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Interproximal Cavities: The Inside Story

March 1st, 2023

Time to brush! So, you make sure you gently brush the plaque off the outside surfaces of your teeth. You want to present a gleaming smile to the world, after all. And you make sure to brush the inside surfaces as well, because who wants to feel a fuzzy patch of plaque every time their tongue hits their teeth? And, naturally, you remember to clean the tops of your molars, because those crevices make them more cavity-prone than any other surface.

Done? Not quite!

You might be surprised to learn that no matter how well you’ve brushed all the visible surfaces of your teeth, you’ve left quite a bit of enamel untouched—the adjoining, or touching, surfaces of the teeth that sit next to each other.

You’ve probably noticed that your bristles can’t . . . quite . . . reach all the enamel between your teeth (especially between your molars!) when you’re brushing. This means that food particles and plaque have an easier time sticking around. And when the bacteria in plaque are left undisturbed, especially with a banquet of food particles available, they produce acids which gradually eat away at the enamel covering our teeth, creating a cavity.

Here’s where we work in some specific dental vocabulary. “Interproximal” means between the adjoining, or touching, surfaces of the teeth. And an interproximal cavity is a cavity that develops on one of those side surfaces of your teeth.

  • Preventing Interproximal Cavities

Fortunately, prevention is about as basic as it can be—brushing and flossing effectively. Dentists recommend brushing for two minutes at least twice a day and flossing once each day. While most of us are good about keeping up with brushing, sometimes that daily flossing is more a goal than a reality.

But it’s flossing which really does the trick when it comes to interproximal cleaning. If you floss correctly, food particles and plaque are removed from between the teeth and around the gum line—places where bristles just can’t reach.

When you wear braces, though, flossing isn’t quite so basic. Getting that floss just where it needs to be in between brackets and wires and in between teeth can be a challenge!

The good news is there are many products designed just to make flossing easier while you’re in orthodontic treatment:

  • Floss threaders are flexible hoops that help you thread floss behind your wires easily.
  • Precut floss strands use a stiff tip at one end for threading floss through wires.
  • Interproximal brushes are tiny, cone-shaped brushes which can fit between your teeth and braces for precise cleaning.
  • Water flossers eliminate floss altogether, using a pulsing stream of water to clean between and around teeth and braces.

During your next visit to our Richardson or Carrollton office, Drs. Hutcheson, Train, Goodall, Lewis can give you tips on how to use any of these tools effectively for cleaner teeth and cleaner braces.

Preventing cavities on the exterior surfaces of your teeth is probably pretty much automatic by now, but don’t forget the potential for stealth decay! If we find signs of erosion on the sides of your teeth, or if your hygienist lets you know that you’ve got a lot of interproximal plaque buildup, work with your dental team to make sure “interproximal cavity” doesn’t become a working part of your dental vocabulary.

When to Begin Dental Care for Your Baby

February 22nd, 2023

Children’s oral health differs from the needs of adults in many ways. It’s vital for you to understand what your child needs to keep his or her teeth healthy. Drs. Hutcheson, Train, Goodall, Lewis and our team are here to answer your questions to set you and your little one up for success.

In-home dental care should start as soon as your baby show signs of developing that first tooth. At around age one or two, bring your son or daughter to our Richardson or Carrollton office. Drs. Hutcheson, Train, Goodall, Lewis will examine your child’s tooth development and gum health.

The initial appointment will focus on getting your youngster familiar with our office and comfortable with our staff. We will go over several general matters during that first visit:

  • Inspect for signs of decay or other tooth or gum problems
  • Check for gum disease or cavities
  • Examine your child’s bite and possible misalignment
  • Clean the teeth, and apply fluoride if your child is old enough
  • Talk with parents about proper oral health
  • Give you tips for brushing and flossing your little one’s teeth
  • Answer any questions you may have about caring for your son or daughter’s teeth

Once your child is old enough for the first dental visit, you should schedule regular cleanings every six months. Call our Richardson or Carrollton location if you have any conflicts or questions.

When Your Permanent Retainer—Isn’t

February 22nd, 2023

Even though it’s called a “permanent retainer,” your fixed retainer isn’t necessarily meant to last a lifetime. But with care, it should last just as long as you need it, keeping your teeth perfectly aligned after your orthodontic treatment is complete. Why is this retainer the one to choose for challenging alignments?

A fixed retainer is often used for teeth which were very crowded or had large gaps before treatment, especially along the bottom teeth, which tend to shift more. With a permanent retainer, a custom fitted wire is attached with a bonding adhesive to the back of each of the selected teeth. This design makes sure that the teeth can’t shift out of place while your bones and ligaments strengthen around them.

Occasionally, though, your permanent retainer isn’t quite as permanent as it should be. If you think your fixed retainer is becoming “unfixed,” what clues should you look for?

  • Broken wire

A clearly broken wire can be obvious, or you might discover it when you notice pain or irritation caused by the end of a wire poking around your tongue or mouth.

  • Loose bond

The orthodontic adhesive used to bond the wire to each tooth can come loose as the result of an accident, an unfortunately chewy treat, or simply with the passage of time.

  • Shifting teeth

You might not notice anything wrong with your retainer, but what you do notice is that your once-straight teeth have started shifting back to their old positions. If you see any movement in your teeth, your retainer might need repair.

What should you do?

  • Give our Richardson or Carrollton orthodontic office a call! It’s important to act promptly to prevent further retainer damage, oral discomfort, and tooth misalignment.
  • Rinse with warm water if your mouth is irritated.
  • If a wire is poking you, call us for advice on gently pushing it back into place.
  • Orthodontic wax can protect your teeth and tissue from detached wires.
  • If you have a clear retainer, wear it until you can come in. If you don’t have one, and you can’t see us immediately, ask if an over the counter moldable retainer is a good idea to help keep your teeth aligned in the meantime.

One benefit of a fixed retainer is that it’s almost invisible because it’s behind your teeth. But this hidden location can also make it difficult to notice potential problems. Fortunately, there are some proactive steps you can take to help your permanent retainer—and your bite—stay healthy:

  • Avoid foods which are sticky, hard, or chewy. If a food can damage traditional braces, it can damage your retainer.
  • Wear protective gear like mouthguards and helmets when you’re active—they protect more than just your retainer!
  • Ask your dentist to examine your retainer adhesive’s staying power whenever you have a checkup.

If you notice a detached wire or loose adhesive or see your teeth shifting, give Drs. Hutcheson, Train, Goodall, Lewis a call. It’s important to act promptly to fix a fixed retainer, because your teeth and bite alignment are in jeopardy when you delay. And always bring your retainer (or retainer pieces) with you in case we can repair it.

Permanent retainers don’t necessarily last forever. But whether your fixed retainer is going to be with you long-term, or whether you’re going to transition to a removable retainer in the future, let’s make sure your permanent retainer is just as “permanent” as it needs to be!

Understanding Cavities

February 15th, 2023

Getting a cavity seems like delayed punishment for eating that special dessert every weekend or for the few days you forgot to floss. When you are doing everything right with minimal exception and a cavity is diagnosed, it is discouraging. Knowing how cavities form and what causes them is valuable in knowing how to prevent them. In this blog post, Drs. Hutcheson, Train, Goodall, Lewis will help you understand cavities!

A cavity is not a one-time event. It is actually a symptom of a disease called caries. Tooth decay is a result of an active infection and condition in the mouth. There are ingredients to this infection, which include bacteria, acid, your tooth, and a food source. The main bacterial culprit is S. Mutans. Bacteria live in a housing structure called biofilm. This offers them protection, food, and an ideal replicating environment.

Biofilm can be healthy if there is a balance of good bacteria. When you have caries, the numbers of “bad” bacteria increase and produce an environment where they thrive and therefore cause tooth decay. A main indicator of this is a pH measurement of your saliva.

Several factors can influence the biofilm pH. Foods and beverages all have different pH levels. The lower the number, the higher the acidity. Since acid promotes tooth decay, a beverage like soda will promote a cavity. Water, being neutral, is a good choice to promote healthy oral pH. Healthy eating can still cause cavities. Here is an example of a highly acidic, yet traditionally healthy meal:

Toast with store-bought strawberry jam, and a cup of cottage cheese topped with fresh cranberries.

Instead, here is a better choice, which involves mixing acidic healthy foods with alkaline (non-acidic) foods to reduce the overall pH:

Toast with almond butter, and Greek yogurt topped with fresh blueberries.

The first example will result in a very low pH in the mouth and even in the rest of the body. The second meal mixes highly acidic blueberries with an alkaline Greek yogurt. Dairy products from cows are highly acidic. Toast is acidic because of the yeast and almonds are alkaline.

A natural buffer is saliva. Whenever mouth breathing or medications compromise the saliva flow, the pH is going to drop and caries can go rampant. Getting a cavity is not just about the sweets or forgotten flossing sessions. It is about the pH levels and bacterial management.

For more helpful tips about how to avoid cavities, contact our Richardson or Carrollton office.