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TMJ Issues – What You Need to Know

2020-06-11T13:21:55+00:00October 22nd, 2019|Carolina's Dental Choice, General, Oral Health|

If you’ve ever experienced acute jaw pain, you’re not alone. TMJ (temporomandibular joint) disorder is a common issue that currently affects over 10 million Americans. Women tend to be more prone to this disorder than men although researchers don’t yet fully understand why. The good news is that the majority of TMJ disorders do not indicate serious, long term issues and the associated pain is typically temporary in nature. Understanding what TMJ disorder is can help those suffering to better treat and manage any discomfort that might arise.

 

What is TMJ

Your temporomandibular joint is a complicated joint that works to connect your lower jaw to your skull. It acts like a sliding hinge and allows your mouth to move in various directions which, in turn, supports your ability to eat, yawn, smile and more. Due to its design and location within the body, the TMJ is one of the more difficult joints to access and treat. Disorders of the temporomandibular joint typically present in one of three ways:

  1. Pain or discomfort occurring in the tissues that control jaw function
  2. Injury or dislocation within the area of the jaw
  3. Arthritis or inflammation within the joint

Individual causes of TMJ disorder can be difficult to diagnose as there can be a mixture of reasons why a person experiences jaw pain.

 

Causes and Symptoms

While some cases of TMJ disorder can be initiated by injury, most causes are less evident and the origin unknown. Because the disorder is found to be more prevalent in women versus men, researchers are currently studying whether female hormones might play a potential role.

While teeth grinding and jaw clenching can potentially trigger TMJ pain, it isn’t considered to be a definitive cause. Braces and other methods of alignment have also not been proven to bring about TMJ disorder.

People who experience TMJ pain commonly suffer from one or more symptoms including:

  • Pain or discomfort when eating/chewing food
  • Pain in or around your ear (sometimes feels like a dull earache)
  • Inability to fully open and close your mouth
  • Pain traveling in and around the area of the face

 

Diagnosis and Treatment

As of today, there are no set methods for diagnosing TMJ disorder. When assessing the problem, your dentist will observe your jaw, feel in the area of the temporomandibular joint for any clicking or popping, and potentially order an x-ray if he/she feels additional observation is needed. It’s also a good idea to visit your family doctor in addition to your dentist to rule out alternative reasons you might be experiencing craniofacial pain.

Often times, the pain associated with TMJ disorder will go away on its own. However, if treatment is needed, there are a handful of options typically available to most patients.

  • Over the counter pain relievers and anti-inflammatories. Common medications such as ibuprofen and Tylenol will go a long way toward providing relief for most occurrences of TMJ disorder. However, if your case is more serious, your dentist may prescribe a clinical dose to help alleviate the pain.
  • Stabilization splints (Bite Guards). A bite guard is one of the more common solutions that a dentist can provide to help with the pain of TMJ disorder. This appliance fits over either the upper or lower teeth and is typically worn full-time for a short period followed by a short stint of wearing while eating and/or sleeping. While it is not fully understood why this appliance helps it is believed that stabilizing the muscles in the mouth can help to repair any potential damage that might have occurred over time within the temporomandibular joint.

There are also a number of ways that you can control the discomfort of TMJ disorder through specific methods of self-care.

  • Practice facial relaxation techniques. Tightness and pulling of the jaw muscles can aggravate and increase discomfort in your temporomandibular joint. When you begin to feel pain, be aware of whether or not you’re clenching. Practice releasing the tension in your jaw.
  • Avoid exaggerated or repetitive movements of the jaw. Activities such as gum chewing or excessive yawning/yelling can exacerbate TMJ pain and should be avoided if possible.
  • Stay away from hard food. Focusing on eating soft foods when experiencing TMJ pain can help to keep discomfort to a minimum.

 

While there is currently no hard and fast solution to the issues associated with TMJ, there are several ways that you can manage and control the discomforts associated with it. If you are concerned you might have TMJ disorder, don’t hesitate to contact your dentist for more information.

At Carolina’s Dental Choice, our dentists are experts in the management of TMJ disorder and are ready to answer any questions you might have. Feel free to call our office to learn more about the ways we can help.

 

Works Cited

“TMJ Disorders.” National Institutes of Health, National Institutes of Health, Sept. 2017, https://www.nidcr.nih.gov/sites/default/files/2017-12/tmj-disorders.pdf.

“TMJ Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Dec. 2018, https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945.

 

 

 

 

 

 

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Managing Pain and Anxiety During Dental Visits

2020-06-11T13:38:58+00:00October 9th, 2019|Carolina's Dental Choice, Dental Trends, General|

It’s no secret that regular dental visits are an important tool for maintaining good oral health. Despite this, as much as 36% of the population fears a visit to the dentist and 1 in 25 suffers from dentophobia (extreme fear of dental visits). While there are many reasons people might have anxiety around a trip to the dentist, there are also a number of ways that both you and your dentist can help to alleviate those fears.

 

Pain and Anxiety Management

Fear of pain is the number one reason people are afraid to visit the dentist. And while having your teeth worked on won’t necessarily be something you look forward to, it also doesn’t have to be something you fear. Technology has come a long way when it comes to anxiety and pain management. Here is a list of some of the tools you and your dentist have at your disposal to combat any fears that might arise.

 

Pain-Free Shots –  Let’s just say it. Shots are scary. For all of us. No one likes to be poked with needles, especially in their mouths. However, dentists have multiple options at their disposal to help make the experience of getting a shot much easier and a whole lot less scary. If they aren’t already, ask your dentist to use an anesthetic gel or rinse to help numb your mouth before administering the shot. This will desensitize the area and lessen pain significantly.

Studies have also shown that the speed at which a shot is administered can affect the level of discomfort a person experiences. The general rule of thumb is “the slower the better” when it comes to administering numbing medication. If your doctor gives you novocaine, expect it to take approximately 60-90 minutes to wear off after the procedure depending on the amount given.

 

Providing distraction – Oftentimes dentists will offer various forms of distraction that can help to lessen a person’s anxiety and make it easier to get through a procedure. Some of these distractions include tv’s on the ceiling, movie headsets that immerse you in a world outside of your current situation and soothing aromatherapy scents such as orange and lavender. Some dentists even go so far as to have a spa-like atmosphere that provides perks such as a manicurist and reflexologist to be available during procedures.

 

Oral Pain Relief – If an alternative to a shot is needed, there are various oral solutions that can be considered. The first option is the use of nitrous oxide (N2O). We all know nitrous oxide from our childhood by its informal name of “laughing gas”. N2O works to relax you and provide you with a more pleasurable emotional feeling. Pain is intensified when we are stressed or anxious so allowing yourself to relax can be an effective method of management. In addition, N2O is considered safe and effective because it begins to work quickly and the effect is completely reversible with no long-lasting effects. When used for a dental procedure, you will recover quickly enough afterward to be able to drive yourself home.

Another oral method used to help people alleviate the fear of a trip to the dentist is a pill called Halcion. Halcion is a member of the Valium family and is usually administered an hour or two before work is done. Some dentists will also provide a pill the night before to ensure the patient has a full night’s sleep. When this pill is used, patients can feel sleepy and relaxed but are still able to communicate with the dentist.

 

Electronically Delivered Pain Relief – An alternative to injection, this type of pain relief is commonly known as transcutaneous electrical nerve stimulation or TENS for short. TENS uses low voltage electricity to help alleviate pain. Your dentist will place adhesive pads on your face in the area where they are working and send a low current through in order to achieve numbness. TENS can help to relax your jaw and facial muscles, a commonly tense area when people experience anxiety.

 

Laser Drills – While not yet formally approved by the American Dental Association, the organization says that they are cautiously optimistic about how this technology can influence the future of dentistry. Laser drills provide an alternative to traditional drills by using the energy from light to cut or vaporize infected tissues. This form of treatment is less invasive and less painful than traditional methods currently being used. A few examples of how lasers can be used in dentistry include treating tooth decay, remedying issues associated with gum disease, performing biopsies and whitening teeth.

 

IV Sedation – If more moderate sedation is needed, a dentist will sometimes use IV sedation. One advantage to this form of sedation is that the dentist has direct control over the levels you are given and can quickly adjust to meet your individual needs.

 

Additional Sedation Options – While family dentists don’t perform deep sedation or general anesthesia, sometimes when you are referred to a specialist, you may encounter these options. In order to administer deep sedation, providers need to complete a program through CODA (Commission on Dental Accreditation) focusing on deep sedation and general anesthesia. Typically this accreditation is completed by oral surgeons and dental anesthesiologists.

 

Post Dental Pain – What to Expect

While pain management during dental treatment is important, understanding pain post-treatment is equally as important. Having the ability to discern between what type of pain is normal versus when it is necessary to contact a professional can be a huge advantage for someone who is anxious about their recovery. Here are a few examples of different types of pain you might experience after a visit to the dentist.

 

Jaw Soreness/Tenderness – This type of pain is one of the more common types experienced after a dental procedure. It occurs because of your mouth being held open for an extended period of time. The muscles in your mouth are no different from the muscles in any other part of your body. Use them more than they’re used to being used and they’ll become sore and tired. One way to remedy the pain is to ask your dentist if he has a bite block available for you to use. A bite block will allow your jaw to rest while still allowing the dentist to perform dental work. If you do experience this type of pain, it will typically clear up after a day or two depending on the procedure. For people who grind their teeth, it may take slightly longer as grinding is also a major cause of jaw soreness.

 

Pulpitis – Pulpitis is caused by an inflammation of the pulp within the tooth. It can feel like the sudden onset of a toothache. Pulpitis can also cause hot and cold temperature sensitivity within a tooth. This type of pain can occur after any dental procedure where a tooth has been worked on from a filling to the repair of a cracked or chipped tooth. There is both reversible and irreversible pulpitis. With reversible pulpitis, you won’t feel pain unless something comes in contact with the tooth to affect its sensitivity. However, irreversible pulpitis is a constant pain that typically requires a root canal to remedy. Irreversible pulpitis is not a common side effect of performed dental work, rather, it is typically a sign that dental work may be necessary.

 

Referred Pain – Referred pain is when you feel pain in other areas of your body than where the pain originated. So, for example, while you might have had a root canal on your molar, your eye sockets or ears may experience pain as a result. Referred pain can be experienced from any traumatic event and can sometimes be a sign of something more serious. If you experience referred pain that doesn’t go away within a week of your procedure, be sure to check in with your dentist and let him know about the symptoms you are experiencing.

 

Methods for Addressing Post Dental Pain

While there may be no sure-fire method to completely escape the discomfort that comes after a dental procedure, there are ways to lessen the pain and make recovery a more pleasant experience. A few suggestions for improved recovery time are listed below.

  • Eat an anti-inflammatory diet before you go to the dentist. Focusing on foods that help combat inflammation will improve your overall recovery time.
  • For those with TMJ/TMD, focus on relaxing your jaw before your procedure. Consciously working to relax and stretch your jaw muscles will help reduce pain post-procedure.
  • Check for a bite block. As stated above, asking if your dentist has a bite block available can lead to a lot less pain and discomfort after the work is over.
  • Relax! While this tactic is obviously easier said than done, it’s a known fact that stress will tense your muscles and cause a longer recovery as a result. Practicing mindfulness and focusing on your breathing can go a long way towards bringing down the levels of stress associated with a dental procedure.

Of course, taking an anti-inflammatory such as ibuprofen or acetaminophen is also a perfectly acceptable way to deal with pain after a procedure. If your dentist prescribes medication, be sure to follow all the directions associated with it and never share a prescription with someone else. If for any reason, your pain doesn’t diminish or feels like it’s getting worse, call your dentist and set up an appointment to check and make sure everything is healing the way it should.

 

Pain isn’t fun for anyone. The good news is that there are several tools at your dentist’s disposal that they can use to help you through a procedure with a minimal level of discomfort. While the dentist’s chair can sometimes seem like a scary place, remember that first and foremost, they are there to help you maintain a strong, healthy smile. They have their teeth worked on the same as you and, like you, they also desire an outcome that doesn’t leave pain in its wake.

 

Our dentists are sensitive to your needs and are always happy to speak with you about the options we provide when it comes to pain control. Please feel free to call anytime during office hours and we’ll be happy to set up a consultation for you to learn more.

 

 

 

 

Works Cited

 

Boge, Emily. “Dental Phobia, Fear of Dentist & Anxiety: Colgate Oral Care.” Dental Phobia, Fear of Dentist & Anxiety | Colgate Oral Care, https://www.colgate.com/en-us/oral-health/basics/dental-visits/how-dental-phobia-develops-and-what-offices-do-to-help-0515.

Collins, Sonya. “Do You Dread the Dentist?” WebMD, WebMD, https://www.webmd.com/oral-health/features/dentist-anxiety#1.

“Controlling Anxiety and Pain at the Dentist’s Office.” WebMD, WebMD, https://www.webmd.com/oral-health/controlling-dental-pain#1.

DDS, Mark Burhenne. “Pain After a Dental Visit: What’s Normal, and What’s Not.” Ask the Dentist, 30 Aug. 2019, https://askthedentist.com/pain-dental-visit/.

Garret-Bernardin, Annelyse, et al. “Pain Experience and Behavior Management in Pediatric Dentistry: A Comparison between Traditional Local Anesthesia and the Wand Computerized Delivery System.” Pain Research & Management, Hindawi Publishing Corporation, 2017, https://www.ncbi.nlm.nih.gov/pubmed/28293129.

Kasat, Vikrant, et al. “Transcutaneous Electric Nerve Stimulation (TENS) in Dentistry- A Review.” Journal of Clinical and Experimental Dentistry, Medicina Oral S.L., 1 Dec. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312687/.

“Laser Use in Dentistry.” WebMD, WebMD, https://www.webmd.com/oral-health/guide/laser-use-dentistry.

“Sedation Dentistry: Can You Really Relax in the Dentist’s Chair?” WebMD, WebMD, https://www.webmd.com/oral-health/sedation-dentistry-can-you-really-relax-in-the-dentists-chair#1.

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Fluoride: A Comprehensive Examination

2020-06-11T13:28:22+00:00September 19th, 2019|Carolina's Dental Choice, Oral Health|

 

Fluoride. We’re all familiar with the substance. In fact, it’s so common in our modern society, that we tend to take for granted what a complex mineral it actually is.

 

The Basics of Fluoride

So, what exactly is fluoride anyway? If you’re hunting for it on the Periodic Table, you’ll need to update your search a bit. Fluoride actually gets its name from the naturally occurring element Fluorine (F). Fluorine in its purest state is a gas that can be irritating to people when they are exposed to it. However, add a little sodium into the mix and suddenly, you have the fluoride we’re all familiar with; an easily dissolvable, safe in small doses, inhibitor of dental cavities substance. Fluoride can be found in everything from the water you drink to the food you eat. Additionally, it’s used to help waterproof and stainproof items (think Gore Tex®) and is even used in welding as well as the process of frosting glass.

 

Fluoride in Our Water 

Let’s start our fluoride journey with a short lesson in history. Chances are, the tap water you’re currently drinking is supplemented with a small amount of fluoride to aid the general population in maintaining a healthy, white smile. But did you ever consider how the idea to add fluoride to your water came to be? You might be surprised to learn that the first city to add fluoride to their water, Grand Rapids, Michigan, did so back in 1944. However, this was not before over 40 years of research was performed as a way to better understand the relationship between teeth and fluoride. 

Dr. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health, was responsible for the initial introduction of fluoride into the public water system. As a doctor, he witnessed mottled enamel in populations where the water supply contained a higher concentration of fluoride. While he noticed that mottled enamel from excess fluoride exposure created unsightly brown spots on teeth, he also observed that those same patients had an unexpectedly high resistance to cavities. This triggered the idea that smaller, more manageable doses of fluoride could potentially be beneficial to communities as a whole. He presented his findings to the city of Grand Rapids and convinced them to add it to the community’s water supply. After 15 years of testing, it was determined that children born after the fluoride had been introduced into the city’s system decreased their risk of getting cavities by as high as 60%. Today over 200 million Americans benefit from the addition of fluoride in their water systems and worldwide that number is even higher.

 

The Benefits of Fluoride

We now have a better understanding of what fluoride is and where it comes from, but what about the risks and benefits? As with any substance, there is a laundry list for both. Let’s first explore some of the benefits of using fluoride, especially as it pertains to human health.

When we think of the benefits of using fluoride, our minds instantly turn to the positive outcomes in dental health and for good reason. Study after study proves the benefits that the consistent use of fluoride has on our smiles and, in turn, our overall health.  Here are a few quick facts taken from the American Dental Association (ADA) as it relates to fluoride:

  • Fluoride is a natural substance
  • It is safe and effective in protecting against tooth decay
  • Fluoride in drinking water has reduced tooth decay in the US by 20% to 40%
  • Children specifically have seen a 35% reduction in decayed or missing baby teeth
  • Fluoride not only helps prevent cavities but also helps to strengthen enamel
  • It can reduce the occurrence of demineralized enamel in addition to aiding in the remineralization of currently affected areas

 

Fluoride also has benefits to human health outside of teeth. A recent study published in 2018 in the Journal of Fluorine Chemistry provides evidence that adding fluoride into cancer-fighting drugs can increase their overall effectiveness. Researchers learned that the addition of fluoride helped anti-cancer drugs to better permeate membranes and more effectively target the bad cancer cells versus traditional chemotherapy which targets both good and bad cells. Creating a more targeted and stable cancer-fighting drug can essentially help people to live longer and maintain a higher quality of life.

 

Understanding the Risks

While fluoride has revolutionized modern-day dental care, it can still pose risks if consumed at elevated levels. Let’s dive in and examine a couple of the more common risks and side effects caused by excessive fluoride consumption.

Dental Fluorosis is a condition that can occur in young children under the age of eight who are exposed to excessive amounts of fluoride. It appears on the teeth as white streaks or spots and can usually be detected by your dentist. Children at this age are still developing their adult teeth beneath the gum line which is where the condition can occur. Once teeth penetrate through the gum line, fluorosis will stop developing. Typically, mild fluorosis will not affect the way a child’s teeth function and can sometimes improve the enamel’s ability to fight decay. That being said, it is always best to aim for the right level of fluoride for your child’s needs. Here are a few helpful tips to ensure your child is on the right track with their fluoride consumption.

 

CHILDREN UNDER 3 YEARS OLD

  • If possible, breastfeed your child exclusively for the first six months and then add in solids while continuing to breastfeed for at least 12 months.
  • If you are using formula, be sure to consult with your doctor regarding the best type to use as some infant formulas contain fluoride in the powder which, if mixed with fluoridated water, could potentially cause extra fluoride to be consumed.
  • Once teeth begin to appear, follow the ADA guidelines that suggest brushing teeth twice a day.
  • Be sure to use no more than the recommended amount of toothpaste when cleaning your child’s teeth.

 

CHILDREN AGES 3 TO 8

  • Continue to follow the ADA guidelines that suggest brushing teeth twice daily.
  • Teach children to only use a pea-sized amount of toothpaste when brushing their teeth. A little goes a long way!
  • Educate your children on fluoride safety by showing them how to spit out their toothpaste when finished instead of swallowing. Fluoride-free toothpaste works great at this age to help prevent swallowing accidents.
  • Never use mouthwash at this age because many times kids will swallow more than they spit out due to the fact that they don’t yet have a fully matured swallowing reflex.

Skeletal Fluorosis is a more severe condition caused by excess fluoride over a prolonged period of typically 10 or more years. In addition to affecting the teeth, skeletal fluorosis can also affect the bones and joints causing severe pain and sometimes even disability. This type of fluorosis is present worldwide and is endemic in certain countries with water supplies containing naturally elevated levels of fluoride.

Other potential issues and side effects of excess fluoride include acne, fertility issues, high blood pressure, and hyperparathyroidism. It is important to note that none of these issues will result from simply drinking tap water. All of these outcomes are a result of excess fluoride consumption in addition to regulated levels. If digested in the proper dose, the health benefits of fluoride almost always outweigh the risks.

 

Fluoride in Food

In addition to toothpaste and tap water, you might be surprised to learn that fluoride also exists in some of the everyday foods we eat. Let’s examine a few of the options below.

Black Tea – a single cup of black tea can contain as much as 9% of a man’s daily fluoride needs and up to 13% of a woman’s. This fluoride is found in the tea leaves themselves and is not due to the use of fluoridated water. Older leaves contain more fluoride than younger leaves and green tea contains higher levels than black. Higher quality tea tends to consist of younger leaves, so when looking at brands, quality really does matter in this instance. Adding fluoridated water to your tea will up the overall percentage.

White Wine – One glass of white wine such as chardonnay, can contain up to 7.5% of a man’s daily fluoride needs and up to 10% of a woman’s. Wine consumption should be limited to no more than two glasses a day for men and one glass for women. Additionally, choosing wines produced outside of California and/or the United States will typically also lower the levels of fluoride in the product.

Canned Crab – While other kinds of seafood such as oysters also contain fluoride, canned crab takes the crown for the highest levels. A 3.5 ounce serving of canned crab contains just over 5% of a man’s daily allowance and 7% of a woman’s.

Baked Potatoes – One decent-sized baking potato contains approximated 3.5% of a man’s daily intake of fluoride while for women that number is a bit higher at around 5%.

To put these numbers into a bit more perspective, note that daily intake overall for men should be 4 milligrams whereas for women it’s a bit less at 3 milligrams.

Fluoride is a vital tool in the fight for healthy teeth and gums. When used correctly, it can prevent cavities from forming and help you to maintain a bright, white smile. If you have any additional questions about fluoride or are curious about how we use fluoride to aid in your dental health, please don’t hesitate to contact our office at any time. We look forward to hearing from you!

 

 

 

 

 

Works Cited

 

Biolase. “Five Fascinating Facts About Fluoride.” BIOLASE, 24 Aug. 2018, https://www.biolase.com/blog/five-fascinating-facts-fluoride/.

“Fluoride.” Oral Health Foundation, https://www.dentalhealth.org/fluoride.

“Fluorosis.” Mouth Healthy TM, American Dental Association, https://www.mouthhealthy.org/en/az-topics/f/fluorosis.

Kerns, Michelle. “Foods Containing Fluoride.” LIVESTRONG.COM, Leaf Group, https://www.livestrong.com/article/532986-foods-containing-fluoride/.

Krishnamachari, K A. “Skeletal Fluorosis in Humans: a Review of Recent Progress in the Understanding of the Disease.” Progress in Food & Nutrition Science, U.S. National Library of Medicine, 1986, https://www.ncbi.nlm.nih.gov/pubmed/3295994.

Nordqvist, Christian. “Fluoride: Risks, Uses, and Side Effects.” Medical News Today, MediLexicon International, 21 Feb. 2018, https://www.medicalnewstoday.com/articles/154164.php.

“The Story of Fluoridation.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, July 2018, https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation.

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The ABC’s of Whitening Toothpaste

2020-07-16T16:54:54+00:00July 8th, 2019|Carolina's Dental Choice, Dental Trends, General, Oral Health, Teeth Cleaning, Teeth Whitening|

Teeth whitening is on the rise across the country. In 2018 alone, over 40.5 million people used some form of bleaching product to improve their smiles. Whitening toothpaste, in particular, is marketed as an affordable way to brighten your smile, but is it actually doing more harm than good?


    

A Brief History of Tooth Whitening

Despite its recent rise in popularity, you might be surprised to learn that the process of teeth whitening has been around for over 4,000 years. Egyptians were some of the first known people to follow the practice. They used ground pumice stone soaked in vinegar to improve their overall smiles. As time progressed, so did the methods. During the 1600’s people actually relied on their barbers to whiten their teeth in addition to cutting their hair. The barber would file the teeth down and then soak them in nitric acid as a way to whiten someone’s smile. Fluoride was discovered as a way to protect teeth in the early 19th century and toothpaste as we currently know it began to make its way to the public around 1945. Finally, in 1989, Rembrandt officially launched the first whitening toothpaste into the grocery market effectively empowering the general public to whiten their teeth with an affordable over-the-counter product.

Today there are hundreds of different brands of whitening toothpaste to choose from and not all are created equal. With everything from big names to natural alternatives vying for space on the shelves, it’s hard to know which path to take.

     

Understanding Extrinsic vs. Intrinsic Tooth Whitening

In order to understand how whitening toothpaste affects your smile, it’s helpful to first understand how the process of whitening works. When we observe stains on our teeth, we are generally seeing two types, extrinsic and intrinsic. Extrinsic stains are considered surface stains whereas intrinsic stains run deeper inside the tooth and are more difficult to remedy.

 

Causes of extrinsic stains include: Causes of intrinsic stains include:
Coffee or tea Tooth decay
Dark fruits such as blueberries and cherries Overuse of fluoride
Red wines Cracks/Scratches in enamel
Dark vegetables such as carrots and beets Genetics
Smoking or Chewing Tobacco Certain Antibiotics (Tetracycline based)
   

Over the counter products such as whitening toothpaste and strips are only strong enough to handle extrinsic stains. For intrinsic stains, it is recommended that you see a cosmetic dentist to learn more about safe, professional procedures that may be available to you.

 

How Whitening Toothpaste Works

Contrary to its name, one of the main ways whitening toothpaste works to remove stains is through abrasion. Tiny silica particles are added to the paste and are used to essentially “scratch” the stains off of your teeth. While this method may initially remove some of the discolorations, overuse can actually cause staining to become worse. This is because the abrasive material doesn’t just eliminate the tinge, it also scratches through the protective enamel. Loss of enamel can eventually lead to deeper, more permanent intrinsic staining. As the unprotected dentin becomes increasingly exposed to everyday food and drink, discoloration is able to penetrate past the surface and into the underlying layers of the tooth below.

In addition to abrasive particles, whitening toothpaste can also contain bleaching agents. The two most common bleaching agents used to whiten teeth in toothpaste include hydrogen peroxide and carbamide peroxide. While these ingredients are shown to be effective at whitening teeth, they should always be used in moderation as overuse can lead to demineralization of your teeth and if swallowed, can potentially inflame your internal organs or cause internal bleeding.

 

Common Dental Issues that Arise From the Use of Whitening Toothpaste

Some common dental issues that arise when using whitening toothpaste include sensitivity, retracting gum lines, and even increased discoloration as the enamel breaks down and stains are able to penetrate to deeper levels inside the tooth.

Sensitivity – sensitivity can occur for a number of reasons. Some of these include overuse of whitening toothpaste, keeping the paste on your teeth for an extended period of time, and allowing the toothpaste to penetrate through cracks or openings that are exposing the inner dentin. It should be noted that it’s never a good thing to feel sensitivity from the use of whitening toothpaste. If you have this issue, stop using the toothpaste and consult with your dentist for alternative options.

Receding Gums – if whitening products aren’t used properly and in moderation, they can irritate the gums and cause them to recede. Receding gum lines are harmful for a number of reasons. Healthy oral tissue is important not only to help prevent your teeth from getting infected but also to protect the internal area of the tooth from negative exposure to bacteria and germs. When whitening toothpaste isn’t used properly, it can cause permanent damage to gum lines, causing them to recede, and eventually exposing the vulnerable dentin and root below.

Loss of Enamel both abrasive particles and bleaching agents can lead to a loss of enamel over time. It’s important to understand that enamel does not grow back so great care should be taken any time you choose to use a whitening product. Always consult with your dentist before using over-the-counter products so they can instruct on the safest way to achieve the results you want.

 

The Dangers of Children Using Whitening Toothpaste

While whitening toothpaste is problematic for adults, it can be even more detrimental to children. The American Academy of Pediatric Dentistry recommends that all children under the age of 15 refrain from teeth whitening.  This is because a child’s enamel is thinner than an adult’s and the nerve and dentin on the inside of the tooth are still developing. Tooth enamel isn’t fully calcified until approximately two years after the permanent teeth finish emerging. The Pediatric Safety Organization warns of teenage use of whitening products in particular. Teenagers are at a greater risk for misuse and/or overuse because they tend to want to hasten or intensify the process without fully understanding the consequences. This can cause the developing teeth to become over-oxidized, resulting in a permanent breakdown of the teeth’s structure.

In general, improper use of these types of whitening products before a child’s smile is fully developed can result in increased sensitivity, demineralization of the enamel, and variations in tooth color. Children with braces or other mouth hardware are also at risk of uneven coloring to their teeth, as the portion of the tooth that is covered will not be affected by the whitener and will end up showing as a different shade from the exposed portions of the teeth.

 

Natural Alternatives to Traditional Teeth Whitening

Having whiter teeth doesn’t necessarily equate to a healthier smile. However, if you decide you want to brighten your smile using safer, more natural methods, you have a handful of options at your disposal.

Oil Pulling – oil pulling has been shown to have numerous benefits for oral health. In addition to killing the bacteria in your mouth that is responsible for plaque and gum disease, it also helps to reduce inflammation. Currently, there is no definitive evidence showing that oil pulling whitens teeth, however, many people who use the practice claim they notice a visible whitening of their teeth. Add to the fact that it’s a safe and beneficial method overall, and there’s really no reason not to give it a try to see if it works for you.

To try oil pulling, simply choose an oil of your choice (recommended options include coconut, olive, and sesame) and swish it around in your mouth for 5 to 20 minutes. You can also use a soft toothbrush to apply the oil or wipe it over your teeth with a washcloth.

Baking Soda – Sodium Bicarbonate, or baking soda as it is commonly called, is another natural product that can help to whiten your teeth. When used properly, it can reduce plaque, fight bad breath, help maintain a healthy pH inside your mouth, and assist in the overall whitening of your teeth. For the safest use with regards to oral health, it is recommended that you mix a teaspoon of baking soda with enough water to form a paste. Gently apply the mixture using either your finger or a soft toothbrush and let it sit on your teeth for approximately two minutes followed by a thorough rinse. You can apply this tincture multiple times per week for best results. Just be careful to apply gently as baking soda is abrasive and can harm your enamel if applied too strongly and too often.

Apple Cider Vinegar – apple cider vinegar is another effective way to help whiten your teeth. The reason vinegar works as a whitener is because it contains acetic acid which helps to remove the plaque and clean teeth. To use vinegar effectively as a whitener, mix one part vinegar with three parts water and swish in your mouth for about a minute. Be sure to spit it out once you’re finished. A couple of tips to remember when using Apple Cider Vinegar include:

 

  1. Always dilute the vinegar with water before swishing. Straight vinegar has a highly acidic pH and will damage the enamel on your teeth if overused.
  1. Only use organic brands of apple cider vinegar. This is because non-organic brands are typically pasteurized, which removes the majority of the beneficial properties contained in the vinegar.
  1. Be sure to wait at least 30 minutes before brushing your teeth after use. Residual vinegar remains on your teeth and can harm your enamel if you brush while it’s still present.

 

Brush and Rinse After Eating and Drinking – being vigilant about your teeth after eating and drinking can really make a difference in the amount of staining you accumulate over time. Make an effort, when possible, to brush your teeth after eating food and drink so that you can alleviate stains before they happen. If you drink coffee or other staining drinks, try to follow it up with a glass of water to help mitigate the effects. Regular coffee drinkers or smokers may also want to consider a visit to the dentist every three months instead of six to help keep their smile bright and healthy.

Naturally, one of the best ways to keep a sparkling, white smile is to take care of your teeth on a daily basis. Brush at least twice a day for two minutes at a time, floss regularly, and visit your dentist every six months. If you are interested in learning more about professional teeth whitening, please feel free to call our office. We’ll be happy to help answer any questions you might have and discuss how we can safely and effectively help you to achieve a brighter, whiter smile.

 

– Julie Mastbrook

 

 

 

 

 

 

 

Works Cited

 

“Apple Cider Vinegar Teeth Whitening: Can You Safely Use Apple Cider Vinegar to Whiten Teeth?” Emergency Dentists USA, www.emergencydentistsusa.com/apple-cider-vinegar-teeth-whitening/.

 

“Apple Cider Vinegar vs. Organic Apple Cider Vinegar.” LIVESTRONG.COM, Leaf Group, www.livestrong.com/article/107959-apple-cider-vinegar-vs.-organic/.

 

Axe, Josh. “6 Ways to Naturally Whiten Your Teeth.” Dr. Axe, 9 Mar. 2018, draxe.com/6-ways-to-naturally-whiten-your-teeth/.

 

“History of Toothpaste – Toothbrush History.” History of Toothpaste – Toothbrush History, www.colgate.com/en-us/oral-health/basics/brushing-and-flossing/history-of-toothbrushes-and-toothpastes.

 

“Is Teeth Whitening Safe For Children?” Kids Dental Online – Plano & Carrollton, www.kidsdentalonline.com/dental-topics/teeth-whitening-safe-children/.

 

Lee, Sean S., et al. “Tooth Whitening in Children and Adolescents: A Literature Review.” American Academy of Pediatric Dentistry, Pediatric Dentistry, 17 Aug. 2005, www.aapd.org/globalassets/media/publications/archives/lee-27-5.pdf.

 

Pesce, Nicole Lyn. “The Dark Side of Teeth-Whitening Strips.” MarketWatch, 10 Apr. 2019, www.marketwatch.com/story/the-dark-side-of-teeth-whitening-strips-2019-04-10.

“The Risks of Tooth Whitening Toothpastes | Winston Salem Dentist.” Distinctive Dental, 30 Nov. 2017, www.distinctivelydental.com/can-whitening-toothpastes-damage-teeth/.

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The Hidden Dangers of Mouthwash: What You Need to Know

2021-02-05T18:11:46+00:00June 5th, 2019|Carolina's Dental Choice, Dental Trends, Dentist Office Monroe NC, Oral Health, Teeth Cleaning, Teeth Whitening|

Mouthwash is often touted as a safe and effective method for curing bad breath and improving overall oral health. But recent studies show that not all mouthwashes are created equal. Before you add a mouthwash to your daily dental regimen, take a minute to understand some of the potential dangers that might be hiding in that morning and evening routine.

 

The Problems with Conventional Mouthwash

While advertising may state that conventional mouthwash kills 99.9% of all bacteria, that’s not always the full dental story. Many conventional types of mouthwash contain up to a 26% alcohol content in addition to other dangerous ingredients. When you swish mouthwash twice a day in your mouth for an extended period of time, a number of things occur.

  1. Alcohol destroys the friendly bacteria your body needs to maintain normal blood pressure and positive oral health. Think of it like an antibiotic for your mouth. It doesn’t distinguish between good and bad oral bacteria, it simply kills it all.
  2. Conventional mouthwash dries out your mouth and affects saliva production. This can actually result in worsened breath over time in addition to increased cavity production because saliva acts as a natural barrier for both of these dental conditions.
  3. Recent studies have shown that using conventional mouthwash may potentially lead to high blood pressure issues because of disruption with the body’s production of NO (Nitric Oxide), a molecule inside the body that helps to regulate blood pressure.

A sample of ingredients that are the biggest culprits for these dental issues include alcohol (associated with drying your mouth and killing bacteria), Chlorine Dioxide (used as a bleaching agent to whiten teeth), Chlorhexidine (an antiseptic that is also an allergen), and formaldehyde (dangers include cancer risk and respiratory problems).

 

Discovering Natural Mouthwash Alternatives

There are several natural mouthwash alternatives available over the counter that provide a safer option for those that want to maintain their daily swishing regimen. A few choices are listed below.

  1. The Natural Dentist
    This mouthwash can be found at most major retailers and is tailored towards those with sensitive teeth and gums. The ingredients are all natural and contain 20% Aloe Vera which is a natural antiseptic that replaces conventional use of Chlorhexidine without the side effects.
  2. Therabreath
    This mouthwash is also available at most major retailers and helps increase saliva production instead of drying out your mouth. It also uses natural ingredients including aloe vera and tea tree oil which is another natural antiseptic used to aid in overall oral health.
  3. Oral Essentials
    Created by dentists and thoroughly tested, this mouthwash contains sea salt to help maintain the healthy mineral balance in your mouth. In addition, you’ll find such natural ingredients as aloe vera, coconut oil (a natural teeth whitener), and essential oils (aids in freshening breath). This mouthwash can be found on Amazon in addition to other online retailers.

  

Do-It-Yourself Mouthwash? Why not!

A quick search on the internet for do-it-yourself mouthwash will yield plenty of recipes for you to experiment with. When wading through the never-ending list of oral options, keep a few essential ingredients in mind. 

  1. Aloe Vera
    As mentioned above, Aloe Vera is a top-notch replacement for the conventional mouthwash ingredient, Chlorhexidine. Studies have shown that it is equally as effective as an antiseptic but without all the harmful side effects.
  2. Essential Oils
    Essential Oils are a natural way to freshen breath without the drying effect of alcohol. They also contain antibacterial properties and oils such as lemon contain whitening properties to help keep your teeth shiny and bright.
  3. Sea Salt and Baking Soda
    Both these ingredients have strong benefits for oral health. Used as mouthwash ingredients, sea salt will help to restore the mineral balance of your mouth while baking soda will help to ease gingivitis and whiten teeth.

 

Final Thoughts on Mouthwash

Studies show that conventional mouthwashes are not as effective or as safe as typically advertised. They can contribute to dry mouth, mess with the balance of bacteria in your mouth and even cause increased gingivitis and cavity formation. The best way to keep your dental health in tip-top shape is to work on the problem from the inside out. Keep a balanced diet and stay away from processed foods and sugars. If you still want to make mouthwash a regular part of your dental routine, stick with all natural brands or create your own recipe so that you are in control of the ingredients going into your mouth and body.  For more information, please contact Carolina’s Dental Choice.

 

 

 

 

 

 

 

 

 

 

 

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