01: What
should I do if I have bad breath?
02. What may cause bad breath?
03. What can I do to prevent bad breath?
04. How often should I brush and floss?
05. Are amalgam (silver) fillings safe?
06. How often should I have a dental exam and cleaning?
07. How can I tell if I have gingivitis or periodontitis
(gum disease)?
08. Why is it important to use dental floss?
09. How can cosmetic dentistry help improve the appearance
of my smile?
10. What are porcelain veneers and how can they improve
my smile?
11. What can I do about stained or discolored teeth?
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Q:
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.
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Q.
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 blood stream; 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.
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Q.
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.
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Q:
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.
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Q:
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.
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Q:
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.
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Q:
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.
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 support the tooth to the bone).
Pus around the teeth and gums – Sign that there is an infection
present.
Receding gums – Loss of gum around 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.
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Q: Why is it important to use dental floss?
A: Brushing
our teeth removes food particles, plaque, and bacteria from all
tooth surfaces, except in between the teeth. Unfortunately, our
toothbrush can’t reach these areas that are highly susceptible
to decay and periodontal (gum) 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 healthy, beautiful smile for life!
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Q:
How can cosmetic dentistry help improve the appearance of my smile?
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 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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Q:
What are porcelain veneers and how can they improve my smile?
A: Porcelain
veneers are very thin shells of tooth-shaped porcelain that are
individually crafted to cover the fronts 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 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, teeth are prepared by lightly buffing and
shaping the front surface of the teeth to allow for the small thickness
of veneers. The 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 natural, beautiful smile.
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Q:
What can I do about stained or discolored teeth?
A: Since
teeth whitening 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, non-invasive dental
treatment used to change the color of natural tooth enamel, and
is an ideal way to enhance the beauty of your smile. Over-the-counter
products are also available, but they are much less effective than
professional treatments and may not be approved by the American
Dental Association (ADA).
As we
age, the outer layer of tooth enamel wears away, eventually revealing
a darker or yellow shade. The color of our teeth also comes from
the inside of the tooth, which may become darker over time. Smoking,
drinking coffee, tea, and wine may also contribute to tooth discoloration,
making our teeth yellow and dull. Sometimes, teeth can become discolored
from taking certain medications as a child, such as tetracycline.
Excessive fluoridation (fluorosis) during tooth development can
also cause teeth to become discolored.
It’s
important to have your teeth evaluated by your dentist to determine
if you’re a good candidate for bleaching. Occasionally, tetracycline
and fluorosis stains are difficult to bleach and your dentist may
offer other options, such as veneers or crowns to cover up such
stains. Since teeth whitening only works on natural tooth enamel,
it is also important to evaluate replacement of any old fillings,
crowns, etc. before bleaching begins. Once the bleaching is done,
your dentist can match the new restorations to the shade of the
newly whitened teeth.
Since
teeth whitening is not permanent, a touch-up may be needed every
several years to keep your smile looking bright.
The most
widely used professional teeth whitening systems:
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.
Some
patients may experience tooth sensitivity after having their teeth
whitened. This sensation is temporary and subsides shortly after
you complete the bleaching process, usually within a few days to
one weak.
Teeth
whitening can be very effective and can give you a brighter, whiter,
more confident smile!
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