Healthy Living

How to Have Healthy Teeth, a Perfect Smile

An Interview with Robin Brenner

ZEST NOW: What are some simple things a hygentist can teach you to improve the appearance of your teeth?
ROBIN BRENNER: Simple procedures to improve the appearance of one’s teeth are: good oral hygiene, teeth whitening, replacing old stained and broken fillings with composite fillings, and bonding chips and fractures– especially those on the biting edges of upper and lower front teeth. I’ve seen people with teeth that look like the NYC skyline! Not pretty!!

ZN: Do you ever see a difference between your older and younger patients?
RB: Older women tend to have more fillings than younger women. A lot of these fillings are from their younger years when fluoride was not in the water. Silver amalgam fillings were used years ago, and although they could last a long time, eventually they start to break down, which could lead to tooth decay underneath the filling.

ZN: What are some of the biggest mistakes that people make when it comes to everyday oral care?
RB: People tend to scrub their teeth with the toothbrush, eventually carving notches in their teeth at the gum line, resulting in tooth sensitivity. I often tell these patients they get an A+ for effort, but not to work so hard!

ZN: How important is flossing? Is there a “best way” to floss?
RB: Flossing is extremely important, but be sure to hug the tooth with the floss to avoid floss cuts in the gum.

ZN: Do people have to change their daily oral hygiene habits as they grow older? Is there a link between oral health and other physical factors such as heart disease?
RB: Establishing a good oral hygiene regimen at a young age is best. However, if one undergoes changes in their oral environment, such as implants or bridges, then there are additional products to use such as rubber tip or floss-threader, in order to maintain healthy gum tissue. The bacterium in the mouth is bad stuff! I always tell my patients that if we neglect our teeth, the bacteria will eat away at the bone supporting them as well as work against the immune system .

This especially affects a person that has a heart murmur, stents from open heart surgery, or any prosthetics in their body-such as hip, knee replacements. If the bacteria becomes embedded in these areas, an infection could form which can be life-threatening. There are specific guidelines requiring most of these patients to pre-medicate with antibiotics prior to their dental visit. Pregnant women tend to build up more plaque and therefore should have more frequent cleanings. The bacteria in their mouth can affect the health of the fetus. It is suggested they have their teeth cleaned every three months.

ZN: Which foods are the most dangerous in terms of discoloring one’s teeth?
RB: Black coffee, tea, red wine, blueberries and some foods that stain teeth.

ZN: What do you think about people over 50 using Invisalign? What does Invisalign do and are there any alternatives to straightening crooked teeth?
RB: Invisalign is great. I’ve done it. Invisalign straightens out those crooked teeth that always bothered you, but not so crooked that you’d feel it necessary to endure the usual “braces”.

ZN: What type of whitening treatment do you recommend? Why is it better than the other options out there?
RB: In my office I use Sapphire whitening system. It is awesome! Patients do not experience sensitivity, which is very common with other systems. I usually give the patient take-home trays to follow up at their discretion. However, many people are not so good about doing so, and I am often pleasantly surprised that over time, their teeth still look great after the in-office treatment .

ZN: What factors tend to make a smile not-so-perfect? Gum health? Stains? Tooth discoloration from using antibiotics?
RB: A not-so-perfect smile could be due to: a) Unhealthy gums- red, puffy, with marginal plaque, b) Tetracycline antibiotic stain from childhood. This is an intrinsic occurrence, c) Unaesthetic dentistry– bulky crowns, crowns not matching adjacent teeth, d) Tooth positioning and shape.

ZN: What is your opinion of more dramatic dental procedures such as caps, gum reshaping, or veneers?
RB: Depending on the circumstance, caps (crowns), gum reshaping, and veneers are all excellent procedures. Crowns protect teeth from decay and fractures. Gum reshaping is generally for aesthetic purposes, mostly above the two upper front teeth. If a patient has had gum grafting they may need gum reshaping to refine the area.

ZN: What can people over 50 do to achieve and maintain a healthy, pearly-white smile going forward?
RB: First and foremost, good oral hygiene habits are a must. That is why it is important that dental hygienists educate their patients regarding the importance and practice of maintaining good oral health. A person can have teeth that are not picture-perfect, but healthy gums gives one a healthy, attractive appearance, just as unhealthy gums gives one an unhealthy, unattractive, appearance. And that is an absolute turn off! I am also a big fan of whitening! I often suggest whitening before pursuing more involved methods. Many times a combo of healthy gums and whiter teeth is all it takes for a happy, healthy smile!

ZN: Any other tips or suggestions you may have?
RB: Get your teeth cleaned 3x every year! The bacteria in the mouth are relentless. By the time six months rolls around, we really NEED a cleaning. Those vulnerable areas, such as periodontal pockets, or places hard to keep clean on a daily basis, such as crowding, are breaking down even more. It is essential to maintain these areas so that they don’t get worse. Six months is way too long to go between cleanings. Just one extra cleaning a year makes a huge difference. I always tell my patients “don’t work so hard, just work properly”. Achieving and maintaining good oral health is simple and avoids complexity.

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