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Rumor has it that the Queen of England doesn’t allow garlic in the palace. And, even if you have no royal duties in the near future, it might be a good idea to avoid foods like garlic and onion before a big presentation or a first date. But if your diet is filled with mint, fresh apples, and parsley and you still worry about your breath, here are some common causes for bad breath that you might not have considered.

• A Slip of the Tongue

We brush and floss to remove food particles and bacteria. After all, bacteria that linger in the mouth produce acids that damage tooth enamel and cause bad breath. But there is one important brushing target you might be overlooking—your tongue.

Remove food particles and bacteria on the surface of the tongue with a gentle brushing after you have finished cleaning your teeth. With a dab of toothpaste, brush the top of your tongue gently from back to front. There are also tools called tongue scrapers available that are specifically designed to remove food particles and bacteria from the tongue’s surface. However you choose to clean your tongue, remember to move from the back to the front, and always clean gently.

• A Dry Spell

We spend the vast majority of our day not brushing our teeth. What helps keep breath fresh even during the hours between brushings? Saliva! As saliva bathes the teeth throughout the day, it not only washes away food particles and bacteria, but also neutralizes the enamel-damaging acids that are produced by bacteria. Yet another benefit? Saliva is not a friendly environment for the oral bacteria that produce volatile sulfur compounds (VSCs). It is these compounds that cause most of the unpleasant odors we know as bad breath.

If you are drinking the recommended amount of water each day, you are helping your body produce saliva and fight bad breath. Sometimes, a medical condition called dry mouth, or xerostomia, interferes with saliva production. Talk to Dr. Tom Nymberg about ways to deal with dry mouth. Solutions as simple as drinking more fluids or chewing sugarless gum can help, or we can suggest over-the-counter products or prescription medications if needed.

• A Bad Night’s Sleep

We’re all familiar with the concept of morning breath. As we sleep, our saliva production naturally decreases. It’s like a nightly version of dry mouth. Without normal levels of saliva, bacterial growth takes off, VSC’s are produced in greater quantities, and we wake up wondering what on earth happened to that fresh feeling we had after brushing the night before.

Unfortunately for snorers, nighttime brings more problems. Snoring leads to mouth breathing, and mouth breathing creates an even drier environment where oral bacteria increase more quickly. If you find you are consistently waking up with an especially unpleasant case of morning breath, you could be a chronic snorer without even realizing it. If you discover or suspect you have a snoring problem, talk to Dr. Tom Nymberg or your GP. Snoring can have serious health consequences, so let’s discuss possible solutions.

One important note to end on: if you have eliminated all the obvious causes of halitosis but still have persistent bad breath, give our Mason, OH office a call. Chronic bad breath can be a symptom of serious gum disease, oral infections, illnesses such as diabetes or kidney disease, and other medical conditions that should be treated as soon as possible. If the topic is bad breath, let’s make sure garlic is the only thing you have to worry about.

Dental implants are a surgical procedure done by Dr. Tom Nymberg right here at our Mason, OH office. Screw-like parts made of titanium are inserted into your jaw bone and act as the root of your tooth. An artificial tooth will be placed on top of the screw, usually made out of ceramic or layered porcelain. The dental implant will look and feel just like the natural tooth you lost.

How much time will the dental implant surgery take?

There are numerous factors that determine the length of time for the dental implant procedure:

• If you’re having one tooth replaced or several
• The teeth that are being replaced
• If you need a tooth or teeth extracted before the implant placement
• The amount of time it takes for your IV to be placed
• Any last minute questions or concerns you may need addressed

All of the above factors will also govern the amount of visits to our Mason, OH office you will need to make throughout your dental implant treatment period. For example, a single tooth dental implant surgery typically takes one to two hours from the time you arrive until you awaken from the anesthesia. This also includes the amount of time it takes to put on your gown, hair cap, and other surgical dressing preparations before you are able to enter the sterile surgical environment.

Does getting an implant hurt?

With nearly any surgical procedure, you will feel some sort of discomfort. Whether it is the insertion of the IV for the anesthesia, or discomfort you may feel after the surgery. However, most patients report that their pain was tolerable after their dental implant surgery. In fact, the majority of patients said the discomfort was a lot less than they expected. Dr. Tom Nymberg will prescribe pain medications to help with any discomfort you may experience once you get home.

How will I feel after the dental implant treatment?

It is normal to have some bruising and swelling in the soft tissue and gum area. Usually the pain or discomfort does not require the use of anything more than an over-the-counter pain medication such as Tylenol or ibuprofen. In addition, you will have the prescription for a stronger pain medication if you need it. You should be able to work the following day.

Gum (gingival) recession occurs when gums recede from the tops of the teeth enough to expose sensitive roots. People typically experience increased sensitivity to sugary or cold foods when gums no longer cover and protect teeth roots. In addition, untreated gum recession may lead to loosening of teeth and accelerated tooth decay, something Dr. Tom Nymberg see all too often.

Causes of Gum Recession

• Periodontal disease – a serious oral disease arising from poor oral habits
• Gingivitis – gum disease characterized by bleeding and swollen gums
• Aging
• Overly aggressive brushing and/or flossing – brushing hard in a scrubbing fashion will erode gum tissue at the roots of teeth
• Genetic predisposition to gingival recession – having inherited thin, insufficient gum tissue facilitates gum recession
• Bruxism – a condition where someone regularly grinds their teeth, usually during sleep
• Chewing tobacco/smoking – promotes chronically dry mouth and reduced gum health

Periodontal gingivitis may also cause causing drooping of the gums instead of gum recession. A gingivectomy removes excess gum tissue weakened by bacterial decay while a gingivoplasty can reshape gums around the teeth. If sagging or receding gums are left untreated, they may develop pockets (gaps) that provide hiding places for food particles, mucus and other mouth debris conducive to anaerobic bacteria growth. As the most destructive type of oral bacteria, anaerobic bacteria is responsible for tooth decay, cavities, gum disease, and chronic halitosis.

Treatments for Gum Recession

Corrective actions need implemented as soon as possible to reverse gum recession by addressing the cause. For example, people who brush with hard-bristled toothbrushes should switch to a soft-bristled toothbrush and brush more gently. If gum recession is the result of poor oral hygiene, improve oral hygiene habits by brushing after meals, flossing, rinsing with non-alcoholic mouthwash, and getting dental checkups and cleanings every six months. For severe cases of gum recession, soft tissue grafts can add gum tissue to exposed roots by removing tissue from the person's palate and attaching it to existing gums at the area of recession via laser surgery.

If you’re worried about gum recession, visit our Mason, OH office and talk to a member of our team.

Is this a trick question? After all, you probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals which help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Some cavities aren’t discovered until you visit our Mason, OH office, but sometimes there are clear signs that there’s a problem.

• You have tooth pain or sensitivity.
• Your tooth changes color in spots where the enamel has decayed.
• You might even notice enamel loss when a cavity is large enough.

So, if you have any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids—we do it ourselves with our choice of food and drink. Acidic foods are one of the leading causes of tooth erosion.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, wine, fruit juices, flavored teas, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

The symptoms of tooth erosion and damaged enamel can be very similar to those caused by cavities:

• You suffer tooth pain or sensitivity
• Your teeth appear discolored, as the enamel thins to reveal the yellowish dentin underneath
• You notice missing enamel—your teeth become rounded or have little pits known as cupping

You call Dr. Tom Nymberg right away if you suspect a cavity. Be just as proactive if you suspect erosion. Even though your symptoms may not have been caused by plaque and bacteria, acidic erosion from your diet leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Enjoy acidic foods sparingly, or as part of a meal. This helps your saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to help neutralize acids and restore a normal pH balance. (A good reason to pair wine or fruits with cheese.)
• Use a straw! This simple solution keeps erosive drinks from bathing your teeth in acids.
• Drink water instead of an acidic beverage, or drink it afterward to rinse your mouth. The pH of pure water? A perfect, neutral 7.
• And what about brushing right after eating or drinking something acidic? Ask Dr. Tom Nymberg if you should rush for your brush. We may recommend waiting 30 minutes or so after an acidic treat to give teeth time to remineralize after acids weaken them. Otherwise, brushing might cause more wear and tear on your enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing your medical needs.

There’s no trick to it—watching your diet, brushing and flossing as recommended, using a fluoride toothpaste, and visiting All Smiles Family Dental for regular checkups will help prevent tooth erosion. We can restore eroded enamel with bonding, veneers, or crowns if the erosion is serious. Better still is to catch erosion before symptoms appear to keep your teeth their strongest for a lifetime of healthy, beautiful smiles.