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Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Dr. Kozica and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Dr. Kozica and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Kozica Dental team for tips on proper brushing and flossing.

At Kozica Dental, we know the human mouth contains a lot of bacteria. A bacterium can travel through your body with routine activities that are a normal part of daily living. You spread bacteria when you brush or floss your teeth, when you chew, and when you swallow.

For most people, bacteria don’t cause any problem. For some people, however, especially those who have chronic medical conditions, specific cardiac conditions, or whose immune systems are compromised, bacteria that spreads throughout the bloodstream can lead to much more serious bacterial infections.

The goal of pre-medication or antibiotic prophylaxis, Dr. Kozica will tell you, is to prevent bacterial endocarditis, a serious infection of the endothelial heart surfaces or the heart valves. The condition is also called infective endocarditis. A small population of people with certain health problems has a high risk for contracting this potentially deadly bacterium.

The American Heart Association states that people at greatest risk for contracting bacterial or infective endocarditis are:

• Patients who underwent cardiac valve surgery in the past
• Those who have suffered past incidents of infective endocarditis
• Patients who have mitral valve prolapse, resulting in or causing valve leakage
• People who have had rheumatic fever or any degenerative cardiac condition that produces abnormalities in cardiac valves
• Patients who suffer from certain congenital heart diseases

For these patients, any dental procedure may cause bleeding, and prophylactic antibiotic administration is recommended as a preventive measure.

Other patients who require prophylactic antibiotics

The American Association of Endodontists extends recommendations to patients who have undergone joint replacement surgery within the past two years, suffer from type 1 diabetes, or have immune deficiencies from diseases such as lupus, rheumatoid arthritis, or HIV; cancer patients whose immune systems are suppressed because of radiation or chemotherapy; people who have had organ transplants; and hemophiliacs.

The American Academy of Pediatric Dentistry also includes people who suffer from sickle cell anemia, as well as patients who suffer from conditions that require chronic steroid therapy.

Typical endodontic procedures for which antibiotic prophylaxis is recommended include root canal therapy (when it involves going deeper than the root apex), surgical tooth extractions, and any other dental, endodontic, or periodontal procedure during which the doctor anticipates bleeding.

Although different medical societies and organizations offer these guidelines as a way of identifying patients for whom prophylactic pre-medication is essential prior to dental procedures, dentists will take each patient's medical history and personal risk factors into consideration. Some doctors may choose to administer antibiotics following a procedure, especially for patients who have previously suffered from oral infections either as a result of dental procedures or that necessitated oral surgery.

For more information about antibiotic prophylaxis, or to schedule an appointment with Dr. Kozica, please give us a call at our convenient Worcester office!

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Kozica can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Worcester office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Dr. Kozica and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Worcester office to schedule an appointment with Dr. Kozica.