Can Medication Have an Effect on My Oral Health?
oral health medication

Yes, medications can have oral side effects — dry mouth being the most common. Be sure to tell your dentist about any medications that you’re taking, even medicines that you purchase without a prescription.

These are the types of medications that will often produce dry mouth:

  • Antihistamines
  • Decongestants
  • Pain Killers
  • Diuretics
  • High Blood Pressure Medications
  • Antidepressants

Other medications may cause abnormal bleeding when brushing or flossing, inflamed or ulcerated tissues, mouth burning, numbness or tingling, movement disorders and taste alteration. If you experience any of these symptoms,  please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

Follow the development of a cavity and learn how minor changes to your daily routine can help protect your smile.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

How to Care for Children’s Teeth

This short video teaches you the correct way to brush children’s teeth giving them a healthy start toward a lifetime of good oral health.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

Tooth human implant (done in 3d graphics)

Dental implants are increasingly valuable tools in modern dentistry. Although they have been available for more than a quarter of a century, only in the last decade has technology advanced so that implants can be considered the optimal solution for missing teeth. Instead of endless rounds of heroic attempts to save a failing tooth, it is increasingly simpler, less invasive, and more cost-effective to replace the failing tooth with a dental implant.

If relatively little tooth structure remains supragingivally or furcation involvement is incipient, then conventional therapy could be tedious, time-consuming, and short-lived. If root caries are rampant, periodontal disease is aggressive, or systemic health is in decline, then aggressive therapy to save a failing dentition could be as counterproductive as it is contraindicated. Interceptive implant therapy should be considered under these circumstances.

Today, most dental implants can be placed in simple 1-stage surgical procedures. Long-term survival rates have been steadily improving, even in smokers. Restorative processes are simpler and more reliable.

Modern dental implants are generally made from titanium, with a threaded and rough microsurface on the outside. They come in lengths ranging from 7 to 16 mm and diameters from 3.5 to 6.0 mm. Increasingly, implants tend to be manufactured so that tapering aids initial stability. A special subclass of 1-piece small-diameter implants is also available.

Dental Implants

The 4 portionsof implants (Figure 4) are:

  • Implant body;
  • Collar;
  • Connection; and
  • Abutment.[1]

Figure 4. Schematic of a dental implant.

Implant body. The implant body is the portion inserted in the bone, with an exterior surface designed to osseointegrate (fuse) to the bony surface with which it comes into contact.

The rough surface interfacing with bone is generally achieved by abrasively blasting the exterior surface before it is treated with special acids. This creates an extremely porous microsurface, which facilitates osseointegration.[2]The improved osseointegration of modern implants has resulted in higher survival rates over earlier-generation systems.[3]

Collar. The collar is the upper part of the implant body that traditionally starts the passage through the gingival complex into the mouth.

With early implants, bone and gingiva levels used to “die-back,” “lose bone,” or “develop biologic height” when exposed to the oral environment. A variety of collar designs were developed to try and minimize this bone loss. The implants have now improved so that bone loss with modern systems is greatly reduced, with the result that implants are now electively placed deeper into the bone.

Connection. This is a 2-part device. The first part lies generally inside the implant body. The other component of the abutment or restorative device fits inside and is secured with a screw.

This portion can make a restoration either extremely difficult or quite simple. Problems can result if the connection is weak, fragile, easily worn, or has high rotational instability. Clinical procedures can become complex, tedious, and liable to fail. If not stable, screws can loosen and restorations can fall off. In contrast, deep, strong connections with good rotational stability make life simple for the restorative dentist and allow for fabrication of more durable restorations.[4]

Abutment. This device fits into the connection and emerges to pass through the gingival complex with an “emergence profile” (the form passing through the gingival complex) and a final portion, which retains the final crown.

As the trend to place implants deeper continues, development of the “emergence profile” in the abutment becomes more important. When placed properly, the portion of the implant emerging from the gingiva allows the implant to reproduce the shape, appearance, and color of a tooth. Traditionally made of titanium, abutments have also been made with a cast gold process and increasingly with zirconia, at least in the emergence and restorative portion of the implant. This material allows for a custom form, provides the optimal gingival reaction, and has a natural color. A conventional crown provides the final restoration.

A Natural Result

Implant-based restorations can only appear natural when the surrounding soft and hard tissues in the region appear “normal.” As in this case, soft and hard tissue augmentation is often required at the time of implant placement to generate the desired aesthetic and functional result.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

People should avoid or limit consumption of foods and other products that stain teeth, such as tobacco, soy sauce, soft drinks, red and white wine and blueberries.Eating certain foods and avoiding others can help keep your teeth white after you’ve used an at-home whitening kit or had cosmetic bleaching, an expert says.

People should avoid or limit consumption of foods and other products that stain teeth, such as tobacco, soy sauce, soft drinks, red and white wine and blueberries.

“For many individuals who have had good results with either dentist-directed or over-the-counter whitening techniques, a significant concern is how to keep the teeth white after bleaching,” Dr. Raymond Garrison, professor and chairman of the Wake Forest Baptist Department of Dentistry, said in a Wake Forest Baptist Medical Center news release.

“We now know that there are foods that actually help to keep your teeth white rather than stain them. In fact, it may help patients avoid the time and expense of whitening retreatment.”

Firm fruits and vegetables such as apples, green beans, cauliflower, carrots and celery help scrub teeth while you chew. They also help promote the flow of saliva, which neutralizes acids and protects teeth, Garrison said.

Dairy products, especially those high in calcium, and cheeses also help keep teeth white. The lactic acid in these products helps prevent decay. Harder cheeses also help remove food particles left on the teeth.

People should avoid or limit consumption of foods and other products that stain teeth, such as tobacco, soy sauce, soft drinks, red and white wine and blueberries.

While bleaching is an effective method for whitening teeth, it can cause short-term effects such as sensitivity. Too many whitening treatments can lead to permanent damage, such as erosion of tooth enamel.

Before you undergo bleaching or use teeth whitening kits, consult a dentist, Garrison advised.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

crooked teethThe American Association of Orthodontists reports that in the United States 4.5 million people are wearing braces or other dental appliances to straighten teeth and provide a healthy, beautiful smile (1). As many of us know, an orthodontist is a dentist with additional clinical training to treat malocclusions (improper bites), which may result from tooth irregularity and jaw issues.

Why Do Teeth Become Crooked?

Terry Pracht, DDS, past president of the American Association of Orthodontics says that both heredity and environmental factors can create crooked teeth and bite problems. Dr. Pracht mentions that hereditary factors include crowded teeth, teeth where there is too much space and malocclusions. He also mentions that crooked teeth can be caused by thumb sucking and tongue thrusting as well as accidents occurring to the jaw (1).

What are Treatment Options to Straighten Teeth or Malocclusions?

There are three stages of orthodontic treatment. The first is when appliances are used to gain space in the mouth. For example, palatal expanders are used to expand the width of the palate and lingual bars are used to expand the lower jaw. The active corrective stage is next when the braces are placed on the teeth. The teeth are then adjusted and then straightened and malocclusions are corrected over a period of time based upon the severity of the irregularity of the teeth and jaw issues. The third stage is the retention stage after braces are removed and when the teeth are monitored through the use of a retainer (removable or fixed) and semi-annual orthodontic visits are conducted to maintain the straightened smile.

Types of Braces

Braces from over 30 or so years ago included large metal bands that were enclosed and cemented around each tooth. Braces can be attached to the cheek side of the teeth as well as the tongue side of the teeth depending on what your orthodontist recommends to you for treatment. Braces, arch wires and bands can be colorful and a lot of fun for children, adolescents and teenagers to choose from.

Today, tiny brackets are placed onto the front surface of the tooth and are made of metal or ceramic. The brackets are bonded to the front tooth surface with a glue-like material and metal bands can be used on the back teeth. Arch wires are placed inside the brackets and are made of a heat-activated nickel-titanium source that can become warm due to the temperature in the mouth, which will allow it to apply constant pressure on the teeth as well as when the arch wires are adjusted at the orthodontist’s office.

Another newer alternative to braces is the Invisalign system which uses a series of clear removable aligners that are worn during the day and night to help in moving teeth into the correct alignment. When eating or brushing and flossing, the aligners may be removed.

Caring for Braces

Your orthodontist, dentist or dental hygienist will provide you with thorough instruction of how to properly clean your braces. There are many toothbrushes you can use both manual (specifically designed for orthodontic patients), power, electric or sonic. Ask your dental professional which is be best for you. Brushing should be conducted at least 2-3 times per day at a 45 degree angle in a back and forth motion. Be sure to remove plaque at the gum line to prevent gingivitis (inflammation of the gum tissue). Be sure to angle the toothbrush at the gum line and then gently brush around the brackets to remove plaque and food debris.

It is very important to clean in between your teeth with a floss threader and floss, a stimudent (tooth pick cleaner) or a proxabrush (interproximal cleaning brush) may be used if there is space between the teeth. Oral irrigators may be recommended to remove food debris and irrigate the gum tissue to remove disease and odor-causing bacteria that may be there if you have gingivitis. An antibacterial toothpaste and over-the-counter antimicrobial mouth rinses could also be used with the oral irrigator or alone.

How to Maintain a Smile After the Braces are Off

After your orthodontist has determined that your braces can be removed, it is very important that a retainer (a plastic appliance) be worn during the day or night as recommended by them. The retainer can be cleaned with warm water or toothpaste and a toothbrush after you wear it and placed in a plastic container when not in use.

See your dental professional for a twice a year professional cleaning and the orthodontist for regular maintenance appointments.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

What Is It?

bad breath halitosisBad breath, also known as halitosis, is breath that has an unpleasant odor. This odor can strike periodically or be persistent, depending on the cause. In many people, the millions of bacteria that live in the mouth (particularly on the back of the tongue) are the primary causes of bad breath. The mouth’s warm, moist conditions make an ideal environment for these bacteria to grow. Most bad breath is caused by something in the mouth.

Some types of bad breath, such as “morning mouth,” are considered to be fairly normal, and they usually are not health concerns. The “morning mouth” type of bad breath occurs because the saliva that regularly washes away decaying food and odors during the daytime diminishes at night while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.

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

  • Poor dental hygiene — Infrequent or improper brushing and flossing can leave food particles to decay inside the mouth.
  • Infections in the mouth — Periodontal (gum) disease
  • Respiratory tract infections — Throat infections, sinus infections, lung infections
  • External agents — Garlic, onions, coffee, cigarette smoking, chewing tobacco
  • Dry mouth (xerostomia) — This can be caused by salivary gland problems, medications or by “mouth breathing.”
  • Systemic illnesses — Diabetes, liver disease, kidney disease, lung disease, sinus disease, reflux disease and others
  • Psychiatric illness — Some people may perceive that they have bad breath, but it is not noticed by oral-health-care professionals or others. This is referred to as “pseudohalitosis.”


A person may not always know that he or she has bad breath. This phenomenon is because odor-detecting cells in the nose eventually become accustomed to the constant flow of bad smells from the mouth. Others may notice and react by recoiling as you speak.

Other associated symptoms depend on the underlying cause of bad breath:

  • Poor dental hygiene — Teeth are coated with film or plaque, food debris trapped between teeth, pale or swollen gums
  • Infections in the mouth — Gums may be red, swollen and bleed easily, especially after brushing or flossing; pus may drain from between teeth; a pocket of pus (abscess) at the base of a tooth; loose teeth or a change in “fit” of a denture; painful, open sores on the tongue or gums
  • Respiratory tract infections — Sore throat, swollen lymph nodes (“swollen glands”) in the neck, fever, stuffy nose, a greenish or yellowish nasal discharge, a mucus-producing cough
  • External agents — Cigarette stains on fingers and teeth, a uniform yellow “coffee stain” on teeth
  • Dry mouth — Difficulty swallowing dry foods, difficulty speaking for a prolonged period because of mouth dryness, a burning sensation in the mouth, an unusually high number of dental caries, dry eyes (in Sjögren’s syndrome)
  • Systemic (bodywide) illnesses — Symptoms of diabetes, lung disease, kidney failure or liver disease


A dentist or physician may notice the patient’s bad breath while the patient is discussing his or her medical history and symptoms. In some cases, depending on the smell of the patient’s breath, the dentist or physician may suspect a likely cause for the problem. For example, “fruity” breath may be a sign of uncontrolled diabetes. A urine-like smell, especially in a person who is at high risk of kidney disease, can sometimes indicate kidney failure.

Your dentist will review your medical history for medical conditions that can cause bad breath and for medications that can cause dry mouth. Your dentist also will ask you about your diet, personal habits (smoking, chewing tobacco) and any symptoms, including when the bad breath was noticed and by whom.

Your dentist will examine your teeth, gums, oral tissues and salivary glands. He or she also will feel your head and neck and will evaluate your breath when you exhale from your nose and from your mouth. Once the physical examination is finished, your dentist may refer you to your family physician if systemic problems are the most likely cause. In severe cases of gum disease, your dentist may recommend that you be seen by a periodontist (dentist who specializes in gum problems).

You will need diagnostic tests if the doctor suspects a lung infection, diabetes, kidney disease, liver disease or Sjögren’s syndrome. Depending on the suspected illness, these tests may include blood tests, urine tests, X-rays of the chest or sinuses, or other specialized testing.

Expected Duration

How long bad breath lasts depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen the mouth immediately, with even more impressive results after a few days of regular brushing and flossing. Periodontal disease and tooth abscess also respond quickly to proper dental treatment. Bad breath resulting from chronic sinusitis may be a recurring problem, especially if it is caused by a structural abnormality of the sinuses.

Bad breath the results from a systemic illness may be a long-term problem that can often be controlled with proper medical care.


Bad breath caused by dental problems can be prevented easily. Daily maintenance calls for brushing your teeth, tongue and gums after meals, flossing, and rinsing with mouthwashes approved by the American Dental Association (ADA). Regular visits to the dentist (at least twice a year) should be made for dental examinations and for professional teeth and gum cleaning.

Bad breath also can be combated by drinking plenty of water every day to encourage saliva production. An occasional swish of the mouth with water can loosen food particles. Other products that keep breath fresh and prevent plaque from forming include sugar-free gum, sugarless lozenges, raw carrots and celery.


The treatment of bad breath depends on its cause.

When To Call A Professional

Call your dentist promptly if you have bad breath with painful, swollen gums that bleed easily or loose teeth. Also, call your doctor if you have bad breath along with a fever, sore throat, a postnasal drip, a discolored nasal discharge or a mucus-producing cough. Even if you have none of these associated symptoms, call your dentist or physician if your bad breath continues despite a good diet and proper dental hygiene.

If you have diabetes, gastroesophageal reflux disease (GERD) or chronic liver or kidney disease, ask your doctor how bad breath can be a sign that your underlying medical condition needs immediate medical attention.


Once bad breath has been diagnosed, the outlook for fresh breath is usually excellent as long as you stick to your dentist’s or physician’s treatment plan.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

What Is Biofilm?

biofilm teethYou may not be familiar with the term biofilm, but it is something that you come into contact with every day. The plaque that forms on your teeth and causes tooth decay and periodontal disease is a type of biofilm. Clogged drains also are caused by biofilm, and you may have encountered biofilm-coated rocks when walking into a river or stream.

Biofilms form when bacteria adhere to surfaces in some form of watery environment and begin to excrete a slimy, gluelike substance that can stick to all kinds of materials–metals, plastics, soil particles, medical implant materials, biological tissues. Biofilms can be formed by a single bacterial species, but biofilms more often consist of many species of bacteria, as well as fungi, algae, protozoa, debris, and corrosion products. Essentially, a biofilm may form on any surface exposed to bacteria and some amount of water.1

Dental plaque is a yellowish biofilm that builds up on the teeth.

Dental plaque is a yellowish biofilm that builds up on the teeth. Biofilms contain communities of disease-causing bacteria and their uncontrolled accumulation has been associated with cavities and gum disease (both gingivitis and periodontitis).1,3

In the past, scientists studied bacteria by looking through a microscope at cells suspended in a water droplet. Today, scientists believe that the disease-causing bacteria do not exist as isolated cells, such as in the water droplet, but rather they adhere to various wetted surfaces in organized colonies that form diverse communities–biofilms.

Where Biofilms Form

Biofilms happily colonize many household surfaces in the bath and kitchen, including toilets, sinks, countertops, and cutting boards. Poor disinfection practices and ineffective cleaning products may increase the incidence of illnesses associated with pathogenic organisms encountered during normal household activity.

How Biofilms Form

  • Free-swimming bacterial cells land on a surface, arrange themselves in clusters, and attach.
  • The cells begin producing a gooey matrix.
  • The cells signal one another to multiply and form a microcolony.
  • The microcolony promotes the coexistence of diverse bacterial species and metabolic states.
  • Some cells return to their freeliving form and escape, perhaps to form new biofilms.

Antibiotic Control of Biofilm

Although gum disease can be controlled by proper oral hygiene (toothbrushing, flossing, rinsing), gingivitis (the mildest form) is still experienced by most of the US population at some point in life; a smaller proportion (30% to 40%) experience periodontitis (the severe form). Treatment of oral infections requires removal of the biofilm and calculus (tartar) from the teeth and gums by surgical or nonsurgical procedures, followed by antibiotic therapy. Unfortunately, these infections are not completely responsive to antibiotics. For this reason, oral infections are chronic diseases that require ongoing treatment and daily care by proper oral hygiene measures. Prevention is the best strategy.2

Oral infections are chronic diseases that require ongoing treatment and daily care.

Chemical Control of Biofilm

When good oral hygiene practices fail to prevent the development of biofilms, toothpastes and mouthwashes with chemotherapeutic agents can be used. These agents can kill microorganisms in the biofilm. Chlorhexidine, triclosan, and essential oils and minerals–agents proven to kill the harmful bacteria–can reduce the degree of plaque and gingivitis, while not allowing disease-causing microorganisms to colonize.3

Biofilm and Your Health

Biofilms are highly resistant to antibiotics. Consequently, very high and/or long-term doses are often required to eradicate biofilm-related infections. Biofilms are responsible for diseases, such as4:

  • Otitis media the most common acute ear infection in US children
  • Bacterial endocarditis infection of the inner surface of the heart and its valves
  • Cystic fibrosis a chronic disorder resulting in increased susceptibility to serious lung infections
  • Legionnaire’s disease an acute respiratory infection resulting from the aspiration of clumps of Legionnella biofilms detached from air and water heating/cooling and distribution systems
  • Hospital-acquired infections infections acquired from the surfaces of catheters, medical implants, wound dressing, or other medical devices

Is Biofilm on Your Oral Appliances?

In addition to biofilm being present in the mouth, it also forms on dental prostheses and appliances, such as removable dentures and partials, mouthguards, and nightguards. Dental prostheses can become colonized with large numbers of microorganisms within 2 hours. Biofilm on your oral appliances and prostheses can increase your risk for cavities and gum disease, especially on the teeth used to maintain your dental prosthesis in your mouth.5

4 Tips to Control Biofilm

  • Brush your teeth and all mouth prostheses or appliances to mechanically disrupt the biofilm. Choose a toothpaste containing antibacterial ingredients, such as triclosan.
  • Rinse your mouth with a mouthwash containing antibacterial ingredients, such as chlorhexidine, cetylpiridinium chloride, or mixture of essential oils in alcohol.
  • Soak your prosthesis with a commercially available cleaner.
  • If your denture liner is cracked, porous, or peeling, ask your dentist to repair it. To eliminate unwanted diseasecausing organisms, ask your dentist to replace your prosthesis every 7 years.

Each permanent tooth serves a specific function, and keeping yours in good shape requires proper oral hygiene. Affordable dental care could make the difference. Your teeth are not just for chewing – their condition also affects your speaking ability, facial shape and general appearance. Maintaining a healthy mouth should be a priority.


Adults normally have 32 permanents, which start to grow in around age 6. The 20 baby ones gradually fall out to make room for the permanents to grow in. A lost permanent tooth will not grow back in, so affordable dental care could be a good investment.

Your pearly whites can be classified into these categories. (This list starts at the back of the mouth and moves toward the front.)

  • Wisdom teeth are usually the last molars to come in. These commonly emerge during the teen years. They appear at the very back of the mouth with two on top and two on the bottom. In many cases they never break through the gum line. People often think that these should be extracted regardless of circumstances, but this is only true if a dentist determines yours will overcrowd the mouth or become infected.
  • Molars have a wide surface for grinding and chewing food. Aside from wisdom teeth (which are also considered molars), adults have eight molars, two on each quadrant of the mouth. They are somewhat flat, with four pointed “corners” known as cusps to help mash food.
  • Premolars, also known as bicuspids, occupy the space between the molars and the cuspids. Adults have eight, with two in each quadrant. These are similar to but smaller than the molars, with only two cusps on the outside edge of each tooth. They are used to crush and tear food.
  • Canines, also called cuspids, are sharp and help the incisors tear food. Adults have only four, one in each quadrant.
  • Lateral incisors have a sharp, chisel-shaped edge for biting food. Adults have four lateral incisors, one in each quadrant.
  • Central incisors are the four front teeth. There are two on the top and two on the bottom. These are shaped similarly to the lateral incisors, except the two on the top are often significantly larger.

How to Take Care of Them

Careful attention to oral hygiene will help maintain healthy teeth as well as cause any problems or inconsistencies to stand out. If problems are noticed early, the issue can be taken care of before it becomes serious. Regular brushing and flossing should be an important part of your daily routine, and checkups and cleanings at the dentist office can keep excess plaque at bay. If you want to keep your pearly whites in working order for a lifetime, you may want to consider a quality, affordable dental plan.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.