What can I do about bad breath?
If you feel constantly worried about bad breath, you’re not alone. Bad breath (halitosis) is an all too common problem, not to mention embarrassing and distracting for you and others around you. Deducing what is most likely causing your bad breath will help determine what you can do to prevent it.
Greatly reduced saliva flow during sleep (the cause of morning breath), certain foods (such as garlic, onions, and peppers), poor oral hygiene, periodontal (gum) disease, dry mouth, tobacco, dieting, dehydration, and some medical conditions (including sinus infections and diabetes) can all cause bad breath. Brushing your teeth at least twice a day (in the morning and at night) is the first thing to start doing, if you are not already in the habit. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of your teeth. Additionally, clean between your teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning. Toothbrushes should be replaced every couple months.
Biannual dental cleanings and checkups at our office will not only keep your teeth and gums in good shape, but seeing you regularly will also allow us to better detect any problems, such as gum disease, dry mouth (Xerostomia), or other dental conditions (like decay), that may be the cause of persistent bad breath. If you have gum disease, more frequent visits to our office might be recommended for your oral and overall health.
Breaking a tobacco habit (smoking or chewing tobacco) can significantly improve your oral health and the way your breath smells. Ask us about ways we suggest to help break a tobacco habit. Drinking plenty of water and eating healthy also keeps your mouth moist and more free of bad bacteria. Mouth rinses can help, too, but ask us which rinses actually kill the germs that cause bad breath, because some only mask odor as a temporary solution.
When bad breath is a symptom of a larger bacterial problem in your mouth, Dr. Wang can help. If he finds that your mouth is healthy, we may refer you to your physician for further consultation and more comprehensive treatment.
Should I replace my silver (amalgam) fillings with composite fillings?
Silver (amalgam) has been something of the “gold standard” of dental fillings for years, but recently, composite fillings have become a popular method. Dentists and patients have plenty of reasons to prefer composite fillings, but before you surrender your silver, consider some facts about fillings.
Silver fillings are durable, lasting on average at least 10 to 20 years, and they are very strong, making them ideal for use in the large back molars. They also tend to be less expensive than composite fillings, but usually require more invasive preparations. The biggest drawback to silver fillings is aesthetic, as they can cast a gray hue over the surface of a tooth. Silver fillings have gotten a bad reputation because of their mercury content, but the FDA and the ADA agree that there’s no proof that the compound has any adverse side effects. In fact, the mercury in amalgam fillings is only one component of a chemically stable alloy. Silver fillings have been used in dentistry for hundreds of years, and allergic reactions are rare.
Composite fillings, made out of a mixture of glass and quartz materials, provide a tooth-colored restoration that looks more like your natural tooth. Composite materials are also versatile and can be bonded (held adhesively) to teeth, which calls for less invasive preparation and leaves more healthy tooth structure beneath the filling. Compared to amalgam, composite fillings are slightly less durable and are better suited for teeth with light or moderate bite pressure, and they can take longer to place. Depending on your dentist and your insurance options, composite fillings can cost a bit more than amalgam.
Unless your dentist notices cracks or damages in your current fillings or expresses other concerns regarding your dental health, replacing silver fillings is a matter of personal preference.
If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling?
Constant pressure from chewing, grinding and/or clenching can cause dental fillings to wear away, chip, and even crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.
When restorations are large, or if recurrent decay is extensive, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we may need to replace the filling with a natural looking porcelain crown.
How can I tell if I’m at risk for gum disease?
According to MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, about 80 percent of U.S. adults currently have some form of gum disease, ranging from gingivitis to serious periodontal disease. The prevalence of gum disease increases with age, because as we age, our teeth wear down, our gums naturally recede, teeth can become more sensitive, and medications can affect some oral changes. If your gums feel tender or sore, or if they look red and swollen, you may be at risk for gum disease. Other signs include bleeding and/or receding gums, pain or sensitivity in your teeth (and even loose teeth, caused by weakening gum fibers and/or bone loss), and persistent bad breath. If left untreated, gum disease can lead to tooth loss as well as various other health problems. More and more life-threatening illnesses are being linked to the presence of dental diseases.
The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. Wang can help. He strongly believes in and focuses on the importance of healthy gums for a healthy mouth and body. Gum disease used to require surgery more often than not. While surgery is still an option and sometimes needed, many cases are now treated with less invasive techniques first, such as deep cleanings, local antibiotics, and special rinses. Please come in and let Dr. Wang help you achieve and maintain healthier gums for a healthier you.
How can cosmetic dentistry improve my life?
A more beautiful smile can make life more beautiful. Studies have shown that a healthy and attractive smile can raise self-esteem, increase confidence, improve your personal as well as your professional life, and help you make better first impressions on others. Sometimes it doesn’t take much treatment for you to feel better about your smile, and there are a variety of subtle, yet noticeable ways that smiles can be enhanced. There are also more significant and dramatic treatment procedures (and combinations of procedures), often called “smile makeovers,” that can totally change teeth and smile appearance, to give you the smile of your dreams.
While there is no true “specialist” association with cosmetic dentistry, there are a number of organizations with advanced training and awards associated with cosmetic dentistry. Some dentists place greater emphasis on cosmetic dentistry treatments, especially when they have an exceptionally artistic eye and/or particular enjoyment for cosmetic procedures.
Advancements in dental technology have made it possible for dentists to address a wide variety of issues affecting smile appearance. Some common cosmetic dentistry treatments include teeth whitening, cosmetic bonding and enamel shaping, porcelain veneers, bridges, and orthodontic solutions (including braces and aligner therapy). Replacing old, amalgam (silver) fillings with tooth-colored fillings can also be considered cosmetic in nature, as it is done to improve both the health and structure, and the appearance of teeth. Really, all dental treatment aimed to improve the appearance of your teeth, gum shape, and smile can be considered cosmetic in nature.
I have crooked teeth, but I feel like metal braces are for kids. Are there other options?
Metal braces can be a hassle and can take between two to three years of treatment to fully realign your teeth. Advancements in orthodontics are helping adults fit braces into their lives and giving them the smiles they’ve always wanted.
One option is ClearCorrect™. This system involves a series of custom-made plastic trays, called aligners, that are replaced every two weeks to straighten your teeth step by step. The trays are comfortable for the sensitive tissues of your gums and cheeks, and they’re conveniently removable so you can eat and brush your teeth normally. Because the trays are made from a transparent plastic material, ClearCorrect clear braces are hardly noticeable. If you don’t tell them, people might not even notice you’re wearing braces!
Another orthodontic solution is Six Month Smiles™, an accelerated program that gives you great results in less time than traditional braces. Six Month Smiles uses clear braces and thin, subtle wires to realign the teeth that show when you smile. Because they are not intended to completely change your bite, these braces use low force and do not have the risk of causing root or structural damage. The average treatment lasts only 4–9 months, and post-treatment, you will be fitted with a retainer to ensure the longevity of your straight, beautiful smile. Six Month Smiles is a conservative, inexpensive, and efficient way to get the smile you’ve always wanted.
These alternatives to metal braces are great options for patients with mild to moderately crowded teeth, widely spaced teeth, overbites, crossbites, and underbites. If you’re ready for straighter teeth, ask your dentist about your treatment possibilities. A beautiful new smile could be closer than you think!
A couple of my teeth have been worn down and need to be replaced. Should I opt for crowns?
Crowns, often called "caps," cover teeth to restore them to their appropriate shape and size after large fillings, fractures, and/or weakening forces such as intense grinding. In all of these cases, crowns not only cover teeth but provide added support as well. Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth, and even as a preventive measure to protect a tooth in danger of breaking. Crowns can be made of all-porcelain (ceramic) material, porcelain fused to metal (for added strength), gold alloys (high noble), or base metal alloys (non-noble). Each of these restorative materials has its advantages and disadvantages. All-porcelain restorations most closely mimic natural tooth appearance. Their strength depends on adequate porcelain thickness, thus this material requires more extensive preparation. Porcelain fused to metal alloy restorations are tooth-colored and stronger than all-porcelain crowns. Gold alloy crowns are very strong and wear resistant. They are well tolerated in terms of biocompatibility, but metal colors do not match natural teeth. Base metal alloy crowns are similar to gold for strength and durability. However, allergy to the non-noble base metals may be an issue with some patients.
Crowns can be placed in as few as two appointments. For porcelain crowns, properly matching the aesthetics of teeth can take more visits but the natural looking cosmetic results are worth it to most patients. Crowns in general are very strong restorations, and they help to protect teeth. If a crown is placed before the tooth is so badly decayed or so weak that it fractures, the necessity of a root canal can often be preempted. This can also help prevent a broken tooth from becoming so bad that it needs to be removed, which would require a bridge or implant for restoration.
In light of their excellent restorative capabilities, crowns have few disadvantages. As they are more extensive restorations than fillings, their relative cost is higher. However, if Dr. Wang recommends a crown it is because our team wants to help you keep your teeth healthy and looking good for years to come. The problems crowns help to prevent and repair offset the cost.
Also, while crowns are highly resistant, due to normal wear they will eventually need to be re-cemented or replaced. Six to nine percent of teeth that are damaged enough to need a crown may someday need a root canal.
Are there any specific oral health concerns associated with diabetes?
While having diabetes does not automatically put your dental health at risk, it does make a person more susceptible to certain conditions. Uncontrolled diabetes causes high glucose levels in saliva, which can promote the growth of bacteria in the mouth and increase the risk of cavities. Diabetes also reduces the body’s resistance to infection, which can make an individual more likely to develop illnesses such as gingivitis or even gum disease. Symptoms of gingivitis, which is an early form of periodontal disease, are red, sore, receding, or bleeding gums; if you notice these to any degree, be sure to make an appointment with your dentist. Other, less serious, problems that can occur include thrush (a treatable infection in the tongue and cheeks), ulcers, and dry mouth.
Interestingly enough, this connection is a two-way street. For patients with severe gum disease, the infection in the gums can affect the blood glucose levels and the immune system, actually increasing the overall risk of developing diabetes. If you have diabetes, you know the importance of a healthy lifestyle. Smoking can be particularly damaging to diabetics, as it causes excess dryness and damage to the gum tissue. Ultimately, the most important factor is blood sugar. If you keep your diabetes under control with a healthy lifestyle and maintain good oral hygiene through regular check-ups, diabetes won’t get the best of your smile.
I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What’s the problem?
You could be suffering from temporomandibular disorder, or TMJ, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.
TMJ has been associated with a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMJ. TMJ can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.
Professional treatment of TMJ ranges from minor fixes to surgical options. If your dentist determines that the main cause of your TMJ pain is an irregular bite, he or she may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet. If it’s a structural issue occurring in your jaw bone (especially if your TMJ is a result of injury), you may benefit from surgery. When it comes to TMJ treatment, it’s important to choose the most conservative plan for your individual needs.
In the meantime, alleviating the pain through treating the symptoms can give you some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.
How do I choose the right oral hygiene product for me?
The toothpaste aisle can be pretty overwhelming. Over the past few years, companies have introduced so many options for toothpastes, brushes, flosses, and mouthwashes, that even the most discerning consumer wouldn’t know where to begin. Here are a some hints for picking the right products for your particular needs:
Toothbrush. The big question here is, electric or manual? When it comes down to it, it’s really all about your personal preference. Recently, electric toothbrushes have gained popularity, but not necessarily because they’re “better” than manual brushes. Both brushes are effective at removing plaque, but electric brushes can make the process easier for you. If you find manual brushes difficult to use, or just don’t enjoy the process, an electric one might make brushing easier and allow you to do a better job. When choosing a manual brush, opt for soft bristles with the smallest head—they’re easy on gum tissue and can fit around the back molars. Regardless of your hardware of choice, though, just keep brushing, and be sure to brush long enough! Although it takes a full 2–3 minutes to brush every tooth effectively, most people only brush for an average of 30 seconds!
Toothpaste. First and foremost, always check for the ADA seal of approval. Despite the large variety of toothpastes available, most contain similar agents geared toward scrubbing, flavoring, or keeping your paste moist. It’s a good idea to choose a paste that contains fluoride, which strengthens enamel and makes teeth less prone to decay. Tartar-control toothpastes usually contain fluoride, but they also contain chemicals to break down plaque and antibacterials to kill lingering germs. After checking those off, choose your paste based on your personal needs. Whitening varieties have added abrasive agents (not bleach), that polish the surfaces of your teeth without damaging enamel. If you have sensitive teeth, certain toothpastes provide chemical compounds that, when used on a routine basis, can reduce sensitivity over time.
Floss. While most people brush the recommended two times a day, flossing sometimes gets placed on the back burner. However, neglecting to floss at least once daily is doing your mouth a serious disservice, as up to 50% of plaque accumulation occurs between teeth. That’s why you should floss before you brush, to loosen up that plaque for easier removal with your toothbrush. If you find flossing too difficult or unpleasant, try using a flosser. They’re reusable, use disposable heads, and with handles just like toothbrushes, they make flossing as neat and easy as brushing your teeth. You can find them at most grocery and drug stores.
Mouthwash. There are as many different types of mouthwashes available as there are flavors, and it’s important to choose the one that’s best for you. Cosmetic mouthwashes can rinse away debris, provide a pleasant taste, and mask bad breath temporarily. If you’re looking for a mouthwash with a purpose, look for an FDA-approved therapeutic rinse, with either antiplaque or anticavity ingredients. Mouthwashes are particularly useful for people with canker sores, braces, and dry mouth, but they shouldn’t replace brushing or flossing.
Combing all of these factors makes a complete and effective oral hygiene routine, but you don’t need the fancy, expensive products to have your healthiest smile. Just do your part at home and stay up-to-date with professional check-ups, and you’ll be set to go!
What are the benefits of a dental radiograph (x-ray) examination?
X-rays, also known as radiographs, are commonly used in dental exams of patients of all ages. Panoramic x-rays, which are taken every five to seven years and show the entire mouth, are particularly useful diagnostic tools. Panoramic x-rays are taken with a machine that circles your head providing a complete overview of all the teeth as well as the roots, upper and lower jawbones, the sinuses, and other hard surfaces in the mouth. Many problems with teeth and the surrounding tissues cannot be seen when we visually examine your mouth. An x-ray examination is needed to reveal:
- Small areas of decay between teeth or below existing restorations (fillings)
- Deep cavities
- Infections that can develop in the mouth bones
- Periodontal (gum) disease
- Abscesses or cysts
- Developmental abnormalities
- Some types of tumors
- TMJ Dysfunction
Detecting and treating dental problems at an early stage can save you unnecessary discomfort, money, and time. In cases where x-rays help us detect oral cancer and periodontal disease early, radiographs can also help save your life!
Is professional teeth whitening safe?
You have a number of options when it comes to whitening your teeth. Depending on your schedule and your brightening expectations, you and your dentist can decide which is best for you. For the convenience of whitening in your own home, there are a variety of over-the-counter gels, strips, and toothpastes designed to whiten your teeth, but they contain less concentrated ingredients and can take up to a month to show results. As far as safety goes, numerous studies have examined the effects of whitening and bleaching methods. Bleaching is not recommended for children under 16, as their teeth are still developing, and is also not recommended for women who are pregnant.
The most common side effects of teeth-whitening—both the in-office and take-home varieties—are teeth and gum sensitivity. This sensitivity is usually temporary, and should subside soon after you’ve stopped using the product.
Detecting and treating dental problems at an early stage can save you unnecessary discomfort, money, and time. In cases where x-rays help us detect oral cancer and periodontal disease early, radiographs can also help save your life!
Why is fluoride good for my teeth?
Each day, foods and acids feed bacteria in your mouth, which can accumulate on your teeth to form plaque. Plaque wears away at a tooth’s enamel in a process known as demineralization. Fluoride is a naturally-occurring mineral that can promote the remineralization of enamel, replacing important minerals that strengthen your teeth and can protect them from decay. Fluoride can also help reverse early stages of decay.
Children with newly-erupted permanent teeth benefit a great deal from fluoride exposure, but adults should make sure their teeth come into contact with it, too. The safe and easy way to ensure your teeth are getting enough fluoride is to use fluoride toothpaste, available at drugstores in a variety of types and flavors. If your dentist recommends more intense fluoride treatments, there are a number of gels, rinses, or even in-office procedures that can do the trick. Though the most fluoride is absorbed from direct contact with the teeth, many public drinking water systems contain small, safe amounts of fluoride that can have positive health effects.
What causes tooth discoloration?
The two main types of tooth discoloration are extrinsic (external or surface stains) and intrinsic (internal stains). External stains affects the outside of the tooth, while internal stains discolor a tooth from within. External stains can be attributed to anything that comes into contact with the surface of the teeth, such as red wine, coffee, tea, or tobacco products. Internal discoloration reflects the actual condition of the tooth, often occurring as a result of treatment procedures, exposure to excessive amounts of fluoride (Fluorosis), and certain antibiotics.
Some types and degrees of discoloration respond well to whitening methods, while others require veneers, bonding, or other restorative procedures. Dr. Wang can determine which type of stains you have and which whitening method will work best for you.
When I floss, my gums bleed. If they don’t hurt and my teeth look fine, is it really a big deal?
If your gums are not sore, it’s safe to assume your bleeding gums are not the result of hard brushing or flossing. Bleeding gums that apparently have no cause are always a warning sign, often indicating such conditions as gingivitis or even gum disease. Gingivitis (inflamed, bleeding gums) is not a one-way ticket to gum disease; in fact, if it’s caught early enough, gingivitis can be treated and even reversed. The first lines of treatment when it comes to gingivitis are lifestyle changes. Poor oral hygiene, smoking, uncontrolled diabetes, and high levels of stress can all contribute to gingivitis. Choosing a toothbrush with soft bristles can ease gum damage, too, and getting regular dental cleanings will control plaque and tooth decay. It’s important to stop gingivitis before it progresses, as studies have shown more and more serious illnesses are associated with gum disease. Heart disease, strokes, diabetes, even osteoporosis and inflammatory diseases such as Rheumatoid Arthritis have been linked to poor oral health.
Though not the first suspect in a simple case of bleeding gums, oral cancer is also a possibility. Oral cancer can be difficult to diagnose because many of its symptoms are associated with other medical conditions. They include sores, difficulty swallowing or moving the jaw, bleeding gums or cheeks, and a continuous pain in the mouth. If your dentist finds no other causes for your bleeding gums, he may recommend a visit to a specialist.
Regular check-ups are vital to cancer prevention, as are good oral hygiene, avoiding tobacco, and maintaining a balanced diet. Inform Dr. Wang if you’re experiencing any of the above symptoms. You’d go to the doctor if a cut on your hand were infected—do your gums the same service! They’ll thank you later.