Bye-Bye, Bad Breath

Embarrassed by bad breath? Self-conscious about coffee-stained teeth? Worried that your gums are starting to resemble Grandma’s? We have the solutions to 9 common oral health problems...

Oral health isn’t just about brushing your teeth twice a day. It’s about taking care of your entire mouth so your gums and jaw stay healthy for life.

“The mouth is a window to a person’s overall health,” says John A. Valenza, D.D.S., executive associate dean of the University of Texas Dental Branch at Houston. Besides affecting comfort and self-image, poor oral health “can put you at risk for cardiovascular disease, stroke and various systemic infections,” he says.

Yet some dental problems often go untreated. Here are 9 common oral health woes you don’t have to live with:

Problem #1: Bad Breath
Halitosis – aka bad breath – is embarrassing and definitely unpleasant for the people around you. Pinpoint the source and you can nix the odor.

Food, bacteria and poor oral hygiene are the most common culprits. Pungent foods such as garlic and onions are often absorbed into the bloodstream and transferred to the lungs where the odor is expelled, according to the American Dental Association (ADA).

Other causes can include gum disease, dry mouth, tobacco use, and even medical disorders such as respiratory problems, diabetes, GI issues, or liver or kidney disease, Valenza says.

How to Solve It:

Make a dentist appointment: “In most cases, control of the problem starts with a professional dental cleaning, improved oral care at home and some modification of diet,” Valenza says. If your mouth gets a clean bill of health from your dentist, you may be referred to a medical doctor or specialist.

Practice good hygiene: Brushing, flossing and rinsing will temporarily mask offending odors until your body eliminates the food causing your bad breath, the ADA says. Improved dental hygiene will also eliminate food particles in the mouth that collect bacteria, which can cause bad breath. Brush twice a day and don’t forget to brush your tongue too.

Stimulate saliva: Xerostomia – or dry mouth – occurs when the flow of saliva needed to cleanse the mouth decreases. Medications, salivary gland disorders and breathing through the mouth are often to blame. Try sugarless candy and increased fluids to help moisten the mouth and keep bad breath at bay. And ask your dentist about prescription artificial saliva to help lubricate your mouth.
Problem #2: Canker Sores
Not to be confused with cold sores (which appear on the outside of the mouth) canker sores are small ulcers that form inside. More common in women than men, canker sores may be related to hormonal changes, Valenza says.

“The cause is unknown but believed to be related to the immune system and possibly bacteria or viruses,” he says. So fatigue, stress or allergies may increase the likelihood of canker sores.

How to Solve It:
Canker sores are painful, but they aren’t contagious and usually heal on their own within 1-2 weeks regardless of treatment, Valenza says.

But if the irritation is unbearable, the numbing effect of over-the-counter topical anesthetics and antimicrobial mouthwashes can offer some relief. Also, skip spicy and salty foods and dishes that are very hot or cold until your mouth heals.

In some cases, Valenza says, antibiotics or oral dressings can help reduce the risk of infection.

Problem #3: Clicking Jaw
We ask a lot of our jaws. The temporomandibular joint (TMJ), where the lower jaw fits with the skull, moves about 2,000-3,000 times a day. “It’s one of the most complex joints in the body,” Valenza says.

Problems – more commonly reported in women than men – result from trauma, arthritis, wear and tear, autoimmune disease and chronic teeth clenching and grinding.

TMJ pain is also caused by a slipped jaw disk, which causes clicking and locking of the joint, says Glenn Thomas Clark, D.D.S, director of the Orofacial Pain and Oral Medicine Clinic at the University of Southern California School of Dentistry.

The issue can be limited to the joint itself, facial muscles or both. Symptoms include clicking and popping, facial pain, headaches, neck and back pain, and bite problems.

How to Solve It:
Even if your clicking isn’t painful, have it checked out by your dentist to evaluate your risk of other conditions, such as arthritis in the joint and long-term effects of the popping, Valenza says.

While dental treatments for TMJ vary, clear plastic mouth guards can help relieve symptoms in some patients, he says. The devices are reversible and allow your dentist to try different jaw and bite positions without altering the teeth.

For at-home relief of soreness and pain associated with TMJ, try these tips from the experts:

Don’t chew gum.

Avoid foods that require opening your mouth wide to eat, such as apples.

Reduce use of stimulants such as caffeine.

Try over-the-counter anti-inflammatory medications, such as aspirin, ibuprofen and naproxen.

Apply heat to the outside of the face in the painful, sore area.

Reduce tension with meditation, yoga and stretching tight muscles.

Problem #4: Cavities
Dental plaque causes cavities – or tooth decay – and whether you get them depends on your susceptibility, eating habits and at-home oral care, Valenza says. Symptoms range from nothing to a toothache to hot and cold sensitivity.

Your dentist will determine if a cavity is present by an exam, X-ray or more advanced tools, such as fluorescent light to detect decay.

How to Solve It:
Once a cavity has formed, visit your dentist. He or she will remove the decayed portion of the tooth, clean the area and then fill the cleaned-out cavity with a filler made of gold, porcelain, resin or amalgam.

A tooth with a large cavity may be restored with a crown or cap. If the nerve inside the tooth is affected, an endodontist may have to do a root canal by cleaning out the diseased area and sealing the root canal. A crown over the tooth will help strengthen it.
In the meantime, try these tips:

Take an over-the-counter painkiller with water, says Mahvash Navazesh, D.D.S., chair of diagnostic sciences at the University of Southern California.

DON’T put aspirin directly in the tooth to seal a gap caused by a cavity, she cautions. As the aspirin dissolves, it will damage the exposed soft tissue.

Get to your dentist as soon as possible to prevent infection of the tooth.

Problem #5: Receding Gums
When the gums move away from the teeth, exposing the roots, you get oral recession – or receding gums. It's a typical sign of aging and common in patients older than 40. But it can also signal periodontal disease or toothbrush abrasion, Valenza says.

And for post menopausal women, there’s a link between osteoporosis and receding gums because they lose mass from bone that supports the teeth and gums, he says.

How do you know if your gums are receding? Teeth appear longer and notched at the gum line. You may also see visible roots (which may cause sensitivity), cavities below the gum line, red and swollen gums and larger spaces between your teeth at the gum line.

How to Solve It:
The most effective way to prevent gum recession is good oral hygiene, Valenza says. Use a soft bristle toothbrush, practice good at-home care and visit your dentist regularly, especially after age 40.

In some cases, gum grafts are done for aesthetic purposes, to prevent root decay or gum inflammation, or to slow progressing recession, says Hessam Nowzari, D.D.S., director of the Advanced Periodontics Program at the University of Southern California. This procedure is done by harvesting tissue from inside the patient’s mouth and grafting it over the receded teeth.

Problem #6: Dental Fluorosis
Ever wonder what those white marks are on the front of your teeth?

“Dental fluorosis is a discoloration of the teeth caused by too much fluoride,” Valenza says.

The good news is that it's primarily a cosmetic issue. Plus, teeth with the discoloration are more resistant to cavities.
How to Solve It:
The bad news: There are no effective home solutions to get rid of the white spots. But your dentist can treat dental fluorosis with cosmetic dental procedures, such as porcelain veneers or crowns.

Problem #7: Stained Teeth
Wish your pearly whites were pearlier? Yellow or grayish teeth are typically caused by food stains, bad oral care habits and/or porous enamel, Valenza says.

How to Solve It:

Stop smoking and trade in teeth-staining coffee, tea and cola for clear liquids.

In-office teeth whitening offers the best results. At-home custom whitening agent and trays provided by your dentist will get the job done almost as well. But all whitening requires some regular home “maintenance” after the initial treatment, Valenza says.

Try an over-the-counter whitener approved by the ADA. Drugstore remedies may offer some improvement, but use them after the stain is first removed by your dentist or hygienist for the best results.

Problem #8: Knocked-Out Teeth
“Avulsed (knocked out) teeth are common in sports injuries, especially in patients not wearing protective mouth guards,” Valenza says. Other causes include fights, falls and car accidents.

How to Solve It
There’s no need to be a toothless wonder.

“The best chance of saving the knocked-out tooth is to replant it (put it back to its original position) within the first 30 minutes,” says Ramon Roges, endodontist and director of the University of Southern California School of Dentistry, Emergency Clinic.

Here’s how:

1. Gently rinse the tooth with water – hold it by the crown (white area), not the root (yellow area).

2. If possible, place your tooth back into the socket it came out of even if it's bleeding. Ideally, this should be done within five minutes.

3. If you can’t place the tooth back in the socket, temporarily store it in one of the following (listed in order of preference): whole cold milk, saliva, saline or water.
4. Close your mouth after biting into a piece of gauze or cloth between the upper and lower teeth.

5. Get to the dentist immediately, where he or she will examine and X-ray the tooth and socket.

Treatment will depend on how long the tooth has been out of the socket, the patient's age and if any other damage exists such as fractured bone, Valenza says. If the tooth can’t be re-implanted, a permanent bridge or implant can restore smile and function.

Problem #9: Fear of the Dentist
Are you a dental chicken? Fear isn’t uncommon. But avoiding the dentist can result in problems that are more complicated to treat once you actually go.

How to Solve It:
Talk to your dentist about identifying the source of your fear and how to ease your worries. All dentists are trained in basic management of pain and anxiety, but some provide advanced relaxation techniques including of sedation, hypnosis and audio/visual aids.

Sedation, however, has disadvantages, says Peter Alan Stone, D.D.S., associate professor of clinical dentistry at the University of Southern California School of Dentistry.

“After the treatment is done, the patients still retain their fears,” he says.

Ultimately, he says, “Each unique person has a different story and needs an individualized approach.”

What Do Your Oral Hygiene Habits Say about You?
When you smile, what message are you sending to the world?