Staying Fit
Good oral health matters for a healthy smile, but it’s also essential for overall wellness.
Research suggests periodontal disease may play a role in the development or severity of cardiovascular disease, type 2 diabetes, rheumatoid arthritis, inflammatory bowel disease, Alzheimer’s disease and other forms of dementia, and even some cancers.
While these links are still being explored, their root cause may be the body’s response to inflammation. “In disease status, especially with inflammation [as is found in periodontal disease], the body has certain inflammatory markers that are circulating throughout the system … [so] other areas of the body may also result in that [same] type of destructive response,” explains Theresa Wang, a prosthodontist and vice president of clinical innovation with ClearChoice Dental Implant Centers in Schaumburg, Illinois.
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While it’s not clear that gum disease directly causes these other conditions, “the suspicion in medicine and dentistry is that when [these health conditions and gum disease] exist together, they oftentimes kind of fuel each other's severity,” Wang says.
Want to make sure you’re doing all you can to preserve your pearly whites and reduce your risk of disease? Here’s how.
START WITH THE BASICS
1. Visit the dentist regularly — or as needed
Generally, you should get an oral health checkup and teeth cleaning at least once a year, or, even better, every six months. And some insurance plans allow for up to three yearly professional teeth cleanings. But if you have gum disease, diabetes or cardiovascular disease, you might be instructed to visit more often. Find a dentist you feel comfortable with, so going in for regular checkups isn’t something you dread. “I encourage patients to get into their dentist’s office on a regular basis,” says dentist Arwinder Judge, chief clinical officer at Aspen Dental in Naples, Florida. “It’s one of the most important things you can do for your oral health.” Seeing a dentist two or more times a year may lower your risk of mortality from all causes by 30 to 50 percent, according to a Journal of Aging Research study.
2. Address anxiety
Many people experience anxiety at the dentist and it can prevent us from seeking health care. Olga Krikunenko, dentist and owner of Mint Dental in Franklin, Massachusetts, shares this advice: “To help with fear it's important to understand what exactly the patient is afraid of and tailor their care around that,” she says. “We encourage patients to bring things of comfort to their appointments or we provide headphones and movies to watch. But to relieve stress and anxiety we also prescribe medications based on patients’ needs to help calm their nerves before procedures. Additionally, some offices can do treatment under sedation for certain circumstances. But ultimately, the longer you don't go to the dentist the more treatment may be needed, and that will in itself cause people to have anxiety about going. So it’s a matter of breaking the cycle and not delaying care.” If your fear is still preventing you from visiting the dentist, find a good therapist you can talk to about the issue.
3. Brush twice a day for two minutes
The American Dental Association (ADA) has long recommended brushing your teeth twice a day, two full minutes each time. Establishing a regular time of day for both will help make it a habit. Dental professionals say before breakfast and before bed are the best times to brush. And toss that manual toothbrush if you’ve had it longer than three months — the maximum time you should use a toothbrush.
4. Wait 30 minutes to brush
The reason the tip above recommends before breakfast and not after is so you give your teeth enamel time to remineralize and build itself back up again. Wait at least a half hour instead of brushing right after a meal, especially if you ate something acidic, so you don’t damage your tooth enamel.
5. Brush at a 45-degree angle
If you’re brushing with your toothbrush held at a 90-degree angle to your teeth, you’re doing it wrong. Instead, place your brush at a 45-degree angle, advises Melissa Torres, a cosmetic dentist based in Reading, Massachusetts. Holding your brush with this slight tilt will help you more effectively remove plaque and bacteria along the gum line.
6. Use small circles
Brush in small circles from top to bottom on each tooth, rather than using broad, back and forth, horizontal movements. “Brushing back and forth can actually make the gums recede a little bit,” explains Alex J. Delgado, associate professor and director of continuing dental education at the University of Florida College of Dentistry.
7. Switch to your nondominant hand when brushing
If your gum line is receding, switch periodically to brushing with your nondominant hand. Doing so will result in using less pressure against your gums. This exercise also has a neurological benefit: Using your nondominant hand challenges your brain, and can lead to better memory and concentration.
8. Be gentle
Always opt for a soft bristle or extra soft bristle toothbrush. “You should never ever use a hard toothbrush,” says Bill Dorfman, a Los Angeles–based cosmetic dentist and author of the book Billion Dollar Smile: A Complete Guide to Your Extreme Smile Makeover (2006). “Years and years of brushing with a hard toothbrush will brush away your gums and cause attrition of the enamel on the front surface of your teeth,” he adds. Torres agrees, recommending patients always use an extra-soft or soft-bristle toothbrush, which, she says, will “be gentle enough that it’s not going to cause any harm to the gum tissue, but still abrasive enough to remove the plaque and bacteria off the teeth.”
9. Go electric
Research suggests powered toothbrushes are more effective at removing plaque than traditional manual ones. “When you automate how the individual bristles actually work, it imparts an energy into the saliva that creates millions of little bubbles — so in essence you can interrupt bacteria even beyond where the bristles touch the tooth,” notes Tim Donley, a periodontist who practices in Bowling Green, Kentucky. Krikunenko recommends using a plug-in rechargeable electric rather than battery-operated oscillating toothbrushes, which are typically not as powerful.
10. Get smart
If it fits your budget, Donley recommends looking for electric toothbrushes that incorporate artificial intelligence and utilize apps to alert you if you’re using an incorrect amount of brushing pressure or if you’ve missed certain spots entirely.
The Philips Sonicare 9900 Prestige ($379.96) claims to adjust in real time to your brushing, while the Oral-B Genius X Limited Electronic Toothbrush ($199.99) uses artificial intelligence to instantly recognize your brushing style. The BLU Smart Toothbrush and App ($99.99) features a cavity tracker for each tooth. A few less expensive brushes include the Oral-B Pro 1000 Rechargeable Electric Toothbrush ($49.99) and Quip’s Smart Electric Toothbrush ($50), which shares coaching tips through its app.
11. Floss every day
There’s a reason your dentist asks at each visit if you’ve been flossing — because when you don’t, bacteria, plaque and tartar along your gumline irritates and inflames your gums and can lead to bleeding when you do floss. “Flossing is really, really important, especially in between the teeth where plaque will sit, because toothbrush bristles simply can’t get that far in,” says Krikunenko. Flossing well is associated with lower levels of gum disease. Ideally you should floss when you brush your teeth, but at the very least floss before you go to bed. If you see blood when you floss, that’s an indicator you need to ramp up your flossing. The more you floss, the less you may bleed and the better your oral health will be. “Spend the time to floss between the teeth,” says David Frank, owner and founder of Walden Dental in Austin, Texas. “Approach flossing as you would if you’re towel drying your back, rubbing the floss forward and backward like a saw to go gently into the gum line in order to remove the tartar and plaque and bacteria that get stuck between the gums and the roots of your teeth.” Cutting back on sugary foods and drinks and addressing dry mouth symptoms can also help reduce your risk of developing cavities.
12. And floss effectively
Floss picks or string? Waxed or unwaxed? While using floss picks is better than not flossing at all, they’re not as effective as string. In addition to adding more plastic into the environment, they can spread bacteria from one location to another. It’s better to use string floss so you can wrap around teeth and move down the string so each tooth has a fresh area. And opt for thicker, more rigid floss rather than a slick, thin floss. Also, rather than simply flossing in vertical up-and -down motions between each tooth, take the time to floss lower, along the grooves of your gum line. “If you think of your teeth coming together with the gums in the middle forming a little V, you want to go down each side of that V,” says Krikunenko. Unwaxed or waxed, flavored or not — that’s up to you! “It’s about incorporating whatever works for your routine and whatever you’re going to be willing to actually do every day. That’s the key,” says Wang.
13. Eat to banish plaque
If your gums bleed when you brush, it usually means there is plaque buildup on teeth that is inflaming the gum. Eating hard, crunchy foods such as carrots, nuts and seeds help slough off plaque.
14. Try a water flosser
Among professional dentists, you’ll see some debate about whether water flossers are an effective substitute for traditional flossing. Donley opts for water power: “I have not used string floss in 20 years, but I have been wonderfully effective in cleaning in between my teeth using a water flosser,” he says. Meanwhile, Dorfman argues that “water flossers are good at removing some debris, but they do not replace flossing in any way, shape or form.” Consider trying a water flosser if you have mobility issues that make traditional flossing challenging, or if you are simply drawn to their convenience. The American Dental Hygienists’ Association recommends a unit that delivers water pressure of 50 to 90 psi, a level that both healthy and inflamed gum tissue can withstand without damage.
15. Use toothpaste with fluoride
Certain foods and beverages — particularly acidic ones such as sodas, sports drinks and even fruit juices — can cause tooth enamel to demineralize and erode over time. Choosing a toothpaste with fluoride is “essential, even for adults, because fluoride is the key for remineralization of tooth enamel,” Torres says. Always choose a toothpaste brand that is approved by the ADA, so you can be assured it’s safe and effective. Fluoride toothpaste can also help remineralize and strengthen tooth enamel.
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