Ask the Dentist

Got a question for a dentist? This issue, your questions are answered by Dato' Dr how Kim Chuan and Dr David Tan of Imperial Dental Specialist Centre.

March 12, 12:15 PM

BAD BREATH
I’ve been suffering bad breath for a few months now. Apart from a constant bad taste in my mouth, friends and family have similarly complained about my bad breath. While I do carry a toothbrush and toothpaste with me at all times, my breath can’t seem to remain fresh for long. What does this mean and is immediate dental treatment necessary?

Voon, Taman Desa
Bad Breath
There could be a few possibilities for bad breath, but commonly it is due to the bacteria build up on the teeth, gums and tongue from poor oral hygiene. Dental plaque and calculus will build up on the teeth and inside the gums, promoting bacteria growth and those bacteria can produce unpleasant smelling gases.
Besides that, eating strongly flavoured foods, such as garlic, onions and spices is likely to make your breath smell. Strong-smelling drinks such as coffee and alcohol can also cause bad breath, as can smoking. Certain mediation can cause bad breath by drying up your saliva. Lack of saliva will promote the growth of bacteria. Dry mouth can sometimes be caused by a problem in the salivary glands or by breathing through your mouth instead of your nose.
 
The treatment for bad breath will depend on its cause. Visit your dentist to check on your oral hygiene and the health of your teeth and gums. Scaling and polishing will be recommended if there is presence of plaque and calculus. The dental check up should be done every six to 12 months. Do floss your teeth daily, and brush well to ensure that there is no plaque left behind (you may consider using an electric toothbrush), and replace your toothbrush every three to four months, clean your tongue, give up smoking, control strong flavoured or spicy food, alcohol, coffee consumption, drink plenty of water to rehydrate your mouth and try chewing on sugar-free gum to stimulate flow of saliva.


CAVITY MONSTER
My boyfriend has a huge cavity in his back molar. It’s so massive, I can clearly see it with my naked eye. While I’ve constantly reminded him to get it checked out, my advice has fallen on deaf ears. My boyfriend even argues that he can manage symptoms with constant brushing and mouthwash. In your opinion, what advice can I give him and if you make an educated guess, what treatment do you believe is needed at this point?
Huda, KL
Cavity
The only advice that we can give is to visit his dentist, as we will need to know whether the cavity is due to a crack or caries (tooth decay). Once a patient has a cavity that is quite deep, the dentine layer (second layer of the tooth) will have been affected. The walls of the cavity will most likely be soft if it is due to caries. Constant brushing and mouthwash usage may only slow down the caries progression but will not solve his tooth problem. He will continue to have pain until the nerves and soft tissues inside the tooth pulp dies. Recommended treatments may encompass dental filling, a dental crown, if there is a large area of decay without pulp nerve/soft tissue involvement; root canal if there is soft tissue involvement, or extraction if it is a large area of decay/crack with insufficient remaining tooth structure. On the other hand, if that molar is a wisdom tooth, then we may recommend extracting it especially if it is impacted. Please do note that it is better late than never especially if that tooth is actually saveable now.