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How often should I floss my teeth? Can I floss too much?
It is recommended at least once daily because brushing alone does not get in between the teeth and gum line where bacteria get caught below. You can floss either before or after brushing your teeth. There isn't flossing too much, but if you floss incorrectly, you could get floss cuts or damage to your gum tissue. Check with your dental hygienist and choose the floss type and size that fits your condition.

Is a water flosser, such as Waterpik, better than regular floss? How about Cocofloss and nubby floss I keep seeing on Instagram?
According to evidence and research, Waterpiks can be more effective than flossing. Dental floss can only get about 1 to 3 millimeters below the gum line, while a Waterpik gets deeper. Water pressure irrigates and breaks up soft, sticky plaque, which can be especially helpful for patients with periodontal disease. Many people also prefer a Waterpik for dexterity reasons. For other popular flossing products on Instagram, it's hard to tell their effect because there's limited to no research on whether they are a good aid for oral health. Generally, products with an American Dental Association (ADA) stamp on them means that it's supported by the ADA and have gone through research and clinical trials to prove their effectiveness.

Should I use an electric toothbrush or a regular toothbrush?
A lot of research has shown strong evidence that electric toothbrushes are better at removing plaque biofilm and keeping the gum tissue healthier without damaging it. Electric toothbrushes usually have a 2-minute timer and pressure gauges to keep you from brushing too fast or too hard. The two major electric toothbrush brands, Sonicare and Oral B, are both effective. They have different action mechanisms, so it's individual preference. The general rule of thumb is a chargeable electric toothbrush is the top, then a battery-operated toothbrush that runs at a lower frequency. The lowest would be your manual toothbrush. However, brushing at all is better than not brushing.

Do you recommend mouth rinses?
Mouth rinses are great. Some products include fluoride to reduce the risk of cavities and sensitivity; some are antiseptics that help kill bacteria, which would be better for someone with gingivitis or periodontitis. Knowing what you need and your goals helps you select your desired results.

My insurance covers cleanings twice a year. Should I go more often?
That is case by case, depending on the health status of the patient. For some patients with no dental diseases, no cavities, no gum disease and excellent oral hygiene, doing a cleaning and head and neck cancer screening twice a year might just be enough. Individuals with gingivitis or periodontitis should come in more frequently for professional cleanings that can be anywhere from three to even six times a year. But there might be out-of-pocket expenses for extra visits.

Do adults need fluoride treatments?
In dentistry, we use patient-centered care and individualized treatment planning, meaning we look at each individual for what they need. If an adult patient has no recent history of cavities, a good diet of low acidic drinks and sugary food, and good oral hygiene, fluoride would be preventative but might not be necessary. Patients with active cavities, recurrent cavities, a poor diet, and a high risk for caries would be more likely to need professional fluoride treatments and fluoride over-the-counter products.

What kind of training does the average dental hygienist have?
There are three levels of degrees practicing dental hygienists can have: an associate's, bachelor's or master's degree in dental hygiene. There are also dental hygienists in education and research who have their doctorates and could still be practicing. The Commission on Dental Accreditation has standards on how hygienists are trained in classroom and clinic settings for all U.S. dental hygiene programs. All dental hygienists have to pass a national clinical board and a national written board to be registered or licensed, which varies by state. Minnesota is a licensed dental hygienist state.

How has the job changed since COVID?
During COVID-19, so many offices were backlogged. Currently, in Minnesota and across the country, there's a huge shortage of dental hygienists. We don't have enough dental hygienists compared to dentists. So, it's a really good field for interested individuals or anyone who wants to return for a different career with great money, great hours and good job security.

Tooth gems and dental bling: yes or no?
If anyone is going to pursue any dental gems or cosmetics, they should have a licensed dentist operate. Some of those items could be permanent. For example, a diamond on a canine would take away healthy tooth structure. If you were to have that gem fall out or decide to take it out, you would have a hole in the enamel and would need a white tooth-colored filling to cover it up. If dental jewels are made improperly, they could wear your enamel, chip, or fracture your natural teeth. Be very cautious about who does the procedure and whether it is permanent.

What are the telltale signs that a person is eating or drinking too much sugar?
A trained hygienist looks for yellow, brown or black spots on your teeth that could indicate cavities from too much sugar. Or soft spots on the tooth or decay on x-rays. Too much sugar can also relate to other health issues, not necessarily oral health

What's one piece of advice you would give people about taking care of their teeth?
Prevention is key. No dentistry is the best dentistry. The absolute best is your natural teeth, and not having to replace missing teeth. The most cost-effective way is the prevention of dental disease to reduce the need for dental work. Prevention is the best advice. Routine cleanings, X-rays once a year to make sure there's no pathology or decay, and having oral cancer screenings.

Answers by Michelle Arnett, assistant professor in the dental hygiene division at the University of Minnesota's Department of Primary Dental Care.