A dental insurance plan is a business arrangement between the insurance company and your employer, just like a medical insurance plan. You may not have a choice of dental insurance plans, but before you choose or change your dental plan, keep these points in mind:

• What basic preventive services are covered? Although many dental plans will cover 1 to 2 checkups and cleanings per year, they may pay only part of the cost of other treatments such as fillings and root canals.
• Does the plan cover pre-existing conditions? Some plans don’t cover the cost of chronic conditions such as missing teeth, dentures, or dental implants.
• Does the plan allow referrals to specialists? Will your dentist have a choice of specialists for oral surgery or other advanced care?

If your pearly whites have become pearly off-whites, you might be tempted by the variety of at-home tooth-bleaching and teeth-whitening products that are available. But ask your dentist before you choose a product, because not all tooth discoloration is created equal, and commercial whiteners might not solve your problem.

If your teeth are yellowish, a bleaching agent will probably help, but if they are brownish, the bleach may not make much difference. Are your teeth grayish? A bleaching agent won’t help much at all.

Also, if you have tooth-colored fillings or tooth-bonding material on your front teeth, bleaching agents won’t affect the color of these materials, so don’t waste your time and money. Instead, ask your dentist about porcelain veneers or other dental bonding to improve the appearance of your teeth.

If you are a candidate for tooth bleaching, your at-home options include bleaching solutions and whitening toothpastes.

Bleaching solutions contain carbamide peroxide, which bleaches the tooth enamel. You can buy solutions in a range of strengths such as 10 percent, 16 percent, and 22 percent. Start with a mild version; you can always switch if you aren’t satisfied with the results, and you may suffer less of the tooth sensitivity that is a common side effect of bleaching solutions. Treatment regimens vary for different products so be sure to read the instructions on the package, and ask your dentist if you have questions or concerns about any commercial bleaching products.

Or, you can buy whitening toothpaste. Unlike bleaching solutions, whitening toothpastes don’t contain peroxide so they won’t change the color of your teeth. Instead, they have extra chemicals or polishes to improve their stain removing power.

Another option: Ask your dentist about in-office bleaching services, but remember that your insurance may not cover it.

If you have moved, changed your insurance, or have any other reason to find a new dentist, do some homework before you make your decision. If insurance is an issue, start by asking your co-workers who may have the same dental insurance plan whether they are happy with their dentists. And you can search the American Dental Association’s directory at ada.org to find dentists in your area.

Keep these points in mind during your first visit to decide whether a new dentist is right for you:

• Is the office convenient to your home or workplace? You will be more likely to keep your dental appointments if getting to the dentist’s office isn’t a chore.
• Is the office clean and organized?
• Was your medical and dental history noted and filed?
• Is there a procedure to handle emergency dental care outside of regular office hours?
• Is the dentist a member of the American Dental Association? Dentists who are members of the ADA have made a commitment to adhere to the association’s standards of ethics.
• Is the dentist upfront about fees and payment plans before scheduling any procedures?
• Does the dentist explain procedures in a way that you can understand?
• If you are fearful about dental examinations and teeth cleaning, are the office staff and the dentist sensitive to your concerns? Remember that if you visit a dentist and you don’t feel comfortable, try another office. It’s as important to find the right dentist as it is to find any other doctor who can make you feel comfortable and provide the care you need.

Do you wake up in the morning with an achy jaw? Do you have headaches or earaches? Do your teeth look worn down? If you said "yes" to any of these questions, you may be unconsciously grinding your teeth at night, and you should talk to your dentist. Long-term severe tooth grinding can wear away your tooth enamel. Severe tooth grinders may need crowns or other tooth repairs to preserve their dental health.

Tooth grinding (called bruxism) is often associated with anxiety, stress, and a competitive personality type in adults, especially if it occurs at night. But it also can occur as a complication from other medical conditions such as Parkinson’s disease, or as a side effect of some psychiatric medications (especially antidepressants).

To manage bruxism, try to reduce the stress and anxiety in your life (easier said than done) and ask your dentist about a mouth guard that you can wear at night to avoid damage to your teeth. You can buy over-the-counter mouth guards at sporting goods stores or drug stores, but these guards may not fit well and they are more likely to fall out at night. If your dentist recommends a customized mouth guard that is fitted to your teeth, be sure to check your insurance plan. Your dental insurance may or may not cover a mouth guard, but you might be able to use money from a flexible spending account to foot the bill.

And, (of course) be sure to see your dentist regularly so he or she can check your teeth for signs of wear.

If you have chronic bad breath (called halitosis) ask your dentist or doctor for advice. Mints and mouthwashes provide a quick fix, but chronic bad breath can be a sign of some serious medical problems, such as chronic lung infections (a generally foul odor), liver failure (a fishy odor), kidney failure (a urine odor), or uncontrolled diabetes (a fruity odor).

Other less serious causes of chronic bad breath include the following:

• Food. The breakdown of food particles in your mouth can cause odors, as can eating foods such as garlic and onions.
• Alcohol. Although alcohol itself has no odor, the other components of an alcoholic beverage can linger on your breath.
• Poor dental hygiene. If you don’t brush your teeth every day, food particles stay in your mouth and release smelly vapors.
• Dry mouth. Saliva plays an important role in maintaining fresh breath because it keeps your mouth clean and moist. If your mouth is chronically dry, dead cells can build up and cause and odor.
• Sinus infections. When you have a sinus infection, the nasal discharge that hits the back of your throat can cause bad breath.
• Extreme dieting. Someone who is anorexic or severely limiting food intake may develop bad breath from the breakdown of chemicals in the body in response to starvation (a process called ketoacidosis).
• Smoking. Smoking or using other tobacco products dries out your mouth and creates an unpleasant smell.

Plaque is the sticky stuff (it’s a layer of bacteria) that builds up on your teeth when you haven’t brushed them in a while.

So what causes plaque? The foods that you eat, especially sugary, starchy, carbohydrate-rich foods such as milk, soft drinks, candy, and raisins, are the culprits. The bacteria that naturally live in your mouth love these foods as much as you do, and they produce acids in the mouth when there is starchy residue available.

Why should you worry about plaque? Over time, these acids will destroy tooth enamel, and cause tooth decay. Plaque can also get to the root of the tooth and eat away at it from the inside out.

The best and simplest ways to control plaque are to practice good dental care:

• Brush your teeth twice a day.
• Floss once a day.
• See a dentist every six months for a professional evaluation and cleaning.

In addition, eating a healthy diet can prevent plaque buildup. Choose healthy foods such as yogurt, cheese, fresh fruits, and vegetables for between-meal snacks. In particular, snacking on raw celery will help remove excess food from your teeth and help your saliva neutralize the bacterial acids that cause plaque. Saliva plays and important role in keeping plaque in check, so be sure to tell your dentist if you suffer from dry mouth.

Even the most diligent tooth brushers are at risk for developing cavities; tooth decay is among the most common health problems in the world. But if you know what can increase your risk of developing cavities, you will be able to prevent tooth decay before it takes hold.

Factors that can promote tooth decay include the following:

• Not brushing. It almost goes without saying, but if you don’t brush your teeth regularly (twice daily) the plaque buildup can cause decay.
• Radiation treatment for cancer. Having radiation on your head and neck changes the nature of your saliva, which promotes bacterial growth and fosters the development of cavities.
• Old age. As you age, your teeth will wear down and become more vulnerable to decay.
• Eating disorders. People with bulimia are at increased risk for tooth decay because the stomach acid from frequent vomiting can wear away tooth enamel.
• Worn out fillings. If your fillings become worn out or roughened with time they can promote plaque buildup.
• Clingy carb snacks. Certain foods are more likely to stick to your teeth than others, and they aren’t what you think. Believe it or not, candy bars and caramels wash away with saliva more easily than starchy snacks like potato chips.
• Frequent sipping. If you spend all day sipping at a giant cup of soda, the acid in the drink has more time to wreak havoc on your tooth enamel.

The American Dental Association recommends using about 18 inches of floss per flossing. Wrap most of the floss around the middle finger of one hand and the rest around the middle finger of the other hand. Use your index finger and thumb to guide the floss gently between each tooth, unrolling the floss as it becomes dirty so that you always have a clean area of floss to go between each tooth. When you reach the gum line, slide the floss gently between the tooth and gum.

Repeat these steps between each of your upper and lower teeth, and be sure to floss behind the back side of your very last tooth, top and bottom, on each side.

If you find standard dental floss difficult to handle, try a waxed dental floss or dental tape (which is wider than traditional floss and can be easier to hold and use. Or you can buy special cleaning aids such as dental picks or sticks to help you clean between your teeth. Also, "water picks" or similar products aim a stream of water between your teeth to remove extra food particles. But ask your dentist before using these aids so you can be sure to use them correctly and avoid irritating your gums. And remember: Don't try to clean your teeth with toothpicks or any objects that aren't made for teeth cleaning.

You’ve been brushing your teeth since toddlerhood, right? But you may have developed some bad brushing habits over the years, such as brushing too hard, ignoring your back teeth, and forgetting to floss.

Here’s a review of the brushing tips for a healthy smile:

• Hold your toothbrush at a 45-degree angle against the gums. Choose a soft bristle brush (to avoid irritating your gums) and a toothpaste that contains fluoride.
• Move your brush back and forth gently over the front, back, and top (chewing surface) of your teeth. Don’t scrub hard along the gum line; you can irritate your gums.
• Brush for about 2 minutes each time you brush your teeth. If it helps, set a timer, or go through a song in your head that you know is about 2 minutes long.
• Remember to brush behind your top front teeth. Use the top bristles of the brush to reach this area.
• Last but not least, brush your tongue. You’ll freshen your breath and eliminate more cavity-causing bacteria.