You can't walk down a toothpaste aisle or scroll through your social media feed without seeing ads for charcoal toothpaste. It started off in natural oral care product lines as an alternative to traditional whitening products. It quickly became popular and the more mainstream companies jumped on the wagon. So, how do they work and is it worth all of the hype...and the potential mess?

Charcoal toothpastes contain activated charcoal. Activated charcoal is a form of carbon that has been treated to make it's surface rough and porous. The rough surface scrubs stains away while the porous areas attract and grab onto the particles that have been removed from the tooth's surface. Charcoal toothpastes work well on surface level extrinsic stains, but they do not have the ability to change intrinsic stains. Most product comparisons show that charcoal toothpastes are more effective than other popular whitening toothpastes at removing stains. The high efficacy comes from the abrasiveness of the activated charcoal. It is important to use charcoal toothpastes sparingly and not more than 1-2 times per week. If used too often, the abrasiveness of activated charcoal can cause irreversible tooth damage and sensitivity. Bottom Line: Charcoal toothpaste is safe/effective when used sparingly.

There are two types of tooth stain, extrinsic and intrinsic. Extrinsic stains are those that sit on the surface of the tooth. These stains are typically caused by food and drinks such as coffee, tea, wine, and berries. Extrinsic stains are not incorporated into the tooth structure, therefore they can typically be removed by brushing and/or by your hygienist during your professional dental cleaning. Intrinsic stains are those that have become incorporated into the actual tooth structure. These stains can also be caused by food and drinks, as well as medication and some health conditions. Intrinsic stains cannot be removed by brushing or scaling done by your dental hygienist. Intrinsic stains require bleaching procedures to be lightened and removed.

Oral Cancer 2019

April is Oral Cancer Awareness Month. This month, we shine the light on cancers that invade the lips, mouth, and throat. No one wants to think about oral cancer, but knowledge is power and it just may save you or someone you love. #oralcancerawareness2019 #savealife #themoreyouknow

1. More than 53,000 people in the United States will be diagnosed with oral cancer in 2019. That number is rising 3% each year. Over half a million cases will be diagnosed worldwide this year.
2. Most oral cancers have around a 60% five year survival rate, depending on the stage at diagnosis. Nearly 10,000 Americans will lose their battle with oral cancer this year as it kills one person every hour in the United States alone.
3. Oral cancer is more common in men than women and in people over 40, however, the fastest growing group of new oral cancer diagnoses is made up of healthy, non-smoking people under 45.
4. Tobacco use (including cigarettes, chew/snuff, and vaping), alcohol use, and a diet low in fruits/vegetables all increase your oral cancer risk.
5. When you combine tobacco with heavy alcohol use, your risk is significantly increased, as the two work synergistically. Those who use tobacco products and drink have a 15 times greater risk of developing oral cancer compared those who don't.
6. The Human Papilloma Virus (specifically HPV16) is the most common cause of oral cancer in people under 45. HPV16 is transmitted through bodily fluids and is the same viral strain that is associated with cervical cancer.
7. Like with most other cancers, oral cancer outcomes are best when it is detected and diagnosed in the earliest stages.
8. Oral cancer lesions can be painless and seem unnoticeable in early stages. The most common sign/symptom is a red or white patch, sometimes similar to a canker sore, that will not heal.
   Other symptoms include; a painless lump or mass which can be felt inside the mouth or neck, pain or difficulty in swallowing, speaking, or chewing, any wart-like masses, hoarseness which lasts for a long time, or numbness in the oral/facial region.
9. Treatment options depend on location and stage of the cancer but typically involve a multidisciplinary approach between your general dentist, an oral surgeon, as well as medical doctors. Surgery, radiation, and chemotherapy are often needed in conjunction with lifestyle changes.
10. Information on oral cancer can be scary and overwhelming. The good news is that preforming regular self checks and having routine dental exams at least twice a year greatly increases the chance of finding oral cancer in the earliest stages, which typically leads to the best possible outcome.

For more in depth information on oral cancer, click here:

In a world of different toothpastes, what do 9 out of 10 dentists recommend? Why is there always one practitioner that never agrees with the group? Which toothpaste do they pick?

First, let’s look at what makes up a tube of toothpaste. Most contain mild abrasives, stannous fluoride, glycerol like substances, flavoring agents, sodium lauryl sulfate, water, phosphate, and other inactive ingredients.[1] The goal of combining these ingredients is to reduce the formation of biofilm. The biofilm that forms over teeth is made up of food particles, bacteria, and substrates in your saliva. Formation of this film allows bacteria to form a home on the surface of your tooth. Without mechanical removal this film will continue to grow and can cause cavities[2].

It is very important to look at which ingredients make up the toothpaste you use. Many patients exhibit allergic reactions to sodium lauryl sulfate and require a toothpaste free of this ingredient. The ingredients added to increase water retention vary between products as well as the ingredients to create a mild abrasive.

I believe that the best toothpaste is based on individual preference, effectiveness, and use. Many patients dislike the taste of certain brands. Others feel their mouth is not as clean with different flavors. To find the “perfect” toothpaste one should look at ingredients, but most importantly one should be using a toothpaste that will encourage brushing for two minutes twice a day.

[1] http://www.ada.org/en/science-research/ada-seal-of-acceptance/product-category-information/toothpaste[2] Action of food preservatives on 14-days dental biofilm formation, biofilm vitality and biofilm-derived enamel demineralisation in situ. Arweiler et al. German Society of Dental, Oral and Craniomandibular Sciences. 02 Aug 2013

...That is the question!

You know how to get people talking about flossing?  Publish a report that tells them that they don't have to floss! Over the past month we have had more people bring up the subject of flossing than we have over the past year!  So let's break it on down...no I don't mean MC Hammer style!

Many, many moons ago in 1819 a New Orleans dentist by the name of Spear Parmly published a book called A Practical Guide to the Management of Teeth. Dr. Parmly recommended interproximal flossing with waxed silk to dislodge food particles and bacteria.  He noticed a difference in patients who regularly removed plaque that was not accessible by tooth brushing alone and wanted to share his fancy findings with the world! Not long after that, Johnson and Johnson patented the first dental floss product. A dozen packs of floss for $1.50! Jiminy Cricket, who can beat that!?!

In 1979 the US Government added flossing into the Surgeon General's Report for Healthy Living, and later, into the Dietary Guidelines for Americans. Recommendations in these reports are required by law to be backed by evidence-based scientific research. Hygienists everywhere jumped for joy and spread floss samples to the masses!  Less gingivitis! Less bad breath! Less bleeding, less cavities, more teeth saved by prevention! Hooray!

Last year, the Associated Press (AP) asked the Health and Human Services and Agriculture for the evidence behind the recommendation, then later submitted written requests under the Freedom of Information Act. The AP looked at the flossing research that spanned the last 25 years and concluded that it was "weak, somewhat unreliable, and had a moderate potential for bias".  The US Government removed the flossing recommendation for the time being until current evidence-based research is available.

So what does this all mean?  I welcome you to listen to the perspective of someone who is elbow deep in plaque, calculus, and gum disease daily...your hygienist!  There is ABSOLUTELY a difference in the oral health of those who floss versus those who do not.  Even the best toothbrushers in the world do not compare to those who floss with proper technique on a daily basis. Hands down, people who floss have less inflammation (which deserves a blog post all it's own!), less cavities, better breath, and better overall oral health. Believe it or not, we can actually tell if you are flossing or just telling us that you are.  Wink, wink...don't fib to your hygienist! If it didn't make a difference, we wouldn't be able to easily pick out flossers from non-flossers. 

Still need your own proof?  Here is the challenge! Don't floss for 10 days.  Yes, you just heard a hygienist tell you not to floss for 10 days!  Brush, use mouthwash, whatever floats your boat, just no floss.  On the eleventh day, floss!  Make sure you get each surface and reach below the gum tissue. Look at the floss after each tooth.  If you really want proof, smell the floss after each tooth.  That, my friends, is the bacteria that has been globbing together and setting up camp between your teeth and under your gums.  Notice that some places may bleed, that is from inflammation that has set in.  If left to work it's magic, the bacteria will produce enough acid to cause a hole in the tooth.  That's right folks, a good 'ol cavity!  The bacteria gets into your bloodstream and stirs up inflammation around the rest of your body. All of this can be prevented with something that is cheap, fast, and easy! 

The answer to the pressing question...YES, floss.  Although, we do love spending time with you.  If you want to hangout with us more often, try the non-flossing route! Until next time, happy flossing!