textfiles/food/brush1.txt

MOUTHDENTALCAREFLOSSSULCUSORALHYGIENEHEALTHORTHODONTAL
HOW A MOUTH WORKS


How a Mouth Works
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 In order to generate a healthy mouth, you need to understand the 
anatomy  of the mouth and the way in which teeth are supported in 
the  jaw.   When  you put force in the surface of  a  tooth,  the 
weight  is  distributed  through the  periodontal  ligament  that 
surrounds  each tooth into the  lower jawbone.   This  1mm  thick 
ligament  is suspended (from the bone like a hammock of  fibres).  
Into  these  fibres  each  tooth  is  tightly  nestled   It's  an 
extremely efficient system.

 (Just  for fun.  here are a few facts to inspire you to work  at 
keeping your own teeth.  Inuit people, who often use their teeth 
as a third hand, can exert more than 360 pounds of pressure using 
their  first molars.   That's enough pressure to crush a  brass 
pipe.   In comparison,  the average North American can exert 125-
150 pounds of pressure.  The average denture wearer on the other hand, 
can exert a mere 15-17 pounds.   What does all this mean to you?  
Any more than a small amount of pressure and their teeth will pop out!

But we digress...

Now,   probably   nobody  has  ever  told  you  that  it's  your 
responsibility  to  keep  that ligament  clean.   Once  there's  a 
weakness in those self-cleansing areas below the level of the gum 
where  the hard and soft tissues join (it's called  the  sulcus) 
tooth  and  gum disease can begin.  If you are like most   other 
tooth brushers,  chances are you are just brushing with the ends 
of the bristles,  sliding the brush straight across the tops  and 
sides  of your teeth before you race madly off to work or school.  
This  means that you're missing not only the cracks  between  the 
teeth,  but  also you're not even getting near the sulcus. 
If you're wondering how well you're doing,  ask your dentist 
about "disclosing." He'll give you something to chew that will 
highlight the areas that you're missing.

Simple Steps to Home Dental Care

 Sulcus brushing (need funny head brush has only two rows of bristles.)
Ask  you dentist to give you  a sulcus brush or  a  multi-tufted 
brush.   This  small,  two-row brush is used without  toothpaste.  
Why?   Toothpaste  is  only necessary to taste good and give you a
flouride treatment.  Hold  the  brush  against the tooth at a 45  angle  
and gently  jiggle it so that the bristles go into the sulcus.  When  
your gum turns white,  you'll know you're here. Once the bristles 
are in the sulcus,  then brush up.   The action is easy:  gently 
jiggle, moving down on the uppers and up on the lowers.

 Sulcus    brush    is   important  for   three   reasons:     it  
disorganizes plaque  that settles in and causes the gums to bleed 
and the teeth to decay.  Brushing also stimulates saliva to  flow 
and  capillary  action causes your saliva to follow the  bristles  
down  into   the sulcus thereby neutralizing any toxin  that  may 
have  been  produced by the plaque and,   finally,   because  the 
bristles tend to push away from the teeth,  plaque is dislodged.  
The periodontal fibres that are responsible for  maintaining the 
tooth it's socket will tend to tighten up. (A person who has been  
sulcus  brushing will have gums that are so tight,   it  will  be  
difficult to get even the smallest  brush into the sulcus.    The 
average person,   on the other  hand,   usually has spongy, puffy 
gums  with  gaping spaces wide enough to run the INDY 500 in  ... 
well, almost.)

 Sulcus brushing is a very gentle, accurate process that requires 
practice.   Just  as  you can't play Beethoven concerto's  after 
your first  piano lesson,  so it takes some time to learn  where 
the sulci are and how to clean them.  Practice sulcus brushing 
without  a  mirror,  while  you're  watching  T.V.,  reading  or 
listening to the stereo.

 Some  tips:   It's  harder  to reach the  lower  inside  molars 
because the tongue is in the way.   One trick is to keep the heal 
and  toe  of  the brush level,  so that both are resting  in  the 
sulci.   Once  the brush is in place,  then use  a  systematic 
railroad brushing pattern:   start in the front of the tooth,  go 
all  around one side,  then all around the other.   Don't forget, 
it's  a  gentle,   probing  action.   Try  different  angles  and 
experiment while you're doing it.  Sulcus brushing, once you know 
how  to do it,  can be used as a stress breaker.   The action  is 
such that it can actually cause you to relax.

The world's greatest argh:  Flossing

 Chances are you hate to floss.   Every time you do it (which  is 
usually  just  before or just after a dentist  appointment...  on 
average about once or twice a year.) your gums bleed,  your teeth 
hurt,  you  become  all thumbs trying to get the floss  out  from 
between your teeth and then your mouth hurts all day.   Not  only 
that,  sometimes  you  end up with an infection that you  didn't 
have before flossing.  Sound familiar?

 Well,  we  hate to say it but all those problems belong  to  the 
infrequent flosser.  If you learn how to floss properly, and you 
do  it every day...your gums won't bleed,  your teeth won't hurt, 
you'll have no problem maneuvering that wily floss,  your  mouth 
won't  hurt,  and most importantly,  not only will you have fewer 
infections,  you'll  actually end up spending less time  at  the 
dentist's.    Now,   if  that's  not  incentive  enough  to  keep 
reading...

 The most important thing to understand about flossing is that it
is  really the only way to halt the havoc that is surreptitiously 
carrying  on  in your mouth.   Here is a truly  ghastly  analogy.  
Think  of a fork after a spaghetti dinner.   Imagine not  washing 
the  fork and instead just letting it sit somewhere  warm--in  an 
area  about the same temperature as your mouth.   The next  night 
that  fork  is used to eat stew.   Again it  is  left,  unwashed, 
somewhere warm.   The third night,  a casserole is served by that 
same fork.   And again, it is left to sit.  No one would use that 
fork  again, not only because it reeks but also because it  might 
spawn an attack of food poisoning.

 The  human mouth is not much different from that fork.   Between 
the teeth lie food,  bacteria and a pussy discharge called pyria.  
As  these build up,  the little pockets between your  teeth  grow 
into stagnating swamps.  As a matter of fact, if you added up all 
the  infected  areas  between  the  teeth,  you  would  have  the 
equivalent  of  two  six-inch  infected  wounds.   If  they  were 
anywhere  else  other  than in your mouth,  you would be  in  the 
hospital  with a fever.   Flossing is one way to clean  up  those 
swamps and to prevent them from reoccurring.

 Three  quarters  of the battle with flossing is learning how  to 
hold  it  properly.   And although there are  as  many  different 
methods  of  holding floss as there are people to hold  it,  some 
methods  are more effective than others.   One of the best is  to 
wrap the floss around the third finger.   Using this finger as  a 
kind of spool, you can unravel the floss as you use it.

 Where to floss 

 We  recommend a floss that is waxed and  shred-resistant.   This 
kind  is  great for beginners,  especially,  because it  is  less 
likely  to  shred.   Granted,  both good quality floss  and  poor 
quality floss will shred.  Here is why:  there may be a cavity at 
the  contact  point;   a filling may have a  slight  ledge;   the 
filling  may  have a slight overhang;   and/or there is  a  hard 
tartar  deposit on which the floss is catching.   If you know the 
points  at which your floss always snaps,  you can  identify  the 
spots  that need tour dentist's attention.   In the case of tartar;
it may be remover if it is subjected to the however, it may be 
removed if it is subjected to constant rubbing of floss.

 Place  the  floss  on the contact point between  two  teeth  and 
gently  seesaw  it back and forth to ease  the  floss  between the 
teeth  and  down to the gums.   Do not force the floss in to  the 
gums  because they are usually very tender when you  first  start 
flossing.

 Each tooth is surrounded by a sulcus.  Lay the floss gently down 
on the bottom of the sulcus and arc it around the tooth in a "c".  
Then move the floss away from the gum on both sides of the tooth.  
Because the gum crests between two adjoining teeth, when you have 
finished  one tooth come up a bit with the floss,  then move over 
and come down again to do the other tooth. 

 Learn to floss without using a mirror.   That way you are forced 
to  keep  your fingers close to the teeth,  which makes  flossing 
more accurate.   If the fingers are not kept close enough to  the 
teeth, the floss does not arc around the tooth properly, and this 
can lead to damage (of what?).

The magic of flossing

 Systematic  flossing  can actually halt cavities,  even if  they 
have  already  begun so that sometimes it is possible to  keep  a 
cavity on hold and not have it filled immediately.

 Make  sure  you know where your fillings are and  why  they  are 
there    Dental  work generally will not break down  if  you 
floss regularly.  More importantly, a tooth that has been flossed 
regularly   and  properly  actually  squeaks  from  having   been 
polished.  Cavities do not start on smooth, squeaky clean teeth.

Patient Oriented Oral Hygiene

 Starting  patient-centred oral hygiene in your practice  actually 
begins  with  you.   Since it's easier to communicate values  you 
believe  in and practice yourself,  you need to get y our  own 
mouth in order before you start teaching your patients about oral  
health.   Wait until you can honestly say "Look,  I  don't have 
any oral diseases at all. If you're interested, I'll show you how 
easy (and inexpensive) it is to put your mouth in the same  kind 
of  order" At that point your understanding of and empathy  for 
some  of the pitfalls your patients will experience when learning 
to brush and floss,  will enable you to convince them that it's 
worth their while to learn to take care of their own teeth.

Explaining how a mouth works

 The very first step in generating a healthy mouth is to explain 
the anatomy of the mouth and the way in which teeth are supported 
in the jaw.  Patients must first understand that any force put in 
the surface of the tooth is born initially by the  periodontal 
ligament  around  the tooth down into the  lower  jawbone, the 
stronger that ligament (and that jawbone) are,  the more pressure 
the  teeth can bear without popping.   (Telling people that  the 
average  denture  wearer can only apply a fraction of  the  force 
that  the average North American can is  often incentive  enough 
for people to keep as many of their teeth as possible.)

 You  know that keeping a healthy mouth starts with cleaning the 
areas around the base of the tooth where this ligament lies.   
Chances are,  however,  your patients do not know this fact.  You 
need to explain that tooth decay starts in the sulcus,  where the 
hard  and soft tissues join  Since that junction  is  below 
the level of the gum,  people have to be told where it is and how 
to clean it.  Probably most of your patients use only the ends of 
the bristles as they slide their brush straight across the tops 
and  sides of their teeth in a mad frenzy befor they race off  to 
work  or  school.   Some patients may be a bit more systematic, 
brushing  both back and forth and up and down,  but few  will  be 
getting  under  the  sulcus.   It's  a simple  matter  to  check. 
Disclosing takes the guess work away from everybody.

Teaching about dental care

 First,  give the person a sulcus or a multi-tufted  brush.   Ask 
the  patient to the brush on a 45 degree angle and gently  jiggle 
it so the bristles go into the sulcus.   Once the brush is in the 
sulcus, ask them to brush up.  The action is easy:  gently jiggle 
then  up  but  it requires practice.(reasons  it's  effective  in 
patient manual.) Once the patient has got the idea,  get him/her 
to  practice it without a mirror.   They can do it while watching 
TV,  reading or listening to music.   Once they know how to brush 
the  sulcus,  they  don't really have to think about  the  entire 
procedure.

note:  Make  sure they practice getting the brush into the  areas 
around  the  molars.   That area is trickier to  reach  since  the 
tongue is in the way.

Why floss?

 Most  patients  are sick and tired of being reminded  to  floss. 
That's  usually because they only do it just before coming in for 
a  dentist appointment or just after the appointment in a fit  of 
resolve.   And  because  they don't understand that  flossing  is 
really  the  only way to halt the havoc  that's  surreptitiously 
carrying on in the mouth,  they have no incentive to keep flossing when 
it's an awkward,  bloody,  messy and painful thing to do.  If you 
can  effectively  explain just  what  flossing  does,  and,  most 
importantly  that  if a patient continues to floss  his/her  gums 
will tighten up and the bleeding will stop, you'll have done them 
an enormous favour.

Learning about the warning signs

 A  patient  has to be taught the warning signs of poor teeth  or 
gum disease.  Few patients come into the office when they notice 
little red halos on their gums or because of occasional blood  on 
the  tooth  brush or because someone has told them they have  bad 
breath.   Usually  they wait until the damage has been  done:   a 
tooth  has fallen out,  decayed or broken off.   That's why  it's 
important  to make patients aware of the early signs  of  disease 
and show how they are linked not only to the teeth,  but also to 
the gum supporting structures.  A person with a healthy mouth has 
a  strong front-line resistance to infection and disease not only 
in the teeth and gums,  but also in the glands,  in the  digestive 
tract  and  even in the colon.   Good oral hygiene affects  teeth, 
gums,  alveolar (jaw) bone  the circulatory system,  the digestive 
system and the colon.  A healthy mouth gives a person a chance at 
overall health.