How Does Your Dentist Detect Cavities?
For most people who go to the dentist, they have to take it on faith that when their dentist tells them they have a cavity that they do actually have a cavity. Ever wondered how exactly your dentist knows when you have a cavity? Let’s take a look at all the ways this can happen…
Visual Inspection
For surfaces your dentist can see, they look for changes in the enamel surface of the tooth. Early cavities can change the enamel to a white color while later on it can take on a brown, black, or gray appearance. Visual inspection alone can be challenging because several other things can appear similar to cavities such as developmental problems with teeth or staining. They’ll also look for any staining or breakdown around the edges of any existing fillings or crowns you have. These can sometimes be an indication that decay is starting or will be starting soon in those areas.
By Feel
Cavities start to break down the surface of the tooth, leading to a soft or sticky feel with an instrument known as an explorer. Most dentists have started to move away from using these instruments aggressively as they damage enamel surfaces as well as push bacteria deeper into grooves of teeth. A light touch with these instruments is ok. Again, this method only works on surfaces your dentist can get to. Surfaces in between the teeth (which are some of the most common areas for adults to develop decay) can only be checked with x-rays or certain electronic cavity detection systems.
X-Rays
For a cavity to show up on a x-ray, nearly 50% of the tooth structure has to be already missing. Cavities in the mouth are always bigger than they appear on x-rays. X-rays are most helpful for cavities in between teeth (the surfaces your dentist can’t see). Cavities on the front or back side of a tooth as well as on the biting surfaces usually don’t show up until they are quite large.
The challenge with all the previous methods is that they are very subjective. Different dentists see and feel different things, even on the same patient. Many studies have been done about how accurate these types of cavity detection are and the results are disheartening for dentists. Generally dentists are pretty accurate in that if they say there is a cavity there, they are usually right. The real problem is not diagnosing some cavities that are there. Sometimes none of the methods are able to detect the decay until it is quite a bit larger than we’d like. Because of this, several companies have developed electronic devices to help with the process (with varying success).
Cavity Detection Devices
Fluorescence based cavity detection devices such as Diagnodent – These devices detect the fluorescence of certain proteins in bacteria associated with cavities. Some of the machines will beep faster and others show higher numbers when they detect this protein. The big challenge with these types of systems is that they tend to have a lot of false positives (saying there is a cavity when there actually isn’t). If there is polishing paste left on the tooth, even this can trigger it. I personally don’t like these types of systems for that reason. I also think they’ve been misused by many dentists (more on that later).
Transillumination based systems – In these systems, a special wand shines a very bright light on both sides of the tooth and a camera takes a picture of the tooth. Any less dense areas of the tooth (say where a cavity is) will show up as a dark area on the picture. I’ve found this type of system to be a very helpful piece of information in the puzzle about cavities but it definitely can’t replace the other methods.
Laser based systems – These systems are probably the most advanced of all of them. The most well known is the Canary System. They use a special laser that detects breakdown in the structure of of the crystals of the tooth. Research indicates that this is the most accurate of all the detection methods and can detect a cavity at the very early stages.
The Verdict on Electronic Cavity Detection Systems
One thing that is both good and bad about these systems is that they can pick up decay at a very early stage, when it has just started to barely break down the enamel and hasn’t spread into the dentin. Many dentists will see these very early cavities and go ahead and put a filling in when maybe they should just watch the area and try to remineralize it. Remember that cavities can be remineralized (fixed!) when they are only in the enamel layer of the tooth. This requires diet change and aggressive use of fluoride but it can and is done.
I’m ok with dentists using these systems as long as they are not the only tool that is used to determine whether the cavity needs to be taken care of or not. Ideally, they’ll use information from all the different methods and their brain (the best tool) to decide whether or not a filling at this time is the best course of action.
Questions To Ask Your Dentist
If in doubt about whether or not you need treatment for your cavities, ask your dentist to show you specifically where the cavities are. An honest dentist will be happy to do so. Most dentists nowadays have small cameras that can quickly take pictures of your teeth. If the cavities are on a visual spot, they can easily take a picture and show it to you. If the cavities are in between the teeth, they can show you on your x-rays. These may look relatively minimal and hard to see, but if you can see even a small shadow where they are pointing, it likely needs to be taken care of. Lastly, if they are using a digital detection system, ask about how big the system is estimating the cavity to be. If it is very minimal, ask whether remineralization is still an option (only before it has spread into the dentin of the tooth). If, they dodge the questions or you don’t feel comfortable, get a second opinion! Again, an honest dentist should have no problems with this. The treatment plan from the second dentist may be slightly different (there are always differences of opinion on when exactly to treat, even among honest dentists) but should be relatively close to what your other dentist recommended.
The Corners of My Mouth Are Cracked, Red, and Sore!
Most people at one point or another will develop cracked, red and sore areas in the corners of their mouth. This condition is technically known as “angular cheilitis”. These areas will oftentimes bleed when you open your mouth wide, scab over, and then crack again. It can be painful to open your mouth, eat, chew, or speak. Spicy or salty foods tend to irritate the areas even more.
There are several common reasons for developing angular cheilitis…
- Infections – These are most often fungal infections but can sometimes be bacterial. Fungal infections like areas that are moist and warm which the corners of your mouth definitely are.
- Lip licking, thumb sucking, or finger sucking – It is most often kids who do this consistently enough to cause problems but I have seen adults who do this as well. These habits keep the area moist allowing for infection to set in. Some of the enzymes in saliva are also thought to irritate the skin in the area leading to more inflammation.
- Not having any teeth – When you don’t have teeth, your mouth closes more so than before. This overclosure causes saliva to pool in the corners of your mouth, setting up an environment that makes this problem much more likely to happen. Wearing dentures will restore the correct dimensions of your mouth and help this problem to go away.
- Allergy to products such as makeup.
- Vitamin Deficiency – Another common cause is Vitamin B deficiency. If other treatments haven’t been effective, consider taking B vitamins.
Treatment:
In most cases it will resolve pretty quickly with treatment. An anti-fungal cream is the best first step. You can use the same types of creams that are used for athletes foot such as Lotrimin or Lamisil. Hydrocortisone cream will help reduce some of the inflammation. Apply a small amount to the corners of your mouth several times a day. If it doesn’t start feeling better within a couple of days, add some triple antibiotic ointment to the mix. Apply this several times a day as well. Your dentist or physician can also give you a prescription for something similar.
Five Common Questions About Braces
Is it normal for my teeth to feel loose?
Absolutely. Constant light pressure applied to teeth (as with braces) causes changes in the tissues and bone around your teeth that allow them to move. A side effect of this process is that the teeth become quite loose. You’ll be able to notice and possibly see movement of your tooth with pressure from your tongue, finger, or when you bite. No, your teeth aren’t going to fall out even if they feel like they’re going to!
The looseness of the teeth also makes it vitally important that you wear a sports mouthguard while playing any kind of contact sports. There are mouthguards made especially for when you are wearing braces. I have recommendations for the best over the counter products here.
What foods should I avoid?
The brackets for braces are bonded to your teeth. While this bond is pretty strong it can be broken if the forces are strong enough. Your jaw generates a ton of force when chewing so if you combine hard, sticky, or chewy foods with braces, the braces will lose every time. Some of the common foods you should avoid include…
- Nuts
- Popcorn
- Corn on the cob
- Ice
- Biting into apples without cutting them up first
- Hard candies
- Sticky candies such as starbursts or skittles
- Gum
- Crusty bread
- Beef jerky
- Hard tacos
What kind of pain is normal with braces?
When you first get your braces on, you’ll have some pretty significant soreness in all of your teeth for about a week. With time this soreness with get quite a bit better. For some people the soreness goes away entirely while other people continue to have very mild soreness throughout the process.
Thereafter, every time your orthodontist or dentist changes your wires, adds springs, adds build-ups, adds powerchains, or any other orthodontic technique to apply more force you’ll develop soreness for about 3 days afterwards. This will subside more quickly than when you first got your braces on.
Do I really need to wear my bands?
Only if you want to get your braces off! There are certain types of tooth movements that only work if you wear the bands your dentist or orthodontist recommends. Not wearing your bands only increases the amount of time you need to wear braces. Also, if you’re going to wear bands, wear them for the amount of time recommended. If you don’t wear them consistently throughout the day and night they won’t be effective.
What is the best way to clean my teeth with braces?
I really think everyone with braces should get an electric toothbrush and a waterpik. Most electric toothbrushes have a special attachment that is good at cleaning around braces. The waterpik should be used in conjunction with your electric toothbrush. Waterpiks have proven to be just as effective as regular string floss in cleaning between your teeth. It’ll save you time and help you clean far more effectively. If you don’t get those areas clean you can develop cavities around your braces or your gum tissue can get really irritated and swell around your teeth and braces.
Painkillers For Dentistry
If you’ve ever dealt with severe dental pain you know how important it is to be able to use a painkiller to help deal with the pain until you see your dentist. I’m going to go over all the different types of painkillers that are typically used for dental pain and which ones are best in certain situations. Broadly, we can break up painkillers into two categories: Opiates and Non-opiates. The non-opiate painkillers are all over the counter while opiate painkillers are all by prescription only.
Non-Opiate Painkillers
Aspirin – Aspirin was one of the first painkillers discovered. It is in a class of drugs known as salicylates. One of the side effects of aspirin is that it increases bleeding which is generally not great in dentistry when you need a tooth taken out or other surgery. You don’t get great pain control with aspirin compared to other options. Aspirin can also cause a very serious condition known as Reyes Syndrome is taken by a child. I don’t recommend aspirin for dental pain.
Tylenol / Acetaminophen – Tylenol is an analgesic that is good for mild pain. Tylenol works by blocking pain messages from your brain. Unlike Ibuprofen, it doesn’t reduce inflammation in any meaningful way. A common dosage for Tylenol for is 400-500 mg however you can take up to 1000 mg every 6 hours. Too much Tylenol can cause severe liver damage so you don’t want to take high doses for more than a couple of days. If you have liver disease, consult with your doctor before taking. Tylenol is often combined with opiate medications (see the next section) for better pain control.
Ibuprofen / Motrin / Advil – If you are able to take Ibuprofen, it is the recommended over the counter medication for dental pain. It works very well for mild to moderate pain. Ibuprofen is in a group of medications known as non-steroidal anti-inflammatory drugs (NSAIDS). Another common NSAID is naproxen sodium which works in a similar manner. The most common dosage of Ibuprofen is 400 mg but you can take up to 800 mg every 6 hours. Ibuprofen tends to upset your stomach and can cause kidney damage at high dosages. If you have problems with your GI system or kidneys, ask your doctor if you should be taking Ibuprofen.
Combination – When better pain control is needed with over the counter medications, you can take Ibuprofen and Tylenol at the same time. They work in separate ways and will not cause an overdose when taken together.
Opiate Painkillers (also known as Narcotics)
Opiate painkillers are usually used when someone is expected to have moderate to severe pain. In most dental cases this means after a tooth extraction, dental surgery, or a toothache in which you need a root canal.
Hydrocodone / Acetaminophen – The most commonly prescribed opiate medication for dental pain is a combination of hydrocodone and acetaminophen. Dosages of the hydrocodone usually range from 2.5 mg to 10 mg and the dosage of acetaminophen is 325 mg. This combination goes by several different names including Vicodin, Lortab, or Norco.
Oxycodone / Acetominophen – For more severe pain a combination of oxycodone and acetaminophen is used. Oxycodone is a slightly stronger opiate than hydrocodone. Dosages usually range from 2.5 mg to 10 mg with a 325 mg dosage of acetaminophen. As with any medication that is in combination with Tylenol, don’t take more than 1000 mg every 6 hours or you risk liver damage.
Demerol (Meperidine) – This is prescribed for people who have a true allergy to codeine / morphine based opiates. It is in a separate class of opiates known as phenylpiperidines. It isn’t quite as effective as hydrocone or oxycodone. The most common dosage is 50 mg.
Some cautions about using opiate painkillers. Side effects of opiates include constipation, nausea, stomach upset, and itchiness. Taking them on a full stomach can alleviate some of these side effects. Opiate painkillers should also never be taken at the same time as alcohol or benzodiazepines. These can interact strongly leading to a variety of complications up to and including death. Most accidental overdose deaths are a result of taking multiple drugs (including alcohol) at the same time. Opiate medications also carry a very real risk of addiction if you have a personality susceptible to this. If you have any inkling that you might be at risk, please be mindful of the risk and take precautions. Opiate painkillers should only be taken when absolutely needed and discarded afterwards. It is good to put someone else (responsible) in charge of discarding them when you don’t need them anymore.
Gaps in Baby Teeth
Many parents come to me worried because their child has gaps in between all of their baby teeth. They are worried because they think that gaps in baby teeth mean that they’ll have gaps in their permanent teeth. Is this actually the case? What do gaps in baby teeth actually mean?
Good news for all parents out there. Gaps in between baby teeth are perfectly normal and healthy. In addition to being used for chewing, the primary reason for baby teeth is to hold the space for your permanent teeth. Children who lose their baby teeth early due to cavities or accidents actually lose space in their mouth leading to crowded adult teeth. Adult teeth are also quite a bit larger than baby teeth. Those gaps ensure that there will be enough space for the adult teeth to come in properly.
I would much rather a child have a child with gaps in between their teeth than no gaps. These children almost always have better spacing of their adult teeth than children without gaps. Children who already have crowded baby teeth almost always end up with crowded permanent teeth. One other benefit to gaps in between baby teeth is that it reduces the risk of developing cavities in between them. Teeth that are touching tend to catch food between them and develop cavities there. Smooth surfaces that can be easily cleaned by your saliva and toothbrushing are far less likely to develop a cavity.
So, again, if your child has gaps in their baby teeth, don’t worry! Yes, it is possible that they may develop spaces in their adult teeth but it is also very likely that they’ll develop normal straight adult teeth too. If they do develop gaps, those are much easier to fix than highly crowded teeth.
Snap On Smile Review
Snap On Smile is a really interesting new appliance in dentistry. It is a relatively inexpensive solution for a large number of cosmetic problems. I’ll go over everything you need to know about Snap On Smile so that you can make an informed decision about whether or not Snap on Smile is right for you.
There are two different ways you can have a Snap On Smile Made.
- At Your Dentist. Your dentist will take impressions of your teeth and go over picking the right tooth shape and shade. They’ll send this to a dental lab who will make the Snap on Smile. The process usually takes about a month before you’ll get it back. Most dentists charge somewhere between $1500 – $3000 per arch.
- Direct Through A Dental Lab. Several dental labs offer the ability to get a Snap on Smile directly through them. In these cases they’ll provide a self impression kit for you to take a mold of your teeth at home. You’ll send this mold to them and they’ll create the Snap on Smile for you. The benefit to this way is that the price is significantly less than what you’ll find at your dentist. The downside is that if you have problems with it, you won’t have anyone to adjust it for you. If you do go this route, I’d highly recommend having a check-up at your dentist to make sure you don’t have any gum disease or active cavities. Either of these can cause problems long term with your Snap On Smile. You’ll also need to take an extremely accurate impression of your teeth which can be a bit challenging the first time you do it. The lab I recommend has a guide on self impressions and you can also check out my guide on self impressions here. Doing it direct will usually cost you about 1/2 of what you’d pay at the dentist.
If you do go direct, I recommend using Brighter Image Dental Lab. They have a lot of experience in making Snap On Smile’s direct for patients.
What Conditions Are Best Treated With A Snap On Smile?
There are a lot of different cosmetic conditions that this appliance can treat. It is actually the most versatile appliance cosmetically of anything I have available as a dentist. Some of the main things it is good for include…
- Missing teeth (No more than 2 teeth in the back with no teeth behind them or more than 4 teeth in a row if you have teeth in front and behind the space)
- Heavily stained teeth
- Spaces
- Crowded teeth
- Small teeth
- Worn teeth
This graphic is from DenMat (the company that creates the Snap on Smile Product) and shows a couple before and after pictures of people that were treated with a Snap On Smile. As you can see, you can get a really nice result!
Don’t Use Snap On Smile In The Following Situations…
Just like everything else, Snap on Smile, isn’t great for every situation. Some people aren’t a good candidate for it and it can actually cause permanent damage. If any of the following describe you, you shouldn’t pursue this appliance unless the issue is corrected first.
- Moderate to severe gum disease with loose teeth
- Teeth that are flared forward significantly
- Too many teeth missing (see above)
- Severe underbites
- You have no teeth and/or wear dentures
Also I’d highly recommend using Snap On Smile with caution if you have a lot of cavities and would like to use it cover them up. While this will provide a nice cosmetic result over top of your teeth, underneath the cavities will continue to develop. As soon as one of these teeth break your Snap On Smile will become an expensive paperweight. Get those cavities treated before doing something like this.
What Is The Process Like For Getting A Snap On Smile Made?
The first step (either direct or at your dentist) is taking impressions of your teeth, selecting the correct tooth shape, and selecting a shade for your teeth. The impressions should be as accurate as possible to get the best possible result. Once all this is completed, everything is sent to the dental lab who will create your Snap On Smile. The process of creating it takes about a month from start to finish. Once it comes back from the lab, you should be able to just pop it in place over your teeth and you’re all done!
Benefits to A Snap On Smile
- Quickly change your entire smile
- Very inexpensive compared to veneers or braces
- Looks better than a partial denture with metal clasps
Downsides to Using A Snap On Smile
- Initially you may have some problems speaking correctly until your tongue gets used to having it in place
- You may have problems with food getting caught around or under it
- Cosmetic results aren’t as good as more expensive options such as veneers or braces
- If you have dental work done such as large fillings or crowns, it may no longer fit
Common Questions About Snap On Smile
Can you eat with a Snap On Smile in place?
Yes you can eat with the Snap on Smile in place. I’d caution against eating anything super hard with it in place though. This would include nuts, hard candies, and chewing on ice.
How long does a Snap On Smile last?
This can be difficult to answer without knowing the specific design of your Snap on Smile. Most labs have a two year warranty on breakage. With good care of it, and no major changes in your mouth, you can expect it to last about five years. Snap on Smiles with large areas of teeth to replace will have a tendency to break more quickly than those that don’t replace teeth.
Does a Snap On Smile get stained easily?
No, the material used to create the Snap On Smile is stain resistant. Some people who build up stain quickly will get some staining on them depending on their specific diet.
How do you clean a Snap On Smile?
You should brush it with soap and water. I don’t recommend using toothpaste as it can scratch and dull the surface and make it pick up more stains.
What Causes Sensitive Teeth?
There are a lot of different things that can cause your teeth to become sensitive. If you can figure out why your teeth are sensitive, you’ll know better how to treat the sensitivity.
Receding Gums – Your gums can recede from aggressive tooth brushing, periodontal disease, or with age. This exposes the root surface of your teeth which are much more sensitive. Treatments for receding gums include using a sensitive toothpaste, placing fillings over the root surfaces, or in severe cases, gum grafts over the receded areas.
Cavities – Cavities expose the more sensitive inner areas of your tooth. Large cavities can also irritate the nerve of your tooth. Both of these can cause your teeth to become sensitive. The only solution for this is to have your dentist take care of the cavity.
Whitening – During the whitening process, peroxides lift stain and debris out of the small tubes that make up your teeth. This leads to some temporary sensitivity until the holes become blocked up again (usually within a couple of days). No damage is done to your teeth during the process.
Acidic Foods and Drinks – Acidic foods and drinks break down the enamel layer of your teeth. The enamel layer is very dense and does a great job of protecting the nerve of your tooth from most hot and cold sensations. When this layer starts to break down you can develop sensitivity. Avoiding acidic foods and drinks will help the enamel layer remineralize and decrease your sensitivity.
Recently done dental work – Any time a tooth is drilled on it irritates the nerve of the tooth. The nerve becomes hypersensitive to any sensation which just takes some time to go away. This sensitivity can last from a day up to several weeks. Occasionally if the irritation is too much the nerve will become so irritated that it can’t heal anymore. This causes a constant, severe toothache that only goes away once you’ve had a root canal, an extraction, or the nerve dies altogether.
Bite is high – If you’ve recently had dental work done and your bite is slightly off it also irritates the nerve of the teeth. This irritation can cause the same type of sensitivity that you have from recently done dental work. Your bite may not even feel “off” but you may be hitting on the tooth in a different direction when you grind or move your teeth all around. Have your dentist take a look and see if your bite needs an adjustment.
Sinus pressure – Sinus pressure can irritate your top, back teeth. Sometimes it is a dull ache and other times your teeth will be sensitive. Once the sinus pressure resolves the tooth will settle down and the sensitivity should decrease.
Tooth extracted next to it – When you have a tooth taken out it exposes the side of the tooth or teeth next to it. These areas haven’t been previously exposed to the environment in the mouth and tend to be more sensitive than other areas. Usually this sensitivity will subside with time as the tubes in the tooth in those areas get blocked up again.
Genetic Predisposition – Some people just have more sensitivity than others. You may have had the same exact type of dental work done on a tooth and the same amount of receding gums but have far more sensitivity than someone else.
What To Do After A Tooth Extraction
The First 24 Hours After Your Tooth Extraction
Be careful while you’re numb as a lot of people have a tendency to bite their lips, cheek, or tongue without knowing it. This is especially common when you’ve had a bottom tooth pulled as your entire bottom lip and side of your tongue are usually numb.
Take medication for pain by the clock for the first 1-2 days. Depending on the type of extraction you had and your pain tolerance, the pain can range from mild soreness to pretty significant pain. The best way to keep it under control is by taking pain medication consistently over the first 48 hours (this is when the pain is the worst). If your dentist prescribed narcotic medications, they may make you drowsy or sleepy. They can also cause nausea, upset stomach, or constipation. Taking your medication with food and drinking a lot of water will help to counteract some of these side effects.
If you’d prefer not to have any impairment, the best medication for pain will be Ibuprofen. I usually recommend 600-800 mg every 6 hours for the first two days. 800 mg every 6 hours is the maximum dosage and shouldn’t be exceeded.
Avoid any hot foods or drinks. This can dissolve the blood clot and cause you to develop a dry socket.
Avoid anything crunchy, spicy, or acidic. Crunchy foods tend to traumatize or get stuck in the extraction socket. Spicy and acidic foods tend to cause a very uncomfortable burning sensation in the area.
For The First Week
Avoid smoking. Smoking impairs your body’s ability to heal. The suction created by the physical act of smoking also has a tendency to dislodge the blood clot leading to a dry socket.
Avoid blowing your nose. For certain teeth, especially top molar teeth, any excess pressure can cause a hole to develop between your sinus and your tooth socket.
Avoid straws. This is the same as with smoking. The sucking motion tends to dislodge your blood clot putting you at a high risk for a dry socket.
Clean your teeth as normal, being slightly more gentle in the area of where the tooth came out. You may experience some very slight bleeding from this which is normal and ok.
What To Do To Control Bleeding
Some people will continue to bleed pretty strongly after a tooth extraction. So what you can do to stop the bleeding after a tooth extraction?
The first thing you should do is bite down firmly on gauze for at least 30 minutes. Don’t chew on it or just hold it in place passively. You want to apply significant pressure by biting down on it hard! Don’t change the gauze out unless it becomes entirely soaked and is no longer absorbing anything else.
If you’re still having bleeding after using gauze as described, take a tea bag (black tea is ideal) and bite down on it just like you did with the gauze. The tea has chemicals known as tannins in it that help control bleeding. Bite on this for at least 30 minutes as well.
Rest and lay down. Your head should be at the same level as your heart. This decreases your blood pressure.
Common Complications
There are quite a few common complications of tooth extractions.
Swelling – Swelling typically is the worst in the first day after the extraction and decreases quickly after that. Swelling is most common in difficult extractions or in extractions where the gum tissue had to be cut.
Bone fragments – During an extraction, small pieces of bone can be dislodged from the tooth socket. Over time these fragments will start to work their way out. You’ll generally feel some discomfort while this is happening and eventually you’ll notice a small sharp piece of bone sticking out of the gum tissue. Small fragments can be pulled out with a pair of tweezers or you can see your dentist to have them remove it.
Dry Socket – A dry socket develops when you’ve lost the blood clot that forms in the socket where the tooth came out. This most commonly occurs with difficult extractions on lower molars but can happen with any tooth. Hot foods and drinks, smoking, and using a straw are all risk factors for developing a dry socket.
Jaw soreness – Jaw soreness after having a tooth taken out is pretty common. It can be the result of the injection, having to stay open too long, or the pressure from the actual extraction. This soreness takes anywhere from a couple of days to a couple of weeks to go away.
Bruising – With difficult extractions or if you bruise easily, you might notice a bruise on the outside of your face near where the tooth was taken out. It’s not usually
The Best Way to Clean Dentures
Anything that stays in your mouth for long periods of time without being cleaned will get dirty, REALLY quickly Bacteria, fungi, and mineral deposits can build-up on any surface. Occasionally I see patients who have infections under their denture because they haven’t been cleaned. Other times I see denture patients who have so much hard build up on their dentures that they don’t fit anymore. Don’t be like these people! Clean your denture regularly!
Before we look at the best ways to clean your dentures, let’s go over what should not do. Many people think that since you clean your teeth with toothpaste and a toothbrush that you should do the same with your dentures. This is actually one of the worst things you can do! Toothpaste is highly abrasive and will put small scratches all over the entire surface. These scratches provide a perfect place for bacteria and other things to build up on the denture.
Now that that is out of the way, let’s look at the best way to clean your dentures.
- Brush your denture daily with soap and water. You can use a toothbrush or a specially designed denture brush. Both work just fine.
- Store overnight in a glass of water with a denture cleaner in it. This won’t replace the need to physically brush it. Think of your dentures in the same way you think of your teeth. Mouthwash is a great addition to keeping them clean but you’ve still got to do the physical work of brushing them. Anytime you take them out, they should be put in water. The acrylic can warp if it stays out of your mouth or water too long.
- Buy an ultrasonic denture cleaning machine and put your denture in it about once a week. This will help to clean off any hard build up that has accumulated on the denture. If you do see hard build up on your denture, don’t try and scrape it off yourself. You’ll be likely to scratch it and cause it to build up even more material in that area.
Follow these simple steps and your denture will stay clean and looking bright and new for a long time!
Triclosan
In the ongoing quest of toothpaste companies to come up with the most effective toothpaste, every company seems to have some special formulation or chemical they add that they say makes their toothpaste “the best”. In the case of Colgate Total, they may actually be able to say their toothpaste is the “most effective” in combating plaque, gingivitis, and decay. Their special ingredient? Triclosan plus a co-polymer.
About Triclosan
Triclosan is a highly effective antibacterial and antifungal chemical. It has been in use since the 1970’s in hospitals for hand scrubbing prior to surgery. Since then it has been added to a multitude of other products including toothpaste, mouthwash, soaps, deodorants, and some plastics for its antibacterial effects. Interestingly enough, in soaps, it hasn’t been found to be more effective than washing with just soap and water at the current concentrations used (hospitals use a higher concentration and amount of time, which is very effective).
The triclosan used in Colgate Total is combined with another ingredient called a co-polymer. What Colgate found out was that when triclosan alone was used it didn’t stay around in your mouth very long. The co-polymer helps the triclosan to stick to your teeth extending its effect significantly. This property is known as “substantivity”.
How Effective Is Triclosan In Toothpaste?
The Cochrane Collaboration did a review on toothpastes containing triclosan/co-polymer vs other toothpastes with just fluoride as the main ingredient. The review was based on 30 studies completed from 1990 to 2012. Their finding included…
- A 22% reduction in plaque
- A 22% reduction in gingivitis
- A 48% reduction in bleeding gums
- A 5% reduction in tooth decay
They couldn’t come to a conclusion about whether it reduces your risk of developing periodontal disease. Gum disease develops over many years and it is difficult to create a reliable study to test it.
Overall, these are really large differences from just using a different toothpaste.
Concerns About Triclosan:
Just because triclosan is very effective doesn’t mean there aren’t concerns about it. Over the years there have been several concerns brought up about it…
- Environmental accumulation – There are so many products using triclosan now that a significant amount is discarded into the water system. Wastewater treatment facilities remove a large portion of it but some still makes it through. When released into waterways it can have an adverse effect on algae populations.
- Hormone modulation – Triclosan has been detected in saliva, breast milk, and blood likely as a result of cumulative exposure from many different products. In rats researchers found that it did have some effects related to estrogen regulation. To date, no studies have found the same problem in humans but there is still some concern there.
- Increased allergies – It is thought that the rise in food allergies is due to our highly sanitized society. We value cleanliness so much that we aren’t exposed to many different bacteria, allergens, etc. A potent antibacterial product like triclosan could definitely reduce your exposure to different bacteria.
My Overall Thoughts:
The reductions in plaque, gingivitis, and bleeding gums are very significant. While there isn’t any evidence either way on whether it reduces periodontal disease, I’d be surprised if there wasn’t some benefit long term there either. Based on the overall health benefits of maintaining healthy gums (see our articles on the Mouth Body Connection) I do recommend using a triclosan containing toothpaste. I do not recommend using other triclosan containing products such as soaps or deodorants. There isn’t much benefit and there are minor risks to both you and the environment.