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How should I avoid bad breath?

Bad breath, medically called halitosis, is a result of poor dental hygiene and may also be a sign of other health issues. The problem of bad breath in healthy individuals is due to microbial deposits on the tongue, especially at the back of the tongue. Other factors which can cause bad breath are dry mouth, use of tobacco products, eating foods such as garlic and onions, dehydration or periodontal (gum) disease.

You can prevent bad breath by avoiding dehydration; follow a good oral hygiene, use mouth rinses, include regular brushing and flossing and stop smoking and the use of tobacco. Brush or use a tongue scraper to clean the tongue and reach the back areas. Brush from the back towards the front of the tongue since the back areas always smell the worst. Replacing your brush every 2 to 3 months is very important. It is also necessary to clean your dentures or bridges every day.

If you have a severe bad breath problem, your dentist may prescribe a course of antibiotics to reduce the overgrowth of bacteria on the tongue.

How can cosmetic dentistry help improve the appearance of your smile?

Cosmetic dental treatments offer various solutions for a more beautiful and confident smile if you want to improve your smile or you feel self-conscious about your teeth. Cosmetic dental treatments can dramatically change your smile based on your needs.

The cosmetic procedures available are:

  • Composite (tooth-coloured) Fillings

    are used to repair teeth with cavities, and replace old defective fillings. They are also used to repair chipped, broken, or discoloured teeth. This type of filling is also very useful to fill the gaps and protect sensitive, exposed root surfaces caused by gum recession.

  • Teeth Whitening

    involves bleaching of the teeth that have been stained or discoloured by age, food, drink, and smoking. The darkened teeth due to injury or medications can also be bleached.

  • Porcelain Veneers

    are thin tooth-coloured shells that are customised and bonded onto the front of the teeth. They can help in restoring and masking the discoloured, damaged, poorly shaped, or misaligned teeth. Veneers require removal of a minimal amount of tooth structure from the tooth surface to create a beautiful smile.

  • Dental Implants

    are artificial roots surgically placed into the jaw for replacing one or more missing teeth. The implants are used to attach porcelain crowns or to provide a stable, durable and strong solution for removable dental appliances such as dentures.

  • Some other procedures such as

    bridges, periodontal plastic procedures, crowns and braces

    can be used as cosmetic dental treatments. You should talk to your dentist about the best options for correcting your dental problems and creating a smile that you can be proud of.

How often should I have a dental examination and cleaning?

Regular dental check-ups are necessary even if your teeth may be in good condition. Prevention of tooth diseases and providing regular care to the teeth is important for dealing with dental problems such as tooth extraction or root canal therapy in the long run. Sometimes, certain symptoms in the mouth not related to dental conditions can also be revealed during a regular dental check-up.

For most people it is recommended to have a dental check-up and tooth cleaning twice a year. You may have more frequent check-ups for continuing ideal dental care if you have a weak immune system, problems of plaque build-up, cavities or gum disease. A twice-yearly examination may have the advantage of checking for non-visible dental problems, early signs of decay and treating other oral health issues.

Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health. These include reviewing your medication history and imaging findings, evaluating oral cancer and gum diseases, examination of tooth decay and existing restorations, removal of calculus (tartar) and plaque, and teeth polishing. A good dental examination and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so, will require regular check-ups and cleaning.

How should I brush and floss?

The plaque and bacteria causing dental diseases can be controlled by brushing and flossing. Also, if plaque is not removed, it turns into calculus (tartar) and begins to destroy the gums and bone, causing periodontal (gum) disease.

  • Brushing:

    Regular and thorough brushing is a very important step in preventing tooth decay and gum disease. You should make it a habit of brushing after every meal since the teeth are attacked within minutes after eating. Brush at least once a day and before you go to bed in the night with a soft bristle brush and toothpaste.

    Brush at an angle of 45 degree to your teeth by directing the bristles to the meeting point of your teeth and gums. Avoid scrubbing and use gentle, circular up and down motions while you brush. Make sure you clean every surface of the teeth; the tongue side, cheek side and the chewing surface. Change your usual brushing pattern by reversing it after few days. Avoid rushing while you brush; a thorough brushing should take at least two to three minutes. You can ask your dentist to suggest the best brush suitable for your teeth.

  • Flossing:

    Flossing helps in cleaning the spaces between the teeth and under the gum line. It also disrupts plaque colonies from building up, thereby preventing damage to the gums, teeth, and bone. If you are not in the habit of flossing, you will be missing more than one-third of your tooth surface. If you floss at least once a day, the plaque never gets the chance to harden into tartar.

    Steps to be followed during flossing include:

    • Take dental floss whose length is equal to the distance from your hand to your shoulder, and wrap it around your middle fingers, leaving about 2 inches of floss between the hands.
    • Curve the floss into a “C” shape around each tooth and under the gum line by gently moving up and down, cleaning the side of each tooth.
    • It is important to brush your teeth after you floss.

    Your gums may bleed when you initially begin to floss, but the bleeding gradually stops after regular flossing for a few days. Rinse your mouth with water after brushing and after meals if you are unable to brush.

How can I tell if I have gingivitis or periodontitis (gum disease)?

Presence of plaque and tartar on the teeth for a prolonged time can be harmful and result in gum inflammation known as “gingivitis.” Your gums may turn red, swollen or even bleed. This condition can be reversed with regular cleaning by a dentist and brushing and flossing regularly. Untreated gingivitis may progress to “periodontitis” (inflammation surrounding the tooth) which results in pulling of the gums away from the teeth thereby forming infected pockets. If gingivitis or periodontitis is left untreated, the gums, bones and tissue supporting the teeth may be destroyed and cause loosening of the teeth.

Signs and symptoms of periodontal disease include red and puffy gums, bleeding gums, persistent bad breath due to bacteria in the mouth, new spacing between teeth, loose teeth due to bone loss or weakened periodontal fibres, pus around the teeth and gums revealing infection, receding gums (loss of gum around a tooth), tenderness, or discomfort to the gums and teeth. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

What are the options available if I have missing teeth?

Injury, accident, fracture, severe dental decay, and gum diseases are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is necessary to replace the lost tooth to avoid cosmetic and dental problems in the future. When a tooth is lost, the teeth on either side start shifting into the open space of the lost tooth.

These changes may cause tooth decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

There are various options for replacement of missing teeth such as removable bridges, fixed bridges, dentures and implants.

If you have missing teeth, ask your dentist if they need replacement and what options are available. Together with the dentist you can select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

What can I do about old unattractive or discoloured fillings?

The fillings in our mouth may have been placed many years ago or during our childhood. These fillings turn old and unattractive which may cause you to feel self-conscious when you laugh, talk or smile. The spaces among the old fillings may allow for bacterial growth due to leftover food particles and can cause tooth decay. The condition of the fillings can be evaluated and replaced if required. Various options are available for replacing old, unattractive, or discoloured fillings:

  • Porcelain veneers

    are a great solution for fixing discoloured, pitted, malformed, or slightly crooked teeth and to fill up spaces between the teeth. They are very thin shells of tooth-coloured porcelain that are individually crafted and permanently cemented to the front surface of your teeth. Veneers can restore your smile as they are very durable, natural looking, and do not stain.

  • Crowns (Caps)

    are used for damaged teeth that cannot be repaired with a filling or other type of restoration. Crowns can be used to cover and encase the entire surface of the tooth and restore it to its original shape and size. They can be made of gold, porcelain, or other tooth-coloured materials.

  • Inlays/Onlays

    are utilized to repair teeth that have large defective/unattractive fillings or have been damaged by decay or trauma. They can be made of composite resin, porcelain or gold.

  • Composite (bonding) fillings

    are suitable for use in front teeth or visible parts of teeth. These are tooth-coloured fillings that can be closely matched to the colour of your existing teeth.

What can be done about stained or discoloured teeth?

Aging causes wear of the outer layer of tooth enamel and reveals a darker or yellow shade. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull. Sometimes, teeth can become discoloured from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discoloured.

There are many products and methods available to solve the problem of unattractive or discoloured teeth. Teeth whitening (or bleaching) is a simple, non-invasive dental treatment which changes the colour of the natural tooth enamel, and is an ideal way to enhance the beauty of your smile. Since teeth whitening is not a permanent remedy, a touch-up may be needed every several years to keep your smile looking bright. The most widely used professional teeth whitening systems are:

  • In office teeth whitening:

    Your dentist will apply a bleaching solution to the teeth and use a special light to enhance the action of the teeth whitening agent. More than one visit, each visit lasting around 30 to 60 minutes may be required.

  • Home teeth whitening systems:

    A product in the form of gel is placed in a mouth guard that is created from a mould of your teeth. The mouth guard is worn twice a day for approximately 30 minutes, or overnight while you sleep. Several weeks are required to achieve the desired results which depend on the desired level of whitening and the degree of staining present on the teeth.

Can periodontal disease cause heart attacks and stroke?

There is an important connection between periodontal disease and risk of heart disease. Periodontal disease may be an early sign of cardiovascular problems. It is difficult to detect heart disease as you can never feel your arteries hardening or your cholesterol rising, but you will notice pain and bleeding gums. It is recommended to prevent oral health problems if you are at high risk of developing heart disease. Advanced cases of periodontal disease will require treatment and a careful cleaning of the roots of the teeth. Your dentist may prescribe antibiotics if you have had recent cardiac surgery to avoid infection of the heart tissues thus preventing endocarditis. Research has suggested the presence of oral infection to be a risk factor for stroke. Hence, regular and through brushing, flossing and maintaining good oral hygiene is necessary to prevent many more serious health problems in the long run.


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