Dr. Susan Chen

While it may be easy to know when to replace your scuffed up shoes or faded blue jeans, knowing when to change your toothbrush isn’t always obvious. It often depends upon usage and your overall health.

By now, most of us know to brush our teeth twice daily for two minutes and floss every day for a clean, fresh and cavity-free smile. If you’re brushing correctly, that toothbrush will get a lot of use. Over time, the bristles will begin to breakdown and lose its effectiveness.

The ADA recommends replacing your toothbrush every three to four months, even sooner if the bristles become frayed and tattered. Studies show that after three months of normal wear and tear, toothbrushes are much less effective at removing plaque from teeth and gums compared to new ones. With frayed bristles, they just can’t get to those awkward corners around your teeth anymore. Children tend to brush more vigorously, so they may need a new toothbrush even more often.

Cleaning and storing your toothbrush

In most cases, you won’t need anything fancy to clean your toothbrush. The American Dental Association recommends just rinsing it under tap water after each brushing to wash away remaining toothpaste, debris and saliva. Then, store it in a vertical position so the bristles can air dry, ideally away from other toothbrushes to reduce spreading bacteria.

Do I need to disinfect my toothbrush?

It’s true that bacteria and microorganisms can grow on toothbrushes after use. But, according to the Centers for Disease Control (CDC), researchers have found little connection between bacteria growth and adverse oral health issues. Further, there is no clinical evidence that soaking a toothbrush in antibacterial rinses or using a special sanitizer has any positive or negative effect on oral or systemic health. Additionally, the CDC advises against using a dishwasher, ultraviolet sanitizing devices or microwave ovens to disinfect or “sanitize” your toothbrush. These devices do little to improve the performance of a toothbrush, and often do nothing more than damage the bristles.

Just follow a few, common-sense tips to maintain your toothbrush:

• Don’t share your toothbrush. Sharing a toothbrush introduces unwanted risk for infection—a particular concern for anyone with a compromised immune system.
• Keep your toothbrush holder clean. Simply wipe it down with a gentle cleaner or run it through the dishwasher.
• Don’t store your toothbrush in a closed container. Bacteria tends to grow in dark, warm and moist places, so it’s best to store toothbrushes in an open container to air dry.
• Protect your toothbrush while traveling. A plastic case will shield bristles from getting squashed in your travel kit. Just be sure it’s clean and dry before placing it in the closed container.

For more great oral health tips, talk to your hygienist or Dr. Chen at Pine Lake Family Dentistry. Call us today for your next appointment.

Got a Dental Emergency? Contact Pine Lake Family Dentistry

Dental emergencies happen. But they don’t always happen at a good time! At Pine Lake Family Dentistry, our top priority is patient comfort. So, in an emergency, our goal is to see you immediately, relieve your dental problem as thoroughly and quickly as possible, and get you back on your way. Our state-of-the-art facility is fully equipped, and our expert staff is on-call 24/7 to assist you with urgent dental care.

What to do in a dental emergency

From a broken tooth at soccer practice or a lost filling at lunch to a severe toothache in the middle of the night, dental disasters always seem to strike unexpectedly and without warning, so understanding how to handle them before they happen can be helpful. Here are a few common emergency dental issues and tips to temporary solutions for alleviating pain and preventing further damage.

Lost filling or crown: Use a piece of sugarless gum to cover the empty cavity, or you can use over-the- counter dental cement for a very temporary solution. See your dentist as soon as possible.

Lost tooth: Find the missing tooth, but don’t touch the root! Hold the tooth by the enamel crown and lightly rinse it off with warm water. If possible, attempt to replace the root in its original position in your mouth and hold it there while travelling to your dentist. If that’s not possible, store it in a cup of milk until you see your dentist.

Chipped or broken tooth: Save any pieces of your tooth that you can find. Rinse your mouth and the tooth pieces lightly with warm water. Apply gauze, if your mouth is bleeding, for 10 minutes and use a cold compress on the outside of the mouth to help with swelling. See your dentist right away.

Abscess: Swollen, sensitive pocket around your gums or at the root of a tooth that looks like a gum pimple is called an abscess. This is infection and can be quite serious, so it’s important that you see your dentist immediately. Rinse your mouth with warm salty water to keep it clean.

Mouth wound: Most mouth wounds are rarely serious and require only a light rinse with warm, salty water. However, more serious lacerations that continue to bleed may require dental treatment, a tetanus shot or even stitches. Call your dentist right away. If bleeding persists, apply gauze to the wound and hold a small piece of ice in place to control swelling.

Toothache: Throbbing or sharp pain from your tooth is likely due to a cavity located very close to the nerve, causing unusual and sometimes severe pain. The best thing to do is to first take an over-the-counter pain reliever and then call your dentist.

Like any sudden medical issue, dental emergencies should never be ignored. If you have an emergency dental problem, call Pine Lake Family Dentistry at 425-391-9414.

courtesy American Academy of Periodontology

Yup. You’ve heard it many times before. Brush and floss for a clean and healthy mouth. As a dentist, I personally say it, oh…roughly 30 times a day. And I really do mean it! Brushing and flossing are the most important actions you can take to protect your teeth.

Flossing is particularly important, but often neglected. According to the American Academy of Periodontology, only about 18% of people in the U.S. floss daily and 27% actually lie to their dentist about how often they floss (note: we already know how often you floss!).

Why Floss

While brushing gets the surface of your teeth clean, flossing gets in between your teeth and gums where bits of food get trapped. That rotting food causes bacteria, and bacteria can cause cavities and bad breadth, but the most serious is gum disease.

I’ve talked about the dangers of gum disease before. It’s an inflammatory disorder triggered by bacteria growing in between teeth, causing swollen, painful gums—a sign of infection, which allows that bacteria to enter your blood stream. That bacteria can travel through the body to cause many other problems in an otherwise healthy person. Recent studies suggest links between advanced gum disease and diabetes, heart disease, Alzheimer’s, and a variety of cancers.

The Right Way to Floss

Key message here: don’t skip flossing. With just a little practice, flossing gets easier and naturally becomes part of your routine. Here’s how to do it right…

First, start with a piece of floss about 18 inches long. Lightly wrap most of the floss around the middle finger of one hand and the rest around the middle finger of the other hand. Begin with the upper right quadrant of your gum line, sliding deep between each tooth and wrapping the floss around so that each gets a nice little hug. Repeat this step for the other side, staying with the upper teeth. Now, move to the lower left quadrant and then to the lower right. Follow flossing with brushing for a full two minutes.

It may only add a minute more to your regular brushing routine, but the result is healthier and stronger gums and teeth.

What Kind of Floss

Floss comes in a variety of options, styles and brands. But don’t over think which floss to choose. Keep it simple. I usually recommend a basic waxed floss. It’s often the least expensive and does what you need it to do: clean your teeth thoroughly and quickly. Ribbon or glide floss is a good option if you have very tight contact between teeth, where wax floss may not hold up well. But this type of floss isn’t as effective since it “glides” over the plaque and doesn’t remove as much bacteria. Similarly, floss picks are pre-threaded floss-holders. They’re convenient, but be careful with this option. Because they’re pre-threaded, these picks can’t wrap around teeth effectively to do a thorough cleaning.

No More Excuses

So, there ya have it. Simple. Fast. Easy. Building flossing into your daily routine promises better oral health, which can lead to better general health.

Need more instruction? Your dentist or hygienist is always happy to show you how to floss in your next dental visit. Just call Pine Lake Family Dentistry today to schedule your next appointment. We look forward to seeing you and your lovely smile.

–Dr. Chen

I get a gazillion questions from parents throughout the day about their children’s’ dental health. From foods that cause cavities (sticky sweets mostly and refined carbs) and how many teeth should my kid have (20 baby teeth) to the importance of fluoride (very). But, there’s one question I get from parents more than any other: “When do I bring my child in for his/her first dentist visit?” If you have children, you, too, may be asking the same questions. So here’s a quick and dirty primer on dental health for children.

When should my child see the dentist?

The American Academy of Pediatric Dentistry (AAPD) recommends that a child go to the dentist by age one or within six months after the first tooth erupts. At birth, your baby has 20 primary teeth positioned in the jaw just under the gums waiting to reveal themselves. But good dental care should begin before a baby’s first tooth actually appears. So, even before your baby starts teething, run a clean, damp washcloth over the gums to clear away harmful bacteria.

How should I care for baby teeth?

Baby teeth are very important to lifelong oral health, so it’s important that they stay in place until they are lost naturally. Baby teeth help children chew properly, help speech development, save the space for permanent teeth to grow in and promotes a healthy, happy smile. So taking care of them is just as important as adult teeth.

Once baby teeth are in, brush them with an infant toothbrush and just a tiny bit (size of rice) of toothpaste, non-fluoridated until the child is old enough not to swallow it. When fluoride toothpaste is introduced, use only a pea size and be sure it carries the American Dental Association’s (ADA) seal of approval. As soon as two teeth touch each other, floss between them once a day. You can use regular floss or special plastic floss holders, but supervise children under eight.

The first dentist visit is a great opportunity for parents to learn how best to care for their children’s teeth and ask questions about oral health.

Here are a few more common questions I get.

Will sucking on pacifiers, thumbs or fingers cause problems?

Sucking on fingers and thumbs is a very common way for babies and young children to sooth themselves—even while still in the womb. But most children stop sucking on things between two- and four-years old on their own. Occasionally, the habit may continue for a very long time, so we want to try and break the habit before age five. In some circumstances, the habit can cause the front teeth and jaws to tilt upward toward the lip, preventing the child’s bite from forming properly.

When should I expect adult teeth to grow in?

Adult teeth typically begin growing in around six months of age. Primary teeth are lost as adult teeth start pushing their way up, forcing them out of the way. Your child will start to notice wiggly teeth usually around age five and a half to six-years old. So in the middle of first grade, teachers are seeing a room full of toothless smiles. The best way to help these baby teeth along is to let your child wiggle them free, allowing them to release from the gums gradually. Once the baby tooth is out of the way, you’ll start to see the adult tooth erupting at the gum line, which may take a few weeks to fully emerge. But don’t expect a bright white enamel like you see in baby teeth. Adult teeth are naturally slightly darker in color.

How can I help my child prevent cavities?

Now that adult teeth are in, there’s no better way to help prevent cavities than brushing and flossing. We recommend brushing twice daily for two minutes each time, floss once daily, and see the dentist twice a year.

Best to also reduce sugar. Americans are consuming foods and drinks high in sugar and starches more often and in larger portions than ever before. A steady diet of sugary foods and drinks can ruin teeth, especially among those who snack throughout the day. When sugar is consumed over and over again in large, often hidden amounts, the harmful effect on teeth can be dramatic. Sugar on teeth provides food for bacteria, which produces acid. The acid in turn can eat away at the enamel on teeth, causing cavities. It’s hard to resist, but sugar is not a tooth’s friend. Offer water and healthy, naturally sweet fruits instead. When your kids do indulge, encourage them to brush and floss as soon after as possible.

How can dental sealants help protect my child’s teeth?

The truth is, it takes a while for kids to master brushing and flossing. Getting in between teeth and deep into the grooves can be hard for little hands. Dental sealants help protect your child’s teeth by forming a protective barrier that helps prevent bacteria from causing tooth decay. Sealants keep food particles and plaque from touching tooth enamel, particularly in spots that brushing and flossing can’t reach. It’s a very effective strategy to reduce cavities.

To keep happy, healthy smiles, make sure your kids have a balanced diet, limit snacks, and brush and floss each day. These healthy habits and regular dental check-ups are the keys to a lifetime of healthy teeth and gums.

–Dr. Chen

Every week, I get questions about fluoride. In short, fluoride is important; our teeth and bones depend on it. But how much do we need and where should it come from?

First, a quick primer. fluoride protects tooth enamel from the bacteria in plaque that can build up on and around the tooth. It strengthens teeth and promotes new bone formation. Dentists see it as one of the most important tooth decay deterrents available… along with reducing sugar from our diets and maintaining good oral hygiene habits at home. So, it’s an important part of most dental visits. Fortunately, fluoride is found naturally in the environment, though generally only in trace amounts.

Practice of Fluoridating Water

In the early 1940s, scientists discovered that people in communities with elevated levels of naturally occurring fluoride in their water supply happened to also have significantly better oral health than communities where fluoride was found only in trace amounts. This discovery spawned national interest from public health advocates who pushed to fluoridate community drinking water supplies throughout the United States as a broad measure to improve oral health.

Water fluoridation prevents tooth decay by providing frequent and consistent contact with low levels of fluoride. By keeping teeth strong, fluoride stops cavities from forming and can even rebuild the tooth’s surface. According to the American Dental Association, fluoridation is the most feasible and cost-effective method of delivering fluoride to all members of the community, regardless of age, education, or income—improving lives and saving families money on dental care.

For more than 70 years, fluoridation has shown to be a major factor in lower rates of tooth decay in the United States. So much so that the Centers for Disease Control and prevention (CDC) named water fluoridation as one of 10 great public health achievements of the 20th century. The benefits of fluoride have had an enormous impact generation after generation.

Too Much of a Good Thing?

Today, fluoride is found in a variety of products, including toothpaste and mouth wash. While fluoride is safe in correct doses and usage, too much can cause adverse effects, especially in children. Over exposure to fluoride can cause a cosmetic condition called fluorosis. Most dental fluorosis in the U.S. appears in its milder forms as white spots on the tooth surface, which often goes unnoticed. It can occur when young children (less than 8 years of age) regularly take in more fluoride than needed when their permanent teeth are still developing. As such, dentists don’t recommend fluoride be given to infants, and we suggest children be monitored during brushing so that they don’t ingest toothpaste with fluoride.

To balance the benefits of water fluoridation with the chance for dental fluorosis, the U.S. Public Health Service set guidelines for the optimal level of fluoride in drinking water to prevent tooth decay at 0.7 mg/liter. The recommendation helps ensure an effective level of fluoride to reduce the incidence of tooth decay while minimizing the risk of cosmetic fluorosis in the general population.

The increased use of fluoride products, including fluoridated water, reduces tooth decay by 25% among children and adults. According to the ADA, in communities with water fluoridation, school children have, on average, two fewer decayed teeth compared to children who live in communities without fluoridation.

Fluoridation on the Sammamish Plateau

While the benefits are clear, there is no federal requirement in place to fluoridate community water supplies. States and local communities have the freedom to decide whether or not to fluoridate.

Most water delivered to communities on the Sammamish Plateau are treated with fluoride, but to confirm if your neighborhood is treated, visit the Sammamish Plateau Water and Sewer District for a map of the water treatment areas.

Effective, Safe and Recommended

More than 100 national and international healthcare organizations  recognize the benefits of community water fluoridation, including the American Dental Association.

At Pine Lake Family Dentistry, we recommend drinking fluoridated water and brushing your teeth twice a day with a toothpaste that has the ADA Seal, which means that it has been tested and shown to contain the right amount of fluoride to protect your teeth. Be aware that not all bottled waters contain fluoride.

To learn more about the effects of fluoridation on your specific dental health situation and that of your family members, schedule an appointment with me at Pine Lake Family Dentistry.

–Dr. Chen

Happy Holidays!

Nothing embodies the holidays like sharing treats with family and friends. From candy canes and sugar cookies to mulled wine and chai tea, the holidays are so delicious! They’re also potentially harmful to our teeth. With all the celebrating going on, treats are hard to avoid, so I’m offering you a few tips to keep your pearly whites shining bright.

Our teeth are the strongest element of the body, but they’re not impenetrable. Tooth enamel is still vulnerable to both sugar and acids. Hard, sticky, gooey candy, cookies and cakes are filled with sugar. Sodas, wine, coffee and tea are sugary and acidic. All these goodies can wreak havoc on our teeth enamel, causing decay and stains.

It’s the sticky, gooey sugary foods that are extra bad—especially yummy candies and treats surrounding us during the holidays. Taffy, caramels, candy canes and peanut brittle, for example, can pull fillings out, chip or break teeth, and can lead to cavities. Sodas, wine and coffee are acidic and can erode and dissolve tooth enamel, increasing the chance for stains and cavities.

But don’t say no to all the treats!

Make good choices

When you have a choice, choose soft treats that melt in your mouth, like chocolate. Yup. Those peanut butter cups have your name on them. Even better, make selections from the fresh fruit and veggie trays. Leafy, dark green veggies, carrots, apples, pears, red peppers and celery are great choices—colorful and festive. Or consider replacing high-risk treats (i.e. peanut brittle) with safer options, like smoothies or milkshakes. Those are just as yummy!

Think about what you’ll be drinking, too. While you might think white wine would be a better choice than red, it’s actually more acidic, more capable of etching enamel away, making the surface of your teeth rough and more easily stained (surprise!). Logically, you might think coffee is more acidic than tea. But the opposite is true. Black tea, especially, is high in tannic acid, so much harsher on your teeth than coffee—even more prone to staining them. Choose a dark roasted coffee, which actually stains less because when heat is applied to coffee beans, it breaks down the stain producing molecules, called polyphenols. Who would have thought?

Lastly, don’t chew on the ice. Good for cooling a drink, but ice is not good for teeth. It can damage enamel, and chip or break your beautiful pearly whites.

Tips to protect your teeth

For most of us with good oral hygiene, indulging in a few holiday treats in moderation is no big deal—in fact, most dentists encourage tasting and sampling. No harm in that! But, if you have a history of oral health problems, including cavities and fillings and other dental work, indulging in treats will probably take a bit more consideration.

• Brush and floss often: You know this. Brushing and flossing are the first lines of defense for a healthy mouth, especially during the holidays. Do it often.
• Cleanse often: When a toothbrush isn’t available, drinking or rinsing with water when you finish treats or drinks can make a big difference, immediately washing away some of the food particles and rinsing potential stains away.

• Carry a little mouthwash: Following a meal, take a swish to kill any lingering bacteria—and freshens your breath in case you find yourself standing under the mistletoe.
• Just add milk: If you’re a coffee or tea drinker, milk can dilute acids, so adding just a bit of milk or cream helps minimize staining.
• Chew gum: Sugarless gum with Xylitol fights the growth of bacteria and prevents cavities. It’s a great way to remove food particles, too. As a bonus, chewing gum is known to help reduce the calories that you might consume.

As with all indulgences, practice moderation and make good choices when it comes to those holiday treats. Be especially vigilant about dental hygiene throughout the day to remove trapped food and to wash away stain-causing ingredients. With just a little extra care, you can enjoy treats AND protect your teeth.

Happy Holidays!

Breast cancer is a concern for everyone in the medical field, including dentists.

October was Breast Cancer Awareness month. But for 1 in 8 women in the U.S., breast cancer is a year-round battle. With those odds, most of us know someone who has or will be diagnosed with breast cancer sometime in their lives. We have mothers, sisters, friends and neighbors who fight the disease everyday. Fortunately, dentistry can play a role in both reducing the occurrence of breast cancer and in making the treatment process more comfortable.

Connecting the dots

According to a study in the International Journal of Cancer Research, women with poor oral health or gum disease are 11 times more likely to be diagnosed with breast cancer. Researchers believe the increased risk is in part due to inflammation caused by gum disease, which allows bacteria and viruses to enter the blood stream, causing the body to be more vulnerable to other threats. As the body works hard to fight off the invaders, all that work can suppress the body’s immune response. It can also contribute to abnormal cell changes, resulting in certain cancers, including breast cancer.

Inflamed, red and soar gums should never be ignored. These are symptoms of gum disease. The dental community recommends that everyone should see a dentist for regular checkups at least every three months to prevent gum disease, especially with the presence of cancer.

Resolve dental issues before cancer treatment

Dealing with cancer is stressful enough, but pre-existing or untreated gum disease further complicates the issue when inflammation and infection are present. Because some drugs suppress white blood cells, which normally protect against infection, deep cleanings and other invasive procedures should be done in advance of cancer treatments. While undergoing treatment, gentle oral hygiene is important to avoid further infection, which is particularly dangerous with a suppressed immune system. So it’s important to resolve dental problems before cancer treatment begins. In many cases, oncologists and dentists often work as a team to develop a treatment plan.

Cancer treatment can impact oral health

While dental health can impact cancer treatment plans, the treatments themselves can also cause oral health issues. The IJCR study showed that more than one-third of people being treated for breast cancer develop complications that affect the mouth. Chemotherapy and radiation target cells that multiply quickly. But cells in the mouth also regenerate quickly, so these aggressive treatments often zap healthy cells, as well, causing unpleasant and painful side effects. Mucositis (severe oral inflammation), thrush (oral yeast infection), and bacterial infections often emerge during cancer treatments. And one of the most common is dry mouth, which allows for bacteria to grow and difficulty swallowing, speaking, and eating. Sometimes treatments can cause aching and burning pain that mimics a toothache. Even if minor, all these issues should be reported to the physician and a dental appointment scheduled.

In general, consistently practicing good oral hygiene can help to limit side effects caused by breast cancer treatment, and regular dental check-ups keep gum disease at bay. With all of the research out there linking oral health to overall health, it’s important to be proactive with dental health, particularly if family history indicates a higher risk for cancer.

To learn more about the connection between Breast Cancer and Oral Health, contact Pine Lake Family Dentistry to schedule an appointment.

FACT: I don’t mind ghosts.

They can lurk up and down the hallways and shake their little chains in the attic and make spooky ghost sounds until the cows come home. I really don’t mind. But, I do love a good scare once in a while, and that’s why haunted houses are so much fun. Getting the adrenaline pumping once in a while is a good thing.

The truth is, haunted houses are more excitement than actual fear, yet we still get scared. You pretty much know something will be lurking around that next corner, and that’s why we go, right? In spite of getting the daylights scared out of me, I know that I’ll be safe in the end.

This year, Pine Lake Family Dentistry is thrilled to be sponsoring A Nightmare at Beaver Lake. With elaborate sets and over 100 actors, A Nightmare at Beaver Lake winds you through a spooky Sammamish forest with lots of surprises along with way, ending with a tour through a scary haunted house. Boo!

In its 12^th year, this annual attraction is one of the main fundraisers for the Rotary Club of Sammamish. Proceeds from admissions directly support our local community, providing college scholarships for Sammamish high school students, support for local families in need during the holidays, giving to Sammamish YMCA, Friends of Youth, Eastside Baby Corner, Rotary First Harvest, Medical Teams International Dental Vans, Issaquah Schools, HopeLink, and more.

Canned goods collections at A Nightmare at Beaver Lake support Lifewire, so bring a non-perishable food item and receive $1 off admission.

Go get scared and support your community. Happy Halloween!!

–Susan

Everyone, at some point in their lives, will have a problem in their mouth. Most often, problems are temporary or easily treated. But there are changes in your mouth that should cause concern and prompt a call to your dentist.

Here are five symptoms you should never ignore:

1. Toothache: In most cases, a toothache is a signal that something isn’t going quite right in your mouth. Waiting can cause damage to your tooth…or worse. At the first sign of a toothache, see your dentist.
2. Painful Jaw: Jaw pain can be caused by a variety of issues, but often from sinus problems, bite issues or Bruxism—persistent grinding and clenching teeth. Your dentist is trained to evaluate the health of your oral cavity, including your jaw. Best to see your dentist.
3. Bad Breath: While this might seem like an insignificant issue, it could be a sign of something more serious than an unpleasant aroma from the pizza you ate for lunch. It could be a sign of gum disease. See your dentist. At the very least, you’ll get tips for fresh breath. Hint: brush twice daily for two minutes and floss often.
4. Recurring Mouth Sores: Unlike toothaches, some mouth sores go away on their own, including canker sores and cold sores. But others might be a symptom of infection or a virus—even cancer. If you notice a change in color or texture on the inside of your cheeks, gums or tongue, see your dentist. Don’t wait.
5. Inflamed Gums: Gum inflammation can be caused by something as simple as brushing too hard or not flossing often enough. But more often than not, it’s an early sign of gingivitis (i.e. gum disease). If you experience sore, bleeding or inflamed gums on a regular basis, this isn’t normal. See your dentist.

Ideally, everyone should see a dentist twice a year for a professional teeth cleaning and thorough examination to ensure healthy teeth and gums. Regular dental visits and good oral hygiene can prevent most dental issues, so don’t wait until you have a problem. Your mouth will thank you.

Contact Pine Lake Family Dentistry to schedule your next appointment with Dr. Chen. We’re waiting to hear from you!