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Dental Needs
Dental needs vary from person to person but we all need good oral care. Dental care is a requirement for healthy gums, protection of dental work, and reducing the risk of gum disease from specific health issues. Read below for detailed information on a variety of dental issues.
Orthodontics (Braces)
The benefits that braces produce, such as restoring proper function of the teeth and a winning smile, come with some risk. These potential problems include gum disease and white spots of the teeth.

These negative results can be due to the challenges of cleaning around the brackets. While they are common problems, they can be prevented with care and attention to the teeth.

There are a number of steps involved in caring for teeth with braces.

The first is removing plaque and is primarily done with a toothbrush. A manual toothbrush works well if it is properly used, but individuals with brackets and other fixed orthodontic devices may find it easier to use a power or sonic toothbrush. But even a sonic toothbrush can't remove all the plaque because there remain some areas that can't be reached, so other tools may be needed.

Flossing is difficult without braces and increases in difficulty when working around the brackets. Although, with practice, it can be done, an easier and more effective way to clean between the teeth and under the gums is a Waterpik® Ultra Water Flosser with the new orthodontic tip.

The tip is designed with a tapered brush on the end that helps remove the plaque that sticks to the brackets and between the teeth while also flushing the bacteria and food debris from around teeth and under the gums.

In a recent study the Waterpik® Ultra Water Flosser removed three times more plaque and reduced bleeding better than brushing and flossing in 11 - 17 year olds with fixed orthodontic appliances. And they liked it so much that 92% said they would continue to use the Waterpik® Ultra Water Flosser "every day" or "frequently" when the study was completed.

It's so important to have regular dental check ups during orthodontic treatment. Using fluoridated toothpaste or adding a fluoride rinse to your routine can also help prevent white spots (decalcification) and decay.
Crowns, Bridges, Veneers
Restoring a tooth that is decayed, fractured or lost due to gum disease or an accident is necessary to maintain functionality. The dental materials used today are designed to withstand being in the mouth while also remaining compatible with gum tissue. There are a number of ways to restore a tooth including amalgams (silver, fillings) composites (tooth colored), crowns, bridges, veneers and implants. Crowns cover most or all of the tooth, and a bridge is attached to two or more crowns to fill the space where a tooth is missing. A veneer is a thin tooth colored piece that is cemented onto the front of a tooth. They are used to improve the look of a tooth such as stained or badly shaped teeth or close small spaces or gaps between teeth. A dental implant is a metal post that is a substitution for the root of a tooth. An implant may be used to replace a single missing tooth, several teeth or in some cases, all of your teeth.

Some dental work such as a bridge or implants can be very difficult to clean. The Waterpik® Ultra Water Flosser is designed to clean around all types of dental work and restorations. The pulsating action helps clean under the bridge and around crowns where bacteria and food can get trapped.
Implants
Not long ago the only way to replace missing teeth was with a crown, bridge, or denture. Today, the dental implant has become the treatment of choice for many people. The first dental implant was developed in 1952 in Lund, Sweden and in 1965 the first implant was placed. Since then considerable research has been done and new technology introduced demonstrating long-term success with state-of-the-art implants.

When a tooth is lost the jaw bone begins to dissolve over time. The surrounding teeth may begin to shift into the open space. Drifting teeth can cause a problem with how your teeth meet when chewing or simply closing your mouth and may lead to problems with the jaw joint called the TMJ. As the teeth move it can become difficult to clean the area which can lead to periodontal disease or decay.

An implant may be used to replace a single missing tooth, several teeth or in some cases, all of your teeth. A single implant is made up of 3 parts; the titanium post that duplicates the root of a tooth, the abutment that is attached to the post, and the crown that attaches to the abutment and resembles a natural tooth and is visible in the mouth. Single implants may be used to replace more than one missing tooth or used to support a bridge where 3 or 4 crowns are connected.

The benefits of dental implants include:
  • Replacement of one or more teeth without affecting the adjacent teeth
  • Replacement of a partial removable denture with a bridge
  • Stability for full dentures making speaking and eating easier
  • Improved confidence and a beautiful smile

To find out if an implant is right for you visit your dentist. They will take dental radiographs (x-rays) and perform a comprehensive exam to evaluate the condition of your teeth, bones, gums and general oral health. It may be necessary to improve some areas prior to the placement of implants such as eliminating gingivitis, adding more bone to support the implant, and quitting smoking. An ideal candidate has the following:
  • Good overall health
  • Healthy gums
  • Enough bone to support the implant
  • Is a non-smoker
  • Is committed to taking care of the implants and maintain regular dental check-ups

Dental implants need to be cleaned and cared for just like your natural teeth. Plaque and bacteria can form around an implant causing inflammation known as peri-implantitis. Daily cleaning of all the surfaces above and below the gum line is very important. A manual, power or sonic toothbrush with soft bristles can be used to clean above the gum line. The Waterpik® Ultra Water Flosser with the Pik Pocket™ Tip is ideal for cleaning below the gum line. The soft Pik Pocket™ Tip is placed slightly under the gum line and the gentle pulsations of water or antimicrobial mouthrinse flush out the bacteria.

Implants are the natural looking way to replace missing teeth or can make wearing dentures significantly more comfortable. They are easy to clean if you follow a few simple techniques. Don't wait to replace missing teeth, see your dentist today.

What are dental implants? www.dentalimplants.org/dental-implants
Accessed January 24, 2008.

Gingivitis and Oral Health
Gingivitis is inflammation limited to the gum tissue. If left untreated, gingivitis can progress to periodontitis, a more serious gum disease that destroys the bone and can lead to tooth loss. The results of the Oral Health Survey conducted by the Department of Health in 2001 revealed that 99.2% of adults and adolescents in Hong Kong have some form of gum disease, including gingivigitis.

Gingivitis Symptoms
Signs of gingivitis include red, spongy, shiny, or swollen gums that bleed easily, even during gentle toothbrushing. Gingivitis may only affect a small area of the mouth in the early stages. If it progresses, gum disease can affect the entire mouth, making the gums painful to the touch, and in severe cases, bleed spontaneously.

Gingivitis Causes
The main cause of gingivitis is dental plaque. Dental plaque is a sticky film of bacteria that continually grows on the teeth and under the gums. If not removed or controlled on a daily basis, it accumulates around and between your teeth and below the gum line. Other contributors to the risk and severity of gum disease and oral health problems are smoking and diabetes.

The bacteria in plaque release toxins that irritate the gums and cause inflammation leading to infection and bad breath. If left undisturbed, plaque can harden around the teeth and under the gums to form tartar (calculus), which must be removed by a dentist or dental hygienist.

Gingivitis Treatment and the Waterpik® Ultra Water Flosser
Because gingivitis and gum disease can be caused by poor oral hygiene, gingivitis prevention and treatment often consist of removing plaque on a daily basis.

Adding a Waterpik® Ultra Water Flosser to your toothbrushing routine is one of the fastest and most effective ways to fight gum disease. In fact, a study by the University of Nebraska demonstrated that a manual or power toothbrush plus a Waterpik® Ultra Water Flosser was up to 93% better in reducing gum bleeding and up to 52% better in reducing gingivitis compared to brushing and flossing.

Not all dental water jets are created equal. The Waterpik® Ultra Water Flosser was invented by a dentist and has been clinically shown to have the best combination of pulsation and pressure to clean where brushing and flossing can't reach.

If you see signs of gingivitis or gum disease, call your dentist and make an appointment for an exam and assessment of your oral health, especially if it has been a long time since your last visit. Your dentist and dental hygienist can best determine the cause and treatment of your periodontal disease.
Diabetes
The incidence of diabetes is rising at an alarming rate. In 2000, the World Health Organization (WHO) reported the prevalence of diabetes was 171 million people worldwide. It is projected that in 2030 that number will increase to 366 million people. In the United States alone there are more than 20 million people (7%) with diabetes In Canada there are more than 2 million (6%) people and the United Kingdom has approximately 2.3 million (3.6%).

The majority (90% - 95%) of people living with diabetes have type 2. Type 2 diabetes accounts for the majority of increase in new cases. The rise can be attributed to following factors:
  • Longer lifespan
  • Changes in the diagnostic criteria
  • Rise in obesity

Type 2 diabetes becomes more common as people age, afflicting one in five people aged 60 and older. One of the most important risk factors is obesity which accounts for about 70% of the risk for type 2. The obesity epidemic is largely attributed to increased calorie intake and a sedentary lifestyle. Overweight people have over a 3x increased risk of developing type 2 diabetes and those who are obese have over a 6x increased risk.

Both type 1 and type 2 diabetes can lead to serious complicates affecting the eyes, kidneys, nervous system, and heart. Along with these well known complications, diabetes can also impact oral health. Studies show that having diabetes increases your chances of having periodontal (gum) disease and that people with diabetes may get periodontal disease earlier and it may be more severe. Children with diabetes have been shown to have more gingivitis than children without diabetes. A recent study found that periodontal destruction can begin early in life for children with diabetes and may become more pronounced into adolescence. Additionally, people with poor glycemic control often experience the worst gum health. It often manifests in severe gum bleeding, deeper periodontal pockets and more bone loss. If you have diabetes or are a caregiver for someone who does, it's important to have regular dental exams dental cleanings and excellent oral hygiene habits.

The Waterpik® Ultra Water Flosser is one of the few home care products tested on people with diabetes. When added to toothbrushing, a Waterpik® Ultra Water Flosser is ideal for a diabetic's oral health because it has been found to improve the gums of people with diabetes by significantly reducing plaque, bleeding, and gingivitis better than toothbrushing alone.
Pregnancy
When you're pregnant, it is important to maintain a healthy lifestyle. Pregnant women need a healthy and balanced diet, regular exercise that is appropriate for each trimester, and to avoid certain products such as tobacco and alcohol. It is also important to keep your teeth clean. During pregnancy, hormonal fluctuations can impact your response to the bacteria in dental plaque increasing the risk and severity of periodontal (gum) disease.

During pregnancy many women experience a condition called pregnancy gingivitis. This generally occurs during the second trimester coinciding with increases in hormone levels of estrogen and progesterone. There is also a shift in the type of bacteria to those that are associated with periodontal disease and bone loss. The gum tissue may appear bright red and shiny, swollen, and bleed easily and excessively. These changes can even happen to women who practice good oral hygiene. Often, it is associated with inadequate oral hygiene. Changes in oral hygiene techniques and professional dental care can help to improve or resolve the condition. In some cases it may persist until late in the pregnancy or until delivery and hormone levels return to normal.

Recently researchers have studied the impact of having periodontal (gum) disease during pregnancy on the unborn child. Early studies have shown a link in the number of premature births or low birth weight babies in women with periodontal disease. Researchers continue to explore this relationship to help find answers to reducing the number of preterm births and underweight babies.

This relationship emphasizes the importance of good oral hygiene before, during, and after pregnancy. If you are pregnant or thinking of becoming pregnant schedule an examination with your dentist to discuss your oral health. Your traditional dental hygiene regimen may not be adequate. Along with toothbrushing it is important to clean between your teeth and below the gum line to remove the bacteria and toxins that irritate the gums. Adding a Waterpik® Ultra Water Flosser to toothbrushing is one of the fastest and most effective ways available to healthier gums. In fact, a recent study demonstrated that a manual or power toothbrush plus a Waterpik® Ultra Water Flosser was up to 93% better in reducing gum bleeding and up to 52% better in reducing gingivitis compared to brushing and flossing. Developing good dental hygiene will help you during pregnancy and establish positive habits after your child is born to prevent oral disease in infancy, childhood, adolescence and into adulthood.
Periodontal Gum Disease and Oral Health
Periodontal gum disease can be separated into two general categories; gingivitis and periodontitis. Periodontitis is more serious than gingivitis and affects the gums, the surrounding bone (causing bone loss), and the supportive structures of the teeth.

Symptoms of Periodontitis Gum Disease
In addition to the signs and symptoms of gingivitis, periodontitis gum disease symptoms include:
  • A bad taste in your mouth or persistent bad breath
  • Gums that pull away from the teeth or receding gums
  • Loose teeth or a change in the way your teeth feel when you bite or chew
  • Wider spaces between your teeth
  • Gums that are tender or sore to the touch
  • Pus around the gum line

Causes of Periodontitis Gum Disease
Bacteria in plaque are the main cause of gingivitis and periodontitis gum disease. Plaque is a sticky film of bacteria that continuously forms on the teeth and under the gum line. The bacteria release toxins, especially below the gum line, that irritate the gum tissue and cause inflammation.

The gums will eventually break down and separate from the teeth causing a deep space called periodontal pockets. These pockets are very difficult to clean and the bacteria are allowed to grow and multiply. Other contributors to the risk and severity of periodontal gum disease and oral health problems are smoking and diabetes.

Periodontal Gum Disease Treatment and the Waterpik® Ultra Water Flosser
The best way to treat periodontal gum disease is to prevent it from occurring in the first place. Adding a Waterpik® Ultra Water Flosser to daily oral care is one of the fastest and most effective ways to prevent gum disease. Invented by a dentist, the Waterpik® Ultra Water Flosser offers the best combination of pulsation and pressure to clean where traditional methods, such as brushing, flossing, or rinsing, cannot reach.

If you have been treated for periodontal gum disease, it is not uncommon to have remaining periodontal pockets. To improve cleaning, use a Waterpik® Ultra Water Flosser with a tip called the Pik Pocket™ Subgingival Tip. This tip is easy to use and gently cleans deeper periodontal pockets.

Treatment for periodontal gum disease depends on the extent of the disease. Your dentist or periodontist will diagnosis your periodontal status and prepare a treatment plan for your specific needs.
Periodontal Pockets
Moderate periodontal disease affects the majority of people at some time in their lives. About 80% of adults have some bone loss, and between 40%-50% have bleeding gums. If you've ever been told that you have a periodontal pocket or “pocketing”, you've experienced this. Treatment requirements vary depending on the severity or depth of the pocket or pockets you have. Only your dentist can tell you what your specific treatment needs are. It is not uncommon for people who have been treated for periodontal disease to have some pockets remaining. The biggest problem this creates is in daily cleaning. Traditional methods, such as brushing, flossing or rinsing are limited to how far they can reach into a pocket. To improve your cleaning of a pocket, use a Waterpik® Ultra Water Flosser with a tip called the Pik Pocket® Subgingival Tip. This tip is easy to use and gently cleans the pocket up to 90% of the depth of the pocket.
Smoking
Globally, smoking related-diseases kill one in 10 adults. That's one death every 8 seconds. By the year 2030, if smoking trends continue, it will kill one in 6 adults. For children and adolescents the statistics are just as daunting. About one in five teens (13 - 15 years of age) smokes and between 80,000 and 100,000 start smoking every day. Approximately 15 billion cigarettes are sold daily, or 10 million every minute. In the US, it is estimated that close to 26 million men and 21 million women are smokers. The serious risks of smoking or tobacco use are well know, yet each day nearly 6,000 children under 18 years of age start smoking. Of those, almost 2,000 will become regular smokers, or approximately 800,000 annually.

Smoking increases the risk of developing chronic lung disease, lung cancer, premature birth, heart disease and stroke. It also increases the risk of cardiovascular complications in diabetics. Smoking is also a major risk factor for developing periodontal (gum) disease.
  • People who smoke are four times more likely to have periodontal disease than non-smokers.
  • The heavier you smoke, the more likely you are to have a more severe case of periodontal disease.
  • People, who continue to smoke while being treated for periodontitis, will have ~ 50% of the healing response of non-smokers.

Smokers may not have the usual first signs of gum disease such as redness, swelling, and bleeding. The nicotine in cigarettes constricts blood vessels and impairs this response. However, if you look deeper other signs of periodontal disease are present such as bone loss and periodontal pockets.

If you smoke, the most important thing you can do for yourself and your family is to stop. Quitting smoking cannot reverse the past damage done to your teeth, gums and bone, but the disease process slows down significantly and your response to treatment is similar to someone who has never smoked. Cigars, pipe smoking and smokeless tobacco are also risk factors for periodontal disease.

If you have periodontal disease due to current or former smoking, then you need to consider adding a Waterpik® Ultra Water Flosser to your daily toothbrushing. Studies have shown that people who have been previously treated for periodontal disease who added a Waterpik® Ultra Water Flosser to their daily routine had better reductions in bleeding and gingivitis than those who did not. Additionally, it is not uncommon to have some pockets remaining after treatment. The biggest problem this creates is keeping the pocket clean. To improve your cleaning of a pocket, use a Waterpik® Ultra Water Flosser with a tip called the Pik Pocket™ Subgingival Tip. This tip is easy to use and gently cleans deeper into periodontal pockets.
Bad Breath
Bad breath is not just embarrassing socially, but it may also be a sign of other conditions including gum disease. Bacteria that cause gum disease live below the gumline and can produce a volatile sulfur compound, which is an agent often responsible for bad breath. These bacteria also cause inflammation, but because it's below the gumline it can't be seen and is often not felt. The inflammation may make bad breath worse. If you suffer from bad breath, the first step is to see your dental professional. They may recommend that you use a water flosser (also known as an oral irrigator). The Waterpik® Ultra Water Flosser has been shown to disrupt bacteria that live deep beneath the gumline to reduce the bleeding caused from periodontal inflammation.
Children & Adolescent Health
Advances in medicine have either eliminated or significantly reduced the incidence of the more common disease of childhood such as poliomyelitis, measles, mumps, or chicken pox. Today, health threats to children and adolescents come from lifestyle, particularly adoption of adult habits such as smoking and overeating, coupled with a lack of physical activity. These lifestyle changes contribute to two chronic diseases; diabetes and asthma. In the past twenty years, the number of children who are overweight has doubled for those ages 6 -11 and tripled for those ages 12 -19. Research shows that poor nutrition, lack of exercise and watching too much television all contribute to this increase. An overweight child is more likely to become an overweight adult, especially if one or more parent is overweight or obese.

Up to 85% of children diagnosed with type 2 diabetes are overweight or obese at the time of diagnosis. Children may have no symptoms and go undiagnosed for a period of time. The peak time for diagnosis is middle to late puberty. Children may also have prediabetes. Prediabetes is defined as having an impaired fasting glucose (IFG) of 100 - 125 mg/dL. A recent study found that 17.8%, or 1 in 6 overweight adolescents, had IFG. Those with IFG also had risk factors for heart disease such as high cholesterol, triglycerides, and blood pressure.

Smoking is the leading preventable cause of disease and death in the US. Everyday 4,000 children aged 12 - 17 try their first cigarette. More than half of high school students have tried smoking. Currently, about 23% of high school students report smoking cigarettes, and 14% report smoking cigars, cigarillos, or little cigars. If current smoking patterns continue, 6.4 million of today's children will die prematurely from a smoking-related cause.

The risks of active smoking and diabetes have been studied extensively and are well established as detriments to good oral health. Adolescents with type 1 diabetes have been shown to have increases in the incidence and severity of gum inflammation. Importantly, it is not related to increases in dental plaque but seems to be related to poor glycemic control. Better control of blood glucose levels may help improve gum inflammation along with better oral hygiene. Severe gum (periodontal) disease has also been shown to start earlier and the incidence increases after puberty.

Smoking is strongly associated with gum disease in adults. While not studied in children, young adult smokers ages 19 - 30 years have been shown to have a higher prevalence and severity of periodontal disease. Severe periodontal disease is also more prevalent in smokers younger than thirty-five.

The first step to improving oral health in children and adolescents is to reduce the risk of gum disease by better nutrition, exercise, and quitting smoking. This should be coupled with an oral hygiene regimen that is easy and effective. Proper brushing with a manual or power toothbrush is mandatory along with a device to clean between the teeth and under the gum line. Dental floss can accomplish cleaning between the teeth but all too often it is either done incorrectly or not at all, especially with younger individuals. An easy way to clean is the Waterpik® Ultra Water Flosser . The unique combination of pressure and pulsations gently flush bacteria from between the teeth and under the gum line to reduce gum inflammation.