Bad breath (malodor or halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply cleaning the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

• Tongue – The top surface of the tongue traps bacteria, food debris, dead skin cells and mucous from our saliva.  Together these cause a coating on the top of the tongue which is the primary source of malodor.
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• Gums – Bacteria called plaque and food debris gets trapped along our gumline and between the teeth.  If it not removed thoroughly every day it will start to cause the gums to become infected.  Between the decomposing debris and the infected gums, a bad odor can result.
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• Bacteria  -  The bacteria in the plaque produces odor-causing compounds called Volitile Sulfur Compounds or VSC. Eliminating the bacteria that cause VSC is crucial to controlling malodor.
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• Foods -  Garlic, onions, and some spices contain odor-causing compounds which enter the blood stream; they are transferred to the air in the lungs where they are then exhaled.  This cause of malodor is temporary as it usually last 24-72 hours.  The use of xylitol gum/mints is particularly helpful in masking this temporary type of malodor.
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• Sinuses and Tonsils - Chronic sinus infections and chronically swollen tonsils will trap mucous and debris which can cause a bad odor.
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• Dental Cavities and Crowns with Improperly Fitted Margins - These area will trap bacteria and food debris. 
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• Dry mouth (Xerostomia) – These are both names for an inadequate saliva flow.  Inadequate saliva will further contribute to the coating on the tongue and the debris on the teeth and gums.  It can be caused by some medications, advanced age and mouth breathing.
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• Tobacco Products – Tobacco drys the mouth and coats the tongue, causing malodor.
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• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

What can I do to prevent bad breath?
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• Brush Your Tongue Every Day!!! - This simple step will eliminate bad breath for most patients.  Use a soft manual toothbrush or a tongue scraper to clean the top surface of the tongue.  Be sure to go back as ar as you can as the coating is thickest in the back!  Drag the brush/scraper forward over the top surface of the tongue.  Do not brush back and forth as this is ineffective.  Rinse the tool frequently and brush/scrape the top surface from back to front again.  Repeat until the surface of the tongue is pink.  The top of the tongue should not be white, yellow or brownish in color.
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• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  We recommend an electric toothbrush such as the Sonicare or the Oral-B.  Clean thoroughly between your teeth every day with floss or proxibrushes.   Clean your tongue every time you clean your teeth, especially every morning when bad breath is usually at its worst.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly with a denture brush and place them back in your mouth in the morning.
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• See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist and hygienist will recommend more frequent teeth cleaning visits.
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• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
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• Manage Your Xeristomia (Dry Mouth) - Sipping water throughout the day will help keep your mouth moist and wash away bacteria.  Use an OTC mouthrinse such as Biotene or Oasis which help to replace salivary enzymes.  Use gum or mints sweetened with 100% xylitol  to promote saliva production.  These can be found in natural food stores or online.  Two popular products are Theremints/gum and Spry.  Use an OTC saliva substitute such as Salivart or Oasis to help moisten mouth.  This can be especially helpful before bedtime.
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• Use mouthwash/rinses which Neutralize the VSC's – Special OTC rinses (Closys, SmartMouth, BreathRx and Biotine) help to neutralize the VSC's (volatile sulphur compounds) but you must still practice the suggestions listed above as you can not eliminate bad breath long-term by just rinsing with a "mouthwash".  We recommend Closys and have found it to be very effective.  Closys mouthwash attacks the VSC's with it's active ingredient, chlorine dioxide.  This goes directly to the source of the bad odor rather than simply covering it up like most over the counter mouthwashes do.  Additionally, Closys has a high pH (alkaline) causing the activity of bacteria in the mouth to be reduced to the bare minimum.  Anaerobic bacterial activity is increased under acidic environments.  Many other mouthwashes also contain alcohol which is irritating to the gum tissues and also keeps the saliva dry.  Closys contains no sodium lauryl sulphate or sweeteners and is guaranteed to keep your breath fresh for at least 5 hours.

In most cases, your dentist or hygienist can advise you on how to eliminate your bad breath.  If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician or an ENT specialist to determine the cause of the odor and an appropriate treatment plan.

Brushing and flossing help to removel the biofilm (commonly called plaque) and food debris that cause dental disease (gum disease and cavities).

Biofilm is a coating of numerous different types of  bacteria that together, stick to the teeth and gums.  The bacteria in biofilm converts certain food particles into acids that cause tooth decay.  Also, if the biofilm is not removed frequently, it hardens and turns into calculus (tartar).  If biofilm  and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Biofilm formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.  There is NO mouthwash that will remove biofilm. It must be mechanically removed from the teeth and gums.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and fluoridated toothpaste.

• Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside of the front teeth.
• Brush your tongue to remove bacteria and freshen your breath. (See our FAQ about how to prevent bad breath.)

Electric toothbrushes are strongly recommended. We recommend the Sonicare for any adult patient with large fillings, crowns, bridges, implants or a history of gingivitis/gum disease.  Children and patients without a history of these problems can also use a Braun Oral-B electric brush. Electric toothbrushes are easy to use and will usually remove biofilm more effectively and efficiently than a manual toothbrush.  Using light pressure, place the bristles of the electric brush at a 45 degree angle into the crevice where your gums meet the teeth. Allow the brush to do its job for 3-5 seconds per tooth, then move the brush to the next tooth or two.  Do not scrub with an electric brush the way you would with a manual toothbrush, this makes the electric brush LESS effective.  Start in the back and move the brush slowly across that arch then move to the insides and move slowly back across the arch.  Do the same on the other arch.  Finish by holding the brush on all of the chewing surfaces of the back teeth. 

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts biofilm colonies from building up, preventing damage to the gums, teeth, and bone.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently rub the floss up and down several times on one tooth then rub up and down on the side of the other tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Proxabrushes - Many people are now able to clean very effectively between their teeth with small brushes called proxabrushes.  For some of our patients, when proxabrushes are used properly they can be as effective or more effective than dental floss and can be used instead of floss.  Ask your dental hygientist if proxabrushes are right for you.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Over the years there has been some concern as to the safety of amalgam (silver) fillings.  An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury.  Dentists have used this blended metal to fill teeth for more than 100 years.  The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth.  The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.

The general consensus is that amalgam (silver) fillings are safe.  Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective.  The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling.  The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels.  For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them.  However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings.  We encourage you to discuss these options with your dentist so you can determine which is the best option for you.

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

• Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Removes stain that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam 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 cleanings.

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.

• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Persistent bad breath – Caused by bacteria in the mouth.

• New spacing between teeth – Caused by bone loss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  This is the beginning of periodontal disease.

How to floss properly:

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings.  Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers may be used to restore or correct the following dental conditions:

• Severely discolored or stained teeth
• Unwanted or uneven spaces
• Worn or chipped teeth
• Slight tooth crowding
• Misshapen teeth
• Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Cavities are an infection of the tooth caused by bacteria in the mouth.  These bacteria are "fed" with sugar in foods we eat. The more the bacteria are fed sugar, the more active they become and they produce a toxic by-product that is acidic to the enamel on the teeth.  These toxic by-products weaken the enamel and the bacteria invade the weak spot resulting in an infection or cavity in the tooth. 

You must have three things to cause a cavity:  a tooth, bacteria and sugar or food for the bacteria.  Preventing cavities is focused on altering these three things.

All patients should practice the following steps to prevent decay (cavities):

-  Remove all plaque thoroughly, every day by brushing a minimum of 2-3 times daily and cleaning between the teeth BEFORE brushing with dental floss or proxibrushes a minimum of once daily.

-  Limit exposure to sugar

Ulcers inside the mouth are different from the "cold sores" on the outer lips.  Ulcers in the mouth are called Recurrent Alphtous Ulcers (RAU) but are commonly called "canker sores" and are completely benign and not contageous (unlike cold sores, see question under that heading).

Thankfully, most RAU are only painful for the first 2-4 days but can take 7-10 days to completely heal.  These will usually heal on their own without treatment but severe or multiple sores may require medication. Should this occur, please make an appointment to see Dr. Adams while the ulcers are still present. 

What causes RAU?

-  RAU are thought to be viral in nature though the exact mechanism is not well understood.  Some people will get one or more several times a year or very infrequently.  Some times a person will have a period of numerous, concurent outbreaks.

- RAU are more common in women than men, most often start in children as young as 10-12 years old but occur most frequently in teens and young adults, and are more common in people with a sensitivity to gluten. 

-  The causative factors assocationed with RAU are: stress (fatigue or trauma), mouth injury (cheek bites or sports injuries), spicy or acidic foods (cinnamon, tomatoes, vinegar in particular) , hard or sharp foods, oral appliances (braces, dentures, mouth guards), hormone fluctuations (pre-menstrual), nutitional deficiency (B12, zinc, iron, folic acid), toothpaste containing Sodium Lauryl Sulphate (SLS) and heredity.

How Can I Prevent Canker Sores (RAU)?

- Prevention of RAU includes avoiding the causative factors above and may require some experimentation to determine the triggers as this can vary for each person.  However, switching to an SLS-free toothpaste is highly recommended.

SLS-free toothpastes include: Sensodyne Pronamel, Biotene and Biotine Sensitivity, The Natural Dentist Anti-Cavity , Oral-B Rembrandt Canker Sore Toothpaste, Burt's Bees Natural with Fluoride, and Tom's of Maine Clean and Gentle Toothpaste with Fluoride.

Non-Prescription Treatments include: 

Zylactin-B and  Orabase with Benzocaine can be used to protect and numb the sore.  While these products will not "cure" the sore, they will provide relief long enough to eat a meal if the sore is on a very painful spot.

Home Remedies

Rinsing with warm salt water can help to prevent infection of the sores and placing a wet tea bag (a black tea, not herbal) against the sore for 20 minutes 2-3 times a day can offer some relief.  The tannins in the tea help to speed healing.

If you suffer from canker sores try the suggestions offered here but do not heistate to call our office if you need any further support or information.

Xylitol is a natural sweetener which is gaining in popularity in the United States because of it's ability to reduce decay!!.  It has been in use for decades in many European countires and Japan.  Xylitol is extracted from natural plants sources but most commonly from the bark of birch trees.  Because it's production is more expensive than processing other forms of sugar it has not been as widely available in the US but it's popularity is growing because of the health benefits.

Currently you must go to a "health food" store or online to purchase xylitol products.  This should change as the demand for xylitol in the US grows.  Xylitol can be purchased in a granular form for addition to coffee, tea, etc... but it's greatest benefit comes from it's use in gum and mints.

Xylitol can not be absorbed by the cavity causing bacteria we all have in our mouths.  When these harmful bacteria try to absorb the xylitol they break apart and are washed away by the saliva.  So regualr use of xylitol products throughout the day can help to reduce a person's cavity risk by as much as 85%!!!

The easiest way to expose your teeth/mouth to xylitol is to chew gum or suck on mints sweetened 100% with xylitol at least 5 times a day!!

This article is incomplete and still under contruction... please check back for additional information.

Sensitivity of the teeth is very common in adults and can be caused by one or more of the following conditions.

-  Abrasion -  over aggressive scrubbing with a toothbrush, especially if it is medium or hard.

-  Erosion -  a slow chemical dissolving of the tooth caused by ingesting acidic foods and beverages.

-  Abfraction -  the slow, microscopic fracturing of the teeth caused by clenching and grinding.

-  Teeth Whitening/Bleaching - the bleaching agent can cause temporary sensitivity which is sometimes very uncomfortable but temporary and not harmful to the teeth.

To reduce overall sensitivity at home and at your dental cleanings try these techniques.

- NEVER use a medium or hard toothbrushes.  We recommend that our patients use a soft, electric toothbrush... and NEVER scrub!

- Rinse your mouth with water after eating or drinking especially if it is acidic.  Do NOT brush your teeth for 20 minutes after ingesting anything acidic.

-  Try to stop clenching or grinding your teeth if you do it while awake.  If you do it while asleep, talk to Dr. Adams about an occulsal appliance which would protect the teeth from damage.

-  Discontinue using any toothpaste with a whitening agent.  These toothpastes do not really whiten and can be very harsh and irritating.

-  If you bleach your teeth use a toothpaste for sensitive teeth for at least one week before bleaching.  If the teeth are still sensitive  talk to our staff about obtaining a prescription strenght fluoride gel or MI Paste Plus to use nightly to ease this kind of sensitivity.

-  Keep teeth free of plaque throughout the day, especailly along the gumline.  Plaque produces acidic toxins which are irritating to the teeth.

-  Use one or more of the following products as recommended by Dr. Adams or your Hygienist

  1.  Sensodyne or Pronamel toothpaste (OTC)-  contains Potassium Nitrate which is absorbed into the tooth and helps to block the sensitive nerve endings.  Use at least 2x's/day and do not mix with other OTC toothpastes.

  2.  Prevident Sensitive Toothpaste (Rx only, can be purchased at our office)  - contains Sodium Fluoride and Potassium Nitrate in higher concentrations than the OTC products.  Use at least 2x's/day and do not mix with other toothpastes.

 3.  Gel-Kam (Rx only, can be purchase at our office) - Stannous Fluoride Gel is absorbed into the tooth to block sensitive nerve endings.  Apply to teeth at bedtime after flossing and brushing.

 4.  MI Paste Plus (Can only be purchased through a dental office, not available at pharmacys)  Apply nighly after flossing and brushing.

If your teeth are ONLY sensitive during cleaning appointments, use one of the products above for 2 weeks prior to your cleaing appointment.

However, if you teeth are sensivitve during cleanings, tell your Hygienist at the start of the appointment and the Hygienist can do one or more of the following:

  -  Use warm water only

  -  Use the ultrasonic scaler on the lowest power

  -  Apply Pro-Relief Desensitizing paste before treatment.  Pro-Relief contains Pro-Argin which provides instant sensitivity relief.  This is a Rx only product and not available for home use.

  -  For extremely sensitive teeth the area can be injected with an anesthetic as needed to completely numb the tooth.