Periodontal Disease

What is Periodontal Disease

peridontal-diseasePerio– means around, and dontal– refers to teeth. Periodontal diseases are infections of the structures around the teeth. Swollen and bleeding gums (gingivitis) are early signs that your gums are infected with bacteria. If nothing is done, the infection can spread and destroy the structures that support your teeth in your jaws. Eventually, your teeth can become so loose that they have to be extracted. For many years scientists have been trying to figure out what causes periodontal disease. It is now well accepted that various types of bacteria in dental plaque are responsible. In recent years, gum disease has been linked to other health problems like:

  • Atherosclerosis and heart disease: Gum disease may increase the risk of clogged arteries and heart disease. The extent of this connection is unclear. Gum disease is also believed to worsen any existing heart disease.
  • Stroke: Gum disease may increase the risk of the type of stroke that is caused by blocked arteries.
  • Premature births: A woman who has gum disease during pregnancy may be more likely to deliver her baby too early. The infant may be more likely to be of low birth-weight. One study showed that up to 18% of premature, low birth-weight babies might be linked to the mother’s gum disease.
  • Diabetes: Diabetic patients with periodontal disease may have more trouble controlling their blood sugar than diabetic patients with healthy gums.
  • Respiratory disease: Gum disease may cause lung infections and worsen existing ones.

What Causes Periodontal Disease?

Periodontal disease is caused by bacteria in dental plaque. Plaque is the sticky substance that forms on your teeth soon after you have brushed. In an effort to get rid of the bacteria, the cells of your immune system release substances that inflame and damage the gums, periodontal ligament and the alveolar bone. This leads to swollen and bleeding gums, called “gingivitis” (the earliest stage of periodontal disease). The damage from periodontal disease causes teeth to become loose. This is a sign of severe periodontatis (the advanced stage of disease).

How could I prevent periodontal disease?

You can prevent periodontal disease by having good oral hygiene and visiting your dentist regularly. Most people should see the dentist about once every six months. But if you already have gum disease you should visit more often.

Daily brushing and flossing, when done correctly, helps to remove most of the plaque from your teeth. Professional cleaning by your dentist or dental hygienist will keep plaque under control in places that are harder for a toothbrush or floss to reach.

Tooth Discoloration

What is tooth discoloration?

tooth-discolorationYour teeth can become discolored by stains on the surface or by changes in the tooth material. Dentists divide discoloration into three main categories:

  • Extrinsic discoloration: This occurs when the outer layer of the tooth (the enamel) is stained by smoking, coffee, wine, cola or other drinks and foods.
  • Intrinsic discoloration: This is when the inner structure of the tooth darkens or gets a yellow tint. Causes include excessive exposure to fluoride during early childhood, the maternal use of tetracycline antibiotics during the second half of pregnancy and the use of tetracycline antibiotics in children 8 years old or younger.
  • Age-related discoloration: This is a combination of extrinsic and intrinsic factors. In addition to stains caused by foods or smoking, the dentin naturally yellows over time. The enamel that covers the teeth gets thinner with age. Sometimes when the nerve of the tooth has been damaged the tooth can change its colour.
  • In rare cases, children with a condition called dentinogenesis imperfecta are born with gray, amber or purple discolorations.

How to prevent tooth discoloration?

  • Brushing your teeth after every meal will help to prevent some stains. Dentists recommend that you rinse your mouth with water after having wine, coffee or other drinks or foods that can stain your teeth.
  • Regular cleanings by a dental hygienist also will help to prevent surface stains.
  • Intrinsic stains, that are caused by damage to a nerve or blood vessel in the inner part of a tooth, can be prevented by having root canal treatment. However, teeth that undergo root canal treatment may darken anyway.
  • To prevent intrinsic stains in children, avoid water that contains a high fluoride concentration. You can check the concentration of fluoride in your drinking water supply by calling the public health department.

How can I improve the appearance of discolored teeth?

  • Discoloration can often be removed by applying a bleaching agent to the enamel of the teeth. With a technique called “power bleaching,” the dentist applies a light-activated bleaching gel that causes the teeth to get significantly whiter in about 30 to 45 minutes. Several follow-up treatments may be needed.
  • It’s also possible to remove discoloration with an at-home bleaching gel and a mouth guard given to you by your dentist. The bleaching gels designed for use at home are not as strong as those applied by your dentist, so the process takes longer, usually two to four weeks. Whitening toothpaste may remove minor stains, but they are not very effective in most cases.
  • If you have had a root canal and the tooth has darkened, your dentist may apply a bleaching material to the inside of the tooth.
  • When a tooth has been chipped or badly damaged or when stains do not respond to bleaching, your dentist may recommend covering the discolored areas. This can be done with a composite, that is color-matched to the surrounding tooth. Another option is to get veneers, which are thin shells of ceramic that cover the outer surfaces of the teeth.

Bad Breath

What is Bad Breath (Halitosis)

Halitosis simply means bad breath. It is estimated that 40% of the population suffers from chronic halitosis at some time. Many things can cause bad breath, including:

  • Poor oral hygiene (not brushing and flossing properly)
  • Gum disease
  • Eating certain foods like onions or garlic
  • Tobacco and alcohol products
  • Dry mouth (caused by certain medications, medical disorders and by decreased saliva flow during sleep – hence the term “morning breath”)
  • Systemic diseases such as cancer, diabetes, liver and kidney disorders

How can I help prevent Halitosis?

In addition to avoiding foods that cause bad breath, you can prevent the chances of bad breath by:

  • Brushing thoroughly twice a day and flossing daily to remove plaque and food particles
  • Removing dentures each night and cleaning them well before replacing them each morning
  • Visiting your dentist regularly for dental check-ups and cleanings
  • If you have persistent bad breath that is not improved with brushing and flossing, see your dentist for a thorough dental examination as this could indicate a more serious problem. Only a dentist can tell if you have gum disease, dry mouth or excess plaque build-up as a possible cause of bad breath.


What is Bruxism?

If you find yourself waking up with sore jaw muscles or a headache you may be suffering from bruxism, the grinding and clenching of teeth. Bruxism can cause teeth to become painful or loose, and sometimes parts of the teeth are literally ground away. Eventually, bruxism can destroy the surrounding bone and gum tissue. It can also lead to problems involving the jaw joint, such as temporomandibular joint syndrome.

How do I know if I have Bruxism?

For many people, bruxism is an unconscious habit. They may not even realize they are doing it until someone comments that they make a horrible grinding sound while sleeping. For others, a routine dental check-up is when they discover their teeth are worn or their tooth enamel is fractured. Other potential signs of bruxism include aching in the face, head and neck. Your dentist can make an accurate diagnosis and determine if the source of facial pain is a result of bruxism.

How is Bruxism treated?

The appropriate treatment for you will depend on what is causing the problem. By asking careful questions and thoroughly examining your teeth, your dentist can help you determine the potential source of your bruxism. Based on the amount of tooth damage and its likely cause, your dentist may suggest:

  • Wearing an appliance while sleeping: custom-made by your dentist to fit your teeth, the appliance slips over the upper teeth and protects them from grinding against the lower teeth. While an appliance is a good way to manage bruxism, it is not a cure.
  • Finding ways to relax: everyday stress seems to be a major cause of bruxism, anything that reduces stress can help…listening to music, reading a book, taking a walk or having a bath. It may help to seek counseling to learn effective ways of handling stressful situations. Also, applying a warm, wet washcloth to the side of your face can help relax muscles sore from clenching.
  • Reducing the “high spots” of one or more teeth to even your bite — An abnormal bite, one in which teeth do not fit well together, may also be corrected with new fillings, crowns or orthodontics.

Accident & Trauma

What should I do if an 'adult' tooth is knocked out?

If a tooth is knocked out do not panic but act quickly. Follow these simple steps and you may save your smile.

  • Find the tooth: Hold the tooth by the crown (the part usually visible in the mouth) not by the root (the pointed end).
  • Do not scrub the tooth or place it in disinfectant.
  • If the tooth is clean: Hold it by the crown and gently push it back into its socket, making sure that it is the right way round. This is usually painless if done immediately after the accident.
  • If the tooth is dirty: Rinse it in milk or cold water before gently pushing it back into place.
  • Hold the tooth in place: Ask the person to bite on a clean handkerchief.
  • Go to your dentist immediately: If this is not possible go to your hospital casualty department and ask to be seen by the dentist on duty.

What do I do if I cannot put the tooth back in.

  • Place it in a cup of milk.
  • Do not scrub the tooth.
  • Do not let the tooth become dry.
  • Do not place the tooth in disinfectant.
  • Go to your dentist immediately: If this is not possible go to your hospital casualty department and ask to be seen by the dentist on duty.

Tooth Decay

What is tooth decay?

Dental caries or tooth decay is the formation of cavities by the demineralization of the tooth by the action of bacteria. The causes of caries are:

  • Plaque bacteria
  • Dietary sugars
  • Exposure to acid attack
  • Susceptible tooth surfaces

Tooth decay occurs when bacteria in plaque reacts with dietary sugars to produce acid. The production of acid by the bacteria alters the natural environment of the mouth; this environment becomes more acidic and the enamel becomes more at risk of decay. Under normal circumstances, minerals in your saliva, as well as the fluoride that is contained in toothpaste during regular brushing, helps to decrease the risk of decay. However, for various reasons, some individuals may need additional protection. For example, people with exposed dental root surfaces are more sensitive to acid attacks.

How do I to protect my teeth against decay?

Whenever there is an increased risk of tooth decay, there is an increased need for protection against it. This includes treatments at the dental practice as well as through your oral hygiene regime at home. Visit your dentist regularly and follow their advice on how to look after your teeth and gums. Caries prevention at home

  • Brush your teeth twice daily.
  • Clean the interdental spaces with dental floss and/or an interdental brush.

Individuals with an increased need for protection against tooth decay are people with:

  • Decay in the roots of the teeth, on tooth surfaces, or in interdental spaces
  • Previous periodontal disease/receding gum lines
  • Extensive bridgework and crowns
  • Chronic dry mouth
  • Orthodontic appliances

Tooth Sensitivity

What is tooth sensitivity?

Tooth sensitivity is something that affects many people. It is often caused by eating or drinking something hot, cold, sweet or acidic. Under normal conditions, the underlying dentin of the tooth (the layer that immediately surrounds the nerve) is covered by the enamel in the tooth crown and the gums that surround the tooth. Over time, the enamel covering can get thinner, thus providing less protection. The gums can also recede over time, exposing the underlying root surface dentin. The dentin contains a large number of pores or tubes that run from the outside of the tooth to the nerve in the centre. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods.

What causes tooth sensitivity?

Exposure of the dentin can occur due to a number of factors. Some of them are:

  • Consumption of acidic drinks that cause enamel erosion and dentin exposure
  • Gum recession due to age or improper tooth brushing
  • Tooth grinding: this may actually cause most or all of the teeth to feel sensitive
  • Brushing with very abrasive toothpaste, brushing incorrectly and/or brushing more than three times a day could result in the loss of enamel
  • Gum disease, which can result in gum recession
  • A chipped or fractured tooth may expose the dentin

In addition, some dental treatments can cause sensitivity. Treatments such as teeth whitening, professional dental cleaning, having braces put on or getting a filling placed have been known to cause sensitivity during or after the procedure.

How can I avoid tooth sensitivity?

The first step in doing something about dental sensitivity is to find out what the cause is. A dental professional can help you with this. If the sensitivity is due to exposed dentin, there are a number of steps you can take, as can your dental professional, to help reduce the sensitivity. These can include:

  • Using a very soft bristle toothbrush
  • Brushing correctly to help prevent abrasion of the enamel and recession of the gums
  • Using a toothpaste specially formulated to help reduce sensitivity

The dental professional can:

  • Apply a fluoride varnish on the sensitive areas to help strengthen the tooth
  • Prescribe a high fluoride toothpaste to use every day
  • Place a dental restoration to build up the areas that have lost enamel

In the end, whether you need an in-office procedure or over-the-counter products, the most important step is to see a dental professional so that he or she can determine the cause of the tooth sensitivity and help you find a solution that will work.