Preventative and Hygiene-click a category to learn more.
Note: This information was compiled for you by the Academy of General Dentistry. Your dentist cares about long-term dental health for you and your family and demonstrates that concern by belonging to the Academy of General Dentistry. As one of the 37,000 general dentists in the United States and Canada who are members of the Academy, your dentist participates in an ongoing program of professional development and continuing education to remain current with advances in the profession and to provide quality patient treatment. Visit the AGD's website at the link provided at the bottom of the page.

Brushing :: Flossing :: Sealants :: Tobacco Sessation :: Treatment of Gum Disease

Dentistry has pioneered preventive health care. Our staff will thoroughly explain all preventive care appropriate to your particular case and will suggest customized treatment options. Our goal is to help you maintain a lifetime of healthy teeth and gums. Routine dental check ups allow us to detect decay at the early stages, when simple fillings can be used. If it has been a long time since your last check up, there may be many cavities that have gone undetected. Some of these fillings may have become deep, and even started hurting. At this stage root canal therapy and or crowns may be required to save your teeth. If the decay is even worse, the tooth may be considered hopeless and have to be removed. Dr. Belote will create a treatment plan to stop active disease, and then prevent future dental disease.

Q: What Is The Best Technique For Brushing? :: Back to Top
A: There are a number of effective brushing techniques. Patients are advised to check with their dentist or hygienist to determine which technique is best for them, since, tooth position and gum condition vary. One effective, easy-to-remember technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth. Place a toothbrush beside your teeth at a 45-degree angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside the teeth, your tongue and the chewing surfaces and in between teeth. Using a back and forth motion causes the gum surface to recede, or can expose the root surface or make the root surface tender. You also risk wearing down the gum line.

Q: Soft or hard bristles?
A: In general, a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp. It should have soft, nylon bristles with round ends. Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.

Q: How long should I brush?
A: It might be a good idea to brush with the radio on, since dentists generally recommend brushing 3-4 minutes, the length of an average song. Using an egg timer is another way to measure your brushing time. Patients generally think they're brushing longer, but most spend less than a minute brushing. To make sure you're doing a thorough job and not missing any spots, patients are advised to brush the full 3-4 minutes twice a day, instead of brushing quickly five or more times through the day.

Q: Should I brush at work?
A: Definitely, but most Americans don't brush during the workday. Yet a recent survey by Oral-B Labor-atories and the Academy of General Dentistry shows if you keep a toothbrush at work, the chances you will brush during the day increase by 65 percent. Dentists recommend keeping a toothbrush at work. Getting the debris off teeth right away stops sugary snacks from turning to damaging acids, and catches starchy foods like potato chips before they turn to cavity-causing sugar. If you brush with fluoride toothpaste in the morning and before going to bed, you don't even need to use toothpaste at work. You can just brush and rinse before heading back to the desk. If you don't have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.

The following tips may improve your work-time brushing habits:

• Post a sticky note on your desk or computer at work as a reminder to brush teeth after lunch.
• Brush teeth right after lunch, before you become absorbed in work.
• Store your toothbrush and toothpaste at work in a convenient and handy place.
• Make brushing your teeth part of your freshening up routine at work.

Flosses And Waterpicks :: Back to Top
Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can't reach. This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day. The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them. Some people use waterpicks, but floss is the best choice.

Q: Should I floss?
A: Yes. Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit your dentist or hygienist, ask to be shown.

Q: Why should I floss?
A: Flossing is the one most important step in oral care that people forget to do or claim they don't have time for. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal or gum disease. Flossing cleans away the plaque from between your teeth, decreases the chance of interproximal decay and increases blood circulation in the gums.

Q: Which type of floss should I use?
A: Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss. How should I floss? There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side to side as if you're shining shoes. Bring the floss up and down several times forming a "C" shape around the tooth being sure to go below the gum line. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline forming a "C" on the side of the tooth.

Q: How often should I floss?
A: At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

Q: What are floss holders?
A: You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss, or for caretakers who are flossing someone else's teeth.

Q: Is it safe to use toothpicks?
A: In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. Toothpicks come round and flat, narrow and thick. When you use a toothpick, don't press too hard as you can break off the end and lodge it in your gums.

Q: Do I need a waterpick (irrigating device)?
A: Don't use waterpicks as a substitute for toothbrushing and flossing. But they are effective around orthodontic braces that retain food in areas a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended for persons with gum disease when recommended by your dentist. Solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir.

Sealants: Cavity Prevention At Any Age! :: Back to Top
The most precious gift we can give our children is good health. In the dental profession, we pride ourselves on our stand for the prevention of dental disease. Sealants are, without a doubt, the finest, preventive service that we can provide our patients. In this process, the grooves in the teeth are sealed with a thin but hard plastic resin coating that effectively eliminates the potential for tooth decay. With no pain, no shots, no drilling, sealants are radically improving the health of our children and adult patients. That's great!

• Primary molars
• Pre-Teens molars
• Teens bicuspids and molars
• Adults bicuspids and molars

• Cold turkey, will power …
• Zyban (Wellbutrin), RX drug- reduces your craving for nicotine. You may start taking the drug two weeks before you quit and continue taking it for several months. If this drug causes insomnia, only take the morning dose. Dizziness and seizures are a RARE side effect. If this occurs, stop taking immediately.
• Nicotine patches- help keep a low level of nicotine in your body 24 hours a day, to reduce cravings. You will slowly wean yourself off of this patch. This is available over-the-counter. Be sure to read all the instructions, and DON’T smoke while you’re wearing a patch.
• Nicotine gum- start with this over-the-counter nicotine in gum form. When you would normally reach for tobacco, reach for the gum instead. Slowly wean yourself off of the gum. Be sure to read all the instructions. Chew once or twice, then ”park” the gum in your cheek. If you chew too quickly, you may get too much nicotine and feel nauseated.
• Combination method- use Zyban (Wellbutrin) in combination with the patch and or the gum for a powerful way to combat the nicotine addiction. Your health care provider should monitor your blood pressure during this time.

Brush biopsy and fees: Visual detection of oral cancer at an early stage is difficult because approximately 25% of cancerous lesions appear to be non-cancerous. Since doctors and patients are hesitant to perform a scalpel biopsy on a lesion that appears to be non-cancerous, early detection is not always achieved. In fact, half of all oral cancers are not diagnosed until the advanced stages. A simple brush biopsy has been developed that will help detect cancers in an earlier stage. A sterile brush is rotated on the area in question. Pinkness or pinpoint bleeding indicates proper technique. There is no need for anesthesia. The sample is then sent to a laboratory that uses a computer to assist in the search for abnormal cells. A pathologist looks at the sample and provides the diagnosis. We charge $150 for the biopsy. The pathologist charges about $65 to read the biopsy, and will bill you directly. Insurance may help cover this procedure.

	Gums separate from teeth, forming a periodontal pocket.
	Healing is complete. Periodontal pocket is reduced, and new healthy tissue supports tooth.

What causes periodontal disease?
Bacteria are the primary cause of periodontal infection. Bacteria form in plaque, which is sticky, almost invisible film that forms over the teeth and destroys bone. Plaque that is not removed by regular brushing and flossing hardens into tartar over time. You cannot remove tartar (or calculus) on your own. The only way to remove tartar is by a procedure called scaling, which is done by a dentist.

What are the stages of periodontal disease? :: Back to Top
Stage 1: Gingivitis In this early stage, your gums may look normal but they also may be red, puffy, and bleed easily when you brush your teeth. You also may notice some mouth odor. This is because bacteria in plaque have caused infection.

Stage 2: Early Periodontitis Early periodontitis occurs when the bacterial infection spreads from the gum to the bone that supports the teeth. The bacteria then cause small spaces, or crevices, to form between the gums. These crevices are called pockets. They are deeper than normal spaces, which measures to 1 to 3 mm deep. Bacteria in the pocket also can destroy some bone. As the pocket grows and the amount of bacteria increases, the gums recede down the root of the tooth, increasing the pocket depth. Your dentist measure how deep your pocket is with an instrument called a periodontal probe, which is placed in the gum crevice.

Stage 3: Moderate Periodontitis When the gum has crept further down the root, it is called moderate periodontitis. In this stage, up to one-third of your bone has been lost. When half or more of the original bone holding the tooth has been lost, and pockets are very deep, it is called advanced periodontitis. The tooth may appear longer because the root is exposed, and the tooth may loosen and eventually fall out, or have to be removed by your dentist.

What you and we can do to treat and prevent periodontitis?
Periodontal disease may be prevented if you brush and floss every day to remove bacterial plaque and get regular dental checkups. If you do have periodontal disease, we will normally remove the calculus above and below the gum. This procedure is called scaling. In moderate or severe periodontitis, it may be necessary to smooth the surface of the teeth. This procedure, is called root planing. It removes residual calculus and bacterial by-products. We may also replace old crowns and fillings that no longer fit well because these trap bacteria and food that can cause severe periodontal problems.

Soft Tissue Management :: Back to Top
Over 75% of Americans are losing the battle against a microscopic enemy, plaque. Made up of bacteria and food particles, this stealthy foe is the causative agent of all dental disease, including decay and gum disease. Soft Tissue management is a strategy to neutralize the enemy. When plaque colonies reach a critical size, they release an arsenal of toxins that destroy tooth and bone, the bone that holds your teeth in place. The soft tissue (gums) literally becomes infected. Infected tissue is red, swollen, bleeds easily and contributes to bad breath. The swelling produces “pockets” that we can measure. To eliminate this infectious disease we must reduce the number of bacteria in your mouth. Currently, there is no procedure to remove 100% of the disease causing bacteria. Our strategy is to remove as many bacteria as possible. Then we must keep the colonies from growing to that critical mass with careful home care and routine professional care. A lapse in these defenses will allow the disease process to begin anew.

Root Planing :: Back to Top
To win the war against gum disease, we must remove the bacteria from your mouth. Root planing is the treatment of the diseased root surfaces below the gum line. A routine prophy (cleaning) emphasizes cleaning the teeth above the gum line in a generally healthy mouth. Root planing focuses on eliminating tartar and plaque below the gums and detoxifying the root surfaces where the disease occurs. Obtaining smooth roots and flushing out the pockets allows for healthy reattachment of the gums to the root surfaces.

What do we hope to accomplish with Soft Tissue Management?

• Gums that do not bleed. Healthy gums do not bleed!
• Fresher breath and taste.
• Gums that are not red, swollen or tender.
• Reduced pocket depths
• Control of Periodontal Disease
• Increased ability to control plaque and maintain health

Your Role to Make Treatment a Success

• Complete the therapy prescribed by your dentist.
• Thoroughly clean all tooth surfaces at least twice daily.
• Maintenance of regular re-care visit