Dental Health

What is tooth decay, and how does it happen?

DEAR DOCTOR K: What is tooth decay, and how does it happen?

DEAR READER: Tooth decay is a disease of the mouth that can lead to cavities and infection. But before we start talking about sick teeth, let's talk about healthy teeth. Each tooth has one or more roots that are anchored in the bones of the jaw. Since those roots are inside the jaw bone, they are invisible. The part of the tooth that we see, sticking out above the gumline, is the crown. The crown of the tooth is covered with a hard, whitish material called enamel.

What should I know before I get dentures?

DEAR DOCTOR K: My dentist says it's time for dentures. What should I know before I get them?

DEAR READER: Nearly half of Americans ages 65 and over have lost six or more teeth because of decay or gum disease. Tooth loss can profoundly affect your health and well-being. The more teeth a person loses, the more difficult it is to chew food properly and get needed nutrients. Missing teeth can also make speaking difficult and make you self-conscious about your appearance. (Below, I've put an illustration of our teeth and their functions.)

After a joint replacement, do I need to take an antibiotic before a dental procedure?

DEAR DOCTOR K: I had knee replacement surgery several years ago. More recently, I had my hip replaced. I am scheduled to have a root canal next month. Do I need to take antibiotics before my dental procedure?

DEAR READER: Almost any type of dental work -- extractions, gum surgery, root canals, even routine cleanings -- can injure the gums and other soft tissues of the mouth. The most obvious evidence of this is that they bleed. Bacteria live inside our mouth. When gums are injured, bacteria from the mouth can enter the bloodstream.

What happens during a root canal?

DEAR DOCTOR K: I have to have a root canal. What will happen during this procedure?

DEAR READER: You brush your teeth twice a day, but you probably don't know their inner workings. Every tooth has roots that anchor it to the jawbone. Inside the body of the tooth and inside its roots is a hollow central chamber, or canal. And inside that hollow chamber is an inner pulp containing a network of nerves, blood vessels and tissues.

What should I look for in a toothpaste?

DEAR DOCTOR K: I'm confused by the many types of toothpaste on pharmacy shelves. What should I look for in a toothpaste?

DEAR READER: To prevent cavities and tooth decay, you need to brush away plaque -- that sticky, bacteria-laden material that builds up on teeth. It's best to brush at least twice daily, once after you eat breakfast, and then again before you go to sleep. When it comes to plaque removal, your toothbrush does most of the heavy lifting.

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.