In our first-ever dental-care special, we show how to fend off dangerous oral bacteria, find a decent dentist, and pay for treatment even if you don't have insurance. We also highlight the hottest cosmetic procedures and tell you which over-the-counter products are worth the expense.
Gum disease is the leading cause of tooth loss. Luckily, it's easy to avoid
Most of us know how to care for our teeth. But all too often that knowledge doesn't translate into proper maintenance. "Black women tend to use dentistry as 'pain treatment,'" says Cherae Farmer-Dixon, D.D.S., project director of community-based dental education at Meharry Medical College in Nashville. "We don't see the dentist unless our teeth bother us." The big problem with the wait-'til-it-hurts plan is that periodontal or gum disease--he leading cause of tooth loss--is often painless in its early form. By the time it hurts, you're in the danger zone. Even scarier, recent studies have linked this bacterial infection to cases of diabetes, heart disease, stroke and, for pregnant women, premature birth. Researchers suspect that these health problems are triggered when periodontal bacteria enter the bloodstream, reach major organs, and cause chronic inflammation. The good news? You can protect yourself. Here's how:
UNDERSTAND THE BASICS
Gum disease occurs in two stages. First comes gingivitis, the result of plaque accumulation. Plaque is prime real estate for bacteria that multiply and eventually infect gums. Gingivitis causes minimal pain, but gums swell, bleed and turn red. If you don't heed these warning signs, gingivitis becomes periodontitis.
During this second, irreversible stage, gums recede, teeth loosen, and cavities develop. At best, a periodontitis sufferer can expect to undergo a deep-cleansing procedure called scaling and root planing. At worst, infected teeth are pulled or fall out.
BRUSH UP YOUR SKILLS
If you don't want to join the estimated 42 percent of Blacks ages 30 to 54 who have periodontal disease, brush your teeth at least twice a day for two to three minutes, preferably after meals. Use fluoride toothpaste and a brush with soft bristles. Gently brush both sides of teeth and along the gum line in a circular motion.
Hold 18 inches of floss between your thumbs and forefingers. Gently slide it between teeth, and rub either side of each tooth. Don't neglect the area where teeth and gums meet.
CLEANSE YOUR TONGUE
Food particles--and bacteria--lurk on the tongue. Clean it at least once a day. Tongue scrapers are best, but brushing also works.
Smoke deprives gums of oxygen and nutrients. That's why smokers are four times as likely as nonsmokers to have advanced gum disease, reports the Centers for Disease Control and Prevention. Toss the cigarettes today.
EAT PLAQUE FIGHTERS
Atlanta dentist Arlene Lester calls raw, crunchy vegetables like celery and carrots natural tooth scrubbers--they help loosen plaque. After meals, drink sugar-free beverages containing at least 25 percent cranberry juice. Research suggests that cranberries prevent plaque from sticking to teeth.
BEFRIEND YOUR DENTIST
"The importance of a regular dental exam can't be overemphasized," says Meharry Medical College's Farmer-Dixon. See your dentist twice a year for a checkup and cleaning. Alert her to any health changes, especially a diabetes or HIV diagnosis--risk factors for gum disease. Also tell your dentist if you're pregnant or going through menopause; major hormonal shifts also increase gum-disease risk.--MELISSA EWEY JOHNSON
WHO'S YOUR DENTIST?
Finding the right dental professional can be time-consuming and frustrating. We offer the following tips on where to look and which questions to ask when you're on the hunt
Almost half of the people who responded to an American Dental Association (ADA) survey said they would be less likely to avoid visits with a dentist who had been recommended by someone they trusted. So a referral from a family member, friend or coworker isn't just the quickest way to find a new dentist; it can also be a compelling reason to keep appointments.
Consult the professionals
Professional organizations are wonderful resources. Consult the American Dental Association's Web site (ada.org), or call (312) 440-2500 to request a list of board-certified dentists in your area.
The National Dental Association, which represents oral-health professionals of color (ndaonline.org;  588-1697), can point you to Black member dentists in your state.
If your gums are giving you grief, contact the American Academy of Periodontology (perio.org;  787-5518). And if it's time for braces, the American Association of Orthodontists (braces.org;  424-2841) will provide you with a list of members in your area.
Find your comfort zone
To soothe patient anxiety, a growing number of dentists are creating a spalike office environment, complete with candles, music and DVDs. Call and ask the receptionist if the dentist offers amenities like these. You should also inquire about pain-management options. Does the dentist stick to traditional anesthetic jellies, novocaine and nitrous oxide (laughing gas)? Does she use newer tools such as The Wand, a relatively painless, penlike anesthetic needle; Oraqix, a noninjection anesthesia for gums; and ultraquiet electric drills?
Be assertive about safety
Don't be afraid to ask about how the dentist protects patients from infections such as HIV that are transmitted through blood. "A dentist should be able to tell you, 'Yes, we sterilize all our instruments, we rinse out our waterlines on a regular basis, and we follow every procedure designed to promote the safety of our patients,'" says Kimberly Harms, D.D.S., consumer adviser for the ADA.
Trust your gut
Be sure that you don't ignore any gnawing negative feelings you may have during preliminary phone conversations or even when you make your first visit. Uneasiness or mistrust can lead to avoidance of the dentist altogether. "It's important that you find someone with whom you're comfortable," says Harms. "Patients should be able to form a growing relationship with the dentist."--LASHIEKA PURVIS HUNTER
Whitening, veneers, braces and other popular cosmetic procedures can give you a refreshing new look without an extreme makeover. But be prepared to cough up some cash for a new smile. Procedures can range from a few hundred dollars to well into the thousands, and they usually aren't covered by insurance
BY TONYA ADAMS
Every day it seems as if there's a new toothpaste, home whitener, dental floss or gadget on the market. So we asked a few experts to tell us which products are no-brainers, which are good ideas and which are luxury items BY PENNY WRENN
Good idea For those who skimp on brushing time, New York City dentist Catrise Austin recommends a mechanical toothbrush with a timer. Try one in the Braun Oral-B Advance-Power series or Philips Sonicare Elite models. Electric or battery-operated brushes are also easier on enamel, she adds.
No-brainer Pick a paste with cavity-fighting fluoride and the ADA seal, says Matthew Messina. For added defense against bacteria, the ADA backs baking soda and triclosan, an antibacterial ingredient found in Colgate Total.
Good idea "Chewing sugar-free gum, especially one that contains xylitol, is great for removing plaque and food debris," says dental hygienist Katie L. Dawson, president-elect of the American Dental Hygienists' Association. For best results, chew after meals.
No-brainer Austin favors tongue scraping over brushing the tongue, which "only spreads around the bacteria." The two types of scrapers on the market (one is shaped like a spoon, the other like a horseshoe) provide similar results, she says.
No-brainer Academy of General Dentistry (AGD) spokesman Melvin Pierson, D.D.S., recommends any brush with a head small enough to reach the crevices of teeth. To preserve protective enamel, the brush must have soft bristles, he says.
MOUTHWASH AND RINSES
Good idea Antimicrobial mouthwashes such as Peridex, Periogard and ADA-approved Listerine can help prevent plaque formation. And rinses like Act and Colgate FluoriGard can benefit people who drink bottled water rather than fluoridated tap water.
Luxury item "There area number of reasons why teeth are not white, including periodontal disease and decay," says Matthew Messina, D.D.S., an ADA consumer adviser. "Tooth whitening without the proper diagnosis is a problem." Check with your dentist before whitening at home.
No-brainer Whether you're using flat dental tape or a traditional floss coated in Gore-Tex, our experts agree that it's not about the type of floss you choose but about using it every single day.
Cover Your Mouth
Even if you don't have insurance, you can afford dental work. Consider this option
If you have maxed out your job's dental benefits or don't have any coverage at all, a discount dental plan may be the best way for you to go. Reduced-fee plans such as Aetna Dental Access, GE Wellness and Uni-Care 200 are not insurance. There are no premiums, deductibles or copays. Instead, members pay an annual fee of about $100 for individuals and $190 for families for access to dentists who have agreed to provide their services at a reduced rate. Depending on their geographic location, members can save from up to 50 percent on a wide range of routine, surgical and even cosmetic procedures. As you think about signing up for a discount dental plan, be sure to remember that:
IT'S PAY AS YOU GO Even at a deep discount, some procedures may not be so affordable without a steady cash flow or a long line of credit.
THERE ARE OPTIONS A few major insurers such as Aetna offer national or local plans. Sam's Club sells this kind of coverage to its members. Online clearinghouse dentalplans.com has a comprehensive listing of programs that are searchable by zip code. And the National Association of Dental Plans (nadp.org), a nonprofit trade organization, also lists plans on its Web site.
CHECK THEM OUT State insurance departments do not regulate discount plans. Check with the Better Business Bureau and your secretary of state's office to make sure the company is a legitimate, registered business.
MAKE SURE THAT YOU'RE COVERED Before you plunk down your hard-earned dollars on a plan, request a list of local contracted dentists. Call a few to confirm that they're still on contract and that they're in good standing with the state licensing board.--BEVIN CUMMINGS
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