Ronald Feldman Shares his insight into caring for your teeth like a pro.
My touch of OCD decided to make a guest appearance as I pulled up to my office, closed my door, and locked it. I skipped my typical list of things that I usually ask myself each time I enter my practice, and then I found myself asking my inner dentist a question….. Did I remember to bring my smartphone? Of course, I did! I am OCD and super organized.
A few moments later while working with a patient of several decades, I realized that even after forty years of practicing dentistry, I forgot, or neglected to do something. I never really taught him about prevention. In fact, as OCD as I am about teeth and most everything in general, I never really taught him the details about prevention at all. Sure we have a practice that is conservative and has an emphasis on prevention. But after only a few questions I realized that he did not know much about the objective of most of the preventative procedures we had discussed over the years. After polling a few more patients it became apparent that many people don’t understand what the objectives are with preventative maintenance. Not just my own patients but most everyone. So let’s get right into the meat, or if you’re a vegetarian, the zucchini of the matter.
Generally speaking, the goal of most preventative maintenance is to remove the bacteria off of your teeth. Personally, I think most advertisements confuse the average consumer about what you are supposed to be accomplishing with preventative maintenance. You don’t want to kill the bacteria in your mouth with mouthwashes that contain huge amounts of alcohol or bacteria-killing ingredients. You just don’t want the bacteria to stay on your teeth, in between your teeth, or anywhere on your teeth where they can cause plack. If you kill the bacteria in your mouth you affect digestion, your immune system, and according to studies, you cut down on oxygen formation in your bloodstream. You don’t need to be a science wizard to know that is not good for your health at all.
Of course, we all need to at times freshen our breath, but ff you want to freshen your breath without slaying tons of bacteria chew on an oregano leaf, or a basil leaf. Then rinse with water, and spit it out. You can also use a mint leaf. You can grow these wonderful breath fresheners inside all year round. Even if you don’t own a green thumb.
Even if you eat infrequently or even starve yourself, bacteria will form on your teeth. When bacteria is left on your teeth it will eventually cause cavities and even bone loss. The bone loss is accompanied by gum swelling and very often foul breath. The most important area to remove the bacteria from is obviously in between your teeth and below your gums.
Most people own at least one “Super Toothbrush” that claims to have a gazillion bristles and is superior to anything on the market. There are so many kinds of toothbrushes that change so often, you would need to be a full-time scientist with a teem of Mythbusters to choose between them. There are so many other weapons in the fight against dental disease that the market is flooded with them. So what do you really need to remove the bacteria from between and way under the gum tissue? Well, all you need is a great technique and the right implement for bacteria destruction for your mouth.
What I recommend to my patients is what I use for myself. Here’s my short list:
- stim u dents
3. Oral B electric toothbrush with interproximal head and extra soft head
4. Water Pik, Aquarius model.
Some time after this story is published I will be working with Model Citizens Magazine to produce how to videos for more detailed instructions, however, for now here are some highlights to work with.
I use my stimudents and floss in the shower. It is so much easier to floss in the shower. The water on the floss helps you to hold it better, and the floss goes between your teeth much easier. The wet stimudents go between your teeth easier and more comfortably. With both the stimudents and the floss, you want to stay against the tooth you are cleaning. Go between the gum and the tooth to get down below the gum. With your floss, wrap it around your middle fingers about three times, leaving about three inches between your middle fingers. When you are delivering your floss below the gum, make a “C” shape around the tooth you are cleaning, so the floss will go further below the gum. I’m sure this is hard to visualize. Imagine that you wrapping a rope halfway around a tree. That is your “C” shape.
Then use the electric Oral B with the interproximal head. Use this head only in between your teeth with light pressure. Then use the regular soft head with moderate pressure following the shape of the tooth. Teeth are not flat. They are rounded as they meet their neighbor. Follow those contours. And with light pressure, feel the brush cleaning under the gums. Don’t press too hard. You can cause recession of the gums and bone and create cuts into the root surface of your teeth. Change the heads every 8 weeks. When you change the head, you will feel the cleaning power of the new toothbrush head, even with less pressure.
I usually go eat breakfast at this point, and then use my water pik after breakfast. Use warm water, in the basin, with nothing added to the water. Additives like mouthwash or peroxide can destroy the antimicrobial properties of the water pik’s water lines. When you finish with your water pik, now is the time for some herb leaves. I recommend no toothpaste in the beginning. If you can make your breath nice smelling without toothpaste, you did a good job. (most likely). You can add toothpaste, but don’t let the toothpaste fool you into thinking you did a great performance with your technique.
I like the wooden stimudents because the wood will mold to the irregularities of the tooth anatomy better than plastic. I like thin lightly waxed floss because it gets between your teeth easier. It is easier to pull the floss between your teeth from an angle, rather than push straight down in between the teeth. There are so many great toothbrushes on the market. I chose what I think the majority of people could perform best with. The sonic toothbrushes can do a great job. I feel that they are technique sensitive. You must use a light touch and take two to three minutes. That is about the amount of time I recommend with all toothbrushes. Not to be silly, but brushing is like a zen experience. You want to feel the toothbrush engaging all aspects of the tooth and below the gum. I’m being serious. It’s like anything. The more you are focused and connected to what you are doing, the better your outcome. Believe it or not, I actually feel that a handheld soft bristle toothbrush is the best. But not in the hands of most people. Especially those who are in a rush.
If you are using a handheld toothbrush, do the following. Run it under hot water to soften the bristles. Then deliberately push the bristles under the gum. Now start a very tight circular movement, keeping the bristles under the gum. Imagine that you are cleaning under the cuticle of your fingernails. Don’t move the bristles in and out of the gum. Stay underneath the gum tissue and slowly move onto the next tooth.
There are also many quality waterpiks. Try them if you wish. I found what works for me and I try to make it easier for my patients by recommending a brand. What is important is to use the water pik on the highest, or next to the highest setting. Keep the tip of the water pik right against the tooth where the gum meets the tooth. You should keep the tip in between the teeth for three seconds. The whole water pik experience should take about one and one-half minutes. The entire routine should take under ten minutes.
I want everyone to know that my recommendations are not making a negative statement on the plethora of products that are out there. And I know there are also many varying professional opinions. I am only sharing what has worked well for me and my patients over many years. If any of the information I have shared is helpful, then I’m very grateful I have been of some assistance.
So, remember to remove the bacteria that are forming all over your teeth. Especially in between and below the gum. The bacteria are the reason for cavities and bone loss. For the most part, cavities and periodontal disease are 100% preventable. It’s all about having the right technique with each instrument and taking the time to perform these measures. And I just heard someone ask. “ Can I do different things at different times of the day?” Yes! The bacteria take about 24 hours to form on the teeth. After 24 hours it might become difficult to remove the hardened bacteria. Perform the tasks within 24 hours, and you should be fine.