Frequently Asked Questions about Dental Care

Q: What should I do if I have bad breath?

A: Bad breath (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 causes of bad breath, but in healthy people the major source is microbial deposits on the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What causes bad breath?

• Morning time: saliva flow almost stops during sleep, reducing its cleaning power and allowing bacteria to grow, which results in bad breath.
• Certain foods: foods containing odor-causing compounds, such as garlic and onions, enter your blood stream and are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits: food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease: colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances: may also contribute to bad breath.
• Dry mouth (Xerostomia): may be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products: dry the mouth, causing bad breath.
• Dieting: certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals: drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses: diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with your dentist.

Q: How often should I brush and floss?

A: Brushing and flossing help control the plaque and bacteria that causes dental disease. Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing

• Brush your teeth at least twice a day (especially before going to bed at night) with an American Dental Association (ADA) approved soft bristle brush and 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 front teeth.
• Brush your tongue to remove bacteria and to improve your breath.

Electric toothbrushes are also recommended because they remove plaque efficiently: simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing

• Daily flossing is the best way to clean between 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.
• 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.

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.

Q: Are amalgam (silver) fillings safe?

A: Over the years, there has been some concern about 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 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 Centers for Disease Control (CDC), the World Health Organization (WHO), the U.S Food and Drug Administration (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 the millions of silver fillings placed 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 alternatives to silver fillings, including composite (tooth-coloured), porcelain, and gold fillings. We encourage you to discuss these options with your dentist so you can determine which option is best for you.

Q: How often should I have a dental exam and cleaning?

A: You should have your teeth checked and cleanedat 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 lesions, growths, cysts, and 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 some time and is now firmly attached to the tooth surface— it 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 stains and plaque that are 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, and more).
• 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 much more than simply 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 checkups and cleanings.

Q: What should I do if I have a dental emergency?

A: Please call us if you require an emergency appointment and we will see you as soon as possible. If your emergency is after-hours or on the weekend, please call our office. Someone will get back to you as soon as possible and we will do our best to see you or at least talk to you after-hours.

If you require urgent care due to trauma, facial infection or swelling, or you feel that you cannot wait to see us in our office, you can call the emergency dental service at 613-283-6441. Alternatively, in an emergency, you can also visit your local hospital emergency room.