10 Fun Facts About Tooth Brushes

1. When selecting your toothbrush, look for the ADA Seal. The ADA Seal of Acceptance is the gold standard for toothbrush quality. It’s how you’ll know an independent body of scientific experts, the ADA Council on Scientific Affairs, has evaluated your toothbrush to make sure bristles won’t fall out with normal use, the handle will stay strong and the toothbrush will help reduce your risk for cavities and gum disease.

2. The toothbrush is 5,000 years old. In various forms, that is. Ancient civilizations used a “chew stick,” a thin twig with a frayed end, to remove food from their teeth. Over time, toothbrushes evolved and were made from bone, wood or ivory handles and stiff bristles of hogs, boar or other animals. The modern nylon-bristled toothbrush we use today was invented in 1938.

3. The first mass-produced toothbrush was invented in prison. In 1770, an Englishman named William Addis was jailed for inciting a riot. He saw fellow prisoners using a rag covered in soot or salt to clean their teeth. Addis saved an animal bone from dinner and received bristles from a guard. Accounts state he bored tiny holes into the bone, inserted the bristles and sealed them with glue. After his release, he modified his prototype, started a company and manufactured his toothbrush. That company, Wisdom Toothbrushes, still exists in the United Kingdom today.

4. Manual or powered? Your teeth don’t care, if you do it right. In the manual and powered toothbrush debate, it’s a wash. You just need to brush twice a day for two minutes with a fluoride toothpaste. Both types of toothbrushes can effectively and thoroughly clean your teeth. It all depends on which one you prefer. People who find it difficult to use a manual toothbrush may find a powered toothbrush more comfortable. Talk to your dentist about which kind is best for you. If you do decide to use a powered toothbrush, you must hold it with your fingers, like how you would hold a flute. Don’t hold it in the palm of your hand. Palming your power toothbrush is likely to cause excessive pressure on your teeth and gums.

5. There is no “correct” order for brushing and flossing. Brushing before flossing, flossing before brushing—it doesn’t matter to your teeth, as long as you do both. However, be very careful not to cut your gums when you floss. Over-zealous flossing can cause spaces (dark triangles) to form between your teeth as well as gum recession.

6. Toothbrushes like to be left out in the open. Cleaning your toothbrush is easy: Rinse it with tap water to remove any remaining toothpaste and debris. Store it upright and allow it to air dry. If you store your toothbrush with other toothbrushes, make sure they are separated to prevent cross contamination. And do not routinely cover toothbrushes or store them in closed containers. A moist environment such as a closed container is more conducive to the growth of unwanted bacteria than the open air.

7. Lifespan = 3-4 Months. Make sure to replace your toothbrush every three to four months, or sooner if the bristles are frayed. A worn toothbrush won’t do as good of a job cleaning your teeth.


8. When it comes to choosing a brush, go soft. Whether you use a manual or powered toothbrush, choose a soft-bristled brush. Firm or even medium-strength bristles may cause damage to your gums and enamel. When brushing your teeth, don’t scrub vigorously—only brush hard enough to clean the film off your teeth.

9. Remember: 2 minutes, 2 times a day. 4 minutes a day goes a long way for your dental health. Put the time in each day to keep your smile healthy and keep up this twice-a-day habit.

10. Sharing is caring, but not for toothbrushes. Sharing a toothbrush can mean you’re also sharing germs and bacteria. This could be a particular concern if you have a cold or flu to spread, or you have a condition that leaves your immune system compromised.



For mild to moderate pain after surgery, patients are asked to take over-the-counter (OTC) pills. There are basically two kinds of OTC pills. One is represented by pain pills such as Tylenol and is called acetaminophen. The other is represented by Advil, and is called ibuprofen.

For quite some time now many doctors have advised their patients to take both acetaminophen and ibuprofen together, in the belief that taken together brings about more relief from pain than just taking one kind.

However, it has not been strongly established that this is true. An article reviewing various studies involving a total of 1909 patients published in the September issue of the Journal of the American Dental Association has concluded that taking acetaminophen (e.g., Tylenol) in combination with ibuprofen (Motrin or Advil) would be better for dental post-operative pain than taking only one or the other. In other words, if you take a Tylenol at the same time you taken an Advil, you would have better relief from pain from dental surgery than if you took just Tylenol or just Advil.

According to the author, Ferne Kraglund, D.D.S., these two kinds of over-the-counter pain pills “are widely available and inexpensive, with a well-established reputation for safety and efficacy (effectiveness).” This review of a number of very strident, scientific studies, called randomized clinical trials, involving these 1909 patients showed that the combination of these two kinds of drugs effectively lowers pain intensity and decreases the need for higher dosage or the addition of other supplementary drugs.

Of course, you should only use these over the counter drugs at the direction of your dentist to make sure that in your particular case it is safe and effective. Just as importantly, you need to be instructed by your dentist as to how much and under what circumstances you should take or not take these drugs.

The FDA recommends certain limits as to strength and daily dosage of these drugs. For example, each tablet of acetaminophen should contain no more than 325 milligrams and the maximum dosage should not exceed 4000 mg per day. It is critical you follow your doctor’s instruction and contact your doctor in case of unusual reactions.


Abscessed Teeth Increases Risk of Heart Attacks

In a study carried out at the University of Helsinki in cooperation with the Heart and Lung Centre of the university and published in the Journal of Dental Research a dental abscess ( infection at the root tip of a tooth ) increases the risk of coronary artery disease, even if there no pain.

The study states, “Acute coronary syndrome (heart attack) is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue.” In short, this study suggest a substantially higher risk of heart attacks among those with untreated abscessed (dead) teeth.

Dental abscess is a reaction of the body to microbial infection of the dental pulp, the nerve and blood vessels in the canals of the root. Dental caries (cavities) is the most common cause of abscesses.

Gum infections have been found to be associated with many common chronic diseases. Low grade inflammation generated by oral infections is postulated to be an independent risk factor for coronary artery disease and diabetes. This is the first study to link need for root canal to heart disease. In this study of 508 Finnish patients with a mean age of 62 years who were experiencing heart symptoms, 58 per cent were found to be suffering from one or more dental abscesses. Furthermore these dental abscesses were connected with a high level of serum antibodies related to common bacteria. Thus a dental abscess, whether painful or not, can affect other parts of the body as well.

Cardiovascular diseases cause more than 30 per cent of deaths globally. They can be prevented by a healthy diet, weight control, exercise and not smoking. With regard to the health of the heart, measures should be taken to prevent or treat oral infections, as they are very common and often asymptomatic. Root canal treatment of an infected tooth may eliminate an unnecessary risk of heart disease.

In other words, root canal treatment can save lives.


Acid Reflux

Teeth are so hard you would think they would be indestructible and that they would not be adversely affected by anything. Due to the strength of enamel and bone, they should remain the same from the day the teeth come into the mouth to the day they are no longer needed.

Unfortunately, this is far from true.

While we would like to think of teeth as being strong and unchanging, most people know that teeth can be damaged by tooth decay-causing bacteria. We know, too, that teeth can be damaged by mechanical means – attrition caused by tooth grinding and clenching and abrasion caused by improper tooth brushing. However, few people know that there is a third factor that can destroy teeth – chemical erosion.

Chemical erosion is caused by excess acid coming in contact with a tooth for extended periods of time. The acid attack can be self-inflicted (bulimia) or more commonly from a problem with acid reflux. In acid (gastric) reflux, the acidic and partly digested contents of the stomach are returned back into the throat and oral cavity. Normally, the lower esophageal sphincter muscle (LES), connecting the esophagus with the stomach, closes once food passes into the stomach. This closure prevents the stomach contents from flowing back up into the esophagus. Acid reflux occurs when this sphincter does not work properly and allows acidic fluid to return to the esophagus and higher – the mouth.

This condition sometimes can actually be noted by a dentist long before it is acknowledged by a patient or physician. The dentist will see a characteristic smooth and circular erosion of the cusp tips of the lower first molars. The cusp tips (bumps on a tooth) lose their peak, flatten, and become concave. Soon the enamel cover is broached and the underlying dentin is exposed. Because dentin is “softer” than enamel, the erosion can progress more quickly. This acid erosion has a very different appearance from tooth loss due to a mechanical etiology. Attrition and abrasion have a very sharp, edged, and well-delineated look. Chemical erosion has a softer and more rounded presentation and is localized first to lower first molars (lower first molars are the first permanent molars to erupt into the mouth) so that the permanent teeth have the longest potential exposure. When the acid refluxes (returns) to the mouth, it pools mostly around the lower first molars. This is the site of the most erosive features.

A significant portion of the population experiences acid reflux at least once a month. About 25% of those who are affected are unaware of their problem. Infants and young children can be affected, and there may be a genetic component to this disease. Early diagnosis from erosion of the permanent lower first molars can be made as early as 7 or 8 years of age. A hiatal hernia may weaken the LES and cause reflux. Diet and lifestyle contribute to acid reflux. Chocolate, peppermint, citrus, tomatoes, fried or fatty foods, coffee (especially acidic coffee), alcoholic beverages, garlic, and onions are foods to avoid. Weight gain (also weight gain associated with pregnancy) and smoking (by relaxing the LES) may be contributing factors.

As is true with most medical and dental problems, the earlier the diagnosis is made, the easier it is to treat. Variable factors include the nature and severity of the problem, as well as frequency and type of fluid that refluxes from the stomach. Under supervision of your physician, change in diet, eating habits, and/or medication (over-the-counter or prescription) can be effective. It is recommended that you first consult your physician or a specialist (gastroenterologist) if you suspect you have gastric reflux or other gastro-intestinal ailments.

Dentally, once the enamel is broached and the dentin becomes visible, it is recommended that the affected areas be protected by covering them with an enamel replacement – a tooth-colored bonding material. This material not only protects the dentin and enamel, it may be more resistant to the acid than is naturally occurring dentin. Many times, drilling preparation is not needed. See your dentist regularly so that problems like these can be detected and treated in time.

If you would like more information about acid reflux, call Dr. Chao in Alhambra, CA at (626) 308-9104

Dr. Chao proudly serves Alhambra and all surrounding areas.


7 Reasons Why Sugar Is Bad For You

Refined sugar or added sugar is said to be the most harmful ingredient in the Standard American Diet (SAD).
Its harmful effects on metabolism may be traceable to many other diseases.
Below are 7 of the reasons for you go sugar-free for 2021:
  1. Sugar, as we all know, is bad for your teeth. What you may not know is that it is also bad for your gums. Bacteria which cause gum disease and loose teeth can metabolize sugar in its pure form in the mouth, leading to increase in the growth of these germs. Therefore, sugar can cause cavities and loose teeth.

  2. Sugar and Liver Disease. Overloading your diet with sugar can cause the liver to overwork to convert sugar into glycogen. When the saturation is reached, liver is forced to covert glycogen into fat, which in term has deleterious effect on the body. In more extreme cases of heavy sugar intake, the liver itself can be damaged, leading to Fatty-Liver-Disease.

  3. Sugar and Diabetes. Excessive intake of sugar can cause insulin resistance. Insulin is necessary for glucose to enter the cells and be used for energy. Excessive glucose can cause the cells to become “insulin resistant.” Be insulin resistant can be the cause of diabetes II, metabolic syndrome, obesity, cardiovascular diseases, etc.

  4. Sugar and Cancer. Cancer is characterized by uncontrolled growth and multiplication of cells. Insulin plays a key role in regulating cell growth. Elevated insulin levels because of abnormally high take of sugar can contribute to cancer, according to leading experts. Additionally, high blood glucose is associated with high levels of inflammation, which also contributes to higher risk of cancer.

  5. Sugar and Addiction. Sugar stimulate the production of dopamine from the “feel-good” center of the brain. Those who have susceptibility to addiction may become addicted to sugar and junk foods.

  6. Sugar and Obesity. Strong links have been found between sugar and obesity. That is no surprise. But obesity in children has been found to associated with sugar- sweetened beverages. There is a 60% chance of obesity in children who consume high amounts of these beverages.

  7. Sugar and Heart Disease. Strong links have been shown between sugar and heart disease. High intake of sugar can lead to rise in triglycerides, LDL, high blood glucose and abdominal obesity, all of which are risk factors for heart disease.

So, cutting down or cutting out refined/added sugar in your diet can not only save your teeth, but can save your life. See your dentist regularly.

Make your goal for 2021 to cut down or cut out added sugar altogether.

Do it now! You won’t regret it.


COVID-19 Patients with Severe Gum Disease are 3x More Likely to Experience Complications

A new study of 568 COVID-19 diagnoses with severe gum disease (periodontitis) were at least three times more likely to experience complications including death, ICU admission and need for assisted ventilation, according to an article published in the Journal of the American Academy of Periodontology (AAP).

Additionally, COVID-19 patients with periodontitis showed increased levels of biomarkers associated with worsened disease outcomes including white blood cell levels, D-dimer, and reactive protein.

Conducted using the national electronic health records of the State of Qatar between February and July 2020, this study analyzed patient cases with severe COVID-19 complications (death, ICU admissions or assisted ventilation). The control group was comprised of COVID‐19 patients discharged without major complications. Periodontal conditions in the two groups were analyzed using dental radiographs from the same database.

Periodontal disease, commonly known as gum disease, can cause bleeding gums, bad breath, and if left untreated lead to tooth loss. Research from the AAP and the Centers for Disease Control and Prevention suggests up to half of US adults aged 30 and older have some form of periodontal disease. Periodontal disease has been linked to several other serious conditions in addition to COVID-19, including diabetes, heart disease, and Alzheimer’s.

According to the AAP, systemic inflammation is not only a symptom of COVID-19 but can also be a symptom of periodontal disease. Gum disease experts (periodontologists) are alerting the medical profession and the public to maintain healthy teeth and gums to avoid developing periodontal disease amid a global pandemic like COVID-19.

In other words, those COVID-19 diagnoses with gum disease should take care of their teeth and gums and seek treatment to optimize gum health. Those without COVID-19 should maintain good gum health to avoid gum disease to minimize the risk of being more vulnerable to coming down with COVID-19 and contract severe complications if they do come down with COVID-19.


Gum Disease (Periodontitis) May Predispose You to COVID-19

Gum Disease (Periodontitis) has long been known to possess the ability to incite an inflammatory response in gum tissue just like how COVID-19 similarly incites a much more severe, often lethal, inflammatory phenomenon in the body through chemicals called “cytokines.”

In COVID-19, these cytokines bring about the severe inflammatory responses called a “cytokine storm.” One such cytokine, called IL17, is also found in gum disease as well as the blood stream of the patient with periodontitis. In other words, one of the lethal cytokines (IL17) is found in periodontitis when the patient does not have COVID-19. The question then is, does periodontitis bring about a higher risk for COVID-19?

According to an article to be published in the November 2020 issue of the “Medical Hypothesis, “This common pathway of inflammatory response points towards a possible association between Periodontitis and COVID-19 related adverse outcomes. Understanding of this association underscores the importance of keeping periodontal disease under check and the value of maintaining meticulous oral hygiene in the COVID-19 era. It also points towards the possibility of the presence of periodontal disease as predisposing towards COVID-19 related adverse outcomes,”

In other words, periodontitis may predispose you to COVID-19.

So, how prevalent is periodontitis? According to the CDC one out of every two American adults aged 30 and over has periodontal disease. A study published in the Journal of Dental Research estimates that 47.2 percent, or 64.7 million American adults, have mild, moderate, or severe periodontitis. In adults 65 and older, prevalence rate is 70.1 percent.

So, what is periodontitis? It is a chronic inflammatory disease that affects the gum tissue and bone supporting the teeth, according to the American Academy of Periodontology. If left untreated periodontal disease can lead to tooth loss and other chronic inflammatory disease, such as diabetes, cardiovascular disease and even obesity.

Therefore, use your mask, practice social distancing, and keep your teeth and gums as healthy as possible.

Seeing your dentist can not only save your teeth, but also your life.


Cotton Candy was invented by a Dentist…

It is not known whether Dr. William J. Morrison (1860-1926) had an ulterior motive for inventing the soft confection, but the dentist no doubt helped ensure others in his profession continued drawing in plenty of customers.

In 1897, he partnered with confectioner, John C. Wharton to develop the “Electric Candy Machine” that spun sugar into candy (which at the time was known as “Fairy Floss”), and its been bringing kids cavities ever since.

In 1921, another dentist, Josef Lascaux attempted to improve the design and trademarked the name “Cotton Candy.” Dr. Lascaux sold the cotton candy to his patients.

When cotton candy is spun, the sugar can create up to a 4-mile-long string of sugar! One sticky, sweet cloud of cotton candy has less sugar than a can of soda, no fat, no cholesterol, no sodium and only has about 105 calories for a standard one ounce serving.

The basic cotton candy invented in 1897 is still the same today and is sold worldwide. It is still one of the most popular treats at carnivals, fairs, and festivals. Chewing Gum was first patented by a Dentist….

On December 28, 1869, William F. Semple (1834-1922) filed the first chewing gum patent. It was not the sweet candy that it is today. Dr. Semple hoped it would clean the teeth. His ingredients included chalk and powdered licorice root. Charcoal was also considered a suitable ingredient.

Although chewing gum can be traced back to civilizations around the world, modernization and commercialization took place in the USA.

Humans are the only animals that chew gum. If you give a piece of gum to a monkey, he will chew it for a minute and then stick it in his hair.

In the USA alone, the amount of gum sold in one year would make a stick 3.5 million miles long. Over 100,000 tons of gum is chewed each year, with consumers spending a half-billion dollars!

If you are one of the many who enjoy delicious Cotton Candy and chewing gum, be sure to visit your dentist regularly.


Alzheimer’s and Dental Care

Those with high levels of tooth plaque have a great risk of cognitive decline, although cause and effect is not clear, according to the December 15 issue of the British Dental Journal.  The link of gum disease and Alzheimer’s (AD) may be oral bacteria.

Oral bacteria invade the brain, promote inflammation, increase permeability of blood brain barrier, and have been found in the brains of those with AD and blood clots in cerebrovascular disease.

A USC study of 10,000 people showed twins with AD four times more likely to have periodontal disease in middle age, and a 7 year study of 100,000 found the dental cleanings reduced stroke risk by 13%.

For those with AD, appropriate preventive/treatment should be instigated to minimize dental disease as soon as possible.

Schedule AD patients at times of best alertness, which is late morning and early afternoon. Ensure dentures are labelled, cleaned professionally on a regular basis, and relined and renewed as necessary.

AD patients should be seen by the dentist regularly to maintain status quo, avoid pain and minimize further interventions.

Ensure that fear, stress and embarrassment for the caregiver and the person with AD are minimized.

Feel free to consult your dentist if you have any questions regarding a loved one with AD.


Fight the Flu by Keeping Your Mouth Healthy and Free of Infection

A healthy mouth is positively linked with reduced rates of heart disease and other chronic illnesses. How harmful bacteria in the oral cavity can increase susceptibility to harmful systemic viruses having been received more and more attention from researchers.

Many common oral bacteria associated with gum disease also have an immune-suppression effect that increases susceptibility to cold and flu viruses like influenza and rhinovirus, according to researchers at North Carolina State University in collaboration with the CDC and reported in the RDH Journal. According to the RDH Journal, two of the most virulent bacteria are: Porphyromonas gingivalis. P. gingivalis is found in the oral cavity. While it is generally present in low numbers, it has many ways of suppressing the immune system to evade immune responses. P. ginivalis has been linked to chronic immune conditions, rheumatoid arthritis, and viruses like HIV and herpes.

Streptococcus pneumoniae. S. pneumoniae is a bacteria generally found in the respiratory tract, sinuses, and nasal cavity. It becomes pathogenic when the host immune system is suppressed and colonizes the air sacs of the lungs. S. pneumoniae has a powerful ability to repair its own DNA when damaged by the host immune response, continuing to transfer itself to non-infected cells. While most frequently associated with pneumonia and meningitis, it is also positively associated with periodontitis and oral plaque and increases the risk of death when comorbid with the influenza virus.

Illness-causing viruses and bacteria interact in two ways:

● Direct interactions, in which a virus exploits a bacterial component to penetrate a host cell, leading to viral infestation, such as the flu.

● Indirect interactions, in which a viral infection causes increased spread of bacterial infections.

In short, a review of the literature suggests that heightened oral care may be an under-utilized avenue for prevention of disease and mitigation of lethality during cold and flu season. In addition to conventional flu prevention methods such as handwashing, avoiding exposure, and getting a flu shot, additional preventive methods specifically targeting oral health may be beneficial. Here are some additional ways patients can take care of themselves during the flu season:

● Get regular dental checkups and dental cleanings

● Brush and clean in between teeth regularly

● Wash your hands before flossing to prevent bacteria from entering the mouth

● Replace toothbrushes every 3-4 months, and discard a toothbrush if it was used while suffering from the cold or flu

● Thoroughly rinse toothbrushes after use and allow them to air-dry in an upright position between uses.

So see your dentist to keep your immune system operating at an optimal level.

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