Get the Best Dental Care

Be true to your teeth
or they will be false to you.

If you enjoy biting into crunchy apples, munching on pop-corn and flashing a dazzling smile, you might need to take better care of your teeth–now. Current studies show that nearly 50% of the U.S. population does not receive regular preventive dental care. Why? Part of the reason is that many people fear dental visits. But regular check-ups and cleanings are as important to your oral health as are proper brushing and flossing. In order to overcome any anxiety you may have and keep your mouth in tip-top shape, it’s important to find a dentist you feel comfortable with.

Collecting Names

You should never simply settle for a dentist. Shop around until you find someone you have complete confidence in. Here are some sources for gathering names to consider:

• See Health Pages‘ Dentist Listings.
• Call or write your local dental society.
• Speak to your family physician or local pharmacist.
• Ask friends, neighbors, or co-workers to recommend a dentist.
• Speak to faculty members of dental schools in your area.
• Call or write a nearby hospital that has an accredited dental service.
• Check the American Dental Association (ADA) directory, which can be found in many public libraries and in all dental school libraries.
• If you belong to a dental managed care plan, you will probably have to limit your search to the dentists affiliated with the plan in order to have your treatment covered.

Selecting the Right One

To get the very best oral care, you need to see a dentist on an ongoing basis. It won’t take long for you to evaluate a dentist. In fact, you can tell a lot on your first visit. The dentist should give you undivided attention, be courteous and patient, and take a complete medical and dental history, including any medications you are taking. You should be given a thorough examination and a clear explanation of what work needs to be done and what your treatment options are. Don’t hesitate to talk about fees, especially if you need extensive work.

You should feel free to ask questions and express any fears you have without feeling embarrassed. If you are at all apprehensive, ask about any special options to alleviate fear and pain such as hypnotism, acupuncture, or nitrous oxide (laughing gas). If you get a cleaning, the hygienist should be willing to give you instructions for caring for your teeth between visits.

Additional tips to help you find the right one:

• Are the dentist’s dental-school diploma, license, and other educational certificates in sight?
• What is the general appearance of the office, dentist, and staff? Is everything clean and orderly? Does the equipment appear to be modern and in good condition? Keep in mind that every dental office must abide by the current OSHA (Occupational Safety and Health Administration) guidelines for sterilization and disinfection of instruments.
• How available is the dentist? Is the appointment schedule convenient for you? Is the dentist prompt in keeping appointments? Is the office easy to get to from your home or workplace?
• Do the dentist and hygienist suggest ways to avoid dental problems?
• What arrangements does the dentist have for handling emergencies that occur outside of office hours? Does the dentist have an answering or paging service? You will find that most dentists arrange for a colleague or a referral source to aid their patients when they themselves are unavailable.

Dental Specialties

Qualified dentists in general practice can provide many aspects of dental care. But when specialized treatment is required, they will refer you to one of the following experts:

• Endodontics: Root canal therapy
• Oral Surgery/Oral Pathology: The identification and removal of teeth or tissues from the mouth.
• Orthodontics: Braces and the repositioning of teeth.
• Pedodontics: Care exclusively for children and teens.
• Periodontics: Care of gums and supporting tissues.
• Prosthodontics: Dentists specially trained for full mouth rehabilitation.

Prevention

If you avoid going for regular dental visits, you may allow a condition to worsen. The key to reducing dental complications and high dental bills is prevention. Regular dental checkups are essential for maintaining healthy teeth and gums and catching problems early. Periodically, your dentist may ask you to have X-rays to detect if there are any problems with the structure of your teeth. The ADA recommends that dentists take X-rays based on a patient’s personal health history and an examination of their teeth and gums. Little risk is posed by dental X-rays when modern techniques and equipment are used, but there are a couple of things you can do to avoid having unnecessary X-rays. For one thing, if you move or switch dentists, make sure you have your dental X-rays transferred to your new dentist. Also, when taking X-rays, the dental staff should provide a lead shield to protect your body.

Preventive techniques, such as topical fluoride applications and pit and fissure sealants, have reduced many dental problems. But such measures cannot save your teeth and reduce dental costs unless you share the responsibility for your own oral health. Brushing and flossing the teeth thoroughly at least once a day is necessary to remove plaque–the thin film of bacteria that forms on teeth and causes dental caries (tooth decay) and periodontal (gum) disease. Using a fluoride mouth rinse and toothpaste or gel accepted by the ADA’s Council on Dental Therapeutics helps make teeth more resistant to decay. Eating nutritious meals and limiting the number of sugary snacks you eat between brushings is also an important part of a sound oral health routine as is drinking plenty of water. Water keeps saliva flowing, which dilutes the toxins create by plaque.

Does Your Brushing and Flossing Technique Pass Muster?

It takes more than a quick once-over with the toothbrush to remove plaque from your teeth. But the time you spend brushing and flossing will help preserve your pearly whites. It’s ideal to brush and floss twice a day at bedtime and after breakfast. But if that’s not possible, make every effort to do it once a day–everyday. First, choose a brush with soft, rounded tips (hard, pointy bristles can damage teeth and gums). Then select a fluoride-containing toothpaste approved by the American Dental Association.

Now you’re ready to begin. Start to brush wherever you like, but develop a systematic approach to ensure that you clean every reachable surface of every tooth, front, back and top. Hold the brush horizontally, with the bristles on one side of the teeth, close to the gumline. Tilt the brush so that the bristles form a 45-degree angle with the teeth. Use enough pressure so that the bristles splay out slightly and penetrate the groove at the gumline. Brush back and forth horizontally with short strokes and continue for 10 seconds before moving the brush to the next group of teeth. Brushing the top of the tongue will help combat bad breath. After brushing, you can rinse the mouth thoroughly with plain water or a mouthwash. How often should you change your brush? Dentists recommend getting a new one every month.

Brushing doesn’t reach surfaces between teeth or between the gum and teeth. To banish plaque from these areas, you need to floss either before or after brushing. You may have to experiment with different types of floss (waxed, unwaxed, fuzzy, flat or round) to find what you’re most comfortable with. Or ask your dentist or hygienist for a recommendation.

Snap off an 18-inch piece of floss, and wrap the ends a couple of times around your index fingers. Five or six inches of floss should extend between the fingers. Press your thumbs against your index fingers to hold the floss in place. Extend your middle fingers to press against the rest of the floss so there is a short length of taut floss between them.

Starting at the upper or lower rearmost part of your mouth, place the floss behind the molar until it touches the gum (if the gum bleeds or hurts, you may be pressing too hard). Pull the ends of the floss forward until parts of the inner and outer surfaces of the tooth are covered. Rub the floss a couple of times up and down the tooth surface. Next, insert the floss between the last molar and the next tooth by pulling the floss gently back and forth until it passes through the “contact point” between the teeth. Press the floss against the last molar, and rub the floss up and down a couple of times between the gum and the contact point. Next, press the floss against the other molar, and repeat the process. Remove the floss by pulling gently back and forth as you pass through the contact point. Continue this procedure until every tooth has been flossed. Finally, rinse thoroughly to get rid of the loosened plaque. Flossing technique is a little tricky, so you may want to ask your hygienist to show you exactly how it’s done.

The Use of Fluoride

Millions of people now drink fluoridated water, which helps combat cavities. Although there is still some controversy about the use of fluoride, every major American health organization agrees that it is safe and effective. Fluoride helps stave off decay by strengthening enamel both as teeth are being formed and when they are fully formed. There are two basic ways fluoride becomes incorporated into teeth: It is taken internally or applied directly to teeth surfaces. Children who drink fluoridated water from birth have from 50 percent to 65 percent fewer cavities than those who don’t. And as teenagers, 20 percent of the fluoride group will still be caries-free.

It is possible to get too much fluoride and develop an unsightly mottling of the enamel called fluorosis. But this occurs mainly in areas where drinking water contains an excess of natural fluorides, not in water systems that are artificially fluoridated. If your water supply is not fluoridated, your dentist can prescribe a fluoride supplement. Fluoride may be added to the school water supply if the local water supply is not fluoridated or if thereis no central water supply.

Normally we get adequate protection against cavities by drinking fluoridated water and using toothpastes and mouthrinses containing fluoride (those with the seal of the ADA’s Council on Dental Therapeutics have been proven effective). But additional measures may be needed for people who have receding gums, suffer from dry mouth, or are prone to tooth decay. In these instances, an over-the-counter fluoride rinse can be used, or the dentist can prescribe or apply a fluoride gel or varnish.

Paying the Bill

• Dental Insurance. Find out exactly what dental services your health insurance covers before you require dental care. See Money Talk: Understanding Your Dental Plan Saves.
• Financial Aid. If you need financial aid to obtain dental care, you can contact your local dental society for information on dental care programs that you may qualify for. The dental society knows what assistance programs are available and can refer you to low-cost dental care centers, such as public health clinics and dental school clinics. In dental school clinics the fees charged are minimal because care is provided by graduate dentists or dental students under the careful supervision of faculty experts.

Dental care for children and, in some states, for adults is available through Medicaid, a federal-state program designed to provide medical assistance for people with low-incomes. You can obtain more information about this from your state or county department of public welfare.