J. Peter St. Clair, DMD Blog

There have been lots of changes over time in the materials used to restore teeth. Many of the materials I use today were not in existence when I started to practice. The most significant changes have been to materials that are tooth-colored.

There are very few patients who ask for gold or silver fillings any more. And, while some of these newer materials are tooth colored, there are factors which need to be considered in determining what material is appropriate for each individual situation. The longest lasting restorations I have ever seen are gold done by dentists who really knew the art of working with gold.

Prevention of decay and other factors that require teeth to be restored, is the best defense to not needing restorative dental work. Keeping up with maintenance cleaning appointments and listening to your dental team’s recommendations regarding diet, homecare and other forms of prevention, such as nightguard use, is key to avoiding many dental problems.

One of my favorite quotes in dentistry comes from a pioneer dentist who died in a plane crash back in the 1970’s named Bob Barkley. Aside from being the one who said “The best dentistry is No dentistry”, he also said, “The goal of dentistry is to make the patient worse at the slowest possible rate”. I think about this quote all the time when making recommendations and treating patients. Sometimes it leads me to recommend more extensive treatment, and other times it leads me to not recommend any treatment at all, even despite apparent need. Every individual has their own set of factors that need to be considered.

Dr. Barkley also coined the phrase “co-diagnosis”, which refers to the patient taking an active role in their dental health. It is the role of the dentist to not only educate the patient on their specific situation and different options for care, but to also extract (pun intended) from the patient, their goals for their dental health. It is so important to think beyond the immediate fix sometimes. Taking the time to talk to patients about why things are happening, and about their choices for prevention and treatment, allows patients to become active participants in their health. I wish I could say that was the norm.

There are barriers to this model. One of the biggest issues facing both dentists and patients today is the role of patient’s dental benefit companies. The trend is less costly plans with fewer benefits, and restrictions on providers. Oftentimes, to get the maximum (or sometimes any) benefit, the patient must seek a dentist who is participating in that particular dental plan. I would encourage staying away from any dental plan that forces you to see specific providers. You should always have a choice.

My simple suggestion is to take a more active role in your own dental health. Think forward and ask your dentist or dental hygienist about things that can make your situation worse at the slowest possible rate. You very well may be doing fine, or just need a couple of tweaks to your home care regimen. Find a dental team that listens to your concerns and takes the time necessary to establish a plan that makes sense and you are on board with.

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, “Well, my parents both had dentures”, there is a strong possibility that patient has 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 treated too late, 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!

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

The word is out – taking care of your oral health is better for your whole body, including your mind. However, statistics still indicate only about half of the population goes on a regular basis. For those that do go, most patients usually stay with a dentist unless there is some kind of personality conflict or philosophical discrepancy in the perceived need for treatment. How do you know if another opinion is right for you?

When it comes to larger purchases, such as a car, a house or even home improvements, it’s not uncommon to get a second or third opinion/quote. We use the information we gather to make a more informed decision about where and what we are going to spend our money on.

When it comes to our health, it usually depends on the nature of the issue. More complex issues in medicine, such as a diagnosis of cancer, an unknown diagnosis, or other major medical issues in which we have to make decisions about significant treatment, tend to stimulate people to get more than one opinion.

Routine dental care is generally not that complicated. However, there are many different ways to do the simplest things in dentistry. The method is a function of the dentist’s beliefs and training. It is relatively uncommon for a patient to get a second opinion for this type of maintenance dental care. Although there is some subjectivity as to what different dentists might deem as “needing” to be done, patients usually base their decision on their perceived need. Often times, this perception of need comes from the dentist’s ability to communicate the reasons for treatment.

The patient’s trust in their provider is a big factor. If a patient trusts and genuinely likes their dentist, they may not necessarily do or want to do what the dentist wants them to, but they are comfortable enough with the relationship to make the decision without the need for another opinion. It is when there is a lack of trust, a personality conflict, or the inability of the dentist to properly communicate with the patient effectively, that often stimulates the desire for another opinion.

Another important factor, which falls in the communication area, is that the patient is given choices. Patients always have the right to choose what treatment they feel is right for themselves. If choices are given and the treatment is effectively communicated to the patient, they have a better ability to decide on the direction to proceed that is right for them. If a dentist presents treatment options and the patient decides to do nothing, that is the patient’s choice. It is when treatment presented aligns with the patient’s perception of need or desire, that the patient moves forward with treatment.

Fees tend to be a less common reason for patients to seek another opinion. Fees for treatment can definitely vary between dental offices. The problem with seeking treatment based on fees is that the same treatment in two different offices with different fees can also vary in the level of expertise and precision in which it is done. As a consumer, you have very little control in your ability to evaluate this.

You do have the ability to know whether you feel comfortable to make an informed decision. Regardless of the situation, if you need more information to make the best decision for yourself, get more information. If you feel pressured to make a decision, don’t make it until you feel comfortable.

The doctor-patient relationship should be an open two-way conversation. Find your dental home…..and stay there.

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

Dental hygienists love it when they make suggestions to patients about home care and their dreams are answered when the patient returns 6 months later with noticeable improvement. It might be as simple as adding a good electric toothbrush or waterpik to the patient’s regimen. I would like to say that we are amazed daily by the fruits of our counseling, but that isn’t the case. For whatever reasons there are, changing routines is often difficult.

Over 10 years ago I wrote a column about an article I saw in a magazine, which is apparently also a book, entitled “Change or Die”. What if you were given that choice? What if the doctor said you had to make tough changes in the way you think and act – or your time would end soon? Could you change? Here are the scientifically studied odds: nine to one. That’s nine to one against you. I don’t think we have made much headway on this over the past 10 years.

It’s a pretty common theme. As Americans, we’re dying at a rapid rate from five basic self-induced health problems. We eat too much. We drink too much. We smoke too much. We have too much stress. And, we don’t exercise enough. These five poor choices, manifested in scores of ailments, consume the vast majority of the nation’s healthcare budget. The article is an outpouring of concern from healthcare experts and doctors, all looking for a way to change the behavior of people who love their lifestyle so much that they literally die from it.

In a Johns Hopkins study a while back, 9 of 10 heart surgery patients chose to return to their unhealthy lifestyle, rather than make the changes needed to live longer. Only a few are convinced by their doctors to make radical daily changes. One of the more successful doctors with this is Dr. Dean Ornish, founder of the Preventive Medicine Research Institute. He says NO to meat, fatty dairy products, alcohol and oil. His vegetarian diet is low-fat, high-maintenance and strict. And, it has been shown to reverse heart disease and other factors in patients who were destined for quadruple bypasses – or worse, eternal sleep.

When 90% of patients are back to their old tricks within weeks of open-heart surgery, his program is the one making a difference. How does he do it? Well, it’s easy, really. Dr. Ornish coaches his patients to make changes strictly for the benefit of making them. Instead of telling them they must change or face death, he encourages them to change so that they can enjoy the endless beauty of living. With dedicated support, three-quarters of his patients are still going strong three years into their drastic lifestyle shift. I’m sure it is deeply gratifying to know that it only takes words said a certain way to make a true change in someone’s life.

Why is it so difficult to get people to change? Well, it depends. You have to be sick and tired of being sick and tired, usually, before you’ll make the leap and let go of whatever the resistance is to change. For many, doing more preventively never happens. We wait for chest pain to strike or a toothache to occur before seeking help to solve our crisis problem. Then we hope, and many times expect, that our problem can be solved easily and not too much will have to change to prevent it from happening again.

Dr. Ornish would tell you the change must be profound. He would tell you to never have another cheeseburger. Your hygienist would say you need to follow a new strict homecare routine, radically different than what you currently do. Making changes like these has to mean more to you than the change itself. You must be invested in improving the quality of your 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

Let’s use this hypothetical situation: You have not been to a dentist in a while (pick a time frame), you are well aware you need some dental work, you were given the recommendation of a dentist by a friend…..and, you decide to visit that dentist and four other dentists to compare and make a decision who is the best fit for you. (I realize that most people don’t want to and/or don’t have the time to visit five dentists….but play along).

You already have an idea of what you are looking for. It might be the dentist who says you need the least. It might be the dentist who is the cheapest. It might be the dentist who is closest to where you live. It might be the dentist who gives you the most options, or maybe the least. It might be the dentist who listens to you the best. Be prepared, because you are likely to hear a few different styles/opinions visiting five dentists.

Some practices may feel “clinical and efficient”, while others feel somewhat more home spun and laid back.  The dentist’s personality and experience are reflected in his or her treatment preferences as well.  The fact that different dentists will suggest different plans to treat your condition does not necessarily mean that one plan is better than another. Have an open mind and play an active role in the treatment planning process.

It is important to remember that there are numerous ways to treat the same situation, and it is always important for the dentist to tailor the treatment plan for each patient’s specific circumstances.  A major part of those circumstances may be financial, and since different treatment plans can vary a great deal in cost, it is important for the dentist to discuss costs and options for payment.

Think of treatment plans like various models of cars offered by different dealers.  All of the models are new, have warranties and will work well out of the lot.  The higher end models, however, have some advantages not found in the less expensive models.  Some options add years to the life of the car. Some add to the appearance and enjoyment of driving it.  Having said that, dentistry is not a commodity. There are many factors that need to be taken into consideration when choosing your provider or the treatment you choose for yourself.

What makes sense for you? What are your objectives?  Saving a badly damaged tooth with a root canal and a crown may preserve it for a long time, but what are the circumstances of how the tooth got to that point?  If you haven’t been to a dentist in many years and have many other dental needs, does it make sense?

We have so many great dental providers in our area. Think about what you are looking for in a dental care team Read that list in the second paragraph again.

The focus should be on long-term objectives and prevention. If you are a regular dentist-goer and have a dentist you like, you’re all set. If you haven’t been in a while, consider making the decision to change how you look at your dental health. Start with finding a place that fits your particular needs, and make the commitment to make routine preventive dental care part of your 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

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

It is not uncommon for me to get a strange look when I ask a patient about snoring in the dental office. After an explanation about some of the reasons I include this on my medical history form, the patient will often say, “Well, I don’t snore but my spouse (usually husband) does. In fact, we sleep in separate bedrooms.”

A better way to ask someone about snoring is to ask, “Have you been told you snore?” Snoring can be a huge nuisance to the bed partner and is actually very detrimental to both people. For those without a bed partner, snoring can be assessed with apps such as Snore Lab, which measures snoring levels throughout the night.

Snoring is a sign of a restricted airway, which means that there is a possible depletion of air getting into the lungs and thus the brain. You spend approximately one third of your life sleeping, which means if you live to 90 years old, you may have spent 30 years sleeping. Oxygen depletion during sleep has both short-term and long-term consequences. I have read multiple studies which suggest a reduction of oxygen to the body can take 6-10 years off of your life. Sleep is one of the most mysterious states of being – we don’t know a lot about what is going on during sleep without it being recorded. Wouldn’t you want to know if your body wasn’t being oxygenated properly?

A restricted airway can be caused by numerous different factors. Many times, it is developmental and starts early in life. As we age, this risk for developing a restricted airway increases with things like gaining weight, muscle tone laxity, and even sleep position. Snoring is a fluttering of soft tissue in the back of throat due to there not being enough space for air to pass through. Not only does snoring have the potential to affect your brain and the way you feel on a day-to-day basis, it also disturbs the sleep of the person sleeping next to you….and in some cases, people in other rooms.

Snoring does not mean you have sleep apnea (a serious disorder measured by a sleep test,) but is a significant risk factor. If you do have sleep apnea, you need to know this so that it can be treated and you can live a better quality of life. If you don’t have sleep apnea and just snore, this can also be treated, and you may be able to make it back into your own bedroom.

Aside from snoring, if you have any of the following: familial history of sleep apnea, history of daytime drowsiness, history of clenching/grinding, history of TMJ disorder, history of mood disorders/depression, witnessed apnea events (gasping at night), large tongue with ridges on the sides, tooth wear, high blood pressure, gastric reflux, large neck (Males >17 / Females>16) – you should discuss this with your physician and/or your dentist.

There are different ways to treat snoring and/or sleep apnea including positional therapy (sometimes a wedge pillow strapped to your back so you can’t roll onto your back), a CPAP device (positive air pressure through the nose to keep the airway open), or a dental device (to keep the jaw and tongue from falling back).

Just like exercising and good eating habits are good for the body, quality sleep vital to good health. Just because you get 7-8 hours of sleep doesn’t mean it is good sleep. Don’t hesitate to talk with your doctors about your sleep issues…..and encourage the loud person sleeping next to you to do the same.

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

This week the topic has nothing to do with dentistry. It is a topic that some will be able to relate to and others may not. It is a topic that some may appreciate and others may criticize. It may be something you have thought about before or maybe have never thought about. It is about thinking outside the box and being comfortable with the uncomfortable.

Regardless of your line of work, there comes a point when we all get comfortable with where we are and how we do things. Initially, that is a good feeling, but eventually it is a feeling that challenges us in our own growth. It is impossible to go through life doing things the same way and feel content forever.

In my 25th year in this profession, I do very few things the same as the way I was originally taught. I am constantly learning, but often struggle with how to apply things I learn, or whether to apply them at all.  However, being uncomfortable with being comfortable challenges me to grow.

Many of us, and especially people in a service-related industry, which I can relate to the most, can exhaust ourselves trying to predict and control what other people think about us as individuals and about the work we do. This feeling is a trap and very self-limiting.

Do people understand me? Do they like me? Do they know how much I care about what I do? Do they care? These questions can paralyze us into inaction. These feelings can cause us to never even come close to reaching our full potential. We “play it safe” too often, and need to consider going outside our comfort zone to realize growth, both personally and with our work.

Has this thought ever crossed your mind: “What in the world is my purpose while I’m here on this planet?” We have to have purpose, otherwise we are lost, and we have to have faith or we remain lost.

We all go through the various stages of life and experience joy and happiness, sorrow and pain, confusion and temptation. Some struggle with these things more than others, which can also impede our growth as individuals.  Each of us looks for the things in life that brings us more joy and happiness rather than other things listed above. However, focusing on “what’s in it for me?” can be just as destructive.

Constant growth in mind, body and spirit are essential to mature as individuals. We need to be mature enough to recognize that each of us has our own set of resources, and be able to determine how these resources can help others versus being a roadblock.

We all have our faults, admitted or not. Most of the time we are unable or unwilling to express our faults to anyone because of pride. We want everyone around us to think that we have no “issues”. It takes awareness to allow for self-reflection and at least admitting to ourselves where we need to improve in our personal and professional lives.

This is difficult to do alone. Your best bet is to work together with someone close to you who also has similar intentions so that you can hold each other accountable. Perhaps one of those areas you wish to improve is your own health.

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 some of the content that was presented in a recent U.S. News & World Report which featured seven pages of information on dentistry. This is a continuation of that.

One of the columns in this section of the report entitled, “Guarding Kids’ First Choppers”, mentions that childhood tooth decay is “the most prevalent chronic disease in children”. This is true. According to the report, 28 percent of preschoolers have dental decay. There are many factors that contribute to dental decay, including poor dietary habits and insufficient oral hygiene. This increase is not only in preschoolers but right through high school.

However, the column goes on to say that “dental visits should begin no later than a child’s first birthday”.  I think that is a little early and usually recommend seeing children by age three. However, parents should closely inspect their children’s teeth. If there is anything that is seen that is not tooth-colored or doesn’t look right, the child should be seen by a dentist. Pediatric dentists are one option but many general family dentists are more than willing to see children. If there are issues that warrant a pediatric specialist, the child can be referred.

Another column in the report entitled, “The Wisdom on Wisdom Teeth”, says “the latest data suggests that as many as 80 percent of people will develop problems with their wisdom teeth”. This is true. In most people, wisdom teeth either will not fit with all of the other teeth in the mouth or they erupt crowded. This may not cause a problem right away, but because they are difficult to clean, they either get decay or cause periodontal problems with the neighboring teeth. The current line of thinking is to remove these teeth between the ages of 16-18, or before the roots are fully developed. This generally makes for a much less traumatic surgery.

In the article entitled, “Taking the Cost Out of the Bite”, it is discussed what to do if you don’t have dental insurance. One of the suggestions is “to consider purchasing an individual dental policy”, and the other is to look for discount programs which “give members 10 to 60 percent off at certain providers”. This is tricky. If you don’t get dental insurance from your employer or are not covered under a spouse’s plan, you really have to look at the numbers and also at what you are entitled to with particular plans. If it seems too good to be true, it probably is.

The cost of purchasing your own indemnity dental insurance plan usually outweighs the benefits. Most, if not all dental insurance plans have annual maximums which average $1000 per year. You pay the premium to the insurance company, which might be $750 a year, but then you only get $1000 in benefits. It may make sense for families but usually not for individuals. As far as the “discount plans” the column refers to – this is a buyer beware. These plans force you to choose a dentist from a list and this list is usually not very long. If a dentist is willing to accept 50% of their normal fee for a procedure, it is important to consider the quality of care.

Dental health is important to overall health on many different levels. Make it a priority!

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

A recent U.S. News & World Report featured seven pages of information on dentistry. Although I was surprised that most of the information was accurate, as the media often skews the facts to make a point, there were a few things that I felt needed clarification.

The first article highlights the fact that 75% of adults have some form of periodontal disease. This is true. It also mentions many of the known facts with regards to gum disease and systemic health. One of those is that uncorrected gum problems can make it more difficult for diabetics to control their blood sugar, and in turn worsen their gum problems. This is also true.

With regards to brushing, the article states, “Scrubbing with fluoride toothpaste robs oral bacteria of sustenance.” This is true to some extent but the term “scrubbing” is not completely accurate. Proper brushing technique with either a very soft manual toothbrush or good electric toothbrush is a more accurate description. Also, fluoride, in and of itself, is not truly anti-bacterial. Although it is felt that its anti-cavity action is related mainly to effects on mineral phases of teeth and on the process of remineralization (strengthening enamel), research does show that fluoride also has important effects on the metabolism of bacteria in dental plaque. There are other ingredients in toothpastes with and without fluoride that are more anti-bacterial, but it is the removal of plaque manually that is most important, even without toothpaste.

With regard to electric toothbrushes, the article insinuates that “basic” and “cheap” ($7) models are as effective as more expensive models. This is false. Although you do not have to buy the most expensive model available, there is a huge difference in effectiveness between a $7 battery-operated toothbrush and a $70 wall-charged one.

The article states, “Only floss can reach below the gum-line.” This is not completely true. Proper toothbrush technique gets below the gum-line on two sides of the teeth. Floss is important for removing debris between teeth. A water pik is probably most effective for cleaning the non-brushable areas in the mouth.

For combating bad breath, the article’s first suggestion is to “brush your tongue.” Although it mentions the use of a tongue scraper, it only states the use of this device if your toothbrush makes you gag. The fact of the matter is that a tongue scraper is 100% more effective in removal of the nasty bacteria on your tongue. If the toothbrush makes you gag so will the tongue scraper. One trick is to scrape your tongue while you are exhaling. An article in the report entitled, “21st-Century Dentistry” highlights the use of lasers in treating gum problems.

The beginning of the column gets you revved-up to believe that this is the best thing since sliced bread, but the end of the article states differently. “It is unlikely to fully replace traditional gum surgery anytime soon. The laser therapy isn’t demonstrably superior to surgery, researchers recently reported in the Journal of Periodontology.”

To be continued…….

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