Dental and Oral Health

Dr. Santhosh Mathew BDS, Dental Surgeon, SUT Hospital, Pattom

Dental and oral health is an essential part of your overall health and well-being. Poor oral hygiene can lead to dental cavities and gum disease, and has also been linked to heart disease, cancer, and diabetes.Maintaining healthy teeth and gums is a lifelong commitment.

There are many steps you can take to keep your teeth healthy. For example, dental and oral disease can be greatly reduced by:

• Brushing your teeth with fluoride toothpaste at least twice a day
• Flossing your teeth at least once a day
• Decreasing your intake of sugar
• Eating a diet high in fruits and vegetables
• Avoiding tobacco products
• Drinking fluoridated water
• Seeking professional dental care

Symptoms of dental and oral problems

• Ulcers, sores, or tender areas in the mouth that won’t heal after a week or two
• Bleeding or swollen gums after brushing or flossing
• Chronic bad breath
• Sudden sensitivity to hot and cold temperatures or beverages
• Pain or toothache
• Loose teeth
• Receding gums
• Pain with chewing or biting
• Swelling of the face and cheek

Causes of dental and oral disease

Bacteria near your gumline thrive in a sticky matrix called plaque. Plaque accumulates, hardens, and migrates down the length of your tooth if it isn’t removed regularly by brushing and flossing. This can inflame your gums and cause the condition known as gingivitis.

Increased inflammation causes your gums to begin to pull away from your teeth. This process creates pockets in which pus may eventually collect. This more advanced stage of gum disease is called periodontitis.
There are many factors that contribute to gingivitis and periodontitis, including:

• Smoking
• Poor brushing habits
• Frequent snacking on sugary foods and drinks
• Diabetes
• The use of medications that reduce the amount of saliva in the mouth
• Family history, or genetics
• Certain infections, such as HIV or AIDS
• Hormonal changes in women
• Acid reflux, or heartburn
• Frequent vomiting, due to the acid

Types of dental and oral diseases 

We use our teeth and mouths for a lot, so it’s not surprising how many things can go wrong over time, especially if you don’t take proper care of your teeth. Most dental and oral problems can be prevented with proper oral hygiene. You’ll likely experience at least one dental problem during your lifetime.

Cavities- Cavities are also called caries or tooth decay. These are areas of the tooth that have been permanently damaged and may even have holes in them. Cavities are fairly common. They occur when bacteria, food, and acid coat your teeth and form a plaque. The acid on your teeth starts to eat away at the enamel and then the underlying dentin, or connective tissue. Over time, this can lead to permanent damage.

Gum disease (gingivitis)- Gum disease, also called gingivitis, is inflammation of the gums. It’s usually the result of plaque building up on your teeth due to poor brushing and flossing habits. Gingivitis can make your gums swell and bleed when you brush or floss. Untreated gingivitis can lead to periodontitis, a more serious infection.

Periodontitis- As periodontitis progresses, the infection can spread to your jaw and bones. It can also cause an inflammatory response throughout the body.

Cracked or broken teeth- A tooth can crack or break from an injury to the mouth, chewing hard foods, or grinding the teeth at night. A cracked tooth can be very painful. You should visit your dentist right away if you’ve cracked or broken a tooth.

Sensitive teeth- If your teeth are sensitive, you might feel pain or discomfort after having cold or hot foods or beverages.Tooth sensitivity is also referred to as “dentin hypersensitivity.” It sometimes occurs temporarily after having a root canal or a filling. It can also be the result of:

• Gum disease
• Receding gums
• A cracked tooth
• Worn-down fillings or crowns

Some people naturally have sensitive teeth because they have thinner enamel. Most of the time, naturally sensitive teeth can be treated with a change in your daily oral hygiene regimen. There are specific brands of toothpaste and mouthwash for people with sensitive teeth. Shop for toothpaste and mouthwash made for people with sensitive teeth.

Oral cancer- Oral cancers include cancer of the:

• Gums
• Tongue
• Lips
• Cheek
• Floor of the mouth
• Hard and soft palate

A dentist is usually the first person to recognize oral cancer. Tobacco use, such as smoking and chewing tobacco, is the biggest risk factor for oral cancer.According to the Oral Cancer Foundation (OCF), nearly 50,000 Americans will be diagnosed with oral cancer this year. In general, the earlier that oral cancer is diagnosed, the better the outlook.

The link between oral and general health

Oral health has risen in importance in recent years, as researchers have discovered a connection between declining oral health and underlying systemic conditions. It turns out that a healthy mouth can help you maintain a healthy body. According to the Mayo Clinic, oral bacteria and inflammation may be associated with:

• Heart disease
• Endocarditis, or inflammation of the lining of the heart
• Premature birth
• Low birth weight

Bacteria can spread from your oral cavity to your bloodstream, causing infective endocarditis. Infective endocarditis is a life-threatening infection of your heart valves. Your dentist may suggest you take antibiotics as a preventive measure before they perform any dental procedure that could dislodge bacteria in your mouth.

Treating oral and dental problems

Cleanings- A professional cleaning can get rid of any plaque you may have missed while brushing and flossing. It’ll also remove tartar. These cleanings are usually performed by a dental hygienist. After all the tartar is removed from your teeth, the hygienist will use a high-powered toothbrush to brush your teeth. This is followed by flossing and rinsing to wash out any debris.

Fluoride treatments- Following a dental cleaning, your dentist may apply a fluoride treatment to help fight off cavities. Fluoride is a naturally occurring mineral. It can help strengthen the enamel of your tooth and make them more resilient to bacteria and acid.

Antibiotics- If you show signs of a gum infection or you have a tooth abscess that has spread to other teeth or your jaw, your dentist may prescribe antibiotics to help get rid of the infection. 

Fillings, crowns, and sealants

A filling is used to repair a cavity, crack, or hole in the tooth. A crown is used if a large portion of your tooth needs to be removed or has broken off due to an injury. There are two types of crowns: an implant crown that fits over an implant, and a regular crown that fits over a natural tooth. Dental sealants are thin, protective coatings that are placed on the back teeth, or molars, to help prevent cavities.

Root canal- You might need a root canal if tooth decay reaches all the way inside the tooth to the nerve. During a root canal, the nerve is removed and replaced with a filling made of a biocompatible material, usually a combination of a rubber-like material called gutta-percha and adhesive cement.

Surgery for dental and oral problems- Oral surgeries are usually performed to treat more serious cases of periodontal disease. Certain dental surgeries can also be done to replace or fix missing or broken teeth caused by an accident.

Flap surgery- During a flap surgery, a surgeon makes a small cut in the gum to lift up a section of the tissue. They then remove tartar and bacteria from underneath the gums. The flap is then stitched back into place around your teeth.

Bone grafting- Bone grafting is needed when gum disease causes damage to the bone surrounding the root of your tooth. The dentist replaces the damaged bone with a graft, which can be made from your own bone, a synthetic bone, or a donated bone.

Soft tissue grafts- A soft tissue graft is used to treat receding gums. A dentist will remove a small piece of tissue from your mouth or use a donor tissue and attach it to the areas of your gums that are missing.

Tooth extraction- If your dentist can’t save your tooth with a root canal or other surgery, the tooth will likely need to be extracted.

You may also need a tooth extraction if your wisdom teeth, or third molars, are impacted. Sometimes, a person’s jaw isn’t large enough to accommodate the third set of molars. One or more of the wisdom teeth will become trapped or impacted when it tries to emerge. A dentist will typically recommend that wisdom teeth be extracted if they cause pain, inflammation, or other problems.

Dental implants- Dental implants are used to replace missing teeth that are lost due to a disease or an accident. An implant is surgically placed into the jawbone. After the implant is placed, your bones will grow around it. This is called osseointegration.

Once this process is complete, your dentist will customize a new artificial tooth for you that matches your other teeth. This artificial tooth is known as a crown. The new crown is then attached to the implant. If you’re replacing more than one tooth, your dentist may customize a bridge to fit into your mouth. A dental bridge is made of two abutment crowns on either side of the gap, which then hold the artificial teeth in between in place.