Cavities/tooth decay

By Mayo Clinic staff

Types of cavities

Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, not cleaning your teeth well, frequent snacking and sipping sugary drinks.
Cavities and tooth decay are among the world's most common health problems. They're especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants.
If cavities aren't treated, they get larger and affect deeper layers of your teeth. They can lead to severe toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits go a long way toward preventing cavities and tooth decay.

Bad Breath Causes

By Mayo Clinic staff

Halitosis

Most bad breath originates in your mouth. The causes of bad breath are numerous. They include:

• Food. The breakdown of food particles in and around your teeth can cause a foul odor. Eating foods containing certain oils is another source of bad breath. Onions and garlic are the best-known examples, but other vegetables and spices also can cause bad breath. After these foods are digested and the pungent oils are absorbed into your bloodstream, they're carried to your lungs and are given off in your breath until the foods are eliminated from your body.
• Dental problems. Poor dental hygiene and periodontal disease can be a source of bad breath. If you don't brush and floss daily, food particles remain in your mouth, collecting bacteria that can emit chemicals, such as hydrogen sulfide — the same compound that gives rotten eggs their characteristic smell. A colorless, sticky film of bacteria (plaque) forms on your teeth and if not brushed away, plaque can irritate your gums (gingivitis) and cause tooth decay. Eventually, plaque-filled pockets can form between your teeth and gums (periodontitis) worsening this problem — and your breath. The microscopic uneven surface of the tongue also can trap bacteria that produce odors. And dentures that aren't cleaned regularly or don't fit properly can harbor odor-causing bacteria and food particles.
• Dry mouth. Saliva helps cleanse your mouth, removing particles that may cause bad odors. A condition called dry mouth (xerostomia) can contribute to bad breath because production of saliva is decreased. Dry mouth naturally occurs during sleep, leading to morning breath. Dry mouth is even more of a problem if you sleep with your mouth open. Some medications can lead to a chronic dry mouth, as can a problem with your salivary glands.
• Diseases. In about 10 percent of bad breath cases, the bad odors do not come from the mouth (extra-oral halitosis). For example, illnesses, such as some cancers and metabolic disorders, can cause a distinctive breath odor as a result of chemicals they produce. Diabetes and kidney or liver failure can lead to a fishy smell. Uncontrolled diabetes can also cause a fruity breath odor from chemicals called ketones. And chronic reflux of stomach acids (gastroesophageal reflux disease, or GERD) has been associated with bad breath. In addition, some medications — such as those used to treat high blood pressure, psychiatric conditions, or urinary problems — can indirectly produce bad breath by contributing to dry mouth. Other medications may be broken down in the body to release chemicals that can be carried on your breath.
• Mouth, nose and throat conditions. Another source of bad breath is the nasal passages. For example, bad breath is associated with sinus infections because nasal discharge that drips from your sinuses into the back of your throat (postnasal drip) can cause mouth odor. Sometimes bad breath can be traced to upper and lower respiratory infections, or ulcers in the respiratory system. And malformations of the oral-nasal cavity, such as cleft palate, can lead to bad breath because they provide ideal environments for bacteria to multiply without being disturbed. Bad breath can occasionally stem from small stones that form in the tonsils. These stones can be covered with bacteria that produce odorous chemicals. Bad breath in young children is often traced to a foreign body, such as a toy or piece of food, lodged in a nostril.
• Tobacco products. Smoking dries out your mouth and causes its own unpleasant mouth odor. Tobacco users are also more likely to have periodontal disease, an additional source of bad breath.

Bad Breath Symptoms

Bad breath odors vary depending on the source or the underlying cause of the bad breath. Because it's difficult to rate your own breath, many people worry excessively about their breath even though they have little or no mouth odor. Others have bad breath and don't know it. Because it's difficult to assess how your own breath smells, ask a close friend or relative to confirm your bad-breath questions.
 
When to see a doctor

If you've been told you have bad breath or are aware that you do, review your oral hygiene habits. Try making lifestyle changes, such as brushing your teeth and tongue after eating, using dental floss, and drinking plenty of water.

If your bad breath persists after making such changes, see your dentist. If your dentist suspects a more serious condition is causing your bad breath, he or she may refer you to a doctor to find the cause of the odor.

Bad breath

By Mayo Clinic staff

Halitosis

Bad breath (halitosis) can be embarrassing and may cause anxiety. It's no wonder store shelves are overflowing with gum, mints, mouthwashes and other products designed to combat this condition. But many of these products are mere temporary measures.

Certain foods, health conditions and habits are among the causes of bad breath. In many cases, you can improve bad breath with proper dental hygiene. If simple self-care techniques don't solve the problem, you may want to see your dentist or doctor to be sure a more serious condition isn't causing your bad breath.

Gingivitis Complications

By Mayo Clinic staff Untreated gingivitis can progress to gum disease that spreads to underlying tissue and bone (periodontitis), a much more serious condition that can lead to tooth loss. Periodontitis and poor oral health in general may also affect your overall health in ways that aren't completely understood. Studies link periodontitis to an increased risk of heart attack, stroke or lung disease. And women with periodontitis may be more likely to give birth to premature babies or babies with low birth weight than are women with healthy gums. Although more research is needed, these studies highlight the importance of taking good care of your teeth and gums.

Gingivitis Risk factors

By Mayo Clinic staff Gingivitis is very common, and anyone can develop it. Many people first experience gum problems during puberty and then in varying degrees throughout life.
Factors that can increase your risk of gingivitis include:

• Poor oral health habits
• Tobacco use
• Diabetes
• Older age
• Decreased immunity as a result of leukemia, HIV/AIDS or other conditions
• Certain medications
• Certain viral and fungal infections
• Dry mouth
• Hormonal changes, such as those related to pregnancy, your menstrual cycle or use of oral contraceptives
• Poor nutrition
• Substance abuse
• Ill-fitting dental restorations

Gingivitis Causes

By Mayo Clinic staff The most common cause of gingivitis is poor oral hygiene that encourages plaque to form. Plaque is an invisible, sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing and flossing your teeth each day removes plaque. Plaque requires daily removal because it re-forms quickly, usually within 24 hours.
Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and creates a protective shield for bacteria. You usually can't get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily.

Gingivitis Symptoms

By Mayo Clinic staff

	Healthy tooth
	Gingivitis

Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, you may have gingivitis. Because gingivitis is seldom painful, you can have gingivitis without even knowing it. Signs and symptoms of gingivitis may include:

• Swollen gums
• Soft, puffy gums
• Receding gums
• Occasionally, tender gums
• Gums that bleed easily when you brush or floss, sometimes seen as redness or pinkness on your brush or floss
• A change in the color of your gums from a healthy pink to dusky red
• Bad breath

When to see a dentist
Most dentists recommend regular checkups to identify gingivitis, cavities (caries) and other dental conditions before they cause troubling symptoms and lead to more-serious problems. Also schedule an appointment with your dentist if you notice any signs and symptoms of gingivitis. The sooner you seek care, the better your chances of reversing damage from gingivitis and preventing its progression to more-serious conditions.

Gingivitis

Definition

By Mayo Clinic staff Gingivitis is a very common and mild form of gum (periodontal) disease that causes irritation, redness and swelling (inflammation) of your gums. Because gingivitis can be very mild, you may not be aware that you have the condition. But it's important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease (periodontitis) and eventual tooth loss.
The most common cause of gingivitis is poor oral hygiene. Good oral health habits, such as regular professional checkups and daily brushing and flossing, can help prevent gingivitis.

Other oral health care tips

In addition to daily brushing and flossing, consider using an antimicrobial mouth rinse to help reduce plaque between your teeth.

To remove food particles from your teeth, you might try an oral irrigator — a device that aims a stream of water at your teeth. Resist the temptation to use toothpicks or other objects that could injure your gums. Keep in mind, however, that an oral irrigator doesn't replace daily brushing and flossing, since it doesn't remove plaque.

Flossing for oral health

You can't reach the tight spaces between your teeth or under your gumline with a toothbrush. That's why daily flossing is important. When you floss:

• Don't skimp. Break off about 18 inches (46 centimeters) of dental floss. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand — leaving about 1 inch (3 centimeters) to floss your first tooth.
• Take it one tooth at a time. Use your thumbs and forefingers to gently pull the floss from the gumline to the top of the tooth to scrape off plaque. Rub the floss against all sides of the tooth. Unwind to fresh floss as you progress to the next tooth.
• Keep it up. If you have trouble getting floss through your teeth, try the waxed variety. If it's hard to manipulate the floss, use a floss holder or an interdental cleaner — such as a dental pick or stick designed to clean between the teeth.

Brushing for oral health

Brushing and flossing for oral health

Oral health begins with clean teeth. Consider these brushing basics from the American Dental Association:

• Brush your teeth at least twice a day. When you brush, don't rush. Take enough time to do a thorough job.
• Use the proper equipment. Use a fluoride toothpaste and a soft-bristled toothbrush that fits your mouth comfortably. Consider using an electric or battery-operated toothbrush, especially if you have arthritis or other problems that make it difficult to brush effectively.
• Practice good technique. Hold your toothbrush at a slight angle against your teeth and brush with short back-and-forth motions. Remember to brush the inside and chewing surfaces of your teeth, as well as your tongue. Avoid vigorous or harsh scrubbing, which can irritate your gums.
• Keep your equipment clean. Always rinse your toothbrush with water after brushing. Store your toothbrush in an upright position, if possible, and allow it to air dry until using it again. Don't routinely cover toothbrushes or store them in closed containers, which can encourage the growth of bacteria.
• Know when to replace your toothbrush. Invest in a new toothbrush or a replacement head for your electric or battery-operated toothbrush every three to four months — or sooner if the bristles become frayed.

Electric toothbrush: Better than a manual toothbrush?

It's possible to brush your teeth effectively with a manual toothbrush — but an electric toothbrush can be a great alternative to a manual toothbrush, especially if you have arthritis or other conditions that make it difficult to brush well. The bristle movement of an electric toothbrush might even help you remove more plaque from your teeth and improve your gum health.

If you choose to invest in an electric toothbrush, make sure the toothbrush is comfortable to hold and easy to use. Your dentist might suggest a model with a rotating-oscillating head. Other specific features — such as adjustable power levels, timers and rechargeable batteries — are up to you.
Whether you choose an electric toothbrush or a manual toothbrush, what's most important is daily brushing and flossing.

Sensitive teeth: What treatments are available?

Answer

from Alan Carr, D.M.D. - Mayo Clinic

When you have sensitive teeth, activities such as brushing, flossing, eating and drinking can cause sharp, temporary pain in your teeth. Sensitive teeth are typically the result of worn tooth enamel or exposed tooth roots. Sometimes, however, tooth discomfort is caused by other factors, such as a cavity, a cracked or chipped tooth, or a side effect of a dental procedure, such as bleaching.
If you're concerned about sensitive teeth, start by visiting your dentist. He or she can identify or rule out any underlying causes of your tooth pain. Depending on the circumstances, your dentist might recommend:

• Desensitizing toothpaste. After several applications, desensitizing toothpaste can help block pain associated with sensitive teeth.
• Fluoride. Your dentist might apply fluoride to the sensitive areas of your teeth to strengthen tooth enamel and reduce pain.
• Covering exposed root surfaces. If receding gums are the cause of your sensitive teeth, your dentist might apply a sealant to cover the exposed tooth roots.
• Root canal. If your sensitive teeth cause severe pain and other treatments aren't effective, your dentist might recommend a root canal — a procedure used to treat problems in the tooth's soft core (dental pulp).

To prevent sensitive teeth from recurring, your dentist might offer suggestions to help you maintain your oral health. Twice a day, brush your teeth with a soft-bristled toothbrush and fluoride toothpaste. Floss daily. Avoid vigorous or harsh scrubbing, highly abrasive toothpaste, and excessive brushing and flossing. If you grind your teeth, ask your dentist about a mouth guard. Tooth grinding (bruxism) can fracture teeth and cause sensitivity.
You might also consider limiting acidic foods and drinks, such as carbonated drinks, citrus fruits, wine and yogurt — all of which can remove tooth enamel. When you drink acidic liquids, use a straw to limit contact with your teeth. After eating or drinking an acidic substance, drink milk or water to balance the acid levels in your mouth. It also helps to avoid brushing your teeth immediately after eating or drinking acidic substances, since acid softens enamel and makes it more vulnerable to erosion during brushing.

Whitening toothpaste: Does it whiten teeth?

Answer

from Alan Carr, D.M.D. -Mayo Clinic

Whitening toothpaste can whiten teeth slightly by removing surface stains, such as those caused by drinking coffee or smoking. Whitening toothpaste can also be used after a bleaching treatment to help maintain results. However, whitening toothpaste can't change the natural color of teeth or reverse discoloration caused by excessive exposure to fluoride during tooth development, penetrating surface stains or decay.
To remove surface stains, whitening toothpaste may include:

• Special abrasives that gently polish the teeth
• Chemicals, such as sodium tripolyphosphate, that help break down or dissolve stains

When used twice a day, whitening toothpaste typically takes two to four weeks to make teeth whiter. However, new research shows that whitening toothpaste containing the chemical blue covarine can make teeth appear immediately whiter. After use, blue covarine adheres to the surface of the teeth and creates an optical illusion that makes teeth appear less yellow.
Whitening toothpaste is generally safe for daily use, but excessive use might damage tooth enamel. If you're considering using a whitening toothpaste, look for a brand that has a seal of approval from a reputable dental organization — such as the American Dental Association (ADA) Seal of Acceptance, which indicates that the toothpaste is effective at removing surface stains and reducing tooth decay. If you're not satisfied with the effect of whitening toothpaste, talk to your dentist or dental hygienist about more effective tooth whitening options.

Dental floss vs. water pick: Which is better?

Answer

from Alan Carr, D.M.D.

Standard dental floss is generally considered the most effective tool for cleaning the tight spaces between the teeth. You can also use dental floss to scrape up and down the sides of each tooth.

A water pick (oral irrigator) is a device that aims a stream of water at your teeth. A water pick can help remove food particles from your teeth and might help reduce bleeding and gum disease — but it isn't generally considered a substitute for brushing and flossing.

If plain dental floss gets stuck in your teeth, use the waxed variety. If you have a hard time handling dental floss, try a floss holder. Other options might include special brushes, picks or sticks designed to clean between the teeth.