J. Peter St. Clair, DMD Blog

Bad breath is breath that has an unpleasant odor. It’s also known as halitosis. This odor can occur from time to time, or it can be long lasting, depending on the cause.

Millions of bacteria live in the mouth, particularly on the back of the tongue. In many people, they are the primary causes of bad breath. The mouth’s warm, moist conditions are ideal for the growth of these bacteria. Most bad breath is caused b1y something in the mouth.

Some types of bad breath are considered to be fairly normal. They usually are not health concerns. One example is “morning mouth.” This occurs because of changes in your mouth while you sleep. During the day, saliva washes away decaying food and odors. The body makes less saliva at night. Your mouth becomes dry, and dead cells stick to your tongue and to the inside of your cheeks. When bacteria use these cells for food, they produce a foul odor.

In addition, bad breath can be caused by the following:

Poor dental hygiene – Infrequent or improper brushing and flossing, allows bits of food that are stuck between the teeth to decay inside the mouth. Poor oral hygiene eventually will lead to periodontal (gum) disease, which also can cause bad breath.

Infections in the mouth – These can be caused by either a cavity in a tooth or by periodontal (gum) disease.

Respiratory tract infections – Throat, sinus or lung infections.

External source – Garlic, onions, coffee, tea, cigarette smoking, and chewing tobacco, all contribute to halitosis.

Dry mouth (xerostomia) – This can be caused by salivary gland problems, medicines or “mouth breathing.” A large number of prescriptions and over the counter medicines cause dry mouth. Xerostomia is a major contributor to bad breath and advanced dental decay.

Illnesses – Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others.

Bad breath caused by dental problems can be prevented easily with proper home and professional care. Your dentist will review your medical history for conditions that can cause bad breath and for medicines that can cause dry mouth.

Your dentist may refer you to your family physician if an illness is the most likely cause. In severe cases of gum disease, your dentist may suggest that you see a periodontist (a dentist who specializes in gum problems).

If the cause is systemic, you will need diagnostic tests to check for lung infection, diabetes, kidney disease, liver disease or Sjögren’s syndrome. The type of tests you get depends on the suspected illness. You may get blood tests, urine tests, X-rays of the chest or sinuses, or other tests.

The treatment for bad breath depends on the cause. As with all medical issues, it is best to follow regular professional maintenance appointments.

One of the best things you can do daily is scrape your tongue with a…..you guessed it……tongue scraper. Brushing the tongue is not advised as this pushes bacteria further into the tongue. A tongue scraper is designed to pull and collect millions of bacteria that accumulate on the tongue. If you don’t have one, ask your dentist for one at your next appointment.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

If you have sleep apnea, it’s likely that you feel pretty exhausted throughout the day. In fact, daytime sleepiness is one of the most common warning signs of this sleep condition! It may seem pretty tempting to take a nap to catch up on your sleep, but experts say don’t do it! Napping could be problematic for people who are already struggling to get quality sleep at night, and could potentially even make you more tired. Read on as we go over why you may want to consider avoiding naps, especially if you have sleep apnea.

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I’m sure we all agree that keeping up with technology is not easy. From computers to cell phones to cars, and everything in between, changes take place at lightning speed. No matter what we buy, there is always something right around the corner, or already there, that is better.

I purchased a digital x-ray system back in January of 2008. By June of the same year, the same company came out with a smaller, thinner sensor.  This didn’t make mine obsolete, but made me mad because my $10,000 investment made six months before could now be purchased for half the price.

As with most, if not all industries, technology is sweeping the dental field. We are digitizing everything. Offices that are not already “paperless” are moving in that direction. Automated systems for appointment confirmation via text or email, scheduling appointments, paying bills online, filling out online forms, and digital patient charts have been commonplace in dental offices for a while.

Digital radiology is transforming the way we treatment plan and deliver services such as dental implants. This 3-Dimensional technology allows accurate evaluation of biological structures to provide almost pinpoint placement of dental implants that may not have been able to be done using traditional methods. Notice I said “almost” pinpoint accuracy. It’s still not perfect, but it keeps getting better and better.

You may be aware that some dental offices can make crowns chairside without the use of gooey impression materials or the need of a dental laboratory. This technology has been around for over 25 years. The first generation of this technology was pretty cool back in the day, but delivered less than stellar results. Today, it is safe to say, this technology has greatly improved, continues to get better, and is not going away.

While the technology has gotten significantly better, there are still limitations. Currently, this technology uses a reduction method to fabricate restorations. This means that the restoration is milled from a solid block of material. The material choices are somewhat limited but getting better. What’s next? Maybe 3-D printing of whatever material you would like to use.

I read an article recently about 3-D printing technology where the CEO of this particular company working on dental applications said, “If 3D printing hopes to break out of the prototyping niche it has been trapped in for decades, we need to find a disruptive technology that attacks the problem from a fresh perspective.” I think this technology will be a game-changer.

I have always struggled with when to “jump-in” with certain technologies. It’s not an easy decision. The high cost, the learning curve, and knowing there is always something better right around the corner have been the barriers for me. The more I read about what is on the horizon, the more I want to wait for the “next best thing.”

Dentistry is moving fast forward in technological advances. However, two things come to mind about technology and dentistry. The first, is to keep in mind that sometimes the best option may be an older model. For example, gold is still used in dentistry, and definitely has a place in certain circumstances. The second thing, is that someone has to pay for all this advanced dentistry, and the dental insurance companies haven’t changed their model since the 1970’s. Many insurance companies will pay for more of your filling if get a “silver” one than a tooth-colored one.

We not only need to find “disruptive technology” to help prevent dental disease and treat it earlier and better, we need to have a disruptive revolution of dental insurance.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Contrary to what many denture-wearers believe, dentures require regular maintenance, including relines, repairs, and replacement. In fact, the average denture should be relined every two to three years and replaced every five to seven years for the most optimal fitting prosthesis. There are many reasons for this maintenance interval and for regular dental examinations, whether or not the patient perceives any problem.

The first problem has to do with the basic function of the bone surrounding natural teeth. Natural teeth are held in their sockets by thousands of “cables”, called the periodontal ligament that tug and pull on the supporting bone during function. The bone is designed to be strengthened and stimulated in this manner. When the teeth are removed, the bone no longer has appropriate stimulation, and shrinkage occurs unless it is directly loaded again with dental implants. Bone atrophy is accelerated by inappropriate forces caused by loose and ill-fitting dentures.

Relining, or replacing the tissue surface of the denture, helps preserve bone by adapting dentures to the gums as they shrink, but it is only helpful for dentures that are otherwise in good condition, which includes a proper bite relationship. Relining also helps to encourage health of the soft tissues because dentures plastic is porous and becomes heavily laden with bacteria and yeast over time. Relining refreshes the tissue surface of dentures with new acrylic. Sometimes a more advanced type of relining, called rebasing, is the treatment of choice when all of the pink portion of a denture is in poor condition and needs to be replaced.

New dentures should be made when relining or rebasing of dentures can no longer re-establish proper fit and function. Often this is obvious by wear or fracture of the denture teeth. When dentures contribute to headaches or when the patient’s face begins to look “collapsed” or “old”, the need for new dentures is likely.

Lastly, but certainly not of least importance, denture wearers need to stay current with regular dental examinations for inspection of not only the dentures but the tissue for pre-cancerous lesions. Since most people feel they do not need to go to the dentist once they have dentures, many early pre-cancerous lesions are missed.

Everyone is at risk for oral cancer, whether they have teeth or not. In fact, the constant “trauma” and lack of blood circulation caused by chronic denture wear increases the risk for oral cancer development. For this reason alone, annual dental examinations are recommended for denture wearers.

Many patients with older dentures report their dentures fit fine. You can relate this to the fit of shoes. Shoes get broken in over time and seem comfortable. However, the fact is, over time shoes lose their ability to provide proper support. Even though they may be comfortable, they may be causing other problems due to this lack of support.

If you are a denture wearer and have not seen a dentist in a year or more, it’s time to consider a dental visit. Learn about how your dentures are fitting and whether relining or replacing them makes sense. For most, it is also never too late to consider the benefits of dental implants to help preserve bone and secure dentures in place.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Disease is defined as, “a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.” Symptoms are those which are felt and signs are those which are seen. Disease may show signs but no symptoms. Two areas dentists see signs of, often without symptoms, are bruxism (grinding)/clenching and GERD or gastroesophageal reflux disease, causing chemical erosion of the teeth.

Some people present with symptoms relating to these two issues, but more often than not, people do not have symptoms. Dental patients who present with signs of tooth wear or acid destruction are riskier to treat. Riskier because the “issues” are often times, and maybe even most often, not treated. This is a significant reason for tooth structure breakdown and shorter life-span of dental work.

However, that’s not really what I wanted to highlight in this week’s column. There are many reasons why people have these two issues. Sometimes these problems are preventable with simple lifestyle changes; other times they need more aggressive treatment because they are coming from the central nervous system or related to something else going on in the body. They can also be caused by certain medications.

In today’s world, everyone is being pushed to their limits in just about every aspect that you can imagine. More is demanded with less time to accomplish. All this can become a source of stress, anxiety and even depression.

This “epidemic” spurred the development of newer medications with fewer side effects to help manage these conditions and hence, the SSRIs (selective serotonin reuptake inhibitors) were born in 1988. Since then, recent reports show that the use of the SSRIs (i.e. Paxil, Zoloft, Prozac, Celexa, Effexor, etc.)  has increased more than 400 percent!

Dentists see the signs of bruxism or clenching/grinding of the teeth on a regular basis, and some of it is the result of stress and anxiety. But another factor that we have to keep in mind is that patients are now taking more anti-anxiety and antidepressants than ever before in history. It is often overlooked, but the SSRIs and even some of the SSNRIs (Selective Serotonin Norepinephrine Reuptake Inhibitors) often increase bruxism or clenching and grinding effects at night.

This leads to patients having an increased frequency of headaches, jaw pain and other symptoms of clenching/grinding. I have seen many patients who have presented with increased frequency and intensity of symptoms shortly after the patient starts on these medications. I have found that sometimes a change in medication or reduction in the dosage with the help of the prescribing medical doctor can help.

Sleep can also be affected by all this clenching/grinding going on. Again, symptoms may or may not be present. Dental splints, or orthotics, which are custom-made to treat specific issues, are very underutilized. Often times, patients try generic mouthguards or nightguards with poor results. The right appliance can make all the difference in the world.  

You should certainly discuss any symptoms you have with your dentist and physician. If you don’t have any symptoms but your provider can show you evidence of disease, be open to digging deeper to try to determine the underlying cause. Everything is connected.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.jpstclair@stclairdmd.com

Last week I introduced you to a patient who has been struggling with dental decay (cavities), gum recession, and dental erosion (the chemical breakdown of tooth structure). I discussed how these dental problems are complex multifactorial diseases of epidemic levels affecting both children and adults.

I ended with the idea that a healthy mouth requires more than brushing, flossing, and “fillings”. With current scientific evidence and new technologies, patients and practitioners need to begin to look at these problems not just from a drilling and filling approach, but also from a medical (preventive/therapeutic) approach. If “we” continue to think the same way about dental issues, we will continue to have the same struggles and same results.

There are over 19,000 different bacteria that have been found in mouths and every person has about 1,000 different types. Not all of them cause decay, but many of them have also been found to grow on artery walls. The medical/dental systemic connection is real and we must pay more attention to it.

Dental decay is on the rise. Why the increase? Most of it has to do with dietary trends. We snack more, eat more sugar/carbs, drink more soda, have more gastric reflux, take more mouth-drying medications, etc. Dental caries (decay) is a pH specific disease. The right bacteria, plus sugar, create acid which breaks down the enamel of the teeth. Add an already acidic environment and it is even worse. In most cases it is a preventable disease. The problem is that changing our thinking and behavior, the nemesis of all that is bad, is difficult to do unless there is an awakening among us.

It is time for the dental professional to take a different approach when treating this disease. More focus needs to be shifted to prevention of decay rather just treating it. Filling teeth is treating the result of the disease but does nothing to prevent it. The dentist needs to take a more active role in assessing individual’s risk factors. In the dental world one way to do this is to use CAMBRA, which stands for Caries Management By Risk Assessment.

Based on assessing an individual’s risk factors such as quality of home care, quality of salivary flow, medication and dietary issues, a caries-preventive strategy can be established. Dentists must take some responsibility and be open to a different management of this disease. They must also be able to motivate people to change habits. The bottom line is that if you want to be decay-free, you can be.

For those at high risk, specific behavioral modifications are almost always necessary. To become aware of these often requires an assessment by your doctor. Doctors need to shift time away from treating things to be able to assess more and discuss the specific behavior modifications necessary for each individual patient. The patient needs to be receptive to hear and act on these changes.

There are also some great products currently available and others on the horizon. Everything from new toothpastes and gels with ions in them to rebuild tooth structure, sprays to neutralize pH, and probiotics are on their way. Right now you can use things like the sweetener replacement Xylitol, which by itself is cavity-fighting, but also works synergistically with fluoride. Prescription level toothpastes are also available and there is strong research for the topical application of fluoride varnish, the same stuff the kids get, for adults.

The evidence is very clear – this is a preventable disease. Next time you go to the dentist and find out you have a new cavity, stop blaming the dentist or yourself, and ask to get a specific protocol for prevention of this disease based on your specific risk factors.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.

Changing our behavior, habits, attitude, or any aspect of our lives can be a difficult thing to do. I am not writing as an expert on this subject as I have the same struggles as everyone else with change. However, repeated awareness of changes we want to make is one strategy to move us closer to making that change.

A good example is Mary, a patient of mine. Mary is an adult who has had issues with decay (bacterial disease that breaks down tooth structure), dental erosion (chemical breakdown of tooth structure), and gum recession (loss of the supporting structures of the teeth). When people like Mary present with these problems, we dentists present treatment to “fix” the problems. However, the reasons “WHY” these issues are occurring are just as important, if not more so, than the “fixes” we propose.

Mary drinks diet soda. In fact, Mary doesn’t just drink diet soda; she has a diet soda by her side all day long. At a recent event I saw Mary sitting and listening intently to the presentation. At her side was her diet soda. Every few minutes Mary would unscrew the diet soda cap and take a swig.

The three main dental issues Mary has: decay, erosion, and recession, have many different etiologies. One common denominator is pH, which is a scale used to describe the acidity or alkalinity of solutions or environments. The lower the pH the more acidic the solution or environment is. In order for any of the three disease processes described above to occur, the pH of the oral environment has to be acidic.

While there are many reasons the pH of the oral environment can be acidic, such as medications or disease, dietary factors play a significant role. A pH lower than 5.5 in the oral cavity puts you at risk for dental disease. Most tap water, for example, has a pH of 7. The average diet soda has a pH of 3.28. Stomach acid has a pH between 1-2. Diet soda is very acidic.

Having a diet soda with a meal on occasion is most likely not a problem. Typically, after consumption of an acidic beverage, your saliva will neutralize (make your mouth more alkaline and less acidic) within about a half hour. That is why you may have heard that you should wait at least a half hour before brushing your teeth after meals. The problem with Mary sipping the diet coke all day long is that the pH of her mouth is always acidic. This creates a very dangerous environment.

Quieter drills, new materials and technologies will not solve these problems. While etiologies such as medications that can cause dry mouth and a very acidic environment are difficult enough to manage, behavioral issues are often not discussed in enough detail, or at all, because they can be more difficult to manage.

Avoidable dental problems are the last thing a patient wants to hear about and a dentist wants to see.  In addition, we as providers need to adopt a more preventive approach to the conditions I discussed in this column. Next week I will introduce you to one of those concepts.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.

Do you pay much attention to those cards in a hotel room asking you to reuse your towels? Many people don’t. But one researcher, Robert Cialdini, a University of Phoenix professor and the author of Influence: The Psychology of Persuasion, found a way to get guests to cooperate. He created a card saying that most guests who stayed “in this room” reused their towels. The response beat the typical compliance rate by 33 percent.

Cialdini calls this the “Social Proof Effect,” and it is a powerful force in our increasingly connected culture. It’s not about peer pressure. It’s about peer information, and how we behave and make decisions based on the standards, expectations, and recommendations of our social groups. It’s why people share TV talk around the water cooler, and it explains the popularity of social media like Facebook and Twitter, which make it easier than ever to be plugged into what our peers are thinking and doing.

Many dental offices use social media as a way to connect with patients and bring discussions of dental issues into their cyber-world. It’s not for everyone, but there are many patients who like and benefit from it. 

The same thing goes for “Dr. Google”. It is just another way to get information. Many people use Google to help self-diagnose. Any information helps make you more informed and aids in making decisions when it comes to choices. With many people it’s reassuring—a way of validating that the choice they’re about to make has been endorsed by people like them in similar circumstances.

More and more patients are coming into the office armed with information they have collected from their own web searches. Many times it is good information, which stimulates good discussion. Other times the information brought to the table is misguided information, which can stimulate good discussion, but can also confuse people.

One potential problem is that patients often think that if something didn’t work out for someone they know, it is not right for their particular situation. For example, I have had patients come in and say, “My friend had a miserable time with a dental implant. I don’t want a dental implant.” In this situation it takes a lot more nurturing and education to convince someone that a dental implant is right for them. Sure, there are people who have problems, but there are many more people who have had positive experiences and wouldn’t want anything else.

This is where spending time one on one with patients is so important. TIME is the most precious gift a healthcare provider can give to his or her patients.  Spending time to educate people allows them to make the best decisions for themselves. The trend is to spend less time with patients. There may be many reasons for this, but one definite one is the pressure from insurance companies to control costs.  Who wins in that situation?

Whatever way you get your information, take the time to thoroughly discuss it with your healthcare provider. Bring the information you find and incorporate it into the conversation. Your healthcare provider should be YOUR biggest advocate. It should be a trusting and transparent relationship. If it doesn’t seem that way, maybe you should consider your alternatives.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.

I have had a few patients ask recently about the order of oral hygiene activities. Does it matter if you brush or floss first, and should this be done before or after breakfast? Based on available research, it seems opinion matters as much as scientific facts.

A spokesman for the American Dental Association and a professor of restorative dentistry at the University of California, Los Angeles, recommends flossing first. His rationale? Get the unpleasant task out of the way to avoid the temptation to not do it. “Let’s face human nature, if you’re going to skip one, which one will you skip?”

By contrast, a professor of oral health sciences at the University of Washington in Seattle, advises her patients to brush with a fluoride toothpaste, then floss. She says that way your mouth will be awash with fluoride as you are maneuvering the floss.

So, what’s my opinion? I was taught and have always maintained that flossing before brushing is better. The rationale behind this is that plaque and other debris is dislodged during the act of flossing allowing toothpaste and the mechanical action of brushing to better penetrate the different surfaces of the tooth. Does it really matter? I don’t think so.

Have you heard your dental hygienist or dentist tell you to floss to prevent cavities between your teeth? Based on research, the main reason for flossing is not for prevention of cavities. Rather, flossing’s main benefit is stimulation of tissue to reduce gum inflammation known as gingivitis. Gingivitis can lead to more advanced gum disease and things like bad breath. That is why I believe that regular use of a water pik and an electric toothbrush is most ideal.

A review of 12 randomized controlled trials found that people who brushed and flossed regularly had less gum bleeding than the brush-only camp. No surprises there. There have been no studies, that I am aware of, reporting a reduction in cavities from flossing. Of course, these are difficult studies to conduct. There are many factors that contribute to decay occurring between the teeth.

There are also different schools of thought whether to brush and floss before or after breakfast. I don’t know about you, but I cannot eat or drink anything (especially orange juice) after I brush my teeth. So, although you might expect the solution to be brushing after breakfast, there is some risk with that.

If you eat or drink something sugary or acidic—like the fruits, juices, and other breakfast foods many of us eat in the morning— the mouth is in an acidic environment for at least 30 minutes after consumption. These acids weaken tooth enamel, and brushing too soon can cause damage to the enamel. If you know you’re going to eat or drink something very acidic ahead of time, you may want to brush your teeth first.

Alternatively, you can wait 30 minutes after you eat for your saliva to neutralize the pH of your mouth. Or, re-balance your oral pH right away with an alkaline mouth rinse and then brush. In the end, it depends a little on what you eat. Take stock of what you’re eating for breakfast and judge when you should brush based on its sugar or acid content.

Everyone, well…..almost everyone, can stand some improvement with their oral hygiene. Many dental problems are completely avoidable with excellent home care, which is in your control. Ask your dentist or hygienist how to improve your home care. Strive for constant improvement.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

I have had a few patients ask recently about the order of oral hygiene activities. Does it matter if you brush or floss first, and should this be done before or after breakfast? Based on available research, it seems opinion matters as much as scientific facts.

A spokesman for the American Dental Association and a professor of restorative dentistry at the University of California, Los Angeles, recommends flossing first. His rationale? Get the unpleasant task out of the way to avoid the temptation to not do it. “Let’s face human nature, if you’re going to skip one, which one will you skip?”

By contrast, a professor of oral health sciences at the University of Washington in Seattle, advises her patients to brush with a fluoride toothpaste, then floss. She says that way your mouth will be awash with fluoride as you are maneuvering the floss.

So, what’s my opinion? I was taught and have always maintained that flossing before brushing is better. The rationale behind this is that plaque and other debris is dislodged during the act of flossing allowing toothpaste and the mechanical action of brushing to better penetrate the different surfaces of the tooth. Does it really matter? I don’t think so.

Have you heard your dental hygienist or dentist tell you to floss to prevent cavities between your teeth? Based on research, the main reason for flossing is not for prevention of cavities. Rather, flossing’s main benefit is stimulation of tissue to reduce gum inflammation known as gingivitis. Gingivitis can lead to more advanced gum disease and things like bad breath. That is why I believe that regular use of a water pik and an electric toothbrush is most ideal.

A review of 12 randomized controlled trials found that people who brushed and flossed regularly had less gum bleeding than the brush-only camp. No surprises there. There have been no studies, that I am aware of, reporting a reduction in cavities from flossing. Of course, these are difficult studies to conduct. There are many factors that contribute to decay occurring between the teeth.

There are also different schools of thought whether to brush and floss before or after breakfast. I don’t know about you, but I cannot eat or drink anything (especially orange juice) after I brush my teeth. So, although you might expect the solution to be brushing after breakfast, there is some risk with that.

If you eat or drink something sugary or acidic—like the fruits, juices, and other breakfast foods many of us eat in the morning— the mouth is in an acidic environment for at least 30 minutes after consumption. These acids weaken tooth enamel, and brushing too soon can cause damage to the enamel. If you know you’re going to eat or drink something very acidic ahead of time, you may want to brush your teeth first.

Alternatively, you can wait 30 minutes after you eat for your saliva to neutralize the pH of your mouth. Or, re-balance your oral pH right away with an alkaline mouth rinse and then brush. In the end, it depends a little on what you eat. Take stock of what you’re eating for breakfast and judge when you should brush based on its sugar or acid content.

Everyone, well…..almost everyone, can stand some improvement with their oral hygiene. Many dental problems are completely avoidable with excellent home care, which is in your control. Ask your dentist or hygienist how to improve your home care. Strive for constant improvement.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.