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Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Appalachian Dental Associates team for tips on proper brushing and flossing.

Many dentists and hygienists recommend fluoride treatments for their adult patients. You might ask yourself, “Do I really need a fluoride treatment? I thought those were just for my kids.” After all, most insurance plans cover fluoride treatments only up to the age of 18.

What you need to know as a dental consumer is that studies have shown topical fluoride applications performed by a dental professional create a significant benefit for adults who have moderate to high risk for cavities.

There are several circumstances that warrant extra fluoride protection among adults. Many prescription medications reduce saliva flow or otherwise create dry mouth. A reduction in saliva increases cavity risk.

Adults often experience gum recession, which exposes part of the root surface of teeth. These areas are softer than the hard enamel at the top of the tooth, which makes them more susceptible to decay.

In addition, adults often get restorative work such as crowns or bridges. Fluoride can help protect the margins of these restorations, ultimately protecting your investment.

Today many people opt for orthodontic treatment (braces) as adults. Braces make it more challenging for patients to maintain good oral hygiene. Just ask your kids! Fluoride can keep the teeth strong and cavity-free even with the obstacle of orthodontic appliances.

Have you had a restoration done within the last year due to new decay? If you have, that puts you at a higher risk for cavities. Fluoride treatments are a great way to prevent more cavities in patients who are already prone to them.

How is that flossing coming along? You know you should floss daily, but do you? If your oral hygiene is not ideal, fluoride could be just the thing to keep your neglect from leading to cavities between your teeth.

Fluoride can also help with the growing problem of sensitive teeth. Diets high in acidic foods and beverages, general gum recession, and increased use of whitening products all tend to produce sensitive teeth. Fluoride treatments re-mineralize tooth enamel and reduce that sensitivity.

Patients who undergo radiation treatment for cancer also benefit from topical fluoride applications. Radiation damages saliva glands, thus greatly reducing the flow of saliva. Saliva acts as a buffer against the foods we eat and beverages we drink. Once again, less saliva greatly increases the risk of cavities.

If one or more of these conditions applies to you, consider requesting a topical fluoride treatment. Be sure to ask Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris at your next appointment whether you might benefit from a topical fluoride application.

Five words no one welcomes: “You need a root canal.” But if you are delaying treatment because you are worried about pain and an uncomfortable day in the dentist’s chair, please think again! Modern root canal procedures are designed to repair your damaged tooth gently and efficiently, and leave you with a restored natural tooth that can last a lifetime.

• Why might you need a root canal?

First, a little tooth biology. Each tooth has a crown (the part we see above the gums) and one or more roots (the part of our tooth below the gum line that is attached to bone in our jaw). The tooth has three basic layers: the hard enamel and cementum that cover the outer crown and root, the softer dentin beneath that layer, and, on the inside, the pulp. Pulp is made of living tissue, and contains the blood vessels and nerves that nourish the tooth and keep it vital.

Even with the protection the enamel and dentin provide, sometimes the pulp can be infected or damaged. If you have suffered an injury to your mouth or jaw, or an infection has developed from an opening in the tooth caused by a deep cavity or crack, you may need a root canal to prevent further infection, pain, and even tooth loss. Call our Franklin and Asheville, NC office immediately if you feel pain with chewing or pressure, prolonged sensitivity to heat or cold, swollen, and tender gums around a tooth, or tooth discoloration.

• The Root Canal Procedure

If a root canal is necessary, the procedure is very straightforward. After the area around the tooth is numbed, we will make an opening in the crown to allow access to the pulp inside. Very small instruments will be used to clean the inner tooth and removed bacteria and dead or dying tissue. The area will be thoroughly disinfected, and the inside of the tooth shaped and then filled and sealed. A temporary filling or crown might be placed on the tooth to prevent bacteria and food from entering the site if a permanent crown needs to be created. The entire process usually takes from one to three visits.

If we suggest a root canal, it is because this is the best way to save your tooth. Please feel free to talk to us about your particular needs and concerns. Which tooth is affected, how many roots are involved, what type of filling or crown might be best—we will work with you to provide all the information you need and all the options you have available.

Common Concerns

• Are you concerned about pain?

The most painful part of a root canal is often the severe discomfort your tooth causes before treatment. And infections and damaged nerves can affect not only the injured tooth, but the gums, tissue and even bone surrounding it. With our modern dental techniques, a root canal procedure is often no more uncomfortable than a regular filling. The local anesthetic we use will prevent you from feeling any pain during the procedure, and, while the area around your tooth might be a bit sensitive following treatment, the pain caused by the infection or injury should be gone.

• Are you anxious about the procedure?

If dental treatment causes you anxiety, please let us know. There are several sedation options we can pursue to make this procedure less worrisome. Our goal is to make your treatment as gentle and comfortable as possible.

No one welcomes the news that a root canal is necessary, but with today’s procedures, this treatment can be just what you need to relieve your pain and keep your natural tooth where it belongs for many years to come. And that is welcome news, indeed!

Many studies over the past several years have focused on this question. Since we will all face stressful situations during our life, it is a good question to ask. This question also delves into the mind-body connection—the psychological having an effect on the physical and vice versa.

Studies were performed as far back as the 1940s and continue today. Many of them have shown that stress "downregulates" or hinders cellular immune response. The most common periodontal diseases related to this stress-induced downregulation are gingivitis and periodontitis.

It is believed that stress and depression contribute to a state of chronic inflammation within the body. Stress also raises levels of cortisol in your body, which has been linked in studies to higher levels of tooth loss and deeper pockets between the gums and teeth.

Perhaps the biological side of this equation makes sense, but an important factor is that people who are stressed and/or depressed tend to neglect oral hygiene and other health-promoting activities. The studies seem to support both the behavioral and biological effects as risk factors for periodontal disease.

Here are some things you can do to help prevent stress-related periodontal problems:

• Daily relaxation –You may consider meditation or yoga. Both have been proven effective at easing stress.
• Practice good oral hygiene – Don't let your oral hygiene fall by the wayside. Doing so will obviously have a detrimental effect on your oral health. You should also aim to quit smoking if you do smoke.
• Get regular dental checkups – Getting regular checkups will help you to spot anything that's amiss before it gets out of hand. You can speak with your dentist if you have any pain or concerns and have them take a look.

Stress is something that affects all of us but it can be managed. Each one of us may manage it in a different way. Find what works for you and always make sure to keep up with your oral hygiene routine. For more information about stress-related periodontal issues, schedule an appointment with Dr. James Melzer, Dr. Whitney Jones, Dr. Madison Crumley, and Dr. Bob Harris at our Franklin and Asheville, NC office.