‘Is drinking hot water and lemon a good way to start the day?’

Q: Hot water and lemon – wondering if this is a good start to the day OR does citric acid deplete the enamel coating on teeth?

In short, hot water and lemon first thing in the morning is not a good start to the day for your mouth as acids deplete the enamel that coats our teeth. Our teeth are most vulnerable to an acid-attack first thing in the morning. Most of us will notice how our mouth feels furry and dry in the mornings. This is because our salivary glands that produce the mineral-rich fluid shut-down overnight. We need a good flow of saliva (the good guys) to help remove the acid (the bad guys) from our mouth. If we don’t have enough good guys available, when we drink something highly acidic such as lemon, with or without water, our teeth start to dissolve to help balance the bad guys.

For people who insist that they still drink water and lemon in the mornings, I recommend purchasing metal straws. Metal straws are reusable and sustainable. You would have to try to place the straw between your teeth, as far back into your mouth as possible, so as to by-pass your teeth.

Q: What causes my breath to have a chemical smell?

Bad breath depends on an individual’s perception. Like perfume, some of us might finds some smells pleasant while others may find the same odours offensive. But the key thing is, if someone close to you is commenting on your breath or you think you have bad breath then this is something worth pursuing.

So a chemical smell can mean one to someone and something different to another. That’s why I’m leaving this response quite broad. First of all, let’s tackle a few things that may be out of our control. Bad breath in the morning is common because our mouth dries-out during the night. In turn, people who suffer from a dry mouth, or those who consume certain foods such as garlic. There may be other factors that contribute to bad breath that we might need some help with. So I have divided my response into three potential general causes of bad breath.

1. First start with the mouth

People who suffer from gum disease or have areas where food can get trapped will suffer from bad breath. Gum disease, known as ‘periodontal disease’ is the slow breakdown of the supporting structures that hold our teeth in our jaw bone. It is often painless and unnoticeable until a person notices their teeth moving or develop a gum infection. People with active periodontal disease will develop pockets, which are gaps between the tooth and where the gum that has pulled away from it. Food and dental plaque can get stuck in these pockets and worsen gum disease, while contributing to bad breath as well.

Other known food traps are partial and full dentures, untreated dental cavities and chipped or broken fillings. Food trapped in regions of our mouth ferment and feed bacteria. Certain bacteria are known to cause cavities or gum disease, but these bacteria will also produce smelly by-products that make our breath smell. While regular tooth and tongue brushing, and cleaning between your teeth as well as your dentures help, it may be worthwhile discussing your concerns with your dentist and/or hygienist.

2. Then look at the head and neck

If you can eliminate the mouth as the cause of your bad breath, then we start looking a bit more broadly at the head and neck. So if you recently had a head cold, or suffer from chronic sinusitis, you will suffer from bad breath. These issues are best managed by your GP. While the symptoms of a cold may only last for about a week, sinusitis can be a debilitating chronic issue that may require further management.

3. Finally look at the rest of the body

If you have exhausted the previous more common causes of bad breath, then it’s time to look at less common causes. Sometimes the reactions in our body can cause bad breath. For instance, people who are losing weight rapidly will go into a process called ketosis which can contribute to bad breath. Another cause could be people who suffer from metabolic issues such as Diabetes. If you have exhausted the first two options, and you suffer from other health issues as well as bad breath, it may be worthwhile discussing your concerns with your friendly GP.

Q: Are the whitening toothpastes ok on your teeth for daily use? The ones like Colgate that you buy in the supermarkets.

According to the evidence (Cochrane Review), the effectiveness of home-based whitening toothpastes is unclear. Basically the authors of this review looked at all the research that has been done on different types of home-based whitening products and found that their effectiveness is low.

But for your information, there are two broad categories of whitening pastes; one that whitens by mechanically abrading the surface, and the other that changes the surface of the tooth by bleaching it. Unless you are a heavy coffee or tea drinker or suffer from heavy smoking stains, I don’t recommend using pastes that are highly abrasive. This is because the particles in these pastes will wear down your teeth. The other types of pastes containing a small amount of bleach known as hydrogen peroxide, or carbamide peroxide which turns into the former once it contacts the water in our saliva. While bleach in slightly higher concentrations will change the shade of your teeth, the use of a whitening tooth paste may take a lot longer to achieve the same result.

It is also worthwhile keeping in mind that some teeth won’t change colour. Denture teeth, some root-filled teeth, crowns, bridges and teeth that have been filled or veneered will remain the same. Bleaching teeth with open cavities or leaking fillings can cause tooth sensitivity. If you are concerned about the shade of your teeth, it might be worthwhile talking to your dentist and/or hygienist.

Q: I drink hot water and cider vinegar. Is that OK?

The short answer is, “Not for your teeth”. Apple Cider Vinegar is highly acidic, even in its diluted form in water and regular continual drinking will worsen tooth erosion. One of the risks of tooth erosion is the frequency that you consume acidic foods. People who sip acidic drinks such as soda and energy drinks throughout the day don’t give their mouth a chance to rebalance and recover. Our body just can’t produce saliva to counteract the acid fast enough.

If you feel strongly about the benefits of consuming apple cider vinegar. I suggest using a straw (see response to lemon in hot water question), and only have this once per day. For patients that add ‘flavour’ to their water to make it taste better, I always recommend swapping acidic things with more tooth-friendly food such as mint and cucumber. Even better – switch to plain old water. It’s good for you!

If you have a question for Starts at 60’s health experts, email it to [email protected].