Bad breath? Break free -- and how to tell a friend By Danielle Dellorto, CNNFebruary 14, 2011 10:00 a.m. EST
(CNN) -- Ida Alvarez avoided close conversations. She was afraid of what someone might tell her. She was pretty sure she had really bad breath.
"It is such an embarrassing situation," Alvarez, 31, of Los Angeles told CNN. "There was always a bitter taste in my mouth, but I didn't want to ask anyone if my breath smelled bad because I was afraid of a negative reply."
Her keep-a-distance approach might be a good strategy given most of our natural reaction to bad breath, known medically as halitosis. It can wilt your love life, and even cost you that new job, according to surveys.
However, the 90 million Americans who suffer from bad breath -- and the innocent bystanders -- will be glad to know that the unwanted odor is easier to get rid of than you might think.
Do you have it?
The first thing to do is determine if your breath is fresh or foul. Most people with stinky breath aren't even aware they have it, because the brain becomes acclimated to one's own personal scent. The good news is there are ways to self-diagnose.
Start with a tongue check. What color is it? A pink, shiny tongue indicates fresh breath. However, a tongue that's white and scaly in appearance can indicate bad breath, according to Dr. Harold Katz, bacteriologist and founder of the California Breath Clinic.
Smelling your own breath in cupped hands is not the best way to check for halitosis, Katz says. Instead, lick the back of your hand, let it dry for a few seconds, and then smell the surface.
Alvarez's fears of bad breath had her so self-conscious she avoided kissing her significant other. "I would brush my teeth but was still worried he'd think I was gross."
It's important to remember that bad breath is typically not a sign of bad dental hygiene. "It usually has nothing to do with teeth," Katz says. "You can have good teeth, rotten teeth or no teeth at all and still have bad breath. It has to do with the tongue."
Think of your tongue as a shaggy carpet and your mouth as a mobile chemistry lab. More than 600 types of bacteria are found in the average mouth. Many of those bacteria get trapped under the surface of the tongue and cause the bad breath.
How to fight it
Fighting the smelly bacteria is like preparing for battle.
Stay hydrated. A dry mouth is a breeding ground for offensive-smelling bacteria on your tongue.
"Saliva has oxygen in it, which makes it a natural enemy for the foul-smelling bacteria," Katz says. "They can't live in the presence of oxygen, so drinking water and chewing sugar-free gum can produce saliva and naturally get rid of bad breath."
Popping a sugar-free mint or using mouthwash aren't bad ideas, but they're only temporary fixes. They mask the smell but won't kill the bacteria that cause the odor.
And watching what you eat doesn't just apply to your waistline. Some foods can trigger bad breath. If you're worried, limit consumption of foods like garlic, onions, curry, and fish. Acidic beverages like beer, wine, coffee and soda can also be a trigger. They all contain foul-odor-releasing compounds that get absorbed into your bloodstream. The odor is given off in your breath until all of the food is out of your body. Limit chocolate candy and sweets, as well. The sugar helps bacteria to reproduce in your mouth, leading to bad breath.
On the flip side, there are foods that fix bad breath, Katz says.
Green tea has anti-bacterial properties that knock out the stink. Cinnamon contains essential oils that kill many types of oral bacteria. Try adding fresh cinnamon to your morning toast or oatmeal, or adding a stick to flavor your tea.
Eating crisp fruits and vegetables, such as celery or apples, offers dual bad-breath-busting benefits. Chewing them will produce more saliva in your mouth, and the firm texture will also help scrub away bacteria, according to Katz. Melons and berries also help.
"I tell my patients to load up on berries, melons, oranges, and other foods high in Vitamin C, because they help kill smelly bacteria naturally," Katz says.
If you modify your lifestyle and eating habits yet bad breath persists, contact your health care provider to make sure it isn't a sign of a more serious medical condition. Roughly 10% of bad breath cases are a symptom of chronic sinus or respiratory infection, reflux disease, liver and kidney disorder, cancer or diabetes. These diseases can release chemicals into the body that result in bad breath.
How to break bad breath news
Don't forget that most people can't smell their own breath. So if you detect a friend's bad breath, you should speak up.
Granted, telling a a close colleague, friend or lover that his or her breath is offensive can be awkward for everybody involved. But it is the right thing to do. After all, if you were the one with stinky breath, wouldn't you want to know?
"My mom was the one who finally told me my breath smelled bad. She couldn't hold back," Alvarez says. "It embarrassed me at first, but I'm happy she said something, because now I watch what I eat, drink more water and use products to get rid of it."
Patricia Napier-Fitzpatrick, founder of The Etiquette School of New York, acknowledges the delicacy of the issue, but says speaking up is all part of having good manners. "If people are talking about them behind their back, it turns into a worse situation. If you respect the person, it's your duty to tell them."
There are two possible approaches, according to Fitzpatrick.
Sit down with your friend in a private setting and be direct. Begin the conversation by telling them you believe there is something they would want to know and that you aren't sure they are aware of the problem.
Or, if you know the person is sensitive, you may need to be more cautious about your approach. Delicately bring up the issue by carrying mints with you. Take one yourself first and then offer one to your friend who has bad breath. If the person doesn't accept, Fitzpatrick says it is acceptable to offer a nudge by simply saying, "I think you should."
First impressions, professional and personally, are long-lasting. So don't let bad breath wilt your image. In most cases, taking simple steps to control the chemistry lab living inside your mouth will keep you smelling fresh.
Wednesday, February 16, 2011
Thursday, January 27, 2011
Your 2011 Dental Questions...
10 Oral Health Questions—Answered partner
by Woman's Day, on Tue Jan 11, 2011 3:13pm PST 315 Keep
your pearly whites in peak condition for better overall wellness
By Sarah-Reistad-Long
Your teeth can reveal a lot about your overall wellness—research has linked poor oral health to conditions like diabetes, cancer, heart disease, stroke and autoimmune disorders. The issue is twofold. If you already have one of these conditions, some signs may show up in your mouth: People with uncontrolled diabetes, for example, are more likely to have gum disease, cavities and oral infections. On the flip side, gum disease can increase your risk of developing health issues in the first place. That’s because the bad bacteria in your mouth (a cause of inflammation) can actually make their way into the rest of the body, causing other areas to become inflamed.
“The cardiovascular connection is known to be especially strong,” says New York City–based periodontist James Jacobs, DMD. For example, one British study showed that people who brush infrequently were 70 percent more likely to suffer from heart disease than those who brush twice a day.
Maybe you’re thinking, I brush. I floss—at least sometimes. Isn’t that enough? Probably not, considering that a whopping 85 percent of American adults suffer from gum disease, according to the U.S. Surgeon General. But it’s not too late to reform your ways. Here, we address your top concerns so you can keep your pearly whites in peak condition. Your good health depends on it.
Is there a right way to brush?
Yes! Grip your toothbrush at a 45-degree angle to the gumline, so it’s slightly pointing up, and apply gentle pressure as you use a combo of back-and-forth and up-and-down strokes, says Santa Monica–based dentist Nushin Shir, DDS. Make sure you brush each tooth all over, as well as the gumline. And don’t rush! A thorough brushing lasts about 2 minutes, so aim to spend about 30 seconds on each quarter of your mouth.
Are electric toothbrushes better than manual ones?
Most dentists think so, even though studies are mixed. If you use them the right way, they prevent you from brushing too hard (which can wear away the enamel, the outer protective layer of the tooth, and make gums bleed) or, more important, not long enough (most have a built-in timer that beeps when 2 minutes are up). They’re also thorough. “Some electric toothbrushes go as fast as 40,000 strokes per second. You just can’t do that manually,” says Jeffrey Golub-Evans, DDS, founder of the New York Center for Cosmetic Dentistry and a past president of the American Academy of Cosmetic Dentistry. The downside: Some can cost more than $100, though it’s possible to find them for as low as $30.
For a less expensive option, consider a batteryoperated brush. They may lack some bells and whistles, but whether you choose a brush that uses replaceable batteries or you opt for the disposable variety, they should still work well. Catrise Austin, DDS, author of 5 Steps to the Hollywood A-List Smile, likes the disposable Oral-B Pulsar 3D White Advanced Vivid Toothbrush, which is only $3.49. If you prefer to stick with a manual, that’s fine—just make sure that it’s labeled soft, since harder brushes can wear down the enamel and cause tooth sensitivity. Remember to replace your brush (or change the head) every three months.
What’s the best type of floss?
Whatever kind you’ll actually use (waxed or unwaxed)—studies show they work equally well. The key is to floss every day. In fact, dentists wish you’d do it twice a day—it’s the only way to remove all the food and plaque (a film that harbors bacteria) that gets stuck between your teeth, says Dr. Austin. Plaque ups the risk of tooth decay and gum disease, which makes you more likely to have bleeding gums and even lose some teeth as you get older. But if you’re only going to floss once a day, do it at night (so you don’t sleep with food particles in your mouth).
How can I get rid of bad breath?
Two words: tongue scraper. Researchers from the University of Sao Paulo in Brazil found that using one improved bad breath as much as 75 percent by removing the bacteria and residue that builds up on your tongue.
Other possible halitosis culprits include heartburn or acid reflux (chewing sugar-free gum after a meal can help) and gum disease, which can cause your gums to recede and bacteria to get stuck. If you have persistent bad breath that doesn’t get better when you use a tongue scraper or chew gum, see your dentist or a periodontist. If the problem turns out to be gum disease, you may need a series of deep cleanings (generally done with local anesthesia) to remove bacteria and diseased tissue.
As I’m getting older, it seems as if more food is getting stuck between my teeth. Am I imagining this?
Not at all. The enamel wears down with age, so your teeth get a little smaller and the spaces between them get slightly wider, which means food gets trapped more easily. Eroding enamel can also make your teeth more sensitive. If you have extensive damage to your enamel (you may notice darker, more yellow spots on your teeth), bonding can help, says Emanuel Layliev, DDS, president of the New York Academy of Cosmetic Dentistry. It entails having your dentist apply a toothcolored plastic filling to the front and back of teeth. The cost can add up (about $150 to $300 per tooth), though insurance often covers at least a portion of it when bonding is done to repair damage (as opposed to for purely cosmetic reasons).
Can I tell if I have a cavity?
Sometimes. The tipoffs: pain or sensitivity in just one area, or a brownish stain on the top of the tooth, says Dr. Shir. Bad breath can also be a sign; a decaying tooth can be a breeding ground for bacteria. But of course, the only way to know for sure is to see your dentist.
Do I really need to go to the dentist twice a year?
Absolutely! Waiting too long between visits means more scraping, because plaque that sits on your teeth for a while hardens and turns into tartar (also called calculus). Going twice a year also gives your dentist a chance to catch a cavity early, when it’s just forming. In that case, you might not even need any filling or drilling; you may simply be sent home with a fluoride treatment to redeposit some of the minerals that have worn away, says Dr. Jacobs. Wait too long, however, and the cavity will progress and can infect a nearby nerve, which means you could end up needing a costly root canal. Frequent visits also mean more opportunity for your dentist to spot signs of an illness that’s affecting your whole body.
What is the best drugstore teeth-whitening option?
Whitening strips, such as Crest Whitestrips, says Dr. Golub-Evans. “They deliver a premeasured, evenly distributed amount of hydrogen peroxide to your teeth. Results build over prolonged use, so I’d recommend the 2- to 3-week ones over the stronger 4- to 7-day option.” Spreading it out also results in less sensitivity. You won’t get as powerful a result as you would from a professional whitening treatment, but they can definitely give you a subtle lift that lasts for 6 months.
Whitening kits that use trays (a tray with a gel mixture goes on your upper teeth and another goes on the lower ones) are also effective, but they tend to be messier, harder to use and can irritate your gums (unless you get custom-fit ones from your dentist). If you go this route, make sure to get one that doesn’t require you to measure and distribute the bleach yourself, because it’s too difficult to do it evenly.
I’ve seen laser whitening treatments being offered in spas and malls. Are they safe?
Maybe—but only if a dental professional (such as a dentist or dental hygienist) is administering them. “I once met a banker who was performing these whitenings for extra income!” says Dr. Austin. The problem: An untrained person could end up damaging your teeth, and many people are selling products that haven’t been proven safe or effective. In fact, states including Tennessee and Alabama have recently banned teeth-whitening kiosks that aren’t operated by dentists.
If you do opt for laser whitening (ideally at a dentist’s office), here’s how it works: A highly concentrated hydrogen peroxide formula will be spread over your teeth. You’ll then sit in front of a laser or other activating light designed to help the formula penetrate, and walk out of the office about an hour later with a whiter smile. Dentist-approved treatments including Zoom! and BriteSmile are safe, but some people experience pain and sensitivity during or after the process. Recently, some dentists have started offering a laser-free option called Opalescence. It involves using a higher concentration of hydrogen peroxide, but it also has fluoride to help reduce sensitivity. Expect a professional whitening treatment to cost between $250 and $600 and for the effects to last for one to five years, depending on your habits. Photo: Shutterstock
Head overseas to save on dental work? Maybe
Dental insurance—if you have it—often isn’t very comprehensive. Paying out of pocket or subsidizing a skimpy policy may be fine when it comes to routine cleanings, but if you need substantial work done, it can end up setting you back thousands of dollars. Because of this, a small but growing number of people are jumping on the medical tourism bandwagon. Statistics are hard to come by, but at the last official count (in 2006), about 200,000 Americans were traveling abroad for dental work alone. The top destinations in recent years: Mexico, India, Costa Rica and Hungary (the latter has a high number of well-trained dental professionals per capita, which has driven down costs). The savings are often considerable.
In the best-case scenario, you’ll see a dentist with good credentials (some have even been trained in the U.S.) and maybe do a little sightseeing, says Neilesh Patel, DDS, CEO/ founder of HealthCare Tourism International, a nonprofit medical tourism website that connects patients with safe, accredited international providers. On the other hand, you’re dealing with different standards of care and sanitary practices, and you’re doing it far from home (even if things go well, follow-ups or unforeseen emergencies can pose a tricky problem). From sorting through language barriers to determining which foreign seals of approval are actually credible, it can take a whole lot of work to make sure your practitioner is up to par. “Of the dental work I’ve seen from Mexico, I would say that the majority of cases would not meet the U.S. standard of care,” says Dr. Patel. “It’s important to do your homework.”
If you’re still up to the challenge, start by looking for professionals that are endorsed on a reputable site. Some are: Dr. Patel’s HealthCare Tourism International ( HealthCareTrip.org); the International Association for Medical Assistance to Travellers ( IAMAT.org), a site recommended by the American Dental Association; or Medical Tourism International ( MediTourInternational.com), a for-profit organization made up of international hospitals, doctors, and other healthcare providers that are screened and inspected to ensure that they adhere to a strict set of standards. Once you’ve narrowed down your options, the ADA suggests reviewing the educational information at The Organization for Safety, Asepsis and Prevention’s website ( OSAP.org; click on “resources” and then “travel”).
Lastly, if you’re very concerned about having all your i’s dotted and t’s crossed, you may want to consider booking through a medical tourism travel agency. Planet Hospital ( PlanetHospital.com), a California-based company, is generally considered to be the most reputable.
Original article appeared on WomansDay.com.
by Woman's Day, on Tue Jan 11, 2011 3:13pm PST 315 Keep
your pearly whites in peak condition for better overall wellness
By Sarah-Reistad-Long
Your teeth can reveal a lot about your overall wellness—research has linked poor oral health to conditions like diabetes, cancer, heart disease, stroke and autoimmune disorders. The issue is twofold. If you already have one of these conditions, some signs may show up in your mouth: People with uncontrolled diabetes, for example, are more likely to have gum disease, cavities and oral infections. On the flip side, gum disease can increase your risk of developing health issues in the first place. That’s because the bad bacteria in your mouth (a cause of inflammation) can actually make their way into the rest of the body, causing other areas to become inflamed.
“The cardiovascular connection is known to be especially strong,” says New York City–based periodontist James Jacobs, DMD. For example, one British study showed that people who brush infrequently were 70 percent more likely to suffer from heart disease than those who brush twice a day.
Maybe you’re thinking, I brush. I floss—at least sometimes. Isn’t that enough? Probably not, considering that a whopping 85 percent of American adults suffer from gum disease, according to the U.S. Surgeon General. But it’s not too late to reform your ways. Here, we address your top concerns so you can keep your pearly whites in peak condition. Your good health depends on it.
Is there a right way to brush?
Yes! Grip your toothbrush at a 45-degree angle to the gumline, so it’s slightly pointing up, and apply gentle pressure as you use a combo of back-and-forth and up-and-down strokes, says Santa Monica–based dentist Nushin Shir, DDS. Make sure you brush each tooth all over, as well as the gumline. And don’t rush! A thorough brushing lasts about 2 minutes, so aim to spend about 30 seconds on each quarter of your mouth.
Are electric toothbrushes better than manual ones?
Most dentists think so, even though studies are mixed. If you use them the right way, they prevent you from brushing too hard (which can wear away the enamel, the outer protective layer of the tooth, and make gums bleed) or, more important, not long enough (most have a built-in timer that beeps when 2 minutes are up). They’re also thorough. “Some electric toothbrushes go as fast as 40,000 strokes per second. You just can’t do that manually,” says Jeffrey Golub-Evans, DDS, founder of the New York Center for Cosmetic Dentistry and a past president of the American Academy of Cosmetic Dentistry. The downside: Some can cost more than $100, though it’s possible to find them for as low as $30.
For a less expensive option, consider a batteryoperated brush. They may lack some bells and whistles, but whether you choose a brush that uses replaceable batteries or you opt for the disposable variety, they should still work well. Catrise Austin, DDS, author of 5 Steps to the Hollywood A-List Smile, likes the disposable Oral-B Pulsar 3D White Advanced Vivid Toothbrush, which is only $3.49. If you prefer to stick with a manual, that’s fine—just make sure that it’s labeled soft, since harder brushes can wear down the enamel and cause tooth sensitivity. Remember to replace your brush (or change the head) every three months.
What’s the best type of floss?
Whatever kind you’ll actually use (waxed or unwaxed)—studies show they work equally well. The key is to floss every day. In fact, dentists wish you’d do it twice a day—it’s the only way to remove all the food and plaque (a film that harbors bacteria) that gets stuck between your teeth, says Dr. Austin. Plaque ups the risk of tooth decay and gum disease, which makes you more likely to have bleeding gums and even lose some teeth as you get older. But if you’re only going to floss once a day, do it at night (so you don’t sleep with food particles in your mouth).
How can I get rid of bad breath?
Two words: tongue scraper. Researchers from the University of Sao Paulo in Brazil found that using one improved bad breath as much as 75 percent by removing the bacteria and residue that builds up on your tongue.
Other possible halitosis culprits include heartburn or acid reflux (chewing sugar-free gum after a meal can help) and gum disease, which can cause your gums to recede and bacteria to get stuck. If you have persistent bad breath that doesn’t get better when you use a tongue scraper or chew gum, see your dentist or a periodontist. If the problem turns out to be gum disease, you may need a series of deep cleanings (generally done with local anesthesia) to remove bacteria and diseased tissue.
As I’m getting older, it seems as if more food is getting stuck between my teeth. Am I imagining this?
Not at all. The enamel wears down with age, so your teeth get a little smaller and the spaces between them get slightly wider, which means food gets trapped more easily. Eroding enamel can also make your teeth more sensitive. If you have extensive damage to your enamel (you may notice darker, more yellow spots on your teeth), bonding can help, says Emanuel Layliev, DDS, president of the New York Academy of Cosmetic Dentistry. It entails having your dentist apply a toothcolored plastic filling to the front and back of teeth. The cost can add up (about $150 to $300 per tooth), though insurance often covers at least a portion of it when bonding is done to repair damage (as opposed to for purely cosmetic reasons).
Can I tell if I have a cavity?
Sometimes. The tipoffs: pain or sensitivity in just one area, or a brownish stain on the top of the tooth, says Dr. Shir. Bad breath can also be a sign; a decaying tooth can be a breeding ground for bacteria. But of course, the only way to know for sure is to see your dentist.
Do I really need to go to the dentist twice a year?
Absolutely! Waiting too long between visits means more scraping, because plaque that sits on your teeth for a while hardens and turns into tartar (also called calculus). Going twice a year also gives your dentist a chance to catch a cavity early, when it’s just forming. In that case, you might not even need any filling or drilling; you may simply be sent home with a fluoride treatment to redeposit some of the minerals that have worn away, says Dr. Jacobs. Wait too long, however, and the cavity will progress and can infect a nearby nerve, which means you could end up needing a costly root canal. Frequent visits also mean more opportunity for your dentist to spot signs of an illness that’s affecting your whole body.
What is the best drugstore teeth-whitening option?
Whitening strips, such as Crest Whitestrips, says Dr. Golub-Evans. “They deliver a premeasured, evenly distributed amount of hydrogen peroxide to your teeth. Results build over prolonged use, so I’d recommend the 2- to 3-week ones over the stronger 4- to 7-day option.” Spreading it out also results in less sensitivity. You won’t get as powerful a result as you would from a professional whitening treatment, but they can definitely give you a subtle lift that lasts for 6 months.
Whitening kits that use trays (a tray with a gel mixture goes on your upper teeth and another goes on the lower ones) are also effective, but they tend to be messier, harder to use and can irritate your gums (unless you get custom-fit ones from your dentist). If you go this route, make sure to get one that doesn’t require you to measure and distribute the bleach yourself, because it’s too difficult to do it evenly.
I’ve seen laser whitening treatments being offered in spas and malls. Are they safe?
Maybe—but only if a dental professional (such as a dentist or dental hygienist) is administering them. “I once met a banker who was performing these whitenings for extra income!” says Dr. Austin. The problem: An untrained person could end up damaging your teeth, and many people are selling products that haven’t been proven safe or effective. In fact, states including Tennessee and Alabama have recently banned teeth-whitening kiosks that aren’t operated by dentists.
If you do opt for laser whitening (ideally at a dentist’s office), here’s how it works: A highly concentrated hydrogen peroxide formula will be spread over your teeth. You’ll then sit in front of a laser or other activating light designed to help the formula penetrate, and walk out of the office about an hour later with a whiter smile. Dentist-approved treatments including Zoom! and BriteSmile are safe, but some people experience pain and sensitivity during or after the process. Recently, some dentists have started offering a laser-free option called Opalescence. It involves using a higher concentration of hydrogen peroxide, but it also has fluoride to help reduce sensitivity. Expect a professional whitening treatment to cost between $250 and $600 and for the effects to last for one to five years, depending on your habits. Photo: Shutterstock
Head overseas to save on dental work? Maybe
Dental insurance—if you have it—often isn’t very comprehensive. Paying out of pocket or subsidizing a skimpy policy may be fine when it comes to routine cleanings, but if you need substantial work done, it can end up setting you back thousands of dollars. Because of this, a small but growing number of people are jumping on the medical tourism bandwagon. Statistics are hard to come by, but at the last official count (in 2006), about 200,000 Americans were traveling abroad for dental work alone. The top destinations in recent years: Mexico, India, Costa Rica and Hungary (the latter has a high number of well-trained dental professionals per capita, which has driven down costs). The savings are often considerable.
In the best-case scenario, you’ll see a dentist with good credentials (some have even been trained in the U.S.) and maybe do a little sightseeing, says Neilesh Patel, DDS, CEO/ founder of HealthCare Tourism International, a nonprofit medical tourism website that connects patients with safe, accredited international providers. On the other hand, you’re dealing with different standards of care and sanitary practices, and you’re doing it far from home (even if things go well, follow-ups or unforeseen emergencies can pose a tricky problem). From sorting through language barriers to determining which foreign seals of approval are actually credible, it can take a whole lot of work to make sure your practitioner is up to par. “Of the dental work I’ve seen from Mexico, I would say that the majority of cases would not meet the U.S. standard of care,” says Dr. Patel. “It’s important to do your homework.”
If you’re still up to the challenge, start by looking for professionals that are endorsed on a reputable site. Some are: Dr. Patel’s HealthCare Tourism International ( HealthCareTrip.org); the International Association for Medical Assistance to Travellers ( IAMAT.org), a site recommended by the American Dental Association; or Medical Tourism International ( MediTourInternational.com), a for-profit organization made up of international hospitals, doctors, and other healthcare providers that are screened and inspected to ensure that they adhere to a strict set of standards. Once you’ve narrowed down your options, the ADA suggests reviewing the educational information at The Organization for Safety, Asepsis and Prevention’s website ( OSAP.org; click on “resources” and then “travel”).
Lastly, if you’re very concerned about having all your i’s dotted and t’s crossed, you may want to consider booking through a medical tourism travel agency. Planet Hospital ( PlanetHospital.com), a California-based company, is generally considered to be the most reputable.
Original article appeared on WomansDay.com.
Wednesday, January 5, 2011
Tooth Erosion due to Acidic Foods
According to research done by GlaxoSmithKline, 50% of U.S. dental professionals report seeing an increase in acid erosion compared to 5 years ago. Signs of acid erosion include changing of shape and loss of contour of the tooth, surfaces that lack shine and look dull, loss of surface ridges or texture, transparency, and a dull yellow appearance. In more advanced stages of acid erosion a total loss of the biting edges of the teeth can occur due to the brittleness and lack of enamel. People that suffer from acid erosion are susceptible to cavities, cracks, and loss of teeth.
Foods that are acidic can lead to tooth erosion. Please refer to the chart below for a list of the acidity levels of some foods and drinks. For reference a pH of about 7 is neutral and a pH of 1 is very acidic. (click on chart to enlarge)
Dr. Jason McCargar, a dentist in Scottsdale, Arizona says that "the pH of the food or liquid is not the sole indicator of how damaging it can be to your teeth. For example, soda is acidic and can cause acid erosion to the teeth. But, drinking the soda through a straw and limiting how frequently you drink soda can drastically decrease your chances of having tooth erosion and tooth decay."
Tuesday, January 4, 2011
Your Guide to Fluoride
Fluoride is used to prevent cavities. It was originally thought that fluoride worked to decrease cavities solely by making the enamel stronger. However, new studies have determined that fluoride also helps in re-mineralization (a process of rebuilding the tooth after damage) and fighting bacteria. The use of fluoride has substantially declined the rate of cavities.
When children receive an adequate level of fluoride the enamel of the teeth is found to have a formation of fluorapatite crystals that are smaller and stronger and more resistant to breakdown. Fluoride can also act in a process called bacterial inhibition to stop the production of cavities by interfering with cavity-forming bacteria found in plaque.
Fluoride can be found in many sources. Fluoride is intentionally added to toothpaste, some mouth rinses, fluoridated water, and fluoride supplements. It is found naturally in some well water, in some brewed tea, in some bottled water, and some fish. (Products made from or that come from naturally fluoridated water.)
Fluoride was first introduced into the water supply intentionally to help prevent cavities in the 1940s. Communities in Arizona that have chosen to adjust the fluoride level in their drinking water include but are not limited to: Bisbee, Chandler, Gilbert, Phoenix, Tempe, Glendale, El Mirage, Mesa, and Yuma.
Fluoride levels can fluctuate, but are strictly controlled by the local water treatment plant. “The best source of information on fluoride levels in your water system is your local water utility. All water utilities must provide their consumers with a Consumer Confidence Report that provides information on a system’s water quality, including its fluoridation level. The state drinking water administrator or state oral health program also should be able to help you identify the fluoride level of your drinking water. Optimal fluoride levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates to 1.2 ppm for cooler climates to account for the tendency for people to drink more water in warmer climates.”(2)
For example, The City of Chandler strives to maintain fluoride levels at the Sewage Waste Treatment Plant between 0.7 & 1.0 PPM, which is the level recommended by the National Public Service, EPA and the American Dental Association. Ground water does not receive additional fluoride, however, the natural occurring fluoride averages 0.9 PPM. (2) Furthermore, the city of Scottsdale does not add fluoride to the drinking water. However, Scottsdale water sources contain low levels of naturally-occurring fluoride ranging from 0.3 to 1.0pp.(3)
Data obtained from 1992 to 2004 shows the naturally occurring level of fluoride in Maricopa county. It is broken down in this chart based on the water system. As you can see the levels naturally occurring are higher than the recommended levels by the ADA and the EPA. In cases such as this, as a public health measure, the excess fluoride would be removed during processing.
(4)http://www.fluoridealert.org/pesticides/levels/arizona.html
The Environmental Protection Agency has set a maximum level of 4 mg/L fluoride for human consumption. Levels above this can cause fluorosis. The symptoms of mild fluorosis include white mottled areas of enamel due to hypomineralization which can cause a cosmetic concern. More severe fluorosis can result in pitted and malformed areas of enamel and brittle enamel. Fluorosis does not occur in adults because it must occur during pre-eruptive enamel maturation (development of the adult tooth before it erupts from the gum tissue); ingestion of excess fluoride after this developmental phase cannot result in fluorosis. Generally most children have developed all their adult teeth by the age of 8 and therefore, it is very unlikely to see fluorosis in someone older than this age.
In contrast, Reverse osmosis typically removes at least 80% of most constituents, including fluoride. However, you may want to contact the manufacturer of the reverse osmosis device to determine the removal rate for your system. It is possible that if you have fluoridated water and use a reverse osmosis system in your home, then you are not getting adequate levels of fluoride.
If the water supply does not provide adequate fluoride, then supplementation can help to decrease the risk of developing cavities. For children under 16 years of age, chewing or sucking fluoride tablets and lozenges prior to swallowing will maximize the effect of these supplements by providing an additional topical effect before being absorbed systemically. Current recommendations from the American Academy of Pediatric Dentistry, ADA, and American Academy of Pediatrics are to start fluoride supplements, if required, at 6 months of age because prior to that most infants do not have teeth.
The selection, use, and frequency of various types of fluoride treatments for an individual patient are based on his or her risk level, ADA recommendations, patient age, product efficacy, clinical support, safety, ease of use, and patient preference. Your dentist can provide an in-office fluoride treatment in the form of a varnish, gel, foam or rinse. The concentration of in-office fluoride treatments is significantly higher than at-home treatments. The use of at-home fluoride treatments include toothpastes/ gels, and rinses. At home dentifrice (for example: a toothpaste such as colgate or crest) twice daily provides a regular supply of fluoride that results in the presence of low levels of fluoride intra-orally on the teeth and soft tissues. (5) Dr. McCargar, a dentist in Scottsdale, Arizona states that at-home fluoride treatments are most effective if the patient does not swish with water after using. "Many people after brushing rinse their mouth with water, this washes away the fluoride treatment. An extensive number of clinical trials have demonstrated a significant reduction in cavities if people use the fluoride treatments as directed."
(1) http://apps.nccd.cdc.gov/MWF/Index.asp
(2) http://www.chandleraz.gov/default.aspx?pageid=458
(3)http://www.scottsdaleaz.gov/Water/quality/Drinking/FAQ.asp
(4)http://www.fluoridealert.org/pesticides/levels/arizona.html
(5) Twetman S. Caries prevention with fluoride toothpaste in children: an update. Eur Arch Paediatr Dent. 2009 Sep; 10(3):162-67
When children receive an adequate level of fluoride the enamel of the teeth is found to have a formation of fluorapatite crystals that are smaller and stronger and more resistant to breakdown. Fluoride can also act in a process called bacterial inhibition to stop the production of cavities by interfering with cavity-forming bacteria found in plaque.
Fluoride can be found in many sources. Fluoride is intentionally added to toothpaste, some mouth rinses, fluoridated water, and fluoride supplements. It is found naturally in some well water, in some brewed tea, in some bottled water, and some fish. (Products made from or that come from naturally fluoridated water.)
Fluoride was first introduced into the water supply intentionally to help prevent cavities in the 1940s. Communities in Arizona that have chosen to adjust the fluoride level in their drinking water include but are not limited to: Bisbee, Chandler, Gilbert, Phoenix, Tempe, Glendale, El Mirage, Mesa, and Yuma.
Fluoride levels can fluctuate, but are strictly controlled by the local water treatment plant. “The best source of information on fluoride levels in your water system is your local water utility. All water utilities must provide their consumers with a Consumer Confidence Report that provides information on a system’s water quality, including its fluoridation level. The state drinking water administrator or state oral health program also should be able to help you identify the fluoride level of your drinking water. Optimal fluoride levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates to 1.2 ppm for cooler climates to account for the tendency for people to drink more water in warmer climates.”(2)
For example, The City of Chandler strives to maintain fluoride levels at the Sewage Waste Treatment Plant between 0.7 & 1.0 PPM, which is the level recommended by the National Public Service, EPA and the American Dental Association. Ground water does not receive additional fluoride, however, the natural occurring fluoride averages 0.9 PPM. (2) Furthermore, the city of Scottsdale does not add fluoride to the drinking water. However, Scottsdale water sources contain low levels of naturally-occurring fluoride ranging from 0.3 to 1.0pp.(3)
Data obtained from 1992 to 2004 shows the naturally occurring level of fluoride in Maricopa county. It is broken down in this chart based on the water system. As you can see the levels naturally occurring are higher than the recommended levels by the ADA and the EPA. In cases such as this, as a public health measure, the excess fluoride would be removed during processing.
(4)http://www.fluoridealert.org/pesticides/levels/arizona.html
The Environmental Protection Agency has set a maximum level of 4 mg/L fluoride for human consumption. Levels above this can cause fluorosis. The symptoms of mild fluorosis include white mottled areas of enamel due to hypomineralization which can cause a cosmetic concern. More severe fluorosis can result in pitted and malformed areas of enamel and brittle enamel. Fluorosis does not occur in adults because it must occur during pre-eruptive enamel maturation (development of the adult tooth before it erupts from the gum tissue); ingestion of excess fluoride after this developmental phase cannot result in fluorosis. Generally most children have developed all their adult teeth by the age of 8 and therefore, it is very unlikely to see fluorosis in someone older than this age.
In contrast, Reverse osmosis typically removes at least 80% of most constituents, including fluoride. However, you may want to contact the manufacturer of the reverse osmosis device to determine the removal rate for your system. It is possible that if you have fluoridated water and use a reverse osmosis system in your home, then you are not getting adequate levels of fluoride.
If the water supply does not provide adequate fluoride, then supplementation can help to decrease the risk of developing cavities. For children under 16 years of age, chewing or sucking fluoride tablets and lozenges prior to swallowing will maximize the effect of these supplements by providing an additional topical effect before being absorbed systemically. Current recommendations from the American Academy of Pediatric Dentistry, ADA, and American Academy of Pediatrics are to start fluoride supplements, if required, at 6 months of age because prior to that most infants do not have teeth.
The selection, use, and frequency of various types of fluoride treatments for an individual patient are based on his or her risk level, ADA recommendations, patient age, product efficacy, clinical support, safety, ease of use, and patient preference. Your dentist can provide an in-office fluoride treatment in the form of a varnish, gel, foam or rinse. The concentration of in-office fluoride treatments is significantly higher than at-home treatments. The use of at-home fluoride treatments include toothpastes/ gels, and rinses. At home dentifrice (for example: a toothpaste such as colgate or crest) twice daily provides a regular supply of fluoride that results in the presence of low levels of fluoride intra-orally on the teeth and soft tissues. (5) Dr. McCargar, a dentist in Scottsdale, Arizona states that at-home fluoride treatments are most effective if the patient does not swish with water after using. "Many people after brushing rinse their mouth with water, this washes away the fluoride treatment. An extensive number of clinical trials have demonstrated a significant reduction in cavities if people use the fluoride treatments as directed."
(1) http://apps.nccd.cdc.gov/MWF/Index.asp
(2) http://www.chandleraz.gov/default.aspx?pageid=458
(3)http://www.scottsdaleaz.gov/Water/quality/Drinking/FAQ.asp
(4)http://www.fluoridealert.org/pesticides/levels/arizona.html
(5) Twetman S. Caries prevention with fluoride toothpaste in children: an update. Eur Arch Paediatr Dent. 2009 Sep; 10(3):162-67
Wednesday, December 8, 2010
Thursday, December 2, 2010
Taking care of your teeth during pregnancy
It is very important to take care of your teeth and your gums during pregnancy. The hormones that are helping your baby grow can sometimes cause havoc for your teeth. Watch this video from WebMD... http://www.webmd.com/video/eddleman-dental-hygiene-during-pregnancy
Friday, November 12, 2010
The truth about that sneeze thanks to Mythbusters on the Discovery Channel
You are on an elevator and the person next to you sneezes. If they cover the sneeze with their hand, then there is no way you will get sick, right? Wrong!! Check out this amazing video on Mythbusters by the Discovery Channel. http://dsc.discovery.com/videos/mythbusters-flu-fiction/ It compares covering a sneeze with a hand, a handkerchief, or an elbow. It is amazing to find out the results. Watch for yourself to help protect the people around you this flu season.
Tuesday, October 26, 2010
Do you have the smile of Scottsdale?
Do you have the Smile of Scottsdale? At Scottsdale Dental Arts, Dr. McCargar and his staff are providing a free smile makeover. Tell us why you should be chosen to have the smile of Scottsdale in 250 words or less. How would improving your smile improve your life? Entry details and competition rules available at: www.ScottsdaleDentalArts.com
Complete Smile Makeover courtesy of Scottsdale Dental Arts and Kierland Smile Design.
Ask the Dentist about Dry Mouth
How do I treat this dry mouth?
The first step in treating dry mouth is determining the cause. Are you taking any of the following medications? Tricyclics, SSRIs, clonidine, antihistamines, oxybutynin, or any other anticholinergics? If you answered yes, then discuss with the doctor that prescribed the medicine if it is possible for you to stop the medicine, switch to another, or possibly lower the dose. (Please note we do not recommend you stop any medication without your doctor's permission.) If you answered that you do not use the above medications, then do you use caffeine, or tobacco, or drink alcohol? If you answer yes, then start decreasing the amount that you use. If you use tobacco there are solutions for breaking that bad habit. If you still answered no to the above, then other culprits can be poor diabetes control, cancer radiation, or an autoimmune disease called Sjogren's syndrome.
The second step is finding a treatment that helps. Swishing water in the mouth frequently and using a humidifier at night is a great place to start. Sugarless hard candy or gum can also help to stimulate saliva. (Check the ingredients and choose sugar-free candy containing xylitol which studies show may actually help to prevent cavities). These stimulants will only work if your salivary glands are working properly. If they are not working properly, then you will need to use a saliva substitute, such as Biotene Gel, or Mouth Kote.
Monday, October 18, 2010
"Treat" your teeth this Halloween
Halloween is around the corner, which for most children means bags of free candy and a chance to build up the stockpile of sweets for the winter. Being one of the most fun times of the year for families, Halloween can also present parents with a variety of health and safety challenges.
The American Dental Association, America's premier source of oral health information, has prepared a list of 10 suggestions to help parents maintain good oral health for their children around the Halloween holiday and throughout the year.
1. Consume Halloween candy and other sugary foods with meals.
Saliva production increases during meals and helps neutralize acids produced by bacteria in your mouth and helps rinse away food particles.
2. Avoid hard candy and other sweets that stay in your mouth for a long time.
Besides how often you snack, the length of time food is in your mouth plays a role in tooth decay. Unless it is a sugar-free product, candies that stay in the mouth for a long period of time subject teeth to prolonged acid attack, increasing the risk for tooth decay.
3. Avoid sticky candies that cling to your teeth.
The stickier candies, like taffy and gummy bears, take longer to get washed away by saliva, increasing the risk for tooth decay.
4. Drink more water.
Consuming optimally fluoridated water can help prevent tooth decay. If you choose bottled water, check the label for the fluoride content.
5. Maintain a healthy diet and make sure the meals you eat are nutritious.
Your body is like a complex machine. The foods you choose as fuel and how often you "fill up" affect your general health and that of your teeth and gums.
6. Avoid beverages with added sugar such as soda, sports drinks or flavored waters.
When teeth come in frequent contact with beverages that contain sugar, the risk of tooth decay is increased.
7. Chew gum that has the ADA Seal.
Chewing sugarless gum for 20 minutes after meals has been shown to reduce tooth decay, because increased saliva flow helps wash out food and neutralize the acid produced by dental plaque bacteria.
8. Brush your teeth twice a day with an ADA-accepted fluoride toothpaste.
Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won't do a good job of cleaning your teeth.
9. Clean between teeth daily with floss or an interdental cleaner.
Decay-causing bacteria still linger between teeth where toothbrush bristles can't reach. Flossing helps remove plaque and food particles from between the teeth and under the gum line.
10. Visit an ADA-member dentist for more information on maintaining your oral health. Dr. Jason McCargar is an ADA-member dentist in Scottsdale, Arizona.
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