You are the most important person for keeping your mouth healthy for a lifetime! We are happy to serve you in all ways for your health, and the most important part of our service is providing you with information on all you can do to stay healthy. To understand health, we must understand the disease processes that we are aiming to prevent.
Bacteria are always present in our mouths, and the goal is not to rid our mouths of all bacteria, but to balance the types of bacteria that include the greatest percentage of healthy bacteria, while defending ourselves from the harmful bacteria. Oral bacteria secrete a sticky matrix called plaque which is a biofilm that adheres to the surfaces of teeth. If bacteria were just little spheres bouncing around in our mouths, then all we would need to do is to rinse, and all would be fine. But the truth is that this sticky biofilm requires that we mechanically remove it from the teeth to keep the bacteria under control. Additionally, this biofilm reforms rapidly, and so we need to disrupt and dislodge it twice daily to keep the harmful bacteria from building up. So the classic recommendation of brushing twice daily and flossing once daily is still the best way to control bacteria. Here are our more specific recommendations:
Brushing
As we mentioned above, twice daily brushing with fluoride toothpaste can help keep bacteria at bay, and that brushing must reach all surfaces of the teeth. To avoid excessive tooth abrasion, use a soft toothbrush with a gentle circular technique. Be sure to reach all surfaces – cheek side, tongue side and chewing surfaces. Manual toothbrushes work well, and we really like electric toothbrushes as well. Sonicare, Oral B Braun, and Ultreo are all effective brands.
Flossing
Since brushing cannot reach between teeth, we recommend flossing once daily to reach the places where teeth contact one another. Flossing is also quite helpful for cleaning a few millimeters below gums. Gentle “shoe-shining” polishing of tooth surfaces works well to remove the sticky plaque and it is best to wrap the floss around each tooth to reach around the round surfaces of teeth.
Diet
Frequent intake of sugary foods increases the harmful activity of bacteria in our mouths. Sugary foods can be a special treat, but with how available they are in our diet, it can be difficult to limit our sweet consumption. And it is very important to note that the frequency of intake is far more important than the quantity of sugar. Small amounts of sugar throughout the day is far more harmful to teeth that one special treat at dessert time. The bacterial plaque metabolizes the sugar and creates acid, which then breaks down the enamel. Repeated sugar and acid formation eventually breaks down the enamel enough to form a cavity. So our goal with diet is to starve the bacteria so that their acid production cannot become harmful.

A well -balanced diet full of fruits and vegetables pays off in supporting your overall health, your immune system, and a healthy mouth. We also recommend taking a multiple vitamin daily to help for the times when we can’t eat.

Fluoride

Fluoride is a naturally occurring substance that can strengthen tooth enamel and discourage bacteria from attacking teeth.  We love fluoride, but want our patients to use it appropriately.  Since the City of Bainbridge Island does have fluoridated water, but all other areas on Bainbridge are not fluoridated, we will make individual recommendations to our patients for the optimum level of fluoride for each patient. 

 We recommend brushing twice daily with fluoride toothpaste for all our patients that can adequately spit out the toothpaste after brushing.  For small children who cannot yet spit, we recommend using non-fluoridated toothpaste to prevent them from ingesting too much fluoride.   Currently, there are changes to the recommendations for fluoride supplements for children.  Although water fluoridation is a still a highly successful public health program, the use of fluoride tablets for children in non-fluoridated areas has been found to not be as effective as once believed.  The Centers for Disease Control may be making new guidelines for prescriptions of fluoride tablets for children.  Our goal is to evaluate each child for their individual needs and make appropriate recommendations.   

For adults and teenagers that are prone to tooth decay, we may offer prescription-strength fluoride toothpaste that can offer additional protection against cavities.  This stronger fluoride can also be effective for patients that have tooth wear or exposed root surfaces due to gum recession.
Xylitol
Xylitol products such as gum and mints can be helpful in preventing decay. Xylitol is a natural sweetening product derived from birch trees. The acid-producing bacteria that cause decay take in the xylitol like sugar but cannot produce acid as a by-product. The cavity-causing bacteria diminish in their numbers and harmfulness. For the xylitol to work best, we recommend a xylitol product used 4 times per day, such as chewing 4 sticks of gum throughout the day. Do avoid using too much xylitol, as some stomach upset can occur with overuse