Our Dental Consultant at Wentworth Clinic is frequently asked about common oral and mouth disorders and diseases. To help our patients and visitors to the website better understand these ailments we have created this informative resource to explain the reasons why these diseases occur, and what can be done to treat the problem.
Periodontal (Gum) Disease
Many adults in the UK have some form or gum disease which can result in major damage to the soft tissue and bone that supports the teeth. In advanced cases, teeth may be lost. The severity of the disease, and how your particular case responds to treatment will depend upon how well you care for your teeth and gums on a daily basis.
What is gum disease?
Gum disease is caused by build-up of plaque on the teeth. Plaque is a sticky colourless substance that contains bacteria which forms when we eat and drink. Some bacteria in the plaque are harmless but others are extremely harmful for the health of the gums. If the plaque is not removed from the teeth with regular brushing, the plaque will build up, irritating the gums, and lead to redness, swelling and bleeding.
Types of gum disease
Gingivitis is the mildest form of periodontal disease, often caused by in adequate oral hygiene. The gums become red, swollen and bleed easily but at this stage there is usually little, or no discomfort. Gingivitis is reversible with professional treatment and good oral care, however, if untreated, it can lead to Periodontitis.
A more advanced gum disease, Periodontitis is a serious inflammatory disorder that if left untreated, can result in tooth loss. ‘Periodontal’ literally means ‘around the tooth’ – in periodontitis, the gums pull away from the teeth, forming spaces called pockets, it is these pockets that become infected.
The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to breakdown the bone and connective tissue that holds the teeth in place. If not treated, the bones, gum and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
Risks associated with gum disease
Though the main cause of periodontal disease is plaque, often other factors affect the health of the teeth. These include:
- Age – studies have shown that older people have the highest rates of periodontal disease.
- Smoking – smoking is one of the most significant factors associated with the development of gum disease, and can lower the chance for successful treatment.
- Hormones – changes in woman – these changes can make the gums more sensitive, and gingivitis can develop more easily.
- Diabetes – people with diabetes are at higher risk for developing infection, including gum disease.
- Other diseases/illnesses and their treatment – diseases such as AIDS, and its treatment can also negatively affect the health of gums, as can treatment for cancer.
- Medications – some medications can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infection such as gum disease. Also some medications can cause abnormal over growth of the gum tissue, this can make it difficult to keep teeth and gum clean.
- Genetic susceptibility.
Signs that you have gum disease
- constant bad breath.
- red or swollen gums.
- bleeding or tender gum.
- it is painful to chew.
- loose teeth.
- sensitive teeth.
- receding gums – teeth seem longer.
Treatment for gum disease
- the main goal is to control the infection.
- treatment will be dependent on the extent of the gum disease.
- the patient will be required to maintain regular daily care at home.
- behavioural changes may be required, i.e. stop smoking to improve treatment outcome!
Deep cleaning, also known as scaling and root planning.
- Scaling and root planning is considered the gold standard treatment for gum disease.
- A non surgical procedure that deep cleans the root surfaces to remove plaque and calculus (tartar) from the deep periodontal pockets, and to smooth the tooth root to remove bacterial toxins.
- This procedure is often followed by adjacent therapy such as a local delivery anti-microbials (medication to the site of the infection) as needed on case by case basis.
After scaling and root planning many patients, do not require any further active treatment. However, the majority will require ongoing maintenance therapy to sustain health.
- Surgery may be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medication.
How to maintain healthy teeth and gums
- Brush your teeth twice a day with a fluoride toothpaste.
- Floss regularly to remove plaque between teeth, or use a device such as a special brush, wooden or plastic pick recommended by your dentist.
- Visit dentist routinely for check-up and professional cleaning.
- Do not smoke.
Can gum disease cause other health problems, beyond the mouth?
More researech is required to clarify whether gum disease actually caused other health problems, not related to the mouth, however:
- Some studies have shown that people with gum disease are more likely to develop heart disease, and have difficulty controlling blood sugar.
Burning Mouth Syndrome
What is burning mouth syndrome?
- Burning mouth syndrome (BMS) is a fairly common complaint, characterised as an abnormal sensation of the lining of the mouth. Some describe it as feeling like the mouth has been scalded.
- Usually this sensation develops at the front of the mouth, typically affecting the inner surfaces of the lips, palate, roof and sides of mouth, and the tip of the tongue.
- Some people may experience altered taste sensation (bitter or salty).
- Other people may feel the mouth is dry or sticky.
What is the cause of burning mouth syndrome?
- With primary BMS there is no identifiable cause. Though investigations have suggested it could be related to a defect in the nerves of the mouth.
- It is not related to any other disease, and is not contagious.
- Secondary BMS is caused by other medical conditions, for example: acid reflux, hormonal changes, dry mouth, and allergies – these vary from person to person.
What is the treatment for burning mouth syndrome?
- For primary BMS there is no cure since a cause has not been identified. The condition will eventually resolve itself.
- For secondary BMS, once the underlying cause has been treated this will also cure BMS.
Treatment that may help relieve the symptoms
- Drinking cold water or sucking ice cubes can help relieve pain.
- Drinking more fluids than usual may also help eas the feeling of dry mouth.
- Avoid things that could irritate the mouth, i.e. alcohol, tobacco products, spicy foods, carbonated drinks, and food and drinks high in acid, such as tomatoes and fruit juice.
- An anti inflammatory and pain relieving mouthwash such as ‘Benzydamine’ may help with pain relief.
What are mouth ulcers?
- Mouth ulcers are painful sores inside the mouth, often the result of trauma.
- Common mouth ulcers with no obvious aetiology (cause) are known as Aphthous ulcers.
They appear as minor (the most common), major (more severe and taking longer to heal) and herpetiform (up to 100 tiny ulcers can appear at the same time – though this should not be mistaken for herpes virus, which it is NOT).
- Ulcers as a result of viral infections will have periodontal symptoms prior to frank ulcers and again heal within 7-10 days.
- It is important to diagnose ulcers correctly and treatment is steroid ‘based’.
Causes of oral ulceration / mouth ulcers
Bacterial, viral and fungal.
Mechanical, chemical, thermal, fractitious injury, radiation, eosinophilic ulcer (traumatic granuloma).
Recurrent aphthous stomatitus, minor aphthous ulcers, herpetiform ulcers.
- Associated with systemic disease:
Haematological disease, gastrointestinal tract diseases, Behcet syndrome, HIV infection, other diseases.
- Associated with dermatological diseases
Lichen planus, chronic discoid lupus erythematosus, vesiculobullous diseases.
Squamous cell carcinoma, other malignant neoplasms.