Q. How does one get bad breath?
Answer. Certain foods, such as garlic and onions, contribute to objectionable breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is expelled. Brushing, flossing and mouthwash will only hide the odor temporarily. Odors continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating. If you don't brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that remains between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Dentures that are not cleaned properly can also harbor odor-causing bacteria and food particles. Bad breath is also caused by "dry mouth", which occurs when there is a decrease in the flow of saliva. Saliva is important to cleanse the mouth and remove particles that may cause odor. Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth. If you suffer from dry mouth, your dentist may prescribe an artificial saliva, or suggest using sugarless candy and increasing your fluid intake. Tobacco products cause bad breath, stain teeth, reduce one's ability to taste foods and irritate gum tissues. Tobacco users are more likely to suffer from periodontal disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit. Bad breath may be the sign of a medical disorder, such as a local infection in the respiratory tract (nose throat, windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath. Brush twice a day with a fluoride toothpaste to remove food debris and plaque. Don't forget to brush your tongue! Once a day, use floss or an interdental cleaner to clean between teeth. If you wear removable dentures, take them out at night. Clean them thoroughly before replacing them the next morning. Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odor, see your dentist. If you need extra help in controlling plaque, your dentist may recommend using a special antimicrobial mouthrinse. A fluoride mouthrinse, used along with brushing and flossing, can help prevent tooth decay.
Q. Is there anything I can do about bad breath?
Answer. Regular checkups will allow your dentist to detect any problems such as periodontal (gum) disease, a dry mouth or other disorders that may be the cause. Maintaining good oral hygiene, eliminating periodontal (gum) disease and scheduling regular professional cleanings are essential to reducing bad breath. Regardless of the cause, good oral hygiene is essential. Brush twice a day and clean between your teeth daily with floss or interdental cleaners. Brush your tongue, too. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning.
Q. What is the treatment for bad breath?
Answer. If your dentist determines that your mouth is healthy and that the odor is not of oral origin, you may be referred to your family physician or to a specialist to determine the cause of the odor and for treatment. Of course, if the odor is of oral origin, as it is in the majority of cases, your dentist can treat the cause of the problem. If the odor is due to periodontal (gum) disease, your general dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Periodontal (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. If you have extensive build-up of plaque your dentist may recommend using a special antimicrobial mouth rinse.
Cleaning your teeth & gums:
Q.What is plaque?
Answer. Many of the foods you eat cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, are not the only culprits. Starches, such as bread, crackers, and cereal, also cause acids to form. After many acid attacks, your teeth may decay. Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. Eventually, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, periodontal (gum) disease is a main cause of tooth loss in adults. One way to prevent tooth decay and periodontal (gum) disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.
Q. Any tips for daily oral care?
Answer. The ideal way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice a day. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily. Use toothpaste that contains fluoride, which helps protect your teeth from decay. Cleaning between the teeth once a day with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can't reach. This is essential in preventing periodontal (gum) disease.
Q. How do I floss my teeth?
- Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers.
- Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
- When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
- Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
- Repeat this method on the rest of your teeth.
- Don't forget the back side of your last tooth.
Dental emergency tips:
Q. Bitten lip or tongue?
Answer. Clean the area gently with a cloth and apply cold compresses to reduce any swelling. If the bleeding doesn't stop, go to a hospital emergency room immediately
Q. Broken tooth?
Answer. Rinse your mouth with warm water to clean the area. Apply cold compresses on the area to keep any swelling down. Call your dentist immediately.
Q. Jaw possibly broken?
Answer. Apply cold compresses to control swelling. Go to your dentist or a hospital emergency department immediately.
Q. Knocked-out tooth?
Answer. Hold the tooth by the crown and rinse off the root of the tooth in water if it's dirty. Do not scrub it or remove any attached tissue fragments. If possible, gently insert and hold the tooth in its socket. If that isn't possible, put the tooth in a cup of milk and get to the dentist as quickly as possible. Remember to take the tooth with you!
Q. Objects caught between teeth?
Answer. Try to carefully remove the object with dental floss; avoid cutting the gums. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can?t dislodge the object using dental floss, contact your dentist.
Answer. Rinse your mouth with warm water to clean it out. Gently use dental floss or an interdental cleaner to ensure that there is no food or other debris caught between the teeth. Never put aspirin or any other painkiller against the gums near the aching tooth because it may burn the gum tissue. If the pain persists, contact your dentist.
Q. How can a sealant help prevent decay?
Answer. A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth- premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids. Thorough brushing and flossing helps to remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants can help protect these vulnerable areas by "sealing out" plaque and food.
Q. Is sealant application complicated?
Answer. Sealants are easy for your dentist to apply, and it takes only a few minutes to seal each tooth. First, the teeth that will be sealed are cleaned. Then the chewing surfaces are roughened with an acid solution to help the sealant adhere to the tooth. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
Q. Sealants are just for kids, right?
Answer. The likelihood of developing pit and fissure decay begins early in life, so children and teenagers are definite candidates. But adults can benefit from sealants as well. Key ingredients in preventing tooth decay and maintaining a healthy mouth are twice-daily brushing with a fluoride toothpaste; cleaning between the teeth daily with floss or interdental cleaners; eating a balanced diet and limiting snacks; and visiting your dentist regularly. Ask your dentist about whether sealants can put extra power behind your prevention program.
Diet & oral health:
Q. How can tooth decay result from food?
Answer. When you eat, food passes through your mouth. Here it meets the bacteria that live in your mouth. These bacteria love sugars found in many foods. When you don't clean your teeth after eating, plaque bacteria use the sugar to produce acids that can destroy the hard surface of the tooth, called enamel. Eventually, tooth decay occurs. The more frequently you eat and the longer foods are in your mouth, the more damage occurs.
Q. How do I choose foods wisely?
Answer. The key to choosing foods wisely is not to avoid these foods, but to think before you eat. Not only what you eat but when you eat makes a big difference in your dental health. Eat a balanced diet and limit between-meal snacks.
Q. What are tips for better dental health?
Answer. 1. To get a balanced diet, eat a variety of foods. Choose foods from each of the five major food groups:
- breads, cereals and other grain products
- meat, poultry and fish
- milk, cheese and yogurt
2. Limit the number of snacks that you consume. Every time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.
3. If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit.
4. Foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, which helps wash foods from the mouth and helps lessen the effects of acids.
5. Brush twice a day with a fluoride toothpaste.
6. Clean between your teeth daily with floss or interdental cleaners.
7. Visit your dentist regularly. Your dentist can help prevent problems from occurring and catch those that do occur while they are easy to treat.
Periodontal (gum) disease:
Q. What is periodontal (gum) disease?
Answer. Periodontal (gum) disease is an infection of the tissues supporting the teeth. It is a major cause of tooth loss in adults. Because periodontal (gum) disease is usually painless, however, you may not know you have it. Periodontal (gum) disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums. In the early stage of periodontal (gum) disease, called gingivitis, the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing. In the more advanced stages of periodontal (gum) disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be removed by a dentist.
Q. Are there signs of periodontal (gum) disease?
Answer. If you notice any of the following signs of periodontal (gum) disease, see your dentist immediately:
- gums that bleed when you brush your teeth
- red, swollen or tender gums
- gums that have pulled away from the teeth
- bad breath that doesn't go away
- pus between your teeth and gums
- loose teeth
- a change in the way your teeth fit together when you bite
- a change in the fit of partial dentures
Q. Can I prevent periodontal (gum) disease?
Answer. You can help prevent periodontal (gum) disease by taking good care of your teeth every day and having regular dental checkups. Here's how to keep your teeth and gums healthy: Brush your teeth well twice a day. This removes the film of bacteria from the teeth. Toothpastes and mouth rinses containing fluoride strengthen the teeth and help prevent decay. Clean between your teeth every day. Cleaning between your teeth with floss or interdental cleaners removes bacteria and food particles from between the teeth, where a toothbrush can't reach. Early periodontal (gum) disease can often be reversed by daily brushing and flossing. If you use interdental cleaners, ask your dentist how to use them properly, to avoid injuring your gums. Eat a balanced diet. Choose a variety of foods from the basic food groups, such as breads, cereals and other grain products; fruits; vegetables; meat, poultry and fish; and dairy products, such as milk, cheese and yogurt. Limit between-meal snacks. Visit your dentist regularly. It is important to have regular dental checkups, and professional cleaning is essential to prevent periodontal diseases.
Q. How can one get a dry mouth?
Answer. Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics. Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive cavities can form. Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.
Q. What is dry socket?
Answer. Dry socket (alveolar osteitis) is a condition that sometimes occurs after a tooth is extracted when a clot doesn?t form properly or is removed and bone is exposed. When the socket is slow to heal, the condition can be very painful for three to five days or so. The dentist's treatment may include cleaning the site and placing a medicated dressing in the socket, which helps provide relief of pain. The dentist may change the dressing daily until the pain diminishes and the socket begins to heal. The dentist may recommend a nonsteroidal anti-inflammatory drug, such as aspirin or ibuprofen, or prescribe other pain relievers. Cigarette smoking or other tobacco use can delay healing and should be avoided.
Q. Can you explain the phenomenon of facial pain?
Answer. Some common symptoms include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth, or even headaches and neck aches. Two joints and several jaw muscles make it possible to open and close the mouth. They work together when you chew, speak, and swallow. These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ's. The TM joint is located on each side of the head. These joints work together and can make many different movements, including a combination of rotating and translocational (gliding) action, used when chewing and speaking. Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side. Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.
Q. How can I tell where the source of the facial pain is coming from?
Answer. A dentist can help identify the source of the pain with a thorough exam and appropriate x-rays. Often, it's a sinus, toothache or an early stage of periodontal disease. But for some pain, the cause is not so easily diagnosed. The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear. Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding. Several conditions may be related to TMD, but they can be quite varied, and they are often difficult to pinpoint. TM disorders can result when the jaw muscles or jaw joints are affected. The joint, ligaments, and muscles used for chewing and grinding food may all be involved. In some cases, it is not possible to clearly determine the causes. Some TM problems result from arthritis, dislocation, and injury. All of these conditions can cause pain and dysfunction. Muscles that move the joints are also subject to injury and disease. Injuries to the jaw, head or neck, and diseases such as arthritis, might result in some TM problems. Other factors that relate to the way the teeth fit together- the bite- may cause some types of TMD. Stress is thought to be a factor. TMD affects women of childbearing age more than men, or older men and women. Diagnosis is an important step before treatment. Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving. Your dentist may take x-rays and may make a "cast" of your teeth to see how your bite fits together. Your dentist may also request specialized x-rays for the TM joints. Depending on your case, the dentist may refer you to a physician or another dentist.
Q. How can I have a tooth replaced other than a bridge?
Answer. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits.
Q. What are the steps involved in placing implants?
Answer. First, surgery is performed to place the anchor. Surgery can take up to two hours, and up to four to five months may be required for the bone to grow around the anchor and firmly hold it in place. Some implants require a second minor surgery in which a post is attached to connect the anchor to the replacement teeth. With other implants, the anchor and post are already attached and are placed at the same time. After the gums have had several weeks to heal, the next step is begun. The artificial teeth are made and fitted to the post portion of the anchor.
Q. Who is a candidate for getting a mouth protector?
Answer. Anyone who participates in a sport that carries a significant risk of injury should wear a mouth protector. This includes a wide range of sports like football, hockey, basketball, baseball, gymnastics, and volleyball. Mouth protectors, which typically cover the upper teeth, can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft tissues of the mouth.
Q. What are the advantages of using a mouth protector?
Answer. A mouth protector can help cushion a blow to the face that otherwise might result in an injury to the mouth. A misdirected elbow in a one-on-one basketball game or a spill off a bicycle can leave you with chipped or broken teeth, nerve damage to a tooth or even tooth loss. A mouth protector can limit the risk of such injuries as well as protect the soft tissues of your tongue, lips and cheek lining.
Q. Is it possible to use a mouth protector with braces?
Answer. A properly fitted mouth protector may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouth protector also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries. Talk to your dentist or orthodontist about selecting a mouth protector that will provide the best protection. Although mouth protectors typically only cover the upper teeth, your dentist or orthodontist may suggest that you use a mouth protector on the lower teeth if you have braces on these teeth too. If you have a retainer or other removable appliance, do not wear it during any contact sports.
Q.What is plaque?
Answer. Your teeth are covered with a sticky film of bacteria called plaque. Bacteria release acids that attack tooth enamel following a meal or snack. Repeated attacks can cause the enamel to break down, eventually resulting in cavities. Plaque that is not removed with thorough daily brushing and cleaning between teeth can eventually harden into calculus or tartar. Brushing and cleaning between teeth become more difficult when tartar collects above the gum line. The gum tissue can become swollen or may bleed. This is called gingivitis, the early stage of periodontal (gum) disease.
- Brush your teeth twice a day with fluoride toothpaste.
- Clean between teeth daily with floss or an interdental cleaner.
- Eat a balanced diet and limit between-meal snacks.
- Visit your dentist regularly for professional cleanings and oral exams.
- Ask your dentist about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.
Q. Is there a connection between my diet, pregnancy and my oral health?
Answer. Eating a balanced diet is necessary to provide the correct amounts of nutrients to nourish both you and your child. What you eat during the nine months of pregnancy affects the development of your unborn child -- including teeth. Your baby's teeth begin to develop between the third and sixth month of pregnancy, so it is important that you receive sufficient amounts of nutrients- especially calcium, protein, phosphorous, and vitamins A, C, and D.
Q. Does a woman lose calcium from her teeth during pregnancy?
Answer. It is a myth that calcium is lost from the mother's teeth during pregnancy. The calcium your baby needs is provided by your diet, not by your teeth. If dietary calcium is inadequate, however, your body will provide this mineral from stores in your bones. An adequate intake of dairy products "the primary source of calcium" or the supplements your obstetrician may recommend will help ensure that you get all the calcium you need during your pregnancy.
Q. Is a dental radiograph examination safe when I'm pregnant?
Answer. A radiograph may be needed for dental treatment or a dental emergency that can't wait until after the baby is born. Untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Radiation from dental X-rays is extremely low. However, every precaution is taken to minimize radiation exposure. A leaded apron minimizes exposure to the abdomen and should be used when any dental radiograph is taken. A leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children. Dental radiographs are not contraindicated if one is trying to become pregnant or is breast feeding.
Q. Are my gums affected during pregnancy?
Answer. During pregnancy, your body's hormone levels rise considerably. Gingivitis may cause red, puffy or tender gums that tend to bleed when you brush. This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone in your system. Your dentist may recommend more frequent cleanings during your second trimester or early third trimester to help you avoid problems.
Q. What are pregnancy tumors?
Answer. Occasionally overgrowths of gum tissue, called pregnancy tumors, appear on the gums during the second trimester. These localized growths or swellings are usually found between the teeth and are believed to be related to excess plaque. They bleed easily and are characterized by a red, raw-looking mulberry-like surface. They are often surgically removed after the baby is born. If you experience pregnancy tumors, see your dentist.
Q. What can I do to keep my mouth healthy during pregnancy?
Answer. To help prevent tooth decay and periodontal disease, brush your teeth thoroughly twice a day with a fluoride toothpaste to remove plaque. Be sure to clean between your teeth daily with floss or interdental cleaners. Ask your dentist or hygienist to show you how to brush and floss correctly.
Q. How do dental X-rays work?
Answer. When X-rays pass through your mouth during a dental exam, more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums) before striking the film. This creates an image called a radiograph. Teeth appear lighter because fewer X-rays penetrate to reach the film. Tooth decay, infections and signs of gum disease, including changes in the bone and ligaments holding teeth in place, appear darker because of more X-ray penetration. Dental restorations (fillings, crowns) may appear lighter or darker, depending on the type of material used for the restoration. The interpretation of these radiographs allows the dentist to safely and accurately detect hidden abnormalities.
Q. How often should radiographs be taken?
Answer. How often X-rays (radiographs) should be taken depends on the patient's individual health needs. It is important to recognize that just as each patient is different form the next, so should the scheduling of X-ray exams be individualized for each patient. Your dentist will review your history, examine your mouth and then decide whether you need radiographs and what type. If you are a new patient, the dentist may recommend radiographs to determine the present status of the hidden areas of your mouth and to help analyze changes that may occur later. If you have had recent radiographs at your previous dentist, your new dentist may ask you to have the radiographs forwarded. The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, or to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.
Q. What are the benefits of a dental radiograph examination?
Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth. An X-ray examination may reveal:
- small areas of decay between the teeth or below existing restorations (fillings);
- infections in the bone;
- periodontal (gum) disease;
- abscesses or cysts;
- developmental abnormalities;
- some types of tumors. Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. It can detect damage to oral structures not visible during a regular exam. If you have a hidden tumor, radiographs may even help save your life.
To learn more about our advanced dental care services or to schedule an appointment, please call our office staff in Worcester, MA at (508) 757-0591 or use our online appointment request form to schedule an appointment. For additional information on any condition, treatment or procedure, visit our Dental Education Library.