A:

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

There are a variety of 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.
• Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds 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 – These situations have been know to be a cause.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – The inherent chemistry of tobacco and dehydration in the mouth caused by using tobacco products.
• 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 the problem.

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.  Refrain from using mouth rinses that contain alcohol as these products will actually dry your mouth and inhibit your body's natural ability to keep your mouth cleansed.

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.

A:

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

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 checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

• Medical history review: Knowing the status of any current medical conditions, new medications and illnesses gives us insight to your over all health and which usually has an effect on your dental health.
• Examination of diagnostic radiographs (X-Rays): Essential for detection of decay, tumors, cysts and bone loss. radiographs also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Periodontal disease evaluation: Check 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 dental instruments.
• Examination of existing restorations: Check current fillings, crowns, bridges, etc. for any signs of recurrent decay or failure.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with dental instruments used by a hygienist.
• 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 (poisons) that inflame the gums.  This inflammation is the start of periodontal disease.
• Polishing: Removes stain and plaque that is not otherwise removed during home tooth brushing and professional 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 quality dental exam and cleaning involves quite a bit more than just checking for cavities and polishing your teeth.  Our practice is committed to providing you with the best in preventative care.

A:

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

Periodontal disease begins when plaque (a sticky, colorless, film of bacteria made up of food debris and saliva) is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Properly brushing and flossing regular will ensure that plaque is not left behind to do its damage.

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

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

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

• Many medications – Steroids, cancer therapy drugs and blood pressure medications (to name a few) may have side effects that reduce saliva, making the mouth dry which provides plaque with an easier surface to adhere to.

• Pregnancy, oral contraceptives, and puberty – These life occurrences can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.  (Dr. Hughson-Otte lecture topic - "The Female Patient")

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

• Genetics – Some patients may be predisposed to a more aggressive type of periodontal disease.  Patients with a family history of tooth loss should pay particular attention to the condition of their gums.

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 adhere the tooth to the bone).

• Secretion around the teeth and gums – A sign that there is infection present.

• Receding gums – Loss of gum around the base of a tooth.

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

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

A:

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

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 colonies from building up, preventing damage to the gums, teeth and bone.

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 (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).  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 beautiful smile for life!

A:

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask the dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as composite fillings are now widely used instead of amalgam (silver) fillings to repair decayed teeth or to replace old amalgam fillings cosmetic reasons.  Tooth-colored fillings are also used to repair chipped, broken or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help transform damaged, discolored, poorly shaped or misaligned teeth.  Unlike crowns, veneers require less tooth structure to be removed from the surface of the tooth.

Porcelain Crowns: A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be repaired using fillings or other types of restorations (onlays or inlays) where there is minimal tooth structure left to restore.  They are ideal for teeth that have large, fractured or broken fillings and for those teeth that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth much more appealing to adult patients.  In some cases teeth may be straightened using custom-made, clear removable aligners that require no braces at all (InvisAlign®).

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

A:

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the front surface of teeth.  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 may be used to restore or correct 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 too large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

With little or no anesthesia, a tooth is prepared by lightly buffing and shaping the front surface to allow for the small thickness of the veneer.  Veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a naturally beautiful smile.