What is the best technique for brushing?

There are a number of effective brushing techniques. Patients are advised to check with their dentist or hygienist to determine which technique is best for them, since tooth position and gum condition may vary.

One effective, easy to remember technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth.

Place a toothbrush beside your teeth at a 45º angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside your teeth, your tongue and the chewing surfaces and in between teeth.

Using a back and forth motion causes the gum surface to recede, or can expose the root surface tender. You also risk wearing down the gum line.

Soft or hard bristles?

In general a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp. It should have soft, nylon bristles with round ends. Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.

How long should I brush?

It might be a good idea to brush with the radio on, since scientists generally recommend brushing 3-4 minutes, the length of an average song. Using an egg timer is another way to measure your brushing time. Patients generally think they're brushing for longer, but most spend less than a minute brushing.

To make sure you're doing a thorough job and not missing any spots, patients are advised to brush the full 3-4 minutes twice a day, instead of brushing quickly five or more times a day.

Should I brush at work?

Definitely, but most people don't brush during the workday. Yet a survey by the Oral-B Laboratories and the Academy of General Dentistry shows if you keep a toothbrush at work, the chances you will brush during the day increase by 65 percent. Dentists recommended keeping a toothbrush at work.

Getting the debris off teeth right away stops sugary snacks from turning to damaging acids, and catches starchy foods like potato chips before they turn to cavity causing sugar. If you brush with fluoride toothpaste in the morning and before you go to bed, you don't even need to use toothpaste at work. You can just brush and rinse before heading back to the desk. If you don't have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.

The following tips may improve your work-time brushing habits:

What is dental amalgam?

Dental amalgams or silver filings have reportedly been used as early as 659 A.D., France began using the materials in 1826 and the United States in 1833. Dental amalgam is made out of a mixture of metals such as silver, copper, tin combined with mercury. The mercury makes up between 45-50% of the mixture and acts as a glue that binds the components into a hard, stable, and safe substance that is manipulated and placed in the tooth. In fact, amalgam is the least costly, quickest way to restore teeth, and is used in approximately 50 percent of all dental cases.

Is dental amalgam safe?

Dental Amalgam has been used for more than 150 years and can last in a patient's mouth for more than 12 years. No double blind clinical studies have demonstrated that the mercury contained in dental amalgam is harmful. For example; studies show that the mercury found in a filling is less than a person's normal exposure to the mercury found in food, water and air. Therefore, dentists continue to place amalgams to preserve a tooth.

Amalgam has been claimed to cause some health problems such as dizziness, headaches, fatigue, nervousness and sometimes compromised general health. The only people. however. who have been found to have a true reaction to amalgam are those who are allergic to mercury, which is approximately 1% of the population. If you think you have a sensitivity to amalgam, ask your physician or dentist for a blood test.

How is my tooth prepared for a filling?

Once your doctor determines that you have tooth decay, it is important to remove it, the amalgam is mixed and placed onto the tooth. The final filling is then carved and adjusted to your bite. Once placed, it can take up to two weeks for your filling to harden completely. However, you may chew on the surface twenty four hours later. If you have any prolonged discomfort with the tooth, contact your dentist for an evaluation.

Should I get my amalgams replaced?

With all questions about amalgam, many people wonder where they should have their fillings replaced. Removal of fillings, however, can cause structural damage to your teeth and cause unnecessary expense. So unless you are allergic to amalgam, leave your teeth alone. It is necessary to replace amalgam fillings when they become loose, cracked or broken.

Are there other options to amalgams?

The decision in placing other restoration materials should be decided by you and your dentist depending on several factors, including aesthetic concerns, cost, tooth location, your wishes and time demands.

Other materials include gold, porcelain and composite resin, all of which can be more expensive. Composite resin and porcelain will allow your teeth to look more natural. These materials may take longer to set and may cost more than traditional amalgams.

What is gum disease? 

Gum diseases may progress to a chronic inflammation and infection of the gums and surrounding tissue and are major cause of about 70% of adult tooth loss, affecting three out of four persons at some point in their life.

What causes gum disease?

Bacterial plaque - a sticky, colourless film that constantly forms on the teeth - is recognised as the primary cause of gum disease. Specific periodontal diseases may be associated with specific bacterial types. If plaque isn't removed each day by brushing and flossing, it hardens into a rough porous substance called calculus (also known as tartar). Toxins (poisons) produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibres that hold the gums tightly to the teeth creating periodontal pockets which fill even more with toxins and bacteria. As the disease progresses, pockets deepen and the bacteria move down until the bone that holds the tooth in place is destroyed. The tooth will eventually fall out or require extraction.

Are there any other factors?

Yes. Genetics is also a factor, as are lifestyle choices A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control.

What are the warning signs of gum disease?

Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, pus between gum and tooth, persistent bad breath, change in the way teeth fit together when the patient bites, and a change in the fit of partial dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental examinations.

What does periodontal treatment involve?

In the early stages, most treatment involves scaling and root planning - removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics or antimicrobial may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums, and removing the hardened plaque build up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.

How do you prevent gum disease?

Removal of plaque through daily brushing, flossing and professional cleaning is the best way to minimise your risk. Your dentist can design a personalised programme of home oral care to meet your needs.

Is maintenance important?

Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of therapy. Patients should visit the dentist every 3-4 months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, patients should brush at least twice a day, floss daily, and brush their tongue. Manual soft nylon brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proximal brushes (small narrow brushes) are the best way to clean in between the recesses in the teeth, and should be used once a day. Wooden tooth picks and rubber tips should only be used if recommended by your dentist.

What is the role of the dentist?

The dentist usually detects gum disease and treats it in the early stages. Some dentists have acquired additional expertise to treat more advanced conditions of the disease. If the dentist believes that the gum disease requires treatment by a specialist, the patient will be referred to a periodontist. The dentist and periodontist work together to formulate a treatment plan for the patient.