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Let’s face it, by now, brushing our teeth is something we pretty much do on auto-pilot. A quick brush after breakfast, a minute or so at night, floss when we think of it. Done. But take a few minutes to review these cleaning tips, and see if a few small adjustments to your routine could make all the difference at your next checkup at our Appleton, WI office.

• Tools

Some of us prefer brushing with a manual brush. Some like the electric brush for ease and comfort. Whichever form of brush you choose, be sure that it fits comfortably in your mouth, reaches everywhere it needs to, and has a handle that is easy to grip. There are many bristle options available, so if you are an energetic brusher, or if you have sensitive gums, try a soft bristled brush for gentler brushing.

If you haven’t been exploring the floss aisle lately, there are now many varieties available to suit your particular needs. Besides the traditional floss, there are coated flosses for easy gliding between teeth that fit closely together, dental tape-style flosses to fit teeth with wider spacing, and even flosses designed just for braces that thread between the wires and brackets. Talk to Dr. Dale Scharine and Dr. Alissa Edwards at your next cleaning for product suggestions if you think there’s an easier, more comfortable option out there for you.

• Technique

With proper technique, any toothbrush and floss you choose will do a fine job of removing plaque.

Brushing? There’s a tried and true method for success. Place the toothbrush at a 45° angle at the gum line. Be sure to brush the outside, inside, and chewing surface of each tooth thoroughly. Remember the expression, “Massage, don’t scrub.” Over-vigorous brushing can actually irritate gum tissue and damage enamel. An electric toothbrush should provide a continuous brushing motion without needing any pressure from the brusher. This might be the model for you if you have a too-vigorous approach to brushing, or sensitive teeth and gums. If you like your manual brush, again, give a soft-bristled brush a try!

As for flossing? That harmless-looking little string can cause gum damage if used too forcefully. You can accomplish the placement and cleaning power you need by easing the floss down to the gumline and flossing with gentle pressure against the tooth surface. If you have any questions about technique, remember—we are always happy to let you know the best cleaning methods for your specific needs.

• Timing

Of course, the best tools and the best technique in the world won’t be effective unless you put the right amount of time into brushing and flossing.

The standard rule is two minutes of brushing in the morning and two minutes at night. If you wear braces or have other special circumstances, we might recommend brushing after every meal. And if you brush after breakfast, give your teeth half an hour or so to remineralize. This natural process uses the calcium and phosphate ions in your saliva to strengthen tooth enamel after it’s been exposed to any acidic foods in your breakfast.

Thorough flossing can be accomplished in a few minutes, and might be needed only once a day. But again, depending on your individual needs, we might have other recommendations. Let’s review what works for you at your next visit—we can tailor suggestions for a brushing routine to your unique needs.

It’s a great idea to review your brushing habits periodically to make sure you are getting the most out of those minutes you spend cleaning your teeth. There won’t be a test at the end of this review, and you won’t get a gratifying grade or a gold star. What you will get is much more important—better checkups, fewer cavities, and healthy teeth and gums. Happy cleaning!

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. Dale Scharine and Dr. Alissa Edwards suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Appleton, WI office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

When your child loses a tooth for the first time, you both have a lot to look forward to. Sharing in the “I’m a big kid!” excitement. Tales of the Tooth Fairy or other traditions to mark the occasion. Seeing the start of a beautiful grown-up smile.

But before that baby tooth wiggles all the way out of your child’s mouth, let’s talk about how to handle a loose baby tooth.

• Be mindful of your children’s feelings. Reassure them that this is a normal part of growing up. If they are anxious about losing a tooth, there are children’s books which can help ease their fears in a soothing and entertaining way.
• Crunchy and healthy foods like carrot sticks and apple slices can help the tooth fall out naturally—and nutritiously!
• Encourage careful wiggling. No need for children to yank or pull—time, and a child’s own gentle wiggling with tongue or clean hands, should do the trick. If wiggling the tooth is painful, it might not be ready to come out just yet.
• If a tooth absolutely is ready, but just won’t come out, you can help your child without resorting to a string and a doorknob. Give our Appleton, WI office a call for some suggestions for helping that baby tooth on its way to the Tooth Fairy in a timely—and gentle—fashion.

And if a tooth is clearly loose before its time? Should you encourage its exit?

Probably not. Baby teeth are temporary, but they’re important for your child’s development. They help with speech production, eating and chewing, and serve as placeholders so that permanent teeth can erupt in the right spot at the right time.

There are some situations when a loose baby tooth means a visit to the dentist is in order:

• Baby teeth usually fall out over a period of years, generally from ages 6 through 12. Since children’s teeth tend to fall out in the same order they arrived, if a molar is loose before the front teeth start to wiggle, give your dentist a call.
• If your child suffers a fall, or a sports injury, or any kind of accident that leaves a tooth or teeth loose, call your doctor or dentist right away to make sure there are no serious injuries or chance for infection.
• Any time you feel a tooth is loose that shouldn’t be, make an appointment with your child’s dentist.

Finally, we’ve been talking about loose baby teeth, but loose permanent teeth are another matter entirely.

If you child has a loose permanent tooth due to an injury, or a bad bite, or night-time bruxism (tooth-grinding), or for any other reason, it’s important to call for an appointment immediately. Dr. Dale Scharine and Dr. Alissa Edwards will be able to pinpoint the cause of the problem and can offer some solutions. In the meantime,

• Make sure your child eats soft foods, and tries to eat on the opposite side of the loose tooth.
• Keep the area clean with gentle rinsing instead of brushing and flossing.
• Tell your child not to wiggle it! If the bone or ligaments holding the tooth in place have been damaged, playing with the tooth can make it looser.

A loose baby tooth is a step in your child’s journey to a beautiful, healthy adult smile. Reassure, encourage, and help your child through this rite of passage—and don’t hesitate to call on Dr. Dale Scharine and Dr. Alissa Edwards for advice!

Probably because, for many kids, molars do get more cavities. So let’s answer two better questions: Why do molars get more cavities? And, how can we help prevent them?

It’s the Pits. (And Fissures.)

The reason molars are so useful—and more likely to develop cavities—is because of their shape. Unlike our front teeth, which are used to bite through foods, molars are used to grind and chew. That’s why they are so much larger, with a flat surface on top. Well, not exactly flat.

When you look at a molar, you’ll notice that the top isn’t really smooth at all. It’s covered with little indentations known as pits and longer grooves called fissures. These irregular features both trap food particles and make it more difficult for bristles to clean them away. Cavities in molar surfaces are so common that they even have a specific name: “pit and fissure cavities.”

But molar biology does not mean tooth decay is inevitable! There are steps you can take to protect your children’s molars as they grow, while you’re providing them with dental strategies that will keep their adult molars healthy and cavity-free.

Preventing Pit and Fissure Cavities

• Don’t Just Brush—Brush Effectively

The first step in preventing any kind of cavity is brushing properly. Your child should be brushing at least two minutes, at least twice each day. And while the time we spend brushing is important, technique is also key.

When you’re showing your child how to brush, be sure that the tops of molars, upper and lower, get brushed thoroughly, with special emphasis on cleaning pits and fissures. Make sure the toothbrush is small enough to fit your child’s mouth comfortably and reach all the tooth surfaces. Replace worn-down brushes or electric toothbrush heads after three to four months when they no longer clean as effectively.

Your child will probably need adult supervision from toddler years through the early years of grade school to learn how to brush properly. This is time well spent, as your child learns cavity-preventing brushing techniques which will last a lifetime.

• Eat a Tooth-Healthy Diet

Plaque bacteria use the sugars in our food to make acids. These acids break down the mineral strength of tooth enamel and eventually lead to cavities. And because pits and fissures are great hiding places for bacteria and food particles (especially sticky ones), molars are even more at risk for cavities. Limiting sugary, sticky foods like sweet treats and simple carbs helps reduce that risk.

Acidic foods like flavored juices, sour candies, sodas, and power drinks also weaken enamel and can leave teeth more vulnerable to decay. Help your child avoid cavities by limiting acidic foods and drinks, making them part of a balanced meal, and/or rinsing with water after eating.

• Use Fluoride Toothpaste

Fluoride toothpaste not only reduces the risk of cavities, it also helps strengthen enamel that has been weakened by bacterial and dietary acids. Win-win!

• Ask About Sealants

Sealants are invisible, safe coatings which protect molars by preventing food and bacteria from getting trapped in their uneven surfaces. The top of the molar is first treated with an etching solution to allow the sealant to bond tightly to the tooth, a thin coat of sealant is painted on, and then it’s hardened under a curing light. That’s all there is to it.

Sealants are often recommended when children’s permanent molars first erupt, when they are especially at risk for cavities. Sealants can last from three to five years (or even longer), and studies have shown a dramatic reduction in cavities for patients who use sealants compared to patients with untreated teeth. Depending on your child’s individual needs, Dr. Dale Scharine and Dr. Alissa Edwards might recommend a sealant for baby molars as well.

• Regular Exams and Cleanings

It might be hard for you to tell if your child’s molars have been affected by sticky plaque, or sugary foods, or acidic drinks, or inadequate brushing, or any other potential cavity-causers. It’s not a difficult job for Dr. Dale Scharine and Dr. Alissa Edwards, though! Through regular checkups and cleanings at our Appleton, WI office, we will discover any conditions that might lead to cavities, and, if necessary, treat small cavities before they lead to more serious decay.

Statistically, childhood molars have a greater chance of developing cavities than incisors and canines. Help your child beat the odds by understanding why these teeth are at risk and by working with your dental team to give your child years of healthy teeth now and a future filled with beautiful smiles!