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Date: 9/13/2017 11:34 AM PDT


Author: Karen E. Nelson, Ph.D.

Research in twins has found that tooth decay results from oral hygiene, and not from a person's genes.

The composition of our oral bacteria when we are very young is predominantly influenced by our genetic background. But as we age, this heritable factor wanes and non-heritable ones such as diet and oral hygiene play a stronger role in shaping the oral microbiome.

This idea is supported by a new study - led by the J. Craig Venter Institute (JCVI) in La Jolla, CA - which has been published in the journal Cell Host & Microbe. It investigated the oral microbiomes of identical and non-identical twins in childhood.

Senior study author Karen E. Nelson, Ph.D., president of the JCVI, and her colleagues chose to investigate twins because, since they are likely to have had a very similar upbringing, they offer ideal subjects for studying the "nature versus nurture" question with respect to oral health.

Dr. Nelson and team note that they "investigated a large cohort of twin children to shed light on the contributions of host genotype and the early shared environment in shaping the oral microbiome in the context of oral health."

Tooth decay, or dental caries, is a major global health issue. Up to 90 percent of school-age children and nearly 100 percent of adults worldwide have dental cavities. Up to 20 percent of middle-aged adults have severe gum, or periodontal, disease, which can lead to tooth loss and other health problems.

In the United States, statistics on tooth decay show that 37 percent of children aged 2 to 8 have it in their primary teeth, 58 percent of teenagers currently have or have had it, and more than 90 percent of adults have it.

Oral microbiome and disease

In their study paper, the authors explain that tooth decay commonly results when certain types of bacteria metabolize "frequent sugar intake." This leads to an acid environment in the mouth that attacks tooth enamel and causes cavities.

They also note that in adults with gum disease, specific groups of bacteria trigger inflammation that leads to destruction of gum tissue, the formation of "pockets," and tooth loss.

There is also mounting evidence of links between the oral microbiome - that is, the collection of oral microbes and their genetic material - and other illnesses, including oral cancer and cardiovascular disease.

However, while there have been numerous studies on the links between the gut microbiome and health and the extent to which this might be influenced by host genetic background, there have been hardly any on the oral microbiome.

For their study, Dr. Nelson and colleagues used mouth swabs to profile the oral microbiomes of 485 pairs of twins aged between 5 and 11 years. Of these, 205 were identical twins and 280 were non-identical, or fraternal, and there was also one set of triplets.

Link to high added sugar intake

As expected, they found that the oral microbiomes of identical twins were more similar to each other than those of non-identical twins. This, the researchers say, suggests that the host genetic background influences the types of bacteria present in the mouth.

But they also found that the types of bacteria most closely linked to host genetic background - the so-called heritable bacteria - were not those that play a role in tooth decay.

Also, when they compared the results from children aged 5 with those of age 11, they found that "the most heritable bacteria decrease in abundance with age."

Finally, they also found that twins whose diet included a lot of added sugar had fewer of the types of bacteria that are linked to lower rates of tooth decay and more of the types that are linked to higher rates of tooth decay.

The researchers plan to continue following the twins and study changing patterns in their oral microbiomes. They also want to compare the health of identical and non-identical twins with functional differences in their oral microbiomes.

"Limiting sugar consumption and acid buildup in the mouth have been part of the dogma of the dental community for some time. This work introduces specific taxa of bacteria that can be acquired through the environment and that have the ability to induce cavities."

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Date: 8/31/2017 7:57 AM PDT

Dr. Brikina, Dr. Rao and their two daughters recently met up with some of Dr. Rao's dental school friends for a relaxing week on the beautiful island of Kauai in Hawaii. This was the first reunion of the group since they graduated from the New York University College of Dentistry. The friends now practice around the country, so getting them all together is a rare sighting. With growing practices and growing families they sure stay busy, but from the looks of it, they seem to have found a way to relax!

The Gang is all Here!

IMG_7286 2

(from left to right): Dr. Rao and Dr. Brikina, Dr. Daniel Elbert and his wife (Thousand Oaks Smile Design in Thousand Oaks, California),  Dr. Lindsey Otero and Dr. Misael Otero (Otero Family Cosmetic and Implant Dentistry in Hampstead, South Carolina), Dr. Michael Wilson and his wife (Wilson Dental in multiple locations in New York)

They were visiting Dr. Michael Lutwin (of the Kalaheo Dental Group in Kalaheo, Hawaii) - not pictured above.

They really did this vacation right! Check out some pictures from their helicopter rides, ATV tours, golfing and sight-seeing around the island! 

Photo Gallery

See More!

In addition to being amazing dentists, Dr. Brikina and Dr. Rao are shaping up to be pretty phenomenal photographers too!

Check out Dr. Brikina and Dr. Rao's gallery of beautiful views an of Kauai here:

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Date: 8/22/2017 5:16 AM PDT

Link between diabetes and teeth health

Did you know that 29.1 million people living in the United States have diabetes? That’s 9.3% of the population. Approximately 1.7 million new cases are diagnosed each year—and 8.1 million people living with diabetes don’t even know they have it.

Diabetes affects your body’s ability to process sugar. All food you eat is turned to sugar and used for energy. In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy. In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.

So what does this have to do with that smile of yours — and how can you protect it? First, it’s important to understand the signs of diabetes and the roles they play in your mouth.

What Does Diabetes Have to do with my Smile?

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low.

If diabetes is left untreated, it can take a toll on your mouth as well. Here's how:

Why People with Diabetes Are More Prone to Gum Disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems.  In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

How Your Dentist Can Help You Fight Diabetes

Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your HbA1c. (This is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)

Your Diabetes Dental Health Action Plan

Teamwork involving self-care and professional care from your dentist will be beneficial in keeping your healthy smile as well as potentially slowing progression of diabetes. Here are five oral health-related things you can do to for optimal wellness:
  • Control your blood sugar levels. Use your diabetes-related medications as directed, changing to a healthier diet and even exercising more can help. Good blood sugar control will also help your body fight any bacterial or fungal infections in your mouth and help relieve dry mouth caused by diabetes.
  • Avoid smoking.
  • If you wear any type of denture, clean it each day.
  • Make sure to brush twice a day with a soft brush and floss correctly daily.
  • See your dentist for regular checkups.

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Date: 8/9/2017 9:03 AM PDT

Braces or Invisalign, Your options for a healthier, straighter smile | Cedar Walk Dentistry

Do you have mouth and jaw pain due to shifting teeth or over-crowding?

Does your overbite, underbite or open-bite drive you crazy?

Are you self-conscious about having a crooked smile?

Are you ready to close that gap in your front teeth for good?

If you thought, "yeah, that's me" to any of those questions, we should talk about Invisalign together.

What is Invisalign?

Invisalign is a type of orthodontic treatment that helps to straighten teeth without the use of the typical metal braces.

Invisalign has quickly revolutionized the orthodontics world.

No more metal!

No more painful adjustments!

No more brushing around brackets!

Now patients have a different option besides ugly metal brackets. Invisalign involves wearing a series of custom-made clear plastic aligners that help shift your teeth into the proper position.

Woman Holding Invisalign Aligner in Dental ChairImage Property of Invisalign

Patients who would have never considered braces before are now giving Invisalign a shot.

Why do you even need straight teeth?

The alignment of your teeth and jaws can not only improve your smile, but also your oral health.

Crooked teeth that do not fit together correctly are harder to keep clean and are at risk for tooth decay and gum disease!

The Cost of Braces vs Invisalign

For many people, though, the choice comes down to cost.

How much do Invisalign braces cost? Are they worth the money, or are you better off going the traditional route?

The typical price of Invisalign braces is usually a bit higher than regular braces. The average cost, according to the manufacturer, is between $3,500 and $8,000.

Your dentist or orthodontist can give you a better estimate of the price.

The factors that come into play are:

  • The extent of the alignment your teeth require
  • How many aligners you will need
  • How long you are in treatment
  • Where you live
  • Your insurance coverage
The typical cost of regular braces varies widely, but is usually in the range of $2,500 to $6,000. Again, the cost varies on a case-by-case basis, depending on your individual needs, and should be discussed with your dentist.

Most dental insurance plans cover Invisalign just as they would regular braces, but check with the insurance company first to determine the extent of their coverage.

The average Invisalign price is not that much higher than regular braces and the unique advantages Invisalign offers - like being able to take the aligners out to eat and brush your teeth - often outweigh the slight difference in price. If cost is a big concern for you, talk to your dentist about payment options. Many providers will offer flexible monthly payment plans to spread out the Invisalign braces cost over a longer period.

In the end, it is up to you and your orthodontist to decide which is the best treatment for your individual case.


Braces vs Invisalign | Cedar Walk Dentistry

Benefits of Invisalign Over Braces


You can take them off! With Invisalign, your brushing, flossing and mouth wash routines can stay the same! You don't have to work around those bulky rubber bands and metal brackets and wires.


When you're wearing the clear alignment trays, they are hardly noticeable. Your family and co-workers will barely be able to tell you are wearing them. You don't have to worry about unsightly metal wires in your mouth or developing a lisp due to bulky equipment.


If you've had braces before, you know the pain that comes with your orthodontist tightening the wires in your mouth. If you haven't had braces before, consider yourself lucky. The Invisalign alignment trays take out the cranking and tightening discomforts of braces!


Based on the severity of your case, the number of trays you need for your treatment, and the amount of time you wear your alignment trays, this painless process can be much easier and quicker compared to braces. The more often you wear your aligners, the faster your teeth will correct! You're in control!

Questions to Ask Your Dentist

From Invisalign


  • Please explain the treatment process. How does it move my teeth?
  • With my case, about how long will my treatment last?
  • How often will I have to visit your office?
  • How much will it cost, and are there payment options?
  • What restrictions will I have when it comes to eating?
  • Will wearing Invisalign aligners affect my speech?
  • What happens after Invisalign treatment is done? Will I need to wear a retainer? Why are Vivera® retainers my best retention option?


  • Please explain the treatment process. How does it move my teen's teeth?
  • With my teen's case, about how long will treatment last?
  • How often will we have to visit your office?
  • How much will it cost, and are there payment options?
  • How does Invisalign fit into my teen's life in terms of eating, school, sports and other activities?
  • I'm afraid my teen might lose or break an aligner. How much extra will this cost me?   My teen doesn't have all of his/her permanent teeth yet. How does Invisalign work in this case?
  • How do I know that my teen is wearing the aligners as recommended/prescribed?
  • What happens after Invisalign treatment is done? Will my teen need to wear a retainer? Why are Vivera retainers the best retention option for my teen?


  • Will my treatment be painful?
  • Can I still play sports or a musical instrument while wearing the aligners?
  • Is there anything that I am not allowed to eat?
  • Will wearing Invisalign aligners affect my speech?
  • How long will my treatment last?
  • What happens if I break or lose an aligner? How much more will that cost my parents?
  • What happens if I forget to wear my aligner? Will that mess up my treatment?

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Date: 7/18/2017 5:36 AM PDT

Bonds vs Veneers vs Crowns - Your Way to a Better Smile | Cedar Walk Dentistry

If you need to tune up your teeth, your dentist can use bonding, veneers, and crowns to fix a range of dental problems.

If your teeth are chipped, broken, cracked, or badly stained or have slight gaps, you and your dentist may discuss a number of remedies. Your dentist should consider the simplest solution that works for you. In order of complexity, these solutions range from bonding to veneers and crowns.


With dental bonding, tooth-colored material (composite resin) is attached, or bonded, with an adhesive to your teeth to repair defects and reshape them. The procedure can be done in a single visit. Aside from fixing chipped, cracked, or stained teeth, bonding can also be used to close spaces in teeth and cover the surface of teeth to change their color or shape. Bonding lasts for several years, but it’s more vulnerable to chipping or staining.


Veneers are thin, custom-made shells designed to cover the front of your teeth. They are used to fix spaces between teeth and teeth that are chipped or worn, permanently stained, poorly shaped, or slightly crooked. Made of porcelain or plastic, they are usually used for the front teeth—particularly the upper front teeth—that are most visible when you smile. If you have a wide smile, some of the posterior teeth may be covered as well.

Veneers made of porcelain are the most durable and color-stable. They may also be an alternative to crowns, which are more expensive.

The process can take up to three visits. At the first visit, your dentist may make preliminary impressions of your teeth to make models to plan for the veneers. At the second appointment, the dentist will reduce some of the enamel on your teeth to make room for the veneers. The dentist will make a mold of the prepared teeth and send it to a dental laboratory, which will make your veneers. At the third visit, the dentist will place the veneers on your teeth with an adhesive resin.


If one of your teeth has a large amount of decay, number of fillings, or is cracked, your dentist might recommend a crown. This restores your entire tooth, not just its front surface. To prepare your tooth for a crown, your dentist will reduce the tooth to a stable foundation so that the crown can fit over it.

The dentist will make an impression to send to a dental laboratory that will make your crown. Your dentist will also fashion a temporary crown to cover your tooth until your permanent crown is made and fitted by your dentist during a second sitting. Dentists using CAD/CAM (computer-aided design/computer-aided manufacturing) technology may be able to make your crown at the same visit as the tooth is prepared.

Crowns are made of materials such as ceramics (porcelain being one type); or metal (alloys of gold, copper, or other so-called noble metals or base metal alloys with a silver appearance) or a combination of ceramics and metal. They are often more expensive than bonding and veneers.

- See more at:,21273#sthash.a0FETrpy.dpuf

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Date: 7/5/2017 5:50 AM PDT

When it comes to kick-starting the day, many of us rely on a cup of joe. But what does it do to your teeth? Coffee lovers take note: Your morning routine might affect your dental health.

If it can stain your clothes, it can stain your teeth. This rule of thumb is unfortunately true about coffee. Coffee contains ingredients called tannins, which are a type of polyphenol that break down in water. They are also found in beverages like wine or tea and cause color compounds to more readily stick to your teeth. When these compounds stick, they can leave an unwanted yellow hue behind. It only takes one cup of coffee a day to cause stained teeth. How can you avoid tooth discoloration without giving up your favorite morning drink?

It is best to drink coffee through a straw, as this keeps coffee from touching your teeth, avoiding any chance of unwanted stains. Start by avoiding creamer and sugar, since it only speeds up the growth of discoloring bacteria. Drink your coffee in one sitting to prevent bacteria buildup throughout the day. Lastly, after you’re finished with your morning mug, brush your teeth.

Removing Coffee Stains

If you’re a coffee lover, there’s no need to panic. The dentist can usually get rid of coffee stains during your bi-annual cleaning. You can also supplement professional cleaning with a home remedy. Brushing your teeth with baking soda twice a month further whitens teeth in between check-ups. Raw fruits and vegetables, like strawberries and lemons, also contain natural fibers that can help clean your teeth by breaking down bacteria.

Other Issues with Coffee

Like any drink that isn’t water, coffee helps the bacteria in your mouth to create acids that can lead to tooth and enamel erosion. This can cause your teeth to become thin and brittle. Coffee can also cause bad breath, or halitosis, because it sticks to the tongue. To avoid these coffee problems, eat food before you drink coffee and use a tongue scraper and toothbrush after you finish drinking.

The Good News

You can still drink coffee and maintain a white, healthy smile. Coffee’s polyphenols can have positive effects, as they keep teeth strong and healthy. To enjoy coffee and avoid oral damage, drink in moderation. We suggest no more than two cups a day, plus regular brushing and visits to your local dental office.


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Date: 6/26/2017 2:15 AM PDT


Congratulations on this exciting and busy time of your life!

You have so much to think about during pregnancy but don't forget about your teeth and gums. It may be easy to overlook your mouth, but all the changing hormone levels that occur with pregnancy can actually make some dental problems worse.

Brushing and flossing contributes to your overall health, too, and if your mouth is healthy, it’s more likely that your baby’s mouth will be healthy. Visit our MouthHealthy slideshow for more information about what to expect for your oral health during pregnancy.

See your dentist

It’s important to continue to see your dentist during pregnancy for oral examinations and professional teeth cleanings. Make sure to tell your dentist that you are pregnant and about any changes you have noticed in your oral health. Good daily care is vital. That means always brushing your teeth twice a day with fluoride toothpaste, cleaning between your teeth once a day, eating a balanced diet and limiting between-meal snacks.

To assist you in making healthy eating choices, the National Maternal and Child Oral Health Policy Center has compiled a list of tips to follow during pregnancy that can be found here.

Visit our other Pregnancy pages on MouthHealthy here:

Then test yourself with the Fact or Fiction Pregnancy quiz. Keeping your mouth healthy now can help set up you and your child to be Mouth Healthy for Life.


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Date: 6/5/2017 5:45 AM PDT

Dental Health

Nutrition plays an extremely important role in oral health, and you might remember from childhood that too much sugar and not enough brushing is one of the biggest barriers to optimum dental health and wellness. We want to make sure that you know what foods to avoid, what deficiencies to be aware of, and the special considerations to take into account if you choose a vegan/vegetarian lifestyle or herbal supplements.

The first line of defense, after cutting down on sugars, is to immediately brush the teeth, but we also recommend that you try to cut as much sugar from your diet as possible.

Dietary Considerations and Decay

By cutting back on simple carbohydrates, the rate of dental caries can be reduced. Simple sugars are found in many foods and have many names. Some of these are table sugar, corn syrup, honey, molasses and dextrose. By reading labels on food products, you can limit foods high in simple sugars and thus reduce the chance of dental caries. Bacteria need carbohydrates for food. Sucrose (table sugar) is the carbohydrate bacteria prefer. However, other simple carbohydrates, such as fructose, lactose and glucose, are easy to ferment and also support bacteria growth.

Bacteria also can ferment complex carbohydrates (starches), but the process takes longer. However, many complex carbohydrates are sticky and become lodged between teeth and gums. This allows the bacteria time to ferment the carbohydrate. Meats and foods high in fiber, such as fresh fruits and vegetables, help clean the teeth of food particles and sugars during the chewing process. These foods promote saliva flow, which helps rinse the teeth of food particles. Saliva also neutralizes the acid.

Although fresh fruits and vegetables do contain carbohydrates that can be fermented by bacteria, the fiber content counteracts the effect and helps clean the teeth, therefore protecting against dental caries. When we eat, we provide food for mouth bacteria. Eating three meals a day is important for adequate energy and nutrient intake, but snacking between meals presents special dental health problems.

Choose snacks that do not harm teeth. Examples of good snacks include cheese, yogurt, meats, plain nuts (not recommended for children younger than school age), peanut butter, fresh fruits and vegetables, unsweetened breads and cereals. The snacks most people enjoy tend to be high in simple sugars like dried fruits such as raisins, sweet rolls, candy bars, pop or caramel corn. Snacking does not need to be completely omitted. In many situations, snacking is important for good physical health.

Categories of Decay Potential of Certain Foods

- High Potential for Decay - Dried fruits, hard and soft candy, cake, cookies, pie, crackers - Moderate Potential for Decay - Fruit juice, sweetened canned fruit, soda, Gatorade, breads - Low Potential for Decay - Raw vegetables, raw fruits, milk - Very Low Potential for Decay - Meat, fish, poultry, fats, oils - Ability to Stop Decay - Cheeses, xylitol , nuts


Beneficial Supplements for Oral Health

In keeping with our whole body approach to dental health and wellness we have prepared a list of known natural ingredients and supplements known to aid in oral and dental health:

- Coenzyme Q10 promotes gum healing and cell growth - Lysine combats canker sores - Vitamin C with Bioflavonoids promotes healing, especially of bleeding gums - Calcium and Magnesium help prevent bone loss around the gums - Vitamins A and E are needed for healing gum tissue - Grape Seed Extract is a powerful antioxidant and anti-inflammatory - Zinc plus Copper enhances immune function - Aloe Vera Gel eases inflamed gums and soothes the tissues when applied directly to the affected area - Chamomile Tea is soothing to gum tissues - Green Tea is helpful in decay prevention and decreases plaque - Clove Oil is good for temporary relief of tooth and gum pain - Echinacea keeps inflammation down and enhances immune function.

A Word of Caution for Herbal Supplements for Dentistry

Many people do not realize that herbal suppliments can interact with other medications and local anesthetics. In one study, nearly 70% of participants did not inform their physicians or dentists about using them. Because herbal supplements including echinacea, feverfew, garlic, ginseng, ginkgo, and St. John’s wort may have the potential for adverse effects during or after dental procedures, please let us know if you are taking ANY herbal supplements so that we can provide you with the best care possible.

Calcium – Good For Your Bones, Good For Your Teeth

Research has confirmed the importance of calcium for your teeth and bones. According to a study published in the Journal of Periodontology, calcium deficiencies are also directly linked to gum disease, which is a leading cause of tooth loss. Researchers discovered that people who consume less than the recommended daily amount of calcium are almost twice as likely to have periodontal disease, an infection caused by bacteria that accumulate between the teeth and gums.

About 75% of people don’t meet their daily calcium needs. Dairy products such as milk, cheese and yogurt are the best sources of calcium. In addition to milk & dairy products there are several other types of non-dairy sources of calcium that you can choose to ensure your daily calcium intake. The soft bones of fish, as with sardines, pilchards and tinned salmon, provide us with valuable calcium. Other useful sources include bean products, such as tofu, as well as sesame seeds, nuts, white bread, dried fruit, and green leafy vegetables particularly okra and curly kale. Soy milk alternatives, bottled water, breakfast cereals and orange juice are also fortified with extra calcium.

Vegan/Vegetarian Nutrition and Your Teeth


Many patients have upped their consumption of vegetables, and some are vegetarians or vegans. Occasionally these diets and lifestyles can result in some nutritional deficiencies. Some vegetarians and vegans experience deficiencies in calcium and vitamin D, putting them at increased risk for periodontal disease. We welcome the opportunity to talk to you about your diet, nutritional choices and how they relate to your dental healthcare needs.

Herbal Supplements for Dental Health

As science finds out more about the beneficial effects of antioxidants, even greater interest has developed in natural foods and natural products. In one study, nearly 70% of participants did not inform their physicians or dentists about using them. Because herbal supplements including echinacea, feverfew, garlic, ginseng, ginkgo, and St. John’s wort may have the potential for adverse effects during or after dental procedures, please let us know if you are taking ANY herbal supplements so that we can provide you with the best care possible.

From: Dental Health and Wellness Boston

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Date: 5/26/2017 7:22 AM PDT

Thank you, Mehul Gadhia, for all of the photos, we had a great time at the South Charlotte Study Club 10th anniversary event with friends and colleagues!










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Date: 4/26/2017 11:16 AM PDT

Screen Shot 2016-02-11 at 11.14.03 AM

Bad breath happens. If you’ve ever gotten that not-so-fresh feeling on a date, at a job interview or just talking with friends, you’re not alone. Studies show that 50 percent of adults have had bad breath, or halitosis, at some point in their lives.

What Causes Bad Breath? There are a number of reasons you might have dragon breath. While many causes are harmless, bad breath can sometimes be a sign of something more serious.

Bacteria Bad breath can happen anytime thanks to the hundreds of types of bad breath-causing bacteria that naturally lives in your mouth. Your mouth also acts like a natural hothouse that allows these bacteria to grow. When you eat, bacteria feed on the food left in your mouth and leaves a foul-smelling waste product behind.

Dry Mouth Feeling parched? Your mouth might not be making enough saliva. Saliva is important because it works around the clock to wash out your mouth. If you don’t have enough, your mouth isn’t being cleaned as much as it should be. Dry mouth can be caused by certain medications, salivary gland problems or by simply breathing through your mouth.

Gum Disease Bad breath that just won’t go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque.

Food Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.

Smoking and Tobacco Smoking stains your teeth, gives you bad breath and puts you at risk for a host of health problems. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease. Since smoking also affects your sense of smell, smokers may not be aware of how their breath smells.

Medical Conditions Mouth infections can cause bad breath. However, if your dentist has ruled out other causes and you brush and floss every day, your bad breath could be the result of another problem, such as a sinus condition, gastric reflux, diabetes, liver or kidney disease. In this case, see your healthcare provider.

How Can I Keep Bad Breath Away?

Brush and Floss Brush twice a day and clean between your teeth daily with floss to get rid of all that bacteria that’s causing your bad breath.

Take Care of Your Tongue Don’t forget about your tongue when you’re taking care of your teeth. If you stick out your tongue and look way back, you’ll see a white or brown coating. That’s where most of bad breath bacteria can be found. Use a toothbrush or a tongue scraper to clear them out.

Mouthwash Over-the-counter mouthwashes can help kill bacteria or neutralize and temporarily mask bad breath. It’s only a temporary solution, however. The longer you wait to brush and floss away food in your mouth, the more likely your breath will offend.

Clean Dentures If you wear removable dentures, take them out at night, and clean them thoroughly before using them again the next morning.

Keep Saliva Flowing To get more saliva moving in your mouth, try eating healthy foods that require a lot of chewing, like carrots or apples. You can also try chewing sugar-free gum or sucking on sugar-free candies. Your dentist may also recommend artificial saliva.

Quit Smoking Giving up this dangerous habit is good for your body in many ways. Not only will you have better breath, you’ll have a better quality of life.

Visit Your Dentist Regularly If you’re concerned about what’s causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth and stop them before they become more serious. If your dentist determines your mouth is healthy, you may be referred to your primary care doctor.


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