Moore Family Dentistry Blog

Garner Dentist Serving Patients From Cary, North Carolina and Surrounding Communities

February 06, 2012
Most people know at least one person that has had to get a dental filling, but what are they and why are they needed?

A dental filling is used to restore function to a tooth by filling in missing parts from, for example, a cavity or other external trauma.

Before a filling or restoration can be performed, the tooth needs to be prepared. This involves cutting the tooth with special dental tools (even sandblasting) to make room for the materials that will be used during restoration of the tooth.

This stage is referred to as a “tooth preparation”.

There are several materials that can be used to restore a tooth, including dental composites, resin-reinforced glass ionomers, porcelain, even gold.

How are Tooth Preparations Performed?

There are two types of tooth preparation: internal and external. Internal preparations, or Intracoronal, and external, or extracoronal. Intracoronal preparations hold restorative material, whatever it may be, within the structure of the tooth. That’s the type that we’re more interested in – a cavity filling. Once the hole is prepared to receive the filling, one of two types of restoration takes place: a direct restoration or an indirect restoration.

Direct Restoration: Quick and Painless

A direct restoration involves putting a soft filling into the tooth and then building the tooth up before the material sets. This restoration can be done in one procedure because it sets quickly, and the material must set while it’s in contact with the tooth. This procedure can usually be completed within an hour, depending upon how many teeth need to be treated this way.

Indirect Restoration: One, Two!

An indirect restoration usually requires two visits, as the restoration must be created outside the mouth and then attached with dental cement. The restoration is built using dental impressions of the tooth that would be made after preparing it to receive the filling.

More About Direct Fillings

The most-used material for direct fillings are white fillings, also called dental composites, and they are tooth-colored. The unfortunate part is that they are more prone to wear and discoloration than porcelain and metal restorations – they also are not as strong or durable.

Dental composites are resin-based, often made up of urethane dimethacrylate and silicon dioxide silica, though composition will vary. After the tooth is prepared, a thin glue is applied and then the composite is filled, layer by layer, with each being photo-polymerised via light. When everything is finished the surface is shaped and polished. This filling feels “sticky” against the other teeth when one is biting, but this feeling gradually fades as the restored tooth gets more use.

Fillings are Important!

If you have a cavity, you need to get a filling – it will prevent further damage to the insides of the tooth, re-build what you have lost, and protect exposed nerves by covering them up again.

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January 30, 2012
Have you heard of Temporomandibular Joint Syndrome? Do you know what the Temporomandibular Joint is? If you answered “No” to either of these questions, keep reading!

The TMJ is what connects the lower jaw to the skull: this is the joint just in front of the ear, and there are two on every person’s face. It’s made up of a powerful set of muscless, the blood vessels that feed them, many nerves, and the bones that are powered by the previously mentioned muscles. These muscles are what power every person’s chewing, they open and close the mouth when we talk, they can rotate the jawbone – in other words, they do a lot of work!

Place your fingers just below your ear and open your mouth and you will feel the TMJ at work. Your lower jaw’s rounded ends move along the joint socket of your skull, then move back into place when your mouth is closed. What keeps this motion smooth? A small, soft disc of cartilage that sits between the rounded ends of the lower jaw – the condoyles – and the skull.

What is TMJ Syndrome?

TMJ Syndrome itself is a pain in the jaw joint, which is often a harbinger of other medical problems. There are many potential causes ranging from age to disease, trauma to habit.

Types of Trauma

The following traumas can lead to TMJ Syndrome:

  • jaw clenching
  • bruxism (grinding of the teeth)
  • impact from an accident or fight
  • having the jaw stretched open for extended periods of time (such as during dental work)

Arthritis and TMJ

Arthritis due to aging or disease can break the joint down, cause cartilage loss, among other issues relating to this particular problem.

Symptoms of TMJ and When to Seek Treatment

TMJ Syndrome causes pain in the muscles of the face and jaw joints, which may also be felt in the neck or shoulders. This pain could lead to headaches or migraines, and be present while eating, talking, even yawning. You may experience pain in your ears, hearing loss, even tinnitus (which is ringing in the ears).

Look out for facial swelling, awkward jaw opening, and listen for clicking or popping when the joints move. Swallowing may also be difficult.

If you experience these symptoms, seek the aid of a dental professional.

What is Involved in TMJ Treatment?

In non-invasive therapy, the patient will have to give their jaw some rest. Warm compresses will be applied and the patient will be given pain medication. Hard candy, chewy foods and gum need to be avoided and the patient will have to stick to a diet of soft food until treatment is complete. A splint or bite plate may be required (it’s a plastic guard that fits over the teeth and helps with reducing clenching and bruxism).

More invasive techniques include using needles to wash the TMJ out. In this procedure, one needle is filled with a cleaning solution and the other needle removes said solution from the body. Pain medication can be delivered in the same manner.

Surgery is a last resort and can be used to replace jaw joints with implants. This is not recommended.

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January 23, 2012
Cosmetic dentistry is made up of services that are used to improve the look of the teeth or gums, but not necessarily the health or function. Cosmetic dentistry is not recognized as a specialty dentistry area by the American Dental Association.

What Are Common Cosmetic Dentistry Options?

  • Bonding, in which a dental composite is applied to the surface of the tooth, sculpted, hardened, and then polished to improve the look of the original tooth.
  • Whitening, the most common procedure, which lightens the color of teeth to help improve their appearance.
  • Reshaping, where parts of tooth enamel are removed to improve tooth appearance. It can be used to correct a chip or alter the shape, position or length of teeth. If a tooth is crooked, this procedure can help correct this problem. Unfortunately enamel cannot be replaced and its removal may expose dentin. Reshaping is occasionally used as a braces substitute and is known by a few other names: odontoplasty, contouring, recontouring, enameloplasty, and sculpting.
  • Veneers are thin, custom porcelain laminates that get bonded right to the teeth and are used to close gaps and disguise discoloured teeth that can’t otherwise be whitened.
  • Bite reclamation, used to open up a patient’s bite, reclaim vertical dimension and get rid of unwanted wrinkles. Excessive wear to the teeth from grinding or acid reflux can have an impact on vertical dimension.
  • Gum lifts sculpt and raise the gum line and involve reshaping of bones and tissue to help create the appearance of symmetrical, or longer, teeth.
  • Dental bridges, or false teeth, are fused between porcelain crowns to fill in the space left by a missing tooth or several missing teeth. A bridge can’t be taken out like dentures can.

Cosmetic Dentistry Credentials

In order to be recognized as a specialist by the American Dental Association, a minimum of 2-3 years of education is required after the professional finishes dental school.

Why Cosmetic Dentistry?

Cosmetic dentistry is for people that are not happy with their smile and want to improve how it looks, or who have suffered damage to their mouth – from an automobile accident, for example – and need to have their smile restored.

These procedures are not performed to improve oral health, though they can contribute to the mental health of some individuals by helping improve the patient’s self esteem and confidence. Self esteem is directly linked to a person’s view of themselves – if they aren’t happy with how they look, self esteem drops. If they are happy with how they look, self esteem goes up.

Is Cosmetic Dentistry Expensive?

Cosmetic dentistry can be expensive, depending upon the procedure. Always check with your dentist and ask plenty of questions before deciding to pursue a procedure, and make sure you are prepared for all of the costs that may be associated with it. Depending on the reasons for undergoing a cosmetic dentistry procedure, there may be financial assistance available, especially if the work is being done to repair damage caused by some form of trauma.

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January 16, 2012
When Veneers were invented by a dentist in California, their main use was for temporarily changing the appearance of an actor’s teeth for the film industry. Since they were held on by denture adhesive, they fell off after a short while, but it was discovered – thanks to some research that was started in 1982 – that composite resins could be used to bond porcelain veneers to a tooth forever.

Present-day veneers can last for up to thirty years.

For cosmetic dentists, veneers are important tools; a single veneer can restore a damaged or discolored tooth, or a patient’s entire smile to give them a look straight out of Hollywood. Veneers can give teeth a uniform look, fill in spaces and restore color lost by age and lifestyle choices.

Unfortunately, these are often overused in situations where they are not needed. Be sure to thoroughly consult with your dentist – there may be another, permanent and cheaper fix for your tooth problems.

Alternatives to Veneers

Today, there are many alternatives to veneers, including crowns, composite resin bonding, cosmetic contouring or orthodontics. Veneers that aren’t permanent can also be obtained – they’re moulded to your teeth and are made from resin instead of porcelain. They can be removed and re-used!

How Are Veneers Applied?

When you first visit your dentist, they may give you a local anesthetic before they remove a portion of the enamel from your teeth. This is done to ensure that there’s enough room for the veneers. The dentist will then make an impression of your teeth, which is sent to the dental lab so the veneers can be made. When they are finished, they are sent to your dentist.

In another visit, a mild chemical is applied to the teeth to roughen them up – this way, the veneers will stick to the teeth without any extra steps. Once that step is complete, the veneers are attached to each tooth using a resin cement.

How Do Veneers Handle Stains?

They don’t. That is, they resist stains and discoloration. Since porcelain is rather glass-like, it doesn’t stain.

The Care and Feeding of Veneers

Like your teeth themselves, your veneers will require proper cleaning on a regular basis. Brush with a non-abrasive toothpaste and floss regularly. Try to avoid biting your nails or other hard objects, and avoid impacts (if at all possible). Even though the veneer itself will not stain, the cement holding it will, so you’ll have to keep an eye on the edges of your teeth.

Avoid clenching or grinding your teeth, too. If you do this while sleeping, talk with your dentist to see what preventative measures can be taken.

Problems With Veneers

It is possible for veneers to break or otherwise come off, and if that happens, the dentist will have to create a new veneer for you (though, if it just fell off and is in decent shape, the veneer can simply be bonded back into place).

Veneers can’t be placed on teeth that are decayed or involved with gum disease, so you will have to get those conditions treated before you can have a veneer put into place. They will not strengthen your teeth, either, and teeth that have lost most of their structure should probably have a crown placed on them instead.

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January 09, 2012
About Dental Services

Dentists provide a large variety of dental services that are important to maintaining a healthy mouth. What are some common dental services, how do they help, and how can you find out more about the services that your dentist provides?

Cleaning and Dental Hygiene

Dentists have specialty tools and materials that go far beyond the toothbrush. These tools, pastes, and other materials are used to clean your teeth, diagnose any issues that may be present in your smile, such as developing or existing cavities. A professional cleaning is a tool in itself – the dentist can thoroughly examine your teeth and figure out what else you can do to contribute to your oral health.

It is important to schedule regular cleanings, if nothing else, for the insight they can provide to your health and the fact that the dentist can use this opportunity to catch developing issues before they become a big deal – like gingivitis.

Extractions

Sometimes, unhealthy teeth need to be removed, or a loose tooth refuses to let go. Your dentist can remove problem teeth in a single visit, with local or general anaesthetic (depending on your preferences and what options are available). Your dentist can then prepare you for implants, if needed, to keep your smile pristine.

Braces or Invisalign

Teeth that are twisted, have large gaps between them, or similar problems can lead to greater issues in the future and your dentist can help correct them before they get worse. Teeth get eased into line over a period of time, easing crowded teeth and leading toward a more natural chewing experience.

Education

Your dentist can teach you about keeping your mouth healthy. If you have concerns about your oral health, including how to keep your teeth clean and cavity-free, your dentist can teach you what to do and how to do it. All you need to do is ask. During a check-up, as mentioned above, your dentist can also point out problem areas and tell you how to deal with them. Knowledge is power, and dentists have plenty of if to provide.

On that note, some dentist offices have educational materials for children that you can take to your own kids, if you have any, or to students and friends. Share the dental love!

How Do I Find Out About My Dentist’s Services?

Most dental offices also have a website that you can visit, which will give an overview of the services that the office offers, as well as providing contact information and all you need to know about the office. If the office doesn’t have a website then front desk staff can answer any questions that you may have about the dentistry services that may be available. Some may have pamphlets and other literature that you can take home and share with your family and friends.

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December 01, 2011
What are “wisdom teeth”?

Your wisdom teeth are the four molars at the very back of your mouth that often grow in between the ages of 17 and 25. Since human mouths have evolved to be smaller than they were at one time, many people don’t have room for their wisdom teeth, and they don’t come in properly – they become impacted, which means they come in sideways and have to be removed.

Wisdom Tooth Impaction

There are four types of impaction:

  • Mesioangular is when the tooth is tilted forward, toward the front of the mouth.
  • Vertical is when the tooth doesn’t fully erupt through the gum line.
  • Distoangular is when the tooth is tilted backward.
  • Horizontal is when the tooth is angled ninety degrees sideways and grows into the roots of the molar next to it. Thankfully, this is the least common form of impaction.

Mesioangular impactions are harder to extract from the upper jaw, but easiest to extract from the lower jaw, while distoangular impactions are actually the opposite. Impactions can also be classified by whether or not they’re completely encased in the jawbone – if they are, they’re referred to as a “bony impaction”. If they have erupted from the bone but not the gumline, they’re called a “soft tissue impaction”.

History Time: The Oldest Impacted Wisdom Tooth

As far as we know, the oldest impacted wisdom tooth belonged to a European woman from somewhere between 18,000-10,000 BCE.

Why Are Wisdom Teeth Extracted?

Usually a wisdom tooth (or multiple teeth) will be extracted because it’s impacted or could cause problems in the near future. Wisdom teeth that have grown in properly can cause infections, too. How? Sometimes food particles get behind the teeth at the very back where it’s difficult to brush or clean. Misalignment that causes teeth to brush against the tongue or cheek, which causes pain, is also a problem that causes these teeth to be removed.

What Are the Side Effects of Tooth Extraction?

After a wisdom tooth has been extracted, there will sometimes be bleeding and oozing. This is totally normal and should last for up to three days. It’s a bad idea to rinse your mouth during this time because that can actually wash blood clots – which stop the bleeding and help the wound heal – away, and we don’t want that.

A dry socket can sometimes occur, too, which is caused by blood clots being dislodged, falling out before they should or just failing to form. A dry socket can also be caused by smoking, blowing your nose, spitting, drinking with a straw, among other things. This will often heal on its own.

Swelling, not to be confused with a dry socket, will also occasionally happen, as can nerve injury.

Always make an appointment for a few days after your surgery so that the surgeon can make sure everything is progressing as it should be! If you are ever concerned, bring it up with your dentist, they can put your mind at ease and make sure that any extra treatment is given if needed.

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November 25, 2011
Halitosis, also referred to as “bad breath”, is a minor health issue in the scheme of things, but deemed so important by people that it keeps the gum, breath spray and mouthwash industries afloat since we spend millions of dollars each year on these products.

What Causes Halitosis?

You’re probably familiar with garlic breath. Well, garlic does contribute to bad breath, as do several other foods, like onions, fish, and any diet rich in fats and meat. Digestion of these foods releases various chemicals that are carried through the bloodstream to the lungs where they are released in our breath. Scary, isn’t it?

Did you also know that, when proteins in the body are broken down for energy, the byproducts of that breakdown are also released through the lungs – so if you’ve missed some meals, are hungry, fasting or on a low-calorie diet, someone could figure that out by smelling your breath!

Smoking, alcohol, gum disease, various infections, pregnancy, various diseases and a lack of oral hygiene can also cause bad breath, as can some medications.

Some People Don’t Even Know They HAVE Halitosis!

Your nose actually gets used to bad smells if it is constantly exposed to them, so if you actually have halitosis, there’s a good chance that you have no idea. You might have to be told, or you might have to watch the reactions of other people when you talk to them! If you didn’t think this was an awkward condition before, well…

Treating Halitosis

As mentioned before, there are lots of gum, spray and mouthwash options out there that provide temporary bad breath relief – but the key word there is ‘temporary’. The most effective way to treat bad breath is to properly care for your mouth! Brush, floss and rinse regularly – don’t forget to brush your tongue, too.

Other ways to get rid of bad breath include:

  • eat regularly! Skipping meals contributes to bad breath. Three small meals per day with a snack between each meal will help keep you feeling full – high protein and fibre intake is important for this!
  • get a cleaning system recommendation from your dentist to give you a more thorough cleaning than what your toothbrush can provide.
  • eat fibrous foods. Chewing herbs like parsley and wintergreen stimulates saliva flow, as does drinking acidic fruit juices or eating acidic fruits like citrus.
  • drink plenty of water – eight glasses per day. More water means more saliva flow, which means more bacteria getting washed away.
  • don’t drink so much alcohol or coffee. Replace some of it with that water you should be drinking!
  • check with your doctor regarding any medications you’re taking – some of them may contribute to bad breath (including antidepressants and birth control)

Trivia

Halitosis is not a new problem. There are records from 1550 BCE detailing cases of halitosis, and one mentioned remedy from such records was a mouthwash made of wine and herbs. Unfortunately I would imagine such a mouthwash, due to the alcohol content, would make things worse – but it would hopefully taste good, at least.

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November 18, 2011
Gum disease, also known as gingivitis, is an inflammation of the gums. It’s a type of periodontal disease, which involves inflammation and/or infection which destroys your teeth’s supporting tissues – gums, ligaments and tooth sockets.

What Causes Gum Disease?

Gum disease is, simply put, caused by plaque deposits. Plaque is a sticky substance made of bacteria, mucus and the remains of what we eat every day; this nasty stuff develops on the exposed parts of our teeth and is a major cause of tooth decay. If plaque isn’t removed, it hardens into tartar and becomes trapped on the base of the affected tooth. Both plaque and tartar can inflame the gums; bacteria and their toxins cause infection of the gums, as well as making them swollen and tender.

Illness, bad dental hygiene, pregnancy and diabetes can increase one’s risk of developing gum disease. Other risk factors include irritation caused by misaligned teeth, rough filling edges, ill-fitting/unclean mouth appliances (e.g. braces, dentures, bridges, crowns).

Symptoms of Gum Disease

If your gums are bleeding, they appear red or purple-red, are tender, swollen or shiny and if you have mouth sores, you most likely have gum disease and ought to get to the dentist as soon as possible.

Your dentist will examine your mouth and teeth to look for swollen, discolored gums and plaque/tartar deposits. They will not usually need to do any more testing, though they might take some x-rays and dental bone measurements may be taken to find out if the swelling has spread to your teeth’s supporting structures.

Treatment of Gum Disease

In order to treat gum disease, your teeth will be cleaned thoroughly which may require a bit of poking and prodding to get rid of stubborn deposits of plaque and tartar. The goal here is to get rid of the stuff that’s irritating your gums so that they’ll be able to recover. After the cleaning, you will have to continue a regimen of careful oral hygiene – if you aren’t sure how to brush and floss properly, ask your dentist to teach you. You’ll need to use an antibacterial mouth rinse on top of your recommended brushing and flossing in order to keep on top of this disease.

Other recommended steps include repairing problem teeth and/or replacing any orthodontic appliances that might be contributing to the development of gingivitis. You can try rinsing with warm salt water to reduce swelling after having professional cleaning done, too, and I would recommend picking up an over-the-counter painkiller and/or anti-inflammatory medication, just in case.

Preventing Gum Disease

The best way to prevent gum disease is to practice good oral hygiene. There’s no replacement for daily brushing and flossing, and certainly nothing better than that combined with having a healthy diet. If you have trouble with brushing your teeth, purchase an electric toothbrush – they can get into places and have movement that a regular toothbrush just can’t compete with.

Anti-plaque and anti-tartar toothpastes are currently on the market that help with the battle against gum disease. Pick one up and add it to your oral care regimen.

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November 11, 2011
That sharp, needle-like pain when something cold or something hot touches your teeth – that actually has a cause. It’s not something that only you have, many people around the world suffer from tooth sensitivity, but what causes it and what can be done to ease the pain?

Wear, Tear and Recession

When your gums recede, that exposes the dentin in your teeth. Dentin contains lots of microscopic tubules which lead right to the nerve center of your tooth – thus, when something hot or cold hits the exposed dentin? WHAM! Pain. Not pleasant at all.

Acid wear, the wearing away of your teeth’s protective enamel, also exposes the dentin to everything. Acidic fruits and fruit juices, wine, carbonated drinks and vinegar-based dressings soften tooth enamel and make it more susceptible to every day wear and tear.

Sensitivity Triggers

What triggers your sensitive teeth may be different from other people, but some common things are cold foods and drinks like water, ice cream, ice cubes and Popsicles; hot foods and drinks like soup and coffee; sweets like chocolate; breathing in cold air and brushing your teeth (especially if you rinse with cold water).

What triggers your sensitive teeth may not trigger another person’s! Pay close attention to your own triggers so that you’re better prepared for dealing with them.

Preventing Sensitivity

Using a soft tooth brush and only using moderate pressure when brushing can help prevent tooth sensitivity. Brushing and flossing correctly are key.

Treating Sensitivity

A fluoride rinse may help decrease sensitivity, especially if yours is caused by tooth decay. A desensitising toothpaste can also help – they fill in the tubules in your dentin and reduce sensitivity that way. I suggest applying the toothpaste at night directly to your teeth. Leave it on overnight, then brush normally in the morning (be sure to brush before you do this).

Other common at-home treatments are:

  • potassium salts
  • chewing gums
  • mouthwashes

Dental Office Treatments for Tooth Sensitivity

Your dentist may recommend special in-office treatments for dealing with your sensitive teeth. Ask them what they recommend, of course, and go with what you can afford. You may find that they simply recommend something that you can do at home and that doesn’t need to be done in the office – it all depends upon how severe your tooth sensitivity is.

  • dental sealants are fillings that are put over the exposed root(s)
  • night guard/retainer: if tooth grinding is causing sensitivity, you may be given one of these to wear.
  • fluoride treatments
  • laser therapy

Is Tooth Sensitivity a Sign of Something Bad?

Tooth sensitivity may be a sign of an underlying problem, such as gum disease. If one tooth is constantly sensitive (and only one tooth), that could be a harbinger of infected tooth pulp or a dying tooth. If desensitizing toothpaste doesn’t help after two weeks of constant use, if your teeth hurt for more than an hour, if the gums around a sensitive tooth change color and if you have very obvious dental decay, you need to go see your dentist. Something more serious is happening, and putting off the visit could be very, very bad for your smile.

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November 04, 2011
Fluoride is something you may know of from stories about it being in the drinking water (in many places, this is true) – but what is it, really? This substance is a mineral that’s found in the earth’s crust, soil, water (fresh and salt) and some foods. It helps prevent tooth decay by making your teeth more resistant to it, and it can even reverse tooth decay that has already started.

This stuff is readily available in toothpastes and rinses that you can buy at any grocery or corner store and your dentist can also provide professional gels and varnishes, if you’re into that sort of thing.

How Fluoride Works

Fluoride gets into growing bones and teeth of children, which helps harden enamel on teeth before they emerge. It also works during de-and-re-mineralization process that happen naturally in the mouth. What’s demineralization? Well, after you eat, the acids in your saliva cause calcium and phosphorous that’s located under the tooth’s surface to dissolve. When saliva isn’t quite so acidic, the calcium and phosphorous are replenished. When there’s fluoride in the mix, the minerals are harder than they normally would be.

On the Flipside: Dental Fluorosis

What is Dental Fluorosis? It’s a change in the appearance of teeth. When you are taking in or using too much fluoride, often in early childhood, this is what happens. In its most common form, the teeth get small white specks on them.

About Water Fluoridation

When the level of fluoride in public drinking water is adjusted and/or increased, that’s dental fluoridation. Why is this done? Fluoride levels in drinking water are increased to help prevent community tooth decay instead of relying on the people to make use of the mineral on their own.

Aside from Dental Fluorosis, there are no health risks associated with water fluoridation.

Further Benefits of Fluoride

Not only does fluoride help protect against tooth decay, it repairs weak spots on tooth surfaces that could turn into cavities which, in turn, reduces the amount of money that people need to spend on dental care. It helps reduce pain and discomfort that tooth decay causes, including permanent tooth damage and tooth abscesses that are caused by tooth decay.

How You Know When You’re Getting Enough Fluoride

Is your drinking water fluoridated? Do you brush with a fluoride toothpaste? Then you’re getting enough fluoride. If your community does not have a fluoridated water source and doesn’t have much natural fluoride in it, your dentist might prescribe extra fluoride for you and your family. Check with your dentist to be absolutely sure.

Fluoride is Not the Be All and End All of Tooth Protection, However.

On top of brushing with fluoride toothpastes, using fluoride mouthwash and flossing regularly, there are other things that can help keep your teeth healthy. By having a healthy diet (more whole grains, fruits and vegetables, less processed stuff and sweets) and making regular dental visits, you can help make sure that you’ll always have healthy teeth.

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