An Iraqi girl learns how to brush her teeth for the first time.

Dental decay is not much of an issue in modern society (thanks to fluoridated water and toothpaste), but a proper hygiene routine is still necessary to prevent gum disease and/or cavities. Brushing and flossing is essential, as this both cleans the smooth surfaces of the teeth, and also helps break up food particles and plaque in between the teeth and gum line. Gum disease starts in between the teeth, and some toothbrushes can’t reach critical areas necessary to be cleaned to prevent bacteria from growing.

Although gingivitis – the bacterial infection that invades your gums – is reversible, periodontitis is gum and bone disease, and is not irreversible! Because periodontal disease is so serious, and can only be managed under the strict supervision of a dental professional, it is important to understand just how periodontal disease can affect you. This disease has been linked to heart disease, stroke, diabetes and other degenerative diseases that can be life threatening! I’ve blogged about periodontitis before, and I can’t stress enough how important and serious it can be to have regular cleanings and check-ups from a dental professional twice yearly. Periodontal disease can disfigure even the most beautiful of smiles. Your gums can be so swollen, receded and bloody that your teeth will look longer, will become loose and eventually will need removal. If you detect gum disease early, you will need a management program that includes regular treatment with your dentist and/or hygienist and solid home care to manage the disease.

Root planing and scaling is the common form of soft tissue management treatment, when a hygienist or dentist uses a precise tool to detoxify the tooth surfaces below the gum line and in between each tooth, and then rinses with antiseptic. With advanced technology, laser energy can also be utilized to remove diseased tissues and eliminate bacteria to allow healing to take place. Your dental professional will discuss the best treatment plan for you  – a routine cleaning is not enough by itself to treat periodontal disease! You may need to visit your dental hygienist more often, up to four times per year in order to properly manage the disease. On a daily basis, a solid home care program (which should be designed by you and your dentist) will help you maintain your oral health. Besides brushing and flossing after every meal, other tools like prescription tooth brushes (like Rotadent) and water irrigators (like Hydrofloss) could be helpful for your hygiene routine. Antiseptic rinses like Tooth and Gum Tonic Herbal Rinse, a healthy diet and/or supplements and antioxidants like vitamin C and B can also help to fight and manage gum disease. Healthy gum supports a healthy smile, which supports a healthy body!

Healthy gum appears pink and firm. Brushing and flossing in the healthy stages of gum tissue will be a pleasant experience and there will be no bleeding. This is the phase that all gum tissue should be in if it is healthy and clean. Once gingivitis sets in (the beginning stages of gum disease), gums will take on a red and puffy look, and bleed easily upon brushing and flossing. Once gum disease progresses, the chances of returning to a healthy condition deceases drastically – once gum tissue has reached the advanced level, it is likely past of the point of no return and will result in tooth loss. Periodontal disease is the #1 reason of tooth loss.

Healthy gums and teeth

Gingivitis, which is the early stage of gum disease, if treated professionally (with an implemented solid home care program), gum can return to be healthy again without further consequences. So how do we categorize the stages of gum disease (besides the clinical characteristics)? A bleeding index and dental radiographs help, along with periodontal probing depths, which are universally used as guide to diagnose and monitor the progress of the treatment and condition of gum disease. The periodontal probing depths are obtained with a read-out, by lightly inserting a needle (thin and finely marked instrument) sliding between the space between the gum and tooth.

The stage of gingivitis.

Gingivitis, could have a normal pocket reading of 0 to 3 mm. Gum will be red, puffy, and tender, it will bleed easily and possibly exhibit bad breath and bad taste.

Early (mild) periodontitis will show a pocket reading range from 3 t o 5 mm. At this stage, gum gets more tender, bleeds more easily, and there is always looming bad breath and bad taste. At this stage of gum disease, immediate attention and treatment is required if there is any chance of reversing the condition to an easily-manageable and healthy state.

Mild Periodontitis

Moderate Periodontitis is characterized by a periodontal pocket depth of 5-7mm. Gum tissue may become even redder and puffier, it will bleed easily, and bad breath and bad mouth taste are constant.Often times teeth may begin to look longer as gum tissue recedes, and gum boils or abscesses may develop. Front teeth may begin to drift apart showing space or becoming loose.

Moderate Periodontitis

Advanced Periodotitis gets a pocket measurement of more than 7 millimeters, and may progress to 11 or 12 mm, indicating that bone and connective tissues have been continuously destroyed. This is the terminal stage of gum disease. If a patient has just been diagnosed with advanced periodontitis and the teeth are still firm (pockets are less than 9mm, with longer roots, and more localized condition), then there is possibility that with gum surgery and graft, bone regeneration still is possible. Keep in mind however, that the prognosis is guarded. In most situations, advanced periodontitis will result in tooth loss. Replacement implant therapy or other restorative options will be advised.

Advanced Periodontitis

Remember that prevention is the best treatment, especially for gum disease. You are the person who can best take care of yourself, be disciplined with your home care program (including hygiene) and schedule regular check-ups with both your dentist and dental hygienist who can help you stay away of big problems.

Ancient Japanese scroll painting of a woman with Halitosis, 12th century.

Apart from being severely embarrassing, bad breath can actually impact your personal and professional relationships. No employer wants a smelly employee (especially one that interacts with customers on a regular basis, like salespeople), and no partner or date wants a stinky kisser. Bad breath can even instill psychosis into patients with halitophobia, or a fear of bad breath. We know halitosis can seriously impact lives, and not in a positive way – so what can we do about it?

Certain foods with strong aromas – like onions, garlic, sea foods and refined carbohydrates (pastas, dairy products and cheese) – can cause bad breath, but bad habits like drinking and smoking can as well. Dental conditions like dental caries, periodontal disease and dry mouth can create halitosis. Physical conditions like indigestion, GERD (GastroEsopageal Reflux Disease), Asthma and Diabetes can also lead to haliatosis. Treatment for halitosis on the physical end is getting to the root of the problem: eliminating the food debris and bacterial factors in the oral cavity (managing the physical illness). Regarding diet and habits, my professional recommendation would be (of course) to stop smoking and drinking! Control the intake of foods / herbs that can cause smelly breath. Consume greens like celery and parsley, drink plenty water and (at the very least) brush and floss your teeth after every meal. If you eat a lot of garlic or fish, even after brushing and flossing a bad smell can linger in the mouth for a long period of time. Over-the-counter mouth washes and breath fresheners can only temporarily mask over halitosis – they will often times not rid the mouth of foul odors.

Bad breath is a social embarrassment, and is also a sign of having poor hygiene or health problems. We must all be aware of the condition our body is in. Maintaining the self is infinitely beneficial, and health professionals are always ready to provide advice to assist you in reaching our goal: healthy and happy living.

Upper full denture

When first starting to wear dentures, eating even the most simple foods may seem difficult. The foreign sensation of wearing a plastic appliance over a portion of the mouth shouldn’t feel painful – be grateful that this treatment option is available to restore your oral function and health back the best it can be! After first receiving the dentures, eat simple, non-sticky foods like yogurts, steamed vegetables and eggs. Raw vegetables and nuts should be avoided as these items tend to require rigorous use of teeth. When chewing, place food on both rear sides of your dentures to keep your mouth balanced. This is something that will become easier with time.

As a general rule of thumb, denture wearers tend to have a poorer diet than non-denture wearers, so getting a healthy balanced diet is key. If you find difficulty eating with your dentures, check with dentist as adjustments are routine to keep everything functioning and feeling as it should. Dentures should be a supplementary device intended to add to a person’s quality of  life, not detract from it. Speech may also be affected by dentures, and although it may seem difficult or cumbersome in the beginning, after about a month, speech should improve. If not, speak with your dentist about the situation.

Remember, keeping your dentures clean is just as important as keeping your mouth clean. Dentures should be cleaned after each meal, during which the mouth should be cleaned with rinse or lightly scrubbed with a soft bristle toothbrush, to prevent food from sitting beneath the dentures and irritating the gum (which can lead to a fungus infection). Remember, do not sleep with dentures in – the gums need a chance to rest!

It is  possible to have a fruitful, fulfilling life with dentures , if the dentures after multiple adjustments or even new sets still have problem to stay in or hurts, there are other options , maybe selections or set up of different denture teeth,ridge augmentation or dental impalnts, Be sure to find out what will be the best restorative options to regain abilit to eat healthy and feeling healthy. every 6 months with your dental professional to prevent any unexpected problems.

It is only natural to be curious about what teeth are made of and how they function within our mouth. The root anchors the tooth below the gum’s surface into the jaw bone, while the crown of the tooth extends out past the gum. The outermost hard shiny layer of the tooth is called enamel, and is the hardest substance in the body and functions as a food grinder. 92- 96% of enamel consists of minerals (hydroxyapatite, a phosphate and calcium salt) with the remaining part being water and organic material .

Lying just beneath the hard, shiny enamel surface of every tooth is the dentin layer. This layer of the tooth is composed mainly of calcified bony-like tissue (mostly hydroxylapatite), and like bone it contains collagen, water and other organic components (and is soft in consistency). Throughout the dentin layer are tiny passageways into the deep pulpal layer, connected to the enamel layer – these passages are known as tubules. Unlike enamel, dentin continues to modify throughout a person’s entire life. Dentin can grow or reform in response to a change in tooth conditions, such as tooth decay or attrition.

The innermost layer of the tooth is known as the pulpal layer. This inner sanctum of every tooth consists of nerves and blood vessels.  This pulp benefits the teeth in several ways: primarily, the pulp keeps the organic components of the teeth healthy and properly supplied with moisture and nutrients. The pulp also conduces senses such as heat, cold and trauma from the teeth into the body’s nervous system.

The important thing to remember about your tooth structure is that it is subject to change – when bacteria and other substances (like alcohol, smoke or even sugary liquid) is introduced into your oral environment, prompt cleaning (with a toothbrush and floss) is necessary to prevent premature decay. Once decay passes through the enamel layer into the dentin, decay will progress rapidly, even when not easily detectable from visual inspection. Only when the enamel has caved in and broken down does a cavity become visible. If the cavity was not treated early and the underlying dentin layer has already decayed (which can actually extend deep into the pulpal tissue), root canal therapy may be necessary, requiring a post and crown to restore the tooth. Ultimately, prevention is the best solution. Proper home care and regular dental check-ups can detect problems early, and are usually fixed easily.

The sad fact of the matter is that less than 10% of people suffering from tooth pain or other signs of future tooth loss ever see a dentist (or dental professional); because nearly all tooth loss is preventable, this is simply unacceptable! Dental phobia, the fear of being judged by a dentist or financial troubles are often contributing factors in why most people suffering from tooth pain never see a dentist, but the consequence of delaying (or avoiding all together) a dental check-up often results in edentulism (missing one or more teeth). Worst of all, oral health problems are systematic (meaning they can affect other systems or parts of the body), and problems grow with time, making the need to see your dentist that much more urgent if you are suffering from tooth pain.

Of course, tooth loss in rare incidences could be due to injury or genetic problems, mainly caused by poor oral hygiene, bad oral habits leading to tooth and gum disease and eventually tooth loss. For starters, brushing and flossing twice daily and after meals is essential! When food particles are left behind embedded between tooth crevices, bacteria begins a destructive process which eats away at your teeth and gum. Secondly, eating sugary, carbohydrate-laden foods and drinking sugary beverages [frequently] without prompt proper care can erode the enamel on your teeth, making you more prone to tooth loss and gum disease. Without timely dental care, these habits will lead to an untreatable situation and inevitable tooth loss. To prevent all that unpleasantness (and the costly consequences of tooth loss), the best solution is prevention. Prevention means having a terrific home care program, proper diet and habit and getting your regular dental cleanings and check ups every year. When the problem is small (or in a earlier stage of deterioration), problems are much easier to correct and restore. To the end the effort is all worthy, and having a healthy mouth is truly the foundation of good physical health (you can eat and digest healthy, high fibrous food) and mental health (self esteem and being able to smile with confidence)!

This person was properly fitted for her mouthpiece!

Scuba diving is a sport enjoyed by over 4 million people a year, and if you dive, get yourself a proper fitting mouth piece to prevent jaw, teeth and gum problem! If you have a mouthpiece that is not fitting right for you plus the pressure changes from diving, you could suffer from what’s known as “diver’s mouth syndrome,” a painful condition caused by a ill-fitting mouthpiece that irritate your mouth, or you have been clenching your jaw very hard combined with the drop in air pressure as you explore beneath the ocean’s surface.

The mouthpiece that regulates oxygen flow from your oxygen tank to your lungs not only delivers fresh air, but it protects your teeth while diving. The tendency to clench your teeth while diving is very common, and because most standard scuba-diving mouthpieces will not really fit your mouth perfectly, the mouthpiece tends to put unnecessary pressure on the gum and jawbone. So biting hard into the mouthpiece, your gum could be full of lacerations and you could suffer from jaw joint pain or toothache as well after your trip is finished. If the pain lasts for over several days, you could even have a TMJ problem, which will take time to recover.

The best prevention is to make sure you are in good dental health before the trip, and to visit your dental professional who can evaluate how well your mouthpiece fits. Also, if you have recently undergone orthodontic treatment or have an extracted tooth (or temporary fillings), you must be extra careful and see your dentist before diving! Enjoy the under water world and be safe!