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1. What should I do if I have bad breath?
A: 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?
2. 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.
3. How often should I brush and floss?
A: 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.
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 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.
4. Are amalgam (silver) fillings safe?
A: Over the years there has been some concern as to the safety of
amalgam (silver) fillings. 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. The controversy
is due to claims that the exposure to the vapor and minute particles
from the mercury can cause a variety of health problems.
According to the American Dental Association (ADA), up to 76% of
dentists use silver containing mercury to fill teeth. The ADA also
states that silver fillings are safe and that studies have failed to
find any link between silver containing mercury and any medical
disorder.
The general consensus is that amalgam (silver) fillings are safe.
Along with the ADA’s position, the Center for Disease Control (CDC),
the World Health Organization, the FDA, and others support the use
of silver fillings as safe, durable, and cost effective. The U.S.
Public Health Service says that 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 has had fewer than 100 reported incidents
of an allergy to components of silver fillings, and this is out of
countless millions of silver fillings over the decades.
Although studies indicate that there are no measurable health
risks to patients who have silver fillings, we do know that mercury
is a toxic material when we are exposed at high, unsafe levels. For
instance, we have been warned to limit the consumption of certain
types of fish that carry high levels of mercury in them. However,
with respect to amalgam fillings, the ADA maintains that when the
mercury combines with the other components of the filling, it
becomes an inactive substance that is safe.
There are numerous options to silver fillings, including
composite (tooth-colored), porcelain, and gold fillings. We
encourage you to discuss these options with your dentist so you can
determine which is the best option for you.
5. How often should I have a dental exam and cleaning?
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.
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 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 sings 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.
6. How can I tell if I have gingivitis or periodontitis (gum
disease)?
A: 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 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, 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. Brushing and flossing regularly and properly 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 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. Many
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 bacteria 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 gums.
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