Tuesday, February 22, 2011

A modified toothbrushing technique that reduces risk of cavities

According to a study published in September’10 by the prestigious American Journal of Orthodontics and Dentofacial Orthopedics, the use of a modified brushing technique significantly reduced the incidence of new carious lesions in orthodontic patients when compared to routine oral hygiene instructions with fluoride toothpaste.

The study titled “Modified fluoride toothpaste technique reduces caries in orthodontic patients: A longitudinal, randomized clinical trial” followed 100 orthodontic patients randomly divided into 2 groups. Each patient was examined before starting orthodontic treatment (baseline) and shortly after removal of the appliances in a 2-year study period. The test group patients were instructed to use the modified brushing technique while the control group patients were given routine clinical oral hygiene instructions.

The modified brushing technique that was more effective in preventing caries in orthodontic patients than normal oral hygiene instructions consists of the following steps:

(1) use ¾ of one inch of toothpaste on a wet toothbrush;
(2) spread the toothpaste evenly on both upper and lower teeth;
(3) brush all surfaces of the teeth for 2 minutes;
(4) use a small amount of water, the equivalent of a handful with the dentifrice remaining in the mouth and filter the dentifrice slurry between the teeth by active cheek movements for 30 seconds before expectorating;
(5) avoid further rinsing with water;
(6) avoid drinking or eating for 2 hours;
(7) brush twice a day, after breakfast and at night before going to bed.

Compared with other dental specialists, orthodontists have a great opportunity to emphasize fluoride toothpaste regimens since patients usually visit the clinic every few weeks, giving the orthodontist an excellent opportunity to stress the importance of using fluoride toothpaste and. Although this technique is highly efficient, patients must be aware that slurry rinsing with the toothpaste can cause some oral discomfort and irritation of the oral mucosa. Also, the use of dental floss lessens the risk of dental cavities between the teeth during orthodontic treatment.

In my website you will find a section especially dedicated to how to maintain good and proper oral hygiene during orthodontic treatment, including brushing techniques and how to use dental floss appropriately. http://www.larchmontortho.com/PatientInfo/OralHygiene/tabid/74/Default.aspx

Saturday, February 5, 2011

Avoiding cavities during orthodontic treatment

If you thought brushing and flossing were important before you got braces…well, you were right. But people undergoing orthodontic treatment need to be even more dedicated to good oral hygiene.

Braces trap food very easily, which contributes to dental plaque formation. If plaque is not carefully removed from teeth and from around braces, patients run the risk of developing gum disease, dental decay and bad breath."

Plaque is a mixture of bacteria, debris and bits of food. The bacteria feed on sugars and produce acids. The acids can irritate your gums, erode the enamel on your teeth and contribute to bad breath. It's important to remove the plaque thoroughly and often. Then, when your braces come off, the surfaces of your teeth underneath the braces will be healthy and strong and look good.

The very early stages of dental cavities are white, opaque spots on the surface of the teeth. These spots are technically called areas of “enamel demineralization.” They are associated with a rapid process caused by cavity-inducing bacteria that develop around the braces.

Despite improvements in materials and preventive efforts, demineralization can occur around orthodontic appliances as early as only 1 month into treatment. There is a higher risk of demineralization adjacent to brackets at earlier ages, because of the lower resistance of enamel and poorer cooperation by younger patients in the orthodontic treatment process.

Toothbrushing remains the cornerstone of good oral hygiene. Many patients ask me about electric toothbrushes (are they better, is it worth it buying one, etc.). Regardless of brand, I believe an electric toothbrush is an excellent addition to anyone’s set of tools for home dental care.

Today’s electric toothbrushes are both highly effective and reliable. Their efficacy in comparison with that of the manual toothbrush has been evaluated in a large number of clinical studies carried out by academic institutions and contract research companies specializing in dental research. These studies consistently have shown the electric toothbrush to be superior, with results demonstrating greater plaque removal and, as a consequence, more improvement in gingival condition than that achieved with a manual toothbrush alone.

Fluoride toothpaste has been widely used for more than 4 decades and remains a benchmark for the prevention of dental caries. It reduces caries in both permanent and deciduous teeth. For this reason, fluoride toothpaste is important as an effective caries-prevention measure worldwide.

Four factors influence the anticaries efficacy of fluoride toothpaste: 1. frequency of brushing; 2. duration of brushing; 3. fluoride concentration; and 4. postbrushing rinsing. Brushing should be done two or three times daily and patients should be persuaded to brush for no less than 2 minutes each time.

Flossing is an excellent aid to oral hygiene during orthodontic treatment. Dental floss is either a bundle of thin nylon filaments or a plastic (Teflon or polyethylene) ribbon used to remove food and dental plaque from teeth. The floss is gently inserted between the teeth and scraped along the teeth sides, especially close to the gums. Dental floss may be flavored or unflavored, and waxed or unwaxed. Whichever type you choose does not matter. The important thing is to use it at least once daily, preferably before bedtime.

Many people tend to disregard flossing in thinking that brushing is more than enough for their dental care. Brushing but not flossing is like cleaning only 65% of your teeth leaving 35 % dirty. The main role of flossing is to eliminate food particles caught between the teeth. Non-removal of those particles often lead to cavities and other problems. Researchers found that gingival bleeding, gum disease-causing bacteria and halitosis (“bad breath”) were greatly reduced when flossing is done at least once daily.

In my website you will find a section especially dedicated to how to maintain good and proper oral hygiene during orthodontic treatment, including brushing techniques and how to use dental floss appropriately.