A: There are several ways that TMD or Temporomandibular Dysfunction can be treated. Some of these possible treatments include an occlusal appliance, Botox injection and Infrared Light Therapy. A common treatment is the fabrication of a custom fitted nightguard. It is true that placing an occlusal guard in the mouth during Bruxism will prevent further damage to the patient's teeth, it is not always completely effective in stopping jaw clenching. I believe that an occlusal guard in addition to muscle relaxation is the best course of treating TMJ pain and mouth damage. I have taken extensive training in the treatment of Temporomandibular dysfunction. I have treated patients with Botox for many years, with good results, but it can be expensive, and it involves the injection of an active toxin. This is why my preferred method of treatment is infrared light therapy in addition to a custom fitted occlusal guard. At Dental Wellness of Suffern, I use the THOR infrared laser as well as LED light in 660nm and 850 nm wavelengths. These wavelengths effectively heal the muscle cells that are in spasm by allowing the mitochondria in these cells to process energy more efficiently. This allows for quick muscle relaxation, sometimes within only a few minutes of treatment. Most patients leave the office more relaxed than they have been in years of TMJ disorder. I then fabricate a custom fitted guard in order to help my patients re learn how to keep their jaw muscles in a relaxed state. This treatment is customized for each patient, I work with 4 different types of guards, and I carefully select which kind will work for each individual. The number of infrared light therapy sessions is also customized for the individual being treated. A typical course of treatment would be 3 times the first week, followed by twice the second week, then once a week until symptoms subside. A patient can use infrared therapy once a month along with a night guard 4-7 nights a week to prevent recurrence. In addition, I teach my patients exercises that keep their muscles of mastication, which includes their neck, limber and free from muscle knots. I also investigate the destructive patterns which can contribute to jaw and neck spasms such as cell phone and laptop use as well as reading in bed. I always work together with my patient in order to come up with the right solution for their lifestyle.

A: The ideal time for implant placement is at the same time as tooth extraction. Although many dentists advise waiting 3- 4 months before implant placement to allow for healing, it is not the most efficient course of treatment for several reasons. First, the area is already numb, and the bone is exposed at the time of tooth extraction. There will never be more existing native bone than immediately after tooth removal. If you can picture drapes which are placed over a large piece of furniture, once the furniture has been removed the drapery collapses. This is what happens to the support structures once a tooth has been removed if it is not replaced with a dental implant on the day of surgery. 

A:

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits. Adults with a family history of gum disease would benefit with dental cleanings 3-4 times a year.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

• Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
• Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
• Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves much more than simply checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so, will require regular check-ups and cleanings.

A: If your newborn has difficulty nursing and is not gaining weight sufficiently, you can bring them to our office for an evaluation and possible Laser tissue release. The Solea Laser has a soft tissue setting that can allow blood free immediate release of tethered oral tissues in our office without the use of drugs or medications. At Denta Wellness of Suffern, we have a private comfortable Nursing Room where the mother and child can nurse immediately after treatment. For many new mothers this is the first time they are able to relax since the birth of their infant.

A: It is never too early to expose your child to the oral care environment. If your child is able to sit in your lap and follow simple directions, they are ready for their first dental visit. At Dental Wellness of Suffern, we make the first dental visit fun for the child and informative for the caregiver. A first dental visit is a great time for you to learn the best way to care for your child's teeth and how to make good food choices. You would be surprised how poor early food choices can influence a child's teeth for their entire life. Something as innocent as using gummy vitamins on the way to school without carefully brushing away the sugary remnants can cause tooth decay and abscesses in a well-cared for child. This can initiate the beginning of dental phobia, since dental abscesses necessitate performing painful dental procedures such as pulpotomies on a sensitive young child before they understand that these procedures are done for their own good. Children who experience painful procedures before they have a good relationship with a caring dentist are set up for a lifetime of bad dental experiences. At Dental Wellness of Suffern, we try to prevent this from happening by educating the adult caregivers in each child's life. We give each child a book written by Dr. Sherri Alpert especially to deal with these issues, so that the child can be emotionally prepared for their dental treatment. The treatment itself can be done in the least painful way with the use of the Solea Dental Laser, which is less painful and needs less needles than traditional dental drills. Each child and caregiver is treated as a unique individual, and their specific needs and requests are always discussed before any treatment is rendered. Procedures such as fluoride treatments, allergies and specific dietary needs are always discussed before products are used.

A:

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.

• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

• Systemic diseases – Diabetes, Sjogren's Syndrome, blood cell disorders, HIV / AIDS, etc.

• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Persistent bad breath – Caused by bacteria in the mouth.

• New spacing between teeth – Caused by bone loss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

At Dental Wellness of Suffern, we have been able to stop the progression of gum disease in many patients with "Perio guide" closed flap periodontal surgery using the innovative Solea Dental Laser.

A:

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, overactive immune cells may begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids. 

Healthy food choices can also affect the growth of disease-causing oral bacteria which encourages dental plaque development.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

At Dental Wellness of Suffern, we encourage our patients to brush and floss or at least rinse their mouths with water after eating any sugary or sticky food.

• Brush at a 45-degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums (right under the gums where it meets the edge of the tooth, this is where plaque usually accumulates).
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth. This usually takes between 2 and 3 minutes
• Brush your tongue to remove bacteria and to freshen your breath.
• rinse with warm water and expectorate in order to get rid of the bacteria from your mouth

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

• When using an electric toothbrush, hold the toothbrush on each surface of each tooth before moving to the next surface, this allows the electric toothbrush to work most efficiently.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone. It is the ONLY way to remove plaque from the irregular surfaces of your teeth. It is also the ONLY way to remove plaque and food from the contact points between your teeth where most cavities start on adult teeth.

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss or to reach the most posterior part of your back teeth. They are not as good as regular floss if you have gum disease.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

A:

Over the years, there has been some concern about the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin, and zinc, bound by elemental mercury.  Dentists have used this blended metal to fill teeth for more than 100 years.  The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth.  The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.

The general consensus is that amalgam (silver) fillings are safe.  Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective.  The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling.  The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of the millions of silver fillings placed over the decades.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels.  For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them.  However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous alternatives to silver fillings, including composite (tooth-colored), porcelain, and gold fillings.  We encourage you to discuss these options with your dentist so you can determine which option is best for you.

A:

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and will also slowly destroy the bone. This is the beginning of periodontal disease.

How to floss properly:

• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Water Flossers despite their name, DO NOT take the place of conventional floss for preventing cavities between teeth

Daily flossing will help you keep a healthy, beautiful smile for life!

A:

If you’re feeling somewhat self-conscious about your teeth or simply want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to advances in cosmetic dental procedures and materials, but also because patients are becoming increasingly focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present. At Dental Wellness of Suffern, we have effectively whitened even Tetracycline-stained teeth using the innovative Kor Ultra Max whitening system.

Composite (tooth-colored) Fillings:  Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities and also to replace old, defective fillings.  Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain or Zirconia Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients.  In some cases, teeth can be straightened with custom-made, clear, removable aligners in place of braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

A:

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and might not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which can become darker over time. Smoking and fluids such as coffee, tea, and wine can also contribute to tooth discoloration, making teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately.  It may require more than one visit with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!

A:

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function.  Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.

Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen.  Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth.  If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth.  Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

Removable bridges  also known as partial dentures- This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal or nylon clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth but might be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges - This type of bridge is generally made of porcelain or zirconia material and is permanently anchored (cemented) to a natural tooth adjacent to the missing tooth site.  The benefit of this type of bridge is that it is fixed (not removable), and it is very sturdy.  The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patient’s original teeth.  

Implants - Are a great way to replace one or more missing teeth. They can also provide great support for ill-fitting dentures.  A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.

If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment are always less involved and less costly than delaying treatment and allowing a serious problem to develop.

A:

We’re all at risk for having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we might be able to save the tooth.  Teeth that are knocked out can possibly be re-implanted if we act quickly and follow these simple steps:

1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
2. DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
3. Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

• Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
• If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
• Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights
• Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

A:

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various causes that attribute to bad breath, but in healthy people, the major source is microbial deposits on the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What causes bad breath?

• Morning time – Saliva flow almost stops during sleep, reducing its cleaning power and allowing bacteria to grow, which results in bad breath.
• Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
• Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
• Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
• Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
• Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
• Tobacco products – Dry the mouth, causing bad breath.
• Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
• Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
• Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?

• Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
• See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.
• Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
• Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
• Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy and bad breath remains persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.