Where the everyday person can learn more about how to take better care of their mouth! There's a new subject every week, so stay tuned.
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Wednesday, August 24, 2016

Big New Beginnings

August, for me has been about new beginnings.
    I am thrilled and excited to share all the new things going on for the Queen of Dental Hygiene.  My keyboard has been a little quiet lately because I've been busy doing, creating, and traveling for summer fun as well as education.  Now I have a little down time to catch all of you up to date!

Big Changes

As I posted previously, I'm working in a new office.  What's changed is I'm now in two new offices and I'm in love with both of them!  How lucky am I to have found not one but two incredible, exceptional dental practices right here in Bellevue.

On Tuesdays and now Wednesdays I'm so lucky to be working with incredibly smart Dr. Alireza Panahpour and his dedicated staff.  Dr. Panahpour centers his practice around the Oral-Systemic Connection and his philosophy is holistically based.  I've written previously about how very important a healthy mouth is to a healthy body.  (IMHO, Traditional dentistry has treated the mouth as a separate planet, and not looked at disease occurring there infecting anything below the chin.  Drilling disease out of a tooth does not cure the cause of the problem, it just puts a band aid on it.)
Prevention is the key word at this office.  We look closely at breathing and swallowing issues- proper breathing, where your tongue is, and how big your airway is!  It all starts with oxygen.  Not breathing correctly is central to the oral-systemic connection breakdown.  Tooth decay occurs when the mouth becomes too acidic, saliva is not healthy (dry mouth, could be from mouth breathing) which takes us right back to breathing dysfunction again.  Gum disease, same issues- thick sticky plaque, growing a thick biofilm of bacteria plus other bad bug pathogens and no saliva to wash it off, thus gum infections.  Breathing could well play a part there too.  Swallowing, who's looking at that?  We are!  I've written before about the mighty tongue- and how it moves your teeth around.  Got open spaces between your teeth? It could be from the way you swallow and where your tongue presses.  This office goes beyond the normal stuff and is dedicated to helping you get well and stay well.  I'm so honored to be a part of this team!

Come see me on Tuesdays or Wednesdays at Dr. Panahpour's office for an in-depth look at your mouth and let's make a plan for you to get and stay healthy.  Call 888-338-6336 option 2 and talk with Elizabeth about coming in to see me and meet the master of oral-systemic connections, Dr. Panahpour.
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AND! now on Mondays and Thursdays, you can find me working with the incredible, fabulous Dr. Lynn Jones and her associates- Dr. Ilya Miloslavskiy and Dr. Kelly Yu, as well as a most welcoming, warm staff of  talented women.  Can you tell I'm in love!?!  Everyone there has made me feel so welcome, and they're as excited as I am to be working together.  Dr. Jones's artistry and knowledge of smile design is a beauty to behold.  Her expertise is exquisite.  Dr. Jones is the first and only female Accredited member of the American Academy of Cosmetic Dentistry (AACD) in Washington state.
The AACD is an organization dedicated to advancing excellence in the art and science of comprehensive cosmetic dentistry.  Accredited members do even more advance training.  Before allowing anyone to touch your smile, ask to see photos of their work.  Dr. Jones is proud to show you what she has done for many patients' smiles.
I'm a fan of beautiful healthy smiles, and if things need a little enhancing or tweaking, why not!?  I'm certainly okay with that.  I love makeup, lipstick and all things lovely (and healthy).  Crowded teeth make cleaning around them difficult, causing gum disease to creep into these hard to access areas.  White teeth make you look younger, and who doesn't want that?   You should love your smile.  It's your signature, it's you telling the world "HELLO".

Dr. Jones and  her associates, however, are not limited to smile design, they also concentrate on helping you create that healthy mouth/body connection as well.  They do caries (cavities) risk assessment, Invisalign braces, and thorough gum disease prevention.  You cannot have a beautiful smile if the underlying support structure - the teeth and gums - have infection!   I'll be adding my expertise to their line up.  I've just started this week, so as that unfolds, I'll keep you updated.   Come see me there on Mondays and Thursdays!  Call Melissa or Juana at 425-284-9336 to schedule time there, and meet Dr. Jones and her team.
                                                                                          *****
How fortunate I am to work in two incredible offices.  Each unique on the outside but dedicated to your oral health and wellness, and willing to add me to their staff.  I'll bring my nonsurgical periodontal therapy programs, as well as more tooth decay prevention, ozone therapies, myofunctional therapies and airway wellness to their offices.  We'll learn much from each other, and I'll share it all with you!

To all my former patients- I miss you!  I thank you from the bottom of my heart for working hard with me to achieve oral wellness.  I'm so very proud of all your accomplishments. Your successes make my job, my career so rewarding.  It's because of you that I love and am passionate about what I do as a dental hygienist.   If I can ever be of any help, if you have questions, please let me know.
I'm your oral health coach for life!

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Washington Oral Wellness (W.O.W.)

More  big changes- I am adding one more thing to my plate- I have started a business called "Washington Oral Wellness".  For now, it's out of my home.  In June, I traveled to Los Angeles to complete my (official) training in Orofacial Myofunctional Therapy.
There's still so very much to learn, so while I may have the credentials, I will keep on educating myself.  In September I head down to Tuscan to attend the  American Academy of Physiological Medicine and Dentistry's Airway Summit.

W.O.W.  officially opens it doors on Friday, September 2nd.  We'll be available on Fridays and Saturdays by appointment.  The goal of W.O.W. is breathing re-training, swallowing, muscle re-education, and even noxious habit elimination- (think thumb sucking, pacifier dependency, or even blanket sucking.)  Walk through the airport and watch everyone with their head down, looking at their phone - airway problems in the making.  We can even do this therapy through video conferencing over the internet.

Stay tuned- there will be more on this soon!
You can reach me at barbaratritz@gmail.com, or through the contact section on the right side panel to learn more and schedule an appointment for evaluation.  Health really starts with the airway.
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Life is such a grand adventure.  For me, it's time to mix things up and move forward, even when those changes are hard.  I've been learning about airway, muscles, and all things tissue related, and how those impact the rest of the mouth/head/body.  How can we not incorporate that into comprehensive 21st Century oral care and total body wellness?  Heart disease, the oral-systemic connections, tempomandibular jaw pain, tongue ties, headaches, crooked teeth, open bites, drooling, malformed jaws, and small airways are not okay to ignore but are often beyond what the traditional dental office knows much about.  It is time for them to learn and grow so they can help you be healthy.

 You, my loyal reader, are curious and obviously want to learn, grow, and be healthy.  Good for you!

Hugs, and keep smiling with the smile you love!
Barbara




Tuesday, July 5, 2016

Infection Control - My Thumb - and - You!

Infection control-  sterilization and keeping things clean.  Hmm, not exactly a hot interesting topic but after a personal event that occurred this last month, thought we might should visit this issue.  It's a little off my usual, and a little bit of a Public Service Announcement-- today's topic is all about the back office, behind the scenes, what we do, and why we do it.

First- what happened to me last month.  For my birthday I splurged and went with my girls to get our nails "done."  I opted for the gel manicure and loved how shiny it looked and how well it held up.  Since I wash my hands a lot, my nails take a bit of a beating.  Polish lasts about 10 minutes, thus I usually don't do manicures often.  So, it was time to get another mani and did another round of gel polish.  Mid-mani I asked my young nail tech how they sterilized the instruments he was using.  His English skills were such that he could not understand my question.  His coworker pointed to a breadbox appearing appliance which I took to be a UV light.  He was further asked by my seatmate how long instruments needed to be in there to disinfect them- he said around two to three minutes.  Hmmm, suddenly I was very concerned but, since we were half done, (I should have known better) I continued on. My manicurist did not wear gloves, another red alert.
Fast forward two days- my right thumb is tender, swollen and pointedly infected.  By Sunday I can not pick up anything without pain, by Monday I had it lanced,  and pus poured out (lovely visual- sorry) and I'm the owner of a bottle of antibiotics.  My doctor's office told me this is not an uncommon occurrence.  I'm giving myself a dope-slap for not paying attention.  Yes, I know better! And that's my point- most of you are trusting the nail salons are doing a proper job of sterilization of their tools.  Hmmm, not so much.

As a dental hygienist, I'm very familiar with infection control.  It's a vital component of what we do. It keeps you safe, protected, and healthy.  Any break in that sterile chain and we automatically start all over.  It's drilled into us. Pun intended ;)
All of our instruments are run through an ultrasonic cleaner to remove debris, then dried and placed in sterilization bags.  Each bag has a sensor on the outside that indicates the bag has been sterilized.  Each bag should also contain an indicator placed inside as a second signal that sterilization has also occurred within the bag.  Bagged instruments are placed in a sterilizer- whether it's an autoclave, oven, or chem-clave.  It takes longer than two to three minutes to achieve sterilization. Some sterilizers are quick and can take four minutes while others take hours.  Sometimes autoclaves are packed too full and not all instruments get properly sterilized, hence the indicator inside the bag is vital. Sterilizers are checked regularly, spore tests done weekly.  (Spores are bacteria that are more resistant to killing.)  Many of these high tech tools can automatically record and document they are working properly and sterilizing.  Computers are in just about everything.

I always open my sterile instruments in front of my patients- and only after I wash my hands and put on gloves.  Our dental rooms are wiped down twice with a disinfectant, and the surfaces are left wet and air dry for ten minutes. We never reuse items that are labeled as "one time use" and are disposable.  Surgical masks and protective eye wear for EVERYONE in the dental operatory is a must in my book.  We also wear uniforms that stay at the office and are laundered there so no contaminates between home and the office!  We take sterilization very seriously.  All this is stuff you never see but happens with every patient, every time, even if it's only for a "quick tooth check." Infection control is vital to keep you healthy and protected.


                                     Back to My Poor Finger

Swollen and infected
SO, why did my finger get such an incredible, raging infection?  I think it's because there's a big difference in infection control between nail salons and dental offices. That difference is disinfection vs. sterilization.  We worry more because yes, I'm in your mouth- a direct line to your body.  You might not think about it, but if your manicurist breaches the skin- maybe around your cuticle, maybe a hangnail, maybe they slip- they also have a direct line into your body.
My finally healing thumb
 The Washington State minimum safety and sanitation standards for cosmetologists and nail salons only requires them to disinfect their tools.  The laws do talk about using autoclaves or dry heat sterilizers but then says they can then place their instruments in a UV sterilizer, which is a much less expensive option.  From what I've seen, most nail salons only use that UV light box.  Disinfection is not the same as sterilization.  Disinfection of instruments does not insure a 100% kill rate.  Rather, it says it eliminates most harmful microorganisms and inactivates viruses.  It does not kill spores.  Sterilization kills all pathogens, including spores.  Nowhere  in my research have I found any information that says a UV light is adequate for disinfection procedures, let alone sterilization.  All my queries about sterilization only bring up the tools I sited above.  A UV light is not good enough to clean tools that may breach your skin.  These are holding places for tools that have already been sterilized.  That's all they are good for.  Now, here's my biggest concern- sterilization is not required in nail salons.  Nowhere in the WAC laws do they require nail salons to sterilize their tools, just disinfect them!  Unfortunately my skin was breached with a nail tool and infection set in, VERY quickly and painfully.  Two days and my thumb started looking like a sausage ready to burst.  I have sent a complaint it to the Washington Health Dept.  Not to single out my manicurist, because many salons treat their tools the same way.  Instead, my goal is to educate and inform both the salon, and also the folks who set the laws, and now you.  Disinfection and sterilization are two distinctly different things.  With MRSA, VRSA, HIV, and Hepatitis, to name but a very few scary diseases, we all need to up our game, be educated and informed and raise our standards.  We all like inexpensive mani/pedi places.  And it's hard to communicate and ask questions of people who don't speak the same language, but it's time to insist on being protected, whether it's at our doctor or dental offices, hospitals, or hair and nail salons.  Don't pay the price, it's not worth it.


 Just as a reminder, gingivitis, gum disease, periodontitis, they're all also infections and infectious.

Be well my friends!
Barbara Tritz RDH
Specialist in Orofacial Myofunctional Therapy
PS. Thumb is on the mend :)



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Tuesday, June 28, 2016

Oral Systemic Dentist - Taking Dentistry to the Next Level


Hello Readers!  I'm excited to announce my partnership with oral systemic dentist- Dr. Aliriza Panahpour.  I will be working for and with Dr. Panahpour on Tuesdays in his Bellevue, Washington office as his dental hygienist/periodontal therapist/myofunctional therapist, alongside an incredible dental team, including Allison, the office dental assistant, and Elizabeth, the smiling face you see first.  It's exciting to have  a dentist with a philosophy similar to mine!

Dr. Panahpour is on the forefront of dental prevention, treating the cause of disease instead of just the symptoms- this is dentistry beyond drill'em, fill'em and yank'em.  He specializes in looking at the entire mouth-body connection.  He uses gentle air abrasion instead of the dental drill to remove tooth decay, as well as ozone to treat infection.  He sees children! (Wouldn't you prefer your child have gentle air abrasion instead of needles and drilling?)   He monitors bacteria and other pathogens.  He's got a 3-D x-ray, lasers and many other high tech instruments.  All my favorite tools, products and philosophies in one office.


As many of my fabulous, faithful readers know, I am passionate about oral health.  I constantly talk about how important it is to treat and prevent oral diseases caused by gum disease, tooth decay, bad breath, and even breathing problems and sleep apnea.  I am a total dental hygiene geek, I fully admit it.  (I read dental journals in my spare time.)  Finding a fellow dental geek is like finding a patient who actually flosses, ;) !  I am deep into readings that Dr. Panahpour has already given me.  He and I are excited to team up and offer you the next level of oral health care.  It's time to close the gap between the medical and dental professions, and work together toward total body wellness.  Dr. Panahpour understands these connections and has many other health professionals he partners with to find the causes of health issues, and help you on your journey towards health.

Elizabeth,  Allison, Dr. Pana and Barbara, ready to help you! 


To Dr. Pana's patients- I'm excited to meet all of you!  I've been a dental hygienist for over 37 years, so while  new to the office, I'm an old hand around the cuspidor!  I'm passionate and totally committed to being a dental hygienist.  I love my profession.  It's evolved over the years to being all about oral health, and total body health.  Life is much better when you're healthy, and health starts with the mouth.  Thus, dental hygiene is so much more than twice a year "cleanings."  That only means your teeth are clean twice, as in 2 days a year - my goal is that you have clean, disease-free teeth, sweet breath, and a truly healthy mouth 365 days a year!  Oral infections, whether from tooth decay or gum disease, may start in the mouth (and cause lots of havoc!), but they don't stay there.  They (bacteria and pathogens) travel throughout the body and cause other serious infections and even cancers!  Breathing or swallowing incorrectly can cause issues related to health problems too!
I've been writing a dental health blog for over two years now, and have many articles discussing these connections.  Please explore my blog posts.  If you have dental questions, please feel free to contact me.  My email address and contact info is on the right.  If you see a highlighted word, click on it and it'll take you to my references.  Everything I write will either be my stated opinion or have a reference or two cited.
My goal, as your personal Oral Health "Life Guard" is to customize a program that will fit your oral needs and goals, and help you learn best practices for a healthy mouth/healthy life.  Yes, from a dental hygienist!  Come see me for a new dental wellness experience.  I'm excited to meet you, and help you stop having cavities, bleeding gums, bad breath, oral pain.  I'm thrilled to be in an office that puts into place all the things I've written about and recommended all these years!

Call Elizabeth - 888-338-6336 select option #2 for the Washington office, and come see me for a unique, positive and gentle dental hygiene experience!  I look forward to meeting you.


Sincerely,

Barbara Tritz RDH, BS
Dental Hygienist/Periodontal  Co-Therapist
Specialist in Myofunctional Therapy

Monday, May 30, 2016

Beat the Bugs- Conquering Periodontal Disease

Here's the follow up to my latest post:  "Gum Disease: Meet the Bugs".  Now that you know how nasty these little buggers are, you need the tools and know-how to finally conquer and beat them!  This post is a little long but filled with a ton of information.

First, a little review:


Gum Disease
*Gum disease really matters.  It's an INFECTION of your gum tissues.

*Gum disease does not hurt (until the final stages).

*Half the population of the USA over age 30 has periodontal disease- that's advanced stage gum disease.

*Periodontal disease is the number one cause of tooth loss in adults.

*Gingivitis- the early stage of gum disease is the gateway to bone loss - and 50 to 90% of adults world wide have gingivitis.
                                 
*This infection is connected to an incredible number of diseases in the body.
                             
*If your gums bleed with brushing, flossing, tooth picking or eating, you may have a gum infection, which means GUM DISEASE.   Bleeding gums, even during a dental hygiene appointment mean infection, and is not a healthy sign.

Step ONE: The Basics 

The key is to get that plaque biofilm outta there!

#1. Get an electric toothbrush.  Really!  It does a way better job than your ancient, old manual brush. Believe me when I say I can always tell which patients use an electric versus a manual brush.  It shows.  It's well worth the money it costs.  Yes, I know they're "expensive."  However, when you see the list of diseases associated with gum infection, an electric brush is a trifle compared to what damage gum disease inflicts on our bodies.
Once you own it, use it at least twice a day, for at least three minutes each time.  As I've said before, plaque's sticky and really likes living under your gums and between your teeth.  It actually takes that long with the electric brush to get if off your teeth.  It takes much longer with a manual brush.

It cleans better 
#2. Clean in-between.  Most folks hate floss, so if you hate it, don't floss.  Stop with the guilt already and use something like soft picks, and piksters, or the good old rubber tip stimulator.  What I'm looking for is not massaging the gums, but rather a way to reach in between your teeth and under the gumline to disrupt and disturb the plaque.  AND, this is the really important part - mix up some baking soda and peroxide, or baking soda and your favorite mouthwash, and work that underneath the gums and between your teeth with your picks. The baking soda acts as an antibacterial agent.  (And it's cheap!)  And, yes, I'm aware it tastes less than stellar, but it works and (did I say?) it's cheap!

#3. Scrape your tongue- twice daily.  The amount of plaque-biofilm on your tongue is substantial.  It needs to go.  Be sure your children also use a tongue scraper.  I taught my then five year old to do that and it's now a part of her daily routine, just like brushing.  Still working on the flossing/cleaning in-between part though...

Step TWO: Because Brushing and Flossing really are NOT enough


You need to disinfect.  The bad guys need to get washed down the drain.  But, here's where we can get creative.  I have several options, so find one system that'll work for you.  The best tools are the ones that work best FOR YOU. 

Option 1. Water pik or Hydrofloss irrigation.  I recommend my patients use either baking soda (about a heaping spoonful) and warm water, or bleach water  (one part  6% bleach to 25 parts water) or Therasol  (concentrated solution is diluted one part to eight parts water).   All those bad mama jama pathogens can't survive that flushing.  Use a full tank of warm water, outline your gums with the pointiest irrigation tip you can find.  Each company has one.  Go around your mouth up and down, tongue side and lip side at least three times.  Keep your head over the sink and do not turn the machine on unless the tip is pointed in the sink or in your mouth or it can get messy.  And, FYI- there's always a little cold water left in the tubing.
There are shower -flosser models for those interested in doing all this in the shower.

Once a day is great, twice is incredible.

OR

Option 2.  Ozone oil and piksters- dip the pikster into the oil and work that under the gumline and in-between the teeth.  I recommend  PurO3 Tooth and Gum Support with peppermint and Stevia--tastes the best. (While you're there, they have a new Bug Bite Relief.  Ozone stops the itch of mosquitoes almost instantly- you'll thank me later. )
  Worldwide you can order ozone oils from GreyCellSales - they take payment in US dollars, UK pounds and Euros.  I love what ozone oils can do to help healing.


OR



Option 3.  Perio Protect Trays - custom made trays that you wear with special 1.7% hydrogen peroxide gel, gentle to your tissues, yet strong enough to breakdown the bacterial biofilm.  Peroxide releases oxygen - which kills the bacteria that lives in your oxygen-less gum pockets.  It also debrides the bacterial cell wall.  The specially made trays are the key to holding the peroxide into the pockets and on gum tissues, and allowing the gel to kill the pathogens.  You start out six times a day for 15 minutes, with the idea you will eventually get to twice a day for 15 minutes.  Takes about two months to transition to the twice daily routine.  And, as a great side benefit, you'll have whiter, cleaner, decay free teeth!   I have many patients using this routine and love the results they have obtained!   Here's a video I took of a patient who's been using her trays - the slide's empty!  That's what I love to see. 

OR

Option 4.  PerioSciences Antioxidant Gel and Rinse - I've just started using this product myself, and like the taste.  I've heard good things about these products from people I respect but in truth, I have not had any patients try this yet so can not vouch as to its long term results.  Check back.  For now I'm trying it on myself, working the gel in-between my teeth with piksters or rubber tips.

OR

Option 5Izun Oral Care's Perio Patch and Rinse - new, new products that heal from the outside in.  They have a unique intra-oral barrier that absorbs wound exudate (pus) and promotes gum healing.  Still learning about this but love what I'm reading!

AND

This is really not optional:
Monitoring the bacteria.  As I've mentioned before, I use a chairside phase contrast microscope to constantly monitor the gum disease bacteria.  It's quick, inexpensive to the patient, and gives us a "look see" to life under the gumline.  Click here to read an excellent article by another dental hygienist who also uses one!  I recommend my patients return frequently to monitor the bacteria and see if they are being successful in their homecare routines. If not, it's time to regroup or change things up, get deeper where the bad guys live.

And One More Thing!


Periostat - Low dose doxycycline - stops bone loss.  This is a sub-antibiotic dose of doxycycline so it does not kill bacteria, instead it alters the host (that's you) response to the pathogens (the bad guys).  The periodontal bacteria cause your body to produce enzymes and it's these enzymes that cause your bone to dissolve.  Periostat helps stop bone loss by inhibiting and suppressing those enzymes.  It's taken twice daily, am and pm, about one hour before meals.  Taking this medication is a commitment and may well be a long term thing, but isn't it good to know there are so many options to stopping bone loss and preserving your teeth!?!


That's seven different ways you can choose from to disinfect your mouth and save your teeth!   Pick one or two!  If you don't like it, try another!  Find one that works for you, and stick with it to save your teeth.

And to make sure you actually do kill them: check on the microscope.


                                                        

Step 3: The Rest of the Story

Diet - it's time to look at what you're eating, and get serious about healthy, nutritious food.  Stop eating sugar and just about anything white.  I have a patient that had a very bad case of periodontal infection  she just couldn't control until she stopped all sugar.  The transition was just about miraculous, it made me even more a believer in the healing power of healthy food.  Sugar causes inflammation


Nutritional supplements - In addition to a nutritious diet, vitamins and supplements are important.  I have an entire post on what supplements to include to support a healthy oral immune system.  Add Vitamin D3, Vitamin C Vitamin K 2, Co Q 10, Magnesium and Omega 3's  to your shopping list.  Look on my post for quantities.  


Mouth breathing - Close your mouth and breathe through your nose - all the time.  Folks that mouth breathe have red, swollen infected gum tissues, in addition to a whole host of other issues.  If you have sinus problems that won't allow you to breathe through your nose, consider having a physical- you might just have acid reflux that's causing your clogged sinuses.  It's all related.  Close your mouth, breathe through your nose.  Sleep apnea and any other airway issues are  important to address as well.   I do have another post or two on mouth breathing/nasal breathing.  Athletes, if you want to improve your performances, then it's time to really learn about nasal breathing  ;) 


Probiotics -  As we change the oral flora by eliminating the bad guys, we need to replace them with good guys!  Brand new research published May 25, 2016 says this improves oral health.  They recommend probiotics with Lactobacillus species.  There are new probiotics out for gum health.  Look at EvoraproVenus Smile Probiotic mints, or Periobalance.  Suck on one tablet in the morning and one after dinner, or whatever their instructions recommend.  These will all have to be ordered online. 


Family - gum infection bacteria are contagious so it would behoove you to have the entire family be proactive and all work on oral health together.  It's your immune system's reaction to the bacteria (i.e. the family gene pool) and viruses that cause bone loss, and you all share the same DNA, so be healthy.  Prevention and learning good oral health habits benefits the entire family!

And then there's the value of good sleep, stress management, and exercise.

Speed Bumps to Recovery: 

Dry Mouth - Many medications change the quality and quantity of your saliva.  Your mouth may not feel "dry" but if you are taking two or more prescription medications, then you can be assured the quality of your saliva is not as healthy either.  Good, healthy saliva flowing in your mouth is a vital part of maintaining a disease free mouth.  And, of course I have a post on products to help keep your mouth moist.  Let me know which products work best for you.   

Smoking and Drugs - Sorry to say, but smokers have an uphill battle to have a healthy mouth.  Drugs are no better.  I hope to do an entire post on this in the near future.   

Other Health Issues- If bleeding continues after doing therapy for a month, it may well be time for a physical and possibly a referral to a specialist.  Look at BMI, family history, gut microbiome, antioxidant levels, diet, autoimmune issues, blood disorders, and other compounding risk factors.  If you have a chronic inflammatory disease and no clue as to its cause(s) then how can you treat it?  Your medical doctor should be part of your wellness team.  More on this in a future post.  

Being Lazy:

Yup, we all are... Make a promise to yourself to get healthy and stick to it.  There's nothing you can't do if you get the habits right.  It's not quick or easy but it is possible- I wrote a post on dental habit development - click here to refresh your memory!  My one suggestion today is to not wait until bedtime to "do your teeth."  Find a way to take care of them in the morning or other time(s) during the day.  Bed time just won't work, even I might be tempted to skip doing my oral care (gasp) when I'm tired and just want to crawl into bed after a long day.


Gum infection, tooth decay in-between the teeth, and heavy grinding all in one picture! 
Hopefully I've inspired and encouraged you with new information, new products and new ideas on gum disease prevention, and on how to achieve a healthy mouth.  You have the knowledge and it's time to fight this infection with all the determination, fire power and ammo you can get your hands on!  Hopefully I've provided you with a bazooka or two for your artillery!   You can win this war!  


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Any time you see a highlighted word, click on it to go to my research.  I appreciate your questions and comments.  And, thank you all for reading. We've hit 36,000 page views!! 
Til next time, 
Keep Smiling!


Barbara RDH
Oral-Systemic Periodontal Therapist
Specialist in Orofacial Myofunctional Therapy

Sunday, May 8, 2016

Gum Disease: Meet the Bugs!

Do you want to be healthy?  Really healthy??  Let's get serious about getting rid of gum disease.  It's time for the dreaded gum disease talk, no floss lectures though ;).   The Queen of Dental Hygiene has discussed gum disease a little- now it's time to really offer up something different.  We are going to war against it!  In warfare, you have to know your enemy- his strengths, his weaknesses, and how to defeat him.  And, then you need the biggest gun!  Bring out the Bazooka!  Let's win this war, and get healthy, finally!  Here's why and then next week is how.

Meet the Bugs  - the Enemy

In periodontal disease there are 11 bad bacteria- we call them "pathogens".   Since I use a phase contrast microscope right here in my operatory (the room where I see patients is called an operatory), my patients can see them squiggling around on my video monitor like real live (microscopic) bugs.  I think "bugs" an appropriate term.  The bacteria are alive and well, living quite happily under your gums, on your tongue and even in your tonsils.  Your mouth is a warm, cozy place with plenty of "food" for the bacteria, so they multiply and invade your gums.
These bugs are crafty, resilient and hardy.
(And, for the record, I have not seen Listerine kill them.  I did my own little experiment with my microscope: plaque samples and slides, using Listerine on a slide instead of saline solution.  No dead bacteria on either the control slide or the Listerine slide. So forgetaboutit!)

Bad Mama Jama's taking over your tooth biofilm
We'll come back to the bacterial weaknesses in a moment.

Dentistry has divided up the bugs into three categories: high, moderate and low risk.  (Clever, I know!)

The high risk group has some very bad mama jama bugs.  Here are the baddest of the bad:

Treponema Denticola  (also called Spirochetes)
Porphyromonas Gingivalis  (also called Pg.)
Tannerella Forsythia  (also called Tf)
Aggregatibacter actinomycetemcomitans (also called Aa- and for good reason!  Don't even ask me to pronounce this one! I stumble every time.)

The Moderate risk group is only marginally less bad.

Fusobacterium nucleatum  (Fn)
Eubacterium nodatum (En)
Peptostrepococcus  (Pm)
Eikenella corrodens (Ec)
Prevotella intermedia
Campylobacter rectus

Low Risk

Capnocytophaga species

Then there're viruses!
Epstein Barr (EBV)
Cytomegalovirus  (CMV)
Human Papilloma Virus (HPV)

and the Fungus amongus
Candida albicans


There's no pop quiz afterwards, but I do want you to know a little about some of these guys, and why they matter.  You'll want to wipe them out once you hear what they do to your body, not to mention your mouth.


The Enemy's Strengths 

Health- that's the goal here, that's why you read this, correct?  So, in order to be truly healthy, you really have to have a healthy mouth.  Heart disease, stroke, and oral health are on the news lots lately.  Here's what you may not know!
The above bad guys pry open your mouth to invade all parts of your body.  Between being swallowed, hitchhiking your blood stream, being inhaled or even just squirreling into nerves, they are a sneaky, invading army.

Tooth Decay + Gum Disease
The oral bacteria are connected to many more serious diseases and Pg is the keystone pathogen!  He's the linchpin- even in small doses he is the key that opens the door for the other bad bacteria to enter the body.  And, he's present in gingivitis and shallow pockets- more on this important fact shortly.  Pg manipulates, changes, and enters white blood cells (WBC), which then transport it throughout the body!  This is huge!  Your white blood cells are suppose to be your attack and healing cells.  Instead, Pg changes the WBC and impairs its ability to kill Pg.  Pg hijacks your immune system!  Pg inhibits wound healing.  Try as you might to get healthy, until you reduce and remove Pg your wounded gums won't heal.  Pg thrives on the fluid around the teeth and under the gumline, which is called the crevicular fluid.  The crevicular fluid makes cortisol, especially when you're stressed, and this cortisol increases the bacterial growth.  Bacteria love cortisol!   And then they get a free ride to other parts of your body, creating havoc along the way:

  •  Pg and Oral Squamous Cell carcinoma -starting with cancer in the mouth. 
  •  Pg and Esophageal Cancer in a new study released February 2016-  Pg was found in 61 percent of patients with esophageal squamous cell carcinoma.
  •  Pg, and  Rheumatoid Arthritis  - periodontitis may be more frequent and severe in  people with Rheumatoid arthritis.  Research published May 2014 connects periodontal disease and RA.    Relatedly: Pg, Pi, and Fn in a study released in 2014 have been found in the synovial fluid of joints, failed joints as well as in the dental plaque biofilm of the mouth. 
  • Pg and Atherosclerosis research from 2015 shows that Pg causes changes in gene expression that boosts inflammation and atherosclerosis in aortic smooth muscle cells.
  •  Pg and Cardiovascular Disease - Research from 2013 supports the heart disease/stroke connection to gum disease.
  •  Pg, Spirochetes and Dementia- yes, even Alzheimer's disease is connected to inflamed gums.   This deserves it's own blog post in the near future. It's pretty scary.


Then there's the other bacteria too.



More new research:

  •  Gum disease and breast cancer connection!  Research published in 2015 connected breast cancer,  former cigarette smokers and gum disease.
  •  Candida albicans and denture wearing while sleeping increases the risk of pneumonia
  • Gum disease byproducts called metabolic small chain fatty acids have been found to wake up HIV in dormant T cells and cause the virus to start up again.  January 2015

There are many more oral-systemic connections. I've just reported some of  the latest research.  For more information  - if you're curious - click here.  There are definitely good bacteria in your mouth as well as these bad boys.  When the system gets out of whack the bad bacteria take over and crowd out all the good bacteria.

Enemy's weaknesses- know whom you are dealing with!

So, now you've met the enemy.  Unfortunately, gum disease DOES NOT HURT so how on earth do you find out if you have it, or if you are hosting these pathogens?

#1.  Know the signs of gum disease- bleeding gums (even a little bit on your toothbrush), red swollen gums, bad breath, loose teeth, shifting teeth, pus (that should go without saying), dentures not fitting correctly, and of course, pain in your mouth.

#2.  Dental examination - your dentist really is your friend, and your dental hygienist is your life guard!  Ask for their help in spotting problems before they grow.  Even better- PREVENTION!  The dental hygienist is your prevention specialist.  We roam the toothbrush isle looking at and for new products, we visit dental conventions for the same reason.  I want to know what's available and how best to use it.  Everything I recommend, from techniques, tools, rinses, pastes, and procedures- know I've done it, tasted it, tried it and figured out what is best for my patients.  My goal is to keep it super simple so it can work for you!
Spend a little extra, get more professional care more often.  There's NO research that says you can keep your mouth healthy with twice yearly hygiene "cleanings".   FYI- those bacteria start repopulating within 24 hours and are right back to the levels they were by the next day.  Twice a year is not enough!  Your homecare really matters- get that plaque off- it's where the pathogens live.

***More on some homecare treatment ideas in next week's post! ***

#3. Testing- yes it costs money.  The tests we recommend run under $400 US.   However, take a second look at that list above.  Cancer, Alzheimer's, and all those other debilitating diseases will cost you much more in the well-being of your family, not to mention possibly your life.  Cancer's a nasty, nasty disease. I urge and implore you to spend the time, effort, and money to prevent gum disease, it will keep you much healthier in the long run.

So, you ask what tests will tell if you have these bacteria?  Great question!

  • #1.  Phase contrast microscopy- I use a chairside microscope to tell me a lot about what's going on under the gumline.  You and I can see spirochetes right away! Plus there are Gram-negative rods and spores. My microscope is important to me. I can't work without one.  That'd be like your doctor saying you have strep throat without testing, you don't know what you're up against without testing! 

OralDNA testing  sample
  • #2. My other "can't live without" test is a saliva test by OralDNA .  There are other companies that also do microbial testing.  I am most familiar with OralDNA since I use their services.  They have a simple saliva test.  You swish with their saline solution for 30 seconds, spit it back in the test tube and mail it off to the laboratory.  They email your dentist the results.  The test looks at all the above bacteria, and for an additional fee can even test for many of the viruses I have listed as well.  The test also tells us what antibiotics will kill the specific bacteria you have.  Using antibiotics may be an option, I consider it one of my Bazookas! (I save it for last though.)


  • #3. Oral DNA also does another very important test- it looks at your genetics.  There are people genetically prone to being what we term hyper-responders.  That means they are much more sensitive to these pathogens than other people, and react much more aggressively to pathogens in that they get more aggressive gum disease.  Did your mom or dad lose their teeth by age 40?  How about grandma or great granddad?   Folks that are hyper-responders in the mouth are also hyper-responders in their arteries - i.e. more susceptible to heart attack and stroke.  
People who are hyper-responders are at increased risk of cardiovascular episodes- actually this puts them at the same risk as if they were a smoker.  Wouldn't it be good to know at age 20 if you found you were at increased risk for gum disease, heart disease and stroke, and  then could monitor your bacterial levels?  Talk about prevention!!   You'd only need to do the genetic test once, although they are adding new tests all the time so down the road you may elect to test further.  Personally I'd love to test each and every patient so we know where we are starting and can further customize preventive care, rather than waiting for disease to show up!

Gingivitis - not so benign 

What does "a little bleeding" really mean?  It really means you have an infection.  Period.  In order to find out what you're dealing with, you would benefit from additional testing.  It's really not a benign infection- ask the mom who lost her baby at 36 weeks due to "just gingivitis".   The bacteria in this case is Fusobacterium Nucleatum, and new research also implicates it in preventing your body from fighting cancer cells.   

Gingivitis is not something to be ignored, and ignored, and ignored until you have bone loss and your dental insurance "will finally pay" for treatment!  This infection is totally reversible, but when it settles into the jawbone, yikes! so much harder to address!!!  And it's contagious!

  Please attack this infection as if your life depends on it, because it DOES!



So, hopefully, you're inspired to eliminate gum disease.  The next post will be the nuts and bolts of fighting gum disease at home with  new tools!  I'll bring the bazooka!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~






Smile! Why? Because it makes you more attractive, it changes your mood, it relieves stress, and it helps you stay positive!

til next time, 
Barbara 








Thursday, April 21, 2016

Queen of Dental Hygiene's Year Two Round Up!



Thank you to all for reading this blog.  We've just completed writing year number two and are closing in on 34,000 page views!  WOW!  For a little old dental hygienist writing about teeth and mouth stuff that's incredible.  It reinforces to me that people want information beyond the basic floss/brush/cavity lecture.  Instead, you want information you can use. Information on how to be healthier.  Good for all of you!






Here's an index of the year's posts. Clicking on the pink words will take you to the article.  Enjoy!


Tooth Decay - why isn't this extinct by now?

K.I.S.S. Tooth Decay GOODBYE!  has some information that might just do that!

Twelve Top Tips to Tip Top Teeth  (I couldn't resist- I love alliteration)  Keeping things simple and easy is the only way to make oral health a part of people's lives.  Just so you know, I don't spend hours working on my oral health.  Find out what I do to keep my pearlies white ;)

Baby Oh Baby, What Pretty Teeth You Have  and let's keep it that way!  Easy tools and plans to help keep those baby chompers chomping away!

Oral Care for Dependent Seniors Just like little guys, bigger folk need extra special loving  care as well.

My Achy Breaky Tooth  - when teeth talk at you, you gotta listen.  Crisis prevention.

Teeth and Gums, Clean and Healthy! 

Habits- they make us or break us!

Make a Dental Habit Stick Like Glue - some helpful hints on changing routines to start new healthful habits.  Doing the same old thing results in the same old problems.

Brace Face - got braces or appliances?  You need specialized tools that fit in all these nooks and crannies. Here's a super list to help you prevent problems while moving those pearly whites around.


Sleeping revisited -  seems many people have sleep issues, and it shows up on your teeth.

Sleep Like Your Life Depends on it!  - no surprise but it really does.  And included is some new research you just gotta know!!!  Please share with all your friends and family!!  please!


Gum Disease - wish this was extinct too!

Why Do My Gums Need Therapy?   Why indeed? Are they just trying to take your money to line their pockets or do you really need it?

Revolutionary Oral Wellness - I love a rebel, folks who shake things up, think outside of conventional wisdom and move the profession forward.  Meet two ladies who are doing that!

Victory Over Dis-ease - disease such as asthma, jaw pain, and perio are controlled and eliminated with myofunctional therapy, proper breathing training, and Perio Protect trays.  More out of the box thinking. Love being a rebel myself!


Planning Ahead -  If it don't hurt, why fix it?  Because when it hurts, it's a crisis!
~Love these clean teeth~

The Game Plan  How much do you want to gamble with your teeth and mouth health?  Avoid that crisis, don't wait.  It's only a matter of time. Plan so you save money, avoid pain and keep your mouth healthy!


Total Body Health Starts in the Mouth 

The Mighty Tongue - the lowly tongue is actually a mighty important muscle!

Cat Got Your Tongue?  The Problems of Being Tongue and Lip Tied  - This post is one of my most viewed posts with well over 2000 views.  It should be a law in the US that every newborn has their tongue and lip lifted. (It is in Brazil!)  It's vital for baby's health to check for lip and tongue ties.  Swallowing and eating are affected. Read on for more.

Dental Hygiene Pearls of Wisdom - I love nuggets of information and I've tucked lots of factoids in this post!


Year One Index

Queen of Dental Hygiene's Year of Post's - 47 posts in year one! Almost one a week. So much info, my fingers couldn't type fast enough!

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

While year two didn't have as many posts, I have been busy taking continuing education courses.  With over 70 hours of CE, there's a lot of reading and processing to do so I can then share with you all this fabulous information.  Year three - I have lots of ideas for topics we haven't addressed yet such as fluoride, and root canals, as well as more in depth information and research on periodontal disease.  If you have burning questions or suggestions for an article, I'd appreciate hearing from you.

It's been fun and rewarding to share this information with you.  Thank you for reading and giving me feedback.  I truly love hearing from my readers, both local patients as well as from all over the world!  The internet is a miraculous invention.
Fish and Chips in a London Pub 
               

 Thanks again,

Til next time,
Keep smiling!
Barbara


Tuesday, April 12, 2016

K.I.S.S. Tooth Decay GOODBYE!


So. You read the last post (you did read it, right? it's here) and now you're armed with the "how-to" knowledge, and ready to start a great new health routine habit. I'm here to help.
What's your Reward? No more new cavities? Never getting the floss lecture, ever again!?  Do you want to have a healthy mouth for you and your family?  YES! Yes!! you do, and good for you!  
It can be done and I'll keep it super simple: 


K.I.S.S.


K.I.S.S. the Decay Away!  

This is how you get decay:
A perfect storm occurs! The formula:
Tooth + Decay bacteria + Sugar (carbohydrates) + Poor quality saliva + Acidic environment = Cavitation (Cavities)
This is the simple reason folks get cavities.  (Read my other posts to get more in depth information on  preventing decay)

See the dark spots under the bright white?
That's lots of root decay beneath a front bridge! 

#1.  Teeth- in order to have decay, obviously you need teeth BUT - people (adults and babies) without teeth can and do have both gum disease bacteria and tooth decay bacteria in their mouths.  They can spread these infections through saliva.

#2.  In order to get a cavity you need to have the pathogens - the bad bacteria.  No bacteria? no cavity.  These bacteria are contagious.  We get them from others and give'm to those we love.  The bacteria excrete (poop) acid on your teeth which "demineralizes" or takes out the minerals from your tooth, causing cavity formation.

#3. Carbohydrates break down in your mouth to simple sugars which then feeds the bacteria.  Bagel or candy bar - almost no difference.

#4. Dry mouth, or even poor quality of saliva (it's liquid gold!), due to medications, immune problems, medical issues and even genetics could play a part in tooth decay.  Good quality saliva is vital to healthy teeth.  Saliva contains minerals.  Having poor quality or no saliva causes tooth breakdown because there are no minerals going back into the tooth thus cavities take over and the tooth breaks down, sometimes rapidly.

#5. Acidic environment, either from what you put into your mouth- soda, energy drinks, lattes- or from your stomach due to acid reflux (even silent reflux) causes the bacteria to flourish.  They love it when the pH of your mouth stays below neutral (which is 7 on the pH scale).  Root decay occurs when the pH  dips below 6.5 and occlusal (tops of the teeth) decay happens when the pH is below 5.5.  

 Here's how to prevent decay:
In order to stop decay we need to break down the formula- interrupt it and reverse the demineralization process. 

#1. Good oral hygiene practices- daily - get the plaque off, get rid of that bad bacteria.

#2. Watch your diet- Stop constantly sipping on that latte or soda, or nibbling on that granola bar or M&M's.  It's the amount of time sugar is on your teeth that really matters. Nonstop grazing feeds the bacteria all day.  That is why we in the dental profession hate hard candies.  After you eat, rinse. (At least.)

#3. Breathe through your nose- mouth breathing leads to dry mouth.  Suck on xylitol candies- it's a good sugar that reverses dry mouth and kills the bad bacteria.  If you have two or more prescription medications- you are at extremely high risk for decay and need extra attention from your fabulous dental hygienist.  Medications result in poor quality saliva.

#4. Water is your friend, just not certain bottled water, which can be acidic.  Crazy, I know, but it can be!  Click here for a list of water pH.  (We did our own experiment here at home with my husband's pH meter.  My readings were a little different  and I was pleasantly surprised at how many of the top ten bottled waters were either neutral or slightly basic.  I will post my results  shortly.)  Where does your water fall on this list?  My ideal water would be alkaline.  In WA state I came across essentia which had a pH of 9.5, and it tastes great!! 


This is your "shopping list"  

#1. Get the plaque off - it really is "All about the Plaque" (see my blog post about plaque) - the bacteria, viruses, and other baaaaad guys hang out there so ya gotta get'em off your teeth and outta your mouth.  I call this the "plaque biofilm." It's alive! and wants to live on your teeth, in your mouth, and then also on your gums, tongue, roof of your mouth and even the tonsil areas.  (Hmmm, brushing just your teeth is not enough, is it?)   

Brush everything! Well, not your tonsils, but don't stop at your teeth- do swipe over your gums, cheeks, roof of mouth, and then clean your tongue. 

       My favorite tool is a power toothbrush - and change the brush head every three months. (I change my entire family's brushes with the seasons.)  Power brushes range in price from $15.00 to over $200.00.  Get the best one you can afford for all your family members, even the kids.

If a power toothbrush just isn't in your budget, then, of course, a manual brush is fine.  Dry brush - no toothpaste, no water, until your teeth feel and taste clean.  (To get all the plaque off with a manual brush can take upwards of 15 minutes.)  Then use toothpaste.  The power brush is really much faster so start saving up for one if you can! 
We'll cover toothpaste in a moment.
SUNSTAR GUM® Soft-Picks® Advanced 60 ct
New and improved! 

Clean in-between.  Yes, I am well aware you dislike flossing.  Yes, a lot.  I agree- it's not a habit you've acquired (yet).  So, let's instead use a different tool that's easy (and is not those floss-on-a-stick things.)  Brushing only cleans 60% of the tooth surface, don't you want to clean 100%?
Many different sizes
My favorite tools in this category- Soft picks and Piksters.  There are many different brands of "interproximal cleaners"-  these are my fave's.  I get no kickbacks from any of these companies, and there are other brands that are just as good.  I'm giving you photos so if your local pharmacy doesn't have them, you can show them what you want or order it yourself from the internet. 
I like Piksters because they have such an assortment of sizes, and the fact you can bend the brush 90 degrees and work it in-between the teeth from the tongue/palate side too.  They last a long time, but do use a little soap and water to wash and clean them. 


Best floss EVER!
If you are a flosser- super! Here's my fave: woven floss.  I use J&J Total Care Gentle Gum Care floss but there are lots of different brands with woven floss.  My problem with other flosses is that all of the waxed or slick/slippery flosses just slide right over the plaque biofilm leaving it still there, which totally defeats the purpose of flossing.  (If you have something stuck between your teeth, though, slick floss is the best.)  

I love water irrigators and cleaning underneath the gumline as well.  Today's post is about trying to simplify routines and make life easier for you.  If you want more details on irrigation, I'll be including a post on that soon.  ;) 

Toothpaste - okay- do you really need it?
Well, maybe - depends. Toothpaste has a job to do - and it needs to be treated as medicine.  My number one, most-read post out there is about toothpaste.  
There are lots of over-the-counter toothpastes, which to choose?  In tooth decay situations I want a paste that'll put minerals back in the teeth, keep plaque from sticking and raise the pH of the mouth.   That's a lot to ask of a little dab of paste.  To accomplish this: brush, spit and don't rinse- let it sit on your teeth and do its thing! 

          My faves: Enamelon - remineralizes teeth
                           Carifree CTx4Gel- remineralizes teeth, and puts xylitol in your mouth
                           Livionex - repels plaque
                           Colgate Total -repels plaque
                           Baking Soda- yes, plain old baking soda- wet it and brush gently. There aren't minerals in there but it kills bacteria, it's so gentle yet cleans well, and of course, raises the pH.

Pick one or two and stick with it!  Be picky about your paste. 
How about this costume?

Tongue Cleaning  probably should have gone completely under plaque removal, but I wanted to make sure it stood out- and this picture just kills me!  Squeeze and scrape that plaque-biofilm  off the very back of the tongue - twice daily.  Yes, I realize you gag, but the more you do it the more you'll desensitize the gag reflex.


          My Fave: Tongue Sweeper- it's metal and will last forever!
Do clean it off now and then.  Top rack of the dishwasher, or soap and water!   

#2. Kill the bad guys - tooth decay bacteria and other pathogens cause the minerals to leave your teeth, which causes cavitations-i.e. the cavities in the teeth.  I've got lots of information on tooth decay- more than you really want to know, but in case you do - click here and here for the science.  The more you know, the better you can stop decay! 

       My favorite killer products!  
          1. Carifree treatment rinse and actually all their products.  Carifree products  make your mouth a less friendly place for the bacteria.  Gargle with the rinses to reach your tonsils and the bacteria there too.  It raises the pH, so, bacteria that cause decay die.  OH  Happy Day! 
          
          2. Xylitol- It has it's very own post, so go read up!  Short version: Five servings of xylitol per day will reduce the plaque biofilm buildup on your teeth by 60% and it tastes great!  The bacteria can't digest xylitol but they try, and lo and behold, they die!  Xylitol is a good sugar - safe for diabetics and just don't overdo it. IT MUST BE KEPT AWAY FROM THE FAMILY DOG.
         
          3. * My Newest Favorite way to kill decay bacteria- bleach whitening trays with 10% carbamide peroxide.  This is actually  one of the original teeth whitening bleaches of long ago.  Use your trays with this bleach once per week - for 30 minutes.  It kills the decay bacteria, raises the pH and reduces the plaque on your teeth.  I just returned from a continuing education course and this was my favorite "take-away" from the course!  This is HUGE!  It's easy, and as a side benefit, you get whiter teeth (if you do it more than once per week).  The 10% carbamide peroxide will not harm your teeth - honestly, it's the tooth decay bacteria that destroy your teeth.  Have your dentist make the trays so they cover part of your gum tissues as well, and be sure they use a nice stiff plastic.  Pay for a "lab made" tray- it'll last longer.  It'll be a little pricier but if it keeps you from getting even one cavity, it'll have paid for itself ten times over!  Click on the link above and take it to your dentist, ask for bleach trays. EASY and so effective. That's why I love going to courses. There's always something I learn that'll make my life and yours better.

#3. Oral Probiotics - after you remove and kill the "bad guys", we need the "good guys" to take over.  Suck and then dissolve one tablet on your tongue after breakfast and then after dinner for 30 minutes.  It reduces plaque buildup, neutralizes the mouth, and it helps with bad breath!  Even children can use these, as long as they can suck on the mint.  If they can't yet suck, then choking could be a hazard.  EvoraPro even has a probiotic for your pets- their breath can get stinky too!  

The only contraindication to using probiotics would be if you are immunocompromised, since there are live bacteria in these lozenges.

There are several on the market, Here are my favorites:

                            Venus Smile Oral Care Probiotic Mints
                            EvoraPlus 
                            PerioBalance 
                            Spry Probiotic


#4. Close your mouth and breathe through your nose.  It will help raise the pH of your mouth and make it healthier.  Check the pH of your mouth with pH strips- pHion balance strips can be used  to test saliva. For more info: Breathing- Not Everyone is Doing it Right. 


So, to  recap- get the plaque off,  kill bad bacteria, put in good bacteria, remineralize, and get that saliva flowing.  Easy, and simple, really!

I spend about 10 minutes max on my teeth daily:
In the morning, I brush- my sonicare is programmed to run for three minutes- then I floss ( I'm a hygienist, I floss) and clean my tongue, which takes about 4 minutes total, I pikster in my car, and then in the PM before bed I brush, tongue scrape, and pikster again.  (You'd be surprised at the amount of food that comes out from between the teeth, even after flossing!)  I do this after dinner- for a personal two-birds-one-stone it cuts down on after dinner snacking!  I've just started using the probiotics, so I will update you on that as I get going, and while I haven't yet started using my bleach trays for decay prevention, I'm planning to get new ones made so I can incorporate that as well!

It's hard to overcome bad habits and start new ones.  In case you didn't read it at the beginning, last weeks's post was dedicated to habit formation so go back and take a closer look at that article.  Try doing things differently.  Instead of brushing after breakfast, as you're running out the door, brush in the shower.  In the evening when you're going to bed and too tired to spend more than two seconds brushing?  That's a recipe for failure.  Instead, brush 30 minutes after dinner, and then pop that probiotic in your mouth while you watch television.  I have a container of soft picks and xylitol mints in my car and use them every time I drive.  Change your routine up or sandwich new quick habits between things you already do daily, and you'll be on your way to a much healthier you!

Now you know how to K.I.S.S. tooth decay good-bye for good!

Questions, comments, or thoughts?  I'd love to hear from you!
Til next time,

Keep smiling!
Barbara