Morning Breath Is A Transient Thing

Morning Breath Is A Transient Thing

It would be tough to find a person who has never suffered from morning breath. We wake up in the morning feeling as though our mouths have been immobile all night long. Indeed, they probably have been. The oral cavity is either parchment dry, from breathing through the mouth (worse if you snore), or glued together from a lack of free flowing saliva. We force our lips to move: the first word is a croak.

Morning breath is actually a consequence of naturally decreased saliva production: the body produces less saliva while we sleep. Since saliva is a potent force against the oral bacteria that produce bad breath, a decrease in saliva allows those bacteria to proliferate during the night - and proliferation of those bacteria means production of volatile sulfur compounds (VSC), which smell really bad and are the main component of bad breath.

Fortunately, morning breath is a transient thing - once we are up and around, and have brushed and rinsed, the higher daytime flow of saliva resumes and all is well in the mouth (unless there is a chronic problem with VSC-producing bacteria). For most of us, a regular program of oral hygiene is all that's needed: brush and floss regularly, and clean the tongue, especially if you notice a white or yellowish coating on it in the morning. Morning breath should be easily vanquished.

There are a few things that make morning breath worse: coffee, alcohol, smoking, snacking during the night, poor oral hygiene, and sinus congestion, to name a few. In addition, many drugs cause a dry mouth, and this effect is accentuated when saliva flow is naturally decreased. These things affect morning breath for different reasons. Some decrease saliva flow; some directly support the proliferation of VSC-producing bacteria by providing nutrients. What's important is that we know they make things worse - avoid them if possible.

If your morning breath bothers you so much that you want to do something significant about it, try stepping up your oral care first. Are you brushing your teeth and rinsing your mouth out first thing in the morning? Are you cleaning your tongue? If these measures seem inadequate, use a good oral rinse that kills or removes VSC-producing bacteria on the tongue. Perhaps you want fresh breath before you even get out of bed - a difficult order to fill, but there are products on the market that claim to stop morning breath from happening at all. Of course, you'd add these into your routine in the evening, before going to sleep.

R. Drysdale

Sinus Drainage Bad Breath

Sinus Drainage Bad Breath

Have you heard of sinus drainage bad breath? This condition implies that the bad breath is coming from the sinuses; however, that is usually not the case. When draining sinuses contribute to halitosis, the odor is coming from the back of the mouth, just as it does with regular halitosis.

When there is a problem in a sinus bad breath results for a very simple reason: drainage from the sinus runs down the back of the throat and onto the very back of the tongue. The drainage is a rich source of protein because it contains dead sinus cells that have sloughed off, blood cells, pus cells, and other molecules produced by the body. These are the exact things that oral bacteria like to use for nutrients. With a steady food supply from sinus drainage bad breath increases with the increase of bacteria.

The bacteria that are particularly known for producing sinus drainage bad breath, and other bad breath as well, are anaerobes, meaning that they live in an oxygen free environment. They cannot withstand significant amounts of oxygen - the back of the tongue is a perfect place for them to hide. They get down in the little grooves between tongue papillae and taste buds, and just wait for food to come to them. When it does, they take what they need and produce foul smelling volatile sulfur compounds as an accidental byproduct of metabolism. Unfortunately for the person with an inflamed sinus bad breath is the final result.

The good thing is that treating sinus drainage bad breath is really no different from treating any other type of bad breath. Many people suffer from post nasal drip, which essentially produces the same type of sinus bad breath. Bad breath products that work for regular bad breath will work just as well for these situations. Of course, a product that works by decreasing the population of anaerobes living at the back of the tongue will be the most effective. Look for oral care products that are antibacterial in some way - they may physically remove tongue bacteria or they may kill them. Either should help decrease the odor on your breath and allow you to focus on alleviating the discomfort of the sinus problem, instead of worrying about your sinus drainage bad breath.


R. Drysdale

Oral Health and Calcium

Oral Health and Calcium

What is calcium?

Calcium is a mineral your body needs to help build strong bones and healthy teeth. Low-fat and fat-free milk and dairy products are especially good sources of calcium.

How does calcium help keep mouths healthy?

* Even before baby teeth and adult teeth come in, they need calcium. And after teeth come in, they continue to take in calcium so they can develop fully.
* Calcium makes gums healthy. Getting enough calcium as a young adult may help prevent gum disease later in life.
* Calcium makes jawbones strong and healthy too. Jawbones need to be strong - they hold the teeth in place!

How else can I help my child have a healthy mouth?

Besides teaching your children to drink milk and eat other calcium-rich foods, there are a number of ways you can help keep your child's mouth health. For example:

* Make sure your children brush with fluoride toothpaste. Fluoride protects teeth from decay and helps heal early decay.
* Ask your child’s dental care provider or health care provider if there is fluoride in your town or city’s drinking water. If there is not, ask about fluoride tablets or drops for your child.
* Ask your child’s dental care provider about proper brushing and flossing techniques and other ways your tween and teen can make sure teeth stay healthy.


Institute of Child Health and Human Development

Dental Health: The Facts

Dental Health: The Facts

Introduction

The major source of knowledge concerning the prevalence of dental health problems comes from periodic national surveys. In 1971-1974, the National Center for Health Statistics conducted the National Health and Nutrition Examination Survey (NHANES I) on a representative sample of the U.S. population. The survey included information concerning prevalence of caries, periodontal disease, edentulousness, and other dental health problems among children and adults. A 1979-1980 National Caries Prevalence (NCP) survey conducted by the National Institute of Dental Research (NIDR) assessed the dental health of U.S. school children aged 5-17. In 1983-1984, the Indian Health Service conducted a cross-sectional study of clinical patients to assess the dental health among American Indian and Alaskan natives. The dental health data that follows comes largely from those national surveys. Fluoridation data is collected and reported by the Centers for Disease Control. In late 1986, the National Institute of Dental Research will complete an Adult Oral Health Survey, which will provide updated Information about progress made in improving dental health among adults.

The prospects of prevention in dental health are encouraging. The use of fluoride at optimal levels before and after eruption of permanent teeth reduces the amount of caries an average of 50%-60%. Newly developed and under-utilized dental sealants can result in a 90% reduction in caries in treated teeth after one year, and a 55% reduction after six years. Lack of public and professional acceptance is a major factor limiting the effectiveness of these currently available prevention strategies.

Prevalence

Caries—Children

The 1979-1980 National Caries Prevalence (NCP) survey of U.S. school children aged 5-17 revealed that, on average, a school child had at least 1 caries lesion in permanent teeth by age 8,4 caries by age 12 and 11 by age 17.

The NCP survey estimated the caries prevalence in the permanent dentition for U.S. school children age 5-17 to be 4.77 decayed, missing or filled tooth surfaces (DMFS) per child and 2.91 decayed, missing or filled teeth (DMFT) per child.

A 1971-1974 National Center for Health Statistics (NCHS) Health and Nutrition Examination Survey (NHANES I) reported that children 1-5 years old averaged 1 primary tooth that was either decayed, nonfunctional-carious or filled.

School children aged 5 years in the 1979-1980 NCP survey averaged over 4 decayed or filled surfaces. Children 5-9 years old averaged 5.3 decayed or filled surfaces and 2.6 decayed or filled teeth per child in their primary dentition.

In the 1979-1980 NCP survey, 36.6% of U.S. school children aged 5-17 had no decayed, missing or filled teeth (DMFT), 39.8% had 1-4 DMFT, 15.9% had 5-8 (DMFT); and 7.7% had 9 or more (DMFT).

White children had more caries (4.89 DMFS per child) than children of other races (4.15 DMFS per child), according to the 1979-80 NIDR survey.

A 1983-1984 study of American Indian and Alaskan Native (AI/AN) children indicated that AI/AN children aged 5-19 years had an average of 6.8 DWI, compared to an average of 4.8 DMFT among 5-17 year olds in the general U.S. population reported by the NCP survey.

Between 1971 and 1974, children 6-11 years old who ate 20% of their total calories as between-meal sweets had 20% more decayed, missing and filled teeth than those children who did not have between-meal sweets.

Among school children in the 1979-1980 survey, 16.8% of the DMF surfaces were classified as decayed and unfilled, while 76.1% had been filled or restored by dental treatment, thereby indicating a relatively high level of restorative dental care among U.S. school children.

Marked regional variation in caries prevalence among U.S. school children exists. Children from the Northeast have been reported to have the highest mean number of decayed, missing and filled surfaces (DMFS) at 6.1 compared to children from the Southwest with 3.4 DMFS.

In the Southwest, 45% of the children are caries-free, compared to 30% of the children in the Northeast.

Caries—Adults

The 1971-1974 National Health and Nutrition Evaluation Survey (NHANES I) revealed that adults aged 18-74 years with at least one natural tooth averaged 16.9 decayed, missing or filled permanent teeth per person, including 1.4 untreated decayed permanent teeth.

Blacks aged 18-74 years averaged 4.7 fewer DMFT than whites in NHANES I. Women of all races averaged 1.2 more DMFT than men, while black women averaged 2.9 more DMFT than black men.

The 1982 National Health Interview Survey reported 11.4 million days of restricted activity, 4.16 million days of bed disability, 2.01 million days of work loss and 1.37 million days of school loss as a result of 3.21 million dental conditions.

Periodontal Disease

The 1979-1980 National Caries Prevalence Survey (NCP) of U.S. school children reported that 92% of the children had moderate gingival treatment needs, 3% had severe needs and 5% had no gingival treatment needs.

NHANES I showed that 31% of U.S. adults 18-79 years old had destructive periodontal disease and 25% had gingivitis.

The prevalence and severity of periodontal disease increases with age and is more common among males than females.

Periodontal index (PI) is a composite index used in oral epidemiological surveys to indicate the presence and severity of disease in the supporting tissues of the teeth. The PI ranges from 0 (indicating no inflammation) to 8 (indicating advanced destruction). The 1971-74 NHANES I survey showed that persons not brushing their teeth daily had a mean periodontal index of 3.54, whereas persons brushing once daily had a mean PI of 1.40, and persons brushing twice daily had a mean PI of 1.05.

The same survey revealed that nonsmokers had a mean PI of 1.01 compared to current smokers whose mean PI was 1.55.

Edentulous Persons

14.7% of the U.S. population aged 18-74 years were missing all of their teeth, according to NHANES I data.

Dental Treatment Needs

A 1975-1976 study showed that more than 9.5 million persons received medical care each year for craniofacial injuries.

Oral Cancer

In 1981, 27,000 new cases of oral cancer were diagnosed, and 9,000 cancer deaths were attributed to oral cancers.

Fluoride

The natural fluoride concentration in domestic water in the U.S. supplies ranges from 0.1 to 10 mg/L. Sea water contains fluoride at 1.0 to 1.5 mg/L.

Fluoride ingested at optimal levels before eruption of permanent molars reduces caries an average of 50%-60%. Reduction of caries continues at 50%-60% only if fluoride in water at 1 mg/L washes over teeth for the lifetime of the teeth.

The use of fluoride at optimal concentrations results in a 75% decrease in premature extraction of teeth among children.

Persons with the highest concentration of fluoride in the enamel of their teeth had more than 50% fewer decayed, missing and filled teeth than persons with the lowest fluoride concentration in a 1971-1974 national survey.

Public and Professional Awareness

When asked about factors important to preventing tooth decay in a 1985 National Health Interview Survey (NHIS), 95% of those surveyed said seeing a dentist regularly, 78% said drinking water with fluoride from childhood, and 96% said regular brushing and flossing teeth.

When asked about the main cause of tooth loss in children in the above survey, 58% said tooth decay; 30% said injury to the teeth; 8% said gum disease; and 4% did not know.

When asked about the main cause of tooth loss in adults during the same survey, 55% listed gum disease; 40% tooth decay; 2% injury to teeth; and 3% did not know.

In a survey for the American Dental Association (ADA), 94% of respondents said they brush their teeth. Of those respondents that brush, 64% do so at least once a day, and an additional 23% brush after each meal.

In the ADA survey, 38% of persons responding floss their teeth. Of the respondents aged 30-40, 47% stated that they flossed their teeth.

In the ADA survey, almost one third of respondents reported visiting a dentist within 6 months of the interview, 23% had visited a dentist between 6 months to 1 year, and 22% had not visited a dentist for 3 years or longer.

Preliminary analyses of the 1983 National Health Interview Survey indicate that 94% of people using a dentifrice use a brand containing fluoride.

Service Delivery

In 1983, there was an average 1.8 dental visits per person in the U.S. 51.8% of Americans in 1983 had visited a dentist in less than one year, 23.7% had not visited a dentist in two or more years and 10.8% had never visited a dentist.

According to the Health Care Financing Administration, $25.2 billion was spent on dentist services in 1984. This represents 6.5% of the total national health expenditures for that year.

In a 1978 survey for the American Dental Association, 26% of respondents had some form of dental insurance. Of those with dental insurance, 79% received it as a job-related benefit.

Mandatory football and ice hockey mouthguard rules exist through the National High School Federation, National Collegiate Athletic Association and the Amateur Hockey Association of the United States.

Fluoridation

The Centers for Disease Control estimates that as of December 1985, 130 million Americans (or 54.8% of the U.S. population) were served by fluoridated water. This figure includes 10.7 million persons who received water with natural fluoridation and 119.3 million who received water adjusted to achieve optimal fluoridation.

In December of 1985, 87.2% of the 236.2 million persons in the U.S. received public water supplies and 62.8% of those on public water supplies were served by fluoridation.

As of December 1985, 41 of the 50 largest U.S. cities had fluoridated water supplies.

28 states, Puerto Rico, and Washington, D.C. provide fluoridated water to over half their populations.

The World Health Organization has estimated an average savings of $40 in costs of dental care per $1 of expense for community foundation worldwide. In the U.S., the benefit-cost ratio for fluoridation of water supplies has been estimated at $50: $1.

Significant Trends

Caries—Children

Surveys of school children revealed a one third reduction in caries prevalence from 1971-1973 to 1979-1980.

Periodontal Illness

National surveys of periodontal disease in adults 18-79 years of age reveal that nearly twice as many people in 1971-1974 were without periodontal disease as in 1960-1962. In 1971-1974, 45.3% of males and 57.1% of females 18-79 years old were without periodontal disease, compared to 20.9% and 31.0% (respectively) in 1960-1962.

Edentulous Persons

Young adults aged 18-24 years had, on the average, 2.3 fewer missing teeth in 1971-1974 than in 1960-1962.

Fluoridation

Since the introduction of the practice of adjusting fluoride levels in community water systems in 1945, the number of people with access to water with optimal levels of fluoride for caries reduction (0.7 parts per million or higher) has increased steadily to an estimated 130.8 million in 1985, approximately 54.8% of the total U.S. population.

Special Issues

Fluoridation Growth Slow

In 1975, 60% of the population on community water systems received fluoridated water. By December 1984, the proportion of those served by community water systems who were receiving fluoridation rose to 62.8%.

Dental Sealants

55% of caries in children 5-17 years old develops in the pits and grooves of the chewing surfaces of teeth where the benefits of fluoride are least effective. Dental sealants are plastic resins which are applied to these occlusal surfaces to prevent caries formation.

A review of studies of a popular dental sealant showed 89%-96% retention of the sealant after 1 year and 58%-68% retention after 6 years. The sealants effectiveness at preventing caries when compared to untreated teeth was 89%-91% at 1 year and 55-56% at 6 years.

A national survey revealed that in 1982, 42% of dentists in private practice were not using dental sealants.

Nursing-Bottle Tooth Decay

The practice of leaving babies with bottles containing sugared liquids results in widespread caries referred to as nursing-bottle tooth decay. A 1983-1984 Indian Health Service (IHS) study showed that up to 50% of American Indian/Alaskan Native (Al/AN) preschool-aged children who seek dental services suffer from nursing-bottle tooth decay. Over 40% of AI/AN children under age 5 years had 7 more decayed and/or filled primary teeth in the IHS study. Children with nursing-bottle caries had almost 4 times the amount of tooth decay as those children without nursing-bottle caries.

A study of children ages 3-5 in Head Start programs in Ohio revealed that 14%-15% of children in urban fluoridated areas and 18% of children in urban nonfluoridated areas had nursing-bottle tooth decay.

Smokeless Tobacco

National data suggest that 12 million people used some form of smokeless tobacco in 1985. It is estimated that 16% of 12-17 year-old males used smokeless tobacco in 1985.

A North Carolina study of women who use smokeless tobacco revealed a 4.2% increase in the relative risk of oral cancer among snuff users.

Steven Parker

Parkinson's Disease - Definition, Causes, Symptoms and Treatment

Parkinson's Disease - Definition, Causes, Symptoms and Treatment

Parkinson's disease is a degenerative disorder of the central nervous system.

Parkinson's disease occurs when nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine. At least 500,000 people in the United States currently have PD. Parkinson's disease belongs to a group of conditions called movement disorders. Parkinson's disease is progressive, meaning the signs and symptoms become worse over time. But although Parkinson's disease may eventually be disabling, the disease often progresses gradually. Parkinson disease affects movement (motor symptoms). Typical other symptoms include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients' symptoms may be quite dissimilar and progression of the disease is also distinctly individual. Parkinson's usually begins around age 60. It is more common in men than in women. Symptoms of Parkinson's disease often start on one side of the body first and then affect both sides.

There are many secondary symptoms associated with Parkinson's disease.

Parkinson's disease patients may notice that they are weaker or more tired. Symptoms include disorders of mood, behavior, thinking, and sensation. Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson's. Shaking (muscle tremor). This is one of the first symptoms in three-quarters of people, and affects most people with Parkinson's disease. Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. The progressive loss of voluntary and involuntary muscle control produces a number of secondary symptoms associated with Parkinson's. Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily.

Parkinson's disease requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition.

Medications can help manage problems with walking, movement and tremor by increasing the brain's supply of dopamine. Amantadine may also be added to carbidopa-levodopa therapy for people in the latter stages of Parkinson's disease. Catechol-O-methyl-transferase (COMT) inhibitors drugs prolong the effect of carbidopa-levodopa therapy by blocking an enzyme that breaks down dopamine. Tolcapone (Tasmar) is a potent COMT inhibitor that easily crosses the blood-brain barrier. A medicine called levodopa is often given to people who have Parkinson's disease. Called "L-dopa," this medicine increases the amount of dopamine in the body and has been shown to improve a person's ability to walk and move around. Thalamotomy involves the destruction of small amounts of tissue in the thalamus - a major brain center for relaying messages and transmitting sensations.

Parkinson's Disease Treatment

• * Carbidopa and benserazide are dopa decarboxylase inhibitors.
• * Tolcapone inhibits the COMT enzyme, thereby prolonging the effects of L-dopa, and so has been used to complement L-dopa.
• * Selegiline and rasagiline reduce the symptoms by inhibiting monoamine oxidase-B (MAO-B).
• * An antiviral drug, amantadine, can help reduce symptoms of PD and levodopa-induced dyskinesia.
• * COMT (catechol-O-methyl-transferase) inhibitors are a new class of drugs that stop the breakdown of dopamine.
• * Other therapies that are important for managing and coping with Parkinson's disease include physiotherapy, speech therapy, and occupational therapy.
• * Amantadine acts like a dopamine replacement drug but works on different sites in the brain.

Juliet Cohen

Parkinson's Disease And Its Effects On The Mind And Emotions

Parkinson's Disease And Its Effects On The Mind And Emotions

When the phrase "Parkinson's disease" is mentioned the majority of people will automatically think about the physical symptoms associated with the condition such as the tremors, the loss of mobility and other motor impairments. However coping with Parkinson's disease also take a tremendous toll on the emotional well being of the sufferer; something that many people don't consider.

Feelings of anxiety, frustration, embarrassment at not being able to do every day things and often depression can have a huge effect on Parkinson's patients. These psychological symptoms occur as a result of the physical symptoms and can have a very negative effect on a person. Depressive episodes are seen in an average of 50% of patients and these episodes often alternate with anxiety attacks so that the patient has the symptoms of a manic-depressive. Alternating emotional outbursts of depression and anxiety are common in around 80% of cases.

Partial memory loss can also add to the psychological stresses felt by a Parkinson's sufferer. As the disease progresses, patients can begin to forget dates, names and faces which can be quite traumatic, especially when the sufferer knows that a person is a loved one but they can not recall their name or what relation they are to them.

However with a loving support system of friends and family and all the information that can possibly be known about Parkinson's disease, many of the emotional symptoms of the disease can be kept under control i.e. depressive episodes and feelings of frustration. It is very helpful to a sufferer if they can join a local support group as well so that they can talk about their emotions with people who understand exactly what they are going through. Simply having someone who is experiencing the same feelings and frustrations can prove to be a very positive influence.

It is also helpful for a Parkinson's sufferer to participate in activities that hold their interest, be they physical activities or mental activities. Having happy experiences can quickly fend off any depressive feelings and mental exercises will help to keep the brains functioning normal for longer. Any activity can be enjoyed with the support of a loved one so for example daily exercises can be made fun if they are performed to music with a partner. They can even become a bit of a competition with a reward for the winner.

For the Parkinson's sufferer, work can be both a burden and a release. Explaining the situation to management can mean that allowances are often made so that stress levels and physical labor are kept to a minimum. People in general are very understanding when it comes to long term illness in the workplace and a good boss will help in any way they can. This means that a Parkinson's disease sufferer can remain active and with the people they know for much of the day, thus leaving less time to sit and contemplate their condition. Research has shown that the most emotionally stable Parkinson's disease patients are those who can make a joke out of their symptoms and who don't let the condition get them down, under any circumstances.

Jeremy Parker