Bad Breath Management
Bad breath, also known as halitosis, is breath that has an unpleasant odor. This odor can strike periodically or be persistent, depending on the cause. In many people, the millions of bacteria that live in the mouth (particularly on the back of the tongue) are the primary causes of bad breath. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. Most bad breath is caused by something in the mouth.
Some types of bad breath, such as “morning mouth,” are considered to be fairly normal, and they usually are not health concerns. The “morning mouth” type of bad breath occurs because the saliva that regularly washes away decaying food and odors during the daytime diminishes at night while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.
Causes of Bad breath
Poor dental hygiene Infrequent or improper brushing and flossing can leave food particles to decay inside the mouth.Infections in the mouth Periodontal (gum) diseaseRespiratory tract infections Throat infections, sinus infections, lung infectionsExternal agents Garlic, onions, coffee, cigarette smoking, chewing tobaccoDry mouth (xerostomia) This can be caused by salivary gland problems, medications or by “mouth breathing.”Systemic illnesses Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and othersPsychiatric illness Some people may perceive that they have bad breath, but it is not noticed by oral-health-care professionals or others. This is referred to as “pseudohalitosis.”
How to control bad breath
Cover up the odor Make it a habit to always chew on something nicely scented (like gum or candy) so that it masks your bad breath. Make sure it’s sugar free, though, so you don’t ruin your teeth (and possibly make the bad breath worse!).Make it a habit to use mouthwash every time you use the bathroom. If you’re drinking enough water every day, that should be every hour or two. It will clear out and cover the bad breath, at least temporarilyRespect personal space. When you’re talking to someone, they shouldn’t be able to smell your breath, unless it is quite powerful. If they can smell your breath, you’re probably too closeBrush your tongue and your teeth thoroughly. You may as well run the brush over the insides of your cheeks while you’re at it. Over 50% of what causes bad breath is not on your teethFloss before you brush If you floss before you brush, you’ll be able to smell how bad your breath stinks and see how your toothbrush is cleaning your teeth.Keep Your Mouth Moisturized. You’ve probably heard this like a million times but a dry mouth is a stinky mouth.Drink a lot of liquids.
A dentist or physician may notice the patient’s bad breath while the patient is discussing his or her medical history and symptoms. In some cases, depending on the smell of the patient’s breath, the dentist or physician may suspect a likely cause for the problem. Your dentist will review your medical history for medical conditions that can cause bad breath and for medications that can cause dry mouth. Your dentist also will ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms, including when the bad breath was noticed and by whom.
You will need diagnostic tests if the doctor suspects a lung infection, diabetes, kidney disease, liver disease or Sjögren’s syndrome. Depending on the suspected illness, these tests may include blood tests, urine tests, X-rays of the chest or sinuses, or other specialized testing.
Gum Decease Prevention
Gum diseases are also known as periodontal diseases. They are caused by bacteria in dental plaque.
Maintaining good oral hygiene and regular dentist visit helps you to prevent gum diseases.
Regular brushing and flossing the teeth removes the plaque.
Regular cleaning of teeth every 6 months by a dentist also helps in preventing gum disease.
Cleaning Root Planing
The objective of scaling and root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Reasons for scaling and root planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.
Here are some reasons why these dental procedures may be necessary:
Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.
Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planing procedure.
Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.
What do scaling and root planing treatments involve?
Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and th e progression of the periodontitis, local anesthetic may be used.
Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.
Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing.
Dental scaling involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time.
If the scale, or calculus (tartar, as dentists like to call it) is allowed to accumulate on the teeth it will unfortunately provide the right conditions for bacteria to thrive next to the gums.
The purpose of the cleaning and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them and you have a better chance of keeping the teeth clean during your regular home care. Also it leaves your teeth feeling lovely and smooth and clean, which is nice when you run your tongue around them.
The dental hygienist or dentist uses specialized instruments to gently remove these deposits without harming the teeth. An ultrasonic instrument uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris and keep the area at a proper temperature. Once the larger pieces of tartar are gone, the dental worker will switch to finer hand tools to remove smaller deposits and smoothen the tooth surfaces. Once all the surfaces are smooth, the dental worker may polish your teeth.
Most people find that cleanings are painless. There may be odd zingy sensations, but many people don’t mind as they only last a nanosecond.
Ideally you should visit your dentist every 6 months. However, there are many factors that determine how often you should have your teeth cleaned. As long as long as you have gum disease, there is no doubt that the hygienist is the one best suited to determine how often.
When A Tooth Can’t Be Fixed…
It needs to be removed. Your dentist may recommend extracting a tooth if:
- Your tooth is too damaged by a fracture or deep cavity to repair.
- You have a sizable infection that cannot be resolved by root canal alone.
- You have teeth that are blocking other teeth from coming in. These may be extra teeth or baby teeth that have not fallen out yet.
- You are getting braces and need to get rid of a tooth that is crowding others.
Wisdom teeth, which typically come in during your teens or twenties, may need to be extracted if they are decayed, infected, or causing pain. They may get impacted—stuck underneath other teeth—which also requires extraction.
Types of Extraction
Most visible teeth can be removed with a simple extraction, where your dentist loosens the tooth, then removes it carefully with forceps. This procedure typically requires just a local anesthetic (an injection).
A surgical extraction may be needed if:
- The tooth has broken off at the gum line.
- The tooth hasn’t come in yet (wisdom teeth, for example)
- The tooth has especially large or curved roots
During a surgical extraction, you may have a local anesthetic along with an IV or general anesthetic.
Both procedures are virtually painless. You might feel pressure or pulling, but no pain.
Tip: Don’t smoke on the day of surgery, as it can increase the chance of dry socket, a painful condition that occurs when a blood clot doesn’t form in the hole, breaks off, or breaks down too early.
Directly after the extraction, you’ll be asked to keep gauze on the extraction site to help the blood clot. It’s important to protect this clot as the wound heals. Eat soft foods, and don’t smoke, use a straw or spit, as these actions can dislodge the clot.
Most people feel some discomfort after having a tooth extracted. You can take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to help relieve the pain. Your dentist can recommend the dosage that’s right for you.
You can also use icepacks to decrease any swelling. If your jaw is still stiff after any swelling has subsided, try warm compresses.
In general, swelling and bleeding last only a day or two after the extraction, and any pain should go away after a few days
Dont wory if a decayed or loose tooth falls out. Be calm. Visit your dentist for replacement of new teeth. Your dentist will check for healing and guide you for further treatment needs.
Our first priority is to save teeth, as it is usually important to the patient's long-term dental and general health to maintain the teeth. Extraction is an option when a damaged or decayed tooth cannot be restored, or when extensive treatment would be necessary to try to save the tooth, but the patient chooses not to proceed with necessary treatment.
The patient will be told what to expect after treatment and what to do in case of emergency. Possible complications are unusual, but will be explained, and are also included on the consent form. A recall appointment may be necessary a few days after extraction to check the healing site. Further appointments will be made to begin the process of replacement of teeth.
After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes.
Do not rinse vigorously, suck on straws, smoke, or drink alcohol for 48 hours. These activities will dislodge or dissolve the clot and retard the healing process. Gentle rinsing with warm salty water (1/2 tsp. salt with 1 cup water) may begin 24 hours after your extraction, rinsing should be done 3-4 times per day. Limit vigorous exercise for the next 24-48 hours as this will increase blood pressure and may cause more bleeding from the extraction site. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. The swelling usually subsides after 72 hours.
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. It is imperative to keep your mouth clean, since an accumulation of plaque, food, or debris may promote infection.
Avoid alcohol for at least 24 hours, as this can encourage bleeding and delay healing. Eat and drink lukewarm food as normal but avoid chewing on that area of your mouth.
After a tooth extraction, your dentist may place a gauze pack on the extraction site to limit bleeding and confine the blood while clotting takes place. This gauze pack should be left in place for 30 to 45 minutes after you leave the dentist's office. There may be some bleeding or oozing after the pack is removed. If so, Fold a piece of clean gauze into a pad thick enough to bite on. Dampen the pad with clean, warm water and place it directly on the extraction site. Apply moderate pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked with blood, replace it with a clean one as necessary.Do not suck on the extraction site or disturb it with your tongue.A slight amount of blood may leak from the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist.
As we have said, it is important not to use anything containing aspirin as this can cause further bleeding. This happens because aspirin can thin the blood slightly. Asthma sufferers should avoid Ibuprofen-based pain relief. Again check with your chemist or dentist if you are worried or feel you need something stronger.
If it has been a particularly difficult extraction, the dentist will give you a follow-up appointment. This could be to remove any stitches that were needed, or simply to check the area is healing well.
No rinsing of any kind should be performed on the day of extraction. The day after surgery you should start rinsing with mouthwash four times a day. Make sure to keep it in the mouth(without heavy swishing) and allow that to stay in and around the surgical site for 30 seconds. Follow with a rinse of warm water (about a cup) mixed with a 1/2 teaspoon of salt. Again allow the rinse to stay in for 30 seconds and let that go gently. Do these two rinses back to back 4 times a day,( after breakfast, lunch, dinner and before bed) each day for one week or until seen post-operatively by the doctor.
Do not be tempted to rinse the area for the first 24 hours as It is important to allow the socket to heal, and you must be careful not to damage the blood clot by eating on that side or letting your tongue disturb it. This can allow infection into the socket and affect healing.
No brushing should be performed on the day of extraction. you can brush your teeth on the following day but avoid getting close to the site of surgery.
There will always be some degree of pain after a tooth extraction. If the pain continues, grows, changes or you just fear that something is not right then immediately call your dentist and explain him what is happening. It is best for everyone than have someone sit worried and in pain at home.
Sometimes an infection can get in the socket, which can be very painful. This is where there is little or no blood clot in the tooth socket and the bony socket walls are exposed and become infected. This is called a dry socket and in some cases is worse than the original toothache! In this case, it is important to see your dentist, who may place a dressing in the socket and prescribe a course of antibiotics to help relieve the infection.
Usually, the wound site takes about 6 weeks to heal. During that time, bone is generated to fill the space and the soft tissue grows to fill the gum line. Any replacement for the missing teeth except an immediate denture must wait until the extraction site has healed.
There are many options for replacement of teeth such as bridges,dentures and implants.
Full Mouth Rehabilitation
Full mouth restoration focuses on the needs of the entire mouth, not simply those elements that define your smile. Dr. Nirali considers the relationship between the teeth and their supporting tissues, including the jaw, temporomandibular joints (TMJs), gums, and underlying musculature in developing a plan to restore optimal oral health. By ensuring that these oral structures are operating in harmony, we can relieve facial discomfort, tooth and gum pain, and other undesirable symptoms while creating a radiant, healthy new smile.
Commonly Combined Treatments
As with all treatment plans devised by dentist, your full mouth restoration plan will be customized to your unique needs and, therefore, be one of a kind. Nevertheless, there are a number of treatments that are commonly included in full mouth restoration plans:
Root Canal Therapy – When the pulp that resides within the tooth, consisting of nerves, vessels, and connective tissues, becomes inflamed or infected, the resulting pain can become intense. Furthermore, if left untreated, the affected tooth will eventually be lost. Through root canal therapy, Dentist can remove this pulp and preserve the remaining healthy tooth structure, relieving pain and helping to keep the tooth’s supporting structures healthy and intact.
Dental Crowns –Dental crowns are porcelain restorations that are crafted to fit over the entire surface area of the tooth. If your full mouth restoration includes root canal therapy on one or more teeth, those teeth will subsequently be covered by dental crowns. Dental crowns can also be used to restore misshapen or badly discolored teeth, as well as teeth that are cracked, chipped, weakened, or otherwise damaged.
Dental Bridges – Typically comprised of one to three beautifully crafted artificial teeth placed between two crowns, dental bridges effectively fill the gaps left by missing teeth. Once in place, bridges prevent teeth adjacent to a gap from shifting out of place while making the smile whole again.
Dental Implants – Simply stated, dental implants are the premier method of replacing missing teeth. The titanium implant posts are surgically embedded into the jaw, where they provide strong, stable support for crowns, bridges, and dentures.
Tooth-colored Fillings – Tooth-colored fillings are made of a strong composite resin material that takes the place of the metal that was used in the fillings of the past. These modern, durable fillings protect the healthy structure of teeth from which decay has been removed while blending seamlessly into the mouth, contributing to a vibrant, natural-looking smile.
Periodontal Therapy – Gum disease affects roughly three-quarters of adults to some degree, whether in its more easily treated early stages (gingivitis) or its more severe form (periodontitis). Healthy gums are necessary to healthy teeth. As part of your full mouth restoration, Dentist will evaluate and thoroughly clean your gums, and make recommendations for more advanced treatment if necessary.
Your specific full mouth restoration may include any or all of these treatments as necessary. Dentist may also integrate purely cosmetic treatments, such as porcelain veneers and teeth whitening, into your plan to ensure that your smile is as luminous and healthy looking as you deserve.
Candidates for Full Mouth Restoration
Every patient who visits our practice is a potential candidate for full mouth restoration, depending on the health of his or her mouth. By definition, the procedure is intended to restore the mouth to optimal health; therefore, we gladly accept any patient whose oral health falls short of that standard. Even if you have been told by other dentists that your case is too complex, we will welcome you into our practice and be grateful for the opportunity to become your partner in good oral health. At Contemporary Dental Arts, no case is too complex.
Revive Your Smile – Contact Us Today!
We invite you take that first step toward optimal dental health today. If you would like to learn more about how you might benefit from full mouth restoration, please contact our practice. We would be delighted to hear from you!
Impacted Tooth Removal
Impacted tooth are the wisdom tooth which have grown crooked, impacted or misshapen.
Unattended impacted tooth can lead to infection surrounding teeth and gum. So it is advised to get it removed to prevent further damage.
Detailed X-rays of the tooth are taken and with the help of local anesthesia, the minor surgery is carried out. The discomfort and pain post the extraction of tooth is also very minimal.
Wisdom teeth are your third set of molars. They usually come in during your teen years.
If you're 16 or older and your wisdom teeth haven't appeared, they may be impacted (stuck). Even if they're fully exposed, they may crowd your other teeth and push them out of alignment. By having your wisdom teeth removed now, you can avoid problems with your teeth later.
Impacted wisdom teeth have not erupted from the gum. They may be stuck, which can cause pain. If you can't feel your third set of molars, there's a good chance they're impacted and may need to come out.
Impacted wisdom teeth can cause a variety of problems, including pain, infection, gum disease, and tooth decay. Fully exposed teeth may push your other teeth out of alignment and cause other problems later in life.
Having your wisdom teeth removed usually takes 30 to 45 minutes. The recovery process requires just a few days' rest at home.
No. Because you'll have had anesthesia, you'll need a parent or guardian to drive you home after the surgery and take care of you for the next couple of days during your recovery.