What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition and many of us may not realize that we have bad breath, especially in the morning. There are various reasons for bad breath, but the major reason is due to microbial deposits on the tongue, especially the back of the tongue.

Possible causes of bad breath are:
  • Morning time: Bad breath is caused by saliva flow almost stopping during sleep and its reduced cleansing action allows bacteria to grow.
  • Certain foods:Foods containing odor-causing compounds, like garlic and onions, enter the blood stream and 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): Possibly caused by certain medications, salivary gland problems or continuous mouth breathing.
  • Tobacco products: Dry the mouth and cause 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 can contribute to bad breath. 
How often should I brush and floss?

Plaque is a film of food debris, bacteria and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay and, if plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation and growth is a continuous process and, only being controlled by regular brushing, flossing and the use of other dental aids.
Are amalgam (silver) fillings safe?

An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. There has been some concern as to the safety of amalgam (silver) fillings due to claims that exposure to the vapor and minute particles from the mercury may cause a variety of health problems. The general consensus is that amalgam (silver) fillings are safe and the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA maintains that, when the mercury combines with the other components of the amalgam filling, it becomes an inactive substance that is safe. However, there are numerous options to silver fillings, including composite (tooth-colored), porcelain and gold fillings.
How often should I have a dental exam and cleaning?

Although your dentist may recommend more frequent visits, teeth should be cleaned and checked at least twice a year because these visits are essential in preventing dental problems and maintaining the health of teeth and gums. At these visits, teeth are cleaned and checked for cavities and several other procedures, including:
  • Medical history review
  • Examination of diagnostic x-rays (radiographs)
  • Oral cancer screening
  • Gum disease evaluation
  • Examination of tooth decay and existing restorations
  • Removal of calculus (tartar) and plaque
  • Teeth polishing
  • Oral hygiene recommendation
  • Review of dietary habits
How can I tell if I have gingivitis or periodontitis (gum disease)?

Most people are not aware of it because the disease is usually painless in the early stages, yet four out of five people have periodontal disease, which begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. These bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
  • Smoking or chewing tobacco
  • Certain tooth or appliance conditions
  • Many medications
  • Pregnancy, oral contraceptives and puberty
  • Genetics
Signs and Symptoms of Periodontal Disease:
  • Red and puffy gums
  • Bleeding gums
  • Persistent bad breath
  • New spacing between teeth
  • Loose teeth
  • Pus around the teeth and gums
  • Receding gums
  • Tenderness or discomfort
Why is it important to use dental floss?

Because our toothbrush can’t reach areas in between the teeth that are highly susceptible to decay and periodontal (gum) disease, flossing our teeth removes food particles, plaque and bacteria from these areas. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth and bone. Plaque, a growing colony of living bacteria, food debris, and saliva, is a sticky, almost invisible film that forms on the teeth. The bacteria produce toxins (acids) 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), further irritating and inflaming the gums , also slowly destroying the bone, which is the beginning of periodontal disease.
How can cosmetic dentistry help improve the appearance of my smile?

There are many cosmetic dental procedures out there to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dentistry can dramatically change your smile, from restoring a single tooth to having a full mouth makeover. Cosmetic dentistry has become quite popular recently because patients are becoming more and more focused on improving their overall health.

Some cosmetic procedures are:
  • Teeth whitening
  • Composite (tooth-colored) fillings
  • Porcelain veneers
  • Porcelain crowns (caps)
  • Dental implants
  • Orthodontics
What are porcelain veneers and how can they improve my smile?

Porcelain veneers are very thin shells of tooth-shaped porcelain individually crafted to cover the fronts of teeth and created from an impression (mold) of your teeth, which is then sent to a professional dental laboratory, where each veneer is custom-made (for shape and color) for your individual smile.They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers are used for restoring or correcting the following dental conditions:
  • Severely discolored or stained teeth
  • Unwanted or uneven spaces
  • Worn or chipped teeth
  • Slight tooth crowding
  • Misshapen teeth
  • Teeth that are too small or large
What can I do about stained or discolored teeth?

As is an ideal way to enhance the beauty of your smile, professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment for changing the color of natural tooth enamel. The color of our teeth comes from the inside of the tooth, which may become darker over time or from the outer layer of tooth enamel wearing away and eventually revealing a darker or yellow shade. Also, Smoking, drinking coffee, tea and wine can also contribute to tooth discoloration that makes our teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline, or excessive fluoridation (fluorosis) during tooth development. Since teeth whitening is not permanent, touch-ups may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems are:
  • Home teeth whitening systems -  At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes or overnight while you sleep. It usually takes several weeks to achieve the desired results, depending on the degree of staining and the desired level of whitening.

  • In office teeth whitening - This treatment is done in the dental office and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.
What are my options if I have missing teeth?

When a tooth is lost, the jaw bone that supported that tooth starts to atrophy and causes the teeth on either side to shift or tip into the open space of the lost tooth. In addition, the tooth above or below the open space will begin to move towards the open space because there is no opposing tooth to bite on. These movements may eventually create problems, such as decay, gum disease, excessive wear on certain teeth and TMJ (jaw joint) problems. Injury, accident, fracture, severe dental decay and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

Options for replacement of missing teeth:
  • Removable bridges
  • Fixed bridges
  • Dentures
  • Implants 
What can be done about old, unattractive, or discolored fillings?

Fillings in our mouths that date back many years and even been placed during our childhood may now be old, dark and unattractive, making us feel self-conscious when we smile, laugh, and talk. While unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) can eventually open and allow bacteria and food debris to enter and potentially cause dental decay. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless and cost-effective options for replacing old, unattractive or discolored fillings:
  • Composite (bonding) fillings
  • Crowns (Caps)
  • Inlays/Onlays
  • Porcelain veneers
What does heart disease and other medical conditions have to do with periodontal (gum) disease?

People seem unaware that having periodontal disease can affect your overall health, as it is one of the most common infections. Periodontal disease is a bacterial infection, starting when an accumulation of plaque is NOT regularly removed from the gums and teeth, producing toxins/acids that irritate and infect the gums and eventually destroying the jaw bone that supports the teeth, leading to tooth loss if not treated. Numerous studies suggest that people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal 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
When are sealants recommended?

Brushing and flossing remove most food particles and bacteria from easy-to-reach tooth surfaces, but they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures), so this is where sealants play an important role.

A sealant is a thin plastic coating covering and protecting the chewing surfaces of molars, premolars and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and helping keep these areas free of decay.

Who may need sealants?
  • Children and teenagers:  As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.
  • Infants: Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity-prone.
  • Adults: Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth.
What should I do if a tooth is knocked out?

We may be able to actually save the tooth if we know how to handle this emergency situation. 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.Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly and follow these simple steps:
  1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots. 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.
  2. Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation. 
Ways to transport the tooth:
  1. 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.
  2. 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.
  3. 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.
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.
Why straighten teeth?

While there are several types of malocclusion, including overbite, underbite, crossbite and overcrowding, each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth. Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth and a straight smile boosts confidence, is aesthetically pleasing to look at and can help stave off a wide variety of dental ailments.
Some of the main disorders associated with crooked teeth are:
  • Periodontitis
  • Temporomandibular Disorder (TMJ)
  • Tooth injury
  • Uneven wear
Teeth are straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration and the brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Aligning trays are fully removable and are used where the malocclusion is less severe and the teeth need to move a shorter distance.
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