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How to Pass the NDEB Canada AFK Exams

We wanted to create a series dedicated to how to pass the NDEB exam when moving your dental practice to Canada. 

This is designed to help ITDs as they make the transition through Canadian immigration and begin to work, practice, or build a dental career in one of the most beautiful and welcoming countries in the world.

 This is part one of our series, where we will get into the details of the AFK Exam in the NDEB process. We will provide some excellent insights and preparation guides as well as insights from one of the top scorers, Dr. Zeina Naous. She is an ITD from Lebanon who is working her way through the NDEB Dental Equivalency process.

We hope this series will result in many more ITDs experiencing the rapid growth potential and lucrative careers available in Canada.

 What is the NDEB Dental Exam in Canada?

 For foreign-trained dentists, the NDEB Dental Exam in Canada is a requirement for certification. The NDEB Dental Exam is offered  consists of two parts: the written exam and the clinical exam.

The written exam is a multiple-choice format that tests your understanding of dental and medical knowledge. The clinical section will test your skills with simulated patients.

While studying for both exams, it's important to keep in mind that there's no right or wrong way to prepare. For example, some students prefer using flashcards while others enjoy reading textbooks or taking online courses. 

NDEB stands for the National Dental Examining Board, which is the body that oversees the competence level of those ITDs wishing to become or practice as Canadian dentists.

 The NDEB equivalency process is designed to establish the credentials of those who have not gone through an accredited dental program.

 The first thing you will need to do in this process is getting your account and profile approved after registering at the NDEB website. 

That can take anywhere from 4-6 months.

We suggest registering, then immediately beginning to prepare for your AFK exam so you can take it as soon as you are cleared.

 What is the AFK Exam in Canada?

 The Assessment of Fundamental Knowledge (AFK) is a written exam that students can take when they are studying for the NDEB certification. 

The purpose of this exam is to test your basic knowledge of the subjects required by the NDEB equivalency process, which includes anatomy, physiology, dental subjects, etc.  

You should know that passing the AFK does not guarantee that you will be able to pass all other exams required.

It's just one step along your journey toward becoming a Canadian dentist. 

The test comprises 200 multiple-choice questions designed to evaluate your knowledge and clinical application capabilities. 

The AFK is held twice per academic year [currently February and August], but that could change in the future as more and more students are using the online version over in-person proctored exams.

There is a 100-question multiple-choice self-assessment you can try out on the AFK website.

The AFK has a dual purpose. Not only is it required for the NDEB equivalency process, but it is also a fundamental step in attending dental school in Canada.

 Where Do You Take the AFK Exam?

 You can sit for the AFK by joining a number of different NDEB prep schools throughout Canada or by directly interacting with the NDEB. This will require 300 questions in two parts, each taking roughly 2 hours to complete. 

The AFK is offered in two available formats. The first is electronic delivery via a Prometric test center.

The other is through a booklet offered at preselected exam sites that are listed when you register.

In order to pass the AFK exam in Canada, you will need a test-equated re-scaled score of 75 or greater. Anything less is considered a fail.

You can register for the AFK in the same portal you used for setting up an account with the NDEB system.

 AFK Exam Insights from Dr. Zeina Naous

 Okay, let’s get to the detailed information from an ITD that not only successfully passed the AFK  and ACJ exam, but received one of the highest scores in ACJ history.

Dr. Naous is originally from Lebanon and currently lives in Canada while completing her NDEB equivalency process. She is 26 years old, a content creator, and a social media influencer. 

Her degree was completed in 2018, and she moved directly after graduation without any dental experience in Lebanon.

How Long to Practice for the AFK Exam?

According to Dr. Naous, the AFK is all about discipline. You should start preparing for your exam about 3-4 months before sitting for the test. 

You want to soak in as much of the practice information as much as possible. She strongly recommends prep programs and courses as part of your studying regimen. 

The reason for this long preparation is because you will be competing against others in your “cycle.”

The more people that join prep courses, the more experience and exposure they will get with mock exams and practice materials compared to you.

 The AFK covers a great deal of information that requires reference materials. While you can do it all on your own, it is easier when you have a curriculum or outline provided by people that have passed the exam and have been researching the material for a long time.

The exams are not very hard, but they are very detailed, so it may take some time in order to understand everything thoroughly enough so that you know exactly what information is necessary when answering questions correctly on the exam day!

 Should I Join a Preparation Program or course for the AFK Exam?

 Yes, if you can afford to join a prep course or school, you should do it. There are many options out there, but few provide the level of support that is needed to pass the AFK exam. 

The first thing to look at when choosing a program is whether or not they offer personalized coaching and guidance from experienced instructors. 

They should offer you resources to prepare like personal study sessions, group workshops, and one-on-one tutoring sessions all designed around your needs as an individual student.

 You also get access to regular updates on how other students are performing on their exams so that you can see how well-prepared everyone else is.

This is a confidence booster because everyone knows what's going on with each other instead of just wondering about things behind closed doors.

 Part of the reason I agreed to be interviewed for this article was that I believe in the personal stories of success as a catalyst for your own completion of the AFK exam. 

Seeing testimonials from former students who were able to pass their exams after using our methods provides you with tips and tricks needed to overcome hurdles.

Check out our list of Best NDEB Canada Training Institutes

  1. Prep Doctors Institute - Best International Experience
  2. Scholars Dental - Highest Rated Dental Center
  3. CIDE Online - Best Value and Financial Aid
  4. ConfiDentist - Best All-Around Program
  5. DSTC Dental - Best for Canada & USA

 Attending Lectures for AFK Topics

 When you study for the AFK exam, attendance at lectures is just as important as preparing for the exam.

The best way to prepare for an exam is by learning all you can about the subject matter. You can do this by attending lectures and reading textbooks and articles about it. 

AFK has its own set of topics that must be covered in order to pass its exams. The subjects covered include local lectures covering Anatomy and Physiology, Dental Practices, and anything else related to the profession of dentistry will only help bolster your experience and workable knowledge.

Other AFK Topics;

⋅ Pharmacology

⋅ Pathology

⋅ Pedodontics

⋅ Surgery

⋅ Prosthodontics

⋅ Restorative

⋅ Endodontics

⋅ Radiology

⋅ Medical Management

⋅ Orthodontics

⋅ Anesthesiology

⋅ Basic Science

⋅ Epidemiology

⋅ Periodontics

 Practicing for the AFK Exam

 Unlike most tests, you don’t want to cram for the NDEB exams. Instead, you should create a study plan that has enough time to allow for memorizing information and understanding the content.

This way, you can avoid mistakes in the exam and feel confident about answering questions correctly. 

Assemble a study group of fellow students who are also preparing for the exam.

Having others help you revise material will make it easier for everyone because they will be able to share their notes with one another and compare notes after each practice session.

 A Monthly Guide to Training for the AFK Exam

Let me share with you how I prepared myself for the AFK and maybe that can help you decide on a structure for studying and adapting your lifestyle.

 Month #1

  ♦ Plan out a specific study time and place that I will use every day

  ♦ Find and attend lectures either online or in-person to help grow my knowledge

  ♦ Do as much reading as possible, and then go over that material 1, 2, or even 3 times

  ♦ Develop a solid understanding of problem-solving in general

  ♦ Dive early into Pharmacology  because that is a heavy topic and requires a lot of memorization

 Month #2

  ♦ Focus more on precise learning going subject by subject

  ♦ Start to divide your time between studying and taking practice exams for each topic

  ♦ This is a good time to build a network of fellow students by preparing and having study groups where you test each other

 Month #3

  ♦ Troubleshooting - time to see where your mistakes are happening the most and focus on those areas

  ♦ You do not want to just correct a bad answer but understand what led you to that incorrect answer so you can retrain your        thought process to avoid the mistake in the future

  ♦ Start to ease back on stress so you can relax more by introducing breaks so your brain will focus more when it is time to study and begin to internalize information

 Month #4

  ♦ It is all about practice testing and honing in on those topics that you are still having trouble understanding

  ♦ The rest is just a refresher to ensure it is still present in your mind

  ♦ If you are attending a course, it is a good idea to participate in mock exams with them too. This will let you see what your scoring level is in general and in comparison to other students in that cycle.

General Tips for the AFK Exam 

Start practicing as soon as you can. The sooner you start, the better your chances of success. Practice at least 5 days a week. 

You need to be able to dedicate some time each day to studying and preparing for the tests, especially if you want to get them done in a shorter period of time.

Study at least 3 topics a week.

This will help ensure that you stay consistent with your studies, which is one of the most important factors when it comes to passing any kind of exam.

 Stay consistent with reviewing all topics covered during each section/topic within an exam so that when it comes time for the actual testing, there won't be any surprises.

 It really helps to have a plan in place from the beginning.

The NDEB equivalency process is a marathon, not a sprint. 

There are many resources online and off that provide you with a solid outline to study from, so spend those first few days of studying just developing your overall plan.

 The goal is to pass your exam on the first try.

The current fee for the AFK is $800 if you register and take it through the NDEB. 

Failing not only means you miss out on that money, but now you have set back the rest of your NDEB equivalency process by probably 6 months. Not to mention that if you took a prep course, that probably set you back an additional $3,000-$4,000 as well.

 The more you delay, the longer it will take to either get into a dental school in Canada or move on to the next step of the NDEB equivalency process.

 What Comes After the AFK Exam?

 After you have successfully completed the AFK exam, you will move on to the ACJ - Assessment of Clinical Judgment. 

This exam has a $1,350 fee, but the preparation courses tend to be slightly more affordable at around $2,000-$2,500, depending on where you go.

This will be what is considered one of the hardest parts of the NDEB equivalency process because it tests your ability to bring the correct tools to the problem.

 You are expressing your ability to function through problem-based learning and how well you design and implement strategies to overcome clinical issues.

This is more than theoretical knowledge. It is how you express your clinical experience.

 Wrapping it Up


 This was only the first part in our series on the NDEB Examination Process in Canada for ITDs wanting a career in dentistry

 We want to thank Dr. Zeina Naous for her valuable insights into the exam, including her personal experience in receiving one o dentistry.

 We hope this article answers many of the questions you may have about the AFK exam and how best to prepare yourself for your upcoming testing date.

 Please be sure to come back to our site as we tackle other topics in this series and walk you through the process of transitioning from ITD to a certified dentist in the beautiful country of Canada.

 If you have any questions about this article or the ITD process, be sure to send us a note through our contact page. Thank you for reading and stay tuned for more helpful ITD articles!


Dr. Zeina Naous' achievements are inspiring.

Follow her  on Instagram   @zeina_dentist and on  Tiktok

About the Author

Karen Nunez was born in Valenzuela, Philippines. She received her Doctor of Dental Medicine degree from Centro Escolar University in Manila.

Karen currently is a practicing oral health care professional based in Alberta, Canada; and runs a Blog where she writes a slew of articles to empower internationally trained dentists to integrate into Canadian dentistry.

Read more of her blogs here.

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9 Tips to Prevent Carpal Tunnel Syndrome for Dentists

With the increased demand in Canada for well-trained ITDs and other dental professionals, the amount of time you are bound to be performing procedures for patients will be high.

Canadians have experienced a significant decrease in dental decay over the past 40 years, and that is because roughly 75% of Canadians visit a dental clinic every year.

All of that demand probably has you a bit concerned about how to prevent carpal tunnel syndrome for dentist work.

Dentists are a bit more likely to develop carpal tunnel because many of the procedures  conducted involve the same repetitive motions, placing an extremely high demand on your hands.

From repairing a tooth to extracting a child’s teeth, you need to do your best to protect the health and endurance of your hand, arms, and upper body.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common issue for anyone who uses their hands regularly for the same types of movements over and over again.

People like mechanics, plumbers, and even concert pianists are susceptible to the carpal tunnel because their daily activity requires using the muscles and tendons of their hands and wrists at a high level.

Dentists are the same. Every day you see patients, you will use the same basic movements.

You may start to feel pain, numbness, and general weakness along in your hands and wrists. This is the result of a median nerve that provides sensation to the thumb, index, middle fingers, and half of the ring finger.

Once that nerve receives too much pressure, it starts to cause tingling and other unwanted sensations. There are also tendons around this nerve inside the carpal tunnel that may get inflamed or irritated from repetitive stress.

What are the Symptoms of Carpal Tunnel Dentists Should Watch For?

When you are experiencing carpal tunnel syndrome, it can negatively impact your dentistry practice. This is because it can cause weakness in your hands, remove your ability to conduct delicate motions, and often lead to dropping objects.

While those are the later signs, they are also clear indications that your dentistry career may be in jeopardy if left untreated.

More likely, you will experience slight numbness and tingling during the nighttime when your hands are resting.

During the day, you can expect decreased feeling in your fingertips, tingling, and difficulty handling smaller tasks like grasping a steering wheel, writing, or holding a book to read.

If you are experiencing any of these symptoms, we encourage you to seek out the care of a doctor. They will most likely run a few tests like:

    ♦ Tinel’s sign: Your doctor will tap over where the median nerve should be in your wrist and see if that causes any tingling in your fingers.

    ♦ Wrist flexing test: Here, you place your elbows on a table and then allow your wrist to fall forward freely. If you have carpal tunnel, you can expect to feel tingling in your fingers within about a minute.

    ♦ X-rays: If a doctor suspects you have limited motion or range in your wrist, they may request x-rays.

    ♦ Electromyography (EMG): This is a nerve conduction test to see if the median nerve is functioning properly.

How to Treat Carpal Tunnel Syndrome

The good news for all you ITDs out there preparing your move to Canada is that there are treatments for carpal tunnel syndrome.

This is a common ailment, and that means there has been plenty of research and development of treatments, including surgical and non-surgical methods.

Non-Surgical Treatments of Carpal Tunnel Syndrome

These are the treatments most dentists prefer because they do not involve long healing periods. Most often, you will be asked to wear a splint when you are not performing procedures.

You may also be prescribed nonsteroidal anti-inflammatory drugs and possible cortisone injections to lower the pain and remove the swelling.

Beyond that, a doctor will work with you to make lifestyle changes. This is challenging because the most likely cause of your carpal tunnel syndrome is your dentistry work.

That is not something you can avoid without changing careers. We will get into steps you can take to prevent further damage below.

Surgical Treatments

Whenever your non-surgical treatments are not effective, you can expect the topic of surgery to come up.

The goal is to increase the size of the tunnel so that the pressure is released from your median nerve and tendon.

This is a fairly standard procedure with an excellent success rate.

The downside is that it will take time away from your practice. You can expect to experience some healing pain and stitches.

You will also be given some minor physical therapy techniques to improve the flexibility and strength of your wrists.

The risk of surgery is that you could lose some fine motor control, but that can be discussed with your doctor based on your age and other factors.

Also, Check Out

          ♦   How to Become a Dentist in Canada (A Step by Step Guide)
          ♦   How to Immigrate to Canada as a Dentist

How to Prevent Carpal Tunnel Syndrome for Dentists

Now that we have gotten the background information out of the way, let’s get to the good stuff. We want to be sure you are living your best new life in Canada now that you have gone through the tests and paperwork of being an ITD, and that includes offering health tips, so you have a long and lucrative practice.

Here are some basic tips and tricks to preventing carpal tunnel throughout your dental career.

1 - Introduce Wrist Exercises


Your career requires maintenance, just like an athlete needs to stretch or a vocalist needs to warm up their vocal box. The more pain and inflammation you are experiencing, the harder it will be to maintain fine motor control. Introducing some simple wrist exercises is a great way to prevent carpal tunnel syndrome from developing.

There are quite a few excellent exercises to research and ask your healthcare provider about, but an excellent place to start would be these three:

    ♦ Spiders - Start by placing your palms together in a prayer pose, then rotate your wrists so your fingers are pointing to the ground. Now, slowly separate your palms while keeping all your fingers together as if with glue. Think of a steeple motion and use your thumbs to push down to your other fingers. Continue doing this out and in motion for a couple of minutes.

    ♦ The Shake - It may seem elementary, but shaking your hands out like you would if air drying them is a great way to keep your muscles and median nerve from cramping.

    ♦ Wrist Flexor Stretch - A lot of dentists swear by this stretch. Start by extending your arm in front of you with the palm facing up. Now bend your wrist back while pointing your hand toward the floor. Use your other hand to bend your wrist farther until you feel the stretch, then hold for about 15-30 seconds. Repeat this 2-4 times with both arms.

    ♦ Rubber Stress Balls - We highly recommend you purchase a few rubber stress balls that you can squeeze and release every so often. This both strengthens your wrist while also working out the median nerve, so it stays a bit more pliant.

2 - Ergonomic Equipment

We understand the costs of running a dental practice, even in Canada, where the government is extremely friendly toward helping you get going.

However, when you select what tools to purchase for you and your team, spend the extra few dollars and get the highly ergonomic equipment.

This is going to save you so much time and money in the long run because it will encourage your team to use motions that do not place as much stress on the wrists as older tools.

3 - Improve Your Seating

There is a habit in dental offices around the world to use the same equipment you learned your profession on in Canada.

Keep in mind that most schools have to save costs and may not get the most advanced or ergonomic equipment.

Improving your seating not only helps your back by the end of the day but also encourages a health-conscious team that will increase the use of proper body movement.

This is a great way to protect yourself from the same motions that cause carpal tunnel syndrome.

4 - Take Breaks

Yes, your schedule will fill up quickly. Canadians are well aware of their dental care, and you can expect to have a fully booked day almost from the beginning of opening or joining a practice.

However, you need to be sure to schedule breaks between patients to rest your hands or do some exercises.

Do not think of this as time spent away from your patients, but as necessary habits that improve your overall ability to treat your patient’s needs.

Talk to your team and assistants and ask them to make sure you are taking an appropriate amount of breaks if you are like most dentists and end up being focused on getting through your schedule more than your personal health.

5 - Manage Your Overall Health

ITDs understand that oral health both impacts and is affected by the rest of the body. The same is true for carpal tunnel syndrome.

If you are obese, have diabetes, or are at risk of other health conditions, you may be putting yourself at greater risk of carpal tunnel syndrome.

Creating a healthy lifestyle with a balanced eating habit and getting in 20 minutes of exercise a day will help you stay fit for duty.

This does not have to be hitting the gym every single free moment. A simple 20-minute walk with your dog and partner will do the trick.

6 - Pay Attention to Your Back Office Work

Maybe you are a fantastic dentist who follows all of the advice in front of a patient, but the second you are behind closed doors doing computer work, you start to hunch your back and fall into poor keyboard/mouse movements.

Do not forget that the care of your wrists extends beyond the dental office.

You need to watch all of your other activities to be sure you are not adding to the problem by something completely unrelated.

7 - Keep Your Wrists Warm

Canada is pretty well known for having cooler temperatures, which can be a problem for carpal tunnel syndrome.

The colder your wrists and nerves are, the more likely stiffness will occur.

You need to have supple wrists and fingers to perform your dental work, and that requires wearing gloves and longer jackets to stay warm when out and about.

8 - Wear a Brace at Night

It may not be the sexiest bedroom accessory for your dating life, but wearing a brace or splint at night on your wrists will help them stay in a neutral position.

Even getting in a short session of an hour or so a day helps return your wrists to a state of rest. When you do take the braces off, be sure to move your wrists naturally at first to regain strength and flexibility.

9 - Stop Smoking

Canada does have a smoking population of around 4.6 million, or roughly 15.1%. As an ITD or dental student in Canada, you are more aware than others of the damage smoking can do to a human body.

This is also true for carpal tunnel syndrome. Smoking can interfere with the blood flow throughout your body.

This will make what symptoms you may already have much worse and slow down your recovery or prevention methods.

If you are smoking, now is a great time to buy a nicotine patch and quit the habit.

Where to Find More Information

We want to make sure all of your carpal tunnel syndrome questions are answered as you develop your ITD career in Canada.

There are two excellent online resources to learn more about prevention, diagnosing, and treatment for this common situation:

They should connect you with a healthcare provider that specializes in the care and treatment of carpal tunnel syndrome.

As always, we hope you have found this information valuable to your future work here in the beautiful country of Canada.

We do our best to provide as much knowledge and insider tips to ITDs as they make the transition to Canadian dentists.

Please do not overlook the risks of a diagnosis of carpal tunnel syndrome.

You are going to be using your wrists an awful lot and will be susceptible to this issue. Do your exercises and treat your body like a refined tool necessary for your career development.

If you do suspect that you may have developed symptoms, go see a doctor sooner than later.

This is a common ailment and can be easily mitigated the earlier it is addressed by a professional.

A simple appointment could make a significant difference in your ability to practice dentistry in the future.

Karen Nunez was born in Valenzuela, Philippines. She received her Doctor of Dental Medicine degree from Centro Escolar University in Manila.

Karen currently is a practicing oral health care professional based in Alberta, Canada; and runs a website where she writes a slew of articles to empower internationally trained dentists to integrate into Canadian dentistry.

Read more of her blogs here.

Oral Care Related Posts

How To Get Rid of Bad Breath Permanently

#1 Remedy for Bad Breath and Mouth Odor

We’ve all had our fair share of bad breath at some point. Whether it’s morning breath or, more serious, chronic conditions, bad breath is unpleasant for those around you (surprise, surprise) and detrimental to your health. 

You’ll know you’re guilty of it when alongside the bad breath odor, you have a residing bad taste in your mouth–which can be either from trapped food particles or an underlying condition. Whichever symptom, it’s uncomfortable, undesirable, and unhealthy.   

So in this short read, we’re going to cover everything you need to know about bad breath’s causes, risks, fixes and prevention, and when to see a dentist. 

Travel toothbrush

Why do I have bad breath? (Causes)

Poor oral hygiene

Every time we eat, our mouths have bacteria that break down food particles trapped in between the teeth or mouth. It’s handy, but the combination of decaying food and bacteria also produces bad breath. So if you don’t brush, rinse, and floss to pick out the sneaky food remains, you’re letting the harmful bacteria multiply in your mouth. That stinks. 

Irregular brushing also causes plaque build-up, which is another culprit for bad breath odor. The unhealthy build-up can cause cavities and periodontal disease–if there were a way to snowball bad breath, perio breath would be it. 

Lastly, if you have dentures and don’t clean them regularly, bad breath will find you, too.

Sinus, mouth, or throat conditions

You could also develop bad breath if you have certain oral conditions. Such as:

»   Sinus infection/bronchitis/postnasal drainage: the mucus developed in any of these conditions, like your infected sinus, smells bad. So, as it drips out of the sinuses or backs down the throat while your mouth is open (since your nose is usually congested), it meets the air you’re exhaling–from where it transfers to your breath. 

»   Dry mouth: saliva deficiency also causes bad breath. The saliva in our mouths cleans it and removes particles that may cause bad odors. You can increase saliva flow for a dry mouth and keep your mouth moist by drinking more water during the day, sucking sugarless lozenges, or chewing sugarless gum.


Smoking can cause bad breath because the tobacco smoke itself lingers on your breath well after you’re done with the cigarette. It also dries up your mouth, which, as mentioned in the previous section, causes bad breath because there’s no saliva to clean up the mouth. Lastly, smoking or even chewing tobacco-based products causes gum disease–another source of bad breath.

Stenchy foods and beverages

Some foods, like garlic and onions, have strong odors, and when your stomach absorbs their oils during digestion, they pass into your bloodstream and travel to your lungs. 


♦   Diabetes: higher glucose levels promote bacteria growth, infection, and thereby bad breath. It’s also harder to fight infection if your blood sugar is high–so your gums are more susceptible to disease with slower recovery. 

♦   Kidney disease: bad breath is a common oral symptom because the dysfunctional kidney can’t filter out the excessive urea in the bloodstream.   

♦   Liver disease: if your breath has a strong, musty smell, then it could be a sign that your liver is having trouble filtering out toxic substances.

♦   Gastroesophageal reflux disorder (GERD): a medical condition where your stomach contents like undigested food, bile, and stomach acid reflux up your esophagus–leaving residue around your mouth and mixing with oral bacteria to make the foul breath odor stronger.  

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Revitin Oral Therapy

How to get rid of bad breath (tips & treatments)

Bad breath is already unsettling and disgusting as it is, and the probability of disease is greater. As if that’s not bad enough, it can also impact your body image and self-confidence. You may have even noticed yourself being anti-social or distant, so people don’t have to be around your smelly breath. 

Low self-esteem won’t help you make valuable relationships with others. So there goes a nice social life, too.

You have all the reason to say “screw you” too bad breath and no reason to let it go on. The following are tips and treatments for getting rid of bad breath. 


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Proper oral hygiene for bad breath prevention

For most people, poor dental hygiene is one of the leading causes of bad breath. So, the solution? Good oral hygiene, of course. It can eliminate existing bad breath and prevent it from recurring in the future. We cover what that entails here:

♦   Brush your teeth twice a day for 2 minutes–as that’s the optimal time to make sure your teeth are cleaned thoroughly. An electric toothbrush is also advisable because it’s more effective in removing dental plaque and improving gingival health

♦   Flossing your teeth can help minimize bad breath by removing hard-to-reach food remains and regulating bacteria and plaque build-up in the gums.

♦   Mouthwash will only temporarily mask bad breath if you use it without brushing–but using it in conjunction with brush and floss has been shown to reduce plaque. Look for an antiseptic mouthwash that can reduce or control plaque over a cosmetic one (strictly for fresh smell). Also, try to stay away from alcoholic mouthwashes that can dry the mouth, and as aforementioned, salivary deficiency can lead to bad breath. 

♦   Professional dental cleaning may be required if the situation is beyond DIY methods. Dental hygienists have advanced tools and training to thoroughly clean your mouth,  and give you a fresh start. 

Treat the diseases causing lousy breath

If conditions or diseases are causing your bad breath problem, then your situation is just as much a physician’s problem as a dentist’s. In other words, you need to treat the medical issues that are causing bad breath odors as a byproduct. 

Photodynamic therapy (PDT)

Halitosis has recently been treated with antimicrobial photodynamic therapy (PDT). Basically, photosensitizers (light-absorbing molecules) absorb a specific wavelength of visible light–which triggers a series of reactions that ultimately transfer energy to a bacterium’s oxygen molecules, killing the cells within.  

PDT has demonstrated promising results in treating bad breath. Unlike chemical mouthwashes, tongue scrapers, chewing gum, sprays, or tablets that may cause excessive tongue excoriation with transudation and desquamation, there are zero reports of adverse effects or toxicity from PDT

When to seek professional help

If your bad breath is persisting after all the troubleshooting, check in with your dentist. With professional advice, you can discover what may be causing the problem. After a thorough dental exam and cleaning, your dentist can help rule out any oral health concerns and provide advice on the next steps. That includes dental products to use, dental hygiene instructions, and referrals to other medical providers if need be.  

Bad breath can be annoying. But, now you know its potential origins and what to do about it. You’re equipped with the proper knowledge to fight and prevent bad breath. 



About The Author:

Karen Nunez was born in Valenzuela, Philippines. She received her Doctor of Dental Medicine degree from Centro Escolar University in Manila.

Karen currently is a practicing oral health care professional based in Alberta, Canada; and runs a Blog where she writes a slew of articles to empower internationally trained dentists to integrate into Canadian dentistry.

Read more of her blogs here.


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5 Culprits For Yellow Teeth & What To Do About It

A smile is contagious–that’s not just a saying, but a scientific fact. Dental aesthetics has been shown to boost your self-esteem– fact again. Needless to say, a beautiful white smile helps, but a dirty, yellow one doesn’t.

 That’s why you’re here, looking for answers to the million-dollar question: “Why are my teeth yellow? AND HOW CAN I FIX IT?”

We’ve identified five culprits and brought you some remedies. Let’s go.

Natural Ageing

Advancing age is a natural factor for teeth discoloration. Genetics plays a role in how fast it happens, too. With age, the outer layer of our teeth thins out, and that, in turn, reduces your teeth’ shiny white appearance, resulting in a yellower shade. Hence, the reason you lost those once sparkling and white teeth.



Faulty Diet

Certain foods tend to stain the teeth. Excessively consuming sauces, dark curries, black coffees, and other staining drinks tarnishes your enamel with tannins (food chemicals with blemishing properties). Their darker pigments called chromogens bind to your teeth resulting in tooth discoloration.


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Some teeth-staining foods to look out for are:

Sauces (e.g. soy/tomato)



Wine (red and white)

Fruit juices (e.g. grape/cranberry)



The tar and nicotine from smoking can cause yellow and stained teeth. Beyond just yellow teeth, the tobacco from cigarettes is bad for your oral hygiene because it increases the risk of oral and throat cancer as well as tooth decay.

Smokers are more prone to developing plaque- which can cause gum disease. The infected gums don't heal because smoking causes a lack of oxygen in your bloodstream - and you might end up in tooth loss.



Poor Oral Hygiene

If you don’t regularly brush, floss, and rinse enough to remove plaque and food debris, your teeth will remain unclean and yellow. Dirty teeth are a sign of carelessness and poor health because the toxic build-up can bring about other internal health problems.

Taking care of your mouth is a part of good overall health.  Remember, your mouth is a window into the rest of your body.


Medications for high blood pressure, antipsychotics, and some antihistamine drugs have side effects that can alter the color of your teeth. Chemotherapy and head and neck radiation can also darken your pearly whites.

Exposure to Doxycycline and Tetracycline during the formative years of young children may have intrinsic staining of their adult teeth later in life.

Last on the list- Chlorhexidine in mouthwashes. Your teeth will get brownish stains from this cleaning agent when used for more than two weeks.

Preventive tips to prevent yellow stains on your teeth

Nothing beats a clean and healthy mouth. Do your part in brushing and flossing your teeth. Brush twice a day for two minutes. And floss once daily.

Visit your dentist regularly.

Get a professional cleaning from your dental hygienist every six months, or as recommended.

Cut back on the coffee or tea.  Now that could be a challenge for many. Consider using a straw to avoid staining your front pearly whites.

Don't smoke or use tobacco.

Eat Calcium-rich foods. Dairy products and non-dairy calcium-rich foods contain minerals to strengthen your enamel.  Healthy enamel means the inner layer of your teeth doesn't show- making them whiter in color.

Use fluoride toothpaste. Fluoride makes your teeth strong. It strengthens your enamel against wear and tear when eating acidic foods and beverages.

How to Get Rid of Yellow Teeth

There are two kinds of teeth stains: extrinsic (superficial stains on the outer layer of teeth, caused by coffee, tea, soda, etc.) and intrinsic (deeper stains beneath the enamel, on the tooth’s dentin–these are harder to remove).

For stubborn yellow and brown discoloration, here  are five proven ways to help you get rid of those pesky stains:

We recommend products we genuinely believe may be beneficial to your oral and dental health. If you purchase the products using the links below, we may earn  commissions at no extra cost to you. Please read our policy here for more information.


Whitening Toothpaste

How it works: The scrubbing action of the toothpaste’s abrasives helps remove the surface discoloration. It contains tiny granules or polishing agents that remove the stains on the outer layer of your teeth. Perfect for extrinsic yellowish staining!

Our recommendation:

Crest Gum and Enamel Repair Toothpaste

Whiter Teeth. Strong enamel. Healthy gums.

This toothpaste has got it all. Formulated with fluoride to make your teeth strong. Keep the compliments coming as you wear your new, healthy, and white smile.

Contains hydrated silica that lifts off surface stains -to make your teeth nice and bright.

Your gums will love this-  clinically proven to help reverse gingivitis in seven days.

Spa-Dent VEGAN Whitening toothpaste   


Smile more with toothpaste that comes from nature.

Spa Dent Whitening toothpaste with coconut oil and sea salt reduces the harmful bacteria in your mouth while making your teeth white. What's more, you will be delighted with its minty and pleasant flavors- and the promise of organic and preservative-free ingredients.


Whitestrips: Gentle At-home Teeth Whitening Kit

How it works: Whitestrips work both on surface stains and beneath the surface of the tooth. It goes beyond where most whitening kinds of toothpaste leave off and would give a whiter overall dazzling smile.

Our recommendation:

Crest 3D Whitestrips Kit

Be ready for a total make-over. Crest 3d white strips gently erase 15 years of stains; in just two weeks.

The strips mold to the unique shape of your teeth and come off with great ease. Use them just once a day for 30 minutes elevates your whiter smile to the next level.

It's very easy to use- apply the hydrogen peroxide-coated strips to the front of your teeth and let it seep into them to help remove stains and lighten the teeth.


Whitening Pen

 How it works: Treat yourself like a painting and the whitening pen as a brush. Apply the gel with strokes and see the glow of your teeth.

Caliwhite  Teeth Whitening Pen

Discover the ease of teeth whitening. Caliwhite whitening Pen makes your teeth white instantly- in 7 to 10 minutes. Paint it on your teeth and in between the crevices, and see the magic happens.

Certified organic- no worries about artificial ingredients

Contains Hydrogen peroxide -a chemical agent that is safe and effective in teeth whitening, that breaks down stains giving that shiny and white smile.

No parabens, sulfates, and GMO- only the real stuff for you

LED Light Teeth Whitening System

Want to wear those dazzling pearly whites longer?

Your best bet- The light-activated whitening system.

How it works: You need to brush and floss your teeth, as usual, apply the whitening serum while avoiding your gums and teeth, whiten using the LED mouthguard and rinse.

As simple as that!

Cali White Vegan Teeth WHITENING KIT with LED Light

The legendary Caliwhite Whitening System will surely boost your confidence. Experience a 2-8 Shade Whiter Smile in 7 days with its safe Hydrogen Peroxide Formula -effective in removing both surface and inner stains. It comes with a LED light which increases the lightness of your teeth than the nonlight activated ones.

The VEGAN plus-side: You can ensure that you’re supporting cruelty-free production because no animal tests and harm are done.

Patented Universal Comfort fit Tray- allows the gel to fill crevices between teeth giving a uniform whitening effect on all teeth.

Sensitive Teeth After Whitening

Teeth slightly become dehydrated as the whitening agent opens up the pores of your teeth. When this happens, you may experience sensitivity to hot and cold drinks/food.

Try this Smile Brilliant Desensitizing gel to get moisture back to your teeth. It has Fluoride that gives instant and long-term relief after teeth bleaching. Double the relief with its Potassium Nitrate- help reduces discomfort by blocking the pain signals you may have.

That is one gel you want to get for a brighter and pain-free smile.

Facts About Teeth Whitening

Only natural teeth can be whitened, not fillings or dental restorations like bridges, implants, or crowns.

Carbamide Peroxide or  Hydrogen Peroxide is the popular agent in teeth whitening and is proven to be readily absorbed by the hard dental tissue. Use with caution as they can result in some sensitivity and gum irritation.

Tooth whitening is safe and effective when consumers follow the manufacturer’s instructions, but results vary in some cases.

Parting Words

Yellow teeth can be attributed to a couple of reasons: age, faulty diet, smoking, poor dental care, and medications. You can overcome tooth discoloration by using the aforementioned teeth-whitening products and be more confident in social settings with your bright smile.  

Remember that your overall oral health is also as important as having white teeth. So don’t just prioritize whitening strips and gels but take care of your entire mouth, too!


Nutrition Oral Care Related Posts

Best Dental Hygiene Advice For Older Adults

Good oral hygiene shouldn't be taken for granted. But for many adults over 55, practicing healthy oral hygiene habits is more difficult than it once was. 

By not taking care of their teeth proactively, older adults may see some serious health problems, not just those related to your teeth, but those related to other parts of your body as well. With a weaker immune system at an older age, can you really afford to get sick?  

Practicing good oral hygiene can prolong the life of your teeth and lower your risk of other diseases as well. That’s right, strong oral health is directly linked to good overall health elsewhere in your body. 

So, in addition to our age-old recommendation to visit your dentist regularly and observe good hygiene, in this short guide, we’re going to help you address your oral health with research-backed products and improve your quality of life. Let’s get started!


We recommend products we genuinely believe may be beneficial to your oral health.  The products reviewed are not intended to diagnose, treat, cure, or prevent any disease or health condition. Consult with your healthcare practitioner for your dental concerns.

If you purchase the products using the links below, we may earn a small commission at no extra cost to you. Please read our policy here for more information.

Treating Weak Enamel & Tooth Structure

Enamel wears away with age, leaving the teeth vulnerable to damage and decay. When their teeth begin to deteriorate, it becomes more difficult to chew. In turn, older adults (who are usually the victims) will miss out on nutritional foods, which can cause vitamin deficiencies.

A great non-invasive solution for weak teeth, enamel, and structure, is rinsing with a special mouthwash that does more than freshen your breath.   

The CloSYS Silver Fluoride Antimicrobial Mouthwash contains sodium fluoride, which after regular use, has shown to strengthen demineralized dental tissue like enamel and dentin to help rebuild weak spots. The chemical has also been clinically shown to make your teeth more resistant to bacteria that cause cavities.

One minor drawback to this mouthwash is that it contains Sucralose, which gives it an extra sweet taste–some may find that a bit unpleasant. 



Denture Cleaning

With age, many older adults develop arthritis and experience motor incoordination. That makes it harder to clean dentures with a manual brush and water. With residual bacteria and germs remaining in the teeth, you risk infections, bad breath, and other oral and bodily diseases. 

The BlumWay Ultrasonic Cleaner is an excellent solution for those who can’t physically brush away unwanted germs and bacteria. All you have to do is press one button and let your dentures sit for 5 minutes in a cleaning solution–research has shown that alkaline peroxide and ultrasonic vibration are superior auxiliary agents to just brushing with water

Though relatively expensive, it’s a one-time purchase that guarantees the effective removal of biofilm (adhering to surface bacteria) from your dentures and flexes a healthy white smile.


Fixing a Dry Mouth

It’s common for older people to suffer from dry mouth (salivary hypofunction, xerostomia). Because of decreased saliva production, you’re more prone to significant oropharyngeal (back-of-the-mouth) disorders, pain, and overall lower quality of life. 

Many things can lead to a dry mouth, from local salivary disorders to ingesting more medication than younger populations and other conditions that come with old age. When treated early, though, older people are protected from the negative consequences of this condition.


A great dry-mouth fix is, for example, Oracoat Xylimelts. These pills have been clinically proven to increase salivary flow and help combat dry mouth, and promote mineralization for solid and healthy teeth. Just see that you don’t take the Xylitol in excessive amounts, as that has shown to produce laxative effects. Not pretty. 



Another great option is the Biotene Oral Rinse. In addition to removing odors of a dry mouth, the alcohol-free, no-burn solution uses the LP3 salivary enzyme-protein system to act as artificial saliva to moisten and clean the mouth. 

Compared to regular mouthwashes in your local drug store, it’s a lot pricier given the same liquid volume. However, it’s worth the investment to many because you can comfortably enjoy drinking, chewing, and speaking after rinsing with this product. 


Preventing Gum Infection

As mentioned before, advancing age makes it difficult to brush teeth well because of motor incoordination. Dry mouths can also make you more prone to cavities and gum infection due to decreased salivary flow. That’s why it’s more important than ever to properly clean our teeth at an older age and prevent gum infection. 

The cariPRO™ Electric Toothbrush is more effective in removing plaque and germs to avoid gum diseases than using a manual toothbrush. Powered toothbrushes clean more thoroughly with less physical effort and reach the hard-to-reach places in your teeth for a deep clean. It’s perfect for older adults who lack the mobility and strength for a strong brushing session. 

As you get older, sensitive teeth and weak gums will pose more of a problem when you’re flossing the traditional way. You’ll bleed more, it’ll hurt, you’ll feel uncomfortable. 

The cariPRO™ Water Flosser is a less-invasive alternative to string flossing that uses water pressure to push out dirt in your crevices. Research has shown that along with a brush, a water flosser is significantly more effective than a manual brush and string floss for removing biofilm from tooth surfaces.

Both cariPRO™ devices are highly effective for preventing periodontal disease by efficiently removing germs and biofilm. However, they’re on the pricier side and more resource-intensive –requiring batteries, electricity, and water (for the water floss) to function correctly. 

Parting Words

Getting older doesn’t mean you have to compromise your oral health. You’ll continue to feel great and healthy for years to come if you take care of your teeth now. By following the research-backed recommendations in this article, you’re setting your dental health up for success for a better quality of life.