Hot or Cold Water to Brush your Teeth?
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I love this cartoon of a woman brushing her teeth with a cup of hot tea (New York Times, April 29, 2013).  The question is:  “why don’t we use hot water to brush our teeth?”  I have to confess that I have never asked myself this question, nor has anyone ever asked it of me.  But someone did think to ask it of the Times‘ C. Claiborne Ray.  He, in turn, contacted the American Dental Association.

Their spokesperson, searching for an answer, offered that hot water might soften toothbrush bristles, rendering them less effective. But where is the study that shows this?  The spokesperson also suggested that hot water that sits in a hot water tank may harbor harmful chemicals.  But in the end he contradicted himself in recommending that hot water be used to rinse the brush after brushing.  The bottom line: brush and floss carefully – regardless of the water temperature – and visit the dentist regularly!

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Who Made That?” is the title of a design article in today’s New York Times Magazine that is about – of all things – the toothbrush!   According to the article, toothbrushing began in China during the Middle Ages when people cleaned their teeth using animal bristles.  Several centuries later, William Addis carved a bone and stuck it full of bristles while he was in Newgate prison, becoming the first person to patent the toothbrush.  Nevertheless, people continued to rub their teeth with a rag even after toothbrushes began to appear in the stores.  As late as the 1920’s, many Americans still did not brush their teeth.  The early toothbrushes were harsh and it wasn’t until the 1940’s with the advent of synthetics that the bristles were soft enough not to damage the gums.  New shapes began to appear.  The Reach toothbrush had the angled head, and the company even manufactured a brush with two heads.  Toothbrushes even traveled to the moon.  So we have gone from the twig to hog-bristles to plastics and today to the electric toothbrush.

Dr. Ben Swanson, the former president of the American Academy of the History of Dentistry, has over 40,000 artifacts of dental history in his basement storehouse.  According to Dr. Swanson there are thousands of toothbrush patents on file.  He owns a few hundred different brushes, but he gave up on his dream of owning every kind of toothbrush in existence because “there were so many of them.”

A new consensus statement on the safety and importance of dental health care for pregnant women is available to the public in PDF format at www.mchoralhealth.org.  Just click on the Consensus Statement link for a PDF of this 24 page document.  The document was prepared as a result of a meeting of the Health Resources Services Administration, the American Dental Association (ADA) and the American College of Obstetricians and Gynecologists in October, 2011.

The document states that dental care is both safe and important throughout pregnancy.  Emergency or acute care may be provided at any time during pregnancy.   Use of xrays, pain medication and local anesthesia, if necessary,  are all safe throughout pregnancy.  It is important to have the oral cavity checked for swollen or bleeding gums, dental decay, tooth-related pain, soft tissue lesions, signs of infection or trauma, problems eating, and history of vomiting since becoming pregnant.

The document advises that when a pregnant woman is being treated by her dentist her head should be elevated above her feet.  She should be in a semi-reclining position, as tolerated, and frequent position changes should be allowed.  A small pillow should be placed under the hip and she should turn slightly to the side to avoid dizziness or nausea from hypotension.

The document  includes a table of common drugs: their indications, contraindications and special considerations during pregnancy.  It also includes information on maintaining good oral health and how to take care of the new infant’s oral health.

Major League Baseball (MLB) teams will be playing ball this year with limits on the use of smokeless tobacco.  As part of the agreement between the MLB and the Players Association, team members will not be allowed to keep smokeless tobacco in their back pockets or anywhere else in their uniforms when on the field or whenever ball fans are in the park.  Likewise they will not be allowed to chew a wad of smokeless tobacco when meeting fans or being interviewed.

Smokeless tobacco impacts on oral health as it can cause oral cancer.  Its use has risen nearly 37% among high school boys since 2003.  Baseball player are often role models for these youngsters who emulate their heroes – chewing, spitting, and reloading a wad of tobacco under their lower lip (dipping) – and follow the path to addiction.  The former San Diego Padres hitter, Tony Gwynn, who now coaches baseball at San Diego State University, is a prominent former dipping addict.  He was unsuccessful in quitting the habit and now has salivary cancer.  He has had four oral surgeries to remove cancerous tumors.

The American Dental Association (ADA) has a new consumer website, www.MouthHealthy.org, which will launch in June.  The theme is “Mouth Healthy for Life.”  The site will provide up-to-date oral health information on prevention, dental care and dental treatment.  Topics include nutritional information, smoking cessation ideas, and issues for children and the elderly.  I like the new slogan “Mouth Healthy,” which validates the importance of oral health as being more than just a white smile.

“Health” is the most searched topic on the web, and the ADA’s new website should be the leading source for oral health information.  Dr. W. Carter Brown, chair of the ADA Council on Communications stated, “We believe that informed patients are more likely to make better health choices and understand the benefits of having an ADA dentist as part of their oral health for a lifetime.”

I have been a member of the ADA since graduating from dental school – it is our professional organization.

Dentists spend much of their working hours talking to patients about proper care of their teeth and have studied the ill effects of poor home care.  So how do dentists measure up?  Do they follow their own advice?  The results of a recent study of the oral care habits of pediatric dentists was a big surprise to me.

Turns out that the dentists surveyed do not always follow their own advice.  Although most of the dentists (55%) brush twice a day and 33% brush still more – 7% brush only once a day.  Forty-eight percent of the dentists consume sugar products once or twice a day between meals and 14% consume them more than twice a day.  A large majority (92%) do use fluoride toothpaste.  But 13% floss only occasionally and 21% floss only 2-3 times a week.  A quarter of the dentists do their own check-ups.  (How is that possible and can this be an adequate dental exam?)  Twenty-seven percent last had a dental exam 1 to 2 years ago and 5% had an exam even less frequently.  In their favor, the overwhelming majority of  dentists (90%) have never smoked and another 3% have stopped the habit.

So a significant number of surveyed dentists are remiss in their own oral health care.  And you may ask, where do I stand?  I see too much dental decay and gum disease not to follow recommendations and then some.

A retired couple came into my East Setauket dental office today for a consult.  They are on a limited income and were worried that I would tell them that they needed new dentures.  His dentures were loose – he kept denture adhesive in his back pocket for frequent application.  Her dentures had fractured, and she kept the dentures in her mouth with difficulty. One of the teeth had fallen out and a clasp on her partial denture had broken off.  New dentures would have been nice but given the couple’s health and financial circumstances, I suggested a denture repair and denture reline at minimal cost.  Were they ever relieved!

For denture repairs and relines, we take impressions and send the dentures to Lords Dental Laboratory, an excellent dental laboratory that specializes in dentures and partial dentures. Using our excellent tooth impressions, they reline the dentures and make necessary repairs.  The fit is vastly improved. You should not have to use adhesive if your denture is properly fitted.

I find that denture patients too often do not return for regular checkups.  But regular oral checkups are as important for people without teeth as for people with teeth. Your oral tissues change over time and we need to check that the dentures fit properly.  We also check for oral cancer, fungal and other oral pathologies.

Are your dentures loose? Broken? Missing teeth?  Are you afraid that you will need a new denture? Give us a call at 751-4433 and I’ll see what I can do for you with a denture repair and reline.