Did you know that Americans spend nearly 3 billion dollars each year on fresh breath remedies including gum, mints and mouthrinses to address their fears of halitosis (bad breath)? This simple fact clearly reveals that Americans are obsessed with having pleasant breath. Some other interesting statistics on this subject include:

• 60% of women and 50% of men say they use breath freshening products like candy, chewing gum and sprays
• 50% of middle-aged and older adults have bad breath
• 25% of the population has chronic bad breath
• 20 to 25% of adults have bad breath due to their smoking habits

However, the best way to determine what is causing your bad breath is to have a thorough dental exam followed by a professional cleaning. The first important step of this process begins when we obtain a thorough medical history. This includes asking you questions so that we can:

• Identify your chief complaint and whether or not your bad breath is noticed by others or just a concern you have
• Learn about your medical history as well as what medications (prescription and over-the-counter), supplements, and vitamins you are currently taking
• Learn about your dietary history to see if pungent foods such as garlic and onions are foods you often eat that are contributing to the problem
• Conduct a psychosocial assessment to learn if you suffer from depression, anxiety, sleep or work problems
• Identify personal habits such as smoking cigarettes, cigars or a pipe that contribute to your bad breath

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.” Or you can contact us today to schedule a consultation for an examination, cleaning and treatment plan.

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

Contact us today to schedule an appointment to discuss your questions about pregnancy and your oral health. You can also learn more by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

If you think your child is too young to need root canal treatment, think again — there is no age limit for this treatment. If his/her primary (baby) teeth have been injured, or if decay has advanced deep into the roots of your child's teeth, a root canal treatment to stabilize teeth may be needed. Root canal treatment removes infection from the pulp, the living tissue that is found inside the tooth's roots. The pulp contains the tooth's nerves, so tooth pain is often an indication that decay has moved into the pulp.

When performing root canal treatment on primary teeth, we must keep in mind that the primary teeth's roots will be resorbed as part of the normal process in which the body makes room for the growing permanent teeth that will take their place.

If a child experiences tooth pain that is related to changes of temperature or pressure, or exposure to sweet or acidic foods, the infection is likely to be minor and easily repaired. But if he or she feels a constant or throbbing pain regardless of stimulation, it may indicate an extensive infection of the pulp and surrounding area.

If the infection is advanced, the baby tooth may have to be removed. But if baby teeth are lost prematurely, a malocclusion (from “mal” meaning bad and “occlusion” meaning bite) can easily result; so we make every effort to keep the baby teeth in place to guide the permanent teeth that are forming underneath them, inside the child's jaw. In such cases an endodontist (from the root “endo” meaning inside and “dont” meaning tooth) or pediatric dentist may perform root canal treatment, removing the diseased and infected pulp from within the tooth's roots and replacing it with a substance that can be absorbed when it is time for the baby tooth's roots to be resorbed naturally.

When baby teeth are injured through a fall or blow to the face (referred to as traumatic injury) they may develop discoloration varying from yellow to dark gray. This is a sign of damage to the pulp tissues inside the tooth's roots. Dark gray discoloration often indicates that the pulp tissues have died. In such cases root canal treatment is needed to remove the dead tissue. If a tooth is completely knocked out of the child's mouth, most dentists agree that it should not be replanted because of the risk of damage to the developing tooth underneath.

Root canal treatment for baby teeth is a better choice than tooth removal if at all possible. It helps a child retain full function of their teeth, jaws and tongue, preventing speech problems, and it helps guide the permanent teeth into their proper places.

Contact us today to schedule an appointment to discuss your questions about treatment for children's teeth. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment for Children's Teeth.”

Just as you would expect, we highly recommend the use of protective mouthguards to anyone participating in contact sports or rigorous physical exercise. The primary reasons we feel this way are substantiated by evidence-based research and experience within our practice. If you don't think mouthguards are helpful, here are some facts you should know:

• Research conducted by the American Dental Association (ADA) found that individuals are 60 times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise. This shocking fact alone illustrates the importance of protective mouthguards.
• A study reported by the American Academy of General Dentistry (AAGD) found that mouthguards prevent more than 200,000 injuries to the mouth and/or teeth each year.
• Sports-related injuries often end-up in the emergency room; however, the US Centers for Disease Control (CDC) reports that more than 600,000 of these visits involve injury or damage to the teeth and mouth.
• In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending $10,000 to $20,000 per tooth over a lifetime for teeth that are not properly preserved and replanted. This staggering statistic is from the National Youth Sports Foundation for Safety.
• While protective mouthguards were first used in the sport of boxing during the 1920s, the ADA now recommends their use in 29 (and growing) different high contact sports and activities. Some of these include acrobatics, baseball, basketball, bicycling, field hockey, football, handball, ice hockey, lacrosse, martial arts, skateboarding, skiing, soccer, softball, volleyball and wrestling.
• It used to be that only males were considered when it came to needing mouthguards. However, recent studies have revealed that the growing interest and participation of females in these same sports and activities makes it just as important for them to protect their teeth.

To learn more about the importance of mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” You can also contact us today to schedule an appointment or to discuss your questions about protecting your mouth and teeth. And if you have already suffered from a dental injury, let us evaluate the damage and work with you to restore the health and beauty of your teeth.