Preventive Dentistry #4: Professional Dental Care

Doctor's Insight.

The key to preventing gum disease and tooth decay is daily at-home dental care.

However, at-home care has its limitations and even if you brush your teeth as recommended, you may still lose your teeth due to gum disease or tooth decay.

So what should you do?

Take a look at this data.

Beginning in 1972, a 30-year clinical study was conducted in Sweden that looked at the survival rate of teeth in adults.

First, the average number of teeth was counted in a group of 550 people between the ages of 30 and 50.

Then, after 30 years, the number of teeth was counted in the same group and they were found to have lost an average of only 0.6 teeth.

The number of cases of tooth loss had been drastically reduced.

This astounding result was achieved through taking a certain action in addition to proper at-home care.

The data from Sweden we just saw is astonishing.

It tells you how very few people lose their teeth.

So what is the secret to keeping healthy teeth?

The secret lies in getting professional care from dental hygienists.

This long-term study shows that 97.7% of teeth can be protected with the help of a professional, a dental hygienist.

So how does professional care help prevent gum disease and tooth decay?

It involves more than just getting your teeth cleaned!

Today's expert is assistant professor Adachi Naoko from Tokyo Medical and Dental University.

Professor Adachi is a dental hygienist and also conducts research on preventive dental care.

Dr. Adachi, welcome back to our show!

Thank you for having me.

Professional care involves more than just getting your teeth checked.

Yes, exactly.

In order to be able to keep eating well, it's essential to receive professional care from a dental hygienist.

This care can help prevent not only gum disease and tooth decay, but also diseases in other parts of your body.

That's why we encourage people to visit their dental office routinely.

Now, let's find out what exactly is involved in professional care.

Professional care you receive during a dental checkup starts with questions about your lifestyle and at-home dental care.

Then, you get your teeth cleaned and receive instructions on proper brushing.

In addition, depending on your condition, you may also get advice on how to stimulate saliva production or how to make improvements in your daily life,

such as addressing Tooth Contact Habit or TCH, which may cause gum disease to worsen.

The first step is to gather information.

You will be asked to provide information on dietary habits, brushing habits, and tools used for brushing, all of which are relevant to dental caries and gum disease.

Next, they will check for dental plaque.

A disclosing tablet will be used to stain any plaque left on your teeth.

The purple stains are areas that have not been brushed properly.

Using the results, you will receive instructions on how to properly brush your teeth.

Here, it is effective if patients bring their own toothbrush they normally use at home.

For patients with much plaque, the dentist or dental hygienist may recommend other tools besides toothbrushes to effectively control plaque.

Next is cleaning.

An ultrasonic scaler is used to remove tartar that cannot be removed with regular brushing.

In the next step, the surface of the teeth is cleaned with a polisher using fluoride-containing toothpaste.

Finally, dental floss is used to remove plaque between the teeth.

I now understand that it's really important to get rid of tartar during cleaning.

Yes. Plaque, a sticky film made up of bacteria, eventually hardens into tartar.

There are two types of tartar.

One forms on the gum line and the other adheres to the tooth's surface inside the gum pocket.

Both types are difficult to remove with at-home dental care.

If they are left untreated, gums around the tartar buildup become inflamed, which worsens gum disease.

In Japan, manual dental scalers are available at drug stores.

Should we use one, if we want to get rid of tartar?

No, I would not recommend it.

A dental scaler has a blade and it can damage the gums and mucous membrane, or scratch the surface of the teeth, making people more prone to plaque and tartar.

That doesn't sound good.

If tartar builds up, it's time to get professional care.

Tartar removal using scalers should be done by a dental professional.

The brushes used by dental professionals...

do those remove tartar as well?

No. They are called polishers and are used to polish the surface of the teeth.

Dental surface cleaning can also remove cigarette tar and discoloration such as wine or coffee stains.

I understand that they use toothpaste that contains fluoride.

How are they effective?

Fluoride toothpaste strengthens the teeth, which increases the effectiveness of preventing tooth decay.

Some dentists may finish with gel or foam fluoride that sinks into your teeth.

What are other things that are involved with professional care?

People who have taken prior testing, that are known to have low saliva production, will be given advice such as staying hydrated, chewing food more often, and chewing gum to stimulate saliva production.

I see. How is saliva related to prevention?

Saliva has antibacterial and cleansing properties, which is said to reduce the risk of gum disease and plays a particularly important role in the prevention of tooth decay.

Saliva neutralizes the acid produced by caries bacteria and prevents teeth from breaking down.

It also has the ability to restore the dissolved minerals back to the teeth in the early stages of dental caries.

The amount of saliva secretion decreases with age, but this could be made up for by following such advice.

There are so many steps we can take for preventive care.

That's right.

Some patients exhibit TCH, tooth contact habit, in which the upper and lower teeth are in constant contact.

TCH can lead to Temporomandibular Joint, or TMJ, a disorder in which the jaw hurts to the point where you cannot open your mouth.

And, if you cannot open your mouth wide enough to be able to brush your teeth daily, your dentist can provide you with advice on how to remedy the problem.

Please tell me what we should do if we find out we have TCH.

Pay close attention to your motions and consciously separate your teeth and relax.

It's a good idea to post notes, for instance, "drop your jaw" to remind yourself in your daily life.

You can also set a reminder on your smartphone to relax your jaw.

Some people find that this alone could work in about one to two weeks.

Now I understand the importance of getting routine dental checkups and following the personalized advice in my daily life.

On the other hand, I have a feeling it would be hard to stay motivated and continue at-home care.

Is there anything to help keep our motivation?

Now, an increasing number of dentists in Japan are adopting cloud services that connect them to the patients, to solve such issues.

Patients can check the results of their dental checkups online anytime they want.

They can also view the details of the advice they got from their dental hygienist, so it's okay if they can't remember everything they heard during their previous visit.

That sounds great.

If we can see that our condition is improving with each visit, that would be very satisfying.

Yes. Keeping patients aware is one of the issues we have in preventive dentistry.

One way to maintain your motivation may be to choose a dentist who offers such services.

I really agree.

And finally, do you have any messages for our viewers before we wrap up?

Dental health is maintained through both at-home care and professional care.

Make sure to visit your dental office regularly and have a dental hygienist help you to maintain a healthy smile.

Dr. Adachi, thank you so much for all of your wonderful and useful tips.

And thank you for being on our show.

It was a pleasure. Thank you for having me.

Thank you.