COMMON DENTAL PROBLEMS

	Cavities

Cavities are tooth decay.

Tooth decay is heavily determined by our lifestyle- what we eat, how well we take care of our teeth, and the presence of fluoride in our water and toothpaste.

Genetics also plays a role in how susceptible your teeth may be to decay- you can inherit certain aspects of oral health from your parents. Cavities are more common among children, but adults can also get them.

There are several different types of cavities, all of which are very serious. Left untreated, cavities can destroy your tooth and kill the nerves at the tooth’s center, which can result in an abscess, an infection which can only be treated with a root canal, surgery or extraction.

	Plaque and Tartar

Plaque is a sticky, colorless film of bacteria and sugars that constantly forms on our teeth. It is the main cause of cavities and gum disease, and can harden into tartar if not removed daily.

Tartar can also form at and underneath the gumline and can irritate gum tissues. Plaque causes cavities when the acids from plaque attack the teeth after eating. With repeated acid attacks, the tooth enamel can break down and a cavity will form.

Plaque that is not removed can also irritate the gums around your teeth, leading to gingivitis, periodontal disease and tooth loss. Luckily, plaque is easy to prevent with proper oral care, which includes brushing at least twice a day and flossing daily. Once plaque has hardened into tartar, however, only your dentist can remove it.

	Gum Disease

Gum disease is an inflammation of the gums caused by the bacteria found in plaque. If left untreated, it can progress to affect the bone that surrounds and supports your teeth.
There are three stages of gum disease

• Advanced PeriodontitisThis is the final stage of gum disease. The fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment fails, teeth may need to be removed.
  Gum disease can occur at any age, but is mostly found in adults. If caught early enough, damage can be undone, so see your dentist immediately if you notice any of these symptoms
• Red, puffy, swollen, or tender gums.
• Gums that bleed during brushing or flossing.
• Teeth that look longer because of receeding gums.
• Gums that have separated, or pulled away from your teeth, creating a pocket.
• Changes in the way your teeth fit together when you bite.
• Pus from between your teeth and gums.
• Bad taste in your mouth or constant bad breath.

 

 

 

	Oral Infections and Disorders

 

 

 

 

Mouth irritations and oral lesions are swollen spots or sores on your mouth, lips or tongue. Although there are many types of mouth sores and disorders, among the most common are canker sores, cold sores, leukoplakia and candidiasis (thrush).

 

	Canker sores

are small white swellings or sores surrounded by an area of redness. While canker sores are not contagious, they are often confused with cold sores, which are caused by the contagious herpes virus. It may help to remember that canker sores occur inside the mouth, while cold sores usually occur outside the mouth. Canker sores are common, and can recur.

Although the exact cause is uncertain, some experts believe that immune system problems, bacteria or viruses may be involved. Factors such as stress, trauma, allergies, cigarette smoking, iron or other vitamin deficiencies, and heredity may also make one prone to canker sores.

	Cold sores

also called fever blisters or herpes simplex, are groups of painful, fluid-filled blisters around the lips and sometimes under the nose or around the chin. Cold sores are usually caused by a type of herpes virus and are very contagious. The first infection, which often occurs in children, is sometimes without symptoms, and may be confused with a cold or flu. Once a person is infected, the virus stays in the body, occasionally causing recurrent attacks. For some people, however, the virus remains inactive.

	Leukoplakia

looks like a thick, whitish-color patch on the inner cheek, gums or tongue. It is often associated with smoking and smokeless tobacco use, although other causes include badly fitting dentures, broken teeth and chewing on one's cheek. Your dentist may take a biopsy, because an estimated 5% of leukoplakia cases progress to cancer. Leukoplakia often heals when tobacco use is stopped.

	Candidiasis—oral thrush—

is a fungal infection caused by candida albicans (a yeast). Candidiasis can be recognized by the creamy, yellow-white or red patches that occur on moist surfaces in the mouth. Tissues under the patch can be painful. Thrush is most common among denture wearers, newborns and those whose immune system is not functioning properly. People who have a dry mouth, or who are taking or have just completed antibiotic treatment are also susceptible.

Treatment varies according to the type of condition you have.

Canker Sores usually heal within a week to ten days, although recurrent outbreaks are common. Over-the-counter topical ointments and pain relievers can provide temporary relief. Antimicrobial mouth rinses may also help reduce irritation. Antibiotics are sometimes prescribed to reduce secondary infection.

Cold Sores usually heal in about a week. Because there is no cure for herpes infections, the blisters may reoccur during times of emotional upset, exposure to sunlight, allergies or fever. Over-the-counter topical anesthetics can provide temporary relief. Prescription antiviral drugs may reduce these kinds of viral infections -ask your dentist or physician.

Leukoplakia treatment begins by removing the factors causing the lesions. In some cases that means quitting tobacco use. For others, it may mean removing ill-fitting dentures and replacing them with properly fitting ones. Your dentist will monitor your condition,and examine the lesion at three to six month intervals, depending on its type, location and size.

	Tooth Sensitivity

Tooth sensitivity is tooth pain due to the wearing away of the tooth's surface or gum tissue. Exposed tooth roots due to receding gums is the most common cause of sensitive teeth in adults. Because these roots are not covered by enamel, thousands of tiny channels leading to the tooth's nerve center are exposed. When heat, cold or pressure touches these channels, you feel pain.

Ignoring sensitive teeth can lead to other oral health issues. Especially if the pain causes you to brush poorly, making you vulnerable to tooth decay and gum disease.

Sensitive teeth can usually be treated successfully. Your dentist may prescribe a brush-on fluoride gel or a fluoride rinse. You can also try low-abrasion toothpastes with formulations made especially for sensitive teeth. Ask your dentist which anti-sensitivity products are right for you.

	Bad Breath (Halitosis)

Bad breath (also known as halitosis) is breath containing an unpleasant odor. This odor can strike periodically or be persistent, depending on the cause. In many patients, the millions of bacteria that live in the mouth (particularly on the back of the tongue) are the primary culprits of bad breath. The mouth's warm, moist conditions make an ideal environment for these bacteria to grow.

Some types of bad breath, such as "morning breath," are considered to be fairly normal, and are usually not health concerns. The "morning breath" type of bad breath occurs because the saliva that regularly washes away decaying food and odors during the daytime diminishes at night while you sleep. Your mouth becomes dry, and dead cells adhere to your tongue and to the inside of your cheeks. Bacteria use these cells for food and expel compounds that have a foul odor.

• Bad breath can also be caused by poor dental hygiene, infections in the mouth, dry mouth, and systemic illnesses.

The duration of bad breath depends on its cause. For example, when the problem results from poor dental hygiene, proper dental care will begin to freshen the mouth immediately, with even more impressive results after a few days of regular brushing and flossing. Periodontal disease and tooth abscess also respond quickly to proper dental treatment. Bad breath that results from chronic sinusitis may be a recurring problem, especially if a structural abnormality of the sinuses is the underlying cause.

• Bad breath resulting from a systemic illness may be a long-term problem that can often be controlled with proper medical care.

	Temporomandibular Disorders (TMJ)

TMJ, or temporomandibular joint disorder, means that the hinge connecting the upper and lower jaw isn't working properly. This hinge is one of the most complex joints in the body, responsible for moving the lower jaw forward, backward and side-to-side. Anything that prevents this complex system of muscles, ligaments, discs and bones from working as it should is called TMJ. Often, TMJ feels like your jaw is popping or clicking or even "getting stuck" for a moment. The exact cause of this misalignment is often impossible to determine.

TMJ disorders have many symptoms. Often your dentist will need to take a complete medical and dental history, conduct a clinical examination and take x-rays in order to diagnose TMJ, because one or all of the symptoms can also be present for other problems.

Some of the most common TMJ symptoms include

• Headaches, earaches, and pain and pressure behind the eyes.
  A clicking or popping sound when you open or close your mouth.
  
• Pain brought on by yawning, opening the mouth widely or chewing.
  
• Jaws that "get stuck," lock or go out.
  
• Tenderness of the jaw muscles.
  
• A sudden change in the way the upper and lower teeth fit together.

While there is no single cure for TMJ, there are different treatments you can follow that may reduce your symptoms dramatically.

*** Try to eliminate muscle spasm and pain by applying moist heat or taking medication such as muscle-relaxants, aspirin or other over- the-counter pain-relievers, or anti-inflammatory drugs.

***Reduce the harmful effects of clenching and grinding by wearing an appliance, sometimes called a bite plate or splint.
Learn relaxation techniques to help control muscle tension in the jaw. Your dentist may suggest you seek training or counseling to help eliminate stress.

*When the jaw joints are affected and other treatments have been unsuccessful, jaw joint surgery may be recommended.

	Bruxism (Tooth Grinding)

If you find yourself waking up with sore jaw muscles or a headache, you may be suffering from bruxism-the grinding and clenching of teeth. Bruxism can cause teeth to become painful or loose, and sometimes parts of the teeth are literally ground away. Eventually, bruxism can destroy the surrounding bone and gum tissue. It can also lead to problems involving the jaw joint, such as temporomandibular joint syndrome (TMJ).

For many people, bruxism is an unconscious habit. They may not even realize they're doing it until someone comments that they make a horrible grinding sound while sleeping. For others, during a routine dental checkup they discover their teeth are worn or their tooth enamel is fractured.

Other potential signs of bruxism include aching in the face, head and neck. Your dentist can determine if the source of facial pain is a result from bruxism.

The appropriate treatment depends on the cause. Some common solutions are

• Wearing an appliance while sleeping. While an appliance is a good way to manage bruxism, it is not a cure.
  Finding ways to relax. Because everyday stress seems to be a major cause of bruxism, anything that reduces stress can help.
• Also, applying a warm, wet washcloth to the side of your face can help relax muscles sore from clenching.
  
• Reducing the "high spots" of one or more teeth to even your bite. An abnormal bite, one in which teeth do not fit well together, may also be corrected with new fillings, crowns or orthodontics.

	Wisdom Teeth

Wisdom teeth are the last molars on each side of the jaws. They are also the last teeth to emerge, usually when a person is between 16 and 20.

Since wisdom teeth are the last permanent teeth to come in, there is often not enough room left in your mouth to accommodate them. This can lead to wisdom teeth that are impacted , teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding and disease. Since teeth removed before age 20 have less developed roots and fewer complications, the American Dental Association recommends that people between 16 and 19 have their wisdom teeth evaluated to see if they need to be removed.

A tooth extraction is a relatively routine procedure. Your dentist or a dental specialist, called an oral surgeon, will recommend either "going to sleep" using general anesthesia, or numbing this area in your mouth with a local anesthesia such as Novocain®.

After the tooth (or teeth) is removed, you may be asked to bite down softly on a piece of gauze for 30 to 45 minutes after you leave the office, to limit the bleeding that may occur. Some pain and swelling may occur but it will normally go away after a few days; however, you should call your dentist if you have prolonged or severe pain, swelling, bleeding or fever.

Removal of wisdom teeth due to crowding or impaction should not affect your bite or oral health in the future.

	Dry Mouth

Dry mouth means you don't have enough saliva to keep your mouth moist. Everyone has a dry mouth once in a while, especially if you're nervous, upset or under stress. But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to more serious health problems or indicate that a more serious medical condition may exist. Saliva does more than just keep the mouth wet- it helps digest food, protects teeth from decay, prevents infection by controlling bacteria in the mouth, and makes it possible for you to chew and swallow.

There are several reasons that the salivary glands might not function properly.

These include

• Side effects of some medications.
  
• Disease - Diseases that affect the salivary glands, such as diabetes, Hodgkin's, Parkinson's disease, HIV/AIDS and Sjogren's syndrome, may lead to dry mouth.
  
• Radiation therapy- The salivary glands can be damaged if your head or neck are exposed to radiation during cancer treatment. The loss of saliva can be total or partial, permanent or temporary.
  
• Chemotherapy- Drugs used to treat cancer can make saliva thicker, or "ropey," causing your mouth to feel dry.
  
• Menopause- Changing hormone levels affect the salivary glands, often leaving menopausal and post-menopausal women with a persistent feeling of dry mouth.
  
• Smoking- Many pipe, cigar and heavy cigarette smokers experience dry mouth.

Everyone's mouth feels dry from time to time. It's when the feeling is persistent that you may have a problem with saliva production.

Symptoms of dry mouth include

The only permanent way to cure dry mouth is to treat its cause. If your dry mouth is the result of medication, your doctor might change your prescription or your dosage. If your salivary glands are not working properly but still produce some saliva, your doctor might give you a medicine that helps the glands work better.

If the cause of your dry mouth cannot be eliminated, or until it can be, you can restore moisture to your mouth a number of different ways. Your dentist may recommend mouth moisturizers, such as a saliva substitute. Rinsing with mouthwashes specially formulated to help dry mouth may also bring relief. You can also drink lots of water, avoid caffeine, alcohol and tobacco, chew sugarless gum or hard candy to stimulate saliva flow, or use a humidifier at night.