What causes it?
Generally, bad breath is caused by fermenting food debris and saliva. However, it may also be caused by conditions such as:
- habits like smoking or drinking
- foods like garlic or onions
- ulcers
- respiratory tract infections
- cirrhosis
- sinus infections
- nasal disorders

Diagnosis:
First, see your dentist. Your dentist can assess the problem and let you know if it is related to some condition in your mouth such as gum disease, a tongue coating, leaky crowns, worn fillings, or old dentures.

3 Types of Bad Breath:

     1. Habit (smoking,drinking) and Food (garlic) Related

You are what you eat. So if you continue to smoke or eat pungent foods, your breath will remain unpleasant. This cosmetic problem can be treated by brushing your teeth, and using a mouthwash and breath mints.

     2. Mouth Condition

If you have one of the mouth problems mentioned above, your bad breath is caused by bacterial plaque that produces large amounts of sulfur compounds.

     3. Medical Condition

If your dentist determines that your mouth is healthy, you should be referred to a physician for investigation into a medically related cause.

Treatment:

If your dentist determines that your bad breath is caused by a mouth condition, you should get that condition treated. This may involve oral hygiene instruction, a professional dental cleaning, some new fillings, or prescription oral rinses.

What Are They?

They are small ulcers that affect the mucous membranes in the mouth.

What Do They Look Like?

A small, round depression 1/8" to 1/4" in diameter, with a grayish-white center surrounded by a reddened area of inflammation. Underneath the grayish-white center, the tissue is very red and raw looking.

Where Do You Get Them?

Canker sores are usually found on the inner cheeks, gums or lips, and occasionally, the tongue.

How Long Do They Last?

They usually heal without scarring in 10 - 14 days. Canker sores are likely to recur.

What Causes Canker Sores?

The exact cause is not known.

Are They Contagious?

There is no evidence that they are contagious.

Can Anyone Get Them?

Women are twice as likely to have canker sores as men. People whose parents have canker sores have a 90% chance of developing them early in life.

How Are They Treated?

Nothing will stop canker sores from occurring, but there are things that can be done to relieve the discomfort and to prevent an infection in the area during the three to four days when the sores are likely to be painful.

Keep The Area Clean

A mixtures of hydrogen peroxide diluted with water to half-strength and one teaspoon each of salt and baking soda to four ounces of water. These should be used as rinses or gargles four times a day. There are also commercial over-the-counter preparations that help relieve the pain and cleanse the area.

Avoid acidic foods that may irritate the sores.

Neither vitamins nor special foods help the condition unless a specific deficiency exists.

Avoid Stress

Do I Need To See My Dentist?

You should see your dentist for a proper diagnosis of the condition, or if the sore is very painful or present for more than two weeks.

Cancer Treatment: Effect on your Teeth

Radiation Therapy

What Are The Side Effects Of Radiation Therapy?

- Loss of Sense of Taste (due to irradiation of the taste buds. May be permanent.)
- Dry Mouth (due to irradiation of saliva glands. May be permanent.)
- Mucositis (an irritation of the lining of your cheeks and mouth)
- Infection
- Radiation Cavities
- Trismus (muscle stiffness)
- Osteoradionecrosis (dead bone)
- Soft Tissue Necrosis (dead soft tissue)

Why Should I See A Dentist Prior To Radiation Therapy?

You should see a dentist to:
make sure your radiation treatment will not be interrupted by complications
help prevent future complications with your teeth and gums
maintain existing teeth and gums so that oral function is maintained

Can I Have Regular Dental Treatment After Radiation Therapy?

Yes, you can receive regular care -- except no dental extractions should be done without consulting your radiation oncologist.

What's The Big Deal About Having Teeth Extracted?

Following radiation therapy, the blood supply to the radiated area is reduced which results in impaired healing. If a tooth is extracted following radiation therapy, there is a chance of osteoradionecrosis. This means that instead of the bone healing normally at the extraction site, bits of bone may die due to the reduction in blood supply and impaired wound healing.

What If A Tooth Must Be Extracted?

If a tooth extraction is required, contact your radiation oncologist or the dental department at the hospital where you received your radiation treatment. They can arrange for the treatment to be accomplished with the least possible chance of complications.

Chemotherapy

Oral Hygiene during chemotherapy for cancer is very important to ease the side effects of this therapy. All oral health procedures must be done dependant upon your blood counts.

What Are The Dental Side Effects Of Chemotherapy?

Bleeding
Mucositis
Infection
Dry Mouth

What Dental Treatment Should Be Done Before Chemotherapy?

The goal is to minimize the risk of infection or trauma. This can be done by providing:

Dental Hygiene Services
Extractions as necessary
Fillings as necessary
Impressions For Mucosal Guards

What Is A Mucosal Guard?

This is an oral appliance made of a soft plastic material. It fits over your teeth and prevents your tongue and cheeks form being irritated by the teeth. Ulcerations in the mouth are common during some types of chemotherapy and can be prevented or minimized with the use of mucosal guards.

Can Dental Treatment Be Done During Chemotherapy?

Elective procedures should be deferred once chemotherapy has begun. If treatment is necessary to eliminate infection or trauma, limited treatment may be done during the first four to five days of chemotherapy. After this point, the blood values are depressed and treatment is not possible until the blood values have recovered.

Changing Your Smile or Cosmetic Dentistry

Improving Your Smile

Modern dental techniques and procedures can change and improve the appearance of almost anyone. An improved smile may augment self-esteem and self-confidence. A wide range of problem smiles can be treated -- from yellow teeth to small teeth, from a gummy smile to crooked teeth. There are many new and surprisingly inexpensive techniques to improve your smile, including one or more of the following ...

Bleaching:

This can be done either in the dentist's office or at home. These days, most people prefer home bleaching because of its low cost and convenience. Your dentist makes custom-fitted bleaching trays, gives you instructions and bleaching solution, and the rest is up to you. The bleach is applied for a few hours a day for a few weeks, until you are happy with the color of your teeth. After that, you may need to touch things up every month to maintain the color.

Microabrasion:

This technique is good for superficial tooth stains. A small amount of tooth structure is worn away, thereby removing the stain.

Bonding:

This refers to the use of a plastic material called composite resin. The resin comes in many shades and can be used to build teeth up, fix cracked or chipped teeth, and mask stains or crooked teeth.

Veneers:

These are custom made porcelain shells and are bonded to the front surface of your teeth to make them look straighter, whiter, longer, wider -- whatever you want. This treatment is done in two visits.

Orthodontics:

Corrects crooked or crowded teeth or bite problems in children and adults.

Crowns:

These are usually done if your teeth are very discolored, poorly shaped, weak, or have large fillings. Numerous materials can be used to make a crown, although for aesthetics, porcelain or ceramic crowns are best. Usually, two visits are required for a crown. At the first visit, the dentist prepares your tooth for a crown or cap by reducing the outer portion of your tooth to accommodate the crown. An impression is then taken so a dental lab can make your crown. At the second visit, the crown is cemented into place.

Gum Surgery:

Sometimes people think they show too much gum when they smile, or they believe that their teeth are too short. In certain cases, gum surgery will be used along with one of the other cosmetic procedures above to achieve the desired result.

Crowns And Bridges:

When you look in your mouth, most of the tooth structure you see is called enamel. This material is from 1 - 1.5 mm thick and covers the softer interior of the tooth, the dentin. Enamel is the hardest material in the body and protects the tooth.

A Dental Crown or Cap

The portion of the tooth in your mouth is called the crown of the tooth. If part of the crown of your tooth has been destroyed by cavities or is broken or defective in another way, it may need a dental crown or cap. The tooth is trimmed so that the cap can be placed over the tooth like a hat on your head. The cap is cemented in place and replaces the natural enamel crown of your tooth.

A Bridge

If you are missing one or more teeth, a bridge may be used to fill the space. Teeth on either side of the space are trimmed like they are for a cap or crown. A bridge is then made and cemented into place.

Dentures

What are they?

Dentures are removable oral appliances that replace teeth. There are two classifications of dentures:
full dentures (replace all teeth)
partial dentures (replace some teeth)

What Do They Do?

Dentures replace your natural teeth and provide support for your lips and face.

What Are They Made Of?

They are usually made of a plastic type of material that is flesh colored so it looks like your own teeth and gums.

How Long Does It Take To Make Dentures?

Techniques vary, but usually four appointments will be required.

How Long Do They Last?

Full dentures can last for many, many years. Over time, your gums that support the dentures will shrink and the dentures will become loose. When this happens, you may need a reline for a better fit.

What Is A Reline?

A procedure where new material is added to the side of the denture that rests on your gums. This new material lines the underside of your denture so that it better conforms to your gums.

Partial Dentures

What Do They Do?

They replace missing teeth and anchor on to the remaining teeth you have.

What Are They Made Of?

There are two types of partial dentures commonly made:

     1) Cast Partial

This has a metal framework, pink acrylic is later added along with teeth. This partial denture fits better but is more expensive.

     2) Acrylic Partial

This partial denture is made of a type of plastic called denture acrylic. This does not fit as well as a Cast Partial, but it is significantly less expensive.

How Long Does It Take To Make Partial Dentures?

Techniques vary, but usually four appointments are required.

How Long Do They Last?

Partial dentures can last for many, many years. Periodically adjustments may be required if the dentures feel loose. Even if you lose a tooth, a partial denture can often be 'repaired' by adding another false tooth to the denture.

The major cause of dry mouth is prescription drugs. In fact, over 500 medications list dry mouth as a possible side effect.

What Else Can Cause Dry Mouth?

Dry mouth can also be a result of age, caffeine, alcohol, diabetes, leukemia, Sjogrens Syndrome, head and neck radiation and salivary gland diseases.

Is Dry Mouth Serious?

It can be serious depending on the severity of dry mouth. A dry mouth can alter taste, cause bad breath, lead to increased cavities and gum disease, make dentures less stable, and cause the tissues in your mouth to become red,inflamed and sore, making them more susceptible to infection.

What Can I Do to Prevent Problems?

talk to your physician to see if a medication can be changed.
increase fluid intake.
use a saliva stimulant such as a lozenge.
brush and floss regularly.
use a fluoride mouth rinse.
see your dentist regularly so problems can be diagnosed early.

Bruxism - Grinding Your Teeth

What Causes It?

A number of factors are thought to play a role in grinding your teeth (bruxism), such as stress, malocclusion, and sleep disorders. However, no definitive cause of bruxism has been identified.

Is It Common?

Yes, one quarter to one third of the population grind their teeth.

What are the signs of Grinding/Bruxism?

abnormal tooth wear
headaches
sensitive teeth
loose teeth

How Is It Treated?

The most effective treatment for Bruxism is a night guard. A night guard is a plastic appliance that fits comfortably over your teeth and is worn at night. It protects the surfaces of your teeth so that if you grind you will not wear your teeth down.

What Is It?

It is a disease of the supporting structures of the teeth. Gum disease involves the inflammation of the gums (gingivitis) and the degeneration of the bone structure around your teeth. Gum disease progresses slowly and is generally not painful.

Signs And Symptoms Of Gum Disease

bleeding gums
red gums
discharge from the gums
foul odor
loose teeth
receded gums

Treatment

Varies with the severity of the disease. For early gum disease all you may need is a thorough dental cleaning. If the disease is more advanced, one or more of the following may be necessary:
scaling and root planing (thorough dental cleaning)
gum surgery
medicated oral rinse
antibiotics
extraction of teeth

Dental Implants

What Are They?
Implants consist of a metal screw that is inserted into the jaw. Part of the implant protrudes through the gums and is used to retain some type of prostheses or artificial tooth. Implants can be used to replace a single tooth, a few teeth or a whole mouth full of teeth. Implants can also be used to retain dentures and even hearing aids, although you wouldn't see your dentist for that.

How Long Does It Take?

From start to finish the process can take up to one year. The implants are surgically placed in your jaw and it is very important that enough time is allowed for healing so that the implants can integrate with the bone of your jaw.

How Is It Done?

The procedure will vary depending on how many teeth are being replaced and what type of implants you have placed. The basic steps are as follows:

Step 1:  Using regular dental freezing, an incision is made in your gums. A special drill is used to prepare your jaw bone for the implant. The metal screws or implants are then placed in your jaw bone and a cover screw is placed on the implant. Your gums are then stitched back together and allowed to heal. It takes 3-6 months for the bone to heal and integrate with the implant.

Step 2:  Using regular dental freezing an incision is again made in your gums. The top of the implant is exposed and the cover screw is removed. A second stage is screwed on to the implant in your jaw bone. This second stage extends from the level of your jaw bone through your gums and is visible in your mouth.

Step 3:  When your gums have healed after the second stage surgery, impressions are made and your artificial tooth or bridge is fabricated and attached to the implant.

What Is It?

A word describing the procedures used in dental offices to sterilize and disinfect instruments, countertops, and materials in order to kill bacteria and viruses.

Is My Dentist's Office Safe?

Every dental office should be safe and practice Universal Precautions. This means that your dentist uses the same protective measures with every patient to prevent contamination by bacteria or viruses. If you have any concerns about the safety of your dentist's office, ask him what his infection control procedures are. He should be happy to reassure you.

What Are Universal Precautions?

These are procedures that are used after every patient seen by a dentist, to prevent the transmission of any infectious diseases. These procedures include:

wearing gloves, mask and glasses.
changing gloves for every patient.
sterilizing dental instruments after each use.
cleaning and disinfecting all surfaces in the treatment room.
using barrier techniques, such as rubber dam.
the use of many single use disposable items i.e. scalpel blades, needles, masks, gloves.

Can I Get AIDS At The Dentist?

Universal precautions were designed to protect you from getting any infectious diseases from the dental environment. To date, there are no documented cases of patients getting AIDS from a visit to the dentist. There are also no documented cases of dentists getting AIDS from treating infected patients.

There are generally two causes:

     1) Irritated Tooth Nerve

The symptoms of this are sensitivity to hot or cold that is very intense and prolonged. You may need a root canal. (see our section on Root Canals)

     2) Exposed Tooth Roots

This is the most common cause of sensitive teeth. The symptoms of this are sensitivity to hot or cold that is of a mild to moderate intensity, which goes away seconds after the stimulus.

How Does It Happen?

Roots are exposed when gums recede. The main reason that gums recede is that you brush your teeth too hard.

What's The Big Deal About Exposed Roots?

The roots of your teeth have tiny openings on their surface that lead down tiny tubes to the nerve of your tooth. (It's true, I'm not making this up) It is these tiny openings that are responsible for tooth sensitivity.

What Can I Do About It?

There are two ways to deal with this problem:

     1) Prevent Gum Recession

This can be accomplished by using a soft bristled brush and proper brushing technique. Ask your dentist to show you how.

     2) Cover The Openings on the root surface

Use a sensitive tooth toothpaste such as Sensodyne. These cause the crystallization of minerals in your saliva which clog the tiny openings on the surface of the root. Your dentist has various materials that can either be applied to the tooth to clog the openings on the root, or can be bonded to the tooth much like a white filling to clog the openings