oral irrigators, i.e. Via-jet or Water Pik, etc

abc987

Toothsmith wrote: »

And your comment at the end - "Are you a dentist, or do you work in this field?".
!

If the person is giving advice we do need to know where they earn their money, so that we can ascertain the amount of spin they may or may not be putting on the advice given.

Many years ago when I went for an eye test I was told i needed glasses.
So i thought I'd get a second opinion, and within a week had an eye test at another place. They said my eyes were perfect.
You see the issue of trust or mistrust.
What about mercury in fillings?
The era when most dentists was drilling and filling?


You seem to be a dentist - are you saying that Gum disease (which seems to be the main cause of teeth lost/pulled out) can be prevented by brushing and flossing alone?

Pop_Up_Pirate

I've heard it all now....oral irrigators??

What's wrong with brushing your teeth, using a tepe brush or two and limiting sugars?

maddiemay

Pop_Up_Pirate wrote: »

I've heard it all now....oral irrigators??

What's wrong with brushing your teeth, using a tepe brush or two and limiting sugars?

As a rule of thumb I would agree with you, but in my case:-

a) I am an old thing with with painful joints and dexterity problems.
b) In the last few years I have developed areas where food always lodges, most uncomfortable and ripe for decaying food (:()
c) I now have to use 3 sizes of teepee as well as those flossing things and then end up with sore spots and bleeding.

My trusty irrigator leaves me with a fresh clean mouth and quickly gets rid of the debris:D Having said that (which you did not really want to know anyway:rotfl: I agree that so many products and gadgets are un-necessary if people cleaned properly.

Ilona

abc987 wrote: »

If the person is giving advice we do need to know where they earn their money, so that we can ascertain the amount of spin they may or may not be putting on the advice given.

You seem to be a dentist - are you saying that Gum disease (which seems to be the main cause of teeth lost/pulled out) can be prevented by brushing and flossing alone?

May I suggest, abc987, that you click on Toothsmiths user name and check out where this DENTIST has been posting in the last 12 years. Surely the name is an indication.

Ilona

Toothsmith

abc987 wrote: »

You seem to be a dentist - are you saying that Gum disease (which seems to be the main cause of teeth lost/pulled out) can be prevented by brushing and flossing alone?

There are a (very) few people with a genetic risk to it.

But that is what the evidence points to, yes. All very cheap, no-one needs to be sold anything other than regular new toothbrushes, and interdental cleaning aids. (Floss isn't particularly good recent new evidence has suggested - interdental brushes are much better)

Changed diets, supplements, special bacteriological tests are all unsupported by evidence and an expensive waste of time.

In my experience - I have never seen gum disease start up in a non-smoker that has good cleaning habits.

I cannot think of any patients I have whose gum condition has not vastly improved once they have improved their own self-care especially if that includes giving up smoking if they do.

I would only refer someone to a specialist periodontist if, having improved self-care and given up smoking (if they do) and been regularly seen by my hygienists they still show signs of active disease. In 20 odd years I have only referred 2 patients. That doesn't mean we've 'cured' everyone else - there are some that just don't bother to improve how they brush - and for them, a referral to a specialist would just be a waste of money! As the first thing they would try to achieve is an improvement in self-care!!

I note that the article you linked to talks of 'Pyhorrea'. That is a term that was abolished in the 70s!! It was back in the time when it was thought the only 'cure' for gum disease was teeth all out and dentures. It also talks about gum surgery. This too is very much out of favour these days. The non-surgical approach of giving the teeth a good professional clean, then teaching the patient good cleaning habits and encouraging smoking cessation are very much the way it's done nowadays. So the article is protesting against a treatment regime that really isn't happening any more (at least in this country)

Oh - and although I am a dentist - I am always at pains to point out I could be a teenager with a text book!! Never trust blindly what I say but check it with a proper dentist who can see your teeth.

abc987

Toothsmith wrote: »

I would only refer someone to a specialist periodontist if, having improved self-care and given up smoking (if they do) and been regularly seen by my hygienists they still show signs of active disease.

Thanks for detailed reply.
I agree, the patient has do give up smoking and improve self-care.
Seems common sense, but I guess there are people out there who don't look after their teeth and gums.

Do you recommend any mouth washes/rinses to use at home , and the frequency of their use?

PS - the idea of these posts is not to bash dentists, but to establish what patients can do themselves to look after their teeth and gums.

And I wouldn't blindly believe what Dr Mercola or anybody else said.

brook2jack

98% of all mouthwashes are classed as cosmetics , that is they have no real clinical benefit.

The only mouthwashes that do have some clinical benefit should be prescribed by a dentist for short term use only.

Mouthwash does not control gum disease, effective cleaning does.

The key to the treatment of gum disease is "physical disruption of the biofilm" in other words you have to physically remove the plaque and bacteria and that can only be done with effective toothbrushing and interdental cleaning e.g. Tepe brushes.

Any intervention a dentist makes is only to allow a patient to better control their gum disease themselves. Even scaling is useless in someone who does not change their cleaning habits as plaque left undisturbed starts to turn into tartar within 48 to 72 hours , so in other words within 2 to 3 days you will be back to square one, health wise, without effective cleaning.

theoretica

Toothsmith wrote: »

T
Changed diets, supplements, special bacteriological tests are all unsupported by evidence and an expensive waste of time.

Can you confirm what you mean by changed diets? I was under the impression that the evidence was good for both reducing sugar and reducing snacking between meal times/brushings.

brook2jack

Reducing sugar stops decay , but unless you're diabetic does nothing to help gum disease. You can get decay without gum disease and vice versa or both together as the root causes of both are different.

There have been some claims for particular dietary supplements and changes to diet to help with gum disease , but in general there is no concrete evidence for them ,other than to say that oral health, like all health, is helped by a healthy balanced diet.

Toothsmith

Indeed - by 'changing diet' I meant adopting some fad diet with peculiar ingredients & often paid-for supplements.