Denver Dentist

2100 S Lincoln St, Denver, CO 80210

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Phone: 303-759-0731

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February 9, 2018

Home Oral Care

Key Points

  • Home oral care recommendations from the ADA are based on data from clinical studies.
  • While general recommendations may adequately address the needs for many patients, a dentist may tailor home oral care recommendations to fit the individual patient’s needs and wants.
  • Home oral care is an important contributor to oral health and can help lessen the need for extensive dental intervention in the future.


Spending the right amount of time engaged in appropriate home oral care is undoubtedly essential to helping minimize the risk of caries and periodontal disease.  An individual who visits the dentist twice a year for an oral exam and dental prophylaxis will spend approximately two hours per year in the dental chair.  The time for that same person to brush and clean between his or her teeth each day might be estimated to be around 30 hours per year.  Considering the amount of time that should be devoted to daily oral hygiene, it is important to understand the scientific evidence that supports home oral care recommendations made to patients.

In 2017, the ADA Council on Scientific Affairs identified three aspects of home oral care that dentists should discuss with their patients:

  1. General recommendations that are applicable to most people;
  2. Personalized recommendations specifically targeted to meet the needs of the individual patient, especially patients at increased risk of caries and/or gingivitis; and 
  3. Lifestyle considerations to enhance oral health and wellness.

The general and personalized recommendations were developed in accordance with a rapid evidence assessment methodology,1 meaning that the evidence examined was derived from existing systematic reviews.  Lifestyle considerations comport with current ADA policy.  This Oral Health Topic page is an executive summary of that work and relevant ADA policy.

General Recommendations for the Prevention of Caries and Gingivitis

1) Brush your teeth twice a day with a fluoride toothpaste

While a seemingly simple statement, the guidance for brushing twice daily with a fluoride toothpaste weaves together a number of discrete components.

Toothbrushing frequency
Review of the scientific literature, along with guidance from governmental organizations and professional associations found sufficient evidence to support the contention that twice-daily brushing, when compared with lower frequencies, was optimal for reducing risk of caries,2-4 gingival recession or periodontitis.5-7  It is important to recognize that in these studies, it was the frequency of tooth-brushing with a fluoride toothpaste that was evaluated rather than tooth-brushing alone.

Fluoride toothpaste
Although the measures used to assess the benefit varied, studies examining the effect of over-the-counter (OTC) fluoride dentifrice on caries incidence in children and adolescents found the fraction of caries prevented ranged from 16% per tooth to 31% per surface versus placebo or no dentifrice, and concluded that fluoride-containing toothpaste was effective in caries control.4, 8, 9  In addition, high level evidence shows that 5,000 ppm fluoride (available with a prescription) results in significantly more arrest of root caries lesions than use of OTC levels of fluoride (1,000 - 1,500ppm).10

Toothbrushing duration
Data examining the question of optimal duration of daily tooth-brushing encounters relies on plaque indices which are surrogate measures rather than direct measure of caries or gingivitis.  Understanding that the use of surrogate measures decreases the certainty with which a recommendation can be made, the available systematic reviews found a brushing duration of two minutes was associated with bigger reduction in plaque than brushing for a single minute.11, 12  Two minutes per whole mouth can also be expressed as thirty seconds per quadrant or about four seconds per tooth.

2) Clean between your teeth daily

While cleaning between teeth is important to maintaining oral health, it is a concept that must overcome several barriers to adoption. ” Flossing” is often used as a shorthand, common term for interdental cleaning, which can become problematic in the real world where many report a strong distaste for that activity.13 Some people presume flossing as ineffective or unnecessary, which can also make it harder for them to adopt the daily habit. Flossing is a technique-sensitive intervention14 as exemplified by the disparity in benefit observed when comparing study designs involving self-flossing and professional flossing.15 Where patients do not see positive results from flossing, they may not continue to do so.

Using flossing as shorthand for interdental cleaning can also be problematic in that patients may be unaware of alternative devices that may be more pleasant or effective for them. A meta-review, which included the available devices developed for this purpose (i.e. dental floss, interdental brushes, oral irrigators, and wood sticks), addressed the question “What is the effect of mechanical inter-dental plaque removal in addition to tooth brushing on managing gingivitis in adults?”  The strength of the evidence on the benefit ranged from weak to moderate depending on the device in question.16

Thus, there may not be one “best” interdental cleaning method; rather, the best method for any given patient may be one in which they will regularly perform. A guiding principle which is relevant to  interdental cleaning is: “best care for each patient rests neither in clinician judgment nor scientific evidence but rather in the art of combining the two through interaction with the patient to find the best option for each individual.”17

3) Eat a healthy diet that limits sugary beverages and snacks

While eating a healthy diet is important for overall health and well-being, a review of the literature found little in terms of the effects of micronutrients on the risk of caries or periodontal disease.  However, the conclusion of numerous systematic reviews on the effect of the macronutrient content of the diet, specifically of sugar, is that there is an association between sugar intake and caries.18-20  A review of the evidence supporting nine international guidelines recommending decreased consumption of sugar found consistent recommendations from all the groups while noting that they relied on different data and rationales.18

4) See your dentist regularly for prevention and treatment of oral disease

Viewed through the prism of the primary prevention of caries and/or gingivitis, a systematic review of the literature failed to arrive at consensus regarding optimal recall frequency to minimize either caries21, 22 or periodontal disease risk23 in part due to limited availability of studies addressing this topic.  Nonetheless, in terms of the balance between resource allocation and risk reduction, it can be concluded that there is merit in tailoring a patient’s recall interval to individual need based on assessed risk of disease.21, 24

Previously, the ADA Healthy Smile Tips advised people to “Visit your dentist regularly.”  However, dentists are doctors of oral health, which encompasses both the prevention and treatment of oral disease.  The current recommendation goes a step further than its predecessor in articulating the duality of the dental visits.  Dental care includes actions to reduce disease risk, as well as the formulation and execution of a treatment plan when disease is present.

Personalized Recommendations for the Prevention of Caries and Gingivitis

While generalized recommendations for home oral care may be appropriate to help optimize oral wellness for many patients, those found to be at elevated risk of caries and/or gingivitis, may ask their dentists to provide guidance on additional action steps that they can take to reduce their risk of oral disease.25  To help address this reality, the Council on Scientific Affairs recommends that dentists: 

  • Design a home care regimen with specific recommendations for oral hygiene. This may involve consideration of not only the person’s individual oral disease risk, but the needs and wants of the patient.
  • Offer direction concerning lifestyle changes.  This is addressed in the next section, entitled “Lifestyle Considerations.”  
  • Provide guidance on dental products and mechanical devices. This includes detailed suggestions that can help patients make decisions about dental hygiene practices and products.  Patients may look to their dentists for guidance and recommendations to help discern among the plethora of home oral care products and mechanical devices that lay claim to oral health benefit.  Dentists and patients can look to the ADA Seal of Acceptance program as a source of validated information regarding the safety and efficacy of many home oral care products.

After careful review of the available evidence, the Council on Scientific Affairs provides the following rationale to inform decision-making between dentists and patients on products and mechanical devices that can be considered as adjunct therapies and modalities for the prevention of caries and/or gingivitis:

1) Antimicrobials
For individuals with increased risk for gingivitis or periodontal disease, there is evidence that over-the-counter oral care products containing specific antimicrobial active ingredients can decrease risk of gingivitis.  Systematic reviews found that mouth rinses containing an antimicrobial effective amount of essential oil(s) (with or without alcohol) or cetylpyrdinium chloride,26-28 and toothpastes containing triclosan or stannous fluoride,29-31 were associated with decreased risk of supragingival plaque and gingivitis.

2) Fluoride Mouth rinses
With regards to caries risk reduction, there is strong evidence supporting the use of fluoride-containing mouth rinses by children at elevated caries risk;32 and low level evidence on the benefit of adults using fluoride mouth rinse to decrease their risk of root caries.10

3) Power Toothbrushes
Powered toothbrushes provide effective removal of dental plaque and reduction in gingival inflammation.11, 33 Though there may be statistically significant improvement in dental plaque removal or gingival inflammation when comparing use of a powered toothbrush with a manual toothbrush, the difference may not be clinically meaningful.33 However, when brushing technique is a concern such as for patients with special needs, those who require the help of a caregiver for activities of daily living, or those with manual dexterity deficit, the use of a powered toothbrush has been found to provide substantive benefit in plaque reduction.34-38

4) Interdental Cleaning Devices
Recent analysis using NHANES data found that adults who more frequently reported using floss or other devices to clean between their teeth were found less likely to have periodontitis.39  Because of the barriers to interdental cleaning, it may not be effective to tell patients that they must floss and expect it to become a regular part of their oral home care routine. Instead, dentists can support effective home oral care by gauging their patient’s level of understanding, learning about their motivation, and then serving as a “coach” by communicating and promoting daily cleaning between their teeth.40 Discussing the various interdental cleaning devices can help educate patients on available options and provide them with some of the skills necessary to be effective stewards of their own oral health.

Lifestyle Considerations for the Prevention of Caries and Gingivitis

Dentists can provide, promote or direct patients to information about lifestyle behaviors and/or services that can aid in reducing their risk.

Beyond the general and personalized recommendations above, there are three specific ADA policies regarding aspects that fall under the rubric of lifestyle considerations with roles to help prevent caries and gingivitis:

1) Consumption of Fluoridated Water
Much of the literature evaluated in systematic reviews examining the association between consumption of fluoridated water and reduced levels of caries in primary and permanent dentition derives from studies conducted before the 1980’s.41  One experiment, in which a Canadian community discontinued its community water fluoridation to allow for the comparison of caries rates within a socioeconomically similar, adjacent community which maintained its water fluoridation demonstrated a significant increase in primary tooth decay and an increasing trend for increased decay in permanent dentition 2.5 – 3 years post cessation among residents who reported usually drinking tap water.42  In 2016, the U.S. Surgeon General expressed the view that community water fluoridation was an important component for developing a culture of disease prevention and helping to ensure health equity for all.43

2) Use of Tobacco Products
While the various forms of tobacco have a variety of health consequences, the oral consequences of cigarette smoking44 and smokeless tobacco products45 can include adverse effects on gingival health, enamel discoloration and erosion, and oral cancer.  For these reasons, the ADA has long advocated for smoking and tobacco cessation initiatives both at the policy and practice levels.

3) Oral Piercings
The literature on the oral consequences of oral piercings show tooth fracture, tooth wear and gingival recession among the commonly reported adverse events,46 and the ADA established policy discouraging oral piercing in 1998.

This information was prepared & provided by the ADA Science Institute's Center for Scientific Information. The ADA Council on Scientific Affairs reviewed and approved the content of this page.

Last Updated: January 18, 2018


January 22, 2018

Massage: Get in touch with its many benefits

Massage: Get in touch with its many benefits

Massage can be a powerful tool to help you take charge of your health and well-being. See if it's right for you.

Massage is no longer available only through luxury spas and upscale health clubs. Today, massage therapy is offered in businesses, clinics, hospitals and even airports. If you've never tried massage, learn about its possible health benefits and what to expect during a massage therapy session.

What is massage?

Massage is a general term for pressing, rubbing and manipulating your skin, muscles, tendons and ligaments. Massage may range from light stroking to deep pressure. There are many different types of massage, including these common types:

  • Swedish massage.This is a gentle form of massage that uses long strokes, kneading, deep circular movements, vibration and tapping to help relax and energize you.
  • Deep massage.This massage technique uses slower, more-forceful strokes to target the deeper layers of muscle and connective tissue, commonly to help with muscle damage from injuries.
  • Sports massage.This is similar to Swedish massage, but it's geared toward people involved in sport activities to help prevent or treat injuries.
  • Trigger point massage.This massage focuses on areas of tight muscle fibers that can form in your muscles after injuries or overuse.

Benefits of massage

Massage is generally considered part of complementary and alternative medicine. It's increasingly being offered along with standard treatment for a wide range of medical conditions and situations.

Studies of the benefits of massage demonstrate that it is an effective treatment for reducing stress, pain and muscle tension.

While more research is needed to confirm the benefits of massage, some studies have found massage may also be helpful for:

  • Anxiety
  • Digestive disorders
  • Fibromyalgia
  • Headaches
  • Insomnia related to stress
  • Myofascial pain syndrome
  • Soft tissue strains or injuries
  • Sports injuries
  • Temporomandibular joint pain

Beyond the benefits for specific conditions or diseases, some people enjoy massage because it often produces feelings of caring, comfort and connection.

Despite its benefits, massage isn't meant as a replacement for regular medical care. Let your doctor know you're trying massage and be sure to follow any standard treatment plans you have.

Risks of massage

Most people can benefit from massage. However, massage may not be appropriate if you have:

  • Bleeding disorders or take blood-thinning medication
  • Burns or healing wounds
  • Deep vein thrombosis
  • Fractures
  • Severe osteoporosis
  • Severe thrombocytopenia

Discuss the pros and cons of massage with your doctor, especially if you are pregnant or you have cancer or unexplained pain.

Some forms of massage can leave you feeling a bit sore the next day. But massage shouldn't ordinarily be painful or uncomfortable. If any part of your massage doesn't feel right or is painful, speak up right away. Most serious problems come from too much pressure during massage.

What you can expect during a massage

You don't need any special preparation for massage. Before a massage therapy session starts, your massage therapist should ask you about any symptoms, your medical history and what you're hoping to get out of massage. Your massage therapist should explain the kind of massage and techniques he or she will use.

In a typical massage therapy session, you undress or wear loose-fitting clothing. Undress only to the point that you're comfortable. You generally lie on a table and cover yourself with a sheet. You can also have a massage while sitting in a chair, fully clothed. Your massage therapist should perform an evaluation through touch to locate painful or tense areas and to determine how much pressure to apply.

Depending on preference, your massage therapist may use oil or lotion to reduce friction on your skin. Tell your massage therapist if you might be allergic to any ingredients.

A massage session may last from 10 to 90 minutes, depending on the type of massage and how much time you have. No matter what kind of massage you choose, you should feel calm and relaxed during and after your massage.

If a massage therapist is pushing too hard, ask for lighter pressure. Occasionally you may have a sensitive spot in a muscle that feels like a knot. It's likely to be uncomfortable while your massage therapist works it out. But if it becomes painful, speak up.

McGlone Dental Care has Massage Therapist on Staff

Michelle Stefun, LMT

Michelle’s philosophy - 'Massage' means many things to many people. Some massage is comparable to getting your nails done---full of treatments and pampering. Some forms mimic physical therapy involving a significant amount of pain and effort on your part. And others are basically your daily rub-down of moisturizer---honestly, your toddler could do that. There's nothing wrong with these forms of massage, but I've chosen a starkly different course for my work. I am, first and foremost, a healer. Patients get my full attention in each session. I've found that the body heals best in a state of rest. Therefore, my work is a blend of medical treatment and relaxation. 

​Similar to the human body, trees require a degree of flexibility and balance. They are flexible enough not to snap with every wind gust. Their branches spread over them for balance. And finally, trees pour back into their environment. They provide oxygen, habitats for wildlife, and food for many. In the same way, massage therapy should enable you to be more active in your world---whatever that world looks like. I make no claims to 'fix' anything, yet I've seen this treatment provide dramatic improvement for my patients. I am a facilitator to each individual's journey toward healing.

The take-home message about massage

Brush aside any thoughts that massage is only a feel-good way to indulge or pamper yourself. To the contrary, massage can be a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are just looking for another stress reliever. You can even learn how to do self-massage or how to engage in massage with a partner at home.

Article provided by The Mayo Clinic Newsletter

December 11, 2017

Use it or Lose it!

Dental Insurance Use It or Lose ItDo you have money left on your annual Dental Insurance Plan? Have you checked it lately? If not, you can check, or you can have us check for you. Most insurance plans are run on a calendar year and if you don’t use all your benefit each year you lose those funds.

So, what does that mean for you? It means that it’s a great time to maximize your dental insurance benefits and make sure that you use your yearly maximum amount allowed according to your plan. If whatever dental work you need to have done is completed before 12/31/17 and billed on or before that date, that work will be applied to this year’s maximum amount that is allowed according to your plan. Most insurance plans cover 2 cleanings per year and cover 100% of any preventative work. You should make sure that you get your full value out of the benefits that you work hard and pay for.

We have openings in our schedule for the rest of the year and are even open three days the week of Christmas. If you have dental work that you need to have done or just want to have your teeth cleaned before the end of the year, give us a call. We will do our best to make sure that your dental insurance coverage is maximized for you and you are able to get the full amount of your plan for the year.

We are also having a Whitening Special in December. Insurance won’t pay for teeth whitening, but if you’d like to have a brighter smile for the holidays, come in and take advantage of this great special. For $150 (normally $200) you will get custom whitening trays and a tube of whitening gel (for up to 6 whitening treatments) to take home. You can whiten your teeth in an hour at your own time and in the privacy of your own home. This special is good until 12/31/17.

Call for an appointment today before we are all booked up through the end of the year: 303-759-0731.

Happy Holidays from the McGlone Dental Team!

November 1, 2017

Smoking and Your Oral Health

Smoking and Your Oral HealthWhile most people are aware of the impact tobacco use has on their overall health, some might not consider its effects on oral health, including:

  • 50 percent of smoking adults have gum (periodontal) disease.
  • Smokers are about twice as likely to lose their teeth as non-smokers.
  • Cigarette smokers are nearly twice as likely to need root canal treatment.
  • Smoking leads to reduced effectiveness of treatment for gum disease.
  • Smoking increases risk of mouth pain, cavities and gum recession (which can lead to tooth loss).
  • Tobacco reduces the body's ability to fight infection, including in the mouth and gums. Smoking also limits the growth of blood vessels, slowing the healing of gum tissue after oral surgery or from injury.
  • Smokeless tobacco (snuff or chewing tobacco) is associated with cancers of the cheek, gums and lining of the lips. Users of smokeless tobacco are 50 times more likely to develop these cancers than non-users.
  • Cigars, chewing tobacco, snuff and unprocessed tobacco leaves (used as cigar wrappers) contain tiny particles that are abrasive to teeth. When mixed with saliva and chewed, an abrasive paste is created that wears down teeth over time.
Tobacco Use and Children 

All parents, even those who do not use tobacco, should educate their children about the dangers of smoking:

  • 3,000 children and teens become regular users each day (including chewing tobacco).
  • Nearly one-quarter of all high school students smoke.
  • Some tobacco companies target children with cherry-flavored chewing tobacco sold in colorful containers.
  • Children exposed to tobacco smoke may have delays in the formation of their permanent teeth.
  • Women who smoke may be more likely to have children born with an oral cleft (cleft lip or cleft palate).
What You Can Do

If you are a smoker or a parent with a child or teen who you suspect may be using tobacco, you can start by understanding that tobacco dependence is a nicotine addiction disorder.

There are four aspects to nicotine addiction: physical, sensory, psychological and behavioral. All aspects of nicotine addiction need to be addressed in order to break the habit. This difficulty can mean that tobacco users may need to try several times before they are able to successfully kick the habit.

*Content provided by Delta Dental

October 22, 2017

No Dental Insurance? We Have the Solution!

No Dental Insurance? We Have the Solution! mcglone dental denverAt McGlone Dental Care, the customer always comes first – and we know that many of our friends and neighbors don’t have dental insurance. We also know that not having dental insurance makes dental care decisions more stressful – How much is a filling going to cost? Can I afford getting a new crown?

We understand, and we want to help. For our friends and neighbors who don’t have dental insurance, we are offering a simplified way to think about dental care – and to help make those tough decisions a little easier – a flat fee of $300 per hour for ALL routine dental work, including fillings, crowns, bridges, periodontal deep-cleanings, extractions and complete and partial dentures.

To put it in perspective, we can usually complete 2 to 3 fillings in ONE HOUR, using highly rated materials and careful techniques.

Of course, some procedures simply take more time - crowns, bridges and full or partial dentures require help from an outside lab.  Together, we will choose the appropriate lab and proper material to be used. We will work with you to establish an accurate cost estimate, and the lab fee will be charged with zero mark-up.

Your dental health is as important as any other health decision you make. And we believe it should be available to ALL our friends and neighbors.

Call us today to find out how simple and affordable your dental care can really be – without all the stress and unknowns. We’re here for you and look forward to visiting with you soon.


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