How can you brighten your smile?

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn’t just for the movie stars, and it isn’t just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is a very strong, and tooth bleaching safely lightens the colour of the teeth. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?

Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the colour of yellow, brown, or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking, or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching.

What’s involved?

First, the dentist will determine whether you are a candidate for tooth bleaching. At the next appointment the dentist will make impressions of your teeth to fabricate a mouth guard appliance for you. The mouth guard is custom made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouth guard is so thin that you should be able to talk and work while wearing your mouth guard. Along with the mouth guard, you’ll receive the bleaching materials. You’ll be given a set of instruction on how to wear the mouth guard.
Most systems recommend bleaching at night while you sleep. This type of system usually requires only 10-14 days to complete.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch up. This procedure may not be as costly because you can use the same mouth guard. The retreatment time also is much shorter than the original treatment time.

Is it safe? Any side effects?

Several studies, during the past five years, have proven bleaching to be safe and effective. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

What are realistic expectations?

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist’s shade guide. This success rate depends upon the type of stain involved and your compliance. Bleaching can only provide a shift in colour form gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as resins, silicants, or porcelains.

What is periodontal disease?

Periodontal (gum) disease may result from gingivitis, and inflammation of the gums usually caused by the presence of bacteria in plaque. Plaque is the sticky film that accumulates on teeth both above and below the gum line. Without regular dental checkups, periodontal disease may result if gingivitis is left untreated. It can also cause inflammation and destruction of the tissues surrounding and supporting teeth, gums (gingival), bone, and fibres which hold the gums to the teeth. A number of factors increase the probability of developing periodontal disease, including diabetes, smoking, poor oral hygiene, diet, and genetic makeup; and it is the primary cause of tooth loss in adults.

How are periodontal disease and diabetes related?

Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal disease than those who do not have diabetes. Oral infections tend to be more severe in diabetic patients than non-diabetic patients. And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems. These infections occur more often after puberty and in ageing patients.

What types of problems could I experience?

Diabetics may experience diminished salivary flow and burning mouth or tongue. Dry mouth (xerostomia) also may develop, causing an increased incidence of decay. Gum recession has been found to occur more frequently and more extensively in moderate and poorly controlled diabetic patients because plaque responds differently, creating more harmful proteins in the gums. To prevent problems with bacterial infections in the mouth, your dentist may prescribe more frequent hygienist visits.

How can I stay healthy?

Make sure to take extra good care of your mouth and have dental infections treated immediately. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease. Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status. To keep teeth and gum strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your changed of obtaining periodontal disease.

What is the best time to receive dental care?

If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care. Dental procedures should be as short and as stress free as possible. Also make morning appointments because blood glucose levels tend to be better under control at this time of day. If you have a scheduled appointment, eat and take your medications as directed. See your dentist and hygienist on a regular basis, keep him or her informed of your health status, and keep your mouth in good health.

What is halitosis?

In most cases bad breath originates from the gums and tongue. The odour is caused by bacteria from the decay of food particles, other debris in your mouth, and poor oral hygiene. The decay and debris produce a sulphur compound that causes the unpleasant odour.

Does bad breath come from other sources than the mouth?

Bad breathe may occur in people who have a medical infection, gum disease, diabetes, kidney failure, or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to the problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age, and hormonal changes can have an effect on your breath.
An odour that comes from the back of your tongue may indicate post-nasal drip. This is where the mucus secretion, with comes from the nose and moves down your throat, gets stuck on the tongue and causes an odour. Bad breath originating in the stomach, however, in considered to be extremely rare.

Why is saliva so important in the fight against bad breath?

Saliva is the key ingredient in your mouth that helps keep odour under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva allowing the bacteria to grow inside the mouth. To alleviate “morning mouth,” brush your teeth and eat a morning meal.
Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware because the odour may reappear even if you’ve brushed your teeth.

Do certain foods cause bad breath?

Very spicy foods, such as onions and garlic and coffee may be detected on a person’s breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach and the odour excrete through the lungs. Studies have shown that garlic rubbed on the soles of feet can show up on the breath.

How do I control bad breath?

It is important to practice good oral hygiene, such as brushing and flossing your teeth twice a day. To alleviate the odour, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds up on the tongue. Chewing sugar-free gum also may help control the odour. If you have dentures or a removable appliance, such as a retainer or mouth guard, clean the appliance thoroughly before placing it back in your mouth.
Before you use mouth rinses, deodorizing sprays, or tablets, talk with your dentist or hygienist because these products only mask the odour temporarily, and some products work better than others.

What is my dentist’s role?

Visit your dentist regularly because checkups will help detect any physical problems. Checkups also help get rid of the plaque and bacteria that build up on your teeth. If you think that you suffer from bad breath, your dentist and hygienist can help determine its source. He or she may ask you to schedule a separate appointment to find the source of the odour. Or, if your dentist believes that the problem is caused form a systemic source (internal), such as an infection, he or she may refer you to your family physician or a specialist to help remedy the cause of the problem.

Oral Cancer How common and how serious is oral cancer?

Oral cancer, the sixth most common cancer. The vast majority of oral cancers occur in people older than 45 years, with men being twice as likely as women to develop the disease. The most frequent cancer sites are the tongue, the floor of the mouth, soft palate tissues in the back of the tongue, lips, and gums. If not diagnosed and treated in its early stages, oral cancer can spread, leading to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery, and even death. Your general dentist can perform a thorough screening for oral cancer.

What causes oral cancer?

Scientists aren’t sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol, and certain foods, as well as excessive exposure to the sun have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited.

What are warning signs to watch out for?

Oral cancer—represented by red, white, or disordered lesions, patches or lumps in or around the mouth—is typically painless in its early stages. As the malignant cancer spreads and destroys healthy oral tissue, the lesions or lumps become more painful. However, oral cancer is sometimes difficult to self-diagnose so routine dental exams are recommended. See your dentist immediately is you observe: any sore that persists longer than two weeks; a swelling, growth or lump anywhere in or about the mouth or neck; white or red patches in the mouth or on the lips; repeated bleeding from the mouth or throat; difficulty swallowing or persistent hoarseness.

How does a dentist screen for oral cancer?

Your dentist and hygienist should screen for oral cancer during routine checkups. He or she will feel and look for lumps or irregular tissue changes in your neck, head, cheeks, and oral cavity, and thoroughly examine the soft tissues in your mouth, specifically looking for any sores or discoloured tissues.

How is oral cancer treated?

If your dentist suspects oral cancer, a biopsy of the lesion is required to confirm the diagnosis. Surgery is required to remove the tumours, which may cause disfiguration. Radiation therapy may be used as part of the treatment.

What can I do to prevent oral cancer?

Of all major cancer, oral cancer has the worst five-year survival rate at about 54 percent. Because oral cancer is usually not diagnosed in its early stages, less than half of all oral cancer patients are cured. You can help prevent oral cancer by not smoking, using spit tobacco, and drinking alcohol. When tobacco use and alcohol use are combined, the risk of oral cancer increases 15 times more than non-users of tobacco and alcohol products. Research suggests that eating plenty of fruits and vegetables may safe guard against oral cancer. Because successful treatment and rehabilitation are dependent on early detection, it is extremely important to see your dentist for an oral cancer screening and regular check up at least every six months. Survival rates greatly increase the earlier oral cancer is discovered and treated. During your next dental visit, ask your dentist about oral cancer screening.

What should I be concerned about?

Researchers are finding possible links between periodontal infections and other diseases throughout the body. Current studies suggest that there may be a link between periodontal (gum) disease, heart disease, and other health conditions. In fact, research suggests that gum disease may be a more serious risk factor for heart disease than hypertension, smoking, cholesterol, gender, and age. New studies suggest that people with gum disease seem to be at a higher risk for heart attacks, although no one is certain how this relationship works. Your oral health affects your overall health, but the studies that will find exactly why these problems are linked are still underway.

How can gum disease affect my overall health?

The current theory is that bacteria present in infected gums can come loose and move throughout the body. The same bacteria that cause gum disease and irritate your gums might travel to your arteries. Researchers are unsure what causes the bacteria to become mobile, but it has been suggested that bacteria can be dislodged and enter the bloodstream during tasks like simple brushing, flossing, or even chewing. Research shows that risk varies according to the level of gum infection. The worse the infection, the more likely the bacteria are to become blood-born. Infected gum bleed, making it easier for bacteria to enter your bloodstream. If bacteria become dislodged, the bacteria enter through cuts or sores in your mouth and travel to other parts of your body through your bloodstream. Once the bacteria reaches the arteries, they can irritate them in the same way that they irritate gum tissue. This could cause arterial plaque to accumulate in the arteries, which can cause hardening and block blood-flow. Compromised blood-flow to your heart can cause a heart attack. Also, arterial plaque can come loose and travel to other parts of the body. If blockage occurs in the brain, it can cause a stroke. Your dentist may use a special rinse immediately after dental procedures to neutralize these bacteria, but your best protection is to maintain a healthy mouth.

What should I do?

Keep your mouth healthy! See your dentist at least twice a year for periodic maintenance. Gum disease is a serious gum infection that should always be taken seriously. Although gum disease can often show few or no symptoms at all, watch for gums that are red and irritated, or gums that bleed easily. There are many new treatments available to control and help reverse gum disease.
Always remember that gum disease is caused by plaque build up. Brush and floss regularly to remove plaque that you can’t see below the gum line and remember to schedule regular check-ups. If you remove the plaque, you minimize the chance for gum disease. If you have any questions about your oral health, ask your dentist or hygienist.

How can I take care of my teeth?

Proper oral care can keep you smiling well into retirement. Brushing at least twice a day with fluoride toothpaste and a soft-bristle brush are as important as ever. Flossing can help you save your teeth by removing plaque between teeth and below the gum line that your toothbrush cannot reach.

What are some problems I should watch for?

Gingivitis. Most people don’t realize how important it is to take care of their gums. Gingivitis is caused by the bacteria found in plaque that attack the gums. Symptoms of gingivitis include red, swollen gums and possible bleeding when you brush. If you have any of these symptoms, see a dentist at once. Gingivitis can lead to gum disease if problems persist. Three out of four adults over age 35 are affected by some sort of gum (periodontal) disease. In gum disease, the infection becomes severe. Your gums begin to recede, pulling back from the teeth. In the worst cases, bacteria form pockets between the teeth and gums, weakening the bone. All this can lead to tooth loss if untreated, especially in patients with osteoporosis.

What if it’s too difficult to brush?

If you have arthritis, you may find it difficult to brush and floss for good oral health care and prevention of disease. Ask your dentist or hygienist for ways to overcome this problem. Certain dental products are designed to make dental care less painful for arthritis sufferers. You may want to try strapping the toothbrush to a larger object, such as a ball, to make the brush more comfortable to handle, or electric toothbrushes can help you by doing some of the work for you.

What are signs of oral cancer?

Oral cancer most often occurs in people over the 40 years of age. See a dentist immediately if you notice any red or white patches on your gums or tongue, and watch for sore that fail to heal within two weeks. Unfortunately, oral cancer is often difficult to detect in its early stage, when it can be cured easily. Your dentist can perform a head and neck exam to screen for signs of cancer. Since oral cancer is often painless in its early stages, many patients will not notice signs until it is too late. In addition, many older people, especially those who wear dentures, do not visit their dentists enough and problems go unseen.

Should I be concerned about dry mouth?

Dry mouth (xerostomia) happens when salivary glands fail to work due to disease certain medications, or cancer treatments. This can make it hard to eat, swallow, taste, and speak. In certain cases, such as radiation therapy, dry mouth can lead to severe complications, which is why it is important you see a dentist immediately before beginning any treatment. Drinking lots of water and avoiding sweets, tobacco, alcohol, and caffeine are some ways to fight dry mouth. Your dentist can also prescribe medications to fight severe dry mouth. Maintaining your overall health Studies have shown that maintaining a healthy mouth may keep your body healthier and help you avoid diabetes, heart disease, and stroke. The best way to achieve good oral health is to visit your dentist and hygienist regularly.

Why are my teeth sensitive?

Tooth sensitivity is caused by the stimulation of cells within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp). When the hard enamel is worn down or gums have receded—causing tiny tube surfaces to be exposed—pain can be caused by eating or drinking food beverages that are hot or cold; touching your teeth; or exposing them to cold air. Hot and cold temperature changes can cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking, and breathing habits. Taking a spoonful of ice cream, for example, can be a painful experience for people with sensitive teeth. Is tooth sensibility a common condition? Sensitive teeth is one of the most common complaints among dental patients. At least 45 million adults in the United States and 5 million Canadians, suffer at some time from sensitive teeth.

How can I avoid sensitivity?

Some toothpastes contain abrasive ingredients that may be too harsh for people who have sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel, and sodium pyrophosphate, the key ingredient in tartar control toothpastes may increase tooth sensitivity. To prevent sensitivity from occurring, use a soft-bristled toothbrush. Avoid using hard bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth’s root surface ad expose sensitive spots. The way to find out if you’re brushing your teeth to hard is too take a good look at your tooth brush. If the bristles are pointing in multiple directions, you’re brushing too hard.

How do I know when it’s time to see a dentist?

If a tooth is highly sensitive for more than three or four days, and reacts to hot and cold temperatures, it’s best to get a diagnostic evaluation from your dentist to determine the extent of the problem. Before taking the situation into your own hands, an accurate diagnosis of tooth sensitivity is essential for effective treatment to eliminate pain. Because pain symptoms can be similar, some people might think that that a tooth is sensitive, when instead, they actually have a cavity or abscess that’s not yet visible.

How do I describe my symptoms to my dentist?

Sensitivity may be defined as a short sharp pain, which is usually initiated by hot or cold foods or exposure to cold air. Aching often follows. Because sensitivity may mean different things to a patient and dental professional be sure to clarify exactly what you feel when you discuss the condition with your dentist. Be sure to tell the dentist when the pain started and if there is anything, such as the application of a warm compress, that helps eliminate the pain.

Do some products work to decrease sensitivity?

Toothpastes for sensitive teeth usually contain a desensitizing agent that protects the exposed dentin by blocking the tubes in the teeth that are connected to nerves. In most cases, these products must be used on a regular basis for at least a month before any therapeutic benefits may be noticed.

What can dentists and hygienists do for my sensitive teeth?

Dentists have a variety of regimens to manage tooth hypersensitivity, including both in office treatments and patient-applied products for home use. If you are diagnosed with dentin hypersensitivity, your dentist may apply a desensitizing agent or protective coating. You may be prescribed a stannous fluoride gel or an over-the-counter desensitizing toothpaste containing fluoride and either potassium nitrate or strontium chloride. These ingredients help block transmission of sensation from the tooth to the nerve. It also might help to massage the special paste onto your gums with your finger after brushing.

What should I do after the dentist or hygienist has applied a desensitizing agent?

Listen closely to your dentist’s instructions. He or she may advise you not to eat or drink for a short period of time, to eliminate all sources of irritation, such as acid foods or medication, high concentrated foods or flavoured toothpastes. You may also be instructed to change oral hygiene habits that are likely to cause abrasion and to use a daily fluoride application (a rinse or a brush-on gel.

What is tooth decay, and what causes it?

Tooth decay is the disease known as caries or cavities. Unlike other diseases, however, caries if not life threatening and is highly preventable, though it affects most people to some degree during their lifetime. Tooth decay occurs when your teeth are frequently exposed to foods containing carbohydrates (starches and sugars) like fizzy drinks, candy, ice cream, milk, cakes, and even fruits, vegetables, and juices. Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These acids damage tooth enamel over time by dissolving, or demineralising, the mineral structure of teeth, producing tooth decay and weakening the teeth.

How are cavities prevented?

The acids formed by plaque can be counteracted by simple saliva in your mouth, which acts as a buffer and demineralising agent. Dentists often recommend chewing sugarless gum to stimulate your flow of saliva. However, though it is the body’s natural defence against cavities, saliva alone is not sufficient to combat tooth decay. The best way to prevent caries is to brush and floss regularly. To rebuild the early damage caused by plaque bacteria, we use fluoride, which helps to demineralise the tooth structure. Fluoride is added to toothpaste to fight cavities. The most common source of fluoride is in the water we drink. Fluoride is added to most community water supplies. If you are at medium to high risk for cavities, your dentist may recommend special high concentration fluoride gels, mouth rinses, or dietary fluoride supplements. Your dentist may also use professional strength anti-cavity varnish, or sealants—thin, plastic coatings that provide an extra barrier against food and debris.

Who is at risk for cavities?

Because we all carry bacteria in our mouths, everyone is at risk for cavities. Those with a diet high in carbohydrates and sugary foods and those who live in communities without fluoride water are likely candidates for cavities. And because the area around a restored portion of a tooth is a good breeding ground for bacteria, those with a lot of fillings have a higher chance of developing tooth decay. Children and senior citizens are the two groups at highest risk for cavities.

What can I do to help protect my teeth?

The best way to combat cavities is to follow three simple steps:

1. Cut down on sweets and between-meal snacks, Remember, it’s these sugary and starchy treats that put your teeth at risk.

2. Brush after every meal and floss daily. Cavities most often begin in hard-to-clean areas between teeth and in the fissures and pits—the edges in the tooth crown and gaps between teeth. Hold the toothbrush at a 45-degree angle and brush inside, outside, and -between teeth and on the top of your tongue. Be sure the bristles are firm, not bent, and replace the toothbrush after three months to safe guard against re-infecting your mouth with old bacteria that can collect in the brush. Only buy toothpastes and rinses that contain fluoride. Children under six should only use a small pea-sized dab of toothpaste on the brush and should spit out as much as possible because a child’s developing teeth are sensitive to higher fluoride levels. Finally, because caries is a transmittable disease, toothbrushes should never be shared, especially with your children.

3. See your dentist and hygienist at least every six months for checkups and professional cleanings. Because cavities can be difficult to detect a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods, or if you notice signs of decay like white spots, tooth discolouration, or cavities, make an appointment right away. The longer you wait to treat infected teeth the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself.

You can prevent gum disease by controlling the amount of plaque and tartar that builds up on your teeth. Regular visits to your dentist or hygienist, brushing and flossing your teeth properly and stopping smoking will help to do this.

Dental floss or inter-dental brushes can remove plaque and small bits of food from between your teeth and under your gum line – areas that a manual toothbrush can’t reach. You may prefer to use an electric toothbrush. There is some evidence to suggest that certain types of electric toothbrush may be more efficient at removing plaque than manual toothbrushes. It’s important to use the correct technique, so ask your dentist or hygienist for advice.

Some antiseptic mouthwashes reduce the amount of plaque bacteria when combined with regular brushing. However, there isn’t enough evidence to say whether mouthwash can help to prevent gum disease. If you do use an antiseptic mouthwash, it’s important that you don’t use it for too long as it can stain your teeth. Always read the information on the mouthwash box or bottle and if you have any questions, ask hygienist for advice.

Even thorough brushing and flossing can’t remove every trace of plaque. Most people have irregularities in their teeth where plaque can build up out of reach and harden into tartar. This can only be removed by your hygienist during scaling.