Common Dental Issues

Why Are Oral Exams Important?

Just like a regular physical exam, a regular oral exam helps keep your entire body healthy and happy. It helps you to maximize good oral hygiene and minimize future dental problems. Regular exams also identify any existing dental issues and diseases early on, preventing bigger problems down the line.

Those bigger problems—infections and gum disease—don’t just impact your mouth. Your body is the sum of its parts, and disease in one area typically affects other organs and/or systems. Studies have linked gum disease with diabetes, cardiovascular disease, dementia, and more.

An oral exam can help detect gum disease and oral cancer, and diagnose the need for fillings, root canals, orthodontic, and other treatments. To be most effective, though, an oral exam typically needs the additional information supplied by x-rays.

Tooth decay

Tooth decay is one of the most common of all disorders, second only to the common cold. It usually occurs in children and young adults but can affect any person. It is a common cause of tooth loss in younger people. Brushing your teeth every day, as well as avoiding foods and drinks that are bad for your teeth, can help prevent tooth decay.

Bacteria, acid, food debris, and saliva combine in the mouth to form a sticky substance called plaque that adheres to the teeth. Plaque begins to build up on teeth within 20 minutes after eating. If this plaque is not removed thoroughly and routinely, tooth decay will not only begin, but flourish.

The acids in plaque dissolve the enamel surface of the tooth and create holes in the tooth (cavities). Cavities are usually painless until they grow very large and affect nerves or cause a tooth fracture. If left untreated, a tooth abscess can develop. Untreated tooth decay also destroys the internal structures of the tooth (pulp) and ultimately causes the loss of the tooth.

Signs and symptoms of possible tooth decay
  • Tooth pain or achy feeling, particularly after sweet, hot, or cold foods and drinks
  • Visible pits or holes in the teeth

Most cavities are discovered in the early stages during routine checkups. The surface of the tooth may be soft when probed with a sharp instrument. Pain may not be present until the advanced stages of tooth decay. Dental x-rays may show some cavities before they are visible to the eye.

Oral hygiene is necessary to prevent cavities. This consists of regular professional cleaning (every 6 months), brushing at least twice a day and flossing daily.

Chewy, sticky foods are best if eaten as part of a meal rather than as a snack. If possible, brush the teeth or rinse the mouth with water after eating these foods. Minimize snacking, which creates a constant supply of acid in the mouth. Avoid constant sipping of sugary drinks or frequent sucking on candy and mints.

Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash.

Gingivitis is a form of periodontal disease. Periodontal disease involves inflammation and infection that destroys the tissues that support the teeth.

Gingivitis is due to the long-term effects of plaque deposits. Plaque is a sticky material made of bacteria, and food debris that develops on the exposed parts of the teeth. It is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.

Many people have gingivitis to a varying degree. It usually develops during puberty or early adulthood due to hormonal changes and may persist or recur frequently, depending on the health of your teeth and gums.

Symptoms
  • Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
  • Bright red or red-purple appearance to gums
  • Gums that are tender when touched, but otherwise painless
  • Mouth sores
  • Swollen gums
  • Shiny appearance to gums

Good oral hygiene is the best prevention against gingivitis because it removes the plaque that causes the disorder. The teeth should be brushed at least twice daily and flossed gently once per day. For people who are prone to gingivitis, brushing and flossing may be recommended after every meal and at bedtime.

Regular professional tooth cleaning is important to remove plaque that may develop even with careful brushing and flossing. We recommend having your teeth professionally cleaned at least every 6 months.

Bad breath (called halitosis) is a common problem. In most cases, bad breath is the result of poor oral hygiene. Poor brushing and flossing leaves food particles between the teeth. Bacteria that build up on the back of your tongue or in between your teeth set up camp in your mouth, and release sulphur compounds which have the nasty habit of spreading a strong unpleasant odor.

These four important areas in the mouth need your concern

Tongue

The tongue may be loaded with decaying food particles and bacteria that cause bad breath. Brush or scrape your tongue first thing in the morning and before bed. Brush with a toothbrush soaked in chlorhexidine (an antibacterial agent)or use a tongue-scraper. Pay extra attention to the back of the tongue. This part of the tongue is relatively dry and - as a rule - not well cleansed.

Teeth

Brushing your teeth three times a day is very important. Also flossing after a meal is a must. Get your teeth cleaned and any cavities filled twice a year. Make sure you use the right toothpaste.

Gums

Regularly clean your gums, followed by rinsing. Put an ounce of hydrogen peroxide in the water.

Saliva

Saliva helps prevent reproduction of bad smelling bacteria in the mouth. It contains an enzyme that can destroy the cell walls of bacteria. Talking a lot reduces saliva. As a result, people in conversational occupations (like politicians, anchors, actors and teachers) are at "prime risk".

Oral cancer most commonly involves the lips or the tongue. It may also occur on the cheek lining, floor of the mouth, gums (gingiva) or the roof of the mouth (palate). Most oral cancers are a type called squamous cell carcinomas. These tend to spread quickly.

Our office has the skills and tools to ensure that early signs of cancer and pre-cancerous conditions are identified. Together, we can fight and win the battle against oral cancer. Know the early signs and see our office regularly.

Oral cancer screening is a routine part of our dental examination. Regular check-ups, including an examination of the entire mouth, are essential in the early detection of cancerous and pre-cancerous conditions. You may have a very small, but dangerous, oral spot or sore and not be aware of it.

We will carefully examine the inside of your mouth and tongue. Harmful oral spots or sores often look identical to those that are harmless, but testing can tell them apart. To ensure that a spot or sore is not dangerous, we may choose to perform a simple test, such as a brush test. A brush test collects cells from a suspicious lesion in the mouth. The cells are sent to a laboratory for analysis. If precancerous cells are found, the lesion can be surgically removed if necessary during a separate procedure.

Prevention and Detection

Regular dental check-ups, including an examination of the entire mouth, are essential in the early detection of cancerous and pre-cancerous conditions. Many types of abnormal cells can develop in the oral cavity in the form of red or white spots. Some are harmless and benign, some are cancerous and others are pre-cancerous, meaning they can develop into cancer if not detected early and removed.

Finding and removing epithelial dysplasias before they become cancer can be one of the most effective methods for reducing the incidence of cancer.

Knowing the risk factors and visiting our office for oral cancer screenings can help prevent this deadly disease.

Other factors that may increase the risk for oral cancer include:
  • Chronic irritation (such as from rough teeth, dentures, or fillings)
  • Human papilloma virus (HPV) infection
  • Taking medications that weaken the immune system (immunosuppressants)
  • Poor dental and oral hygiene

Tooth sensitivity is due to the exposure of dentin, the part of the tooth which covers the nerve, either through loss of the enamel layer or recession of the gums. Temperature changes and certain foods (acidic or sweet) can cause the tooth or teeth to be painful.

The best way to find out why a tooth is sensitive is to have our office examine you. We can look for the signs of dentin exposure, and run tests to determine what the true cause of the sensitivity is. Sometimes, the sensitivity is due to a cavity or gum disease – these can be treated to address the sensitivity. Other times, the cause of the sensitivity is because the enamel has been lost through abrasion or erosion, or the gums have receded, causing the roots to be exposed.

There are a number of treatments available, and we can help you find those that will work best, depending on your situation.

Tooth erosion is caused by acidic foods and drinks 'dissolving' away the surface of the tooth. It is becoming increasingly more common, especially due to greater consumption of fizzy drinks - including 'diet' brands.

Acids in the mouth can dissolve away tooth surfaces. Given the chance, teeth will repair themselves, using minerals from saliva. But if acid is in the mouth too often, teeth cannot repair themselves and the hard tooth surface (the enamel) becomes thinner - this is called 'erosion'.

The teeth can then become extra sensitive to hot and cold food and drink. Eroded teeth can also be more likely to suffer decay.

The main cause of erosion is too frequent consumption of certain kinds of food and drink. All fizzy drinks (including 'diet' brands and fizzy mineral water), all 'sports' drinks, all squashes and all fruit juices are acidic to varying degrees. Pickles and citrus fruits are examples of acidic types of food.

Key Tips to Prevent Erosion
  • Try and avoid consuming acidic food and / or drink too often during the day. Try to have them only at mealtimes.
  • Drink acidic drinks quickly - don't sip them. And don't swish them round your mouth.
  • Between meals you should only have 'safe' drinks, which are not sugary or acidic. Milk and water are 'safe' drinks. So are tea and coffee if you do not add sugar to them (you can use non-sugar sweeteners).

You should try and avoid snacking between meals. If you do snack, only have 'safe' snacks, which are not sugary or acidic. Fruits, vegetables and products (such as sandwiches, toast, crumpets and pitta bread) are all 'safe' snacks. You should try and avoid snacking between meals. Some fruits, especially citrus fruits, are acidic and are known to cause erosion if they are consumed in large quantities. This is not normally a problem for most people; however, you could discuss with your dentist or hygienist the safest way of enjoying these fruits.

You should brush your teeth twice a day, and always use a fluoride toothpaste.