What you eat affects the air you exhale. 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 mouthmash will only mask 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 collects between the teeth, on the tongue, and around the gums can rot, leaving an unpleasant odor. 

Bad breath can also be caused by dry mouth (xerostomia), which occurs when the flow of saliva decreases. Saliva is necessary 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. 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, 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. 

Maintaining good oral health is essential to reducing bad breath. Schedule regular dental visits for a professional cleaning and checkup. If you think you have constant bad breath, keep a log of the foods you eat and make a list of medications you take. Some medications may play a role in creating mouth odors. Let your dentist know if you’ve had any surgery or illness since your last appointment. 

Brush twice a day with flouride toothpaste to remove food debris and plaque. Brush your tongue, too. Once a day, use floss or interdental cleaner to clean between teeth. 

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 mouth rinse. A flouride mouth rinse, used along with brushing and flossing, can help prevent tooth decay. 

Regular checkups will allow your dentist to detect any problems such as periodontal (gum) disease, a dry mouth or other disorder that may be the cause. Maintaining good oral hygiene, eliminating periodontal disease, and scheduling regular professional cleanings are essential to reducing bad breath. 

Regardless of what may be 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. 

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 disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only professional periodontal cleaning can remove the bacteria and plaque that accumulate. Sometimes more extensive treatment is necessary. 

If you have extensive build-up of plaque, an invisible layer of bacteria, you dentist may recommend using a special antimicrobial mouthrinse. Your dentist may also recommend that when you brush your teeth, you also brush your tongue to remove excess plaque.

People with periodontitis often have particularly active forms of bacteria in their mouth and/or have difficulty fighting off this form of infection. The inflammation from the bacteria causes the bone surrounding the teeth to be dissolved away which can cause loosening and drifting of teeth and may even lead to loss of teeth because of lack of support. The gums usually show signs of problems (e.g., gingivitis, including swelling, redness and, in addition to bleeding, there may also be pus present). This condition can be made worse by smoking and by other medical conditions such as diabetes, leukemia, and other ailments resulting in poor immune function.

Most gum and tooth problems are due to poor oral hygiene. It is essential to regularly remove the bacteria (plaque) that naturally forms on teeth to prevent gingivitis and periodontitis. Bleeding gums are not normal. The bleeding is a sign of irritation caused by bacteria. Bleeding gums need more (or better) brushing and flossing, never less. The following are warning signs that you may have periodontal disease: 

• gums that bleed easily
• red, swollen, tender gums
• gums that pull away from the teeth
• persistent bad breath or bad taste
• permanent teeth that are loose or separating
• changes in the way your teeth fit together
• changes in the fit of partial denture 

Progress of Periodontal Disease 

Healthy gingiva, periodontal ligament and bone anchor teeth firmly in place. Gingivitis develops as toxins, enzymes, and other plaque byproducts irritate the gums, making them tender and swollen and likely to bleed easily. 

Periodontitis occurs when plaque byproducts destroy the tissue that anchors the teeth and bone. As the disease progresses, pockets form, which allow more plaque to collect below the gum line. Tooth roots are easily exposed and become susceptible and sensitive to cold and touch. 

In advanced periodontitis, the teeth lose more support as the disease continues to destroy the periodontal ligament and bone. Unless treated, the affected tooth frequently becomes loose and may fall out and removal by a dentist may be required. 

A toothbrush with a small head and soft bristles will more than adequately clean your teeth without causing damage to teeth and gums. Always make sure you brush all your teeth both inside and outside to ensure thorough cleaning. 

Hold the brush with the bristles about 45 degrees to the tooth and gum and move the brush in a small circular action (concentrating on one tooth at a time). When a circular action is too difficult to manage, try using a small horizontal scrubbing action. Use firm pressure but never press too hard to not wear away the enamel. It is important to clean both teeth and the gum next to the teeth. 

Brushes can only clean some surfaces of the teeth. To clean between teeth, it is important to use floss. Flossing can be a little difficult in the beginning, but after a few weeks practice it becomes very easy. Most floss comes with instructions on the pack. It is important that the floss passes lightly below the gum line to clean out the small crevice between the tooth and the gum. Brushing and flossing will not remove good fillings. Only fillings that are in poor condition may be removed by flossing and are best replaced before any further decay has the chance to form. 

Health Care 

As with all dental conditions, your dentist should be consulted. Patients with periodontitis need special attention and will sometimes be referred for special treatment from a periodontist. Your dentist will diagnose and treat your particular problem. Periodontitis can usually be controlled, but once the bone loss has occurred, it is very difficult to ever restore it. Ask your dentist about how to brush and floss your teeth. Your dentist may recommend other oral hygiene aids such as special toothbrushes and interdental cleaning sticks (toothpicks) which are available from your pharmacist. Ask your dentist to show you how to use these. 

Diet Tips 

• Having a wholesome, balanced diet helps to promote healthy teeth and gums. It is a good idea to eat plenty of fruits and vegetables which are good sources of vitamins, minerals, and soluble fiber. 
• Food should be as fresh as possible, and it is best to eat vegetables raw or lightly steamed, if possible, to help retain the nutrient content. 
• Try not to snack between meals. Eating between meals without brushing afterwards allows plaque to build up which can result in periodontitis and gingivitis. Eating between meals becomes a habit. 
• After eating, it is important to clean your teeth to reduce the formation of bacteria which can cause periodontitis and gingivitis.
• Make sure that you clean your teeth before going to sleep. Going to bed without brushing allows plaque to grow on teeth and gums all night. 

The importance of good oral hygiene cannot be overemphasized. Having an adequate diet alone will not prevent gingivitis and periodontitis. There is no substitute for regular manual cleaning with a toothbrush, toothpaste, and floss. 

Calculus (tartar) is a hard and calcified plaque deposit on the surface of the teeth which cannot be brushed or flossed away and needs to be removed by your dentist. Calculus is always coated with a microscopic layer of plaque which may cause periodontitis. It can form underneath the gum line and needs to be carefully removed by your dentist. Due to the serious nature of this condition, your mouth should be thoroughly checked by your dentist on a regular basis. 

Current research suggests that there may be a link between periodontitis and other diseases that affect the entire body (systemic diseases). Periodontitis has been linked to cardiovascular problems, stroke, bacterial pneumonia, diabetes, and problems related to pregnancy. More research is needed to determine the direct correlation between periodontitis and systemic problems. 

There are other factors that may increase the risk of developing periodontal disease. They include: 

• smoking or chewing tobacco.
• medication such as steriods, some anti-epilepsy drugs, cancer therapy drugs, and some calcium channel blockers.
• bridges that no longer fit properly, crooked teeth or worn, loose or cracked fillings that may hold plaque in place.
• pregnancy or use of oral contraceptives.

Follow these recommendations to keep your teeth healthy: 

• brush your teeth thoroughly twice a day.
• clean between your teeth with floss or other interdental cleaner every day.
• eat a balanced diet and limit snacks.
• visit your dentist regularly for an exam and professional cleaning.
• avoid tobacco.
• smile with confidence. 

THIS IS a popular subject in cosmetic dentistry. Does Hollywood smile ring a bell? With the likes of Tyra Banks, Alyssa Millano, Julia Roberts, Cameron Diaz, Tom Cruise, Jude Law, Shania Twain, etc. The common factor among these actors and actresses is their pearly white teeth. 

There are two popular processes in obtaining this dental procedure: The chair-side whitening system (in-clinic treatment) and the at-home whitening system (at-home bleaching), which uses a thermoforming tray and a whitening gel. 

You may want to start by speaking with your dentist. He or she can tell you whether whitening procedures would be effective for you. The degree of whiteness will vary from patient to patient, depending on the structure of the teeth. Whiteners may not correct all types of discoloration.

For example, yellowish-hued teeth will probably bleach well, while brownish-colored teeth may not bleach well at all. Likewise, bleaching may not enhance your smile, if you have had bonding or tooth-colored fillings placed in your front teeth. The whitener will not affect the color of these materials and they will stand out in your newly-whitened smile. In these cases, you may want to investigate other options, like porcelain veneers or dental bonding. 

If you are a candidate for bleaching, your dentist may suggest a procedure that can be done in his or her office. This procedure is called chair-side bleaching. It is safe, effective, and fast. In less than one hour, your teeth will become dramatically whiter. 

Chairside Whitening is ideal for anyone looking for immediate results. During chairside whitening, the dentist will apply either a protective gel to your gums or a rubber shield to protect the soft oral tissues. A bleaching agent is then applied to the teeth and a special light may be used to enhance the action of the agent. Laser have been used during tooth whitening procedures to enhance the action of the whitening agent. 

At home bleaching solutions contain peroxides, which actually whiten the tooth enamel. These products usually rely on percent carbamide peroxide as the bleaching agent placed in a mouthguard or molded upper and lower tray. Usage regimens vary depending on the type of products. If you obatin the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely. You may also want to speak with your dentist should any side effects become bothersome. 

For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation either from a tray that doesn’t fit properly or from solution that may come in contact with the tisses. If you have concerns about such side effects, you should discuss them with your dentist.

WISDOM TEETH

Why wisdom teeth are sometimes removed?

Because they are far back in the mouth, wisdom teeth often are not needed for chewing and are difficult to keep clean. Your dentist may recommend the early removal of impacted wisdom teeth because waiting until you are older can increase complications.

Removal of wisdom teeth can prevent these possibilities:

• A wisdom tooth partially erupting through the gum. This creates an opening where bacteria may enter and cause infection. Pain, swelling, and jaw stiffness may result.
• An impacted wisdom tooth growing without having enough room, which may damage adjacent teeth.
• A fluid-filled sac (cyst) or tumor forming on or near an impacted tooth, destroying surrounding bone or tooth roots.
• A general dentist can perform wisdom tooth extraction. However, if your dentist anticipates a need for any special care, you may be referred to an oral and maxillofacial surgeon– a dentist who specializes in dental surgery, including the removal of impacted wisdom teeth.

What can you expect?

Before surgery, the dentist will explain what to expect and help you plan for the appointment. Advice probably will include dressing comfortably in loose clothing and perhaps arranging for someone to be with you after your dental visit.

Extractions can be performed under local anesthesia. Your dentist can discuss what types of anesthesia and pain or anxiety-reducing medication are available and suitable for you.

Following surgery, you may experience some swelling and discomfort, which is part of the normal healing process. Cold compresses can help decrease the swelling. Medication prescribed by your dentist can also help relieve discomfort. You may be instructed to drink only clear liquids after the surgery until such a time as you can comfortably begin to eat soft foods.

Some patients experience numbness or tingling in their face of jaw after the surgery. Normal sensation usually returns within a few days. A condition called “dry socket” occasionally occurs when the blood clot breaks down sooner than normal. If this happens, your dentist may place a special dressing in the tooth’s socket to protect it, as it heals.

Wisdom teeth are so called because they are the last teeth to come in, at about the time of young adulthood— presumably the age when a person gains maturity and wisdom. The majority of us have most of our permanent (adult) teeth by age 13, followed by our wisdom teeth (third molars), which usually push their way through the gums between ages 17-21. One or more of the four wisdom teeth never form in some.