Six Causes of Bad Breath

There are many reasons for having bad breath and while most are innocuous, bad breath can be a sign of something more serious! According to the American Dental Association, 50% of adults have had bad breath. Here are six causes of bad breath of which you should be aware.

  1. Bacteria – There are hundreds of bacteria that are indigenous to the human oral cavity. These bacteria help to initiate the digestive process but also contribute to Dental Plaque formation. Without good oral hygiene these bacteria will contribute to bad breath.
  2. Dry Mouth – Dry mouth (the absence of saliva) can be caused by many medications, problems with the salivary glands or simply by breathing through the mouth. Saliva has many anti-bacterial properties and without sufficient saliva, bacteria can overtake the mouth and cause odors.
  3. Gum Disease – Simply put, bacterial plaque causes gum disease. Bad breath is one of the subtle warning signs for gum disease.
  4. Food – Aromatic compounds in foods like onions and garlic are eliminated through the lungs, not the digestive tract! No matter how good your home care, these foods will cause breath problems!
  5. Smoking – Smoking causes bad breath as well as a whole host of other potentially more serious problems like gum disease and cancer. It also affects your ability to smell and your sense of taste.
  6. Medical conditions – Bad breath can result from sinus problems, liver or kidney diseases, gastric reflux or any of a host of other causes. In the absence of other obvious causes, referral to a physician may be needed.

In the meantime, if you have any questions regarding how to prevent bad breath, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.  Next blog- 7 Solutions to Bad Breath!

Ten Tips To Treat Dry Mouth

Prescription drugsDry mouth  (Xerostomia) is a problem faced by many folks which can be difficult to diagnose and treat. The most common cause among adults is various prescription medications. Sometimes our well meaning physicians prescribe medications independently of each other, the result being a multitude of dry mouth causing medications that potentiate each other, making the problem that much worse.

There are over 400 medications that cause dry mouth! Please speak with us as soon as possible if you are experiencing any of these problems. In the meantime, here are some tips to deal with dry mouth!

  1. Frequent sips of water will keep the mouth moist.
  1. Sleeping with a humidifier nearby will help moisten nasal passages.
  1. Only use alcohol free mouth rinses. (Alcohol dries out the oral tissues.)
  1. Avoid caffeine, alcohol and carbonated beverages, all of which can cause dry mouth.
  1. Chew Xylitol sweetened gum to stimulate salivary flow.
  1. Use over the counter (OTC) products like Biotene (toothpaste, mouth rinse, gum spray and   mouth moisturizer.)
  1. Avoid tobacco in all forms. Tobacco encourages the growth of oral bacteria   and irritates the nose and sinuses making them more vulnerable to infection.
  1. Check to make sure any medications you are taking do not cause dry mouth.
  2. Ask your dentist, physician about prescription medications that can increase salivary flow.
  3. See your dentist regularly!!

In the meantime, if you have any questions regarding dry mouth, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.

Photo courtesy of cdc.gov

 

What To Do About Dry Mouth – 10 Recommendations

dry mouth“Dry mouth”, or xerostomia, is an annoying condition that I am seeing almost daily in the office. Dry mouth is actually a symptom of an underlying problem and not a disease in itself. It is usually caused by medications but can also be related to various systemic diseases, chemotherapy, radiation to the head and neck, dehydration and certain life style activities such as tobacco use.

Most people who have dry mouth are generally aware of it. Symptoms include problems swallowing and chewing, alterations in taste, bad breath, dry lips, trouble wearing dentures, rampant tooth decay, and thick and sticky saliva to name a few.

Beyond annoying symptoms that dry mouth can present, there are more important reasons to be concerned. It is important that we maintain adequate amounts of saliva in our mouth in order to neutralize acids produced by plaque, moisten food to enable swallowing, and control the bacteria that lead to decay and gum disease.

So here is a short list of things you can do to alleviate the symptoms of dry mouth:

  1. Suck on ice during the day.
  2. Drink water frequently.
  3. Sleep with a humidifier in the bedroom.
  4. Minimize alcohol consumption.
  5. Refrain from smoking or chewing tobacco.
  6. Check with your physician to rule out systemic causes and to see if any medications causing dry mouth can be changed.
  7. Use prescription fluoride products obtained through the dental office.
  8. Make liberal use of over the counter products. (See me for a complete list!)
  9. Use only non-alcoholic mouth rinses.
  10. Avoid caffeinated beverages and soda.

In the meantime, if you have any questions regarding dry mouth, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.

Polypharmacy – Are you at risk for prescribing cascade with your medications?

Pills_polypharmacy_DrLarryStone

As the population in the United States ages, so does the population of dental patients that are typically seen each day. One of the most noted characteristics of this group is the sheer number of prescription medications they take. The average 65 year old is taking five or more medications for a variety of reasons. One of the most serious side effects of many medications is drug-induced xerostomia (dry mouth), which can be devastating to one’s oral health!  (See my prior blog on Xerostomia.)

Another aspect of this “polypharmacy” is that patients taking five or more drugs are at risk of experiencing “prescribing cascade”, which occurs when unrecognized side effects of an existing drug prompts physicians to prescribe a new drug to then treat these new symptoms! The elderly and persons with disabilities are especially prone to prescribing cascade. The Beers list, developed by an expert panel to assess inappropriate drug prescribing, consists of a list of medications that are particularly prone to adverse effects in the elderly.

Please consult with your personal physician should you have any questions regarding this issue. And please let us know if you are experiencing “dry mouth”. Be sure to ask us at your next visit how you can best treat dry mouth. You can contact me or the staff at my office, Dr. Laurence Stone in Doylestown, PA to discuss any concerns you may have and to schedule an appointment.

Three Ways That Modern Dentistry Can Help Improve Your Love Life!

lovelife

Three Ways That Modern Dentistry Can Help Improve Your Love Life!

Don’t believe it? Well, it’s true. There may even be more! I can think of at least three ways that modern dentistry could change your love life. I’ve seen it happen time and again. Here are the three ways that come immediately to mind:

1.Cosmetic Dentistry

Repeated studies have shown that people with attractive smiles have an advantage – at work and at life in general. They are more likely to get that job, a date, or a new spouse because a beautiful smile naturally attracts more positive  attention. Whether it’s tooth whitening, porcelain laminate veneers or cosmetic bonding, dentistry today can help you get that winning smile!

2. Fresh Breath

Bad breath, or halitosis, is a real “buzz kill”. No one wants to kiss someone with bad breath. Most bad breath comes from inadequate home care. Just brushing and flossing properly can solve most of these problems.

Other causes can, however, occasionally be the culprit. These include: smoking, sinus infections, periodontal disease, eating foods that contain aromatic compounds  such as garlic and raw onions that are eliminated through the lungs, and Xerostomia or dry mouth. Whatever the cause, the dental office is the place to start. By asking a few questions we can usually determine the cause and solving the problem can sometimes be surprisingly easy.

3. Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a serious and sometimes life threatening medical condition that is often treated with CPAP (Continuous Positive Airway Pressure) machines but can in many cases be alleviated with oral appliances. Patients with OSA show more sexual dysfunction relating to erectile dysfunction and sexual dissatisfaction when compared to normal subjects. Treating patients with OSA with oral appliances when possible has been shown in controlled studies to improve erectile dysfunction as discussed by Aarnoud Hoekema in his book: Oral-appliance Therapy in Obstructive Sleep Apnea-hypopnea Syndrome.

And there you have it, three ways in which modern dentistry can improve your love life! I’d be interested to hear from any of you who have your own stories to share.

Any questions? Don’t hesitate to contact me or the office, Dr. Laurence Stone in Doylestown, PA, today to schedule your next appointment and we can talk more about this. See you soon!

15 Prescription Drugs That Can Lead to Dry Mouth (Xerostomia) – and why you should be worried

pills

Xerostomia (dry mouth), is a serious dental problem affecting millions of people.
Saliva has antibacterial properties and when we don’t have enough of it we can suffer
from increased tooth decay and  gum disease. Additionally,  dry mouth makes it difficult for denture wearers to tolerate their appliances and affects our ability to taste the foods we enjoy.

According to a study by Clinical Research Associates, of the top 20 most prescribed drugs in the U. S. in 2010, the following 15 have been associated  with Xerostomia:

  1. Hydrocodone/Acetaminophen – a narcotic
  2. Lisinopril (Prinivil,Zestril) – an antihypertensive
  3. Simvastatin (Zocor) – an antiperlipidemic to fight cholesterol
  4. Amlodipine (Norvasc) – an antihypertensive
  5. Alprazolam (Xanax) – an anti-anxiety medication
  6. Hydrochlorothiazide – a diuretic
  7. Omeprazole (Prilosec) – an anti-ulcer agent
  8. Atorvastatin calcium (Lipitor)– an antihyperlipidemic to fight cholesterol
  9. Furosemide (Lasix) – a diuretic
  10. Metoprolol Tartrate (Lopressor) – an antihypertensive
  11. Sertraline HCL (Zoloft) – an antidepressant
  12. Metoprolol Succinate (Toprol) – an antihypertensive
  13. Zolpidem (Ambien) – a sedative/hypnotic
  14. Oxycodone/Acetaminophen (Percocet) – a narcotic
  15. Citalopram Hydrobromide (Celexa) – an antidepressant

The average 60-year-old in this country is taking at least three prescription medications daily. If you believe you suffer from drug-induced Xerostomia or just feel like you have a dry mouth in general, ask us about it. There are many treatments available to help with this  potentially serious problem.

Any questions? Don’t hesitate to contact me or the office, Dr. Laurence Stone in Doylestown, PA, today to schedule your next appointment and we can talk more about this. See you soon!

Taste Disturbances – When “It’s All a Matter of Taste!”

troublewithtaste_drlarrystone

It doesn’t happen often, but occasionally I have a patient who complains of a change or loss of their ability to taste food. I may see cases like this a few times a year and it can be very disconcerting if it happens to you!

Tasteis a very complicated issue and there is not much research explaining the complexity of the taste system,and few definitive treatments exist. Patients often confuse taste changes with flavor changes. There are 5 basic tastes:

  • Salty
  • Sweet
  • Sour
  • Bitter, and
  • Umami (often described as a savory or meaty flavor)

Flavor is a combination of taste, aroma and the sensation of food in one’s mouth. Loss of taste results in a person’s lack of response to one of these five tastes, while loss of the perception of flavor is a result of damage to specific nerves or disturbances in our ability to smell!

Taste disturbances can often be associated with malnutrition, decreased salivary flow (dry mouth), radiation and chemotherapy, the use of certain medications (specifically diuretics and ACE inhibitors used to treat high blood pressure), chronic inflammation, autoimmune disorders and damage to the nerves innervating the taste and olfactory pathways. Taste disturbances are rarely associated with external sources such as leaky fillings or infection, but rather usually emanate from problems within the taste system itself.

Got all that? As my mother used to say: “Clear as mud!” Please let me know if you think you may be experiencing a problem affecting your ability to taste, as there is often an easy fix to the problem. See you soon!

 

What is Dry Mouth (Xerostomia) and Why Should You Be Concerned?

Drinking water to alleviate dry mouth

(Hint: Think Desert)

One of the most serious problems facing the dental profession today Is dry mouth (xerostomia).

First of all, let’s look at what produces dry mouth. There are actually many reasons you could experience dry mouth including:

  1. Dehydration
  2. Medications – there are over 400 medications that create dry mouth as a side effect
  3. Smoking
  4. Aging – aging salivary glands naturally produce less saliva

Why is dry mouth such a problem?

Your saliva not only contains enzymes (naturally produced chemical compounds) that aid in the digestive process, but it also contains antibacterial elements that fight tooth decay and gum disease.

So, you can imagine that without an adequate quantity and quality of saliva, our mouths can suffer from the ravages of tooth decay and gum disease.

What are the signs of dry mouth?

  1. A cottony feeling in the mouth
  2. Difficulty in chewing food properly
  3. Difficulty swallowing
  4. Alterations in taste

 What can you do?

There are many things we can do to help alleviate xerostomia.

  1. First on my list is keeping adequately hydrated, by drinking enough water.
  2. Use products like Biotene that are specifically designed to help alleviate the problem.
  3. Avoid foods high in acid content like sodas, which can demineralize the teeth.
  4. Chew Xylitol gum. Xylitol is an all natural sugar substitute that kills the bacteria that cause tooth decay and the very act of chewing stimulates salivary flow!

Also, call our office and request a salivary test! There are new diagnostic tests that are easy and painless that will guide us in customizing a treatment for you if you are suffering from dry mouth!