Many people consume carbonated beverages, fruit juice and highly acidic foods every day but probably don't realize that they may be harming their teeth. The acid in the foods we eat and drink can cause tooth enamel to wear away and teeth can become sensitive and discolored. In many cases, it's not what you eat and drink that is as important as how you consume these foods.

What is tooth erosion?

Tooth erosion, or tooth wear, is the loss of tooth structure caused by the weakening of dental enamel. Dental enamel is the thin, outer layer of hard tissue that helps maintain the tooth's structure and shape. When the enamel weakens, it exposes the underlying dentin (the tissue that makes up the core of each tooth), causing the teeth to appear yellow.

What causes tooth erosion?

Tooth erosion may occur when the enamel on your teeth is weakened by the acid found in many foods and drinks. Usually the calcium contained in saliva will help remineralize (or strengthen) your teeth after you consume small amounts of acid; however, the presence of a lot of acid in your mouth does not allow for remineralization. Acid can come from many sources, including the following:

• Carbonated drinks. All soft drinks (even diet varieties) contain a lot of acid and can dissolve enamel on your teeth very quickly.
• Fruit juice and wine. Juice and wine have similar effects on your teeth because they contain acid.
• Fruit, pickles, yogurt and honey. These foods are acidic; don't let them linger in your mouth. Swallow them as soon as you've chewed them enough.
• Bulimia and acid reflux. Bulimia and acid reflux also can cause tooth damage from stomach acids coming into contact with teeth. Medical and dental help should be sought for anyone who suffers from either of these conditions.

What are some signs of tooth erosion?

Acid wear may lead to serious dental problems. It is important to notice the signs of tooth erosion in its early stages (sensitivity, discoloration and rounded teeth) before more severe damage occurs (cracks, severe sensitivity and other problems).

• Since protective enamel is wearing away, you may feel a twinge of pain when you consume hot, cold or sweet food and drink. As more enamel is worn away, teeth become increasingly sensitive.
• Teeth can become slightly yellow because the thinning enamel layer exposes the underlying dentin.
• Rounded teeth. Your teeth may have a rounded or 'sand-blasted' look.
• Your front teeth may appear slightly translucent near the biting edges.
• Advanced discoloration. Teeth may become more yellow as more dentin is exposed because of the loss of protective tooth enamel.
• Small cracks and roughness may appear at the edges of teeth.
• Cupping. Small dents may appear on the chewing surface of the teeth. Fillings also might appear to be rising up out of the tooth.

What can I do to prevent tooth erosion?

Because there are different reasons why you may experience tooth erosion (swishing carbonated drinks, drinking a lot of juice or wine, eating disorders), talk to your dentist about your habits so that a plan for preventive action can be determined. Be smart about how you consume acidic foods and you can continue enjoying the things you like.

Here are some general ways to protect your teeth:

1. Reduce or eliminate drinking carbonated drinks. Instead, drink water, milk or tea — but skip the sugar and honey!
2. If you must consume acidic drinks, drink them quickly and use a straw so that the liquid is pushed to the back of the mouth. Don't swish them around or hold them in your mouth for long periods.
3. Don't let acidic foods linger in your mouth; swallow them as soon as you've chewed them enough so that they are ready to digest.
4. Instead of snacking on acidic foods throughout the day, eat these foods just during meal times in order to minimize the amount of time the acid is on the teeth.
5. After consuming high-acid food or drinks, rinse with water to neutralize the acids.
6. Chew sugar-free gum to produce more saliva, as this helps your teeth remineralize.
7. Brush with a soft toothbrush and be sure your toothpaste contains fluoride.
8. Your dentist may also recommend daily use of a toothpaste to reduce sensitivity (over-the- counter or prescription strength) or other products to counter the effects of erosion.

Your teeth are covered with plaque, a sticky film of bacteria. After you have a meal, snack or beverage that contains sugars or starches, the bacteria release acids that attack tooth enamel. Repeated attacks can cause the enamel to break down and may eventually result in cavities.

When diabetes is not controlled properly, high glucose levels in saliva may help bacteria and plaque thrive. Plaque that is not removed can eventually harden into tartar. When tartar collects on your teeth, it makes a thorough cleaning of your teeth more difficult. This can create conditions that lead to chronic inflammation and infection in the mouth. Diabetes lowers your resistance to infection and can slow the healing process.

What you can do

• Reduce or eliminate sugars and starches from your diet, eat healthy foods and exercise regularly.
• Brush twice a day with fluoride toothpaste and clean once a day between your teeth with floss or an interdental cleaner to remove decay-causing plaque.
• Keep teeth and gums strong by keeping track of blood sugar levels. Also, have your triglycerides and cholesterol levels monitored.
• Treat dental infections immediately. Diabetics who combine good dental care with insulin control typically have a better chance of avoiding gum disease.
• Provide your medical and oral health histories to both your medical and dental care providers.

What is a mouthguard?

A mouthguard is a flexible appliance made out of plastic that is worn in athletic and recreational activities to protect teeth from trauma.

Why should I wear a mouthguard?

To protect your mouth from injuries. The dental profession unanimously supports the use of mouthguards in a variety of sports activities. More than 200,000 injuries to the mouth and jaw occur each year.

Do mouthguards prevent injuries?

A mouthguard can prevent serious injuries such as cerebral hemorrhages, incidents of unconsciousness, jaw fractures and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouthguards are effective in moving soft issue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances.

In what sports should I wear a mouthguard?

Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard. Players who participate in basketball, soft ball, football,wrestling, soccer, lacrosse, rugby, in-line skating, martial arts as well as recreational sports such as skateboarding, and bicycling should wear mouthguards while competing.

Why don't kids wear mouthguards?

Parents are sometimes uninformed about the level of contact and potential for serious dental injuries involved with sports in which the child participates. Some, though not all schools, reinforce the health advantage of mouthguards for their contact sports. Cost may be another consideration, although mouthguards come in a variety of price ranges.

What are the different types of mouthguards?

Stock mouthguard: The lowest cost option is a stock item, which offers the least protection because the fit adjustment is limited. It may interfere with speech and breathing because this mouthguard requires that the jaw be closed to hold it in place. A stock mouthguard is not considered acceptable as an facial protective device.

Mouth-formed protectors: These mouthguards come as a shell-liner and "boil- and-bite" product. The shell is lined with acrylic or rubber. When placed in an athlete's mouth, the protector's lining material molds to the teeth and is allowed to set.

Custom-made mouth protectors: The best choice is a mouthguard custom- made by your dentist. It offers the best protection, fit and comfort level because it is made from a cast to fit your teeth.

How should I care for a mouthguard?

• Clean your mouthguard by washing it with soap and warm (not hot) water.
• Before storing, soak your mouthguard in mouthwash.
• Keep your mouthguard in a well-ventilated plastic storage box when not in use. Make sure the box has several holes so the mouth-guard will dry.
• Heat is bad for mouthguards, so don't leave it in direct sunlight or in a closed automobile.
• Don't bend your mouthguard when storing.
• Don't handle or wear someone else's mouthguard.
• Call your dentist who made the mouthguard if there are any problems.

If you’re a woman, particularly age 50 or above, your dentist may be the first health professional to suspect you have osteoporosis — and refer you to a physician before the disease advances. Osteoporosis weakens bones by reducing their density. Although the disease may strike any gender at any age, the vast majority of sufferers are women over age 50. Osteoporosis is difficult to detect, and most patients are not diagnosed until their bone density has decreased to the point that a fracture occurs. However, symptoms of tooth loss or gum (periodontal) disease could indicate early stages of osteoporosis. Your dentist may detect the onset of the disease based on oral symptoms, your medical history (including risk factors) and results of a clinical and x-ray examination. This is why it’s important to visit your dentist regularly and to provide him or her with your complete medical history, even if you don’t think it relates to oral health.

Signs of osteoporosis

There are several signs that alert dentists to the possibility of osteoporosis:

• Bone loss in the jaw. This may be a sign of bone loss in other parts of the body.
• Tooth loss. Studies suggest that women with low bone mineral density tend to lose more teeth.
• Ill-fitting dentures in post-menopausal woman. Studies show that post- menopausal women with osteoporosis need new dentures three times more often after age 50 than women without osteoporosis. Bone loss may become so severe that it may be impossible to create functional dentures. Without the aid of dentures to chew many types of food, older patients may suffer severe nutritional deficiencies.

If your dentist suspects you have osteoporosis, he or she can refer you to a physician for medical assessment and subsequent treatment. In addition to scheduling regular dentist visits, you can help prevent osteoporosis by:

• Getting enough calcium each day, through diet or supplements (women/1,200mg; men/800mg; anyone over age 65/1,500mg)
• Adding vitamin D to your diet
• Exercising
• Quitting smoking
• Decreasing caffeine and alcohol intake

Brushing and flossing are important parts of your daily routine. But it's not enough to brush at least twice a day and floss at least once a day - you have to do it correctly. Here's how:

Brushing technique

• The head of your toothbrush should be placed beside the teeth, and the tips of the bristles placed at a 45-degree-angle to the gumline.
• Move the toothbrush back and forth, using short strokes and a scrubbing motion, several times in each spot.
• Keep the bristles angled against the gumline, while you brush both the inner and outer surfaces of each tooth.
• Brush the chewing surfaces straight on.
• Clean the inside surfaces of the front teeth by tilting the brush vertically and making several up-and-down strokes with the front of the brush.
• Finish by brushing your tongue, which helps remove bacteria from your mouth.

Brushing tips

• Brush your teeth gently using short strokes. Apply just enough pressure to feel the bristles against the gums. If you are squashing the bristles, you're brushing too hard.
• Replace your toothbrush approximately every two to three months or as soon as the bristles are worn or bent. A worn-out toothbrush does not clean your teeth properly, and may actually injure your gums. You should also replace your toothbrush after you've had a cold.
• Be sure you are reaching every tooth. The toothbrush can only clean one or two teeth at a time, so you should be moving the toothbrush around frequently.
• Use a toothpaste that contains fluoride.
• Avoid toothbrushes with hard bristles, which can damage your gums. Use a toothbrush with soft, end-rounded bristles.
• Ask your dentist to recommend the type of toothbrush that would work best for you.

Flossing technique

• Break off about 18 inches of floss, and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the other hand. This finger will take up the floss as it becomes used.
• Hold the floss tightly (without any slack) between your two hands, with about an inch of floss between them. Guide the floss between your teeth using a gentle sawing motion.
• When the floss reaches the gumline, curve it into a C-shape against the tooth. Gently slide it into the space between the gum and the tooth until you feel resistance.
• Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum.
• Repeat this technique on all of your teeth, including the teeth in back.

Flossing tips

• Establish a regular pattern for flossing so that you don't miss any teeth.
• As with brushing, flossing should be done gently. Improper flossing can injure your gums.
• If you have not been flossing regularly, your gums may bleed and be sore for the first five or six days. As plaque is broken up and bacteria removed, your gums will heal and the bleeding will stop.
• By age eight, children should be able to floss their own teeth. To make it easier, use a loop of floss. Simply tie the ends of a 10-inch piece of floss, forming a circle. Hold the floss tightly between the thumbs and forefingers, and use the technique above.

A floss holder can make flossing easier for those who do not have good finger dexterity. Special picks and sticks are also available to help those who find floss difficult to work with. Consult your dentist about the best technique for you.

How important is flossing? Flossing is the single most important weapon against plaque.

Floss removes plaque and debris that sticks to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. By flossing your teeth daily, you increase the chance of keeping them for a lifetime and decrease the chance of getting gum disease.

Most people cite lack of time as a reason for not flossing. However, flossing even two or three times a week has its benefits and is far better than not flossing at all.

Choosing your floss

Whether waxed or unwaxed, flavored or unflavored, wide or regular size, floss of any type helps clean and remove plaque. Here are some tips about the characteristics of different types of flosses:

• Wide floss, also known as dental tape, may be a better choice for people with bridgework. Dental tape also is recommended when people have wider-than- average space between their teeth.
• Waxed floss can be easier to slide between closely spaced teeth.
• Unwaxed floss will squeak against cleaned teeth, indicating plaque has been removed.
• Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.
• Which type you use depends upon your mouth, personal preference and dentist's recommendations.

Do not substitute waterpicks for brushing and flossing. Unlike flossing, waterpicks do not remove plaque. They are effective for people who have orthodontic braces, which may retain food in areas a toothbrush cannot reach.

How to floss

• Break off about 18 inches of floss, and wind most of it around one of your middle fingers.
• Wind the remaining floss around the same finger of the other hand. This finger will take up the floss as it becomes used.
• Hold the floss tightly (without any slack) between your two hands, with about an inch of floss between them. Guide the floss between your teeth using a gentle sawing motion.
• When the floss reaches the gumline, curve it into a C-shape against the tooth. Gently slide it into the space between the gum and the tooth until you feel resistance.
• Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum.
• Repeat this technique on all of your teeth, including the teeth in back.

Tartar control. Baking soda. Whitening action. With so many toothpastes on the supermarket shelf, how do you choose the one that's most effective?

A toothpaste with the Indian Dental Association (IDA) Seal of Acceptance is the easiest way to know the product has been thoroughly tested, is effective and has the proper mix of ingredients

For most patients IDA recommends a fluoride, tartar control toothpaste with the IDA seal. Most experts agree that as long as your toothpaste contains fluoride and has the IDA seal of approval, the brand you buy doesn't really matter. All toothpastes with fluoride work effectively to fight plaque and cavities. Of course, they also clean and polish tooth enamel.

Why is fluoride important?

Fluoride is a mineral that helps harden teeth and prevent tooth decay. It occurs naturally in small amounts in all water sources. Studies show that fluoride reduces cavities in people of all ages and is effective and safe when used correctly. The correct use of fluoride has been said to have dramatically reduced tooth decay over the past few decades.

Check for the IDA seal

For 70 years, the Indian Dental Association (IDA) has awarded its "Seal of Acceptance" to dental products that are safe and effective.

The seal generally is awarded for a three-year period, and manufacturers must reapply to continue using it. If the composition of an accepted product changes, the manufacturer must resubmit the product for review and approval.

In addition to information submitted by manufacturers, the IDA has more than 100 consultants and staff scientists who review oral health products and their effectiveness to determine whether they meet IDA standards. Today, nearly 400 dental products available to consumers carry the IDA seal, including toothpaste, dental floss, mouth rinses and toothbrushes.

Special needs and personal preferences

Some factors that go into choosing a toothpaste are usually personal preferences, such as flavor, whitening, tartar control and price. If you have small children, you might want to try some fun, flavored children's fluoride toothpaste. When deciding on toothpaste, you may also want to consider any special needs that you have such as sensitive teeth or dentures. Those with special needs should also consult their dentist.

Sensitive Teeth. If you have sensitive teeth from gum recession or tooth abrasion, you may need a toothpaste without heavy abrasives. You can also choose a desensitizing paste with either strontium chloride or potassium nitrate as an added ingredient. Expect it to take about four to six weeks to see improvement in sensitivity.

Tartar Control. Brands of toothpaste that advertise "tartar control" usually have the active ingredient pyrophosphate. While it will not remove tartar, studies have shown it will reduce tartar formation up to 36 percent. Tartar (calculus) can only be removed with a professional prophylaxis (cleaning).

Abrasiveness. Many types of toothpaste now contain baking soda, which is less abrasive than traditional toothpaste ingredients. This is advantageous for reducing tooth sensitivity in people with gum recession or for those who have eroded their teeth by rigorous brushing with abrasive toothpaste.

Whitening. Bleaching teeth to make them lighter has recently become popular. Whitening toothpastes help maintain the tooth shade after bleaching procedures. If you want the benefits of a whitening toothpaste, look for the active whitening agents of carbamide peroxide or hydrogen peroxide.

Dentures. If you wear partial or full dentures, they will stain and absorb odors. Ask your pharmacist or dentist to recommend an effective denture cleaning paste or solution.

In reality, almost any toothbrush you feel comfortable using works well. What is most important is to brush your teeth correctly – and brush them long enough. Most people brush for less than a minute, but to effectively reach all areas of your mouth and scrub off cavity-causing bacteria, you should brush for at least two to three minutes, at least twice daily.

How do you find the toothbrush that’s most comfortable for you?

Here are some guidelines from the Indian Dental Association:

1. Any toothbrush you choose should have soft bristles. Hard bristles may cause gum tissue to pull back from teeth, which can expose the tooth root and lead to increased sensitivity to heat, cold or certain foods and drinks.
2. Select a toothbrush head size that can easily fit into the mouth and can brush one to two teeth at a time (the general size is 1" long and ½" wide).
3. Powered toothbrushes don’t clean teeth any better than regular toothbrushes. However, if a powered toothbrush motivates you to clean your teeth more often and for the required length of time, it is worth the investment.
4. Powered toothbrushes are better choices than manual toothbrushes for anyone who needs assistance brushing teeth, including seniors, people with arthritis (or any condition that may limit mobility), anyone wearing braces or people with misaligned or uneven teeth surfaces that make a thorough cleaning more challenging.
5. Replace your toothbrush as soon as the bristles begin to look worn or frayed (usually every three months). A worn toothbrush does not do a good job of cleaning your teeth. Remember always to replace your toothbrush after an illness.

If you’re still undecided about which toothbrush to use, consult your dentist for advice.

If you are shopping for a child, select a toothbrush with the following characteristics:

• Soft bristles (for gentle cleaning)
• Very small heads (designed for baby teeth)
• Large handles (easier for children to grip)

In recent years, prescribed and over-the-counter medications have emerged as the most common cause of dry mouth. Suspect medications include antihistamines, decongestants, painkillers, diuretics, antihypertensive medications and antidepressants. In fact, dry mouth is listed as a potential side effect of more than 400 medications. Be sure to read the literature that accompanies your medications and, if you think a medication is causing dry mouth, tell your dentist or physician. In some cases, a different medication may alleviate the problem.

What is dry mouth?

Dry mouth is caused by a decrease in the amount of saliva in the mouth when the salivary glands do not work properly. The salivary glands help keep your mouth moist, which helps prevent tooth decay and other oral health problems. The medical name of the condition is xerostomia.

Although a common cause of dry mouth these days is medication, the condition may occur when a person experiences stress, or it may even be a sign of a serious health problem, such as AIDS, diabetes or Sjogren’s Syndrome (an autoimmune disease). Other possible causes include aging, radiation therapy and chemotherapy. People with Alzheimer’s disease or who suffer a stroke have been known to experience dry mouth.

How to relieve dry mouth

Tips on how to ease dry mouth include:

• Brush and floss twice a day
• Chew sugarless gum
• Avoid alcohol, caffeine, carbonated beverages and smoking
• Avoid certain juices (orange, grapefruit and tomato)
• Avoid dry foods, such as toast or crackers
• Avoid overly salty foods
• Use alcohol-free oral rinses
• Visit your dentist regularly. Ask your dentist for advice specific to your situation.
• If your dry mouth persists, you should contact your physician.

When it comes to chewing gum, it's the type of gum you chew that makes a difference in whether it's helpful or harmful to your teeth. While chewing gum containing sugar may actually increase your chances of developing a cavity, there is clinical evidence that demonstrates just the opposite for sugar-free gum. There's even better news when it comes to chewing sugar-free gum that is sweetened with xylitol.

Sugar-free gum helps to clean teeth

Studies have shown that chewing sugar-free gum after meals and snacks can help rinse off and neutralize the acids released by the bacteria in plaque, which are harmful to tooth enamel. Both the act of chewing and the flavor of the artificial sweeteners in the gum stimulate ten times the normal rate of saliva flow. Not only does the increased saliva flow neutralize the acids in your mouth, it also washes away food particles, helping to keep your teeth clean.

Xylitol reduces decay-causing bacteria

Sugar-free gum sweetened with xylitol has the added benefit of inhibiting the growth of Streptococcus mutans, one of the oral bacteria that cause cavities. In the presence of xylitol, the bacteria lose the ability to adhere to the tooth, stunting the cavity-causing process. With xylitol use over a period of time, the types of bacteria in the mouth change and fewer decay-causing bacteria survive on tooth surfaces.

To chew or not to chew

Although chewing sugar-free gum can be beneficial in most instances, there are some cases in which chewing gum is not recommended. For example, if you are experiencing any type of jaw pain or temporomandibular disorder symptoms (TMD/TMJ), you should refrain from chewing gum and talk to your dentist about what options are available to you.

For most people, chewing sugar-free gum (especially gum sweetened with xylitol) can be a good preventive measure in situations when toothbrushing and flossing aren't practical, but sugar-free or not, chewing gum should never replace good dental hygiene practices.

Question:

If you start smoking at age 18 and smoke one pack a day, how many teeth are you likely to lose by the time you are 35 years old?

Answer:

Between 4 and 5 teeth.

Smokers are about twice as likely to lose their teeth than non-smokers, according to the results of two separate 30-year studies at Tufts University in Boston that investigated the relationship between smoking and tooth loss among males and females.

In one study, male smokers lost an average of 2.9 teeth after 10 years of smoking one pack a day, while nonsmokers lost an average of 1.3 teeth after 10 years.

Why does smoking lead to periodontal (gum) disease, which leads to tooth loss? One theory is that tobacco may restrict the blood flow to the gum tissues, which would limit the nutrients necessary to the bone and periodontal support of the teeth. Another theory is that smoking causes a chain of events in the mouth that eventually leads to tooth loss. The chain starts with plaque build-up on teeth, which is linked to tartar build-up, which can cause gingivitis. From there, the smoker develops periodontal disease. The final result is tooth loss.

The chain can be broken by brushing and flossing regularly and by stopping the use of tobacco.

The average man is less likely to brush his teeth after every meal (20.5 percent compared with 28.7 percent for women).

The average man is less likely to brush his teeth twice a day (49 percent compared with 56.8 percent for women).

Men are more likely to develop periodontal (gum) disease than are women:

30 to 54 years: 34 percent of men compared with 23 percent of women

55 to 90 years: 56 percent of men compared to 44 percent of women.

Assessing the risk

Recent studies suggest there may be a connection between gum disease and cardiovascular disease, which can place people at risk for heart attacks and strokes. Because of this, men should be especially vigilant for signs of periodontal (gum) disease such as red, swollen, tender or bleeding gums, persistent bad breath or loose teeth.

Although it’s important for all men to be diligent with their oral care, some men should take extra care to make sure they are practicing good oral hygiene:

Men who take medications. Some medications, such as heart or blood pressure medications or antidepressants, can cause dry mouth. Men who take these medications could develop inhibited salivary flow, increasing the risk for cavities. Saliva helps reduce the cavity-causing bacteria found in the mouth by washing away food particles. Saliva also helps neutralize the tooth-attacking acids formed by plaque.

Men who have dry mouth may need to increase their water intake to ease their symptoms. Other ways to ease dry mouth include:

• Chewing sugarless gum
• Avoiding alcohol, caffeine and carbonated beverages
• Avoiding smoking
• Avoiding overly salty foods
• Using an alcohol-free mouth rinse.

Men who have inhibited saliva flow should also ask their dentist about saliva substitutes or other alternatives to promote saliva flow.

Men who use tobacco. Men who smoke or chew tobacco have a greater risk for gum disease and oral cancer. Even men who don’t use tobacco are more likely than women to have gum disease or cancer, so using tobacco increases that risk. Age is also a factor: 95 percent of oral cancers occur in those over 40 years of age.

The most frequent oral cancer sites are the tongue, the floor of the mouth, soft palate tissues in back of the tongue, the lips and gums. If not diagnosed and treated in its early stages, oral cancer can spread, leading to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery, and even death.

It is important for men who use tobacco to see a dentist frequently for cleanings and to ensure their mouth remains healthy. A general dentist can perform a thorough screening for oral cancer.

Men who play sports. Men who participate in sports have a greater potential for trauma to their mouths and teeth. When playing contact sports, such as football, soccer, hockey, basketball or baseball, it is important to use a mouthguard, which is a flexible appliance made of plastic that protects teeth from trauma. Men who ride bicycles or motorcycles should wear a helmet.

Taking care of your teeth

The following are some tips — whether you are a man or a woman — to improve your dental health:

• Brush your teeth with fluoride toothpaste for two to three minutes at least twice daily. (Choosing a toothpaste with fluoride can reduce tooth decay by as much as 40 percent.)
• Use a soft-bristled toothbrush and brush properly by positioning the brush at a 45-degree angle where your gums and teeth meet.
• Replace your toothbrush every three months or after you’ve been sick.
• Floss daily. Use the proper technique and gently insert floss between teeth using a back-and-forth motion. Curve the floss into a C-shape against one tooth and then the other.

Visit the dentist at least once a year for cleanings and exams.

not just smoking tobacco that has negative effects on your oral health: use of smokeless tobacco can be just as harmful to your oral health. The good news is that the risk of tooth loss decreases after you quit smoking or using smokeless tobacco.

Limit Your Alcohol Intake

You may already know that excessive alcohol intake can have an effect on your overall health, but did you know that it may also affect your oral health? According to the Academy of General Dentistry, those who smoke, eat poorly and consume excessive alcohol also have increased gum recession (periodontal pocketing). Their studies show that smokers who regularly consume alcohol are less likely to brush their teeth on a regular basis and are less concerned about their basic health than nonsmokers.

Brush at Least Twice a Day and Floss at Least Once a Day

Brushing and flossing protect your teeth from decay and gum disease, which is caused by your teeth’s most persistent enemy, plaque – a sticky, colorless, invisible film of harmful bacteria that builds up on your teeth every day. Both brushing and flossing are equally important for good oral health: according to the Academy of General Dentistry, only flossing can remove plaque from between teeth and below the gumline, where decay and gum disease often begins.

Without proper brushing and flossing, you may develop bleeding gums, which may worsen to severely swollen, red, bleeding gums (gingivitis) and, eventually, gum disease. Because diseases of the mouth can affect the rest of your body, it is especially important to maintain good oral health.

See Your Dentist for Regular Checkups

By seeing your dentist at least twice a year, you can help prevent any dental health problems before they cause discomfort or require more comprehensive or expensive treatment. Regular visits allow your dentist to monitor your oral health and recommend a dental health regimen to address areas of concern.

For this new year, resolve to treat your mouth right: improve your diet, quit smoking and improve your oral hygiene habits – your teeth and your body will thank you for it!

What is the condition of "sensitive teeth"?

When the tooth's hard enamel wears down or gums recede, tiny microscopic tubes located in the layer of tooth below the enamel are exposed. Tooth sensitivity is caused by the stimulation of cells within these tubes, causing a short, sharp pain when the area is exposed to hot or cold temperatures through food and beverages — or even by the air.

Another cause of tooth sensitivity is cracks in the tooth's enamel surface. Extreme temperature changes cause teeth to expand and contract. Over time, microscopic cracks may develop, allowing hot or cold sensations to seep through to the nerves beneath the tooth enamel.

What you can do

The pain of sensitive teeth can be managed with a few simple steps:

Change your brand of toothpaste. Some toothpastes increase tooth sensitivity, including whitening toothpastes that lighten or remove stains from enamel, and tartar-control toothpastes containing sodium pyrophosphate. There are toothpastes specially made for people with sensitive teeth. Be aware that these products typically must be used on a regular basis for at least a month before you notice any therapeutic benefits. (You may see benefits more quickly if you massage the special toothpaste onto your gums with your finger after brushing your teeth with it.)

Take it easy on your teeth. Avoid using hard-bristled toothbrushes and brushing your teeth too vigorously, which can wear down the tooth's root surface and expose sensitive spots. Take a good look at your toothbrush. If the bristles are flattened or pointing in multiple directions, you're putting too much pressure on your teeth.

Skip the marinara sauce. Some foods or drinks can aggravate sensitive teeth. Avoid or limit acidic items (for example, food or drink with a high concentration of tomatoes, oranges or lemons) and sodas.

When to see a dentist

If a tooth is highly sensitive for more than three or four days and reacts to both hot and cold temperatures, it’s best to get an evaluation from your dentist to determine the extent of the problem. Because pain symptoms can be similar, some people might think that a tooth is sensitive when they actually have a cavity or abscess that's not yet visible. Be sure to tell the dentist when the pain started and if there is anything (such as the application of a warm compress) that reduces or eliminates the pain.

If you are diagnosed with sensitive teeth, your dentist can prescribe one of a variety of treatment options, including both in-office treatments (applying a desensitizing agent or a protective coating to the teeth) and take-home products for personal use. If your tooth sensitivity is severe and persistent or it cannot be treated by other means, your dentist may recommend root canal treatment.

To prevent gum disease

Gum (periodontal) disease is a bacterial infection caused by plaque – the sticky, colorless, bacteria-filled film that adheres to your teeth. As plaque builds up on teeth, it hardens and becomes tartar, which can be difficult to remove. The bacteria in plaque produce toxins that irritate the gums and cause inflammation and gingivitis. If bacteria are not removed and the inflammation continues, the gum tissues can be destroyed and more advanced stages of gum disease may follow. Learn more about gum disease.

To keep your teeth

As gum disease advances, the pockets grow deeper, and plaque moves further down the tooth root, destroying supporting bone. The affected teeth may loosen and eventually fall out. Since gum disease is the leading cause of tooth loss in adults, regular dental exams and cleanings and brushing and flossing in between visits are vital to keeping your teeth. Learn more about brushing and flossing in between dental cleanings.

To have a brighter smile

Personal habits – such as tobacco use or drinking coffee, tea and other beverages – can cause tooth staining. Certain medications also can discolor teeth. Teeth cleaning by your dentist or hygienist, however, can often remove these external stains – and it promotes good oral health. In addition to removing plaque and tartar during your cleaning, your hygienist will also polish your teeth to a beautiful shine. The result? A whiter and brighter smile! Learn more about keeping your teeth white.

To prevent bad breath

Persistent bad breath (halitosis) has oral causes such as poor oral hygiene, periodontal disease, a coating on the surface of the tongue, food stuck between teeth, unclean dentures, oral carcinomas or throat infections. Good oral hygiene is essential in preventing many of these conditions and can, in turn, prevent bad breath. Regular checkups and cleanings are the best way to make sure that you are maintaining good oral hygiene. Learn more about preventing bad breath.

To help maintain overall health

There is mounting evidence of a connection between a person’s oral and overall health. Recent studies have linked heart attacks and strokes to gum disease. Although no causal relationships have been discovered, a dental cleaning every six months to keep your teeth and gums healthy could possibly reduce your risk of heart disease and stroke. In addition, if you have regular oral examinations, your dentist may be the first health care provider to diagnose a health problem in its early stages. Learn more about the connection between oral and overall health.

Economic pressures, family visits, holiday shopping – believe it or not, the season’s stresses may show up in your mouth. If you’re feeling tense or anxious, you should keep a watchful eye for signs of the following stress- related oral disorders.

Bruxism

Bruxism is the technical term for grinding teeth and clenching jaws. Although it can be caused by sleep disorders, an abnormal bite or teeth that are missing or crooked, it can also be caused by stress and anxiety. Nervous tension, anger and frustration can cause people to start showing the signs of bruxism:

Tips of the teeth appear flat

Tooth enamel is rubbed off, causing extreme sensitivity

Tongue indentations

Your dentist can examine your teeth to determine whether you may have bruxism and, if so, can suggest the best method of treatment.

TMD (Temporomandibular Disorders)

TMD refers to a group of conditions that affects the jaw joint (temporomandibular joint) and the associated muscles used in moving the jaw and neck. Stress is thought to be a factor in TMD. Stressful situations can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth (as with bruxism). But even if you aren’t seeing signs of bruxism, such as flat tips of teeth or decreasing tooth enamel, you may still experience other symptoms of TMD such as jaw joint pain or popping and clicking of the jaw. If you experience any of these, you should check with your dentist to see if TMD may be the cause.

Gum Disease

Studies at State University of New York at Buffalo, the University of North Carolina and the University of Michigan found that emotional factors played a significant role in the development of adult gum (periodontal) disease. Researchers also discovered that the severity of gum disease increased with amount of stress (from spouse, children, lack of companionship, finances or work) experienced in a patient’s previous 12 months.

In addition, the researchers found that those at greatest risk for gum disease were highly emotional in dealing with financial problems. But there’s good news: patients who dealt with their financial strain in an active and positive manner had no more risk of severe gum disease than those without money problems.

Canker Sores

Canker sores (or mouth ulcers) generally occur inside the mouth and are not contagious. They often are triggered by trauma such as biting your cheek, jabbing your gum with your toothbrush or even overzealous tooth cleaning.

Maintaining Your Oral Health When Stressed

One of the best ways to fight the negative effects of stress is to remove the source of stress. If that’s not possible, these other activities may help reduce your tension:

Counseling

Exercise such as yoga or jogging

Relaxation or meditation

Massage

Physical therapy

Depending on your symptoms, your dentist can also recommend specific treatments. For example, if you have bruxism, your dentist can fit you with a mouthguard to protect your teeth during sleep. For TMD, your dentist may suggest some adjustment, such as orthodontic treatment, to correct teeth alignment that may be magnifying orofacial pain. Check your benefits to see what treatments are covered under your dental benefits plan.

You might be surprised. In the past decade, dentists have seen a considerable increase in the number of these cases in people under 30 who have no identifiable risk factors for developing the disease.

Because oral cancer is typically painless in its early stages and often goes unnoticed until it spreads, many of these young, low-risk patients aren’t diagnosed until they are already suffering from chronic pain or loss of function. However, if detected early, oral cancer can be cured. Early detection of oral cancer improves the survival rate to 80 percent or more.

If you visit the dentist regularly, you are probably already receiving an oral cancer screening during your regular dental checkup and don’t even realize it.

The dentist checks your neck and mouth for signs of oral cancer such as discolorations, lumps or irregular tissue changes. The most frequent sites for oral cancer are the tongue, the floor of the mouth, tissues in back of the tongue, lips and gums. The exam is quick and painless.

The next time you visit your dentist, ask about your oral cancer screening. If you haven't visited the dentist recently, be sure to schedule an appointment so that he or she can check for problems before they cause pain or become harder to treat.

You can learn more about the warning signs and causes of oral cancer and what you can do to protect yourself in this article about oral cancer.

While most people are aware of the impact tobacco use has on their overall health, some might not consider its effects on oral health, including:

• 50 percent of smoking adults have gum (periodontal) disease.
• Smokers are about twice as likely to lose their teeth as non-smokers.
• Cigarette smokers are nearly twice as likely to need root canal treatment.
• Smoking leads to reduced effectiveness of treatment for gum disease.
• Smoking increases risk of mouth pain, cavities and gum recession (which can lead to tooth loss).
• Tobacco reduces the body's ability to fight infection, including in the mouth and gums. Smoking also limits the growth of blood vessels, slowing the healing of gum tissue after oral surgery or from injury.
• Smokeless tobacco (snuff or chewing tobacco) is associated with cancers of the cheek, gums and lining of the lips. Users of smokeless tobacco are 50 times more likely to develop these cancers than non-users.
• Cigars, chewing tobacco, snuff and unprocessed tobacco leaves (used as cigar wrappers) contain tiny particles that are abrasive to teeth. When mixed with saliva and chewed, an abrasive paste is created that wears down teeth over time.

Tobacco use and children

All parents, even those who do not use tobacco, should educate their children about the dangers of smoking:

• 3,000 children and teens become regular users each day (including chewing tobacco).
• Nearly one-quarter of all high school students smoke.
• Some tobacco companies target children with cherry-flavored chewing tobacco sold in colorful containers.
• Children exposed to tobacco smoke may have delays in the formation of their permanent teeth.
• Women who smoke may be more likely to have children born with an oral cleft (cleft lip or cleft palate).

What you can do

If you are a smoker or a parent with a child or teen who you suspect may be using tobacco, you can start by understanding that tobacco dependence is a nicotine addiction disorder.

There are four aspects to nicotine addiction: physical, sensory, psychological and behavioral. All aspects of nicotine addiction need to be addressed in order to break the habit. This difficulty can mean that tobacco users may need to try several times before they are able to successfully kick the habit.

The IDA strongly recommends that a dentist or hygienist perform a dental cleaning every six months. This professional dental cleaning reinforces the home-care oral health regimen of brushing and flossing and gives the dentist an opportunity to locate areas in the mouth that may need special attention.

People who regularly practice good oral hygiene at home with proper brushing and flossing techniques typically do not experience discomfort during a cleaning. However, those who have neglected their oral hygiene habits may experience some discomfort or sensitivity during a dental cleaning. The dentist can use a topical anesthetic before the cleaning to alleviate any discomfort.

During a dental cleaning, you’ll receive preventive and educational services from your dentist as well as any needed educational information.

Preventive services may include:

• Removal of plaque and tartar
• Stain removal
• Fluoride application
• Sealants (for children)
• Polishing teeth, including fillings and crowns
• Cleaning and adjustment of dentures and partial dentures

Educational services may include:

• Tooth brushing and flossing instructions
• Nutritional counseling
• Recommendations for future treatment: when to return for follow-up hygiene treatment, periodontal (gum) concerns or restorative options
• Evaluation of self-care effectiveness
• Tobacco-cessation counseling

Today’s nutritional approaches to oral health go beyond "don’t eat sugar."

Ongoing research indicates that antioxidants and other nutrients found in fruits, vegetables, legumes and nuts may strengthen immunity and improve the body’s ability to fight bacteria and inflammation, all of which can help protect the teeth and gums. And some foods and dietary habits even have distinct effects on the mouth’s ability to handle cavity-causing bacteria attacks.

For example:

• Calcium-fortified juices, milk and other dairy products are rich in calcium and vitamin D and help promote healthy teeth and bones, reducing the risk for tooth loss. Adding powdered milk to cooked dishes helps those who don’t like milk or cheese to get some of the calcium needed to protect teeth and jawbones.
• Cheese unleashes a burst of calcium that mixes with plaque and sticks to the teeth, protecting them from the acid that causes decay and helping to rebuild tooth enamel on the spot.
• Crisp fruits and raw vegetables, like apples, carrots and celery, help clean plaque from teeth and freshen breath.
• Antioxidant vitamins, such as vitamin C, and other nutrients from fruits and vegetables help protect gums and other tissues from cell damage and bacterial infection.
• Recent studies indicate that fresh cranberries interrupt the bonding of oral bacteria before they can form damaging plaque.
• Folic acid promotes a healthy mouth and supports cell growth throughout the entire body. This member of the B vitamin family is found in green leafy vegetables and brewer’s yeast.

You may already know that cavity-causing organisms feed on the sugar in foods such as soda, chocolate milk and candies and convert it to acid, which attacks tooth enamel and causes tooth decay. But did you know the following:

• Acidic foods and drinks such as carbonated drinks, citrus fruits and juices, wine, pickles and honey can cause tooth enamel to wear away and teeth to become sensitive, cracked and discolored.

Timing is everything

A diet that promotes good oral health is not just about the foods you eat or avoid — when and how you eat them is equally important.

• Foods that take a long time to chew or that you hold in your mouth (such as cough drops) can damage teeth as they hold sugar against teeth longer than do other foods.
• Instead of snacking on sugary, carbohydrate-rich or acidic foods throughout the day, eat these foods just during meal times in order to minimize the amount of time teeth are exposed to acid. In addition, the body produces more saliva to help digest larger meals, which washes away more food and helps neutralize harmful acids before they can attack teeth.