The importance of good oral health care

Drs. Laura and Josh Abbott, DDS

Suzanne Stewart
Staff Writer

Oral health care is a pivotal part of taking care of the whole body. More than just brushing teeth, the entire mouth must be looked after to not only ensure healthy teeth and gums, but a healthy body, as well.

Josh Abbot and his wife, Laura, are dentists at West Virginia Community Care Dental in Green Bank, and Josh said there are several easy and effective ways to care for your mouth at home.

“We kind of go through the routine of the rule of twos,” he said. “Brush your teeth twice a day for two minutes at a time. It is recommended that you see your dentist twice a year. As far as other home care things – we encourage daily flossing, because brushing does a really good job of cleaning the outside surfaces of the teeth, but it doesn’t really clean in between the teeth, so if you’re not flossing on a regular basis, there’s a lot of stuff that gets missed.”

Daily mouth washes are also helpful. Brushing with fluoride toothpaste is recommended, but it is possible to use a mouthwash with fluoride, as well.

Maintaining a healthy diet is another easy way to keep a healthy mouth.

“People will say, ‘I brush every day, I floss all the time, why do I still get cavities?’” Abbott said. “If you’re eating sugars or a lot of starchy foods – people don’t think of potatoes as a sugar-filled food, but they have a lot of starch in them. They’re sticky. The carbohydrates in those get broken down and can cause cavities just the same as if you’re eating candy.”

Along with watching your diet, Abbott said it is important to watch how many times a day you eat.

“You may not sit down and eat a large meal during the day, but if you sit down and eat a small snack every one or two hours, every time you expose your mouth to any type of sugar, there’s a buffer period where your saliva tries to break that stuff down to get the pH back to neutral,” he said. If you’re constantly eating or drinking, you’re also constantly exposing your teeth to sugars,” he said. “You might brush your teeth a lot, but when you’re putting that much sugar on your teeth all day long, it adds up and it makes a big difference.”

While some people try to brush after every meal, Abbott said they should give a small buffer period between a meal and brushing for the sake of their teeth.

“Cavities are caused by a bacteria, so when that environment becomes acidic, that bacteria is able to break down the surface that it’s living on which is our teeth in this case,” he said. “So, for about twenty minutes, they are able to basically feed themselves. After that twenty-minute window, your body kind of self buffers, so you actually want to wait twenty minutes after you eat as a good rule of thumb.”

Brushing immediately will only scrub the acid into the teeth and give it a better opportunity to cause a cavity.

“I don’t do anything special that I don’t encourage my patients to do,” Abbott said. “I brush twice a day. I floss. If I ate something extra sticky for lunch or something like that, I might brush a third time during the day, but I don’t all the time. I stick by the two rule – just like I tell my patients to do, and I make sure I drink plenty of water so that I am rinsing my teeth after I’ve eaten.”

For those who like to snack a lot or don’t have time to brush after every meal, Abbott said sugar free chewing gum is a helpful alternative.

“It helps increase the fluid in your mouth and the chewing motion actually helps scrape off some of the plaque build-up on your teeth,” he said.

When a cavity does appear, Abbott said it is important to get to the dentist as soon as possible in order to treat the problem before it gets worse.

“Everyone has different pain tolerances, so something might be really painful for one patient that might not be for somebody else,” he said. “I’ve had cases where someone comes in and they have a cavity that has gotten into the nerve of the tooth and they still weren’t having problems with it and it was by chance that we found it.”

Like skin, the tooth has several layers – the visible layer is the enamel; below that is the dentin and then the inside layer is the nerve. Once the cavity gets into the dentin, that is when it is time to get a filling – to keep it from getting into the nerve.

“Once a cavity gets into that middle layer, that’s where it needs to be filled,” Abbott said. “At that point, the tooth won’t re-mineralize itself.”

It is important to fix a cavity before it gets to the nerve, because the nerve is connected to the body’s bloodstream and if the bacteria gets that far, it can lead to other health issues.

“If bacteria gets in the bloodstream, it starts to spread and that’s when an infection will form and basically, once enough of that bacteria builds up, it forms an abscess,” Abbott said. “That’s when you start to have swelling, pain, more moderate to severe discomfort.”

Tooth decay can also lead to heart disease in adults, if not treated early.

“They’re starting to see a lot of correlations between patients that have heart disease that also are suffering from – we call it periodontal disease – a lot of people just say gum disease,” Abbott said.

If a cavity is not addressed or if it returns, it can lead to the need for a crown, root canal, or worst case scenario, removal of the tooth – an act dentists do not take lightly.

“Our goal is to save the tooth if at all possible,” Abbott said. “People often don’t know this, but if you get a tooth pulled, it’s not just as simple as that because then, it changes the bone around it because once the tooth is gone, your mouth settles. It’s like a hillside. If you take a tree out of the ground, the ground settles and your jaw will do the same thing.

“That’s why people who are missing their teeth have a sunken look,” he continued. “It’s not always just an eating issue because it also changes face structure. It can change your looks quite a bit, especially if you have more than one tooth taken out.”

So, when is a good time to start oral health care and seeing the dentist on a regular basis?

Abbott says it’s never too early.

“As far as home child care, we recommend even before teeth come in – we encourage parents get a washcloth and wipe off the child’s gums,” he said. “For one thing, it just gets them used to you being in their mouth, but also, you get films that build up on the gum tissue. It doesn’t take much and you get a plaque biofilm to build up and that bacteria in your mouth sticks when it’s in there for awhile.”

Wiping the gums of an infant will help keep the bacteria at bay and will help prepare them for brushing once their teeth do break through. The American Academy of Pediatric Dentistry also recommends using a fluoride toothpaste once the child’s teeth begin to emerge.

Just know, a little dab will do you.

“It is important when you’re using the fluoride toothpaste – especially for a child –that you only use about the size of a grain of rice,” Abbott said. “You don’t load the brush up, because if they do swallow it, they could potentially get sick. You want to limit that. You want to be there as the parent helping them brush, helping them get used to it. They do recommend, as far as when to start coming to the dentist, it is usually by the time the child turns one or when the first tooth comes in.”

But, Abbott assures, there isn’t much they do to the child in those first visits. He said it is important to get them used to a dentist and the equipment in the office.

“We usually discuss home care, diet and basically, it’s allowing the child to get used to coming to the dental office,” he said. “If they never go and then their first visit is because they have something that hurts, then they start to associate going to the dentist with something that is going to hurt them.”

It is important to care for baby teeth as if they are permanent teeth because their health does have an effect on the permanent teeth.

“If you lose a baby tooth too early, we do have concerns with that,” Abbott said. “The baby tooth saves the space for the permanent tooth to come in. If one gets infected and you lose it before the permanent tooth is ready, the remaining baby teeth will start to move because they’re spreading out and filling that space.”

With the remaining teeth reacting to the gap, the permanent tooth will have issues with breaking through. It could come in crooked or get locked and not come in at all.

If a baby tooth has to be removed or falls out due to an infection or cavity, that infection may carry on into the permanent tooth and lead to a cavity early in the tooth’s life.

“If there is an infection and it has to be removed, that can affect the developing permanent tooth underneath it,” Abbott said. “Sometimes, the permanent tooth will come in and we all of a sudden see a dark spot on a brand new tooth. So sometimes those infections will actually scar the permanent teeth because it affects their growth.”

While teeth are the dentist’s main focus, the mouth as a whole has other issues that a dentist can help with, including problems with dry mouth.

Dry mouth causes the mouth not to create enough saliva and leaves an individual at a higher risk of getting cavities because the bacteria is given a better chance to grow.

“There’s a product called Biotene that we recommend to a lot of patients,” Abbott said. “It is a mouthwash. They also have gums and different things, but the mouthwash is the one that a lot of people use. We encourage patients to use that – even four or five times a day.

Everything Abbott recommends is what he does at home for his own oral health.

“Prevention goes a long way,” he said. “I get it, dentistry is not cheap.”

But the investment in trying to prevent dental issues is usually much less that trying to fix things later.

Community Care Dental opened in 2012 and is open Monday through Friday, 7 a.m. to 3 p.m.

“We’re here and we’re happy to help,” he added. “That’s why we’re in the community. We want to be as much help to people as we can.”

Contact Community Care Dental at 304-456-5433.

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