Most people agree that bad breath is more than embarrassing. It affects personal, social and business relationships. Although Americans spend roughly $3 billion annually on gum, mints and mouth rinses that promise relief, they are nothing more than temporary cover ups. Discovering the underlying cause of the problem is the only way to effectively eliminate the halitosis (“halitus” – breath; “osis” – disorder) long term. If you have bad breath, we can help.

While it's true that there are a few systemic (general body) medical conditions that can cause bad breath, including lung infections, liver disease, diabetes and cancer, the majority of causes originate in the mouth. We can conduct a simple oral examination to help diagnose the underlying cause of your bad breath. We will check your mouth thoroughly for signs of any dental problems that can produce an odor, including decayed or abscessed teeth, diseased gums, a coated tongue or infected tonsils. Typically, halitosis occurs when bacteria collect on the surface and back of the tongue where it is drier. Bacteria thrive in this environment, resulting in a “rotten egg” odor that so many of us are all too familiar with. This odor actually emanates from volatile sulfur compounds (VSFs), but will go away with proper treatment.

Once the exact cause is pinpointed, your halitosis can be treated in several ways. For example, we can show you how to brush and floss properly to more effectively remove bacteria responsible for tooth decay and gum disease — don't be embarrassed, nobody really knows until they're shown by a professional. We can also show you how to use a tongue scraper or brush to carefully clean the surface of your tongue. Treatment of tooth decay, the repair of defective or broken fillings, extraction of wisdom teeth (third molars) and periodontal (gum) therapy such as scaling and root planing (deep cleaning) will all help treat infection and consequently bad breath.

You don't have to be embarrassed by bad breath any longer! The sooner you call our office to schedule an examination, the sooner you will be able to breathe a lot more freely. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

Imagine this: your active, adventurous child — or adolescent — loves high-risk contact sports like hockey or football, and while playing breaks a front tooth. After an emergency trip to our office, we recommend bonding as a good choice for this repair.

“What is bonding?” you ask. Here's what you need to know. In a bonding procedure, a composite resin restoration material is attached (bonded) to the broken tooth, and it looks as good as new.

Composite resin restorations are tooth-colored filling materials composed of a special plastic-based matrix for strength, with glass filler for aesthetics and translucence. The combination looks just like a natural tooth. The composite resin material is physically bonded to the remaining healthy tooth structure. First the natural tooth enamel or dentin must be etched so that the composite resin can attach and actually join to the tooth. In the end it will function as one and look exactly like a tooth.

Composites can be placed directly on the teeth in our office, quite easily, and they are relatively inexpensive. They look natural and can be matched to your child's natural tooth. They require little to no tooth reduction. Bonded composite resin restorations are the best choice for children and teenagers because their teeth and jaws are still growing and developing. What's more, they are still active in their sports and could need further restorations.

Composite resin restorations may need to be replaced with more permanent restorations after your child is fully grown. The bonded resin restorations may wear over time, and may stain and dull somewhat with age. When your child has completed growth, more permanent restorations such as porcelain veneers or crowns may be necessary.

By the way, a custom-made mouthguard might have prevented injury in the first place and certainly should be considered in the future.

If your child has chipped or damaged a tooth, contact us today to schedule an appointment or to discuss your questions about bonding and a protective mouthguard. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

Is there a single orthodontic appliance that can help your child get a wider, better-looking smile, correct problems with the bite, make room in a crowded upper jaw for new teeth to erupt (come in)... and shorten the overall time he or she will need to wear braces? The answer is yes: It's the palatal expander, a device that works with the natural growth patterns of a child's mouth, and offers dramatic results.

What's a palatal expander? Basically, it's a custom-made orthodontic appliance that fits between the rows of back teeth at the top (roof) of the mouth, close to the palate. After it has been put in place, it can be tensioned with a special key. Because it is contained inside the mouth, it's invisible when worn — but its benefits are easy to see.

How does it work? The palatal expander takes advantage of the fact that the left and right halves of a child's upper jaw bone don't completely fuse (knit together) until sometime after puberty. Until that happens, the upper jaw is relatively soft and easy to manipulate. When tension is applied, the palatal expander gently moves the bones apart, just like braces do for teeth. Then new bone tissue naturally fills in the space.

The appliance is tightened daily for a few weeks — while spacing improves dramatically — and then it's left on for several weeks more to stabilize the expansion. The total time a child needs to wear it is generally 3-6 months. After that, a set of braces can be put on if needed. So, what's so great about a palatal expander?

For one thing, the device can correct a crossbite, which occurs when the back top teeth bite inside (instead of outside) the bottom teeth. For another, expanding the upper jaw can relieve the condition known as crowding, which happens when the jaw isn't big enough to accommodate all the teeth. A related situation — impacted teeth — occurs when a tooth that hasn't yet erupted is blocked by another tooth above it. Both these conditions formerly required tooth extraction: an invasive and sometimes complicated procedure. Both can now be remedied by a palatal expander.

But maybe the biggest plus to a youngster — where a month can seem like an age — is the prospect of having to wear braces for less time. And that alone is a good reason to smile.

If you have questions about palatal expanders, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Palatal Expanders” and “The Magic of Orthodontics.”

What do burnt eggshells, crushed bones, brick dust and ox-hoof ashes have in common? Are they things you discovered in your kid's pocket? Ingredients in a witches brew? Funky organic compost materials?

It may be hard to believe — but they're all substances that were once used to make toothpaste, from ancient Egyptian concoctions through 18th century British blends. But don't worry: You won't find any broken crockery or ashes inside a modern tube! Today's toothpastes are scientifically formulated to be effective in removing plaque, which helps prevent tooth decay and gum disease (not to mention bad breath.) So what makes them work so well?

One class of ingredients found in all toothpastes is abrasives — also called cleaning and polishing agents. These slightly grainy substances make the mechanical action of brushing more effective. But unlike crushed bones, or the harsh, gritty particles of yore, today's abrasives are designed to remove stains and bacterial films without damaging tooth structure.

Next come detergents, which account for the foam you see when you brush vigorously. Detergents (sometimes called “surfactants”) help to break up and wash away materials that would otherwise be difficult to dissolve. An ingredient called sodium lauryl sulfate, which is also found in many shampoos, is probably the most common detergent used in toothpastes.

Fluoride, first included in toothpaste in 1914, is another common ingredient. In fact, all toothpastes that carry the seal of the American Dental Association contain it, typically in the form of sodium fluoride, stannous fluoride or sodium monofluorophosphate. It has been proven to make tooth enamel stronger and more resistant to decay.

In addition to these primary components, toothpastes generally contain flavorings to make them more palatable, and binders and preservatives to hold them together and keep them from drying out. Special-purpose toothpastes — like those designed to whiten teeth, prevent tartar, or help reduce sensitivity — have added ingredients.

But regardless of what's in your toothpaste, there's one thing you should remember: It's not the paste (or the brush) that keeps your teeth and gums healthy — it's the hand that holds it! Brushing once or twice a day, using a soft brush with the proper technique (and your favorite toothpaste!) is probably the most important thing you can do at home to enhance your overall oral health.

If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?”

Oral cancer is not as uncommon as people think. In 2008 an estimated 34,000 cancers of the mouth and throat were diagnosed. In order to minimize your risk of developing oral cancer, be aware of habits that increase your risk.

Risk Factors for Oral Cancer include:

• Use of smoking or chewing tobacco: Tobacco smokers have 5-9 times greater risk of developing this cancer than non-users; snuff and chewing tobacco users have a four times greater risk than non-users.
• Excessive use of alcohol: Moderate to heavy drinkers at are 3-9 times greater risk than non-drinkers.
• Exposure to sun: Chronic sun exposure is associated with development of lip cancers.
• Certain viral infections such as the human papilloma virus that can cause cervical cancer in women can also cause oral cancer.
• Compromised immune (resistance) systems that are not functioning properly can be associated with cancers.
• Poor nutrition including diets low in fruits and vegetables can increase risk for all cancers including oral cancer.
• Family history: People carry a predisposition in their DNA (the genetic material they inherited from their parents) for developing cancer.

Oral Cancers Can Mimic Harmless Sores

Early signs of oral cancer can mimic harmless sores that occur in the mouth such as canker sores, minor infections, or irritations that occur from biting or eating certain foods. Cancers in the lip area can easily be mistaken for harmless sores.

Early Detection is Key

It is important to have regular oral examinations to detect signs of oral cancer. Although 90 percent of oral cancers occur in people who are over 40, it is becoming more prevalent in younger people, particularly those who adopt risky behaviors: smoking, drinking and oral sex.

• If you notice any unusual lesions (sores or ulcers), or color changes (white or red patches), anywhere in your mouth that do not heal within two to three weeks, come and see us and have it examined immediately.
• Definitive diagnosis may require a small biopsy, the microscopic examination of a piece of tissue from the affected area.

It is important not to let a suspicious sore go unchecked. If detected and treated early, while a lesion or growth is small, survival rates can exceed 80 percent. Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”