Why are my gums inflamed even though I brush and floss every day?

This is a question that is commonly asked. How can my gums still be inflamed even though I spend so much time cleaning them? The answer usually is that even though many brush and floss their teeth every day many are not doing so optimally. Often people do not clean their tooth effectively at the gum line. This is probably the most important part of the tooth to get clean since plaque left near the gum is what usually causes the inflammation. Also another common mistake is to not do a systematic enough job of brushing and certain teeth are missed. Some people hope that spreading toothpaste around their teeth will get their teeth clean but that is not the case. Toothpaste does very little cleaning. It is the motion of the tooth brush that does the job and it must contact every accessible tooth surface in order to clean the teeth properly.

Similarly, many people floss incorrectly. Floss has to be wrapped around the tooth and moved up and down against it in order to properly clean the proxmal surface.

I have made two videos for About.com that may be helpful for people seeking help with improving their oral home care. One video is tittled "How to floss properly" and demonstrates how to use floss effectively. The other tittled "How to brush teeth" demonstrates a suggested method for brushing teeth using a manual tooth brush.

Is dentistry an easy profession?

Although often dentists are often portrayed in the cinema as happy buffoons, dentistry is a challenging profession. Performing dentistry on a daily basis requires discipline, concentration and it helps if a dentist develops a skill in managing people.

Every day , dentists are presented with patients suffering from a variety of dental problems, many of whom have fears or anxieties that need addressing as well.

It is not a coincidence that the dental profession pioneered the use of Nitrous Oxide and Ether anaesthesia as well as the use of local anesthetics. Management of fearful patients has always been a big part of the job.

Dentists use a variety of techniques to lessen the apprehension of their patients, including painless injection technique, music, and often make use of conversation to aid in making their patients more comfortable.

Aside from dealing with nervous patients, dentists must be able to perform exacting procedures on teeth that involve a high degree of hand eye coordination and the ability to sculpt dental restorations that will be not only durable but look and function like the natural tooth structures that they replace.

Most dentists function under time constraints since most work with multiple scheduled appointments for patients who do not like to be kept waiting. Keeping an eye on the clock is certainly part of their job. To complicate matters on many days some of their patients present with dental emergencies and we often must find a way to shoe horn their treatment into an already crowded schedule.

As a practicing dentist for over thirty years I have found dentistry to be a rewarding and ever challenging profession. At the end of most days I am tired but can look back on what I have accomplished and leave my office with the feeling that I have been engaged in a worthwhile endeavor. Nothing accomplished easily is challenging or ultimately interesting and any profession that is mastered in a year or two is most likely ultimately boring.

My bite feels wrong after a filling. What can be done?

This one is almost too obvious. When a filling is placed often dentists ask their patients if the bite feels right. Since most patients are numb they can have difficulty judging whether the bite is correct. When their anesthesia wears off it easy for them to judge if their teeth are meeting properly.

A high bite can cause a patient significant pain and should not be ignored. Aside from causing a 'tooth ache' it can even lead to a fracture of the tooth since it is bearing the bulk of the pressure exerted from a patient's jaw muscles.

If the bite is off after a filling is placed, the dentist should be called and a short appointment made so that he can adjust the bite. This usually involves the dentist having the patient bite on articulating paper so that the 'high' spots on the new filling can me marked. These are adjusted using with the dental drill. This process can be repeated until the patients bite is correct. The whole process usually takes several minutes and requires no anesthesia.

Is tooth bleaching only temporary?

This is a frequently asked question by people contemplating whitening their teeth. I usually answer, not really. Teeth that have been 'bleached' using hydrogen peroxide or carbamide peroxide formulations do tend to turn more yellow over time, but often the results can last for years.

Most patients interested in maintaining a 'bright' smile do perform bleaching touch ups using custom trays or over the counter formulations such as Crest Whitestrips. Usually only a few treatments are needed to renew a smile's brightness. It should be noted that diet and oral habits such as smoking or chewing tobacco can shorten the span of time needed between touch ups.

For patients contemplating chair side whitening with any light assisted system , we strongly recommend that custom whitening trays are also fabricated for later use. They will be useful for touch ups or in achieving more whitening afterwards (if needed).

What are the symptoms of pericoronitis?

Pericoronitis is an infection involving a partially impacted lower wisdom tooth. Usually there is a small flap of gingiva that partially covers this tooth and the area becomes infected. Patients with a pericoronitis experience soreness in the gums behind their mandibular second molar. Other symptoms can vary, but can include trismus (pain on opening), restricted opening, pain when swallowing and also localized swelling of the cheek on the affected side. Patients may or may not run a fever. Treatment of this condition is indicated and usually involves a visit to the dentist and course of the appropriate antibiotic. Rinsing with warm saline solution is also often recommended.

Once the infection diminishes and the symptoms subside a decision should be made on whether the tooth involved should come out. If the tooth frequently get re-infected than an extraction is usually indicated.

Does medicare cover dentistry?

No it does not cover dental care in a private denal office setting. Medicare is designed to provide primary medical coverage for those 65 or over. It is not intended to cover dental procedures. AARP does offer dental coverage though Delta Dental. If you are member you are eligable to apply. For more information go to their website at: http://www.deltadentalins.com/aarp/?sourcecode=6NT