We all know prevention is better than cure. But too often, we forget that this applies to our oral health as well. Gum disease and tooth decay are silent diseases in the early stages. Both are caused by plaque. Plaque is a biofilm lining the teeth and gum surfaces and consists of food debris and bacteria which constitute the microflora of the mouth. These bacteria release toxins and acid.
What causes gum disease?
The toxins irritate the gums to various degrees causing inflammation. This inflammation is known as gingivitis and does not cause pain or obviously visible changes to the gums. However, when more severe, gingivitis leads to gums that bleed easily. The gums can also become red and swollen and can start feeling tender. Over time, the chronic gingivitis can lead to the gums receding away from the teeth. This gum recession is irreversible. The roots of the teeth usually covered by the gum tissues, become exposed leading to loosening of teeth and sensitivity to cold. By the time a patient starts experiencing obvious symptoms from gum disease, the damage is already done. It is not possible to regrow lost gum tissue and if the teeth are already loose, they are more likely to fall out eventually.
How causes tooth decay?
Acid produced by plaque bacteria initially cause dissolution of the enamel surface. Over time, the enamel becomes more porous and fragile and allows bacteria to enter the tooth subsurface (the dentine). Once established in the dentine, the bacteria proliferate and start progressing deeper into the tooth. Up to that point, there is usually no pain. Eventually, the bacteria cause softening of the affected tooth substance which then crumbles, forming a cavity in the tooth. The cavity might then be noticed by the patient if it is on a visible surface. Often, however, the cavity could be developing on a non-visible surface, such as between the teeth. In such cases, only a dentist can detect these lesions by taking radiographs (x-rays). As decay progresses deeper into the tooth, symptoms can then start to develop. The patient could experience actual pain with cold foods and drinks, the tooth might start to ache or throb as well. This indicates that the bacteria are getting close to the very centre of the tooth – the pulp- where microscopic blood vessels and nerve fibres supply the tooth.
Pain indicates that this pulp is becoming inflamed from the bacterial invasion. If the decay is treated at that point, there is a chance the tooth might recover. However, if the bacteria have already invaded the pulp, the pulp can stay inflamed and eventually die. The bacteria spread further down into the tooth down the root/s and spread into the adjoining bone and gum causing an abscess, often with pain and swelling. At this stage, when the patient seeks treatment, the tooth either has to be extracted or undergo root canal treatment. Root canal treatment cleans the bacteria from the tooth by removing the infected pulp. However, if the tooth is too decayed, root canal treatment is not useful as there is not enough sound tooth substance left to treat.
How can you keep your teeth and gums healthy?
The best way to avoid tooth loss from advanced gum disease and decay is prevention. Catching the disease in its early stage allows us to prevent progression by providing simple treatments and measures, such as regular professional cleans to control plaque levels and oral hygiene instructions to improve home care. Regular dental examinations by your dentist and the use of radiographs are the only way to detect the presence of disease in the early stages when there are no symptoms.
It is recommended for patients to see their dentist every six months for regular examinations and cleans. The 6 monthly examinations allow earlier detection of decay as it takes at least six months for changes in the enamel to become visible on x-rays when decay is present. Other pathologies of the mouth such as oral cancer will also be screened for and again, early detection is key.
Having a professional clean every 6 months also ensures that plaque levels are kept low enough to reduce the risks of gum disease and decay. AT the Melbourne Smile Clinic, Dr Yew is your dentist in Northcote for all your preventive care. Did you know that if you are a regular patient at the Melbourne Smile Clinic and if you refer a friend or relative, you are eligible for a complimentary (or gap-free) clean at your next appointment?
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