FAQs

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

• Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
• Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?

• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a biofilm of bacteria that sticks to the teeth and gums If plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they lead to the destruction of the gums and bone, causing periodontal (gum) disease.

Plaque formation and buildup is perpetual and can be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also acceptable. They are easy to use and can remove plaque efficiently. Place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, its a good idea to consult your dentist or dental hygienist on its appropriateness for you.

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and examined to maintain your dental health.  These include:

• Medical history review: Updating the status of any current medical conditions, new medications, and illnesses, gives your dentist insight to your overall health and helps them to effectively see to your dental needs.
• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Oral cancer screening: Examination of the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Examination of the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins that inflame the gums. This inflammation is the start of periodontal disease.
• Tooth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

A thorough dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and, to do so, require regular check-ups and cleanings, typically  alternating between your general dentists' office and our office.

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in it's early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Maintaining regular dental check-ups will help detect if periodontal problems arise.

Other than poor oral hygiene, there are several factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.

• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

• Certain medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacterial toxins.

• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their oral health.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Persistent bad breath – Caused by bacteria in the mouth.

• New spacing between teeth – Caused by bone loss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Proper oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, but it disrupts plaque from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible biofilm that forms on the teeth. The bacteria produce toxins that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.

How to floss properly:

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

Injury, accident, fracture, severe decay, and periodontal disease are the major reasons for tooth removal.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. The teeth above or below the open space may also move towards the open space because there is no opposing tooth to bite on. These movements may lead to further dental problems, which is why it is typically recommended to replace missing teeth.

Options for replacement of missing teeth:

Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They consist of artificial teeth with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to natural teeth adjacent to the missing tooth. Fixed bridges tend to be more sturdy than removable bridges. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants - Implants are a great way to replace one or more missing teeth. They may serve to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the bone underneath the gums to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are often the most aesthetically pleasing tooth replacement option.

If you are missing teeth, ask your dentist what options are available to you. Together you can select the best replacement option for you. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

Many people are unaware that periodontal disease can affect your overall health. Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Numerous studies have revealed the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at greater risk of developing systemic disease. They also indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs. Research suggests that oral bacteria in the blood stream may:

• Contribute to the development of heart disease
• Increase the risk of stroke
• Compromise the health of those that have diabetes or respiratory diseases
• Increase a woman’s risk of having a preterm, low-birth weight baby

While much research is yet to be done to understand the link between periodontal disease and systemic disease, there is enough evidence to support that infections in the mouth can  wreak havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, maintaining regular dental appointments is recommended.

Taking care of your oral health may contribute to your overall medical health!

More than 5 million teeth are knocked out every year! Teeth lost in this manner can be reimplanted by a dentist if the following steps are met in a timely fashion:

1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
2. DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
3. Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation. If after office hours, seek emergency medical care.

Ways to transport the tooth

• Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
• If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
• Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years. So be prepared and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights
• Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you notice any of these symptoms, be sure to contact your dentist or periodontist.