If You’ve Got it, Floss it

By: Tammy Ellingson, for Portland Family

“I don’t have false teeth. Do you think I’d buy teeth like these?” — Carol Burnett

The Best Defense is a Good Offense

Once upon a time, extractions and false teeth were just about the only remedy for tooth problems. Now we have options, but prevention is still the best medicine. As the saying goes, “only brush the ones you want to keep.” So where to start?

In the beginning, there were gums, and percolating under those gums are precious baby teeth. These are the gems the tooth fairy pays big bucks for, and when they begin erupting, around the one year mark, it’s time for your child’s first dental visit.

Pediatric dentists understand that the office environment sets the tone for a child’s first visit, so offices are vibrant and colorful, as opposed to the sterile and antiseptic offices we endured as kids. Such offices aim to bring a smile to a child’s face, and smiles are what it’s all about for Dr. Michelle Stafford, DDS, of World of Smiles. Her calm and friendly manner helps build trusting relationships with her patients so that she can educate them on prevention and care.

Dr. Stafford set out to create an inviting environment for all kids. From the colorful fish and frog tanks in the lobby, to the around-the-world office theme, there is something in every corner that’s designed to atttract a child’s attention. Dr. Stafford, who also holds a certificate in public health, is passionate about her role in teaching kids and parents how to prevent problems with proper care. She believes in early-prevention education; so early, in fact, that she spends a great deal of time volunteering in the community giving talks and answering questions for expectant and new parents.

Learning how to brush and floss properly starts young. Dr. Stafford says that “children can begin to brush their teeth adequately about the time they are learning cursive handwriting. It’s the small motor control that allows them to really brush the surfaces properly.” Before the age of eight, parents should still be supervising and flossing.

Dr. Stafford makes time to demonstrate proper brushing whenever she can. She speaks at local elementary schools, taking along an oversized stuffed dinosaur, which has a full set of teeth, to demonstrate proper brushing techniques. For those transitory baby teeth that make an exit gradually, or with a bit of assistance, Dr. Stafford has a hotline to alert the tooth fairy that teeth will soon be under the pillow, awaiting a proper exchange.

As kids enter their pre-teen and teen years, their oral healthcare questions change, and although they might not be as enamored of colorful and toy-laden offices, they aren’t quite ready to jump into the adult dental care system. Dr. Dustin James, DMD, of Dentistry for Kids says, “Teens tend to have more anxiety than five and six year olds. They’ve outgrown the need for stuffed animals and yet still need gentle care.”

Although Dr. James’ colorful, toy-filled office is a hint that he serves kids of all ages, his practice is especially attuned to the needs of teen patients. Dr. James remembers what it was like to be a teen, an age with the anxieties of growing up and adults giving advice at every turn. He says, “I might not always be able to control the needles or pain involved in a procedure, but I can control the environment. I can alter the lights, music and distractions to meet the needs of each patient.” His goal is to “strip down the intimidation of the doctor’s office.”

Dr. James’ Wilsonville is one of the first teen-specific dental practices in the U.S. Everything in the reception areas and exam rooms is designed to educate, entertain, and treat teenage clients. Dr. James has even been known to play a computer game or two with a patient if that’s what it takes to build rapport.

Although the office environment at Dentistry for Kids is designed with kids in mind, it’s just one aspect of what makes Dr. James’ approach so unique. He sees himself as a “health mentor and partner” in the lives of his patients, using each visit as a time to highlight the positives about their teeth as well as giving them one thing to work on and improve.

While patients wait, they can use an iPad to watch presentations geared toward their areas of concern — a savvy use of technology that is sure to capture the attention of teens. As a pediatric dentist, Dr. James has the opportunity to provide care for his patients for many years and talk to them about school, friends, and health choices. He has had patients who are interested in dentistry as a career shadow him on the job.

Let’s Shed Some Light on the Subject

Longtime Portland dentist, Dr. Michael Royse, DMD, also emphasizes the need to educate parents early on about cavity prevention, because “many parents don’t really understand what produces cavities.” While most people know sugar causes cavities, it’s not that simple. Dr. Royse says, “It’s a frequency-of-ingestion issue. Every time a child ingests a carbohydrate, like a cracker or juice, the mouth produces an enamel-eating acid for the next thirty minutes.”

In addition, around the time the first tooth erupts into the gums, bacteria are introduced into the mouth, and the theory is it’s usually by a parent. These bacteria are partly responsible for cavity susceptibility. All bacteria are not created equal, so the parent who may inoculate the child with their salivary bacteria is the one who will have most impact on the cavity-producing tendency of their child. Spit roulette anyone?

Speaking of bacteria, the adult mouth is not immune. Dr. Kris Blodgett, who along with his brother Dr. Kelly Blodgett, form Blodgett Dental Care says, “Some people are at greater risk of developing cavities due to the types of bacteria present in their mouth and the body’s genetic response to the bacteria.”

How to know your risk? Well, there’s a test for that. Your mouth is swabbed and the biofilm sample is then placed in a CariScreen diagnostic machine that tells the dentist your “bioluminescent” score. What does this mean to you? It means the dentist can tell you what kinds of bacteria are present in your mouth and what damage they may cause. The benefit of this quick in-office test is a teachable moment. Dr. Blodgett uses this information to educate patients how to prevent bacteria from running amok, and to develop a dental care plan that matches the patient’s priorities.

Now, let’s talk not so gingerly about gingivitis; gum disease can be a real stinker. Not only can it cause bad breath and lead to tooth loss, but it’s also linked to an increased risk of some forms of cancers, hearth disease, and diabetes. Preventing gum disease is preferable, but it’s also quite treatable. Lasers are the new frontier in the treatment of periodontal disease, eliminating the need for invasive oral surgery in many cases. Dr. Blodgett uses a PerioLase laser to perform Laser-Assisted New Attachment Procedure (LANAP), which has demonstrated success in regenerating both hard and soft tissue and creating significantly healthier gums.

Calling in Reinforcements

While genetics, diet, and brushing can help determine your cavity potential, it’s not the whole story. Today’s dentist has an arsenal of options to protect, strengthen, and re-invigorate teeth.

Sealants, made of various types of resins, like those used in tooth-colored filling materials, are one weapon of choice. They are bonded onto the chewing surface of molars to prevent decay. Sealants can last for many years and are proven to reduce the occurrence of tooth decay.

Already have a cavity? Pick a filling. The choices available include composite resins, ceramics and glass ionomer. Glass ionomers release fluoride into the tooth, which helps prevent further decay. Many dentists use this type of filling to protect and strengthen children’s teeth. There are pros and cons to all types of filling materials, so discuss your options with your dentist.

For those that may be a bit longer in the tooth than the tykes, there are new technologies that will have you out of the dentist’s office in an hour with a newly crowned tooth. Dr. Blodgett uses a Cone Beam 3-D imaging system to create a three-dimensional map of your tooth and mouth. The image is sent wirelessly to an in-office milling machine and the crown is created while you wait.

Let’s Recap

While starting early is best, it’s never too late to improve your dental health for the long-term. Knowledge is power when it comes to prevention and treatment, and today’s dentists are healthcare educators as much as they are healthcare providers; constantly seeking innovative solutions and technologies that literally give their patients something to chew on, or at least with. While our eyes might be the windows to our soul, we can’t take a bite out of life without strong teeth.