Question 1

What should I do if I have bad breath?

Accepted Answer

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 bloodstream; 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 you 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.

Question 2

How often should I brush and floss?

Accepted Answer

Brushing and flossing help control the plaque and bacteria that cause dental disease.  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.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.  Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.  Tooth Brushing – 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 recommended.  They are easy to use and can remove plaque efficiently.  Simply 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 colonies 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, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Question 3

How often should I have a dental exam and cleaning?

Accepted Answer

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 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 overall health and also your dental health. 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: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer. Gum 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 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 sometime 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 (poisons) that inflame the gums.  This inflammation is the start of periodontal disease! Teeth 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. As you can see, a good 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 will require regular check-ups and cleanings.

Question 4

What are my options if I have missing teeth?

Accepted Answer

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function.  Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.  Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen.  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.  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.  Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.  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 are usually made of tooth-colored, artificial teeth combined 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 a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. 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 patient’s’ original teeth.  Implants – Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone 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 the most aesthetically pleasing tooth replacement option.  If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

Question 5

How can cosmetic dentistry help improve the appearance of my smile

Accepted Answer

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 to 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 your 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 “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings.  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 restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.  Porcelain Crowns (caps): 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 restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those 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 with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.  Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

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