Save Your Smile - oral hygiene tips

Poor oral hygiene can affect your teeth and your health. What you can do

BELIEVE IT OR NOT: More than 400 species of bacteria--with names such as Porphyromonas gingivalis and Campylobacter sputorum--are creeping around in your mouth right now. These silent organisms have a field day in your teeth and can cause serious problems, as Tyree Fuller, 36, of Raleigh, North Carolina, learned five years ago. That's when Fuller, a retail sales manager, noticed that her gums would bleed occasionally when she brushed them. In time, her teeth became sensitive to cold and hot beverages and felt loose. Last year she was diagnosed with periodontal disease.

To manage this progressive infection of the gums, bone and tissues surrounding the teeth, Tyree has had to undergo two periodontal surgeries (to clean around the teeth and bone where diseased pockets were forming), the bracing of four loose teeth and professional cleanings every three months.
Now she must brush three times a day, floss twice a day and apply a medicated antibacterial gel to her teeth daily. "It is frustrating," says Fuller, "but it's what I've been told I have to do to keep my teeth."

Approximately 75 percent of adults over 35 in the United States have some form of periodontal disease, according to the American Dental Association (ADA). And because of lack of awareness, as well as lack of access to dental care, people of color are more at risk. A survey by the National Institute of Dental Research found that about 25 percent of Blacks have severe periodontal disease, compared with 20 percent of Mexican-Americans and 17 percent of Whites.

Even more disturbing are recent studies showing that gum disease may contribute to or aggravate health problems throughout the body, including heart disease, diabetes, pneumonia and premature birth. Researchers at the University of North Carolina at Chapel Hill (UNC-CH) found that women with periodontal disease were seven times more likely to have premature low-birth-weight babies than women who were not affected by the disease. Studies also suggest that people with periodontal disease are twice as likely to die of a heart attack and nearly three times as likely to suffer a stroke. Experts believe that bacteria in the mouth enter the bloodstream and lead to clogged arteries, blood clots and changes in heart function. The bottom line? "There is more at stake than just your teeth," says Janet Southerland, .S., .H., research assistant professor at UNC-CH School of Dentistry.

From Dental Neglect to Disease

As you read these words, bacteria and debris from food are multiplying in your mouth, forming a sticky, colorless film called plaque around your teeth. The effect will be accelerated at night when saliva production--the main mechanism for flushing bacteria from the mouth--decreases. If you don't remove plaque every day by brushing and flossing, the buildup can irritate the gums and cause them to swell and bleed. This condition, known as gingivitis, is a mild and reversible form of gum disease, which almost everyone experiences at some point, Southerland says.

As the disease progresses, the infected gums gradually recede, forming deep pockets where the bacteria destroy underlying tissue and bone. This advanced condition, called periodontitis, affects some 15 percent of American adults. If left untreated, it can lead to tooth loss. While not curable, it is manageable through strict oral hygiene, frequent professional cleanings, medicated mouthwashes and oral surgeries.

Dental Do's and Don't's

Although gum disease can progress over a period of several months to years, make efforts now to prevent permanent damage: Brush twice a day for three to four minutes each time. This will loosen and remove disease-forming bacteria and plaque. Use toothpaste that contains fluoride and has the American Dental Association's seal of approval.

Angle your toothbrush 45 degrees to reach beneath the gum line where plaque lies. Gently brush in a circular motion. Be sure to reach behind the teeth, between teeth and over the chewing surfaces. Brush the tongue, which also harbors bacteria.

Floss every day for two to three minutes. Wind the ends of an 18-inch piece of floss around the middle fingers of each hand. Using your index fingers and thumbs, wedge floss down between teeth. Bring the floss up and down, forming a C shape around the tooth. Be sure to go below the gum line and scrape the wall of the tooth.

Buy a new toothbrush every three months. Brushes with small, soft, rounded bristles made of nylon are less abrasive on teeth. Electric brushes offer a more consistent brushing motion and last longer, but cost more.

Eat to protect your teeth. Periodontal disease is more common in adults who consume little calcium. Aim for 1,000 to 1,200 milligrams of calcium--about four 8-ounce cups of milk--a day. If you don't drink milk, opt for calcium-rich foods: turnip greens, kale, beans, sardines, canned salmon with the bones and tofu. Avoid sugary foods and drinks.

Get that checkup once a year, or more often if you are prone to cavities, have symptoms of gum disease or have a chronic condition such as diabetes, heart disease or leukemia. To find an African-American dentist in your area, contact the National Dental Association at 3517 16th St., ., Washington DC 20010; (202) 588-1697 (voice); (202) 588-1244 (fax).

FLOSSING MADE EASY If dental floss puts your fingers in a painful bind, check out Floss Rings from Dix Preventive Products. Simply use the slot to guide the floss into a small hole at the top of each ring, then place the plastic rings on your index fingers to begin flossing. Floss Rings are especially helpful for folks with arthritis, multiple sclerosis or dexterity problems. A two-ring pack costs $2. Floss Rings are available in most drugstores. Or you can order them from Dix Preventive Products, 145 E. 15th St., New York NY 10003; (212) 254-7563; .com.

RELATED ARTICLE: The Truth About Teeth Whiteners

When it comes to keeping your pearly whites bright, there's no shortage of solutions. But how can you get the most gleam for your buck, and what's safe? According to George McLaughlin, .D., of the Academy of General Dentistry, options include:

* Toothpastes. Those with mild abrasives such as baking soda are cheap ways ($3 to $7) to remove minor stains. However, they won't do much for deeper discolorations, says McLaughlin.

* Bleaching kits. For $10 to $20 you can buy an over-the-counter whitening kit containing dental trays and bleaching solution. But because the trays are not custom-fit, solutions can leak into the mouth, causing gum and mouth irritation. Animal studies suggest that high concentrations of hydrogen peroxide may be linked to cancer.

* Dentist-supervised bleaching. Custom-fit trays and solutions prepared by the dentist are safer and more effective than over-the-counter kits, says McLaughlin. However, professional whitening costs from $300 to about $600 for an entire set of teeth and is not covered by insurance.

* Laser bleaching. A highly concentrated bleaching solution is applied to the teeth before being exposed to a laser. The newest weapon in teeth whitening, this procedure can cost from $800 to more than $1,500 and is not covered by insurance. Long-term effects and risks are not known.

The bottom line: To whiten teeth safely and effectively, visit your dentist for an assessment and take it from there, says McLaughlin. Results from professional whitening procedures generally last one to three years. .H.

Joyce Clark Hicks is the health-and-fitness writer for The News & Observer in Raleigh, North Carolina.