Common dental problems and how you can help prevent them.

Here are a few of the most prevalent oral diseases, their causes and how you can prevent them from occurring, and recognise and help manage them should you be affected by them.

Gum Disease

Gum disease (also known as periodontal disease, periodontitis or pyorrhoea) is an infection of the supporting structures of the teeth namely gum and bone. These infections destroy the gum and bone around your teeth and if left untreated can result in bad breath, swollen bleeding gums and eventually tooth loss. Unfortunately, unlike tooth decay, periodontal diseases are painless until it is almost too late to save the teeth.

The primary cause of these diseases is bacterial plaque, a sticky, colourless film that always forms on your teeth. Some of the bacteria from this plaque are able, and so your immune system doesn't like having this bacterial plaque around. Your immune system attacks the invading bacteria, but unfortunately it also irreversibly damages the body's own tissues.

If plaque is not removed daily, it can build up on the tooth surface and turn into a hard substance called calculus. Calculus, also known as tartar, is a calcified dental plaque and is considered a contributing factor in causing periodontal diseases. Smoking and diabetes are also believed to be significant risk factors.

Signs of Gum Disease

1. Gums bleeding when brushing the teeth

2. Red and swollen gums

3. Tender Gums

4. Gums pulling away from the teeth, exposing roots and creating receding gums

5. Pus between teeth and gums

6. Sudden swellings that are painful to the touch

7. Loose teeth or spaces suddenly appearing between teeth

Now for the good news

Regular dental check-ups along with brushing at least twice a day and flossing daily interdental cleaning play an essential role in preventing gum disease. Hygienists can change the composition of the bacterial plaque using ultrasonic cleaning which will help reduce the number and types of aggressive attacking bacteria.

Tooth Decay

Tooth decay, also known as cavities or caries, is unfortunately still prevalent. Tooth decay occurs when long-standing bacteria coated on tooth surfaces (known as dental plaque) are exposed to sugar. The sugar is used by certain bacteria in plaque to produce acids which dissolve minerals from the tooth which ultimately weakens them. Eventually, after enough mineral has been dissolved away the surface of the tooth breaks resulting in cavities. Once a hole forms, it becomes challenging to clean the area effectively to remove plaque and so the cavity can get bigger and bigger eventually resulting in pain and if left will result in the tooth losing its blood supply and the nerve dying. Other foods such as processed white bread, starchy cereals and pasta can also result in tooth decay because a digestive enzyme present in saliva can break down these processed foods very quickly to produce sugars that dental plaque can thrive from.

Now for the good news

Tooth decay is preventable and in the early stages, even reversible. The process by which mineral is dissolved away can be reversed by your own saliva. This yo-yoing of the mineral in and out of the tooth is perfectly normal, but if there is a net loss of minerals a cavity eventually forms. It does, however, take longer for the minerals to be driven back into the tooth compared to dissolving it away, but it is doable. All you have to do is allow your saliva enough time to do it, and that means not having anything sugary (or food which is processed) for 3-4 hours after your first sugar hit, but this very much depends on the quality of your saliva. If your saliva is great at neutralising acids, then the time period for mineral to be put back is short. If, however, its of poor quality, it may take an age to neutralise and so you are at higher risk of tooth decay. I usually advise my patients to restrict their sugar intake to meal times only as most foods from supermarkets contain hidden sugars, even the savoury ones. I also suggest cleaning in between the teeth to dislodge the cavity forming plaque in between the teeth and brushing effectively. You can also have saliva tests carried out by your dental team which help assess the neutralising capabilities of your saliva as well as dietry analysis should you keep developing cavities.

Tooth Sensitivity

Tooth hypersensitivity is a painful complaint, and those affected by this condition complain of discomfort while eating, drinking, cleaning their teeth and even, on occasion, while breathing. With an increase in acidic beverages consumed by the young and an increase in human life expectancy, it is believed that this condition will become increasingly common.

Tooth hypersensitivity is a nerve response to exposed root surfaces being exposed to various stimuli but usually thermal. The stimuli cause a change in the rate of flow of a fluid that oozes out of the root through lots of little tunnels that run from the root surface all the way back to where the nerve resides in the middle of the tooth.

Now for the good news

It can be managed by using de-sensitising kinds of toothpaste (don't forget just to spit out and not rinse after cleaning your teeth) and reducing your consumption of acidic beverages and foods. Desensitising toothpaste work by either clogging up the ends of the tiny tunnels or by numbing the nerve.

Additionally, cleaning your teeth before meals and not immediately after, will also help reduce the discomfort as you’re less likely to remove any plugs that have formed at the end of the tunnels.

Davinder Raju.