The Removable Partial Denture

The quickest and least expensive solution to replace a missing tooth is with the use of a removable partial denture (RPD). This is a removable appliance that can be used to replace one or more missing teeth in the entire upper or lower part of the mouth. The advantage of a RPD is that for one fee, a patient can have all or most of his or her missing teeth replaced with a single appliance. Additionally, if a patient has lost lots of bone and/or teeth in the smile region of the mouth and cannot afford the surgical procedures needed to correct the defects, a RPD is a great option.

However, when only replacing one or even two teeth, a RPD is rarely the option of choice. This is usually due to the drastic changes a patient must make in his or her lifestyle in order to accommodate this new prosthetic that is only replacing one or two teeth. RPD’s tend to be a little bulky and uncomfortable to a patient who once had nothing in the roof or floor of his or her mouth before the teeth were lost. In addition, the prosthetic is not only bulky and uncomfortable, it is also removable and sometimes less efficient when chewing food than something that is permanent and non-removable such as a fixed bridge (discussed later) or dental implant. Furthermore, the teeth that support the partial usually become highly sensitive to hot, cold, and even chewing due to the constant torque on them during chewing and removing the appliance.

The consequence that concerns me the most with this option is that even though the spaces have been treated, the issue of bone loss has not. Therefore, as time goes on, the bone in each space will continue to atrophy. Hence, a patient must cautiously consider this option because if implants are to be placed in the future, the bone that was once there in the past, may not be in the future.

— Jason R. Doucette is a Doctor of Dental Medicine with Incline Dental Care.

The Fixed Bridge

Prior to the arrival of dental implants, the true gold standard for replacing a missing tooth for decades was with the use of a fixed or cemented porcelain/ gold bridge. Today these bridges are used routinely for numerous reasons such as when there is not enough room for an implant, the teeth on both sides of the space need crowns, or maybe because a fixed bridge is more affordable concerning insurance when compared to an implant. All are valid reasons for choosing a fixed bridge, but there are consequences that follow this option that are sometimes unavoidable. The first is that when either of the teeth are prepared for crowns in order to retain the bridge, they may become irritated and require root canals. This may happen during the phase of treatment or years down the road, it is an unknown. Another consequence of this option is the likelihood that a patient will need this bridge replaced seven to 10 years later due to recurrent decay under one or both crowns supporting the bridge. Due to the design of a bridge, it is more difficult for most patients to adequately clean them when compared to natural teeth.

Finally, the most damaging consequence still exists, which is again the continual loss of bone where the fake tooth in the bridge hovers over the space. Therefore, the issue of placing an implant in the future may not be as easy or as inexpensive as it would have been when the tooth was initially lost. More importantly, as the bone shrinks away under the fake tooth in the bridge, the patient may experience problems such as food impaction or unsightly gaps if the bridge is in the smile region of the mouth. In either case, the bridge would have to be re-done or another option like a dental implant with a bone graft may need to be considered.

The Dental Implant

The invention and implementation of dental implants into the world of dentistry has revolutionized the way dentists are able to treat patients with missing teeth. Due to this phenomenal technological advancement, we are now able to replace a missing tooth without a trace of evidence that it was ever lost. Additionally, because the implant is placed directly into the bone, replacing the root of the missing tooth, the supporting bone around the implant is again stimulated and maintained. Thus, meaning that the supporting bone will remain intact and never shrink away as long as the implant is present. Even more exciting, the adjacent teeth are not required to treat the space.

Additionally, if a dental implant is going to replace an extracted tooth, in most cases, a bone graft should be done at the time of extraction if the implant is not placed at the same time the tooth is extracted. This will prevent the bone from atrophying. Otherwise, there may not be an adequate amount of bone for an implant at the time of placement six months later when the extraction site has healed. This could result in more costly surgeries to prepare the site. Most of the time, these voids can be grafted with a pre-packaged syringe of bone grafting material. These syringes usually consist of either a synthetic bone or a highly processed (de-mineralized and freeze-dried) cow or human bone. So immediately after a tooth is extracted, the grafting material can be injected into the void and then secured with one or more sutures. Rarely is it necessary to harvest the graft from a patient’s hip or jaw to fill the void from one extracted tooth.

A dental implant is a small titanium cylinder that replaces the root of a missing tooth. It is usually placed at the time a tooth is extracted if it is in the smile region, or it is placed four to six months later if the extraction site was too large for initial placement.

If a front tooth is lost and the healing of the surrounding bone is not properly controlled or stopped with a dental implant and/or bone graft (both discussed later), numerous issues can arise that will compromise the final outcome of the patient’s smile. The most common of these esthetic complications is either a reseeded gum-line at the neck of the new tooth or an absence of gum tissue in between the new tooth and adjacent teeth. Both of these outcomes will result in what most refer to as “black holes” or “gaps.” These gaps are not only unaesthetic, but are also at risk for periodontal disease (dental bone disease). This is because the gaps allow food to be trapped at or below the gum-line of the adjacent teeth. If these food particles (plaques) are not completely removed, an infectious process (periodontal disease) will ignite and lead to a progressive amount of bone loss in that area. This in fact, may lead to the loss of more teeth if left untreated.

When the implant has completely attached itself to the surrounding bone (after four to six months of healing), a connector is attached to the dental implant bringing the assembly above the gum line. Then to complete the process, a crown is cemented in place.

When fully integrated (attached) to the bone, a dental implant is stronger than the original tooth. Chewing with a dental implant assembly feels like the original tooth was never lost. As for cleaning the implant and its crown, it is no different than cleaning the original tooth. More importantly, the implant is made of pure titanium, so it can never acquire a cavity. This however, does not mean that cleaning the implant is not required because the implant is still surrounded by living gum tissue and bone. Therefore, it is highly recommended that the implant assembly be cleaned routinely as any other tooth in the mouth. If properly cared for by the patient and the dentist (meaning cleanings and check-ups are never missed), there is no reason why a patient should have to replace an implant in his or her lifetime.

An implant is among the few prosthetics in dentistry that I believe will withstand the test of a lifetime in full function without damage or distortion. Over time, there is no doubt that a dental implant is far more cost effective than any other treatment option available today concerning a missing tooth. Due to its superior qualities in the replacement of a missing tooth, if applicable, a dental implant, in my opinion and clinical judgment, is the optimal solution to the problem.

From tahoebonanza.com

Implants- Support for Fixed Upper Teeth

January 28, 2012  By Shanna Cramer

Have you ever seen someone with bad teeth suddenly have beautiful teeth that are not dentures? If so, what you encountered was someone with dental implants, which means their teeth are not real despite the fact they look authentic. The bearer of the implants opted for the procedure because of its permanence, eliminating the need for dentures. Dentures, while impressive, can possess that artificial look when observed closely and they lack the security and permanence of implants.

Dental Implant Procedure

As for the dental implant procedure, it involves the implantation of small titanium posts that are inserted into the jawbone. The bone and the titanium bond to one another, creating the perfect root substitute for artificial replacement teeth to be anchored. The end result is a not-so-perfect smile being made perfect with teeth that are 100% functional. The recipients of dental implants can easily forget that their teeth are artificial and many claim that they do.

But before the insertion of dental implants can take place, the ridge bone must be evaluated. This is the bone that surrounds and supports the teeth. There are individuals that experience breakdown of this bone due to age or disease and breakdown can make it impossible to place dental implants. Fortunately, the ridge bone can be repaired so that dental implants can be placed securely. This procedure is referred to as “ridge expansion” and is performed by using special tools that laterally widens the bone so that the ridge is properly expanded for secure implant placement.

The Sinus Lift?

Another option is the sinus lift, which adds bone to the upper jaw so that dental implants can have the perfect foundation. The bone may come from your body or from another source. The procedure is necessary when there is very thin bone that separates the mouth from the sinuses, which means that the bone is too thin for the implants. The sinus lift will thicken that bone by doing a bone graft. So anyone with a thin or deteriorating ridge bone can have dental implants after these ridge expansion procedures are performed.

In regards to how extensive the process is, an individual can have one tooth or ten teeth replaced. Some patients need a complete dental prosthesis, which means all of the teeth in the upper or lower jaw are replaced, and others just need to fill in the gaps. Patients have their choice between a fixed prosthesis, which can only be removed by a dentist, or a removable ball and socket attachment. These are procedures that are typically performed in-office in a sterile environment.

Benefits and Candidacy

Overall, the benefits are enormous in that existing teeth are not harmed by bridging gaps, there is no having to worry about the insertion or removal of full or partial dentures (or anything getting stuck under them), and they look authentic.

To find out if you are a candidate for dental implants, you will need to have a thorough examination, including a comprehensive dental and medical history. If your mouth is not suitable for implants, options, such as bone grafting, will be discussed with you. If you find that dental implants are not for you at all, there are other options to improve your smile.

From hivehealthmedia.com

Zach was a life-long teeth grinder.  “It seemed that as soon as his teeth came in, he started grinding,” his mother told me.

It was so loud and frequent that Zach was given his own room because his little brother couldn’t get any sleep when they shared. For years he had slept at the end of the hall far from his parents’ and his brother’s room, so one suspected that the grinding was getting worse.

When a dentist noticed a progressive worsening of wear on his patient’s teeth, he discussed his concerns about a possible underlying sleep disorder with both Zach and his mother. They then came to me.

Sleep-related bruxism is the official term for grinding your teeth during sleep. It occurs in approximately 14% to 17% of children, although these rates decrease with age. Bruxism does show a familial pattern but no genes have been identified. It affects both sexes equally.

Nocturnal grinding can cause not only extensive wear on your teeth, but also jaw and facial pain, headaches, and when it is severe, it can cause sleep disruption that results in daytime drowsiness.

There are two types of bruxism. If there’s no clear cause, bruxism is termed “primary.” Secondary sleep-related bruxism has been associated with various other disorders, as well as the use of psychoactive medications and recreational drugs.

An overnight sleep test is not always necessary. However, a careful evaluation by a sleep specialist is warranted if, as in this case, the grinding is becoming worse rather than better with age. Bruxism must be distinguished from partial complex seizure, facio-mandibular myoclonus and sleep disordered breathing.

Often, grinding can be an accompanying feature of obstructive sleep apnea and confusional arousals, and it can improve with treatment of the underlying sleep disturbance.

Even in the absence of a clear psychiatric or medical cause, sleep specialists often note heightened stress and anxiety as a predisposing factor. Some specialists have found an association with a Type A personality or someone who is hyper-vigilant and easily aroused from sleep.

In Zach’s case, we figured out that he did have a lot if increased stress due to his busy academic and extra-curricular schedule. He was also worried about getting into a good college and was working around the clock to assure his success. He was stressed in the daytime and it carried over into his sleep. We ruled out any other sleep or medical problems. His dentist made him a bite guard to protect his teeth at night.

He and his parents worked on simplifying his schedule, ensuring adequate time for sleep. They also talked a lot more about his college application process which, Zach admitted, really made him feel less alone and less anxious about the outcome.

If you are – or suspect you are – a grinder, see your dentist to evaluate if there is any damage to your teeth. A visit to a sleep specialist is warranted if there are other symptoms.

From thechart.blogs.cnn.com

Yvetta Federova

I admit to being jealous of my sons for growing up in a time when vaccines spared them miseries like the measles, mumps and polio scares that marred my childhood. But I’m most envious of their freedom from the dental decay that forced me to spend countless miserable hours with my mouth propped open while the dentist did his best to stay on top of rapidly rotting teeth.

By my mid-20s, I had already lost one molar and all four wisdom teeth, and every remaining molar had been restored with fillings.

It’s not that I failed to brush my teeth or that I noshed constantly on sweets. It’s that my teeth lacked the protection of fluoride, which was introduced to New York City’s water supply in 1964, five years before my twin sons were born but 23 years too late for me.

The Centers for Disease Control and Prevention calls fluoridation one of the 10 most valuable public health measures of the 20th century. In the early years, rates of tooth decay among the young dropped by 60 percent in communities that adopted fluoridation. My sons, who consumed fluoridated water in reconstituted milk and orange juice as well as in tap water, completed childhood with not one cavity.

Eventually, 70 percent of the country’s towns and cities adopted this measure, at an annual cost that today ranges from 95 cents to as much as $10 per person, depending on the size of the community. And even though it may have diminished the fortunes of the dental community, the American Dental Association, as well as most national and international health agencies, endorsed fluoridation without reservation.

In the years since, fluorides have been proved to reduce the rate of tooth decay in adults as well as in children. Older adults whose exposed tooth roots are highly susceptible to decay have particularly benefited.

The Diffusion Effect

It didn’t take long for commercial interests to hop on the fluoride bandwagon, introducing toothpastes and mouthwashes with fluoride, along with professionally prescribed fluoride tablets and drops, gels and varnishes. In addition, through the so-called diffusion effect, people living in communities without fluoridated water wind up consuming it in drinks and foods prepared elsewhere.

Together, these secondary effects have diminished the benefit that can be attributed directly to fluoridated water supplies to a reduction in tooth decay of about 25 to 40 percent. Still, the cost-to-benefit ratio remains strongly in favor of fluoridation.

Every $1 invested in fluoridation saves approximately $38 in dental treatment costs, according to the C.D.C. The cost of a single filling averages $140, and that’s only the beginning. Through the years, a filled tooth is likely to require further repairs and maybe even extraction and replacement with a bridge or implant costing thousands of dollars.

None of this, however, has quelled the controversy over the safety of fluoridation, which dates back to the first studies in the 1940s. In addition to being labeled a Communist plot and an unconstitutional form of mass medication, fluoridation has been accused of causing a host of medical horrors: heart disease, cancer, Down syndrome, AIDS, allergies, Alzheimer’s disease, mental retardation, osteoporosis and fractures, among others.

None of these supposed risks has ever been established in scientifically valid studies. The only proven risk, a condition called fluorosis, which results in white and sometimes brownish markings on the teeth from too much fluoride, rarely results from a normal intake of fluoridated water.

Still, given our increased exposure from other sources, in January 2011 the Food and Drug Administration proposed reducing the amount of fluoride put into water supplies to 0.7 milligrams per liter; a range of 0.7 to 1.2 milligrams had long been the standard.

As with most substances, the dose makes the poison: In very high amounts, fluoride is toxic, and products containing it should be kept out of reach of children. The government recommends that fluoride not be given to babies younger than 6 months — infant formula should be prepared with water that is not fluoridated — and children younger than 2 should not use fluoridated toothpaste. Those younger than 6 should use it only with supervision, to be sure they spit it out.

In the last four years, about 200 communities, looking to save money and rallied by opponents of fluoridation, have opted to stop adding fluoride to public water supplies.

Fluoridation confers the greatest benefit to those who need it most: the poor and poorly educated and those with limited access to regular dental care. In the years ahead, removal of fluoride from drinking water will almost certainly cost taxpayers millions of dollars in increased Medicaid expenditures.

Out-of-pocket costs will grow for other consumers, too — if not directly from increased treatment of tooth decay, then from having to use alternate treatments to glean fluoride protection.

Initially it was thought that fluoride had to become incorporated into tooth structures as they form in order to be protective. It was later shown that fluoride’s primary benefit is topical, working on teeth already in the mouth.

Tooth enamel is “fluid” — every day minerals are lost from it and added to it in processes known, respectively, as demineralization and remineralization. Tooth decay is an infectious disease. Decay occurs when bacteria in the mouth break down carbohydrates to produce acid that dissolves the minerals in tooth enamel and dentin.

Compromising Bacteria

Fluoride, which is present in saliva and concentrates in dental plaque, inhibits the action of acid on tooth minerals. It also promotes remineralization by sticking to tooth surfaces, where it attracts calcium ions present in saliva.

In addition, fluoride in drinking water is taken up by decay-producing bacteria, which inhibits their ability to produce acid.

Unchecked, dental decay can cause debilitating pain, tooth loss and the need for dentures. In severe cases, the infection can become blood-borne and deadly.

Some people are especially susceptible to tooth decay, including those with a history of frequent cavities, people with gum disease, and those who already have crowns or bridges or who wear braces. Others at high risk include people with dry mouth problems, like those with Sjogren’s syndrome; people taking medications that reduce saliva, like antihistamines and hypertensive drugs; and people being treated with radiation to the head and neck.

Filtered tap water may or may not contain fluoride. Reverse-osmosis filters and carbon filters with activated alumina remove most of the fluoride, but water softeners and charcoal or carbon filters do not.

Some water supplies are naturally fluoridated. If you use well water, it must be tested to learn the fluoride content. If you drink bottled water, check the label or contact the company. Distilled water contains no fluoride.

From nytimes.com Tara Parker-Pope on Health

Original post by general dentistry – Google News

Malocclusion

When your teeth are improperly aligned in your mouth it creates what dentists and orthodontists call “malocclusion.” Left untreated, malocclusion can lead to periodontal disease, stress on teeth and jaws, and premature wear of your teeth.

Crowding – If you have crowded teeth, it’s more difficult to brush and floss properly. This may cause gum inflammation and periodontal disease. In turn, it can lead to soft tissue damage, receding gums, the formation of pockets between teeth and gums, bone loss, and eventually tooth loss.

My husband has crowded teeth and has had to undergo painful gum scrapings in the past. To prevent gum disease, he gets his teeth professionally cleaned four times instead of twice a year. He also makes sure to brush and floss several times a day and uses a dental water flosser on a daily basis. He makes a lot of effort to make sure his teeth and gums are healthy. However, it’s a lot of work and something many people aren’t willing to do.

Spacing between teeth – If you have wide spaces between your teeth, food may lodge between your teeth and cause sore, tender gums, which could result in periodontal disease.

Deep bite – If you have a deep bite, your over-erupted lower front teeth can damage your palate. Also, a deep bite can cause premature wear and chipping of the lower front teeth.

The benefits of straight, properly aligned teeth

Properly aligned teeth are easier to brush and floss than crowded or crooked teeth. Properly positioned teeth can help gums “fit” more tightly around them, which may lead to better periodontal health. Since you’re able to brush and floss more effectively, the chances of having plaque build up, tooth decay, and periodontal disease can be reduced.

Properly aligned teeth also mean that you reduce the risk of expensive procedures required to repair the effects of abnormal force, such as tooth chipping, breaking, or wear. There’s also less stress on your jaw joints when your teeth are properly aligned.

Dental health affects overall health

According to the Mayo Clinic, your oral health may contribute to various diseases and conditions.

Gum disease may allow bacteria to enter your bloodstream. If you have a weak immune system or a damaged heart valve, this can cause infection in other parts of the body such as endocarditis, an infection of the inner lining of the heart.

Some research suggests that cardiovascular disease, clogged arteries and stroke may be linked to oral bacteria, possibly due to chronic inflammation from periodontitis.

Gum disease has been linked to premature birth and low birth weight.

Osteoporosis may be associated with periodontal bone loss and tooth loss.

Tooth loss before age 35 may be a risk factor for Alzheimer’s disease.

Taking care of your oral health is an investment in your overall health. Isn’t it worth getting braces or Invisalign to feel good as well as look good?

From thismamacooks.com 1-30-2012

Drinks That Destroy Teeth

Trendy drinks are causing a generation of young people to experience decay and loss of tooth enamel unprecedented in modern times. Over consumption of sugar-laden, acidic drinks, such as boxed juice, sport drinks and soft drinks, is reversing more than 50 years of public health gains realized through preventive measures like fluoridated water and dental sealants.

From their early years into young adulthood, children are drinking increasing quantities of these sugary, acidic drinks from morning until night. They consume fruit juice at breakfast, soda at lunch and sport drinks or flavored sweet tea or coffee after school.

Drinks Cause Dental Erosion and Decay

Constant drinking attacks the body’s natural ability to cleanse the mouth. The acid in the drinks causes dental erosion. These drinks soften the protective enamel which dissolves then exposes the second layer of tooth. The sugar in the drinks feeds bacteria in the mouth which causes decay. Bacteria have a much easier time eating through soft enamel.

Young people should enjoy the best dental health that modern prevention can offer. Unfortunately this group also has the most to lose in terms of a lifetime dental problems.

The Indiana Dental Association wants parents, educators and consumers to know which drinks can destroy teeth, and how, if these drinks will be consumed, how to do so wisely and in moderation.

Acid Drinks-phdata pdf- Indiana Dental Association

From indental.org 10-28-2011

Diabetics With Untreated Gum Disease Struggle with Glucose Control

By: Sheryl Ubelacker, Health Reporter, The Canadian Press

TORONTO – People with diabetes are far more prone to developing serious gum disease than those without the disorder, but it’s not only tooth loss they need to worry about.

Experts say chronic periodontal disease can also affect the ability to keep blood-sugar levels under control, leading to worsening diabetic symptoms and an increased risk of complications like heart disease, peripheral nerve damage and vision loss.

“People with diabetes are about two to three times as likely to have periodontitis as are people who don’t have diabetes,” said Dr. Doug Brothwell, associate dean, academic, of the faculty of dentistry at the University of Manitoba in Winnipeg.

“And the complications of periodontitis make people with diabetes about 15 times as likely to lose all of their teeth and to wind up with full dentures,” Brothwell said in an interview Thursday.

One reason may be that people with diabetes have a somewhat elevated level of glucose in their saliva that remains on the teeth and gums.

“And that does give a little extra food to the bacteria that grow on your teeth, the biofilm that’s present on everyone’s teeth,” he said. “But it goes quite a bit deeper than that, too.”

When the bacteria metabolize sugar from both food and saliva, it produces an immune response that leads to inflammation, Brothwell explained. “That’s why people with gum disease, their gums will sometimes get swollen, they’ll get red, they bleed a little bit easier.”

But it’s now known that the inflammatory response isn’t confined just to the gums: it can affect other cells in the body and lead to insulin-resistance, the major hallmark of Type 2 diabetes.

“The reaction is a vicious circle,” he said. “When you have diabetes, it tends to then make any gum disease that you have worse. As your gum disease gets worse, it leads to an increase in systemic inflammation and your diabetes gets worse again, which in turn makes your periodontitis worse.

“Left unchecked, it will continue on until you either lose some teeth or you have further complications from your diabetes.”

Brothwell, in Toronto to discuss the link between diabetes and gum disease at a meeting of diabetes specialists, said people with glucose-control dysfunction need to diligently care for their teeth and gums with regular brushing and flossing to remove bacteria-laden plaque.

“But added to that for people with diabetes and with periodontitis is the added importance of regular dental care.”

Regular cleanings under the gums by a dentist or dental hygienist — typically every three months for moderate to severe periodontal disease — can help keep inflammation in check, he said, noting that research has shown that treatment can lead to a 13 per cent improvement in blood-sugar levels, on average.

Dr. David Miller, a Victoria endocrinologist attending the Toronto meeting, said periodontal disease isn’t an issue that comes up much in his customary discussions with diabetes patients and he suspects many of his colleagues probably don’t routinely ask their patients about it either.

“I describe it as what I call one of the forgotten associations with diabetes,” Miller said. “So we spend a lot of time with complications of diabetes that are clearly causative, like kidney disease and heart disease.”

But he agreed the issue is an important one and said patients need to keep on top of oral health with regular dental care, in the same way they should routinely see an eye specialist.

Brothwell said tobacco use is also a huge contributor to periodontal disease. “People who smoke get a lot worse gum disease, two to three times as much gum disease as do non-smokers, both with or without diabetes.

“Any patient who smokes should quit, but there’s added importance for people with diabetes. By improving the periodontitis, they ultimately may end up with better control of their diabetes.”

From winnipegfreepress.com 10-27-2011

Floss Your Teeth to Keep Them Healthy

I go to the dentist twice a year for a checkup. I’ve always worried about my teeth—almost every tooth in my mouth has a filling. However, with all my concerns, I still don’t do what I’m supposed to do to try to keep my pearly whites healthy.

I don’t floss, and, yes, I do admit it to my dentist, Dr. Dan DeMarco, whose office is in Murrysville.

According to the American Dental Association, flossing helps remove plaque and food particles from between teeth and under the gum line where toothbrush bristles can’t reach.

About three years ago I had a bad checkup—six cavities all in between my teeth. Dr. Dan said these could have possibly been prevented had I been flossing regularly. Oops. I felt so dumb.

I’m not alone, though. According to the ADA, one in 10 people say they never floss. I think those other nine are lying. Everyone I’ve been asking said they only floss if they have to, like if something is in their teeth, or not at all.

What’s your reason for not flossing?

Flossing takes too long

How much time do you think it takes? When the dental hygienist flosses my teeth at checkups, it takes maybe a minute. Before, I couldn’t take a minute to floss each day, which resulted in having to have three different hour-long appointments to fill my cavities.

It’s costs money

Floss is a dollar or less at drug stores like Rite Aid and Walgreens and can even be found at dollar stores, like It’s a Dollar.

I brush my teeth really well so I don’t have to floss

Wrong. Brushing doesn’t get everything. Bacteria that can cause tooth decay still linger between teeth where toothbrush bristles can’t reach, according to the ADA.

It hurts

According to Dr. Dan, it hurts when you floss because you don’t floss as much as you should. Flossing once a day should be less painful after a week or so. Also, don’t floss too vigorously. You’re cleaning your teeth, not the side of a barge.

It’s awkward

Yes, sometimes flossing is like some kind of finger and wrist acrobatic spectacle and can be difficult if you can’t grasp things too well. There are tools that can help with flossing, like dental floss holders or interdental cleaning devices, which are small brushes that clean between teeth, available at drug stores and from your dentist.

I don’t know how

Ask your dentist, dental hygienist or follow these steps from the American Dental Hygienists’ Association:

1. Wind 18 inches of floss around middle fingers of each hand. Pinch the floss between thumbs and index fingers, leaving a one to two inch length in between. Use thumbs to direct floss between upper teeth.
2. Keep a one- to two-inch length of floss taut between fingers. Use your index fingers to guide the floss between the contacts of the lower teeth.
3. Gently guide the floss between the teeth by using a zigzag motion. Contour floss around the side of the tooth.
4. Slide floss up and down against the tooth surface and under the gum line. Floss each tooth thoroughly with a clean section of floss.

Children also need to floss once daily, and the whole family should visit the dentist regularly.

I’m proud to say I’ve flossed every day for two weeks now—since my last check up where the dentist told me the pain I was having was because of food stuck in my teeth and not more cavities. Haven’t I learned? That was the wakeup call I needed.

From plum-oakmont.patch.com 4-23-2011