Q: What should I do If I have bad breath?

A: bad breath (halitosis) can be an unpleasant & 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 in due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue can reduce bad breath by as much as 70%.

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 bloodstream; 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 & improperly fitting dental appliances-may contribute to bad breath
  • Dry mouth (Xerostomia)- May be caused by certain medications, saliva gland problems, or continuous mouth breathing
  • Tobacco products- Dry mouth, causing bad breath
  • Dieting-Certain chemicals called ketones are released in the breath as the body burns fat
  • Dehydration, hunger, missed meals- Patients will be given instructions on the proper usage and answer any patients questions & concerns water and chewing foods increases saliva flow and washes bacteria away
  • Certain medical conditions & illnesses- Diabetes, liver & 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 the bad breath.  Also review your current medications, recent surgeries or illnesses with your dentist.

What can I do to prevent bad breath?

  • Practice good oral hygiene- Brush at least twice a day with a ADA approved fluoride toothpaste & toothbrush. Floss daily to remove food debris and plaque from between teeth and under the gumline.  Use a tongue scraper to clean the tongue and reach the back area.  Replace your toothbrush every 2-3 months.  If you were dentures or removable bridges, clean them thoroughly & place them back in your mouth in the morning.
  • See your dentist regularly-Get a checkup & dental hygiene appointment at least twice a tear.  If you have or 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 rises 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 & an appropriate treatment plan.

Q: How often should I brush & floss?

A: Brushing & flossing help control the plaque and bacteria that causes dental disease.

Plaque is a film of food debris, bacteria & saliva that sticks to the teeth & 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 (tarter).  If plaque & calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation & growth is continuous and can only be controlled by regular brushing, flossing and other dental aids.

Toothbrushing-Brush your teeth a least twice a day (especially before going to bed at night) with an ADA approved soft bristle 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 of the front teeth.
  • Use a tongue scraper to remove bacteria to clean & 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 & 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 & under the gumline.  Flossing not only help clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth and bone

  • Take 12-16 inches (30-40cm) 0f dental floss and wrap around tour middle & fourth fingers, leaving about 2” (5cm) of floss between the hands.
  • Using your thumbs and index finger to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C”” shape around each tooth & under the gumline.  Gently move the floss up & down, massaging the tissue & cleaning the sides if the 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 using OTC products for rinsing, it’s important to consult with your dentist or dental hygienist on its appropriateness for you.

Q: Are amalgam (Silver) filling safe?      

A: Over the years there has been some concern as to the safety of amalgam (Silver) fillings.   Amalgam is a blend of copper, silver, tin & zinc, bound by elemental mercury.  Dentist has used the blended metal to fill teeth for more than 100 years.  The controversy is due to the claims that the exposure to the vapors and minute particles from the mercury can cause health problems.

According to the American Dental Association, (ADA), up to 76% of dentist use silver containing mercury to fill teeth.  The ADA also states that silver fillings are safe and the 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 other support of 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 the components of silver fillings and this countless millions of silver fillings over the decades.

Although studies indicate that there are no measurable health risks to the 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 amalgams filling, the ADA maintains that when 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.