Monday, April 6, 2026

Healthy Gums do not Bleed

 




When I was a teenager, my father arranged for me to observe dentists in several dental offices, in order to convince me that dentistry was not what I wanted to do for my livelihood.  My parents’ plan backfired.  I loved what I saw, and knew in my heart that I would be a good dentist. Some of what I heard, however, did not sit well with me.  One dentist, in response to his patient’s concern about her bleeding gums, stated “everybody’s gums bleed.” NO! Everybody’s gums do not bleed, and they should not bleed.

If your hands bled when you washed them, you would be concerned.  You should also be concerned if you clean your teeth and your gums bleed.  Bleeding gums are sick gums. 

Healthy gums are light pink in color, are flat to the tooth surface, come to a neat point between the teeth, and are stippled like an orange peel.  Sick gums are more red in color, especially around the necks of the teeth, they are rolled like a bagel near the tooth surface, the triangular areas between the teeth are bulbous (they puff out) and the surface is shiny. The first stage of gum disease is gingivitis, the inflammation in the gums that creates the red appearance, that allows the gum tissue to flop in the breeze, and which bleeds when you brush, floss, or touch it. The more you avoid touching it, the more the bacteria build up, the more the tissue reacts to the toxins from the bacteria, the worse the inflammation gets.  You can only break the cycle by brushing and flossing (or brushing and irrigating with a water-pik.)  If your gums are bleeding they are saying, “Help, I’m sick. Please clean me.” If you continue to neglect your gums, the disease process will progress to periodontitis.  Now the whole attachment around the teeth is inflamed, and the bone that holds the teeth in your mouth starts to go away so that the necks of the teeth start to stick out of the gums. Over time the teeth also get loose, and some will fall out.  Gum disease is the leading cause of tooth loss in adults.

If you move teeth orthodontically, or with mouth habits like leaning your tongue on your teeth or sucking your thumb, and your teeth are not clean, you are at risk of accelerating the damage caused by gum disease.  For information on how to clean your teeth, watch our hygiene videos on-line at https://www.okunortho.com/brushing-and-flossing

Sunday, March 1, 2026

Spring is in the air, Let's keep our teeth for a lifetime

 


Spring is in the air (the snow is starting to melt). Soon all the seedlings will sprout and new plants will crop up everywhere.  If only it were so easy with teeth.  We only get two sets.  Most of the time, if everything is normal, we grow a total of 20 primary teeth.  These baby teeth are replaced between the ages of five and twelve (on average) with adult teeth.  New adult teeth also erupt distal to (further towards the back of the mouth than) the full set of primary teeth. The total number of permanent teeth, including wisdom teeth which erupt in adulthood, is 32.  We do not get replacements for the “second set.”  Despite the fact that we call adult teeth “the permanent dentition”, if we don’t take care of these adult teeth they do not last for a lifetime. Neglect can lead to a lifetime of restoring the damage with fillings, gum grafts, and replacement teeth (bridges, implant crowns, and dentures.)

In my recent agricultural volunteer experiences, I have learned that growing plants is not effort-free. It is not simply waiting for new plants to crop up everywhere. In addition to planting seeds in containers, clearing and fertilizing the fields and planting the seedlings in the ground, keeping the plants well-watered, and weeding out the unwanted vegetation, the plants need pruning (removing extra leaves that are sapping nutrients and removing extra fruits that are too heavy for the plant), pests have to be kept away from the plants, the plants need to be protected from the weather, and the fruits need to be harvested, boxed, and sent to market. (Did you know that cauliflower gets sunburned [i.e. it turns brown] if it gets too much sun?  The farmers need to bent the leaves over the head of the cauliflower daily to keep the cauliflower white.) Farmers don’t just plant the seeds and harvest the fruit.

People have to take care of their oral health with just as much effort.  We need to properly brush and floss to remove bacteria from our teeth daily in order to prevent cavities and gum disease.  We can also use other aids for cleaning our teeth like the Waterpik Dental Irrigator and ultrasonic electric toothbrushes like the Philips Sonicare toothbrush. Many of us need to use fluoride rinse daily to strengthen the enamel to resist decay and discoloration. We can use special rinses to keep the gums healthy (examples are The Natural Dentist Healthy Gums rinse, StellaLife VEGA rinse, warm salt water, or a combination of hydrogen peroxide and water.) We need to visit our dentist every 6 months to make sure that we are keeping the disease processes at bay.  If we are having issues, like cleaning the crooked teeth, or having enough space for the adult teeth to erupt properly, we need to visit the orthodontist to make the teeth easier to clean.  The orthodontist also puts the teeth into their best positions to withstand the functional forces of chewing and talking.  If we have parafunctional habits that put excessive forces on our teeth, we need to have the orthodontist make acrylic devices to wear on our teeth at night to protect our teeth from habits like grinding our teeth, leaning our tongue on our teeth. We also need to break habits like chewing our shirtsleeves, sucking our fingers, or biting our pens. Keeping teeth for a life-time is a lot of work!


 


Valentine’s Day is coming and millions of Americans are planning to take their loved ones out to eat, buy them flowers, and buy them jewelry.  Relationships take effort and time to maintain, even relationships with family members, friends and co-workers.

Teeth also take effort and time to maintain. We need to clean them effectively (brushing and flossing daily (https://www.okunortho.com/brushing-and-flossing) is the number one priority, because all diseases of the mouth are caused by the bad bacteria which build up when you don’t clean effectively. Eating fewer sugary things, keeping the time that the sugar is bathing your teeth to a minimum, and rinsing the sugar off your teeth after eating, will all help to minimize dental decay.  Eating fewer acidic things, and rinsing after having acidic beverages (like carbonated beverages, fruit smoothies and sports drinks) will help to keep decay and erosion to a minimum. 

Teeth that are well aligned are easier to clean than teeth that are crowded. Dr. Okun will happily show you how to clean difficult areas, but she will also recommend orthodontic treatment (braces) when it is indicated for the longevity of your teeth. Properly aligned teeth are in positions and angulations that help them to function at their best, and to hold up to the functional forces of chewing and speaking. But even well aligned teeth have trouble holding up to excessive forces that are generated by clenching and grinding your teeth (bruxism) and generated by leaning your tongue on your teeth at rest or when swallowing (tongue thrust).  Obviously, it’s best to eliminate these damaging habits, but it’s impossible to monitor habits when you are sleeping.  Therefore, if Dr. Okun diagnoses you with one of these habits, she will recommend that you wear acrylic appliances (such as a hard full occlusal coverage maxillary guard, or a Hawley retainer) at night (indefinitely) to protect your teeth and their supporting structures from these damaging habits.

(NOTE: This blog was written in January, and  did not post on it's scheduled post date. Sorry it's late.)

Tuesday, January 6, 2026

Help your teeth celebrate the New Year

 


New Years 2026 blog

How did you celebrate New Year’s? Did you curl up with a book, watch a movie on TV with your family, or go out with friends?

Human beings are social creatures.  We often share our special occasions with other people.  Too much “alone time” often leads to depression. Teeth are not too different.  One tooth that stands alone does not do very well; it has too many forces applied to it from chewing, speech, and swallowing.  But if that tooth has “friends” nearby, they can share the functional forces, and each one “suffers” less. When orthodontists rearrange teeth to a more ideal alignment, each tooth gets less abuse. The front teeth, with narrow edges, incise or cut the food. The corner more pointy teeth guide the chewing forces. The back teeth, with a wide biting surface, support the vertical forces of chewing.  The back teeth also support the vertical height of the face, while the front teeth help the tongue and lips to enunciate (speak more clearly).

The teeth are only one component of the chewing process.  The chewing muscles, tongue, and saliva also play a role.  The muscles help the jaws open, close, and move sideways in order to cut and crush food.  The tongue helps push food onto the chewing surfaces so the teeth can crush the food. The saliva helps by moisturizing the chewed food and filling it with digestive enzymes before swallowing.

There are also some “bad players” that live in the mouth's neighborhood.  Anaerobic bacteria (the ones that live without oxygen) cause cavities and gum disease.  It is our job to help our teeth by effectively removing the bacterial build-up daily with proper home care. If we don’t remove the bacteria effectively, within 24 hours the plaque layer gets thick enough to provide a place for the bad bacteria to live.

If you are not sure how to clean your teeth properly, please view our hygiene videos at https://www.okunortho.com/brushing-and-flossing.