Health Experts
Dentist
Advice from our online dentist
Dr Keith Cohen advises Saga website readers what to do about halitosis, receding gums, ulcers and dentures
Bad breath
Q: I have very offensive breath yet a brilliant oral hygiene routine. It’s seriously affecting my life. I even got my tonsils removed in the hope that it would help. I really don’t know what else I can do - please help.
A: Bad breath, also known as halitosis, can come from a number of sources. It is most often due to organisms in the mouth and can be related to gum disease, poorly fitting fillings or crowns but also from different types of diet. It is well known that onions, garlic, smoking and drinking alcohol can cause bad breath. Less often there can be bad breath from nose and lung infections, from the intestines, uncontrolled diabetes and other medical conditions.
Clearly any dental problems need to be resolved first. Many people underestimate the skill required for good oral hygiene and regularly miss out certain teeth or do not clean in between teeth.
You should check with your dentist for his/ her opinion about the bad breath and to see if you have any gum disease or other causes related to the mouth.
Consider improving your oral hygiene as much as possible; look into your diet particularly avoiding spicy and strongly flavoured foods, smoking, alcohol and coffee; you can brush your tongue or use a tongue cleaner; an antiseptic mouthwash or use of sugar-free chewing gum may also be helpful.
Ulcers and implants
Q: I had implants in my lower jaw 12 years ago that were done at a dental hospital. I now have ulcers around some of them but due to ill health and moving to a different area am unable to return to the hospital. NHS dentists will not touch them and the estimated cost of private treatment is £12,000 - quite beyond me as a pensioner. Any suggestions as to what I can do? I cannot travel and live in a small town with no facilities.
A: It is difficult to make a diagnosis without seeing you; however, ulcers alone would not be a cause for undue concern. I think you need further advice and would suggest that you ask your dentist to refer you to a local dental hospital or private specialist for an opinion as to the cause and possible lines of treatment. (Initially, it may also be possible for your dentist to email pictures and X ray images of your mouth to the specialist.)
Dentures don't fit
Q: After receiving a top set of dentures I find that there is no way they will stay in position. My dentist has tried several things including some form of filler to adjust the shape. The denture appears to be too big and also out of shape: is there anything that you can suggest? The cost so far has been nearly £200.
A: People’s mouths vary greatly and in some cases it can be technically difficult to achieve a good result. I would suggest that your dentist could refer you to the 'prosthetics' department of a dental hospital or a private specialist (although this would be significantly more costly).
Receding gums and stained teeth
Q: I have receding gums across my top front teeth, and the area is becoming quite stained, and can’t be cleaned. The dentist proposes to cover the stains with the material used for composite fillings costing £700 for nine front teeth and an hour's work. The stains are not visible being above the "smile line" but the dentist says if I don’t have the work done, my teeth will get a lot worse. What would you advise and is the cost reasonable?
A: Stains can have numerous causes but treatment would not be essential unless this is due to decay on the tooth surface. It is unlikely that your dentist would be able to complete nine fillings in one hour unless he is a very fast worker. I think that if you have any doubts you should seek the opinion of another dentist to confirm the diagnosis and treatment required.
Cost of NHS dentures
Q: Can you tell me how much I will have to pay for a full set of dentures on the NHS please. I’m 67.
A: The fee for a set of complete dentures on the NHS is currently £198.
More advice from Dr Keith Cohen
- NHS check ups; ulcers
- Discoloured milk tooth; osteoporosis and dental implant; white patch on gums
- Dr Keith Cohen's archive
More on oral health
More information from Saga
Saga Health Cash Plan can help with everyday healthcare expenses by providing financial support towards dental bills, optical bills, specialist consultations, physiotherapy, hospital treatment, home help, specialist care and many other common healthcare needs.
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.