String Floss vs. Floss Picks


Flossing! Everyone’s favorite thing to do, NOT! Flossing is the biggest thing my patients struggle with as part of their homecare routine, but yet is an essential part of preventing tooth loss and gum disease. U.S News and World Report published a statistic that only about 1/3 of the U.S population flosses daily (1).  Flossing is done by moving the floss in a deep “c” motion around the margin of the tooth above and below the gum line between your teeth.  So what is the difference and concern about using  floss picks vs. string floss?

Traditional String Floss can be waxed, unwaxed, tape, glide or satin. Typically you use one long piece (about the length of your forearm). Wind the floss around your right index finger, and two or three times around your left, then use your middle fingers and thumbs to control the deep “c” motion around both sides of each tooth. As you go around your mouth you want to make sure you change the section of floss between each tooth or every other tooth so you don’t drag bacteria around your mouth. String floss is a great way to have awareness of what’s going on in your mouth. If you notice an odor or abnormal color that’s a sign you may have an active infection. If you pull out a lot of plaque/ food or notice bleeding, those are also signs of a possible dental concern.  Traditional floss can be difficult to control, but is proven to be the most effective with proper technique.

Floss picks are typically Y or F shaped plastic handles with a small piece of floss attached to either side of the opening. Floss picks are great for children and people who really struggle with traditional floss due to large hands, gag reflex, or limited use of their hands. Flossers have become popular to use because they are easy and portable. Some people who have tighter teeth may struggle with getting floss picks in between their teeth properly; in this situation traditional floss is recommended.  Gum tissue likes to be massaged, but not tortured by the flosser snapping through the contact of the two teeth into the gingival pocket. Although, floss picks have become popular and have allowed more people to become better flossers, there are some health and environmental concerns with using them. Most people use a single floss pick for the entire mouth, this creates an increased risk of an unhealthy oral environment because you can spread bacteria from one section of your mouth to another. The plastic handles limit the movement of the floss, which makes them less effective in removing plaque and bacteria.  The plastic handles are also a “single use plastic” which people throw on the ground rather than in the trash causing an environmental concern.  If you choose to use floss picks, it’s important to know they are not always as effective as traditional floss, but they are a great option over not flossing at all.

No matter what form of floss you use, the most important thing is that you are doing it, and doing it properly. Flossing is an essential tool in preventing tooth loss, tooth decay, maintaining good oral health and decreasing risk of many overall health issues. If you struggle with flossing, discuss with your hygienist the best way to approach flossing and what tools may best suit you.


HPV- Related to Oropharyngeal Cancer

The Human Papilloma Virus (HPV) is the most commonly sexually transmitted disease in the United States (1).  Papillomas are not cancers, they present most commonly as warts, but infections with certain types of HPV can cause some forms of cancer (2). There are approximately 40 types that can be spread through direct sexual contact to genital areas, as well as the mouth and throat.  Oral HVP is transmitted most commonly to the mouth by oral sex. This virus can infect the mouth and throat and cause cancers of the oropharynx, commonly known as Oropharyngeal Cancer. The oropharynx is referring to the back of the throat, including the base of the tonsils and tongue.  According to the CDC; “HPV is thought to cause 70% of Oropharyngeal Cancers in the United States” (1).  Although, most people who have HPV infections of the mouth and throat have no symptoms, the following list is what symptoms would include.

Symptoms include:  * let your dentist know if you experience any of these for longer than 2 weeks

  • Long- lasting sore throat or irritation that does not go away
  • Lumps, thickening tissues, rough spots or crusty areas
  • Red or White patches, or pain, tenderness or numbness in mouth or lips
  • Hoarseness or Swollen lymphnodes
  • Difficulty chewing, pain when swallowing, speaking or moving jaw
  • Unexplained weight loss or Earaches

The number of Oropharyngeal Cancers that are linked to HPV has increased over the last few decades, and it’s becoming more common in younger people with no history of alcohol abuse of tobacco use. They feel this is due to the increase in the sexual practices over the last few decades, especially with the increase in oral sex. These cancers usually take many years to develop which is why they were prevalent in patients 55 years and older but is now changing as HPV cancers are becoming more common.

According to the CDC it is still unclear if having HPV alone is enough to cause Oropharyngeal Cancer or if additional risk factors such as smoking or chewing tobacco can cause these cancers.  A risk factor is anything that changes one’s chance of getting a disease such as cancer. Tobacco and alcohol use are 2 of the strongest risk factors for oral cavity and oropharyngeal cancers according to the American Cancer Society.

The number one way to protect yourself from Oropharyngeal Cancer is the HPV vaccine. The CDC recommends that 11-12 year old boys and girls get two doses of HPV vaccine.  It is also recommended that girls and women through age 26 and boys and men through age 21, who did not get vaccinated when they were younger, get vaccinated. The number of doses may differ depending on how old the patient is when they receive there 1st vaccine. Additional ways to protect yourself is to use condoms, and dental dams, as well as limit your alcohol consumption, and don’t use tobacco products. Talk to your primary care about this vaccine, and talk to your dentist if you are experiencing any of the above symptoms.




Spring into Summer with Whiter Teeth!

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It’s that time of year again for Proms, Weddings, Mothers Day and Family Vacations! Who would not want a brighter whiter smile? There are many forms of whitening available but remember you need to be cautious with what you use, and how often because it can cause sensitivity, and weaken the tooth enamel. Professional whitening I feel is the best, and safest option for optimal whitening results. Phillips Zoom whitening is the most commonly known in-office whitening product that you can get 4-6 shades whiter in 45 minutes. This product is safely applied to your tooth structure and does not get on the gum tissue, and uses a LED whitening lamp to accelerate the results. In addition to leaving with whiter teeth you will be provided with custom whitening trays that you take home to use when you need a touch up 6-12 months later or right before a big event. These trays are cut to fit your teeth perfectly and not allow any whitening gel to touch the soft tissues around your gums. It’s important to remember that when you are whitening you are opening the pours of your teeth so you want to avoid anything that would stain a white shirt during the whitening process; especially coffee, tea and red wine.

Whitening products can be safe if used within moderation and you follow the guidelines carefully and properly. As I mentioned before whitening can cause sensitivity, and irritate your gums. I would encourage you to discuss whitening with your dentist or hygienist first.

Check out our Facebook Page or call our office 978-255-1891 for our Spring Whitening Special going on till May 1st.


Is Bottled Water Harmless?


Image from the -Daily Mirror –  Show devastating impact of plastic pollution as idyllic Caribbean waters choke in rubbish.

Most people don’t think twice about bottled water and its source, or potential risks. Companies have done a great job advertising and making us all believe that bottle water is safer and the best option for us over tap water. The truth is, that is not always the case.

Bottle water is a convenient and quick way to hydrate your body. The bottles are spill proof and help you to track your water in-take as most are labeled with the volume of water you’re consuming.  It can be the safer option in some areas especially when natural disaster disrupts the waterlines, but overall it is more expensive, can contain chemicals, does not contain fluoride, promotes the use of fossil fuel and increases environmental hazards. Studies have also found that with the increase of bottle water consumption, there has been increase in tooth decay (2).

What chemicals could bottled water contain? Bottled water can be dangerous to your health if not stored properly. Direct sunlight or high temperatures can cause the plastics to leak out the following chemicals; antimony (Sb) and Bisphenol A (BPA) (5).  These chemicals are being researched and linked to increasing the risk of cancer and other medical conditions.

What environmental hazards? It takes 17 million barrels of oil to make the 900,000 tons of plastic for bottled water, that’s enough to fuel 1 million cars for a year! The worst part is they have found that only 20% of these bottles get recycled (1).  When these bottles are not recycled they end up in landfills and pollute our ocean. As of this past Friday March 23, 2018 CNN reported that the Great Pacific Garbage Patch is about 1.6 million square kilometers in size, and up to 16 times bigger than previous estimates, this makes it more than double the size of Texas and its growing much faster than expected (6).

It is known that soda, beer, and coffee are bad for your teeth but some of the most popular brands of water also have a dangerous pH level and lack fluoride, both of which can increase risk of decay.  Enamel starts to erode at a pH level of 5.5, so it is best to avoid drinks with anything lower than that. Brands with pH levels closer to zero are more acidic and can erode your tooth enamel. Brands with pH levels between seven and fourteen are alkaline. There have been many tests done on different bottled waters and their pH levels, you can find most of them online, but here are the results on the most common ones (3).

  • Smartwater: 4 (Acidic- worst for your teeth)
  • Aquafina: 4
  • Voss: 4
  • Dasani: 4
  • Poland Spring: 7 (Neutral – if drops below 5.5 can harm your enamel)
  • Volvic: 7.5
  • Fiji: 8
  • Essentia: 8
  • Evian: 8.5 (Alkaline- this is the safest for your teeth)

Water from the tap tends to be less convenient, and sometimes has an odor or taste that does not appeal to people.  Tap water is less expensive, and also contains regulated amounts of fluoride, depending on where you live. This fluoridated water has proven to play a huge role in decreasing tooth decay.  (Check out my previous blog on water fluoridation for more details and facts) Although, most people say they don’t like tap water, did you know that 40% of all bottled water is taken from municipal water sources (a.k.a tap water) (4).

At the end of the day water is essential for survival and important in your daily routine. You should be drinking six to eight 8-ounce glasses of water daily to keep the body properly hydrated. There are so many BPA free fun reusable water bottles on the market if you want to help the environment and put money in your pocket. If you prefer your bottled water be sure to recycle your plastic bottles, check the type of water you are drinking for its pH levels. If you have young children who are also drinking bottled water ask their dentists about the option of fluoride tabs. Everyone should be using fluoride toothpaste & rinse no matter what water you drink.



What you need to know about Triclosan!

Image result for triclosan


Triclosan is an antibacterial ingredient that is added to many products to help reduce or prevent bacterial contamination. The FDA has been trying to regulate it since 1978 (1). The concern is how it has been added to many different toothpastes, soaps and body washes, it could also be found in clothing, kitchenware, furniture and toys. The thought was by adding this antibacterial agent it would help decrease bacteria from the environment, but it has actually been traced in 75% of American bodies in urine, breast milk and blood (1). As Triclosan is being flushed down our drains its being introduced into our waterways and into our foods increasing our exposure.  The increased amounts of Triclosan is interfering with important hormone function in our bodies and its causing the bacteria in our bodies to become resistant to antibiotics. The World Health Organization feels that it is a “threat to global health security” (2). On September 6, 2016 the FDA published its final rule on consumer antibacterial hand soaps, which prohibits the use of Triclosan and 18 other antibacterial ingredients (3). All manufactures, except for one had until September 6, 2017 to pull their products containing Triclosan off the shelves.

What is the one product the FDA allowed to stay on the shelves containing Triclosan? Colgate Total toothpaste, which after being review by the FDA and its rigorous New Drug Application (NDA) they found Triclosan in this product it to be safe and effective. Colgate Total’s active ingredient is Triclosan (0.3%), which is formulated to fight against harmful plaque and gingivitis, which is the cause of most oral health problems (4). Gingivitis is inflammation and redness around your teeth, 3 out of 4 American’s have it and it can advance to periodontists if left untreated. With regular dental visits and proper oral habits at home, gingivitis can be controlled, although some people need more advanced dental cleanings first. I am a fan of Colgate Total, but the potential long-term risks to our bodies and the environment does make me question the risk to benefit.  When recommending this product I’m going to limit it to people who really need the added benefit to prevent gingivitis.

When it comes to hand washing and hand sanitizers here is what you need to know. A good non-antibiotic hand sanitizer that does not contain triclosan, but kills both bacteria and viruses is Purell. Hand washing with soap and water is still important to remove dirt and anything else you may have touched. The water can be luke warm, does not need to be hot and scrubbing for 30 seconds or having your kids sing the happy birthday song will provide a proper hand washing to remove dirt and bacteria.

In closing the FDA has said that there is no evidence that products containing Triclosan give any extra benefit over most products without Triclosan, except for Colgate Total Toothpaste, which is effective in reducing gingivitis (2). The next time you are at the store and looking at different OTC products and want to know if it contains Triclosan, look at the active and inactive ingredient list and it should be listed. This post is not to stop you from brushing your teeth or washing your hands. It’s to make you more aware of the products you are buying, and the ingredients in them, as well as the effects they have on you, your family and the environment.


Strong Teeth in Children Starts with Healthy Eating!

Kids- strong teeth

Starting children off with good eating habits is important to a healthy life style, as well as having strong and cavity free teeth. Many people are unaware of the effects that children’s eating habits have on their teeth. Foods that contain high levels of carbohydrates, starches, and sugars can increase the risk of dental decay when consumed in moderate amounts or left on tooth structure for too long. My blog today is focused on providing tips on food and snacks that are good choices and foods that would be considered poor choices when it comes to nutritional choices to keep children’s teeth healthier.

We all know the outer aisles of the grocery store are the ones to stick to and where you will find most of the foods I encourage, but if you are purchasing any packaged foods be sure to read and check the sugar content.

Good Nutritional Choices:

  • Water is best- Soda, juices and even milk can contain large amounts of sugar, which when sipped on for longer periods of time can cause dental decay. Do not put your child to bed with any of these items either, as it will accelerate the risk of dental decay. It’s best to encourage your children to primarily drink water, if you don’t introduce them to other options daily then most children don’t mind water.
  • Fruits and Veggies– These are great options in place of carbohydrate snacks like granola bars, teddy grams, crackers or even gold fish. Melons, pears, celery and cumbers are great because they are high water content foods which help clean off the teeth. Hard crunchy fruits and veggies are also good because they help remove substances that get stuck on teeth. Bananas do contain a concentrated sugar though, so be sure to brush your children’s teeth right after consumption.
  • Vitamin C– Found in fruits such as oranges, limes, kiwis, cantaloupe, papaya and strawberries help kill bacteria in your mouth. It’s also found in the following vegetables: red, yellow, and orange peppers, tomatoes and sweet potatoes. Although these are good foods, be sure to wait 30 minutes before brushing after eating them, as the citric acid can temporally weaken the tooth enamel and leave the teeth vulnerable to erosion caused by brushing.
  • Lean meats, nuts and proteins– These items are a great source of protein which helps strengthen the outer structure of your tooth called enamel. Examples include, turkey, chicken, and white fish. Nuts are a great snack as long as your child is old enough to chew them and not choke and trail mix is great starting at age 4. Nuts and seeds contain natural fats that coat teeth and help them shield against bacteria, the oils in the seeds strengthen the enamel making them more resistant to cavities.
  • Calcium (Vitamin D)– This is important in building strong bones and teeth. Calcium mixes with plaque and sticks to teeth, protecting them from lingering acids, it also strengthens the bones around your children’s teeth, making them more resistant to periodontal disease as adults. Good sources of calcium include; low-fat milks, cheese, yogurt and broccoli. Aged cheeses like cheddar, swiss and monterey jack also help generate the flow of saliva.
  • Sugarless Gum– If your child enjoys chewing gum, be sure its sugar free, and if it contains Xylitol even better. Gum can be beneficial as the chewing stimulates saliva production. The saliva loosens plaque and can help prevent tooth decay. So if you are out and about and unable to brush, chewing 1 piece of sugarless gum for no more than 20 minutes is a nice option.

Poor Nutritional Choices:

  • Snacking- We all have a bad habit of snacking occasionally, but it is harmful to our teeth especially children’s. It’s best to limit snacking between meals to decrease risk of decay. Time between meals is important because it allows the mouth to keep itself clean, but when we continuously snack it changes the PH levels in our mouths and allows for bacteria to grow, causing plaque and tooth decay. If your child is a snacker, I would encourage you to limit  it to only one snack between meals where water is being drank at the same time and brushing after lunch when possible.
  • Sticky, Chewy foods, Sweets- Gummy snacks/ candies and vitamins, taffy, caramels, lollipops, hard candies, cough drops, potato chips, raisins, and honey all get stuck on the surfaces of your teeth which in large amounts without proper brushing can increase your decay risk. If you are going to give your child a sweet treat its best to give it to them right after a meal as the saliva is already working at cleaning the mouth. If sweet treats are used for potty training or incentives regularly I would encourage simple chocolate over the more sugary options and even dark chocolate if you can, as it has antioxidants. When it comes to dessert it’s all about moderate, so limit your child’s consumptions and be sure to brush their teeth right after.
  • Sugar sweetened drinks, Chocolate milk & Sports drinks- These should all be in moderation (no more than one a day) and for special occasions.

Medicine Children get sick and we try not to give them medicine but sometimes they need it to be comfortable and to get better. Some medicine contains sugar, which the bacteria in your mouth uses to make acids and can eat away at the enamel, so be sure to brush your children’s teeth after giving them any type of medicine orally.

In addition to picking the right foods and snacks for your children, be sure to continue brushing their teeth twice a day, flossing once a day and using Act Flouride rinse nightly. Also bring them to the dentist twice a year for their dental cleanings and exams and follow suggested dental treatment.