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# Fluoride Treatment
Fluoride is the most effective agent available to help prevent tooth decay.  It is a mineral that is naturally present in varying amounts in almost all foods and water supplies.  The benefits of fluoride have been well known for over 50 years and are supported by many health and professional organizations.
Fluoride works in two ways:
***Topical fluoride*** strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay.  We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, and gels.  Dentists and dental hygienists generally recommend that children have a professional application of fluoride *twice a year* during dental check-ups.
***Systemic fluoride*** strengthens the teeth that have erupted *as well as those that are developing under the gums*.  We gain systemic fluoride from most foods and our community water supplies.  It is also available as a supplement in drop or gel form and can be prescribed by your dentist or physician.  Generally, fluoride drops are recommended for infants, and tablets are best suited for children up through the teen years.  It is very important to monitor the amounts of fluoride a child ingests.  If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white spots on the teeth) may result.
Although most people receive fluoride from food and water, sometimes it is not enough to help prevent decay.  Your dentist or dental hygienist may recommend the use of home and/or professional fluoride treatments for the following reasons:
* Deep pits and fissures on the chewing surfaces of teeth.
* Exposed and sensitive root surfaces.
* Fair to poor oral hygiene habits.
* Frequent sugar and carbohydrate intake.
* Inadequate exposure to fluorides.
* Inadequate saliva flow due to medical conditions, medical treatments or medications.
* Recent history of dental decay.
***Remember, fluoride alone will not prevent tooth decay!*** It is important to brush at least twice a day, floss regularly, eat balanced meals, reduce sugary snacks, and visit your dentist on a regular basis.
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Greenway Dental Center
Andres M. Ramirez, DDS MS
Creating Beautiful Smiles
 2025
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#### Our Office
3555 Timmons Lane Suite 1080❘Houston, Texas 77027❘❘(713) 993-9777
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# Oral Hygiene Aids
Regular dental check ups are essential for maintaining excellent oral hygiene and diagnosing potential problems, but they are not a “fix-all” solution. Thorough oral homecare routines should be practiced on a daily basis to avoid future dental problems.
Periodontal disease (also called gum disease and periodontitis) is the leading cause of tooth loss in the developed world, and is completely preventable in the vast majority of cases. Professional cleanings twice a year combined with daily self-cleaning can remove a high percentage of disease-causing bacteria and plaque. In addition, teeth that are well cared for make for a sparkling white smile.
There are numerous types of oral hygiene aids on the supermarket shelves, and it can be difficult to determine which will provide the best benefit to your teeth.
Here are some of the most common oral hygiene aids for homecare:
**Dental Flosses**
Dental floss is the most common interdental and subgingival (below the gum) cleaner and comes in a variety of types and flavors. The floss itself is made from either thin nylon filaments or polyethylene ribbons, and can help remove food particles and plaque from between the teeth. Vigorous flossing with a floss holder can cause soft tissue damage and bleeding, so great care should be taken. Floss should normally be used twice daily after brushing.
**Interdental Cleaners**
Many hygienists and periodontists recommend interdental brushes in addition to dental floss.  These tiny brushes are gentle on the gums and very effective in cleaning the contours of teeth in between the gums. Interdental brushes come in various shapes and sizes.
**Mouth Rinses**
There are two basic types of mouth rinse available: cosmetic rinses which are sold over the counter and temporarily suppress bad breath, and therapeutic rinses which may or may not require a prescription.  Most dentists are skeptical about the benefits of cosmetic rinses because several studies have shown that their effectiveness against plaque is minimal. Therapeutic rinses however, are regulated by the FDA and contain active ingredients that can help reduce bad breath, plaque, and cavities. Mouth rinses should generally be used after brushing.
**Oral Irrigators**
Oral irrigators, like Water Jets and Waterpiks have been created to clean debris from below the gum line. Water is continuously sprayed from tiny jets into the gum pockets which can help remove harmful bacteria and food particles. Overall, oral irrigators have proven effective in lowering the risk of gum disease and should not be used instead of brushing and flossing. Professional cleanings are recommended at least twice annually to remove deeper debris.
**Rubber Tip Stimulators**
The rubber tip stimulator is an excellent tool for removing plaque from around the gum line and also for stimulating blood flow to the gums. The rubber tip stimulator should be traced gently along the outer and inner gum line at least once each day. Any plaque on the tip can be rinsed off with tap water. It is important to replace the tip as soon as it starts to appear worn, and to store the stimulator in a cool, dry place.
**Tongue Cleaners**
Tongue cleaners are special devices which have been designed to remove the buildup of bacteria, fungi and food debris from the tongue surface. The fungi and bacteria that colonize on the tongue have been related to halitosis (bad breath) and a great many systemic diseases like diabetes, heart disease, respiratory disease and stroke. Tongue cleaners can be made from metal, wood or plastic and shaped in accordance with the contours of the tongue. Tongue cleaning should be done prior to brushing to prevent the ingestion of fungi and bacteria.
**Toothbrushes**
There are a great many toothbrush types available. Electric toothbrushes are generally recommended by dentists because electric brushes are much more effective than manual brushes. The vibrating or rotary motion helps to easily dislodge plaque and remove food particles from around the gums and teeth. The same results can be obtained using a manual brush, but much more effort is needed to do so.
Manual toothbrushes should be replaced every three months because worn bristles become ineffective over time. Soft bristle toothbrushes are far less damaging to gum tissue than the medium and hard bristle varieties. In addition, an appropriate sized ADA approved toothbrush should be chosen to allow proper cleaning to all the teeth. Teeth should ideally be brushed after each meal, or minimally twice each day.
*If you have any questions about oral hygiene aids, please contact our practice.*
# Dental X-Rays
Dental radiographs (X-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam.  Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan.  Without X-rays, problem areas may go undetected.
**Dental X-rays may reveal:**
* Abscesses or cysts.
* Bone loss.
* Cancerous and non-cancerous tumors.
* Decay between the teeth.
* Developmental abnormalities.
* Poor tooth and root positions.
* Problems inside a tooth or below the gum line.
Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!
**Are dental X-rays safe?**
We are all exposed to natural radiation in our environment.  The amount of radiation exposure from a full mouth series of X-rays is equal to the amount a person receives in a single day from natural sources.
Dental X-rays produce a low level of radiation and are considered safe.  Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental X-rays.  These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each X-ray.
**How often should dental X-rays be taken?**
The need for dental X-rays depends on each patient’s *individual* dental health needs.  Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.
A *full mouth series* of dental X-rays is recommended for new patients.  A full series is usually good for three to five years.  *Bite-wing X-rays* (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
# Home Care
A beautiful, healthy smile that lasts a lifetime is our ultimate goal when treating patients.  Your personal home care plays an important role in achieving that goal.  Your personal home care starts by eating balanced meals, reducing the number of snacks you eat, and correctly using the various dental aids that help control the plaque and bacteria that cause dental disease.
**Tooth brushing** – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
1. Place the brush at a 45 degree angle to the gums and gently brush using a small, circular motion, ensuring that you always feel the bristles on the gums.
2. Brush the outer, inner, and biting surfaces of each tooth.
3. Use the tip of the brush to clean the inside of the front teeth.
4. Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
**Flossing** – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
1. Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
2. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
3. Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
**Rinsing** – It is important to rinse your mouth with water after brushing and after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Use other dental aids as recommended by your dentist or dental hygienist:  interdental brushes, rubber tip stimulators, tongue cleaners, irrigation devices, fluoride, medicated rinses, etc., can all play a role in good dental home care.
# How to Properly Brush & Floss
Brushing and flossing are of paramount importance to oral hygiene.  Though bi-annual professional dental cleanings remove plaque, tartar, and debris, excellent homecare methods are equally valuable.  Proper brushing and flossing can enhance the health of the mouth, make the smile sparkle, and prevent serious diseases.
Reasons why proper brushing and flossing are essential:
* **Prevention of tooth decay** – Tooth decay is one of the leading causes of tooth loss, and its treatment often requires complex dental procedures.  Tooth decay occurs when the acids found in plaque erode the natural enamel found on the teeth.  This phenomenon can easily be prevented by using proper home hygiene methods.
* **Prevention of periodontal disease** – Periodontal disease is a serious, progressive condition which can cause tooth loss, gum recession, and jawbone recession. Periodontal disease is caused by the toxins found in plaque and can lead to serious health problems in other parts of the body. Removing plaque and calculus (tartar) from the surface of the tooth using a toothbrush and from the interdental areas using dental floss, is an excellent way to stave off periodontal problems.
* **Prevention of halitosis** – Bad breath or halitosis is usually caused by old food particles on or between the teeth.  These food particles can be removed with regular brushing and flossing, leaving the mouth healthier, and breath smelling fresher.
* **Prevention of staining** – Staining, or yellowing, of teeth can be caused by a wide variety of factors such as smoking, coffee, and tea.  The more regularly these staining agents are removed from the teeth using brushing and flossing techniques, the less likely it is that the stains will become permanent.
**The Proper Way to Brush**
The teeth should be brushed at least twice a day, ideally in the morning and before bed.  The perfect toothbrush is small in size with soft, rounded-end bristles, and is no more than three months old. The head of the brush needs to be small enough to access all areas of the mouth, and the bristles should be soft enough so as not to cause undue damage to the gum tissue.  The American Dental Association (ADA) has given electric toothbrushes their seal of approval, stating that those with rotating or oscillating heads are more effective than other toothbrushes.
Here is a basic guide to proper brushing:
1. Place the toothbrush at a 45-degree angle where the gums and teeth meet.
2. Use small circular motions to gently brush the gumline and teeth.
3. Do not scrub or apply too much pressure to the teeth, as this can damage the gums and tooth enamel.
4. Brush every surface of every tooth, cheek-side, tongue-side, and chewing surfaces. Place special emphasis on the surfaces of the back teeth.
5. Use back and forth strokes to brush the chewing surfaces.
6. Brush the tongue to remove fungi, food, and debris.
**The Proper Way to Floss**
Flossing is a great way to remove plaque from the interdental regions (between the teeth).  Flossing is an especially important tool for preventing periodontal disease and limiting the depth of the gum pockets.  The interdental regions are difficult to reach with a toothbrush and should be cleansed with dental floss on a daily basis.  The flavor and type of floss are unimportant; choose floss that will be easy and pleasant to use.
Here is a basic guide to proper flossing:
1. Cut a piece of floss to around 18 inches long.
2. Wrap one end of the floss around the middle finger of the left hand and the other end around the middle finger of the right hand until the hands are 2-3 inches apart.
3. Work the floss gently between the teeth toward the gum line.
4. Curve the floss in a U-shape around each individual tooth and carefully slide it beneath the gum line.
5. Carefully move the floss up and down several times to remove interdental plaque and debris.
6. Do not pop the floss in and out between the teeth as this will inflame and cut the gums.
*If you have any questions about the correct way to brush or floss, please contact our office.*