Teeth grinding, or bruxism, is a fairly common occurrence that results when people clench their teeth and gnash them together in a grinding motion. Many people do this during the day, either subconsciously or as a habit. Sleep bruxism, however, occurs when people grind their teeth at night. It is just as common, though it has the potential to become more problematic.

While grinding your teeth on occasion is not a cause for concern, the repeated or habitual grinding of your teeth can lead to a variety of complications. When people grind their teeth at night, they do so in their sleep, and are not aware of it. Prolonged, unconscious teeth grinding is where issues often arise.

Symptoms and Effects of Teeth Grinding

How do you know if grinding your teeth is an issue if you do it during your sleep? You may be unaware that you’re doing it, but if it happens on a regular basis, you’ll start to notice certain symptoms. Some of these symptoms include:

●  A dull, constant headache originating in the temples

●  Teeth that are suddenly more sensitive to heat, cold, or sweetness.

●  Soreness on your tongue or the inside of your cheeks, as people who grind their teeth often bite themselves.

●  Tired or tight jaw muscles.

If you are experiencing any of these symptoms, consult with your dentist to determine whether or not you grind your teeth. Please keep in mind that many of these symptoms might be indicative of other conditions, which is why it’s important to confirm or rule out teeth grinding as the cause. During your regular dental checkups, your dentist will typically check for signs that you grind your teeth.

Grinding your teeth weakens your enamel. It can flatten or wear down your teeth, which causes issues with your bite, and if left untreated, you can potentially loosen or fracture a tooth. Lockjaw and other temporomandibular joint dysfunctions (TMD, or disorders of your jaw muscles) can result from chronic, repeated teeth grinding.

What Causes Teeth Grinding?

Doctors don’t have a full understanding of all the causes for grinding your teeth. Stress, anxiety, or even pure force of habit are some common causes. Teeth grinding is very common in childhood, and it can also be caused by sleeping disorders, such as sleep apnea. If your dentist believes your teeth grinding is caused by a sleeping disorder, or another psychological condition, he or she may refer you to a sleep specialist to determine the underlying causes that must be addressed before the teeth grinding can be alleviated. People with overbites or an abnormal alignment of their upper and lower teeth may also experience bruxism.

How to Prevent Teeth Grinding

There are different methods to keep yourself from grinding your teeth at night, and you and your dentist will determine the technique that is right for you. Here are five ways you can stop grinding your teeth.

1.  Wear a mouthguard

Mouthguards are the easiest and most typical measures taken against teeth grinding. Your dentist will fit you with a custom plastic mouthguard that you wear every night to sleep. While you’ll probably still move your mouth during the night, the guard acts as a buffer by preventing your teeth from grinding against each other. The soft plastic keeps your teeth safe and prevents further weakening of the enamel.

2.  Dental correction

In cases where your teeth grinding is caused by a dental problem, the proper procedure to correct the issue might be the right course of action. If you grind your teeth because of a dental misalignment, braces or Invisalign might gradually help you stop by improving the issue. If you have damages to your teeth that cause irregularities in the chewing surfaces, crowns could alleviate your teeth grinding.

3.  Stress management

For many people, teeth grinding is an instinctual response to stress or anxiety. Oftentimes, if somebody is stressed at work, the subconscious anticipation of the next day’s probable stress can cause them to grind their teeth during their sleep the night before. While your dentist cannot recommend the method of stress management best suited for you, if your teeth grinding is determined to be a result of stress, seek out healthy forms of relieving stress that might help you sleep easier and grind your teeth less.

4.  Avoid stimulating substances

Certain substances such as caffeinated beverages, or even alcohol, when consumed before bed can increase the frequency of teeth grinding.

5.  Consult with a sleep specialist

If it is determined that you grind your teeth as a symptom of a sleeping disorder, you may need to consult with a sleep specialist to determine the proper treatment for the disorder. By addressing your sleeping issue at its source, the symptoms of the disorder, including your teeth grinding, should gradually be minimized.

Do you think you grind your teeth at night? If you experience any of the symptoms mentioned above, and have not been able to determine another probable cause, it’s possible that you do. Ask your dentist to examine you for signs that you grind your teeth before your symptoms get worth, and explore which preventative measures are right for you.

Your smile is one of your most distinguishing characteristics,
and it is oftentimes one of the first things people notice about you. That is
why a healthy smile is so important; it can potentially contribute to a greater
sense of overall well being and a higher self esteem. Having clean, white teeth
is key to a healthy smile. But the measures taken to maintain the whiteness of
your teeth are not merely just cosmetic dentistry. Teeth whitening
contributes to the removal of plaque and stains that can weaken enamel and
leave your teeth vulnerable to further damage.

Fortunately, there are a wide array of options available for
whitening your teeth. From at-home techniques such as hydrogen peroxide, whitening trays, and whitening strips, to in-office procedures, you’ll surely be able to
find a tooth whitening method that works for you.

One of the most popular, and arguably more effective, ways to
whiten your teeth is with laser teeth whitening. Typically, laser teeth
whitening involves a hydrogen peroxide-based gel that is applied to the teeth
by your dental professional. The dentist then exposes the teeth to laser
energy. The laser “excites” the hydrogen peroxide, or speeds up its molecules,
which is essentially what removes the stains. So, what makes laser teeth
whitening a more popular option than other whitening methods? Let’s explore
some of the benefits.

1.  Laser Teeth Whitening is Effective

Whitening strips and special
toothpastes can only remove surface stains. Laser teeth whitening, however,
penetrates deep to remove stains at their core, even if they go deeper than the
enamel. This is due primarily to its laser itself, and how it triggers the
hydrogen peroxide in such a way that it attacks the stain on a molecular level.

2.  Laser Teeth Whitening is Fast

Laser whitening can dramatically
whiten your teeth in just one session. While several sessions may be needed to
experience the full effect, patients often report seeing a difference of seven
to eight shades in just the first session. That means your smile is
significantly whiter after just one 30
to 60 minute session. At-home whitening solutions and other products often need
to be applied daily for several hours or overnight, for a duration of two to
four weeks, before patients start seeing results.

3.  Laser Teeth Whitening is Less Damaging

Laser teeth whitening is non-invasive.
There are no appliances or additional equipment used that can cause irritation
or bleeding of the gums, and no after-effects of laser whitening. Furthermore,
a lot of the bleaching products used in over the counter at-home procedures can
be too abrasive and damage the enamel. In fact, few, if any, at-home teeth
bleaching products carry the ADA seal of approval. Laser teeth whitening is
safer, gentler, and done with expert supervision.

4.  Laser Teeth Whitening Can Last Longer

With any whitening procedure, the
longevity of the whitening effects depends primarily on your daily oral care
routine. Brushing your teeth at least twice daily, using mouthwash, and
following any other steps your dentist has recommended prevent the buildup of
plaque and can keep stains from settling. While this is key to a white smile
that lasts longer, laser teeth whitening can
last for years, because it removes old stains as well as stains you’ve
accumulated since your last cleaning.

PearlInBrite Laser Tooth Whitening

Linhart Dentistry uses Dr. Linhart’s patented laser whitening
system: PearlInBrite Laser Tooth Whitening, a unique system that
whitens teeth using specially formulated gels that are activated by two lasers. Patients can expect a 9-10
shade change in just one visit. The procedure takes approximately two hours,
and speeds up the whitening process so that results are achieved immediately.
Dr. Linhart can even whiten one or two teeth adjacent to where other cosmetic
dentistry has been performed.

PearlInBrite uses proprietary technology, where the two lasers
activate three different gels applied to the teeth. These whitening gels
contain Energy Transfer Crystals (ETC), which absorb the laser energy and
transfer it to the hydrogen peroxide, creating a heightened, more efficient
“excited” state whereby the hydrogen peroxide molecules remove stains from the
teeth. Following treatment, patients can maintain their smile by using any of
Dr. Linhart’s PearlInBrite dentistry products at home. The
PearlInBrite system has been attributed almost 100% to tooth whitening success
in most of Dr. Linhart’s patients. Learn more about this unique and
revolutionary system at www.pearlinbrite.com.

While there are
various costs to consider, the efficiency and benefits of laser teeth whitening
make it a worthwhile investment that can drastically improve the health of your
teeth and lead to a brighter, more fulfilling smile. Consult with your dentist
to determine which of the many tooth whitening solutions out there is right for
you. Remember: a happy smile is a healthy smile.

Flossing is an essential part of your daily regimen for proper dental care and hygiene. While there is ongoing debate as to whether or not flossing is necessary to prevent cavities, there is no denying that it is crucial to your periodontal health. Periodontics concerns the health of your gums and the bone surrounding your teeth, and any periodontist will tell you that flossing is integral to maintaining healthy gums.

People who do not floss may be more prone to infections of the gum. Gingivitis is the beginning stages of a periodontal infection, and presents as bleeding, inflamed, or red gums. If left untreated, gingivitis can develop into periodontal disease, a severe infection that can lead to bone loss and even the loss of teeth.

Infections of the gums and inflammation can be caused by plaque and particles of food that get caught in the spaces between the teeth, or even between the gum and the tooth itself. These particles may be too small for your toothbrush to clean, and too tightly-packed for mouthwash to clear away. Over time, bacteria accumulates and your gums may redden or become inflamed, thus leading to infection.

Flossing every day is one of the most effective ways to prevent gingivitis before it even begins. It is one of the best ways to ensure you’re cleaning between your teeth to avoid a buildup of plaque and bacteria. Unfortunately, not everybody flosses as often as they should. Flossing takes more time and requires more careful attention to each tooth, and many people mistakenly assume that if they brush thoroughly, they can catch all those hard to reach places. Furthermore, not everybody knows the proper way to floss. Welcome to Flossing 101: an examination of different ways to improve your flossing techniques and products that can help you stay thorough and consistent.

How to Floss

When it comes to flossing, consistency is key: the American Dental Association recommends flossing at least once a day. Because flossing requires a couple of extra minutes, it is a good idea to floss when you have the time, or the patience, and stick to that time each day. Some people prefer to floss right before bed, others first thing in the morning. While once a day is sufficient, there are people who floss after every meal. As long as you have the time and attention to devote to flossing every day, it doesn’t matter when you do it.

To floss thoroughly, you need to make sure you’re reaching the spaces between each tooth on both sides–including the back side of your last tooth. It is important not to be too rough on your gums; don’t snap the floss into your gums, and be careful to ease the other flossing instruments you use into the spaces between. Bleeding of the gums usually occurs when they are inflamed, so if bleeding persists beyond the first week or two, you may be flossing too hard. Consult with your dentist just to be sure.

The following technique is for flossing using traditional floss. Keep reading onto the next section for more on flossing with various other products.

●  Snip off an 18-inch piece of floss, and wind the floss around the middle finger of each hand, leaving a one or two-inch length of floss in between.

●  Decide which direction feels most comfortable to you: beginning with your upper teeth or your lower teeth, from left to right or from right to left. It is best to floss your teeth in order and to finish one row before continuing on to the second.

●  For your upper row, use your thumbs to guide the floss between your teeth using a gentle rubbing motion.

●  The floss should hug your tooth: wrap it around each tooth gently working your way down to the gum and below the gumline, then working your way back up with up-and-down motions.

●  Repeat for each one of your upper teeth.

●  For your lower row, use your index finger to guide the floss between your teeth, and repeat the aforementioned technique.

●  Use clean segments of floss as you go along.

Products for Flossing

Traditional floss is highly effective in cleaning between teeth and preventing gum disease and gingivitis. However, some people choose to use other products to get the job done. There is no right or wrong product for flossing–it’s essentially a matter of preference. Whichever product you’re the most comfortable with and feel will give you the most out of your dental routine.

●  Floss

Floss is the traditional product for cleaning between teeth. There are several different types of floss, each designed for your own comfort and ease of use. Most flosses are available in different flavors, as well.

●  Nylon floss, or multifilament floss, is composed of multiple strands of thread and is available waxed or unwaxed. Wax provides for a more silky feel and can be easier to glide across your teeth. because it is made of multiple strands, there may be some shredding or tearing when flossing in tight spaces.

●  PTFE, or single filament, floss is more expensive, but it’s shred resistant as it is composed of a single fiber.

●  Ribbon or tape floss is a wider floss that covers more surface between teeth and is optimal for wide spaces, though fine floss can be just as effective.

●  Floss Picks

Floss picks are delicate two-pronged instruments with approximately an inch of taut floss between each prong. They are single-use instruments that function in much the same way as floss. Simply hold the pick in your hand and use your index finger or thumb (depending on which row of your tooth) and gently guide the floss between your teeth, flossing the way you would with traditional floss. Floss picks usually have a point at the tip of their handle that can be used like a toothpick. Some people find using a floss pick to be easier because it only requires one hand, and you do not have to wrap the floss around your fingers.

●  Interdental Brushes

Interdental brushes are short, very thin brushes that fit between your teeth to clean both sides of the space simultaneously. The brush portion has 360 degrees of bristles that function much like a toothbrush to sweep away plaque and debris between teeth. They are particularly useful for cleaning around crowns, bridges, permanent retainers, and other dental work.

While interdental brushes are also very effective, they are more difficult to use for people whose teeth are spaced closely together. If you have difficulty guiding the brush between some of your teeth, do not force it. Instead, use floss or a floss pick for those teeth, and use your interdental brush for more widely spaced teeth.

●  Oral Irrigator

An oral irrigator is an electronic or battery powered device that uses a stream of pulsating water to remove plaque and debris from between teeth. Perhaps the most widely known brand of oral irrigator is the Waterpik. The base of the oral irrigator is filled with water, which is connected to the instrument via a thin hose.

The instrument itself has a long, thin neck with a pointed head that controls the stream of water. Many oral irrigators come with different tips you can switch out depending on how pressured or focused you want the water. While oral irrigators are generally sufficient for flossing, keep in mind that water may not clean as thoroughly as an instrument that can actually get between your teeth.

Proper flossing is something your dentist or dental hygienist can teach you fairly quickly before or after your dental examination. They can go over your options with you to find the right tools and techniques that work for you. Remember: flossing daily is essential, and if the idea of devoting an extra two minutes to your dental regimen each day seems daunting, it is important that you work with your dentist to find a way with which you are comfortable and can remain consistent. 

A fractured tooth is a fairly common occurrence. While teeth are incredibly strong, the day-to-day wear and tear of using our teeth can lead to cracking, chipping, and even breaking. Sometimes, the chipping of a tooth can be so small that you may not even notice it. Other times, the fracture is large enough to be visible, or jagged enough to feel with your tongue. In extreme cases, by damaging your tooth you may have exposed the nerve inside the tooth, which can cause pain.

Endodontists are the dental professionals who specialize in the root and pulp of our teeth–the layers beneath the enamel. In addition to performing root canals, they are able to diagnose and treat fractured teeth, as cracks that reach beneath the surface of the tooth can have serious implications for the inner layers.

If you experience a minor chip in your tooth, make a non-emergency appointment with your dentist to have it treated. A broken or cracked tooth is an urgent matter, and you should try to see your dentist as quickly as possible. Some dentists have in-house endodontists on staff, but if yours does not, ask to be referred to a specialist. Unfortunately, fractured teeth do not heal, but dental solutions can seal or cover the tooth to prevent the fracture from deepening or spreading to the root of the tooth.

Causes and Symptoms of a Fractured Tooth

A common cause of fracturing a tooth is biting down on a hard object. You may chip or fracture a tooth when chewing ice or hard candy, or when using your teeth in improper ways, like to open or loosen something. A hard impact to the face can be dangerous for many reasons, and this includes damaging your teeth. For those who play contact sports, a mouth guard should always be worn. If you fall while walking, or are about to collide with another hard surface, try turning your face away to prevent a direct impact.

Cavities and old amalgam fillings that don’t support the entire tooth can weaken your enamel and may lead to cracks in your teeth. People who clench or grind their teeth are also prone to fractures, and if you have a history of grinding your teeth at night, you may consider consulting your dentist about using a mouth guard.

The severity of your symptoms depends on the size and location of the fracture. A small chip on the surface may very well cause no pain or discomfort. When a tooth cracks completely, the sides can move against each other during chewing, and this leads to discomfort and irritation in the layers beneath (the pulp). If left untreated, the pulp will become irritated enough to cause pain. By this point, the pulp–which contains the nerves and blood vessels–can no longer heal itself. Sometimes, a crack can be large enough that it strikes right down to the nerves and you may experience pain immediately.

When exposed, the nerves in our teeth are extremely sensitive. Pressure and movement from chewing, biting down, and even releasing your bite can cause varying degrees of discomfort or pain. Extreme temperatures can irritate the tooth, as can very sweet or sugary foods. The pain can be constant, or it may come and go. Eventually, an untreated fracture can lead to tooth decay or infection of the pulp.

Treatment and Procedures for Fractured Teeth

Dentists and endodontists determine the proper treatment for a fractured tooth depending on the extent and location of the crack. There are actually several different kinds of fractures in teeth, some of which require more intensive treatment than others, and your dental professional must diagnose your fracture before they proceed. In most cases where the tooth has not decayed or become infected, restoring the tooth and preventing further damage is an entirely feasible and routine procedure.

● 
Chipped teeth: A
surface-level chip in your tooth will rarely need treatment. These are
considered minor fractures, and your dentist will more than likely use filling
material only if there appears to be a risk of the chip getting worse. For
aesthetic appearances, your dentist can file down and polish the tooth.

● 
Craze lines: Craze
lines are also surface-level fractures. In this case, they are minor cracks on
the enamel that don’t reach below the surface. Your dentist may decide that
treatment isn’t necessary, or they may polish the area to smooth out the
surface.

● 
Fractured cusp: Fractured
cusps occur when a piece of the tooth’s chewing surface breaks off. They often
occur around fillings, but are generally considered to be minor fractures. It
is rare that a fractured cusp damages the pulp, and it usually does not cause
pain. Dentists often place a new filling or crown over the area to protect the
fracture from deepening.

● 
Cracked tooth: A
cracked tooth involves the entire tooth–a
fracture that reaches from the enamel down to the nerve. While the tooth is not
broken into pieces, the crack will gradually spread. It is at this stage when
you may need to consult with a specialist for treatment. Sometimes, cracks can
be repaired with filling material, but more often than not, a crown is
necessary to prevent it from worsening. If the pulp becomes damaged, an
endodontist may need to perform a root canal. A serious break exposes the nerve
and will almost always cause pain or bleeding. In this case,a root canal is
critical to remove the exposed nerve.

● 
Split tooth: A
split tooth often results from the prolonged spreading of a cracked tooth, and
causes a completely vertical break that splits the tooth into two separate
parts. An endodontist will likely perform a root canal and cover the root with
a crown. Molars have more than one root, and when they split, it is sometimes
possible to save one of the roots. The endodontist will remove the roots that
cannot be saved and cover the remaining piece with a crown. When no roots can
be saved, the tooth must be removed.

● 
Vertical root
fractures:
These fractures begin in the root of the tooth and move upward
toward the surface. They can often go unnoticed because they show minimal
symptoms until the surrounding bone and gum become infected. Extraction of the
tooth is the most common treatment, but if the tooth can be saved by removing
the fractured portion, endodontic surgery may be performed. 

Even in cases when a fractured tooth must be removed, there are still options available to preserve your smile and overall oral health. Dental technology has advanced in leaps and bounds; innovations like dental implants allow dentists to anchor and reinforce prosthetic teeth that look and function like natural teeth. No matter how severe the fracture in your tooth, consulting your dentist as soon as possible and determining the appropriate treatment can effectively resolve the issue.

Topical anesthetics, or “numbing gels” as you may hear them called in the dental office, are basically just that. They are liquids or gels that can be applied to mucous membranes, such as inside the mouth, to cause surface numbness.

In dental offices, these gels are typically applied prior to an injection of anesthesia in order to numb the gumbs and lessen the pain of the injection.

Topical anesthetics belongs to a group of medicines known as topical local anesthetics (an-ess-THET-iks ) . In addition to dentistry, they are used to relieve pain and itching caused by conditions such as sunburn or other minor burns, insect bites or stings, poison ivy, poison oak, poison sumac, and minor cuts and scratches.

Topical anesthetics deaden the nerve endings in the skin. They do not cause unconsciousness as do general anesthetics used for surgery.

Most topical anesthetics are available without a prescription; however, your doctor may have special instructions on the proper use and dose for your medical problem.

These medicines are available in the following dosage forms:

Topical

  • Benzocaine
    • Cream (U.S.)
    • Ointment (U.S.)
    • Topical aerosol (U.S.)
    • Topical spray solution (Canada)
  • Benzocaine and Menthol
    • Lotion (U.S.)
    • Topical aerosol solution (U.S. and Canada)
  • Butamben
    • Ointment (U.S.)
  • Dibucaine
    • Cream (U.S.)
    • Ointment (U.S. and Canada)
  • Lidocaine
    • Film-forming gel (U.S.)
    • Jelly (Canada)
    • Ointment (U.S. and Canada)
    • Topical aerosol (Canada)
    • Topical spray solution (Canada)
  • Pramoxine
    • Cream (U.S. and Canada)
    • Lotion (U.S.)
  • Pramoxine and Menthol
    • Gel (U.S. and Canada)
    • Lotion (U.S.)
  • Tetracaine
    • Cream (U.S.)
  • Tetracaine and Menthol
    • Ointment (U.S.)

Before Using This Medicine

If you are using this medicine without a prescription, carefully read and follow any precautions on the label. For topical anesthetics, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to a local anesthetic, especially when applied to the skin or other areas of the body. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes, especially aminobenzoic acid (also called para-aminobenzoic acid [PABA]), to parabens (preservatives in many foods and medicines), or to paraphenylenediamine (a hair dye).

Pregnancy

Although studies on effects in pregnancy have not been done in humans, topical anesthetics have not been reported to cause problems in humans. Lidocaine has not been shown to cause birth defects or other problems in animal studies. Other topical anesthetics have not been studied in animals.

Breast-feeding

Topical anesthetics have not been reported to cause problems in nursing babies.

Children

Benzocaine may be absorbed through the skin of young children and cause unwanted effects. There is no specific information comparing use of other topical anesthetics in children with use in other age groups, but it is possible that they may also cause unwanted effects in young children. Check with your doctor before using any product that contains a topical anesthetic for a child younger than 2 years of age.

Older adults

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of topical anesthetics in the elderly with use in other age groups.

Other medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems

The presence of other medical problems may affect the use of topical anesthetics. Before using a topical anesthetic, check with your health care professional if you have any other medical problems, especially:

  • Infection at or near the place of application or
  • Large sores, broken skin, or severe injury at the area of application—The chance of side effects may be increased

Proper Use of This Medicine

For safe and effective use of this medicine:

  • Follow your doctor’s instructions if this medicine was prescribed.
  • Follow the manufacturer’s package directions if you are treating yourself.
  • Unless otherwise directed by your doctor,do not use this medicine on large areas, especially if the skin is broken or scraped. Also, do not use it more often than directed on the package label, or for more than a few days at a time. To do so may increase the chance of absorption through the skin and the chance of unwanted effects. This is especially important when benzocaine is used for children younger than 2 years of age.

This medicine should be used only for problems being treated by your doctor or conditions listed in the package directions.Check with your doctor before using it for other problems, especially if you think that an infection may be present. This medicine should not be used to treat certain kinds of skin infections or serious problems, such as severe burns.

Read the package label very carefully to see if the product contains any alcohol. Alcohol is flammable and can catch on fire.Do not use any product containing alcohol near a fire or open flame, or while smoking. Also, do not smoke after applying one of these products until it has completely dried.

If you are using this medicine on your face,be very careful not to get it in your eyes, mouth, or nose. If you are using an aerosol or spray form of this medicine, do not spray it directly on your face. Instead, use your hand or an applicator (for example, a sterile gauze pad or a cotton swab) to apply the medicine.

Dosing

The dose of a topical anesthetic will be different for different patients.Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change itunless your doctor tells you to do so.

For benzocaine and for benzocaine and menthol combination

  • Fortopicaldosage forms (aerosol solution, cream, lotion, ointment, and spray solution):
    • For pain and itching caused by minor skin conditions:
      • Adults and children 2 years of age and older—Apply to the affected area three or four times a day as needed.
      • Children younger than 2 years of age—Dose must be determined by your doctor.

For butamben

  • Fortopicaldosage form (ointment):
    • For pain and itching caused by minor skin conditions:
      • Adults—Apply to the affected area three or four times a day as needed.
      • Children—Dose must be determined by your doctor.

For dibucaine

  • Fortopical creamdosage form:
    • For pain and itching caused by minor skin conditions:
      • Adults and children 2 years of age and older—Apply to the affected area three or four times a day as needed.
      • Children up to 2 years of age—Dose must be determined by your doctor.
  • Fortopical ointmentdosage form:
    • For pain and itching caused by minor skin conditions:
      • Adults—Apply to the affected area three or four times a day as needed. The largest amount that may be used in a twenty-four-hour period is 30 grams, but much smaller amounts are usually enough.
      • Children 2 years of age and older—Apply to the affected area three or four times a day as needed. Do not use more than 7.5 grams in a twenty-four-hour period.
      • Children up to 2 years of age—Dose must be determined by your doctor.

For lidocaine

  • Fortopicaldosage forms (aerosol solution, film-forming gel, jelly, ointment, and spray solution):
    • For pain and itching caused by minor skin conditions:
      • Adults—Apply to the affected area three or four times a day as needed.
      • Children—Dose must be determined by your doctor.

For pramoxine and for pramoxine and menthol combination

  • Fortopicaldosage forms (cream, gel, and lotion):
    • For pain and itching caused by minor skin conditions:
      • Adults and children 2 years of age and older—Apply to the affected area three or four times a day as needed.
      • Children younger than 2 years of age—Dose must be determined by your doctor.

For tetracaine and for tetracaine and menthol combination

  • Fortopicaldosage forms (cream and ointment):
    • For pain and itching caused by minor skin conditions:
      • Adults and teenagers—Apply to the affected area three or four times a day as needed. The largest amount that may be used in a twenty-four-hour period is 30 grams (a whole tube of the medicine), but much smaller amounts are usually enough.
      • Children 2 years of age and older—Apply to the affected area three or four times a day as needed. Do not use more than 7 grams (about one-fourth of a tube of the medicine) in a twenty-four-hour period.
      • Children younger than 2 years of age—Dose must be determined by your doctor.

Missed dose

If your doctor has ordered you to use this medicine according to a regular schedule and you miss a dose, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and use your next dose at the regularly scheduled time.

Storage

To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Keep the medicine from freezing.
  • Do not puncture, break, or burn aerosol containers, even when they are empty.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

After applying this medicine to the skin of a child,watch the child carefully to make sure that he or she does not get any of the medicine into his or her mouth. Topical anesthetics can cause serious side effects, especially in children, if any of the medicine gets into the mouth or is swallowed.

Stop using this medicine and check with your doctor:

  • If your condition does not improve within 7 days, or if it gets worse.
  • If the area you are treating becomes infected.
  • If you notice a skin rash, burning, stinging, swelling, or any other sign of irritation that was not present when you began using this medicine.
  • If you swallow any of the medicine.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

  • Less common
    • Large swellings that look like hives on the skin or in the mouth or throat 
  • Symptoms of too much medicine being absorbed by the body–very rare
    • Blurred or double vision;  confusion;  convulsions (seizures);  dizziness or lightheadedness ;  drowsiness;  feeling hot, cold, or numb;  headache;  increased sweating;  ringing or buzzing in the ears ;  shivering or trembling;  slow or irregular heartbeat;  troubled breathing;  unusual anxiety, excitement, nervousness, or restlessness;  unusual paleness;  unusual tiredness or weakness 

Also, check with your doctor as soon as possible if any of the following side effects occur:

  • Burning, stinging, or tenderness not present before treatment ;  skin rash, redness, itching, or hives 

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Oil pulling, or oil swishing is a traditional folk remedy that has recently re-gained popularity.  The process involves swishing, or pulling, for 3-15 minutes with a natural oil such as sesame, sunflower, olive, coconut, and others.  It is said to cure/help with all kinds of health issues including whitening teeth, plaque buildup on teeth, hormonal issue, digestion.  Now spreading across the web, claims about oil pulling are begging the question, is this for real?

Let me start by saying, as a dentist, that in my 5+ years of dental education I have never heard of oil pulling.  The closest thing to it is that some mouthwashes, namely Listerine, use essential oils to help kill bacteria, freshen breath, and keep the mouth healthy.  So this idea of keeping an oil in your mouth for up to 20 minutes is certainly not involved in a core dental education.

Oil Pulling Claims

Oil pulling enthusiasts make 3 general claims about the practice that I will address one at a time:

1. Pulls Toxins: 

Unless you have a high level of toxins in your cheeks and tongue, the claim of pulling toxins is extremely far-fetched. There is no scientific evidence to show that toxins can be pulled from your body by swishing with oil.

2. Clean Mouth: 

Some claims, such as killing oral bacteria and reducing plaque, seem more plausible.  Doing a quick search on PubMed, the go-to scientific article search engine, one finds a scant dusting of articles on this ancient practice.  Basically, every relevant study was done by one man, a faculty member at a dental school in India.  The studies do show reduced plaque, improved health, and decreased bacterial loads in oil pulling patients.  However, the studies lack strength and do not compare oil pulling to common solutions like mouthwash, or Chlorhexidine (Peridex), the gold-standard in oral rinses.

3. Tooth Whitening: 

Now, we get to the last, and possibly most tantalizing claim about oil pulling. Whiter teeth!  A quick Google search results in numerous before-and-after shots, which as a dentist I know are completely useless unless done with the exact same lighting, F-stop, flash, etc.  None of the photos I found met my criteria for actual whitening as a result of oil pulling.  In addition, no scientific article can be found about the whitening effects. The placebo effect often drives people to perceive treatments as successful, when in fact they are not.  And any whitening effects of Oil Pulling appear to be purely placebo.

Oil pulling is an ancient practice that is being rejuvenated by young, easily persuaded individuals around the country, however there is virtually zero scientific evidence backing it up.

Do yourselves a favor! Go buy a bottle of mouthwash at the store. Use that once a day for the same effect as oil pulling without wasting 20 minutes of your life and making yourself feel sick.

Brush twice a day, everyday.  Use a pea-to-chickpea size amount of toothpaste, and make sure it has fluoride which is essential in preventing cavities.

How to Brush Your Teeth

Angle the soft bristles of your brush towards the gums as to remove as much plaque as possible.  Don’t scrub, this can damage the enamel and cause your gums to recede. 

Remember, 2 minutes of brushing twice a day = a healthy smile!

Check out www.pearlinbrite.com for our Aloe Vera Fluoride Toothpaste and Nano-Silver Soft Toothbrush.