Happy New Year!!! Tips for Caregivers on excellent oral hygiene…

Caregivers are responsible for the oral and overall health of those they care for.  As a caregiver, many questions may come to mind regarding your responsibilities for one’s oral health:


How should I go about caring for someone’s mouth and teeth?  What type of dental hygiene routine is best for my loved-one, friend or patient?  What is the proper way to brush and floss teeth?  How often should my dependant see his/her Professional Dental Team?  What types of oral health products should I use that will allow me to provide the best oral care I can?  How do I clean false teeth?


Our goal is to help answer these questions and to provide information that you can use to improve your overall practices for excellent dental health, whether it be your own or someone else’s.


When the question of how to provide care for someone else’s oral health comes to mind, try to think of how you would care for your own mouth.  Brushing your teeth twice a day (morning/night) and flossing once a day, should come to mind…  When brushing, be sure to use a soft-bristled toothbrush and a toothpaste that contains fluoride.  Fluoride helps strengthen the outer layer of the teeth to prevent cavities.  You shouldn’t use a medium or hard-bristled toothbrush because the rigid bristles can damage the gums and cause them to recede.  When the toothbrush bristles become ‘wilted or frayed’ in appearance, it’s time to change to a new one.  A good rule of thumb is to replace your toothbrush every three months, or whenever you’ve been sick.  Changing your toothbrush after you’ve been sick is extremely important—the bristles can harbor bacteria and prolong your illness.  Always use a light, but firm pressure when brushing.  For instance, imagine that you are brushing a ripe tomato and don’t want to bruise it.  These use and maintenance tips also apply to those who use electric toothbrushes.


It can be more difficult flossing someone else’s then than flossing your own, but the principles are the same.  To properly floss, take a piece of floss approximately           18-inches long and wrap it around your middle fingers.  Use your index fingers and thumbs to guide the floss between the teeth.  Once the floss is in between two adjacent teeth, be sure to adapt the floss to each tooth, forming the floss into a ‘C’ shape.  Gently slide the floss below the gumline, adapt to the adjacent tooth and do the same.  There are several flossers or floss picks on the market that can help assist with this motion.  The concept remains the same…you must adapt the floss to each tooth!



Ideally, everyone should see their dentist every six months and in some cases, more frequently.  Your dentist and dental hygienist work together at these visits to assess the health of your gums and teeth.  The dental team will determine the proper visit interval to ensure that an excellent level of health is maintained in your mouth.  Aside from assessing the health of your mouth and having a professional cleaning, the doctor will also perform an oral cancer screening at your regular visit.  The members of your dental team are the only health care professionals that look into your mouth on a regular basis.  It is imperative for them to establish a baseline of what your mouth looks like and record the presence of any abnormalities.  Regular oral cancer screens ensure your mouth is examined for cancer on a consistent basis and the necessary precautions and/or treatments are performed in the event an abnormality is found.



The following are important points when caring for those with false teeth or dentures:  Make sure the dentures are taken out every night before sleeping.  Your gums need to breathe!  Keeping the dentures in place all day and night can cause the gum tissue to become red and irritated.  Irritated gum tissue can cause discomfort when wearing the dentures.  Constant wearing of dentures can also cause oral infections.  When cleaning dentures, be sure to brush them as you would your own teeth.  Use a denture brush or a soft-bristled toothbrush and denture cleaner—you may also use an antibacterial soap or a mild dishwashing liquid.  When the dentures are out of the mouth, they can be soaked in a denture cleanser or water, to help avoid drying and potentially losing their form.  Before replacing the dentures in the mouth, gently brush the gums and tongue to stimulate circulation and remove any plaque debris that may be present.



Remember that your Professional Dental Team is here to help you.  If you need any assistance or have any questions about caring for your loved ones, don’t hesitate to contact them.  As a caregiver, be sure to remember what is necessary to care for one’s oral health: brushing twice a day with fluoridated toothpaste, daily flossing, eating well-balanced meals, and visiting your Dentist regularly.


Holiday Reminders from Norman Dental!!

Just Some Reminders…


The year has flown by, and the holidays will be here before we know it!  With our schedules changing due to get-together’s, family coming into town, or work outings, we wanted to mention a few things that tend to get neglected this time of year!


Don’t forget to brush!  Sometimes with the hustle and bustle of the holidays, it’s easy to fall into bed before doing your oral hygiene regimen at night!  We get so exhausted, it’s easy to forget.  Try to continue your brushing and flossing habit throughout the holidays, even if you’re getting to bed later, have company at your house, or travelling more.





There have been speculations that cranberries have properties that help prevent tooth decay.  As it has been shown that the pigmentation in cranberries help prevent plaque formation on your teeth, which in turn helps prevent cavities, just keep in mind that cranberries are acidic and cranberry juice is typically full of sugar—both of which can tend to cause tooth decay!  So again, remember your brushing and flossing techniques after having cranberries, or juice.



Keep your regular dental visits!  During the holidays, we tend to ignore our diets a bit—eat more desserts, have a nightcap with friends or family—so it’s crucial to remain on your routine dental visits.


With the holidays approaching, it’s always good to have reminders, even for the simple things!

Diabetes and Oral Health



In the US alone, there are currently around 30 million people living with diabetes and another 86 million with pre-diabetes.  Diabetes is a metabolic disease that causes a person to have high blood sugar, for a long period of time.  People that have diabetes can suffer from a wide variety of health issues and we are learning more and more about the relationship between diabetes and having a healthy mouth.


As diabetes progresses, so does the likelihood of an individual developing chronic periodontitis or disease of the gum tissues.  If a patient that has diabetes develops periodontitis or gum disease, it’s likely the both conditions will worsen if both are not treated and kept under control.  There is huge amount research currently being done regarding uncontrolled diabetes and its interference with glucose (sugar) regulation in the body.  Interference with glucose regulation makes the diabetic condition worse; leading to other medical conditions.  Diabetic patients commonly have swollen and inflamed gums and can notice a bad taste in their mouth. When our gums become inflamed, our inflammatory response sends mediators into the blood stream which cause a negative effect on glucose regulation, therefore worsening the diabetic condition.


By properly treating periodontal disease, sugar levels have a much better chance of returning to a more normal state and improving overall health. Home care for a diabetic should be strict and consist of brushing twice a day, flossing once a day and seeing a dentist twice a year. In some cases, diabetics may need to see a dentist more often.  Please contact your dental team at Norman Dental if you have any questions or concerns about how diabetes can affect your overall health.

The Ease of Tooth Whitening

The Ease of Tooth Whitening

Matthew Norman, DDS and Michelle Phillips, RDH

Who doesn’t want their teeth a little whiter and brighter?  The number one question we get asked at Norman Dental about teeth whitening is: “Is it safe for my teeth?”  The answer…Absolutely, it is completely safe for your teeth!

Our whitening process at Norman Dental requires three appointments.  At your first appointment, we will take impressions of your teeth.  We use these impressions to pour exact models of your teeth that are used to build whitening tray custom whitening trays specifically for your mouth.  We will also take pre-treatment photos of your teeth and record the current shade or color.  This only takes about 15-20 minutes.  During the second appointment, two to three days later, we will deliver your trays to you.  We try your trays in to make sure everything fits okay, and go over all instructions as to how use your trays…how and where to place the bleaching material in your trays, how long to wear them, and answer any questions you may have.  The third appointment, usually two weeks later, is a follow-up to see how your bleaching process is going.  We will also take post-treatment photos and record the new shade of your teeth.  The pre and post-treatment photos allow us to visually assess the whitening that has occurred over the two weeks and will help you to see the progress which has been made.

Your initial bleaching process will take approximately four weeks.  Whitening is very subjective, so if you’re not satisfied after four weeks, you may continue treatment longer.  On the other hand, if you’re happy with the progress before four weeks is up, you may stop early.  After the initial process, you will need to “touch-up” your whitening.  Most people do this once or twice a year.  A convenient time to do this is just after your hygiene visit…your teeth are clean from any stains or tartar, and if you need more bleaching material, it’s convenient to pick up more.

whitening before-after

Unfortunately, tooth whitening is not for everyone.  If someone has several areas of tooth decay, or lots of restorative work (crowns, fillings, etc.) on front teeth, bleaching isn’t going to be suitable for you.  Our team at Norman Dental can assist you in identifying if you’re a good candidate for teeth whitening.

The Benefits of Fluoride

The Benefits of Fluoride

Matthew Norman, DDS and Michelle Phillips, RDH



Fluoride is a naturally-occurring substance which has important uses in dentistry, such as preventing tooth decay and treating tooth sensitivity.  Fluoride is commonly found in most toothpastes and some mouthwashes on the market today.  Fluoride is available in prescription-strength forms for application in the dental office, over-the-counter products for use at home, and is found in most public/municipal drinking water systems in the United States.  In fact, the US Centers for Disease Control and Prevention consider the fluoridation of water to be one of the 10 great public health achievements of the 20th century.


Fluoride comes in two basic forms: topical and systemic.  Topical fluoride is simply a fluoride that is applied directly to the teeth currently in your mouth.  It helps make these teeth more cavity-resistant.  Systemic fluoride is a fluoride that is ingested and helps the developing teeth (teeth have yet to erupt in the mouth and are totally under the gums).  Systemic fluoride exposure is very important and beneficial for children aged 6 months up to 16 years old, as tooth development is occurring during this time.

  • Your toothpaste, mouthwash, dental office applications are all topical. 
    • Most toothpastes and mouthwashes contain minimal amounts of topical fluoride.
    • Dental office applications are significantly stronger and contain much more fluoride, designed to last longer. Fluoride Varnish application Most dental offices may use a fluoride rinse, gel, foam, or varnish.  Norman Dental uses a fluoride varnish.  Studies have shown that the varnish has much more fluoride uptake than any other professional delivery method.


  • Prescription tablets/drops and drinking water are examples of systemic fluorides.
    • If you have private-well water and your child isn’t exposed to a regular fluoride source, your Dentist maySodium Fluoride Tablet recommend a prescription fluoride supplement.  These generally come in a liquid form, or chewable tablets, designed for children.   It’s best to have your water tested to see the fluoridation levels present in your water, to determine if supplemental fluoride is necessary.
    • Municipal/city water also contains fluoride.  Although this delivery method is considered systemic, it still has topical benefits because the fluoride is present in the water that contacts your teeth and saliva.  Water fluoridation is extremely inexpensive and effective in the prevention of tooth decay.


Fluoride is very beneficial when used appropriately.  Over the past several decades with fluoride being more prevalent, especially with the advent of the fluoridation of drinking water supplies, a significant decline in tooth decay rates has been observed.  If you have any concerns or questions about the uses of fluoride or if you think your child needs to be supplemented, please let us know the next time you’re in our office.

Oral Cancer Awareness and HPV

Oral Cancer Awareness and HPV

Matthew Norman, DDS and Michelle Phillips, RDH


It was once thought that the incidence of oral cancer was predominantly caused by the effects of tobacco and heavy alcohol use.  In recent years, we have changed this line of thinking to include the Human Papilloma Virus (HPV) in the group of leading oral cancer risk factors.  In fact, HPV-associated oral cancers are increasing at a more rapid rate than oral cancers associated with smoking and tobacco use. 


The American Cancer Society defines heavy alcohol use as two or more drinks per day for men, and one or more drink per day for women.  Tobacco use includes cigarettes, cigars, pipes, and smokeless tobacco.  Malignancies caused from tobacco and alcohol use are most commonly found in adults between 50-70 years old.  These lesions typically occur on the floor of the mouth (beneath tongue), tip of the tongue, lining of the cheek, and the attached tissue surrounding where the teeth are.

  tongue cancer

HPV is one of the most common virus groups across the world that affects skin and mucosal areas of the body.  The HPV virus is transmitted by skin-to-skin contact and sexually transmitted.  HPV is now recognized as a risk factor for developing oral cancer and is often found in younger individuals.  Oral cancer lesions originating from the HPV virus typically occur on the tonsillar area, base of the tongue and throat areas. 


oral cancer exam

April is Oral Cancer Awareness month.  The oral cancer screen is an integral part of your doctor examination at all hygiene or maintenance visits.  It is very important to keep routine hygiene visits scheduled so that these screenings can be performed.  Your Norman Dental team members are the only healthcare professionals that routinely evaluate your oral condition and monitor for any abnormalities.

Early Detection is Key

Early Detection is Key

Matthew Norman, DDS and Michelle Phillips, RDH


Oral cancer is like any other cancer…the earlier it is detected, the better the outcome.  Oral cancer is cancer of the oral cavity, which includes:  the lips, tongue, lining of the cheek, palate (roof of the mouth), floor of the mouth (beneath tongue), gums, and throat.  Your team at Norman Dental performs a thorough oral cancer screening at every hygiene visit.


According to the American Cancer Society, about 36,000 Americans will be diagnosed with oral cancer in 2013, and approximately 6,850 people will die from these cancers.1  The ACS  suggests that men are twice as likely to develop oral cancer as women, and these cancers are equally common amongst various races.

oral cancer tongue

Oral cancer doesn’t have just one “look”.  When we perform an oral cancer screening at Norman Dental, the Doctors look for the following conditions:

  • Red or white patches
  • A sore that bleeds easily, or doesn’t heal within 2 weeks
  • A lump
  • A rough or crusted area
  • Anything that looks “out of place”

Things you may notice:

  • Difficulty chewing, swallowing or speaking
  • Changes in your voice
  • A lump in your neck
  • Drastic weight loss
  • Numbness, pain or tenderness


There are several avoidable risk factors associated with the development of oral cancer. oral cancer lipSmokers (cigarettes, pipes, or cigars), heavy drinkers (2+ drinks a day for men; 1+ drinks a day for women) and those that use smokeless tobacco are at a greater risk of developing oral cancer.  Prolonged sun exposure is associated with an increased risk of developing cancer on the lips.  Norman Dental provides chap-stick with SPF 15 sunscreen to help protect your lips.



Any lesion or sore in your mouth should heal within two weeks.  If ever you have an ulcer or sore that is still present after more than two-weeks, call our office so we can evaluate it.  When your dentist performs the oral cancer screening, we look for abnormalities in your mouth.  If an abnormality is detected, it is likely that we’ll have you return in two weeks to see if the lesion is gone.  If the lesion is still present, the next step is to perform a biopsy to gain a definitive diagnosis on the nature of the lesion.


It is very important to see your dentist regularly for hygiene visits so that you are being screened for oral cancer.  Your dentist is the only healthcare provider that thoroughly evaluates your mouth on a consistent basis and is in the best position to detect an abnormality early.  And remember, early detection is the key to a positive outcome!


1 American Cancer Society, “What are the key statistics about oral cavity and oropharyngeal cancers?”,

http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/oral-cavity-and-oropharyngeal-cancer-key-statistics, Feb 26, 2013.

Tooth Erosion: It’s on the Rise

Tooth Erosion: It’s on the Rise

Matthew Norman, DDS and Michelle Phillips, RDH

The trend of healthier eating in the past couple of years has lead to more incidents of tooth erosion in patients.  With increased consumption of fruits, juices, and even salads, more and more are complaining of tooth sensitivity and have a clinical presence of acid erosion.


Prior to the last couple of years, the two most common causes of acid erosion in one’s tooth enamel was acid reflux or an eating disorder.  Today, the most common reason for erosion seems to be from eating healthy!   The table below shows the pH of many “healthy” foods, along with their level of erosion.

 pH chart


Over time, acid erosion causes the enamel of the teeth to slowly dissolve, which can make the teeth appear darker in color.  The shape and size of the teeth can also slowly diminish.  As the enamel is eroded away, the underlying layer of the tooth, the dentin, is exposed.  The exposed dentin provides a direct passageway to the inner layer of the tooth, the nerve or pulp.  This is why erosion can cause tooth sensitivity.


As you can see in the illustration, the acidic foods and beverages slowly remove the enamel from your teeth.  This example is somewhat extreme, but it provides a great representation of what erosion can do.




Here are some examples of acid erosion along the gumline of the top front teeth.

facial erosion


The best way to reduce your risks of tooth erosion, especially with a highly acidic diet, is to drink lots of water.  Remember the pH of water is 7…it’s neutral.  This is the best way to neutralize the pH of your mouth and prevent the acids from doing damage to your enamel!

Your Dental Health Can Indicate Other Health Issues

Your Dental Health Can Indicate Other Health Issues

By: Matthew Norman, DDS and Michelle Phillips, RDH


Your teeth, gums, tongue, and overall oral health are a reliable indicator of other overall health issues. Heart disease, diabetes, HIV, osteoporosis and eating disorders are examples of health issues which have symptoms visible in the mouth. Teaming with your Dental Office for regular checkups can help identify these conditions.


Cardiovascular disease is very closely linked with the health of your mouth and the presence of infection. Those with periodontal (gum) disease are at higher risk of developing cardiovascular disease. Some studies have suggested that heart disease, clogged arteries and even stroke may be associated with the oral bacteria present with periodontal disease. Your mouth has an abundance of bacteria— both good and bad. Bacteria have the ability to enter your bloodstream, especially in an unhealthy mouth with swollen or bleeding gums. Once in your bloodstream, the dangerous bacteria can pass to your heart and cause infection in the inner lining of the heart. This is a very important reason to maintain optimal oral hygiene. By practicing good brushing and flossing habits, bacteria remain at healthy levels and have a lessened chance of entering the bloodstream.



Your mouth is the gateway to the rest of your body and can reveal a great deal about your overall health.  Diabetes is an example of a systemic disease which has a direct relationship with your oral health.  Diabetes inhibits the body’s ability to fight against infection.  People with diabetes must keep their blood sugar levels under control.  When a diabetic patient has uncontrolled blood sugar levels, the risk of having more-frequent and severe gum infections increases—opposed to those with controlled blood sugar levels.



Other systemic diseases that can be detected based on conditions present in the mouth.  HIV / AIDS patients are prone to having painful sores in the mouth.  They also have an increased risk of developing thrush—a fungal infection in the mouth.  Osteoporosis is a condition in which the bones become weak and fragile. This includes the bones of the jaw that support your teeth, which can eventually lead to tooth loss.  Patients suffering from eating disorders, such as bulimia, can cause chemical erosion to their teeth due to the stomach acid which consistently comes in contact with the teeth.


Not only is saliva your main defense mechanism against the harmful bacteria and viruses in your mouth, but it can be a tool in diagnosing systemic disease.   Dental offices now have the ability to test and analyze your saliva.  The testing can diagnose many diseases such as: diabetes, Parkinson’s disease, cirrhosis of the liver, oral cancer, breast cancer, HIV, hepatitis, periodontal disease and cardiovascular disease.  These conditions have specific markers which show up in your saliva that these tests can identify.  Salivary tests are completely harmless and non-invasive to perform.


Your mouth is a vital information source about the condition of your overall health.  Practicing excellent oral hygiene will help to keep your mouth and teeth healthy, as well as other areas of your body.  It is important to see your dentist on a regular basis to ensure your mouth is in a healthy condition.  Your regular dental appointment is also an opportunity for your dentist to examine your mouth and check for conditions which can indicate the presence of other diseases.


Radiation & Chemotherapy – the Effects on Your Mouth

Written By:

Matthew Norman, DDS and Michelle Phillips, RDH


With the prevalence of cancer becoming more widespread, it is important to be aware of and know how to manage side effects that cancer treatment can cause in your mouth.  Radiation and chemotherapy are two different types of treatments for cancer, but can have similar effects in the oral cavity.  Radiation therapy and chemotherapy can cause cavities, mouth sores, oral infections, dry mouth, bleeding gums, and mouth pain/soreness.  Most symptoms are acute, meaning that they begin shortly after treatment begins and go away shortly after treatment ends.  The symptoms can last indefinitely when there is direct treatment to the head and neck.

Cancer cells are generally the fastest growing cells in the body and these rapidly dividing cells attack the healthy cells.  Chemotherapy works by killing all the rapidly growing cells in your body, while killing healthy cells at the same time.  Radiation therapy is generally more site-specific, targeting the cancerous lesion but healthy cells are affected too.  The cells lining the mouth are fast-growing, making it more likely for these cells to be damaged by the treatment. 

Dry mouth can arise from both radiation therapy and chemotherapy treatments.  Dry mouth is typically the root to the other side effects associated with cancer treatments.  When the gum tissue is dehydrated and very dry to the touch, any trauma (from a toothbrush, floss, or food) can not only cause your gums to bleed, but this trauma can also cause a mouth sores.  Because your immune system is compromised while going through radiation and chemotherapy treatments, these areas heal at a slower rate.  When the tissues in your mouth are really dry, it may even be painful to eat and swallow, which can create nutritional deficiencies.  Your taste perception can also be altered by these treatments, which can compound the problem of malnourishment or dehydration.  Dry mouth is a major instigator of rampant dental caries (or decay), especially on root surfaces of teeth.  Saliva is very important in protecting our teeth from tooth decay—there are certain enzymes present in our saliva to defend against the formation of dental caries.  Saliva helps to wash the teeth clean to remove the plaque or food debris that may be present.

Maintaining a healthy mouth is very important while going through radiation therapy and chemotherapy.  There are several things that can be done to help keep your mouth healthy.  To help keep the mouth moistened, you can suck on ice chips, sip water frequently, chew sugar-free candy and gum, or use saliva substitutes.  You also want to be sure to keep your teeth and mouth as clean as possible.  Using an extra-soft toothbrush and gentle flossing will be kinder to your gums.  Try to keep away from foods with sharp edges, like chips, to avoid any scratching or trauma to the gum tissue.  Additionally, hot and spicy foods may be uncomfortable if you’re suffering from dry mouth, as it may cause a burning sensation.

Fluoride exposure is especially important when undergoing cancer treatments.  Fluoride helps to strengthen the teeth and prevent cavities, especially when a dry mouth is present.  Fluoride-containing toothpaste and mouthrinses are critical throughout your treatment.  Fluoride varnish treatments should be applied at your regular dental hygiene appointments.  If dental decay becomes a problem during your treatment, your Dentist may recommend making custom fluoride trays to allow for frequent fluoride treatments at home.  If mouth sores become a problem, your Dentist can prescribe a rinse to help with the discomfort.  This rinse contains a numbing agent (for pain), and an anti-fungal/anti-bacteria component to speed up healing.

It is extremely important to be examined by your Dentist to ensure your mouth is in a healthy condition before you begin your cancer treatment.  As you undergo your cancer treatments, be aware of your mouth and the condition it is in.  Keep in mind these tips which will help you to manage the possible symptoms that may arise while going through radiation therapy and chemotherapy.  Continue your hygiene appointments with your Dental Office and don’t hesitate to call if you have any problems.