Frequently Asked Questions.

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What do I do if I have bad breath?
In most cases, bad breath originates in the mouth. Everybody knows your mouth stinks if you haven't brushed or flossed regularly. Bacteria on the teeth and in the gums give off a bad smell. Because the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening ("morning breath"). This common bad breath is usually transient, often disappearing following eating, brushing one's teeth, flossing, and rinsing with specialised mouthwash. 95% of bad breath is in this catagory.

Bad breath may also be persistent (chronic bad breath), which is a more serious condition. Most chronic bad breath is caused by decay and gum disease, and will not be cured until the dentist treats your disease. Persistent bad breath can also be caused by some diseases of the tonsils, throat, lung, and stomach. Kidney failure, liver failure, and diabetes can effect the breath. Persistent bad breath can negatively affect the individual's personal, social, and business relationships, leading to poor self-esteem and increased stress.

It is most important that you visit our office to have your bad breath diagnosed. In the meantime here are seven bad breath control methods that are safe and effective:

Gently cleaning the tongue surface twice daily an effective way to keep bad breath in control; that can be achieved using a tongue cleaner or tongue brush/scraper to wipe off the bacterial biofilm, debris and mucus. An inverted teaspoon may also do the job; a toothbrush should be avoided, as the bristles only spread the bacteria in the mouth, and grip the tongue, causing a gagging reflex. Vigorous scraping or otherwise damaging the tongue should be avoided, and scraping of the V-shaped row of taste buds found at the extreme back of the tongue should also be avoided. Brushing a small amount of antibacterial mouth rinse onto the tongue surface will further inhibit bacterial action.
Eating a healthy breakfast with rough foods helps clean the very back of the tongue.
Chewing gum: Since dry mouth can increase bacterial buildup and cause or worsen bad breath, chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. Chewing may help particularly when the mouth is dry, or when one cannot perform oral hygiene procedures after meals. This aids in provision of saliva, which washes away oral bacteria, has antibacterial properties, and promotes mechanical activity which helps cleanse the mouth. Some chewing gums contain special anti-odor ingredients.
Chewing on fennel seeds, cinnamon sticks, mastic gum or fresh parsley are common folk remedies.
Gargling right before bedtime with an effective mouthwash. Several types of commercial mouthwashes have been shown to reduce malodor for hours in peer-reviewed scientific studies. Mouthwashes often contain antibacterial agents including cetylpyridinium chloride, chlorhexidine, zinc gluconate, essential oils, and chlorine dioxide. If you find that your bad breath returns worse than before, try a mouthwash without alcohol (which can dry out the mouth for some patients).
Maintaining proper oral hygiene, including daily tongue cleaning, brushing, flossing, and periodic visits to dentists and hygienists. Flossing is particularly important in removing rotting food debris and bacterial plaque from between the teeth, especially at the gumline. Dentures should be properly cleaned and soaked overnight in antibacterial solution (unless otherwise advised by your dentist).
Maintain water levels in the body by drinking several glasses of water a day.

It is important to visit the dentist if none of these treatments work for your bad breath, so that we can diagnose your problem.

How important is flossing?
The most important way to prevent cavities is to clean the bacteria off the teeth. Flossing is a necessary part of your daily home care. Let me explain. Cavities can only attack your teeth if bacteria grow on your teeth, forming plaque. If you clean the plaque off your teeth often enough, you can never get cavities. Look at your teeth. If you have no fillings, then find a friend who does and look at their teeth. Notice how all the fillings are on the tops of the teeth, or between the teeth. There is a reason for this - the tops of our teeth naturally have grooves and fissures that are hard to clean. And you can't clean all the way between your teeth with only a brush. Look again. Notice that there never seems to be a filling right on the front of a tooth (the part you see when you smile). Again, that is because it is so easy to clean there. Flossing is the only way to get the last little bit of plaque cleaned away from between the teeth. Simply pop the floss between the teeth, wiggle it around on the "in-betweens", then pop it out. (Patients with gum disease will have extra instructions to follow.) Flossing is also effective at treating and preventing most forms of bad breath.

At my office we have many adult patients who have never had a cavity, nor gum disease. In every case they report that they floss at least once a day. Every single one.

Is there something I should do in addition to regular brushing and flossing to protect my teeth?
Here's our list of safe and effective things that healthy patients can do to protect their teeth. Patients that are battling cavities or gum disease will be given extra steps as a part of their treatment.

Brush with a soft bristle tooth brush for 2 minutes at least twice a day.
Floss between all your teeth at least once a day
Use a flouride toothpaste. (It's hard to find one that doesn't have fluoride, so this is easy.)
Avoid sugar. Sugar feeds the bacteria that cause cavities in your teeth. If you eat sweets, rinse or brush the sugar away.
Rinse before bedtime with a fluoride mouthwash that is labelled "Anti-cavity". Anti-cavity is a medical claim that is regulated by the FDA, so this means the mouthwash has the right amount of fluoride.
Always end the day with brushing and flossing. Cavites grow the most at night, so patients who have a late night snack are just setting themselves up for a night of bacteria growth and decay. Enjoy the snack, but follow it with brushing. Make sure fluoride is the last thing that hits your teeth before bed.
Visit your dentist twice a year for a professional cleaning and thorough oral examination. We can clean off the buildup that your brush and floss can't get. The examination will find any problems before they can grow into nightmares. See "how often should I come in for a cleaning?" for more information.

What do I do if my teeth are sensitive to hot and/or cold?
Sensitive teeth can sometimes be treated at home. First, try toothpaste "For Sensitive Teeth" that contains potassium nitrate. Sensodyne is one brand, but the other big brands all have their version. Find the one you like the taste of the most, so that you brush for the recommended full two minutes. You must brush with only this toothpaste, as other toothpastes will "scrub away" the effect.

If your teeth don't get completely comfortable within two weeks, then you must see a dentist. Simple sensitivity responds to the above home remedy. If your sensitivity persists, it could be due to cavities, cracks in your teeth, grinding or clenching your teeth, infections, gum disease, malocclusion, or something else. Let us check everything out, diagnose the problem, and recommend any further treatment you may need, before it gets worse than just sensitive teeth.

How often should I come in for a cleaning?
It depends who you are. Healthy people should get their teeth professionally cleaned and examined every six months. Scientists have studied this timing for years. Six months is the perfect interval: your teeth get cleaned before they get really bad and any new cavities are found when they are really small. Receiving a professional cleaning more often than six months (for healthy people with healthy mouths) is overkill.

Many patients have dental problems that require them to visit the dentist more often. Gum disease is an infection that has crawled far enough under the gum edge that patients cannot effectively control the disease with professional cleanings every six months. Most of these patients are seen four times a year, which is based on studies that show patients and their dentists controlling this disease successfully.

Do you recommend a certain tooth paste?
Check the label. The ADA Seal of Approval indicates that a toothpaste is safe and effective. We recommend that the toothpaste also say "Anti-cavity" on the label, which indicates that the FDA has confirmed that the toothpaste has fluoride present in the correct dosage. Of the toothpastes that are labelled this way, pick one that taste great to you. We want you brushing for two full minutes, and nobody wants to do that with a yucky toothpaste.

How does Fluoride work? Why is it in our water?
Fluoride is a salt that is naturally occurring in our world. It is in the soil and in the oceans. It strenthens our teeth if it is available in the right concentration. Our teeth are made of crystals called Calcium Hydroxyapatite. Our bones have the same crystal, but our teeth have more because they have to be stronger. Calcium is important for strong bones and strong teeth, and must be present in our diet to achieve this result. So we have it added to our milk, which helps make sure kids get enough calcium while their growing bones and teeth. Fluoride is needed too, but in much less concentration. We add it to our water to make sure kids get just enough to grow strong teeth. It is no coincidence that the 7 parts per million concentration of fluoride in our water supply is the same concentration in the oceans where teeth and bones first developed. Our teeth are strongest when they grow inside the jaws of a kid who gets just the right amount of fluoride.

For adults, fluoride in the water has little effect because our teeth are already grown. But for those people who get cavities, concentrated fluoride applied right to the surface of the teeth is able to rebuild and strength the surface, and therefor fight decay. Toothpaste has fluoride. Some mouthwashes have it. And for those patients who are most suseptible to decay, we offer a prescription strength fluoride at our office.