Q: What mouthwash is best for halitosis? I know it doesn’t cure it, but I’m getting treatment for bad gum disease and need a way to control the halitosis until my mouth is healthy again. I’m looking for a mouthwash that will last more than an hour.

A: There are a number of over the counter mouth rinses that can help until you get your necessary periodontal treatment. I highly recommend a LANAP laser trained periodontist to do your evaluation. There is a Chlorhexidine mouth rinse that is by prescription.

Q: I am 24 years old and until recently had not been to a dentist since my pre-kindergarten screening. I am thankful to report, despite 5 years of chewing tobacco (I did quit for good 2 1/2 years ago), that the dentist reported no cavities and a “great set of teeth”. He did tell me that I have some gingivitis in the gums and told me to keep an eye on it. Is there a way to reverse the effects or just maintain? What mouth washes and toothpastes should I use and what should I stay away from?

A: If you keep up excellent oral hygiene techniques you can usually keep the gingivitis under control. I am assuming that you had a full series of digital x rays to rule out any bone loss? There are many mouth rinses on the market which can aid in controlling the bacteria surrounding the gums. You can consult the dentist who diagnosed your gingivitis to recommend specific products. I would recommend seeing your dentist 3-4 times a year for cleanings and close follow up. Please don’t wait years again to see your dentist.

Q: I am a female, age 63. I traveled this week, drank lots of coffee and orange juice each morning, slept less than normal. The inside of my mouth, cheeks and gums are raw and sore. It’s hard to eat. Can you suggest a remedy to alleviate the pain?

A: It sounds like you are run down and might have something systemic brewing. Avoid citrus products, spices, and mouthwashes with alcohol. I suggest a visit to the Periodontist to confirm a diagnosis. In the meantime, you can use a combination of milk of magnesia and liquid Benadryl in equal amounts in a bottle, mix and shake, and then swish/rinse your mouth with about 5cc several times a day. However, do not swallow! If you have allergies to any of these ingredients please don’t use this home regimen. A pharmacist can also prepare this mixture for you. This rinse regimen will help alleviate the pain. This is not a cure. I want to emphasize that a visit to the Periodontist is mandatory as soon as possible.

Q: What home remedies for swollen gums and sore teeth are there? My gums became inflamed overnight, (I had drunk a sugary pop the day before), and they’ve been this way for a week now. The sorest area moves to different parts of my mouth, and my jaw has become very sore. Any help would be great; I would like to treat it without having to go to the dentist.

A: I think you should go to a qualified Periodontist and have a consultation. There are so many possible causes of your problem. To give you a home remedy for the wrong condition could actually make you feel worse. It will be worth it to you in the long run to treat this unknown condition the correct way.

A: What can a person do to treat gum disease at home? Does gum disease have to be treated professionally?

Q: I highly recommend a consultation with a Laser Periodontist to determine what stage of gum disease you have. Treatments vary depending on the severity of the disease. Homecare, including flossing and brushing, are important. However, before recommending any rinses or other homecare regimens, a consultation is important to give you the appropriate treatment plan that is best for your situation.

Q: I burned my gums along the inside of my upper teeth and I keep scraping it with my toothbrush. What can I do so it will heal?

A: I would suggest using “magic mouthwash”, which consists of a combination of Milk of magnesia and Liquid Benadryl 1:1 elixir (equal amounts). Rinse several times a day and do not swallow. Just rinse, and spit out. Also, back off using the toothbrush and use a moistened cotton tip applicator to clean your teeth near the burned area. In a few days, go to a very soft toothbrush and start to clean gently. By the way, what did you burn your gums with? Do not use any alcohol products and avoid smoking. If the area doesn’t heal in few days, call your dentist for follow up.

Q: What are milky white sores inside the mouth? The sores are painful and don’t look like canker sores or aphthous ulcers. They are swollen, larger, and there is a milky white ‘line’ alongside of the tongue. These sores remind me of strep throat. I have osteomyelitis on other side of mouth. I’m being treated with Clindamycin HCL 300MG caps and Magic Mouthwash by an ENT. My dentist said I must have bitten my tongue and cheek. I can’t afford ENT at this time; I have appointment in 4 weeks. These milky white sores require pain medication to eat and sleep. I fear dependency. If I learn what I have, maybe I can treat myself. Help!

A: I am sorry you are having these issues. From your description, it sounds like you have mucosal lesions that might be something similar to Pemphigus, E Multiforme or Pemphigoid. I would strongly recommend seeing either an oral surgeon or oral pathologist. You could also have this type of reaction from taking medications such as antibiotics. The osteomyelitis is also a concern. Magic Mouthwash will help ease the pain but won’t cure the problem. Please seek help ASAP from one of the above specialists.

Q: I woke up about a week ago with a toothache and now my gums are slightly swollen with little pockets between some of them. I haven’t eaten anything since last week because I’m afraid to get something in between my teeth and make this worse. I have no dental insurance and currently am out of work. I was wondering about your personal opinion on getting oraMD. I’ve read good things about this product and would like your professional opinion on what I should do about this because the pain is getting worse. I rinse with Listerine and salt water every day and have been brushing 3 to 4 times a day hoping to halt this pain before something extreme happens. Thank you for your time.

A: I would recommend you see a dentist as soon as possible. It is extremely difficult to know what is happening without examining you, getting an accurate medical and dental history and taking the necessary x- rays to diagnose your condition. Most rinses alleviate some of the symptoms of various dental conditions, but some oral rinses can actually make conditions worse. Many dentists take credit cards and offer payment plans if that would be helpful to you in your situation.

Q: Is there a particular brand or kind of toothpaste that you recommend for people who have or are prone to having periodontal disease?

A: There’s a wide variety. I don’t advocate a particular brand. I like the natural products, because they contain fewer preservatives and also contain fewer artificial sweeteners and chemicals.

Q: Is there a medicine, whether prescription or over-the-counter, which effectively treats gum disease?

A: There’s no magic bullet. We rarely use low-dose antibiotics which can be taken long-term, such as Doxycycline. However, I am not a big advocate of long-term antibiotic usage. A short-term regimen is indicated for some patients. Laser treatment has replaced the use of long term antibiotics. Long term antibiotics can allow resistant strains of the bacteria to develop which will render antibiotics ineffective if needed for other future medical uses in your lifetime.

Q: How can I treat periodontal disease at home?

A: Good home care, a balanced diet, professional check-ups. Also, try to reduce stress. Periodontal health is compromised when people are under a lot of stress.

Q: Do you recommend any sort of natural or alternative treatment for gum disease, such as homeopathy?

A: If a patient is using something I don’t know about, I always ask them to bring it in and show me the ingredients. As long as it doesn’t do anything detrimental, I don’t have a problem with it. Laser therapy could be considered a natural treatment in that we don’t use any external bone grafting and we use the body’s own cells to regenerate bone. We do have to anesthetize the patient, but the laser protocol is an effective and innovative procedure which can often obviate the use of traditional invasive surgery.

Q: Can vitamins or minerals help prevent or reverse gum disease?

A: About 15 years ago I had a patient who had severe periodontal disease and needed a lot of treatment. She declined treatment and instead started on a regimen of about 25 vitamin supplements recommended by her dentist. A year later she lost eight teeth and needed surgery. I wholeheartedly endorse a good balanced diet with vitamin supplementation (not megavitamins) but we still do not have proof that supplements prevent or stabilize gum disease.

Q: Can peroxide help fight gum disease?

A: There was a professor name Dr. Keyes, a microbiologist in the late sixties, early seventies, who came up with a mixture of sodium peroxide and baking soda that patients brushed on their gums. In the lab, it kills bacteria. But then researchers found that peroxide causes cancerous or pre-cancerous changes in the gingival gum tissue. So we stopped using peroxide. I used to put peroxide on after gum surgery with a Q-Tip. No more. Never rinse with hydrogen peroxide.

Q: Are there oral rinses for gum disease that do not stain the teeth?

A: Chlorhexadine antibacterial rinse is very effective for gum disease. It does stain some people’s teeth, but not all. Smokers and heavy coffee and tea drinkers have a greater tendency to stain. It is available by prescription only. We have some patients on it long-term. Each case is different. There are many other rinses on the market that don’t stain. We have no preference.

Q: Are there any home remedies to get rid of periodontal disease?

A: If there were, I’d be out of business. Other than mechanical removal, there are a variety of natural, organic, anti-plaque agents on the market. I don’t advocate anything in particular, but I do avoid alcohol-containing mouthwashes like Listerine. If someone wants to use that to freshen their mouth, I recommend they dilute it – not use it full-strength. Tom’s of Maine makes some interesting products. Each person gets different results from different products. One product might work for one patient but not be the best for another.