Why do I need to floss my teeth?

 

Why do I need to floss my teeth? Flossing is effective at removing food, bacteria, and plaque between your teeth and along the gum line where the toothbrush cannot reach. While tooth brushing removes bacteria and food debris on the outside surfaces of the teeth, the toothbrush cannot remove plaque and bacteria that is between the teeth.

BENEFITS OF FLOSSING

• Removes bacteria between the teeth
• Removes food and plaque that can be stuck and caught between your teeth and along the gum line
• Can help improve your breath and decrease likelihood of halitosis, bad breath.  Food and bacteria between the teeth can cause halitosis.
• Helps prevent cavities between your teeth.
• Helps prevent gingivitis (bleeding gums) and periodontitis and the possible need for deep cleaning
• Can help your teeth remain whiter by removing foods that can cause extrinsic stains
• If someone is currently undergoing orthodontics (braces), brackets and bands can act as an annoying food trap.  Flossing will help remove such food and bacteria stuck between the teeth.

 WHAT HAPPENS IF I DON'T FLOSS

• Increased risk of tooth decay
• Increased risk of gingivitis, gum bleeding, and bone disease
• Increased risk of halitosis (bad breath)
• If someone is currently undergoing orthodontics (braces), if one does not floss, this exponentially increases one's risk of gingivitis and tooth decay.

 HOW OFTEN SHOULD I FLOSS?

Studies have shown that daily flossing is efficient at removing bacteria, food, and plaque between the teeth.  Along with twice a day brushing, daily flossing is an effective method at keeping your teeth and gums healthy and vibrant. 

It's debatable whether one should floss before or after tooth brushing, but as long as the flossing is done daily, that's the important thing!

HOW SHOULD I FLOSS?

1. Start with approximately 18-20 inches of fresh new floss each time.  Waxed floss is a good choice as the wax may flossing easier go between the teeth.
2. Wind most of the floss around each of your middle fingers, leaving about an inch of floss in between the middle fingers
3. Hold the floss tightly between the thumb and index finger, and slide it up and down between the teeth gently
4. Very gently curve the floss at the end base of the tooth.  Make sure the floss gets underneath the gums.  Try not to force the floss down as this may injure or bruise the gums.
5. Use clean sections of the floss as you move tooth to tooth.
6. When done flossing, dispose of the floss and wash your hands with water and soap.
7. Repeat steps 1-6 daily.

If you have any questions about the importance of flossing your teeth, be sure to ask your dental hygienist and dentist.

Warm  Regards,

Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
425-615-1600

Signs Wisdom Teeth Need Extraction

Impacted Wisdom Tooth

WISDOM TEETH

"Wisdom teeth" can be an anomaly in its own right.  Some people have them and those teeth are just fine.  Others have to put up with the occasional discomfort.  And still others have to deal with persistent throbbing pain.  So how does one know if wisdom teeth need to be extracted?

WHERE ARE MY WISDOM TEETH?

Wisdom teeth are typically the very last molars in the mouth.  Also called third molars, they are usually the most posterior teeth in each quadrant (upper right, lower right, upper left, lower left).  Most adults have four wisdom teeth, one in each quadrant.  In very rare cases, some adults have develop a "fourth molar" which is usually nonfunctional, atypical in shape, and may be located deep beneath the jaw bone.

WHEN DOES MY WISDOM TEETH NEED TO BE REMOVED?

Some common signs and symptoms that wisdom teeth need an extraction include:

• Persistent throbbing and aching pressure adjacent to the wisdom teeth that is not going away.  This may be due to insufficient space for the wisdom tooth to fully erupt.  May be also known as hard tissue impaction, and feel like a toothache, and as such may require emergency dentistry.
• Swollen and bleeding gums directly on top of the wisdom tooth.  This is also known as soft tissue impaction and pericorinitis.
• Wisdom tooth causing tooth decay and cavity to the tooth next to the wisdom teeth.  In some cases the wisdom tooth is erupting at an angle (mesial impaction) causing decay and/or external resorption of the adjacent tooth.  After the wisdom tooth is extracted, the affected tooth may need a filling or root canal and porcelain crown, or even an extraction, depending on the size of the cavity.
• When the wisdom tooth is so far back in the jaw it is hard to keep the area clean, and the tooth has a large cavity that is difficult to restore.
• If the wisdom tooth is difficult to keep clean, there is bone loss that causes the tooth to have periodontal involvement.

WHAT IS THE FUNCTION OF THE WISDOM TOOTH?

Research suggests that humans in the past had larger jaws to accommodate wisdom teeth, and it is thought that the wisdom teeth were used to help with chewing of foliage and plants due to a predominantly plant based diet.  As humans evolved and diets changed that included meat, the jaw decreased in size and wisdom teeth no longer serve its once thought to be designed function for foliage chewing.  The result is wisdom may become impacted, overgrown, and thus need to be either restored or surgically extracted.

If you have any questions on wisdom teeth extractions, be sure to consult your family dentist or oral surgeon.

From your gentle family dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600

Bone Graft and Dental Implants Why Need

DENTAL IMPLANTS AND BONE GRAFTS

Dental implants have become a increasingly popular option to replace missing teeth.  But before your general dentist, periodontist, or oral surgeon places a dental implant to replace one or more missing teeth, a bone graft may be required prior to the placement of the implant.  It may sound a little intimidating at first, but bone grafts are in general a very predictable, painless, and routine part of dental care.

WHAT IS A BONE GRAFT?

As we age and get older, our oral soft and hard tissue structures change.  Specifically gingival and bone structures supporting where teeth were once present and now missing, atrophies and becomes smaller.  A predominant reason why our jaws have the current density and amount of bone they do is due to the presence of existing teeth.  With teeth in support and in constant function, it stimulates the bone and allows continuous bone regeneration and prevents bone from degeneration.  Without teeth to support the adjacent bone, the jaw bone atrophies and degenerates to a basal bone level.

Most jaw bone will atrophy within the first year and a half after the tooth is initially missing, and will then continue to undergo bone loss at a indefinite slow rate.  For patients with total complete loss of teeth, this usually results in a very thin ridge of bone in the lower jaw (mandible); for the upper jaw (maxilla) the results are less pronounced.

BONE GRAFT HISTORY

In the past, bone grafts were frequently done in a hospital setting.  It was not uncommon for surgeons to use a patient's ribs or hip bone to increase lower jaw size.  Sometimes skin grafts were also taken from a patient's thigh and placed inside the mouth to prevent the tissues from moving the denture while patient is talking and chewing.  Fortunately with modern research and technology, a more preventive and contemporary approach has made the dental implant procedure less invasive and more minimalistic. 

WHAT CAN CAUSE BONE LOSS  THAT MAKES BONE GRAFT NECESSARY?

Potential bone loss causes within the oral cavity may include the following below: 

• Tooth Extraction - In cases where it is a dental and medical necessity to remove a permanent adult tooth, bone loss within the jaw can happen if the tooth is not replaced with an implant.
• Sinus Deficiency - Whereas in cases where a molar is removed from the upper jaw (maxilla), air pressure within the sinus cavity can "push down" on the sinus floor and cause bone resorption.  The result is an enlarged sinus (hyperneumatized sinus).  A sinus lift may be necessary to "push" up the sinus floor. 
• Periodontal Disease - With periodontitis, bacteria not only affects and causes gingival inflammation, but bacteria has begun to erode the bone structure and cause bone loss.  If periodontal disease is not treated with the appropriate dental cleaning, it may lead to tooth loss and subsequent bone loss.
• Tumors - Abnormal growth can be either benign or cancerous.  If either tumors are not controlled or removed it can cause bone destruction and loss.
• Developmental Defect - Some cases of birth defects can cause portions of the jaw bone to be missing or irregular in density and amount. 
  
• Accidental Trauma - Unfortunate accidental circumstance in a dental emergency, these trauma cases may result in tooth loss.  Accidents may include inadvertent heavy sports contact, playground mishaps, automobile accidents, and accidental slips and falls.  With loss of tooth eventually follows loss of bone.
• Orthodontic Malposition and Misalignment - If a tooth does not have an opposing dentition, said tooth can super erupt (over erupt), causing bone loss.
• Dentures -  A denture is a removeable prosthesis that replaces one or more missing teeth.  The denture, complete or partial, can be anchored by a dental implant to help with retention.  The denture area that is not anchored by a dental implant can result in alveolar bone loss as the tissue beneath said area is not stimulated.
• Dental Bridge - A dental bridge is a permanent prosthesis designed to replace a missing space by attaching a "floating" tooth between two or more adjacent front and back crowns. The portion of the bridge filling in the gap of the missing tooth that does not stimulate the jaw's alveolar bone can result in bone loss.  Good oral hygiene via proper brushing and flossing is also needed to prevent bone loss around the attached crowns. 
• Osteomyelitis - Rare case where bacteria has caused an infection of the jawbone and bone marrow.  Result is bone inflammation and reduced blood flow, causing bone necrosis and loss.

SO WHY IS BONE GRAFT NECESSARY?

The jaw bone's, also called alevolar bone, main purpose is to support and hold a tooth firmly in place.  In order for a tooth to be stable and not be mobile, the area needs to have sufficient bone.  Without adequate bone, the tooth can have periodontal issues and eventually lead to tooth loss.

With a dental implant, the bone serves the same structural support purpose.  The jaw needs to have sufficient bone structure to support the implant firmly.  In the case of a tooth extraction, it may be possible to place a dental implant same day immediately after the tooth is removed.  Sometimes it may not be feasible to place an "immediate implant" due to a dental infection.  In such situations a socket preservation graft may be necessary, as this graft fills up the void from the extracted tooth.  The graft retains the bone volume while the adjacent alveolar ridge proliferates and fills the missing space with live bone.  Typically the preservation graft may take between three to six months healing times before an implant can be placed.

If you have any questions on dental implants and bone grafts, be sure to consult your family dentist.

From your gentle family dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600

Dental Implants with Dentures, the Overdenture

DENTAL IMPLANTS

Dental implants have become an increasingly popular method to replace one or more missing teeth.  With an average time span of three to six months after the implant has solidified and osseointegrated into the jawbone, the implant abutment and dental crown are then placed to complete the implant restoration, helping the patient achieve optimal esthetics, chewing, and speech.

IMPLANT SUPPORTED OVER-DENTURE

Complete full dentures often rely on the existing bone ridge and gingiva for retention (ie. to ensure the denture does not fall out and stays in properly).  Denture adhesives can help to ensure the denture stays in, but must be used periodically throughout the day.  Dental implants can also be used in certain denture case to help make sure the denture stays in place.  Also known as implant over-dentures, multiple single implants are placed on top of the ridge.  The dentures then "snap" in place on top of the implants, firmly holding the denture in place.  The result is increased fit and retention, without the need for denture adhesives.

How can Dental Implants Help Hold the Denture in Place?

• There is sufficiently thin bone ridge, denture adhesive does not help and the denture still "wobbles" and moves around.
• The patient does want the constant need to apply adhesive to the denture and wants a more permanent solution.
• Due to extreme muscle and bone atrophy, there is near nonexistent bone structure and ridge to support a denture in place.
• One does not have the physical ability or dexterity to apply denture adhesive, and would like a easier and more convenient method to hold the denture in place

Benefits of A More Secured Denture

• Increased ability to chew
• Eliminates need for denture adhesive
• Increased self confidence
• No need to worry the denture falling out

If you have any questions on how dental implants can help support and retain a complete denture, please contact you family dentist.

From you gentle family dentist in Bellevue,
Dr. Peter Chien
www.bellevuefamilydentistry.com
(425) 614-1600

Toothbrush, stay away from....

Here's an interesting fact about toothbrushes.  Where do we usually brush our teeth?   Probably in the shower, or in front of the bathroom sink and mirror.  But have you given thought where the toilet is in relation to where you brush?

Did you know that when flushing the toilet, water particles from the toilet can travel airborne up to 6 feet away?  Yup, 6 feet, that's quiet a distance isn't?  It's a given that the toothbrush should be clean and only contain toothpaste and clean water, but what if it contained small particles of.... ok, I won't say it, but you get the idea :)

So next time you brush, you may want to stand a little further away from the toilet :)

From your family Bellevue dentist,
Dr. Peter Chien
www.bellevuefamilydentistry.com
4125-614-1600

Baby boomers!

Americans are living longer than ever, and the segment of population >65 years old is expanding.  Hence it's even more important to take preventive measures to maintain your oral health, and the best way begins at home.  Daily brushing with a soft tooth brush and fluoridated toothpaste after meals, along with flossing one to two times a day, is a great and effective way to keep your teeth and gums healthy and free of plaque.  If you have a denture, be sure to brush it every day as well so its free of plaque and food debris.  Soaking the denture daily it in a denture cleanser is also a good way to keep your gums and adjacent teeth healthy.

Be sure to consult your dentist if you have any questions regarding preventive oral hygiene.

Warm Regards from your family Bellevue Dentist,
 Dr. Peter Chien
www.bellevuefamilydentistry.com
425-614-1600

Now that summer is about to end and fall about to start, parents and kids alike are often in that "back to school" rush.  Mornings are often busy times as the family is getting ready for school and work.  Try to take a few minutes of everyone's time to sufficiently brush for at least 2 minutes in the mornings. A good measure would be to try singing the ABCD song 2 times.  By the time the song is over, the brushing is done!

Then in the evenings, try and repeat the 2 minute brush cycle.  With a regular routine set aside, brushing becomes "automatic" and promotes healthy gums and teeth :)

From your family Bellevue dentist at Bellevue Family Dentistry,
Peter Chien, DMD
www.bellevuefamilydentistry.com
425-614-1600