Healthy Mouth and a Healthier You

Best Oral Hygiene: Ask the Dentist

Dentist Steven E. Roth, DMD, answers your additional questions about how to achieve the best oral hygiene.

Question:

What effect can jewelry and diamonds (aka “bling”) have on the teeth? I was trying to tell my student why he should not be putting it on his teeth, like so many rap artists do. He’s in the 10th grade, and I want him to know the possible side effects of following this trend.

Answer:

The problem with putting “bling” on your teeth is that it becomes an area that attracts plaque, sugar, and acid, which can lead to tooth decay, bleeding gums and gum disease, bad breath, and a host of other problems. Appeal to your student’s romantic side. Nobody likes smelly breath.

Question:

After going through chemotherapy for five years, I now experience a burning sensation and have an acidic taste in my mouth all the time, which causes me great distress. What can I do to relieve these symptoms?

Answer:

Chemotherapy knocks out the saliva glands. Saliva lubricates the teeth and protects against acid, decay, and gum disease. When the saliva is diminished, bacteria can run wild and cause the symptoms you described. See a dentist ASAP, because there are solutions. Salivary stimulants, extra artificial saliva, and fluoride supplements can all be excellent aides in combating your problems.

Question:

I brush my teeth regularly, but I’m not a big-time flosser. What are some tips you can give on making daily flossing simple and fast?

Answer:

There are numerous floss aids and products on the market. But you should ask your dental hygienist to help you with proper technique. And remember, practice makes perfect.

Question:

I only remove my upper plate in order to clean it. For the past few days I've noticed that the top of my mouth is a little sensitive and bleeds when I brush. Also, the inside of my lips are red. What could this be?

Answer:

Over-wearing your dentures can cause a fungal infection of the mouth. See your dentist immediately for treatment and for a denture cleaning.

Question:

I'm getting so many cavities and I want to know how I can prevent them. I brush, use mouthwash, and floss.

Answer:

If you brush, use mouthwash, and floss, you should go over your technique and your diet with a dental professional. It could be that the acid content in your saliva is way too high. Surprisingly, food and drink items like sports drinks, diet colas, and exercise bars can contain a lot of acid and sugar, which both cause tooth decay.

Question:

What is the best color for full porcelain dentures?

Answer:

Some say match the tone of the whites of your eyes. But it’s best to review this with the doctor who is fabricating your dentures.

Question:

Should I be stimulating my baby’s gums with those finger tools? When should I start brushing her teeth? Do you start when you can see the first teeth?

Answer:

The sooner the better! At birth, start cleaning your child’s gums with a soft infant toothbrush, or a cloth and water. As soon as the teeth begin to appear, start brushing twice daily, using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use only a small smear of toothpaste to brush the teeth of a child less than 2 years old. For the 2-5-year-olds, dispense a pea-sized amount of toothpaste and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively.

Question:

I just read that brushing too hard is bad for you. I usually brush twice a day for five minutes. I noticed that, over the past two months, my teeth have become rather yellow. Despite my brushing, is that a symptom of tooth damage?

Answer:

Most likely it’s time for a professional cleaning. Aggressive brushing is bad because of possible abrasion of the teeth. But the yellowing is most likely extrinsic staining that can be removed by a dental hygienist.

Question:

I have developed a receding gum line. What can I do to address it?

Answer:

See your dentist for an evaluation. There are terrific grafting procedures available to correct these problems. Gum tissue is the only barrier between bacteria and the bones that support your teeth. So you need to have the correct amount of protection.

Question:

How can I fight dental problems while taking antidepressants? Is there any way to prevent tooth loss and other oral side effects that can come from taking my medication? I will be on these meds for the rest of my life.

Answer:

Some antidepressants dry out your mouth. But most times, this only lasts for the first couple of months. Fluoride supplements and xylitol chewing gum can help protect your mouth. Some antidepressants increase tooth grinding. Be on the lookout for waking up with stiff or achy jaw muscles. Your dentist may need to make a mouth guard for you to wear at night.

Question:

What does “deep cleaning” mean for my teeth?

Answer:

When you go for a regular cleaning, your teeth are scaled and polished above the gum line. Many adults don’t remove all of the plaque below their gum line on their own. They require a deep cleaning or “under the gum” scaling to remove this plaque and tartar. Local anesthesia is frequently given at the dentist to complete this procedure painlessly.

Question:

What causes your gums to bleed while you’re brushing? What can I do to prevent it? I’m not experiencing any pain. But this happens every time I brush ... and I do not brush hard.

Answer:

The most common form of gingivitis, known as plaque-induced gingivitis, develops due to plaque adhering to tooth surfaces. This is also the most common form of periodontal disease. In the absence of treatment, gingivitis may progress to periodontitis, which is a destructive form of periodontal disease. Bleeding comes from inflammation. If you are bleeding every time you brush, you need to see your dentist immediately.

Question:

What is the best way to get rid of odor-causing bacteria on the tongue? Do I need a special tongue brush?

Answer:

There are tongue scrapers available in most pharmacies. But you can just take a little toothpaste, stick out your tongue, and carefully brush it.

Question:

I am a retired dental technician and have always been meticulous about brushing and flossing. But I’m finding that my gums are receding around my anterior maxillary and mandibular teeth. I have noticed bone loss in these areas, as well. My PCP put me on calcium and vitamin D. Will this help or is there something else I should be doing?

Answer:

You should see your dentist. Although many people have receding gums as they age, it sounds like you need a periodontal evaluation. I don’t believe that vitamins will cure periodontal disease.

Question:

I have pink spots on the roof of my mouth. My dentist told me last week that if they don't go away, be sure and let him know. What could they be? They are not bothering me in any way. I didn't even know they were there until my cleaning last week.

Answer:

There are many possibilities, such as canker sores, trauma from hot food or utensils, infection, or a tumor. The advice you received is accurate. If it goes away, don’t worry about it!

Question:

What is the cause of excessive salvia? It just suddenly started, and now I have to spit all the time.

Answer:

You may have a sinus problem or postnasal drip. I wouldn’t worry about it. See your internist if it doesn’t stop.

Question:

I’m confused by all the different types of floss. Is any one kind better than the others? Or is it all a matter of preference?

Answer:

Some dentists feel that unwaxed floss may remove more plaque. I have always felt that whichever product works the best and is the easiest for you to use is the best. If floss gets shredded, stuck, or torn in half in your teeth, it’s probably a sign that a dental procedure is needed.

Question:

What’s the difference between a cap and a veneer? Which is safer for your mouth?

Answer:

A cap, or a crown, is a dental restoration that covers an entire tooth, like a new coat of enamel. A porcelain veneer covers the outside or visible face of the tooth. They are equally safe when used in the proper situations. For example, if a tooth is badly broken down by decay and has no remaining support, it needs a crown. If there is severe discoloration, or chipping, or misalignment of a front tooth a veneer may be the most appropriate treatment.

Question:

I had a wisdom tooth removed yesterday and was wondering how I could help it heal faster.

Answer:

By following your doctor’s instructions. No smoking, no sucking on a straw, follow the dietary recommendations, and return to the office for the post-op treatment. Take your antibiotics. Use ice when you need to, etc.

Question:

I have four blisters on my bottom lip, probably due to the fact that I suck my lip and clench my teeth at night. Is there anything I can put on the blister to help them heal faster and reduce the pain and swelling?

Answer:

The first thing to do is stop the biting or sucking that may be causing the blisters. Petroleum jelly, hydrocortisone, and oral anti-inflammatories are all possible aids in helping you heal.

Question:

What are signs of oral cancer?

Answer:

The following are the more common signs and symptoms of oral cancer:

• Swelling, thickenings, lumps, bumps, rough spots, crusts, or erosion on the lips, gums, or other areas inside the mouth
• The development of velvety white, red, or speckled (white and red) patches in the mouth
• Unexplained bleeding in the mouth
• Unexplained numbness, loss of feeling, pain, or tenderness in any area of the face, mouth, or neck
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal within two weeks
• A soreness or feeling that something is caught in the back of the throat
• Difficulty chewing, swallowing, speaking, or moving the jaw or tongue
• Hoarseness, chronic sore throat, or changes in the voice
• Ear pains
• A change in the way your teeth or dentures fit together – a change in your "bite"
• Dramatic weight loss

If you notice any of these changes, contact your dentist immediately for a professional examination.

Question:

Are the toothbrushes that spin and the water pick sets worth the money? Or am I better off buying a regular toothbrush?

Answer:

In my opinion, the motorized toothbrushes really do help in plaque removal. I also love the water piks with diluted mouthwashes in them. However, if cost is a factor, a regular soft toothbrush and mouthwash will work.

Question:

I’ve noticed that the skin inside my mouth is peeling. What could be causing this?

Answer:

Skin peeling can be caused by food, drink, mouthwash, reflux, medicinal side effects, trauma, burning, aspirin, and a host of other possibilities. See your local dentist for an evaluation.

Question:

Should you floss, use mouthwash, brush your teeth, and use a whitener all in the same day?

Answer:

This is absolutely OK to do. Flossing, tooth brushing, and mouthwash are routine. A tooth whitening procedure, as long as it is monitored by a dentist, is perfectly OK to add on top of your normal routine.

Question:

How do I treat halitosis?

Answer:

Bad breath, or halitosis, is an embarrassing condition with many possible causes. Food, tobacco, alcohol, prescription drugs, and over-the-counter meds can all cause halitosis. In some instances, diseases like diabetes or acid reflux can be the source. Seventy percent of these cases are caused by tongue bacteria, which can be treated by brushing or scraping the tongue. Many times, gum bacteria or tooth decay are the causes. The best place to start is at the dentist for an evaluation and hygiene visit.

Question:

I have tinnitus and was told that I may have had a jaw trauma or neck problems. How can a dentist test for jaw problems?

Answer:

Tinnitus can be a jaw joint or TMJ-related issue. A dentist will do a complete examination, which includes evaluating:

• Changes in the degree to which you can open your mouth
• Deviations in opening and closing
• Clicks, pops, or pain
• A load test
• X-rays
• CT scans
• MRIs

It also could be an ENT or neurological issue. So you may want to see your physician for an exam, as well.

Question:

What can I do for gingivitis?

Answer:

Treatment of gingivitis must begin with a dental examination. This will determine what type of gingivitis you may have and whether there is bone loss or a systemic disease to consider. Then, the appropriate level of hygienic care can begin. This may include a referral to a gum specialist. Your dentist may also provide you with directions for the proper home care regimen, which includes brushing, flossing, and using mouthwash.

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