Dental Care A Commitment For Life

By Nancy K. Crevier

February is National Children’s Dental Care Month, an ideal time to get children on the right track for caring for their teeth, said Dr David Kessler of Dental Associates in Newtown, at 11 Church Hill Road.

“The American Academy of Pediatric Dentistry recommends starting dental visits at age 1,” said Dr Kessler. It may seem very young, but doing so enables the dentist to do an assessment of the dental development. Early exams allow a dentist to look at the space a child will have as teeth develop, and to do intervention to guide the growth of the bone, if necessary.

Twice yearly visits to the dentist from age 1 on get children into the habit of regular visits and enables the dentist to teach children how to brush properly and care for teeth themselves, as they become able.

Dental Associates recommends fluoride supplements to strengthen teeth while they are developing, said Dr Kessler, if water tests show that a child is not receiving enough in drinking water. Once the adult teeth have formed, though, around age 13, internally taken fluoride is no longer useful. Then, topical fluoride treatments, continuing for as many years as a client’s needs dictate, are used. Regular application of fluoride can actually stop a cavity as it forms in the exterior enamel of a tooth, before it reaches the soft inner lining, the dentin, and requires filling.

“Advances in orthodontics and pediatric dentistry have given today’s generation the potential to be decay-free for life,” Dr Kessler said. X-rays are now digital, and contain more information to help dentists provide the best care for patients, he said. He is also excited about the Velscope, a handheld device that can be used in lieu of manual examination of the tongue and mouth to check for cancer.

“The Velscope uses ultraviolet light to look at the cellular level,” Dr Kessler said. “Precancerous or cancerous cells appear black, so we can detect cancer before we can feel a lump in the mouth. It’s a regular part of each check-up now,” he said.

For daily care at home, there is nothing better than a piece of dental floss, said Dr Kessler. “That little piece of string can do wonders,” he declared. Stimudents are triangularly shaped “fancy toothpicks” that are an option for people with larger spaces between their teeth.

A soft toothbrush is effective in removing plaque from teeth, but what most patients do not realize, is that it takes longer to brush than most take the time to do. “Brush for two minutes,” he said, taking 30 seconds to clean each quadrant of the mouth. “Get a timer, or get a toothbrush with a timer,” he recommended. “You can’t believe the difference when you actually brush for a whole two minutes,” said the dentist.

A handheld toothbrush is a good tool, but an electric toothbrush works far better than what can be done manually, he said.

Dental rinses with fluoride are another good tool for dental hygiene, said Dr Kessler, as long as a child is old enough to know not to swallow the rinse. Swallowing fluoride can result in a bad stomach ache, and too much fluoride can cause discoloration of the teeth.

There is no harm in using tooth whitening pastes, which are slightly abrasive, to remove exterior stains, he said, nor do whitening strips or professional whitening plans, both of which contain an oxidizer that whitens the entire tooth, cause harm to the tooth.

National Children’s Dental Care Month is also a good time for adults to think about their own dental care, as well.

“People who are now in their 30s have probably had good dental care all along,” said Dr Kessler. The use of sealants, fluoridation, preventative care, and education over the past three decades has made the need for restorative dentistry far less than it was a generation ago, he noted.

“Those who are between 45 and 60 years old probably had many fillings. They may be seeing a need now to have those old fillings reassessed. The mouth,” he pointed out, “is a hard environment.”

Older patients, ages 65 and up, have different care requirements than younger patients.

“As we age,” said Dr Kessler, “the quantity and quality of saliva changes. The saliva flow is reduced. Saliva is nature’s way of cleaning the mouth, flowing over the contours of the teeth in response to food and drink intake.” A dry mouth, whether due to natural aging or certain medications, or radiation treatments, can lead to decay.

Because a dry mouth can indicate underlying health problems or a reaction to a medication, Dr Kessler said that people experiencing dry mouth should mention it to not only the dentist, but to the family doctor and the pharmacist, as well. Salivary replacements are available for severe instances of dry mouth.

Healthy adults can continue to see the dentist twice a year. If a dentist recognizes that a patient is developing recession of the gums or decay, he or she may suggest visits three to four times a year, in order to address smaller issues before they become big problems.

There is always some recession of the gums with aging, Dr Kessler said — leading to the expression, “long in the tooth.” With root surfaces exposed, they become more susceptible to decay.

Those patients will be given a prescription for a toothpaste containing sodium fluoride, in a strength equal to that of a treatment at the dentist office, and potassium nitrate, a desensitizer, at Dental Associates, he said.

He highly promotes a power toothbrush, with a timer, for the older patient. “As we age, we simply have less dexterity,” he pointed out. For patients no longer able to manipulate floss effectively, Dr Kessler suggested using a dental floss holder or an air flosser that blows bursts of air and water in between the teeth.

Good dental care is a lifelong commitment. “Better overall health, better hygiene, and better education mean that we see people with less instances of dentures today and other dental problems,” said Dr Kessler. “But like I tell my patients: you only have to brush or floss the teeth you want to keep.”