What’s The Deal With Flossing? Do I or Don’t I?

So, everyone in dentistry has been in a heated discussion over the past week and a half. The genesis of the discussion was when the Associated Press released an article last week titled ‘Medical Benefits Of Dental Floss Unproven’, and everyone lost their collective minds. Patients ran screaming through the streets as if they had won the lottery, and many dentists curled up in corners of their dental oflossmemeffices, sobbing uncontrollably, while article after article was released on the subject:

‘Forget the floss? Not so fast.’ ‘Flossing dilemma solved.’ ‘So, does Michael Phelps believe in flossing?’ Really? ‘Do we really need to floss? Dentists say yes, science says no.’ ‘Sorry Haters, You Do Have To Floss’ and on and on, so of course, we wanted to weigh in too.

In the original AP article, the author, Jeff Donn writes, “The federal government has recommended flossing since 1979, first in a surgeon general’s report and later in the Dietary Guidelines for Americans issued every five years…When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice.”

I don’t know about any of you, but I am not leaving my teeth in the hands of the federal government. And if you stop flossing, your teeth will eventually end up in someone’s hands because they won’t be in your mouth for very much longer. Our opinion matches up with that of Matthew Messina DDS, “The dietary guidelines removing flossing actually kind of makes sense. Floss is not a food or drug. I don’t need federal guidelines to include flossing.”

Thankfully, some members of the dental community, and actual dentists that went through dental school, like Dr. Messina, continued to weigh in on the topic. The American Dental Association released a statement saying, “Interdental cleaners, such as floss are an essential part of taking care of our teeth and gums. Cleaning between teeth removed plaque that can lead to cavities or gum disease from the areas where a toothbrush can’t reach.”

The AP report goes on to say, “In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched.” We thought it was self-explanatory that toothbrushes by themselves couldn’t clean the surfaces between the teeth, and that you needed floss to get in and clean those surfaces sufficiently, and Ronald Goldstein DDS, author of ‘Change Your Smile’ agreed, “It was so obvious centuries ago that flossing is necessary to help clean the teeth that it didn’t take research to prove it. They’re saying there are not sufficient long-term results with the flossing, there’s no evidence to support it, but logic takes over sometimes from lack of evidential research.”floss

To sum up our stance, plaque and food particles still get in between your teeth, and really the only way to get them out is to floss. So, yes, it is our recommendation that everyone still flosses, even though we know that is NOT what anyone wants to hear. If you still aren’t convinced, give us a call here at the office at 602-993-4200 or bring it up next time you are in for your appointment.

9 Factors You Didn’t Know About Gum Disease

Gum disease is a huge hot topic in dentistry today. With the onset of corporate dentistry, it seems like periodontal disease is the biggest point of contention between dentists, and hygienists alike. Dentists will never agree on the subject, some studies say that 85% of Americans have gum disease, and some reports say that the number is closer to 60 percent. That is a very wide gap, but on the low end, that is still 60% of all Americans that have some sort of periodontal disease. There are numerous factors contributing to gum infection like age, genetics, smoking, and gender. But some contributing factors may come as a surprise to you. The top nine factors that come as somewhat of a surprise are:


Many systemic diseases have been linked to periodontal disease with the biggest being diabetes and heart disease. Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications. Some studies have shown tha the inflammation associated with gum disease can contribute to heart disease as well.

Other diseases that have been linked to periodontal disease are osteoporosis, respiratory disease, high blood pressure, and cancer. Also, post-menopausal women have an 86% higher chance to develop gum disease.


Studies have shown that certain types of oral contraceptives, antidepressants, and heart medication have a side effect of gingival overgrowth, which can be a contributing factor of gum disease. Also, any drug that has a side effect of dry mouth can increase the risk for gum disease. We will get into this a little later.


Clenching and grinding teeth together breaks down the fibers and bone that hold teeth in place, and can speed up the rate at which the gum tissue is destroyed.


A diet low in fruits and vegetables can compromise the body’s immune system and make it harder for the body to fight off infection, and because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums.


Studies have shown that getting 6 hours of sleep a night or less makes you 3 times more susceptible to periodontal disease.


Stress affects the immune system, which fights against the bacteria that causes periodontal disease, making you much more prone to gum disease. Studies have shown that those at greatest risk for gum disease were those who were highly emotional in dealing with financial problems.

Dry Mouth

Dry mouth irritates the gums which can make them inflamed and more susceptible to infection. Without saliva protecting the teeth and gums, tooth decay and gum disease become more common. Medications like antihistamines, decongestants, painkillers, and diuretics are the most common cause of dry-mouth. Dry-mouth has also been linked to pregnancy and menopause as well.

Oral Hygiene

Oral hygiene habits are the number one contributor to gum disease. If you don’t have good oral hygiene habits, then none of these other factors really matter. Brushing at least twice a day, flossing, and regular visits to your dentist and hyginist are the first line of defense against periodontal disease. These are also the only ways to fight gum disease or to get your mouth healthy again if you already have gum disease.

Our hygienists are trained and highly skilled in the area of periodontal disease detection and prevention. They both would be happy to go through your medical history with you, assess your risk factors, and help you in your fight against gum disease, call or click here to make an appointment today!

What Is a Deep Cleaning? Why Do I Need One? And What Does It Have To Do With My Heart?

Some of the most common questions we get from our patients here at Legacy Dental Group revolve around “deep cleanings”. Many patients come to us as new patients from other offices stating, “the dentist said that I needed a ‘deep cleaning’ and tried to force me into a big treatment plan.” This is actually a very common occurrence here, and we would like to clear up some of the questions we get from those patients.

First off, what is a “deep cleaning”? Well to be totally honest, there are a few different levels of gum disease, so there are a few different levels of cleanings. The different types of cleanings are:

  • Prophylaxis
  • Full Mouth Debridement
  • Localized Scaling and Root Planing
  • Full Mouth Scaling and Root Planing

The first level of cleaning is called a prophylaxis. This is the cleaning that patients come in and get for their bi-annual checkups. This is what most patients consider to be a “regular cleaning”. This is a preventative cleaning and can only be done when the patient’s mouth is completely free of gingivitis and periodontal disease. The other three types of cleanings could all be conveyed as “deep cleanings” as they are not considered preventative in nature.

A Full Mouth Debridement is usually done when a patient has not been to a dentist in a few years and has plaque, tartar, and hard calculus buildup present on their teeth. When there is calcified buildup present on the surfaces of the teeth, the hygienist cannot get correct gum measurements to evaluate how healthy a patient’s gums are. That is the purpose of having the Full Mouth Debridement done, to remove that calcified plaque and tartar to be able to accurately assess the health of the gums around the teeth.

Localized Scaling and Root Planing is also considered a “deep cleaning” by many patients as it is a periodontal procedure. Localized Scaling and Root Planing is only done when there is periodontitis (periodontal disease) present in the mouth. What happens in this case is the plaque and tartar present have reached down below the gums, and have started to infect the gums around the teeth. When this starts to happen, the gums recede away from the teeth and in serious cases, the bacteria starts to erode away the bone of the jaw. Localized Scaling and Root Planing is done when the periodontitis is only present in a few areas of the mouth, hence the “localized” descriptor. The hygienist would start by getting the affected teeth numb first, and then they would focus on cleaning the bacteria out from underneath the gums. This is generally why it is known as a “deep cleaning” because it goes below the gum line.

Full Mouth Scaling and Root Planing is very similar to the cleaning mentioned above, it just isn’t focused on one or two teeth, it is required in the whole mouth. Scaling and Root Planing can be done on a patient that is just at the beginning stages of periodontitis or a more severe stage, but it is best to have the procedure done in the early stages, as severe periodontitis could require periodontal surgery that would need to be performed at a specialist’s office.

As far as the last question posed in the title of this blog, what do deep cleanings have to do with my heart? According to the American Academy of Periodontology, “Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease. Scientists believe that inflammation caused by periodontal disease may be responsible for the association.”

So while everyone is thinking about hearts this Valentine’s Day, protect yours by giving us a call at 602-993-4200 to schedule your cleaning and checkup today!

5 Ways To Improve Your Smile For Valentine’s Day

Valentine’s Day is fast approaching, and we have had a lot of patients ask what they can do to improve their smiles for their big night with their significant other.  We have thought of a few ways that we help our patients quickly, but effectively improve their smile:

Boost In-Office Whitening

The first, and favorite method of our patients, is the Boost In-Office Whitening by Opalescence.  It is a similar process to the Zoom! By Philips, but there are no invasive ultraviolet lights to activate the whitening gel.  Far fewer of our patients complain about sensitivity after the Boost process than they did after the Zoom! process.  The In-Office Whitening procedure takes about an hour and a half start to finish, and while we have seen results vary, a high percentage of our patients have seen a marked improvement.  This process is the fastest that we have tried over the years to whiten teeth.

Take Home Whitening Trays

Another form of teeth whitening would be to have custom trays fabricated here in the office, and then take them home for home use.  This is preferred by patients that like to control their own exposure to the whitening gel, as some post application sensitivity can occur.  This is also a quick process in our office.  It involves taking impressions of your upper and lower teeth to start the fabrication process.  The time to take impressions varies a little patient to patient, but usually it is done within a 10 minute period.  What happens next is that our assistants take the actual mold of your mouth and fabricate custom trays that you would use to administer the bleaching gel at home.  This is usually a lot less costly of a procedure, but It usually takes a little longer to get to the desired shade.


Bonding is basically another word for a filling.  Most bonding is performed on anterior, or front teeth.  It is usually done to fix small chips or fractures in teeth, and in the end looks just like a natural tooth.  This is a cheaper alternative to veneers or crowns, but cannot always be performed.  If too much tooth structure has been compromised, then bonding is not an option, as it doesn’t protect the tooth too well from future chips or fractures.


Sometimes referred to as caps, crowns come in many different shapes and styles.  The standard crown is made up of a metal base with porcelain stacked on top of the metal to make it look like a natural tooth.  Some crowns are made from a gold alloy, with no porcelain on top of it.  These are used in extreme cases where a person’s bite is so small that there is no room for the porcelain, or their bite is so strong that the dentist is fearful that the patient will crack the porcelain with their biting force.

In recent years, technology has advanced so much that some dentists can fabricate the crown in the office while you wait.  A CEREC trained doctor (which Dr. Core has been for years) can take a digital image of the tooth, and send it to the CEREC milling unit, which acts like a 3D printing milling the crown out of a porcelain block.  This technology has come a long way in recent years, and most times Dr. Core can get you in and out of the office with a permanent crown in about an hour and a half.

The downside of having a crown done, is that in most cases the dentist has to remove a lot of tooth structure to have enough room for the crown to fit onto the rest of the tooth.


Veneers are the piece de resistance when it comes to cosmetic dentistry.  They can be used to fill in gaps, change the shape of teeth, and change the shade of teeth more permanently than whitening can do.  Also, to place a veneer, less tooth structure needs to be removed than when placing a crown, so it is usually the best case scenario.

The only real downside to having veneers done is the cost.  They are the most costly procedure on this list, and because they are strictly cosmetic, most insurance companies will not cover any of their cost.

All of the procedures listed above are performed here at our office by Dr. Louis Core, and if you would like to learn more about any of them, one of our team members would be happy to help explain the processes to you, just give us a call anytime!

Watch your heart on Valentine’s Day!

This year is flying by, and Valentine’s Day is fast approaching. When we think of Valentine’s Day, we think of roses, candies, and hearts.  Tying in with those hearts of Valentine’s Day, the American Heart Association has made February American Heart Month.

Heart disease is the leading cause of death for both men and women.  To prevent heart disease and increase awareness of its effects, Legacy Dental Group is proudly participating in National Heart Month.

Periodontal disease has been found to be directly linked to heart disease, as many studies have shown.  Our own hygienists Jamie and Nancy just attended a seminar that talked about the oral-systemic link, so we wanted to sit down with them, and ask them some questions about it:

Q: What is “oral systemic health”?

A:  Oral systemic health is the connection between oral health, and overall health.  Countless studies have demonstrated a link between poor oral health and systemic diseases such as heart disease, diabetes, stroke, and even pregnancy problems.


Q: Is “bad breath” a sign of gum disease?

A:  In a word, yes.  Bad breath happens when bacteria and dead skin cells decay, producing sulfur compounds which give off the bad breath smell.  Chronic bad breath should always be viewed as a bad sign and risk factor for tissue breakdown and disease.  While standard mouthwashes will mask the smell in the short term, they don’t get rid of the bacteria which is really the underlying cause.

Q: What can our patients do at home to protect their oral health?

A:  Well we’d love for them to come in so we can get to know them better, but good home care is vital to help preventing periodontal disease.  It’s going to be the usual suspects, brushing after eating, flossing, and using an antibacterial mouthwash are the best things that they can do.

Jamie has been with us now for a little over 6 months, and has been a hygienist for almost 10 years.  She has quickly become a valued part of our family.  Nancy has been with us on a part time basis since 2006, but came aboard full time 2 years ago, and must be some sort of hygiene ninja, because most of our patients tell us that she is the most gentle hygienist that they have ever been to.  If you are overdue for your checkup give us a call today at 602-993-4200 to schedule an appointment, they would love to meet with you.

Are you afraid of the dentist? There are many ways to overcome that fear.


You would be surprised at the number of people that have some form of fear of coming to the dentist.  It is estimated that approximately 40 million Americans avoid dental care because of fear and anxiety.  This fear can stem from a number of what are called direct and indirect experiences.  The most common reason that people avoid coming to the dentist is that they have had a bad or traumatic experience in the past, and feel that every future visit will be the same.  This is an example of a direct experience.  But others still possess that fear even if they have never had a bad experience, or been to a dentist at all.  Some reasons for this would be that they heard about a traumatic experience from a friend, the negative portrayal of dentists in mass media or cartoons, or a feeling of helplessness and a lack of control.  These are examples of indirect experiences.  All of these factors together lead to people experiencing a “cycle of avoidance,” in which they avoid dental care due to fear until they experience a dental emergency that requires invasive treatment, which can enforce their fear of dentistry.

Dentists today, like Dr. Core, have a breadth of knowledge on how to help patients dental with dental fear.  Dr. Core has attended countless hours of continuing education on this subject alone.  There are a number of ways to deal with dental anxiety that fall into two main categories, behavioral techniques and sedation techniques.

Behavioral Techniques:

Positive Reinforcement – Dr. Core makes positive comments before and during the procedure being done, helping to relax the patient he is treating.

Non-Threatening Language – most dentists speak mostly in clinical terms that no one can understand but them, but Dr. Core uses patient-friendly, non-threatening language with all of his patients, so that they understand what is involved in the treatment that they need.

See-Show-Do Techniques – if you have questions on what any procedure will entail, Dr. Core will first go over it verbally, so that you understand the procedure, and then show you how the procedure is done.  Most anxiety comes from fear of the unknown, and after Dr. Core explains everything, and shows patients what he is going to do, our patients are reassured and the anxiety dissipates.

Distraction Techniques – we have televisions in every room, as well as headphones so that you can listen to music during your appointment, which will take your mind off the dental treatment that is being done.


Sedation Techniques:

Inhaled Minimal Sedation – You breathe nitrous oxide, commonly known as “laughing gas,” combined with oxygen through a mask that is placed over your nose.  Dr. Core can control the amount of sedation you receive, and the gas tends to wear off quickly.  This is the only form of sedation that you should be able to drive yourself home after the procedure.

Oral Conscious Sedation – Depending on the total dose given, oral conscious sedation can range from minimal to moderate sedation.  With oral conscious sedation, you take a pill, usually Halcion (a member of the Valium family), and it is taken an hour prior to your appointment.  The medication will make you drowsy, and better able to handle any procedure that needs to be done.

IV Sedation – you receive the sedative through an IV, so it will go to work quicker.  This method allows Dr. Core to continually adjust the level of sedation.  This is the preferred method of sedation for our patients that have a lot of fear or anxiety, or need a lot of treatment done at one time.

Deep Sedation and General Anesthesia – you will receive medications that will make you either almost unconscious or totally unconscious (deeply asleep) during the procedure.  This involves having an anesthesiologist come to our office to provide the anesthesia.

Dr. Core truly understands the level of fear that people have about coming to the dentist, and has done everything he can to make an experience at our office the most pleasant it can be.  He is even a sedation certification specialist for the Arizona Board of Dental Examiners who evaluates every other doctor in Phoenix to make sure that they are following policies and procedures.  Call our office today at 602-993-4200 or visit our website to schedule an appointment so that we can get you back on the road to good oral health, and help you to be as comfortable as you can while doing it.

Baby Bottle Tooth Decay – Are your children’s teeth at risk?



We all want to protect our children from all the dangers that today’s society brings.  But one you may not even know existed is called Baby Bottle Tooth Decay or Early Childhood Caries.  Many of you may think that baby teeth aren’t very important because they are temporary, but that is surely not the case.  Baby teeth play a very important role in a child’s development.  They hold the place for permanent teeth to come in straight, they help children chew and speak clearly, and they allow children to have that heart-warming smile that they all have.

What is Baby Bottle Tooth Decay?

Baby bottle tooth decay is usually caused when the baby teeth come in contact with sugary liquids frequently, or for a prolonged period of time.  These sugary liquids include, but are not limited to milk, formula, and fruit juices, which most of us give to our children without a second thought.  Another cause for the decay is when a parent dips their pacifier in honey, sugar, or syrup.  Every time an infant ingests sugar, their teeth come in contact with those bacteria that produce the acid that leads to tooth decay.  The risk worsens when they come into contact with sugar right before a nap, as the mouth dries out while they are sleeping.  These bacteria thrive in a dry mouth, leading to a higher risk of cavities(decay).  The cavities usually occur in their upper front teeth, but other areas can be affected.


How can I prevent Baby Bottle Tooth Decay?

The good news is that tooth decay is easily preventable with good oral home care, good eating habits, and regular visits to the dentist.  Prevention methods include:

      • Start to brush your children’s teeth with a child-sized toothbrush and water, without toothpaste, as soon as their first tooth comes in.
      • Don’t allow your child to fall asleep with a bottle containing milk, formula, or juice.  If your child must have a bottle while they are sleeping, replace the sugar liquids with water.
      • Wipe your baby’s teeth and gums with a clean washcloth after each feeding, and massage the gums in the areas without teeth.
      • Floss your children’s teeth once they have all come in.
      • Change from a bottle to a sippy cup sooner rather than later, usually be their first birthday.  But don’t switch too soon, as the sucking motion that the baby gets from using the bottle helps to develop facial muscles.
      • If you get your water supply from a well (well water is not fluoridated), make sure your child is getting enough fluoride, as that helps strengthen the enamel of teeth, which protects the teeth against cavities.
      • Schedule your child’s first dental appointment around their first birthday so that we can evaluate their baby teeth, and get them accustomed to coming to our office.

Remember that staring early with good oral home care habits, good nutritional choices, and regular visits to our office for professional cleanings and examinations is the key to a lifetime of good oral health.  If your children have not been in for their first visit to our office, or if they have been, and are due for their checkup, we encourage you to call today or go to our website at www.legacydentalgroup.com to schedule an appointment with us.  We would be happy to assist you in keeping your children’s teeth as healthy as possible for the rest of their lives.  For more information on nutrition and your baby visit the Academy of Nutrition and Dietetics.