What to know about teeth whitening strips

 Whitening strips are a popular dental product that may help remove stains from and whiten the teeth. While they are not as effective as treatments from a dentist’s office, they can be a simpler and cheaper alternative. However, people should take care to check the ingredients of the strips and apply them carefully.

Teeth are an important part of a person’s self-image. Inevitably, teeth begin to yellow with age, but people can use various techniques to slow the process. Among these techniques are whitening strips, which people can purchase over the counter (OTC) and use to help remove stains and whiten teeth.

People apply whitening strips directly to their teeth. Although the strips contain chemicals, such as carbamide peroxide or hydrogen peroxide, the American Dental Association (ADA) states that they are safe and effective if they bear the ADA Seal of Acceptance. However, people may experience adverse effects when using any whitening products.

In this article, we look at whether whitening strips work, what to look for when buying them, how to use them, their pros and cons, and how to avoid teeth staining.

Do they work?

According to the ADA, teeth whitening products, including strips, can help effectively remove both internal and external stains on teeth. However, they do not work on fake teeth. A 2020 review also states that teeth whitening strips are an effective OTC agent that typically works better than other OTC whitening agents, such as whitening toothpaste.

However, it is important to note that at-home whitening strips contain lower concentrations of whitening ingredients than dentist-supplied products. People with heavily stained teeth or high expectations will not get the results they want using OTC whitening strips.

Additionally, the effectiveness of the strips may rely on the strength of the chemicals and how long people keep them on the teeth. Therefore, it may be advisable to discuss the use of these products with a dentist.

What to look for

When shopping for whitening strips, people may wish to consider the following:

• Ingredients: People should opt for products that contain proven effective ingredients, including carbamide and hydrogen peroxide.
• Dentist approval: It is advisable to look for products with approval from dental organizations, such as those with the ADA Seal of Acceptance.
• Customer reviews: People can also check online reviews to see what others have to say about a product. A comparison of before and after photos can provide an accurate view of what to expect from a particular brand of whitening strip. Additionally, a person can ask their dentist for specific advice.

How to use

People should carefully read any information on the product’s packaging and instructions before using whitening strips.

However, a person typically applies the strips directly to their teeth. Manufacturers may recommend avoiding brushing the teeth shortly before applying the strips. A person will then leave the strips on their teeth for the recommended length of time. This duration may vary among products, but it is common to leave the strips on for about 30 minutes.

Manufacturers may also recommend the ideal frequency of use for their whitening strips. A standard recommendation is to apply whitening strips twice daily for 2 weeks.

However, these instructions may vary depending on the product. Therefore, a person should follow the guidelines on the packaging and never wear the strips for longer than the manufacturer suggests.

Pros and cons

The pros of using whitening strips may include:

• effective whitening
• ease of use
• no need to visit the dentist
• affordable

While there are advantages to using whitening strips, there are also some downsides. These include:

• The strips can cause side effects, such as tooth sensitivity and gum irritation.
• Some people might not get the results they want with at-home whitening strips, which may not have dramatic effects. A person may have to do several sessions to get noticeable results.
• It can be difficult to keep the strips in place, so using them might be fiddly.
• Whitening sessions can take roughly 30 minutes, so using them requires time and patience.

People are more likely to experience side effects if they do not follow the manufacturer’s instructions for a product. If a person has gum disease or another dental disease, they should consult a dentist before trying OTC whitening strips.

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Why stains develop and prevention

There are various reasons why teeth may stain over time. These include:

• high intake of certain foods and drinks, such as coffee, red wine, and tea
• use of tobacco products
• medications, such as allergy medications and blood pressure drugs
• wear and tear due to aging or trauma

People can attempt to avoid staining by limiting their consumption of foods and drinks that are known to discolor teeth. They can also try to stop smoking or chewing tobacco, if applicable. If medications are the culprit, a doctor may be able to recommend alternatives if they are available.

Alternatives

There are two categories of dental whitening products: those available through a dentist and those for sale OTC.

Aside from whitening strips, other products available OTC include:

• whitening toothpaste
• whitening mouthwash
• whitening gels
• whitening trays
• whitening powder

A person can also get whitening products or services through their dentist. Dentist-supplied whitening products are usually more concentrated. The options available directly from dentists include:

• custom dental trays with bleaching gels, for either at-home or in-office application
• light-activated bleaching, which is an in-office procedure

Some people prefer to use natural products to remove stains, but most reports of effectiveness are anecdotal at best.

Like the possible risks of carbamide and hydrogen peroxide, it is important to apply caution if using certain products that people sometimes recommend, such as fruit juices, vinegar, or scrubs. These may instead cause damage to the teeth or make staining even worse.

Summary

Teeth whitening products, such as whitening strips, are generally safe to use and can be a beneficial and a cost-effective way to remove stains from the teeth. However, it is important that people use them correctly to avoid adverse effects.

Some people may experience gum irritation and tooth sensitivity after using whitening products. In some cases, if people use them incorrectly, these products may damage the enamel on the teeth and result in long-term complications.

People considering the use of teeth whitening products may wish to discuss them with their dentist. It is also important to check user reviews, dentists’ recommendations, and ingredient lists.

People should also set their expectations and understand that it may take time to achieve noticeable results. Although at-home bleaching products work, they may not produce results equal to those of in-office bleachi

How to use ventilation and air filtration to prevent the spread of coronavirus indoors

The vast majority of SARS-CoV-2 transmission occurs indoors, most of it from the inhalation of airborne particles that contain the coronavirus. The best way to prevent the virus from spreading in a home or business would be to simply keep infected people away. But this is hard to do when an estimated 40% of cases are asymptomatic and asymptomatic people can still spread the coronavirus to others.

Masks do a decent job at keeping the virus from spreading into the environment, but if an infected person is inside a building, inevitably some virus will escape into the air. 

Once the virus escapes into the air inside a building, you have two options: bring in fresh air from outside or remove the virus from the air inside the building.

 

All of the air in a room should be replaced with fresh, outside air at least six times per hour if there are a few people inside.

 

It’s all about fresh, outside air

 

The safest indoor space is one that constantly has lots of outside air replacing the stale air inside. 

In commercial buildings, outside air is usually pumped in through heating, ventilating, and air-conditioning (HVAC) systems. In homes, outside air gets in through open windows and doors, in addition to seeping in through various nooks and crannies.

 

Simply put, more fresh outside air inside a building. Bringing in this air dilutes any contaminant in a building, whether a virus or a something else, and reduces the exposure of anyone inside. Environmental engineers quantify how much outside air is getting into a building using a measure called the air exchange rate. This number quantifies the number of times the air inside a building gets replaced with air from outside in an hour.

While the exact rate depends on the number of people and size of the room, most experts consider roughly six air changes an hour to be good for a 10-foot-by-10-foot room with three to four people in it. In a pandemic this should be higher, with one study from 2016 suggesting that an exchange rate of nine times per hour reduced the spread of SARS, MERS and H1N1 in a Hong Kong hospital. 

Many buildings in the U.S., especially schools, do not meet recommended ventilation rates. Thankfully, it can be easy to get more outside air into a building. Keeping windows and doors open is a good start. Putting a box fan in a window blowing out can greatly increase air exchange too. In buildings that do not have operable windows, you can change the mechanical ventilation system to increase how much air it is pumping. But in any room, the more people inside, the faster the air should be replaced. 

 

Air cleaners

If you are in a room that cannot get enough outside air for dilution, consider an air cleaner, also commonly called air purifiers. These machines remove particles from the air, usually using a filter made of tightly woven fibers. They can capture particles containing bacteria and viruses and can help reduce disease transmission.

The U.S. Environmental Protection Agency says that air cleaners can do this for the coronavirus, but not all air cleaners are equal. Before you go out and buy one, there are few things to keep in mind.

The first thing to consider is how effective an air cleaner filter is. Your best option is a cleaner that uses a high-efficiency particulate air (HEPA) filter, as these remove more than 99.97% of all particle sizes.

The second thing to consider is how powerful the cleaner is. The bigger the room – or the more people in it – the more air needs to be cleaned.

The last thing to consider is the validity of the claims made by the company producing the air cleaner.

The Association of Home Appliance Manufacturers certifies air cleaners, so the AHAM Verified seal is a good place to start. Additionally, the California Air Resources Board has a list of air cleaners that are certified as safe and effective, though not all of them use HEPA filters.

 

Keep air fresh or get outside

Both the World Health Organization and the U.S Center for the Disease Control and Prevention say that poor ventilation increases the risk of transmitting the coronavirus. 

If you are in control of your indoor environment, make sure you are getting enough fresh air from outside circulating into the building. A CO2 monitor can help give you a clue if there is enough ventilation, and if CO2 levels start going up, open some windows and take a break outside. If you cannot get enough fresh air into a room, an air cleaner might be a good idea. If you do get an air cleaner, be aware that they do not remove CO2, so even though the air might be safer, CO2 levels could still be high in the room. 

If you walk into a building and it feels hot, stuffy, and crowded, chances are that there is not enough ventilation. Turn around and leave. 

By paying attention to air circulation and filtration, improving them where you can and staying away from places where you cannot, you can add another powerful tool to your anti-coronavirus toolkit.

 

WHAT TO KNOW ABOUT MORNING BREATH

Morning breath is the term that people commonly use to describe breath that smells bad when a person wakes up. It is a very common problem.

The Academy of General Dentistry have estimated that 80 million people in the United States experience chronic bad breath. However, there are many straightforward ways to treat morning breath.

What is morning breath?

Good oral hygiene can help prevent morning breath.

Morning breath is a type of bad breath that affects people when they wake up. The medical term for bad breath is halitosis, which describes chronic bad breath that does not go away.

Causes of morning breath

According to the American Dental Association (ADA), morning breath occurs due to a buildup of bacteria in the mouth overnight.

Food particles

During the night, the enzymes in saliva will break down food particles remaining in between teeth, on the tongue, or around the gumline. This breakdown releases volatile sulfur compounds (VSCs), which give off a bad smell.

The specific foods that a person eats can also influence how their breath smells. The list of foods that can cause bad breath is very long and includes:

       garlic

       onions

       coffee

       spices

Smoking

Smoking can also cause bad breath. A person may not be aware of the effect that smoking can have on their breath odor because smoking dampens the sense of smell.

Dry mouth

A person may experience morning breath if they have a dry mouth. Saliva helps the mouth clear out bacteria that build up over the day and night. If the mouth is not producing enough saliva, bacteria will be able to build up more often. As a result, the release of VSCs overnight may be higher, potentially causing morning breath.

One study that investigated the effect of water on morning breath found that drinking water or rinsing the mouth with water in the morning reduced VSCs by 30–50%, leading to an overall improvement in morning breath.

Breathing through the mouth can also dry it out. People who sleep with their mouth open or snore heavily may have a drier mouth and be more likely to have bad breath in the morning.

Poor oral hygiene

Poor oral hygiene is a common cause of morning breath. Proper brushing and flossing remove bacteria and food particles that cause bad breath.

If a person does not regularly and effectively clean their teeth, they could also develop tooth cavities and gum disease. Gingivitis and periodontitis are types of gum disease that can cause bad breath.

Tooth cavities resulting from bacteria that produce plaque can trap more bacteria in the mouth, as can the deep pockets that gum disease causes. A person can then find it hard to clean the bacteria away when they brush their teeth.

Underlying medical conditions that cause morning breath

The cause of morning breath can be as simple as poor dental hygiene, especially if it leads to complications. Tooth decay or a “dead tooth” can cause bad breath that may be even worse in the morning.

However, certain underlying chronic conditions that are not directly related to the mouth can sometimes be responsible for an unpleasant breath odor.

For instance, untreated diabetes can be a cause of bad breath. Some infections — such as tonsillitis, sinusitis, and bronchitis — and fungal infections of the mouth, lips, and tongue can also have an adverse effect on the breath.

In some cases, liver or kidney disease may result in bad breath.

A person will experience other symptoms alongside bad breath if an underlying condition is the cause.

Treatment and remedies

People can often improve their morning breath by doing the following:

Keeping the mouth clean

A person can treat morning breath or longer lasting halitosis by improving their dental hygiene.

Brushing the teeth twice a day and cleaning in between them with dental floss or interdental brushes can keep mouth bacteria under control. A person can also use mouthwash to help clear bacteria out of the mouth.

One study on the effectiveness of mouthwash against morning breath found that the daily use of mouthwash significantly reduced the number of bacteria in the saliva. Flossing and mouthwash can also ensure that no food remains in the mouth overnight.

A person can also use a tongue scraper as part of their brushing routine to remove bacteria from the tongue. Tongue scraping is a gentle technique, but some people may find it uncomfortable because it can trigger the gag reflex.

Anyone who wears removable dentures should take them out at night and clean them thoroughly before wearing them again the next day.

It is also important to make regular visits to the dentist to help maintain oral hygiene.

Drinking more water

A person may find that increasing their water intake and reducing how much caffeine and alcohol they consume leads to an improvement in their breath odor.

Staying well-hydrated by drinking water can increase the amount of saliva that the mouth produces, which will help keep mouth bacteria under control.

Caffeine, alcohol, and smoking can dry out the mouth. Certain types of medication can also have this effect.

When to see a dentist

Usually, there is no need to worry about waking up with morning breath.

However, if a person finds that their morning breath is not going away with conventional treatments, such as improving dental hygiene and keeping their mouth from becoming dry, they may need to seek advice from a dentist.

A person should see a dentist if:

       they have a constant bad taste or smell in their mouth

       they are experiencing other new symptoms along with bad breath

       they spit blood when they brush their teeth

Blood in the saliva after brushing the teeth can be a sign of gum disease and requires medical treatment. If the dentist finds that the odor is not due to oral factors, they may advise the person to consult a doctor.

A person may experience poor mental health and self-esteem if they are aware that they have morning breath or halitosis. They may feel constantly stressed about having bad breath, which might adversely affect their social life and relationships.

If a person is very worried about morning breath or halitosis, a psychiatrist may be able to help them overcome their anxiety around this issue.

Summary

Morning breath is very common among the general population, and it does not usually last long into the day.

A person can improve their breath odor by brushing the teeth thoroughly, using mouthwash and dental floss, and staying hydrated to stop their mouth from becoming dry.

A person should seek medical advice if their bad breath does not go away or if they are experiencing symptoms of an underlying condition that may also be causing bad breath.

        

What is trismus?

Trismus, or lockjaw, is a painful condition in which the jaws do not open fully. As well as causing pain, trismus can lead to problems with eating, speaking, and oral hygiene.

Trismus occurs when a person is unable to open their mouth more than 35 millimeters (mm). It can occur as a result of trauma to the jaw, oral surgery, infection, cancer, or radiation treatment for cancers of the head and throat.

Most cases of trismus are temporary, typically lasting for less than 2 weeks, but some may be permanent.

In this article, we explore the causes and symptoms of trismus. We also look at the current treatment options for this condition.

Causes

Trauma and inflammation are possible causes of trismus.

There are many possible causes of trismus, including the following:

Trauma

Injury or damage to the jaw can lead to trismus. Examples of such trauma include fractured jawbones or tissue damage following dental surgery.

Others include:

• contusion of the temporomandibular joint (TMJ)
• hematoma, which is a collection of blood outside of blood vessels
• injury to the muscles of mastication, which people use when chewing

Inflammation

Some medical conditions that cause inflammation in the mouth may cause trismus. One example is pericoronitis, which is inflammation of the soft tissue around a tooth, potentially leading to an impacted molar.

Others include:

• arthritis in the jawbones
• scleroderma, which is an autoimmune disease that affects connective tissue
• soft tissue fibrosis, which occurs when excess fibrous connective tissue forms

Dental surgery

Oral surgery, including wisdom tooth extraction, may cause inflammation in the mouth, which can lead to trismus.

Hyperextension, which is having to open the mouth wider than its usual range of motion, during surgery may also lead to lockjaw.

Infection

Infections can contribute to trismus in some cases.

Types of infections that may do this include:

• mumps
• tetanus
• tonsillitis
• peritonsillar abscess
• other types of abscess

Cancer or cancer treatment

Cancerous tumors in the head or throat can affect the function of the jaw.

Radiation treatment for these tumors can also cause trismus.

According to a small 2016 study consisting of 30 participants with oral cancer, trismus affected 53.3% of them at the time of diagnosis.

This number increased to 86.7% after surgery and 85.7% after radiotherapy.

Risk factors

While anyone can develop trismus, some factors may increase the chance of developing it.

These include:

• having head or neck cancer
• undergoing radiation treatment for head or neck cancer
• recent oral surgery to remove a wisdom tooth
• recent trauma to the mouth or jaw
• having certain types of mouth infection

Symptoms

The defining symptom of trismus is the jaw not opening fully or opening to 35 mm or less.

Other symptoms include:

• jaw pain and cramping
• difficulty biting, chewing, or brushing the teeth
• inability to swallow some foods
• headaches
• earache

Treatment

Typically, treating the underlying condition should resolve many cases of trismus.

Generally, the earlier a person seeks treatment, the better the outcome.

Treatment options include:

Medication

It may be necessary to take medication to reduce pain and relax the jaw muscles. Common medications for trismus include muscle relaxers and nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain.

Depending on the severity of the symptoms, a doctor may prescribe oral medications or drugs that require injection into the jaw.

Some forms of NSAIDs are also available over the counter.

Jaw-stretching devices

A doctor or physical therapist may recommend the use of a jaw-stretching device.

In a 2014 study, people who used such a device when performing specific mouth exercises had an average increase in mouth opening of 5.5–7.2 mm.

Dietary changes

Individuals may need to make dietary changes until the condition improves.

For most people, moving to a soft foods diet is helpful because it is possible to eat these foods without opening the mouth too much.

Examples of soft foods include:

• soup
• smoothies
• yogurt
• mashed potatoes
• oatmeal
• beans
• steamed vegetables
• stewed fruits
• cheese
• fish
• scrambled eggs

Until trismus resolves, it may be beneficial to avoid foods that are hard, crunchy, or chewy, such as candy bars, uncooked apples, and tough meats.

Diagnosis

A doctor will carry out a physical examination and take a person’s medical history to diagnose trismus.

They may ask about recent injuries or dental work and look for signs of cancer or abnormalities in the bones or tissues of the jaw.

A doctor may use one or more of the following tests to help them diagnose or rule out trismus:

• a measurement of the mouth opening
• a CT scan
• an MRI scan

Complications

Trismus may cause a variety of complications that can affect a person’s quality of life, including:

Oral hygiene problems

If a person cannot open their mouth fully, this makes maintaining oral hygiene more difficult.

Poor oral hygiene can lead to:

• bad breath (halitosis)
• dental caries (cavities)
• infection

Trismus may also make it challenging for those wearing dentures to insert the dentures or remove them for cleaning.

Difficulty eating

If people cannot bite, chew, or swallow properly, there is a chance of malnutrition and dehydration.

Temporarily moving to a predominantly liquid and soft foods diet may help reduce these risks.

Many of the infectious and traumatic causes of trismus may also have associated complications. For example, an odontogenic infection that causes trismus may lead to further infection with facial cellulitis or mandibular osteomyelitis.

Infection

If an infection is the cause of trismus, there may be associated complications, such as cellulitis.

Cellulitis is skin inflammation that is often due to infection. The symptoms include:

• edema, or swelling
• reddening of the skin
• warmth emanating from the infection site
• pain

Summary

Trismus is a painful condition involving a reduction in the size of the mouth opening between the jaws.

Most cases are temporary, and medications, physical therapy, and other treatments can often effectively alleviate trismus and reduce or prevent complications. Early treatment typically provides the best outcomes.

Individuals who have concerns about trismus or their risk of developing it should speak to their doctor or dentist.