Disclaimer:  We are electric toothbrush fans.  As dentist we see the difference between the users and non-users.  Both dentist and all staff members in our dental office use Sonicare Electric Toothbrushes as their personal toothbrush.

It can be very confusing when looking for a new electric toothbrush.  There are so many options on the market today.  This review will focus on the Sonicare Diamond Clean tooth brush.  This is Phillips newest electric toothbrush.

Design

The Sonicare Diamond Clean toothbrush looks like a piece of technology you would find at the  Apple Store.  It is very sleek, white and silver, and minimalistic in appearance.  It even has the ability to charge via a USB adapter.  Phillips has also redesigned the brush heads for this model making the head feel like it is more dense but without being too firm.

Specifications

• Suggested Retail – $219.99
• Speed: Up to 31,000 brush strokes per minute
• Charged brush last up to 3 weeks.
  • Modes: 5 Modes
  • Display: Illuminated display indicates selected mode, becomes invisible when power is off.
  • Brush heads Included: 2 Diamond Clean
  • Battery type: Lithium-polymer rechargeable

Features

• Built in timer – electric toothbrushes with a built in timer keep patients honest and brushing for the full 2 minutes.  The average manual toothbrush user brushes for less than 30 seconds.  Further many timers divide the two minutes in into four 30 second increments which allow brushers to equally divide time in the four quadrants of the mouth.
• Sonic Technology :  creates powerful yet gentle dynamic cleaning action that reaches deep between teeth and along the gum line
• Superior movement: means it has fastest movements per second, around 31,000 brush strokes per minute, try doing that by hand.
• Reduction in  Toothbrush Trauma- Most high quality electric toothbrushes have built-in mechanisms to reduce power when user is pressing too hard to avoid gum trauma.  This helps reduce recession of the gums which comes from over-zealous brushing.
• Removable/Replaceable brush heads – the ability to remove and replace brush-heads periodically allows the user to select a brush head that best fits their needs (i.e. small for smaller mouths), share the electric base with a spouse, and upgrade to a newer brush-head without having to change their entire unit. (FYI – toothbrushes/tooth brush heads should be changed every 3 months or following sickness)

Summary

Pros

One of the easiest changes we recommend to our patients in order to improve their oral health is switching to a rechargeable electric toothbrush.  Not only is a rechargeable electric toothbrush our recommendation, it is has been proven in research studies to be significantly more efficient at plaque removal than a manual toothbrush.  The Sonicare Diamond Clean is an excellent example of all the necessities (easy to use, effective plaque removal, timer, long battery life) that we like to see in a high quality electric toothbrush.  The Sonicare Diamond Clean does not disappoint.

Cons

• The cost of Sonicare Diamond Clean is high.
• The brushing modes are difficult to change once you have started brushing without removing the brush from the mouth.
• Does not have the UV Sanitation options of the previous model  (Sonicare Flexcare)
• Cost of replacement heads has increased.

This may seem like an expensive choice but remember if a cleaner mouth prevents one cavity, then the brush has already paid for itself.  It should also be noted that the new Diamond Clean brush head attachments can be used with the Sonicare Flexcare model. If  you are looking for a reason to get a more high-tech version of the Sonicare Electric Toothbrush then the Diamond Clean may be the brush for you.

Dentist Note

Our final grade for the Sonicare Diamond Clean is an “A”.  However, our recommendation would be to get the skip this brush and instead purchase the lower cost Sonicare Flexcare with the UV Sanitation Station (which we love) and upgrade the brush heads to the Diamond Clean.

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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(Part 1)

One of the most common reasons we see people at our dental office for an unplanned dental visit is because of a broken posterior tooth.   I am not talking about the type of tooth fracture that occurs because of an athletic injury or an accident.  I am referring to the broken cusp (mound of tooth structure) that fractures off during normal activity such as chewing food.

There are several reasons that broken cusp on posterior teeth are so common:

Large Metal (amalgam) fillings.

Many people over the age of 30 have large metal fillings because sealants were not the standard of care several decades ago.  Subsequently they developed decay in the pits and fissures of their teeth and their dentist chose the best material of the time to restore their tooth.   While metal fillings had/have their place there are some negative consequences.  First, metal fillings are mechanically retained.  What this means is that no glue is used to hold the fillings, therefore the dentist must shape the cavity preparation like a pyramid where the base of the fillings is larger than the top.  This shape undercuts the cusp of the teeth making them more susceptible to fracture.  Additionally because metal fillings are not glued or cemented to place they don’t provide any structural support to the tooth.  The cavity preparation quite literally divides the tooth in half and the metal fillings are just resting in the hole.

Clenching and Grinding

Most teeth free of decay or fillings are able to withstand the stress of normal function without fracture.  However in the presents of night time clenching and grinding the teeth can develop cracks and fractures.  After all the jaw muscle (the masseter) is the strongest muscle in the body in terms of absolute force.  It can create force of 55 lbs. on the incisors or 200 lbs. on the molars!

Teeth in the wrong position

Most people think that orthodontics (braces) are purely for cosmetics.  While cosmetics are many times a motivating factor for braces, the primary reason is to have the teeth interact with one another in a proper way.  Each tooth is shaped for a specific set of functions in the mouth.  When the teeth are hitting against each other in a way outside of their intended design they are susceptible to wear and fracture.

Stay tuned for Part 2 when we discuss what to do about a broken tooth

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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A family that brushes together – stays together!  OK, maybe not – but it is true that dentistry should be a priority for the entire family and there are a number of advantages of having the entire family be patients in the same practice.

Choosing a dentist for your family can be very tricky, especially when small children are involved.   As general dentist we (my wife and I) are big supporters of a family practice!  You might think “of course you are!”  Yes, that is a self serving philosophy but there are a lot of very good reasons to have your entire family in the same dental practice.

First of all, dentistry is a different healthcare model than medicine.  The same general dentist remains the primary person responsible for the treatment of patients (often for decades or a lifetime) where as specialist are used as tools to treat specific problems in a very limited time frame.  Dental patients return to the dentist following completion of a specific procedure.  This allows the general dentist to serve as clearinghouse for a person’s dental health with an abundance of information with all data in the patient’s history.

Most people would not dream of taking their child to see someone other than a pediatrician; however the same does not apply to dentistry.  However a family dentist with a developed pediatric protocol is an excellent place for most children’s dental care.  All dental practices are not created equal and if you need one that is equipped to meet the needs of a first visit one year old, the changing dentition of a growing child as well as the complex needs of an adult you must choose wisely.

Advantages of a Family Dentist:

• Parents are welcome in the treatment rooms
• By treating the entire family – can help minimize the behaviors that are detrimental for both parent and child – (studies show that parents dental health directly corresponds with children’s dental health)
• Convenience of scheduling with other family members
• The ability to recognize cosmetic problems and correct earlier (such as bonding misshaped teeth)
• Ability to be seen short notice (general practices often offer much more flexible scheduling)
• As a young patient’s mouth grows they are treated differently in response to their need – (teeth are cleaned by a dental hygienist as opposed to a dental assistant)
• Continuing Care through orthodontics -
• The ability to maximize the usage of dental insurance and flexible spending accounts across all members of the family

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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Most people do not associate a visit to the dentist with seasonal allergies.  However every year in the Spring and Fall, (especially in Greensboro, NC where seasonal allergens are some of the worst in the United States) we see a number of patients in our dental office with toothache symptoms on teeth without a reason to hurt.  These symptoms are most commonly localized to the maxillary (upper) premolars and molars.  Symptoms include, hypersensitivity to cold, pain on biting, sensitivity to tapping and throbbing sensation.  While it is true all of these symptoms mimic an infected tooth, they also are indicative of sinus pressure.

Sinus Pressure is a common side effect to the body’s response to seasonal allergens.  The body produces thick mucus to eliminate the allergens.  The thick mucus often does not easily flow out and this creates congestion.   The congestion creates pressure and subsequent pain build-up in the cavities in our head.  These cavities are known as sinuses.  There are actually multiple sinuses located in the skull all capable of becoming congested.  The maxillary sinuses are most commonly affected by congestion and pressure because the drainage point is not located at the floor of the sinus but instead up the wall of the sinus.  (Imagine how well your shower would empty if the drain were located on the side wall instead of the floor).

The maxillary sinuses are located at the root tips of the upper molars and premolars.  When the pressure builds up in the maxillary sinus pressure is placed on the tips of the teeth roots and indirectly causes tooth pain. A good analogy is to think about putting your finger next to a partly blown up balloon, and then blow up the balloon so that the tip of your finger is surrounded by balloon.  Like your finger in the balloon the teeth do not perforate the sinus cavity but intimately rest up against the sinus wall.  Sinus Pressures can equal a toothache.

Treatment:

Once you have seen your dentist and ruled out a tooth infection you can treat the symptoms.  In order to treat sinus congestion and pressure to relieve tooth pain you must eliminate the congestion which causes the pressure. A good trio of medications we recommend to our patients to treat these symptoms are:

1. -Antihistamine (Claritin, Allegra, Benadryl)
2. -Decongestant (Pseudofed, Claritin-D)
3. -Topical Nasal Spray- (Afrin)

If toothache symptoms don’t resolve be sure to revisit your dentist for a reevaluation and/or referral to a specialist.

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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One of the easiest changes we recommend to our patients in order to improve their oral health is switching to a rechargeable electric toothbrush.  Not only is a rechargeable electric toothbrush such as a Sonicare Flexcare our personal recommendation, it is has been proven in research studies to be significantly more efficient at plaque removal than a manual toothbrush.  There are many reasons we are such enthusiastic supporters of electric toothbrushes:

• Built in timer – electric toothbrushes with a built in timer keep patients honest and brushing for the full 2 minutes.  The average manual toothbrush user brushes for less than 30 seconds.  Further many timers divide the two minutes in into four 30 second increments which allow brushers to equally divide time in the four quadrants of the mouth.
• Superior technology which means it has fastest movements per second, around 31,000 brush strokes per minute, try doing that by hand.
• Reduce Toothbrush Trauma- Most high quality electric toothbrushes have built-in mechanisms to reduce power when user is pressing too hard to avoid gum trauma.  This helps reduce recession of the gums which comes from over-zealous brushing.
• Removable/Replaceable brush heads – the ability to remove and replace brush-heads periodically allows the user to select a brush head that best fits their needs (i.e. small for smaller mouths), share the electric base with a spouse, and upgrade to a newer brush-head without having to change their entire unit.
• UV Sanitizer – Many high quality electric toothbrush charging units have a UV Sanitizer which allows the user to store the brush heads in a closed compartment that kills 99.9% of bacteria on the brush-head.  Toothbrushes are well documented to be excellent places for bacterial colonies to flourish.

A good electric toothbrush such as a Sonicare Flexcare is likely to cost over $100.  This may seem like an expensive choice but remember if a cleaner mouth prevents one cavity, then the brush has already paid for itself.

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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Do you floss every day?  It is not necessarily critical that you use floss everyday, BUT it is very important to clean in between your teeth on a regular basis. Dental Floss  just happens to be a very cost effective and practical way for most people to effectively clean between their teeth.

Did you know a third of the tooth’s surfaces are the side/proximal surfaces and ignoring a 33% of your mouth opens the door for a variety of dental problems?

Gum disease and tooth decay begin at the gum line and between teeth.  Plaque and food particles stick to the contact areas of  adjacent  teeth.  The bacteria in plaque are convert these food particles into acids demineralize e the tooth causing cavities and allow the bacteria flourish.  Cleaning between the teeth prevents this process from taking place

How To Floss Your Teeth?

• Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers.
• Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
• When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
• Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
• Repeat this method on the rest of your teeth.
• Don’t forget the back side of your last tooth.

• People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. . If you are looking for an alternative with the latest in technology read our review of Sonicare’s New Airfloss! 

Flossing Facts

• Did you know that National Flossing Day is the day after Thanksgiving – November 25th, 2011?
• Over three million miles of dental floss are purchased in North America each year!
• Proper flossing should require the average person to use 122 yards of floss per year. However, sales data shows that the average person only uses about 18 yards per year.
• Only 28 percent of people say they floss every day.
• 73 percent of people report they would rather go grocery shopping than floss.
• Prison inmates have tried to braid floss into a rope to escape, or use it as a knife or chainsaw

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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“When should my child see an Orthodontist?”  Is a very common question we hear from parents in our dental office.  The answer is earlier than you might think and comes to a surprise to many families.  The American Association of Orthodontist (AAO) and the American Dental Association (ADA) recommends that:

All children see an orthodontist no later than ages 7. 

The reason it is recommended that all children see an orthodontist no later than ages 7 helps identify problems with a growing jaw and emerging teeth while there is an opportunity to intercept the problem.  By taking advantages of growth spurts and the partial bone development early treatment may help prevent more serious problems from developing.  In addition helping prevent more serious orthodontic problems early orthodontic treatment also:

• Helps guide jaw growth
• Lower the risk of tooth trauma
• Correct harmful oral habits
• Guide the permanent teeth into favorable positions
• Improve the way the lips come together

The surprising fact is that most orthodontic treatment begins between the age of 9 and 14.  Parents are often mis-informed about the right time to see an orthodontist and are incorrectly lulled into a false since of security because their assessment of their children’s smile is that they  appear to have ”straight teeth”  or a “normal smile.”  However is not always easy to tell by looking at your child’s teeth if they have orthodontic problems.  Some helpful signs when evaluating your child include:

• Early or late loss of baby teeth
• Difficulty chewing or biting
• Breathing through the mouth
• Thumb-sucking past the age of 4
• Crowded or protruding teeth
• Biting the cheek or roof of the mouth
• Upper and lower teeth that don’t meet in the front
• Grinding of teeth

Remember that there is an ideal age for every patient to begin orthodontic treatment and unless your child is seen by an orthodontist before the age of 8, a window of ideal opportunity may be missed.

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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The primary goal of having this visit so early is to prevent tooth decay.  The (ADA) American Dental Association says recommends the first dental visit to occur within six months of the appearance of the first tooth, and no later than the child’s first birthday.  As soon as teeth appear in the mouth, decay can occur.  A large contributor to child tooth decay is the baby bottle and sippy cups.  This is often referred to as baby bottle tooth decay.

A major  risk factors for early childhood tooth decay is frequent and prolonged exposure of a baby’s teeth to liquids, such as fruit juice, milk or formula, which all contain sugar.  Tooth decay can occur very rapidly when a baby is put to bed with a bottle or sippy cup.  Infants should finish their nap-time or bedtime bottle before going to bed and ideally their teeth cleaned before going to sleep.  Because decay can destroy the teeth of an infant or young child, parents should encourage children to drink from a cup by their first birthdays.

Many training cups, also called “sippy cups” are popular alternatives to bottles.  Sippy cups are really baby bottles in disguise. In addition to allowing frequent and prolonged exposure to cavity causing liquids, these training cups can often be inadequate at learning how to use a real cup.  These training cups often include a valve beneath the spout to stop spills. However, cups with these valves do not allow your child to sip very easily.  As a result he child gets liquid by sucking on the cup, much like a baby bottle. This practice defeats the purpose of using a training cup, as it prevents the child from learning to sip.

Additionally, we recommend not letting your child carry the training cup around. Toddlers are often unsteady on their feet. They take an unnecessary risk if they try to walk and drink at the same time. Falling while drinking from a cup has the potential to injure the mouth.

A training cup should be used temporarily. Once your child has learned how to sip, the training cup has achieved its purpose. It can and should be set aside when no longer needed.

Tips for Sipping Success and Cavity-Free:

1. Choose a valve-less cup that encourages sipping and not sucking
2. Choose non-sugary liquids when prolonged exposure occurs (water instead of juice or milk)
3. Limit how frequently your child sips
4. Encourage your child not to carry the cup around

Remember to have your child see a dentist by age 1.

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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Most people know that smoking cigarettes and using smokeless (chewing) tobacco are bad for you.  However, there seems to be some questions and confusion when it comes to smoking tobacco cigars.   For example, “Since you don’t inhale a cigar are they still bad for you?”   “Cigars are all natural with no added chemicals, so they are safer than other forms of cigarettes, right?”

The topic of cigar smoking compared as a health risk has recently come up in our dental practice.  We turned to the Greensboro Chapter of TRU – Tobacco Reality Unfiltered for some facts about the health risk involved with cigar smoking.  The take home message is there is no such thing as a “safe” tobacco product.

 Facts About Cigar Smoking

 1.      One cigar may contain as much tobacco as an entire pack of cigarettes.

A single cigarette typically has less than gram of tobacco, while a single cigar may contain as much as 5 to 17 grams of tobacco.

 2.      Cigars are addictive.

Cigar smoke breaks down in saliva, allowing the smoker to easily absorb nicotine through the lining of the mouth in quantities sufficient to cause addiction, even if the smoke in not inhaled. And, the amount of nicotine in a single cigar is many times greater than what is found in a cigarette.  A typical cigarette contains one to two milligrams of nicotine, while the nicotine content of a cigar is 100 to 200 milligrams, with some as high as 400 milligrams.

 3.      Cigar Smoke is more concentrated and toxic than cigarette smoke.

Secondhand smoke from cigars varies from that of cigarettes for a couple of reasons.  First, the manufacturing process for cigars requires a fermentation period.  During this time, high concentrations of tobacco-specific- nitrosamines (TSNAs) are produced. TSNAs are some of the most carcinogenic compounds known to man.   Secondly, cigar wrappers are not as porous as cigarette wrappers, making the combustion of a cigar less complete.  These two factors result in higher concentrations some of the toxic chemicals in cigar than in cigarettes.

 4.      Smoking as little as one cigar a day increases the risk for cancer.

Cigar smoking has been linked to several different cancers, most notably those of the oral cavity, which include lip, tongue, mouth, throat and larynx.  Cigar smokers who inhale are also at an increased risk for lung cancer, cancers of the pancreas and bladder, as well as heart and lung disease.

 5.      Cigar and pipe smokers are risk for early tooth loss.

 In a study published in the January 1999 issue of the Journal of the American Dental Association, it was discovered that cigar and pipe smokers are at an increased risk for early tooth loss, compared to that of their nonsmoking counterparts.  Cigar and pipe smokers are also at an increased risk for alveolar bone ( the bone that holds the tooth in place ) loss.

6.       Cigar smoking has been linked to erectile dysfunction in men.

 Smokers are twice as likely to be impotent as nonsmokers due to the adverse effects smoking has on circulation, hormones and the nervous system.  Cigar smoking and exposure to second hand smoke in particular have been shown to be significant risk factors for erectile dysfunction.

For help quitting, call the NC Quitline at 1-800- QUITNOW

Today’s post was written personally by Drs. David and Janna Civils. Do you have a question for either Dr. David or Dr. Janna?  We would love to hear from you!

Drs. David and Janna Civils

1114 Magnolia Street 
Greensboro, NC
336-272-4177
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Have you ever wondered why you really need to go to the dentist every 6 months?

Y-E-S.  If ever there was a perfect application for the old adage that an ounce of prevention is worth a pound of cure, this is it.  As a matter of fact, the answer for most people should really be – at least twice a year.

We have discussed this topic before (read our blog).

However, many of us fall into this trap thinking  “ If I take good care of my teeth at home, I can wait a few extra months, right? “  The answer is not as simple as you might think

The cleaning not only makes your mouth feel better, but improves overall health of the oral tissues that support the teeth.  Plaque and tartar first begin to accumulate along the gum-line, when left alone, the accumulation begins to force its way under the gums, causing bleeding and tenderness in the gums known as gingivitis.  When tartar accumulation is not removed for extended periods it can cause chronic infection in the gums which leads to bone loss known as, periodontal disease and loss of teeth. Regular checkups and excellent home-care efforts can often prevent this from happening to you!

Not only are your teeth cleaned at your 6 month appointment, the entire mouth is thoroughly examined and evaluated.  During this evaluation your dentist and hygienist check bone and gum levels, evaluate for possible decay, examine oral tissues for possible lesions and make notes regarding any significant findings.

Radiographic images ( X-rays) are taken to evaluate areas between the teeth for decay.  Often patients ask if it is “ok” to put off  x-rays stating , “I think I would know if anything was wrong because it would hurt”.  While patients occasionally know that they have decay because something doesn’t feel quite right, x-ray images are designed to assist the dental team in finding decay before the lesion is large enough to cause pain.  Lesions that are found while small can be treated with conservative restorations that are less expensive and take fewer visits to the dental office.  Putting off dental treatment often results in more extensive treatment needs.  Prevention is always the best course to follow when considering your dental checkup schedule.

Early detection is key to a positive dental experience.

Today’s post was written personally by Drs. Civils and their hygienist.  Do you have a question for either Dr. David or Dr. Janna? Let us hear from you!

Drs. David and Janna Civils
1114 Magnolia Street
Greensboro, NC
336-272-4177
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