Tooth decay is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form.
Cavities are more common among children, but changes that occur with aging make cavities an adult problem, too. Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque. Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. It’s common for people over age 50 to have tooth-root decay.
Decay around the edges, or a margin, of fillings is also common for older adults. Because many older adults lacked benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and tend to fracture and leak around the edges. Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
Possible causes include:
- Tooth decay (cavities)
- Fractured teeth
- Worn fillings
- Gum disease
- Worn tooth enamel
- Exposed tooth root
In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin.
Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
Gum Disease/Periodontal Disease
Gum disease is an infection of the tissues that surround and support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by plaque, the sticky film of bacteria that is constantly forming on our teeth.
Here are some warning signs that can signal a problem:
- gums that bleed easily
- red, swollen, tender gums
- gums that have pulled away from the teeth
- persistent bad breath or bad taste
- permanent teeth that are loose or separating
- any change in the way your teeth fit together when you bite
- any change in the fit of partial dentures
Some factors increase the risk of developing gum disease. They are:
- poor oral hygiene
- smoking or chewing tobacco
- crooked teeth that are hard to keep clean
- medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
See your dentist if you suspect you have gum disease because the sooner you treat it the better. The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.
Advanced gum disease is called periodontitis. Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.
Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.
Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.
It is possible to have gum disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring. Remember:You don’t have to lose teeth to gum disease. Brush your teeth twice a day, clean between your teeth daily, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
Periodontics is the dental specialty focusing exclusively in the inflammatory disease that destroys the gums and other supporting structures around the teeth. A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal, or disease, and in the placement of dental implants. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. As specialists in periodontal disease, they are experts in the latest techniques for diagnosing and treating periodontal disease. They are also trained in cosmetic periodontal procedures.
Periodontists treat cases ranging from mild gingivitis to more severe periodontitis. Periodontists offer a wide range of treatments, such as scaling and root planing (the cleaning of infected root surfaces), root surface debridement (the removal of damaged tissue), and regenerative procedures (the reversal of lost bone and tissue). When necessary, periodontists can also perform surgical procedures for patients with severe gum disease. Additionally, periodontists are trained in the placement, maintenance and repair of dental implants. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
Bad Breath (Halitosis)
Whether you call it bad breath or halitosis, it’s an unpleasant condition that’s cause for embarrassment. If you’re concerned about bad breath, see your dentist. Bad breath can be caused by a number of sources, and he or she can help identify the cause and determine the best treatment.
What causes bad breath?
- Food. What you eat affects the air you exhale, like garlic or onions. If you don’t brush and floss daily, particles of food can remain in the mouth, collecting bacteria, which can cause bad breath. Dieters may develop unpleasant breath from infrequent eating.
- Gum disease. Persistent bad breath or a bad taste in the mouth can also be one of the warning signs of gum disease; which is caused by plaque.
- Dry mouth. This occurs when the flow of saliva decreases and can be caused by various medications, salivary gland problems or continuously breathing through the mouth. Without enough saliva, food particles are not cleaned away. If you suffer from dry mouth, your dentist may prescribe anartificial saliva, or suggest using sugarless candy or increase your fluid intake.
- Smoking and tobacco. In addition to staining teeth and being bad for overall health, tobacco can add to bad breath. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit.
- Medical conditions. Some diseases have symptoms related to bad breath. Sinus or lung infections, bronchitis, diabetes, and some liver or kidney diseases may be associated with bad breath.
If you’re concerned about what’s causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth. Bad breath may be the sign of a medical disorder. If your dentist determines that your mouth is healthy, you may be referred to your primary care physician.
Maintaining good oral hygiene, eliminating gum disease and scheduling regular professional cleanings are essential to reducing bad breath. Brush twice a day and clean between your teeth daily with floss. Brush your tongue, too. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning.
It’s important to note that mouthwash will only mask the odor temporarily. Mouthwashes are generally cosmetic and do not have a long-lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odor, see your dentist. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
Canker sores develop inside the mouth as small white or gray sores that have a red border. They are not contagious and may occur as one sore or several. Their exact cause is uncertain but some experts believe that immune system problems, bacteria or viruses may be involved. In some cases, trauma to the mouth’s soft tissues can cause a canker sore.
Canker sores usually heal on their own after one or two weeks. Over-the-counter topical anesthetics and antimicrobial mouthwashes may provide temporary relief. Stay away from hot, spicy or acidic foods that can irritate the sore. Antibiotics from your dentist and some oral bandages can reduce secondary infection. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org
A bite that does not meet properly (a malocclusion) can be inherited, or some types may be acquired. Some causes of malocclusion include missing or extra teeth, crowded teeth or misaligned jaws. Accidents or developmental issues, such as finger or thumb sucking over an extended period of time, may cause malocclusions.
Sleep apnea is a common and serious sleeping disorder that happens when your regular breathing is interrupted during sleep. Snoring is common among patients with sleep apnea but not all snorers have sleep apnea.
There are two main types of sleep apnea:
- Obstructive sleep apnea. The more common form, it is the result of blocked airflow during sleep, usually when the soft tissue at the back of the throat collapses while you sleep. Health factors, such as obesity may contribute.
- Central sleep apnea. Results from a problem with how the brain signals the breathing muscles. The airway is not blocked, instead the brain fails to signal the muscles to breath. This type of sleep apnea can occur with conditions such as heart failure, brain tumors, brain infections, and stroke.
- over 40
- with large tonsils, large tongue or small jaw
- with a family history of sleep apnea
- with a nasal obstruction due to a deviated septum, allergies or sinus problems.
- high blood pressure
- heart failure, irregular heartbeat and heart attack
- worsening of ADHD.
Sleep apnea can be treated. There are several options:
- Adjusting sleeping habits. This may mean simply not sleeping on your back
- Continuous positive air pressure (CPAP). This is a device which improves breathing while you sleep. The device supplies air through the nasal passages and the air pressure keeps the airway open while sleeping.
- Oral appliances. Certain oral devices can shift and support the jaw to prevent the airway from collapsing. Research shows that oral appliances can successfully prevent sleep apnea in some mild to moderate cases.
- Surgery. According to the American Academy of Dental Sleep Medicine, upper airway surgery may be recommended when other treatment options are unsuccessful in eliminating the symptoms of sleep apnea. Depending on the location and nature of the airway obstruction, the procedure may be minimally invasive or more complex. It may be necessary to remove the tonsils or other parts of the soft palate or throat.
If you think you have sleep apnea, make sure to speak with your physician or dentist for more information and possible evaluation. More information on these and other topics can be found on the American Dental Association’s website: MouthHealthy.org.