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Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. Cynthia Stephenson at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.

When we don’t keep up with our dental hygiene, plaque buildup can result in three kinds of cavities. Pit and fissure cavities are found on the tops of molars, where food particles get stuck in the irregular surfaces. Smooth surface cavities are located on the smooth sides of teeth.

Wait. Top, all around the sides—what’s left for plaque to attack?

Our roots. The roots of our teeth are generally protected by their concealed position in the jaw. Sitting securely in alveolar bone, held firmly in place by connective tissue, with gum tissue snugly surrounding them, roots are generally not cavity prone.

But these cozy conditions can change. Due to gum disease, abrasive habits, or simply the passage of time, gums can recede and expose root surfaces. And this exposure can lead to root cavities.

If you look at a complete tooth, it looks like enamel is covering the entire tooth surface. In fact, enamel, the strongest substance in the body, only covers the visible part of the tooth, called the crown. The roots are covered by a substance called cementum, which is softer than enamel. And if enamel can’t stop decay, cementum is even more vulnerable when it’s exposed to plaque, bacteria, and acidic foods.

How do we protect our roots from decay? Protecting our gums is the first line of defense.

• Gum Disease

Receding gums caused by periodontitis can be treated by Dr. Cynthia Stephenson. Deep cleaning procedures such as scaling and root planing can remove accumulated plaque and tartar, and help gum tissue reattach to teeth. For serious recession, gum grafts can replace lost tissue.

Early treatment can prevent recession. If you notice any signs of early gum disease, including bleeding, swelling, tenderness, or persistent bad breath, it’s time for a visit to our Walnut Creek, California office.

• Gum Abrasion

It’s not just gum disease that can lead to gum recession. Some personal habits are hard on gums and teeth, and can leave roots exposed. If you bite your nails, grind your teeth, irritate your gums with oral piercings, you are at risk for gum recession. Talk to Dr. Cynthia Stephenson about preventing abrasive damage.

A surprising cause of receding gums? Over-vigorous brushing. Use a soft-bristled brush—and don’t use a heavy hand when brushing—to protect your delicate gum tissue.

• Aging

As we age, our gums recede. So it’s no wonder that older adults are especially at risk for root cavities. That’s why it’s very important to keep up with brushing (at least two minutes twice a day) and flossing (once a day, or more often if needed) to prevent the buildup of plaque and tartar.

And it’s more important than ever to schedule regular dental exams and cleanings. Dr. Cynthia Stephenson can help stop small problems from becoming major ones, and suggest brushing and flossing techniques, fluoride treatments, or other procedures to encourage gum and dental health.

If a cavity develops, no matter what kind, it should be treated as soon as possible. And time is especially important for a root cavity.

Because cementum is weaker than enamel, cavities can progress more quickly in roots. A cavity which has reached pulp tissue might require a root canal and a crown to restore tooth function. Serious decay could lead to extraction.

Don’t let root cavities undermine your dental health. If you notice any sign of gum disease or recession, it’s time for a visit to our Walnut Creek, California office. After all, even though they go unnoticed, strong roots are the foundation of a healthy, attractive, life-long smile.

That’s a good question! But first, we’re going to do that roundabout thing where we consider other questions before circling back to our original topic. Trust us, we’ll get there!

• Why Get Your Teeth Cleaned Professionally?

Before you consider how often to have your teeth cleaned, you might be wondering why you need to have them cleaned professionally at all. After all, you’re doing all the right things. You brush twice a day for two minutes each time. You floss at least once a day. You even use a soft-bristled brush to protect your enamel. Shouldn’t this be good enough?

Conscientious dental hygiene at home is a very good thing, but, when it comes to plaque and tartar, it might not be good enough. Plaque, especially between the teeth and along the gum line, is easy to miss. In a matter of days, that overlooked plaque hardens and becomes tartar. While you can do a lot to remove food particles and plaque at home, once plaque hardens into tartar, a professional cleaning is necessary to remove it safely.

• Why Worry About Plaque and Tartar You May Have Missed?

Because you want to avoid cavities and gum disease. You know that the bacteria in plaque cause tooth decay, but did you know that plaque and tartar can be a real problem for your gum health as well? Plaque and tartar irritate delicate gum tissue, causing inflammation and gingivitis (mild gum disease). If you have chronic bad breath, if your gums are swollen, red, or painful, if your gums bleed easily when you’re brushing and flossing, you might have gingivitis.

Left untreated, mild gum disease can become periodontitis, a more serious condition. Irritation and inflammation cause gum tissue to pull away from the teeth, forming deep periodontal pockets where bacteria and infection spread. Infection and inflammation response damage the bone and tissue supporting the teeth, and teeth become loose or lost altogether. In fact, periodontal disease is the leading cause of tooth loss in adults.

A professional cleaning at our Walnut Creek, California is one of the preventive steps you can take to reduce your risk of gum disease.

• What Happens During a Cleaning?

First, your teeth and gums will be checked carefully to see if there are any problems that we need to address before the procedure begins.

The first step in cleaning usually involves removing plaque and tartar. This may be done with an ultrasonic scaler, a hand scaler, or a combination of both. Plaque and tartar need to be scraped from tooth enamel above and below the gum line to prevent cavities and gum disease, so this is definitely a job for a dental professional. Gum attachment around the teeth will be checked, and shallow pockets will be cleaned. Your dentist will have suggestions if you have deeper periodontal pockets caused by gum disease.

After all the plaque and tartar have been removed, your teeth will be polished with a gentle abrasive to remove surface stains. There are two common methods of polishing: applying a special gritty toothpaste with a small rotating cup, or air polishing, which uses a stream of fine abrasive powder, water, and pressurized air. (If you have your teeth cleaned more than twice a year, your dentist will let you know if polishing is advisable during every visit.)

Next, flossing. A professional flossing will remove any remaining plaque from between the teeth. This is a good time to double check your own flossing technique and ask for any tips which will make your personal flossing more effective.

Finally, after rinsing, a fluoride treatment might be applied to strengthen your enamel, and you’re good to go. The entire process usually takes between 30-60 minutes.

• So, How Often Should You Have Your Teeth Cleaned?

That is a good question, and we did get there! But we don’t have just one answer for you. As with every aspect of your dental care, Dr. Cynthia Stephenson will recommend cleaning treatments and procedures with your specific dental needs in mind.

• If your teeth and gums are healthy, and you don’t have periodontal disease or risk factors for periodontal disease (such as smoking, a family history of gum disease, or medical conditions such as diabetes), you might be able to get by with two cleanings each year.
• If you have a history of periodontal disease, or are at higher risk for periodontal disease because of one or more risk factors, Dr. Cynthia Stephenson might recommend more than two cleanings each year.

Professional cleanings play an important role in your preventive dental care. Whether it’s done once a year, twice annually, or more often as needed, a cleaning performed by a dental professional takes only a short amount of your time and provides you with long-term benefits—not only a brighter smile, but healthier teeth and gums!

Imagine that you’re only going to brush your teeth once tomorrow. Don’t worry, we know you would never skimp on your dental hygiene like that, but let’s just pretend for a moment. When would be the best time to brush? When you wake up? During the day? Or perhaps before you go to bed?

Actually, whenever you choose to brush, you’ll receive important overall dental benefits as well as specific benefits tied to the time of day. Let’s explore your daily schedule to see why.

Brushing in the Morning

Brushing when you first jump out of bed produces several positive results.

• Cleaning plaque from your teeth

Plaque is a sticky film made up of oral bacteria, food particles, and saliva. As you sleep, these oral bacteria multiply and produce acids which attack the minerals in your enamel, leaving weak spots which, over time, can become cavities. Brushing removes these bacteria and acids from your enamel before they cause serious harm.

Moreover, plaque hardens if it’s left undisturbed, turning into tartar in a relatively short time. And once plaque becomes tartar, it must be removed by a dental professional. Brushing first thing in the morning removes this plaque buildup and helps prevent tartar from forming.

• Fresh breath

That bacterial growth we mentioned? It’s also responsible for morning breath. If nothing else, brushing when you wake up means greeting a fresh day with fresh breath, and that’s reason enough to pick up your brush in the morning.

Brushing During the Day

Brushing after meals and snacks also has a lot to recommend it.

• “Leftovers” lead to cavities

Foods, especially foods rich in sugar and carbohydrates, are converted by oral bacteria into acids which weaken enamel and lead to cavities. When food particles remain in the mouth after a meal, bacteria have more time and more fuel to manufacture these acids.

• Acidic foods also affect your teeth

If you have eaten something acidic, such as citrus fruits, sodas, or pickled anything, the acids from these foods can temporarily weaken the mineral strength of your enamel. But brushing immediately after eating or drinking acidic foods can damage weakened enamel. Better to rinse well with water and brush after half an hour or so.

Brushing at Night

Growing up, you probably received regular reminders to brush before bedtime—for several really good reasons:

• Saliva production slows while you sleep

During the day, saliva helps to wash away food particles and neutralize acidity in our mouths. It also contains proteins and minerals which help keep tooth enamel strong. But as we sleep, saliva production slows dramatically, and our bodies can’t remove bacteria and acids as effectively.

• Food particles fuel bacterial growth

If you haven’t brushed since morning, you’ve accumulated a whole day’s worth of food particles from meals and snacks. Remember, oral bacteria use the sugars and carbs we eat as fuel to produce the acids which attack our tooth enamel throughout the night.

• Brushing helps prevent both of these problems

Brushing your teeth before bed not only cleans away the accumulated food particles of the day, but also eliminates the plaque and bacteria which would have a much easier time sticking to your teeth without that daytime saliva flow to wash them away.

So, When’s the Best Time to Brush?

In the morning, during the day, at night —there are solid advantages to brushing any time of day. The question isn’t so much when to brush as how often you should brush.

While many dental professionals consider brushing before bedtime as the most important brush of the day, brushing at least two full minutes, at least twice during a 24 hour period, is a necessity for basic dental hygiene. (And don’t forget to floss at least once each day.)

If you wear orthodontic appliances, if you’ve been eating sugary snacks, if you’re showing signs of gingivitis or getting more than your share of cavities, if you want to reduce the chance of plaque and tartar buildup, or if you simply want to make sure you’re doing everything you can to maintain your overall dental health, brushing after meals is also highly recommended.

Talk to Dr. Cynthia Stephenson about your brushing habits the next time you visit our Walnut Creek, California office. No need to use your imagination to plan your best brushing schedule. We have all the answers you need to help you brush your way to your best—and healthiest—smile!