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Blog of Cawthra Dental

What To Know About Mouthwash

Mouthwash is an antiseptic-based rinse used to kill harmful bacteria in your mouth. While it can help kill oral bacteria, it is essential to understand the limitations of mouthwash.

Mouthwash cannot manually remove all plaque from your tooth, gum and tongue surfaces, and not all mouthwash can fight against gum disease or dental decay. Therefore, the use of mouthwash cannot replace the need to brush your teeth twice daily and floss once daily. Not all mouthwash is created equal. Some have better and more medicinal ingredients than others. Be sure to look for a mouthwash that is either approved by the CDA (Canadian Dental Association) or the ADA (American Dental Association.)

When to Use Mouthwash 

As stated above, mouthwash cannot remove all plaque from your teeth and gums. It can only help kill bacteria. Be sure to brush and floss your teeth first to remove as much bacteria manually as possible.

If you use a toothpaste containing fluoride, wait 30 minutes before using mouthwash to ensure the fluoride takes full effect. Also, be sure not to rinse your mouth with water after using toothpaste. After 30 minutes, you can use mouthwash. You don’t need to fill your mouth with mouthwash. A few teaspoons are enough if the liquid can access all tooth surfaces and tissues.

Swish the liquid back and forth fur the duration of the rinsing time. Be sure not to swallow any of it! Rinse the liquid for 30 seconds to 1 minute, then spit the contents into the sink.

You can use mouthwash as part of your morning or evening routine or in a pinch if you don’t have access to a toothbrush or have enough time to brush and floss your teeth. General guidelines are to use mouthwash once to twice per day and that it does not replace the need for brushing and flossing. 

Does Mouthwash Work?

Mouthwash helps as an antiseptic to help kill bacteria, but since it cannot remove bacteria colonies on your teeth or gums, it plays a small role in preventing gum disease. If the mouthwash contains fluoride as an active ingredient, it can help to prevent cavities. It may be that people who use mouthwash also take better care of their teeth, so it’s difficult to prove in a study that the simple use of mouthwash helps to prevent gum disease.  

Mouthwash Considerations

It is crucial to avoid swallowing mouthwash, particularly when it contains fluoride or alcohol. Alternatively, there are many brands of mouthwash that do not contain alcohol, which also helps reduce the “burning” sensation that we usually remember when we think about mouthwash. 

Children should be monitored while using mouthwash until they are trusted not to swallow– around 6. 

In short, mouthwash can be a supplemental aid to help with a complete oral hygiene routine, but it likely doesn’t help significantly prevent gum disease or gum inflammation. If the mouthwash contains fluoride, it can help with preventing cavities. Mouthwash works best when used in conjunction with adequate brushing and flossing. Please call us today to book an appointment if you have questions about mouthwash. 


What You Need To Know About Dental Fluorosis

There have been many debates and mixed opinions on the use of fluoride in recent years. Mixed opinions range from whether or not it should be in the municipal water supply and consumed systemically, and also whether it should be used topically at the dentist or in products such as toothpaste. Although fluoride has ample benefits, it is toxic when ingested in significant amounts. 

What is fluoride?

Fluoride is a naturally occurring mineral that has been proven to reduce cavity risk in children and adults by strengthening the outer layer of our teeth, called the enamel. Fluoride accomplishes this by making the structure more ridged. Fluoride has been added to many municipalities’ water supply in low doses to help reduce the cavity risk of entire populations. It is also added to products, such as toothpaste and mouthwash, to be used topically to achieve the same outcome.

What is dental fluorosis?

Dental fluorosis occurs when there is too high an intake of fluoride. Too much fluoride can cause brittle teeth and bones by altering the integrity of the organic structures in our bodies. Dental fluorosis can be caused by too high an amount of fluoride in the drinking water or by swallowing products that contain fluoride, such as toothpaste. Fluorosis typically affects the adult teeth because a child will begin using products containing fluoride around three years old until the adult teeth start erupting. 

Fluoride in municipal water 

Adding fluoride to the municipal water supply started when it was observed that natural drinking water in Colorado contained higher amounts of naturally occurring fluoride, and the surrounding communities had lower rates of cavities. At first, many municipalities added too much fluoride to the drinking water, leading to many cases of fluorosis. Since then, fluoride has been reduced to a level that will not cause fluorosis. 

Signs of dental fluorosis 

The teeth will appear discoloured and have white, yellow, or brown notches. These discolorations can range from mild to severe, depending on the level of fluorosis. The enamel will be rough, pitted and not smooth. Teeth with fluorosis will be more susceptible to chipping, breaking and wear. 

Preventing dental fluorosis 

Drinking water is safe to consume in most municipalities, as the fluoride content has been greatly reduced. Children should be monitored while using products containing fluoride until at least the age of 6 to make sure they aren’t eating or swallowing it. 

Treating dental fluorosis 

Treatment may be required to repair the teeth’ surfaces, including dental bonding, veneers or dental crowns. 

If you have questions about dental fluorosis, we encourage you to contact us today.

Most Common Oral Conditions

Let’s review the most common oral conditions that patients experience, the signs and symptoms associated with these conditions, and ways to help prevent and treat these conditions. 


Cavities are one of the most common dental conditions in children and adults. They are holes in the tooth’s structure caused by bacterial accumulation called plaque. Cavities can occur on the biting surfaces, gum lines or between the teeth, leading to infection and tooth loss if left untreated. Cavities are treated with dental fillings, which are used to fill in and replace the decayed tooth structure. To prevent cavities, maintain good oral hygiene and use toothpaste containing fluoride. Also, be sure to limit your exposure to sugars. 

Gum Disease 

Another prevalent oral condition is gum disease. Gum disease starts out as gingivitis, an inflammation of the gums. When left untreated, gingivitis progresses to periodontitis, an infection of the bone and ligament surrounding the teeth. Signs and symptoms of gum disease include bleeding/ tender gums, bad breath, gum recession and loose teeth. Good oral hygiene and regular dental visits are vital to preventing gum disease. 


Tooth staining and discolouration can happen for many reasons and sometimes occurs with time and age. There are two types of staining, external staining (caused by dietary choices such as coffee and tea or smoking) and internal staining (caused by factors such as health, trauma and past dental work.) Internal staining can be removed at a simple dental cleaning and is easier to prevent. To remove internal staining, whitening products containing hydrogen peroxide should be considered. Prevent staining by maintaining good oral care, rinsing your mouth after coffee, tea and red wine, and quitting smoking.  

Chipped Teeth 

A chipped tooth occurs when a portion of the enamel, and sometimes even the underlying structure called the dentin, chip off due to trauma. This may occur for many reasons, such as a blow to the face, clenching or grinding or biting on something hard. Chips are challenging to prevent but can usually be fixed with dental fillings. 

Impacted Teeth 

The most commonly impacted teeth are the wisdom teeth. These are the 3rd molars that tend to erupt around 18 years old if there is space for them. If no room exists for these molars to erupt, they are considered impacted and may need to be extracted. Impacted wisdom teeth can lead to pain, infection and even cavities on neighbouring teeth. 


Tooth sensitivity is a common oral condition experienced by most patients at some point. It isn’t always possible to identify why sensitivity occurs, but it can be related to aggressive brushing, gum recession, tooth erosion, or wear. The best course of action is to use sensitivity toothpaste twice daily for prevention. 

If you have any questions or concerns about these common oral conditions, we encourage you to contact our office today to schedule an appointment.

How Peg-Shaped Teeth are Treated

Peg-shaped teeth, often referred to as “peg laterals,” are a dental condition that affects the size and shape of the upper lateral teeth, which are the second from the centre. It occurs when the teeth do not fully form and erupt smaller in size and sometimes pointier. It may affect both or just one of the upper lateral teeth. The condition may be mild, not affecting the size of the tooth very much, or severe, causing a large discrepancy in size and shape.

Treatment for peg-shaped laterals will depend on size, shape, cost of treatment, recommendation by your dentist and your preference. Listed below are treatment options for peg-shaped teeth. 

No Dental Treatment

Of course, the first option we will discuss is no treatment. If a patient isn’t concerned with the appearance of these teeth and there is no functional problem, they can certainly be left as is. 

Dental Bonding

If the peg laterals are large and strong enough, your dentist may be able to use filling material to bond to the front, edge and side portions of the teeth to build them up and modify their appearance. This is a very cost-effective solution but may not last as long as a more permanent solution such as dental crowns or veneers. Bonding may chip and wear with time and need to be touched up.

Dental Veneers 

A veneer is made in a dental lab and is created to precisely fit your teeth and preferences, changing the tooth’s size, shape and colour. A small portion of the tooth’s outer structure is sanded down, and the veneer is bonded to the front surface. Veneers are a more permanent and lasting solution than dental bonding, but they will also be more expensive. In addition, there has to be enough natural tooth structure to bond the veneer, and if there isn’t, a crown is the only option. 

Dental Crowns 

A crown is the best solution for a peg-shaped tooth’s structural integrity, function, aesthetics and longevity. It is a full coverage cap that gets cemented onto the tooth once it is sanded down. Like a veneer, it is fabricated in a dental lab suited to your mouth to your specifications. Because it is the best and most lasting option, it is also the most costly. 

Call us to book an appointment today to discuss the treatment of your peg-shaped teeth.

Oral Health Effects of Eating Disorders

What we eat and drink can affect the health of our teeth and mouth. Eating disorders cause nutritional deficiencies that affect the soft or hard tissues of the mouth and teeth. An eating disorder can sometimes exhibit the first symptoms in the mouth. These effects may be temporary or even permanent, given the severity.

Early detection of an eating disorder may help and make the recovery process easier and more successful. Having the correct information and receiving guidance from your dentist and dental hygienist through recovery is essential.

Gums and oral tissues are more likely to bleed easier with inadequate nutrition. You may experience swollen salivary glands, and your mouth may become drier.

The key nutrients from a balanced diet that promotes oral health are B vitamins, iron and calcium. Low calcium can lead to tooth decay as well as gum disease. Vitamin B aids the body in the absorption of calcium. Low iron levels may cause mouth sores, and low niacin levels contribute to canker sores and bad breath. Overall lack of vitamins can cause dry mouth, dry cracked lips and gingivitis.

In cases of bulimia, which entails frequent vomiting, stomach acids more regularly bathe the teeth, leading to enamel loss and wear. This will cause teeth to become thinner and more yellow in appearance. They may change in shape, become shorter in length, appear more translucent at the edges, and become more brittle and prone to chipping. This process is called erosion. Eroded teeth will feel more sensitive to hot and cold temperatures. They will be more likely to need fillings and even root canals in the future. Be sure not to brush your teeth for at least 30 minutes after vomiting, as this can lead to further damage to the teeth. Rinse your mouth with water to reduce acids.

Purging behaviours can cause trauma to the soft palate (back of the mouth), such as redness, cuts and scratches. This may be a telltale sign to your dentist or dental hygienist, as this area of the mouth rarely receives trauma. Another sign of frequent purging is redness or scraps from the teeth on the knuckles.

Maintaining healthy teeth and gums as much as possible is vital, including regular dental visits and daily brushing and flossing. Your dentist and dental hygienist can help you to maintain your oral hygiene throughout the treatment process. Fluoride treatments may help prevent tooth decay and sensitivity. If you are experiencing a dry mouth, a salivary substitute may be recommended.

If you are struggling with an eating disorder or have questions about eating disorders and oral health, we encourage you to contact us today to schedule an appointment.

What You Need To Know About TMJ Disorders

TMJ is the abbreviation for the temporomandibular joint. This joint is near your ears and connects the upper jawbone to the lower jawbone and your skull.

A TMJ disorder occurs when the joint causes pain or has a reduction in movement. TMJ disorders may be caused by several combined factors, including age, arthritis and genetics. In most cases, TMJ disorders are temporary and can be alleviated with treatment, while surgery is an option as a last resort. 

Symptoms of a TMJ Disorder 

  • Pain, swelling or tightness in the jaw 
  • Ear aching 
  • Difficulty or pain when fully opening the jaw
  • Locking of the jaw joint
  • Pain when biting and chewing  
  • Clicking or grating sound when opening jaw or chewing 

 Causes of a TMJ Disorder 

The temporomandibular joints move in sliding and hinge-like motion. There is cartilage covering the bones and a small disk that aids in movement. Erosion of the disk, if the disk moves out of alignment, damage to the cartilage or the joint can all cause a TMJ disorder. Sometimes there is no known cause of TMJ disorders. 

Risk Factors for TMJ Disorders 

The most common risk factors for TMJ disorders include age, arthritis, jaw injury and long-term clenching and grinding habits. 

Diagnosis for TMJ Disorders 

The most appropriate way to diagnose TMJ disorders is for your dentist to look, feel and listen to your jaw when opening and closing. In addition, your dentist will check your jaw motion range and try to identify sites of pain. Further diagnostic tools include x-rays, CT scans and even MRIs.

Treatment for TMJ Disorders 

TMJ disorders often go away on their own, depending on what causes the issue. If you experience symptoms that persist, there are treatment measures that your dentist and doctor can recommend. Standard treatment measures include:

  • Medications such as pain relievers and anti-inflammatories. It is best to keep the use of these medications for a limited time and not rely on them. 
  • Certain antidepressants used in small doses can actually help with bruxism and sleeplessness. 
  • Muscle relaxants can help relax the jaw muscles and prevent bruxism. 
  • Use a night guard to help remove the pressure on the teeth and jaws from bruxism. 
  • Physical therapy includes stretching/strengthening the jaw muscles and ultrasound, heat and ice.
  • Massage therapy helps take pressure off the jaw muscles and reduce muscle stress. 
  • Corticosteroids or Botox helps relax the facial and jaw muscles. 
  • In severe cases, surgery on the TMJ may be necessary.

If you experience a TMJ disorder, be sure to talk with your dentist and doctor about the symptoms you may be experiencing associated with it. If you have any questions about TMJ disorders, we encourage you to contact us today to schedule an appointment


What You Should Know About Bruxism

Teeth clenching and grinding are nocturnal habits in both children and adults. The medical term for this is “bruxism.” During teeth grinding, the jaws clamp down, and teeth shift back and forth. With teeth clenching, the jaws forcefully clamp over an extended period. Both clenching and grinding can cause extensive damage to the teeth and surrounding structures. 

Risk Factors for Bruxism 

Although this condition is extremely common and can affect anyone, some risk factors include:

  • Age, children have a higher rate of grinding, while adults have a higher rate of clenching 
  • Stressful personality or stressful life events
  • Certain medications or substances such as alcohol, tobacco, caffeine and psychiatric medications 
  • Health conditions such as Parkinson’s, epilepsy and ADHD

Signs and Symptoms of Bruxism 

  • When children grind at night, is it likely that a parent or guardian will hear the grinding noise 
  • Waking up with headaches 
  • Sore jaw and cheek muscles 
  • Pain with opening the jaw, clicking or cracking with opening and closing 
  • Teeth sensitivity 
  • Teeth wear, chips and fractures 
  • Worn down or shortened lower front teeth 

How to Stop Daytime Bruxism

Unfortunately, stopping yourself from clenching or grinding your teeth during the day takes focus and mindfulness. Bruxism may be brought on by periods of stress, intense emotion, caffeine or alcohol. Be sure to reduce smoking, caffeine and alcohol consumption, reduce stress levels, and be aware to stop when you notice you have started. At night, a guard will be necessary to break the habit or provide cushioning between teeth. 

What is a Night Guard? 

There are several different varieties of night guards to help protect your teeth from wear. The main versions are a moderately soft plate that fits on the upper arch, a guard with a bite pad on the front to prevent the back teeth from touching, and a guard made with balls and clasps to avoid any teeth from biting down against each other. All night guards will protect your teeth, jaw and surrounding structures from damage and prevent pain. Talk with your dentist about which type of guard is best for you. 

How is a Night Guard Made?

Impressions are taken of your upper and lower teeth and then sent out to a lab. The lab will fabricate the guard to fit precisely to your teeth and mouth, taking about a week to make. They are usually covered by dental insurance. 

If you have any questions about bruxism or night guards, we encourage you to contact us today to schedule an appointment

What You Should Know About Baby Bottle Caries

Your toddler’s baby teeth, though temporary, are still prone to tooth decay. Early childhood caries, commonly known as baby bottle caries, often affect young children’s upper front teeth.

Most people don’t realize that healthy baby teeth contribute to healthy permanent teeth. Therefore, you must address any signs of tooth decay as early as possible and help your child develop good oral hygiene from an early age. Strong baby teeth are also necessary for your child to chew and speak properly. 

Why do baby bottle caries happen?

There is no single cause of tooth decay, though one of the most common causes is prolonged exposure to sugar, which is prevalent in many drinks. However, sugar is not the only culprit. Tooth decay is primarily caused by bacteria, which can be passed from you to your child. For example, if you put their pacifier or spoon in your mouth. Using a bottle as a pacifier to appease your infant can also result in the appearance of caries.  

How do I prevent baby bottle caries?

It is always a good idea to bring your young child to your dental office for a consultation and quick check-up when their first teeth are coming out. You may also want to ensure they receive the right amount of fluoride as a preventative measure against tooth decay.

There are also a few things that you can do at home, like brush the newly arrived teeth with an appropriate toothbrush and a very tiny amount of fluoride toothpaste. You can increase the amount of fluoride for children aged 4 to 6, though it should not exceed the size of a small pea-sized amount.

As mentioned above, to prevent sharing your saliva with your child, you must refrain from licking their spoons or putting their pacifier in your mouth. We also recommend that you only pour milk, breast milk or formula into their bottle, and avoid using the bottle to give them sugary drinks or juice or dipping their pacifier in sugar or another sweet substance. You can also gently wipe your child’s gums with clean gauze or cloth after they are done eating. While it may be challenging for some children, they should finish their bottles before their naps or bedtime. 

What can I do to treat baby bottle caries?

The enamel of your child’s baby teeth can be repaired with fluoride, which means that if you and your dentist take the appropriate steps and come up with the right treatment plan, in some cases, reverse the effects of tooth decay. This treatment could be as simple as your dentist recommending that you use specific fluoride toothpaste or a treatment at the clinic that can help remineralize your child’s enamel.

If the tooth decay is advanced and quite severe, stainless steel crowns may be recommended for the affected tooth or teeth. Lastly, your dentist will recommend changes to your child’s diet, which is an effective way to fight against tooth decay. 

Contact us today to schedule your child’s visit.

Oral Care for Cancer Patients

Up to one-third of patients dealing with cancer will have complications that affect the mouth, such as cavities, gum disease, mouth sores, and dry mouth. These symptoms may range from mild to severe, depending on the treatment and type of cancer. Cancer can affect the health of your teeth, gums, soft tissues and even your salivary glands. This may make it difficult to bite, eat, chew, swallow and even talk. 

How Does Cancer Affect Your Mouth?

Your body has a reduced ability to respond to stressors. Cancer weakens your immune system, which reduces your body’s ability to fight off bacteria and infection. This can cause more plaque and oral bacteria to develop, leading to cavities and gum disease. Also, specific cancer treatments such as radiation can limit the salivary gland’s ability to produce saliva, leading to a dry mouth. 

Cancer and associated treatment can also make it challenging to keep up with proper oral care, such as regular brushing and flossing, due to how you may feel and dealing with other priorities. 

Thankfully, there is a team of doctors and dentists who are there along the way that can help you maintain your oral health as best as possible. This team includes oral oncologists, general dentists, oral surgeons and periodontists (gum specialists.)

Oral Side Effects 

The main causes of oral effects (such as cavities and gum disease) during cancer treatments are dry mouth, thickened saliva, infection, bone disease, mouth sores and jaw stiffness. Not to mention a general feeling of unwell that is likely to contribute to less upkeep with oral hygiene routines. 

Oral side effects from chemotherapy include changes to taste, mouth sores, peeling soft tissues of the cheeks and tongue, infection and bleeding gums. 

The best way to maintain adequate oral hygiene, as best as possible, during cancer treatment is to brush twice a day gently using a soft-bristled toothbrush, use fluoride in your toothpaste and even in a mouth wash, avoid alcohol, avoid rough textured food, avoid spicy food and consume an adequate amount of vitamin D and calcium to promote good bone and teeth health. 

To help with mouth sores and painful tissues, you can try using a salt-water rinse or baking soda rinse, sucking on ice chips, over-the-counter pain medications and even salivary substitute products that help promote salivary flow. Be sure to ask your doctor before taking any medications. 

If you have any questions about your oral health during cancer treatment, we encourage you to contact us today to schedule an appointment

What You Should Know About Tonsil Stones

Your tonsils are glands that are located at the back of your throat, on each side. They are made up of tissue containing lymphocytes. The primary function of your tonsils is to help prevent infection; they act in a way that traps viruses and bacteria from entering, thus aiding your immune system. The structure of your tonsils has many crevices where dead cells and mucus get trapped. This means that your tonsils can also be prone to other material getting trapped, such as debris and food particles. When these unwanted pieces of debris enter the tonsils and calcify (harden), they are called tonsil stones, or tonsilloliths. 

Signs & Symptoms of Tonsil Stones 

Bad breath – One of the most common symptoms of a tonsil stone is bad breath. Because tonsil stones are made up of calcified bacteria, they will definitely contribute to halitosis. 

Pain/trouble swallowing – If you have a tonsil stone, you may be able to feel it while swallowing. This may make swallowing difficult or sore. 

Ear pain – There are nerves that travel to both your tonsils and ears, so a tonsil stone may actually cause ear pain 

White patch in tonsil – A dead giveaway is actually noticing the tonsil stone. It appears as a patch of white debris trapped in the tonsil. 

Treatment for Tonsil Stones 

Most tonsil stones do not require any treatment and will come out on their own, tiny stones. If a tonsil stone is persistent or large, it may require intervention. The most common forms of treatment for tonsil stones are antibiotics, surgical removal of the stone, or surgical removal of the tonsils if they are prone to collecting tonsil stones.

Prevention of Tonsil Stones 

Unfortunately, some people are more prone to developing tonsil stones due to anatomy (such as larger tonsils with more crevices.) If a person is very prone to tonsil stones, the best course of treatment is to have the tonsils removed. It is always essential to maintain good oral health, including brushing twice a day and flossing daily. 

If you believe you have a tonsil stone or have any questions about them, it is best to see your family doctor for an assessment.