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Flossing is one of the most important parts of your oral care routine. Many patients know they need to do it but find it difficult to fit into their busy lives. Well, here's the good news: flossing once a day is enough if you're doing a good job!

Some patients like to brush before they floss and others like to floss before they brush. Some like to floss in the morning when they have more energy, others like to floss at night so they can go to bed with a clean mouth. Don't get hung up on any of this, the important thing is that you floss and floss effectively no matter when you do it.

Effective flossing contributes to oral health in these ways:

• It reduces the chance of cavities between teeth, since cavities can only form on teeth covered with dental plaque and you're scraping that plaque away when you floss.
• Along with brushing, it reduces the amount of time the plaque is left on your teeth, allowing them to be in a state of healing and remineralization for longer.
• It removes plaque that accumulates at or below the gum line, aiding in the prevention of gum disease.

As you can see, flossing offers many benefits for such a simple and inexpensive technique. So if you're still wondering how much to floss, don't worry about it. Don't mistake the frequency of your flossing with the effectiveness of it. Choose a dental floss that you like and one time during the day when you can floss thoroughly and just do it! If you need more tips on how to floss correctly, ask Dr. Rothstein or any member of our Livingston team—we'd be glad to help you pick up this healthy habit!

Oral-systemic health is the idea that oral health is a critical and interconnected component to a patient’s overall health and well-being. Studies show that people who have poor oral health are more likely to have other health conditions such as heart disease, diabetes, or a high likelihood of stroke.

Some of the data suggests that oral pathogens may trigger up to 50% of heart attacks, and that the oral bacteria P. gingivalis may cause a 13.6-fold increase in patients’ risk of a heart attack.

Still, the exact relationship between oral and overall health isn't fully known — whether one causes the other or how treating one might affect the other. But it should serve as a warning call to anyone suffering with poor oral health, especially periodontal disease.

More studies need to be conducted to establish the precise link between the two, but whatever it is, one thing is certain: good oral hygiene makes for good oral health. Many dentists and doctors realize the need to work together as a cohesive healthcare team to improve and maintain the health of their communities.

The American Dental Association says oral health is essential to overall health, and not just a luxury. They are setting goals to reduce the amount of tooth decay in low-income communities for both children and adults.

So what is a patient about this information regarding oral-systemic health? Here are some tips to increase and maintain your overall well-being:

• Have an effective oral hygiene routine. Brush twice a day for two minutes each time, floss daily, clean your tongue, and avoid sugary beverages.
• Visit your dentist regularly. Regular cleanings and checkups at your dentist’s office will keep your mouth clean and ensure you’re taking good care of it.
• Eat a healthful diet. A diet rich in fruits, vegetables, whole grains, and natural, unprocessed foods contributes to the overall health of your body.
• Stay hydrated. Drink plenty of pure, clean water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses a day.
• Relax, destress. Stress can play a big role in all forms of disease. Take time during your day to relax, meditate, stretch, and allow your body and mind to rest.

If you have questions about your oral health and how it may be affecting your general health, feel free to ask Dr. Rothstein during your next visit to our Livingston office.

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Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Dr. Rothstein and our team at A R Periodontics want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Livingston office if you have any questions about water picks, or ask Dr. Rothstein during your next visit!

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals, which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria that don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gum line, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gum line.
• Floss to remove plaque from between the teeth and near the gum line.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us about the best way to keep plaque at bay. If you have plaque and tartar that has spread below the gum line, talk to Dr. Rothstein about procedures such as scaling and planing. These non-surgical, deep cleaning treatments available at our Livingston office remove plaque and tartar around the roots and smooth away rough surfaces where bacteria can hide.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.