Grinding or bruxism

Bruxism -- also known as tooth grinding -- can either directly or indirectly cause teeth to become painful or loose. Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel. There is no single theory for the reasons of grinding, but it is thought that both emotional and physical factors are involved. Some of the contributing factors may be stress or sleep disorders, an abnormal bite, or crooked or missing teeth.

Treatment of bruxism

There are a number of ways to treat bruxism. Your dentist will determine which single or combination of treatments is right for you. When stress is the major cause of bruxisrn, people need to find ways to relax. People who have difficulty handling stress may nee to seek counseling or the dentist may prescribe muscle relaxants to relax jaw muscles. To help alleviate muscle pain, physical therapy may be needed. The following tips can be helpful to prevent grinding:

Because it is thought that an abnormal bite may predispose a person to grinding, treatment may involve removing the interfering "high spots" of a tooth. Another treatment involves wearing a plastic mouth guard at night to prevent tooth grinding. A night guard is a removable plastic device that prevents teeth from coming together. In some cases, such as an overbite, it may eventual improve the bite. A method used to treat the damage caused by more serious cases of grinding involves reshaping or reconstruction of the biting surfaces with crowns or inlays.

Grinding is a common occurrence among many people at some time or another. If you develop facial pain, fatigue or other problems, treatment may be needed. Talk with your dentist if you suspect that you are grinding your teeth. Your dentist will help to relieve you from the daily grind of bruxism.

Gum (or periodontal) diseases

Gum disease, also called periodontal disease, is chronic inflammation or infection of the gum and bone that surround and support the teeth. About 75% of adult population above age 35 years have different levels of gum disease. It is the major cause of tooth loss among adults.

Your personal level of oral hygiene directly affects the health of your gums. Plaque is the primary reason for gum disease. Plaque if not removed gets mineralized and becomes tartar or calculus. Plaque and calculus harbor bacteria which cause or promote gum disease.

Gum diseases are caused by plaque and tartar.

Signs of gum diseases

The following two images show healthy gum versus inflamed gum.

Healthy gum Inflamed gum

When you check your mouth, see if you have any of these:

Any of the above might indicate gum disease.

Different stages in gum diseases

1. Healthy
Symptoms: Gums have pink healthy color; gum line holds teeth tightly; no bleeding
Treatment: Keep your gum healthy by continuously taking good care of oral hygiene. Proper brushing and flossing are very important daily care.

2. Gingivitis
Symptoms: Gums between teeth may look reddish or bluish in color; gums bleed easily during brushing, flossing, or upon dental probing; gums are inflamed and sensitive to touch; possible bad breath and bad taste; no affection of  bone and fibers supporting teeth
Treatment : The inflammation can be stopped by proper teeth brushing, flossing and other oral hygiene cares to remove plaque and food debris.

3. Early Periodontitis
Symptoms : Gums may begin to pull away from the teeth to cause minor loss of attachment or pocket development (3-4mm); inflammation of fiber tissue; slightly loss of bone; bleeding, puffiness and inflammation more pronounced; bad breath and bad taste; no teeth shift
Treatment : Professional teeth cleaning, scaling and root planning done by hygienist or dentist may stop the inflammation getting worse.

4. Moderate Periodontitis
Symptoms : Gum boils or abscesses may develop; teeth look longer as gums begin to recede; moderate loss of attachment and/or moderate to deep pocket formation (4-6mm); 30-50% loss of bone support; bad breath and bad taste; front teeth may begin to drift, showing spaces
Treatment : Proper treatment or surgery needed to save the teeth.

5. Advanced Periodontitis
Symptoms : Teeth may become mobile or loose; bad breath, bad taste are constant; roots may be exposed and are sensitive to hot and cold; severe pocket depth (excess of 6mm) or significant gum recession; severe loss of attachment, >50% loss of bone support
Treatment : If the involved teeth can not be saved, they need to be removed to stop further damage.

 

Gum disease is reversible Gum disease is caused by bacteria, so it can recur. Daily oral hygiene care and regular dental checkups are very important to reduce gum disease returning.

Prevention

Periodontal diseases are accumulated by time. Daily oral hygiene maintenance is the most important way for periodontal diseases prevention. If you do not brush and floss your teeth, but only let your hygienist do your oral hygiene care, you will still get periodontal diseases. Your hygienist only sees you every three or six months, but your mouth needs cleaning everyday.

In order to keep dental hygiene, you should do the following:

 

Signs of infection

Over 40% of all grown-ups have experienced bleeding in gums. Therefore most people think it is normal. As a matter of fact, it is not, and should be taken as a sign of an infection called gingivitis.

Your gums are constantly under attack from bacteria that accumulate around your gum line. A major source is plaque, which holds the colonies of bacteria. Plaque can cause bleeding and swelling. Occasional bleeding is also a sign of gingivitis.

The space between tooth and gum is called gingival pocket. When gums are healthy, gingival pockets are less than 3mm. But when gum has infection, gingival pockets will become deeper to form periodontal pockets. When periodontal pockets are formed, the infection becomes severe.

 

Tooth decay

Almost everyone has experienced tooth cavities, which is also called tooth decay. Only very small population is cavity-free during the lifetime. Tooth decay can cause pain, tooth structure damage, infection, even tooth loss. Sugar intake is an important factor to cause tooth decay. Good home care and healthy diet would help to prevent it.

Formation

High sugar intake and plaque are the main reasons for tooth decay. Bacteria from plaque can convert sugar (sucrose) to acid. Acid keeps eroding teeth to cause tooth decay.

Sugar + Bacteria (from Plaque) ---> Acid

Acid + Healthy Tooth ----------------> Tooth Decay

Prevention

To avoid tooth decay prevention is very important. When hard tissues of the teeth are damaged, they are damaged forever. To stop this from happening

Secondary cavities or Recurrent Decay

Many people think:" since I have fillings and caps, I do not need to take care of them too much, they are not my teeth, and would not be hurt or get damaged any more." this kind of thinking is very common, but it's totally wrong. Acid is still attacking your teeth structures around the fillings and underneath the caps, and will lead to secondary cavities. It may cause loss of fillings or caps, nerve infections, and abscess.

 

Tooth sensitivity

Tooth sensitivity is a common problem for most people. Our teeth can be greatly affected by hot, cold, sweet, and sour food or drink. Over-enthusiastic brushing, recession of gums, gum disease (periodontitis) all can expose the soft, porous structure of the tooth (dentin), making it susceptible to external stimuli.

Pain can be mild and tingly or sharp and intense. This symptom sometimes is a sign for more serious diseases. Whenever you are suffering from pain of sensitivity, you should go see your dentist before it starts to persist or worsens.

Helpful hints

A review of brushing techniques and diet can help reveal causes of sensitivity. Avoid over-brushing because it can cause damage to your teeth and/or gums. Sensitivity protection toothpaste works by blocking the opening of the exposed dentin or by preventing the transfer of the pain signal from the nerve to the brain.

You should start to feel relief by using sensitivity protection toothpaste after approximately two weeks. If you stop using the anti-sensitivity toothpaste prior to that, the sensitivity may continue.

Also, some prescribed desensitizing agents may help you. Consult your dentist about it.

Oral cancer

Oral cancer Includes cancers of lips, tongue, buccal mucosa, floor of mouth, and pharynx. Tobacco usage is primary risk factor. Oral cancer is two times more prevalent in males. There are twice as many deaths in males as females.

Older men, heavy users of alcohol and tobacco, and individuals exposed to sunlight are most likely to contract oral cancer. Among them, males 40 to 65 years of age have highest number of lip and tongue cancers

Risk factors

Smoking, alcohol consumption, painful and ill-fitting dentures, chronic inflammation, smokeless tobacco products. Chronic habits are attributed as the cause.

Some statistic reports

Below is the table showing the location and frequency of oral cancel.

            From US Dept. of Health, Education, and Welfare:
           Management guidelines for head and neck cancer,
               Public Health Services Publ. 80-2037, 1979

Predisposing factors in oral cancer development

The following deals with a more advanced topic. Scientifically proven to be the predisposing factors in developing oral cancer include: