Teeth, Gums, Plaque And Nutrition

Dental disease, including dental decay and gum disease, is almost completely preventable. The next generation does not have to suffer from dental disease. The responsibility for prevention lies primarily in the hands of the patient but in reality, this responsibility is shared with the patient’s own dentist and hopefully a dental hygienist to help prevent and save your teeth & gums from dental disease.

Prevention is far better than cure

Prevention of dental disease is achieved in two ways; firstly by having regular examinations by a general dentist and receiving advice on what you can do yourself to avoid disease and secondly by following the advice you receive in terms of cleaning technique and the use of products (medicines such as antibacterials and fluoride or remineralising agents) that may help to either reduce the numbers of bacteria in the mouth or products that can help to reverse the early stages of dental decay thereby healing early decay before they become “true” cavities. Before you go out and buy whatever has been advertised on the TV, talk to your dentist or hygienist and find out what they say works. Not all advertising is sound!

Difficulties with tooth brushing

The maintenance of a high standard of cleaning is translated into effective plaque removal from tooth surfaces. BUT, there’s a problem; the one thing you can buy in the shops nowadays and that comes without any clear and accurate instructions on how to use it most effectively is a toothbrush.

If you buy an electric toothbrush (and they are not all good believe me), the instructions are about how to assemble it and plug it in but not necessarily on the details of the best way to remove the plaque efficiently. Also the method some electric brushes use to remove plaque (due to their design) is far from effective in the inaccessible areas of the mouth.

There have been so many different tooth-brushing “techniques” for removing plaque suggested over the years that patients have received differing advice from various dentist and hygienists.

What toothbrush should we use?

Now modern, effective and affordable sonic technology toothbrushes using high-frequency vibration are available. These brushes are more effective than the older style rotating and contra-rotating electric brushes.

Sonic vibration technology brushes are much better at removing plaque than a conventional hand-held toothbrush, achieving as much as 5 times more plaque removal with minimal effort.

These brushes include the Colgate Omron ProClinical A1500 or C600 and Phillips Sonicare (FlexCare or Diamondclean) brushes. These sonic brushes are easy to use once the correct technique has been demonstrated and they are extremely effective when used correctly at disrupting the sticky plaque film that covers all tooth surfaces and lives between teeth and under gum margins. The sonic vibration technology is much more effective than your hand-brush movements can ever be.

What about the toothpaste?

TOOTHPASTE DOES NOT CLEAN TEETH! Yes, I did say that! I am being a bit contentious but I’ll explain.

The toothbrush filaments mechanically disrupt the plaque film on the teeth and gums. The toothpaste has really only one essential benefit and that is it provides Fluoride to be adsorbed onto the surface of the tooth enamel and this is of benefit long term in making the tooth surface less susceptible to the acids produced by the plaque and hence helps to resist the process of decay (dental caries).

Manufacturers claims…

Yes, I know the toothpaste manufacturers claim their paste does everything; delays plaque formation, strengthens teeth, protects against decay, protects against gum disease, gets rid of sensitivity, and probably makes you tea in the morning too! No single product can do everything. Chemically, it’s just not possible. One chemical system will interfere with another and no single chemical system can do all the above. It’s just common sense!

If you have a tooth sensitivity then use a product designed to treat it whether it be Colgate Pro-Relief or Sensodyne. If one works, use it. If not, try the other one. Nothing works for everyone.

The problem with toothpaste

From our youngest age, we have been brought up to associate foaming and bubble formation with effective cleaning. Think of your washing-up detergent in the sink when you wash the dishes. But in toothpaste the formation of all those bubbles does not do anything to help in cleaning plaque off teeth. Remember it’s sticky. The use of detergent may remove grease from pots and pans but not plaque from teeth. The brush does that! What bubbles do sadly, is they make it far more difficult to see what the brush head is doing and at what angle it is against the teeth (it should be 45 degrees approximately). Also, a mouthful of bubbles has to be spat out in the wash basin so you choose not to brush for too long or you dribble! So remember, longer is better.

So what toothpaste should you use?

I use Colgate Total because I like the taste and it may have some minimal plaque formation delaying property because it contains Triclosan but really my main interest is in which sonic brush I use and my technique in using that brush.  I am particularly interested in making sure that I am using the brush at the right angle, and for long enough at each site.

What about mouthwashes?

There are a number of mouthwashes available at the chemist and the supermarket. Which is the right one? The simple answer is, there is no “right one”. For example, Fluoride helps reduce decay and in a person with a lot of decay, it might help reduce the number of fillings they need over a period of time. Alternatively, if you suffer from a dry mouth then you should use one designed for people with dry mouths containing artificial salivary systems to help keep the mouth moist for longer and these include Biotene and Colgate Dry Mouth Relief. If you have just had surgery in the mouth then you need something to kill the large numbers of bacteria in the mouth to prevent post-surgical infection and then you would use either Savacol or Curasept containing either 0.12% or 0.2% Chlorhexidine. However, if you use Savacol, don’t use it for more than 2-3 weeks or your teeth and tongue will go brown (it stains badly). Then we come to “the others”. Most people buy the one they like the taste of and that’s fine because it at least focuses them on the care of their mouth but mouthwash is not going to remove your plaque for you, nor prevent gum disease. That is what your brush is designed to do if it is used in the correct manner for the desired length of time.  This can be learned by visiting Sharon, my dental Hygienist.

Stickiness of plaque is the problem…

The big problem with removing plaque off teeth is that plaque is extremely sticky and although it is easier (but definitely not easy) to remove it from the flat sides of teeth, it is a great deal more difficult to remove it from the surfaces of the teeth where they touch the tooth next door. To be effective we must not overlook interdental surfaces of teeth and it is also important to pay particular attention to cleaning under the edge of the gum around all the teeth. It is the plaque between teeth that leads to most decay starting in children and young adults and it is the plaque left under the edges of the gums and between teeth that is responsible for causing gum disease.

Plaque removal takes time…

Cleaning takes time and few people spend adequate time on their oral hygiene. Most spend around 2 minutes (get someone to time you, you’ll be surprised). This is inadequate to clean all the inaccessible surfaces throughout the mouth. To find out exactly how you can achieve the most effective cleaning, speak to your someone experienced in treating gum disease like my dental hygienist, Sharon Everett, and she will be happy to show you ways to remove plaque using a variety of dental cleaning devices and techniques. It is important that everyone understands what they need to do, how they need to do it and how long they need to do it for!

What causes dental disease

There are three factors at work in the cause of dental decay, these being sugar (fermentable carbohydrate), plaque (live bacteria capable of using the sugars as food), and of course teeth (without these there would be no dental decay).

Gum disease relies on the presence of a thickened plaque in contact with the gum and the large numbers of disease-causing bacteria in the deeper plaque layers next to the gum and bone, leading to inflammation and consequently bone loss in those individuals who are susceptible to gum disease.

It is interesting that cutting edge research is now suggesting the incidence of gum disease is higher than we have believed.  Until recent evidence was presented we thought 15-20% of people were highly susceptible to destructive gum disease but this figure may now be over 50%.  More data is required to identify true disease experience.

The balance of diet and cleaning…

If we maintain a really good standard of plaque removal by performing the detailed cleaning measures that may be demonstrated and taught, then it is safe to eat a limited amount of refined carbohydrates. However, if tooth and gum cleaning is less than ideal, then a restriction of refined carbohydrate intake will be essential to reduce the experience of tooth decay and to some extent gum disease. Ideally, it would be best to maintain good cleaning and restrict refined carbohydrate!

The recipe for dental disaster is when you have poor plaque control and plenty of refined carbohydrates in the presence of teeth and you will suffer from extensive dental decay and probably gum disease too.

Our frequent and sad experience…

At NQ Surgical Dentistry, sadly we have to see young children who have extensive decay in their baby teeth and often by the time they are 6-9 years old, in their permanent teeth too. This often results in our having to remove these teeth under a general anaesthetic because the child is too young to be able to cope with a tooth extraction while awake. This is a very sad start to their dental experience in life, particularly when this situation is avoidable if parents are given the necessary level of dental education before the baby teeth begin to erupt.

Baby teeth are more susceptible to decay than adult teeth and it takes very little time for decay to attach these teeth, so parents need to keep a close check on their child’s teeth and if any spots of tooth discolouration are seen, they should immediately see their dentist.  Regular dental checks should start as soon as the baby teeth begin to erupt. 

Too little too late…

Taking out the decayed teeth is rather like “shutting the stable door after the horse has bolted”. In order to try to prevent this situation repeating itself, we also try to help the child and more importantly their parents to better understand dietary importance in dental disease and offer them professional advice on what they can eat, how often and what they should try to avoid, along with a host of advice on better plaque removal.

Nutrition, nutrition, nutrition…

From the point of view of nutrition and diet, the best person to offer this advice is an experienced nutritionist who has a background working with the dental profession and with patients who have suffered from the dental consequences of unsatisfactory dietary choices. One such nutritionist is Vivienne Salu. She is always happy to help both our patients, and patients sent to see us by other local dentists, to get the right messages across to them, and to offer support and advice to set them up for a healthy mouth and a healthy body for life.

Prevention is so achievable

Dental disease is probably the most preventable of all diseases. Yes, that is true. Prevention really is better than cure. If you have extensive decay or if you have young children or are about to start a family, then you should make an appointment with two people. The fist person is Sharon Everett my dental Hygienist who can talk with you to ensure you have the information you need to make the right choices for your child concerning oral hygiene/plaque control, preventive visits to the dental team, and basic nutritional advice. The second person is Vivienne Sulu who is a nutritionist with extensive dental understanding; she is someone you really need to talk to.particularly if there is a background of extensive dental decay and lots of fillings in your family.  This suggests that underlying issues exist, almost certainly nutrition is a very significant part.

Start off by calling us and making an appointment with Sharon Everett, our dental hygienist, for advice on the dental care of your young family or for yourself.

Save money

Some advice and understanding given by a nutritionist might just save you many thousands of dollars in the future that would otherwise have been spent on dental treatment and re-treatment for you and your family.

Remember once you have a tooth filled it will need replacement fillings for life. Every time a filling is replaced it gets a bit bigger and eventually there’s more filling than tooth and then you end up with a root canal treatment and a crown and eventually, most likely, loss of the tooth. REMEMBER dental fillings are all temporary, not permanent.  No filling lasts forever.  Some research reports fillings vary in their life expectancy in general from 5-10 years, so the earlier in life you receive a filling, the more often it will have to be replaced

At NQ Surgical Dentistry our focus is on the treatment of gum disease, and the provision of surgical dental treatment including the removal of wisdom teeth, the preparation of mouths for complete dentures and the provision of dental implants. Routine dental care, including fillings and regular dental check-ups are the domain of dentists providing routine general dental care. Dr. Priestland is always willing to help patient get their dental disease back under control with the involvement of Sharon Everett and can help provide patients with a logical sustainable dental treatment plan to achieve a stable dental outcome within the budget of the patient as we understand that whatever you choose has to be affordable.

Dental care of anxious patients

At NQ Surgical Dentistry, general dental care including fillings is available for those patients who suffer from dental anxiety or dental phobia and find dental treatment intimidating. Treatment of anxious patients represents an important part of the care offered at NQ Surgical Dentistry.  Dr. Priestland has many years of experience working with such patients and enjoys caring for these patients who need that bit more help and support.

Intravenous sedation is used to treat these patients, removing all anxiety and allowing treatment to be provided in a relaxed and pleasant atmosphere. Dr. Colin Priestland is accredited to offer intravenous sedation for dental treatment and has been a dental seditionist since 1986. For more information on intravenous sedation read our article on the treatment of nervous patients and sedation.

contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812

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