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Illness & Disease

Gum Disease

Gum disease is an infection of the tissues surrounding the teeth. Infection leads to a red, swollen and tender area. This area often bleeds when the teeth are brushed or the tender area is touched.

Gum disease occurs when large amounts of bacteria stick together to form a sticky substance called dental plaque. Plaque is found where the gum and the teeth meet. It can cause extreme irritation which leads to a red, swollen and tender area.

As the area becomes more swollen the gums separate from the teeth leading to the development of a pocket where more dental plaque lives and eventually damages the gum and kills the bone around the tooth.

Approximately 80% of Irish people have got some degree of gum disease with the level worsening as we get older.

Halitosis

Halitosis, better known as bad breath, is a common reason why people attend their dentist. In about 90% of genuine halitosis cases, the origin of the odour is in the mouth itself. The most common location for mouth related halitosis is the tongue.

Not all who think they have halitosis have a genuine problem and there are a number of simple effective measures to combat bad breath:

Gently cleaning the tongue surface twice daily is the most effective way to keep bad breath in control. Eating a healthy breakfast with rough foods helps clean the very back of the tongue.
Chewing sugarless gum can help with the production of saliva, and thereby help to reduce bad breath. Maintaining proper oral hygiene, including daily tongue cleaning, brushing, flossing, and periodic visits to dentists and hygienists.

Mouth wash

Mouth wash will help to freshen breath and fight tooth decay but should never replace regular brushing and flossing.

Mouth, head and neck cancer

Mouth, head and neck cancer is the sixth most common cancer in men worldwide with over 400 cases diagnosed in Ireland each year. It is mainly diagnosed in men and primarily affects older people but more women and young people have been diagnosed in recent years. If caught early your chances of survival are greatly increased and regular visits to your dentist will assist this as a routine visit includes a check for any abnormalities.

Mouth, head and neck cancer can affect your lips, gums, cheeks, tongue, palate, tonsil, throat (oropharynx), salivary glands, sinuses, nose and voice box (larynx).

Some symptoms to be aware of are:

A sore or ulcer that doesn’t heal
White or red patches inside your mouth
Difficulty chewing or swallowing food
Numbness of the tongue or face
Loose teeth
These could be symptoms of other ailments but if they persist longer than three weeks always attend your doctor or dentist.

To reduce your risk between visits to your dentist:

Don’t smoke
Limit your intake of alcohol
Use a lip balm that contains sun block
Eat a healthy diet high in fruit and vegetables
Check your mouth regularly for changes, for example, when brushing your teeth
Visit your dentist regularly, even if you have no teeth and wear dentures

Diabetes and periodontal disease

Periodontal disease includes conditions known as gingivitis (inflammation of the gums) and periodontitis (destruction of the tissues which hold the teeth in place). People who have diabetes are more at risk as they tend to have high or fluctuating blood glucose levels. They may also have more difficulty fighting the germs which cause it.

Periodontal disease can cause an infection which destroys the bone supporting your teeth if it is not detected or treated. As the gum disease progresses, symptoms might include tooth loosening or moving, bad breath, or bleeding gums.

Common Conditions

You are not alone! As dentists, we are often asked about these conditions that affect your mouth. Don’t suffer in silence; speak to one of our dentists today to get your mouth back in full working order.

Bleeding gums

Do you have bleeding gums when you brush or floss? Bleeding gums is a sign of gum disease and inflammation. Gum disease can easily be prevented by ensuring optimum oral hygiene.

Gingivitis is the first stage of gum disease, which is caused by a build-up of plaque at the gum line. When plaque is allowed to gather beneath the gum, it releases inflammatory and destructive cells. This leads to swollen, bleeding gums and recession. In some people, it may progress to periodontitis.

Periodontitis is the loss of bone and tissues around the teeth. These tissues act as scaffolding which hold the teeth in place, and without which the teeth will start to become loose and ultimately be lost.

Factors that lead to and exacerbate bleeding gums and gum disease include:

• Poor oral hygiene
• Smoking
• Genetics
• Diet
• Pregnancy
• Medical conditions (diabetes, immune-compromised, medications)

The main factor is plaque build up, which starts the entire cycle and which can be prevented. Follow our guide on caring for your teeth to keep bleeding gums and gum disease at bay.

Mouth ulcers

1 in 5 people suffer from mouth ulcers, recurrent aphthous ulceration, intermittently throughout their life. The ulcers tend to appear towards the front of the mouth appearing on the inside of the lip, cheek or on the tongue. They can be very painful and when they occur on the tongue they can make eating and speaking difficult and uncomfortable. Sometimes ulcers can have no symptoms and go unnoticed.

Mouth ulcers can be brought on by a number of immune system factors including stress, illness, hormonal changes, and deficiencies in vitamin B12, iron and folic acid. Other factors that can cause ulcers are sharp edges on fillings or braces, ill-fitting dentures, injury from foods (hot or sharp), and chemical burns e.g. aspirin.

If you have an ulcer, it is important to keep your mouth as clean as possible. Avoid hot, spicy and sharp foods. Orabase gel can be applied to the ulcer to give relief and protection, this is an over the counter treatment that promotes healing.

Mouth ulcers should heal within 3 weeks. If not, you should seek professional advice from your dentist. Non-healing ulceration may be a sign of oral cancer or gastro-intestinal tract disease.

Cold sores

Cold sores are caused by a virus, herpes labialis, which remains in your system once infected and reactivates periodically.

There are a number of things that can trigger a cold sore, including:

• Stress or exhaustion
• Low immune system
• Menstruation
• Extreme weather
• An injury to the mouth, surgical operation or dental treatment

Cold sores go through a cycle from a prodromal tingling or itching stage through visible blistering, open lesion, crusting and healing. Typically, the cold sore will heal in 2 weeks. During this time, try to keep your mouth as clean as possible. Avoid kissing, contact sports and any dental or beauty treatments.

As it is caused by a virus, cold sores can be treated with anti-viral creams such as Zovirax. This treatment only works in the prodromal tingling phase of the sore, so once it is visible it cannot be treated.

Sensitive teeth

Does the idea of a cold drink or ice cream send shivers down your spine? Sensitivity can affect one or more teeth and may be an early sign of a dental problem that could be prevented.

Tooth sensitivity is caused by:

• Tooth wear
• Gum recession
• Poor oral hygiene
• Recent white filling or teeth whitening
• Clenching or grinding
• Broken tooth
• Defective filling
• Tooth infection
• Sinusitis

In many cases, teeth are sensitive as the outer protective enamel layer has worn away revealing the inner dentine layer. Dentine is soft and porous and transmits signals to the nerve inside the tooth. Dentine can be exposed in cases of tooth wear or gum recession. Sensitivity also increases with plaque build up on exposed areas, so excellent oral hygiene is important.

Minor sensitivity can be eased by using desensitising toothpaste such as Sensodyne or Colgate pro-relief. These pastes can also be used therapeutically by directly applying to the sensitive area and leaving in place for 10 minutes.

Ongoing sensitivity may be a sign of something more sinister that requires professional treatment. Teeth grinding or clenching should be managed with a protective night guard and jaw exercises to avoid damage to the teeth and joint. Tooth fracture or a defective filling will need to be restored. Tooth infection, with symptoms of ache after hot, will require root canal treatment. Sinusitis can disguise as tooth sensitivity in the upper molar teeth, and may require decongestants or antibiotics. If you have sensitivity that is ongoing or severe, please visit your dentist for an assessment.

Bad breath

Bad breath, halitosis, can be an embarrassing and sensitive topic, but as dentists we are experienced in helping our patients achieve fresh breath.

For most patients, the cause of bad breath is easy to remedy:

• Dehydration
• Poor oral hygiene
• Smoking
• Trapped food
• Smelly food

Bad breath is primarily caused by a build up of odour-causing bacteria. Usually, with optimum oral hygiene, our saliva is able to keep this bacterial level low. If you are dehydrated, such as in the morning, the balance is shifted and your breath is likely to be bad. Remedy this by staying hydrated throughout the day and starting each morning with a glass of the fresh stuff.

Poor oral hygiene leads to an increase in plaque and odour-causing bacteria around the mouth. Follow our guide on caring for your teeth and gums to ensure you keep your mouth plaque free. Remember to brush your tongue, a prime suspect for breath-related plaque!

Smoking contributes to bad breath in a number of ways – the tobacco scent itself, creating a dry mouth, increasing bacteria and coating the tongue. Reduce your level of smoking and increase your oral hygiene to freshen your breath and reduce other smoking-related health risks.

Food particles that get trapped around your mouth can also decay and start to smell. Be sure to clean between your teeth each night to reduce bad breath and lower your risk of tooth decay.

Clinical dry mouth, xerostomia, is a condition caused by lack of saliva production either due to a problem with the gland itself or as a side effect from certain medications, such as anti-depressants. See our section on medical conditions for more information.

Top tips for fresh breath:

1. Take up good oral hygiene habits
2. Stay hydrated with water
3. Reduce or quit smoking
4. Eat healthily, include foods high in roughage
5. Chew sugar free gum or try xylitol mints
6. Use alcohol-free mouthwash after lunch for a mid-day freshen up
7. If you wear dentures or a removable brace, clean it twice per day
8. Visit your dentist and hygienist regularly

Cracked lips

Chapped or cracked lips, cheilitis, is an inflammation of the skin around or at the corners of the lips.

Causes of cracked lips include:

• Licking, biting or rubbing habit
• Sun damage
• Nutritional deficiency (iron, vitamin B, folate)
• Ill fitting dentures
• Allergy to lipstick, lip balm or toothpaste

In most cases, chapped lips can be soothed with a protective barrier, such as Vaseline, so that they can heal. It is important to wear high SPF lip balm if outdoors for long periods of time.

If you notice that your lips are cracked for more than 2 weeks, visit your dentist for advice. You may require a cream containing an anti-fungal or anti-microbial. If sun related, you may require a biopsy to rule out other serious conditions such as skin cancer. If you are concerned about nutritional deficiency, visit your GP for assessment.

Jaw pain

As dentists, we have noticed an overwhelming increase in patients with jaw pain, tenderness, cracked teeth and migraine headaches. No doubt, with today’s economic and social pressures, stress levels are increasing and consequently more people are grinding and clenching (bruxism).

Teeth grinding and clenching at night-time can lead to jaw discomfort, tooth fracture, tooth wear, sensitivity, headaches and in severe cases can cause long-term damage to the jaw. In many cases you may not be aware that you are grinding, but a loved one might point it out, having heard noises in the night. Physical signs include soreness in the cheeks in the morning, shortening or fracture of the teeth, or indentations along your tongue and cheeks.

Speak to your dentist  if you feel you are grinding or clenching. Treatment includes a custom night guard, jaw exercises, and incorporating stress-relief into your lifestyle.

Caring for Teeth & Gums

Optimum oral health starts at home with caring for teeth and gums. Keeping your mouth healthy is important for your overall health and wellbeing. Follow this simple advice to ensure that your smile is pristine clean!

Brushing

Brushing is the first step in your daily oral hygiene routine. Brush twice a day for two minutes, in the morning and at night, using fluoride toothpaste.

Choose a toothbrush that suits you – medium bristles for normal gums or soft bristles if you have recession. Electric brushes are great for those with stains or who need an extra helping hand.

Brush all of the surfaces of your teeth and don’t forget your tongue. Angle your brush at 45º to the gum, gently massage the gum by vibrating your brush in a circular motion, and then roll down the tooth to the edge. Focus on 2-3 teeth at a time. Brush the outside, inside, and biting surfaces of your teeth. Once you finish, spit your toothpaste but don’t rinse. This allows the active ingredients in your paste time to work on the surfaces of your teeth.

Make sure to change your toothbrush every three months.

Cleaning Between Your Teeth

The next critical step is to clean the surfaces between your teeth or interdentally. Here, plaque and food get trapped and can cause decay. To clean interdentally, you can choose from floss or tape and interdental brushes.

To floss, start by wrapping the floss or tape around your thumbs and index fingers. Gently guide the floss between the teeth and wrap it around the side of one tooth in a ‘C’ shape. Repeat this on the opposing tooth, gently following the contour of the tooth. Release and repeat around the mouth, using a clean piece of the floss each time.

To brush, choose a size that goes between the teeth with only a small resistance. If you need to push, it is too big and can damage the gum. Insert the brush from the outside, and once between the teeth, gently brush it along the contour of each tooth, slightly below the gum line. Rinse your brush between uses, either under the tap or in mouth rinse.

Diet and Lifestyle

A healthy nutritious diet and balanced lifestyle are important for your entire body, and also for your mouth. Sugar affects our teeth by leading to tooth decay. Acid leads to tooth wear. A tooth-friendly diet is possible by limiting high-sugar and high-acid foods, especially between meals. Swap biscuits, sweets and fizzy drinks for cheese, raw vegetables and water. Staying hydrated with water reduces bad breath and also helps to wash away food debris.

Maintaining a healthy lifestyle with exercise and not smoking is very important for optimising healing and warding off disease.

Keeping in Check

Regular visits to your dentist and hygienist will help keep your mouth healthy as well as highlight any potential issues early on. Visit your dentist every six months, or as prescribed, to keep your jaw, teeth, gums and restorations in their optimum condition. Professional dental cleaning every six months will reduce your risk of gum disease from plaque and tartar that remain in hard to reach areas.

How much sugar are you having?

Find out the effects of sugar on teeth from your favourite soft drinks… Your morning coffee purchase could contain up to 20 teaspoons of sugar. Make informed choices!