1. Do I really have to floss every day?
If you want to keep your teeth and body healthy, yes. Cleaning between your teeth and below the gum line with floss not only dislodges the corn that got stuck there at dinner, it also helps protect against gum disease as well as more serious health problems. Flossing helps control bacteria that are linked with chronic, body-wide inflammation, a serious risk factor for heart disease, stroke, lung disease, and preterm births.
Incidentally, don’t believe claims that rinsing with mouthwash is just as good as flossing. While one study, sponsored by the manufacturer of a famous antiseptic mouthwash, found that swishing beat flossing, later research found that a dental-care routine that included tooth brushing, flossing, and using an antiseptic mouthwash cut dental plaque by 50 percent, better than flossing or mouthwash alone.
2. Are white fillings better than silver fillings?
Cosmetically speaking, they’re more appealing because they blend in with your teeth. But they’re no safer than old-fashioned silver (amalgam) fillings, and they generally don’t last quite as long. While about half of all tooth-colored composite fillings need to be replaced within 10 years, amalgam fillings last about 20 percent longer (their durability depends on the size of the filling, your chewing pattern, and the strength of the tooth surrounding the filling). Composite fillings may also cause more tooth sensitivity in some people, but the effect is usually temporary.
Silver fillings, a mix of elemental liquid mercury with a powder containing several other metals, have been blamed for triggering a wide variety of health problems. While it’s true that exposure to mercury vapors on a large scale can lead to health problems, the minute amounts released by metal fillings in your mouth are too small to pose a threat. Studies show that they do not raise the risk for Alzheimer’s disease, multiple sclerosis, memory loss, or tremors in adults. And they do not harm intellect, memory, coordination, focus, nerve conduction, or kidney function in children.
3. Is tooth whitening safe?
The active ingredient in home and dentist’s office tooth-whitening bleaches is carbamide peroxide, which breaks down into hydrogen peroxide in your mouth. Studies show that this chemical does not raise your risk for oral cancer, which had been an early concern. However, it can temporarily make teeth more sensitive for up to 78 percent of people who have their pearly whites lightened.
Your teeth become sensitive because the hydrogen peroxide in whiteners soaks through the protective outer coating of enamel and into the softer layer of dentin underneath, irritating the nerve-rich dental pulp at the core. Microscopic cracks and leaks along dental fillings increase your odds for tooth sensitivity. Up to 40 percent of people who use whitening trays also experience temporary gum irritation as well. It goes away in a few days or at most in a week or so.
Don’t use tooth-whitening bleaches more often than recommended. Research shows that these products do wear away microscopic amounts of tooth enamel, which could increase tooth sensitivity and in rare cases, even tooth decay.
4. Nothing I do — brushing, flossing, mouthwash — gets rid of my bad breath. What will work?
Brush your tongue or clean it with a tongue scraper.
Bad breath usually means bacteria are munching on food residue in your mouth, then emitting nasty-smelling sulfur compounds. Cleaning the tongue removes the film of microscopic food particles and also evicts some of those ill-mannered microbes before they can gas again. In one New York University study, people who brushed their teeth and tongues twice daily for 60 seconds had a 53 percent reduction in breath-souring sulfur compounds after 2 weeks.
Rinsing with a mouthwash containing a germ-fighting ingredient, such as chlorhexidine, cetylpyridinium chloride, zinc lactate, or chlorine dioxide, is also effective. If these strategies don’t work, check your dinner plate: Garlic and onions contain odoriferous oils which, when digested, wind up in your bloodstream; they’re released in your lungs and can sour your breath for up to 3 days.
Talk with your doctor or dentist if nothing seems to help. Stubborn bad breath can be a symptom of advanced gum disease, dry mouth, a sinus infection, tonsillitis, cryptic tonsillitis (when white debris collects in pockets in the tonsils), acid reflux, or a gastrointestinal or respiratory infection.
5. I just brushed my teeth and my gums were bleeding. Do I have gum disease?
Of course, you could be just brushing too hard. Gums can also bleed if you’re taking medications or supplements that thin the blood, such as warfarin (Coumadin), aspirin, or coenzyme Q10. Still, bleeding gums usually means you’re not getting rid of all the plaque at the gum line, where the tooth meets the gum. The best way to do this is with regular flossing in addition to brushing.
6. How often do I need dental x-rays?
That’s up to your dentist, but the American Dental Association recommends these guidelines:
- All new patients should have a complete set of x-rays.
- If you don’t have cavities and you’re a model patient — that is, you brush and floss regularly — your dentist should take a set of posterior bitewing x-rays (that is, of the back teeth) every 2 to 3 years. Some dentists may suggest annual x-rays.
- If you have cavities or other dental problems, you may need x-rays every 6 to 18 months.
- The ADA recommends more frequent x-rays for children and teens.