My Blog

Posts for: July, 2019

By James V Gagne, DMD
July 28, 2019
Category: Oral Health
Tags: oral hygiene   floss  
FlossFirstorLastHereareReasonsforEitherApproach

A certain news story a few years ago notwithstanding, dentists still recommend flossing along with brushing to adequately remove disease-causing plaque. If there is any controversy at all about flossing, it's whether you should perform it before brushing or after. Each perspective has good reasons.

"Brush First" proponents say their way encourages the formation of a daily hygiene habit, a must for preventing disease. That's because brushing can remove most of the plaque built up on the teeth, while flossing can then remove what's left. If you floss first, though, you'll have to plow through the sticky film with the floss, which can be an unpleasant experience. Facing that every day could make a person less enthusiastic about developing a hygiene habit.

But it's not just about the sensation: depending on the person, the plaque buildup could be so much that the floss becomes clogged with it. You're then moving the plaque rather than removing it. Brushing a lot of the plaque out of the way first will increase the cleaning power of your floss.

The "Floss First" team, though, is undaunted with their own take on the matter. Flossing can loosen up any stuck debris between teeth, making it easier for brushing to clear it away. It can also expose plaque-covered areas between teeth to allow better contact with the fluoride in your toothpaste. And, the amount of plaque you're pulling out in certain areas during flossing could tip you off to beef up your brushing efforts on those areas of heavier plaque accumulation.

One of the prime reasons for flossing first, though, goes back to the comfort factor and human nature. To be honest, for most people flossing isn't as much "fun" as brushing. If you put it off until after brushing, you're more likely not to do it if you find it unpleasant. Doing it first gets the less likeable task out of the way, so you can then do the more likeable one, brushing.

Which approach is best for you? It's really a personal decision, one you can discuss with your dentist. Try both ways, and see which one seems better. But whether you floss first or last, do floss to really reduce your risk for dental disease.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Brushing and Flossing: Which Should be Done First?


AnchorageToolsHelpOrthodontistsCorrectComplexBiteProblems

While braces are often the stars for straightening smiles, they're not the only cast members in an orthodontic production. Orthodontists occasionally turn to other appliances if the bite problem is challenging. Whatever the tool, though, they usually have something in common—they use the principle of anchorage.

To understand anchorage, let's first consider the classic kid's game Tug of War. With teams on either end of a rope, the object is to pull the opposing team across the center line before they pull you. To maximize your pulling force, the player at the back of your rope, usually your stoutest member, holds steady or "anchors" the rest of the team.

Like a Tug of War team, braces exert force against the teeth. This stimulates the supporting periodontal ligament to remodel itself and allow the teeth to move. The braces use the teeth they are attached to as anchors, which in a lot of cases are the back teeth. By attaching a thin wire to the brackets or braces on the teeth, the orthodontist includes all the teeth on the arch, from one end to the other. Anchored in place, the wire can maintain a constant pressure against the teeth to move them.

But not all bite situations are this straightforward. Sometimes an orthodontist needs to influence jaw growth in addition to teeth movement. For this purpose, they often use orthodontic headgear, which runs around the back of the head or neck and attaches to orthodontic brackets on the teeth. It still involves an anchor but in this case it's the patient's own skull.

In some situations, an orthodontist may feel he or she needs more anchorage as the teeth alone may not be enough. For this, they might establish a separate or additional anchor point using a temporary anchorage device (TAD). A TAD resembles a tiny screw that's inserted into the jawbone near the tooth intended for movement. The orthodontist can then attach the TAD to braces hardware using some form of elastics. After treatment, they remove the TAD.

These are just a couple examples of specialized tools an orthodontist can use for bite correction. Thanks to them and similar devices, even the most complex bite problem can be overcome to create a healthier and more attractive smile.

If you would like more information on correcting a poor bite, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontic Headgear & Other Anchorage Appliances.”


SedationcanMakeDentalTreatmentEasierforHighAnxietyPatients

Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.

But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.

One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.

But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.

Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.

IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.

For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.

If you would like more information on IV sedation, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “IV Sedation in Dentistry.”