Leland Dental

Mouthrinses

I have had a number of questions of late regarding mouthrinses, when to use them and what type to use.  Here’s my take on mouthrinses:

Mouthrinses are used for a variety of reasons: to freshen breath, to help prevent or control tooth decay, to reduce plaque, to prevent or reduce gingivitis, to reduce the speed that tartar forms on the teeth, or to produce a combination of these effects. Most mouthrinses are available without a prescription.

What ingredients are commonly found in mouthrinse?

Basic ingredients include water, alcohol, cleansing agents, flavoring ingredients and coloring agents. Active ingredients vary depending on the type of mouthrinse, but they can be placed into four general groups:

• Antimicrobial agents act directly on oral bacteria to help reduce plaque, decrease the severity of gingivitis and control bad breath.
• Fluoride helps reduce tiny lesions (tooth decay) on tooth enamel and make teeth more resistant to decay.
• Astringent salts can serve as temporary deodorizers that mask bad breath.
• Odor neutralizers act by chemically inactivating odor causing compounds.

What’s the difference between cosmetic and therapeutic?

Cosmetic mouthrinses may temporarily control or reduce bad breath and leave the mouth with a pleasant taste. But they don’t deal with the causes of bad breath. They don’t kill the bacteria that cause bad breath or chemically inactivate odor causing compounds. Also, none of the cosmetic mouthrinses helps reduce plaque, gingivitis or cavities.

Therapeutic mouthrinses, on the other hand, can help reduce plaque, gingivitis, cavities and bad breath. Some fight the bacteria present in plaque, a sticky film that forms on teeth and gums. Plaque bacteria create toxins that can damage the gums. Plaque that is not removed with daily brushing and flossing can cause gingivitis, an early stage of gum disease. If plaque is allowed to continue to accumulate, gingivitis can progress to advanced gum disease, called periodontitis, which only a dentist can treat. Plaque can also turn into tartar (or calculus), a hard substance that can only be removed during a professional cleaning. Some therapeutic mouthwashes contain agents that either fight bad breath bacteria or that chemically inactivate odor causing compounds. Some therapeutic mouthrinses that contain fluoride help prevent or reduce tooth decay.

Do I need a mouthrinse?

We can advise you whether you need a mouthrinse depending on your oral health needs. Rinsing helps remove debris from the mouth. It can be done before or after brushing, but it is not a substitute for brushing or flossing. You may consider using a mouthrinse with fluoride or antimicrobial agents as part of your daily oral hygiene routine.

If you have difficulty brushing and flossing, a mouthrinse may provide additional protection against cavities and periodontal (gum) disease. Anti-cavity rinses with fluoride help protect tooth enamel.

There has been a lot of recent press about tooth whitening services that are done in the mall.  I even saw a recent exposé on local news regarding these vendors.  As far as I see it, these vendors, while promising great results, may be putting the public at risk.

The bottom line with these whitening kiosks is that they are not staffed or overseen by anyone trained in the dental health field.  These services are administered without examination to determine if the person receiving the treatment is even a candidate for whitening, or has underlying oral health issues that make whitening ill-advised or even potentially harmful to the patient.

Don’t get me wrong, I believe in the safe administration/application of whitening products where it is deemed appropriate.  That is why it is best to consult a trained dental health professional before embarking on a quest for a whiter, brighter smile.  That being said, if whitening is appropriate, here is a little background about whitening materials and processes and ways to safely and effectively whitening your smile:

Nearly all whitening products will whiten teeth to a certain extent because they all have the same active ingredient, either carbamide or hydrogen peroxide. However, the percentage of the active ingredient in whitening products varies between what a dentist uses and what is contained in over-the-counter products.

Over-the-counter products (Crest White Strips, for example) contain about 5 percent or less of active whitening ingredients, whereas a dentist will use products that have 10 to 35 percent of active whitening ingredients. Because of this, store-bought whitening products may not be as effective and could take a longer time and require a larger quantity to achieve any significant results.

There are two different whitening systems used by a dentist.  In-office whitening takes roughly 60 to 90 minutes per visit. A chemical solution is applied to the teeth and a special light may be used to help activate the bleaching agent. To complete the process, multiple visits may be required.

With at-home whitening, we produce a custom-fitted mouthguard that holds whitening gel. The mouthguard is worn during the day or at night, and the treatment period varies (generally 4-6 hours per day/night for 2-3 weeks).

Those who use the store-bought kits lose the benefit of a custom-made mouthguard to apply the gel, and results may not be uniform. Therefore, anyone with moderate to severe discoloration could be disappointed with the results of the store-bought kits.  Patients with only mild, yellowing teeth, either due to age or food and beverage stains, may benefit from diligent use of a store-bought product.

Teeth may often be sensitive during the period when any type of whitening solution is used. In most cases, this sensitivity is temporary and should lessen or disappear once the treatment is finished.

Those who are thinking about whitening their teeth should understand that only natural enamel will whiten. This means that if you have had any type of restorative procedures done—such as tooth-colored fillings, bonding, crowns, or veneers on your teeth—those particular teeth will not whiten. Plus the restorations, which used to blend in very nicely with the previous shade of your teeth, will now appear much darker and distinct. This could result in additional dental work to fix the problem.

Basically, check with us before you decide which whitening product or system is right for you.

Your mouth can, and does, say a lot about your overall health and well-being.  There are significant and direct connections between your oral health and your overall health. In fact, as many as 90% of systemic conditions such as heart disease and diabetes are linked to symptoms in the mouth. Surprisingly, many of these symptoms can be detected by a dental professional even before you are aware of them.
Oral Health and Diabetes

Bleeding gums, dry mouth, fungal infections, and new decay are oral signs which can alert your dentist to a possible serious health issue — diabetes. These are also symptoms that could suggest other serious conditions, such as leukemia and HIV.

Diabetes is one of the fastest growing health concerns in the United States. According to the Centers for Disease Control (CDC), one-third of children born after 2000 will be diagnosed with diabetes during his or her lifetime. Diabetes is also the one condition that can have a direct impact on infections in the bones and gums around the teeth.

Diabetes and your mouth have blood sugar in common. If blood sugar levels are out of control in your body because you are unaware that you have diabetes, the blood sugar levels in your mouth are also out of control. With sugar to feed on, bacteria find a receptive home in which to grow and thrive. The increased bacteria can then attack the protective enamel layer on your teeth. Over time, as the enamel breaks down, cavities develop which can be one of the dental signs of diabetes.

A person with uncontrolled diabetes has more mouth health issues to be concerned about. Uncontrolled diabetes reduces the body’s first line of defense against infection — white blood cells — which can then put a person’s oral health at risk. With bacteria teeming around the gums from high blood sugar levels, periodontal disease can develop more easily.

Because diabetes lowers a person’s resistance to infection, managing periodontal disease is not easy, but is extremely important. Your dental team should be one of your best allies if you are among the 20-plus million Americans living with diabetes.

Frequent professional oral care is important in preventing or controlling periodontal disease as well as diligent home care which requires flossing and brushing after every meal.

Your oral healthcare professionals are extremely important to your overall well-being especially if you are currently one of the more than 50-plus million Americans who is “pre-diabetic.”  Your dental providers can often detect oral signs and symptoms related to pre-diabetes before confirmation of the diagnosis by blood testing and a comprehensive physical examination.

Oral Health & Heart Disease

While follow-up research is ongoing and still to be completed, initial studies from the American Heart Association have linked poor oral health with increased chances of developing heart disease, even more so than the usual suspects such as elevated cholesterol and triglyceride levels. According to the American Academy of Periodontology, a group representing dental professionals who deal extensively with gum and bone health, it has been reported that of major oral diseases, pericoronitis, an infection in the gum tissue around a tooth, is the strongest predictor of coronary disease.

Further, according to the American Academy of Family Physicians, it is the bacteria in your mouth, or the inflammatory response to the bacteria, that may cause inflamation of the heart and more plaque buildup in the blood vessels. Although neither your dentist nor your doctor fully understands the connection between the mouth and the heart, that connection does mean that maintaining proper gum health is very important in helping to prevent possible systemic health issues.

Questions to Ask Your Dentist

Talk to your dentist while you are in the dental chair. When it comes to your health, this is a perfect opportunity to obtain answers to some important questions which could have significant impact on your overall health such as:

How do my oral health habits — how often I brush and — affect the rest of my body, not just my gums and teeth?

What are signs to watch out for in my mouth that might indicate a systemic illness or disease?

What do you need to know about my health history to evaluate my oral health?

Have you seen any warning signs of a possible serious condition that I should relay to my primary physician?

It is a statistical fact that a member of your dental team likely sees you more often than any other healthcare provider. Because of the frequency of your visits, your dentist is often in a better position to look for and detect any early signs of oral disease that may be connected to systemic health problems.

The connection between good oral health and whole body health is one of the most important reasons to maintain a routine of regular visits to your team of dental professionals. You’ll enjoy not only a healthier smile, but a healthier body as well!