J. Peter St. Clair, DMD Blog

Research shows that babies are born without any harmful bacteria in their mouths. However, once bacteria colonize in the mouth, children are more prone to cavities in their baby teeth and permanent teeth. How do they get the bacteria? Caregivers.

Most parents don’t know that they can pass harmful bacteria from their mouth to their baby’s mouth. The most critical time is during the child’s first 2 ½ years of life. Most children are born without a single tooth. Can bacteria passed to children without teeth affect their decay potential for their whole life? According to research the answer is yes.

Here’s a shocker…..If you have a history of poor oral health, including many fillings in your mouth, you are much more likely to transfer these harmful bacteria to children. How? Typically, this takes place through common parental or caregiver behaviors such as sharing utensils or cleaning a baby’s pacifier with your own saliva.

Prevention starts as early as 6 months into a pregnancy. Research shows that expectant mothers who chewed gum containing the sweetener xylitol are much less likely to have decay-causing bacteria in their saliva. So, take-home point number one, it is essential for expectant parents and caregivers to keep their own mouths healthy. If you reduce the bacterial levels in your own mouth, you are not only benefiting yourself but also that of your unborn child. Visiting a dentist regularly, even more often when you are pregnant, improving your homecare, and using products that specifically reduce bacteria are all essential.

Your baby is born; now what? First, eliminate potential ways of transferring saliva to your baby. Do not share utensils or let grandma or grandpa lick a cloth to clean around a baby’s mouth. Wiping your baby’s gums with a clean cloth after meals is also good practice to help reduce bacterial levels.

Once a child starts getting teeth, diet plays a significantly greater role. Minimizing snacks and drinks with fermentable sugars is key. This starts with the bottle. Bottle syndrome, also known as baby bottle tooth decay, occurs when teeth become exposed, at length and frequently, to liquids containing a form of sugar. All liquids that contain sugar can cause bottle syndrome, including breast and cow’s milk (which contain the sugar lactose), formula, fruit juice (which contains the sugar fructose), soda and other sweetened drinks. It is caused by the constant presence of milk, formula, or fruit juice in a child’s mouth during the night, during breastfeeding, during naps, or for extended periods during the day. The liquid pools around the teeth and gums, providing food for the bacteria in plaque. The bacteria produce acid as a byproduct when they consume the sugar. This acid attacks your child’s teeth and causes decay.

When your child feels comfortable with a toothbrush, brush their teeth and gums twice a day with an extra-soft toothbrush. Use a pea-sized amount of toothpaste without fluoride until your child is old enough to spit.  If your child doesn’t like toothpaste, it’s fine to brush without it.

Prevention starts before babies are born. It starts with taking care of your own mouth.

Next week, in the second part of this 3-part series, we will explore some important issues to consider during the next phase of life.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

You’ve heard it before – three in four adults over 35 have some form of gum disease. A preponderance of clinical research reveals that gum disease poses a far greater threat to health than just losing a tooth. Periodontal disease may actually increase your risk for a variety of health concerns including heart attacks, low birth weight babies, diabetes, stroke, and other bad things.

Dr. Isadore Rosenfield, noted cardiologist and media health consultant once said – “People with chronically infected gums have twice as much heart disease as the rest of us. We have an imperative to treat gum disease – to save not only teeth but also patients.”

Dr. Steven Offenbacher, former director of the Center for Oral and Systemic Disease at the University of North Carolina at Chapel Hill – “In many ways, periodontal disease is like high blood pressure – it’s painless and only becomes evident when it’s quite severe.”

All gum disease begins with the accumulation of plaque, a sticky deposit of bacteria, mucus and food particles that build up along the gum line and between the teeth. Plaque can cause gingivitis – inflammation of the gums. Plaque must be removed daily to prevent buildup. Excellent home care, coupled with a minimum of twice-yearly professional cleanings, will combat gingivitis in most people.

There is a strong genetic component to periodontal disease. One of the questions I always ask my patients is whether or not they know their familial history with regards to gum disease. If a patient says that both of their parents had dentures, for example, there is a stronger likelihood that the patient carries the gene for gum disease. There are two main reasons that people lose teeth – gum disease and decay. Decay is 100% preventable. Gum disease, like diabetes, is controllable but not curable; it requires intervention.

If gingivitis is not treated, or is not treated soon enough, the result can become periodontitis. This occurs when plaque invades beneath the gum, turning into a hard substance called tartar or calculus. Calculus can only be removed during a professional cleaning. At this stage, skilled care is essential to stave off tooth loss. In more advanced cases, a procedure called scaling and root planning (aka deep cleaning), is performed to remove hidden plaque and tartar from below the gum line.

Do you have gum disease? Warning signs may not be evident to you but may include red, swollen, tender, bleeding or receding gums, loose teeth, persistent bad breath, changes in tooth position, and the development of pockets between gums and teeth. Having said that, if you have any of those symptoms, you’ve waited too long.

For most people, good health requires investment. Today, periodontal disease can be successfully treated BEFORE teeth get loose from bone loss. Your hygienist can measure the pockets and bleeding points around your teeth and institute non-surgical treatment before you suffer the irreversible bone destruction of periodontal disease.

So, remember two things: First, lack of pain is NOT a good indicator that you don’t have problems – Second, the hygienists of the 21^st century don’t just clean teeth – they save lives!

The mouth is the gateway to the rest of the body; take good care of it.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

What is your definition of oral health? Is there even a standard definition of oral health? One thing is clear; the definition of oral health is not solely the absence of pain. Pain is also not necessarily an indication of poor oral health.

It wasn’t until the year 2000 that oral health was brought to the forefront of the surgeon general’s report as a critical component to overall health. This was an important event, but unfortunately never amounted to much in terms of being incorporated into most healthcare policies. This has led to continued poor to non-existent cross-over coverage between medical and dental insurance.

In 2005 at the World Congress of Preventive Dentistry, participants from 43 countries made it clear that oral health is an integral part of general health and overall well-being. They even concluded that oral health is a basic human right.

More recently, the United Nations recognized oral disease as an integral part of other non-communicable diseases such as diabetes, cardiovascular disease, stroke, chronic respiratory diseases and cancer. This association with these other diseases was based on common social determinants such as socioeconomic status, diet, tobacco and alcohol use, and not on the basis of transmission. However, there is still no solid definition of what oral health really is.

According to a column in the Journal of the American Dental Association, the American Dental Association is working on a proposed definition of oral health. The authors of the column state, “A proposed definition is necessary to achieve a common understanding of the scope of oral health, to help understand the array of complex oral and systemic health issues facing dental and medical professions now and, in the future, and to provide a rationale to position oral health professionals as partners within primary health care.”

The authors go on to say that the definition of oral health needs to align with the current definition of dentistry. That definition currently states, “dentists are responsible not only for the evaluation, diagnosis, prevention and treatment of diseases and conditions of the oral cavity, the maxillofacial area and adjacent areas but also for assessing their impact on the human body.”

As new tests and knowledge in the area of oral health increases, the days of simply recording missing and decayed teeth and poking patients with instruments to chart periodontal (gum) issues may not be enough to best serve patients. What we can learn from things such as genetic testing and salivary diagnostics will change the way we interact with our medical colleagues and greatly benefit our patients.

In conclusion, the authors state, “As the definition of oral health evolves and likely will continue to evolve well into the future, no matter how oral health is defined, the message remains: Oral health is essential to an individual’s general health and quality of life.”

So, while the powers that be work on the definition of oral health, it is our individual responsibility to take care of ourselves. If we know that oral health is connected to the rest of the body and if we care enough to take care of our body, then regular professional maintenance and constantly improving our home care should be at the forefront of our self-care.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

I have had a few patients ask recently about the order of oral hygiene activities. Does it matter if you brush or floss first, and should this be done before or after breakfast? Based on available research, it seems opinion matters as much as scientific facts.

A spokesman for the American Dental Association and a professor of restorative dentistry at the University of California, Los Angeles, recommends flossing first. His rationale? Get the unpleasant task out of the way to avoid the temptation to not do it. “Let’s face human nature, if you’re going to skip one, which one will you skip?”

By contrast, a professor of oral health sciences at the University of Washington in Seattle, advises her patients to brush with a fluoride toothpaste, then floss. She says that way your mouth will be awash with fluoride as you are maneuvering the floss.

So, what’s my opinion? I was taught and have always maintained that flossing before brushing is better. The rationale behind this is that plaque and other debris is dislodged during the act of flossing allowing toothpaste and the mechanical action of brushing to better penetrate the different surfaces of the tooth. Does it really matter? I don’t think so.

Have you heard your dental hygienist or dentist tell you to floss to prevent cavities between your teeth? Based on research, the main reason for flossing is not for prevention of cavities. Rather, flossing’s main benefit is stimulation of tissue to reduce gum inflammation known as gingivitis. Gingivitis can lead to more advanced gum disease and things like bad breath. That is why I believe that regular use of a water pik and an electric toothbrush is most ideal.

A review of 12 randomized controlled trials found that people who brushed and flossed regularly had less gum bleeding than the brush-only camp. No surprises there. There have been no studies, that I am aware of, reporting a reduction in cavities from flossing. Of course, these are difficult studies to conduct. There are many factors that contribute to decay occurring between the teeth.

There are also different schools of thought whether to brush and floss before or after breakfast. I don’t know about you, but I cannot eat or drink anything (especially orange juice) after I brush my teeth. So, although you might expect the solution to be brushing after breakfast, there is some risk with that.

If you eat or drink something sugary or acidic—like the fruits, juices, and other breakfast foods many of us eat in the morning— the mouth is in an acidic environment for at least 30 minutes after consumption. These acids weaken tooth enamel, and brushing too soon can cause damage to the enamel. If you know you’re going to eat or drink something very acidic ahead of time, you may want to brush your teeth first.

Alternatively, you can wait 30 minutes after you eat for your saliva to neutralize the pH of your mouth. Or, re-balance your oral pH right away with an alkaline mouth rinse and then brush. In the end, it depends a little on what you eat. Take stock of what you’re eating for breakfast and judge when you should brush based on its sugar or acid content.

Everyone, well…..almost everyone, can stand some improvement with their oral hygiene. Many dental problems are completely avoidable with excellent home care, which is in your control. Ask your dentist or hygienist how to improve your home care. Strive for constant improvement.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Last week I talked about a sometimes not so silent epidemic – sleep apnea. This week’s epidemic is much quieter but shares the general idea of decreasing the quality of life.

With more than 24 million diabetics and 57 million pre-diabetics in the United States, there are a lot of people affected by diabetes. That’s nearly a quarter of the nation’s population. The most up to date research shows the connection between dental health and diabetes has never been more critical.

As an indication of our general health, the rapidly rising rate of diabetes should be ringing alarm bells everywhere. The litany of health implications from diabetes is a long and grisly list. It is the sixth leading cause of death in the U.S. That is probably vastly understated because as many as 65% of deaths from diabetes are attributed to heart attack and stroke. People with diabetes have about twice the overall risk of death as those who don’t have the disease.

Complications from diabetes cut years off productive lives and interfere with the quality of those lives through a host of debilitating health effects. Heart disease and stroke rates are as much as four times higher among diabetics. Nearly three-quarters of diabetics have high blood pressure. Each year, diabetes causes blindness in as many as 24,000 Americans. It is the leading cause of kidney failure, nervous system disease, amputations – the list goes on.

The facts about the connections between oral health and diabetes are even more alarming than those about diabetes alone. Here are just a few:

Diabetics are twice as likely to develop gum disease. This is especially true if your diabetes is not under control. The gum disease then worsens your diabetes through an automatic response that your body uses to fight the infection.

People with gum disease are 270% more likely to suffer a heart attack than those with healthy gums.

People who have diabetes and severe gum disease have a premature death rate nearly eight times higher than those who do not have periodontal disease.

Those who have gum disease and diabetes together are more than three times more likely to die of combined heart and kidney failure.

In people who have type 2 diabetes, gum disease is a predictor of end-stage kidney disease.

In people who have pre-diabetes – blood glucose levels that are higher than normal but not in the diabetic range – gum disease makes it more likely that they will become diabetic.

Once established in a person who has diabetes, the chronic infection that causes gum disease makes it more difficult to control diabetes, and increases damage and complications in blood vessel disease.

These are simply the facts and, yes, they are sobering. If you have diabetes or are pre-diabetic, make sure you are doing all you can to control these diseases. These two diseases can twist each other into a tight downward spiral of amplifying negative health effects. Unless they are halted by your physician and your dentist working in tandem as a health care team, together with your commitment to hold up your end of the bargain, these effects can continue to compound.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Last week I discussed teenager sleep patterns and issues. This week we start a conversation about sleep for the majority of those reading this column.

My body has become accustomed to a certain amount of quality sleep. I have always had difficulty sleeping past a certain time in the morning, regardless of what time I go to bed. On the days over this holiday period that I stayed up later than I normally do, my amount of sleep hours was less and my quality of sleep tended to be lower. This had an impact on the way I felt the next day. Sleep “hygiene”, including regular bedtime, is so important.

There are many reasons for poor quality sleep. Everything from a poor mattress, poor pillow, sleep position, medical issues, diet, alcohol consumption, and work schedule can have an impact on the quality of sleep that we get. Although some people can notice subtle changes in sleep quality, many others do not realize that some of the issues they have routinely can be caused from poor sleep quality.

Sleep plays a vital role in good health and well-being throughout our lives. The way you feel while you’re awake depends in part on what happens while you’re sleeping.

Sleep helps your brain work properly. Studies show that a good night’s sleep improves learning. Studies also show that sleep deficiency may cause you to have trouble making decisions, solving problems, controlling your emotions and behavior, and coping with change.

Sleep plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, stroke, sexual dysfunction, ADHD, obesity and depression.

Sleep issues can affect the young, the old and everyone in between. The many changes that take place in our bodies as we age can increase the risk of sleep disorders.

Sleep apnea is one of many sleep disorders. It is a serious, potentially life-threatening sleep disorder that affects approximately 18 million Americans. It comes from the Greek meaning of apnea which means “want of breath”. People with sleep apnea have episodes in which they stop breathing for 10 seconds or more during sleep.

People with sleep apnea usually do not remember waking up during the night. Some of the potential problems may include morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, excessive snoring, choking/gasping during sleep, insomnia, or awakening with a dry mouth or throat.

Some simple questions to ask yourself are: Have you been told that you snore?

Do you often feel tired, fatigued, or sleepy during daytime?

Has anyone ever told you that you stop breathing while you were asleep – or- Have you ever woken yourself up with a gasp?

Do you have high blood pressure or are you on more than one medication to control high blood pressure?

Is your body mass index greater than 28?

Are you a male with a neck circumference greater than 17 inches or a female greater 16 inches?

If you answered yes to more than two of these questions, or if there is anything else in this column that makes you believe you may not be getting the quality of sleep you would like, please discuss these with your physician.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

When we were all young children, most of us got plenty of sleep, and for that matter, we didn’t think much of it. Our parents told us it was time for bed and we went to bed. We slept until the morning at which time we were woken by our parent’s gentle touch.

As we progressed into our teenage years, our responsibilities increased. This typically led to staying up later and getting up earlier to be able to keep up with these added responsibilities. Today, it seems that getting enough good sleep is even more of a challenge for our teenagers.

One of the contributing factors of this teen sleep crisis is that parents are not as strict with setting rules for sleep as they were when their children were younger. It is not uncommon for teenagers to say to their parents they are going up to their room to do homework and then go to bed.

I recently asked my daughter (a freshman in college) what time she generally “packed it in” and settled down to fall asleep. She told me that after she finishes her homework she will lie in bed and watch something on her laptop until she feels sleepy. This trend is an antithesis to good sleep and one that must be discussed with every teenager by their parents.

Rules about electronics, which include cell phones, computers, games and the television, are especially crucial. In a study done by the National Sleep Foundation, it was determined that teens who have electronic devices on prior to going to sleep, get an average of 30 minutes less sleep. There are other studies that show that the quality of sleep is also greatly affected by this same practice.

Another, more obvious rule that parents must enforce, is the consumption of caffeine at night. Any form of caffeine should not be consumed after dinner. Studies indicate that caffeine in the system accounts for almost a full hour less of quality sleep. We, and our teenagers, cannot afford this deprivation of sleep.

We all start our days at different times. For the teenager, getting up to get ready for school can start pretty early. There is a “start school later” movement that recently received a powerful boost from the Centers of Disease Control and Prevention (CDC). The CDC report showed that teenage students have biologically different sleep patterns and needs than in other stages of life. Starting school a half hour later or more provides the teenager the opportunity to consistently get a better night’s rest.

For the teenager, managing homework and extracurricular activities is also definitely a barrier to sufficient sleep. We as parents must discuss this with our children to provide support with time management. If necessary, we must also not be afraid to discuss this with teachers and coaches if our teenager is struggling to get everything accomplished, thus affecting their sleep patterns.

As adults, many of us have our own routines that could use a revision to get more quality sleep. That is a subject for another time. As parents, it is our responsibility to guide our children to practice good habits. Discussing and enforcing better sleep habits is a gift that keeps on giving.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Xylitol is a naturally occurring sugar alcohol that is commonly used as a sweetener in many products, such as chewing gum, toothpaste and nasal spray. Xylitol kills bacteria by disrupting their ability to metabolize glucose, which is a necessary process for their survival. When bacteria consume xylitol instead of glucose, they are unable to use it effectively as a source of energy, leading to a depletion of their energy stores and eventual death.

The dental benefits of xylitol have been known since the 1970’s. Xylitol is not metabolized by the decay-causing bacteria Streptococcus mutans (S. mutans), making it non-acidogenic and thus noncariogenic (not decay causing). Studies have also indicated xylitol decreases the levels of S. mutans in both plaque and saliva. As a result, patients who use xylitol have demonstrated a reduction in decay.

Xylitol is slowly absorbed by the human intestines; as a result, it has minimal side effects on humans. There are some minor side effects, mainly diarrhea, although this generally occurs after ingesting large amounts xylitol (four to five times the recommended amount for cavity prevention). A 1982 study suggested that the body can adapt to higher dosages of xylitol and that symptoms can subside as the body’s tolerance increases. However, even in small quantities, xylitol is toxic to dogs.

While the dental community embraces xylitol for its cavity prevention, most people, including dental professionals, are unaware of its toxic potential to dogs. While xylitol has little effect on insulin production in humans, dogs can experience rapid and severe increase in insulin production after just a small amount of xylitol ingestion. A dog that ingests a xylitol equivalent of three to four pieces of gum is at risk for hepatic (liver) failure and necrosis (tissue death).

Dogs tend to be scavengers by nature and their likelihood of encountering potentially toxic substances in and around the house is common. The ASPCA web site lists a multitude of substances, many of which are harmless to humans but potentially dangerous to dogs. Chocolate, grapes, raisins, avocado, onion, and citrus fruits make the list. However, xylitol is unique in that it is contained within foods; as a result, consumers may not even be aware that a product or food item contains xylitol.

For dogs suspected of ingesting xylitol, early intervention is paramount. Prompt medical treatment for uncomplicated xylitol-related hypoglycemia can yield a good prognosis. Xylitol hepatic toxicosis yields a much graver prognosis.

While veterinarians have been aware of the potential danger of xylitol to dogs for several years, that awareness has escaped most of the dental community – and the general public. This has become a more significant issue as more dental professionals promote products that contain xylitol for its human benefits.

It is important for dog owners to know the different foods and products, such as xylitol, that can be harmful to their pooches. Make sure to keep these items out of a dog’s reach – and that includes the garbage. If you suspect ingestion of any of these foods, including xylitol, contact your veterinarian immediately.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

There aren’t too many people who really want a denture, but for many people, this is a viable way to replace loss of teeth. Regardless if it is replacing one or all the teeth, it is something removable; that is, the patient takes it in and out of their mouth.

As with many things in life, there can be a significant difference in the quality, appearance and functionality between different dentures. Here’s what Wikipedia says about making dentures:

“The fabrication of a set of complete dentures is a challenge for any denturist, including those who are experienced. There are many axioms in the production of dentures that must be understood, of which ignorance of one axiom can lead to failure of the denture case.

One of the most critical aspects of dentures is that the impression of the denture must be perfectly made and used with perfect technique to make a model of the patient’s edentulous (toothless) gums. The denturist must use a process called border molding to ensure that the denture flanges are properly extended. An endless array of never-ending problems with denture may occur if the final impression of the denture is not made properly. It takes considerable patience and experience for a denturist to know how to make a denture, and for this reason it may be in the patient’s best interest to seek a specialist, either a Denturist or a Prosthodontist, to make the denture. A general dentist may do a good job, but only if he or she is meticulous and usually he or she must be experienced.”

It is true that fabrication of dentures can be challenging and requires a strict protocol. If the techniques taught in dental school (a dental student usually makes about 2 or 3 dentures) are the only techniques used, the outcome will be mediocre at best. People may be able to get by with a $395 denture advertised on television. You can also drive around on 4 flat tires for a while.

The impression is the key for a successful denture. However, simply taking an impression of the tissues in the oral cavity is not enough to produce a high quality, precision fitting prosthesis. Using a technique called a functional impression produces a far superior result over conventional techniques. The functional impression takes a couple more visits than a traditional impression, but it is much more accurate.

Other differences of a custom denture vs. a conventional denture are the materials and laboratories used to produce the prosthesis. The quality of the materials, including the teeth themselves, play a huge role in producing a denture that not only fits meticulously, but also looks natural and life-like. Poorly made dentures are often easy to identify in normal conversation.

Staining of the “gum” portion of the denture, by a laboratory technician trained and qualified to do so, adds an even more life-like appearance, which far surpasses any conventional technique. A denture made with this technique rarely needs any adjustments, and will fit well for years.

Dental implants can be used to secure lower dentures, or eliminate the palatal coverage of an upper denture. These are the two main issues that patients have with dentures: the lower denture flops around, and the upper denture covers the palate, which decreases enjoyment of eating.

Poorly fitting dentures can decrease quality of life, cause discomfort, difficulty eating, speech problems, oral sores, bone loss and social anxiety. It makes a world of difference to have a well-made denture.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

In an online report I recently read in a journal that was forwarded to me by a patient, they listed 9 “healthy” habits that they claim are a waste of time. Three of them had to do with oral health. Let’s take a look.

The first on the waste of time list was to see your dentist twice per year. I have seen this reported somewhere else in the media recently. According to the authors, close to 30 studies have apparently found no conclusive evidence supporting a need to see a dentist every 6 months. They went on to say, “If your teeth and gums are healthy, once per year is enough to catch developing problems.”

I absolutely agree. There are definitely people who only need to see a dentist/hygienist once per year. Most dentists use a classification system to rate a patient’s periodontal (gum) health. Type I patients are the ones that only need to see a dentist once per year. They are healthy, they have good homecare habits and are low risk for disease. In the average dental practice, I would say this is about 10-15% of the population.

Type II patients are those with gingivitis and should be seen twice per year. This group makes up about 50% of the typical dental patient population. Many of these patients could move into the Type I group if they had better homecare habits and technique.

Type III & IV patients are the remaining 30-35% of the population who should be seen every 3 or 4 months, and in some cases even more frequently. Because of genetics and/or bad habits, this group has active disease and is at high-risk for problems.

Let’s also not forget the other 50% of the population who don’t even visit a dentist once per year. While I think there are people who can be healthy and see a dentist once per year, it is irresponsible to make it seem that it pertains to everyone. The only one who can determine how healthy you are is your dentist. It should be up to you and the dentist you trust.

The #7 waste of time reported was to use a hard toothbrush. According to the report, a soft one cleans your teeth just as well and is less damaging to your teeth and gums. This is old news and is true.

The next one shocked me. The #8 waste of time – brushing and flossing twice per day. According to the authors, everyone only needs to visit the dentist once per year and brush and floss one time per day. They recommend brushing for at least 2 minutes before you go to bed and flossing one time per day. They also mentioned that people who did not floss frequently (whatever that means) are 3 times more likely to develop stomach cancer. I am assuming the author is relating lack of flossing to getting periodontal (gum) disease. More recent research is showing that, “Risk factors for precancerous lesions and gastric cancer are being identified, one of which may be periodontal disease”. Although lack of flossing does not automatically cause gum disease, poor oral health is clearly a risk factor for other health problems.

Here’s the bottom line:

1. Establish a relationship with a dentist you are comfortable with and trust. Determine with that person how frequently you should be seen.
2. Use a good quality soft electric toothbrush. Get instructions on proper use from your hygienist.
3. Brush at least twice per day, preferably at least 30 minutes after meals. Floss or water pik at night before you brush.

It is as simple as that.

Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com