FAQ

• Morning time: Saliva flow almost stops during sleep, so it doesn’t cleanse the mouth as much, allowing bacteria to grow.
• Certain foods: Garlic, onions, and other foods with odor-causing compounds enter the bloodstream, are transferred to the lungs, and then exhaled.
• Poor oral hygiene: Food particles remaining in the mouth promote bacteria growth.
• Periodontal (gum) disease: Colonies of bacteria residing under inflamed gums can cause bad breath.
• Dieting: Certain chemicals called ketones are released in the breath as the body burns fat.
• Dry mouth (Xerostomia): This may be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products: These can dry out the mouth.
• Dehydration, hunger, and missed meals: Drinking water and chewing food increase saliva flow, washing bacteria away.
• Medical conditions: Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keep a record of what you eat to help identify potential causes of bad breath. Also review your current medications, recent surgeries, and/or illnesses with your dentist.

• Practice good oral hygiene: Brush at least twice a day with an ADA-approved fluoride toothpaste and a toothbrush not more than three months old.
• Floss daily to remove food debris and plaque from between the teeth and under the gum line. Brush or use a tongue scraper to clean the tongue and reach the back areas. 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 checkup and cleaning at least twice a year, more often if you are prone to periodontal disease.
• Stop smoking and/or chewing tobacco: Ask your dentist for advice on how to break the habit.
• Drink water frequently: Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash or rinses: Some over-the-counter products provide a temporary solution, masking unpleasant mouth odor. Ask your dentist about antiseptic rinses that also kill germs.

Discuss your concerns with your dentist. In most cases, he or she can treat the cause. If your mouth is healthy, your dentist may refer you to a physician to determine the cause of the odor.

• Brushing and flossing are the most important steps you can take to achieve good oral health. They help control the plaque and bacteria that cause dental disease, so you’re keeping your mouth healthy and safe when you maintain a regular brushing and flossing routine.
• Plaque is a thin 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. If plaque isn’t removed, it turns into calculus (tartar). Plaque and calculus begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation is continuous and can only be controlled by regular brushing, flossing, and use of other dental aids.
• Brushing: Always brush your teeth at least twice a day, especially before going to bed for the night, with an ADA-approved soft-bristle brush and toothpaste. Brush at a 45-degree angle to the gums using a small, gentle circular motion, ensuring that you always feel the bristles on your gums. Make sure to brush the outer, inner, and biting surfaces of each tooth, using the tip of the brush head to clean the inside front teeth and to brush your tongue. Electric toothbrushes are an excellent way to efficiently remove plaque — simply place the bristles on your gums and teeth and let it 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 cleans those spaces, but also disrupts emerging plaque colonies, contributing to long-term health. Take 12 to16 inches of floss and wrap it around your middle fingers, leaving two to three inches between your hands. Use your thumbs and forefingers to guide the floss gently between teeth, sawing back and forth, and then curve it into a “C” shape around each tooth and under the gumline. If you have difficulty using conventional floss, floss holders are just as effective.
• Rinsing: Rinsing your mouth with water after brushing is important. Rinsing after meals when you can’t brush helps keep your mouth cleaner. If you use an over-the-counter product to rinse, consult with your dentist to make sure it’s the best option for you.

Discuss your concerns with your dentist; in most cases, he or she can treat the cause. If your mouth is healthy, your dentist may refer you to a physician to determine the cause of the odor.

Amalgam fillings are made from 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. However, there are some concerns about the safety of amalgam fillings, and claims that the vapor and minute particles from the mercury can cause health problems. The American Dental Association has investigated the fillings and declared them safe, saying studies have failed to find any link between silver containing mercury (which is used by up to 76% of dentists) and any medical disorder. The Centers for Disease Control, the World Health Organization, the Food and Drug Administration, and other organizations affirm that silver fillings are safe, durable, and cost effective. According to the U.S. Public Health Service, the only reason not to use silver fillings is if the patient has an allergy to any of the components. There have been fewer than 100 reported incidents of such allergies, out of millions of fillings throughout the decades.

There are numerous alternatives to silver fillings, including composite (tooth-colored), porcelain, and gold. If you have concerns about amalgam, talk to your dentist to determine the right choice for you.

At a minimum, you should visit the dentist for a checkup and cleaning at least twice a year. Your dentist may recommend more frequent visits if you have a history of periodontal disease or other concerns. Regular exams and cleanings are essential to preventing dental problems and keeping your mouth healthy. At your visit, your dentist and dental hygienist will:

• Clean your teeth and check for cavities
• Review your medical history and dietary habits
• Examine diagnostic x-rays
• Screen for oral cancer
• Evaluate for gum disease
• Examine tooth decay and/or existing restorations
• Remove plaque and calculus (tartar)
• Polish your teeth
• Recommend oral hygiene aids

Dental exams and cleanings consist of much more than just shining up your teeth. They’re critical for maintaining complete oral health, so be sure to schedule one at least every six months.

Most people are not aware of periodontal disease in the early stages because it’s painless, unlike tooth decay. Regular dental checkups and periodontal exams are important to help detect the disease before it becomes too severe. 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 acids, which inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is removed before it can cause problems.

Other risk factors for periodontal disease include:

• Smoking or chewing tobacco, which increases plaque and tartar
• Certain tooth or appliance conditions, such as ill-fitting bridges or defective fillings, which can trap bacteria
• Many medications, such as steroids and blood pressure meds, can reduce saliva, making it easier for plaque to adhere
• Pregnancy, oral contraceptives, and puberty, which change hormone levels that can cause gum tissue to become more sensitive to bacteria toxins
• Systemic diseases, such as diabetes, blood cell disorders, HIV/AIDS, and others, increase the chances of periodontal disease
• Genetics can play a role, so patients with a family history of tooth loss should be aware

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

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

A toothbrush is excellent at removing food particles, plaque, and bacteria from tooth surfaces, but it can’t get in between the teeth. Thus, that area becomes highly susceptible to decay and gum disease. Daily flossing is the way to keep those spaces healthy. Flossing not only helps clean the area, but it also 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’s a growing colony of living bacteria, food debris, and saliva, which produces acids that cause cavities and irritate and inflame the gums. When plaque isn’t removed, it turns into calculus (tartar), which slowly destroys the bone — the beginning of periodontal disease. To floss properly, take 12-16 inches of floss and wrap it around your middle fingers, leaving two to three inches between your hands. Use your thumbs and forefingers to guide the floss gently between teeth, sawing back and forth, and then curve it into a “C” shape around each tooth and under the gumline. Floss holders are just as effective if you have difficulty using conventional floss. Daily flossing will help you keep a healthy, beautiful smile, for life!

Many people feel self-conscious about their teeth, or want a better smile. Thankfully, there are a variety of cosmetic dentistry treatments that can achieve a brighter, whiter, more symmetrical smile. Cosmetic dentistry has been increasing in popularity, as people realize the positive impact on their appearance and confidence. Depending on your particular needs, cosmetic dentistry can restore a single tooth, give you a full mouth makeover, or anything in between. Talk to your dentist about which of the following cosmetic procedures can give you the results you desire:

• Teeth whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, or smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness may vary.
• Composite fillings: Tooth-colored fillings, also known as bonding, are now widely used instead of amalgam (silver) fillings. They fill new cavities and also replace older fillings. Composite fillings are also used to repair chipped, broken, or discolored teeth, as well as to fill in gaps and protect 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 restorations. They are ideal for teeth that have large, fractured, or broken fillings, or are badly decayed.
• Dental implants: Implants are artificial roots 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, providing a strong, stable, and durable solution to removable dental appliances.
• Orthodontics: Less visible and more effective brackets and wires are making orthodontics much more appealing to adult patients. In some cases, teeth can be straightened with custom-made, clear, removable aligners, requiring no braces at all.

Porcelain veneers are very thin shells of tooth-shaped porcelain, individually crafted to cover the fronts of teeth. They are durable and non-staining, making them a popular solution for those seeking to restore or enhance the beauty of their smile. Veneers can be used for:

• 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

Getting veneers usually requires two visits, one to take an impression of your teeth, and a second to install the newly created veneers. Little or no anesthesia is required; the teeth are lightly buffed and shaped, and then bonding cement adheres the veneers. Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile. See our page on Veneers for more detailed information.

Since teeth discoloration has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile. Professional teeth whitening, or bleaching, is a simple, noninvasive dental treatment used to change the color of natural tooth enamel; it is an ideal way to enhance the beauty of your smile. Over-the-counter products are much less effective than professional treatments and may not always meet the standards of the American Dental Association.

As we age, the outer layer of tooth enamel wears away, exposing a darker or more yellowed shade. Smoking or drinking coffee, tea, or wine can contribute to tooth discoloration, making teeth yellow and dull. Excessive fluoridation during childhood can also cause teeth to have spots that have an unattractive color.

Discuss teeth whitening with your dentist to ensure that it’s the right solution for you. It only works on natural enamel, so the placement of fillings and crowns may preclude the results you seek. Not all stains are bleachable; your dentist can advise you as to the likely outcome of whitening. Since it is not a permanent procedure, a touch-up may be required every few years.

There are two widely used teeth whitening systems. In one, you do the whitening at home, with a gel used inside a custom-fitted mouth guard (a tray made from a mold of your teeth). It’s worn twice a day for half an hour, or overnight while you sleep, and will show results after several weeks.

The second option occurs solely in the dental office, though it may require more than one visit. While your gums are protected, a bleaching solution is applied to the teeth, sometimes accompanied by an enhancing light.

Some patients may experience tooth sensitivity afterwards, but this is temporary and will subside within a few days. Teeth whitening is the most effective way to achieve a brighter, whiter smile with minimal hassle.