Oral Health

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• What is oral health?
• How might problems in your mouth be linked to health problems in other parts of your body?
• What are the most common oral health problems?
• What are some other problems I might have with my mouth?
• As a woman, why do I have to worry about oral health?
• I’m pregnant. Do I need to take special care of my mouth?
• I’m a new mother. What can I do for my baby's oral health?
• I’m confused! What type of toothpaste or mouthwash should I use?
• I’m not happy with the stains on my teeth. How can I safely whiten them?
• What small, easy steps can I take to have a healthy smile?
• For More Information...

 

What is oral health?

Good oral health does not just mean you have pretty teeth. Your whole mouth needs care to be in good health. The word “oral” refers to the mouth, which includes your teeth, gums, jawbone, and supporting tissues. Taking good care of your oral health can prevent disease in your mouth. Oral health can also affect the health of your body. It is easy to take your oral health for granted. But good oral health is key to your overall health.

How might problems in your mouth be linked to health problems in other parts of your body?

The health of your mouth can be a sign of your body’s health. Mouth problems are not just cavities, toothaches, and crooked or stained teeth. Many diseases, such as diabetes, HIV, cancer, and some eating disorders, can cause oral health problems. For instance, people with diabetes can develop tooth and gum problems if their blood sugar stays high. Regular dental exams help you maintain good oral health and avoid related health problems.

What are the most common oral health problems?

The most common oral health problems are cavities and gum disease.

Dental cavities

We are all at risk of tooth decay, or cavities. Bacteria (germs) that naturally live in our mouths use sugar in food to make acids. Over time, the acids destroy the outside layer of your teeth. Then holes and other tooth damage occur.

Gum diseases

Gum diseases are infections caused by bacteria, along with mucus and other particles that form a sticky plaque on your teeth. Plaque that is left on teeth hardens and forms tartar. Gingivitis (jin-juh-VEYE-tuhss) is a mild form of gum disease. It causes red, swollen gums. It can also make the gums bleed easily. Gingivitis can be caused by plaque buildup. And the longer plaque and tartar stay on teeth, the more harm they do. Most gingivitis can be treated with daily brushing and flossing and regular cleanings at the dentist’s office. This form of gum disease does not lead to loss of bone or tissue around the teeth. But if it is not treated, it can advance to periodontitis (pair-ee-oh-don-TEYE-tuhss). Then the gums pull away from the teeth and form infected “pockets.” You may also lose supporting bone. If you have periodontitis, see your dentist for treatment. Otherwise your teeth may loosen over time and need to be removed.

Your risk of gum disease is higher if you:

• smoke
• have a disease such as diabetes or HIV/AIDS

Normal, healthy gums Healthy gums and bone anchor teeth firmly in place.	Periodontitis Plaque left on teeth hardens into tartar. As plaque and tartar build up, the gums pull away from the teeth and pockets form between the teeth and gums. Bone supporting the teeth may get infected and start to weaken.	Advanced periodontitis The gums recede further, destroying more bone and the ligament around the tooth. Teeth may become loose and need to be removed.

What are some other problems I might have with my mouth?

Burning mouth. People with this condition describe a burning feeling in the mouth or tongue. It is most common in postmenopausal women. The cause is unknown, but might be linked to:

• hormones
• dry mouth
• taste problems
• nutritional deficiencies
• use of ACE inhibitors (blood pressure medicines)

Talk to your doctor or dentist if you have burning mouth. Treatment depends on the cause—if it can be determined—and might include menopausal hormone therapy, vitamin supplements, or pain or other medicines.

Cold sores. These small, painful sores are caused by herpes simplex virus type 1. Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include:

• getting too much sun
• having a cold or infection
• having your period
• feeling stressed

Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring. You can buy over-the-counter drugs to put on cold sores to help relieve pain. If you get cold sores a lot, talk with your doctor or dentist about a prescription for an antiviral drug. These drugs can help reduce healing time and the number of new sores.

Canker sores. These sores are small ulcers inside the mouth. They have a white or gray base and a red border. Women are more likely than men to have canker sores that recur. The cause of canker sores is unknown. Risk factors include:

• fatigue
• stress
• your period
• a cut on the inside of your cheek or on your tongue
• allergies
• celiac disease
• Crohn’s disease

Canker sores most often heal on their own in 1 to 3 weeks. See your dentist if you get a large sore (larger than a half inch). You may need medicine to treat it.

To help with pain:

• avoid hot, spicy foods
• use mild mouthwashes or salt water
• try over-the-counter coatings or pain medicines

No proven way exists to prevent canker sores. If you get them often, talk with your dentist.

Thrush, called oral candidiasis (kan-dih-DEYE-uh-suhss). These fungal infections appear as red or white lesions, flat or slightly raised, in the mouth or throat. They can be caused by overgrowth of the fungus Candida. This fungus lives naturally in your mouth. Your risk of getting thrush increases if:

• you have a weak immune system
• you don’t make enough saliva
• you take antibiotics

Treatment includes antifungal mouthwash or lozenges. If the infection spreads or your immune system is weak, you may need antifungal medicine.

Thrush is common among:        

• denture wearers
• people who are very young or elderly
• people with dry mouth

If you wear dentures, clean and remove them at bedtime. Talk with your dentist about medicines that may be helpful if you have thrush.

Dry mouth, called xerostomia (ZEER-oh-STOM-mee-uh). This problem happens when you don’t have enough saliva in your mouth. Some reasons why people get dry mouth include:

• side effect of medicines or medical treatment
• health problems, such as saliva and salivary gland disorders and rheumatoid arthritis
• blockage of a salivary gland

Dry mouth may make it hard to eat, swallow, taste, and speak. If left untreated, it can lead to cavities. This is because saliva helps rid your mouth of bits of food and helps stop acid from forming plaque on your teeth. Treatment of dry mouth depends on the cause and can range from medicines to diet changes. To lessen the dryness, use artificial saliva, suck on sugarless candy, and use a humidifier.

Bad breath, called halitosis (hal-lih-TOH-suhss). Bad-smelling breath can be caused by several things, including:

• poor oral hygiene
• some foods
• dentures
• gum disease
• dry mouth
• tobacco use
• respiratory, digestive, or other health problems
• some medicines

Practicing good oral hygiene and avoiding tobacco and some foods often helps people with bad-smelling breath. But if doing so doesn’t seem to help or if you always need mouthwash to hide bad breath, talk to your dentist.

Oral cancer. This cancer can affect any part of the mouth. If you smoke or chew tobacco, you are at higher risk. Alcohol use along with smoking raises your risk even more. Yet more than 25 percent of oral cancer affects nonsmokers.

Oral cancer most often occurs after age 40. It isn’t always painful. So it may go undetected until the late stages. Ask your doctor to check for signs of oral cancer during your regular checkup. Oral cancer often starts as a tiny white or red spot or sore anywhere in the mouth. Other signs include:

• a sore that bleeds easily or does not heal
• a color change in the mouth
• a lump, rough spot, or other change
• pain, tenderness, or numbness anywhere in the mouth or on the lips
• problems chewing, swallowing, speaking, or moving the jaw or tongue
• a change in the way the teeth fit together

Oral problems from cancer therapies. Treatments such as chemotherapy or radiation to the head and neck can cause dry mouth, tooth decay, painful mouth sores, and cracked, peeling lips. Get a complete dental exam before starting cancer treatment.

As a woman, why do I have to worry about oral health?

Everyone needs to take care of their oral health. But female hormones can lead to an increase in some problems, such as:

• cold sores and canker sores
• dry mouth
• changes in taste
• higher risk of gum disease

Taking good care of your teeth and gums can help you avoid or lessen oral health problems.

I’m pregnant. Do I need to take special care of my mouth?

Yes! If you are pregnant, you have special oral health needs.

Before you become pregnant, it is best to have dental checkups every 6 months. You want to keep your mouth in good health before your pregnancy.

If you are pregnant and have not had regular checkups:

• Have a complete oral exam early in your pregnancy. Because you are pregnant, your dentist might not take routine x-rays. But if you need x-rays, the health risk to your unborn baby is small.
• Remember dental work during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. In the last months, you might be uncomfortable sitting in a dental chair.
• Have all needed dental treatments. If you avoid treatment, you may risk your and your baby’s health.
• Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis. Both poor oral hygiene and higher hormone levels can cause pregnancy gingivitis. Until now, it was thought that having gum disease could raise your risk of having a low-birth-weight baby. Researchers have not been able to confirm this link, but studies are still under way to learn more.

I’m a new mother. What can I do for my baby’s oral health?

You can do a lot! Below are some things you need to know about your baby’s oral health.

• The same germs that cause tooth decay in your mouth can be passed to your baby. Do not put your baby’s items, such as toys, spoons, bottles, or pacifiers in your mouth.
• Wipe your baby’s teeth and gums with a clean gauze pad or baby toothbrush after each nursing and feeding. This can help remove sugars found in milk that can cause tooth decay.  
• If you bottle-feed your baby, try to finish bottle weaning by age 1. Avoid giving your baby bottles or pacifiers at naps and bedtime. Sucking on a bottle when lying down can harm your baby’s teeth.
• All babies should visit a dentist by age 1. The dentist will screen for problems in your baby’s mouth. You will also be shown how to care for your child’s teeth and mouth.
• Talk with your doctor about the best water choices for infants. Fluoride is good for teeth. But too much fluoride can harm development of tooth enamel in infants.

I’m confused! What type of toothpaste or mouthwash should I use?

Many types of toothpastes line the store shelves. Some say they’re made for whitening, others for reducing gingivitis and plaque, and others for sensitive teeth. Before choosing toothpaste for your family, know the basics.

• As long as toothpaste contains fluoride and its box has the American Dental Association’s (ADA) seal of acceptance, it is good for your oral health. Beyond that, choosing toothpastes is a personal choice.
  
• Mouthwashes claim to freshen your breath. But they really only mask breath odor for a few hours. If you always need to use a mouthwash to hide bad breath, see your dentist.

I’m not happy with the stains on my teeth. How can I safely whiten them?

Safe whitening options vary in price and how well they work:

• Chairside bleaching or “power bleaching.” In your dentist’s office, he or she applies a gel or rubber shield to protect your gums and oral tissues. Then bleach is put on your teeth. Ask if the bleaching agents have the ADA seal. A special light or a laser may be used to help the bleach work better. But no products that use lasers are accepted right now by the ADA. With this method you may have to go for more than one visit. You will see results right away (about five shades brighter). It works well on a range of stains.
• Dentist-dispensed and over-the-counter bleaching products. These products are for home use. They contain peroxide(s), which bleach the tooth enamel. Most come in a gel and are placed in a mouth guard or tray that fits inside your mouth. How long you use them depends on the results you’re looking for and if you are sensitive to the bleach. Some products are used twice a day for 2 weeks, and others are used overnight for 1 to 2 weeks. They help many types of staining. Your teeth turn about six shades brighter with long-lasting results. But only the dentist-dispensed solutions have the ADA seal.
• Over-the-counter whitening products. These products are for home use and include whitening strips, paint-on products, gels, and trays. They have a low amount of peroxide. You wear some during the day and apply some at night before bedtime.  They can help staining due to age and certain foods. Your teeth turn about two shades brighter for up to 6 months. For better results, have a cleaning at the dentist before you use these products. These gels and trays do not have the ADA seal.
• Whitening toothpastes. All toothpastes help remove surface stain through mild abrasives. "Whitening" toothpastes that have the ADA seal have special polishing agents that remove even more stains. Unlike bleaches, these products do not change the actual color of teeth. They help surface stains only. You might see short-term results that are one to two shades brighter.

Products used to whiten teeth can make teeth more sensitive. They can also bother your gums. These side effects most often go away after you stop using the product.

Before using whitening products, talk with your dentist. He or she can help you decide which method is best for the type of stains on your teeth. Not all products work on all people. Options offered by your dentist can be expensive, so ask your dentist to fully explain the results you can really expect. Keep in mind that whitening your teeth does not make your mouth any healthier. 

What small, easy steps can I take to have a healthy smile?

1. Brush your teeth at least twice each day with fluoride toothpaste. Aim for first thing in the morning and before going to bed. Once a day, use floss or an interdental cleaner to clean food your toothbrush missed.

Make sure you:

• Drink water that contains added fluoride if you can. Fluoride protects against dental decay. Most public water systems in the United States have added fluoride. Check with your community’s water or health department to find out if there is fluoride in your water. You also may want to use a fluoride mouth rinse, along with brushing and flossing, to help prevent tooth decay.
• Gently brush all sides of your teeth with a soft-bristled brush. Round and short back-and-forth strokes work best.
• Take time to brush along the gum line, and lightly brush your tongue to help remove plaque and food.
• Ask your dentist or dental hygienist to show you the best way to floss your teeth.
• Change your toothbrush every 3 months, or earlier if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque.
• If you wear dentures, be sure to remove them at night and clean them before putting them back in the next morning.

2. Have a healthy lifestyle.

• Eat healthy meals. Cut down on tooth decay by brushing after meals. Avoid snacking on sugary or starchy foods between meals.
• Don’t smoke. It raises your risk of gum disease, oral and throat cancers, and oral fungal infections. It also affects the color of your teeth and the smell of your breath.
• Limit alcohol use to one drink per day for women. Heavy alcohol use raises your risk of oral and throat cancers. Using alcohol and tobacco together raises your risk of oral cancers more than using one alone.
• Limit how much of soda you drink. Even diet soda contains acids that can erode tooth enamel.

3. Get regular checkups.

• Have an oral exam once or twice a year. Your dentist may recommend more or fewer visits depending on your oral health. At most routine visits, the dentist and a dental hygienist will treat you. During regular checkups, dentists look for signs of diseases, infections, problems, injuries, and oral cancer.
• See your dentist right away if
• your gums bleed often
• you see any red or white patches on the gums, tongue, or floor of the mouth
• you have mouth or jaw pain that won’t go away
• you have sores that do not heal within 2 weeks
• you have problems swallowing or chewing
• Besides your dentist, other types of dental providers include:
  • Dental hygienists: Members of the dental staff who clean gums and teeth and teach patients how to maintain good oral health.
  • Periodontists: Dentists who treat gum disease and place dental implants.
  • Oral surgeons: Dentists who operate on your mouth and supporting tissues.
  • Orthodontists: Dentists who straighten teeth and align jaws.
  • Endodontists: Dentists who perform root canals.
  • Prosthodontists: Dentists trained in restoring and replacing teeth.

4. Follow your dentist’s advice.
Your dentist may suggest ways to keep your mouth healthy. He or she can teach you how to properly floss or brush. Follow any recommended steps or treatments to keep your mouth healthy.

5. If you have another health problem, think about how it may affect your oral health.
For instance, if you take medicines that give you a dry mouth, ask your doctor or nurse if there are other drugs you can use. Have an oral exam before starting cancer treatment. And if you have diabetes, practice good oral hygiene to prevent gum disease.

For More Information...

For more information on oral health, call womenshealth.gov at 1-800-994-9662 or contact the following organizations:

Division of Oral Health, NCCDPHP, CDC, OPHS, HHS
Phone: (770) 488-6054
Internet Address: http://www.cdc.gov/OralHealth/index.htm

National Institute of Dental and Craniofacial Research (NIDR), NIH, HHS
Phone: (301) 496-4261
Internet Address: http://www.nidr.nih.gov

National Oral Health Information Clearinghouse (NOHIC), NIDR, NIH, HHS
Phone: (301) 402-7364
Internet Address: http://www.nidcr.nih.gov/OralHealth

American Academy of Pediatric Dentistry (AAPD)
Phone: (312) 337-2169
Internet Address: http://www.aapd.org

American Dental Association (ADA)
Phone number: (312) 440-2500
Internet address: http://www.ada.org

Academy of General Dentistry
Phone number: (888) 243-3368
Internet address: http://www.agd.org/public/OralHealthFacts/

All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the sources is appreciated.

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Content last updated September 23, 2008.