So does it all “boil down” to just what your preference might be or is one type of toothbrush actually “better” than the other?

First let’s explore what is available.

Manual toothbrushes

As with many “everyday” products we use, toothbrushes go through annual model changes.  Toothbrush manufacturers stay busy developing the “latest” model that just might have the right feel in your hands, the right look and feel in your mouth.  One of the latest models from Oral B has a cantilevered head that is designed to absorb the extra pressure some “hard brushes” use, thus mitigating some of the damage to tooth structure caused by too much brushing pressure.  A pretty neat idea. 

There are three key elements involved in using a manual toothbrush that determine effectiveness.  By “effectiveness” I mean how much of the total plaque accumulation is removed from the surfaces of the teeth without tooth damage once you are finished brushing.

Key element #1 is time devoted to the process.  The “gold standard” is 2 minutes (if you have a full set of teeth).  So it should not be a “fast and furious” process where the idea is to just get done, but rather a slower deliberate process focused on doing a thorough job, in much the same way as I observe my wife applying make - up!

Key element number two is technique.  A circular or elliptical pattern of brushing has been shown conclusively to do a better job of removing plaque while at the same time avoiding tooth damage observed when the “back and forth sawing” type pattern is used.

Number three is the use of a “soft” bristled brush and for those “Type A” personalities even “extra soft”.

For the most part, the style or shape of the brush head turns out to be personal preference since observing the key elements above will assure effective plaque removal.

Power Toothbrushes

There are basically two types:

(a)    Battery Powered- These brushes typically have limited features and have a circular rotating head.  They use AA batteries and are quite inexpensive.  A battery powered brush can be very effective at removing plaque and is a good place to start if you are contemplating moving away from your manual brush.

(b)   Rechargeable Electric- These are the “gold standard” when it comes to current toothbrush technology.  They are available in different price ranges with different features.  The better ones use an oscillating-rotating kind of action such that all one needs to do is simply guide the brush head along the tooth surfaces for effective plaque removal.  Other interesting features include:

·         Numerous brushing modes specialized for sensitive teeth, whitening benefits or gum-massaging action

·         Pressure sensors to signal when you’re brushing too hard

·         Timers to help you keep track of how long you’re brushing each quadrant of your mouth

·         Digital reminders to replace your brush head

·         Oscillating-rotating or sonic technology

·         Multiple brush head compatibility so you can choose which kind of bristle design you prefer.

 

So, back to the question which is best- power or manual?

Well, independent studies have shown that rechargeable electric brushes remove plaque better than manual brushes.  However, a manual toothbrush, properly used and when the three key elements, referred to earlier, are observed will do an adequate job.

Well, Doc (you might ask). Which do you use?  A fair question.

I use both!  Not at the same time of course!  Right now I use an Oral B with the cantilevered head manual brush and Oral B Triumph 5000.

Ask us about toothbrushes anytime and we will kindly offer our advice.

---

 

Facial Esthetics- Botox and Juvederm - What’s it all about?

Facial Esthetics is a broad term that generally is understood to refer to products and procedures designed and/or developed to give one a more pleasing and “youthful” appearance.  Many over-the-counter (and some prescription) products were developed to tighten and smooth facial skin to help lessen the effect of natural collagen loss as we age and are exposed to environmental pollutants and ultraviolet rays.
“Face Lifts” and related surgical procedures also come under the broad definition of “Facial Esthetics” but our purpose here is to address basic non-surgical approaches to facial esthetics.

So, as the facial skin ages the natural collagen and hyaluronic acid in the skin diminishes resulting in volume loss and weakened structure leading to unwelcome lines and wrinkles like the “parentheses” lines around the nose and mouth.  Further, as the skin becomes less elastic, the repeated contraction of the facial muscles of expression leads to the deep furrows on the forehead and the deep wrinkles between the eyebrows which often look like the number “11”.

Botox has the effect of temporarily “relaxing” or “inactivating” the facial muscles that causes the overlying skin to “wrinkle”.  Hence the skin becomes smoother and causes one to appear more youthful which is why many people choose to use Botox instead of daily expensive “lotions and potions” which were developed to have a similar effect as Botox.

As a rule-of-thumb Botox is effective for treating “dynamic” wrinkles.  That is, wrinkles/creases that are caused by facial muscle contraction.  So, if you can cause a furrow or wrinkle by making a facial expression, then Botox can be used to prevent those furrows or wrinkles from occurring.  Jevederm (and other dermal fillers), on the other hand is effective at treating “static” wrinkles/creases such as the “parentheses” that are seen from the base of the nose to the corner of the upper lip.  Juvederm is used to “fill” in and bulk up those type wrinkles/creases that do not depend on muscle contraction, they form naturally over time as we lose elasticity and volume in our face.

So let’s recap how Botox & Juvederm may benefit you.  Botox is a quick, safe and FDA approved treatment to:

1. Reduce frown lines that develop on the forehead

2. Reduce frown lines at the bridge of the nose that sometimes form the number “11”

3. Reduce the “crow’s feet” at the outside corners of the eyes

4. Reduce the “smoker’s lines” often seen along the upper lid

Botox usually lasts from 4 to 6 months.  Juvederm is an FDA approved form of hyaluronic acid which is found naturally in the connective tissue just below the skin.  Juvederm is useful to “fill in” wrinkles/creases like the “parentheses” found typically going from the base of the nose to the corner of the upper lip.  This treatment usually lasts up to about 9 months.
Check out current rates/specials on our web site: www.smiledesigncenter.net

---

 

How’s your Headache?

November 15, 2011

America’s 29 million migraine headache sufferers spend dizzying sums of money purchasing medication to treat their pain. Most are unaware that there is a new alternative to prescription drugs. Dentists all over the country are recommending a treatment for migraine (and other types) headaches using a dental mouthpiece referred to as “NTItss”. “NTI-tss” is an acronym for Nociceptive Triqeminal Inhibition- Tension Suppression System. The “NTI-tss Plus” is an FDA approved dentist provided mouthpiece for the treatment of migraine type” headaches. In clinical trials reviewed by the FDA, 82% of medically diagnosed migraine su¬ffers using the NTI-tss had a 77% average reduction of migraine attacks within the first eight weeks of use.

The NTI-tss works by reducing jaw clenching during sleep. It fits over the central teeth on the bottom arch of the mouth and keeps the molars and canines from touching. Many patients unconsciously clench and grind their teeth, mostly at night. For some, clenching serves as a catalyst for migraine inducing strain on the muscles in the head, face, and neck. To demonstrate how the NTI-tss works, touch the muscles of the temples while biting down on a pencil with the back teeth. The temporal muscles will bulge and intensely contract. Now bite down on a pencil with only the front teeth. Those same temporal muscles remain relaxed. This diminished clenching intensity prevents a hyperactive nerve response, and thus, prevents migraines and other clenching stress type headaches.

Often an appliance (“Night Guard”) that covers all of the upper (or sometimes lower) teeth is prescribed for clinchers and grinders. This type appliance usually works well if bruxing (grinding) is occurring in the absence of clenching. However, if clenching is occurring with or without bruxing, then headache symptoms along with tired muscles usually occur. This is because a “full coverage” appliance provides a good surface to clench against. By separating the black teeth the NTI-tss prevents the hyperactive muscle activity which leads to headaches and tired jaw muscles.

We have been using the NTI appliance at The Smile Design Center for several years and have seen it help patients who prior to using it relied heavily on both over the counter and prescription drugs to help get through the day.

The NTI appliance was developed by a dentist, Dr. James Boyd, to treat him for chronic daily headaches and frequent migraines he had su¬ffered for 12 years. If chronic headaches have been plaguing you, you might be a candidate for an NTI appliance.

Visit www.Nti-tss.com for more detailed information than we have been able to provide in this article.

 

---

October 14, 2011  -  Bad breath… Uggh!

 

Well how many times have you finished a great burger (with onions of course) or had a slice or two of awesome tasting garlic bread, and been told by your mate, girlfriend, boyfriend etc. that your breath, well… was a bit offensive.

 

Known scientifically as “halitosis” or oral malodor, bad breath is one of the most elusive conditions for which there seems to be few easy solutions, but nonetheless hope.

 

The primary constituents of bad breath are chemicals called volatile sulfur compounds (VSC), primarily hydrogen sulfide and methyl merceaptan. VSC’s are the byproducts of both human and bacterial cellular breakdown occurring in the “furrows” of the tongue, areas in the back of the throat, in the sinus cavities, and underneath the gum tissue in the presence of gum disease

 

The Level of Volatile Sulfur compounds that may be present and Thurs constitute how bad “bad” breath will likely be is a function of all of some combination of the following:

 

 

• Diet – garlic, onions, curry, strong cheese, etc.
• Infections – sinus, throat, (tonsils), gum disease
• Lack of good oral hygiene – brushing, flossing
• Lack of saliva production – saliva production slows significantly at night during sleep and is caused by various medications
• Various medical conditions like diabetes, some lung and liver disorders.

 

So what does one do?

Well, the obvious answer is to decide which of the above might be the culprit(s). Begin “checking off” all that might apply to you.

We will, of course, provide you with all the help, needed regarding dentally related factors.

It is worth monitoring, that there are occasions when one believes they have bad breath and it is apparent only to that person. Naturally, this presents a whole new set of issues for which we do not have the space to cover at this time.

In closing to eliminate/control any dental factors that may be involved, it is very important to…

• Get timely check-ups
• Develop a thorough home care routine that would include, (a) brushing the tongue as far back as you can tolerate and perhaps experimenting with a tongue scrapper, and flossing between all teeth at bedtime – (flossing tip) Since all floss is not “created equal” sometimes it has a tendency to slide through the tooth-to-tooth contact and while it may be removing plaque it may not actually pick up small particles of food debris hiding around the fum. So I tie a knot and gently dray the floss through after I do the “up and down” movement to remove plaque and volia? Our comes more stuff that if left would definitely pose a “bad breath” problem.

---

 

Gum Recession occurs when the gum tissue that is "attached" to the tooth moves further away from the tooth, exposing more tooth causing the tooth to appear larger.

One can have a perfectly healthy mouth and still experience gum recession.

Some Causes of Gum Recession:

All of these either alone or in some combination can lead to gun recession.

So what's so bad about gum recession? To list a few:

• More likely to develop tooth sensitivity.
• More likely to develop decay in the area where recession occurs.
• Bone loss from around the tooth - hence more likely to lose teeth.
• Affects appearance.

Treatment Options:

Several treatment techniques are used to treat gum recession. One involves the removal of tissue from the roof of the patient's mouth and using that to cover the area of recession. This technique extends healing time since it involves two separate surgical sites.

The technique most preferred in our office is to use only one surgical site by releasing the tissue that is still attached around the tooth - place a special kind of "artificial" gum tissue underneath the patient's tissue, then pull the loosened tissue down around the tooth and suture it down to cover the tooth.

Insurance?

Most dental insurance policies offer coverage for treating gum recession.

If you have noticed that you have developed gun recession, we will be happy to discuss the best approach to treating your particular

---

situation.

---

---

Refer a Friend or Family Member:

We appreciate so very much all of you who refer your family, co-workers, and friends to us for their dental care. This is the single best compliment we could ever receive from our great patients!

---

August 9, 2011 - Infection

Infection - Most infections we see in the office are either the result of tooth decay or gum disease and sometimes a combination of both. An interesting observation is that (unlike most infections we experience) antibiotics are usually ineffective as far as curing the dental infections.

The reason for this is that infections in the gums and teeth are generally chronic; that is there is a continuous "supply" of (bad) bacteria coming from inside the tooth or from plaque and tartar around the gums.

The solution for these infections must involve removing the plaque and tartar and/or removing the supply of bacteria inside the tooth (e.g. root canal, treatment) or removing the tooth. Additionally, numerous studies have shown that gum and tooth infections cause already existing heart problems as well as diabetes to become worse.

So the moral of this story is to avoid those unhealthy infections that lead to pain and tooth loss. And, of course, one avoids such calamities by getting those regular check-ups at your friendly Smile Design Center!

If you haven't had your "on time" check up please give us a call today. Also please refer a friend/family member. We appreciate so very much all of you who refer your family, co-workers, and friends to us for their dental care. This is the single best compliment we could ever receive from our great patients!