A: An abscessed tooth is one that has become infected. Tooth decay is often the culprit; when tooth decay advances deep into the tooth, it can cause destruction of the pulp, the core of the tooth. When this happens, the pulp gets infected and swollen and pus builds up near the jawbone.
Left untreated, infected pulp can cause more serious problems, including damage to surrounding tissue and bone.
Root canal treatment is the most common form of treatment for an abscessed tooth. Root canal treatment involves removing the infected tissue, cleansing and sealing the canal of the tooth and restoring the tooth with a crown, or cap.
Q: Bad Breath (halitosis)
A: Bad breath is a common affliction with many people. When it advances or doesn't go away, it becomes known as chronic halitosis.
Bad breath is caused by decaying particles of food and bacteria that pass into your bloodstream and to the lungs, where odor is emitted from breathing.
While people spend lots of money on products that treat the symptoms of bad breath, they often neglect to take steps to address the root causes of bad breath-such as bacteria, and decaying food particles remaining in spaces between the teeth, on the gums and on the tongue. In many cases, good daily oral hygiene, including brushing, flossing and rinsing, can keep bad breath in check. This also applies to denture-wearers.
Other conditions, such as gum disease, can cause persistent bad breath. Under normal conditions, your saliva acts to cleanse your mouth of the particles that can decay and later cause bad breath. People with a condition known as dry mouth, in which saliva production is diminished, can sometimes suffer from bad breath. Of course, if you eat certain kinds of food (like garlic and onions), take certain kinds of medications, or smoke cigarettes or cigars, you may also experience symptoms of bad breath.
In some cases, persistent bad breath may be a sign that you have a more serious health problem, including a gastrointestinal, respiratory or sinus problem.
In most cases, over-the-counter mouthwashes and rinses will temporarily freshen breath, but only mask the root cause. The American Dental Association acknowledges the effectiveness of some anti-microbial mouth rinses that are shown to reduce plaque and gingivitis. Good oral health habits can contribute to reducing and eliminating halitosis: brushing and flossing daily as well as regular professional cleanings performed by our office.
Q: Bulimia Nervosa
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.
Q: Canker/Cold Sores
A: 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.
A: People living with diabetes are vulnerable to a host of systemic problems in their entire body. Unfortunately, the mouth and teeth are not immune from such problems, and many diabetics with oral problems go undiagnosed until conditions become advanced.
Infections and other problems such as receding gums and gum disease, or periodontal disease, are common afflictions among diabetics for many reasons; for instance, diabetics often are plagued by diminished saliva production, which can hamper the proper cleansing of cavity-causing debris and bacteria from the mouth. In addition, blood sugar levels that are out of balance could lead to problems that promote cavities and gum disease.
As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing needless problems.
Q: Dry Mouth
A: 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 gum and avoiding smoking. Of course, there is no substitute for regular checkups and good oral hygiene.
A: 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.
Q: Gum Disease (Gingivitis)
A: Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping.
Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay.
Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable.
If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur.
Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure.
Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman's body that promote plaque production.
Q: Impacted/Wisdom Teeth
A: Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.
If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: pain, inflammation, and some kinds of infections.
Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one's ability to properly bite down, speak or eat.
Q: Lacerations and Cuts
A: Any kind of cut to your face and the delicate soft tissues inside your mouth should be addressed immediately in order to prevent further tissue damage and infection.
If a traumatic injury involves a broken facial bone such as the jaw, nose, chin or cheek, maxillofacial surgery may be required.
With jaw surgery, rubber bands, tiny wires, metal braces, screws or plates are often used to keep a fractured jaw in place following surgery. This allows the bone to heal and stay in proper alignment. Dental splints or dentures may also be required to supplement the healing process following jaw surgery.
Q: Oral Cancer
A: 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.
A: Plaque is an insidious substance: a colorless, sticky film that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.
Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.
Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.
Q: Sensitive Teeth
A: Many people suffer from sensitive teeth: a condition in which hot and cold foods or liquids, and even sudden puffs of air can cause discomfort and pain.
Tooth sensitivity can be caused by a number of things. An unnoticed cavity or abscessed tooth can sometimes be a culprit. But over time and as you age, changes in temperature, as well as such behaviors as tooth grinding (bruxism) and overly aggressive brushing, can cause small, often microscopic cracks or fissures on the chewing surfaces of your teeth (or near the gum lines), which exposes the inner structures called dentin.
Hypersensitive teeth can cause people to change their eating habits, avoid social situations, or even avoid proper oral hygiene because the simple act of brushing or rinsing causes pain. Relief can sometimes be had by using a desensitizing toothpaste, sealants, or special fillings.
Q: Teeth Grinding (Bruxism)
A: 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.
A: Simple toothaches can often be relieved by rinsing the mouth to clear it of debris and other matter. Sometimes, a toothache can be caused or aggravated by a piece of debris lodged between the tooth and another tooth. Avoid placing an aspirin between your tooth and gum to relieve pain, because the dissolving aspirin can actually harm your gum tissue.
Broken, Fractured, or Displaced Tooth
A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken. If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist. First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the check near the injury. This will keep down swelling.
If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown - not the root. Next, place it in a container of warm milk, saline or the victim's own saliva and keep it in the solution until you arrive at the emergency room or dentist's office. For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling. If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged. If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.
Q: Jaw Disorders
A: 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.