Patient Education

Plaque and Calculus

Plaque
Research has shown that controlling plaque is important in the control of decay and gum disease. Plaque is neither food or food residue. Plaque is a clear, sticky deposit of of bacteria that adheres to the surface of teeth and gum tissue. It is so adherent that it can only be removed by mechanical cleansing. Plaque contains a variety of different types of bacteria. For this reason, certain types of plaque are associated with dental decay, others with calculus formation, and others with the inflammatory response of the gums (gingivitis).

Plaque begins forming on the teeth in as little as 4 hours after brushing. This is why it is so important to brush your teeth at least twice a day and floss daily. The rate at which plaque forms and the location in which it develops can vary between individuals and even between different teeth in the same mouth. One of the prime areas in which plaque accumulates is at the gingival margin and sulcus where the tooth meets the gum.

Calculus
Plaque which is not removed regularly by brushing and flossing can harden into calculus (also called tartar). Calculus is plaque that has mineralized, forming a tough, crusty deposit that can only be removed by your dentist or hygienist. These deposits can form above (supragingival) and below (subgingival) the gum line. Calculus deposits are a significant contributing factor in periodontal disease because it is always covered by a layer of non-mineralized plaque. The calculus keeps the plaque close to the gingival tissue and makes it much more difficult to remove the plaque bacteria. Thorough removal of these deposits is necessary to prevent the progression of periodontal disease.

Some people form heavy calculus deposits rapidly while others form little or no mineralized deposits. This is due to differences in the saliva, the types of plaque bacteria, and dietary factors. One can help reduce the formation of calculus by brushing with and ADA-accepted tartar control toothpaste and by having regular professional cleanings every 6 months or more frequently as recommended by your dentist or hygienist.

The prevention of gum disease and decay requires a life-long commitment to fighting plaque and calculus formation.

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Tooth Brushing Simplified

The Brush To Use
Hard bristles were once recommended but are now thought to be too abrasive to the teeth and gums. We now suggest a soft, rounded-end nylon bristle brush. Be sure to discard brushes when the bristles are bent or frayed or approximately every three to four months.

How To Brush
Begin by placing the head of the brush beside your teeth, with the bristles angled against the gum line (where the teeth and gums meet ). Think of the brush as both a toothbrush and a gum brush. With the bristles contacting both tooth and gum, move the brush back and forth several times across each tooth individually.

Use a short stroke and a gentle scrubbing motion, as if the goal were to massage the gum. Don’t try to force the bristles under the gum line; that will happen naturally, especially with a brush that has soft, flexible bristles.

Brush the outer surfaces of the upper and lower teeth. Then use the same short back-and-forth strokes on the inside surfaces. Try to concentrate harder on the inside surfaces; studies show they’re more often neglected. For the upper and lower front teeth, brush the inside surfaces by using the brush vertically and making several gentle up–and-down strokes over the teeth and gums.

Finish up by lightly scrubbing the chewing surfaces of the upper and lower teeth. You should also brush your tongue for a fresher breath.

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Flossing

Instructions
With all of the wonders of modern man available to you there is no better way to clean the sides of your teeth than DENTAL FLOSS. Inexpensive, readily available and easy to use. A modern wonder, maybe not. But it is and has always been an excellent tool in the fight against dental decay and periodontal disease. There are many types of dental floss available in your local drugstore. Please speak with our hygienist regarding the best floss for your particular set of dental needs.

Here’s How To Floss
You should floss under both sides of each flap of gum tissue between your teeth. The following technique has proven to be very effective: Break off about 18 inches of floss and wind a good bit of it around one of your middle fingers. Wind the rest around the middle finger of the other hand. Grasp the floss with the thumb and forefinger of each hand, leaving about an inch of floss between the two hands to work with.

Pull the floss taut and use a gentle sawing motion to insert it between the two teeth. When the floss reaches the tip of the triangular gum flap, curve the floss into a C Shape against one of the teeth. Then slide the floss gently into the space between the tooth and the gum until you feel resistance. Holding the floss tightly against the tooth, scrape up and down five or six times along the side of the tooth. Without removing the floss, curve it around the adjacent tooth and scrape that one too. Repeat on the rest of your teeth. Don’t forget the far sides of your rear teeth. When the floss becomes frayed or soiled, a turn of each middle finger brings out a fresh section of floss. After flossing, rinse vigorously with water.

Flossing Problems
If you don’t like manipulating floss, try one of the commercial floss holders. They have limited flexibility, however, and you must use them with care to avoid injuring the gum. You may have trouble working with the floss between certain teeth, or the floss may consistently break or tear in certain areas. Several causes are possible, including calculus buildup, or improperly installed fillings. Please let us know if this problem occurs. Flossing between bridges requires additional instruction and the use of floss threaders. Alternatives to floss includes such things as Stimudents, Perio-Aids or Plac-piks. Please discuss these tools with your dentist or hygienist before using them. None of these are as good as floss in tight areas between teeth.

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Sealants

Pit and Fissure Sealants Prevent Cavities
Dental Caries (tooth decay) is the most wide-spread dental disease. Your dentist can help prevent or reduce the incidence of decay by applying sealants to your teeth.

What Causes Decay?
Decay is caused by dental plaque, a thin sticky, colorless deposit of bacteria that constantly forms on everyone’s teeth. When sugar is eaten, the bacteria in plaque produce acids that attack the tooth enamel. After repeated acid attacks, the enamel breaks down, and a cavity (hole) is formed.

What Is A Sealant?
A sealant is a clear or shaded plastic material that is applied to the chewing surfaces of the back teeth.

Why Are Sealants Necessary?
The back teeth have depressions and grooves on the chewing surfaces of the enamel. These irregularities are called pits and fissures. They are impossible to keep clean, because the bristles of a toothbrush cannot reach into them. Therefore, pits and fissures are snug places for plaque and bits of food to hide. By forming a thin covering over the pits and fissures, Sealants keep out plaque and, thus, decrease the risk of decay.

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Extraction

One of the main goals of modern dentistry is the prevention of tooth loss. All possible measures should be taken to preserve and maintain your teeth because the loss of a single tooth can have a major impact upon your dental health and appearance. However, it is still sometimes necessary to remove a tooth. Stewart Brody, DDS can perform these procedures when necessary.

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Glossary of Terms

A

Abrasion: wearing away of a tooth due to abrasives.
Abscess: the formation of a sac of bacteria. Symptoms are swelling pain, throbbing, and a sensation of heat.
Anaesthesia: drug to block off any pain impulses from the nerves.
Analgenic: pain killer.
Ankylosis: teeth that do not fully erupt because they are attached to the bone..
Antibiotics: medication to fight off bacteria causing infection.
Asepsis: sterilization of the surroundings and instruments to prevent infections.
Attrition: wearing away of a tooth due to the opposing tooth and grinding.

B

Bleaching: oxygenating and conditioning the teeth with an acid based gel
Bridge: when missing teeth, a dentist can use two or more teeth present to “bridge” the space.

C

Calcification: the pulp is hardened due to calcium and phosphorous salts.
Calculus: hardened plaque.
Cavities: when acids decalcify the tooth enamal and disintegrates the dentin. Caused by acids produced by microbialenzymatic action on ingested carbohydrates.
Cementum: the dull yellow surface of a root.
Cingulum: an enlargement or bulge on the lingual aspect of the front teeth.
Contact point: area where two adjacent teeth touch each other. You floss the contact point.
Crossbite: when the lower back teeth overlap the upper back teeth when closing the mouth
Crowding: lack of space produces teeth that are overlapping
Cusp: a point or peak on the top surface of a tooth.

D

Deciduous dentition: (Baby Teeth) the primary dentition, also known as the milk teeth (20).
Dentin: the hard tissue under the enamel and cementum.
Denture:
Full denture: when the patient has no teeth (edentulous).
Immediate: getting a denture at the time the patient gets teeth extracted.
Partial: when the patient has a few teeth (partially edentulous).
Diastema: the space present when the central incisor are separated.

E

Edgewise: orthodontic appliance
Enamel: the hard shiny surface of a tooth.
Erosion: a dissolution of tooth due to reason unknown.
Excision: cutting and harvesting the tissue usually for study of possible pathology
Extraction: removal of a tooth.

F

Fistula: tract made by infection exiting often through the gingiva and resembling a pimple.
Full denture: when the patient has no teeth (edentulous).
Fusion: tooth appears double but a separation is present due to two teeth fusing together.

G

Gemination: tooth appears double due to splitting of a single tooth germ.
Gingiva: the soft tissue that surrounds a tooth (the gum).
Gingivitis: inflammation of the gingiva (bleeding gums).
Graft: a piece of tissue taken from one area and placed at another.
Groove: a sharply defined linear depression.

H

Hutchinson’s teeth: screwdriver shaped teeth due to prenatal syphilis.

I

Immediate denture: getting a denture at the time the patient gets teeth extracted.
Impacted Tooth: a tooth that is blocked fully or partially from exiting the gum line by an adjacent tooth.
Full bony extraction: the tooth is submerged in the bone, full bone removal is necessary.
Fully soft tissue extraction: the tooth is submerged in the tissue, full cutting is necessary.
Partly bony extraction: partial bone must be taken out to be able to reach the tooth to be extracted.
Partly soft tissue extraction: partial cutting of the tissue is needed to reach the tooth to be extracted.
Implant:
A substitute for a lost tooth. It functions as additional support, most often providing the very important option of esthetics, non removable rather than removable tooth replacement. Implants are fabricated from body compatible bio-materials, most often titanium or one of its alloys. It can vary in shape from a blade-like shape to a screw type shape.
Incision and drainage: cutting of tissue in order to allow the infection to flow out and reduce pain and the swelling.
Incision: cutting.
Inlay: restoration used when less than 3/4 of a tooth is present and the cusps are not missing.
Intravenous sedation: putting someone to sleep with an IV.

L

Laminate Veneer: fingernail like restoration made of porcelain or composite.

M

Mandible: the lower jaw.
Maxillae: the upper jaw.

N

Nightguard: occlusal guard.

O

Occlusal guard: appliance used to prevent grinding (nightguard).
Onlay: restoration used when 3/4 of a tooth and part of the cusps are missing.
Open bite: due mostly to thumb sucking, the front teeth do not touch when closing the mouth
Overbite: when the upper front teeth overlap the lower front when teeth when closing your mouth
Overdenture: denture made over existing teeth or root tips that have had root canal. These roots are left there in order to reduce bone loss.
Overjet: the distance between the upper and lower front teeth, when the upper are bucked out and the lower are more refracted inside towards the tongue.

P

Palate, Hard: the front part of the roof of the mouth.
Palate, Soft: the back part of the roof of the mouth.
Paraesthesia: lack of sensation at the sensory level.
Papillate: gums between the teeth. Partial denture: when the patient has a few teeth (partially edentulous).
Pericoronitis: gingival tissue area of an empty tooth that is inflamed. Most often the Wisdom Tooth.
Periodontitis: inflammation of the bone (bone loss).
Pin and tube: orthodontic appliance
Plaque: film of materials made up of saliva, molds and bacteria. Dead cells, blood cells, food particles and bacterial residues.
Post and core: used in order to build up tooth to be able to place a crown on it.
Pulp: the center of a tooth made up of vessels and nerve tissue.

R

Recontouring: reshaping the teeth.
Retainer: appliance to hold the teeth in a certain position.
Ribbon arch: orthodontic appliance
Root canal: removal of the nerve tissue due to infection from cavities or trauma, and filled with gutta percha.
Root planning: scraping root below the gums.

S

Scaling: scraping of the tooth above the gums.
Sinus: air spaces above the upper teeth.
Space maintainer: appliance used to allow teeth to come into a certain area.
Splint: appliance used to stabilize loose teeth.
Succedaneous dentition: the permanent dentition (32).
Suture: stitches.

T

TEETH
Canines: the cornerstone of the mouth, the fangs or the cuspid (upper and lower).
Incisors, Lateral: the next teeth on either side of the central incisors (upper and lower).
Incisors, Central: the two front teeth, the cutting teeth (upper and lower).
Molars: the back teeth, the chewing teeth (upper and lower).
Premolar: the middle teeth or the bicuspid (upper and lower).
TMJ(TMD): temporomandibular joint(disorder), the place near the ear where the lower jaw “joins” the skull. A defect of the disc or other parts are involved. A clicking is most common.

U

Uvula: a small fleshy structure hanging from the center of the soft palate.