Red Oak Dentistry
Reinforcing Healthy Habits While at Home
In Raleigh NC
As we embark on a new month, we round out a full year of sheltering at home during the pandemic. We have each weathered a change in our routines, expectations, and daily activities, and our lives have felt uncertain and unpredictable much of the time. As you look back on the year, what were you able to manage? What was still within your control? We at Red Oak Dentistry want to encourage you to take care of your oral health. This is one thing you can do while laying low at home.
Working from Home
Of course, maintaining healthy oral habits is easier said than done. But as we continue to wait for the dust to settle and our life to pick up where we left off, oral health can seem like a small thing and so easily fall by the wayside if we are not careful. Here’s what we recommend you do while you work from home to maintain optimal oral health and avoid a mouthful of cavities and other dental issues.
Studies have shown that the consumption of comfort foods, processed snacks, and alcoholic beverages is on the rise as we cope during these prolonged periods of constant family togetherness and isolation. We’ve all discovered that our new normal is anything but normal, so it’s natural that we have been grasping for some variety of comfort. But it’s no secret that sugary and acidic food and drink can destroy enamel and wreak havoc on teeth. If this has been your reality, limit your intake, create new habits, and change old ones that have developed over the past year. Drinking lots of water to wash away potential cavity-causing bacteria is a helpful hack when you do indulge in some of your favorite feel-good food and drink.
If you haven’t already implemented daily exercise into your routine, it’s never too late. Not only does exercise help to reduce stress, boost our moods, and aid in better sleep, it also has shown to benefit our teeth and gums. Studies show that regular exercise helps prevent periodontal disease and boost gum health. Those with a healthier weight are much less prone to developing gum disease. As the weather changes, get outside more, take a walk, and move your body.
One thing to keep in mind is that this pandemic will not go on forever, and caring for ourselves now means optimal oral health once social distancing and masking is a thing of the past. When that time comes and the masks are removed, your breath and the state of your teeth will matter even more. How you care for yourself now, or fail to do so, will have an impact on your future oral health. Brush now for a healthier tomorrow. When this virus is in the rearview mirror, you’ll be glad you did.
Get the Kids into a Routine
If you’ve got children, you’ve been forced to oversee their Zoom school as they’ve endured a new form of education. Like you, life has become much more fluid, sedentary, and online. What can you do to create for them a healthier daily routine? Now that they no longer need to get fully dressed as they learn from home or eat breakfast before leaving for school, forgetting to brush their teeth is a real thing. But a morning brush is as crucial to the success of their oral health as ever. So, set up a regular practice for them. Have them brush right after their breakfast or during their first Zoom school break. Schedule it into their morning routine.
The key to excellent oral health is to carry these new healthy habits forward as restrictions are lifted. Healthy, happy smiles don’t just happen. And what we need to do to maintain them isn’t rocket science. But routine is essential. And incorporating healthy habits around your diet, daily body movement, and self-care will bolster your oral health. Make oral hygiene and all that might enhance your dental health be your focus today.
Mar 29th, 2021
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Dealing with Stress without Hurting Your Teeth
The toll that the global pandemic has taken on our mental and emotional health is real, and unfortunately, it can have negative effects on our teeth as well. If you’ve developed new bad habits or physical oral reactions that you don’t typically experience, they could be a result of the stress you’ve been under. There are several ways stress and trauma can impact our oral health, and we hope the tips we provide here can be used as a tool to keep you comfortable and care for your dental health.
4 Ways Stress Impacts Dental Health
Be on the lookout for newly developed bad habits or habits you’d thought you’d once kicked but that have resurfaced. Unhealthy patterns are often stress-related. Likewise, our bodies and mouths can respond negatively to stress. Read on for natural oral reactions to stress that you can likely control with a little guidance.
Teeth grinding when you sleep is a common response to stress. How does it harm your oral health? In addition to making your jaw sore and damaging your teeth, severe cases can even break or loosen teeth. If the stress-management techniques at the end of this article do not reduce the stress that is causing your teeth grinding, we would be happy to make you a mouth guard to wear while you sleep.
Teeth grinding and jaw clenching can lead to swelling and stiffness in your temporomandibular joints (TMJ) which are what we use to move our lower jaw. If you’re experiencing clicking, popping, and pain for the first time, you may have developed a TMJ disorder. First, attempt to manage the stress that is causing your clenching and grinding, and eat a soft diet. If that doesn’t ease your discomfort, contact our office.
It’s not uncommon to subconsciously develop the habit of finding comfort in food during times of stress. Chips and other starchy snacks can lead to plaque buildup. And bacteria in your mouth love to use sugary treats, alcohol, and sports drinks to produce acids that attack your enamel. Hard candies and ice put your teeth at risk for dental emergencies, such as chipped or broken teeth. Citric fruits and juices erode enamel and make your teeth more susceptible to decay. Constant exposure to too much of any of these foods can be harmful to your teeth.
If you’ve developed a habit of smoking to cope with the stress of the pandemic, you’re not alone. But it’s important you’re aware of the havoc it can wreak on your oral health in addition to your overall health. The adverse effects smoking can have on your mouth range from oral cancer, periodontal disease, bone loss, and discoloration of your teeth to increased levels of bacteria that hide out in pockets that smoking creates between the teeth and gums. As plaque and bacteria begin to grow, gum disease, bad breath, tooth decay, and other dental issues can result.
Healthier Ways to Deal with Stress
The following suggestions for dealing with dealing with stress in a healthy way do not have to be added to your routine all at once. Take some time alone for yourself and implement what you can. Start today.
- Identify what it is that stresses you. Naming it gives you power over it.
- Make a list of your responsibilities and put them in order of importance.
- Practice meditation and deep breathing.
- Talk with someone you trust.
- Exercise daily.
- Get 7 to 8 hours of sleep every night.
Stress is a natural response to COVID-19, but it is crucial that we find healthy ways to cope. Taking care of yourself is more important than ever right now. So, minimize the amount of time you spend on your phone each day, care for your body, make time to unwind, and stay connected with others. Your mental, physical, and oral health deserve attention, so make self-care a priority today.
Mar 8th, 2021
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Dental Health Impacts Overall Health
How would you change your oral health hygiene and habits if you knew it could protect you from heart disease, pregnancy complications, diabetes, and other health issues?
Gateway to the Body
The link between our oral health and overall health is real, and we can affect positive change in our bodies and prevent serious health problems by caring for our mouths. We can make conscious efforts to maintain our overall health when we realize that it can be affected by our oral health.
Maintaining Dental Health
The best way to maintain dental health is practicing good oral hygiene and visiting your dentist regularly. Your goal should be a set of teeth that are free of cavities and disease and gums that don’t bleed when you floss and brush. Use those as indicators of your overall health, and if you suspect you have gum disease, call us today to schedule an evaluation. Read on for more details about how to maintain oral health that leads to excellent overall health.
Your mouth, teeth, and gums are the first step in your dietary process, and so what you eat is not only important for your overall health, but your teeth and gums too. To protect and rebuild tooth enamel, replenish your dietary intake with plenty of calcium-rich food (cheese, yogurt, leafy greens, milk, and almonds) and protein-packed food (fish, milk, eggs, and meat). And don’t forget to drink plenty of water, the understated tooth-friendly beverage that hydrates while washing away all the debris in your mouth that can lead to tooth decay.
On the flip side, try to limit the sugary foods because, cavities aside, they can damage your overall health, wreaking havoc on energy levels and heart health by triggering an inflammatory response. This can be especially difficult these days, as we continue to quarantine and work from home. Comfort food is no joke when we’re stressed and anxious. That’s why it’s crucial to establish some healthy habits to ensure optimal dental and overall health.
Did you know?
Apples clean your teeth as you eat them! The old saying holds true for dental health: An apple a day keeps the doctor away.
The following healthy habits may seem obvious. But how can you establish them as part of your daily routine? Make a list, reinstate the following habits into your day, and watch how much better your mouth, body, mind, and spirit feel.
- Daily, brush for two minutes twice and floss once before bed.
- Fill up your water bottle and keep it by your side all day. Woman should drink about 2 liters a day and men 3 liters. That means women, with a standard 32-ounce water bottle, need to fill it up twice a day and men three times.
- If you must eat sugary or acidic foods, do so with your meal. This will help to allow your saliva (which is already caused by your chewing) to wash away any bacteria.
- Notice your triggers. If you tend to eat more when you’re stressed or emotional, make a point of keeping healthy snacks on hand that you can conveniently grab.
- Set up outlets for your stress, like walking, exercising, meditation, etc.
As your dental team, we use your mouth as a window into the rest of your body to gain insight into its health. Poor oral health is closely connected to chronic overall health conditions. And as it affects the tissues and bone that support your teeth, the bacteria in your mouth can enter the bloodstream and cause inflammation and infection wherever it goes. That’s why we strongly encourage you to practice good oral hygiene and keep up on your regular dental cleaning and checkups- it’s good for your whole body.
Professional Dental Care
Professional dental cleanings are one of the best things you can do for your dental and overall health. The removal of plaque and tartar with our specialized tools so that you can walk out the door with a whiter and brighter smile is just one way you benefit from a cleaning. On a deeper level, our expert dentist, Dr. King, examines your mouth for signs of cancer, identifying potential problems early before they develop into larger problems. Read more about the advantages of our professional teeth cleanings here.
Did you know?
Floss can only reach so far below the gum line. Dental professionals can provide a deeper cleaning with specialized tools and techniques than you can with flossing at home.
Red Oak Dentistry considers your whole-body health as we care for your teeth and gums, understanding the deep connection between our mouths and the central nervous system, heart, circulatory system, and immune system. We provide thorough dental procedures, treating oral infections that elevate systemic inflammation. Now more than ever, as we continue to make our way through the pandemic, pay extra attention to your oral health so that down the road, when COVID-19 is in the rearview mirror, you’ll be feeling healthy and happy from head to toe.
Call us today! Raleigh Office Phone Number 919-781-8984
Feb 22nd, 2021
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3 Benefits of a Professional Teeth Cleaning
What is it that keeps us from scheduling (and keeping) a dental cleaning appointment?
For many of us, it’s that we feel fine.
Why fix what’s not broken, right?
We brush regularly, and we’re healthy people. Or maybe we think something might not be quite right, but anxiety and fear of dental visits keep us away. And then there are those of us who just don’t have the time or energy or money to squeeze in yet another appointment.
Dental Health Beyond the Brush & Floss
No matter your reason for missing, whether it’s intentional or accidental, regular teeth cleanings are, hands down, one of the very best things you can do for your dental health and well-being.
Here’s why dental cleanings keep your teeth, gums, and whole person healthy.
Plaque & Tartar Removal
Regular morning and evening brushing and flossing to remove plaque is critical to healthy teeth and healthy gums, but tartar buildup cannot be fully removed at home.
During dental cleanings, we use special instruments to gently clean below the gum line and polish your teeth, removing stains and flossing difficult-to-reach areas between teeth.
Professional cleanings keep your teeth and gums healthy, and at Red Oak Dentistry, we ensure you’re relaxed and comfortable while we tend to your pearly whites.
A Brighter Smile
One of the most obvious and immediate benefits of regular teeth cleanings is the whiter and brighter smile you’ll carry out the door when you leave.
And that’s especially helpful this time of year as many of us consume more coffee and tea during the cooler weather and more red wine during the holidays.
As part of your cleaning with us, we remove most of the stains that dull and discolor your teeth, leaving them fresh and polished. Indeed, upon leaving our office, your smile will not only be fresh, but also confident and bright.
An Expert’s Perspective
The first part of a teeth cleaning involves a full examination.
We look for cavities, plaque, tartar, and gum disease.
We check out your tongue, throat, face, head, and neck for swelling, redness, and signs of cancer.
Our skilled and experienced professionals are able to detect miniscule indications of decay and disease that the untrained eye would normally miss.
A regular dental cleaning guarantees we identify potential problems and treat them appropriately before they’ve spiraled out of control and require more invasive procedures.
Dec 18th, 2020
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5 Reasons Patients Prefer Dental Implants Over Dentures
Let’s get right down to it. You’re missing a tooth and you need a replacement. What is your very best option and why? Without a doubt, dental implants surpass all other teeth replacement methods in diverse and incalculable ways. Here are the top 5 reasons why dental implants are the superior option.
What is the number one complaint about dentures? They move around and can fall out when you’re eating. That’s because they are only able to provide a fraction of the bite force that natural teeth do. So, those who wear dentures must focus on each bite, its size, and how to chew it instead of enjoying life and the meal in front of them.
Dental implants are as close to natural teeth as you can get. Why? Because they consist of a titanium screw that is placed in your jaw and acts as the root for your new implant tooth. The solid attachment prevents any chance of movement or slippage. The bite force of implants is comparable to that of a natural tooth.
Problem number two for many denture wearers is that they can’t taste their food. This is because a denture usually covers your palate in order to maintain proper suction and stay in place.
Again, this is a not an issue for folks with dental implants. A dental implant is made of 3 parts: the titanium screw that fuses with your jawbone, the crown that you see above your gumline, and an abutment that connects the two. That’s it. There’s nothing that covers your palate or impairs your sense of taste.
Sores and rawness are common side effects of dentures because they rest on top of the gums and can cause pain when you’re eating. These problems happen because dentures often can’t handle the kind of force that eating requires.
Anchored to the jaw like natural teeth, dental implants distribute the force evenly and make eating a painless experience. In fact, eating with dental implants is like eating with your natural teeth, so your gums are never in jeopardy of being damaged.
Perhaps, the biggest difficulty when it comes to dentures is having them pop out when you least expect it, resulting in a humiliating experience. Whether you are eating or speaking or even sneezing, no one wants the focus of their activities to be making sure their teeth stay in place.
Dental implants stay put. Since they have the unique ability to integrate with bone, they become as solid as natural teeth. The biocompatibility creates a stable and permanent solution for missing teeth that ensures they are locked in place for life, providing peace of mind and one less thing to worry about.
Did you know that the reason dentures always need to be adjusted, resized, and relined is because the jaw of a denture wearer is slowly shrinking? The bone in your jaws exist to maintain and support your teeth. Once your teeth are gone, the surrounding bone no longer serves a purpose and it begins to resorb. As that process occurs, dentures that once fit great can become ill-fitting and move around much more as a result.
Dental implants, on the other hand, are made out of titanium and readily integrate with the surrounding bone creating a solid anchor and platform on which to place your implant crown that will look and feel just like your natural teeth! While maintaining healthy bone levels in your mouth, you will also naturally maintain a more youthful appearance as you prevent bone from resorbing away.
Oct 15th, 2020
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3 Ways the Pandemic is Staining Your Teeth
At Red Oak Dentistry during the past few months, we have seen a moderate increase in the number of people who are complaining of increased teeth staining. The recent COVID-19 pandemic has forced many of us to change our daily routines and adapt (at least temporarily) to a “new normal”. Many of us are now doing school from home or working from home.
As a result of being home more, some people have found themselves drinking more coffee during the day or consuming more wine in the evening than they did before the pandemic. Our favorite food and drinks are now much closer than they use to be and as a result, teeth staining is on the increase! One way to combat this is to rinse out with water after eating food or drinks that are likely to stain your teeth. These can include food and drinks that are high in sugar and acid like energy drinks, soda and Gatorade as well as food that is otherwise considered healthy including: Blueberries, Cherries and other citrus fruits, coffee, tea and wine to name a few.
With increased stress and the change in routines, oral health care may have taken a back seat. Poor oral care is a common cause of tooth discoloration. If people fail to brush and floss regularly, it’s all too easy for bacteria, acid, and plaque to accumulate and harden into tartar. Plaque and tartar both create a yellow coating around your teeth that may leads to other issues like bad breath, decay, and tooth loss.
2. Tobacco Use
Stress during this time may cause an increase in tobacco product use. Cigarette smoking, chewing tobacco, and other tobacco products not only exposes you to certain cancers but it also puts you at a very high risk of contracting gum diseases and other oral issues such as yellowing of your teeth and discoloration.
3. Natural Discoloration
Teeth naturally come in a range of colors and shades. Young teeth tend to look whiter when compared with older teeth. There are a few reasons for this. As we age, our teeth can pick up stains and develop wear marks from grinding or craze lines (thin fracture lines usually limited to enamel). Also, as we age, our enamel on our teeth grows thinner through normal attrition of enamel from brushing too vigorously and eating abrasive foods. All of this can combine to give the appearance of darker teeth.
This natural staining coupled with people who may be delaying their regular cleanings and check-ups due to the pandemic will result in darker teeth. At Red Oak Dentistry, we are taking this pandemic very seriously. Please see what preventative measures we are taking by clicking here.
What You Can Do About Stained Teeth
These are just a few reasons why tooth discoloration might be increasing during this difficult time. By making a few simple lifestyle changes, you may be able to prevent teeth discoloration. Fortunately, there are way to help prevent excessive tooth discoloration caused by certain staining.
- Brush and floss twice a day
- After eating or drinking sugary foods try to rinse or swish with water to help remove sugar, acid and stain.
- Reduce or eliminate tobacco use
- Get regular cleanings from your hygienist
- If your teeth are discolored, teeth whitening may be a good option for you. In-office whitening and take-home whitening kits are both available at Red Oak Dentistry if you would like to have whiter teeth.
If you have any questions, please call us at Raleigh Office Phone Number 919-781-8984.
The Team at Red Oak Dentistry
Aug 28th, 2020
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Hello Everyone, I hope you are doing well considering our circumstances.
Last time I discussed how to help prevent tooth decay, but what about crack lines, tooth wear and recession? In other words, how do we prevent tooth damage that has nothing to do with cavities?
Crack lines in teeth, tooth wear and gum recession can all be caused by grinding your teeth or clenching them. These days, we are all much more stressed out than we were just 2 months ago. Simple things like grocery shopping have suddenly become stressful. Things we previously took for granted like going to work or simply going to a friend’s house are suddenly more difficult or out of the question all together. All of this increases our stress levels, which in turn makes some of us clamp down and have a good grind!
The result? Our teeth can develop cracks in them or wear down from all of this additional force over time. This damage isn’t limited to just your teeth. Clenching and grinding your teeth over time can cause gum recession and sore jaw muscles, as well as headaches. In severe cases, it can cause Temporomandibular Disorders (TMD).
This clenching and grinding may occur at night when you aren’t aware of it or it can happen during the day, perhaps also without you being aware. A good rule of thumb is to keep your: “Tongue relaxed, teeth apart, and lips together”. If we are grinding our teeth during the day without realizing it, being mindful can go a long way to stopping the behavior. Pick a personal item that you see all the time, perhaps your phone. Every time you look at this item, think “what are my teeth doing?” If your teeth are together, remember: “Tongue relaxed, teeth apart, lips together”. Night time grinding is more difficult to stop on your own. Often, if severe enough, a night guard is your best bet to limit damage to your teeth and gums. If you feel you are grinding your teeth at night, we would normally make a custom fit night guard for you. Under the current circumstances, you could order a night guard from a sporting goods store. It might not fit perfectly or be really comfortable but it may hold you over until we can make one for you.
Chewing on certain things such as almonds or ice can also cause fracture lines in your teeth over time. Ice is especially bad as it is hard and it’s also cold! The rapid temperature change can cause teeth to expand and contract in a similar way that a wooden house does in the summer vs. the winter.
Brushing your teeth too aggressively can also cause gum recession. One of the best ways to combat this is to use one of the more recent electric toothbrushes that has a “brake” on it. If you push too hard while brushing your teeth, the electric brake will slow down the toothbrush to alert you that you are pushing too hard.
Please continue to stay safe and I hope to see you all soon!
Michael King, DMD
Apr 28th, 2020
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Now, more than ever, it is important to be as safe as possible to avoid any unnecessary trips to the dental office or the emergency room, as we want to limit our exposure to COVID19. Many of us have been thrown off of our usual routine; perhaps some of us are home-schooling our kids (best wishes to those of you who are!) We are probably all clenching our teeth more than we normally do. We are idle and maybe eating more than we normally do and, therefore, more prone to cavities!
I’ve been hearing from a lot of people who are worried about getting cavities now that they are stuck at home with food or they are on the go, drinking energy drinks to help stay awake during a long ED shift, for example.
The bacteria that create decay in our mouths love sugar and acid. Therefore, anything we can do to limit sugar and acid in our mouth is a good thing. Here are the top 3 things you can do to avoid cavities:
- Swish with or drink water after eating or drinking anything acidic. This includes energy drinks, soda, sweet tea, sports drinks, juice and wine. This includes sugar free (diet) versions of your sodas and energy drinks. If you are curious about the acid level of your drink, check the back and see if citric acid or phosphorus acid is toward the top of the list.
- Brush your teeth with a fluoride toothpaste after each meal (or alternatively you can chew a piece of sugar free gum). Brushing your teeth, does 2 things, it mechanically removes food debris, which deprives the bacteria of a food source, and it spreads fluoride on your teeth, which kills bacteria and helps to re-mineralize damaged enamel.
- Make sure you are flossing before going to sleep. Mechanically removing any food caught between your teeth before you go to sleep ensures the bacteria aren’t feasting on that left over food and multiplying while you sleep!
Please let me know if you have any questions, until next time, stay safe and stay sane!
Michael King, DMD
Apr 28th, 2020
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Your Mouth and Heart Disease
Today, we often hear in the news that oral health is connected to and an important component of our overall health. More than 80 percent of Americans are living with periodontal disease which is an inflammatory condition affecting the bone and gums around teeth. Periodontal disease often goes untreated in people who don’t regularly visit the dentist because they don’t experience any pain initially and therefore don’t follow up with a dentist.
The American Heart Association (AHA) and American Dental Association (ADA), among other associations, both cite plenty of evidence for the association between oral health and heart disease. While the association has not been shown to be causative, that is, it has not been proven that periodontal disease causes heart disease, patients with periodontal disease had a 20% higher risk for heart disease.
Why are these things related? While there is still more research being done on finding a direct causative link between periodontitis and heart disease, if there is one, there is certainly a more general connection between the 2 conditions. Chronic inflammation in the body in localized areas like the mouth, increases the overall tax on the body as your body tries to fight these areas of chronic inflammation. Lowering your body’s defenses drains defensive resources and can lead to other problems like heart disease.
According to the AHA and the American College of Cardiology (ACC) in 2017, it is recommended that patients who have had prosthetic heart valves, congenital heart disease, previous Infective Endocarditis and cardiac transplant with regurgitation engage in antibiotic prophylaxis prior to dental procedures to limit the risk or Infective Endocarditis. Your Cardiology and Dentist can tell you more specifics about these parameters.
Symptoms and Warning Signs
According to the American Association of Periodontology (AAP), you may have gum disease, even if it is in the early stages, if:
- Your gums are red, swollen and sore to the touch.
- Your gums bleed when you eat, brush or floss.
- You see pus or other signs of infection around the gums and teeth.
- Your gums look as if they are “pulling away” from the teeth.
- You frequently have bad breath or notice a bad taste in your mouth.
- Or some of your teeth are loose, or feel as if they are moving away from the other teeth.
Good oral hygiene and regular dental examinations are the best way to protect yourself against the development of gum disease. It is recommended that you brush your teeth twice a day with a soft bristle brush or an electric tooth brush such as Oral B Braun or Sonic Care brush. It is also important to floss once a day and use an ADA accepted toothpaste with fluoride. You should also visit your dentist for regular professional cleanings. We look forward to seeing you and helping you to maintain your optimal oral health!
Carolyn S. RDH
Jan 20th, 2020
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Foods That Cause Tooth Decay
When it comes to tooth decay, it’s important to know the main culprit – acid. Acid is what eats away at our enamel and causes cavities.
Acid can enter our mouths in one of two ways: either directly through what we eat (citrus fruits, for example), or as a byproduct when oral bacteria consume the sugars that we eat.
Ultimately, a simple way to identify foods that cause tooth decay is to ask whether it’s acidic or sweet/starchy.
Acidic foods include things like energy drinks, soda, coffee, Gatorade, wine, citrus fruits, and sour candy.
Sweet foods include things like candy or sugar-sweetened beverages and fruit while starches include food like bread, chips, cereal, pasta and crackers.
The longer these things interact with your teeth, the greater the chance for tooth decay to occur. For example, sipping on soda throughout the day, or chewing a gooey caramel treat, increases the amount of sugar that coat your teeth. Bacteria love to feast on this sugar, creating an acidic environment and putting your teeth at risk for decay.
To help protect your teeth against tooth decay:
- Reduce your consumption of sweets and refined starches
- Enjoy acidic foods in moderation or as part of a meal
- Decrease or eliminate your consumption of soda or sugar-sweetened beverages
- Swish with water after meals and snacks
- Maintain good oral hygiene to brush away plaque buildup (floss at least once a day and brush twice a day)
And, as always, make sure to visit us regularly so we can remove tartar buildup and assess for early signs of decay.
If it has been more than 6 months since your last dental cleaning and exam don’t hesitate to call us today and book your next appointment. Raleigh Office Phone Number 919-781-8984
Carolyn S. RDH
Dec 23rd, 2019
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