Bad breath can have a serious impact on a person's social and business life. Americans are well aware of this fact, and spend nearly $3 billion each year on gums, mints, and mouth rinses in order to make their breath “minty fresh.”

Bad breath or halitosis (from the Latin halitus, meaning exhalation, and the Greek osis, meaning a condition or disease-causing process) can originate from a number of causes; but oral bacteria are the most common source. About 600 types of bacteria grow in the average mouth. If bacteria act on materials that have been trapped in your mouth, many of them produce unpleasant odors.

Most often, bad breath starts on the back of the tongue, the largest place in the mouth for a build-up of bacteria. In this area bacteria can flourish on remnants of food, dead skin cells, and post-nasal drip. As they grow and multiply these bacteria produce chemical products called volatile sulfur compounds or VSCs. These compounds emit smells of decay reminiscent of rotten eggs.

In addition to bacteria on the tongue, halitosis may come from periodontal (gum) disease, tooth decay, or other dental problems. If you have halitosis, it is thus important to have a dental examination and assessment, and to treat any such problems that are found. Treating bacteria on the tongue without treating underlying periodontal disease will only temporarily cure bad breath.

The next step is to take control of tongue bacteria by brushing or scraping your tongue, with possible addition of antiseptic mouth rinses. People who have bad breath have more coating on their tongues than those who don't, and regularly cleaning the surface of the tongue has been demonstrated to reduce bad breath.

Implements have been designed specifically for the purpose of scraping or brushing the surface of the tongue. Using a toothbrush is not as effective because it is designed to clean the hard tooth surface, rather than the spongy surface of the tongue. To keep your breath fresh, you must regularly remove the coating from your tongue. This means acquiring a tongue scraper or brush and using it every day.

Contact us today to schedule an appointment to discuss your questions about tongue cleaning and bad breath. You can also learn more by reading the Dear Doctor magazine articles “Tongue Scraping” and “Bad Breath.”

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”

A veneer is a cosmetic dental procedure that we use in some situations to correct discolored teeth, small spaces or gaps between teeth, small chips or oddly shaped teeth, and teeth that are slightly misaligned by placing a thin shell covering over the teeth. They are artistically hand-crafted by lab technicians out of tooth-colored porcelain using precise molds that we have made in our office. We attach veneers to the tooth's surface using a special adhesive that creates a chemical bond. Veneers are often a key component in a smile makeover.

Traditional veneers will require some tooth preparation, a process where we reduce or file down some of the facial (front, visible) portion of your tooth by 0.3 to 0.7 millimeters. For this reason this cosmetic procedure is not reversible.

How Long Do They Last?

Veneers can last from 7 to 20+ years depending on how you care for them. This may include sleeping in a protective, professionally made mouthguard. And while porcelain is a durable material that can withstand a great deal of pressure, you must remember that they are a type of glass. You could possibly shatter a veneer if you bite into anything that requires a hefty amount of twisting movement and biting pressure.

By using the latest technologies and procedures, we will create the naturally beautiful smile of your dreams and we will restore your mouth to full functionality and optimal health. Contact us today to discuss your questions or to schedule a consultation.

Want To Learn More?

Learn more about veneers when you continue reading the exclusive article from Dear Doctor, “Smile Design Enhanced With Porcelain Veneers.”

When it comes to chronic pain, one of the most common problems you can face is Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ). TMD is a condition that can be tricky to diagnose because it frequently mimics other conditions. This is why many healthcare professionals refer to it as “the great imposter.” However, regardless of what it is called, the pain it causes is real and can become quite severe — especially if left undiagnosed and untreated.

To grasp the condition fully, you must first understand the TMD pain cycle. It can start with any traumatic, psychological, metabolic, or mechanical stimulant that causes spasm in the muscles that move the jaw joints (opening, closing, chewing, and even smiling.) This is because of the constricted blood supply to the muscles resulting in less oxygen along with the accumulation of waste products. This is followed by chemical changes in the muscles and a buildup of lactic acid due to muscle fatigue. Abnormal or involuntary muscle contractions or spasms lead to pain signals to the brain that can stop muscle movement. Depending on the severity, this cycle can repeat itself resulting in acute pain that may be extremely severe at times. The pain may then seem to disappear only to resurface again later. The good news is that our office has highly trained professionals who cannot only diagnose but also treat your TMD.

If you suffer from chronic jaw pain and feel that you might have TMD, please let us know so that we can address your concerns and conduct a thorough history and examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading the article “TMD — Understanding The Great Imposter.”

Time to tune up the brightness on your teeth? Here are six modern methods of whitening and brightening your smile.

• In-office “power” bleaching under the supervision of my staff and me is recommended if your teeth are badly stained, or if you are about to have veneers or crowns made. It's quick, safe, and effective. Gels containing high concentrations of bleach are applied to your teeth in our office, often with the enhancement by heat and light to make them act faster. Results show teeth becoming up to ten shades lighter in about an hour.
• “Take home” whitening solutions and trays are designed to fit your mouth and can also be provided by my office. The technique is easy to perform and is less expensive than in-office power whitening system, although it takes longer to see the same results. General recommendations are for 30 minute applications twice a day. You can usually see a change after two to four sessions. This requires patience, because it is important not to exceed recommended exposure in order to avoid damage to your teeth, gums, and the inside skin of your mouth. After two weeks of use, teeth can be expected to be about eight shades lighter.
• Whitening strips look like clear Band-Aids that are applied to the tooth surfaces. They should be worn twice a day for 30 minutes each time, for seven days. On average, they claim to lighten teeth more than three shades. They take about two weeks to work at 30 minutes per day.
• “Paint on” or “Brush on” whitening formulas are also available. These are gels that are painted onto the teeth every night at bedtime, for two weeks. Some claim that this line of home whitening can whiten teeth two to five shades. These gels may make your mouth feel goopy, but they are relatively inexpensive. Some gels come with a small brush to scrub them onto the teeth.
• Over-the-counter “mouth-tray” whiteners use mouth trays that are not designed for your particular mouth, so they may not fit well and may be messy or uncomfortable. They are filled with gel and worn 45 minutes a day for one week. On average, teeth become two shades whiter.
• Whitening gum is a relatively new product. It requires chewing two pieces for at least 20 minutes, four times a day, to see an effect.

Contact us today to schedule an appointment to discuss your questions about tooth bleaching. You can also learn more by reading the Dear Doctor magazine article “Teeth Whitening.”