Dental Conditions

Periodontal Disease
Bruxism
Tooth Sensitivity: Erosion
Cracked Teeth

Periodontal Disease

Gum Disease is a leading cause of tooth loss and abscesses in adults. With Periodontal Disease we speak of risk groups. The two largest risk groups are smokers and diabetics. If a diabetic smokes it makes it very difficult to retain their teeth for life.

The good news is though, as quite a number of our patients have found that if they give away the “smokes”, the “ciggies”, the “bungers”, whatever you like to call them, their periodontal disease will get a lot easier to treat. Diabetics can be very successfully treated.

One lady, now in her 70’s, was very motivated, attended regularly and worked very hard to keep her teeth clean and hasn’t lost a tooth in 20 years.

Another smoker, whose gums looked terrible in the 1980’s gave it away and now, 15 years later, his teeth and gums are in excellent shape.

Chances are, you’ve been hearing a lot about periodontal disease. Most people don’t realise how common periodontal disease – also known as gum disease – is.  In fact, three out of every four adults have some form of this disease.

Occasionally a patient will come in for a checkup and discover that the teeth they thought were ok had been destroyed – painlessly – by periodontal disease.

In most cases, the early stages of periodontal disease do not cause any pain and goes unnoticed. However early detection and treatment are extremely important.  Gum disease is a leading cause of tooth loss in adults and painful abscess.

Periodontal disease occurs when plaque builds up and irritates the gum and bone, leading to inflammation and infection. The earliest stage of gum disease is called gingivitis. The gum has a puffy red appearance, bleeds easily and is often accompanied by bad odour.

If left untreated, the condition can progress to the bone, called periodontitis. In later stages of the disease, the bone and soft tissues that support the teeth are destroyed. This may cause the teeth to become loose, cause pain when chewing food, infected and eventually must be removed.

At this point it is as if the soil that supported a fence has been washed away leaving the fence not held in by anything, rocky, ready to fall over.

For these reasons, it’s important to schedule regular dental visits and to brush and floss between your teeth daily to prevent gum disease. Please call our office at 3269 2443 to schedule an appointment at your earliest convenience. We’d like to help you keep your teeth and gums healthy for a lifetime.

Our computerised charting system is excellent for recording the state of your gums at the commencement of treatment and then for following up with comparative readings as you progress.

SMOKER: One lady, in her early 50’s, a smoked, came into the practice with her tooth in her hand, it had just fallen out.

Another lady who was a smoker got a new gum abscess annually. Once she stopped smoking the abscesses stopped too.

Bruxism (technical term for clenching or grinding)

• Sometimes a patient can come in haggard and worn, suffering pain and sleeping badly
• Commonly mistaken for ear ache or occasionally toothache
• Often accompanied by a clicking jaw
• One lady we saw was so embarrassed by her loudly clicking jaw that she was afraid to eat out at a restaurant

Grinding can cause teeth to become painful or loose.  Patients can literally grind away parts of their teeth, leaving them with worn surfaces or fractured enamel.  The body is only built to cope with so much. If more pressure is put on than it can cope with something has to give. Either the teeth through wear, fracture or loosening, the muscles through pain or the joint, through pain or degeneration. Rough edges on a front tooth can be a telltale sign.

Teeth grinding may be caused by stress or sleep disorders, an abnormal bite, or crooked or missing teeth. If you wake up in the morning with stiff and painful jaw muscles, you may well have been clenching during the night. This habit can not only cause aching muscles but also can wear down your teeth and damage dental work.  It is often associated with stressful times in a person’s life: job changes, relationship problems, money worries, bereavements, moving house etc.

If you think you might be grinding your teeth, schedule an appointment to talk with us about your symptoms and concerns. We’ll help you develop a treatment plan that is right for you. Tooth grinding doesn’t have to be a pain any more, often isn’t expensive to treat but can be expensive if left.

One middle aged man had strong well developed facial muscles and, guess what, cracked most of his back teeth over a five year time frame.

Tooth Sensitivity: Erosion

Tooth sensitivity can have a number of causes. The common causes being tooth decay, gum disease, cracked teeth, bite problems, food packing and erosion.  It is very important for the dentist to differentiate which is the underlying cause to your sensitivity.

This sheet is written to provided information on erosion.  Erosion is defined dentally as loss of tooth structure due to chemical causes. The typical chemical culprit is acid, either dietary (see our acid doc) or gastric (from your stomach via reflux). The effect of acid on the tooth is as follows:

Think of what happens when you put a tooth in a gloss of coke.

Enamel:  is a hard non-sensitive glass-like material, acid will etch it giving it a dull appearance. It will only be very slowly dissolved by acid. If it is worn off by tooth grinding (bruxism) or over zealous tooth brushing (abrasion) dentine will become exposed.

A high acid diet combined with a high sugar intake can be very destructive. A person can dissolve and decay their whole dentition in as little as 5-10 years.

Dentine:  is a supporting tissue – it supports enamel. It is more softer and more soluble in acid than enamel.  Dentine softened by acid will be much more easily brushed off by a tooth brush or ground off during tooth grinding – causing erosion cavities. Dentine is also a live tissue, it has fine cell bodies running through it and acid will irritate these cell bodies causing sensitivity.

Erosion is worse in a dehydrated mouth. You will be dehydrated when you first wake up or after work, sport or exercise. Saliva dilutes and neutralizes acid in the mouth, with decreased salivary flow the teeth will be susceptible to erosion. Medications, smoking, alcohol and caffeine can decrease salivary flow.

In any of these instances avoid acid foods and re-hydrate with water. If you have a problem with sensitivity eat acid foods only at meal time when saliva flow is greater (another neutraliser). Drink plenty of water when eating acid foods. Eat less of the very high and high acid foods and more of the low and moderates.

A common presentation is the teenager who has drunk a lot of cola drinks – the biting tips, or cusps, of their back teeth are gone, dissolved away, leaving small cup shaped indentations in their place. These areas can be very sensitive to touch.

Another patient, a cyclist, liked stone fruit and before he went cycling ate 2 or 3 peaches. He just couldn’t figure out where the pain was coming from.

One very fit woman who played a lot of golf used to get out of bed in the morning, chop up a pineapple and eat it. As her mouth was very dry she got considerable pain from the acid.

Another young man had been drinking red wine.  He confessed he was a bit hung over but he had tooth pain.  The acid in the wine was stirring up the nerves in his teeth, made worse by a dry mouth, putting his teeth “on edge”.

Dietary acid: Alcoholic drinks, soft drinks, sports drinks, energy drinks and fruit juices.

Stomach acid (gastric) in patients with bulimia, morning sickness and gastric reflux can lead to dental erosion.

Treatment

Can be as simple as just a minor alteration to the diet by drinking more water in combination with less of the causative agent.

One of the most exciting advances is a product called tooth mousse which is similar to dairy foods and acts by neutralising the acid, but also by encouraging decayed enamel to reform into fresh new enamel! Oh, and I shouldn’t forget to say, it comes in 5 flavours that all taste great.

If erosion is allowed to progress destruction of tooth structure can be severe. It is not uncommon to see an elderly patient with teeth worn to the gum line. This can be expensive and time consuming to treat and reminds us that an ounce of prevention is better than a pound of cure.

Cracked Teeth

Do you feel a sharp pain when you bite down or release biting pressure?  Do you avoid certain foods or chew on only one side of your mouth? If you answered “yes” to any of these questions, you may have a cracked tooth.

A crack is a defect in the tooth structure.  Sometimes cracks are invisible to the naked eye and do not even show up on x-rays, although our intra oral camera which magnifies an image forty times is a useful tool in the detection of cracks. Cracks can result from a blow to the mouth;  tooth grinding; temperature extremes; loss of tooth structure from a large cavity, filling or other restoration; and chewing on hard objects or foods.

One patient came off a motor bike and fractured all the teeth on his upper left side. Only one was saveable, the rest had to come out.

Even though your pain may only be occasional, it’s important to tell us that you’re having these symptoms.  Over time, cracks can worsen and affect the pulp deep inside the tooth. If the pulp becomes inflamed or infected, the tooth may need root canal treatment. If a crack becomes too severe, the tooth may need to be extracted.

One of our patients had had pain with a tooth for years until the crack was diagnosed. That particular tooth was treated with a crown and has been perfect ever since.

Another patient hadn’t been to the dentist for years. He had had intermittent pain before we went to Fraser Island fishing where he bit on a piece of fish bone cracking the tooth in two. When he saw us he was in extreme pain and had to have the tooth extracted.

One lady got to know her symptoms so well she would come in and say “you better have a look at this one” as she pointed to one of her teeth “I think I’ve cracked it”.

One old family friend had excruciating pain and a lot of testing before we finally located the problem upper molar tooth, which once treated has been fine ever since. On other occasions the patient isn’t so lucky and the tooth needs to come out.

Cracks are like a crack in a china plate – once it cracks it is only time before it works through to the other side and breaks.

Patients often tell us they notice sharp pain when they eat on multigrain bread