Dental diseases include conditions affecting both teeth and other soft tissues present in the mouth. Most of the dental diseases are due to lack of proper oral hygiene and can be prevented by proper care and healthy dental habits. Various dental diseases are as following:
1. Dental plaque and calculus- Plaque is a soft, sticky film that forms on the teeth. It is colourless or of pale yellow and causes many dental diseases like caries and gum problems. If not removed properly, dental plaque leads to the formation of tartar and calculus. Calculus is mineralized dental plaque and is hard and cannot be removed by brushing. It is of two types:
- Subgingival based on its location
CAUSES- Plaque develops when food containing refined carbohydrates is present on the tooth surface for a long time. Bacteria present in the mouth act on these and produce acid which leads to tooth decay. Plaque also harms the gingiva. Plaque turns into calculus over time.
SYMPTOMS- There is no specific symptom except the presence of unsightly film on the teeth. Bad breath, bleeding gums and pain may be present. Calculus is seen as a hard yellow deposit on the teeth and causes gingival recession and may lead to shaking of teeth.
CHECK-UP- Both plaque and calculus are seen during dental check-up by the dentist. No tests are required.
TREATMENT- Plaque and calculus are removed by cleaning by the dentist. Maintaining proper dental hygiene by brushing twice a day and flossing can prevent the accumulation of plaque. Use of mouthwash can help with bad breath. Food which is sticky and has high content of sugar should be avoided and regular visits to the dentist should be made.
2. Stains- There are two types of stains:
- Intrinsic Stains
- Extrinsic Stains
They make the teeth look unattractive.
CAUSES- Extrinsic stains-
- Brown stains- caused due to lack of oral hygiene.
- Tobacco stain- seen as black or brown deposit.
- Black or green stains- caused by bacteria
Intrinsic stains- They are below the tooth surface and in the enamel. Fluoride and other chemicals can cause these stains. Few diseases also result in staining of the teeth. Trauma to the teeth can also cause stains. Developmental disorders can also result in discoloured teeth.
SYMPTOMS- Discoloured teeth or stains on the surface of the teeth can be seen. Stains can be of different colours.
CHECK-UP- No special tests are needed. It is diagnosed by clinical examination and relevant medical history.
TREATMENT- Some stains can be removed by professional cleaning. Teeth whitening treatments can be used. Veneers and other materials can be used by the dentist to cover the stained tooth permanently.
3. Tooth Sensitivity- It is one of the most common dental diseases. It is experienced as a sharp pain while consuming hot or cold food. It can affect a single tooth or several teeth and can be a fleeting or long-lasting pain.
CAUSES- The causes of tooth sensitivity include:
- Vigorous tooth brushing can cause enamel erosion leading to tooth sensitivity
- Tooth decay
- Gum diseases
- Fractured tooth
- Receding gumline
- Habit of grinding teeth
- Bleaching of teeth
SYMPTOMS- It involves pain or discomfort while consuming certain food or as sensitivity to hot and cold temperatures. The pain is sharp and sudden in nature. It is described as a shooting pain.
CHECK-UP- Diagnosis is based on the symptoms and clinical findings.
TREATMENT- The treatment for tooth sensitivity includes:
- Use of desensitizing toothpaste
- Fluoride application
- Treatment of gum diseases
- Use of soft toothbrush
- Avoiding acidic food
- Mouth guard in patients with teeth grinding habit
- Tooth fillings and treatment of fractured and decayed teeth
4.Gingivitis – An inflammation or swelling of the gums which is a common dental disease. The most common cause of gingivitis is poor oral hygiene. The gums are red and swollen and bleeding is also present.
CAUSES- The major causes of gingivitis include:
- Accumulation of dental plaque
- Hormonal changes
- Diseases like HIV, diabetes and cancer
- Some medications can cause inflammation of gums
- Risk of gingivitis increases with age
SYMPTOMS- The symptoms of gingivitis are:
- Reddish colour of the gums
- Bleeding from gums
- Pain or tenderness in the gums
- Soft and receeding gums
- Bad breath
CHECK-UP- The presence of the above symptoms confirm the diagnosis of gingivitis.
TREATMENT- Gingivitis can be completely reversed with proper treatment. It includes proper brushing and flossing. Cleaning of teeth by a professional should be done. Use of mouthwashes andante-gingivitis toothpaste should be recommended.
5. Periodontitis- It is a serious dental disease which leads to the destruction of the gums and the underlying bone.
CAUSES- The causes of periodontitis include:
- Plaque and gingivitis. It is the progressive stage of gingivitis.
- Poor oral hygiene
- Old age
- Hormonal changes and pregnancy
- Genetic factors
- Certain medicines
- Systemic diseases like leukemia, HIV and diabetes
SYMPTOMS- The symptoms of periodontitis include:
- Tender, swollen and puffy gums
- Loose teeth
- Pain in chewing
- Bad breath
- Bleeding gums
- Red or purplish discolouration of gums
- Bone loss and spacing between teeth
CHECK-UP- Clinical assessment is done on the basis of symptoms. Radiographs are taken to see the bone loss.
TREATMENT- The treatment includes:
- Maintaining good oral hygiene
- Scaling and cleaning
- Medication like mouthrinses, antiseptic gel and oral antibiotics are used.
- In advanced cases, bone graft and flap surgery is done.
6. Halitosis or bad breath- It is characterized by unpleasant odour in breath. It is persistent and can be embarrassing. It can be caused due to poor oral hygiene, dental diseases or other health conditions.
CAUSES- The causes for bad breath are:
- Poor oral care
- Dental diseases like gingivitis or periodontitis
- Dental diseases like decayed teeth and cavities
- Tonsillitis or tonsil stones
- Oral, nasal and throat infections
- Certain systemic diseases
- Dry mouth
SYMPTOMS- The main symptoms that indicate halitosis are:
The type of mouth odour may depend on its causative disease. Bad odour that can be detected by others and bad taste in the mouth are present. A thick white coating on the tongue and deposits around the teeth are present. It may sometimes be accompanied by thick saliva and burning sensation on the tongue.
CHECK-UP- The aim of the check-up should be to diagnose the underlying dental disease or the condition causing bad breath. This is done by complete clinical examination and a few tests as following:
- Halimeter- Detects level of sulphur
- BANA test- It measures the enzyme causing halitosis
- Beta-galactosidase test- It also detects the enzyme
- Gas chromatography- Measures sulphur compounds
TREATMENT- The treatment for halitosis include:
- Regular dental check-up and cleaning by professional
- Healthy poral practices like brushing twice, flossing and using mouth rinses can help
- Keeping the tongue clean
- Avoiding dry mouth
- Treatment of the dental diseases like cavities, gingivitis etc
- Treatment of the underlying systemic diseases.
- Stop smoking and other tobacco products
- Denture users should keep the dentures clean.
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7. DENTAL CARIES
It is the most common dental disease. It affects all age groups and all the teeth. It is commonly known as tooth decay or cavity and is caused by the bacteria Streptococcus mutans. The bacteria acts on the food debris present on the teeth and produces acid which destroys the enamel of the teeth. It also affects the inner layer called the dentin in advanced cases. The acid seeps through the broken enamel and reaches the softer dentin layer. As the enamel and dentin break down, a cavity is created. It is the most common, widespread persistent dental disease. It is not communicable and easily preventable.
CAUSES- The causes of dental caries include:
- Poor oral hygiene- Accumulation of plaque on the surfaces of the teeth leads to cavities. Plaque supports the growth of bacteria which in turn produces acids leading to tooth decay. Inadequate brushing causes plaque formation. If good oral practices like brushing and flossing are not followed, the chance of developing caries increases.
- Fluoride- It prevents and reverses caries. If enough fluoride is not present, it increases the incidence of caries. Fluoride is supplied in community water and in the form of toothpastes and mouth rinses.
- Form and location of the tooth- Teeth like premolars and molars which have lots of depressions usually accumulate food debris. Also these being located at the back of the mouth so cleaning them becomes difficult. Presence of deep pits and fissures on some teeth make them more liable to decay. Food trapped in between the teeth is not easily removed by brushing. Lack of flossing can lead to caries in these areas.
- Age- Children and teenagers show high incidence of caries. It may be due to poor oral care and negligence. Older people are also vulnerable as with age, the gums recede and expose the roots which can cause decay. Certain medical conditions or medications can also affect the oral health and increase the risk of dental diseases.
- Dry mouth- Decrease in level of saliva or thick saliva increase the risk of caries.
- Old fillings and appliances- Old and worn fillings may have cracks and rough edges which increases the retention of plaque. Old crowns and ill- fitting appliances also increase plaque retention.
- Acid reflux or heartburn- In this condition, the stomach acid comes in the mouth. It causes wearing away or enamel and may lead to caries.
- Eating habits- Consuming refined food with high sugar content increases the risk of caries. Also frequent snacking habit and eating sticky food can lead to caries.
- Lack of awareness about dental diseases and hygiene also promotes caries incidence.
SYMPTOMS- The symptoms for dental caries include:
- Toothache and pain in the surrounding areas
- Visible holes in the tooth
- Brown or black discolouratin of the tooth
- Pain or discomfort in chewing
- Damaged or broken teeth
- Bad odour and taste in the mouth
- Swelling and pus around the tooth
CHECK-UP- The check-up for caries includes:
The carious tooth is diagnosed by the dentist by clinical examination and radiographs.
TREATMENT- The treatment for caries are listed below:
- Maintaining good oral hygiene and brushing and flossing regularly
- Visiting dentist regularly
- Use of fluoridated toothpaste and mouth rinses
- Preventive fluoride applications and fillings to prevent further spread of the caries
- Proper treatment of the carious tooth and medications to cure the infection completely
8. Tooth Attrition, Abrasion and Erosion
All three of these processes result in tooth wear. Attrition is the tooth wear due to tooth -tooth contact. Abrasion results as the interaction between tooth and other materials such as food. Erosion occurs due to destruction of the hard tissue due to acidic substances. This results in progressive loss of the tooth surface and alterations in the tooth structure. These are common dental diseases which do not cause significant problems in the beginning but can cause problems later and lead to other dental diseases.
CAUSES- The causes for tooth attrition are:
- Age- related wear and tear
- Para-functional habits like teeth grinding
- Acid reflux disease
- Vigorous brushing
- Food with acidic content
SYMPTOMS- The symptoms of tooth attrition are:
- Loss of tooth enamel
- Sensitivity to hot and cold
- Change in appearance or shape of the tooth
- Tooth discolouration
- Mobility and drifting of teeth
CHECK-UP- The check-up for tooth attrition includes:
These dental diseases are diagnosed by clinically examining the teeth and the gingiva. The history provided by the patient is also taken into account.
TREATMENT- The treatment for tooth attrition are:
- Improving oral hygiene habits
- Avoiding acidic food
- Use of night gaurds
- Using the correct brushing technique
- Dental fillings and crowns for treatment of affected teeth
9. Oral ulcers
Mouth ulcers are painful sores that appear on the soft tissues of the oral cavity. They are yellow or red in appearance. They can make eating or drinking difficult. Mouth ulcers can be caused by a number of factors.
CAUSES- The causes for oral ulcers are:
- Accidental biting of the inside of cheek can cause an ulcer. It is known as traumatic ulcer. It can also be caused by dentures or ill-fitting dental appliances.
- Oral infections -fungal and bacterial infections can cause ulcers in mouth. Several viral diseases like chickenpox, hand foot and mouth disease and herpes also cause ulcers in the mouth.
- Vitamin B12 deficiency causes mouth ulcers
- Genetic factors
- Certain medicines like NSAIDS and beta-blockers also sometimes cause mouth ulcers
- Autoimmune diseases
- Stress and anxiety
- Hormonal changes
- Quitting smoking
- Toothpastes containing sodium lauryl sulfate.
SYMPTOMS- The common symptoms of oral ulcers are:
- Painful sores on the mucous lining of the mouth
- Swelling and tenderness around the ulcer
- Burning sensation in the mouth
- Difficulty in eating and drinking
- Sometimes fever and loss of appetite is seen
CHECK-UP- The check-up for oral ulcers are:
Most of the oral ulcers are harmless and disappear after sometime. The doctor diagnoses these ulcers by clinical examination. The other symptoms and medical history is checked to find the cause of the ulcers. Further investigations like a biopsy can be recommended by the doctor.
TREATMENT- The treatment for oral ulcers are listed below;
Most oral ulcers resolve on their own within ten days. They do not require any treatment but symptoms can be managed to decrease the discomfort. This includes:
- Avoiding spicy food which can cause irritation until the ulcers heal
- Consuming plenty of fluids
- Maintaining good oral hygiene
- Using mouth rinses
- Application of antiseptic gels on the ulcers
- Topical steroid gel or mouthwash can be used
- Painkillers can be prescribed
- Supplements like vitamin B12
- Certain medicines can also be given to manage the symptoms
10. Oral Cancer
Oral or mouth cancer appears as a sore or a growth in the mouth that is persistent. It can occur anywhere in the mouth. Common sites are the surface of the tongue, cheek, gums, palate and the floor of the mouth. It can also occur in the tonsils and the salivary glands. Cancer is a serious dental disease and can be fatal if not diagnosed and treated early.
CAUSES- The various causes for oral cancer are:
- Smoking and the use of other tobacco products like snuff dip and chewing tobacco.
- Family history of cancer
- Excessive exposure to the sun
- Alcohol consumption
- HPV or human papilloma virus
- Age and eating habits
SYMPTOMS- The symptoms include:
- Mouth ulcers or sores that do not heal
- Pain in swallowing
- Loosening of teeth with no apparent reason
- Pain or stiffness in the jaw
- Painful tongue
- Soreness in throat
- Swelling which lasts for more than three weeks
- Red white patches on the lining of tongue or mouth
- Pain in neck or ears
- Feeling of something stuck in the throat
- Hoarseness of voice
CHECK-UP- The check-up procedure includes:
Physical examination is done which is followed by laboratory tests like biopsy and other imaging tests like CAT scan and MRI. Usually an incisional biopsy is done and assessment is made.
TREATMENT- The treatment depends on type and size of the cancer and how far the cancer has spread. If the cancer has not spread to the surrounding tissues, surgery alone is enough. If the cancer is large and invades the surrounding structures, surgery along with chemotherapy and radiotherapy is required. The aim of the surgery is to remove the cancerous tissue and radiotherapy kills the cancerous cells. Chemotherapy is used in combination of radiotherapy when the cancer is widespread and anti-cancer medication is used to stop cancerous cells from growing further.