Most people agree that bad breath is more than embarrassing. It affects personal, social and business relationships. Although Americans spend roughly $3 billion annually on gum, mints and mouth rinses that promise relief, they are nothing more than temporary cover ups. Discovering the underlying cause of the problem is the only way to effectively eliminate the halitosis (“halitus” – breath; “osis” – disorder) long term. If you have bad breath, we can help.

While it's true that there are a few systemic (general body) medical conditions that can cause bad breath, including lung infections, liver disease, diabetes and cancer, the majority of causes originate in the mouth. We can conduct a simple oral examination to help diagnose the underlying cause of your bad breath. We will check your mouth thoroughly for signs of any dental problems that can produce an odor, including decayed or abscessed teeth, diseased gums, a coated tongue or infected tonsils. Typically, halitosis occurs when bacteria collect on the surface and back of the tongue where it is drier. Bacteria thrive in this environment, resulting in a “rotten egg” odor that so many of us are all too familiar with. This odor actually emanates from volatile sulfur compounds (VSFs), but will go away with proper treatment.

Once the exact cause is pinpointed, your halitosis can be treated in several ways. For example, we can show you how to brush and floss properly to more effectively remove bacteria responsible for tooth decay and gum disease — don't be embarrassed, nobody really knows until they're shown by a professional. We can also show you how to use a tongue scraper or brush to carefully clean the surface of your tongue. Treatment of tooth decay, the repair of defective or broken fillings, extraction of wisdom teeth (third molars) and periodontal (gum) therapy such as scaling and root planing (deep cleaning) will all help treat infection and consequently bad breath.

You don't have to be embarrassed by bad breath any longer! The sooner you call our office to schedule an examination, the sooner you will be able to breathe a lot more freely. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

We are often asked about the role the tongue plays with bad breath or halitosis, as it is known medically. The truth is that everyone will experience it at some point in life; however, there can be a number of reasons for its cause. Some of these include:

• Consuming odorous foods and/or drinks such as coffee, onions and garlic. This is usually just a temporary condition that can be resolved by brushing and flossing your teeth and using mouthwash. Also consider chewing gum containing xylitol, a sugar-free gum that both promotes saliva flow and reduces tooth decay.
• Diabetes, a disease caused by a faulty metabolism of sugar, as well as diseases of the liver and kidneys can also cause bad breath. Be sure to always let all your health care professionals know if you have any unusual symptoms or you been diagnosed with any of these or other illnesses.
• Poor oral hygiene, which causes gingivitis (gum disease), is one of the most common reasons for bad breath. And if your gum disease is progressive, you could eventually lose your teeth.
• If you use tobacco and regularly drink large amounts of alcohol, you are dramatically increasing the likelihood of having halitosis.
• And lastly, if you do not drink enough water to maintain proper hydration, you can develop bad breath.

There are more than 600 types of bacteria found in the average mouth, many of which can cause bad breath. And the back of the tongue is where these bacteria typically produce Volatile Sulfur Compounds (VSC), the culprits responsible for the worst odors attributed to halitosis.

As for cleaning your tongue, there are two common methods. You can use your toothbrush to brush your tongue, or you can use a tongue-scraper. The latter can generally be purchased at a drug or discount store. The keys to remember are that a clean, healthy tongue should be pink in color and not have a yellow or brownish coating.

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.

The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.

The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.

And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.

So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”