5 Tips for Staving Off Gum Disease (& 4 for Making Sure You Don’t “Forget” to Floss)

flossing teethAs we mentioned last time, a healthy mouth isn’t a 100% “germ-free” mouth – something that’s impossible to achieve anyway – but one with a healthy balance of oral flora. For most Americans, maintaining that is a bit of a struggle – to put it mildly. But hey, red, swollen gums or a little blood when you floss is no big deal, right?

Wrong. They’re signs of periodontal (gum) disease. Other symptoms include bad breath, gum recession, loose teeth and sores in your mouth. It’s been estimated that up to 75% of US adults have some degree of gum disease. It’s the 6th most prevalent health problem in the world.

And bleeding gums are just the start.

As the disease progresses, the normal space between the teeth and gums (the sulcus) gets deeper. These “pockets” become perfect little harbors for bacteria and other pathogens to proliferate: dark, wet and lacking oxygen. The immune system goes on red alert to fight the infection. Unless treated and successfully managed, the disease process ultimately breaks down connective tissue and supporting bone.

Eventually, with less structure there to support them, teeth will loosen and come out.

And that’s just the damage that happens in the mouth. Through recent years, a vast amount of research has shown links between gum disease and all manner of other inflammatory disorders, including diabetes, heart disease, stroke, Alzheimer’s, kidney disease, rheumatoid arthritis and cancer.

Fortunately, periodontal disorders are not only treatable but largely preventable. How?

  1. If you smoke or otherwise use tobacco, quit. Tobacco use is the number one risk factor for gum disease.
  2. Get enough good quality sleep and take steps to manage stress. Lack of sleep and chronic stress have both been shown to make you more vulnerable to perio problems.
  3. Eat a whole foods-based diet, rich in fresh produce, low in added sugars. Avoid soft drinks.
  4. Exercise – or at least stay physically active. Those who are regularly physically active are at lower risk of gum disease, even if they used to smoke.
  5. Practice optimal oral hygiene at home – brushing and flossing regularly – and have dental visits at least twice a year for exams and professional cleanings.

And yes, the flossing part really does matter. A lot. Remember: Brushing only reaches about 60% of the total surface area of your teeth. You need floss to get the rest, as well as below the gumline. And you need to floss effectively:

Here are a few tips to help you not forget – or to push past excuses for not flossing:

  1. Floss before you brush.
  2. Floss in the shower.
  3. Keep floss nearby where you usually watch TV or video so you can floss while you watch.
  4. If you really don’t like the feel of traditional floss, try using flossers. The handle makes them a little easier to maneuver well. Other alternatives include interproximal (proxy) brushes and oral irrigators. Some suggest these last two may be even more effective than traditional floss.

And if you have gum disease already? Typically, treatment includes frequent deep cleanings from a dentist or periodontist (a dentist who specializes in the health of the gums and other supporting tissues). Antibiotics – pharmaceutical, natural or homeopathic – may be used, as well. Both ozone and laser therapy can be extremely helpful for disinfection. There’s been some suggestion that these may even stimulate bone growth in the jaw.

The most important thing is to do something. Left unaddressed, gum disease never gets better, only gets worse. The earlier we spot it and help you manage it, the better – and easier and less expensive – the outcome.

Image: Patricia H. Schuette

Guest Post: Don’t Like to Floss?

Our thanks to the Tooth-Body Blog for letting us share this great post on how periodontal health supports heart health:

Let’s face it: Committing to flossing regularly is a tough task for a lot of people. The most generous surveys say only about half of us floss daily. Others put the figure around 20%. Some folks never floss at all.

Maybe flossing feels awkward or icky. Maybe it doesn’t have the same kind of instant gratification that smooth teeth and minty breath give after brushing. Maybe it’s painful. Maybe braces or dental work make it seem too tricky.

There are lots of reasons why people don’t floss. But there are even more reasons to make flossing a habit, not the least of which is lowering your risk of heart disease.

The Heart of the Matter

heart disease diagramMost people have no idea how inextricably connected the mouth is to the heart. Dentists have to take special care with patients who suffer from heart disease, as the connection between heart health and periodontal (gum) health has been well established over the years.

Though dental plaque is nothing like the plaque that can build up your arteries – a sign of heart disease – both both are a sure indicator that the body needs help maintaining its natural waste management systems.

Your body is designed to constantly regenerate itself, but if it gets overwhelmed by lifestyle choices like poor diet and smoking, and underwhelmed by proper maintenance measures like exercise and oral hygiene, things do tend to pile up. Often that happens in those tiny, life-giving arteries that pump oxygen, blood and nutrients around your body, leading to high blood pressure, atherosclerosis, heart attack and possibly even stroke.

Inflammation sets in. That’s one of the things the body does when it is under stress, constantly releasing a pasty substance called C-reactive protein which, like arterial plaque, builds up over time and increases the risk of all the unpleasant situations mentioned above.

Research has shown that flossing can reduce that risk – as well as your risk of other inflammatory conditions, including Alzheimer’s.

Still not persuaded to floss? Well, some recent research points to an excellent alternative.

“Flossing” by “Proxy”

interproximal brushesA recent study linked the consistent use of floss or interproximal (“proxy”) brushes to a reduction of coronary heart disease, suggesting it’s not the specific tool that matters so much as the activity of cleaning between the teeth (“interdentally”).

You see, when you brush your teeth you really only get part of the job done. No matter how fancy the brush is, it just can’t get all the way through the narrow gaps between teeth where most of the trouble starts. (In fact, some of the biggest increases of tooth decay we’re seeing involves interproximal caries, or cavities between the teeth.) This is where floss comes in – to scrape away bacteria and debris that your toothbrush misses.

And if you don’t like to floss, a proxy brush can be a fun and effective alternative. These tiny brushes are designed to get between the necks of the teeth. Instead of scraping like floss, the action is more like a miniature bottle brush for your teeth. As you gently slide the brush back and forth, the bristles dislodge food particles, break up biofilm (bacterial colonies) and gently massage your gums.
 

 
According to a 2009 research review in Evidence-Based Dentistry, proxy brushes may be even more effective than floss.

In fact, you can make them even more effective by periodically dipping the proxy brush in an herbal rinse such as the Dental Herb Co.’s Under the Gums or Tooth and Gum Tonic as you brush.

You can find proxy brushes in a variety of sizes in virtually any drugstore, but unless you have noticeably large gaps between your teeth, it’s best to start small and adjust sizing to your needs. But be aware, you may still have some spaces too narrow for the brush – your front teeth, in particular. Such spaces usually require flossing. You never want to force the brush between your teeth.

Give proxy brushes a try and let us know what you think in the comments!

Proxy brush image by Sommarflicka

The Perfect Toothbrush?

brushing teethLooking for a $1,000,000 idea? How about the perfect toothbrush?

That’s exactly what entrepreneur Mike Davidson and dentist Mike Smith set out to do. Since 2007, this team has been working towards creating a toothbrush that scrubs and polishes better than any other toothbrush on the market. (Not that others haven’t tried before.)

What’s so special about this brush?

To remove the bacteria that cause gum disease, most dentists say you should hold the brush so the bristles are at a 45-degree angle to the gum line. Easy enough, but most people don’t. Davidson’s brush has an unusual handle that automatically puts the bristles at the correct angle.

Note the phrase “most dentists.” But it turns out there’s actually little consensus on the matter.

This we know thanks to a paper that came out in the British Dental Journal not long before NPR’s feature on Davidson’s and Smith’s brush. (Talk about lousy timing!) A review of online materials and dental texts found that

There was a wide diversity between recommendations on toothbrushing techniques, how often people should brush their teeth and for how long. The most common method recommended was the Modified Bass technique, by 19. Eleven recommended the Bass technique, ten recommended the Fones technique and five recommended the Scrub technique. The methods recommended by companies, mainly toothpaste companies, differed from those of dental associations, as did advice in dental textbooks and research-based sources. There was a wide difference in the toothbrushing methods recommended for adults and for children.

So what to make of all this? As the study’s lead author told the New York Times, “a simple scrub” may be effective enough.

And truth be told, the kind of brush you use matters less than you may think. A toothbrush can’t make you brush your teeth effectively any more than a treadmill can make you exercise.

What matters is that you clean all of your teeth. By “all,” we mean every single surface where plaque and bacteria might lurk.

That means between the teeth, too. Bristles can’t reach these areas, making them the ideal breeding grounds for oral bacteria and other pathogens. This is where flossing comes into the picture. Not only does it help clean these surfaces, as well as remove any food debris that’s been caught, but it also helps lower your risk of gum disease – and the host of other inflammatory conditions that have been linked to it.

If flossing is a problem for you, you may find it easier to achieve the same result – a clean mouth – by using interproximal or “proxy” brushes, perio-aids or an oral irrigator such as Waterpik. (Another benefit of using an irrigator: It’s easy to add herbal medicaments such as Dental Herb Company’s Under the Gums that can enhance oral health.)

The main thing: Get every surface clean. It’s your best insurance against decay and disease, supporting both your oral and systemic health.

As for the best toothbrush? As we’ve said before, the best brush is the one you use regularly.

Image by Just Jefa

Reflecting on Our First Blogiversary…

It’s hard to believe we’ve been blogging for more than a year now! And in recognition of this first “blogiversary,” we thought we’d take a look back at our very first post – a post on an absolutely fundamental point of optimal oral health: practicing good cleaning habits at home. As the title reminded, it’s about more than just brushing…
 

Toothbrushing Isn’t Enough

The statistics are all over the map, but one thing is clear: for most Americans, flossing isn’t a high priority. Most brush their teeth – if not as often or as well as they should – but less than half floss regularly. Some “forget.” Some make excuses.

 

 

Is it any surprise that half of us have periodontal (gum) disease, according to data from the CDC? This inflammatory condition has been linked with a number of systemic health problems, including diabetes, heart disease, stroke and rheumatoid arthritis.

It’s as simple as this: When you brush, you clean only about 60% of the surface area of your teeth – even if you use a fancy, sonic brush. It’s like bathing by washing from your feet up to the middle of your torso, leaving everything else increasingly filthy.

Flossing is what cleans the rest of your teeth – their necks, between them and at the gumline. As periodontal disease progresses, pockets form between your gums and teeth, becoming safe harbors for oral pathogens (bacteria, viruses and the like). The deeper the pockets, the harder to clean and the more gum disease advances.

And the more advanced your gum disease, the more likely you are to eventually wind up with a mouth like this:

 
edentulous
 

Yes, gum disease also contributes to tooth loss. The disease ravages both the bone and soft tissues that support your teeth. As you lose this structure, your teeth begin to loosen. Eventually, they fall out (or your dentist recommends extracting them).

Knowing this, flossing suddenly doesn’t seem so bad, does it?

But there’s another option for cleaning the parts of your teeth that toothbrushes can’t manage: interproximal, or interdental, brushes. These fit between your teeth, where they can be manipulated along the necks and at the gumline. Many people find them easier and more comfortable to use than floss.

In fact, some research suggests they may be even better than floss! A research review in Evidence-Based Dentistry, for instance, found them more effective at removing biofilm. Pocket reduction also was much more “pronounced” among “proxy” brush users. A similar paper published early last year in the Canadian Journal of Dental Hygiene found these brushes to be “an effective alternative to dental floss for reducing interproximal bleeding and plaque.”

Here’s a quick demonstration of how they’re properly used:

 

 

You should be able to find proxy brushes at Walgreens or any other good sized drugstore. If all else fails, they’re readily available online from numerous retailers.

Whether you floss or use a proxy brush or even both (some do, especially if their gum disease is advanced), the main thing is this: Do it. Make it part of your routine for a healthy mouth (and a healthy rest-of-you, too).

Toothless mouth image via doctorspiller.com.

Toothbrushing Isn’t Enough

The statistics are all over the map, but one thing is clear: for most Americans, flossing isn’t a high priority. Most brush their teeth – if not as often or as well as they should – but less than half floss regularly. Some “forget.” Some make excuses.

 

 

Is it any surprise that half of us have periodontal (gum) disease, according to data from the CDC? This inflammatory condition has been linked with a number of systemic health problems, including diabetes, heart disease, stroke and rheumatoid arthritis.

It’s as simple as this: When you brush, you clean only about 60% of the surface area of your teeth – even if you use a fancy, sonic brush. It’s like bathing by washing from your feet up to the middle of your torso, leaving everything else increasingly filthy.

Flossing is what cleans the rest of your teeth – their necks, between them and at the gumline. As periodontal disease progresses, pockets form between your gums and teeth, becoming safe harbors for oral pathogens (bacteria, viruses and the like). The deeper the pockets, the harder to clean and the more gum disease advances.

And the more advanced your gum disease, the more likely you are to eventually wind up with a mouth like this:

 
edentulous
 

Yes, gum disease also contributes to tooth loss. The disease ravages both the bone and soft tissues that support your teeth. As you lose this structure, your teeth begin to loosen. Eventually, they fall out (or your dentist recommends extracting them).

Knowing this, flossing suddenly doesn’t seem so bad, does it?

But there’s another option for cleaning the parts of your teeth that toothbrushes can’t manage: interproximal, or interdental, brushes. These fit between your teeth, where they can be manipulated along the necks and at the gumline. Many people find them easier and more comfortable to use than floss.

In fact, some research suggests they may be even better than floss! A research review in Evidence-Based Dentistry, for instance, found them more effective at removing biofilm. Pocket reduction also was much more “pronounced” among “proxy” brush users. A similar paper published early last year in the Canadian Journal of Dental Hygiene found these brushes to be “an effective alternative to dental floss for reducing interproximal bleeding and plaque.”

Here’s a quick demonstration of how they’re properly used:

 

 

You should be able to find proxy brushes at Walgreens or any other good sized drugstore. If all else fails, they’re readily available online from numerous retailers.

Whether you floss or use a proxy brush or even both (some do, especially if their gum disease is advanced), the main thing is this: Do it. Make it part of your routine for a healthy mouth (and a healthy rest-of-you, too).

Toothless mouth image via doctorspiller.com.