Are Runners Ruining Their Teeth?

 In a study conducted by the School of Dental Medicine at the University Hospital in Heidelberg  Germany, researchers analyzed the teeth of triathletes who put in at least 10 hours of training per week, and determined that the harder the triathletes worked, the more acidic their saliva became and - unsurprisingly - the worse their levels of tooth erosion.

Add to this dilemma the carbohydrates and sugars in sports drinks and protein and power bars that athletes often consume before and after working out, and their mouths now become a perfect environment for cavities to develop. The sugars will feed the decay-causing bacteria. Additionally the lower saliva rates will create a dry mouth condition that makes it harder for your mouth to keep itself clean. This in turn decreases the natural defenses our saliva provides against "bad bacteria". As the mouth becomes drier the concentration of bacteria also increases in the mouth due to the lower volume of available saliva, thus increasing the risk of tooth decay and gum disease. This is sometimes referred to as "runner's mouth" Another factor that plays a role in the erosion of the teeth is the high consumption of power drinks by athletes. Power drinks such as Gatorade or Powerade are not known for having high levels of sugar but the drinks are quite acidic, and it is the acidity that has the potential to cause problems with the teeth. We often see the affects of these highly acidic drinks on teeth in the form of deep pitting of the teeth and erosion of the enamel, and it can be evident in adults and children.

So what is the remedy for runners? Most runners tend to run numerous times a week and this can induce mild levels of dehydration. Staying hydrated even when not exercising is an important preventive measure, and if you are a long distance runner, increasing your salt intake will allow your body to retain more water and potentially improve the salivary flow.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Your Diet and the Health of Your Teeth

 You may not know it but your diet can affect the health of your teeth in more ways than you might think. Traditionally we think of foods with high sugar contents as being the only culprits that can affect the health of our teeth but there are others. With the advent of  "power or energy" drinks there has been a marked increase in the number of people's teeth being damaged by these types of drinks. We are seeing it primarily in children because of their frequent consumption of drinks such as Gatorade and Powerade at their sporting events. These drinks do not contain high levels of sugars but instead they are highly acidic, and it is the low pH of the drink that is doing the damage. We often see the affects of these highly acidic drinks on teeth in the form of deep pitting of the teeth and erosion of the enamel. The damage can sometimes be quite extensive. Certain foods if consumed regularly can also affect the enamel of one's teeth. In our office we have seen people's teeth completely destroyed as a result of habits such as sucking on lemons. Lemon's are highly acidic and will erode tooth structure over time if eaten in inappropriate manners. Some people enjoy eating lots of citric fruits or even sucking on them, but the results of these habits can be very devastating to the teeth. We're not recommending you avoid all foods that are acidic but moderation is the key. As for the energy drinks that are so prevalent these days these are best kept to a minimum. Below is chart showing some common foods and their accompanying acidity levels.
Experts believe that consuming as few as four acidic drinks or foods a day can increase the risk of acid erosion to your teeth.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Implants and Their Benefits

 One of the areas of dentistry where some of the greatest technological advances have taken place in the last 10 years has been in the field of implant dentistry. In the past when a tooth was lost there were two options on how to replace it. One was to replace the tooth with a removal partial denture that was both cumbersome and awkward in the mouth. It was also not very cosmetically appealing and often times the metal clasps would show. The second method was to place a bridge that was not removable but did require preparing or shaving down the adjacent teeth on either side of the missing tooth space. A false tooth was attached between the two anchor or abutment teeth. On our web site is a short video demonstrating how a bridge works. The problem with this technique is a two or more perfectly good tooth had to be shaved down, and once the bridge was permanently cemented into place there was no way to floss in between the teeth as you normally would. A special device called floss threader is used to thread the floss in between the false tooth and the anchor teeth.

Implants have been around for decades but in the last 20 years there has been much research and advancements made in the area of the biomechanics and biomaterials of dental implantology. Implants are typically made of special titanium that has a special coating on it that promotes the growth or integration of bone to the implant itself. It is through this mechanism that the bone attaches to the implant. When a tooth is lost there is a natural loss of bone that takes place in the area where the tooth once was. This can result in a poor cosmetic outcome or there may even be insufficient bone available to allow an implant to be placed. These days there are many choices the doctor has to perform bone grafts and provide additional needed bone if necessary. The bone used for bone grafting is typically a freeze-dried bone that has been rendered in such that it can be used on anybody without the worry of rejection or disease. Today when a tooth has to be removed a bone graft is often placed in the socket of the tooth after it has been extracted in order to preserve bone so that an implant can be later placed in the same area. Implants offer many advantages over removable partial dentures and prosthetic bridges, and have a very predictable outcome. They provide a superior cosmetic result, preserve bone where the tooth was lost, provide an easily cleansable area that can be easily flossed, and eliminate the need to unnecessarily prepare adjacent teeth.

The process of replacing a missing tooth with an implant retained prosthetic crown is very straightforward and predictable. Following the removal of the tooth the doctor must allow 3-4 months time to pass to allow for new bone to fill in where the old tooth root once existed. This is true whether a bone graft is placed or not. Sometimes an implant can be placed at the same time the tooth is removed. Once it is deemed that the bone has filled in sufficiently a small hole is drilled into the bone  and an implant is placed within the space and the surrounding  bone is allowed to grow and integrate with the implant. A small healing cap is placed on top of the implant during this healing phase, and this process typically takes 3-4 months. A short video of an implant placementcan be seen on our web site Since bone has no nerve endings in it there is surprisingly very minimal discomfort, if any, following the procedure. Most of our patients will take one ibuprofen when they leave our office and that will be the last pain relieving medication they need to take after that. There is also no swelling. After the 3-4 month period of bone growth has passed the healing cap that was covering the top of the implant is removed and an implant abutment is screwed into the implant and a crown is placed permanently over the abutment. This process can be seen on a short animated video on our web site. Once completed an implant will function and look just like a natural tooth. In order to maintain them properly implants do require very good oral hygiene and regular check ups.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Bad Breath and Why People Get It

 Bad Breath, otherwise known as halitosis, is experienced by millions of people every day. Halitosis can be a minor transitory embarrassment or it can be a constant severe problem that never goes away and consumes one’s life and is a constant source of embarrassment.  There are numerous reasons a person might experience bad breath, but at the same time there are a lot of myths surrounding the causes and treatments for halitosis. I will touch on some of the more common causes and also some common myths surrounding this condition. Let’s address some common causes of bad breath first.

Probably the most common cause of halitosis is simply poor oral hygiene. This is usually the main cause of minor transitory bad breath issues and is easily resolved with proper oral hygiene. Gum disease, also known as periodontal disease, can produce mild to severe chronic halitosis. The gram (-) anaerobic bacteria that are responsible for causing gum disease produce volatile sulfur compounds (VSC), and these are what people notice when they are near someone with bad breath. Once the gum disease is treated the bad breath usually resolves rather quickly. The most common reason people suffer from long term chronic halitosis is due to an imbalance in the oral bacteria in their mouth. This does not mean they have poor oral hygiene. It merely means they have more anaerobic bacteria in the mouth than they normally should. There are numerous reason why this imbalance may occur but some common causes are due to dryness of the mouth (xerostomia), excessively long taste buds that allows excessive anaerobic bacteria and mucous to accumulate in and on the tongue, and post-nasal drainage which results in the buildup of a biofilm or mucous on the tongue. I have been treating patients with the chronic forms of halitosis for over 18 years and many of our patients travel great distances to seek a resolution to their condition. In fact the majority of our patients travel from outside of the state or even the country to seek our help. It may be hard to understand why someone would travel such distances for help with this problem but unless you have experienced such a condition is it hard to relate to it, or understand how much it can affect a person’s life. Over the years I have studied the causes or etiologies of chronic halitosis and this has provided me an insight as to how to help patients suffering from this problem.

Unfortunately there are a lot of myths related to halitosis, it’s causes, and how to resolve it.  Some common myths that we see related to halitosis are:


1.     Halitosis comes from the stomach.
        Only in extremely rare cases does this occur. Cleansing the intestines offers no benefits in
        treating halitosis.

2.     Halitosis comes from the lungs.
        Only rarely does this occur and it can be a manifestation of a serious disease.

3.     Halitosis is a hereditary problem.
        This is absolutely not true. Certain conditions that can contribute to a bad breath condition can
        be hereditary, but there is no halitosis gene that can be passed on to an offspring.

4.     Mouth washes and breath mints can help a breath problem.
        This is not true. They only mask the problem for a few short minutes at best. Alcohol based
        mouthwashes in fact will worsen the problem because they dry out the mouth thus increasing
        the volatilization of breath odors.

5.     Internal breath fresheners can eliminate a chronic halitosis condition.
        Products taken for food-induced odors will have little effect on a chronic halitosis condition.
        There are, however, many food induced odors that can be offensive to others and there are ways
        to resolve those types of problems. The only product we have tested that has been shown to be
        effective against food induced odors such as garlic breath or onion breath is a product called
        Breath Gemz™. This product has the ability to eliminate the odors during or even well after a
        person consumes the foods that will produce strong or offensive breath odors.

6.     Brushing my teeth more will help eliminate my breath condition.
        This is also not true. Excessive brushing can dry one's mouth, thus increasing the halitosis
        problem. Excessive brushing can also damage the teeth and gums over time. It is very difficult
        to remove the specific odor causing bacteria with brushing and flossing alone, and most patients
        we see at our center tend to have very good oral hygiene.

7.     Halitosis is caused by foods.
        Foods such as onions, garlic, or cauliflower can induce certain odors but these are only
        transitory, and can be easily eliminated by avoiding that particular food. The odors they produce
        also are not of the "sulfur" type commonly seen in true halitosis conditions, and generally are
        not as offensive.

8.     There is no treatment for halitosis.
        There is a highly effective treatment for this problem, at the Center For Breath Treatment.

9.     Probiotics can help in eliminating my bad breath.
        There is no scientific evidence to support the benefits of probiotics in the treatment of halitosis.
        The use and benefits of probiotics for treating a bad breath condition is very overstated and over
        simplified. For that reason we do not recommend the use of these products.

10.   I have heard that the bacteria H. Pylori causes halitosis. Is this true?
        This is absolutely false. H. Pylori is a common cause of peptic ulcers and when patients have
        been placed on antibiotics to eliminate the H. Pylori they sometimes find that their chronic
        halitosis condition improves. The reason for the improvement has nothing to do with the
        elimination or reduction of the H. Pylori. I may occur because the antibiotics temporarily reduce
        the amount of the anaerobic bacteria that are contributing to the halitosis condition. Once the
        antibiotic regimen is completed the bad breath always returns.

11.   Rinsing with hydrogen peroxide will help cure my bad breath.
        Hydrogen peroxide has never been shown to be helpful in treating halitosis. It is considered a
        cytotoxic product (toxic to cells) that will damage the tissues in the mouth. An occasional use of
        the product will not cause any significant damage to the oral tissues but any prolonged or regular
        use of hydrogen peroxide will breakdown the tissues and cause ulcerations of the tissues. We
        recommend patients do not use it for oral purposes.

When patients seek help from us in resolving a chronic halitosis condition we take them through a diagnostic process in which we determine what the causes of their halitosis condition are. There are always multiple causes and therefore the treatment usually requires a combination approach to resolving it. Treatment typically is focused on addressing the conditions that are resulting in the bacterial imbalance. For more information on treating this problem please visit the section on halitosis treatment on our web site.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.