If you have ever had halitosis (bad breath), you know it can cause you to feel self-conscious and embarrassed. And while the odor is typically a primary concern, determining what is causing it is a task we can assist you with resolving. This is especially true when you experience bad breath outside of those times when you've just consumed pungent foods and drinks such as coffee, garlic or raw onions. For example, it is quite a different scenario to have family members, friends, co-workers or even total strangers consistently complaining or using body language to denote your bad breath. If the later best describes your situation — and be honest with yourself — then you need a thorough dental exam to discover the ultimate cause (or causes) of your halitosis. This is especially important because so many people are unaware that there can be numerous oral and/or general health concerns triggering their bad breath.

Most unpleasant mouth odors arise from the more than 600 types of bacteria found in the average mouth, with several dozens of these bacteria being the primary culprits for producing foul odors. And while food particles left between teeth can be key contributors to bad breath, the tongue or more specifically, the back of the tongue, is the most common location. Dry mouth is another cause for bad breath, as evident by the dreaded morning breath we all experience from mouth breathing as we sleep. Bad breath is also caused by certain medical conditions such as liver disease, lung infections, diabetes, kidney infections or failure and cancer.

The good news is that we can work with you to develop an effective treatment for your bad breath. And if necessary, we can work with your physician on a total treatment plan should your condition be due to health conditions outside your mouth. However, if your bad breath originates in your mouth, we may recommend any or all of the following to return your mouth to optimal oral health:

• Oral hygiene instruction to learn the proper ways to brush, floss, scrape your tongue and use mouthwashes
• Denture hygiene instruction for proper cleaning and maintenance of both full and partial dentures and bridgework
• Periodontal (gum) therapy that includes professionally cleaning your teeth (scaling), smoothing your teeth's root surfaces (root planning) and possible antibiotic therapy
• Removal of tooth decay where large, open cavities (caries) are present
• Repair of broken fillings
• Removal of wisdom teeth (third molars) with gum flaps
• Treatment of yeast infections (candidasis)

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”

Ready To Take The Next Step?

If you want to address your own concerns with bad breath, contact us today to schedule a consultation for an examination and treatment plan. You will find yourself smiling and laughing more once you are confident you have a clean, healthy mouth.

What is composite resin bonding?
This term refers to a kind of tooth-colored material that is a mixture of a plastic resin and a glass filler. The glass gives the mixture, or composite, strength and translucency that is similar to a natural tooth. The composite is bonded to the tooth by slightly abrading or roughening the tooth so that the resin fills in small cuts in the tooth surface and bonds with it. The end result functions and looks like part of the original tooth.

What is bonding used for?
This technique is a good way to restore chipped or stained teeth or to change a tooth's shape or color. It can also be used to restore parts of a tooth near the gum line where the gums have receded and left the root partially exposed.

What are the advantages of bonding?
Composite resin tooth restorations have several advantages.

• They take only a single dental visit because they are done right in the dental chair rather than having to be sent to a dental lab for preparation.
• They are less expensive than many other dental restorations.
• They leave most of the original tooth intact since little tooth preparation or drilling has to be done in order to make the composite material bond to the tooth.
• They can be made in a wide range of colors and can be matched well with the teeth around them.
• Because little of the original tooth has to be removed, they are a good choice for teens, whose dental arches (upper and lower jaws) are still developing.

What are the disadvantages of bonding?
The composite resin material is not as strong as the original tooth material, so the bonded restorations may not last over a long time. If it does last, the material may also stain as it ages.

When should you choose bonding?
Composite resin bonding is a good choice for a quick and attractive tooth restoration that may be replaced later by something more permanent, such as porcelain veneers.

Contact us today to schedule an appointment to discuss your questions about bonding. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

Dental implants are in much demand when it comes to replacing missing teeth. And although they have long-term success rates of well over 95% when properly placed, the dental profession's current rule-of-thumb is to not use them as a treatment option for teenagers because jaw and facial growth are not complete.

As with most things in life, timing can be everything. However, having missing teeth as a teen can contribute to significant loss of self-esteem and psychological issues. All this means is that we must review each patient's needs on a case-by-case basis so that we can determine the optimal time to place implants while maintaining your teen's self-esteem. However, the good news is that there are some temporary tooth replacements available until the timing is right for implants.

Unlike natural teeth, which move and change position along with normal growth and jaw development, implants don't. Because implants replace tooth roots by fusing with the jawbone, their position is fixed. If placed before normal jaw growth and maturity are complete, they appear to sink as the jaws grow and leave them behind!

Given the above details, you can clearly see why it is critical for jaw and facial growth to be complete prior to placing a dental implant. To determine this timeline, we will work with our dental team, which include orthodontists (specialist in the study of the growth, development and moving teeth into the right positions). Working together, we will best be able to assess when the time is right to plan and place dental implants — usually around late teens.

To learn more on this subject, continue reading the Dear Doctor magazine article “Teenagers & Dental Implants.” You can also contact us today to schedule an appointment for your teenager or to discuss your questions about dental implants or other treatment options.