Category: Dentist

Define Halitosis, and Describe Halitosis Causes, Treatments

infected mouth, halitosis in adult male

There’s a big difference between bad breath and halitosis.   Bad breath is easily overcome and can literally be wiped away.  While embarrassing, it’s often only temporary. Halitosis on the other hand is usually a symptom of something more sinister.  If you have halitosis for real, then it won’t just go away by itself.  The condition is trying to tell you something, and at Archer Dental we listen with our noses.

What is Halitosis?

Halitosis describes the regular occurrence of an unpleasant odor in the mouth. Fetor oris or ‘chronic bad breath’ is a medical condition, as opposed to occasional bad breath which could have more benign causes. Halitosis is the symptom of a more complex medical issue, and only in the best and more easily remedied scenarios is it caused by certain foods, and corresponding poor oral hygiene; more often it relates to excess alcohol or tobacco use, dry mouth, and underlying medical conditions and or related medications.

See below for a long list of medical scenarios your bad breath may be signalling.

What Causes Halitosis?

Similar to body odour, there are many causes of chronic bad breath and only one is easily treatable: poor oral hygiene.  That just takes elbow grease to eradicate the odoriferous circumstances, and learning better habits helps keep it clean.  Below are seven other more serious causes for chronic bad breath.  Poor oral hygiene can often be cured with brushing and by using antiseptic mouthwash and other toiletries over time.

Poor Oral Hygiene can cause Halitosis

Some people have terribly unhealthy mouths, and this is mostly because they don’t put much effort into cleaning them up. They don’t brush often enough, and when they do brush their teeth, they don’t do a proper job of it.  In the short term, this behaviour will likely result in some unpleasant after-dinner aromas and morning breath scenarios, but long term the daily neglect can cause more complex oral health issues.

Pungent foods such as onions and garlic and other strong-smelling flavourings can leave particles behind in your teeth and on your tongue. Fish oils and other greasy substances don’t rinse away easily, and this results in an unpleasant odor.  Large quantities of sugar can also boost the bacteria count in your mouth. As the tiny organisms that live on your teeth and tongue digest the sugars, your breath turns sour.  Anaerobic bacteria can produce various byproducts, including sulfur compounds which smell terrible. By and large however, this is NOT halitosis.  It’s just bad breath. When food remains anywhere in the mouth, bacteria will break down the material creating a sulfur-like compound that gives off a fermented, bad-breath smell. This is the reason why Dr. Archer recommends that patients floss their teeth before they brush for best results. But this scenario is easily treated with a toothbrush and toothpaste, tooth floss and antiseptic mouthwash, and as such, this is NOT halitosis which is a medical condition that is not so easily mitigated.

Halitosis is chronic bad breath, and this medical condition is always a symptom of a greater malaise than malodorous meal choices. Repeated indulgences in smelly food combined with poor oral hygiene can create halitosis yes, but at some point, we go beyond oral health and enter into a discussion about mental health.

Natalie Archer n CBC Halitosis, bad breath

Dr Archer appeared on CBC The Goods to discuss Halitosis and bad breath prevention on Tuesday Jan 22nd 2018. Bad breath affects an estimated one in four people in North America. There are a number of possible causes of halitosis and the vast majority come down to inferior oral hygiene.

Dental Problems can cause Halitosis

Along with pain and discomfort, bad breath can be another way the body signals the presence of gum disease and tooth decay.  Dental issues can allow bacteria to hide in cavities, or inside pockets around the gums caused by conditions such as gingivitis and periodontal disease.  So chronic bad breath might be a signal its time to visit the dentist. Short-term breath freshening methods might mask the problem, but the smell always returns when core issues remain uncorrected.

Periodontitis, also generally called gum disease or periodontal disease, begins with bacterial growth in your mouth and may conclude with tooth loss due to destruction of the tissue that surrounds your teeth. Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis. Read more about the treatment of Periodontal disease at Archer Dental.

Other dental causes of bad breath include poorly fitting dental appliances.

Health Problems can cause Halitosis

Besides gum disease (periodontal disease) which was discussed above, there are other health conditions that can cause halitosis. People who suffer from diabetes, cancer, kidney disease, liver disease, lung disease and respiratory tract infections, or other lesser-well-known metabolic disorders often experience chronic bad breath because of a co-symptomatic dry mouth condition.  This document explores how dry mouth causes bad breath in detail below.

Diseases that affect the lungs and liver can cause halitosis in the mouth because of chemicals emitted by the body in each exhale.  Your liver regulates your body’s blood sugar. If your liver can’t function properly, toxins will build up in your bloodstream and give you foul-smelling breath that takes on a sweet, musty odor.  Lung cancer can (and usually will) result in bad breath.  Lung cancer causes a distinct breath odor that can be measured and used in early detection of the disease. Cystic fibrosis and asthma are two other lung disorders that have a distinct odor that is associated with them (both of them smell somewhat acidic). People suffering from sinusitis, pneumonia, postnasal drip, and polyps which affects the airways may also have foul breath. Chronic bronchitis is a long-term swelling and irritation in the air passages in your lungs.  The lung damage often gets worse over time, and it is usually permanent, but early signs and symptoms may include a morning cough that brings up mucus from the lungs and a bad taste or bad breath that is noticed by others.

Medications can cause Halitosis

Certain medications can cause chronic bad breath mostly because they cause dry mouth.  The term dry mouth is a medical condition called xerostomia which is dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease by itself. This is a symptom of another related medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. Because saliva is necessary to moisten the mouth, neutralize acids produced by plaque, and remove dead cells that accumulate on the tongue, gums, and cheek, foul odours can be produced in this region of the body simply because there wasn’t any water there to wash them away.

Other medications and drugs such as nitrates which are used in treating angina, and chemotherapy chemicals and tranquilizers such as phenothiazines (which also reduces saliva production) can increase the occurrences of mouth odor because of the breakdown and release of chemicals from the body into the patient’s breath.

Crash Diets can cause Halitosis

low carb diet - ketones can cause halitosisLow-carb diets can cause halitosis when certain chemicals are released in the lung’s exhale as the body burns fat. This is called ketogenesis.  Ketogenesis is the biochemical process through which organisms produce ketone bodies through breakdown of fatty acids and ketogenic amino acids. During the process of ketogenesis, which is when ketone bodies are formed from the breakdown of fatty acids, acetoacetate is the first ketone that’s created. Beta-hydroxybutyrate is then formed from acetoacetate. Both acetoacetate and beta-hydroxybutyrate are responsible for transporting energy from the liver to other tissues in your body. Acetone, a biproduct of acetoacetate, smells like nail polish remover and this is the odour most commonly associated with this olfactory phenomenon.

Acetone, which is the simplest and least-used ketone body, is created spontaneously as a side product of acetoacetate.  Acetone, or propanone, is the organic compound with the formula (CH₃)₂CO. It is a colorless, volatile, flammable liquid and is the simplest and smallest ketone. Acetone is miscible with water and serves as an important solvent in its own right, its most typically used for cleaning laboratories and as nail polish remover. If your breath smells like acetone, or nail polish remover,  it may indicate that there are high levels of ketones in the blood. This may stem from your low carb diet, or diabetes, alcohol use, or dietary habits. If acetone is not needed for energy, it will break down and be removed from the body as waste through the breath or urine. Acetone is the cause of a characteristic fruity smell on the breath when someone is in ketosis or ketoacidosis.

Whether a person has type 1 or type 2 diabetes, an acetone-like scent in the breath can indicate diabetic ketoacidosis (DKA), a potentially life-threatening complication that needs immediate medical attention.

Acid Reflux can cause Halitosis

Chronic acid reflux, which is also known as gastroesophageal reflux disease is a medical condition. Acid reflux is the backward flow of stomach contents such as undigested food, regurgitated bile, and stomach acids into your esophagus. This can lead to tooth decay (as the acid dissolves enamel) and bad breath.

What causes acid reflux? The primary cause of this medical condition in most sufferers is a faulty or relaxed lower esophageal sphincter.  The LES for short is a valve-like muscle (like a thick rubber band) that forms a barrier between your esophagus and your stomach. When the LES works appropriately, it opens when you swallow to let food enter the stomach, and then it closes tightly. A faulty LES however, remains open, and this allows acids to flow back-up and into your throat.  The regurgitation of stomach contents can cause heartburn and a bitter or sour taste in your mouth. What’s more, you’re also likely to experience bad breath as a result of your symptoms. Bad breath can be controlled not only by managing your GERD, but also by making a few changes.  You can read more about how everyday acids and bases affect oral health and human homeostasis.

Tonsillitis can cause Halitosis

Tonsil Stones cause halitosisNormally your tonsils help fight infection. The small, soft, fleshy bits of tissue that reside at the back of the mouth evolved to help detect and filter bacteria and viruses that enter through the mouth. They protect the blood stream by producing white blood cells and antibodies.  But tonsils are sensitive instruments that are covered with the same mucous membrane, or mucosa, that lines your mouth, nose and throat. It’s the crevices, or crypts, in your tonsils’ mucosa that may lead to smelly health problems. Inflamed tonsils get red and swollen and can cause a sore throat. Bad breath and throat irritation can also be signs of tonsillitis.

Tonsils are designed to trap bacteria; that’s their job. Unfortunately, bacteria can cause infection, and is stinky, and has a host of other characteristics that spell trouble. This is why so many children (and adults) end up getting their tonsils removed. Sometimes this bacteria becomes struck, and attracts more bacteria and other things until it eventually forms a small mass that calcifies. Tonsil stones are small calcium deposits that harden and grow on the tonsils. These are actually visible in the featured image of this blog post. The model has tonsilloliths or tonsilliths which is the medical term for this phenomenon. It’s not a serious condition, but since it is entirely composed of bacteria and other debris, it smells bad. Some people say it smells like vomit.

Smoking can cause Halitosis

If halitosis is defined as regular occurring bad breath and smokers get their mouth fouled after every cigarette, then technically smoking cigarettes all by itself causes halitosis.

Tobacco products cause their own types of mouth odor as the smoke is filled with hundreds of toxic chemicals.  Additionally, tobacco smoke (and marijuana smoke) may increase the chances of gum disease which also causes bad breath.  Three common bacteria are involved in gum disease.  Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia are all present in higher amounts in smokers than non-smokers.  We could discuss prevention, and cessation but once again we would be departing the province of oral health and entering into the realm of mental health.

Fetor hepaticus – the breath of the dead

Fetor hepaticus occurs when your breath has a strong, musty smell. It’s a sign that your liver is having trouble doing its job of filtering out toxic substances, usually due to severe liver disease. As a result, sulfur substances end up in your bloodstream and can make their way to your lungs. When you exhale, these substances give your breath a distinct smell which some say is similar to the smell of rotting flesh.  This is how and why you may hear fetor hepaticus referred to as the “breath of the dead.”


The Many Smiles of Archer Dental

toronto dentist

Now its time for an Archer Dental Video Rewind:  This clever video was made a few years ago, and we thought to bring it back, and post it on the blog because it shows so many of the different dental services we provide, and it so nicely imagines all the different patient needs that are accommodated at all three Archer Dental locations in Toronto every single day.

Each of the seven characters has real personality and different oral health requirements, and so in this respect the video could be showing ‘a day in the life’ at any one of our three dental clinics.

smiles video

Nelly is nervous and gets laughing gas to help her through her treatment. We think it’s terrific how the cartoon graphics depict Nelly dreaming of puppy dogs wearing sweaters while getting her teeth cleaned. The voice over narrator laughs a little when she introduces Noah who can wear his propellor beanie during a pediatric dentistry appointment.  Harry’s single origin coffee bean obsession is a terrifically creative way to introduce the need for teeth whitening and making ‘Insta-worthy’ social media profile pictures. Stunt double Donna noticed her smile was going off-track and so she received 3D digital scan of her teeth and a little course correction with an orthodontic treatment and Invisalign. William needs wheelchair compatable dental services. Grandma Gertrude chooses Archer Dental for her sensitive teeth and relaxes on lavender scented pillows while watching Netflix. Lucha Lucas gives his all in the ring (nevermind the boxing goves as we all know Lucha is always wrestling and never boxing), but when he loses a tooth he receives a dental implant from Archer Dental.

We love this little video, and we hope you enjoy it too.

Leading Men Who Gave Their Front Teeth For Movie Roles

Johnny Depp waves goodbye showing gold teeth, veneers, gold capped teeth

“I’d give my eye teeth to play that part,” the actor says, and the casting director should not doubt this leading man’s sincerity; there are many examples of A-list Hollywood actors who’ve had advanced dental surgery to either prepare for iconic movie roles, or to actually adopt their character’s dental perspective.  The practice goes all the way back to the Golden Age of cinema with UK horror movies and continues today with Jerry Bruckheimer’s classic Pirates of the Carribean series. Here’s a list of some of the iconic characters and the actors who gave their front teeth for movie roles.

Boris Karloff removed dentures for The Haunted Strangler (1958)

Boris Karloff as the The Haunted Stranger, 1958, dental modification for classic horror movie roleThe Haunted Stranger is a 1958 British horror film directed by Robert Day, and a decidedly low budget production. In this story, the famed horror-movie actor Boris Karloff took it upon himself to design the slow transformation from average man into the the Haunted Strangler character by altering his own face. No producer or director would have ever asked a screen actor like Boris Karloff (already famous from iconic roles in the 1930s) to do such a thing, but he volunteered, as the story goes to remove his lower false teeth to make his appearance more ghastly. He did this to achieve the gaunt, undead appearance of the film’s antagonist. His bottom lip (and maybe top lip too) were then further constricted with wire to enhance the terrifying appearance. It doesn’t seem like much compared to the rest of the list below, but it marks the first time a leading man altered his own real-life dental situation to help make his on-screen performance more believable.

Nicholas Cage had baby teeth pulled for Birdy (1985)

Nicolas cage loses teeth for movie role, dentist for moviesTo prepare for the role playing wounded Vietnam veteran, Al Columbato, in Birdy, a young Nicolas Cage had two teeth removed without anesthesia to better understand the character. The extraction of the actor’s baby teeth had been planned previously, but Cage scheduled the procedure to coincide with shooting schedule and lend to his experience playing a Vietnam war veteran with horrible facial injuries. “They were baby teeth,” the future Oscar winner told the Telegraph’s Anne Billson in 1985. “So I took advantage of it and had them out. I thought it would add an interesting dimension to the role.” Cage also took to wearing a bandage around his head during filming, which when removed gave him a sinister, sickly appearance due to the resulting acne and ingrown hair.  For his pain and suffering, Nicolas cage was well paid, and while the movie was not a huge commercial success, the Alan Parker film won the grand jury prize at Cannes, and if nothing else, helped establish Cage’s reputation for risk-taking.

Brad Pit rechipped a front tooth for Fight Club (1999)

Brad Pitt broken tooth dentistry during Fight Club movie productionFor his role as Tyler Durden in Fight Club, Brad Pitt felt that his character wouldn’t have perfect chompers if he spent his free time fighting strangers in a basement. Brad already had a chipped tooth, and so he had his dentist remove the fake portion of the tooth prior to shooting. It’s not like he broke his teeth to play Tyler, he just found an opportunity to be closer to the character that already existed inside his mouth.  When Fight Club came to the theaters in 1999, it was a disappointment financially as North American audiences were overwhelmed with Tarrantino’s Dusk till Dawn and other violent films at the time.  People probably felt that this movie which had ‘fight’ in the title was yet another violent offering.  But they were wrong and while many missed it in the theatre, the DVDs sold off the shelves. Today, this movie has a tremendous cult following and the Tyler Durden character will live forever in the minds of future generations. His existence is a parable for what evils may await people who don’t take proper care of their teeth.

Jonah Hill wore prosthetics in Wolf of Wall Street (2013)

Jonah Hill ads Donnie in Wolf of Wall Street with huge prosthetic front teethA famed Hollywood dentist name Gary Archer created removable dental veneers for Jonah Hill to wear in The Wolf of Wall Street (2013).  In this movie the Jonah Hill ‘s character was a wealthy young stock broker who had perfect white teeth which were veneers but not really, they were instead a top-of-the-line acrylic disguise. More specifically, they were a highly polished and glazed acrylic that Jonah could wear over his own real teeth. He could snap them in and out of his mouth, and leave them in a case in the make-up trailer when he wasn’t on set.  The story is that Jonah Hill had to learn how to speak again with the extra big teeth in his mouth and he used the awkwardness to play Donnie, because he could not kick a very audible lisp. In the days and weeks before filming however the actor spent several hours calling various speech therapy businesses to reduce the lisp. Hollywood actors can overcome anything and when you listen to him talk in the movie you cannot hear any issues with his words.  During the fight scene between Brad and Donnie, Jon Bernthal actually punched Jonah Hill for real. In fact, he punched him so hard that Hill’s prosthetic teeth split and fell out of his mouth. Scorsese then filmed the actor’s swelling face for the movie.

Ed Helms removed a dental implant for The Hangover

ed helms missing tooth, removed dental impant for The HangoverIn the 2009 smash hit comedy The Hangover Ed Helms’ character wakes to discover, eventually, that he lost a tooth after taking a punch from Mike Tyson. The image to the left was so iconic it was on the movie posters.  In the film he loses his tooth, but inreality Helms pulled out a tooth implant that he already had in his mouth from when he was a teenager. The actor is one of the rare sufferers of …. which is when an adult tooth does not appear in the mouth.  If this were the still the 1800s, he would have a very awkward smile, but instead he received a permanent implant when he was 16yrs old.  Upon learning that he had the role and after experiementing with several ways to make the character lose the tooth that the script called for, Helms called his own family dentist and asked about having the implant removed. To make it more authentic, reports state that the crown was broken off, and the post unscrewed from the implant. Medical professionals fashioned a guard to the gum to stave off infection.

Rami Malek wore a prosthetic overbite as Freddie Mercury in Bohemian Rhapsody (2018)

Rami Malek wore prosthetic front teeth to play Freddie Mercury in Bohemian RhapsodyRami Malek wore prosthetic teeth in the 2018 biographical drama film about Freddie Mercury, the lead singer of the British rock band Queen.  The movie follows the singer’s life from the formation of the band up to their 1985 Live Aid performance at the original Wembley Stadium. In one scene, Freddie Mercury approaches Brian May and Roger Taylor after their band Smile had just split up. He told them he wanted to be their new singer. “Not with those teeth, mate” was their reply. Also in the script, Freddie explains, “I was born with four additional incisors. More space in my mouth means more range.” And after giving them a singing demonstration, Freddie lands the role that will make him famous. In real life, Mercury is frequently said to have been embarrassed about his large overbite. But with a net worth of $60 million on his death in 1991, aged 45, Mercury could easily have paid to address what’s known as an anterior overjet or a class II malocclusion, which he probably inherited from his mother. Caused by four extra teeth at the back of his mouth pushing the front ones forward, he could have suffered health issues as a result of the teeth damaging his mouth, and he could also have had to deal with eating difficulties.

Johnny Depp had gold caps on front teeth during Pirates movies Johnny Depp had gold crowns in all Pirates of the Caribbean movies

For his role as the swashbuckling Captain Jack Sparrow in Pirates of Caribbean, Depp underwent extensive gold capping of his teeth. He held onto the gold caps until filming closed on Pirates 3 after which he endured the painful process of removing the caps. Depp complained to trade magazines about the pain he felt during the process but honestly, with today’s anesthetics and topical gels he probably had only minimal discomfort.  Modern dental needles are much smaller and finer pointed so that most patients are pleasantly surprised how little they experience after their lips and gums go numb. Gold is much more forgving as a tooth structure compared to porcelain which needs to be thicker. And it’s easier for dentist to cut into gold metal and easier to see due to the color contrast. But there is a reason only Hollywood villians and music rappers wear gold on their front teeth.

Downtown Toronto Dentist, Emergency Dental Courier Bike Ride

Archer Dental Rosedale emergency dental courier delivery

On Wednesday the 12th of June 2019, at approximately 1:00 pm in the afternoon, a speedy bicycle courier transported a freshly constructed flipper (a temporary bite device made from denture acrylic that resembles the patient’s gums, and supports the replacement tooth) between Archer Dental’s two downtown Toronto dental clinic locations.  It’s a great ride that glimpses the city on a busy day.

The one-way cross-town trip takes seventeen and a half minutes to complete and shows congested intersections, public transit and life in the downtown core of Canada’s biggest city. The bike courier who supplied the video told us he could have done the ride in half the time, but instead of going all out, he stuck to the bike lanes and obeyed the signal lights.  The ride begins at Archer Dental Rosedale (600 Sherbourne St) in Bloordale Village, and the courier takes a direct route west along Gerrard St through the University of Toronto campus (where you can see the Graduating Class of 2019 Convocation Ceremonies occurring) all the way west along the College St bike lanes right to Archer Dental Little Italy (564 College St)   If you are a cyclist you will enjoy the speed (and he makes no huffing and puffing sounds!) and if you are from out of town you will enjoy seeing the urban scenery and faces of the residents as the camera zooms past.


How Everyday Acids & Bases Affect Oral Health & Human Homeostasis

Oral Health and Human Homeostasis

Human saliva has been linked to general health & wellness ever since Aeschylus, the ancient Greek tragedian penned, in 455 BCE, “I have learned to hate all traitors, and there is no disease that I spit on more than treachery.”  When everyday acids erode your teeth and cause cavities, it feels like treachery!  It causes sufferers to wonder if they’re cursed somehow; all their brushing and flossing seems to be in vain as regular check-ups continually discover new issues.  Well of course they are not cursed, or destined to suffer regardless of their efforts, these people may have chemically imbalanced mouths and for the reasons we discuss below, they have slipped out of their natural homeostasis.

What is Homeostasis?

Walter Cannon, Homeostasis

Walter Cannon -1926, The Wisdom of the Body

The concept of the regulation of the internal environment was described by French physiologist Claude Bernard in 1865, but the word homeostasis which we still use today, was coined by American physiologist Walter Cannon in his ground-breaking 1926 book, The Wisdom of the Body. He defined the term as the human body’s ability to regulate certain factors like its own internal temperature and the concentration of lubricating substances like tears and sweat.  At Archer Dental we look for signs the body is manufacturing enough saliva, the lubrication for teeth, and whether or not it exists at the correct pH balance. Measuring and regulating the pH level of tears, tissue, hair, urine and saliva can yield important insights into patients’ medical heath.  Each of these fluids, including your blood, can tell stories about what’s happening inside your human body.  At Archer Dental we’re concerned primarily with your oral heath, but in a more holistic perspective we do try to make ourselves aware of each patient’s general homeostasis.

In biology, homeostasis is the state of steady internal physical and chemical conditions maintained by living systems. This dynamic state of equilibrium is the condition of optimal functioning for the organism and includes many variables, such as body temperature and fluid balance, being kept within certain preset limits (homeostatic range). Other variables include the pH of extracellular fluid, the concentrations of sodium, potassium and calcium ions, as well as that of the blood sugar level, and these need to be regulated despite changes in the environment, diet, or level of activity. Each of these variables is controlled by one or more regulators or homeostatic mechanisms, which together maintain life.  The connection between oral health and general health has been proven.  In the year 2000, the U.S. Surgeon General declared that oral health reflects general health and is essential to achieve a state of wellness.

What Makes A Healthy Mouth?

There are lots of bacteria and other things alive in your mouth.  That’s a fact. Even after a thorough brushing and swishing with mouthwash, some some of these tiny organism will always remain. New research into the dental microbiome expands what we know about bacteria on teeth. New scientific studies show how how unhealthy mouths may be implicated in non-oral health outcomes such as heart disease and stroke.  A lot of the science explores the energy and growth environment available to the tiny organisms, and how humans inadvertently make it so easy for malign forces to multiply in their otherwise healthy mouths. The enemy thrives in acid.

acid base beverages

Tap water is pH level 7 which is exactly neutral; water is neither an acid nor a base.  As the numbers get smaller than 7, the substance becomes more acidic, and as they get larger than 7 (up to 14), it becomes more alkaline or basic. Saliva in a healthy mouth can range anywhere from pH 6.4 to pH 7.6. These numbers vary widely when eating foods and drinking liquids. Even a normal meal has wide pH level variances.  Cooked lean meat is quite acidic, while steamed broccoli and egg plant are very alkaline – good meals balance pH loads!  Coca cola is quite acidic, while carrot juice is the same strength alkaline.

Studying the pH level of saliva important to oral health care and there are plenty of everyday acids that we put in your mouths that can erode our teeth.  Healthy human saliva has a pH of 7.4, just like blood.  When acidic foods and beverages are consumed, the pH is tipped, creating an imbalance that demineralizes tooth enamel.  This happens when the pH levels in the mouth drop below 5.5.

Studies show, and the video embedded below chronicles in real time, how the pH level of your saliva can drop below 5.5 when drinking acidic beverages. When this happens, the acids in your mouth start to demineralize (break down) tooth enamel. If the tooth enamel becomes too thin, the dentin is exposed. This can lead to discomfort when consuming hot, cold, or sugary drinks  When teeth experience demineralization, this erosion causes a thinning of the enamel, exposing the dentin.  Dentin is bone-like, but it contains microscopic tubules that lead right to the pulp, where the nerves are.  If tooth enamel is eroded, consuming hot, cold, or sugary drinks can become quite painful.

Everyday Foods and Beverages that Affect pH Balance of Saliva

Our teeth are exposed to acid everyday. When you eat or drink something sour and it tastes tart, then you are tasting the acid.  Even when you cannot taste it, after you consume something sugary or starchy, oral bacteria eats whatever food remains in your mouth after meals and produces acid as a waste product.  Also people who suffer from strong acid reflux or who vomit regularly also expose their teeth to their own strong stomach acid, which can increase tooth decay.

acidic soft drinks, alkaline soda pop

Notice that when one drinks soft drinks (pH 3) or white wine (pH 4) it feels like there are socks on the teeth, or they feel fuzzy.  That is because the pH in the mouth is not balanced. It is acidic, causing de-mineralization of the enamel.

Naturally acidic foods include citrus fruits of course, and strawberries, but you may be surprised to learn that, according to the US Food and Drug Administration, some vegetables can also be quite acidic, like green cabbage (pH 5.5) and also everyday foods like cheddar cheese (pH 5).  Cherries are particularly acidic as they register at pH 4 raw, and they’re even more acidic when frozen (pH 3.32). You can read more in a recent Archer Dental blog post about healthy snacks that are surprisingly bad for your teeth.

Alkaline mineral waters can decrease bone resorption and even lower parathyroid hormone levels which regulate the release of calcium from bone. An alkaline diet is one that incorporates foods that can increase the pH levels. Interestingly, an alkaline diet is associated with an increase in growth hormone which can burn fat, improve libido, and help people retain a general sense of well-being.  Alkaline foods are harder to identify – they are not sweet or sour or tart. The best examples of alkaline food you might choose to eat are nuts, cheese, oatmeal, mangos, melons, bananas, apples, eggs, vegetables, brown rice and whole grain cereals.  We’ve blogged about the Dental Diet last summer.

Tooth Enamel

CGI inside human mouthTeeth, and more specifically tooth enamel is the hardest substance produced by the human body.  Its harder than bone and claws (fingernails and toenails) and kidney stones. But unlike other body parts, it’s highly susceptible to acid erosion.  All it takes is a prolonged environment of pH 5.5 or lower for the enamel on your teeth to begin dissolving.  This happens all the time, in tiny electrochemical assaults every time we put food in our mouths and eat a meal.  Once tooth enamel is damaged, it cannot be easily repaired. However, weakened enamel can be restored to some degree by improving its mineral content, and this is done by improving your diet and taking mineral supplements.  Toothpastes and mouthwashes can never rebuild teeth, but they can contribute to the body’s own remineralization process.

Enamel and hard tooth structures demineralize at pH of 5 or 5.5. During the demineralization process, calcium ions from our teeth leave enamel and make them weak or porous. That is until saliva can assist saturating the enamel back to its original form.  This is another good reason why you should drink water with your meal and make sure you rinse your mouth thoroughly at the end of the meal with water and not wine or beer.  The pH level of wine ranges from 2.5 to 3.5, being quite acidic.

Saliva: The First Line Of Defense

The best natural defense our teeth have against acids is saliva, which has a pH slightly above 7. Saliva washes food particles away and helps keep oral bacteria populations in check. This is why dry mouth is such a dangerous problem for oral health. The less saliva we have, the more vulnerable our teeth are.

Sipping soda or snacking throughout the day is also a problem for our teeth, because saliva needs time to neutralize our mouths afterward, and constantly introducing more acid makes that much harder. Behavioral factors can explain why some folks have great teeth and others suffer.  Poor choices and bad eating and drinking habits lead to the excessive consumption of acids. The lifestyle and biological factors like composition of saliva, flow rate, buffering capacity, dental and soft tissue anatomy, pellicle formation, dental and soft tissue anatomy, tooth composition, can all modify the erosive process. If you are incorrigible soda pop consumer, then you really should tell your dentist. This is one of the criteria included in a recent blog post about things you should tell your dentist.

A More Alkaline Diet Will Help Your Teeth

A great way we can help out our saliva in the fight to protect our teeth, aside from the usual methods of daily brushing and flossing and regular dental appointments, is to eat fewer acidic foods and trade them for alkaline ones. That means adding in more fruits and veggies and leaving off some of the breads, dairy, and meats.

Some Things You Should Tell Your Dentist

intake form at dentist office Toronto

During your first visit to a dental clinic, when you meet your new dentist for the first time, he or she should transform into a mini health detective already at work on their next big case, your teeth.  Dentists can gather a lot of clues all by themselves, just by looking in your mouth.  But if they ask you questions when you’re sitting in the chair, well there are some things you really cannot lie about as they can easily check for themselves.

Generally speaking, your dentist won’t ask about your love-life like your hairdresser does, or about your driving habits like your mechanic does, nor will they pry into your private life like your personal doctor. But they do ask important questions about your medical history and possibly your diet, and they may ask about your lifestyle if they see you have mouth piercings.  That’s good. It proves they are professionals who care about your overall health.  If they’re asking odd questions, then you should probably give honest answers.  There are some things your dentist should know.

Dentists and Medical History Forms

Raymi filling out forms at the dentist

Filling out medical forms at the dentist

Nobody likes writing about themselves, or filling out medical forms filled with personal details. Why is all this information even necessary? You may wonder where all the data ends up, and what about identity theft?  Don’t worry.  At Archer Dental, all information you provide on your medical history questionnaire is kept strictly private, and is protected by doctor-patient confidentiality. It will not be shared with anyone outside our office without your permission. Every field on Archer Dental’s intake forms has been included for a reason as your information helps dentists better understand your over-all health.

Medical history forms at the dental office may request for info that doesn’t specifically relate to your mouth, but you have to trust the process, and understand that your dentist needs background data and especially medical details as they relate to your general health and any medications you’re using.  Just about every medicine can have dental health implications, and certain health conditions also require notification; diabetes, leukemia, oral cancer, pancreatic cancer, heart disease, and kidney disease are all ailments that need to be disclosed to your dentist.

Diabetes, for example, increases risk of gum disease.  Heart problems and digestive problems and medicines to remedy these conditions can also have dental related side-effects.  Are you taking birth control pills? If you are taking birth control and your dentist gives you antibiotics, that medication can render your birth control ineffective.  If you’re on a blood thinner and you need a tooth removed, a conversation about the medication you are taking is absolutely necessary, as you may experience excess bleeding following the dental surgery. Blood clotting can be affected by many conditions, such as liver disease. Medications, including aspirin and even some herbal preparations, can also interfere with normal blood clotting.

testosterone vials - drugs with steroids

Vials of testosterone medication, Frank Rumpenhorst / dpa / AP file

Some modern pharmaceuticals have steroids which can reduce the effectiveness of your immune system.  Patients who are using such remedies need to take preventive antibiotics before certain dental procedures are performed. For example, patients with an artificial heart valve may need to take an antibiotic prior to certain treatments to help prevent a serious infection from occurring.  Are you on any pain medications? Do they make your mouth feel dry? Some medications cause dry mouth, which can increase your chances of getting a cavity as the drug restricts the flow of cleansing saliva in your mouth.  If you tell you dentist this, you can have a conversation that could yield remedies for better long term care.  It’s your responsibility to make sure your dentist is aware of all medical concerns before any treatments begin. Information about the medicines you are using is vital to your oral health.

When Dentists Ask About Your Life

After your first initial visit, let your dentist know whenever there is a change in your current health status.  Examples of changes in your health status might include becoming pregnant, or starting any new medications, new allergies, or maybe increased smoking.  It’s important to keep your medical record up to date so that your dentist can provide you with the best care possible.  Make a point to bring it up before the session really begins as you can hardly talk them when they have their fingers in your mouth. But questions should get answers all the same.

There are even some foods that should be discussed.  Are you passionate about your afternoon teas and morning coffees?  Medical studies always say these beverages, in moderation, have positive effects on our body, but when it comes to our teeth they actually weaken and stain them at any level of consumption. Of course, if you’re eating too many sweets, or prefer synthetic foods or drink soda pop everyday, well this can have more of an effect on your oral health, and your mouth will likely require a deeper cleaning when you go to the dentist.  Tell them your habits so they can tackle the problem immediately.

Tell Your Dentist about Strange Pains and Discomforts

Rob in dentist's chair with natalie archer dentist Toronto

One on one with dentist Dr Natalie Archer

Have you ever experienced discomfort in your teeth or gums, but it disappears after a few days, and so you forget to mention it to your dentist. This could be a big mistake.  Its true you only visit the dentist a couple of times a year, and remembering things like that might require writing them down.  But any mouth pain and even unusual sensitivities is certainly something worth mentioning. Make sure to point out strange sensitivity, odor, pain or any change in your mouth.  Sometimes your oral health can be a caution-light blinking a warning about serious disease, or a related health issue, and other times it may be that your body’s battle with illness is affecting your oral health.

Are you Scared of the Dentist?

filling medical forms dentistIf you are feeling particularly anxious, or scared, well this is also something else you should discuss with your oral health care providers. If they know you’re an anxious dental patient, they can prepare a calmer environment, and select sleep dentistry and laughing gas to really put you at ease. Sometimes dental patients can receive pain medication before major surgeries as well as afterwards during recovery.

Sometimes your dentist may wish to speak with your family doctor or medical specialist to get more details about your medical situation. If your dentist needs to consult with your doctor or another health-care provider, this will be discussed with you first. It is very important for your dentist to understand as much as possible about your past and current health condition. It also means that it is important for your dentist to take an initial complete medical history, and to keep it up-to-date by checking with you on a regular basis. As you can see, your medical health and your dental health are closely linked. You and your dentist are partners, working together to provide you with the best possible dental care.

Tooth Floss Threads Dental Medical History in Canada

cute guy tooth floss bathroom

‘Don’t be a savage’ is what well-mannered folks might say when they see their friends picking their teeth with business cards or any bits of paper handy on the table after a meaty dinner.  But Early Man didn’t have anything so fine as paper or thread. The best oral device that a savage could hope for was a sharp pointed hardwood splinter or fractured bone. Whoever came up with the idea of tooth floss?

Levi Spear Parmly, an American dentist in Canada invented tooth floss.

Levi Spear Parmly, a practical guide to the management of teeth

The man credited with inventing tooth floss was an American dentist named Levi Spear Parmly who was a prolific traveler and writer of medical dentistry books.  It was Parmly who introduced the idea of using waxen silk thread as dental floss.

That may not be the first-ever use, but it’s the first time the idea appears in print, in his book, A Practical Guide to the Management of Teeth.  In this text he stated that the silk thread should be run “through the interstices of the teeth… to dislodge that irritating matter which no brush can remove, and which is the real source of disease.”

Levi Spears Parmly, incidentally, also wrote Canada’s first dentistry book.  At some point in those two turbulent decades at the beginning of the 1800’s (there was a War in 1812 remember) he traveled from Vermont to Montreal, and after a short stay there he moved up river to Quebec City where he wrote and published the 65-page Summum Bonum in 1815.  The name is a Latin expression meaning “the highest good”, a Classical idea that was first introduced by the Roman philosopher Cicero. The book was published by John Nielson, a Scots-Quebecer politician and the editor of the newspaper La Gazette de Québec (The Quebec Gazette)  in what was then Lower Canada.

Although historians credit Parmly with the invention of modern dental floss, the first patent for dental floss was granted in 1874 to Asahel M. Shurtleff for An Improved Pocket Thread Carrier and Cutter that resembled modern floss packages.   Shurtleff was a partner in a Massachusetts medical devices company called Codman & Shurtleff which made and sold tooth floss comprised of unwaxed silk thread.  The business was not terrifically successful as dental floss didn’t become popular right away.  This medical supplies firm was acquired by Johnson & Johnson ninety years later in 1964.

What is modern dental floss?

close-up dental patient uses tooth floss to clean between teeth

Today we know dental floss as an impossibly strong cord nylon filament that’s used to remove food and dental plaque from between teeth in areas a toothbrush is unable to reach. Tooth floss is a relatively new medical product because there wasn’t suitable materials for widespread adoption until the invention of nylon thread. Ordinary household sewing thread (cotton thread) wasn’t strong enough to withstand the wear and tear of passing between teeth, and the stronger silk dental floss was hard to obtain in North America because it was a luxury item and too expensive to use as a utility textile. Plus the public demand wasn’t there yet. Training people to use tooth floss would take another half century.  In July 1898 Johnson & Johnson patented and marketed waxed silk floss in 12 and 24 yard spools. It was initially packaged in flat round metal containers, and then that evolved into more practical cylindrical tins that held a small amount of floss with a built-in sharp edge that allowed consumers to cut specific lengths, much like today.

Flossing teeth with nylon thread is the modern refinement of a very old idea.

monkey, chimp uses human hair as tooth flossWhile we don’t know the exact beginnings of tooth flossing, but it looks like as long as food has been getting stuck in our teeth we’ve used some type of inter-dental cleaner. Discoveries have been made that suggest cleaning between teeth was practiced as early as the Prehistoric period.  The act of tooth flossing can be observed in higher primates living in nature, as more than one species of monkeys practice flossing. The phenomenon has been most prominently observed in Thailand where Long-tailed macaque monkeys have been known to pull out hair from their human visitors and use it as floss. They have also been observed flossing with coconut fibers or twigs, and mothers have been observed showing children how to do it properly.

Despite being introduced at the beginning of the 19th century, tooth flossing didn’t catch on right away. Victorian’s were more interested in using fancy toothpicks rather than touching their teeth. Gold and ivory handled toothpicks were a status symbol to flash after fancy dinners and the Victorians loved knick-knacks.

Tooth Flossing Went Mainstream When New Materials Lowered Prices

It wasn’t until the mid-20th century that flossing became more widespread and that was due entirely to the high price of silk in the United States and Canada. It wasn’t cheap. During World War II it was especially precious and conserved as a strategic resource.  Right after the war, Dr. Charles C. Bass, known in the USA as The Father of Preventive Dentistry, developed nylon floss, noting that it was more elastic and durable than silk. After the war, the daily ritual of flossing teeth went mainstream across the Western Hemisphere and then all over the world.

Modern Tooth Floss

Tooth floss is still made of nylon, but now there’s a lot more options including dental tape, waxed floss or woven floss. There are pre-threaded floss picks and floss threaders for orthodontic patients; there are even devices that floss your teeth with water or compressed air.

All in all, it doesn’t much matter what you use to floss, what matters is that you do! Correct daily flossing can make all the difference in your oral health and is one of the simplest ways to prevent tooth decay. So, since human beings have been cleaning between their teeth for centuries, all we have to say is keep up the good work, and floss on!

Biodegradable tooth floss products clean teeth and give consumers some peace of mind knowing they are helping the environment.  All-natural floss is biodegradable and becoming more popular in the marketplace. The threads are designed to be strong when you need them but to break down rapidly and not harm the planet.  Several environmentally-friendly alternatives to nylon floss  exist today that produce almost no waste.

History of floss pick

The Flosspick schematic for patent library of congress, tooth flossing device A floss pick is a disposable oral hygiene device generally made of plastic and dental floss. The instrument is composed of two prongs extending from a thin plastic body of high-impact polystyrene material. A single piece of floss runs between the two prongs. The body of the floss pick generally tapers at its end in the shape of a toothpick. There are two types of angled floss picks in the oral care industry, the ‘Y’-shaped angle and the ‘F’-shaped angle floss pick. At the base of the arch where the ‘Y’ begins to branch there is a handle for gripping and maneuvering before it tapers off into a pick.

Floss picks are manufactured in a variety of shapes, colors and sizes for adults and children. The floss can be coated in fluoride, flavor or wax. In 1888, a practitioner named B.T. Mason wrapped a fibrous material around a toothpick and dubbed it the ‘combination tooth pick.’  In 1916, J.P. De L’eau invented a dental floss holder between two vertical poles.  In 1935, F.H. Doner invented what today’s consumer knows as the ‘Y’-shaped angled dental appliance, the schematic pictured to the left.  In 1963, James B. Kirby invented a tooth-cleaning device that resembles an archaic version of today’s F-shaped floss pick. In 1972, an inventor named Richard L. Wells found a way to attach floss to a single pick end.  In the same year, another inventor named Harry Selig Katz came up with a method of making a disposable dental floss tooth pick.  By the end of 1980’s, floss-picks became mass marketed in many different shapes and sized disposable appliances.