In this, part one of a two-part article, we will be focusing on the important role quality oral hygiene plays in the preservation of dental restorations.
“Dr. Atlas, how long will this restoration actually last?”
In my practice (which is dedicated to restorative dentistry) this is a question I hear quite a bit. In the early days of my career it was a lot more difficult to answer. If the restoration (crown, filling, etc.) didn’t last as long as I might predict, then patients would assume its lack of success was because of something I had done in creating or placing the restoration. And poor dentistry can certainly lead to premature failure of any dental restoration (including using materials that aren’t the ones best suited to achieving optimal results). But the reality is, often times a restoration will fail or fall short of patient expectations for a number of other reasons – most of which are out of any dentist’s control.
Dental restorations do not cure dental disease
Once I had the opportunity to review the findings other dentists were publishing, I discovered that the number-one reason for early failure of restorations is new dental disease or decay forming under and around existing restorations. Although many patients aren’t aware of this complication, it’s one that they do have the power to combat.
If you’re a patient who’s consistently having restorations placed year after year – either new or replacements – this fact alone may be a strong indication that there are risk factors affecting the health of your mouth. Health concerns such as excessive tobacco use, acid reflux, Sjogren’s syndrome, bulimia, diabetes, head or neck radiation therapy, dry mouth and daily use of medications may place you at greater risk for dental decay around existing restorations and other teeth as well.
Great oral hygiene makes the difference
The good news, however, is the risk for dental decay (and subsequent restoration failure) can be can significantly reduced by simply making a commitment to outstanding oral hygiene. Here is my list of high-priority recommendations you may want to discuss with your dentist and hygienist:
1. Brush a minimum of two times per day, preferably AFTER a meal. I find many of my patients wake up and brush their teeth before eating breakfast. While it’s certainly important to brush in the morning to rid your mouth of a night’s worth of bacteria, by waiting until after you eat, you will doing your teeth an even bigger favor.
2. Opt for a battery-powered or electric toothbrush to help assist in plaque removal. Manual toothbrushes are fine in a pinch, but for regular use, I find that powered toothbrushes – when used properly – are better at removing plaque and food particles. Additionally, depending on whether you are right-handed or left-handed, many patients prefer to brush more on the side of their mouth that is opposite their dominant side (because it’s easier and more comfortable to do so.) But really, for effective cleaning, you should balance your brushing by monitoring the time you dedicate to each side. A powered toothbrush can help in areas of your mouth that are more difficult to access.
3. Add a high-strength prescription fluoride treatment. This type of therapy uses a special type of toothpaste that can only be obtained using a prescription from your dentist, and is clinically proven to help protect the “vulnerable” areas around existing restorations. Here’s how it works: Each night, after completing your normal two-minute brushing routine, dry your toothbrush and place a small amount of the prescription, high-strength toothpaste on the toothbrush. Brush an additional 30-60 seconds, making sure the toothpaste makes contact with all your teeth. After brushing, spit out the excess toothpaste, without rinsing with water. If you’re not going right to sleep, be sure and wait 30 minutes before drinking anything.
4. Replace sugar-based chewing gum. Rather than chewing sugary gum or breath mints, I advise my clients to use Xylitol-type mints and chewing gum, as they are natural products that reduce the effects of bacteria-causing tooth decay.
5. Visit your dentist at least two times a year for pro-active preventive care. Receding gums, dry mouth, sensitive teeth, visible plaque on teeth and inadequate home-care brushing and flossing techniques make your teeth much more vulnerable to tooth decay. Regular visits to your dentist are not only valuable for identifying these issues, but also in helping you to find the right treatments and solutions to improve or eliminate them.
Now at this point in my career, I know one thing for certain. And that is, one of the best ways of protecting and preserving your dental restorations is with quality dental care and exquisite oral hygiene. The solution is in your own hands!
Be sure and check out part two of this article, “A Patient’s Guide to Extending the Longevity of Your Restorations. Part II: Old Habits (Unlike Restorations) Die Hard.”
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