Under Armour Performance Mouthware-Worth Looking at.....

In the past 50 years, a considerable volume of research has concluded that clenching one’s teeth completes a neuro-physiological feedback loop responsible for a complex series of responses resulting in an increase in adrenaline and cortisol production as well as blood pressure and heart rate.  That this “stress response” is invariably initiated during instances of physical exertion is undeniably counter-intuitive because of its detrimental effect on athletic performance.  Cortisol in particular can, at high levels, cause the body to enter a state of constant muscle breakdown and suppressed immune function, thereby increasing the risk of illness and injury while at the same time reducing muscle.

The first research into the application of an oral appliance in athletic performance first began in 1958.  Further research has continued over the years.  A 2009 study involved an in depth comparison of muscular endurance with and without a mouthpiece and concluded a significant improvement in sporting performance resulting from the use of a specially designed oral appliance.  Trial participants showed an increase of 1% in mean bench press repetitions and 17% in preacher curl repetitions when wearing a Bite Tech product.  Perhaps more significantly, cortisol levels were found to be on average 49% lower.

Under Armour Performance Mouthwear (UAPM) Products are engineered using Bite Tech’s patented technology and clinical trials have shown that there is a definite improvement in the response to auditory clues and a potential improvement in response to visual clues when these products are used.  The UAPM Products use ArmourBite Technology that is backed up by 15 years of research.  It positions a patented, uniquely shaped Power Wedge between the molars to help maintain optimal spacing and reduce the effects of clenching by reducing cortisol production as well as reducing lactic acid build-up by up to 25%.  Over 1,000 professional athletes wear Armour Bite; the appliance is a powerful tool in the quest to enhance athletic protection and performance.

UAPM has been engineered to unlock the body’s true potential and has a positive impact on an athlete’s ability to train harder and perform at a higher level by increasing strength and endurance and reducing the impact of the stress response that omits physical performance.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Choosing a Toothbrush......

Tooth brushing is the major behavior performed by patients to fulfill their needs to feel clean and fresh and to avoid dental problems.  It is also considered by the dentist-dental hygienist team to be the major tool in the removal and control of dental biofilm and the prevention of periodontal diseases and dental caries. 

Effective brushing is important but so is the design and selection of the brush.  Not all brushes are the same.  By using the appropriate brush and technique together, patients can maximize their daily oral hygiene efforts.

Why must plaque be removed?  When the plaque matures, the microbial ecology changes and becomes pathogenic due to the different microorganisms, their by-products, and in the case of gum disease, the inflammatory response provoked by the host.

For gum health the plaque must be removed from:

*the healthy sulcus or shallow pocket, the ideal anaerobic breeding ground

*the gum tissue where maturing and growing supra gingival plaque deposits are in contact with the marginal gum tissue and can alter the sub gingival environment

*the interproximal areas-in between the teeth, which are hard to reach.

For cavity prevention:

Plaque must be removed from the the gum line, pits and grooves in the teeth and the interproximal areas.

Understanding the different elements of toothbrush design will help with making the correct selection.

Head and Bristles

The toothbrush head is an extension of the handle and is contoured to position the bristles.  Bristles are typically round nylon filaments.  The degree of hardness is determined by the diameter and the length of the bristles.  Larger diameter bristles are stiffer and do not extend as easily into hard to reach areas.  The shape of the end of the bristle has evolved over many years.  The tapering of the bristle allows greater flexibility and slenderness to reach deep into the sulcus.  A recently introduced bristle has a feathered tip, providing up to 70% more surface contact with the tooth.  Positioning of the bristles is also important.  Positioning tufts10 -20 degrees away from the vertical axis increases interproximal penetration.  A dome-shaped head of bristles, where the bristles are raised in the center, has been shown to increase plaque removal.

Handle

The ideal handle grip should aid in holding the brush at the correct angle so the bristles are present at 45 degrees to the long-axis of the tooth.  Is should be long enough to provide adequate grip to give full control, and the distance between the grip area and the head should enable easy access to the most posterior teeth.

Toothbrushes alone do not lead to adequate plaque removal.  There is a clear need for between-the-teeth cleaning.  This includes flossing and interproximal brushes.  These are available in a wide variety of designs and a high level of customization is available.

Summary

*The bristles must be effective in cleaning the hard-to-teach areas-extremely tapered bristles have demonstrated superiority

*The handles should have a grip designed to automatically position the brush to achieve the correct angle

*The brush is only one element of a plaque removal system

*The brush should be readily available commercially

*The brush head should be compact to reach to the back of the mouth and have soft bristles to minimize soft and hard tissue trauma and sensitivity, while maximizing cleaning

*The brushes should be designed and manufactured by a long-established supplier of scientifically tested toothbrushes

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Mussels can help with certain tooth pain

 From a recent Readers Digest article-

Some tooth pain develops when the hard outer enamel wears away and exposes the softer underlying dentin, which is sensitive to stimuli such as hot and cold.  Pain-fighting toothpastes and chewing gums contain minerals that can augment enamel but don't adhere long enough to permanently rebuild it.  For a solution, Chinese scientists turned to mussels, which secrete an adhesive to attach to underwater rocks, and they created a substance with similar sticky properties.  When scientists coated worn-out teeth with the mussel-like adhesive and then soaked them in a bath of minerals, the teeth rebuilt a protective layer that simulates enamel.  This discovery lead to better products for sensitive teeth.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem , Virginia , 24153

540-387-3844

Chewing Gum Can be Healthy for Your Teeth

There has been evidence of improved oral health associated with chewing gum containing xylitol, twice a day for 15 minutes.  There is a a definite increase in saliva production and flow.  This increase results in lower plaque and healthier gums.  This is particularly significant for our aging population who typically experience decreased salivary production and flow.  The resultant decrease leads to increased decay and gum disease.  Chewing sugar-free gum can add to the quality of life for the aging population.

Dentistry Today-August 2012

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

Don't forget to Floss

Don't forget to floss  by Dr. Patel

It's an activity almost no one enjoys, yet is so important when it comes to staying on top of your oral health.

Flossing:  It can be awkward, difficult, time-consuming or maybe you just don't understand the importance of it, but it's an essential part of your daily cleaning routine.

Just the Facts:  Floss at least once a day to achieve optimal oral health.  Daily flossing helps remove plaque from the areas between your teeth where the toothbrush can't reach, which is important because plaque that is not removed by brushing and flossing can eventually harden into calculus or tartar.  Flossing also helps prevent gum disease and cavities.

REMEMBER:  NOTHING ELSE YOU CAN DO TAKES THE PLACE OF FLOSSING.  NOT TOOTHPICKS, NOT CHEWING GUM, NOT EVEN MOUTHWASH.

Getting it done:  Try to make flossing a priority in your daily life.  It makes no difference when you floss--pick a time of day when you can devote an extra couple of minutes to your oral hygiene.  And it's just not adults who need to floss--children should be having their teeth flossed by an adult as soon as they have 2 teeth that touch.

Flossing should not be painful with normal, healthy gums.  You may feel discomfort when you first start flossing, but don't give up.  That discomfort should ease within a week or two.  If your pain persists, talk to your dentist.

If you find flossing difficult, consider a different flossing method.  People who have difficulty handling dental floss may prefer to use another kind of device such as a wooden plaque remover, dental pick or pre-threaded flosser.  Ask your dentist how to use them properly to avoid injuring your gums.  You may simply need to try another type of dental floss--waxed, unwaxed, thick or comfort floss.  Stick with it and you'll have adopted a health habit for life!

Dr. Caroline  Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

Preparing Patients For Future Oral Healthcare Decline

Elderly dental patients typically are challenging to treat due to their poor cognitive skills and manual dexterity.  Older patients need treatment-planning strategies specific to their individual needs.

Prepare for the Future:  Patient Education

The discussion needs to begin with the 50-60 year old patient regarding the need to prepare their mouths for the future assault that aging brings.  Like their physicians do, a dental plan of action should be established.

There are a number of issues that pre-retirement patients should be aware of, such as dry mouth secondary to medications.  The dental plan should address both the financial and treatment planning arrangements in anticipation of future challenges.  This plan needs to protect the teeth from dry mouth and resultant root caries, maximizing the patient’s individual insurance benefit. 

Routine care for the elderly is critical.  Some even benefit from a 3-4 month cleaning schedule.  Daily use of fluoride may also be recommended.

There are a number of common myths in our culture about aging teeth that should be discussed:

• If there is no pain, there is no tooth problem
• Teeth become softer with age and are more susceptible to decay
• Tooth loss is a normal part of aging
• If bleeding occus with brushing, stop immediately
• Teeth are not as important for an older person since they prefer to eat soft foods
• Dentures, just like real teeth, stay in the mouth 24/7
• Dentures are a great alternative to real teeth—simpler to clean, more cost-effective, and easier to function
•  

Dental treatment planning for the future decline should start in the 50’s, 60’s, and 70’s.  Dental restorations should be designed to withstand the lack of oral care that commonly occurs as a result of the aging process.  Fillings and crowns need to be easy to keep clean.  Extraction and implant placement should be considered in situations where there is a guarded prognosis.  Treatment planning should provide for implant retained lower dentures to allow proper nutrition and bone preservation and help prevent ill-fitting dentures from rubbing ulcers.  This level of care needs to be completed when the patients are healthy and able to receive the care.

Focus on Prevention

Most of the dental care needed by the elderly is long-term care facilities (LTCFs) is not provided by a dentist.  A recommended protocol is outlined below:

Daily Oral Care

1. Every resident should have a daily oral care plan
2. Supervised tooth-brushing should occur twice daily-after breakfast and before bedtime—with a regular toothbrush and fluoride toothpaste, not a toothette or sponge.
3. An accountability system with regular evaluation should be established.
4. Yearly oral health education of staff should be provided via inservicing

Daily Fluoride Application

1. A decay risk assessment should be performed to determine fluoride need.
2. An assessment of resident pharmacy formularies should be performed to determine fluoride prescription coverage and availability.
3. Appropriate fluoride application should be administered depending on the level of decay risk:  fluoride toothpaste, fluoride rinse, and fluoride gel.
4. Staff training should occur annually for proper administration of fluoride toothpaste, fluoride rinse and fluoride gel.

Regular Professional Cleanings

1. The last cleaning and due date for the next cleaning should be documented in the resident’s medical record upon admission.
2. Assessment and identification of barriers to obtaining regular professional cleanings should be performed (id, funds, transportation, behavior challenges).
3. Confirmation and documentation that the facility dental provider offers regular professional cleanings (ie, every 3-6 months) for the residents should be secured.

Dentists need to play an active role in the oral healthcare of geriatric patients, including those residing in LTCF’s.

From Compendium Feb. 2013

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

 Salem , Virginia , 24153

540-387-3844