Dental Flossing

Proper dental flossing removes plaque and food particles from areas where your toothbrush cannot reach including under the gum-line and between teeth. Daily flossing is highly recommended.

What is plaque?

Plaque is a “furry” coating that forms on and between teeth and it forms due to starches and sugars reacting with bacteria found in the mouth. Plague requires removal daily (via brushing and flossing); if not removed, the bacteria in plaque forms acid which damage enamel and cause tooth decay.

How to floss?

To ensure you get to all areas that are inaccessible by toothbrush and to ensure you do not damage the gums, it is important to use the correct technique. Start with approximately 15 inches of floss. Wind the majority of the floss around each middle finger allowing about two inches of floss to floss with. Grip the floss firmly between the thumbs and index fingers; glide it very gently up and down between the teeth. It is important to curve the floss gently around the base of each tooth and ensuring the floss goes beneath the gum-line to where more food can be trapped. Do not use a “sawing” motion as this will cut into the gums and damage the gums and cause bleeding. Likewise, do not snap or force the floss as this will also damage the gums. It is best practice to use clean sections of floss when moving from tooth to tooth. To remove floss, use the same gentle back and forth movement to glide the floss out and away from each tooth base.

What Type of Floss Should I Use?
To be very general, there is two main type of floss, a flat “tape like” floss and round floss which is thinner (basically like a thread). The “tape” floss is designed to increase contact area with the tooth.

There are other slight differences between different flosses including differences in the material they are made from (nylon or Polytetrafluoroethylene), whether they are waxed or unwaxed (waxed is meant to slide easier between teeth), different flavours, whether floss is stretchable or not, with or without fluoride etc; however these subtle differences do not make too much difference; the most important thing is that you floss at least once daily and that you use the correct technique to remove plaque and debris between your teeth. It is up to your individual preference which brand and type you use.

More about flossing

It is reckoned that 80% of people don’t floss. Brushing only reaches 65% of the surface area of your teeth; flossing is needed to reach the other 35%. If you have never flossed before, your teeth may bleed slightly during the first few times, however this bleeding will stop after a few times as your gums get used to flossing.

Dental Advice event

Whelehans are holding a dental advice event on Friday October 3^rd where you will be able to get free expert advice on dental hygiene, teeth whitening, dry mouth and more from a dental expert.

This article is shortened. For more detailed information, logon to www.whelehans.ie or contact Whelehans at 044 93 34591 or info@whelehans.ie and we will forward you a more detailed copy for free

By Eamonn Brady MPSI, pharmacist and owner of Whelehans Pharmacy, 38 Pearse St, Mullingar

 

 

 

Dry Mouth

Dry mouth (medically known as xerostomia) is due to a reduction in saliva produced by salivary glands. Dry mouth is often a side effect of medication and less frequently is caused by a condition that damages or blocks salivary glands. Dry mouth can vary from being a slight nuisance to a major effect on general health and dental health. It affects appetite and taste, hence reducing ability to enjoy food and reducing nutrition.

Saliva has many roles including aiding digestion and enhancing our ability to taste food and allow easier swallow. Saliva prevents tooth decay by neutralising acids caused by bacteria, preventing growth of bacteria and washing away food pieces.

Causes

Medicines
Many medicines, including many over the counter medicines can cause dry mouth. These include some antidepressants and mood stabiliser drugs, drugs used for nerve pain (known as neuropathy), benzodiazepines (used to treat anxiety), some antihistamines (especially the ones that cause drowsiness), decongestants, pain killers and muscle relaxants.

Aging
The aging process does not cause dry mouth but older people have increased likelihood of conditions that cause dry mouth as well as increased likelihood to be taking medicines that cause dry mouth.

Cancer treatment

Both chemotherapy and radiation therapy change the quality of saliva and can reduce the amount and quality of saliva produced. Radiation treatment of the head and neck area is especially known to damage salivary glands thus reducing saliva. This may be reversible after treatment but in some cases it may cause permanent damage and hence ongoing dry mouth.

Nerve damage

A head or neck injury or surgery that results in nerve damage to the head or neck can lead to dry mouth.

Other health conditions

Dry mouth can be a result of some health conditions, including Sjogren's syndrome (an autoimmune disease which is a relation of arthritis and causes enlarged salivary glands, dry mouth, and dry eyes) and HIV/AIDS. Stroke and Alzheimer's disease can make a person perceive they have dry mouth despite normal functioning of the salivary glands. Snoring and breathing with an open mouth (while sleeping) can also contribute to dry mouth.

Smoking

Smoking can cause and exacerbate symptoms of dry mouth

Symptoms

While dry mouth is a nuisance, it is the symptoms and problems caused by dry mouth that has the major impact on people’s lives. When not enough saliva is being produced, problems caused will include: dryness of the mouth or throat; thick and stringy saliva; bad breath; changed taste sensations (or inability to taste flavours properly); problems with chewing; swallowing and speech problems; increased tooth decay and gum irritation and gum disease and problems wearing dentures including friction and pain.

 

Reduced saliva also leads to more oral problems including increased plaque, tooth decay and gum disease, mouth sores, fungal infection (candida) in the mouth, coated (discoloured) tongue, cracked lips, sores or skin splits occurring at the corners of the mouth. All these problems can lead to poor nutrition due to reduced ability to chew and swallow.

Treatment

Your doctor, dentist or pharmacist can advise on the condition. Initially an examination of your mouth, review of your medical history and details of medicines being taken (including over-the-counter medicines) will be required to rule out and determine possible causes.

Depending on the causes of dry mouth your doctor may need to change medicines that can cause dry mouth. In most cases there are alternative options that will not cause dry mouth. In some cases, it may not be possible to change the medicines causing the dry mouth as there may not be suitable alternatives and the benefits may outweigh the risks.

Mouth moisturising products

Options include mouth rinses, artificial saliva or moisturisers that lubricate the mouth. For severe dry mouth, options include prescription medication that works by stimulating saliva. Options include pilocarpine or cevimeline that stimulates saliva production.

There are over-the-counter saliva substitutes available from pharmacies including the Xerostom^® range of products. In Whelehans we find good results from Xerostom^®. Xerostom^® products (includes a gel, mouthwash, toothpaste and chewing gum) have been shown in studies to increase saliva flow by up to 200% and shown to relieve pain associated with dry mouth and improve taste and flavours. Xerostom has an acid free lemon flavour that is pleasant to take and does not cause any burning sensation (unlike some lemon flavoured products); this is especially important to cancer sufferers as the mouth is particularly sensitive due to chemotherapy and radiation treatment.

 Other Tips

Sip water or sugar free drinks regularly to moisten mouth and drink water during meals as it will help make chewing and swallowing easier.

Use sugar-free chewing gum or suck sugar-free hard sweets. Bear in mind however that xylitol is often a sugar substitute in sugar-free products and it can bring on diarrhoea and cramps if taken in large amounts.

 Aim to breathe through the nose, not the mouth. Treatment for snoring may be recommended as snoring causes breathing through the mouth during the night. A room humidifier may also help as it will add moisture to the air while you sleep. Regular moisturisation of the lips will soothe dry or cracked areas. Because of increased risk of dental problems, regular check-ups from your dentist are recommended.

What to avoid?

Avoid substances that can exacerbate dry mouth including caffeine and alcohol (these can cause dryness and irritation), avoid mouthwashes containing alcohol;  avoid salty and dry food; stop smoking and  ask your pharmacist what medicines to avoid including over the counter medicines that can cause dry mouth (such as antihistamines and decongestants).

Dental Advice event

Whelehans are holding a dental advice event on Friday October 3^rd where you will be able to get expert advice on dental hygiene, teeth whitening and dry mouth from an expert from Swordfish Medical. Call in for free expert dental advice and there will be great offers on the day.

Disclaimer: Information in this article is general; consult with your healthcare professional before making any changes recommended

This article is shortened. For more detailed information, logon to www.whelehans.ie or contact Whelehans at 044 93 34591 or info@whelehans.ie and we will forward you a more detailed copy for free

By Eamonn Brady MPSI, pharmacist and owner of Whelehans Pharmacy, 38 Pearse St, Mullingar

Gum Disease (Gingivitis)

Gingivitis (Gum Disease)

Gingivitis is more commonly called gum disease (also known as periodontal disease) and is caused by a build-up of bacteria in the gums. It causes gum irritation, red swollen gums, and bleeding. Gingivitis can be mild and many are not aware they have the condition and only get treatment when it is too late (ie) gum and dental damage is evident. Gingivitis is generally not painful but if not treated early it will result in more serious gum disease (periodontitis) which can cause tooth loss. Gum problems can begin in adolescent years and continue into adulthood.

Periodontitis and general poor oral health can have a detrimental effect on your overall health. Periodontal disease is associated with more risk of heart attack, stroke and lung disease. In women, it is linked to premature birth or low birth weight babies. It is not fully understood if periodontal disease is a cause of any of these conditions or why people with periodontal disease have higher incidences of these health problems.

Poor oral hygiene is the main cause of gingivitis as it increases formation of plaque. Plaque is a “furry” coating that forms on tooth; it can be colourless or sometimes a pale-yellow colour. Plaque is a sticky film of bacteria that forms on teeth due to starches and sugars reacting with bacteria found in the mouth. Plague requires removal daily (via brushing and flossing) as it reforms quickly again within 24 hours after last removal. If not removed, the bacteria in plaque forms acid which damage enamel and cause tooth decay and when it develops under the gums on the tooth’s root is can lead to bone damage and eventual tooth loosening and loss.

While poor oral hygiene is the most common cause of gingivitis, other factors that increase risk include smoking, being diabetic, increasing age, dry mouth (I will discuss dry mouth a separate article on www.whelehans.ie or ask for a free copy in Whelehans), hormonal changes (due to pregnancy, menstrual cycle or taking the contraceptive pill), poor diet, substance misuse (eg. alcohol or illegal drugs) and poorly fitting dentures.

Symptoms

Healthy gums will be firm and a pale pink colour. Signs of gingivitis include soft, puffy, tender, dark red and easy bleeding gums (may be seen as red or pink colour on your toothbrush or floss). Other signs include swollen gums, receding gums and bad breath.

An dental appointment is important if you notice some of these symptoms; a dentist can quickly diagnose gingivitis and advise on the just course of action. Prompt treatment will clear gingivitis symptoms and prevent development of more serious gum disease and tooth loss. Treatment requires professional care through your dentist followed by improved regular oral hygiene practice at home.

What your dentist will do

After checking your teeth, your dentist (or dental hygienist) will thoroughly clean to remove all plaque and tartar. Your dentist will remove all plaque and tartar using a procedure called scaling. Scaling may be temporarily be uncomfortable, especially as gums are sensitive (which is often the case with gingivitis) or there is excessive plaque and tartar build-up.

Your dentist may fix crowns or fillings (dental restorations) that make brushing and flossing in certain areas difficult. Teeth that are misaligned, crowns that are poorly fitting, bridges or fillings can irritate gums and prevent removal of plaque in certain areas by flossing and brushing; thus your dentist may need to fix some of these issues.

Your dentist will advise on effective brushing and flossing techniques at home. Regular professional check-ups and cleaning from your dentist is important.

What to do

Gingivitis will clear up with a thorough professional cleaning by your dentist or hygienist and if the person then practices good oral hygiene by brushing and flossing. There are steps a person can take to prevent and reverse gingivitis. These include regular professional dental cleanings (generally recommended as every 6 months). A soft toothbrush is best if you have gum problems and aim to replace it every three or four months to ensure maximum cleaning capacity. Consider the use of an electric toothbrush as it may be better for removal plaque and tartar. It is important to brush teeth twice daily or better again, after every meal or snack. Floss at least once daily (this is where many people fall down and it is very important).  Use an antiseptic mouthwash if your dentist advises. A thorough cleaning using a toothbrush and floss will take three to five minutes if done properly.

 

More about flossing

Flossing before brushing is important as it clears bits of food and bacteria between teeth that a toothbrush cannot reach. It is reckoned that 80% of people don’t floss. Brushing only reaches 65% of the surface area of your teeth; flossing is needed to reach the other 35%. If you have never flossed before, your teeth may bleed slightly during the first few times, however this bleeding will stop after a few times as your gums get used to flossing. Ask your dentist or hygienist how you should floss properly. If you start with a consistent daily oral hygiene routine, gums should return to a healthy pink colour within a few weeks.

Dental Advice event

Whelehans are holding a dental advice event on Friday October 3^rd where you will be able to get expert advice on dental hygiene, teeth whitening and dry mouth from an expert from Swordfish Medical. Call in for free expert dental advice and there will be great offers on the day.

Disclaimer: Information in this article is general; consult with your healthcare professional before making any changes recommended.

This article is shortened. For more detailed information, logon to www.whelehans.ie or contact Whelehans at 044 93 34591 or info@whelehans.ie and we will forward you a more detailed copy for free

By Eamonn Brady MPSI, pharmacist and owner of Whelehans Pharmacy, 38 Pearse St, Mullingar