Wouldn’t it be wonderful if every time you visited the dentist, he or she said: “Your teeth look great. See you in six months.” While a perfect checkup isn’t always in the cards, there are things each person can do to make sure they are taking the best possible care of their teeth. We’ve reached out to a handful of our top dentists asking them what advice and tips they wish all of their patients knew so they could have the best visits possible.
Find out what they had to say.
Dr. Philip A Gentry, Arlington
“It is true that sugar does cause cavities, but it’s not the sugar directly. The naturally occurring streptococcus bacteria that live in our mouths consume the sugar, ferment it and produce acid such as lactic acid. It is these acids that cause teeth demineralization and the formation of cavities, so it is actually the acid from the bacteria in plaque in our mouth that eats the holes in our teeth and causes cavities.
Here’s the interesting part: It’s not the total amount of sugar we eat, but the total amount of time the sugar is in contact with our teeth. It is preferable to have a piece of pumpkin pie with a scoop of ice cream for Thanksgiving dessert rather than sip on a soda all afternoon. It is better to have a few sugar cookies or slice of Christmas apple pie than to repeatedly sip on coffee with sugar all morning long. One Altoids mint or cough drop per hour throughout the day is 10 times more cavity-producing than one big piece of cake for dessert, even though the cake has much more sugar and calories.
The repeated cycles of eating sugar and acid formation is what is key. It is the frequency, or the amount of time the sugar is in the mouth, not the total amount of sugar. So enjoy a few nice (and quick) holiday desserts, but make sure to brush and floss after every meal and visit your dentist regularly.”
Drs. Mehrdad Favagehi and Lourdes Christopher, Falls Church
“As we get older, our bodies produce less saliva. Dry mouth, or xerostomia, is more prevalent now because so many patients take different medications. It’s hard to find a medication that doesn’t have dry mouth in the list of its side effects. Dry mouth is associated with halitosis, periodontal disease and caries (tooth decay). Many old restorations fail due to recurrence of caries due to xerostomia. Saliva acts as a buffer to neutralize the harmful acid produced by oral bacteria that cause caries.
There are many special oral gels and rinses that act as an intra-oral moisturizer to help us eliminate dry mouth. Sugar-free gum can also increase salivary flow and can be beneficial. If dry mouth is due to a medication, you should inform your physician or pharmacist because they may be able to find an alternative medication that causes less xerostomia.”
Dr. Zach Casagrande, Ashburn
“Most of my adult patients come into the office seeking aesthetic improvement and straightening of the teeth alone. What many adults with crooked teeth (crowding) are unaware of is the periodontal benefit of having proper alignment. I can’t tell you how many of my adult Invisalign patients come back for their second or third appointment and rave about how ‘easy it is to floss and brush now.’ It’s also a huge benefit when they go for professional cleanings at their dentist as it makes it much easier for the hygienist to access the subgingival areas under the gum line. And we all know now that periodontal health is linked to heart health. The mouth is the gateway to the body, and heathy teeth and gums limit bacteria in the bloodstream that can lead to plaque not only in the mouth, but also in the heart.”
Dr. Kristen Donohue, Burke
“The common misconception a lot of people have is about sugar and how cavities form. Drinking an occasional soda or sugary food can be fine if it’s consumed with a meal and consumed quickly. It’s the amount of time it takes to consume that drink or food that is most critical to cavity formation. When someone continuously sips on a sweetened iced tea or Coke (or Diet Coke—less sugar but still very acidic) or nibbles on candy or chips periodically through the day, they are getting the worst insult to their teeth. Bacteria consume the sugar residue around the teeth and release acidic byproducts that cause cavities. Saliva works to neutralize the acids and essentially washes away much of the sugar residue and clears the acids. Saliva is extremely effective, unless every 10-15 minutes there is a new sip of tea or another handful of snacks. The saliva can’t keep up with the demand, and the bacterial acids take over, causing cavities.
A few cookies with lunch or a soda won’t be the end of your dental health. But sipping on acidic sports drinks during a long game, snacking at your desk or sipping a soda over an hour or more would be far worse.”
Dr. Shane Costa, Great Falls and Brambleton
“We always tell our patients that the mouth is the gateway to your body. Everyone thinks it’s normal that when you brush or floss that your gums bleed. That is not the case. If you went to the sink and washed your hands with soap and water and they started to bleed, you’d probably be pretty worried. We try to educate our patients that bleeding is not normal, and it’s a low-grade bacterial infection. There is a lot of research these days relating periodontal disease and heart disease, diabetes and other inflammatory responses throughout the body. The same thing that is going on in your mouth is going on in your circulatory system. Maintaining proper oral hygiene and a healthy mouth is super important for the rest of your body.”
“I have three kids—8, 6 and 3—and after every meal they get a piece of gum. The first thing it does is starts the cleaning process by getting the plaque and food debris from your meal out of your teeth, but more importantly it stimulates your salivary flow, and that is your No. 1 defense against decay. It buffers the pH in your mouth to an environment where bacteria don’t thrive. Older people taking medication that cause their mouths to be dry get decay relatively quickly. And people having any sort of cancer treatment—radiation therapy—their glands have been destroyed by the treatment; they can get decay very quickly.”
Dr. John Kling, Alexandria
“Many people wake up with a bitter taste in the back of their mouth, have heartburn, nausea after eating, stomach aches or feel bloated after eating. These are some of the symptoms of acid reflux disease. This can also be referred to as gastroesophageal reflux disorder. Basically, this disorder occurs because in certain individuals a portion of the stomach contents will back flow or be regurgitated into the esophagus. This condition will need to be evaluated by a physician. However, the acids generated by this disorder may also damage the teeth. If people suffer from acid reflux disease, they should brush their teeth multiple times during the day and be sure to floss their teeth at least one time a day.”
METHODOLOGY
To compile the Top Dentist listing, we sent surveys to all Northern Virginia dentists asking them to recommend other dentists to whom they would refer friends and family. Those on the listing received the most nominations and are in good standing with the Virginia Department of Health Professions.
See our Top Dentists List 2015
(November 2015)