Common Dental Issues
If you wince with pain after sipping a hot cup of coffee or chewing a piece of ice, chances are that you suffer from "dentin hypersensitivity", or more commonly, sensitive teeth.
Hot and cold temperature changes cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking and breathing habits.
At least 45 million adults in the United States suffer at some time from sensitive teeth.
Sensitive teeth result when the underlying layer of your teeth (the dentin) becomes exposed. This can happen on the chewing surface of the tooth as well as at the gum line. In some cases, sensitive teeth are the result of gum disease, years of unconsciously clenching or grinding your teeth, or improper or too vigorous brushing (if the bristles of your toothbrush are pointing in multiple directions, you're brushing too hard).
Abrasive toothpastes are sometimes the culprit of sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel, and sodium pyrophosphate, the key ingredient in tartar-control toothpastes, may increase tooth sensitivity.
In some cases, desensitizing toothpaste, sealants, desensitizing ionization and filling materials including fluoride, and decreasing the intake of acid-containing foods can alleviate some of the pain associated with sensitive teeth.
Sometimes, a sensitive tooth may be confused by a patient for a cavity or abscess that is not yet visible.
In any case, contact your dentist if you notice any change in your teeth's sensitivity to temperature.
Grinding and Clinching Teeth
Also known as "bruxism", Grinding or clenching your teeth and the resulting excessive wear of the enamel can lead to a host of dental problems.
In many cases, teeth grinding occurs unintentionally during sleep. Teeth grinders, or bruxers, often also bite their fingernails, pencils and chew the inside of their cheeks.
About one in three people suffer from bruxism, which can easily be treated.
Teeth grinding over time can lead to hypersensitive teeth. Bruxers experience jaw pain, tense muscles and headaches, along with excessive wear on their teeth. Forceful biting when not eating may also cause the jaw to move out of proper balance.
Signs of bruxism Some of the signs of bruxism include:
⇒ Tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth (dentin).
⇒ Pain in the temporomandibular joint (TMJ)- the jaw - which may manifest itself as a popping and clicking sound.
⇒ Tongue indentations. Anger, anxiety, pain and frustration can trigger teeth grinding.
If your dentist notices signs of bruxism, prescribed therapy may include behavior modification techniques to learn how to rest the tongue, teeth and lips properly.
Your dentist may also recommend a mouth appliance, such as a bitesplint or "occlusal guard" that is worn at night to absorb the forces of biting. This appliance can prevent future damage to the teeth.
Biofeedback is sometimes used to measure muscle activity and teach patients how to reduce muscle activity when the biting force becomes too great.
Anyone who participates in a sport that carries a significant risk of injury should wear a mouth protector. Sports like basketball, baseball, gymnastics, and volleyball all pose risks to your gum tissues, as well as your teeth. We usually think of football and hockey as the most dangerous to the teeth, but nearly half of sports-related mouth injuries occur in basketball and baseball.
A mouth guard can prevent serious injuries such as concussions, cerebral hemorrhages, incidents of unconsciousness, jaw fractures and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouth guards are effective in moving soft issue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances.
Mouth protectors, which typically cover the upper teeth, can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft tissues of the mouth. If you wear braces or another fixed dental appliance on your lower jaw, a mouth protector is available for these teeth as well.
A properly fitted mouth protector may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouth protector also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries. Although mouth protectors typically only cover the upper teeth, your dentist or orthodontist may suggest that you use a mouth protector on the lower teeth if you have braces on these teeth too. If you have a retainer or other removable appliance, do not wear it during any contact sports.
Types of mouth guards
There are three types of mouth protectors:
Inexpensive and come pre-formed, ready to wear. Unfortunately, they often don't fit very well. They can be bulky and can make breathing and talking difficult.
⇒ Boil and bite
Can be bought at many sporting goods stores and may offer a better fit than stock mouth protectors. They should be softened in water, then inserted and allowed to adapt to the shape of your mouth. If you don't follow the directions carefully you can wind up with a poor-fitting mouth protector.
Made by your dentist for you personally. They are more expensive than the other versions, but because they are customized, they can offer a better fit than anything you can buy off the shelf.
Teeth Grinding (bruxism)
Teeth grinding, also called bruxism, is often viewed as a harmless, though annoying, habit. Some people develop bruxism from an inability to deal with stress or anxiety.
However, teeth grinding can literally transform your bite relationship and worse, severely damage your teeth and jaws over long periods of time.
Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin.) Bruxism can also lead to chronic jaw and facial pain, as well as headaches.
If no one has told you that you grind your teeth, here are a few clues that you may suffer from bruxism:
⇒ Your jaw is often sore, or you hear popping sounds when you open and close your mouth.
⇒ Your teeth look abnormally short or worn down.
⇒ You notice small dents in your tongue.
Bruxism is somewhat treatable. A common therapy involves use of a special appliance worn while sleeping. Less intrusive, though just as effective methods could involve biofeedback, and behavior modification, such as tongue exercises and learning how to properly align your tongue, teeth and lips.
People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth. One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.
People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.
Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.
Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint.
Bad Breath (halitosis)
An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have "chronic halitosis," which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.
Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.
What causes bad breath?
Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth - on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.
Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.
Gum disease is caused by plaque - the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.
Here are characteristic bad breath odors associated with some of these illnesses:
- Diabetes - acetone, fruity
- Liver failure - sweetish, musty
- Acute rheumatic fever - acid, sweet
- Lung abscess - foul, putrefactive
- Blood dyscrasias - resembling decomposed blood
- Liver cirrhosis - resembling decayed blood
- Uremia - ammonia or urine
- Hand-Schuller-Christian disease - fetid breath and unpleasant taste
- Scurvy - foul breath from stomach inflammation
- Wegner`s granulomatosis - Necrotic, putrefactive
- Kidney failure - ammonia or urine
- Diphtheria, dysentery, measles, pneumonia, scarlet fever, tuberculosis - extremely foul, fetid odor
- Syphilis - fetid
Bad breath may also be caused by medications you are taking, including central nervous system agents, anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics, anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.
Caring for bad breath
Daily brushing and flossing, and regular professional cleanings, will normally take care of unpleasant breath. And don't forget your often overlooked tongue as a culprit for bad breath. Bacterial plaque and food debris also can accumulate on the back of the tongue. The tongue's surface is extremely rough and bacteria can accumulate easily in the cracks and crevices.
Eliminating periodontal disease and maintaining good oral health helps to reduce bad breath. If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.
Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.
If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.
If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.
Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.
If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and for treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.
Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe, including "Zytex," which is a combination of zinc chloride, thymol and eucalyptus oil that neutralizes the sulfur compounds and kills the bacteria that causes them. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the American Dental Association for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odor, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.
Saliva is one of your body's natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials. Dry mouth (also called Xerostomia) is a fairly common condition that is caused by diminished saliva production. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Eating foods such as garlic, tobacco use, and some kinds of medications, including treatments such as cancer therapy can diminish the body's production of saliva, leading to dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems.
Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.
If dry mouth isn't readily apparent, you may experience other conditions that dry mouth can cause, including an overly-sensitive tongue, chronic thirst or even difficulty in speaking.
If you don't have a medical condition that causes it, dry mouth can be minimized by sipping water regularly, chewing sugarless gum and avoiding smoking. Of course, there is no substitute for regular checkups and good oral hygiene.
Fluorosis is a condition in which your body has been exposed to too much fluoride. In normal doses (typically found in a safe drinking water system and an ADA-approved toothpaste), fluoride is a healthy compound that promotes strong teeth, which has the ability to fight cavities and other problems.
But sometimes, fluorosis occurs when fluoride-containing toothpastes or rinses are swallowed, instead of expelled.
Fluorosis causes a number of aesthetic problems, including abnormally darkened or stained teeth. While such problems are generally harmless to your health, they can create concerns with your appearance.
People sometimes confuse canker sores and cold sores, but they are completely unrelated. Both can be painful, but knowing the differences can help you keep them in check.
A canker sore is typically one that occurs on the delicate tissues inside your mouth. It is usually light-colored at its base and can have a red exterior border.
A cold sore or fever blister, on the other hand, usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid.
In most cases, patience is the best medicine for treating canker sores. A healthy diet and good oral hygiene are usually the best remedy, but some special rinses and anesthetics can help. Cold sores can be treated effectively with some over-the-counter topical creams; sometimes, an antiviral medication will be prescribed by your doctor.
People with eating disorders can suffer from oral health problems as well. This is because many of the behaviors associated with anorexia nervosa and bulimia nervosa-such as binge eating, self-induced vomiting, and use of diuretics or laxatives-cause changes in the mouth.
For example, repeated episodes of vomiting, which is common in people with bulimia, releases harmful stomach acids that wear away tooth enamel and lead to gingivitis and tooth decay. Other problems, such as poorly fitting fillings and braces, are another byproduct of such eating disorders.
Brushing after episodic vomiting is actually more harmful than one would think. The best practice is to rinse thoroughly with a neutral solution such as baking soda and water.
Oral cancer is one of the most common cancers today and has one of the lowest survival rates, with thousands of new cases being reported each year. Fewer than half of all people diagnosed with oral cancer are ever cured.
Moreover, people with many forms of cancer can develop complications-some of them chronic and painful-from their cancer treatment. These include dry mouth and overly sensitive teeth, as well as accelerated tooth decay.
If oral cancer is not treated in time, it could spread to other facial and neck tissues, leading to disfigurement and pain.
Older adults over the age of 40 (especially men) are most susceptible to developing oral cancer, but people of all ages are at risk.
Oral cancer can occur anywhere in the mouth, but the tongue appears to be the most common location. Other oral structures could include the lips, gums and other soft palate tissues in the mouth.
In general, early signs of oral cancer usually occur in the form of lumps, patchy areas and lesions, or breaks, in the tissues of the mouth. In many cases, these abnormalities are not painful in the early stages, making even self-diagnosis difficult.
Here are some additional warning signs:
⇒ Hoarseness or difficulty swallowing
⇒ Unusual bleeding or persistent sores in the mouth that won't heal
⇒ Lumps or growths in other nearby areas, such as the throat or neck
If a tumor is found, surgery will generally be required to remove it. Some facial disfigurement could also result.
Prevention is the key to staving off oral cancer. One of the biggest culprits is tobacco and alcohol use. Certain kinds of foods and even overexposure to the sun have also been linked to oral cancer. Some experts believe certain oral cancer risk factors are also hereditary.
A diet rich in fruits and vegetables is one of the best defenses against oral cancer. Maintaining good oral hygiene, and regular dental checkups, are highly recommended.