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Dr. Steven D. Cohen, DMD PC

Sudbury Dental Center      57 Codjer Lane, Sudbury, MA 01776

Phone: (978)443-3992   Fax: (978) 443-6941   Email:





Q: What causes bad breath and how can I prevent it?

A: Most halitosis or bad breath is caused by bacteria. These bacteria live under your gums, between your teeth and nestled between the stalks of the taste buds on the back of your tongue. These bacteria eat the same foods that you eat. Some of their waste products are sulfur mercaptans. The compounds release the characteristic odor of bad breath.

There are several things that you can do to control or eliminate bad breath. First and foremost is to increase the efficiency of your oral hygiene: brush and floss more. Brush or use a special tongue scraper to clean the back of your tongue. Incorporate special bad breath rinses and creams that you can get from your dentist. Avoid mouth rinses that contain alcohol. Alcohol is reported to dry your gums which promotes bacterial growth. The few over the counter alcohol free mouth rinses available do not contain the same bad breath fighting ingredients that are in the dental office rinse.

Q: Can teeth be vaccinated against decay?

A: Protection against decay is possible, by covering teeth with a protective shield called a SEALANT. First recognized by the A.D.A. in 1971, it is one of the best kept secrets in dentistry. The A.D.A. states that as long as a sealant remains intact, the tooth surface will be protected from decay. Both children and adults can benefit from sealants. They are EASY AND PAIN FREE to place.

Flourides are a second option for preventing decay. In office fluoride gel applications and coating the teeth with a fluoride varnish greatly reduce the possibility of decay. Also, brushing twice a day with a fluoridated toothpaste, flossing once a day, fluorinated water and regular professional cleanings are the norm for preventing decay.

Q: Can chewing ice damage my teeth?

A: YES. Many fractured teeth are the result of ice chewing. Once exceptional pressure has been placed on a tooth it may fracture in several ways. A simple fracture is where only enamel and dentin cleave off the tooth. A more complicated fracture is when the defect enters the nerve or splinters below the gum. It is possible to save some of these teeth with these types of fractures. The worst type of fracture is when the tooth splits in two./ Here, the ice has worked like a wedge to divide tooth in two. This type of fracture is usually non-treatable and results in an extraction.

Q: What are my options for whitening my teeth?


This is the most predictable and usual form of at home dental whitening. Two visits are required. At the first visit dental impressions are taken. In the interim between the first and second appointments custom made whitening trays are created just for your mouth. At the second visit these trays are fitted to your mouth and you are given a prescribed concentration bleaching gel and instructions. For most patients in less than two weeks your teeth are whiter.

Q: Do I really need to floss?

A: Most bad breath originates from bacterial decomposition of food trapped under the gums, between the teeth and around the long filament type of tastebuds located on the back of your tongue. Remove the bacteria and food daily by brushing, flossing and scraping and you'll help sweeten your breath. These same bacteria living between the teeth cause cavities. Tooth brushing along won't remove them, only floss will clean between your teeth. That is why if you get a cavity in this area, it is called a flossing cavity.

The bacteria living on and below the gums cause both gum and bone disease. As they eat or decompose the food, they produce waste products called toxins that are cellular "poisons" that cause your gums to become swollen, red, painful and to bleed easily. This is a common gum disease called gingivitis. The only way to prevent gingivitis from occurring is to floss under the gums and to brush above the gums. If enough time elapses without flossing then gum disease can worsen into bone disease. In this stage, the bacteria have actually invaded the gums and have produced an infection of the bone, gums and ligament. Bone disease, unlike gum disease is not reversible. If caught early enough bone disease can be halted, if left untreated long enough then the bone surrounding the tooth will have resorbed or "rotted" away leaving the tooth loose and mobile. At this point the tooth might not be able to be saved.

Your dentist should be checking your gums at each of your three, four or six month cleaning. The health of your gums is evaluated by noting location and amounts of bleeding, location of food collection, measuring the space between the tooth and the gum and by reviewing your brushing and flossing skills and habits. Heart disease and heart attacks are linked to bacterial dental plaque. Current research has indicated that arteriosclerotic plaques found in your arteries (yes, we all have some deposits) could have been initiated by bacteria associated with gum disease. Other current research indicates that blood clots formed by bacteria found in dental plaque could have caused heart attacks.

Q: Do dentists and hygienists get cavities?

A: Not usually. Three main reasons why dental professionals do not get cavities are:

  1. Because most of us brush and floss regularly and we use the proper toothbrush.
  2. Because when we can't brush after eating, then we will rinse our mouths with water and/or chew some sugar free gum.
  3. Because most of us receive regular professional dental cleanings



Q: What is a sealant?

A: A sealant is a plastic resin covering the chewing surface of a tooth. It is bonded into the depressions and grooves of the chewing surface. Its purpose is to act as a barrier, protecting the enamel of the chewing surface from decay.

Q: How long do sealants last?

A: Sealants usually last several years before a reapplication is needed. During regular dental visits part of the oral examination is to check the condition of your sealants.

Q: Are sealants just for kids?

A: Because decay starts early, kids are the usual candidate for sealants. But adults benefit from sealants too! A history of decay, lack of fluorides and chronic dry mouth are factors that help determine if an adult is a candidate for sealants.

Q: How can I make my child’s dental visit as positive as possible?

A: A pre-appointment doctor-parent consultation is a good first step for insuring a positive first visit. If that is not feasible then hear are a few tips: First, never let anyone tell your child scary dental stories, second never tell your child that the visit won’t hurt, that sets them up to expect pain. Third, don’t let your child know if you feel any anxiety about going to the dentist. Fourth, don’t bribe your child to go to the appointment and never use a dental visit as a punishment or threat. Finally and most important, be sure to tell your dentist if your child has ever had an unpleasant hospital emergency room visit or cried at a medical visit. Click here for more information on Children's Dentistry.

Q: When should my baby’s teeth come in?

A: On average primary teeth, your child’s first set, usually begin to erupt at 6 months of age and continue to erupt until 25-33 months. At 6 years of age the first of the adult teeth begin to erupt and that process continues until 17-21 years when the third molars or wisdom teeth erupt. Again, these are average dates and each child will differ in their eruption process.