If you have ever had tooth decay, you should know:

1. Tooth decay is one of the most common of all diseases, second only to the common cold.
2. Tooth decay affects more than one-fourth of U.S. children ages 2 to 5, half of those ages 12 to 15, and more than 90 percent of U.S. adults over age 40.
3. Tooth decay causes pain, suffering and disability for millions of Americans each year — even more disturbing, tooth decay is preventable.
4. If it is not treated, in extreme and rare cases tooth decay can be deadly. Infection in an upper back tooth can spread to the sinus behind the eye, from which it can enter the brain and cause death.
5. Tooth decay is an infectious process caused by acid-producing bacteria. Your risk for decay can be assessed in our office with a simple test for specific bacterial activity.
6. Three factors are necessary for tooth decay to occur: susceptible teeth, acid-producing bacteria and a diet rich in sugars and refined carbohydrates.
7. Babies are not born with decay-causing bacteria in their mouths; the bacteria are transmitted through saliva from mothers, caregivers, or family members.
8. Fluoride incorporated into the tooth structure protects teeth against decay by making the enamel more resistant to acid attack.
9. Sealants, which close up the nooks and crannies in newly erupted teeth, stop bacterial collection where a toothbrush can't reach. Teeth with sealants have been shown to remain 99 percent cavity-free over six years.
10. Restricting sugar intake is important in preventing tooth decay. Your total sugar intake should be less than 50 grams a day (about ten teaspoons) including sugars in other foods. A can of soda may have six teaspoons of sugar — or more!

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay – The World's Oldest & Most Widespread Disease.”

Oral cancer accounts for approximately 3% of cancers in men and 2% in women. That may not sound like a lot, but the disease often isn't detected until it has progressed to its later stages when it's harder to treat and the outlook for survival is significantly diminished.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and underneath)
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Risk Factors You Can't Control

Even if you can't change these risks, awareness helps raise your vigilance in order to catch potential problems early when treatment options and positive outcomes are greatest.

• Heredity
• Aging — More than 90% of all oral cancers occur in individuals over 40. However, the incidence among younger people has been on the uptick recently, perhaps related to lifestyle behaviors.
• Race — African Americans have a higher incidence of oral cancer than Caucasians.

Risk Factors You Can Address

• Smoking and chewing tobacco — Smokers are at five to nine times greater risk and snuff and tobacco chewers at about four times greater risk
• Alcohol — Moderate to heavy drinkers are at three to nine times greater risk; the higher the alcohol content, the greater the risk
• Chronic sun exposure — Often connected with lip cancers.
• Viral infections — Namely the human papilloma virus “HPV 16,” which has been linked to sexual transmission (oral sex) and cervical cancer in women.

One way you can address these risk factors is to have a diet rich in fruits/vegetables, which are high in antioxidants because they been found to have a protective effect against a variety of cancers, including oral.

As part of your routine oral hygiene, you should be closely monitoring any non-healing changes in your mouth (e.g., ulcers or sores, white or red patches on the tongue). And rest assured that as part of your regular check-ups, our office performs a comprehensive visual screening for signs of oral cancer.

If you would like more information about oral cancer prevention and detection, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

Sleeping disorders impact people in different ways. For some people, they may feel they do not have a problem — except for the fact that their sleeping partner complains about their snoring. For others, they may know they have a snoring issue because they constantly wake themselves up gasping for air. This is a dangerous condition known as Obstructive Sleep Apnea OSA (“a” – without; “pnea” – breath). If any of these scenarios sound like your experience, then you may have OSA or another type of Sleep Related Breathing Disorder (SRBD). However, before jumping to conclusions, you need to obtain a thorough examination from a primary-care physician who is trained in sleep medicine in conjunction with our office. We have received training in the diagnosis and treatment of sleep disorders. But the good news is that sleep apnea is a treatable condition.

As for your question, yes, there are many things we can do to treat your snoring after the cause of your problem is properly established. One helpful approach is through the use of a specially designed oral appliance that we custom make and fit to your mouth. It is easy to use during sleep. Once in place, it will keep your lower jaw in a forward position so that your tongue is held forward to stop blocking your upper airway (i.e. the back of your throat and area causing your snoring and hindering your breathing while you sleep). Another option is to use a Continuous Positive Airway Pressure (CPAP) machine. This specialized machine requires you to sleep with a mask that covers your mouth and/or nose. While you sleep, it delivers continuous pressure to your windpipe so that your tongue is forced away from your airway.

If your snoring is keeping you or your loved ones awake, we are a good place to start. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late.

If you think you may have gum disease, here is what to look for:

• Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed.
• Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth.
• Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth.
• Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover.
• Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease.
• Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection.

If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact us today to schedule an appointment.

Considering that over 90 million Americans suffer from chronic bad breath and everyone else has dealt with some form of it at one time or another, we want to address some common causes and cures so you are prepared if it happens to you.

What are the most common causes of bad breath?

Halitosis or bad breath most often occurs when you have poor oral hygiene and/or routinely consume odorous foods and drinks. In fact, 90% percent of mouth odors come from the food you eat or bacteria that’s already there, according to the American Dental Association. Other causes for halitosis include:

• Excessive bacterial growth in the mouth and especially on the tongue
• Known and characteristically odor producing foods and drinks such as onions, garlic, coffee, tobacco and alcohol products
• Diabetes and diseases of the liver and kidneys
• A poorly hydrated body (and mouth) from not drinking enough water everyday

What should I do if I feel (or people tell me) I have chronic bad breath?

Contact us to schedule an appointment for a proper diagnosis and plan of action for returning your mouth to optimal health.

What are some tips I can do to prevent occasional bad breath?

In most cases, bad breath is totally preventable when you follow the tips below:

• Brush your teeth in the morning and at bedtime using a fluoride toothpaste and a proper (and gentle) brushing technique.
• Floss your teeth at least once a day.
• Clean your tongue after brushing your teeth with either a scraping tool you can purchase at a drug or discount store or by gently brushing it with your toothbrush.
• Keep your mouth moist by drinking plenty of water during the day.
• Be prepared by having some mouth cleaning tools (floss, a toothbrush, toothpaste or some sugar free gum) handy to freshen your mouth after consuming bad smelling foods, drinks or using tobacco or alcohol.
• Eat fresh fruits and vegetables to increase saliva production in your mouth and help remove food particles that can lodge between teeth.
• Maintain regular dental check-ups.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about halitosis by reading the Dear Doctor article, “Bad Breath — More than Just Embarrassing.”

Everyone agrees that education is an important part of personal growth. However, one area of study that often slips through the cracks centers on oral healthcare basics. And whether or not we all do it as often as we should, most people know they should brush and floss their teeth daily. But other than that, do you feel you are knowledgeable and thus have a healthy dental IQ?

We have developed a quick and easy oral health IQ test to help you self-assess your expertise. The answers are listed at the bottom of this article.

The Quiz

1. What has been the largest, single factor influencing the decline in tooth decay over the past 40 years in America?
1. Fluoridated water
2. Fluoridated toothpaste
3. Flossing
4. Sealants
2. Your dentists can help treat which of the following problem(s)?
1. Halitosis (bad breath)
2. Snoring and sleep apnea
3. Headaches, Temporomandibular Disorder (TMD), or Temporomandibular Joint Dysfunction
4. All of the above
3. The most important aspect of brushing your teeth is...?
1. The brand of toothpaste you use
2. Your brushing technique and frequency
3. The brand of your toothbrush
4. Using an electric toothbrush
4. At a minimum, how often should you have a thorough dental evaluation?
1. Every six months
2. Once a year
3. Every five years
4. Only if you are experiencing pain
5. At a minimum, how often should you have your teeth professionally cleaned?
1. Every six months
2. Once a year
3. Every five years
4. It depends on your age and oral health

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

The Answers

1) a = fluoridated water, 2) d = all of the above, 3) b = your brushing technique and frequency, 4) b = once a year, 5) d = It depends on your age and oral health

We are often asked about the role the tongue plays with bad breath or halitosis, as it is known medically. The truth is that everyone will experience it at some point in life; however, there can be a number of reasons for its cause. Some of these include:

• Consuming odorous foods and/or drinks such as coffee, onions and garlic. This is usually just a temporary condition that can be resolved by brushing and flossing your teeth and using mouthwash. Also consider chewing gum containing xylitol, a sugar-free gum that both promotes saliva flow and reduces tooth decay.
• Diabetes, a disease caused by a faulty metabolism of sugar, as well as diseases of the liver and kidneys can also cause bad breath. Be sure to always let all your health care professionals know if you have any unusual symptoms or you been diagnosed with any of these or other illnesses.
• Poor oral hygiene, which causes gingivitis (gum disease), is one of the most common reasons for bad breath. And if your gum disease is progressive, you could eventually lose your teeth.
• If you use tobacco and regularly drink large amounts of alcohol, you are dramatically increasing the likelihood of having halitosis.
• And lastly, if you do not drink enough water to maintain proper hydration, you can develop bad breath.

There are more than 600 types of bacteria found in the average mouth, many of which can cause bad breath. And the back of the tongue is where these bacteria typically produce Volatile Sulfur Compounds (VSC), the culprits responsible for the worst odors attributed to halitosis.

As for cleaning your tongue, there are two common methods. You can use your toothbrush to brush your tongue, or you can use a tongue-scraper. The latter can generally be purchased at a drug or discount store. The keys to remember are that a clean, healthy tongue should be pink in color and not have a yellow or brownish coating.

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”