Brushing the Effective Way

By Aishwarya Jayadeep

During my fourth year of dentistry, while in the preventive dentistry class, my professor asked the class how many times a day does each of us brush our teeth.  It was almost a tie between those who brushed twice a day and those who did it only once. Her subsequent questions about the reason of why we were brushing once or twice a day and what time of the day  were we brushing were all eye openers for a discussion on the right frequency of brushing and the best times of the day to do it. Even being dental students, most of us had not thought about these things much - so you can imagine how it would be with most people.
So for today's post I thought of discussing about the brushing techniques, timing and the frequency of brushing that would help keep that smile on your face longer.

What is the right brushing technique?
There are different methods of brushing teeth. But the key to an effective brushing is cleaning every exposed tooth surface in a gentle, massaging motion. If you are squashing the bristles, you're brushing too hard.
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 45-degree angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside the 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 or make the root surface tender. You also risk wearing down the gum line.

How long do you take to brush your teeth?
Most people think they brush for at least a minute or two, but in reality they brush for 30 seconds or less.Time yourself and see how you do. An effective brushing takes 2 - 3 minutes.Using the technique I have described above brush your entire mouth and see how long it takes. That is the average time you will need.

How many times should I brush my teeth?
Brushing twice each day is what the experts recommend. Although there is research indicating that brushing once a day is sufficient to disrupt the formation of plaque that feeds the bacteria that cause decay, this may not be enough for some people, depending on factors such as their diets and the efficacy of their brushing technique.
So now many of you would be thinking when to brush if you are going to brush only once. If you can only brush once then the best time to brush would be before going to bed,because while we sleep our salivary flow is low hence there would be a higher susceptibility to cavities and plaque. So for your health reasons burshing in the night is a must and brushing in the morning is suggested if you want to keep your near and dear one's close to you :-)

Caring for your Child's Teeth

By Aishwarya Jayadeep

Many believe that caring  for a child's teeth isn't as important as caring for secondary or permanent teeth. As they think that milk teeth or primary teeth are going to be replaced by nature with another set of teeth soon.If that's what you  thimk that's one big mistake on our part as parents. I believe that Milk teeth or primary teeth is that set of teeth kids get to practice on how to take care of  permanent teeth . That way, when the time comes for them to take care of  their permanent teeth they are well practiced in tooth care. Thus, they won't make any mistakes and can  have  them life long .
Ways to care for your babies teeth
1. Clean your infant's gums with a clean damp cloth.
2. As soon as the first teeth come in, begin brushing them with a small soft-bristled toothbrush and a pea-sized dab of fluoride toothpaste.
3. To avoid baby bottle tooth decay and teeth misalignment due to sucking, try to wean your child off of the bottle by one year of age and monitor excessive sucking of pacifiers, fingers and thumbs.  Never give your child a bottle of milk, juice or sweetened liquid as a pacifier at nap-time or bedtime.
4. Help a young child brush at night- the most important time to brush due to lower salivary flow and higher susceptibility to cavities and plaque.  What I advice is to let the child brush by themselves in the mornings to build self-confidence. This is so, as in the mornings there won't be any food debris or plaque to remove as the child was given a brushing by the parent in the night.  Usually by age five or so, the child can learn to brush his or her own teeth with proper parental guidance.
5.I also have found dental floss with holders very helpful in flossing a  child's little teeth with your big hands.
6.  Finally, the best way to teach a child how to brush is to lead by good example. Allowing your child to watch you brush your teeth teaches the importance of good oral hygiene. Yet another reason for you to brush twice a day.

Selecting Toothbrushes

Cartoon by Aishwarya Jayadeep

Selecting a tooth brush is something that should be done with utmost care. Or else, a tooth brush that's supposed to help you retain that pretty smile of yours would do you more harm than you can imagine. My mom and my mother in law are the two people I have seen who take a serious interest in the maintenance of their pearly whites, but sadly their ignorance of this crucial aspect led to the deterioration of their gum's health. Both these ladies used to vouch on their hard-bristle tooth brushes for doing a better cleaning job than any other. What they ended up with are receded gums and tooth sensitivity because of exposed dentin. To make it more clear how it happens, please look at the figure. Usually, the exposed part (Crown) of the tooth is protected with enamel. But this protection is not there from the point the gum starts. So what happens when one uses hard-bristled toothbrush is that it pushes the gum back, thus exposing that part of the sensitive dentin. This would make it painful if you were to take hot or cold liquids. But more than the pain, once the dentin part is exposed, if you continue using the hard-bristled brushes, the brushing would erode the dentin itself (as these are not as resistant to abrasion as the enamel is). What this means is that you could even end up having fresh cavities.

Now the question is how to select a toothbrush that is best suited for you.
Tooth brushes have different bristle firmness ratings – soft, medium, and hard. This tells you how firm the bristles are and how much pressure they put on your teeth and gums when you brush. This can be very confusing when you select a toothbrush. Most people, like my mom and MIL , select toothbrushes with firmer bristles, believing they’ll do a better job of cleaning their pearly whites. Then these zealots would brush their teeth vigorously to clean it to a fault. As I mentioned earlier all of that brushing causes gum irritation and aggravates sensitive teeth. or even ends up making new cavities in some cases. So to select the right toothbrush that does the right work without causing more harm make sure that:

1. Any toothbrush you choose have soft bristles. Soft toothbrush gets the job done without gum irritation or contributing to receding gums.
2. Select a toothbrush head size that can easily fit into the mouth and can brush one to two teeth at a time (the general size is 1" long and ½" wide) with end-rounded bristles
3. Powered toothbrushes are better choices than manual toothbrushes for anyone who needs assistance brushing teeth, including seniors, people with arthritis (or any condition that may limit mobility), anyone wearing braces or people with misaligned or uneven teeth surfaces that make a thorough cleaning more challenging. These would be a good choice for kids who has teeth that are a mix of baby teeth and adult teeth.

Now the next question is when to replace your tooth brush.

1. Replace your toothbrush as soon as the bristles begin to look worn or frayed (usually every three months). A worn toothbrush does not do a good job of cleaning your teeth. 
2. Remember always to replace your toothbrush after an illness. Otherwise, your brush will be retaining the germs that caused the illness and you may fall sick again.

For children, most of the above holds good. And specifically select a brush that has:

1. Soft bristles (for gentle cleaning)
2. Very small heads (designed for baby teeth)
3. Large handles (easier for children to grip)

And from my experience, when the child is having mixed teeth (some adult and some baby teeth), a powered toothbrush with soft bristles, specially for kids would work best.


Keep Smiling!

Baby's First Dental Visit

Cartoon by Aishwarya Jayadeep

Let me take you people a few years back to when my little girl was a baby.  Aishwarya,my bundle of joy and apple of my eyes, had her first teeth at the age of around 6 months. They were small milky white; and to me, her mother, the prettiest little teeth. Before I go on with my story I want to let you people on some facts. Babies can have their little chompers as early as 3 months or as late as 14 months, depending on their genes and depending on weather or not the baby was a preemie (preemies tend to teeth late). In short, what I am trying to convey is that there could be differences between one baby and another with regard to their teething patterns.
Now, back to where I started. Soon Aishwarya had a full set of teeth and she was flashing her pearly whites and making all of us dance to her tunes. I didn't feel it was that important to take her to the dentist  for a check up (I had stopped practicing  dentistry by then). I always thought her teeth were safe with me being there and that she was not losing anything by not having her formal dental checkup. How wrong I was!
When she turned 4 her dad Jai had to take up a position in the US. So Aishwarya and I had to stay for about 4 months at my parents and inlaws before we joined him. During that time Aishwarya was eating her share of chocolates and chips as if there is no tomorrow, mostly without me knowing. She had her grandparents around her little pinky and used to play her cards so well that they danced to her tunes. During that same time I myself was not keeping that well. So I trusted Aishwarya, who I now considered to be a big girl, to brush by herself. My! My! That was the second mistake. In short, by the time we both landed in the US, Aishwarya had her first cavity. We took her to a pedodontist(Dentist specializing on kid's teeth). Aishwarya being a shy kid didn't even open her mouth,so the dentist suggested oral sedation. I being a mom who wanted only the very best for my baby didn't want to try this on my baby when I looked into the possible side-effects of the sedation. I tried consulting two other dentists who were just after my money only. That is a story for another day. In the end I consented for the oral sedation and got Aishwarya's tooth filled without much ado. Only then I realized that had I taken Aishwarya to a dentist before, she would have been more comfortable with the dental office experience and wouldn't have needed the oral sedation. With this experience behind me, here I am stressing the importance of early dental check-up for kids, not just as a dentist, but as a mom as well.

Now questions would be when should the child first see a dentist; how to find a good dentist; what you can do to make it an easy experience and how often you need to take the child to the dentist.

The ideal time is six months after the first tooth erupts or approximately at one year of age. This is an ideal time for the dentist to carefully examine the development of your child's mouth.
Even though many general dentists do take-up children as patients, my suggestion would be to find a Pedodontist ( one who is trained and is specialized in treating kids). They would know how to deal with kids better and would be more knowledgeable about issues specific to kids.
Try to schedule a morning appointment when the child is in a good mood. Don't ever portray the dental office as a bad place to be and always give them an idea about what to expect there.Bring with you to the appointment any records of your child's complete medical history. Ideally ,children, like adults should see the dentist every six months.
Hope this will retain a lasting smile on your babies teeth.

Dental Visits: How Important?

Cartoon by resident artist Aishwarya Jayadeep

I myself is a person who has a white apron phobia, and is still struggling to overcome this. So this post is for people like me who always want to reschedule or avoid a dentist's or doctor's visit as much as possible. The three main reasons that I feel prevents a person from visiting a dentist's office are:

1. Past bad experience
2. Ignorance
3. Cost

Past bad experience:

One reason may be that you had a bad experience with one particular dentist and now is scared of all of the class. I am in this category. It does happen sometimes to those of us who are unlucky. Growing up, didn't we all had some good teachers and some really bad ones? But did we quit school because of one bad teacher. (Well, if you are one of such a rare breed, I am sure, by now you would know the consequences). So let us not take this as an excuse. Let us move forward and find that perfect dentist; and schedule that long overdue visit immediately.

If you are still in doubt, remember this: DENTAL PROBLEMS DO NOT GET BETTER OR JUST GO AWAY -  if only a toothache would take you to a dentist, then it is already too late, and it would probably take a root canal treatment or crown - which means more visits. As the saying goes: " A stitch in time saves nine"

Ignorance:

The other day I was talking to a friend of mine. She was ranting about her recent visit to the dentist. As we talked more and more, I realized that her last dental visit had been 5 years ago, and when she made it to the dentist's yesterday, her so called "greedy" dentist suggested 6 fillings, 1 root canal treatment and a crown to follow! According to her, all these years she was perfectly fine without seeing a dentist. So feels that she would be fine without making any more scheduled visits.

I had to have a long talk to convince her that the cavities were probably not felt previously as those were not deep enough, but as a matter of fact, they might have been there all along. And if not treated now, would do her more harm in the long run. This wouldn't have happened if she had kept up her bi-annual check-up.

Cost:

Many of us including me had seen stars on receiving a treatment plan for a dental work, because of the  high costs involved. This again is something that could have been avoided with regular check-ups. If the cavity was detected early enough, you would have needed only a filling; but gone undetected it would need a root canal treatment and a crown - almost 10 to 15 times the cost. 

Your teeth are made to last you a lifetime. It is up to you to help them stay healthy and strong.  For miles of smiles, I have 3 secrets to share with you:

1. Brush twice a day
2. Floss daily
3. Routine dental check-ups

I hope I convinced you to schedule that long overdue visit; I am off to schedule mine.

Ciao! Keep smiling till we meet again!