Monthly Archives: March 2017

Do Ergonomic Toothbrushes Clean Teeth Better?

The practice of brushing your teeth hasn’t changed much since 1938, the year that the modern toothbrush was introduced. But the toothbrush itself has evolved quite a bit. Stroll through the oral health aisle at your local drugstore and you may be surprised by the number of toothbrush styles available and the claims made by manufacturers about the effectiveness of their toothbrushes.

The key, toothbrush manufacturers say, is ergonomics — the science of improving the ease and efficiency with which people use products. So-called ergonomic toothbrushes sport specially designed handles or brush heads to help get teeth cleaner.

Whether manual or electric, these ergonomic toothbrush designs are marketed with the promise that their shape can help you perfect the proper brushing angle and feel more comfortable during the brushing process. Some are even said to brush teeth and massage gums simultaneously — and last much longer than run-of-the-mill toothbrushes.

Do these promises hold up? According to dentist Catrise Austin, DDS, of VIP Smiles in New York City, the handles of ergonomic toothbrushes are often lighter and include grips to help people hold their brushes more easily. The heads serve different functions, too — the bristles on some models form a convex shape to help clean the lower front teeth. “They’re designed to make brushing easier, especially in the most difficult-to-clean areas of the mouth, like the lower front teeth or the upper back molars,” Dr. Austin explains.

Ergonomic vs. Regular Brushes

Despite the comfort factor, using an ergonomic toothbrush is not a guarantee of good oral health. Most adults won’t see major benefits from them as compared to ordinary toothbrushes. “If you know how to use a normal, regular toothbrush, the advantages won’t be extremely significant,” Austin says.

People who may benefit from an ergonomic toothbrush include children who have not yet developed the manual dexterity needed to brush properly and adults who have physical limitations, such as people who have had strokes or those with Parkinson’s disease. “They could also help people who are just not effective brushers, so they can get to areas they can’t easily reach,” says Austin.

What Really Keeps Teeth Clean

Often, Austin says, brushing practices can have more impact on oral health than the type of toothbrush a person uses. She recommends brushing three times a day, preferably after meals. “That will help keep plaque levels down and avoid cavity formation,” she says. You should also floss once a day. If brushing your teeth isn’t an option at certain times of the day, like after lunch, it’s also acceptable to chew sugar-free gum or rinse with a mouthwash as a temporary measure.

Austin also recommends brushing for at least two full minutes to be sure that you’ve thoroughly cleaned all of your teeth, but be careful — overly vigorous scrubbing can actually wear away enamel and cause tooth and gum sensitivity. To help counteract this, Austin suggests choosing a toothbrush with soft bristles rather than medium or hard ones.

No matter what type of toothbrush you use, it’s also important to replace it regularly — about every three to four months, but sooner if the bristles become worn. If you’re worried about keeping your toothbrush clean between uses may want to check into using a toothbrush sanitizer, which works by exposing the brush to ultraviolet light.

Dental Health and Overall Health

The condition of your mouth is closely tied to your overall health. Find out how oral health is linked to diabetes, heart disease, cancer, and more.

Taking care of your teeth isn’t just about having a nice smile and pleasant breath. Recent research has found a number of links between oral health and overall health. While in many cases, the nature of this link still isn’t clear — researchers have yet to conclude whether the connections are causal or correlative — what is certain is that the condition of your mouth is closely tied to your overall physical health.

Oral Health and Diabetes

Doctors have known for years that type 2 diabetics have an increased incidence of periodontitis, or gum disease. In July 2008 the connection was further highlighted: Researchers at Columbia University’s Mailman School of Public Health followed 9,296 nondiabetic participants, measuring their level of periodontic bacteria over the course of 20 years.

“We found that people who had higher levels of periodontal disease had a twofold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, associate researcher at the department of epidemiology at the Mailman School and the lead author.

While more research is needed before doctors can conclude that gum disease actually leads to diabetes, there are already a few theories about why this might be the case: One proposes that when infections in your mouth get bad enough, they can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

Oral Health and Heart Disease

As with diabetes, the connection between poor oral health and cardiovascular conditions has been recognized — the two are often found together — but it still hasn’t been determined conclusively whether or not there is a direct causal relationship between them. (One reason is that there are a number of other potential risk factors — such as smoking and old age — that can lead both to gum disease and heart disease.)

However, in a 2005 study funded by the NIH, 1,056 randomly selected participants with no prior heart attacks or strokes were evaluated for levels of periodontal bacteria: After removing the effects of the other risk factors of age, gender, and smoking, it was found that there was an independent relationship between gum disease and heart disease, says Moise Desvarieux, MD, PhD, associate professor of epidemiology at the Mailman School and lead author of the study.

One theory about why this may occur, says Dr. Desvarieux, is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007 established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

Pregnancy Complications and Gum Disease

For many pregnant women, gum infections stem from the fluctuating hormone levels that come with pregnancy, says Marsha Rubin, DDS, practicing diplomat of special-care dentistry at New York-Presbyterian/Weill Cornell, who sees many pregnant patients in her practice. Others neglect their oral care during pregnancy, since they have much on their minds, she adds. But that’s a mistake: Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor.

While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well. A number of studies — including a 2007 study of 3,567 Turkish women and a 2007 study of 1,305 Brazilian women — found a relationship between periodontal disease, preterm birth, and low birth weight.

Pneumonia and Gum Disease

There has been a link established between poor oral health and pneumonia, though much of the research focuses on high-risk populations. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Rubin. “Even in a healthy mouth there is lots of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.

Pancreatic Cancer and Gum Disease

A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer.

This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux. Reasons for why this might be are as yet unknown.

Tips to Prepare Your Smile for a Special Event

There are many times in your life when you want your smile to be at its absolute best — and maybe you even want it to work a little harder for you. According to a recent psychology study at the Max Planck Institute in Germany, smiling can increase positive behaviors, instill confidence, and even make you appear more youthful and attractive, according to a recent Berlin-based study at the Max Planck Institute. So whether you’re going on a first date, scheduling a job interview, planning your wedding, or attending a graduation or reunion, it’s time to start thinking about how you can make the most of your smile.

There isn’t always a lot of lead time when it comes to preparing for a first date or interview, so in this case, the biggest bang for your buck is bleaching, and you have two options. You can schedule an appointment with your dentist for professional, in-office teeth whitening, or get an over-the-counter whitening product and do it yourself.

Teeth Whitening in a Pinch

If you can get a last-minute appointment with your dentist, the professional bleaching that she provides will be a quicker (and more impressive) fix than what you’ll achieve with drugstore whitening kits — though it will be considerably more expensive. An in-office whitening session may set you back anywhere from $500-1,000, while an over-the-counter treatment costs between $20-100. But if you have the time and the budget, getting your teeth whitened by a professional is both faster and more effective than doing it yourself, according to Donna Zak, DDS, of Zak and Frankel Dental Associates in New York City.

The concentration of whitening ingredients used in the dental-office product is much higher (about 15 to 35 percent hydrogen peroxide) than the amount in the products you can buy at your local drugstore (about 3 to 10 percent hydrogen peroxide). During your office treatment, your dentist will apply a whitening gel to your teeth and may activate the bleaching process with a laser technology that is thought to penetrate teeth and create a deeper whitening effect (known as power bleaching). Typically this process only takes one hour and can yield drastic results.

But if you can’t score an appointment with your dentist — or your budget simply won’t allow it — “go ahead and get an over-the-counter product and bleach your teeth a week or a few days before,” says Dr. Zak. She recommends Crest Whitestrips or Aquafresh White Trays. “Whitening toothpastes can also help,” says Gregg Lituchy, DDS, of Lowenberg & Lituchy in New York City.

“But they really only remove the external stains on the tooth surface, whereas whitening strips penetrate the deeper tooth layers to actually bleach the teeth.” When used together, Dr. Lituchy suggests that teeth whitening strips with whitening toothpaste is a good combo for making teeth appear whiter.

In a real pinch, the easiest way to achieve a whiter smile is to try a new makeup routine. Both Zak and Lituchy agree that wearing a shade of lipstick with a blue undertone is a good trick to make your smile look instantly brighter. Darkening your skin tone with a bronzer, says Lituchy, will also help create a greater contrast to the teeth and make them appear whiter. Additionally, he suggests avoiding any food or drinks that are likely to darken the teeth before the big event, so avoid coffee, black tea, red wine, and dark-colored berries — and don’t smoke! Tobacco is one of the worst teeth-staining offenders.

A Serious Smile Makeover

Million-dollar smiles are no longer just for the rich and famous — and they’re not as costly as they used to be either. More and more everyday people are getting their teeth professionally bleached, straightened, and even replaced with long, straight rows of porcelain veneers. And if you’re getting ready for a longer-term event like wedding, graduation, or reunion, you can take advantage of these more time-intensive procedures.

With extra time to prepare for a special event, patients have the opportunity to visit the dentist for multiple teeth whitening treatments and can achieve more impressive results than from just a one-time session. Echoing Zak’s assessment, Brian Kantor, DDS, of Lowenberg & Lituchy, says that patients can maintain and boost the bleaching process by getting custom-made bleaching trays to take home with them. Your dentist will take dental impressions to produce the trays that will fit comfortably and help the bleach sit against the teeth better than a generic OTC product. Because they are custom fit for your mouth, they also prevent the whitening agent from irritating the gums. “The in-office whitening combined with the prolonged use of the take-home trays will give the best possible results from bleaching,” Dr. Kantor says. These custom trays may also be available for patients who opt out of the in-office procedure and only wish to whiten at home with a professionally-dispensed product.

But color may not be the only obstacle in your way of a great, white smile. As you age, the wear-and-tear on your teeth is reflected in your smile. Before your big event, you may want enhance your smile — and your overall oral health — with a complete smile renovation. Replace old fillings, fix an improper bite, straighten crooked teeth that have shifted over the years, and repair any cracks or chips.

“If you are looking to do dentistry on your teeth to change them, such as crowns or veneers, I would start at least six months before the big day,” says Zak. In addition to factoring in your dentist’s availability and the dental lab’s schedule, the exact amount of time depends on how many veneers would be needed. For example, replacing only the upper front teeth with veneers could take about a month. However, if the work is more extensive and includes the back teeth, then Zak says it could take between six months and a year. Veneers are a great choice for a smile makeover for those deemed candidates by their dentist and who have the time and budget (porcelain veneers can cost $1,000 to $2,500 per tooth). “Not only can they straighten the teeth,” says Kantor, “they can also improve the color and shape of the teeth.”

To create your ideal smile, make a consultation appointment with your regular dentist or consider seeking out a dentist who specializes in smile enhancement. Share your concerns about your teeth and your goals for your new smile. Since beauty is always in the eye of the beholder, photos and images from magazines can be helpful when you try to convey what you consider attractive. Your dentist will then discuss your treatment options and get you on track with a plan that fits the timeline leading up to your special event.

Dentist Gives Advice to Keep Holiday Smiles Bright

The busy holiday season may disrupt many people’s daily routines, but at this time of year it is especially important to remember to look after your teeth, an expert advises.

“Holiday get-togethers tend to lead people to consume sugary treats and drink alcoholic beverages more than usual,” Dr. George Shepley, spokesperson for the Academy of General Dentistry, said in an academy news release.

“Additionally, with their busy schedules and increased stress levels, I’ve noticed that my patients’ oral hygiene suffers. They forget the most basic of oral hygiene tasks that can counteract the effects of sugary snacks and drinks,” he pointed out.

Shepley offers suggestions on a number of ways to protect your teeth during the holiday season.

To reduce the risk of damage from drinking red and white wines, which are highly acidic and can eat away at a tooth’s enamel, refrain from swishing wine around in your mouth and drink water between glasses of wine to rinse acid from your teeth.

And, while holiday goodies such as cookies, chocolate and candy canes are tempting, the sugar in them promotes the growth of cavity-causing bacteria. If you can’t brush or floss after eating sweet treats, drink water or chew a piece of sugarless gum, which will increased saliva flow and help wash away the bacteria.

Finally, Shepley pointed out, holiday stress can cause some people to grind or clench their teeth, potentially resulting in chipped teeth, jaw pain and headaches.

“Finding ways to alleviate your anxiety can help, but it’s also important to see your dentist, who can recommend solutions like a custom night guard,” Shepley said. “Wearing one at night will prevent you from taking out the holiday stress on your teeth while you sleep.”