Dental Health

Am I too old for braces?

DEAR DOCTOR K: I'm in my 40s and can finally afford to straighten my teeth. Am I too old for braces? What are my options?

DEAR READER: Adults have 32 teeth whose job is to break down the variety of foods in the human diet. If someone is born with crooked teeth, childhood is the best time to get teeth straightened. But adults can and often do opt for orthodontic treatment -- with excellent results.

How can I prevent my bad morning breath?

DEAR DOCTOR K: My breath is OK during the day, but when I wake up in the morning, it's terrible. What causes bad morning breath? And what can I do to prevent it?

DEAR READER: Bad breath, or halitosis, is a common problem -- especially "morning breath." (Some people call it "dragon breath.") Certain foods can cause bad breath. Garlic and onions are classic examples. Reflux of stomach contents can do the same. So can serious diseases of the liver or kidneys. Infections of the tonsils, sinuses or respiratory tract can also be responsible for bad breath.

Is tooth decay the same as a cavity?

DEAR DOCTOR K: What is tooth decay? Is it the same as a cavity?

DEAR READER: Tooth decay is not the same as a cavity -- but tooth decay can lead to the formation of a cavity. Tooth decay (also known as dental caries) originates with plaque, the sticky, bacteria-laden film that collects on your teeth between brushings. In recent years, we've learned that many types of bacteria produce filmy substances that act like a protective foam.

Should I use mouthwash, in addition to brushing my teeth?

DEAR DOCTOR K: I brush and floss regularly. Do I need to use mouthwash too?

DEAR READER: Judging from the ads, you need mouthwash to prevent plaque (the yellowish film of bacteria that attaches to your teeth and leads to cavities) and gingivitis (inflammation of the gums). But mouthwash actually plays a fairly minor role in the prevention of plaque and gum disease. Brushing and flossing are much more important.

How can I keep my mouth healthy as I get older?

DEAR DOCTOR K: As I age, what can I do to keep my mouth healthy?

DEAR READER: Your mouth is not exempt from the effects of aging. Older people suffer higher rates of gum disease, dental decay, mouth infections and tooth loss. Fortunately, you can keep your mouth looking and feeling younger than its years by practicing good oral hygiene.

Is fluoride bad for you?

DEAR DOCTOR K: I'm confused. Is fluoride harmful or not?

DEAR READER: I know there are people who think fluoride in drinking water, toothpaste or mouthwash is harmful, so I'm likely to get some mail about this column. But my job is to tell you what the scientific evidence shows.

What can I do about a dry mouth and throat?

DEAR DOCTOR K: My mouth and throat are always parched, even though I'm constantly sipping water. It's very uncomfortable. I'd appreciate any advice you can offer.

DEAR READER: Most of the time dry mouth, also called xerostomia, causes more discomfort than damage. But severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease. My colleague Dr. Harvey Simon recently wrote about dry mouth in the Harvard Men's Health Watch. Here's what he and I advise.

Should I whiten my teeth at home?

DEAR DOCTOR K: Should I whiten my teeth at home or have my dentist do it?

DEAR READER: If discolored teeth are making you self-conscious, you've got a lot to smile about. The interest in whitening teeth has grown greatly in the past decade, and these days there are many teeth-whitening options -- both at the drugstore and at the dentist's office

Are electric toothbrushes better than manual toothbrushes?

DEAR DOCTOR K: I've been brushing with a manual toothbrush my entire life. But my best friend insists that electric toothbrushes are better. Should I switch?

DEAR READER: What matters most is that you brush your teeth at least twice a day. That's the way you keep plaque from forming. Plaque is a sticky film that attaches to the surface of your teeth. If it isn't removed, it can lead to tooth decay and gum disease. Brushing regularly keeps plaque in check.