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Posts for: December, 2013

By Bruce P. Mercado, DDS, PC
December 30, 2013
Category: Oral Health
Tags: bad breath  
BanishBadBreath

Treating bad breath is big business. Just check your local drug store or supermarket and you'll find a mind-numbing array of mints, gums, mouthwashes, sprays, strips and other products that promise to sweeten your breath and make you (or your mouth at least) irresistible. But most of these products only mask halitosis (from the Latin “halitus” – exhalation, and Greek “osis” – disease) and some even contain ingredients, like sugar, that contribute to tooth decay and gum disease. In most cases, for enduring, healthful results, nothing beats a trusty toothbrush, toothpaste and floss, used faithfully and correctly, along with periodic dental checks and cleanings.

Oral bacteria are the number one reason for noxious breath. More than 600 types inhabit our mouth, and some of them emit awful odors — predominantly volatile sulfur compounds characterized by a “rotten egg” smell) — as they consume remnants of food trapped in our mouth. Brushing and flossing regularly, especially after eating, can dislodge food trapped between teeth (interdental) and under the gums (subgingival), depriving microbes of a ready-made meal. It also disrupts the buildup of sticky plaque (microbial “biofilms”) where odor-causing germs can flourish.

When cleaning your mouth, pay special attention to the back of the tongue. It is the primary location for generating halitosis because it is drier and less efficiently cleansed by saliva and normal oral activity than the front. Our office can instruct you on proper oral hygiene including the gentle use of a tongue scraper or brush.

Sometimes more involved periodontal techniques such as scaling and root planing (deep cleaning) are called for; antibiotics may be useful in targeting the offending microbes. If tooth decay and/or periodontal (or gum) disease is contributing to halitosis appropriate treatment is necessary.

Remember that foul breath is just a symptom of some underlying condition. If diligent oral care at home doesn't do the trick, our office can help you get to the root of the problem and determine the appropriate therapy.

If you would like more information about halitosis and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bad Breath.”


By Bruce P. Mercado, DDS, PC
December 27, 2013
Category: Dental Procedures
HughJackmansShockingTeeth

Australian heartthrob Hugh Jackman has won international recognition for his work on stage, screen and television, including his long-running portrayal of Wolverine in the X-Men film series, and his Academy-Award-nominated starring role in Les Miserables. Oh, and did we mention he was named the “sexiest man alive” by People magazine in 2008? So when Jackman once said “I have shocking teeth”… what did he mean?

“[My dentist] looked at my teeth and went, ‘Oh, my God, you've got gray teeth,’” the actor stated. The proposed cure: tooth whitening. But what if the action hero's teeth were brightened too much — would his look still convey his trademark rugged charm? To see how that issue was resolved, let's look a little closer at various methods of tooth whitening.

All Whitening Isn't the Same
Everyone has seen the kind of over-the-counter tooth whitening strips advertised in magazines and sold in drug stores. Most dentists agree that, given enough time, they can work in many cases. But there may be problems, too.

One is that unless you know what's actually causing the darkening, you can't be sure if there is an underlying issue that needs treatment — a root-canal problem, for example. Bleaching a diseased tooth is like painting over a rusty car: it camouflages the problem, but doesn't fix it. That's one reason why, before any whitening treatment is attempted, it's important to have a complete dental examination, with x-rays.

Another is that without professional supervision, it's more difficult to control the degree of whitening you will end up with. For safety reasons, over-the-counter whitening products have the least concentrated bleaching agent, and will probably require weeks of use to produce noticeable results. The next step up — a custom-designed, at-home bleaching kit from our office — will likely produce results twice as fast.

The Professional Advantage
At-home bleaching done under our supervision uses stronger whitening agents with a flexible plastic tray that's custom-made to fit your teeth. It's a cost-effective way to achieve several shades of whitening in a relatively short time. Plus, with the advantage of our experience and guidance, you can get excellent results safely and efficiently.

If you want the fastest and most controllable whitening, however, in-office whitening treatments are the best way to go. According to one study, using the most concentrated whiteners in a safe clinical setting produced a six-shade improvement in just three office visits! This would have required a week or more of at-home bleaching, or upwards of 16 daily applications of the over-the-counter whitening products!

In-office whitening also offers the greatest degree of control over the outcome. That's why it was the method Hugh Jackman chose for his treatments. By adjusting the concentration of the bleaching solution and the treatment time, Jackman's dentist made sure his teeth were pleasingly light — but still looked completely natural. And in our office, we can do the same for you.

So whether you're looking for a dazzlingly bright smile or a more subtle enhancement, the best way to start is to call our office for a consultation. For more information, see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”


By Bruce P. Mercado, DDS, PC
December 12, 2013
Category: Oral Health
Tags: cracked mouth  
TreatingandPreventingCrackedMouthCorners

You may be suffering from an uncomfortable cracking of the skin at the corners of the mouth. This condition is known as perleche (or angular cheilitis). From the French word “lecher” (“to lick”), it derives its name from the tendency of sufferers to lick the affected areas.

There are a number of causes for perleche. It’s found most often in children who drool during sleep, or in teenagers or young adults wearing braces. Older adults develop perleche due to the wrinkling of skin caused by aging; and anyone can develop the condition from environmental factors like cold, dry weather. Conditions from within the mouth may also be a cause: inadequate saliva flow; inflammation caused by dentures; or tooth loss that diminishes facial support and puts pressure on the skin at the corners of the mouth. Systemic conditions such as anemia, diabetes or cancer can dry out oral tissues and membranes, which may lead to perleche.

Our first priority is to treat any underlying infection. Cracked mouth corners are easily infected, most commonly from yeast called candida albicans. The infection may range from minor discomfort localized in the affected area to painful infections that involve the entire mouth and possibly the throat. Any of these can be treated with an oral or topical anti-fungal medication, including anti-fungal ointments applied directly to the corners of the mouth until the infection clears up. Chlorhexidine mouth rinses can also be used to treat minor yeast infections.

As for healing the cracked skin, a steroid ointment for control of inflammation combined with a zinc oxide paste or ointment will serve as an antifungal barrier while the tissues heal. If the condition is related to missing teeth or dentures, we can take steps to replace those teeth or ensure the dentures are fitting properly. Good oral health also goes a long way in preventing further reoccurrence of perleche, as well as dermatological techniques to remove deep wrinkles due to aging.

If you would like more information on perleche and other mouth sore issues, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cracked Corners of the Mouth.”