If you think you have a problem with bad breath, you probably do.

A relative of mine (to be kept nameless) asked me how to fix bad breath. Interestingly enough, when I am at work and a patient asks me to close the door to give them some privacy to ask a "personal" question, 9 times out of 10 it is about bad breath. It is such an embarrassing problem, but there are some steps you can take to fix it.

Bad breath is caused by odor-producing bacteria that grow in the mouth. When you don't brush and floss regularly, bacteria accumulate on the bits of food left in your mouth and between your teeth. The sulfur compounds released by these bacteria make your breath smell. Certain foods, especially ones like garlic and onions that contain pungent oils, can contribute to bad breath because the oils are carried to your lungs and out through your mouth. Smoking is also a major cause of bad breath.

There are lots of myths about taking care of bad breath. Here are three things you may have heard about bad breath that are not true:

Myth #1: Mouthwash will make bad breath go away.

Mouthwash only gets rid of bad breath temporarily. If you do use mouthwash, look for an antiseptic (kills the germs that cause bad breath) rinse, such as Listerine. I also really like Crest Pro Health mouthrinse because it doesn't contain alcohol, which dries your mouth out and can lead to a better environment for those bad-breath-causing bacteria. Try the Nighttime version of the Crest Pro Health because the Daytime version seemed to cause (temporary) staining of teeth in about 1% of people that used it.

Myth #2: As long as you brush your teeth, you shouldn't have bad breath.

The truth is that most people only brush their teeth for 30 to 45 seconds, which just doesn't cut it. To sufficiently clean all the surfaces of your teeth, you should brush for at least 2 minutes at least twice a day. Remember to brush your tongue, too — bacteria love to hang out there. It's equally important to floss because brushing alone won't remove harmful plaque and food particles that become stuck between your teeth and gums.

Myth #3: If you breathe into your hand, you'll know when you have bad breath.

Wrong! When you breathe, you don't use your throat the same way you do when you talk. When you talk, you tend to bring out the odors from the back of your mouth (where bad breath originates), which simply breathing doesn't do. Also, because we tend to get used to our own smells, it's hard for a person to tell if he or she has bad breath. If you're concerned about bad breath, make sure you're taking care of your teeth and mouth properly. Some sugar-free gums and mints can temporarily mask odors, too.

If you brush and floss properly and visit your dentist for regular cleanings, but your bad breath persists, you may have a medical problem like sinusitis or gum disease. Bottom line is that bad breath can be prevented and fixed.  Do these things and you won't have to worry about getting close to your special someone and whispering them sweet nothings... 

Can Diet Coke cause cavities?

A friend of mine who lives out of town contacted me over Facebook with a good question. She never had cavities growing up and now that she is in her 20's, she is getting a few. When she goes to the dentist, he makes her feel like she "just ate a candy store." But, this girl takes good care of herself and doesn't really eat sweets. She wondered if the 2-3 Diet Cokes she drinks during the day can cause cavities. So, can something without sugar cause cavities?

Yes, Diet Coke can cause cavities. Basically, you need four things to get cavities: bacteria (everyone has it), sugar, acid, and time. While Diet Coke doesn't have the sugar, it is really high in acid. So, let's say you have a sandwich for lunch (there is sugar in bread) and you have a Diet Coke (acid) and then you sip on your Diet Coke for an hour or two, you then have everything you need to get cavities. So, here is my advice. Have sugar, have acids, whatever, but drink water afterwards. This will rinse the acids and sugars off of your teeth. Another good trick is to chew sugar-free gum, which will do the same thing as water. Don't sip on a can of Diet Coke for a long period of time. Drink it over a shorter period of time and then have water. If you do that, use an electric brush, and floss once a day (I know it's a pain), you'll be home free.

Kiosk Teeth Whitening... yeah right.

So, after a couple margaritas a friend pulled me aside and said that she had been "swindled by those bastards at the mall" saying that they could bleach her teeth for $99. Just as everyone wants their teeth lighter, everyone who hears this kiosk sales pitch first is pessimistic. And they should be...

Ok, so here is how the kiosk bleaching works. They give you a mouthguard (one size fits all sort of thing) with some bleaching gel in it and have you put it in your own mouth. The reason they have you do it is because they are not dentists and by law cannot do it themselves. So, the gel runs all over your mouth, gets on your gums, and down your throat. Think about it, if the gel is safe enough for it to get on your gums and even swallow it, how is it going to be strong enough to bleach your teeth? Oh, and that light they use basically does one thing. It heats up your teeth, which dries them out, which makes your teeth lighter. Lighter until your teeth re-hydrate, which takes a couple of days, then the "bleaching" fades. No good.

So what are your other options. I tell my patients they have three options:

1) Over-the-counter whiteners like Crest WhiteStrips. These are ok, but they are also one size fits all, so the same gel that bleaches your teeth also bleaches your gums, which leads to increased sensitivity. Plus, the strips generally are only long enough to bleach your front six teeth, and most people smile bigger that that. BTW- do not waste your money on whitening gums, toothpastes, and mouthwashes. Basically, these are crap.

2) In-office Bleaching (Zoom or Britesmile). This is actually similar to the kiosk, but it is used with gels that only dentist can purchase and apply. Also, there is no mouthguard so it is more comfortable. There is a lot of debate whether the light used with it actually does anything, but we use it anyway. I like this much better than #1, because it does work, but there are a couple negatives to this as well. It is the most expensive (in our office it is $450), there are dietary and other restrictions for the first 24-48 hours (no lipstick), and you still use custom trays to get the best results possible. To me, this is best for people too busy to use custom trays or for those with something big coming up quickly, like a wedding or anywhere pictures will be taken.

3) Custom Trays used at home. To me, this is the best. Your dentist makes you thin, custom trays that hold the gel against your teeth either for an hour or overnight. You do this for a week or two and your teeth get lighter. It's comfortable, effective, and costs less than the Zoom (in our office it is $250). So, save yourself $200 and do it the way I have bleached my teeth and most everyone in my family's.

One caveat... bleaching does not work on tetracycline-stained teeth (a grey and yellow banding on teeth caused by antibiotics taken as a baby) or on existing dental work. It won't make it worse, but don't expect these teeth or areas of teeth to get any lighter.

So, I hope this info helps. Feel free to post other questions or contact me directly.

Dr. P

Why do I do what I do?

Growing up, I never wanted to be a dentist.  In fact, I hated going to the dentist.  I used to squirm, whine, and even bite fingers.  I'm not proud of that, but it's the truth.  So how does "that kid" grow up to be a dentist?  The best answer is that I'm not sure, but I'm sure glad I did.  

I feel like I have the best job in the world.  Every day I get to talk to people, hear their stories, and joke around with them.  Most of my patients were like me- they hated going to the dentist.  They tell me their horrific stories of past experiences in "the chair" and I quickly see why dentistry gets a bad rap.  The good news is that I think I can change people's views of the dentist.  

I don't have any tricks up my sleeve.  I just listen.  That's what people want.  They want to tell me why they haven't been to the dentist in a while.  In other words, don't do what made me stay away.  Done.  They want to tell me what they want their smile to look like.  Fantastic, now we have a vision.  They want to tell me their restrictions to treatment (time, money, anxiety).  Perfect, now we know what we have to overcome.

Now comes the fun part.  Often times people come in because they don't smile in pictures, they laugh with their hands covering their mouths, or men will even have grown mustaches to cover their embarrassment.  Just think about how this makes people feel.  One of the biggest signs of self-confidence is smiling.  This lack of self-confidence makes people feel that they can't succeed in their careers or even have close personal relationships.  I get to help people transition from a smile they are embarrassed of to one that they can't stop showing off! 

I truly love what I do.  In fact, I'm obsessed with it.  

This is the last bit about me for awhile (unless for some strange reason people actually want to hear more).  On to answering my random social questions...

Dr. P

Why have a dentistry blog anyway?

So, It's Saturday night.  My wife Lauren (the uber talented graphic designer from Giddy Ink) and I have a friend's 40th birthday party to go to at Nada in downtown Cincinnati.  We're having a good time and catching up with people we don't get to see very often.  A friend we haven't seen in a couple of years pulls me over with a very serious look on her face and says the words I hear so often, "I know you don't want to talk about teeth outside of work, but..." 

The odd thing is that for some reason I DO want to talk about teeth.  I love what I do.  I read every journal that comes across my desk cover to cover, I attend continuing education courses all over the country, and I am constantly on the internet researching the latest and greatest advancements in dentistry.  Basically, I am obsessed with what I do and if someone wants advice or just has a question, I am more than happy to help. 

So, in the future this blog will contain (hopefully) helpful pieces of advice from questions people have asked me in social settings.  I know that if one person has the question there must be a hundred people that want to know my answer.  Plus, if people want to ask me a question on here, I'll do my best to answer.

Jordan Pelchovitz (Dr. P)