Dr. Mintzer's Basic Hygiene Instructions for Teeth & Implants: One size does not fit all!

Toothpaste: The basic ingredients in a "decent," commercial toothpaste are a grit abrasive to remove stain from the surface of teeth and fluoride, to make the exposed part of the tooth more resistant to decay. That's it. The rest are flavors and things that bubble, pretty much. Toothpastes are somewhat over-rated. Some toothpastes contain "whiteners" and rarely, antiseptics. Be careful of claims made that the toothpaste can detoxify bacteria, as this is marketing based upon little science (yes, I'm talking to you, Crest). For implants and crowns, toothpaste does little or nothing, and the fluoride concentration is less than the below, prescribed fluoride. Lastly, if you are using toothpaste (likely once a day if you follow these suggestions) then use a high concentration, dentist dispensed or prescribed Fluoride brand. See Below:

Fluoride: Makes teeth "stronger" by resisting acids produced by bacteria. It's a good thing! Santa Barbara does not fluoridate its public drinking water like most metropolitan districts do, unfortunately, but studies show that the best time to be exposed to fluoride is from age 2 - 12 years old, when teeth are forming. Alternately, you can have fluoride treatments during your hygiene visits, but these are overall less effective than early exposure to fluoride. In addition, fluoride may be prescribed or dispensed if you appear to be prone to cavities, but the concentration of fluoride for a prescribed item is about 1.1%, much higher than regular toothpaste. While the overall caries rate for young adults had reduced tremendously, evidence points to early fluoride exposure in toothpastes, which are often consumed during brushing by toddlers and youth during those formative years.

Toothbrushes: Electric! Electric! Electric! The only two to consider are the Braun/Oral-B and the Sonicare. We favor the Oral-B because of the choices available for interchangeable heads, the size of the heads and the mechanism of action. That being said, half of the 6 or more heads for sale are not recommended and you should use only the very basic, soft bristled heads. Look for the words: Sensitive, Soft & Gum in the titles. The Sonicare is OK if you have thicker gums and are resistant to gum recession.

Mouth Rinses (Over the Counter): Listerine and compatible rinses are supported by decades of use as effective antiseptics. Most contain alcohol, which can desiccate, or dry tissue but there is a non-alcohol version available. Listerine does kill "germs by the millions," like the advertising says, but mostly in a lab petri dish. Still, they're effective for daily use. You can start by using drug store (3%) hydrogen peroxide for 30 sec brushing prior to Listerine. Hydrogen Peroxide 3% is labeled safe for rinsing, and is suggested to take a 1/2 tsp (swig, not swallow) and brush with your electric toothbrush prior to brushing for another 1 1/2 minute with either the rinses Listerine or Chlorhexidine or a fluoride containing toothpaste.

Floss and Interproximal Brushes: Best for between the teeth, the rule of thumb is to use the biggest instrument that will fit easily between your teeth. Sometimes difficult to master; our hygienists can show you how. I like PLACKERS floss holder and the Soft-Picks from Sunstar/Gum to substitute for flossing daily.

PerioAid: This fancy, glorified toothpick holder is a mainstay for our hygienists in their mission to keep your teeth and implants healthy for a lifetime. Wooden toothpicks have a very interesting habit; after using them for 30 seconds the wood fibers in the tip soften and behave just like a tiny brush. Perfect for getting into the "gum line" where bacteria threaten! You can place them into a cup with peroxide before use...

Implants: Implants can be at higher risk than teeth for gum and bone loss because only the bone attaches to the implant and not the gum. What this means is that you should have xrays every 2 years or so to check bone levels, and signs of Peri-Implantitis (just like Periodontitis) should suggest referral to a periodontist for evaluation.

Specialist Treatment for Ailing Teeth & Implants: There are additional treatments and products available, but require demonstration and practice beyond this web page.

BASIC HYGIENE PROTOCOL:

• Figure out your issues. Do you get cavities more than you like? Do you build up bacteria at the gum line? Do you have unacceptable stain? Are you prone to gum or bone loss for either teeth or implants? Do you have bad breath?
  
• Address your priorities:
  • Cavities: Fluoride! Ask your dentist where your cavities are forming and focus on that. Old restorations? Crowns? Most crowned teeth don't benefit from fluoride unless you attack the gum line where they may be susceptible.
  • Stain: See your hygienist more often! Having "cleanings" twice a year may no longer be the norm.
    
  • Gum & Bone Loss: Same as with stain, in that 3-4 "cleanings" may be mandatory. While insurances may only pay for two, we often see that 3-4 times a year prevents problems! Periodontal hygienists excel in these recalls, and often we alternate recalls with general dentists.
• Brushing Protocol: If you're not too prone to cavities or have lots of crowns, you can forgo most toothpaste. Brush your teeth with Listerine! It's a lot less radical than it sounds. Take a "swig" and tip your head back, then start brushing with an electric brush for 30 seconds, distributing most of the rinse, before spitting out. Keep brushing for a total of 2 minutes. Twice a day.
• Flossing: Every other day should be sufficient. Be careful when you floss, you can actually cause recession if done incorrectly. If you're an irregular flosser, then pay special attention to any areas where the floss removes food, smells "funky" or bleeds. This is a "cry for help." Up your flossing or interproximal brush use!

Feel free to contact us for specifics about the above. Happy brushing!