What causes bad breath?

Bad breath (halitosis) can be caused by many things. It may be the result of odor-causing foods, tooth decay, periodontal (gum) disease, continued mouth dryness, use of tobacco products, sinus or respiratory infections, some medical disorders, inadequate oral hygiene or some medications. Your dentist can help identify the cause and, if it's due to an oral condition, can develop a treatment plan to eliminate this common source of embarrassment.

What is gum disease?

National surveys show that most adults in the UK suffer from some form of gum disease, but only about one in ten has serious problems. If not treated, gum disease can ultimately make extraction necessary. With good oral hygiene, gum disease can be prevented. If you smoke, give it up for dental reasons too because there is a well-established link between smoking, gum disease and increased tooth loss.

What are white fillings?

Fillings replace parts of the tooth removed because of decay or lost through accidental damage. White fillings will normally be used where the filling can be seen. They come in a range of shades to match your own teeth.

Unlike an amalgam (silver) filling, which is held in place by the shape of the tooth, a white filling can stick to the tooth.

You will probably hear the dentist talk about composite or glass ionomer - these are just different types of white filling.

What does the dentist do?

There are several steps:

• Any decay is removed;
• Some or all of any old filling might also be removed;
• The tooth is etched (made ready to receive the white filling);
• The hole is washed and dried by blowing water and then air into it. You will see the dentist holding an instrument at the end of a pipe which sends air, water or a both into your mouth;
• The filling is shaped while still soft, and then trimmed and polished;
• It might be polished again at your next visit.

What are the benefits?

• Less shaping of the hole is needed to keep a filling in place, once any decay has been removed;
• White fillings can be used to reshape and rebuild teeth - broken edges or worn teeth, for example.

They can also be used to cover discolouration if it can't be removed by cleaning.

What is oral hygiene?

Like most people, you know that having a clean mouth is important. It makes you feel good about yourself. It gives you fresh breath and a nicer-looking smile. Since childhood, you've probably heard that brushing and flossing your teeth daily are necessary for good dental health. Like many people, you may not be sure why.

Brushing and flossing remove a thin sticky film of bacteria that grows on your teeth. This sticky film, called plaque, is the main cause of tooth decay and gum disease.

What is plaque?

Many of the foods you eat such as sweets and cakes cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, are not the only culprits. Starches, such as bread, crackers, and cereal, also cause acids to form. If you snack often, you could be having acid attacks all day long. After many acid attacks, your teeth may decay.

Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, gum disease is a main cause of tooth loss in adults.

One way to prevent tooth decay and gum disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.

What is the best way to remove plaque?

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces. Brush your teeth twice a day, ideally with an electric toothbrush or a soft-bristled brush. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily. Use a toothpaste that contains fluoride, which helps protect your teeth from decay. When choosing any dental product, seek the help of your dentist or hygienist who will always be happy to help..

Cleaning between the teeth with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can't reach. It is essential in preventing gum disease.

By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life. Follow these tips to keep your teeth and mouth clean:

How should I brush?

• Place your toothbrush at a 45-degree angle against the gums.
• Move the brush back and forth gently in short (toothwide) strokes.
• Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
• Use the "toe" of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
• Brush your tongue to remove bacteria and freshen your breath.

How should I Floss?

• Break off about 18 inches of floss and wind most of it around one of your middle fingers.
• Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty.
• Hold the floss tightly between your thumbs and forefingers. Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
• When the floss reaches the gumline, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
• Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
• Repeat this method on the rest of your teeth. Don't forget the back of your last tooth.
• People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. If you use interdental cleaners, ask your dentist or hygienist how to use them properly, to avoid injuring your gums.

What are scaling and polishing?

'Scaling' means cleaning your teeth thoroughly, especially to remove bits of calculus (tartar) that can form on your teeth like the 'scale' inside a kettle. Tartar can't be removed by brushing and may help cause gum disease.

Scaling cleans above and slightly below the gums. Hard tartar is removed as well as trapped food and sticky 'plaque'. Stains from coffee, cigarettes or red wine are also cleaned away.

Your teeth will be scaled by a dentist or by a dental hygienist.

What happens?

There are two ways to scale teeth:

• Hand scalers come in different sizes and shapes, to reach different parts of the teeth. This is why you will see the dentist or hygienist changing instruments quite often;
• Electric scalers use very fast vibration with water. The water is removed from your mouth using suction. A hand scaler is used to check whether the teeth are completely clean.

For polishing, a rotating brush or rubber polisher is used with toothpaste.

You may be given advice on how to clean your teeth if there are signs that you are not doing this properly.

What are the benefits?

• Regular scaling by a dentist or hygienist helps you keep your gums healthy by making it easier for you to keep your teeth clean at home. You will feel and see the difference;
• Some people are worried about bad breath. Good oral hygiene is usually the answer;
• Early gum disease can get better without any permanent damage to your gums. But if your teeth are not kept clean some of the bone around your teeth can dissolve away, so that eventually the teeth become loose and possibly have to be extracted;
• Bone cannot re-grow but red and swollen gums can get better after deep scaling and other treatment. If you have this problem, talk to a dentist.

If your gums bleed when you clean your teeth, this is usually a sign of gum disease and you should go to the dentist for advice.

What is tooth bleaching?

Over time, teeth's natural whiteness is diminished by factors such as aging, coffee, tea, red wine and nicotine. Teeth bleaching reverses these effects. A carbamide peroxide solution soaks into the tooth's dentin and enamel. It removes stains that have soaked into the teeth as well as changing the colour of the inside of the tooth by an oxidation process.

How does teeth bleaching work?

The dentist fits the patient with top and bottom mouth trays and provides a bleaching kit containing several syringes to take home. Each syringe contains a high viscosity gel substance containing from 10% to 22% carbamide peroxide. The patient fills each tray with a small amount of the gel and places them in the mouth. 4 hours later the trays are removed and washed. The process continues for 5 - 18 days.

What does teeth bleaching affect?

The bleaching process will only affect natural enamel and dentine and will not change the colour of fillings, caps, crowns or dental restorations. Yellowish stains from aging, coffee, tea, red wine and nicotine are most susceptible while stains from congenital discolourations or antibiotic tetracycline show little improvement.

Are there problems with bleaching?

Some individuals experience increased tooth sensitivity to cold while others report temporary discomfort such as gum or tooth sensitivity. These symptoms should disappear within 1 to 3 days after interruption or completion of treatment.