My Blog

Posts for: September, 2019

By Megha Joshi DDS and Achyut Joshi DDS
September 25, 2019
Category: Oral Health
Tags: gum disease  
PeriodontalMaintenanceCanHelpYouAvoidAnotherEpisodeofGumDisease

To keep a healthy smile, brushing and flossing your teeth every day should be at the top of your to-do list, along with regular dental visits. Dental visits are usually scheduled every six months when your dental professional will remove any built-up plaque and tartar (hardened plaque deposits) missed during everyday hygiene.

If you've experienced periodontal (gum) disease, however, these dental visits may become even more important toward preventing a re-infection. For one thing, your dentist may want to see you more frequently.

Gum disease is caused by bacteria living in dental plaque, which first infect the superficial layers of gum tissue. Even though the body initiates an inflammatory response to fight it, the infection continues to grow as long as there is plaque present to fuel it. The problem isn't just plaque on the visible tooth surface—hidden plaque beneath the gum line can create deep pockets of infection that can be difficult to treat.

To stop the infection, dentists must manually remove plaque through procedures known as scaling and root planing. Any and all plaque and tartar deposits must be removed, even those deep around the roots, to arrest the infection. This often requires several treatment sessions and sometimes gum surgery to access areas below the gum line.

These types of treatments, especially in the disease's early stages, have a good chance of restoring health to your gums. But because of the high possibility of reinfection, your dentist will need to step up your regular dental maintenance from now on. This could mean visits as frequent as every few weeks, depending on your particular case of gum disease and your dentist's recommendation.

Your dental visits after gum disease may also become more involved than before. Your dentist will now monitor you closely for any signs of reinfection and at the first sign initiate a new round of treatment. You may also need surgical procedures to make some areas around your teeth more accessible for future cleaning and maintenance.

Periodontal maintenance after gum disease helps ensure another infection doesn't rise up to undermine your progress. To paraphrase a well-known quote, eternal vigilance is the price of continuing good dental health.

If you would like more information on professional dental health maintenance, please contact us or schedule an appointment for a consultation.


By Megha Joshi DDS and Achyut Joshi DDS
September 15, 2019
Category: Oral Health
Tags: oral hygiene  
ImprovingHygieneSkillsMaximizesRemovalofDisease-CausingPlaque

Your mouth is teeming with bacteria—millions of them. But don't be alarmed: Most are benign or even beneficial. There are, however, some bacteria that cause tooth decay or periodontal (gum) disease, which can damage your oral health.

These disease-causing bacteria feed and multiply within a thin biofilm of leftover food particles on tooth surfaces called dental plaque. To reduce these bacterial populations—and thus your disease risk—you'll need to keep plaque from building up through daily brushing and flossing.

Now, there's brushing and flossing—and then there's effective brushing and flossing. While both tasks are fairly simple to perform, there are some things you can do to maximize plaque removal.

Regarding the first task, you should brush once or twice a day unless your dentist advises otherwise. And "Easy does it" is the rule: Hard, aggressive scrubbing can damage your gums. A gentle, circular motion using a good quality toothbrush will get the job done. Just be sure to brush all tooth surfaces, including the nooks and crannies along the biting surfaces. On average, a complete brushing session should take about two minutes.

You should also floss at least once a day. To begin with, take about 18" of thread and wrap each end around an index or middle finger. Pulling taut and using your thumbs to help maneuver the thread, ease the floss between teeth. You then wrap it around each tooth side to form a "C" shape and gently slide the floss up and down. Continue on around until you've flossed between each tooth on both jaws.

You can get a rough idea how well you did after each hygiene session by rubbing your tongue against your teeth—they should feel slick and smooth. If you feel any grittiness, some plaque still remains. Your dentist can give you a more precise evaluation of your cleaning effectiveness at your regular dental visits. This is also when they'll clean your teeth of any missed plaque and tartar.

While professional dental cleanings are important, what you do every day to remove plaque is the real game changer for optimum oral health. Becoming a brushing and flossing "ninja" is the best way to keep your healthy smile.

If you would like more information on daily oral care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”


By Megha Joshi DDS and Achyut Joshi DDS
September 05, 2019
Category: Oral Health
Tags: snoring   sleep apnea  
YourDentistMightHoldtheKeytoSolvingYourSleepApneaProblem

When you awake in the morning do you still feel exhausted? Are you irritable during the day, unable to think or focus clearly? Is your loud snoring bothering your bed partner?

If you answered affirmatively to any of these questions, you may have sleep apnea. This happens when an obstruction (usually the tongue) blocks the airway during sleep, preventing you from breathing. Your brain notices the drop in oxygen and wakes you to re-open the airway. The arousal lasts only a few seconds, and you may not even notice. But because it can happen many times a night, these waking episodes can rob you of the deep sleep your body needs.

Sleep apnea is more serious than simply waking up grumpy. Over time, it could contribute to dangerous health conditions like high blood pressure or heart disease. If you’re noticing any of these signs, it’s important then that you undergo a complete examination by a physician or dentist trained in sleep-related issues.

Fortunately, there are ways to reduce sleep apnea. One of the most common is continuous airway pressure (CPAP): This method uses a small pump that pushes pressurized air through a face mask worn while the patient sleeps. The forced air keeps the airway open and reduces apnea episodes.

While it’s an effective method, it can be uncomfortable and cumbersome to use—some people can’t tolerate wearing the mask while they sleep. But if your sleep apnea symptoms are mild to moderate, your dentist may be able to provide an alternative therapy with a specially designed oral appliance.

Similar to a mouthguard or retainer, a sleep apnea appliance worn during sleep holds the lower jaw forward, which helps move the tongue away from the airway. It’s much less cumbersome (and noisy) than a CPAP machine. And your dentist can custom design and fabricate your appliance for a comfortable fit.

Not all cases of sleep apnea can benefit from such an appliance, or even from CPAP therapy. Extreme cases could require surgery to remove tissues blocking the airway. But most sleep apnea patients don’t require this invasive intervention. Getting checked by a qualified medical professional could open the door to a more convenient and effective way to a better night’s sleep.

If you would like more information on dental solutions for sleep apnea, please contact us or schedule an appointment for a consultation.