Gum Disease (Gingivitis / Periodontal Disease)

Gum disease is a bacterial infection of the gum tissue, it is a serious condition that starts as gingivitis and can progress to periodontitis. According to the British Dental Health Foundation “19 out of 20 people suffer from gum disease (gingivitis) at some point in their life making it the most common disease in the world”.

Gingivitis is an inflammation of the gum tissue due to a build of plaque or tartar around the gum-line            and if treated can be reversed. If left untreated gingivitis can lead to periodontitis which is far  more serious and is irreversible but can be stopped from progressing any further. If you think you may have gingivitis it is important you go to your dentist.

Periodontitis occurs when the inflammation has progressed and starts to destruct the bone supporting the tooth. If left untreated periodontitis will result in tooth loss. Hopefully you will have  gone to your dentist in the early stages of gingivitis, however if not it is even more important to go to your dentist if your gingivitis has progressed to periodontitis.

A buildup of plaque or tartar along the gum line or between teeth is the main cause of gingivitis but       the following are major factors that contribute to the likelihood of gingivitis occurring:

Genetics.
Hormonal changes – such as during puberty or pregnancy.
Stress.
Smoking.
Bruxism – clenching and grinding your teeth.
Medication.
Poor nutrition.
Diabetes.

Symptoms of gingivitis are:

Bleeding gums.
Gums are swollen and a deep red colour or very pale.
Receding gum line.
Bad breath.
Tooth sensitivity.
Loose teeth.

Treatment of gingivitis depends on the severity of the condition. It is important to see your dentist so they can recommend the appropriate treatment at the early stages of gingivitis which may be as follows:

Gingivitis treatment is a good oral hygiene routine and regular visits to the dentist to remove any  build up of plaque.
Antibiotics may be needed.
Periodontitis treatment may involve scaling and root planing to remove the build up tartar.
A local anaesthetic may be needed.
In severe cases surgery may be necessary.

Teeth Grinding (Bruxism)

 

Bruxism refers to unconsciously grinding or clenching the teeth during the night. Bruxism can occur whilst your awake but this is rare.

The cause of bruxism is not certain, popular beliefs are that grinding and clenching of the teeth can be caused by:

Stress.
An overbite.
Malfunction in the nervous system.
Bruxism has many negative effects, symptoms include:

Worn down teeth
Sensitive teeth – due to the enamel being worn down and dentin being exposed
Decayed teeth
Fractured or chipped teeth
Loose teeth
Receding gumline
Damage to the inside of the cheek
Sore facial muscles
Headaches
Bruxism can lead to problems with the jaw known as Tempor-Mandibular Joint syndrome (TMJ) .
Treatment of Bruxism involves having a nightguard fitted which will decrease the damage caused by bruxism. If the bruxism is obviously stress related then relaxation tecniques before sleep will also help.

Mouth ulcers (canker sores)

Mouth ulcers are open woulds in the mouth, usually white in colour. Contrary to popular belief mouth ulcers are not contagious.

The causes of mouth ulcers are:

Physical damage such as biting the tongue or cheek.
Allergic reaction.
An auto immune system reaction to biological or chemical agents.
Stress.
Deficiency in B12 vitamin, folic acid or iron.
Using a toothpaste or mouthwash with sodium lauryl sulphate (SLS) in.
Viral infections such as the herpes simplex virus or han, foot and mouth disease.
Intestinal conditions.
Mouth cancer.
Once the above have taken place and created an opening in the inner lining of the mouth or on the tongue then bacteria get to work turning the damage into a painful mouth ulcer. The bacteria release toxins in the wound killing more cells causing the mouth ulcer to get larger and resulting in pain.

It is important to see your doctor if your mouth ulcer does not heal within a few weeks as it can be a sign of mouth cancer, although this is rare.

Treatments of mouth ulcers vary and are a matter of personal preference:

using a mouthwash made of salt and warm water, chlorhexidine or povidone or iodine mouthwash.
local anaesthetic.
carmellose gelatin paste forms a protective layer over the mouth ulcer.
Parecetamol
Mouth ulcers usually heal within a week or two so it is important to see your doctor if your mouth ulcer does not heal as it can be a sign of a more serious condition.

 

Tooth Sensitivity (Dentin Hypersensitivity)

Tooth sensitivity is the most common complaint dentists hear, apparantly one in five adults in the USA suffer from tooth sensitivity.

Tooth sensitivity is a short sharp pain felt when the tooth is exposed to hot/cold and sweet/sour food or drink. In extreme cases just exposure to cold air can cause pain for people with sensitive teeth. The sensitivity occurs because the enamel of the tooth has been worn down and the dentin is left exposed.

There are many causes of tooth sensitivity, the most common are

Bruxism – teeth grinding
Loose or missing fillings/crowns
Cracked Tooth
Gum Disease/gingivitis
Gum Recession
Plaque
Vigorous abrasive brushing
Teeth Whitening
Acidic Foods
Preventing and treating tooth sensitivity is easy with the many products available

Use a desensitizing toothpaste such as Sensodyne
Use a flouride mouthwash
Our remineralising gel will rehydrate your teeth, specifically densigned for sensitivity caused by bleaching your teeth.
Avoid frequent intakes of acidic foods.
Wear a nightguard if your sensitvity is caused by grinding your teeth.
Use a toothbrush with soft bristles.
Brush your teeth gently, an electric toothbrush will help, particularly one with a pressure sensor such as the Braun Oral-B Professional Care 8500 Delux
You should visit your dentist if you experience tooth sensitivity so that they can recommend the best treatment whether over the counter or surgical. If none of the above methods relieve your tooth sensitivity then it is likely the dentist will carry out a procedure called iontophoresis whereby the sensitivity is treated with a positive electric current while flouride is applied.

Dry Mouth (Xerostomia)

Dry mouth occurs when the saliva glands stop producing enough saliva . Dry mouth is a very common problem as it can be caused by stress. Its very important to go to your dentist or doctor is you have a constant dry mouth as it can be sign of other diseases.

Saliva plays a vital role for many reasons. It helps us to talk, chew, taste, swallow and digest our food. Saliva controls the bacteria in our mouths so lack of it would increase the likelihood of infection. Saliva also protects our teeth from decay, so having a dry mouth can cause many complications.

Symptoms of dry mouth are:

Thick saliva – the feeling of not being able to swallow or talk properly due to sticky saliva.
Rough tongue
Dry feeling in the throat as well as the mouth.
Burning sensation in the mouth – sensitivity to salty or spicy foods.
Bad breath
Mouth sores
Cracked lips
Dry, red, raw tongue
Difficulty wearing dentures
Unusual thirst
Causes of dry mouth are:

A side effect of other medication such as diuretics, antihistamines, antidepressants and muscle relaxants.
Stress.
Alcohol abuse.
Depression.
Cancer treatment such as radiation therapy and chemotherapy.
Sarcoidosis – the inflammation of body tissue.
Nerve damage.
Rheumatoid conditions.
Hormonal disorders such as diabetes.
Neurological disorders such as parkinsons disease.
Autoimmune conditions such as Sjogren’s syndrome.
Dysfunctional immune system such as AIDs.
Hypothyroidism – below normal thyroid hormone production.
Treatment of dry mouth depends on the cause, doing the following will help if you suffer from dry mouth…

If the cause of your dry mouth is a side effect of medication then alternative drugs may be prescribed or a lower dosage.
Cevemeline or pilocarpine may be prescribed to stimulate saliva production.
Use a humidifier.
Chew sugar free gum or suck on suger free sweets.
Drink plenty of water and avoid caffeine drinks.
Don’t smoke tobacco or drink alcohol.
Breathe through your nose and not your mouth as much as possible.
Use a tongue scraper.
Brush and floss thoroughly and regularly to avoid a build up of plaque which leads to tooth decay.
It is important you see your dentist regularly if you have dry mouth as tooth decay is far more likely to occur if there is no saliva to control the bacteria in the mouth.

Toothache is a common problem that can be prevented with good oral hygiene.
Toothache occurs because the pulp of the tooth is exposed, disturbed or infected. The pulp is the inner layer of the tooth which is engulfed in a layer of dentin and then by the hard layer that we see called the enamel, which is packed full of minerals. Toothache can also occur if just the outer enamel layer is damaged exposing only the dentin.

It is very important that you go to a dentist if you have toothache so that they can find a cause and apply appropriate treatment to ease your discomfort.

The most common dental causes of toothache are:

Tooth Root Sensitivities – oversensitivity when consuming hot or cold, sweet or sour food and beverages.
Tooth Decay – also known as tooth ‘cavities’ or tooth ‘caries’.
Tooth Abcess – a complication of tooth decay.
Gum Disease – also known as gingivitis and in severe cases periodontal disease.
Jaw Disease – also known as TMJ (Temporo-Mandibular Joint) dysfunction.
A Cracked Tooth.
Tooth Root Sensitivities occur when bacterial toxins get to work and dissolve the bone arount the root of the tooth, the gum and bone recede exposing the root of the tooth causing the sensitivity and toothache. This is then likely to lead to chronic gum disease.

Treatment: Visit your dentist. Flouride gel and sensitivity toothpastes that contain flouride will both help the root to become stronger and in turn reduce the toothache. If the root sensitivity causes the inner pulp to die a root canal procedure or tooth extraction will need to be carried out to stop the toothache.

Tooth Decay occurs when the minerals of the enamel are dissolved by acid created by bacteria in our mouths (a build up of this bacteria is known as plaque). This demineralisation of the enamel forms a hole in the tooth exposing the dentin causing the toothache. If the toothache is severe then the hole has most likely exposed the inner pulp as well.

The obvious prevention for tooth decay is to eat as little sugar as possible because the acid that causes the enamel to decay is created by the bacteria eating the sugar and starch left in our mouths. So brush your teeth preferrably after every meal or snack with flouride toothpaste. Flossing will also help alot. Being thorough with your brushing and flossing will stop any build of plaque forming.

Treatment: Your dentist will in most cases apply a filling to the tooth cavity, large cavities may need a crown. If the cavity damages the inner pulp then a root canal procedure or extraction of the tooth may be necessary to stop the toothache.

Tooth Abcesses occur when a dental cavity has been left untreated. The bacteria has infected the tooth from the inner pulp all the way up to the bone tissue at the end of the root causing severe toothache.

Treatment: Your dentist will have to carry out a root canal procedure where the pulp of the tooth is removed and then filled and sealed with an inert material. If this is unsuccessful then the tooth will have to be removed.

Gum Disease occurs when the soft tissue in our mouths becomes infected due to a build up of plaque or tartar along the gum line. It is highly likely that your toothache will be accompanied with bleeding gums if you have gum disease.

Treatment: In mild cases of gum disease your dentist will help you become more informed in order to improve your oral hygeine, they will also remove any build up of plaque. Root planning may need to be done which is the removal of plaque and tartar from the exposed roots. In more severe cases the surface of the inflamed gum tissue will have to be removed which is known as subgingival curettage. Oral antibiotics will also need to be taken alongside these procedures.

Jaw Disease usually occurs when there has been an impact or injury to the head such as whiplash. Bruxism (grinding of the teeth) often leads to TMJ as well as arthritis and having an over-bite. Jaw disease is often characterised by pain in the muscles around the jaw and limitaions in jaw movement.

Treatment: Your dentist will fit a special intraoral splint for you to wear. If your bite needs to be fixed then crowns and orthodontic treatment are likely as well as medication to relieve the toothache.

Cracked Tooth can occur for many reasons such as an injury to the mouth, bruxism, chewing on hard objects or extreme changes in temperature on your teeth (such as eating hot food immediately followed by an iced drink) can all cause a tooth to crack and expose the dentin or inner pulp. The toothache may occur when the crack closes after releasing the pressure of a bite. The toothache gets worse over time if left untreated as the inner pulp can become infected.

If you have visible a crack in your teeth that is not accompanied by toothache then it is known as a ‘craze’ line and is considered to be part of the natural anatomy of the tooth, they usually occur as we age.

Treatment: Your dentist will evaluate the treatment needed depending on the severity of the crack. This can involve bonding for a small crack or a root canal treatment for a large crack where the inner pulp of the tooth has been damaged. In severe cases the tooth may need to be removed to stop the toothache.

In very rare cases toothache can also be caused by the following:

Angina – a disease of the throat marked by spasmodic attacks of intense suffocative pain
Heart Disease.
Myocardial Infarction – destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle.
Whatever the cause of your toothache it is important you see a dentist so that they can determine the cause and apply the appropriate treatment or refer you to a doctor. If you have to wait for your appointment then to soothe the pain you can apply a cold compress to the area of the cheek where the toothache is. Rinsing your mouth with warm salt water and taking aspirin will also help. A good oral hygiene routine will prevent any toothache occurring.