Monthly Archives: December 2016

Tips to Choosing a Mouth Rinse That’s Right for You

Anti-plaque, anti-gingivitis, alcohol-free — your pharmacy’s oral health section has dozens of mouth rinse products to choose from, all promising to protect your teeth and gums and freshen your breath.

But how can you know which claims are true? And do you really need to use a mouth rinse — or is good brushing and flossing enough?

“There are three major categories [of mouth rinses], from a consumer perspective,” says Michelle Henshaw, DDS, MPH and assistant dean for community partnerships and extramural affairs at Boston University, Henry M. Goldman School of Dental Medicine. These include mouth rinse products that contain fluoride, anti-gingivitis and anti-plaque mouth rinses, and cosmetic mouth rinse products. Some of these mouth rinses are available over-the-counter; others will require a prescription.

Here’s what you should know when shopping for a mouth rinse.

Fluoride-Containing Mouth Rinses

Fluoride helps prevent tooth decay by helping your body strengthen enamel — the white, harder-than-bone substance that covers teeth. But most people will not require fluoride-containing mouth rinses, says Dr. Henshaw. “You pretty much get that from your fluoridated toothpaste,” she says. But, there are some exceptions.

“People with xerostomia (abnormal dryness of the mouth) might use this kind of mouth rinse, and there are other reasons, like dental caries (cavities),” says Henshaw. Severe dry mouth can lead to a change in the bacterial balance of your mouth, while too much bad bacteria can lead to tooth decay. Fluoride mouth rinses can help prevent these problems.

Check with your dentist if you’re not using fluoride toothpaste. In this case, it might be a good idea to supplement your oral health routine with a fluoride mouth rinse.

Mouth Rinse to Freshen Your Breath

Many mouth rinses are available that make your breath smell good, but, they don’t necessarily offer any long-term dental health benefits.

“Cosmetic rinses reduce mouth odors, or halitosis,” Henshaw says. “Some do kill bacteria for a short time, but there is no lasting health impact that you could ascribe to them.” The bacteria killed by these types of mouth rinses will grow back eventually, and while you’ll have fresh and minty breath in the short-term, these rinses don’t actually improve your oral health.

Anti-Plaque or Anti-Gingivitis Mouth Rinses

“For adults, it’s a good idea to include this kind [of mouth rinse] with brushing and flossing,” Henshaw says. Although brushing and flossing are the key components of good oral health, we don’t always do as good a job with these tasks as we should. Anti-plaque and anti-gingivitis mouth rinses can give a boost to your dental care habits by killing potentially damaging bacteria.

“If it has the American Dental Association (ADA) seal of approval that means that the claims made on the bottle have been verified by an independent scientific body,” Henshaw explains. “These rinses work by killing a different spectrum of bacteria than the breath-freshening rinses,” Henshaw says. Oral bacteria can cause gum disease, so using a rinse that eliminates some of these organisms will help your overall oral health.

For people with more serious oral health concerns, dentists can prescribe stronger mouth rinses. “Another level is available by prescription to fight advanced plaque and gingivitis. This will keep inflammation down,” Henshaw says.

Mouth rinses do serve a purpose, whether to freshen your breath or help fight plaque and gingivitis. But, mouth rinses are not a substitute for regular and effective brushing and flossing. Don’t get lazy with your toothbrush and dental floss. And when choosing a mouth rinse product, pick one that has the ADA seal of approval.

FDA’s Warning to Mouthwash Makers

In September 2010, the Food and Drug Administration (FDA) warned a number of mouthwash producers — including Johnson & Johnson, CVS, and Walgreens — that they needed to stop making “unproven” claims in their packaging. The mouth rinses targeted were mainly those containing sodium fluoride, which has found to be an effective cavity-fighter but ieffective at removing plaque or preventing gum disease.

Tobacco Use and Your Oral Health

In addition to affecting your overall health, tobacco use and smoking can cause a number of oral health issues, ranging from oral cancer to discolored teeth.

“You can get yellow teeth [and] a yellow tongue,” says Thomas Kilgore, DMD, professor of oral and maxillofacial surgery and associate dean at the Boston University Henry M. Goldman School of Dental Medicine. “You see a lot of staining on the tongue.”

Smoking and tobacco use can lead to more serious oral health complications as well, including gum disease and oral cancer.

Smoking and Oral Cancer

“The most serious issue is mouth cancer,” Dr. Kilgore says. “It’s hard to say what percentage of people who smoke will get mouth cancer, but the death rate of those who do get it is high — between 40 and 50 percent of all cases, and that hasn’t changed over the last few decades.”

The American Cancer Society estimates that 90 percent of people with oral cancer (cancer affecting the lips, tongue, throat, and mouth) have used tobacco in some form. Likewise, the risk of oral cancer is six times higher among smokers relative to non-smokers. Your individual risk of oral cancer depends on how long you’ve been using tobacco — the longer you use it, the greater your risk.

Smoking and Periodontal Disease

“Smoking cigarettes doesn’t cause dental decay, but it does cause periodontal, or gum, disease,” Kilgore explains. “Bone loss is part of periodontal disease. It starts out as inflammation of the gums. In the natural and unfortunate progression, the bone supporting the roots of your teeth becomes inflamed,” and then the underlying bone can deteriorate, he adds.

“There are surgical and nonsurgical therapies to reverse or slow the progression of periodontal disease,” Kilgore says, but without proper treatment, gum disease does eventually lead to tooth loss and jawbone damage. One study found that smoking was associated with more than 50 percent of periodontal disease cases.

For Oral Health, No Tobacco Is Safe

People often think that different forms of tobacco are “safer” than others. However, says Kilgore, “Tobacco in any form has risks. It’s hard to figure out which is worse” — when tobacco is chewed, smoked, or inhaled.

The bottom line is that regular exposure to tobacco in any form can compromise your health. Kilgore points out that “pipe smokers may not smoke very often, but they can [still] get cancer of the lips, as they’re always holding the pipe in the same place on the lip.” Additionally, “there’s a myth that chewing tobacco has less risk, but it’s been shown pretty clearly that this isn’t true.”

And people who use smokeless (chewing) tobacco are at a four to six time greater risk of oral cancer than people who don’t use tobacco at all. People who use smokeless tobacco are also at higher risk of tooth decay and cavities because some varieties of chewing tobacco contain sugar for a sweeter taste, and sugar is a primary cause of tooth decay.

Protecting Your Oral Heath

The following three principles can help to ensure good oral health throughout the years:

  • Quit smoking. After you’ve quit smoking, your risk of oral health problems decreases significantly. And the longer you remain a non-smoker, the lower your risk becomes. A decade after you’ve quit, your risk for periodontal disease is similar to that of a person who never smoked at all. “A lot of dentists now are taking the initiative to ask patients about their smoking habits, and are talking about the [nicotine] patch” and other ways to help people quit, Kilgore says.
  • Get regular dental checkups. As with most cancers, early detection can improve your outcome. “The good news is that regular checkups by a dentist are a good way to catch oral cancer early,” advises Kilgore. “Any mouth ulcers can be checked out with a biopsy, and you can get a diagnosis.” The sooner you start treatment, the better your odds of survival.
  • Brush properly. “Most people who have periodontal disease develop it from not brushing and flossing properly,” Kilgore notes. The heat and carcinogens found in cigarettes and tobacco are also damaging to your mouth and gums. So people who use tobacco need to be doubly careful about brushing and flossing correctly and doing so as often as recommended. Ask your dentist or dental hygienist to watch you brush and floss to make sure you’re doing a thorough job.

Having Trouble Quitting? Visit the Dentist Regularly

If you do use tobacco, cutting back and eventually quitting are some of the most important actions you can take to improve both your oral health and your overall health.

Tobacco use “is a tremendously addictive habit, so in the meantime, regular dental visits can help with early detection” of gum disease and precancerous mouth sores, Kilgore says. He adds that the people at greatest risk for oral cancer are chronic smokers who don’t visit their dentists regularly. “By the time oral cancer is detected, it’s hard to treat,” he says. Plus, the treatments can be more challenging at later stages. Surgery and radiation treatments are often disfiguring and can affect your ability to speak and eat.

Talk to your dentist or general doctor about what can help you to kick your smoking and other tobacco habits today.

Oral Hygiene and Your Overall Health

How well you care for your teeth and gums has a powerful effect on your overall health. Neglecting your oral health lead to more than just sore teeth and bad breath — it can open the door to all sorts of health problems, including some pretty nasty diseases like oral cancer. Researchers have found possible connections between gum problems and heart disease, bacterial pneumonia, stroke, and even problem pregnancies.

“You cannot be healthy with an unhealthy mouth any more than one can be healthy with an infected foot,” says Richard H. Price, DMD, spokesperson for the American Dental Association (ADA) and a former clinical instructor at the Boston University Dental School.

The Role of Diet and Lifestyle in Oral Health

A number of dietary habits and lifestyle factors can affect oral health, including:

Sugar consumption. “Having a sugar-laden diet will contribute to tooth decay and gum problems, as the bacteria in the mouth thrive in this environment,” producing tooth and gum-destroying enzymes and acids, says Dr. Price, who retired after 35 years as a dentist in Newton, Mass.

  • Smoking. Dental care experts have long known that smoking cigarettes and cigars and using tobacco products can cause periodontal disease (gum disease), tooth decay, and oral cancer. Cigars can also cause periodontal disease and throat, or pharyngeal, cancer. “The smoke from tobacco has a toxic effect on gum tissue, and can interfere with blood flow,” Price explains. “Smoking also stains the heck out of teeth, is a direct cause of oral cancer, and can contribute to bad breath.”
  • Drinking alcohol. “Drinking can contribute to oral problems indirectly by resulting in a dehydrated mouth, which can allow bacteria to run rampant,” Price says. In addition, people who have alcohol addiction issues are probably less likely to consistently follow good dental care habits, he says.
  • Changes in weight. For those who wear dentures, changes in body weight tend to affect the way dentures fit, Price says. “Just as weight gain or loss affects the way clothes fit, that gain or loss also affects the gum pads on which dentures rest,” he says. To help maintain a healthy weight and fight tooth decay, the ADA advises people to eat a diet rich in high-fiber fruits and vegetables.
  • Medication. “Some medications, for example, some antibiotics, can cause internal staining of teeth, such as tetracycline staining, depending on the age at which you take them,” says Price. Also, “there are 200 to 400 medications, prescribed or over-the-counter, that have the side effect of drying up saliva. A dry mouth is more prone to gum disease and tooth decay, as well as bad breath.”

Healthy Mouth, Healthy Body

To maintain your oral health — and overall good health — Price says you should see your dentist regularly to head off any problems early. You should also practice good oral hygiene at home by carefully brushing and flossing your teeth regularly in order to prevent plaque from accumulating and causing problems. There is nothing a dentist can do that a patient can’t undo by neglecting their dental care, says Price.

Maintaining Good Dental Care Habits

Taking care of your teeth at home can help you maintain your dental health and prevent periodontal, or gum, disease from developing.

Richard H. Price, DMD, spokesperson for the American Dental Association and a former clinical instructor at the Boston University Henry M. Goldman School of Dental Medicine, says regular home care should include daily brushing and flossing. “My advice is to brush thoroughly, at least twice a day, once in the morning and once in the evening before going to bed,” says Dr. Price. “Be sure to floss at least once a day. I do it after every meal when I can.” Proper dental care at home, combined with seeing your dentist regularly, is your ticket to good dental health, says Price, who is retired from a 35-year private group dental practice in Newton, Mass.

Dental Health at Home

“Use products that have the ADA (American Dental Association) seal,” says Price. “This means that the products — toothbrush, toothpaste, floss, etc. — are safe to use as directed and will keep your mouth healthy — no gum disease, no cavities.”

Here are some basic principles to follow:

  • Spend at least three minutes brushing your teeth two times a day. Use a timer if you have to to ensure that you’re spending enough time on your oral care routine.
  • Use floss at least once a day every day to clean between your teeth.
  • Buy ADA-approved dental cleaning tools and toothpaste.

“Basically, brush and floss, and do it correctly,” says Price.

The goal of regular home care is to combat the buildup of plaque in and around your teeth and gums, and fight bad breath, tooth decay, and gum disease. Adults who neglect their teeth and who let plaque build up often develop infections in the delicate tissue around their teeth, Price explains.

A whole arsenal of dental health tools is available in drugstores to help you clean your teeth at home. These range from regular toothbrushes to power toothbrushes, inter-dental cleaners (picks, etc.), waxed and unwaxed floss, oral irrigators, and mouth rinses. You should ask your dentist which of these tools you might want to include in your daily cleaning routine.

Consequences of Poor Oral Hygiene

Poor oral hygiene invites plaque to accumulate around the base of your teeth and gum line, causing your gums to become red and inflamed.

“Plaque is the bacteria-laden film that, if allowed to accumulate on teeth and gums, will cause tooth decay and gum disease,” Price explains.

If you neglect the care of your teeth at home and fail to go to the dentist regularly, accumulated plaque could potentially lead to the development of empty spaces around your teeth. These spaces could eventually lead to the destruction of bone and other fragile tissues supporting your teeth, and you could lose your teeth.

The good news is that being diligent about your dental health care and getting regular dental checkups can prevent plaque from forming and even reverse early gum disease. “A plaque-free mouth is a healthy mouth,” says Price. Along with regular dental checkups, “proper bushing and flossing are the only effective ways I know of preventing plaque buildup.”