EXPERT: Maximum Mouth Health

Oral hygiene – it’s common sense, right? Most of us know that we’re supposed to floss daily, brush twice a day and go to the dentist at least twice a year. But when it comes to the finer points of dental health, it’s easy to forget the things you were taught – or never learned – in health class. We called on Jeffrey L. Angart, DDS, and Jacque Spurlock, dental hygienist, of the Center for Dental Health on Market Street to fill in the gaps for us.

Q&A:

What type of toothbrush do you recommend for the average adult?

What about electric toothbrushes?

Jeffrey L. Angart

Jeffrey L. Angart, DDS has been practicing dentistry for nearly 25 years. He has conducted extensive research and lectured nationally and internationally on cosmetic materials and tooth bonding. A graduate of The Ohio State University’s College of Dentistry, he holds a Bachelor of Science in Ceramic Engineering. Angart has been practicing in the Columbus area since 1991. He began his professional career as a ceramic engineer, specializing in dental materials. After graduating in 1984, he served a comprehensive practice in Mansfield that included periodontics, pediatric dentistry and extensive work in implant dentistry. Angart is a dental materials consultant to several dental manufacturers, has published extensively and has been involved in many round table meetings. He is a member of the Academy of General Dentistry, the American Academy of Cosmetic Dentistry, the Midwest Implant Institute and many other professional organizations.

Angart’s Center for Dental Health opened in New Albany in 2003. Angart lives in New Albany with his wife and two children.

Soft bristles on a toothbrush should always be used. Hard and medium bristles make microscopic abrasive lesions on the enamel over time, and lead to more plaque and stain adhering. The sonic frequencies of electric toothbrushes, such as Sonicare, are highly effective in the disruption of the biofilm bacteria that leads to gum disease (periodontitis) and tooth decay. This irrigation will also disrupt bacteria and soft deposits between the teeth to stimulate the gums and become tighter around the tooth so that less debris sits underneath them.

Should I use mouthwash?

What type of mouthwash is best?

Mouthwash should only be used with the recommendation of a dental professional, as it does not remove the biofilm bacteria like a toothbrush does. The most harmful types of mouthwash are those with alcohol because it is extremely drying to the oral tissues. When the mouth is dry, a condition known as xerostomia, bacteria will flourish and can cause decay and gingivitis due to the lack of saliva, which regulates or neutralizes the pH in your mouth. Some non-alcoholic mouth rinses can beneficial, such as chlorine-based (Oxyfresh) and lubricating ones for xerostomia (Biotene). Many medications, age, anxiety and cancer can cause the mouth to be dry, requiring the need for oral rinses for lubrication and hydration.

Some studies in the last few years have shown a correlation between dental plaque and cancer. Why do you think this is the case?

It is not yet clear why there are increases of cancer rates in individuals diagnosed with periodontal disease. It is well documented that patients with periodontal disease have an increase of cancer rates from 30 percent with lung cancer and 50 percent with kidney and pancreatic cancer, to 90 percent with colon cancer and 500 percent with oral cancer of the tongue. It is thought, just as we see increases of heart disease and stroke in individuals with periodontal disease, that inflammation and the host immune response to the inflammatory changes are responsible. The release of C-reactive proteins in the immune response, which is also seen with heart disease and strokes, also target the organs or systems initiating a change with the host immune response increasing the risk for a change, leading cells to mutate into cancer.

What should parents do to care for their children’s teeth?

Brush your children’s teeth even before you can see them with a fluoride-free children’s toothpaste. This develops good habits and strengthens the gums so that infection is less likely as the tooth erupts. Make sure to floss the teeth if they are close together to prevent cavities. The baby teeth molars are kept until pre-teen years. Many times, a lap visit is done at 18 months, knee to knee with the parent. A child should be seen no later than 3 years old or when the first and second primary molars have erupted because of the rapid growth, development and changes that occur. Anytime there are questions or concerns about the baby’s dentition or oral hygiene, a visit is welcomed. Are particular drinks worse for your teeth and dental hygiene than others?

The worst drink is the one that is sipped on for a long period of time. Every time you take a drink, chew or eat, the saliva and pH in your mouth drop