Most Common Oral and Dental Problems

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Most Common Oral and Dental Problems

The term oral refers to the mouth. Not merely comprised of the teeth and gums, the mouth also includes the hard and soft palate, the mucous lining of the mouth and throat, the tongue, the lips, the salivary glands, the chewing muscles and the upper and lower jaws. Furthermore, these are all set within a series of skull and face components referred to as craniofacial structures.

Oral health means much more than healthy teeth. Furthermore, it is often said that the mouth is the mirror of overall health. Examining oral tissues can reveal a wealth of information about the rest of the body. A thorough oral assessment can detect signs of a number of most common oral and dental problems such microbial infections, immune disorders and even cancer. It is apparent that oral health plays a major role in and inextricably linked to overall health and general well-being.


Most common oral and dental problems


Results of common oral and dental problems:

The health of the mouth and surrounding tissues affects us physically, emotionally, mentally and socially and it is integral to overall health status. The effects of poor oral health are systemic and that they impact fundamental elements of a person’s identity such as the foods they choose, how they look, how they communicate. If the common oral and dental problems are left untreated, simple dental caries can result in cavities, pain, infection, diminished quality of life, heart diseases and even lead to cancer.

Most Common Oral and Dental Problems:

Poor oral health can lead to numerous diseases in the mouth. Oral diseases are progressive and commutative and become complex over time. The two leading dental diseases are dental caries, also known as tooth decay, and periodontal or gum diseases such as gingivitis and periodontitis. Other major diseases include oral and pharyngeal cancer – cancer of the lip, tongue, pharynx, mouth.

Dental caries:

Dental caries is a type of bacterial infection. Colonies of bacterial, commonly referred to as dental plaque, adhere to the surface of the teeth. These bacteria produce acids, which in turn dissolve minerals in the tooth enamel and form opaque white or brown spots under enamel. These spots are called caries or cavities. If the caries go unchecked, the infection can extend through the entire tooth. 

Such a cavity typically results in a severe toothache often accompanied by sensitivity to temperature and sweets. If treatment is still not obtained, the infection can lead to the formation of an abscess and the destruction of bone and can spread via the bloodstream.

Dental caries can occur at any age after teeth erupt. Early in development, primary teeth are vulnerable to a particularly damaging type of caries called early childhood caries. These often appear in children who are given bottles of juice, milk, or formula to drink during the day or overnight. Other risk factors for early childhood caries include arrested development of tooth enamel, altered salivary composition, mouth breathing and blockage of saliva flow.

What is Dental Caries:

Dental caries is a microbial disease of the teeth that results in decalcification of calcified tissue and dissolution of un-calcified tissues (soft tissue) of the teeth. The word caries derived from Latin word meaning ‘rot’ or ‘decay’.

What causes dental caries:

Dental caries has multifactorial causes in initiation and progression. It is a dynamic and complex process.

Many theories have been proposed for the cause of dental caries like Miller’s acidogenic theory, proteolytic theory and proteolytic chelation theory. Most widely accepted one is the Miller’s acidogenic theory.

According to Miller’s acidogenic theory the dental caries is a chemico-parasitic process. The microorganisms, diet and tooth surface plays a role.

Role of microorganism:

The mouth is full of bacterial species and many of it plays a role in causing dental caries. the main role is by bacteria Streptococcus mutans which initiates the caries process. The other bacteria lactobacillus acidophilus paly a role in caries progression and actinomyces is implicated in root caries.

The carbohydrate foods are the main substances for microorganisms. Sticky food like chocolates and other carbohydrates are more caries producing than other foods.

Role of tooth surface:

Retentive and difficult areas to clean like pit and fissure, grooves, crowded and meal-aligned teeth, sides of the teeth which make contact with other teeth and partially erupted impacted tooth can cause food retention and these areas of the teeth are more prone for dental caries.

Role of dental plaque:

 Dental plaque is a bio-film made of bacteria’s and salivary proteins. It forms on the teeth that are not adequately cleaned. It plays a role in dental caries by locating the bacteria and carbohydrate on the tooth surface so that fermentation and acid formation takes place.

Who are prone to get dental caries:

Dental caries affects all the age groups a with teeth, both the age groups with teeth, both genders in all races and all socio-economic groups. Poor oral hygiene and food habits paly a major role. sticky carbohydrate foods especially junk food and snacks get stagnated in the tooth surfaces. If they are left retained for long time, it can initiate dental caries. children do get more of dental caries because of craving for sweets and chocolates.

What are the types of dental caries:

The dental caries can be classified:

A. Based on duration –

  1. Acute caries and
  2. Chronic caries

B. Based on surfaces –

  1. Smooth surface caries
  2. Pit and fissure caries
  3. Root caries

C. Based on age –

  1. Infant-nursing bottle caries
  2. Adolescent caries
  3. Senile caries-old age

D. Based on location of the tissue involved:

  1. Enamel caries
  2. Dentinal caries
  3. Cemental caries

How to detect dental caries:

In the initial stages caries is chalky white because of decalcification. Later on it becomes dark either black or brown because of accumulation of debris and staining of the surface.

Why caries causes cavity:

Caries activity starts from the surface and starts involving the deeper tissues which results in loss of the decayed tissue causing cavity.

When does caries cause pain:

When caries involve only enamel there is no pain, when it reaches dentin causes sensitivity and when reaches pulp which has nerve fibers there will be pain because of inflammation of pulp. It is called pulpitis.

What are the signs and symptoms of dental caries:

An individual has to do self examination of teeth in front of the mirror and look out for any changes like discoloration of the teeth especially black or brown color. If the there is stagnation of food or any other obvious cavity on the surface of tooth can be dental caries. Sensitivity and pain are felt in the later stages if the caries is deep. In advanced stages the tooth itself will be grossly destructed with only root stumps remaining.

When to visit dentist:

If any changes in the teeth as mentioned in signs and symptoms of dental caries are noticed then it is better to seek a professional approach by visiting a dentist.

What happens if the dental caries left untreated:

If the dental caries is left untreated, it results in loss of teeth. The functions of teeth are for good appearance, speech and chewing. All these functions get affected. healthy teeth are needed for a pleasant smile which is foremost for self-confidence and appearance. A person without teeth cannot pronounce words accurately. For digestion of food it has to be chewed before swallowing. A person without teeth cannot chew food leading to indigestion.

What are the treatment options of dental caries:

Teeth with caries cavity and not involving the pulp can be treated conservatively by doing filling. Various materials are used like silver amalgam, cements and resins. Cosmetic fillings can  restore the tooth to its original color, shape and function.

If the caries involves the pulp then root canal treatment has to be done to relive the pain and save the tooth. The root canal treated tooth has to be protected by an artificial tooth.

If the caries is extensive and grossly destructed then the tooth has to be extracted and replaced by artificial tooth.

How to prevent dental caries:

Maintenance of oral hygiene is vital to prevent dental caries and for overall general health. Brushing of teeth with standardized tooth brushes and tooth pastes to be done both in the morning and night. rinsing the mouth after every meals and drinking water helps to remove the food debris. Chlorhexidine mouth washes, interdental brushes and dental flosses can be used in selected cases. Sugarless chewing gums containing xylitol helps to prevent dental caries. Fluorinated tooth pastes help to reduce caries attack in children. On the whole a good oral hygiene is mandatory to prevent dental caries.

Periodontal Diseases:

Like dental caries, periodontal diseases are infections caused by bacteria of dental plaque. There are two main classifications of periodontal diseases: gingivitis and periodontitis. Gingivitis affects gums, whereas periodontitis may involve both the soft tissue and bone of the mouth. Gingivitis and milder forms of periodontitis are common in adults. Moderate to severe periodontitis, where the destruction of tissue causes teeth to fall out, becomes more common with increasing age.

  • Gingivitis:

Gingivitis is an inflammation of the gums. The gums typically become red, sensitive and tender and may swell and bleed. These changes are due to the immune system’s response to bacteria containing dental plaque that accumulates along the edges of the gums. The early stages of gingivitis are reversible by brushing the teeth and flossing to reduce plaque. However, without adequate oral hygiene, early changes can become more severe as chronic infection takes hold.

Causes of Gingivitis:

Such gum infections can persist for months or years. Gingival inflammation may be influenced by steroid hormones, which encourage the growth of certain bacteria and trigger an exaggerated response to plaque buildup.

  • Periodontitis:

There are two common forms of adult periodontitis: general/moderately progressing and severe/rapidly progressing, the latter of which is often resistant to treatment. With moderately progressing periodontitis, the periodontal ligament gradually detaches from the gums and bone. Supportive bone structures of the jaw also begin to deteriorate. 

The destruction of periodontal ligament and bone results in the formation of a pocket between the tooth and the adjacent tissues, which harbors plaque beneath gums. General periodontitis is often accompanied by gingivitis. It typically begins in adolescence but is not clinically significant until the mid-30s. One of the strongest behavioral associations is tobacco use.

Causes of Periodontitis:

The risk of bone loss for heavy smokers is seen seven times greater than for those who have not smoked. Increased prevalence of periodontitis is also associated with increasing age, infrequent dental visits, low education level. Men often have higher levels of periodontitis than women. Some systemic diseases such as diabetes and osteoporosis also increase risk.

Oral and Pharyngeal cancer:

Oral and pharyngeal cancer affects approximately 30000 people annually and claims 8000 lives in the same period. With only 52 percent of people diagnosed surviving five years, oral and pharyngeal cancer, has one of the worst five-year survival rates of any cancer. Moreover, men have twice the risk of women of being diagnosed with oral cancer and African and American men suffer disproportionately. 

While oral cancer is the sixth leading cancer in U.S men, it is the fourth leading cancer in African American men. Approximately 95 percent of cases of oral cancer occur in people over the age of 40, and the average age of diagnosis is 60. Oral cancer treatment  including surgery and radiation  can be painful, disfiguring, and costly, both monetarily and psychologically.

Causes:

Tobacco and alcohol use are the major risk factors fir oral and pharyngeal cancer. Risk increases with greater consumption. For instance, heavy drinkers who smoke more than one pack of cigarettes a day are 24 times more likely to develop oral cancer. Warning signs of oral cancer include a sore in the mouth that does not heal, a white or red patch on the gums, tongue, tonsils or lining of the mouth, a lump or thickening in the cheek, and difficulty chewing and swallowing.

Early detection of oral and pharyngeal cancers is critical and greatly increases survival rates, but unfortunately only 35 percent of oral cancer is detected at its earliest stage.

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Other diseases related to oral and dental problems:

Impacting more than simply the teeth and mouth, poor oral health has consequences throughout the body. Associations between chronic oral infections and diabetes, heart disease, stroke, low-birth-weight, premature births have been noted.

Diabetes:

There is an increased prevalence of gum disease among people with diabetes. This association between gum disease and diabetes is a two-way street. Diabetes increases the risk of serious gum disease, but serious gum disease also increases the risk of diabetes. This is because gum disease can impact blood glucose control which can fuel the development of diabetes. On the other hand, individuals with diabetes have an increased risk for serious gum disease because they are generally more susceptible to bacterial infection and have a decreased ability to fight bacteria that invade the gums.

Heart Disease:

Connections between periodontal disease and heart disease have also been made. Researchers have found that people with gum diseases are almost twice as likely to suffer from coronary artery disease. 

It is posited that chewing and tooth brushing in people with periodontitis releases bacteria into bloodstream . Some of these bacteria attach to fatty plaque in the arteries of the heart. This plaque, in turn, contributes to clot formation and the thickening of the walls of the arteries. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for heart to function properly. This may lead to heart attack.

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Causes of common oral and dental problems:

Poor Dietary Choices:

It is stated that an apple a day keeps the doctor away. A nutritious diet helps to prevent tooth decay and other oral diseases. With an individual eats has a large impact on the health of his or her mouth. Starches and foods high in sugar greatly increase the likelihood of tooth decay. 

Plaque bacteria in the mouth convert sugars and starches into waste in the form of acid. The longer the sugar and starch sit on the teeth, the longer the bacteria produce the acid. The acid then erodes the enamel on the teeth and eventually causes tooth decay. Moreover, poor nutrition by failing to supply the body with necessary nutrients, weakens the entire immune system and thereby leaves people at a higher risk for gum disease.

Tobacco Use:

Smoking increases the risk of many oral diseases. Tobacco use in any form increases the risk of gum disease, oral pharyngeal and throat cancer, oral fungal infection. Chewing tobacco containing sugar increases the risk of tooth decay. Pipe and cigar smoking have an adverse effect on gum disease. Beyond periodontitis, smoking also increases the risk of bone loss and depresses healing and defense mechanisms by reducing the delivery of oxygen and nutrients to gingival tissue. This means that smokers are more likely to lose teeth, not respond to treatment,  and develop infections, such as periodontitis.

Excessive Alcohol Use:

Heavy use of alcohol can cause a host of oral health problems. Those who use alcohol in excess have a higher risk of periodontal diseases and of tooth decay from the increased exposure to sugars and acids within drinks. Perhaps most threatening, though, is the greater incidence of oral and throat cancers among people who drink heavily.

How to prevent common oral and dental problems:

The irony of dental caries, periodontal disease and oral cancer is that while they are the most widespread and common oral and health problems, they are also the most preventable. There are numerous ways that people can achieve good oral health and prevent the development of dental caries, periodontal disease, and other oral and dental problems.

Fluoride:

Research showed that people living in communities with naturally fluoridated water supplies had fewer dental caries. Fluoride is protection against tooth decay works at all ages. It has been shown to decrease tooth decay by 18 to 40 percent. For most people, the low levels of fluoride found in water coupled with the use of a fluoride-containing toothpaste twice a day provides sufficient dosage to protect their teeth. However, people at high risk for dental caries might require more frequent or more concentrated exposure to fluoride and might benefit from use of other fluoride products.

Tooth Brushing:

Thorough tooth brushing at least twice a day without a fluoride toothpaste is a simple, widely recommended method of maintaining good oral health. Brushing reduces bacteria-containing dental plaque, thus preventing tooth decay and gingivitis. The use of fluoride toothpaste also helps to prevent cavities. There are several recommendations about appropriate brushing. To begin, the toothpaste should be rinsed in water after use to remove bacteria, saliva and other particles from the mouth that collect on it.

Dental Sealants:

Dental sealants complement the use of fluoride in preventing dental caries. Dental sealants are thin plastic coatings that are applied to the grooves on the chewing surfaces of the back teeth to protect them from tooth decay. The films prevent decay from developing in the grooves, which are hard to reach with brushing and where fluoride may be less effective.  Sealants tend to work most effectively on permanent molars, which come in at 6 years and 12 years of age. It is best if the sealant is applied soon after the teeth have erupted, before they have a chance to decay.

Visits to Dentist:

Having regular visits to a dentist or dental hygienist is critical to maintaining good oral health. Check-ups can detect early signs of oral and dental problems and can lead to treatments that will prevent further damage. Also, professional tooth cleaning is important for preventing oral problems, especially when self-care us difficult.

Conclusion:

Prevention is better than cure. Effort and care should be taken from the childhood to prevent common oral and dental problems by maintaining a good overall oral hygiene. Healthy fibrous food should be taken. Minimize or avoid the intake of sticky junk food. Everyone should do self examination to notice any changes like black discoloration and cavity in the tooth. If there is any suspicion of dental problem, better to visit a dentist to restore and save tooth.

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