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Mary E. Gregory DDS
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The Low Down on Bad Breath

 There are numerous causes for bad breath, including bad dental habits, but they can also be indicative of other health problems, and exacerbated by diet and lifestyle.

What Causes Bad Breath?

Foods with strong odors are digested by the body. These foods are eventually carried back to the lungs where their odors are exhaled eventually. Bad breath acquired this way is only gotten rid of when the food has passed through the body; mouthwash and brushing can only alleviate the smell temporarily.

Poor dental habits, such as infrequent brushing and flossing allow bacteria to grow in the mouth: between teeth, surrounding gums, and on the tongue. This can be counteracted by gargling antibacterial mouthwash.

Other health problems may also manifest as bad breath. Periodontal disease, a kind of gum disease caused by plaque buildup on the gums gives off a foul odor in one’s breath. Xerostomia, or dry breath, is a condition where not enough saliva is produced. Thus, the mouth is not cleansed of remaining food particles, and dead cells, resulting in bad breath.

Bad Breath Prevention:
Good oral hygiene is one of the easiest ways to prevent bad breath. Teeth should be brushed twice a day with fluoride toothpaste, or after every meal. Flossing also prevents buildup of food particles and plaque. Gargling mouthwash with peroxide can help keep your breath fresh during the day. Drinking lots of water helps prevent dry breath as well, and is thus an effective preventive measure too.

Remember to visit the dentist at least twice a year for both cleaning and an oral exam. Cavities and gum disease that can cause bad breath can be detected and remedied by the dentist to prevent bad breath. If you regularly visit your dentist, you will be able to maintain good oral health.

Brushing 101

You’ve probably heard it ever since you were a kid: brush your teeth everyday so that they can remain strong and healthy. However, it’s not as simple as picking up any toothbrush from your local supermarket, going home, and scrubbing away at your teeth for a few seconds.  

Here’s your Brushing 101 handy guide:

Use the right toothbrush
Not all toothbrushes are created the same. Some toothbrushes are better quality than others, and believe it or not, both the material and the structure of the toothbrush matters when it comes to cleaning your teeth. Soft bristles with rounded ends and a rounded head toothbrush is generally the best type, because it cleans without damaging your teeth or gum tissue, and it can get into the small crevices of your mouth.

Replace your toothbrush regularly
Whether it’s because of convenience or sentiment, a lot of people don’t take the time to change their toothbrush regularly. A used toothbrush does not clean as well as a new one. The American Dental Association recommends that you change your toothbrush every 3 to 4 months, both for practical and sanitary reasons.

Use the Proper Strokes
Even the motion of brushing is something that you should take into consideration. Proper brushing technique is a combination of up and down, side to side, and various movements of the toothbrush in your mouth. Basically, you need to hit every spot in your mouth to make sure that you get every surface you need to reach.

Time and Touch
You need to brush for at least 2 minutes; and when you brush, you should brush just hard enough to get the job done, but not so hard that you draw blood from your gums.

If you really want to learn how to brush your teeth properly, ask your hygienist at your next visit to demonstrate proper toothbrush techniques to you and even give you a critique of how you are brushing. 

What should I do if my tooth is sensitive to cold after it is crowned?
There are two types of sensitivity that can commonly experience after a crown is cemented. One is sensitivity to biting pressure and the other is sensitivity to cold (and or hot) liquids. If a patient is experiencing either of these after a permanent crown is placed, then probably the best thing to do is to let their dentist know.

Sensitivity after a permanent crown is placed is not that uncommon. If a patient reports sensitivity to me, I check their bite, since a high bite can be irritating to the ligaments holding a tooth and can even cause pulpal sensitivity. A patient should be able to close their mouth comfortably without feeling any pain. If when they close their mouth (without chewing any food) they experience pain from a new crown, the bite should be adjusted.

If a patient can comfortably close their mouths, but does experience pain on heavy chewing, I usually ask them to wait and see if the pain gets better with time. A crown cementation can sometimes irritate the pulp and with time this irritation can diminish. This can take months to go away and if a patient is willing, it’s usually best to wait. If I see them at their next recall, the tooth is still sensitive to chewing or when drinking cold liquids, I take a radiograph and if no pathology is evident, I usually try to get the patient to wait longer, since the only real other options are to perform a root canal on the tooth or to cut off the crown and place a temporary crown with a sedative filling. Which of these I would choose, if I feel the need to treat the tooth, is dependent on whether I believe the pulp has a reversible or irreversible pulpitis?

Deciding whether a pulpitis is reversible is not always easy, but the prior history of the tooth has a lot to do with the decision. If a tooth was asymptomatic prior to me working on it initially, I am more likely to choose to remove a crown and place a temporary. If a tooth had a pre-existing crack in it or was symptomatic prior to me preparing it for a crown, I am more likely to recommend the patient visiting an endodontist and have a root canal done through the crown.

I feel that the pulp is still vital and not infected; there is usually no harm in watchful waiting, since with enough time sensitive crowned teeth can calm down. I explain this to my patient and if the symptoms are bearable we often wait for the symptoms to slowly go away. If the symptoms are worsening instead, we can always choose the root canal option.

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A great place to buy bottle of wine for that perfect meal!

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“Being able to provide family dentistry is our focus.  My practice mainly focus on preventative treatments for tooth decay and gum disease,”
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