Bad Breath (halitosis)

FAQ 1. Is Flossing REALLY Important?

Honesty is the best policy! Here at Clatskanie Dental, we won't judge you. We're here to educate you & help you reach your oral health goals!

So...is flossing REALLY important?

Flossing cleans the surfaces in between the teeth that you can't reach with a toothbrush. The American Dental Association recommends people clean in between their teeth daily, but flossing is just one modality. When used correctly, people can achieve the same oral hygiene using small interdental brushes or oral irrigators (aka 'water flossers").

Cleaning between the teeth can reduce harmful inflammation and therefore lower your risk of PERIODONTAL DISEASE, which is said to affect at least 50% of Americans.

Still unsure? Ask your Dentist before implementing any new oral hygiene regimen.

Learn more here:
http://www.ada.org/en/science-research/science-in-the-news/the-medical-benefit-of-daily-flossing-called-into-question

 


FAQ 2. How Can I Make Dental Care More Affordable?

How a Health Savings Account (HSA) May Reduce Your Dental Costs*

WHY open a HSA?

To help save you money on dental or medical care!

WHAT is a HSA?

A Health Savings Account is a separate account you or your employer can put money into before taxes are taken out, which may save you money on your dental care.

WHO can open a HSA?

You may ask your employer if they offer HSA to employees or you may apply for your own HSA through your financial institution or bank.

Interested in opening a HSA? Contact your employer or financial institution/bank for more information!

To learn more, see article: click here


FAQ 3. Painless Dental Injections: Fact or Myth?

Can getting a dental injection really be a 'painless' experience?

At Clatskanie Dental Clinic, we think it can! Let's explore why we believe this and why you should care.

What do most people dread about going to the dentist: the injection! However, there are actually quite a few techniques your dentist can implement to make the injection 'painless.' Here at Clatskanie Dental, Dr. Ross uses 3 distinct methods to ensure you have the most comfortable injection possible:

  • We Warm It Up: We warm the dental anesthetic so that it is near body temperature. Your body can interpret cold substances as pain, so this helps the body absorb the anesthetic more comfortably.
  • We Go Slow: We administer the anesthetic very slowly, which gives the body more time to adjust and therefore reduces the chance of it feeling painful.
  • Remember To Breath: Most people forget to breathe during dental injections because they're afraid. We gently remind you to breathe during the injection, which calms our patients. Also, the body interprets pain less during exhalation so you don't feel it as much.
  • Topical Agent: Our topical agent is very effective at "pre-numbing" the area, making the injection even more painless!

We strive to make our patients feel as comfortable as possible and we know dental fear is real. If you're suffering from dental pain and are avoiding going to the dentist because you're afraid, you're not alone!

We want to help you in any way we can. Let us help you by calling us today to schedule a complimentary DENTIST MEET AND GREET so you can get to know us!

FAQ 5. Can a Dental cleaning really lower my risk of heart disease?

For decades, medical researchers have hypothesized the link between oral health and whole-body systemic health. Is this link still considered ambiguous in the medical community or is there hard evidence to prove that poor oral health leads to systemic deterioration? Recent studies published in the Journal of Clinical Periodontology (2013), Journal of Oral Science (2016) and Journal of Cardiology (2010) suggest the answer is clear in regards to the link between oral health and cardiovascular disease (CVD).

Oral Disease

Have you or a family member ever been told by your dentist that you need a “deep cleaning?” According to the CDC (2010), 1 in 2 Americans (47.2%) have moderate to severe periodontitis. Once you hit age 65 your odds of developing periodontitis skyrocket to 70%. Periodontitis is caused by harmful bacteria such as Porphyromonas gingivalis that, through multiple complex processes, illicit production of host immune and inflammatory chemicals that lead to the deterioration of the endothelial cells of the gums and subsequent bone supporting the teeth, similar to the way termites eat and destroy wood, potentially leading to serious acute infections and eventual tooth loss. Although periodontitis is an incurable condition, treatment modalities have shown to be effective long-term in slowing the progression and stabilizing the condition. The traditional treatment for periodontitis is non-surgical periodontal therapy, aka a “deep cleaning”, performed at your dentist’s office. Periodontal therapy, depending on the severity and presence of co-morbidities such as diabetes, may include adjunctive treatments such as local antibiotics that help treat the diseased tissue directly or even laser therapy.

Cardiovascular Disease

Heart disease is the number one cause of death in Americans, killing over 600,000 people every single year (CDC 2017). Atherosclerosis, an immune and inflammatory disease that presents as dysfunctional thickening of blood vessels, presents in patients with cardiovascular disease (CVD). The process by which atherosclerosis, or blood vessel thickening, takes place is multifaceted. Basically, as plaques build up in the arteries, endothelial cell breakdown leads to foam cell formation that narrows the blood vessel leading to blood flow blockage. These atherosclerotic plaques may burst open, potentially causing a blood clot that can block the flow of blood causing a thrombotic stroke. The destructive inflammatory processes involved in CVD lead to increased cardiovascular risk markers such as destructive inflammatory blood markers (CRP, fibrinogen, interleukin-6), increased systolic and diastolic blood pressure, increased left ventricular mass (an enlarged heart), and arterial stiffness (thickened blood vessels). Biomarker interleukin-6 is especially correlated with cerebral ischemia (stroke).

Oral-systemic Link

So, what is the connection between periodontitis and the number one killer, heart disease? Both diseases exhibit a mechanism of endothelial (blood vessel wall) breakdown which leads to increased inflammatory biomarkers CRP, IL-6, haptoglobin and leukocytes, which present as bone and soft tissue destruction around teeth (periodontitis) and blood vessel thickening and subsequent heart blockage or stroke (atherosclerotic cardiovascular disease). The microbiological processes and components involved in both processes are analogous and the bacteria P gingivalis is present in most (64%) atherosclerotic plaques seen in patients with cardiovascular disease. Because research to find a causal relationship between oral bacteria and heart disease is extremely difficult and complex, as technologies improve medical researchers are finding more and more correlative and causative relationships between certain biomarkers. In a 6-month randomized clinical trial, non-surgical periodontal therapy was shown effective in reducing levels of systemic inflammatory markers such as ESR and triglycerides (significant reduction), as well as reduction in CRP and total cholesterol (moderate reduction). Periodontal therapy helps to stabilize these biomarkers up to 6-months post-operatively in patients with periodontitis.

In a 2013 study published by the Journal of Clinical Periodontology, non-surgical periodontal therapy (deep cleaning) was shown to significantly reduce all cardiovascular risk markers evaluated, including systemic inflammation plasma markers (CRP, fibrinogen and interleukin-6), systolic and diastolic blood pressure, left ventricular mass (heart enlargement) and arterial stiffness, which lead to a lower cardiovascular risk. Scaling and root planing, aka “deep cleaning”, was shown to produce an even greater systemic reduction of inflammatory markers seen in patients who receive adjunctive therapies such as local administration of antibiotics such as minocycline.

Rainier Dentist


Online Dental Education Library

Our goal here at Clatskanie Dental Clinic is to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Feel free to use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.  Call us today at ((503) 308 4119

Have questions for Dr. Ross?  Call her at (503) 308 4119

 

An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have "chronic halitosis," which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.

Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.

What causes bad breath?

Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth - on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.

Gum disease is caused by plaque - the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Here are characteristic bad breath odors associated with some of these illnesses:

  • Diabetes - acetone, fruity

  • Liver failure - sweetish, musty

  • Acute rheumatic fever - acid, sweet

  • Lung abscess - foul, putrefactive

  • Blood dyscrasias - resembling decomposed blood

  • Liver cirrhosis - resembling decayed blood

  • Uremia - ammonia or urine

  • Hand-Schuller-Christian disease - fetid breath and unpleasant taste

  • Scurvy - foul breath from stomach inflammation

  • Wegner`s granulomatosis - Necrotic, putrefactive

  • Kidney failure - ammonia or urine

  • Diphtheria, dysentery, measles, pneumonia, scarlet fever, tuberculosis - extremely foul, fetid odor

  • Syphilis - fetid

Bad breath may also be caused by medications you are taking, including central nervous system agents, anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics, anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.

Caring for bad breath

Daily brushing and flossing, and regular professional cleanings, will normally take care of unpleasant breath. And don't forget your often overlooked tongue as a culprit for bad breath. Bacterial plaque and food debris also can accumulate on the back of the tongue. The tongue's surface is extremely rough and bacteria can accumulate easily in the cracks and crevices.

Controlling periodontal disease and maintaining good oral health helps to reduce bad breath.  If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.

Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.

If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.

Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe, including Zytex, which is a combination of zinc chloride, thymol and eucalyptus oil that neutralizes the sulfur compounds and kills the bacteria that causes them. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the American Dental Association for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odor, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.


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