Having someone tell you that you have bad breath can be humiliating, but it can also be a sign that you need to see your dentist. Bad breath (or halitosis) can be a sign of an underlying dental or health problem, so before you run out and stock up on breath mints, make an appointment with our office. Using breath fresheners will only disguise the problem and not treat the root cause.

It's important to remember that if you have bad breath, you're not alone — it's the third most common reason people seek a dental consult. We use a systematic approach to determine the cause of your halitosis and offer a solution.

Causes: Ninety percent of mouth odors come from mouth itself — either from the food you eat or bacteria that may be present. Most unpleasant odors originate from proteins trapped in the mouth that are processed by oral bacteria. When left on the tongue, these bacteria can cause an unpleasant smell. Dry mouth, sinus problems, diet and poor oral hygiene can also cause bad breath. In rare cases, a medical condition may be the cause.

Treatment: The best solution will depend on determining the real cause of your halitosis. If bad breath emanates from the mouth, it most commonly is caused by gum disease or even tooth decay, which need to be treated to correct the problem. If halitosis is of systemic (general body) origin, a more detailed examination might be needed from a physician. But the solution may also be as simple as demonstrating how to effectively remove bacterial plaque from your teeth, or offer instruction on proper tongue cleaning. If the cause is gum disease, we may suggest a deep cleaning and possible antibiotic therapy.

Contact us today to schedule an appointment to discuss any questions you may have regarding bad breath. Read more about this topic in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

When treating Temporomandibular (jaw joint) Disorder (formerly known as Temporomandibular Joint Disorder, TMJ), we feel we have two equally important challenges facing us. First, we must start your treatment by relieving the symptoms of pain and discomfort. We typically accomplish this with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. Once we have begun to relieve your pain, our second critical objective is to identify and remedy what is causing the pain. It could be the result of an injury or trauma to the jaws and/or teeth or it could be due to a bite issue or a filling or crown that is too high and thus causing a misaligned bite. There are many other reasons, so it is first necessary to obtain a thorough medical history and conduct a comprehensive evaluation so that we can properly diagnose and treat the TMD condition and what is causing it.

Next to stress resulting in clenching and grinding habits, the four most common causes leading to TMD include:

• Underlying dental conditions that are triggering muscle pain
• Internal joint derangement (displaced or improperly positioned jaw joint)
• Osteoarthritis (degenerative joint disease)
• Synovitis — the painful inflammation of a synovial joint-lining membrane that is characterized by swelling, due to effusion (fluid collection)

If you or another family member suffer from chronic jaw pain, please let us know so that we can properly address your concerns and conduct a thorough examination. Or if you are in constant or severe pain, contact us as soon as possible to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

1. Xylitol is a kind of sugar.
   True or False
2. Xylitol is made from
   1. Bark of birch trees
   2. Coconut shells
   3. Cottonseed hulls
   4. All of the above
3. Xylitol is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol.
   True or False
4. Xylitol is broken down by decay-causing bacteria to produce acid.
   True or False
5. Decay-causing bacteria are transmitted from a parent to a child through oral contact such as a simple lip-to-lip goodnight kiss.
   True or False
6. Researchers have found no difference in prevention of tooth decay in gum made from xylitol compared to gums containing sorbitol/xylitol and sucrose.
   True or False
7. Other xylitol products such as mints, candy and cookies also seem to decrease the incidence of tooth decay.
   True or False
8. Xylitol products increase salivary flow and allow saliva to neutralize acids in your mouth.
   True or False
9. The only side effect of too much xylitol ingestion is a possible mild laxative effect.
   True or False
10. The target dose of xylitol is one to two teaspoons spread throughout the day.
    True or False

1. True. Xylitol is a kind of sugar that does not contribute to tooth decay.
2. All of the above. It is also found naturally in some fruits and vegetables.
3. True. The others, mannitol and sorbitol, are used as sugarless sweeteners.
4. False. Unlike sucrose (table sugar), xylitol is NOT broken down by bacteria to produce acid. Xylitol also stops saliva from becoming acidic so your mouth becomes an unfriendly environment to acid-producing bacteria.
5. True. However, xylitol inhibits growth and attachment of the bacteria to your teeth, so it also inhibits transmission to your children.
6. False. Systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Xylitol gum also appears to halt the development of tiny cavities when compared to other types of chewing gum.
7. True. Use of these products seems to stop the progression of active decay.
8. True. Xylitol and your saliva combine to re-mineralize (harden) your teeth after an acid attack.
9. True.
10. True. This means two pieces of xylitol gum or two pieces of xylitol candy or mints should be consumed for five minutes four times a day after eating meals or snacks.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is a condition that is unusual in that it frequently is quite hard to diagnose, because it often mimics many other conditions. For this reason, many healthcare professionals refer to it as “the great imposter.” The condition arises when there are problems inside the temporomandibular joint and the muscles that attach to it causing pain. The pain is most often due to muscle spasm, thereby limiting the ability to open and close the jaw and to function normally. TMD can impact anyone and has a wide range of similar symptoms.

One of the common causes of TMD is stress, and it may manifest itself through clenching or grinding of teeth while awake or asleep. These habits are often completely subconscious until pointed out by a dental professional or sleeping partner. With stress-induced TMD, the pain often comes and goes in cycles. In other words, it may be present when you are stressed, seem to disappear for a while, and then reappear when you are stressed again. Another cause of TMD can be from an injury or trauma, such as a blow to the jaw. However, regardless of the cause of TMD, the pain is real and needs to be treated properly.

If you feel that you might have TMD, please let us know so that we can address your concerns, starting with a full history and conducting a thorough examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”