Saturday, August 22, 2015

dentist at work

DENTIST AT WORK


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Proper Toothbrushing

    How to Brush Our Teeth Properly?




Brushing your teeth is not just for a whiter smile and fresher breath, it's important for your overall health.[1] When you brush, you remove plaque—a thin film of bacteria that sticks to your teeth and will cause cavities, gum disease, and if you ignore it long enough, will cause your teeth to fall out! Bad breath due to a smelly mouth may keep people away from you especially your elder siblings..[2] You know why to brush, but if you would like to learn how to brush your teeth effectively, this article is for you. Read on!


Part 1 of 3: Using the Right Tools

  1. Brush Your Teeth Step 1 Version 3.jpg
    - Watch a 10 second video
    1
    Use a good toothbrush. Choose a toothbrush with soft nylon bristles. This must effectively remove plaque and debris from your teeth, without irritating the gums or eroding tooth enamel like hard bristled brushes can do when used with sideways action. The toothbrush should also fit comfortably in your hand, and have a head small enough to easily reach all of your teeth, especially the ones at the back. If you have difficulty fitting the toothbrush into your mouth, it is probably too big.[3]
    • Electric toothbrushes are a great choice if you are a lazy brusher and think that the electric toothbrush might encourage you to spend more time on your teeth. However, you can do just as good of a job with a manual toothbrush -- it's all in the technique.
    • You should definitely avoid toothbrushes with "natural" bristles made from animal hair as these can harbor bacteria.
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    - Watch a 10 second video
    2
    Replace your toothbrush regularly. The bristles will wear out over time, losing their flexibility and effectiveness. You should get a new one every 3 to 4 months, or as soon as the bristles start to splay out and lose their shape. Visual inspection of the toothbrush is more important than the actual timeline. You can also buy toothbrushes nowadays whose handles will change color when its time to get a new one.
    • Research has found that thousands of microbes call toothbrush bristles and handles "home," and can cause infections.[4]
    • Always rinse your brush after using it, and store it upright and uncovered so that it can dry before your next use. Otherwise bacteria will grow.[5]
  3. Brush Your Teeth Step 3 Version 3.jpg
    - Watch a 10 second video
    3
    Use a fluoride toothpaste. It not only helps remove plaque, it also helps strengthen tooth enamel.[6] However, it's important to note that fluoride toothpaste is not to be swallowed, as ingesting too much can have serious health consequences. It should not be used for children under the age of 3.[7]
    • You can get toothpastes to target a wide variety of dental and gum problems, including cavities, tartar, sensitive teeth and gums, gingivitis and stained teeth. Opt for the one that suits your best or ask your dentist or hygienist for advice.[8]
  4. Brush Your Teeth Step 4 Version 3.jpg
    - Watch a 10 second video
    4
    Use dental floss. Flossing your teeth is just as important as brushing, as it removes built up plaque, bacteria and food particles that get trapped between the teeth and which soft floppy toothbrush bristles can't reach even when used with up/down natural motion. You should always floss before brushing your teeth so that any food or bacteria that comes loose during flossing doesn't remain in your mouth.
    • Remember to floss gently. Don't "snap" the floss between the teeth as this can irritate sensitive gums. Ease it down gently, following the curve of each tooth.
    • If you find dental floss awkward to use or you have braces, look for dental picks instead. These are small wooden or plastic sticks which you can insert between teeth, achieving the same results as flossing if spaces are large enough.

Part 2 of 3: Mastering the Brushing Technique

  1. Brush Your Teeth Step 5 Version 3.jpg
    - Watch a 10 second video
    1
    Use a small amount of toothpaste. Squeeze only a pea-sized amount of toothpaste onto your toothbrush. Applying too much toothpaste can cause over-sudsing, tempting you to spit and finish too early. Plus, it increases the risk of you ingesting more fluoride-filled toothpaste, which is very unhealthy. [9]
    • If brushing is painful, try brushing more gently with accurate up/down motion only or switch to a toothpaste formulated for sensitive teeth.
  2. Brush Your Teeth Step 6 Version 3.jpg
    - Watch a 10 second video
    2
    Set your bristles at the gum line at a 45-degree angle. Gently brush with a short, vertical or circular motion. Don't brush across your teeth.[10]
  3. Brush Your Teeth Step 7 Version 3.jpg
    - Watch a 10 second video
    3
    Spend at least three minutes brushing. Brushing just a few teeth at a time, work your way around your mouth in a cycle (start outside lower left round to outside lower right then outside upper right to upper left, change to inside uppers before inside upper right ,inside lower right, finally inside lower left). so that you get every tooth, spending about 12 to 15 seconds in each spot. If it helps, you can divide your mouth into quadrants: top left, top right, bottom left, and bottom right. If you spend 30 seconds on each quadrant, you'll get a full two minutes of brushing time in.
    • If you get bored, try brushing your teeth while watching television or hum a song to yourself while you brush. Brushing your teeth for the duration of an entire song will ensure that you brush thoroughly!
  4. Brush Your Teeth Step 8 Version 3.jpg
    - Watch a 10 second video
    4
    Brush your molars. Position the toothbrush so that it's perpendicular to your lips, or so that the bristles are resting on top of your bottom molars. Work the toothbrush in an in-and-out motion, and move from the back of your mouth to the front. Repeat on the other side of your mouth. When the bottom teeth are clean, flip the toothbrush over and work on the top molars. To access outside top molars always swing the lower jaw to the side you are working on. This will increase the space available to move your brush up and down by several times so that no sideways motion occurs .
  5. Brush Your Teeth Step 9 Version 2.jpg
    - Watch a 10 second video
    5
    Brush the inner surfaces of your teeth. Tip the toothbrush so that the head of the toothbrush is pointing towards your gum line, and brush each tooth. Dentists report that the most commonly skipped area is the inside of the lower front teeth, so be sure not to forget those! Check that your mouth is opening wide enough by holding teeth apart with 2 or 3 fingers of your other hand. This will allow correct vertical angle to reach edge of gum.[11]
  6. Brush Your Teeth Step 10 Version 3.jpg
    - Watch a 10 second video
    6
    Gently brush your tongue. After you've cleaned your teeth, use the bristles of your toothbrush to gently clean your tongue. (Don't press too hard, or you'll damage the tissue.) This helps keep bad breath away and gets rid of bacteria on your tongue.

Part 3 of 3: Finishing Up

  1. Brush Your Teeth Step 11 Version 3.jpg
    - Watch a 10 second video
    1
    Rinse out your mouth. If you choose to rinse after brushing, take a sip of water from a disposable cup, or cup your hands under the faucet. Swish it around your mouth, and spit it out.
    • Note that there is some debate on whether or not this is recommended. While some feel that it reduces the efficacy of the topical fluoride treatment, others wish to ensure that no fluoride is ingested. There are also those who just don't like having toothpaste in their mouths! If you're at a high risk of getting cavities, it may be beneficial not to rinse, or rinse with just a small amount of water—effectively creating a fluoride mouthwash.[12]
    • Other studies have shown that rinsing after brushing has no significant impact on the effectiveness of brushing with a fluoride toothpaste.[13]
  2. Brush Your Teeth Step 12 Version 3.jpg
    - Watch a 10 second video
    2
    Rinse your toothbrush. Hold your toothbrush under running water for a few seconds to remove any bacteria from the brush. If you don't rinse the toothbrush properly, you can actually introduce old bacteria into your mouth the next time you use it. Rinsing also removes any leftover toothpaste. Place your toothbrush somewhere where it will easily dry out, otherwise bacteria can grow.
  3. Brush Your Teeth Step 13 Version 2.jpg
    - Watch a 10 second video
    3
    Finish with a fluoride-based mouthwash (Optional). Take a small sip of mouthwash, swish it in your mouth for about 30 seconds, and spit it out. Be careful not to swallow any.
  4. 4
    Rinse your mouth with salt water (Optional). Saltwater kills the bad bacteria on your teeth. There is a rumor that saltwater is acidic and can erode teeth if used too often. It's better not to use it too often, as like anything, too much of anything is bad.
  5. Brush Your Teeth Step 14 Version 2.jpg
    - Watch a 10 second video
    5
    Remember to brush at least twice a day. Most dentists recommend that you brush at least twice a day -- once in the morning and once before bed. If you can fit in a third time somewhere in the middle, even better! Try brushing at a 45° angle as this helps remove plaque and food/drink particles on your teeth better than if you did it normally. You should also try to avoid snacking between meals as much as possible, as this results in more food debris and bacteria building up in the mouth.

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Tips

  • At the very least, brush your teeth in the morning and before you go to bed. Brush after every meal if possible, but don't overdo it: too much brushing is not good for your teeth.[15]
  • Wait at least 45 minutes before brushing your teeth after drinking soda, wine, or acidic juices such as orange juice. Sodas and juices leave residual acids on the teeth, and brushing can actually damage the enamel.[14]
  • It is advisable to use mouthwash, but if you do use mouthwash, only use alcohol-free mouthwash.
  • If you can't brush after a meal, at least swish water in your mouth to loosen food particles.
  • Brush for at least two minutes.
  • If your gums bleed easily, that's a sign your might have inflamed gums (gingivitis).See your dentist. Gingivitis is a serious cause not only of tooth loss, and bad breath, but of infection of the heart valves. Don't stop brushing if your gums bleed, but do switch to a softer toothbrush.
  • Don't try to put a really big amount of toothpaste on the brush. You only need a pea-sized amount.
  • Try not to use a harsh toothbrush or brush too roughly, as this can harm your gums.
  • Brush your tongue and the roof of your mouth for better breath.
  • Brush for longer in needed areas.

Warnings

  • Don't brush too hard. Gums are very sensitive tissue.
  • Change your toothbrush every 3 months. Splayed toothbrush bristles can cause gum damage.
  • Never use someone else's toothbrush. You can transfer germs, bacteria, and diseases through microscopic cuts in your mouth.
  • Do not skip brushing your teeth — skipping out on this vital practice can cause tooth decay.
  • Wait for at least 45 minutes after eating acidic foods or drinks before brushing, to prevent erosion of tooth enamel.
  • Do not swallow toothpaste or mouthwash. They contain chemicals that are toxic if you swallow them e.g. ammonia and cetylpyridinium chloride.
    • If more toothpaste or mouthwash than used for brushing or rinsing is swallowed, obtain medical attention or call a Poison Center immediately.

Things You'll Need

  • Floss
  • Toothbrush
  • Toothpaste
  • Water
  • Saltwater (Optional)
  • Mouthwash (optional)
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Restoration Process

Tooth being Restored

The dental bonding procedure. -

 
What steps are involved? / Aftercare, precautions and dealing with problems.
This page contains an overview of the individual steps that a dentist follows when they place any type of bonded restoration.
That includes everything from white fillings that are used to repair actual damage to cosmetic procedures whose primary purpose is simply to enhance the tooth's appearance.
The process includes:
  1. Preparing (trimming) the tooth.
  2. Acid etching the enamel (and dentin)
  3. Applying the bonding agent.
  4. Placing the dental composite.
  5. Curing the restoration.
  6. Final shaping and polishing.
  7. Aftercare. / Precautions.

The procedure:

A) Shade selection.

Taking the shade of teeth.
Selecting a shade of composite for the restoration.
Dental bonding comes in a variety of colors.
The dentist will need to use their shade guide (it contains samples of each of the different colors of bonding they have) to see which shade matches their patient's teeth the closest.

B) Cleaning the tooth.

A strong bond can't be formed unless the tooth's surface is clean. The dentist will polish the tooth to remove any debris that's accumulated (dental plaque, tartar, etc...).
Making the cavity preparation.
Preparing (trimming) the tooth.

C) Tooth preparation (drilling and trimming).

The amount of tooth shaping that will be needed for any specific restoration will vary.
With some cosmetic applications (closing tooth gaps, repairing minor chips), little to no trimming may be needed.
At the other extreme, if a restoration is needed to repair the damaged caused by tooth decay, the amount of drilling required may be relatively extensive.

D) Acid etching the tooth's surface.

Once the tooth has been trimmed (if needed), the actual bonding process is begun. The first step involves etching the tooth's exposed surfaces with an acidic "tooth conditioner."
Acid etching tooth enamel for bonding.
Acid etching the tooth's surface.
The conditioner is usually a gel (that comes in small syringes). It normally contains 30 to 40 percent phosphoric acid.
The conditioner is spread out over the tooth where the bonding will be placed. It's allowed to sit for at least 15 seconds (possibly more) and then is thoroughly washed off.
Tooth's surface has now been prepared and is ready to receive the dental bonding. (If the dentist were to dry the tooth at this point, its etched enamel surface would have a frosted appearance, much like the appearance of etched glass.)

E) Applying the bonding agent.

The dentist will now paint or dab "bonding agent" (a liquid plastic) onto the etched tooth surface using a small brush or applicator.
Sometimes they'll also blow air gently over the tooth so to disperse the bonding agent into a thin, even layer.
Placing bonding agent on an etched tooth surface.
Applying and curing the bonding agent.

F) Curing the bonding agent.

Once the bonding agent has been applied, the dentist will shine a "curing light" on it.
The light from one of these units is usually blue in color. It activates a catalyst in the bonding agent that causes it to harden. It takes about 10 to 20 seconds of exposure.
An initial bond to the tooth has now been created. The bonding agent has established a micromechanical bond with the tooth's etched surface.

Your experience may vary.

There always seems to be changes in the way tooth etchants and bonding agents (now collectively termed "adhesive systems") are formulated and used.
Some of these new systems incorporate the tooth conditioner right in with the bonding agent itself.
This means that there is no "etch then wash" step but instead the bonding agent is applied on the tooth (without prior etching) and then, after a wait period, is simply set with a curing light.

G) Creating the restoration. / Applying composite restorative.

Now that an initial bond has been established with the tooth's surface (by way of the bonding agent), successive layers of dental composite are added, so to give the restoration its needed bulk and shape. As each one is added and set, it creates a chemical bond with the bonding agent layer and/or previously placed layers of composite.
Composite has the consistency of putty. The dentist will apply it in small portions and gently pat each into place, until that part of the restoration that they're currently building has the needed shape.
Placing dental composite on a tooth.
Applying and curing the dental composite.

Curing the composite.

Once the dentist is satisfied with the positioning of the dental composite, they will initiate its set using the same curing light they used to set the bonding agent. About 20 to 40 seconds of exposure time is needed, possibly more.

Building the restoration.

If the shape of the restoration is not yet complete, the dentist will add additional layers of composite (each one is usually no more than about 2 mm thick, which is a little thicker than a dime). As each one is placed, it's set before the next layer is added.
One reason dental composite is added in thin layers is because the light emitted from a curing unit can only penetrate through so much thickness at a time.
Another reason is because when composite sets it shrinks (on a microscopic level). Keeping each layer thin keeps the cumulative effect of this distortion to a minimum (as compared to placing and curing the composite as a single lump).

H) Trimming and shaping the restoration.

A dentist will usually purposely over bulk a restoration and then use their drill to trim it back to the proper shape.
Shaping tooth bonding (dental composite).
Applying and curing the dental composite.
As the dentist sculpts the composite, they'll use successively finer and finer grit polishing stones, burs, discs, and strips until a very smooth polish has been achieved.

Your opinion is important.

Expect that your dentist will give you a mirror and ask for your input.
Everybody in the room (dentist, assistant and patient) will be looking at your tooth from a slightly different angle and each may notice something that the others don't. And besides, it's your tooth. Your opinion matters the most.

I) The dentist will check the patient's "bite."

At this point, even though the placement of the tooth bonding has been completed, it's still very important for the dentist to check the patient's "bite."
They'll need to evaluate how their patient's teeth come together and whether or not the restoration they have just placed interferes with this motion.

Carbon paper.

To do this, the dentist will place a thin strip of carbon paper between the patient's teeth and ask them to close gently and then make a motion where they slide their teeth against each other.
The paper will create marks on those points where the patient's opposing teeth touch. If marks are observed on the new restoration, the dentist will adjust the bonding's thickness until further testing demonstrates that it has the proper form.

J) The final polishing.

Now that everything has been adjusted, the dentist will give the new restoration a final buffing and polishing. Once this has been completed, it's finished and ready for use.

These steps may or may not be needed. -

A) Numbing the tooth.

Tooth bonding encompasses a wide range of applications and a local anesthetic ("Novocain") may not be needed for many of them.
The necessity for it usually hinges on the amount of tooth shaping that the dentist must perform in preparation for placing the bonding.
With some cosmetic procedures, little to no trimming may be required. In other situations, such as one where the damage from a cavity is being repaired, more extensive shaping will be needed and probably an anesthetic too.

B) Tooth isolation.

Most of the steps outlined above need to be performed under dry conditions (meaning that the tooth is kept free of contamination by oral fluids). And this means that the dentist must find a way to "isolate" the tooth they're working on.
Isolation can be as simple as placing rolls of cotton around the tooth. In other cases, the dentist may need to stretch a sheet of rubber (latex actually) around the tooth. This is called placing a rubber dam.

Aftercare / Precautions.

One of the great conveniences of having a bonded restoration placed is that it is fully hardened (cured) by the dentist when it's placed.
This means that once your dental appointment has come to an end, your tooth is ready to be used, enjoyed and admired. However, there are some precautions that should be kept in mind.

a) Anesthetic -

If your tooth has been numbed for your procedure, you'll need to be careful with biting, chewing and other oral activities until the anesthetic wears off. It may take an hour or two for this too occur.

b) Evaluate your bite -

Especially in those cases where an anesthetic has been used, the bite check your dentist performs at the completion of your appointment may not give accurate results.
You shouldn't apply substantial forces to a new restoration until after your numbness has worn off. Once it has, gently check your bite. If anything seems amiss you should report it to your dentist so they can make the minor correction needed.
Don't assume that things will just take care of themselves. Seeking attention too late can result in a broken 

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