of thirteen years for the average soda drinker), Diet Mountain Dew wore away eight percent of the average tooth, while regular Mountain Dew destroyed six percent. Right behind them at nearly five percent was Arizona iced teas. While all three drinks had an acid pH in the low 3′s, (Coke, Pepsi and Dr. Pepper are all around 2.5 pH), they did far more damage to the teeth than their competitors with higher acid contents.

Teeth left in tap water experienced no average loss over fourteen days, likely due to remineralization. Quite unexpectedly, root beer had the same result. Unsweetened tea and coffee also did very little damage to enamel during the study (although these substances may stain your teeth). All other beverages did moderate to major damage to the teeth over the study period.

The doctors’ conclusions were that non-cola drinks (including sweet teas and, we would like to add, sports drinks) do far more damage than cola drinks. In the absence of bacteria, diet drinks still create as much decay, if not more, than sugary drinks. All types of soft drinks, with the exception of root beer, did far more damage to enamel than unsweetened tea, coffee and ordinary water.

How should this affect your drinking habits? Sipping soft drinks throughout the day, instead of only drinking them with meals, is very damaging. When the acidic liquids are constantly reintroduced to the mouth, the saliva has little opportunity to wash them off the surface of the teeth. If you drink acidic drinks, especially those containing citric acid, it is best to rinse the mouth with water or to chew some xylitol sweetened gum afterwards. Consider sweetened drinks as a beverage for meals, instead of a source of hydration. By far, water is the best fluid for your teeth since it rinses them while providing a base component of saliva to your body. The last word is to beware of the enemies of your enamel!

Invisalign is a product that allows your certified general dentist or orthodontist to help achieve that perfect smile by straightening your teeth without the hassle of wearing traditional braces. Many people are candidates for these aligners, no matter what your age or what type of profession you are in. Many patients that have careers where they work with the public on a daily basis do not feel comfortable wearing traditional braces (brackets and wires), so Invisalign is often a great alternative for them.

Invisalign provides a series of clear aligners that are custom made for you to make it easy to straighten your teeth without bands, brackets, or wires. Invisalign uses 3-D computer imaging technology to map your complete treatment from start to finish. From this, a series of custom-made aligners, unique to your treatment, is made. Since Invisalign is a removable appliance, compliance is usually the most important factor in the outcome of treatment. The average person will not notice you are in treatment unless you tell them. There are many benefits for this treatment that make it superior to other alternatives. You can continue to eat your favorite foods, while brushing and flossing to keep your teeth and gums healthy.

There are many health benefits associated with Invisalign that make it even more attractive for both the patient and the doctor. Teeth that are “spaced-out” or “bunched-together” usually have oral health consequences that can lead to problems, such as periodontal (gum) disease. In recent research there has been a direct correlation between periodontal disease and systemic health, including heart conditions. When teeth are properly aligned, brushing and flossing is much easier, and the result is a healthier overall smile and general health.

Unlike traditional braces, it is much easier to keep your teeth clean while going through Invisalign treatment. Since the aligners are a removable appliance, you simply brush and floss your teeth, in addition to the aligner, before you place it back in your mouth. Clinically speaking, I have seen dramatic improvements in the general oral health of patients using Invisalign. Straighter teeth help improve your speech and chewing, and eliminate unwanted interferences between teeth that cause wear and damage to our natural dentition (tooth structure).

Another advantage to Invisalign is it can easily be used in cosmetic procedures, such as whitening treatment. The aligner can act as a custom whitening tray! We always provide patients with a  whitening kit, so they can maximize cosmetic results by straightening and whitening their teeth together. To find out if you are a candidate for Invisalign, the Sacramento Dental Group offers a complimentary thirty minute consultation in any of our comfortable locations.

If you know your enemies and know yourself, you will not be imperiled in a hundred battles. – Sun Tzu

Many people assume that cavities in their teeth, called “caries” by dentists, are simply holes that developed over time. In a certain sense, that understanding is correct. What many clients don’t realize, however, is that the enamel of your teeth constantly undergoes a process of losing its mineral components due to contact with acids, but this process is not irreversible! When exposed to an acid-free environment, your teeth use the minerals in your saliva to rebuild the enamel. What starts as a depression or “cavity” can also be filled back in with the help of proper personal dental care! This process of demineralizing and remineralizing your enamel is like a constant back and forth battle between the destructive forces of decay and the protective steps of good oral hygiene.

Demineralization starts on the hard coating of your teeth, the enamel. Primarily composed of calcium and phosphate in a crystal lattice, the mineral crystals in enamel break apart in the presence of acids. Where does the destructive acid come from?

The bacteria implicated in tooth decay use the fermentation process to produce their energy. As a byproduct, they make lactic acid, which wears away the enamel through demineralization. At the beginning of this negative process, affected areas are called lesions. As the wear goes from shallow to deep due to poor dental hygiene or eating habits, lesions become pits or fissures in the enamel. They are now considered cavities or caries and can only be repaired by the dental restoration commonly called a “filling.”

Studies have demonstrated that highly acidic foods and drinks also break down the enamel. Sodas, sweet teas, and even highly acidic juices can all lead to enamel destruction. The longer bacteria are allowed to feed on remnants of food and drink and the longer their acid remains on your teeth, the greater the damage to your dental enamel.This is why brushing your teeth after every meal, or at least chewing gum or rinsing your mouth when brushing is not possible, are so important to your dental health.

The remineralization process, which can restore minor lesions, is chiefly assisted by saliva. For this reason, patients experiencing “dry mouth,” or xerostomia, are especially subject to tooth decay. Saliva washes away acid on the teeth and provides calcium and phosphate so that the enamel can recrystallize the areas that have started to decay. Examination of lesions that later remineralized demonstrate the effectiveness of this natural oral process. Most sites of remineralization are actually stronger than the surrounding original enamel. So your mouth can fight back against caries!

Another ally in the battle against decay is fluoride. Fluoride acts as a catalyst for the remineralization of your enamel. It encourages calcium and phosphate to crystalize, filling in the depressions started by tooth decay. Next to your natural saliva, fluoride is a major player in the battle to prevent dental caries. Its increasingly common use in most households is directly linked to the decline in tooth decay. Nevertheless, literally billions of people in all countries still suffer from caries.

In future articles we will examine: 1) Which of the common soft drinks are potentially the most damaging to your teeth, 2) Why receding gums increase the risk of caries, and 3) The most common sites for dental caries and what you can do to prevent them.  The Sacramento Dental Group wants you to succeed in the battle against demineralization and dental cavities! So learn about your enemy and what you can personally do to defeat tooth decay!