Cleaning & Prevention
Cleanings & Prevention
Show off your healthy, confident, smile!
A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.
Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.
Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.
Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.
Dental Exams & Cleanings
A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
Professional Dental Cleaning
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
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Fluoride is the most effective agent available to help prevent tooth decay. It is a mineral that is naturally present in varying amounts in almost all foods and water supplies. The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.
Fluoride works in two ways:
- Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay. We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels. Dentists and dental hygienists generally recommend that children have a professional application of fluoride twice a year during dental check-ups.
- Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums. We gain systemic fluoride from most foods and our community water supplies. It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician. Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years. It is very important to monitor the amounts of fluoride a child ingests. If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.
Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay. Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:
- Deep pits and fissures on the chewing surfaces of teeth.
- Exposed and sensitive root surfaces.
- Fair to poor oral hygiene habits.
- Frequent sugar and carbohydrate intake.
- Inadequate exposure to fluorides.
- Inadequate saliva flow due to medical conditions, medical treatments or medications.
- Recent history of dental decay.
- Remember, fluoride alone will not prevent tooth decay! It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.
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Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.
Dental radiographs (x-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.
Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!
Dental x-rays may reveal:
- Abscesses or cysts.
- Bone loss.
- Cancerous and non-cancerous tumors.
- Decay between the teeth.
- Developmental abnormalities.
- Poor tooth and root positions.
- Problems inside a tooth or below the gum line.
Are dental x-rays safe?
We are all exposed to natural radiation in our environment. The amount of radiation exposure from a full mouth series of x-rays is equal to the amount a person receives in a single day from natural sources.
Dental x-rays produce a low level of radiation and are considered safe. Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental x-rays. These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each x-ray.
How often should dental x-rays be taken?
The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.
A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
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A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients. Your personal home care plays an important role in achieving that goal. Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.
Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
Brush the outer, inner, and biting surfaces of each tooth.
Use the tip of the brush to clean the inside of the front teeth.
Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Do not pop the floss in and out between the teeth as this will inflame and cut the gums.
If you have any questions about the correct way to brush or floss, please ask your dentist or dental hygienist.
It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Use other dental aids as recommended by your dentist or dental hygienist: Interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.
Brushing and flossing are of paramount importance to oral hygiene. Though bi-annual professional dental cleanings remove plaque, tartar and debris, excellent homecare methods are equally valuable. Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle and prevent serious diseases.
Reasons why proper brushing and flossing are essential:
- Prevention of tooth decay – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures. Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth. This phenomenon can easily be prevented by using proper home hygiene methods.
- Prevention of periodontal disease – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession and jawbone recession. Periodontal disease is caused by the toxins found in plaque, and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush, and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
- Prevention of halitosis – Bad breath or halitosis is usually caused by old food particles on or between the teeth. These food particles can be removed with regular brushing and flossing; leaving the mouth healthier, and breath smelling fresher.
- Prevention of staining – Staining or the yellowing of teeth can be caused by a wide variety of factors such as smoking, coffee and tea. The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.
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Oral Hygiene Aids
Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.
Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.
There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.
Here are some of the most common oral hygiene aids for homecare:
- Dental Flosses
Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.
- Interdental Cleaners
Many hygienist & periodontists recommend interdental brushes in addition to dental floss. These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.
- Mouth Rinses
There are two basic types of mouth rinse available: Cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription. Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.
- Oral Irrigators
Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.
- Rubber Tip Stimulators
The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.
- Tongue Cleaners
Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.
There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.
Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.
If you have any questions about oral hygiene aids, please ask your dentist or dental hygienist.
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A sealant is a thin, plastic coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay. A sealant protects the tooth by sealing deep grooves, creating a smooth, easy to clean surface.
Sealants can protect teeth from decay for many years, but need to be checked for wear and chipping at regular dental visits.
Reasons for sealants:
- Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16
- Adults – Tooth surfaces without decay that have deep grooves or depressions.
- Baby teeth – Occasionally done if teeth have deep grooves or depressions and child is cavity prone.
What do sealants involve?
Sealants are easily applied by your dentist or dental hygienist and the process takes only a couple of minutes per tooth.
The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. A special solution is applied to the enamel surface to help the sealant bond to the teeth. The teeth are then rinsed and dried. Sealant material is carefully painted onto the enamel surface to cover the deep grooves or depressions. Depending on the type of sealant used, the material will either harden automatically or with a special curing light.
Proper home care, a balanced diet, and regular dental visits will aid in the life of your new sealants.
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Oral Cancer Exam
According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.
Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.
There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:
- Salivary Glands
- Oropharyngeal Region (throat)
Reasons for oral cancer examinations
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
The following signs will be investigated during a routine oral cancer exam:
- Red patches and sores – Red patches on the floor of the mouth, the front and sides of the tongue, white or pink patches which fail to heal and slow healing sores that bleed easily can be indicative of pathologic (cancerous) changes.
- Leukoplakia – This is a hardened white or gray, slightly raised lesion that can appear anywhere inside the mouth. Leukoplakia can be cancerous, or may become cancerous if treatment is not sought.
- Lumps – Soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathological problems.
Oral cancer exams, diagnosis and treatment
The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.
During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
If you have any questions or concerns about oral cancer, please ask your dentist or dental hygienist.
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Identafi® Oral Cancer Screening
Oral cancer is often deemed the “forgotten disease,” because it kills more people than testicular cancer, cervical cancer and cancer of the brain each year and receives little publicity in return. Each year, over 30,000 Americans contract oral cancer, and only 57% of these people will live for more than five years without treatment.
Many people believe that if they abstain from tobacco and alcohol use, oral cancer will not affect them. Tobacco and alcohol use does contribute to oral cancer; however, 25% of those diagnosed abstain from both substances.
The best way to stay protected from oral cancer is to get annual oral cancer screenings. Most dentists perform an oral cancer exam during a regular dental checkup. The FDA-approved Identafi® offers dentists another examination tool to help detect oral cancer in its earliest stages. The Identafi® is a blue excitation lamp, which highlights precancerous and cancerous cell changes.
How does the Identafi® work?
The Identafi® uses Fluorescence Visualization (FV) in an exciting new way. Essentially, bright blue light is shone into the mouth to expose changes and lesions that would otherwise be invisible to the naked eye. One of the biggest difficulties in diagnosing oral cancer is that its symptoms look similar to symptoms of less serious problems. The Identafi® System affords the dentist important insight as to what is happening beneath the surface.
The healthy soft tissue of the mouth naturally absorbs the Identafi® frequency of blue light. Healthy areas beneath the surface of the soft tissue show up green, and the problem areas become much darker.
Here are some of the advantages of using the Identafi® System:
- Can be combined with digital photography.
- Detects lesions, white and red patches.
- Detects problem areas that cannot be seen under white light.
- Exposes precancerous and cancerous tissue.
- Helps dentists check that diseased soft tissue is completely removed.
- Helps diagnose oral cancer in its earliest stages, exponentially increasing the chance of survival.
- Quick, painless examinations.
How is the Identafi® examination performed?
The Identafi® examination literally takes only two or three minutes. It is a painless and noninvasive procedure that saves many lives every single year.
Initially, the dentist will perform a regular visual examination of the whole lower face. This includes the glands, tongue, cheeks and palate as well as the teeth. Next a pre-rinse solution is swilled around the mouth for slightly less than a minute. The dentist provides special eyewear to protect the integrity of the retinas. The lights in the room are dimmed to allow a clear view of the oral cavity.
The small Identafi® is bent to project blue light inside the mouth. Lesions and other indicators of oral cancer are easily noticeable because they appear much darker under the specialized light.
If symptoms are noted, the dentist may take a biopsy there and then to determine whether or not this is oral cancer. The results of the biopsy dictate the best course of action from there. Otherwise, another oral cancer screening is performed in one year’s time.
If you have any questions or concerns about oral cancer screening or the Identafi® system, please contact our office.
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CariVu – Caries Detection Device
A brilliant new approach to discovering caries and cracks.
DEXIS CariVu™ is a compact, portable caries detection device that uses patented transillumination technology to support the identification of occlusal, interproximal and recurrent carious lesions and cracks.
CariVu continues in the long DEXIS tradition of providing intuitive, easy-to-use diagnostic tools for the dental community.
By hugging the tooth and bathing it in safe, near-infrared light, CariVu’s transillumination technology makes the enamel appear transparent while porous lesions trap and absorb the light. This unique caries detector allows the clinician to see through the tooth exposing its structure and the actual structure of any carious lesions with very high accuracy.
Similar in appearance, DEXIS CariVu images read like familiar X-ray images — lesions will appear as dark areas. This provides an edge over fluorescent imaging technologies in that there is no need to clean the tooth of bacteria, calibrate the device or become versed in the meaning of multiple color codes or numeric indicators.
Think of the DEXIS digital X-ray sensor and CariVu as ultimate companion tools for caries detection.
If you identify a suspicious area on a radiograph — especially possible interproximal decay which can be more difficult to detect — your “second opinion” can be a transilluminated image that reveals the extent of the condition and helps you confidently determine whether it needs monitoring over time or requires immediate treatment.
Since transillumination can show lesions in the beginning stages, using CariVu during routine prophylaxis can aid the hygienist in identifying questionable areas early on and decide on a course of preventive care.
When used together, a radiograph, a transilluminated image and an intra-oral photo provide a comprehensive picture of the health of a patient’s tooth.
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