Patient Education

Dental Care at Home—“The Fundamental Four”

Toothbrush
- Brush for 2 minutes, twice daily, with a soft bristled toothbrush.
- Replace your toothbrush every 3 to 4 months to avoid bacterial colonization.
- Studies have shown 8 out of 10 patients using an electric toothbrush have better dental checkups than patients using a manual toothbrush.
Toothpaste
- Colgate Total is the only over-the-counter toothpaste that kills bacteria in the mouth responsible for causing gingivitis.
- Sensodyne Pronamel and Colgate Sensitive Pro-Relief are great over-the-counter options for patients who struggle with enamel sensitivity.
- For cavity-prone patients, prescription Prevident fluoride toothpaste and fluoride-free MI Paste are products available through our office.
Floss
- Woven floss removes up to 52% more plaque than waxed floss. Reach Gum Care is designed to be gentle on gums and has fluoride to help prevent cavities.
- For patients with tight contacts, woven floss can be difficult to use. In this case we recommend Reach Total Care—“it slides like Glide” but removes up to 2x more plaque.
Mouthrinse
- Recent research suggests every patient can benefit from the daily use of an oral rinse. Using a mouthrinse helps eliminate bacteria in the mouth responsible for infection of the teeth and gums; however, not all rinses are effective. Many over-the-counter mouthrinses only temporarily freshen breath. Mouthrinse should be used to treat bacteria which are the source of bad breath. Our office recommends Oxyfresh mouthrinse—an alcohol-free mouthrinse that soothes the gums and kills bacteria in the mouth, thus freshening breath.

Your Child and The Dentist

The American Dental Association recommends a child’s first dental visit be scheduled by age one. We recommend the initial dental visit take place with a pediatric dentist as they are best equipped to treat younger children. Parents are typically encouragedto accompany their children during these initial appointments. By age 5 (or as early as age 3) some children are ready to transition to a general dental office for longer appointments and additional treatment, as needed. We are happy to aid in this transition and prepare children for dental health changes as they approach their adolescence.

According to the American Dental Hygiene Association, a good oral hygiene routine for children includes cleaning your infant’s gums after each feeding with a water-soaked cloth. By age 3, children should be taught about correct brushing technique with a pea-sized amount of toothpaste. Proper flossing technique should be introduced to children by age 8. Both brushing and flossing will help develop your child’s dexterity. Regular six month dental visits should be scheduled to check for cavities and possible developmental problems (i.e. crowded, rotated or missing teeth).

Bad Breath (Halitosis)

Whether you call it bad breath or halitosis, it’s an unpleasant condition that’s cause for embarrassment. Some people with bad breath aren’t even aware there’s a problem. If you’re concerned about bad breath, see your dentist and dental hygienist. Together they can help identify the cause and, if it’s due to an oral condition, develop a treatment plan to help eliminate it.

Common Causes of Bad Breath:

Certain foods—garlic, onion, etc.
Inadequate oral hygiene
Dry mouth (xerostomia)
Gingivitis and periodontal disease
Tobacco products
Medications
Medical disorder—respiratory/sinus infection, bronchitis, diabetes, GERD /acid reflux, etc.

Treatment Options for Bad Breath:

Diet and Nutrition counseling
Improved dental home care as advised by your dentist and dental hygienist
Alternative and/or additional dental care products—toothpastes, mouthrinses, floss, etc.
Scaling and root planing to treat periodontal disease
Tobacco cessation
Regularly scheduled professional cleanings to reduce, treat and prevent bad breath
Referral to a physician for evaluation of underlying medical condition

Dry Mouth (Xerostomia)

Many people experience the sensation of “cotton mouth” however may be unsure of the cause of this unpleasant feeling. Dry Mouth or xerostomia is a condition that affects many adults. It may seem to be a minor condition; however a dry mouth can lead to other dental problems such as cavities and bad breath. To help identify the cause of dry mouth and develop a treatment plan to help eliminate it, see your dentist or dental hygienist.

Common Causes of Dry Mouth:

Medications
Smoking
Medical disorder—Sjögren's Syndrome, eating disorders, etc.
Radiation therapy

Treatment Options for Dry Mouth:

Sip on water throughout the day
Sugar-free lozenges (containing Xylitol)
Over-the-counter Biotene products
Prescription Prevident Dry Mouth Fluoride toothpaste, MI Paste or Carifree Spray

An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have "chronic halitosis," which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.

Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.

What causes bad breath?

Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth - on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.

Gum disease is caused by plaque - the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Here are characteristic bad breath odors associated with some of these illnesses:

Diabetes - acetone, fruity

Liver failure - sweetish, musty

Acute rheumatic fever - acid, sweet

Lung abscess - foul, putrefactive

Blood dyscrasias - resembling decomposed blood

Liver cirrhosis - resembling decayed blood

Uremia - ammonia or urine

Hand-Schuller-Christian disease - fetid breath and unpleasant taste

Scurvy - foul breath from stomach inflammation

Wegner`s granulomatosis - Necrotic, putrefactive

Kidney failure - ammonia or urine

Diphtheria, dysentery, measles, pneumonia, scarlet fever, tuberculosis - extremely foul, fetid odor

Syphilis - fetid

Bad breath may also be caused by medications you are taking, including central nervous system agents, anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics, anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.

Caring for bad breath

Daily brushing and flossing, and regular professional cleanings, will normally take care of unpleasant breath. And don't forget your often overlooked tongue as a culprit for bad breath. Bacterial plaque and food debris also can accumulate on the back of the tongue. The tongue's surface is extremely rough and bacteria can accumulate easily in the cracks and crevices.

Eliminating periodontal disease and maintaining good oral health helps to reduce bad breath. If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.

Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.

If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.

Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe, including "Zytex," which is a combination of zinc chloride, thymol and eucalyptus oil that neutralizes the sulfur compounds and kills the bacteria that causes them. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the American Dental Association for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odor, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.