Unless otherwise stated, the information concerning the following topics is obtained from the Canadian Dental Association.




 Five Point Prevention

 Gum Disease

 Bad Breath and Mouth Odors (Halitosis)

 Snoring and Sleep Apnea

 Dry Mouth



 The Check-Up

 Smoking and Tobacco

 Quitting Tobacco

 Warning Signs

 Mouth Rinses



 The Role of The Hygienist in Comprehensive Care





Regular, thorough brushing is a very important step in preventing tooth decay and gum disease. Brushing removes the bacteria which promote tooth decay and removes plaque which can cause gum disease.


Ideally, you should brush after every meal, because the bacterial attack on teeth begins minutes after eating. At the very least, brush once a day and always before you go to bed.


Brushing your teeth isn't complicated, but there is a right and a wrong way:

  • Brush at a 45 degree angle to your teeth. Direct the bristles to where your gums and teeth meet. Use a gentle, circular, massaging motion, up and down. Don't scrub. Gums that recede visibly are often a result of years of brushing too hard.

  • Clean every surface of every tooth- the chewing surface, the cheek side, and the tongue side.

  • Don't rush your brush. A thorough brushing should take at least two to three minutes. Try timing yourself.

  • Change your usual brushing pattern. Most people brush their teeth the same way all the time. That means they miss the same spots all the time. Try reversing your usual pattern.

The right toothbrush cleans better. Use a soft brush with rounded bristles. Choose a size and shape that allow you to reach all the way to your back teeth. There are many different types of brushes, so ask your dentist to suggest the best one for you. The Canadian Dental Association recommends you replace your toothbrush every three months.






Flossing removes plaque and bacteria that you cannot reach with your toothbrush. If you don't floss, you are missing more than one-third of your tooth surface.


Plaque is the main cause of gum disease. It is an invisible bacterial film that develops on your teeth every day. Within 24 to 36 hours, plaque hardens into tartar (also called calculus) which is much more difficult to remove. Floss at least once a day, and plaque never gets the chance to harden into tartar.


Getting into the habit of daily flossing is easier when you floss while doing something else-watching TV or listening to music, for example:

  • Take a length of floss equal to the distance from your hand to your shoulder. Wrap it around your index and middle fingers, leaving about two inches between your hands.

  • Slide the floss between your teeth and wrap it into a "C" shape around the base of the tooth and gently under the gumline.

  • Wipe the tooth from base to tip two or three times.

  • Be sure to floss both sides of every tooth. Don't forget the backs of your last molars.

  • Go to a new section of the floss as it wears and picks up particles.

  • Brush your teeth after you floss- it increases flossing effectiveness.

Gums sometimes bleed when you first begin to floss.  It most often stops after a few days. If bleeding does not stop, see your dentist.


Floss can shred if you snag it on an old filling or on the ragged edge of a tooth. Try another type of floss or dental tape.   Ask your dentist or dental hygienist for advice. If your floss still shreds, see your dentist.




 Five Point Prevention


The Canadian Dental Association has made it easy for Canadians to remember key tips for maintaining a healthy smile:

  • Brush your teeth carefully at least once every 24 hours: It takes about 2.5 to 3 minutes to do the job right.

  • Floss your teeth daily: Flossing cleans those areas your toothbrush simply can't reach between the teeth and under the gumline.

  • Eat, drink, but be wary: Eat a well-balanced diet! Avoid sweet foods and drinks especially between meals. And please don't smoke. Smoking can promote serious dental problems like gum disease and oral cancer.

  • Check your gums: Check regularly for these signs of gum disease, the leading cause of adult tooth loss: red, puffy or tender gums; gums that bleed even slightly when you brush or floss; persistent bad breath. See your dentist if any occur.

  • Don't wait until it hurts: See your dentist for preventive checkups and professional cleanings. Regular visits are the best way to prevent trouble and unnecessary expense.



 Gum Disease


How common is gum disease?


Very. Nine out of 10 Canadians will develop gum disease at some time in their lives. It is the most common dental problem, and it can progress quite painlessly until you have a real problem. That's why it is so important to prevent gum disease before it becomes serious.


How does gum disease get started?


Gum disease begins when plaque adheres at and below the visible edge of your gums. If plaque is not removed every day by brushing and flossing, it hardens into tartar (also called calculus). Tartar promotes a bacterial infection at the point of attachment. In these early stages, gum disease is called gingivitis. Your gums may be a bit red, but you may not notice anything. As gingivitis gets more serious, tiny pockets of infection form. Your gums may be puffy and may bleed a little when you brush, but it is not painful. Over time, the infection destroys the gum tissue. Eventually, you may be at risk of losing one or more teeth.


How can I prevent gum disease?


Prevention is the most important factor in the fight against gum disease. It is essential to keep your teeth and gums clean. Brush your teeth properly at least twice a day and floss at least once every 24 hours. Using proper brushing and flossing techniques is equally important. Be sure to see your dentist regularly for professional cleaning and checkups, so that he or she can detect any early signs of gum disease, and provide appropriate treatment.


How can I tell if I'm brushing and flossing properly?

  • Brushing: Brush your teeth gently, paying special attention to the areas where your teeth and gums meet. Clean every surface of every tooth. Use the tip of your brush to clean behind your upper and lower front teeth.

  • Flossing: Take a piece of floss about 18 inches long and wrap it around your middle fingers. Using a clean section of floss each time, wrap the floss into a C shape around a tooth. Wipe it over the tooth, from base to tip, a couple of times. Repeat on each tooth.

What if I am already in the early stages of gum disease?


If you have gum disease, getting rid of plaque and tartar gives your gums a chance to get better. That's why in the early stages of gum disease, the best treatment is:

  • Cleaning by your dentist or dental hygienist to remove built-up tartar,

  • Brushing twice a day to remove plaque and

  • Flossing once a day to remove plaque.

When gum disease is more serious, your dentist may refer you to a dental specialist called a periodontist. A periodontist has a least 3 years of extra university training in treating gum disease, and in restoring (or regenerating) bone and gum tissue that have been lost because of gum disease. A periodontist also treats serious forms of gum disease that do not get better with normal dental care. When serious gum disease is found, brushing and flossing become even more important.





 Bad Breath and Mouth Odors (Halitosis)


The following information is part of an article by Steve Ratcliff, DDS, Resident Faculty at the Pankey Institute.


Most commonly, oral odors are created by food or periodontal disease. Other causes can be sinus infections, chronic gastroesophogeal reflux, anorexia, bulimia, and diabetes. Smoking and alcohol cause odors as well.


Foods such as garlic and onion contain large molecules that are responsible for their odor. These large molecules must be excreted fully before the odor is gone. Unfortunately, they are removed from your body by way of your lungs. This can take as long as 24 hours before the odor is gone. Regardless of how carefully and thoroughly you brush, floss and use mouthwash, the odor does not go away; it is only masked. It will return until all the molecules are expended through your lungs.


Sinus infections are characterized by pain, fullness in the sinus area, and a thick mucous like discharge. A bacterial infection can cause a foul odor. Once the infection is treated, the odor will go away.


Diabetics often have a breath odor that is caused by ketoacidosis, a condition that occurs when their sugar/insulin balance is out of control. This odor has been characterized as smelling like acetone.


Chronic gastric conditions and bulimia can lead to changes in the body chemistry that create a sour breath odor that also can be chronic.


Physicians treat all of the above systemic conditions. Dentists can help you determine what might be contributing to breath odors and even help you find the appropriate physician to treat the underlying systemic causes.


Odors caused by poor oral hygiene and periodontal diseases are the easiest to treat. Frequently, they can be treated simply by changing the way you care for your teeth and mouth. If periodontal disease is the cause, the disease must be treated but when the disease is under control, the odor goes away.


Mouthwashes only mask odors for a short period of time. If you have a persistent odor, consult with your dentist to explore the possible causes.




 Snoring and Sleep Apnea


The following information is part of an article by  W. Keith Thornton, Associate Faculty at the Pankey Institute.


Recent articles and advertisements in professional and lay literature promote the use of oral devices as a treatment for snoring and obstructive sleep apnea. In response to patient needs, dentists have expanded their practices to treat sleep disordered breathing. In order to best treat the patient and achieve maximum success, it is imperative for both the dentist and the patient to have a firm understanding of the disorder being treated.


The Pankey Institute is the premiere institute in the field of sleep disordered breathing and oral appliances. Dentists trained at the institute are knowledgeable of the medical implications of oral appliance therapy and have a knowledge of the diagnosis and treatment of the condition. They have been taught how to work with the medical community and to achieve the best results for their patients.



Snoring and sleep apnea represent opposite ends of a continuum that describes sleep disordered breathing. Although snoring is medically benign, it is perhaps the best fire alarm for a more severe medical condition, obstructive sleep apnea. Both result from the inappropriate collapse of soft tissue and the tongue into the pharynx during sleep.


Snoring occurs when a partial collapse in the throat causes vibration of the soft tissue on inspiration and sometimes on expiration. Typically, the jaw has rotated back and open, allowing air to be inspired both through the nose and the mouth. Snoring usually begins as a mild noise occurring occasionally. As the condition worsens, usually with age and weight gain, it becomes continuous, loud and obtrusive indicating a greater collapse of the throat. If the inspiratory effort interrupts the patient’s sleep, the condition is known as Upper Airway Resistance Syndrome (UARS). As the opening continues to decrease to the point of total blockage, causing a cessation of airflow, Obstructive Sleep Apnea (OSA) occurs. Patients with obstructive sleep apnea are at a significantly increased risk for:

  • Hypertension - Stroke - Myocardial infarction

  • Automobile accidents

  • Impotence

  • Weight gain

  • Diabetes

  • Atherosclerosis

Unfortunately, most patients and/or their bed partners complain only of the snoring because they are minimally aware of the other signs and symptoms of sleep disordered breathing.




Treatments for snoring and obstructive sleep apnea fall into one of three areas: surgical correction, Continuous Positive Airway Pressure known as CPAP, and oral appliance therapy. All three try to establish and maintain an open airway.

  • Soft tissue surgery removes some of the soft tissue of the upper airway. This therapy, with a high morbidity, yields highly inconsistent success rates for both snoring and obstructive sleep apnea.

  • Orthognathic surgery moves the maxilla and mandible forward to open the airway. This surgery must be done in conjunction with soft tissue surgery to be effective.

  • CPAP effectively eliminates obstructive sleep apnea in a sleep lab. At home, however, only 2% of the patients will wear a mask attached to a machine for snoring or UARS. Only approximately 25% of the patients diagnosed with OSA wear CPAP consistently, and then only 50% of the time.

  • Oral appliance therapy shows the greatest promise for effectively treating the broad range of sleep disordered breathing. Additionally, it is non-invasive, inexpensive, reversible, and is overwhelmingly preferred by patients. Several appliances have been clinically shown to be able to treat severe OSA.



 Dry Mouth


The source of the following information is the Academy of General Dentistry.


What causes dry mouth?


Dry mouth is caused by a decrease in the amount of salvia in the mouth when the salivary glands do not work properly. The salivary glands help keep your mouth moist, which helps prevent decay and other oral health problems.


Dry mouth may be a sign of a serious health condition or may occur when a person is upset or experiences stress. It also can be caused by aging, radiation therapy and chemotherapy, medications, or diseases such as AIDS, diabetes or Sjogren's Syndrome. Even patients with Alzheimer's disease or who suffer a stroke may experience dry mouth.


Studies show that up to 400 medications, prescriptions and over-the-counter, can contribute to symptoms associated with drymouth. The most common troublemakers are anti-hypertensives, anti-depressants, painkillers, tranquilizers, diuretics, and antihistamines.


Is dry mouth a problem?


Yes, it can cause health problems. You want to prevent dry mouth if possible because it causes difficulty in tasting, chewing or swallowing. It also allows plaque to build up on your teeth faster, leading to a higher risk of cavities. In certain cases, a lack of moisture can make your tongue become very sensitive, causing a condition called burning tongue syndrome.


Why is saliva important?


Saliva helps wash away cavity-causing bacteria, provides enzymes to help digest food, protects teeth from decay and keeps oral tissues healthy. Without saliva, you would lose your teeth much faster.


What is Sjogren's Syndrome?


Sjogren's Syndrome is an autoimmune disease that causes the body to attack its own moisture producing glands. Approximately 2-4 million Americans have this condition. The majority of sufferers are women in their late 40s.


Sjogren's Syndrome is difficult to diagnose because symptoms vary greatly. Patients may experience dryness in the eyes and mouth or fatigue and joint pain, and it also mimics the natural signs of aging.


How can my dentist help?


Your dentist will want to know if you have difficulty swallowing, difficulty with speech, oral soreness or a dry throat. Help your dentist to diagnose the problem by recognizing the symptoms associated with dry mouth. If you have any questions about this condition, ask your dentist.


There are many treatments that can help ease the symptoms, including over-the-counter saliva substitutes. To ease discomfort, your dentist may recommend the following:

  • Brush and floss twice-a-day

  • Chew sugarless gum

  • Avoid alcohol and caffeine

  • Avoid smoking

  • Avoid citrus juices (tomato, orange, grapefruit)

  • Avoid dry foods, such as toast or crackers

  • Avoid overly salty foods

  • Drink plenty of water

  • Use over-the-counter moisture replacement therapies

  • Regular dentist visits





The source of the following information is the Academy of General Dentistry.


What is bruxism?


Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late because so many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in three people suffer from bruxism, which can easily be treated by a dentist.


Can bruxism cause harm?


People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive. They experience jaw pain, tense muscles and headaches along with excessive wear on their teeth. Forceful biting when not eating may cause the jaw to move out of proper balance.


What are the signs?


When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ)-the jaw-which may manifest itself as popping and clicking. Women have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching.


Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism.


What can be done about it?


During regular dental visits, the dentist automatically checks for physical signs of bruxism. If the dentist or patient notices signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy.


The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that's worn to absorb the force of biting. This appliance can prevent future damage to the teeth and helps change the patient's destructive behavior


Biofeedback is used to treat daytime clenchers by using electronic instruments to measure muscle activity and to teach patients how to reduce muscle activity when the biting force becomes too great. Researchers are looking for other ways of treating bruxism, especially for those who tend to clench in their sleep. One researcher developed an experimental lip simulator that electrically stimulates the lip when a person bites down too hard while sleeping. However, that method is being refined because the stimulation can wake sleepers several times in a night.






A balanced and nutritious diet is good for your general health and your dental health. Without the right nutrients, your teeth and gums can become more susceptible to decay and gum disease.


Sugar is one of the main causes of dental problems. The average Canadian eats the equivalent of 40 kg of sugar each year. Here are a few ways to cut down:

  • Try to choose sugar-free snacks.

  • Add less sugar to coffee or tea (or use sugar substitutes). Avoid sugar-sweetened soft drinks. Look for fruit juices and drinks with no added sugar.

  • Read lists of ingredients when you're grocery shopping: honey, molasses, liquid invert sugar, glucose, and fructose are all types of sugar.

When you do eat sweets, there are three ways to avoid harming your teeth:

  • Avoid sticky sweets - they cling to teeth and are harder to brush away.

  • Eat sweets with a meal, not as a snack. The increased flow of saliva during a meal helps to wash away and dilute sugar.

  • Carry a travel-size toothbrush and use it after eating sweets. If you can't brush, at least rinse your mouth with water or eat a fibrous fruit (like an apple) or raw vegetables. Or chew a piece of sugarless gum.

Some great-tasting snacks that won't harm your teeth: plain milk and buttermilk, fruit, raw vegetables, nuts, plain yogourt, hard boiled or devilled eggs, sunflower or pumpkin seeds, cheese and cottage cheese, melba toast, juice, salads.




 The Check-Up


How often should you see your dentist?


It depends. Everyone is different. But as a general rule, regular dental checkups every six months are the best way to make sure your gums and teeth stay healthy. The six month check-up allows your dentist to diagnose any problems, and to take preventive action to stop problems before they develop.


Do I need a dental check-up?


Yes. Everyone needs regular dental checkups. The reason is simple, you can't easily examine the inside of your own mouth. Your dentist is trained to detect potential problems and provide appropriate treatment. Even if you brush and floss daily, your teeth and gums still need regular care from a dental professional.


What's involved in a dental check-up?


A check-up can include some or all of the following procedures:

  • Screening: Your dentist looks for anything unusual and catches small problems before they become big ones (e.g. early signs of gum disease, eroded fillings, infections, oral cancer).

  • Treatment: Your dentist may be able to fix a small problem right away.

  • Cleaning: Your dentist or hygienist removes tartar build-up from your teeth.

  • Advice: Your dentist can give advice and answer your questions based on the results of your check-up.



 Smoking and Tobacco


What would it take to make you quit?


What if you looked in the mirror one morning and looking back at you was a face that looked ten years older than it should? What if you looked inside your mouth and saw strange white or dark red patches that didn't seem to go away? What if you knew that those strange looking patches could turn into cancer?


All of those things could happen to you. If you smoke or use tobacco, there's a good chance you already have one of more of the side effects we've described. And that's just from the neck up!


Talk to your dentist


Start out by having your dentist check your mouth to see what damage your smoking may have caused and whether any immediate treatment is necessary. He or she may screen you for oral cancer and periodontal disease. By visiting your dentist, you've started to put together a stop smoking team. Ask your doctor to join the team as well. New treatments and tools are available that can make quitting easier. It's important for your team to have a game plan. Avoiding other sources of stress and getting enough rest are building blocks of your strategy. Talk about what other steps will work for you. Family and friends can also be important team members and fans.




 Quitting Tobacco


Here is what the Canadian Cancer Society recommends.

  • Set a quit date in the near future. Select a time far enough in the future to allow for mental preparation, but not so distant that it will result in procrastination. Try choosing a memorable day such as a birthday. Quit when life stressors are the lowest.

  • Avoid places and situations that will put you in contact with others who smoke.

  • Attend a quit smoking program in your community. Contact your local health department, Canadian Cancer Society or Lung Association for information on programs available in your community.

  • Investigate and use all resources you have available such as books, videos, pamphlets, self-help booklets or brochures.

  • Encourage your spouse, friends, co-workers, relatives and neighbours to support your efforts in quitting. Having a support system that you can turn to for advice or help will greatly improve your chances of quitting successfully.

  • Reward yourself for reaching small goals. For example, go out for a nice meal with your spouse or friend to celebrate one week smoke-free.

  • Anticipate triggers to smoking and prepare strategies on how to avoid them.

  • Chew sugarless gum. Drink water when cravings hit. Change your diet to include more fruits and vegetables. Incorporate an exercise routine into your day. Keep your hands busy by doodling.

  • Speak to your physician, dentist or pharmacist about using the nicotine patch or gum. You may also want to speak to them about prescription medication that can assist you in quitting.

A referral to a physician for a prescription may be required. For more information about tobacco cessation visit the Canadian Cancer Society’s website at www.cancer.ca/english/RD_Tobacco.asp or call their Information Service at (888)939-3333.




 Warning Signs


Warning Sign The Problem
Bad breath that doesn't go away The cause might be gum disease, food, drinking, smoking, medicine you are taking or a health condition. If you cannot get rid of bad breath with daily brushing and flossing, see your dentist.
Your gums bleed when you brush or floss If you just started to floss, a little bleeding is normal. But if you bleed almost every time you brush or floss your teeth, see your dentist.
Dry Mouth The Change of Life (or menopause) may be the reason for this. It is also a side effect of many common medicines. It does not feel good and it can make dental problems worse. You need to tell your dentist if you have this problem.
A tooth that is a little bit loose This could be caused by gum disease or by a blow to the mouth. In any case, it is a serious problem. You should see your dentist.
A sore mouth This might be caused by false teeth that don't fit well. It could also be from leaving false teeth in overnight. "Burning mouth syndrome" is a problem that affects some older women. Not eating the right kind of food may also be the cause.
Bleeding that you can't explain

Mouth sores that don't heal in 7 to 10 days

White or red patches in your mouth
These may be signs of oral cancer. See your dentist right away.
Teeth that are sensitive to hot, cold, sweetness and pressure Teeth can become sensitive all of a sudden, or it can happen over time. In most cases, this kind of pain means something is wrong. Check with your dentist.




 Mouth Rinses


The source of the following information is the Academy of General Dentistry.


What are the differences in mouth rinses?


Rinses are generally classified by the U.S. Food and Drug Administration (FDA) as either cosmetic or therapeutic, or a combination of the two. Cosmetic rinses are commercial over-the-counter (OTC) products that help remove oral debris before or after brushing, temporarily suppress bad breath, diminish bacteria in the mouth and refresh the mouth with a pleasant taste. Therapeutic rinses have the benefits of their cosmetic counterparts, but also contain an added active ingredient that helps protect against some oral diseases. Therapeutic rinses are regulated by the FDA and are voluntarily approved by the American Dental Association (ADA). Therapeutic rinses also can be categorized into types according to use: antiplaque/antigingivitis rinses and anticavity fluoride rinses.


Should I use a rinse?


That depends upon your needs. Most rinses are, at the very least, effective oral antiseptics that freshen the mouth and curb bad breath for up to three hours. Their success in preventing tooth decay, gingivitis (inflammation of the gingival gum tissue) and periodontal disease is limited, however. Rinses are not considered substitutes for regular dental examinations and proper home care. Dentists consider a regimen of brushing with a fluoride toothpaste followed by flossing, along with routine trips to the dentist, sufficient in fighting tooth decay and periodontal disease.


Which type should I use?


Again, that depends upon your needs. While further testing is needed, initial studies have shown that most over-the-counter antiplaque rinses and antiseptics aren't much more effective against plaque and periodontal disease than rinsing with plain water. Most dentists are skeptical about the value of these antiplaque products, and studies point to only a 20 to 25 percent effectiveness, at best, in reducing the plaque that causes gingivitis.


Many dentists consider the use of fluoride toothpaste alone to be more than adequate protection against cavities. Dentists will prescribe certain rinses for patients with more severe oral problems such as caries, periodontal disease, gum inflammation and xerostomia (dry mouth). Patients who've recently undergone periodontal surgery are often prescribed these types of rinses. Likewise, many therapeutic rinses are strongly recommended for those who can't brush due to physical impairments or medical reasons.


What is the best mouthrinse?


Anticavity rinses with fluoride have been clinically proven to fight up to 50% more of the bacteria that cause cavities. However, initial studies have shown that most over-the-counter antiplaque rinses and antiseptics are not much more effective against plaque and gum disease than rinsing with water. Most rinses are effective in curbing bad breath and freshening the mouth for up to three hours.


When and how often should I rinse?


If it's an anticavity rinse, dentists suggest the following steps, practiced after every meal: brush, floss, then rinse. Teeth should be as clean as possible before applying an anticavity rinse to reap the full preventive benefits of the liquid fluoride. The same steps can be followed for antiplaque rinses, although Plax brand recommends rinsing before brushing to loosen more plaque and debris, a measure which has not been clinically proven to be effective. If ever in doubt, consult your dentist or follow the instructions on the bottle or container. Be sure to heed all precautions listed.


What is the proper way to rinse?


First, take the proper amount of liquid as specified on the container or as instructed by your dentist into your mouth. Next, with the lips closed and the teeth kept slightly apart, swish the liquid around with as much force as possible using the tongue, lips, and sucking action of the cheeks. Be sure to swish the front and sides of the mouth equally. Many rinses suggest swishing for 30 seconds. Finally, rinse the liquid from your mouth thoroughly.


Are there any side effects to rinsing?


Yes, and they vary depending on the type of rinse. Habitual use of antiseptic mouthwashes containing high levels of alcohol (ranging from 18 to 26 percent) may produce a burning sensation in the cheeks, teeth and gums. Many prescribed rinses with more concentrated formulas can lead to ulcers, sodium retention, root sensitivity, stains, soreness, numbness, changes in taste sensation and painful mucosal erosions. Most anticavity rinses contain sodium fluoride, which if taken excessively or swallowed, can lead over time to fluoride toxicity. Because children tend to accidentally swallow mouthwash, they should only use rinses under adult supervision. If you experience any irritating or adverse reactions to a mouth rinse, discontinue its use immediately and consult your dentist.






The source of the following information is the Academy of General Dentistry.


How do I choose and use a toothbrush?


Angled heads, raised bristles, oscillating tufts and handles that change colors with use: you name it, toothbrushes come in all shapes, colors and sizes, promising to perform better than the rest. But no body of scientific evidence exists yet to show that any one type of toothbrush design is better at removing plaque than another. The only thing that matters is that you brush your teeth. Many just don't brush long enough. Most people brush less than a minute, but to effectively reach all areas and scrub off cavity-causing bacteria, it is recommended to brush for two to three minutes.


Which toothbrush is best?


In general, a toothbrush head should be small (1" by 1/2") for easy access to all areas of the mouth, teeth and gums. It should have a long, wide handle for a firm grasp. It should have soft nylon bristles with rounded ends so you won't hurt your gums.


When should I change my toothbrush? Be sure to change your toothbrush, or toothbrush head (if you're using an electric toothbrush) before the bristles become splayed and frayed. Not only are old toothbrushes ineffective, but they may harbor harmful bacteria that can cause infection such as gingivitis and periodontitis. Toothbrushes should be changed every three to four months. Sick people should change their toothbrush at the beginning of an illness and after they feel better.


How do I brush?


Place the toothbrush beside your teeth at a 45-degree angle and rub back-and-forth gently. Brush outside the teeth, inside the tooth, your tongue, and especially brush on chewing surfaces and between teeth. Be sure to brush at least twice a day, especially after meals.


How long should I brush my teeth?


You should brush your teeth at least 2-3 minutes twice a day. Brush your teeth for the length of a song on the radio, the right amount of time to get the best results from brushing. Unfortunately, most Americans only brush for 45-70 seconds twice a day.


Electric vs. manual toothbrushes


Electric toothbrushes don't work that much better than manual toothbrushes, but they do motivate some reluctant brushers to clean their teeth more often. The whizzing sounds of an electric toothbrush and the tingle of the rotary tufts swirling across teeth and gums often captivates people who own electric toothbrushes. They are advantageous because they can cover more area faster. Electric toothbrushes are recommended for people who have limited manual dexterity, such as a disabled or elderly person and those who wear braces. Sometimes, it takes more time and effort to use an electric toothbrush because batteries must be recharged, and it must be cleaned after every use. Most electric toothbrushes have rechargeable batteries that take 10 to 45 minutes to recharge. The gearing in an electric toothbrush occasionally must be lubricated with water. Prices range from $30 to $99.


How do electrics work?


Electric toothbrushes generally work by using tufts of nylon bristles to stimulate gums and clean teeth in an oscillating or rotary motion. Some tufts are arranged in a circular pattern, while others have the traditional shape of several bristles lined up on a row. When first using an electric toothbrush, expect some bleeding from your gums. The bleeding will stop when you learn to control the brush and your gums become healthier. Children under 10 should be supervised when using an electric toothbrush. Avoid mashing the tufts against your teeth in an effort to clean them. Use light force and slow movements, and allow the electric bristle action to do its job.


How long have toothbrushes been used?


The first toothbrush was invented in China in 1000 A.D. It was an ivory-handled toothbrush with bristles made from a horse's mane. Toothbrushes became popular in the 19th century among the Victorian affluent. Mass marketing and the advent of nylon bristles in the 20th century made toothbrushes inexpensive and available to everyone.


Don't forget . . . Visit your dentist regularly because toothbrushing and flossing is most effective with periodic checkups and cleanings.





The source of the following information is the Academy of General Dentistry.


Why is brushing with toothpaste important?


Brushing with toothpaste (also called a "dentifrice") is important for several reasons. First and foremost, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes caries, gum disease, and eventual tooth loss if not controlled. Second, the toothpaste contains fluoride, which makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage can even be seen. Third, special ingredients in the dentifrice help to clean and polish the teeth and remove stains over time. Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.


What type of toothpaste should I use?


As long as your toothpaste contains fluoride, the brand you buy really does not matter, whether or not it is in paste, gel, or even powder form, or containing a certain flavor. All fluoride dentifrices work effectively to fight plaque and cavities and clean and polish tooth enamel. Your dentifrice brand should also bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.


If your teeth are hypersensitive to hot or cold, consider trying a toothpaste designed for sensitive teeth. Dentifrices containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth. Some prefer a tartar control toothpaste containing pyrophosphates to prevent the buildup of soft calculus deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.


How much should I use?


Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze on a pea-sized dab of paste on the top half of your brush. If you brush correctly, holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth. Children under six, however, should be given a very small, baby pea-sized dab of dentifrice on their brush.


Is brushing with toothpaste enough to fight cavities and gum disease? No. Although brushing thoroughly after each meal helps, flossing your teeth every day to remove plaque and food particles between teeth and at the gumline is just as important. Studies show that plaque will regrow on teeth that are completely clean within 3 to 4 hours of brushing.




 The Role of The Hygienist in Comprehensive Care


The following information is part of an article by Sheri Kay, RDH at the Pankey Institute.


Your dental hygienist can play a significant role in enabling you to obtain optimal oral health. However, in order to reach this goal, there are many questions that must first be addressed:

What are your core health values?

  • How can you discover what is possible in your own mouth?

  • How can you be empowered to take ownership of your dental health?

  • What barriers need to be worked through before you will choose to move forward?

  • What is your level of understanding regarding your current oral health?

One of the greatest gifts that can be offered is to help you search out and discover the answers to these questions. The hygienist provides an avenue by becoming a friend, a facilitator, and a partner in health. The best dentists work with hygienists who create a safe arena where you have the time needed to see the big picture and develop your own long-term goals.


Because the hygienist is one member of the team who will have regularly scheduled appointments with you, the relationship that grows holds a wealth of unique possibilities. Your hygienist can carve out the time necessary to earn mutual trust, to offer acceptance of where you are, both physically and emotionally, at any point in time. In short the talented hygienist will stay with you through your individual discovery process.


The hygienist becomes the liaison between "what is" and "what can be." As the resource for passing trust to specialists, understanding procedures, and clarifying treatment plans, the hygienist can support you in whatever ways you want to be supported.


As you walk through the doors of the dental office, you deserve the opportunity to understand what optimal oral health can mean for yourself. Your hygienist can be a key person in facilitating your personal success.