14 questions about oral health answered –

How should whitening be done?

The only safe way to have white teeth is with the application of carbamide peroxide or hydrogen peroxide, in the office or at home, but always under the supervision of a dentist, emphasizes Flavio Goulart, dentist at Clínica Crescità, in São Paulo. Thus, the increase in sensitivity during the whitening process can be circumvented. “Used without guidance, bleaching agents also pose a risk of gum ulcer formation”, warns Marco Antonio Manfredini, secretary of the São Paulo Regional Council of Dentistry (Crosp). He informs that, in response to the Council’s request, the National Health Surveillance Agency (Anvisa) is in the process of regulating the sale of whitening products in the form of tape, strip or gel. They may be included in the category of medical devices and sold only with a prescription from the dentist.

Are whitening pastes effective?

They are rich in abrasive substances (such as silica and bicarbonate). To eliminate stains, these toothpastes wear down the enamel, which can lead to gum recession and greater sensitivity, points out Flávio Goulart. So, it’s best to talk to your dentist before using them.

What about the use of hydrogen peroxide and bicarbonate and sodium?

They are contraindicated, says Flavio Goulart. They cause gum damage and retraction, enamel wear, sensitivity and, in more serious cases, inflammation, which requires root canal treatment – ​​the same damage, incidentally, as whitening products used without control.

Coffee and soft drinks stain your teeth?

Over the years, the teeth darken because the enamel becomes thin and the dentin, which is darker, becomes thicker, clarifies the dentist. Other than that, foods like coffee, dark sodas, red wine and teas are rich in pigments, which impregnate the enamel and contribute to giving the tooth a yellowish color.

Caries at any age?

Yes. “The greater the age, the greater its incidence and the resulting problems, such as loss of teeth”, warns Professor Marcelo Bonecker, president of the Alliance for a Future Free of Caries in Brazil. According to data from the Ministry of Health in 2010, in the age group of 35 to 44 years, the average number of teeth affected by caries reaches 16.75, a high index, since an adult has 32 teeth. Prevention consists of brushing your teeth well, at least three times a day, using fluoride toothpaste, flossing every day and making periodic visits to the dentist.

Do oral antiseptics replace brushing?

No, and they should be used in moderation, recommends Andrea Beder, specialist in Oro Facial Pain, from Instituto Alpha de Saúde Integral, in São Paulo. Excessive use contributes to staining and darkening teeth. Opt for those that contain the antiseptic triclosan and are alcohol-free.

Why do you have to wait half an hour after eating to brush your teeth?

Because saliva needs time to neutralize the pH of food and protect teeth against wear. And the brush itself can cause abrasion. “The right thing is to rinse your mouth with water and about half an hour later brush your teeth”, guides Andrea Beder.

Why do teeth sometimes hurt when we eat ice cream?

Sensitivity occurs when the thousands of microscopic channels in the dentin, the tissue that forms the body of the tooth, are exposed and subjected to pressure, cold, heat, sweet or acidic foods, clarifies José Luis Bretos, scientific director of the clinic/school Núcleo of Dental Studies (NEO), in São Paulo. Treatment varies depending on the cause. The main ones are gum retraction (leaves the root of the tooth apparent), tooth fracture, cracked enamel, caries, reflux and bruxism (gnashing your teeth wears down the enamel).

What is tooth erosion?

It is the progressive loss of enamel, the most rigid and superficial layer of the tooth, informs Andrea Beder. It is caused by acids in foods such as acidic fruits, soft drinks, sports drinks and white wine. It can also be caused by diseases such as hyperthyroidism and bulimia (the resulting vomiting puts gastric acid in constant contact with the teeth). Applications of fluorides and bicarbonates by the dentist and special toothpastes alleviate the problem.

If the gum is bleeding, can I floss?

Yes. Bleeding is mainly due to gingivitis, inflammation of the gum resulting from inadequate removal of bacterial plate from the teeth. Plaque needs to be removed with regular brushing and, above all, flossing, as well as visits to the dentist. Otherwise, it will harden, forming tartar, which aggravates bleeding and contributes to a more advanced form of gum disease known as periodontitis, notes the director of NEO.

Is chewing gum bad for your teeth?

Even if you choose a sugar-free product to avoid cavities, the overload associated with repetitive movement can weaken the tooth structure and lead to tooth erosion, warns Andrea Beder. Hence the increase in sensitivity.

Is it true that a dental problem can cause heart disease?

Yes, if the cavity approaches the pulp of the tooth, through which the bloodstream passes, the bacteria can reach the blood and circulate through the body, reaching different regions, including the heart, explains Marcelo Bonecker.

Can you prevent gum recession?

The main culprits are inadequate brushing, premature contacts (when a tooth is “higher” than the others) and gum inflammation, answers José Bretos. The best prevention is good oral hygiene, with correct brushing technique and a soft bristle brush to avoid accumulation of bacterial plaque and trauma to the gums.

Are there any alternatives to the dreaded little motor?

Although methods based on laser, ultrasound and special gels to dissolve caries have appeared, none are effective enough to replace the little motor with drills in all situations, warns Bonecker. Hence the importance of treating caries as soon as possible – if possible, in the initial phase of the white spot, when the application of fluoride and improved oral hygiene can stop the evolution of the condition.