Book Review: 101 Factors You Should Know Before Going to the Dentist

Book Review: 101 Factors You Should Know Before Going to the Dentist
November 23, 2010 by Todd Rutherford Filed under Health & Fitness
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“Once you find the right dentist, the right dental office with the right attitude, and the right fit for you, going to the dentist will be as pleasurable as going to your salon, your spa, your coffee house, or your favorite restaurant,” says Dr. Haque, and for once I’m with the dentist.
Concise and efficient in his delivery, Umar Haque fully discloses to his readers anything and everything you need to know about your oral health and the important features in choosing the right dentist for you. He reminds his readers how dental health has a huge correlation to your systemic wellness, and overall appearance. He also provides a route through which to acquire your ultimate dental goals that fit within your budget.
Ten chapters of pertinent information, Haque’s 101 Factors You Should Know Before Going to the Dentist, couldn’t be any better. There is no book currently available that explains, in an easy and concise manor, the how to’s and what to’s of opting for the right dentist. Haque’s book empowers readers to make up their own minds on the importance of their dental health.
Umar Haque is a Doctor of Dental Medicine, DADIA, FICOI. He was graduated from the University of Connecticut School of Dentist Medicine and completed his dental residency at the University of Illinois and the University of Chicago. He has completed post graduate training in implant surgery, laser dentistry, bone grafting, mild sedation, sleep apnea appliances, TMJ dysfunction, and minimal orthodontics. Haque founded the Passion 4 Dentistry Study Club, where over 30 doctors meet to discuss and collaborate on hard dental cases, comprehensive dentistry, and implant surgery.
Haque believes in a holistic strategy to dentistry, and at his office, Oak Brook Smiles, he helps his patients achieve the smile of their dreams. Dental 101 is everyone’s guide to a happy and healthy relationship with your dentist and to your oral well-being. Haque helps his readers to become less apprehensive about going to the dentist, more educated about their dental decisions, more excited about achieving their dental goals, and more driven regarding their oral health. Now, what’s better than that? For more information, visit www.eatandsmileagain.com.
Learn more about book reviews . Stop by Todd Rutherford’s site where you can find out all about book reviewers and what they can do for you.

Check out this article discussing the link between your oral health and general health. Very interesting!

7 Things Your Teeth Say About Your Health
Sores, Broken Teeth Can Be Warning Of Serious Diseases


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Posted: 3:37 am PST November 11, 2010Updated: 3:42 am PST November 11, 2010
By Paula Spencer, Caring.com editor

Some messages coming out of your mouth bypass the vocal chords. Turns out that your teeth, gums, and surrounding tissues also have plenty to say -- about your overall health.
"Your mouth is connected to the rest of your body," says Anthony Iacopino, dean of the University of Manitoba Faculty of Dentistry and a spokesperson for the American Dental Association. "What we see in the mouth can have a significant effect on other organ systems and processes in the body. And the reverse is also true: Things that are going on systemically in the body can manifest in the mouth."

So stay attuned to the following warning messages, and have worrisome symptoms checked out by a dentist or doctor.

Flat, Worn Teeth, Headache

Sign of: Big-time stress

Many people are surprised to learn they're tooth-grinders. After all, they do this in their sleep, when they're not aware of it. And they underestimate the physical toll that stress can place on the body. "Crunching and grinding the teeth at night during sleep is a common sign of emotional or psychological stress," says Iacopino. You can sometimes see the flatness on your own teeth, or feel it with the tongue. Or the jaw may ache from the clenching.

What else to look for: Headaches; which are caused by spasms in the muscles doing the grinding. Sometimes the pain can radiate from the mouth and head down to the neck and upper back, Iacopino says. Mouth guards used at night can relieve the symptoms and protect teeth.
Cracking, Crumbling TeethSign of: Gastroesophageal reflux disease (GERD)
Older adults, especially, are vulnerable to teeth that appear to be cracking or crumbling away. The enamel becomes thin and almost translucent. But this erosion isn't a normal consequence of aging. In fact, it can happen at any age.

Disintegrating teeth are usually caused by acid that's coming up from the stomach and dissolving them, Iacopino says. The cause: Gastroesophageal reflux disease (GERD, also called acid reflux disease). GERD causes stomach acid to back up into the esophagus -- and from there, it's a short distance to the mouth for some of the damaging acid. GERD is a chronic disorder caused by damage or other changes to the natural barrier between the stomach and the esophagus.

What else to look for: Dry mouth and heartburn are related GERD symptoms. (But in an older adult in someone else's care -- in a nursing home, for example -- these complaints may go unreported.) Cracking or chipping teeth in a younger person is also a telltale sign of bulimia, the eating disorder in which the sufferer causes herself (or himself) to vomit before digesting. Same net result: Stomach acid washes up into the mouth, over time disintegrating the tooth enamel.

Sores That Won't Go Away

Sign of: Oral cancer

Many people bite the insides of their mouth as a nervous habit. Others sometimes bite the gum accidentally, creating a sore. But when an open sore in the mouth doesn't go away within a week or two, it always warrants showing to a dentist or doctor. "We all injure our oral tissues, but if an area persists in being white or red rather than the normal healthy pink, this needs to be evaluated to rule out oral cancer," says Susan Hyde, an associate professor of clinical dentistry at the University of California, San Francisco, School of Dentistry.

More than 21,000 men and 9,000 women a year are diagnosed with oral cancer, according to the National Cancer Institute. Most are over age 60. Oral [1]cancer has a survival rate of only 35 percent, Iacopino says, but this is mainly because cases are often detected too late. Smokers are six times more likely to develop oral cancer, but one in four oral cancers develop in non-smokers.

What else to look for: Suspicious oral ulcers tend to be raised sores and often have red or white (or red and white) borders. They may lurk underneath the tongue, where they're hard to see. Bleeding and numbness are other signs, but sometimes the only sign is a sore that doesn't seem to go away. A biopsy usually follows a visual check.

Gums Growing Over Teeth

Sign of: Medication problems

If you notice your gum literally growing over your tooth, and you're taking a medication for heart disease or seizures or you take drugs to suppress your immune system (such as before a transplant), it's well worth mentioning this curious development to your prescribing doctor.

"A swelling of the gums to where it grows over the teeth is a sign the dosage or the medication need to be adjusted," the ADA's Anthony Iacopino says. Certain drugs can stimulate the growth of gum tissue. This can make it hard to brush and floss, inviting tooth decay and periodontal disease.

What else to look for: The overgrowth can cause an uncomfortable sensation. In extreme cases, the entire tooth can be covered.

Dry Mouth

Sign of: Sjogren's syndrome, diabetes

Many things can cause dry mouth, from dehydration and allergies to smoking and new medications. (In fact, hundreds of drugs list dry mouth as a side effect, including those to treat depression and incontinence, muscle relaxants, antianxiety agents, and antihistamines.) But a lack of sufficient saliva is also an early warning of two autoimmune diseases unrelated to medicine use: Sjogren's syndrome and diabetes.

In Sjogren's, the white blood cells of the body attack their moisture-producing glands, for unknown reasons. Four million Americans have Sjogren's, 90 percent of them women. Twenty-four million people in the U.S. have type 1 or type 2 diabetes, a metabolic disease caused by high blood sugar.

What else to look for: Other signs of diabetes include excessive thirst, tingling in the hands and feet, frequent urination, blurred vision, and weight loss. In Sjogren's, the eyes are dry as well as the mouth, but the entire body is affected by the disorder. Because its symptoms mimic other diseases (such as diabetes), people are often misdiagnosed and go several years before being properly diagnosed.

White Webbing Inside Cheeks

Sign of: Lichen planus

The last thing you might expect to discover while brushing your teeth is a skin disease. But it happens. Lichen planus, whose cause is unknown, is a mild disorder that tends to strike both men and women ages 30 to 70. The mucus membranes in the mouth are often a first target.
Oral lichen planus looks like a whitish, lacy pattern on the insides of the cheeks. (The name comes from the same roots as tree lichen, a lichen that has a similar webbed, bumpy appearance.) Seventy percent of lesions appear in the mouth before they strike other parts of the body, Iacopino says.

What else to look for: Another common area where a lichen planus rash may appear is the vagina. Lichen planus often goes away on its own, but sometimes treatment is necessary.

Crusting Dentures

Sign of: Potential aspiration pneumonia

Most people don't connect dentures (false teeth) with pneumonia, other than to think they're both words that often refer to the world of the elderly. And yet the two have a potentially deadly connection. "A leading cause of death in older people is aspiration pneumonia, often from inhaling debris around the teeth and dentures," Iacopino says.

In aspiration pneumonia, foreign material is breathed into the lungs and airway, causing dangerous (even fatal) inflammation. Too often, the problem stems from people in the care of others -- those in nursing homes, for example -- who fail to clean dentures properly. Dentures need to be removed daily from the mouth, cleaned with a special brush, and stored in a cleansing solution.

What else to look for:A soft, crusty material developing around dentures. With proper cleaning, though, you don't have to worry about other red flags. "It's amazing. You can get a 100-percent reduction in what's otherwise a leading cause of death for denture wearers," Iacopino says.

Dentistry from the Heart

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Last Friday, October 22, I had the pleasure of working with Dr. Vesna Sutter, Dr. Gregoray Doerfler, and Dr. Richard Rosenblatt in Geneva, IL at Sunrise Dental Care. We had the opportunity to help those in need with their dental issues. Along with volunteers from each office, including Siraj (office manager at Oak Brook Smiles), Mariza (Lead Assistant at Oak Brook Smiles) and Cristy (Mariza's classmate in Dental Assisting school), we were able to provide cleanings, extractions, and fillings at no cost to over 50 patients! It was a great time and a great cause!

Chapter 1 of Dental 101

Chapter 1

Factors 1–10

Top 10 Reasons to Go to the Dentist

Factor #1: To Keep Your Teeth

Dental hygiene is crucial to good health. Our health depends on the food we eat, so we have to take particular care of our teeth. Teeth are primarily used to break food into small pieces, and then chew them until they are in a state fit for digestion. Of course good teeth also produce a sparkling smile! Our teeth are unique to us. An anthropologist would be able to tell us our age and what race we belonged to, from our teeth.

Human beings have 20 primary teeth (also known as milk teeth and deciduous teeth) and 32 permanent teeth. Proper care of teeth begins as soon as they first appear. In fact, the first visit to a dentist should take place not later than 6 months after the first tooth appears, and definitely before your child’s first birthday.

The structure of our teeth varies according to their position. The top front teeth are used for biting, while the teeth on the lower jaw are mainly used for breaking up and grinding the food. Further, teeth are divided into the incisors, canines, and molars. Teeth are made up of the enamel, which is the outermost layer. Underneath the enamel is dentin, a protective layer which also supports the crown. The central pulp is what contains the blood vessels and nerves. Below the gumline, there is cementum which helps the periodontal ligaments to attach the gums to the teeth. The alveolar bone is the jaw bone, which holds all the teeth in place. The gums or gingiva, are tissues that cover the jaws. The roots of the teeth are normally found in the gingiva.3

The dentist will give you the right advice on diet and home care of your teeth. Regular visits to the dentist will keep your teeth and gums healthy and strong, and they will allow the dentist and hygienist to make sure no incipient diseases or problems are present. There are literally millions of bacteria in the mouth. Some are not harmful, but some do attack the teeth and gums. The harmful bacteria are found in a sticky film called the plaque, which collects on all of our teeth. This hardens over time to form tartar (also known as calculus).4 Only a dentist or hygienist can remove this. Plaque leads to dental cavities or caries, a disease which damages the enamel, dentin, and cementum of our teeth. Plaque also leads to gingivitis and periodontitis which damages the gums and bone around our teeth. Over time, periodontitis and severe decay leads to tooth loss. Daily brushing, flossing, rinsing, and massaging of gums at home is essential, and significantly contributes to having great teeth and healthy gums. Going to the dentist will help you prevent periodontal disease and cavities, making it possible for you to keep your teeth longer.

Factor #2: To Maintain Excellent Overall Health

Oral hygiene is directly connected to our overall health. There are a large number of bacteria in our mouth, some harmful, and some not. When we regularly brush and floss our teeth, we ensure that our mouth is cleaned of all bacteria. Healthy gums prevent the harmful bacteria from entering the blood stream. When our oral hygiene is not ideal, the dangerous bacteria form plaque. This leads to an infection in the gums, known as periodontal disease or periodontitis. Once this happens, when we brush and floss our teeth, our gums start bleeding. This is a clear indication that our gums have been infected. Bad breath is another warning of oral ill-health. Tooth decay, gingivitis, and periodontitis are the first problems that occur. Worse, there is a strong chance that the bacteria will even get into the blood stream.

Gingivitis, the beginning stage of gum disease, is often not noticed by us. This is why visits to the dentist must be very regular. Gingivitis, undetected and untreated, will lead to periodontitis. Trouble in the mouth can be quite debilitating, and often very painful. Oral inflammation will consequently result in inflammation in other parts of the body. There is also evidence that oral inflammation is an indication of other health risks. Periodontal disease has been proven to be linked to coronary artery disease (leads to heart attacks), stroke, diabetes, complications during pregnancy (birth of pre-term and low-weight babies), and osteoporosis. Prolonged neglect of oral health can also lead to oral cancer.

For those that would like some evidence, read some of the studies that validate these claims in the following paragraphs. If you would like even more evidence, go to Google and search PubMed. Then type in any key words you want to know more about. PubMed is maintained by the National Institutes of Health (NIH) and the U.S. National Library of Medicine, and comprises more than 19 million citations for biomedical articles from Medline and life science journals. It’s a great resource for any medical or dental questions and is based on scientific data from reputable sources, universities, and hospitals.

The link between gum disease and heart disease has been clearly proven. One of the most prominent studies comes from Dr. Moise Desvarieux, MD, PhD of Columbia University. In a study published in the February, 2005 issue of Circulation: Journal of the American Heart Association, he and his colleagues concluded that there is a direct relationship between periodontal disease and atherosclerosis (Atherosclerosis is defined “hardening of the arteries”).5 This study comes from a physician, not a dentist.

The correlation between gum disease and diabetes is proven by studies out of Stony Brook University. Dr. Maria E. Ryan, DDS, PhD has shown us in a study published in the October, 2003 Journal of the American Dental Association that “If there is oral infection and inflammation, as with any infection, it is much more difficult to control blood glucose levels”.6 Even the American Diabetes Association Vice President of Clinical Affairs, Dr. Sue Kirkman, MD, agrees. She stated “It is now clear that periodontal disease can make diabetes control worse, and there is even some evidence that it increases the risk for diabetes complications.” One of these complications include kidney failure. One study from NIH (National Institutes of Health) by Shultis proved that diabetics with severe periodontal disease had 5 times more likelihood of getting kidney failure than diabetics with no teeth (and no gum disease).7

Oral health has been proven to be correlated to pregnancy in a number of studies as well. One study out of Harvard was published in 2008 proving that periodontal disease is a risk factor for poor pregnancy outcomes in women.8 Another study discussing this correlation is by Polyzos published in the American Journal of Obstetrics and Gynecology in the recent March, 2009 issue. It concluded that periodontal therapy during pregnancy dramatically reduced preterm birth (PTB) and significantly reduced low birth weight (LBW) infant incidence.9

Osteoporosis has also been linked to periodontitis. One extremely relevant study out of Vanderbilt shows that osteoporosis, which affects over 10 million post-menopausal American women, involves the same messenger molecules called cytokines that are found in periodontitis.10

Knowing this, you need to be extremely vigilant about your oral health and hygiene. Brushing and flossing your teeth twice a day is the first step towards having clean, healthy teeth and gums. Using a fluoride toothpaste and mouthwash help. Proper nutrition and good eating habits contribute greatly to oral health. Dairy products, lean meat, fish, green vegetables, fruits, and whole grains, when included in the diet provide us with Vitamins B, C and D, as well as Calcium, Phosphorous, Iron, Magnesium, and Zinc, which keep our teeth and gums strong and healthy. Often just being aware of and bringing about lifestyle changes can lead to great oral health, and consequently overall health. In case braces or dentures have to be worn, careful and regular monitoring by the dentist will also contribute to overall health and well-being.

Factor #3: To Screen for Oral Cancer

One American dies of oral cancer every hour of every day.11 Oral cancer claims over twice as many lives as cervical cancer.

Cancer is an uncontrolled growth of cells that form a tumor. Tumors that are not harmful do not invade the surrounding tissues. These are benign tumors, and they can be removed simply. Malignant tumors, though, enter the surrounding tissues and organs, damage them, and spread all over the body. These malignant tumors are often life-threatening.

Oral cancer may affect the tongue, floor of the mouth, back of the throat, lower lip, tonsils, or salivary glands. From here it can spread to other parts of the body through the lymph nodes (part of the immune system).

Causes of oral cancer12 include:

· Tobacco—smoking, chewing, or dipping snuff are associated with 70–80% of all oral cancer cases13

· Alcohol—heavy drinking, especially if combined with smoking

· Constant irritation from cracked teeth, failing fillings, or worn dentures

· Sun—too much exposure to sunlight

· Poor dental hygiene and oral care

Besides these, if you have a history of cancer of the neck and head, your susceptibility to oral cancer increases.

Symptoms to watch out for are:

· Red, white, or mixed red and white patches inside the mouth or on the lips

· A sore in the mouth or on the lip that is not healing

· Bleeding in the mouth

· Loose teeth

· Pain or difficulty while chewing and swallowing

· A lump in the neck

· A severe earache that is not healing

· Pain and difficulty while wearing dentures

· Thickening in the cheek

· Numbness in the mouth

· A feeling of soreness in the mouth

· A change in the voice

Oral cancer can be detected using visual oral cancer screening, dental x-rays, cone-beam computed tomography (CT) scan, or magnetic resonance imaging (MRI). Today, we can also detect very early signs of oral cancer using VELscope, a revolutionary method utilizing the same fluorescence that lung specialists use for cancer detection. We will discuss VELscope further in Factor #42.

If oral cancer is suspected, the dentist will make a recommendation based on the size, type, and location of the affected area. Often, the dentist will take a brush biopsy (a very simple procedure requiring no anesthesia) and send it to an oral pathology laboratory.14 A preliminary diagnosis is made, and then the dentist and patient sit together to discuss the next step in treatment.

Approximately half of people with oral cancer will live more than five years after diagnosis and treatment. If the cancer is detected early, before it has spread to other tissues, the cure rate is nearly 75%. Unfortunately, more than half of oral cancers are advanced at the time the cancer is detected; most have spread to the throat or neck by the time they are diagnosed.15 Early detection can improve the chance of successful treatment.

Oral cancer is aggressive, and the most effective way to help improve survival rates is early detection and treatment.16 Oral cancer accounts for 8% of malignant types of cancers. Men have twice the chance of getting oral cancer that women do, especially men over age forty.17 The American Cancer Society recommends oral cancer screening exams every three years for patients between the ages of twenty and forty, and then annually thereafter. During your next dental appointment, ask your dentist to perform a comprehensive oral cancer screening with VELscope.

Factor #4: To Prevent Gum Disease

In dental literature, gum disease is known as periodontal disease. Periodontal means around the tooth. Periodontal ligaments attach our gums firmly to our teeth, so that no germs, or the toxins they produce, can get through.

Healthy gums are firm and look pink. As mentioned before, the mouth is full of bacteria, some of which may be harmful. These bacteria encase themselves in a sticky film called plaque. They permeate into our gums and the blood vessels within, and produce toxins.18 In order to fight these toxins, our bodies cause the gums to get inflamed. This is when the gums start bleeding, particularly when we brush our teeth or when we eat. This is a condition called gingivitis.19

If left untreated, the plaque hardens to form tartar. The germs spread deeper into the bone, and the condition is then called periodontitis.20 If nothing is done at this stage, the periodontitis (also called periodontal disease; it was referred to as pyorrhea in literature prior to 1945) will progress to moderate periodontitis and then advanced periodontitis. Eventually advanced periodontitis causes teeth to become loose and fall out. The most surprising thing about periodontitis is that it causes no pain. That is why most of us tend to ignore it. Besides tooth loss, periodontitis has been linked to many systemic conditions, including heart disease, stroke, diabetes, and osteoporosis.

The best ways of preventing periodontal disease are:

· Regular Dental examinations—This should be done at least once or twice a year. X-rays of the mouth might need to be taken every year. The dentist or hygienist will do a periodontal screening and periodontal charting to measure the gum pockets to evaluate the health of the teeth and gums.

· Healthy dietary habits—Plan a well-balanced diet. Reduce, and if possible, avoid sugar. In case we have had something sweet to eat, we need to brush our teeth soon after.

· Giving up tobacco—especially smoking. Tobacco has been shown to accelerate periodontitis.21

· Great daily oral hygiene—Brushing, flossing and gargling with a good mouthwash are the basics. Follow your dentist’s instructions on the best method of brushing our teeth as well as the kind of toothbrush, toothpaste, and mouthwash that should be used. The tongue needs gentle brushing as well. It is also a good idea to learn the correct way of flossing your teeth. In case we are in a situation that does not allow for brushing after our meals, rinsing the mouth with water is a must.

Periodontitis is a disease that is progressive and persistent. If you want to prevent periodontitis or stop it in its tracks, regular dental visits and cleanings are a necessity.

Factor #5: To Have a Bright White Smile

A smile brightens up not only our day, but also evokes a smile from those we meet. A smile has a remarkable impact on perceptions of one’s attractiveness and one’s personality. Previous research in the field of psychology has shown that attractive people are perceived by others as more successful, intelligent, and friendly.22 Teeth alone can have an impact on overall attractiveness and perceptions of personality attributes¹⁶. One’s smile clearly plays a significant role in the perception that others have of our appearance and our personality. Self-esteem and self-perception has also been proven to be positively affected by an attractive smile.23

Teeth get discolored because of:

· Age—as we grow older, there is a build-up of plaque. Dentin, which is the layer below the enamel gets darker, and causes the teeth to get discolored.

· Food and beverages—eating foods that have food coloring, and drinking beverages with caffeine, stain the teeth over time.

· Tobacco—smoking, or chewing tobacco cause discoloration.

· Gum disease and teeth decay—if we neglect our teeth, this will discolor our teeth.

The dentist would first treat any dental problems, and then offer cosmetic solutions. We need to discuss our options with him so that we are clear about the procedure of stain removal as well as the cost.

The various chemical whitening options are:

· Hydrogen peroxide or baking soda—if there are only a few stains, then the teeth whitening products we need are available over the counter. These are hydrogen peroxide or baking soda. Covering the enamel with these does the trick.

· Whitening strips and whiteners—these are not permanent whitening agents, but will suffice for a short while. We need to check with the dentist before using these because they may adversely affect and destroy the enamel of our teeth. Gels contain glycerin which draws out the moisture from the enamel. Another point to remember is that whitening strips will not whiten all the teeth. They can be used only on 6 of the front teeth.

· Laser whitening—the whitening gel contains peroxide. This is put on the teeth, and then laser beams are scanned across the teeth. These beams activate the gel and the stain is removed. This method is painless and very effective. Each session lasts for an hour or an hour and a half, depending on how bad the stain is and how white we want our teeth to be.

· Bleach—should you decide on bleaching agents, the dentist will give you a bleaching kit. He decides the percentage of whitening agent to be used. He will also see to it that the mouth tray is custom-fitted so that you get a better seal. The whitening gel is put into the tray, and when you seat it, the whitening gel spreads evenly onto the teeth.

Another option is a definitive, permanent whitening utilizing masking techniques known as veneers or crowns.

· Veneers or Crowns—A veneer and a crown share a number of common characteristics. Both are fabricated in a dental laboratory and enable patients to achieve white, aligned teeth. Both are custom-tailored to the patient's mouth. Veneers are always made of porcelain. Crowns today usually have porcelain on the outside, but can sometimes be made of metal (hopefully not in the front of the mouth). The biggest difference between a veneer and a crown is that a dental crown encompasses the entire tooth, whereas a veneer only encase the front part of the tooth. A veneer covers the part of the tooth that is visible when a person smiles. Dental crowns are used to repair teeth that are cracked, fractured, decayed, or previously filled with large fillings. Dental crowns are stronger than dental veneers, but do require removal of more tooth structure. Veneers are used on teeth that are still strong and healthy, even though they may be discolored, have gaps, or crooked. Veneers only cover the front part of the tooth, so the tooth does not need to be reduced as much as a tooth needing a dental crown. Veneers are strong but brittle. Certain factors also need to be considered when planning a veneer or a crown, including history of decay, whether or not someone grinds or clenches their teeth, and gum disease.

Factor #6: To Prevent Cavities

There are many bacteria in the mouth. If we do not brush our teeth or rinse our mouth after we eat, these bacteria, the Streptococcus mutans and other anaerobes, work on the remaning food particles to produce an acid which corrodes the enamel of our teeth.24 Gradually, a cavity is formed. Our teeth have some ability to make repairs using the minerals that are in the saliva. However, the acid is corrosive, the destruction is rapid, and initially painless. It is only when the cavity is formed that we experience bad breath and pain. If problems of teeth and gums are genetic, then we need to be doubly careful about our teeth.

Ways of preventing cavities are:

· Regular brushing of teeth—at least two minutes, twice every day. Check to see if the toothpaste has fluoride, which hardens the enamel and prevents the bacteria from eating into the teeth. Get a new toothbrush every 3 months.

· Daily flossing—crucial to preventing cavities between teeth, and to ensure that no food particles remain in the mouth.

· Use a mouthwash—an anti-cavity fluoride rinse strengthens enamel on teeth. Try to utilize an alcohol-free rinse to help protect the roots of adult teeth, which become vulnerable as gums begin to recede with age.

· Eat a healthy diet—include whole grains, dairy products (source of Calcium), and fruits and vegetables (for Vitamins A and C). Drink at least 8 glasses of water per day. Cut back on artificial fruit juices, soda, and power drinks as these weaken the enamel due to acid and sugar. Gradually cut down completely on sugar, especially high-fructose corn syrup, because these aid the bacterial activity. Lessen the amount of starch as well, since starch, when broken down, forms sugar.

· Drinking tea—both green and black tea without sweeteners prevents excessive plaque from forming. Drink water afterwards, because tea does stain teeth.

· Chewing gum—sugarless gum or chewing gum which has Xylitol keeps the saliva flowing.25 The alkalinity of saliva neutralizes the acid from the bacteria, as well as flushes out the debris of food particles. Be aware that chewing should not exceed a few minutes a day, because excessive gum chewing will lead to TMJ (your jaw joint in front of your ears) problems.

· Dental sealants—are protective coatings that can be applied on biting surfaces of the back teeth.

· Regular visits to the dentist—are imperative to detection and prevention of cavities.

Factor #7: To Prevent Bad Breath

Bad breath, or halitosis, could be the result of either poor oral hygiene or problems in the gastrointestinal tract. At the root of both are bacteria. And so, first we need to find out why we have halitosis, and then go about treating it. The most common cause of bad breath is periodontitis. In one recent study, 76% of people got bad breath from either periodontitis or gingivitis.26 Some guidelines to prevent bad breath are:

· Brushing and flossing—this needs to be done at least twice a day. We need to clean the tongue as well at this time with a brush, or a tongue scraper. After brushing, flossing, and cleaning the tongue, rinse the mouth with a mouthwash.

· Drinking water—the minimum amount of water is at least 8 glasses a day. The reason is that the anaerobic bacteria form volatile sulfur compounds (VSCs) from protein and sugar. This causes the bad smell. Water dilutes the VSCs, and also inhibits the bacteria from producing this. Xerostomia (or dry mouth) makes it easy for bacteria to multiply and stick around, so it’s really important to drink water through the day.

· Drinking tea—both green and black tea are good since they prevent the growth of bacteria.

· Eating a proper diet—include apples, celery, cucumbers, and carrots. These crunchy vegetables and fruits keep the mouth clean, and produce more saliva. Chewing on spearmint, coriander, parsley, cardamom, tarragon, basil and rosemary or drinking infusions of these, prevent halitosis and make for excellent digestives as well. Yogurt is wonderful for reducing plaque and gum diseases. Dairy products like cheese and milk supply Vitamin D and citrus fruits, melons and berries are a good source of Vitamin C. Vitamins inhibit bacterial growth. If your diet includes garlic, and onions, ensure that they are used in moderation and that you wash your mouth after eating foods containing these.

· Having breakfast—skipping breakfast causes the stomach to produce acids causing bad breath.

· Stop smoking

· Visiting the dentist regularly—this is the most important guideline. A dentist will be able to diagnose any oral causes of halitosis and prevent them from developing.

Factor #8: Help You Avoid a Dental Emergency

You know you have a dental emergency when:

· You have severe pain in your mouth, especially if it lasts longer than an hour

· You are bleeding profusely from your mouth

· You have suffered a facial injury

· There is a swelling in your mouth or face

· There is a swelling in your gums

· A toothache that is waking you up

The best ways of avoiding any kind of dental emergency are by:

· Ensuring that you have excellent oral hygiene, so that your teeth and gums are strong and free of disease.

· Following all of the dentist’s instructions regarding brushing, flossing, cleaning the tongue and using the right kind of mouthwash, as well as choosing the right kind of toothbrush, toothpaste, tongue cleaner, and mouthwash.

· Avoiding eating hard foods such as hard candy and corn kernels that have not popped. Also avoid chewing ice.

· Never using your teeth to cut strings, open packages, hold metallic objects like nails or screws, or tear anything.

· Using a mouth guard when playing contact sports like baseball, football, basketball, hockey, power lifting, MMA, and boxing.

· Regularly visiting the dentist. The best way of avoiding any kind of dental emergency is to keep your regular appointments at your dentist’s office. There is a two-fold benefit—information about our teeth and what to do in an emergency; and to understand your options in case an emergency comes up. For instance, if your dentist identifies any problems with your teeth and gums, you need to get those issues addressed as soon as possible. Delaying or putting off dental work that needs to be done might have serious repercussions. You also need to understand the costs involved, so that you can plan out a timeline, and also consider third party financing.

You must know that accidents do happen in spite of the best dental care. A dental emergency could be a toothache, a broken tooth, a tooth that has been knocked out, a broken or lost crown, possibly a broken jaw, an injury on the tongue or lip, a broken denture, an abscess in the gums, an infected wisdom tooth, a filling that has failed, or it could be something which has got caught between the teeth.27

Factor #9: To Establish Dental Goals

It is extremely important to have clear dental goals. This enables a dentist to maintain a record of not only your teeth and dental health but also of our general health, since one impacts the other.28 Some dental goals are:

· Proper long-term health of our teeth

· Excellent oral hygiene

· Keeping track of any pain or feeling of discomfort in the mouth. Then having the problem, incipient or obvious, diagnosed and treated immediately.

· Healthy gums—If the formation of plaque is checked in the early stages, then you can rule out getting gingivitis or periodontitis

· Timely correction of any disorder, such as caries, gingivitis, periodontitis, oral cancer, replacing missing teeth, removing wisdom teeth, or restoring teeth to full function

· To avoid losing any teeth

· To prevent oral cancer

· To consult with the dentist in the event of other medical problems in order to see if the teeth and gums have been affected

· To have a beautiful, white, sparkling smile

· Getting implants, bridges or dentures done if required

A treatment plan is necessary in the event of any disease. This is to eliminate disease, and restore the teeth so that they can function normally. The treatment plan, worked out with the dentist, has the following steps:

· Developing the plan—done after some consultation, x-rays, photos, models, and tests

· Plan sequencing—the entire plan is worked out step by step.

· Plan presentation and informed consent—the patient knows exactly what is going to happen since the dentist suggests a variety of techniques, procedures, and products that are possible, and then decides on the best course.

· Comprehensive plan execution—depending on the general health and costs involved, it may be necessary to phase the treatment

· Plan modification—changes in the condition of the patient as well as access to advanced technology will require corrective measures to be taken.

Factor #10: You Deserve It!

Your smile and your teeth are important to your self-esteem¹⁷. Strong teeth, healthy gums, and clean mouth are the foundation to an amazing smile. To this end you need to take good care of your teeth, and gums. Regular dental visits must become a part of your life. Increasingly it is clear that your body works as a whole, especially in terms of the connection between our oral health and systemic health²².

Also, more and more it is becoming evident that lifestyle dictates what kind of health we have. We need to examine our lifestyle and do what it takes to ensure that we do not do anything to harm ourselves.

The first thing we need to scrutinize is our diet. A balanced diet not only guarantees good health, but also safeguards our teeth and gums. Eliminating or at least cutting down on fruit juices, energy drinks, soda, caffeinated beverages, sweet or starchy foods (since starchy foods break down to sugar) is good for sound health and strong teeth. A nutritious, balanced diet is aided by a sound dental care regimen.29 This involves meticulous daily care of the teeth and gums. If we feel that we deserve a prettier smile, then your dentist will recommend cosmetic procedures. He will tell us the various techniques and procedures that would make sure that you look and feel better. Whitening of the teeth, shaping the teeth, dental implants, dental bridges, dental crowns, gum procedures, and braces are all methods you could use to have a gorgeous set of teeth. Sometimes a combination of methods is used to get the effect that you are looking for. And why not?

You deserve to look and feel great! All you have to do is to work out all the details so that the dentist is clear about what you want, and you are clear about what is involved, including the cost. If the treatment is something that you have set your heart on, but is too expensive, then the dental team will tell you what you can do in terms of getting insurance or third party financing, or going in for a phased treatment. You deserve to get the treatment you want!