Salem, Oregon Center of Cosmetic Dentistry
2510 12th Street SE
Salem, OR 97302
503-378-1212

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ProperCleaningTechniquescanHelpyouControlChronicBadBreath

We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.

If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”

In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.

This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.

You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)

Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.

If you would like more information on treating chronic bad breath, 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: More Than Just Embarrassing.”

OtherFactorsBesidesHygieneCouldContributetoGumDisease

Periodontal (gum) disease is an infectious condition that if left untreated could lead to tooth loss. While gum disease is primarily caused by a thin layer of bacterial plaque and calculus left on the teeth due to poor hygiene, you may also have extenuating factors that may make you more susceptible to the disease.

Gum disease is actually a group of infectious diseases in which some forms are more difficult to control than others. All these forms arise from interactions between the bacteria in the dental plaque and your body’s immune system. Depending on both your body’s individual response and the disease form, your resistance to the resulting bacterial infection may be low.

That low resistance to certain strains of bacteria may be genetic — something you’ve inherited from your parents. Your stress level, particularly when it’s high, can also diminish your body’s ability to resist disease. There are also numerous strains of bacteria that could lead to gum disease — your body may not be able to effectively resist the particular “mix” of strains contained in your dental plaque.

Aside from lifestyle issues like stress or oral hygiene, we can at least test and verify any susceptibility you may have due to uncontrollable factors like genetics or the particular bacterial makeup within your plaque. Unfortunately, a minority of people will continue to deal with gum disease even after treatment and adopting a more effective hygiene regimen. Although we can’t cure the disease, we can certainly control it with regular monitoring and treatment when necessary.

The key is to adopt a long-term strategy that will seek to preserve the teeth for as long as possible. In some cases, the best treatment approach is to prolong the life of the affected teeth for as long as possible to give you time to prepare emotionally and financially for eventual tooth replacement.

Indeed, any patient experiencing some form of gum disease should seek professional treatment, followed by a daily oral hygiene program and regular checkups and office cleanings. Taking the right steps in consultation with your dentist will assure you’ll preserve your teeth for as long as possible.

If you would like more information on treatment for periodontal disease, 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 “Periodontal (Gum) Treatment and Expectations.”

PorcelainVeneersCouldChangeYourAppearancefortheBetter

We now have an amazing repertoire in dentistry to restore the look and function of damaged or missing teeth. From tooth-colored crowns to life-like dental implants, we can turn an embarrassing smile into one you’re confident to show the world.

But what if your teeth are visually unappealing but structurally sound? Perhaps they’re slightly irregular or discolored — do you still need the “heavy artillery” in our arsenal of restoration options?

Not at all — dental veneers that provide amazing aesthetic results with minimal tooth preparation may be an appropriate restoration choice for you. As the name implies, veneers are a thin layer of dental material (usually porcelain) that’s permanently bonded to the outside of a tooth. Veneers can be shaped to resemble natural teeth — especially effective for changing the appearance of small or slightly misshapen teeth — and can be customized to match an individual patient’s tooth color.

Veneered teeth require very little preparation compared to other restorations; still, most veneer applications do require some permanent enamel removal so that the applied veneers appear natural. In recent years, however, changes in veneer design and materials have made it possible for some patients to receive veneers without some tooth prep.

If taken care of properly, veneers can last anywhere from seven to twenty years (in some cases, more). While their material composition and the bonding process can withstand normal biting forces, wearers need to keep in mind porcelain is a form of glass — excessive twisting or pressures from excessive grinding habits could cause them to shatter.

And because veneers are made of an inert, non-living material, they can’t adapt to any changes that may occur biologically to your teeth and gums and may need to be updated at some point in the future. The good news is that a loosened veneer can often be repaired.

If you’d like to know if you’re a good candidate for this cost-effective, minimally invasive option, visit us for an examination. Balancing all the factors, porcelain veneers just may be your answer to achieving a better smile.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”

DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on loose teeth, 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 “Loose Teeth.”

By Dr. Karst
September 26, 2014
Category: Dental Procedures
Tags: wisdom teeth  
BeWiseAboutYourWisdomTeeth

The old saying, “If it ain't broke, don't fix it,” doesn't really apply when discussing your wisdom teeth. It's great if they are not bothering you, but don't wait for problems to develop before you take action. This may seem counter-intuitive, but you should know that the best time to have your wisdom teeth removed is when they are not causing problems.

Why do wisdom teeth cause problems?

Wisdom teeth are so-called because they appear at ages 17 to 25, the age of supposedly attaining wisdom. They are also known as third molars and are farthest back in your jaws. For some people they come through the gum-line only partially, or they may not erupt into the mouth at all. Unerupted they have the potential to cause problems associated with the neighboring teeth and surrounding gums.

You may have heard of “impacted” wisdom teeth. This means that they are impacted or forced against neighboring structures, teeth or bone that prevent them from coming into the mouth in correct biting position. Since they are your last teeth to come in, space for them may be severely limited. They may push into the teeth that are already in place, becoming stuck as they try to erupt. When wisdom teeth are trapped like this below the gum line and are pushing against neighboring teeth, these molars can cause problems such as infections, cysts, or gum disease.

My wisdom teeth seem OK, so why remove them?

The dilemma is that if you wait until you feel pain connected with your wisdom teeth, their neighboring teeth may already be in trouble.

Another reason to remove these back teeth before they cause problems is that it's a good idea to have your surgery while you are young. Younger, healthy patients with no infections at the site have the best chance of having their wisdom teeth extracted without complications, with an easier recovery and uneventful healing.

Of course, each situation is different. Make an appointment with us for an examination and a consultation to discuss the risks and benefits of removing your wisdom teeth. For more information read the article “Removing Wisdom Teeth” in Dear Doctor magazine.





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