What are Cavities?	What is Plaque?	What is Tartar?
What is Gum Disease?	What is Gingivitis?	What are Canker?
Oral First Aid at Home	What is Tooth Sensitivity?	Bad Breath
Bruxism	What are Wisdom Teeth?

What are Cavities?

“Cavities” is another way of saying tooth decay. Tooth decay is heavily influenced by lifestyle, what we eat, how well we take care of our teeth, the presence of fluoride in our water and toothpaste. Heredity also plays a role in how susceptible your teeth may be to decay.

While cavities are generally more common among children, adults are also at risk.

The types of cavities include:

* Coronal cavities–the most common type occurring in both children and adults, coronal cavities usually are located on chewing surfaces or between the teeth

* Root cavities–as we age, our gums recede, leaving parts of the tooth root exposed. Since there is no enamel covering tooth roots, these exposed areas easily decay

* Recurrent decay–decay can form around existing fillings and crowns. This is because these areas may have a tendency to accumulate plaque, which can ultimately lead to decay

Adults are especially at risk for cavities if they suffer from dry mouth, a condition due to a lack of saliva. Dry mouth may be caused by illness, medications, radiation therapy and chemotherapy, and may be either temporary (days to months) or permanent, depending on its cause.

Cavities are very serious. Left untreated, a cavity can destroy your tooth and kill the delicate nerves at its centre, which may result in an abscess, an area of infection at the root tip. Once an abscess forms, it can only be treated with a root canal, surgery or by extracting the tooth.

How Do I Know if I Have a Cavity?

Only your dentist can tell for sure whether you have a cavity. That’s because cavities develop below the tooth’s surface, where you can’t see them. When you eat foods that contain carbohydrates (sugars and starches), these carbohydrates are eaten by the bacteria in plaque, producing acids that eat into the tooth. Over time, the tooth enamel begins to break down beneath the surface while the surface remains intact. When enough of the sub-surface enamel is eaten away, the surface collapses, forming a cavity.

Cavities are most likely to develop in pits on the chewing surfaces of the back teeth, in between teeth, and near the gumline. But regardless of where they occur, the best way to spot them and treat them before they become serious is by visiting your dentist regularly for checkups.

How Can I Help Prevent Cavities?

* Brush at least twice a day and floss daily to remove plaque from between teeth and below the gum line

* Have regular dental checkups. Preventive care can help stop problems from occurring and keep minor problems from becoming major ones

* Eat a well-balanced diet that limits starchy or sugary foods. When you do eat these foods, try to eat them with your meal instead of as a snack to minimize the number of times that your teeth are exposed to acid

* Use dental products that contain fluoride, including toothpaste

* Make sure that your children’s drinking water is fluoridated. If your water supply does not contain fluoride, your dentist or paediatrician may prescribe daily fluoride supplements

What is Plaque?

Plaque is a sticky, colourless film of bacteria and sugars that constantly forms on our teeth. It is the main cause of cavities and gum disease, and can harden into tartar if not removed daily.

How Do I Know if I Have Plaque?

Everyone develops plaque because bacteria are constantly forming in our mouths. These bacteria use ingredients found in our diet and saliva to grow. Plaque causes cavities when the acids from plaque attack teeth after eating. With repeated acid attacks, the tooth enamel can break down and a cavity may form. Plaque that is not removed can also irritate the gums around your teeth, leading to gingivitis (red, swollen, bleeding gums), periodontal disease and tooth loss.

How Can I Prevent Plaque Build up?

It’s easy to prevent plaque build up with proper care.

Make sure to:

* Brush thoroughly at least twice a day to remove plaque from all surfaces of your teeth

* Floss daily to remove plaque from between your teeth and under your gum line, where your toothbrush may not reach

* Limit sugary or starchy foods, especially sticky snacks

* Schedule regular dental visits for professional cleanings and dental examinations

What is Tartar?

Tartar, sometimes called calculus, is plaque that has hardened on your teeth. Tartar can also form at and underneath the gum line and can irritate gum tissues. Tartar gives plaque more surface area on which to grow and a much stickier surface to adhere, which can lead to more serious conditions, such as cavities and gum disease. Not only can tartar threaten the health of your teeth and gums, it is also a cosmetic problem. Because tartar is more porous, it absorbs stains easily. So if you are a coffee or tea drinker, or if you smoke, it is especially important to prevent tartar build up.

How do I Know if I Have Tartar Build up?

Unlike plaque, which is a colourless film of bacteria, tartar is a mineral build up that’s fairly easy to see if above the gum line. The most common sign of tartar is a yellow or brown colour to teeth or gums. The only way for sure to detect tartar – and to remove it – is to see your dentist.

How can I Prevent Tartar Build up?

Proper brushing, especially with a tartar control toothpaste, and flossing are necessary to reduce plaque and tartar build up. Once tartar has formed, only your dentist or hygienist can remove it. The process for removing tartar is called scaling. During a scaling, the dentist or hygienist uses special instruments to remove tartar from your teeth above and below the gum line.

Tartar threatens good oral health and makes your smile noticeably less attractive. Once tartar forms, only a professional cleaning can remove it.

What is Gum Disease? What are the Stages of Gum Disease?

Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth. It is caused by the bacteria in plaque, a sticky, colourless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

There are three stages of gum disease:

* Gingivitis: this is the earliest stage of gum disease, an inflammation of the gums caused by plaque build up at the gum line. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected.

* Periodontitis: at this stage, the supporting bone and fibres that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gum line, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.

* Advanced Periodontitis: in this final stage of gum disease, the fibres and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can’t save them, teeth may need to be removed.

How do I Know if I Have Gum Disease?

Gum disease can occur at any age, but it is most common among adults.

If detected in its early stages, gum disease can be reversed so see your dentist if you notice any of the following symptoms:

* Gums that are red, puffy or swollen, or tender

* Gums that bleed during brushing or flossing

* Teeth that look longer because your gums have receded

* Gums that have separated, or pulled away, from your teeth, creating a pocket

* Changes in the way your teeth fit together when you bite

* Pus coming from between your teeth and gums

* Constant bad breath or a bad taste in your mouth

How is Gum Disease Treated?

* The early stages of gum disease can often be reversed with proper brushing and flossing. Good oral health will help keep plaque from building up.

* A professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or “scale” your teeth to remove the tartar above and below the gum line. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there.

* By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in the dental office will be required.

Healthy Gums – healthy gums are firm and don’t bleed. They fit snugly around the teeth.

Gingivitis – gums are mildly inflamed, may appear red or swollen and may bleed during brushing.

Periodontitis – gums begin to separate and recede from the teeth. This allows plaque to move toward the roots, supporting fibres and bone.

Advanced Periodontitis – supporting fibres and bone are destroyed. Teeth become loose and may need to be removed.

What is Gingivitis? Signs and Symptoms

Gingivitis – an inflammation of the gums – is the initial stage of gum disease and the easiest to treat. The direct cause of gingivitis is plaque – the soft, sticky, colourless film of bacteria that forms constantly on the teeth and gums. If the plaque is not removed by daily brushing and flossing, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected. Left untreated, however, gingivitis can become periodontitis and cause permanent damage to your teeth and jaw.

How do I Know if I Have Gingivitis?

Classic signs and symptoms of gingivitis include red, swollen, tender gums that may bleed when you brush. Another sign of gum disease is gums that have receded or pulled away from your teeth, giving your teeth an elongated appearance. Gum disease can cause pockets to form between the teeth and gums, where plaque and food debris collect. Some people may experience recurring bad breath or a bad taste in their mouth, even if the disease is not advanced.

How can I Prevent Gingivitis?

Good oral hygiene is essential. Professional cleanings are also extremely important because once plaque has hardened and built up, or become tartar, only a dentist or dental hygienist can remove it.

You can help stop gingivitis before it develops by:

* Proper brushing and flossing to remove plaque and debris and control tartar build up

* Eating right to ensure proper nutrition for your jawbone and teeth

* Avoiding cigarettes and other forms of tobacco

* Scheduling regular checkups with your dentist

What are Canker and Mouth Sores? What are Mouth Irritations and Oral Lesions?

Mouth irritations and oral lesions are swellings, spots or sores on your mouth, lips or tongue. Although there are numerous types of mouth sores and disorders, among the most common are canker sores, cold sores, leukoplakia and candidiasis (thrush). These are discussed below. If you have a mouth sore, you’re not alone-around one third of all people are affected at some point. Nonetheless, mouth sores, irritations and lesions can be painful, unsightly and can interfere with eating and speaking. Any mouth sore that persists for a week or more should be examined by your dentist. A biopsy (tissue taken for testing) may be advised and can usually determine the cause, ruling out such serious diseases as cancer and HIV.

How do I Know if I Have a Mouth Sore or Oral Lesion?

The following signs may indicate a mouth sore or oral lesion:

* Canker sores are small white swellings or sores surrounded by an area of redness. While canker sores are not contagious, they are often confused with cold sores, which are caused by the contagious herpes virus. It may help to remember that canker sores occur inside the mouth, while cold sores usually occur outside the mouth. Canker sores can recur, and can be minor (small), major (larger) or herpetiform (multiple, in groups or clusters).

* Canker sores are common and often recur. Although the exact cause is uncertain, some experts believe that immune system problems, bacteria or viruses may be involved. Factors such as stress, trauma, allergies, cigarette smoking, iron or other vitamin deficiencies, and heredity may also make one susceptible.

* Cold sores, also called fever blisters or herpes simplex, are groups of painful, fluid-filled blisters around the lips and sometimes under the nose or around the chin. Cold sores are usually caused by a type of herpes virus and are very contagious. The first infection often occurs in children, sometimes without symptoms, and may be confused with a cold or flu. Once a person is infected, the virus stays in the body, occasionally causing recurrent attacks. For some people, however, the virus remains inactive.

* Leukoplakia looks like a thick, whitish-colour patch on the inner cheek, gums or tongue. It is often associated with smoking and smokeless tobacco use, although other causes include badly fitting dentures, broken teeth and chewing on one’s cheek. Because an estimated 5 percent of leukoplakia cases progress to cancer, your dentist may take a biopsy. Leukoplakia often heals when tobacco use is stopped.

* Candidiasis – oral thrush – is a fungal infection caused by candida albicans (a yeast). It can be recognized by the creamy, yellow-white or red patches that occur on moist surfaces in the mouth. Tissues under the patch can be painful. Thrush is most common among denture wearers, newborns, those debilitated by disease and those whose immune system is not functioning properly. People who have a dry mouth, or who are taking or have just completed antibiotic treatment, are also susceptible.

How are Mouth Irritations and Oral Lesions Treated?

Treatment varies according to the type of condition you have. For the most common types of mouth sores and disorders, described above, treatment is as follows:

* Canker Sores – canker sores usually heal after seven to 10 days, although recurrent outbreaks are common. Non-prescription topical ointments and pain relievers can provide temporary relief. Rinsing with antimicrobial mouth rinses may help reduce the irritation. Sometimes, antibiotics are prescribed to reduce secondary infection.

* Cold Sores – the blisters usually heal in about a week. Because there is no cure for herpes infections, the blisters may reoccur during times of emotional upset, exposure to sunlight, allergies or fever. Non-prescription topical anaesthetics can provide temporary relief. Prescription antiviral drugs may reduce these kinds of viral infections – ask your dentist or physician.

* Leukoplakia – treatment begins by removing the factors causing the lesions. For some patients that means quitting tobacco use. For others, it means removing ill-fitting dentures and replacing them with properly fitting ones. Your dentist will monitor your condition, examining the lesion at three to six month intervals, depending on its type, location and size.

* Candidiasis – treatment consists of controlling the conditions that cause the outbreaks.

* Cleaning dentures is important in preventing denture-induced problems. Removing dentures at night can help

* If antibiotics or oral contraceptives are the cause, reducing the dose or changing the treatment may help

* Saliva substitutes are available to help with dry mouth

* Antifungal medications may be used when the underlying cause is unavoidable or incurable

* Good oral hygiene is essential

Oral First Aid at Home

You probably have a first aid kit in your home to handle life’s minor bumps and bruises. But are you prepared for a dental emergency?

According to preponderant majority of experts of Oral Medicine, everyone should have an Oral First Aid Kit in their home as well.

“Dental injuries and emergencies are very common in children and adults,” say experts. “With just a few items from the drug store, you can put together an Oral First Aid Kit in your home to better handle tooth or mouth injuries.”

While the kit does not replace professional treatment, you can use it to treat minor mouth irritations and injuries as well as help alleviate or control major oral problems until the patient can get to a dentist or physician.

Experts also recommend including the following items in your home Oral First Aid Kit: Dental mirror, dental floss, cotton balls, cotton swabs, sterile gauze, sealable plastic bag (to dispose of bloody gauze or swabs), toothbrush, tweezers, wash cloth, aspirin or aspirin substitute, Colgate OraGard, instant ice pack, bottled water, salt, paraffin or dental wax, medical exam gloves and an oxygenating oral cleanser like Colgate Peroxyl Antiseptic.

Experts further recommend the following tips for handling common dental emergencies.

Toothache – rinse mouth with warm water. Use dental floss to remove any food trapped between the teeth, then rinse. If there’s swelling, place an ice pack or cold compress on the outside of the cheek (20 minutes on, 20 minutes off). Do not use heat. An aspirin or aspirin substitute may be taken orally to relieve pain. Do not place directly on gum tissue as this may result in a burn. See your dentist as soon as possible.

Object wedged between teeth – try to remove the object with dental floss, and then rinse vigorously with water to remove any remaining particles. Do not try to remove it with a sharp or pointed instrument. If you can’t remove it, see a dentist.

Canker or mouth sore – canker sores are small white wounds inside the mouth on the cheek, gums or tongue. They can be caused by cheek biting, vigorous tooth brushing, burns from hot foods and irritation from braces or dentures. The bubbling action of an oxygenating cleanser removes food particles and other irritants from the sore.

Knocked out tooth – if possible, retrieve the tooth. If it is a baby tooth, place it in a container of milk, salt water or the patient’s saliva. If these are unavailable, use water. If it is a permanent tooth take care not to touch the root and carefully insert the tooth back in place. Go to the dentist immediately.

Broken Tooth – gently clean dirt or debris from injured area with an antiseptic oral cleanser. Place ice pack or cold compress on the face in the area of the injured tooth to minimize swelling. If the tooth has created a sharp edge, cover with paraffin (wax) to prevent lacerations to the gums or cheek. See a dentist immediately.

Bitten lip or tongue – apply direct pressure to the bleeding area for 15 to 20 minutes using sterile gauze. Rinse with an oral cleanser to alleviate bleeding and clean the wound. If swelling is present, apply ice pack or cold compress. If bleeding continues, go to a hospital emergency room.

What is Tooth Sensitivity?

Tooth sensitivity is a common name for dentin hypersensitivity or root sensitivity. If hot, cold, sweet or very acidic foods and drinks, or breathing in cold air, makes your teeth or a tooth sensitive or painful then you have sensitive teeth.

Is Tooth Sensitivity Common?

Tooth sensitivity is very common and it has been estimated that approximately half the population experiences tooth sensitivity. Tooth sensitivity can come and go over time.

Why does Tooth Sensitivity (Dentin Hypersensitivity) Happen?

Tooth sensitivity is usually caused by dentin on root areas exposed due to receded gums or periodontal disease. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.

When the root of a tooth becomes exposed it does not have a layer of enamel like the crowns of your teeth. Instead the roots have a very soft covering called cementum, which once lost leaves the dentin of the root exposed. Overzealous brushing or using a very abrasive toothpaste can also cause abrasion of the tooth enamel surface and expose dentin. A very acidic diet – for example a diet with a lot of citrus food, pickles or soft drinks – can cause tooth erosion and dissolve the tooth surface, exposing the dentin. Bulimia and GERD can also result in dental erosion and sensitivity due to acid in the mouth.

It is important to tell your dentist or hygienist if you have any sensitive teeth, so that he or she can examine your mouth, see if the problem is tooth sensitivity (dentin hypersensitivity) and help you choose the best treatment. When teeth are sensitive it can be painful to brush them and if you brush poorly because of pain then there is more risk of tooth decay and gum disease. Pain after hot, cold, sweet or acidic food and drinks can also be a sign of decay with a cavity or hole in the tooth, or a sign of a broken tooth, and if this is the case your dentist will treat you with a filling or other treatment.

What Makes Exposed Dentin Painful?

Dentin contains thousands of tiny channels that are only visible with a microscope. These channels run from the surface, through the dentin to the nerve centre of the tooth – the pulp. The channels contain fluid and after eating or drinking hot or cold foods, the fluid in these tiny channels moves and irritates the nerves in the tooth, causing pain.

Can I Prevent Tooth Sensitivity?

You can reduce your chances of getting tooth sensitivity by keeping your mouth as healthy as possible with good oral hygiene to help prevent receding gums and periodontal disease. Brushing and flossing properly as recommended by your dentist or hygienist and using a low abrasion toothpaste can help reduce the chance that you will have tooth sensitivity. A diet that is not acidic also helps prevent tooth sensitivity. Ignoring your sensitive teeth can lead to other oral health problems, especially if the pain causes you to brush poorly making you vulnerable to tooth decay and gum disease.

What Can I Do if I Have Sensitive Teeth?

First tell your dentist or hygienist. He or she can help you and see what the best treatment is. It is also important to tell your dentist or hygienist in case the cause is not dentin (root) hypersensitivity and the tooth is sensitive due to a more serious problem. To treat tooth sensitivity, your dentist or hygienist may recommend that you use a low abrasion toothpaste specially made for sensitive teeth – a desensitizing toothpaste. These toothpastes make the teeth less sensitive if you brush with them twice a day and also contain fluoride to help protect your teeth against decay. Alternatively, your dentist may prescribe a brush-on fluoride gel or a fluoride rinse, or a high fluoride level toothpaste that is specially formulated to make your teeth less sensitive and provides extra protection against decay. These treatments happen at home when you are brushing your teeth and are inexpensive. Other treatments for sensitive teeth that your dentist or hygienist can provide in the dental office are also available. These include treatments that are painted onto the teeth – such as fluoride varnishes and plastic resins, fillings if a lot of tooth area has been lost, and lasers. You should ask your dentist or hygienist about the best way to treat your sensitivity.

Bad Breath (Halitosis)

What Is It?

Bad breath, also known as halitosis, is breath that has an unpleasant odour. This odour 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 odours 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 odour.

In addition, bad breath can be caused by the following:

* Poor dental hygiene – Infrequent or improper brushing and flossing can leave food particles to decay inside the mouth.

* Infections in the mouth – Periodontal (gum) disease

* Respiratory tract infections – Throat infections, sinus infections, lung infections

* External agents – Garlic, onions, coffee, cigarette smoking, chewing tobacco

* Dry 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 others

* Psychiatric 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.”

Symptoms

A person may not always know that he or she has bad breath. This phenomenon is because odour-detecting cells in the nose eventually become accustomed to the constant flow of bad smells from the mouth. Others may notice and react by recoiling as you speak.

Other associated symptoms depend on the underlying cause of bad breath:

* Poor dental hygiene – Teeth are coated with film or plaque, food debris trapped between teeth, pale or swollen gums

* Infections in the mouth – Gums may be red, swollen and bleed easily, especially after brushing or flossing; pus may drain from between teeth; a pocket of pus (abscess) at the base of a tooth; loose teeth or a change in “fit” of a denture; painful, open sores on the tongue or gums

* Respiratory tract infections – Sore throat, swollen lymph nodes (“swollen glands”) in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough

* External agents – Cigarette stains on fingers and teeth, a uniform yellow “coffee stain” on teeth

* Dry mouth – Difficulty swallowing dry foods, difficulty speaking for a prolonged period because of mouth dryness, a burning sensation in the mouth, an unusually high number of dental caries, dry eyes (in Sjögren’s syndrome)

* Systemic (body wide) illnesses – Symptoms of diabetes, lung disease, kidney failure or liver disease

Diagnosis

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. For example, “fruity” breath may be a sign of uncontrolled diabetes. A urine-like smell, especially in a person who is at high risk of kidney disease, can sometimes indicate kidney failure. 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. Your dentist will examine your teeth, gums, oral tissues and salivary glands. He or she also will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth. Once the physical examination is finished, your dentist may refer you to your family physician if systemic problems are the most likely cause. In severe cases of gum disease, your dentist may recommend that you be seen by a periodontist (dentist who specializes in gum problems). 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.

Expected Duration

How long bad breath lasts depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen the mouth immediately, with even more impressive results after a few days of regular brushing and flossing. Periodontal disease and tooth abscess also respond quickly to proper dental treatment. Bad breath resulting from chronic sinusitis may be a recurring problem, especially if it is caused by a structural abnormality of the sinuses. Bad breath the results from a systemic illness may be a long-term problem that can often be controlled with proper medical care.

Prevention

Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing, and rinsing with mouthwashes approved by the Canadian Dental Association (CDA). Regular visits to the dentist (at least twice a year) should be made for dental examinations and for professional teeth and gum cleaning. Bad breath also can be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.

Treatment

The treatment of bad breath depends on its cause.

When To Call A Professional

Call your dentist promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. Also, call your doctor if you have bad breath along with a fever, sore throat, a postnasal drip, a discoloured nasal discharge or a mucus-producing cough. Even if you have none of these associated symptoms, please call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene. If you have diabetes, gastroesophageal reflux disease (GERD) or chronic liver or kidney disease, ask your doctor how bad breath can be a sign that your underlying medical condition needs immediate medical attention.

Prognosis

Once bad breath has been diagnosed, the outlook for fresh breath is usually excellent as long as you stick to your dentist’s or physician’s treatment plan.

Bruxism: Signs and Symptoms

What is Bruxism?

If you find yourself waking up with sore jaw muscles or a headache, you may be suffering from bruxism – the grinding and clenching of teeth. Bruxism can cause teeth to become painful or loose, and sometimes parts of the teeth are literally ground away. Eventually, bruxism can destroy the surrounding bone and gum tissue. It can also lead to problems involving the jaw joint, such as temporomandibular joint syndrome (TMJ).

How do I Know if I Have Bruxism?

For many people, bruxism is an unconscious habit. They may not even realize they’re doing it until someone comments that they make a horrible grinding sound while sleeping. For others, a routine dental check up is when they discover their teeth are worn or their tooth enamel is fractured.

Other potential signs of bruxism include aching in the face, head and neck. Your dentist can make an accurate diagnosis and determine if the source of facial pain is a result from bruxism.

How is Bruxism Treated?

The appropriate treatment for bruxism will depend on what is causing the problem. By asking careful questions and thoroughly examining your teeth, your dentist can help you determine the potential source of your bruxism.

Based on the amount of tooth damage and its likely cause, your dentist may suggest:

* Wearing an appliance while sleeping – custom-made by your dentist to fit your teeth, the appliance slips over the upper teeth and protects them from grinding against the lower teeth. While an appliance is a good way to manage bruxism, it is not a cure.

* Finding ways to relax – Because everyday stress seems to be a major cause of bruxism, anything that reduces stress can help-listening to music, reading a book, taking a walk or a bath. It may help to seek counseling to learn effective ways for handling stressful situations. Also, applying a warm, wet washcloth to the side of your face can help relax muscles sore from clenching.

* Reducing the “high spots” of one or more teeth to even your bite – An abnormal bite, one in which teeth do not fit well together, may also be corrected with new fillings, crowns or orthodontics.

What are Wisdom Teeth?

Wisdom teeth are the last molars on each side of the jaws. They are also the last teeth to emerge, or erupt, usually when a person is between 16 and 20.

Since wisdom teeth are the last permanent teeth to come in, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted, teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.

Wisdom teeth that only partially erupt or come in crooked can also lead to painful crowding and disease. Since teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

How are Wisdom Teeth Removed?

A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral surgeon, will recommend either “going to sleep” using general anaesthesia, or numbing this area in your mouth with a local anaesthesia such as Novocain.

After the tooth (or teeth) is removed, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit any bleeding that may occur. Some pain and swelling may occur but it will normally go away after a few days; however, you should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.

Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.