Your Dental Health Questions, Answered
Brush up on your dental knowledge with this bite-size Q&A and get healthy teeth and gums for life.
Q. Which is better, a manual toothbrush or an electric one?
Either kind of brush is fine, but you are more likely to spend the right amount of time brushing—two to three minutes—when you’re using an electric toothbrush, says Barbara Ann Rich, a spokesperson for the Academy of General Dentistry and a dentist in Cherry Hill, New Jersey. (Manual brushers average less than one minute.) Whichever you use, choose one with soft bristles. Others may be too abrasive and could lead to receding gums. No matter what kind of brush you choose, be sure to floss daily.
Q. What causes receding gums, and what can be done about them?
There are a few main causes:
- Overzealous toothbrushing. Brushing too hard around the gum line, or just brushing with bristles that are too hard, can erode gums.
- Tooth grinding (a.k.a. bruxism). Some people grind so hard that the pressure accelerates gum erosion. In many cases, your dentist can shave down a tooth that is causing your bite to hit against another tooth. In other cases, you may need to get a customized mouth guard to wear at night (when most grinding and clenching occurs) to prevent further damage.
- Gum disease. This is an infection of the gums that occurs when bacteria become lodged between the tooth and the gum. The bacteria eventually eat away at the bone and the supporting tissues at the base of the tooth. As the bone recedes, so does the surrounding gum tissue.
What to do: Depending on the cause and the severity of the problem, a dentist may recommend anything from a deep cleaning of the teeth and gums to a gum graft, a procedure in which tissue is taken from the top of the mouth and grafted onto the gums, where it takes hold over the course of four to six weeks.
Q. How often do I need to visit a dentist and get X-rays?
The answer depends on the state of your teeth and gums. In general, most people (adults and children) should go to the dentist at least once a year and possibly every six months for a cleaning and to get checked for cavities. If your dentist says that you may be prone to gum disease or tooth decay, you may need to go more often than that.
As for X-rays, most dentists recommend having them taken about once a year. “Most decay starts between the teeth, which a dentist can’t see with a visual exam,” says Kimberly Harms, a spokesperson for the ADA and a dentist in Farmington, Minnesota.
Q. What is the best kind of toothpaste to use?
At minimum, purchase a toothpaste that carries the American Dental Association (ADA) seal of acceptance, which means that it has been independently tested, lives up to any label claims, and contains fluoride, a mineral that keeps tooth enamel strong and prevents tooth decay.
If you have sensitive teeth, toothpastes labeled for this can help lessen pain. These products contain minerals, like strontium chloride and potassium nitrate, that block the tiny tubules in teeth that lead to the nerves. You generally need to use the toothpaste for several weeks to feel an improvement, as the mineral needs to accumulate over time.
If your dentist says you have excess tartar (which can lead to tooth decay), look for a tartar-control toothpaste containing pyrophosphate, which can help reduce the buildup. Some new formulas boast the antibacterial ingredient triclosan, which is often found in liquid hand washes and can help cut down on gingivitis, tartar buildup, and bad breath, according to the ADA.
If your teeth look dingy, toothpastes marketed as "whitening" can help brighten your smile. These pastes usually contain tiny crystals or mild chemicals that loosen debris and remove minor stains. Those with baking soda work in the same way.
Q. Do I really need to use mouthwash?
If you brush your teeth at least twice a day with a fluoride toothpaste, floss at least once daily, and have little decay or gum disease, you probably don’t need to use a mouth rinse. If, on the other hand, you are prone to cavities or plaque buildup, you may benefit from using an antiseptic or fluoride-containing rinse (one that bears the ADA seal of acceptance) after brushing. Ask your dentist if he thinks you need one.
Q. What causes tooth sensitivity?
Sensitivity occurs when the microscopic tubes in the dentin layer, which is right under the enamel, become exposed as a result of receding gums or the wearing away of enamel. The tubes lead to the innermost layer of the tooth, where the nerves are located, says Carolyn Taggart-Burns, a professor of dentistry at Creighton University, in Omaha.
What to do: To avoid exposing the dentin layer, brush gently and avoid acidic foods and drinks, including citrus fruits and juices, wine (especially white), and all sodas (especially light-colored ones flavored with citric acid). Even unflavored carbonated water is slightly acidic and can cause tooth sensitivity. Using a toothpaste formulated for sensitive teeth should also help ease the problem. If it doesn’t, ask your dentist about gum grafting or an in-office treatment to help seal the dentin layer, says Susan Karabin, president of the American Academy of Periodontology and an associate clinical professor at Columbia University.
Q. Are tooth-bleaching and other whitening products safe?
For the most part, yes. Tooth whitening does not make teeth more vulnerable to tooth decay. However, both professional and at-home bleaching can have varying degrees of success and can cause some tooth sensitivity, which can range from minor gum irritation to more serious discomfort. (This generally subsides once the treatment is stopped.
Professional bleaching treatments (ones that your dentist supervises) allow for a higher concentration of bleaching solution—up to about 35 percent peroxide—than over-the-counter products.
Over-the-counter treatments, such as gels and whitening strips, contain a weakened bleaching solution—commonly up to 10 percent peroxide. While they may cause less sensitivity to the teeth and gums, they can take longer than professional bleaching to produce a whitening effect.
Laser and light-activated bleaching can yield results in the course of just a few sessions, but the ADA says it has yet to see adequate safety and efficacy studies about these processes.
Q. Do some foods weaken teeth or make them more prone to decay?
Yes. Starchy and sugary foods are the most apt to leave residue that decay-causing bacteria feed on. The bacteria, in turn, give off acids that eat into tooth enamel.
What to do: Brushing right after eating a sugar- or carb-heavy treat is the best way to combat bacteria, but if you aren’t near a toothbrush, rinse your mouth out with water to help neutralize the acidity and loosen debris.
Another easy solution: Pop in a piece of sugarless gum. Chewing gum revs up saliva production, which has antibacterial properties.
Finally, if soda (diet or regular) is your vice, drink the fizzy stuff through a straw positioned toward the back of your mouth so that the sugary or acidic liquid bypasses most of your teeth.
Q. What’s the link between gum disease and heart disease?
Gum disease is the result of an overgrowth of unhealthy bacteria in the gum tissue. Some experts think that these bacteria can contribute to atherosclerosis, a hardening of the arteries and a significant cause of heart disease. Yet another reason to brush, floss, and repeat as necessary.