2013-05-22T09:08:23-04:00 Mark Burhenne http://www.huffingtonpost.ca/author/index.php?author=mark-burhenne Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Mark Burhenne Good old fashioned elbow grease. tag:www.huffingtonpost.com,2013:/theblog//3.2782771 2013-02-28T17:15:05-05:00 2013-04-30T05:12:01-04:00

Mark Burhenne http://www.huffingtonpost.com/mark-burhenne/
Flossing can be icky and awkward -- no one likes feeling like they're shoving their entire fist into their mouth. But the reason why we don't make flossing a habit is a bit more complicated and has its roots in psychology.

During the early 1900s, right around World War I, dental hygiene was so bad, it was said to be a national security risk. Why? People weren't brushing their teeth, of course, and the 1900s marks the period when Americans first began to consume sugary, ready to eat processed foods in the form of crackers, breads, and potato chips.

America's brushing habits were forever changed at this point by a toothpaste campaign that told people, "Just run your tongue across your teeth. You'll feel a film -- that's what makes your teeth look 'off colour' and invites decay. Why would you keep a dingy film on your teeth? Our toothpaste removes the film!"

As Charles Duhigg explains in his book, The Power of Habit, the success of this campaign was in its ability to create a craving in people, which is at the heart of all habits.

In order to make a habit, Duhigg asserts, you need the following:

1. A simple and obvious cue


2. A clearly defined reward

Image courtesy of Charles Duhigg


When people ran their tongue across their teeth like the campaign instructed, that became a simple and obvious cue for them to brush their teeth. The reward? Removing the "dingy film" on their teeth. The ad people had created a craving. If people forgot to brush, they missed that "tingling clean feeling."

Now, back to flossing. The problem with flossing is there is no instant gratification, no clearly defined reward. People don't think it's working.

Unfortunately, our brains are not wired to develop habits that will do good things for our health 10 or 20 years later.

Flossing is going to prevent decay, keep your teeth and smile looking young as you age, prevent your teeth from falling out, prevent gum recession, expensive dental bills, and pain -- so trick your brain into making it an effortless routine that you perform on autopilot.

Start with giving yourself a simple and obvious cue -- you might decide to floss every night before bed, for example -- and a clearly defined reward, like a favorite flavor of floss. For children, a sticker for every day on a flossing calendar in the bathroom is a great way to cement the habit.

Create a cue. I tell my patients to take a blank post-it and stick it on your mirror. That's a cue. Don't write things like "floss" on it -- that sounds too authoritarian and disciplinary. Every time you see that post-it, you'll know deep down, that means to floss. I did this to get into the habit myself.

Make it easy. Keep floss stashed everywhere. The samples of floss you get from the dentist are great for this -- keep one in your desk drawer at work, your gym bag, in the car, in your laptop bag, and your travel toiletry case. We might not think of flossing late at night before bed because we're tired, but the thought (or craving) could hit you during the day.

Invest in a flossing stick, which is basically like the handle of a toothbrush, but with floss on the top. These are fantastic, I use one myself. They turn flossing into a one-handed operation and are awesome for multi-taskers -- you can flip through your phone with one hand while flossing with the other.

Take the pressure off. Don't do what the hygienist tells you, which is, floss every day. This can be too much of a jump and too much to expect right of the bat. It's easy to get frustrated when trying to get in the habit of flossing, especially since so much coordination is involved with it.

What I tell my patients is, floss once a week. What ends up happening is they floss once, and a few days later, begin to crave the feeling again. When you floss once, you get sensation of the separation of the teeth, stimulation of the gums -- it's a distinct feeling, almost like a massage. Which is why you'll crave it again. This can be a much better way to break into the habit of flossing daily.

You can think of flossing like kicking over an anthill each day. You can kick the anthill to destroy it, but each day, the ants come back and build a new one. Flossing one week before your appointment with the hygienist isn't going to prevent gum disease, tooth decay, and gum recession -- but keeping up with that "anthill" and flossing daily, will.

Mark Burhenne, DDS

You can purchase Charles Duhigg's brilliant book, The Power of Habit, here.

]]> tag:www.huffingtonpost.com,2013:/theblog//3.2563879 2013-01-28T17:16:46-05:00 2013-03-30T05:12:01-04:00

Mark Burhenne http://www.huffingtonpost.com/mark-burhenne/
If you ever feel sleepy at any point during the day, it's absolutely imperative you get tested and treated for sleep apnea. Many people think that feeling tired during the day is normal -- it's not. The nature of sleep apnea is that you can be fit, thin and healthy and still have sleep apnea.

The way sleep apnea works is this -- our airways collapse at night because of the heaviness of the jaw. When the airway collapses, breathing becomes compromised, so the brain has to get out of the deeper stages of sleep so it can open the airway and keep you alive and breathing. Adrenal glands are firing and you're grinding and clenching your jaw in an attempt to re-open the airway and this happens several times every hour!

The worst part in all this isn't that you're missing out on restorative sleep that slows the aging process and improves cognitive function -- the worst part is that you're waking up from an entire night of feeling panicked and breathless.

Imagine how that impacts you during your waking hours. For people already under tons of stress, this just compounds the stress you face during the day. For many people, a huge source of their anxiety during the day is actually from a feeling of breathlessness they experience at night. If you suffer from sleep apnea, you're panicked all night long as you gasp for air -- unconscious and unaware the entire time, but still paying the emotional price in the form of anxiety during the day.

Why not get ahead of the stress of the day by waking up feeling positive and optimistic so you can handle the challenges of the day? My recommendation to people who are feeling symptoms of anxiety and/or aren't happy with the sleep they're getting is that they see their dentist to have a mandibular advancement device made and an MD sleep specialist to discuss treatment.

It's the quality of the sleep that's important, but also eliminating that fight-or-flight response at night, to improve anxiety and stress during waking hours.

Click here to follow Ask the Dentist on Facebook.

ALSO: Here are author Michelle Cederberg's 10 ways to get the best sleep:
]]> tag:www.huffingtonpost.com,2013:/theblog//3.2536927 2013-01-24T17:24:55-05:00 2013-03-26T05:12:01-04:00

Mark Burhenne http://www.huffingtonpost.com/mark-burhenne/
How to know when it's serious and when it's not?

Know these dental symptoms that you should never ignore and when to see your dentist:

1. Bleeding Gums
Your gums act like a gasket, sealing the spaces between teeth so food doesn't accumulate and bacteria can't invade the jawbone -- and the rest of your body.

Bleeding gums are an indicator for gingivitis or -- if the gingivitis is left untreated -- periodontitis, which is a serious infection that can lead to teeth loosening or even falling out. Both gingivitis and periodontitis are diseases caused by inflammation in the mouth due to plaque build-up along the gumline -- and inflammation in the mouth can lead to other inflammatory diseases, such as heart disease, stroke, atherosclerosis, and erectile dysfunction.

It's not normal for your gums to bleed if you are flossing and brushing every day. Bleeding gums despite proper oral care can be indicators for malnutrition, cancer, and other serious conditions.

2. Crooked Teeth
If your teeth are crooked or otherwise misaligned, it's a serious health condition. When teeth aren't properly aligned, food gets impacted in spaces in between the teeth and plaque builds up because these crooked spaces aren't easily reached by a toothbrush and floss. Facilitating the build-up of plaque in this way can lead to gum disease and other inflammatory diseases. Many people think that getting braces or wearing Invisalign are about having a "pretty smile" -- but straightening the teeth is actually a preventative health measure.

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3. Clicking or Popping Jaw or Earaches
An earache or sharp pain right in front of the ear can be a sign that you are suffering from TMD (Temporomandibular Disorders). Symptoms of TMD should never be ignored because TMD is a progressive disorder, meaning it only gets worse. If you wait to see a dentist, you may reach a point of no return where the only solution is painkillers for the rest of your life.

Causes of TMD include grinding or clenching the teeth, dislocation of the jaw, arthritis of the jaw, and stress.

Common symptoms of TMD:
• Pain or tenderness in the face, jaw, neck and shoulders, or in or around the ear when you chew, talk, or open your mouth wide
• Limited ability to open your mouth wide
• Jaw getting stuck or "locked" while mouth either open or closed
• Clicking or popping sounds in the jaw joint when opening or closing
• A tired feeling in the face
• Difficulty chewing or uncomfortable bite
• Headaches, dizziness, earaches, hearing problems

4. Flat Teeth
Look in the mirror -- do your front teeth look like they're all the same length or appear worn flat at the bottom? This is an indication that you have been grinding your teeth for quite some time.

See your dentist if you suspect you might be a grinder. Years of grinding have led to people wearing their teeth down to the point of needing veneers or crowns. Grinding can also be an indication that you're struggling to keep your airway open at night, meaning you might have sleep apnea.

5. Bad Breath Despite Flossing and Brushing
If you still have bad breath despite flossing daily and brushing at least twice a day, I'd recommend using a tongue scraper. If bad breath persists after that, you may have a more serious underlying condition, including a liver or kidney disorder and diabetes.

6. Increased Tooth Sensitivity to Hot and Cold
After grinding your teeth for many years, the gums recede and small V-shaped indentations form at the base of your teeth. The strong compressive forces of grinding lead to loss of tooth structure in these areas. These defects are called abfractions and they make your teeth overly sensitive to hot and cold food and liquids, or even to breathing in cold air. Sudden onset of tooth sensitivity can be caused by many factors.

7. Tooth Pain
If you have throbbing tooth pain when trying to bite into a bowl of ice cream or other cold food, it could be that the tooth's nerve has become damaged. Get it out checked out at the dentist's office because it could be a cavity, in which case, the bacteria in your mouth could infect the tooth and you don't want the infection to spread to other parts of your body.

8. Snoring
Snoring is another indication that you may have sleep apnea, as it indicates that your airway closes when you approach the deeper stages of sleep. See a sleep specialist MD and see your dentist to have a mandibular advancement device made for you. The mandibular advancement device will keep your airway open at night, stop the snoring, and improve the quality of your sleep, and health, immensely.

9. Flossing Only Before Your Dentist Visit
Does this sound like you? Many people skip flossing until a week or a few days before their dental appointment, in fear of the hygienist's lecture. This is what I like to call a symptom of denial -- no one likes flossing, but it's absolutely critical to the health of your entire body (not just your mouth) and to preventing disease. Get in the habit now if you aren't already -- you'll save yourself decades of pain and big dental bills later on in life.

As you work to get yourself in the habit, remember this: one day of flossing won't impact your health -- just as one day of exercise isn't going to improve your health either. It'll take time to develop the habit so don't be too hard on yourself when you forget.

10. Fearing the Dentist
If you're not having regular dentist visits because you're afraid of the dentist, this could be a symptom of dental anxiety, which should never be ignored. People who suffer from dental anxiety are often told to "buck up," which is the wrong approach and is why it's so important to instil in your children good dental habits and make sure they have a pleasant experience at the dentist. Dental anxiety is a serious condition that prevents millions from getting the care they need each year. If you have dental anxiety, find a dentist who specializes in addressing it. Years of not seeing the dentist only exacerbates the problem, leaving people with huge dental bills decades later, in compromised health, and a lot of pain.]]>