1)  Pay a visit to your dentist.  If you are prone to skipping the dentist, you are among the 50% of adults in the United States who miss the dentist yearly because of dental phobia, finances, or neglect.  Spend some quality time with your Dentist, at least twice a year, and you’ll catch problems at an early stage when they are treatable, not to mention more affordable to take care of.

2)  Count the years.  Toddlers and older adults tend to fly under the dental health radar, but they need oral maintenance just like the rest of us.  Children should see a dentist by the time they are 4.  Until they are coordinated enough to tie their own shoes, they will need help cleaning their teeth.  Older folks have their own oral health issues.  Arthritis can make brushing and flossing challenging, and as people age, the amount of saliva they produce decreases, which means more tooth decay and sometimes discomfort.

3)  Can the Soda!  Phosphoric Acid and Citric Acid, 2 ingredients of soda, eat away at the surface of your teeth.  While the occasional soft drink will not hurt you, a can or more a day makes your tooth enamel softer and more susceptible to cavities.  Switch to water instead.

4)  Do not sugarcoat it!  Sugar is a major culprit in tooth decay.  It fuels bacteria and acidity in your mouth, causing plaque to form and eat away at your enamel.  Your pearly whites are hit with up to 20 minutes of acid production for every sugar fest you indulge in.  To avoid being among the people who are faced with tooth decay, try to cut down on sugary treats and aim to brush and floss after meals and snacks.

5)  Pack it in.  Quit smoking.  The nicotine and tar in cigarettes not only turns your teeth yellow, but they also effect your gums.  Smoking creates a ripe environment for bacteria and plaque on your teeth and along the gum line.  That harms tissue, degrades the bone that supports the teeth, and eventually increases your risk of tooth loss.  Even worse, tobacco chemicals can lead to oral cancer.

6)  Use the right toothbrush.  You want a brush with soft bristles.  With the right technique, it should last 2 – 3 months.  It is ready to be replaced when you notice bent bristles, but if you have had a toothbrush longer than 3 months, replace it.  Bacteria can lurk between the bristles.

7)  Proper Strokes.   While you know you should brush your teeth at least twice a day, it is important to do it properly.  Hold the toothbrush at a 45-degree angle, pointed toward the gum line, and use gentle, circular motions.  Brush each tooth 10 – 15 times, but do not overdo it.  Overly aggressive brushing can damage teeth and erode your gum line.

8)  Finesse with Floss.  It is simple: flossing promotes healthier teeth and gums.  But like brushing, there is a right and wrong way because flaws in your technique can cause friction or cuts on the gum line.  Keep the floss tight against the tooth to break up plaque while leaving your gums in good shape.

For more information and videos on some on Oral Health Care, please see our web-site at RichmondDentalGroup.com for great tips on keeping a beautiful smile!

Recent studies show that both caries (cavities) and periodontal disease (gum disease) are more prevalent between the teeth than on the flat tooth surfaces which face the cheek and tongue.  You might think the occlusal (biting) surface is the prime target for cavities, but there are only 20 occlusal surfaces in an average adult mouth, compared to 64 inter-proximal surfaces!  These are the surfaces between the teeth which cannot be reached with a toothbrush.  The inter-proximal tooth surface, just below the point where two teeth touch, is where most cavities begin. 

Since the gum tissue between the teeth takes minimal trauma from eating, it does not have as thick of a protective Keratinized layer as the gum tissue on the cheek and tongue side of the tooth.  Therefore, this area is more vulnerable to the acid released by bacteria creating  inflammation.   The inter-proximal gum is more susceptible to disease than the facial and lingual gum tissue.  Yet despite being the biggest target f0r cavities and gum disease, most patients spend more time on tooth brushing, rather than cleaning between the teeth.

How successful is the current brushing and flossing message?  Recent studies have shown that the average person only reduces their plaque scores by 50% with tooth brushing, despite feeling clean from toothpaste.  The concept of flossing is good, but compliance is very poor.  In the United States, only 13% or adults report daily flossing.  If the patient does floss, many do not have a good techniques and leave plaque behind.

To accurately target where the disease is more prevalent, many hygienist recommend that you clean the areas between your teeth first.  Flossing correctly is the primary daily treatment for these areas; however, many alternatives to dental floss are available.  Dental Floss still holds the top spot for inter-proximal cleaners, but triangular wooden/plastic swords and soft tipped plastic picks are available for the patient on the go.  Cleaning between the teeth on a daily basis is the most important thing.   If disease prevention is the goal, it should start between the teeth.   People should still brush their teeth, but if more emphasis is placed on cleaning between the teeth where the greatest risk of disease occurs, we will see a major decline in decay and periodontal disease.

That being said, here are a few of the more popular home remedies that really seem to help!

STEAM  -  A steam shower can be effective in calming coughs.  The moist heat from the shower can provide relief to muscles strained from coughing.  The steam provides warm moisture to the respiratory system, helping to break up mucous and remove it from your system.

HOT SOUP  -  A warm bowl of soup, particularly chicken noodle or onion soup, can help with decongestion, providing moisture to the chest and sinuses while the warmth of the soup sooths the throat.  Soup provides a tasty means of staying hydrated, and ingredients like onion and garlic have antiseptic qualities, potentially helping the body repair itself faster.  At the same time, the sodium found in carrots and celery can help the body metabolize and absorb nutrients.

HOT TEA  -  Drinking hot green tea can also provide some similar benefits as soup.  The heat of the tea soothes the throat, and it is full of antioxidants which helps to strengthen the immune system.

ORANGE JUICE AND VITAMIN C  -  Orange juice is known for boosting the immune system.  A daily dose of Vitamin C as a preventive measure is important because the body does not naturally produce Vitamin C.  A 1000 milligrams dose of vitamin C  is recommended daily as a good preventive measure.

SALINE RINSES  -  Saline rinses are an effective way to reduce congestion symptoms.  Neti pots and saline mists physically remove debris and help you breathe better.  The body’s natural defense  is to flush it out any impurities.  This is why it creates mucus.  Rinsing out mucus and debris can help alleviate allergy and cold symptoms.

HONEY  -  Ingesting local honey every day to reduce allergies is a great help as long as you are not diabetic!  As bees gather nectar from plants to make honey, they are creating a homeopathic remedy for allergies.  This  provides a small doses of the allergen to the patient and builds up their resistance.  Mixing honey into hot tea, however, actually breaks down the enzymes.  It is recommended to eat honey directly from the spoon.

Jessica's before smile

Wow!  What a great Case, and what a great young lady.  Jessica Vipperman began her Orthodontic case at our office with Dr. Freeman on August 18th, 2010, and less than a

Jessica's after smile

year and a half later, we  finished up  her case with excellent results.   How did we finish in such a short period of time ?  Because of the cooperation and help of such a wonderful patient.  Jessica did everything she was told right from the start.  From wearing her appliances to being aggressive with her Home Care/Oral Hygiene, Jessica was the key partner in her orthodontic treatment.  Just take a look at her before and after photos and you can see the results.

Jessica’s original issues stemmed from slightly crowded arches and a deep bite.  Jessica’s arches were too narrow to support the width of her adult teeth.  This lack of space caused crowding and rotations of her anterior (front) teeth.  When Jessica would bite down, her upper anterior (front) teeth almost covered her lower anterior teeth completely.  This is called a Deep Bite, and Jessica’s upper front teeth covered 90% of her lower front teeth.  Deep bites are the root cause of many issues as people get older including cracking of the lower front teeth and the need for multiple restoration in this area.  In extreme cases, the lower teeth can cause tissue damage to the roof of the mouth just behind the larger front teeth.

We began Jessica’s treatment by using a fixed series 2000 appliance to expand her arches.  Patients and parents tend to love these appliances because they have an internal spring system to create a slight even pressure.  As her arches expanded, orthodontic brackets and bio-efficient wire were place on the teeth to guide them to a more proper position while the need space was being created.  Once the expansion was complete, it was time to deal with the deep bite.

An appliance called a Rick-N-Nator was placed on Jessica’s upper arch.  This appliance holds an acrylic block behind the upper front teeth.  When the patient bites down, the lower teeth are stopped by the acrylic block in a more proper bite position.  As the patient wears the appliance, the posterior teeth erupt in further until they touch again.  Once the posterior teeth have established a new bite, the appliance can be removed.  On average, this treatment takes five months.

Once we had met all of our goals and Jessica and her parents were happy, all brackets were removed and Jessica was placed into a retainer system.  Jessica took our office oath to be loyal to her retainer because she knows that the retainer will “hold her teeth in positions” and the longer she wears her retainers, the longer lasting her results will be.  We were so very proud of Jessica, and when she smiles, we can see that she is very proud of her teeth.  Who makes us smile?  Great patients like Jessica.  That’s who.

Jessica's lower teeth before

Jessica's lower teeth after

Jessica's smile before

Jessica's smile after

As her husband’s career progressed from Horticulture student to Landscaper to Adjunct Professor at J. Sargent Reynolds,  Susan worked  3-4 years stints in a variety of offices across Virginia.  It was during this time that her skills grew and her experiences with patients deepened.  Still, she never felt like she had found the right office to work with.  Then she interviewed with Dr. Freeman, and she realized very quickly that this was the family atmosphere she had been looking for.

Impressed with the skill of the Dentists and  the commitment of the other staff members, she found herself doing something she had not done before – - – bringing her family to the office where she was working for their Dental care.  “We even brought my daughter’s boyfriend at one point,” she chuckles.  Susan has worked a two or three day week during her 15 years with us.  Currently, she is happy with a schedule that has her in the office Monday and Wednesday and “on call”  to fill in for others as needed.

So how have things changed across the three decades of her career?  “Patients today are better informed,” she observes.  Information is available from TV, the Internet, magazines and newspapers.  She has seen her patients become more aware of the connection between dental care and their overall health, which makes it easier to encourage good home care.  Susan loves to provide this motivation. This increase in awareness makes it easier to explain concepts and treatment to her patients.  It can also be challenging.

“Sometimes,” she says, “we have to answer lots of questions about issues that are in the media.  A famous Doctor will mention something on a show and everyone will get concerned. ”  She welcomes the conversations and takes care to be sure that her patients have the most accurate information.   Today’s patients, who are interested, informed and engaged, make great partners in their own care.

Some other things have changed as well.  Susan remembers the time before masks and gloves, before suction replaced cuspidors and spit bowls.  “So many of the tools of care have improved.”  Technology has improved as well, but, she emphasizes, the fundamentals of good care remain the same.  She is committed to providing great care, fostering communication and maintaining her patient’s comfort.  Of all the things a Dental practice can provide, she says that quality care tops the list of importance.

One of Susan’s skills that we value the most is her responsiveness to her patients–her ability to assess her patient’s needs, to gauge what they need to know, to listen and to communicate.

We are so grateful for the time, talent, care and concern for her patients that Susan has invested with our office.  As we move into the new year, we look forward to a great 2012 with great friends and team members like Susan.

Dentists can often tell if a patient is a habitual toothpick user by the telltale marks in the mouth.  Overzealous toothpick users can cause serious problems in the mouth, including lacerated gums, damage to tooth enamel, and chipping or breakage of dental veneers or bonding.   Even worse, small notches can be worn into the root structure of the tooth where a patient “holds” a toothpick in their mouth, especially where the gums have pulled away from the teeth to leave the root surfaces exposed.

In more recent years, certain dental supply companies have developed substitutes for the wooden toothpick.  DentalSwords are plastic toothpicks shaped and designed to not only clean between the teeth better but help to minimize the negative issues surrounding wooden picks.  Plastic swords are often triangular in cross-section.  By placing the flat end towards the gums, it helps prevent damage to the gingival tissue.    GUM dental has recently developed a new aid called Soft Picks. These are small plastic picks with a light foam coating on the end used between the teeth.  This foam tip not only protects the tissue and root structure but grab debris from the interproximal site.  Another benefit of plastic swords are that they are bendable to reach into difficult areas.

While toothpicks can be a good solution to cleaning teeth occasionally, our Hygiene Staff would prefer to show you the proper way to floss your teeth so that you can develop a habit of flossing  on a daily basis.  Did you know that it is recommended that you floss your teeth first, before you brush?  This way you can brush away any debris you remove with the floss from between the teeth.  On our web-site RichmondDentalGroup.com, you can find short instructional videos on Brushing and Flossing under the Your Oral Health heading.  (CLICK HERE to go to the brushing and flossing page to watch)  Try to make the time to floss everyday.  If you become a daily flosser, your gums will be healthier and your routine dental cleanings will be much easier.  This is a simple way to improve your smile!

This was not Tori’s  first career choice.  “I got my teaching certificate,”  she recalls, “but I quickly figured out that it wasn’t the right fit for me.”  Calling on the experiences of friends who were already working in the dental field, she set her sights on a degree that would let her work as a Dental Assistant.  She knew that this would give her the skills needed to help others and to find a good job.

Tori  is happy to share how much she loves her job.  When she began working, she did not anticipate how much she would come to know and care for her patients.  Over time, she has learned about their families and their lives and many of her patients have become her friends.  Tori finds it is gratifying to help her patients with their overall health and well being.  She laughs saying  it is like being a nurse, only with better hours.

Unlike the teaching career that she originally contemplated, Dental Assisting allows her to leave her work at work.  This little luxury keeps her  rise to the challenge of each new day.  Some are peaceful and even.  Some bring emergencies, complicated procedures or other challenges, but for Tori, the variety in the work makes things even more interesting.   Unlike the other Assistants, Tori  has worked with several different Dentists over the last ten years at our office.   Dr. Freeman likes to give her the responsibility of breaking in the new Doctors, teaching them our special techniques,  and making sure they know what we expect of them at our office.

“I was lucky, though, to get such a wonderful place off the bat.”  Dr. Mark Freeman & Associates has been Tori’s  professional home for her entire career, and it is easy to see why she has stayed.   “We have a real family atmosphere here.  It is relaxed and fun.”   Tori credits Dr. Freeman and his wife, Christie, with setting a great family-like tone in the office.  “They are such kind, wonderful people.  It is quite a feat to sustain such a positive environment for both the staff and the patients.”   As an example, Tori related the following story:

“We were on the way back from a Dental conference in Las Vegas.  Everyone had a wonderful time.  We were all chatting, joking and laughing about the events that took place that weekend.   A couple on the plane close to us starting asking questions about who we were and the reason for our trip.   I remember talking to the wife, and telling her all about the new techniques I learned that weekend.  A month  later that couple schedules appointments at the office. They thought we were wonderful and fun on that plane ride back to Richmond.  And we are! ”

We asked Tori what has changed over the last ten years.  She replied that new products come on the market always claiming to be better than the one they are replacing, but that good dental care is always good dental care.  Quality work does not change.   “Each day is an adventure in this place.”

Thank you, Tori, for the care and skill you bring to our patients.  We are so glad that you have invested the last decade with us and we look forward to many more years with you on our Dental Care Team.

On this particular afternoon, while walking on the sidewalk along Cox Road, she suddenly lost her footing and fell, face first, onto the pavement.  Shaken, she laid there for a moment.  To her horror, she realized that her teeth had been badly damaged and that she was bleeding profusely.

Frantically, she tried to wave down passing vehicles for over ten minutes.  “Person after person kept driving by without even stopping or showing concern.”  she said.  “I was terrified because even though my mind wanted to, my body could not get off the ground.”

Out of nowhere, she heard a young man’s voice  “I think you need help.”

Carefully , he maneuvered to help her up.  She knew she was dead weight in his arms, and she could feel him struggle to get her off the ground. The boy, Vince,  seemed to be around nineteen years old, give or take a few years, but he quickly understood the severity of her injuries.  He helped her into the passenger side of his car.  Inconvenienced drivers blew their horns at the young man who had dared to stop his vehicle in the right lane.

Our patient hazarded a glance at herself in the side-view mirror.  Looking back at her she saw “what looked like a Halloween mask with missing teeth.  My face and neck were black and blue.  I looked like a very scared senior citizen.”

“Take me to Dr. Freeman’s.”  They were  less than a mile from our office.  Without hesitation, Vince  followed her directions straight to our door.  He helped her from his car and into our office.   When they came through the door, both now splattered with red spots, Vince looked a little rattled.  “I found her on the ground,”  he said.  “She said to bring her here.”

Our Patient was rushed to the back and put into the first open chair we had.  Two Doctors and three assistants worked for most of the afternoon to repair the damage that the fall had caused.  She had several broken teeth.  Her central incisors where knocked sideways and  one tooth was pushed upward into the bone.  Her upper lip was lacerated, and she was bleeding profusely.

Her teeth were repositioned, stabilized with orthodontic wire, and bonding material.   Her wounds were treated.

While  we were  in the back, the young man quietly disappeared from the waiting room, leaving  his name and address.

“Vince was so kind and considerate.” she recalled,  “I could not have made it without him.   In the car, he told me he was a first-year college student and was going to visit his girlfriend when he saw me on the sidewalk.  I thanked Vince for all his help and called him the next day to thank him again.  He was indeed my hero, and I shall never forget him.”

The next day, after things settled down, I felt that the young man should be rewarded for his heroic gesture.  We wrote a thank you note  from our office and sent him a gift certificate to a local restaurant as a reward.  We never heard from Vince, but several weeks later I received a card from his mother.  This is what it said:

Four months and several appointments later, the woman was her own perky self again.  She is back to her walking, making her trips to the store.  We never saw Vincent again, but it warms my heart to know there are people like him out there.    I thank him for his concern for a person in distress, his willingness to help and the inspiration he provided to us all.

I wish you all a wonderful holiday season and a hopeful New Year.

Dr. Mark Freeman

No on is immune.  Unlike other factors, Periodontal Disease seems to effect coronary health in both men and women equally.  Gum disease in women has been associated with a higher risk of pre-term birth and under weight babies.  These dangers have been well reported in the press.

Did you know, however, about the correlation between gum disease and rheumatoid arthritis, kidney disease, and even certain cancers?

While rheumatoid arthritis (RA) and gum disease are both systemic inflammatory diseases, it is interesting to note that patients with RA are eight times more likely to suffer from gum disease than those without RA.

Chronic inflammation may also have a role in the correlation between periodontal and kidney disease.  Worldwide, gum disease is the leading cause of tooth loss in adults.   Adults who have suffered tooth loss are more likely to develop kidney disease than adults who have retained their teeth.  A patient who has lost teeth may have been exposed to chronic oral inflammation and may be susceptable to other inflammation as well.

Men with tooth loss and a history of gum disease are also reported to have an increased risk of developing certain cancers.  Research is ongoing, but associations have been noted between gum disease and kidney, pancreatic and haematological (blood) cancers.  It is possible that  the gum disease may just be a marker of a susceptible immune system.  However, severe gum disease has also been documented as a risk factor for head and neck squamous cell carcinoma.

Please check out our home page at RichmondDentalGroup.com.  Under YOUR ORAL HEALTH, you can easily find more information on periodontal disease and the systemic problems with which it is linked.  (click HERE to go directly to the periodontal health page).  Keep up with your home care and your routine preventive visits, and at your next cleaning, talk about your periodontal health with one of our caring Hygienist or Doctors.   We will work to ensure your healthy body starts with a healthy smile.

MFA: Penny, you have been a valued colleague for the last decade here in our offices.    Clearly, you feel a real sense of dedication for your work and your patients. What is your favorite part of your role as a Dental Hygienist?

PENNY:   The best part of my job here is the daily contact with our patients, who have now become my friends.  They make my life richer and my profession enjoyable.  Patient compliance comes much easier, I believe, because people know I genuinely care.  I take a personal interest in their families and daily life and they in mine. Ironically, I benefit as much as they do from these interactions.

MFA: Your career spans more than two and a half decades. How did you know that this was the career that would bring you such satisfaction? How did you choose this line of work?

PENNY: As a child growing up, I always wanted to be a writer, but as college approached I felt more and more drawn to the medical field.  I took a summer job as a dental assistant in a young practice and immediately loved every aspect of dentistry, especially dental hygiene. It was at the end of this summer that I decided to pursue this career.  I had had negative dental experiences as a child and I thought I might be able to make a difference by choosing this profession.

MFA: What changes have you seen during your career so far? How are things different now from when you started?
PENNY: Since graduation from MCV in 1986, my life has seen many changes both personally and professionally.  Technology has improved the delivery of dental care and has made for more pleasant dental visits.  The recent knowledge that our overall health can be affected  by our daily dental routine such as brushing and flossing has forced my profession to look beyond traditional dental care and take a more holistic view. Contributing to the complete health of my patients is now possible through dental hygiene instruction and care.

MFA: You had a sense of what you wanted when you started. What has surprised you most about the way that events have unfolded for you?

PENNY:   One of the greatest surprises in my 26 years as a dental hygienist is the profound effect that my patients have had on me as a person. I have come to realize that I need them as much as they need me and that they have taught me as much about life as I have them about dentistry. They validate my success in this wonderful profession and I am eternally grateful.

MFA: It is obvious that you are in the right profession and we are very grateful that you’ve chosen to work with us. What has your 10 years with our office meant to you?

PENNY:     Another unexpected gift in my professional life, especially in the last 10 years, is the bond formed with my work family. Just recently I have discovered how truly important these people are to me. We are all very different yet we come together every day with the same goal- to provide the best care we can for our patients.  The daily trials we encounter as a team have never deterred us from that goal and at the end of the day we are still the best dental team I know.  The individuals that make up this team have not only made me a better hygienist but a better person.  I am so grateful that 10 years ago today, there was a job opening for one lucky hygienist at the Office of Dr. Mark Freeman and Associates.

MFA: I’m not sure who was luckier–you or us. Thank you, Penny, for 10 great years and we look forward to the years to come.