Is flossing really necessary?

Unfortunately brushing alone effectively cleans only about 60% of your tooth surfaces!

That means that by skipping flossing, even for a few days, plaque has accumulated on 40% of your tooth surfaces! This is why even the best brushers can have gingivitis!

Why do my gums bleed when I floss?

Typically, the answer is gingivitis which put simply is inflammation of the gum tissue. It can be characterized by irritation, redness, swelling, and bleeding of the gums. The good news is that gingivitis is a REVERSIBLE condition.

So, gingivitis is the cause of bleeding gums, but what causes gingivitis?

In most cases, the major cause of gingivitis is the accumulation of bacteria on our teeth. Unfortunately, our teeth make a great habitat for bacteria to thrive, and there are billions of bacterial organisms from up to 700 different bacterial species present in our mouths! After bacteria are deposited on our teeth from our saliva, they quickly begin to grow and replicate. As they grow into a bacterial colonies, they form the invisible sticky film that is known as dental plaque. Plaque requires daily removal because it reforms very quickly. The bacteria that live in these plaque colonies secrete acids that causes tooth decay and begins to irritate the gums causing the inflammation and other symptoms of gingivitis!

Can crowns and fillings get new cavities?

New cavities can form around fillings and crowns. In fact, teeth that have been previously repaired are actually more likely to get a cavity.

So why does this happen? Is it because there was a problem with the restoration?

If the restoration is not fully sealed to the tooth, it can increase the risk of a new cavity. Over time, fillings can start to wear down, chip, and crack allowing bacteria and debris to enter the tooth and begin to cause a new cavity. Similarly, tooth-colored fillings are bonded, which is what causes them to adhere to the tooth surface. With time, that bond can begin to weaken, breaking the seal, and allowing bacteria in.

Crowns, on the other hand, are sealed to the tooth with cement. With time, that cement layer can start to break down increasing the risk of getting a new cavity.

Sometimes, teeth with fully functional crowns and fillings still get cavities. Think about it this way; the original cavity formed on the tooth surface before a restoration was ever done, and there is still tooth surface exposed under the margin (which is the area where the filling or crown is sealed to the tooth). So, while the restoration is doing its job protecting a portion of the tooth, the surrounding tooth surface can still get a cavity.

How can I prevent cavities?

Good oral hygiene is a great place to start. Make sure to brush at least twice a day and floss every day. Often, these new cavities will form between the teeth under old crowns and fillings, and the toothbrush does not do a good job cleaning those areas! That is why flossing is so important!

Fluoride products can also help increase the lifespan of fillings and crowns. Look for toothpaste and mouthwash that have fluoride in the ingredient list. Often, these products will say ‘cavity protection’ or ‘anti-cavity’. The specific brand really does not really matter if fluoride is included!

After you brush or rinse with mouthwash just spit it out! Try not to rinse with water for 30 minutes if possible. This will allow the fluoride to sit on your teeth longer and really do its job!

How often should I visit the dentist?

It is recommended to see the dentist at least once every 6 months and have x-rays taken every year. In addition to getting your professional dental cleaning, this will help detect problems while they are still small. Often, a filling with a small defect can be replaced with another filling. However, if a cavity is allowed time to grow under that filling, it may require a crown and sometimes even a root canal! Patients that already have fillings and crowns are at a higher risk for new cavities, so it is that much more important for them to ensure to keep up with regular dental visits and x-rays. Taking a year or two vacation from dental visits can result in treatment needs that are much more involved and expensive!

Another huge benefit of keeping your cleaning appointments is the oral cancer screening. The dental office is often the first line of defense and diagnosis when it comes to oral cancer.

For those patients that have active gum disease or are high cavity risk, it recommended to see the dentist more frequently. The recommended frequency for these patients is once every three to four months.