By definition, tooth decay (cavities) occurs when bacteria in the mouth produce
acids that erode teeth. Plaque, which is a sticky substance that contains
bacteria, is constantly forming on your teeth and gums. As the bacteria feed
from the sugars or carbohydrates in your mouth, they make potent acids.
Over time, these acids destroy the enamel on teeth and cause cavities. If not
treated, cavities lead to discomfort, pain, infection, and tooth loss. Most
people can avoid decay by brushing and flossing their teeth regularly, avoiding
foods high in starch and sugar content, and seeing their dentist for regular
checkups and cleanings.
Have you ever taken a sip of coffee or bit into an ice cream bar and winced from
pain? There can be many causes of sensitive teeth, including decay, a cracked
tooth, or tooth roots that are exposed due to gum recession. Our teeth have a
strong layer of enamel, and underneath the enamel is a part of the tooth that is
less dense called dentin. When the dentin loses its protective coating, heat,
cold or air can over-stimulate the nerve cells and cause discomfort. Depending
on the cause, treatment is often successful with several applications of
desensitizing toothpaste or applying a fluoride gel to the affected area.
When these treatments are unsuccessful, the dentist may recommend a more
permanent measure such as a sealant or filling to cover the sensitive area.
Also called "periodontal disease," it is defined as inflammation and receding of
the gums. If severe enough, gum disease can lead to loss of the soft and hard
tissues that holds teeth in place, and ultimately loss of teeth. Plaque, the
key player in tooth decay, is also the cause of gum disease with different types
of bacteria. When not removed properly, plaque can harden around the gumline,
causing the gums to pull away from teeth and forming pockets where more bacteria
can collect. If left untreated, gum disease can lead to the following symptoms:
swollen/bleeding gums, constant bad breath, pus between teeth and gums, and in
advanced cases, teeth that are loose or moving away from one another.
Painful and annoying, a mouth sore of any type can make eating and drinking for a
week or two quite a challenge. Canker sores should not be mistaken for other
mouth sores that are caused by viruses like the Cold sores. Here are the key
differences and their treatments:
Canker sores only appear inside the mouth (inside the cheek, under the tongue, or
in the back of the throat.) They usually have a red edge and a gray center.
They can be quite painful. Canker sores aren't contagious. They may happen if
you have a viral infection. They may also be triggered by stress, food allergies,
lack of vitamins and minerals, hormonal changes or menstrual periods. Sometimes
trauma such as scratches, bites, or cuts in the mouth can also cause canker sores
or further irritate an existing one. In some cases, the cause is unknown. The
only treatment is to relieve its symptoms – they simply have to run their course
of 7 to 10 days. Over-the-counter pain medication (Advil or Tylenol) or topical
numbing agents or antimicrobial mouth rinses (ask your pharmacist) offer
temporary but good relief. Also, avoiding spicy, hot, acidic, hard, or crunchy
foods will keep the canker sore from getting further irritated and thus
delaying the healing process.
Cold sores, or fever blisters, are fluid-filled red blisters on the lips and skin
around them. They are caused by various herpes viruses, are highly contagious,
and are sometimes accompanied by a cold or flu with fever. Some people find a
cold sore painful and others find the sores tingle, itch, or burn. Once a
patient is infected with this virus, it “sleeps” in the nerve cells and
“wakes up” when the body is stressed. Wind, sunlight, and fatigue can cause a
flare up of the herpes virus. Unfortunately, there is no cure for cold sore.
A sore will usually heal on its own without any scar within 12 days by blistering,
breaking open, oozing fluid, and a scab formation. The oozing fluid stage is the
most contagious as the liquid contains millions of infectious virus particles
that can spread to other body parts or other people via skin contact or by
sharing utensils, towels, or drinks. Thus, during the outbreak, prevent your
child from scratching or picking at the sores. Antiviral medication in pills or
ointment can speed healing and can be most effective in early stage of outbreak
(before blistering). Over-the-counter topical anesthetics or antiviral agents
provide good temporary relief of discomfort. Contact your pediatrician or
pediatric dentist to arrange a visit. Avoid your child from eating foods that
can further irritate the sore such as acidic, spicy, hard, or crunchy foods.
Using sun block before being in the sun and lip balm for dry lips can help
prevent such outbreaks.
Post Extraction Care Make certain that your child continues to bite on the gauze pad for 20-30 minutes after leaving our office. The biting pressure on gauze pad stops the bleeding and allows better clotting. A slight oozing of blood for a day is normal. Call our office if there is any excessive bleeding. Avoid using straws and rinsing for one day. Doing so can disturb the clot and delay healing.
Maintain a soft diet for the rest of the day (soups, pasta, eggs, oatmeal, yogurt, gelatin, puddings, apple sauce, soft cheeses, mashed potatoes are good examples). Avoid hot foods and anything with seeds.
Be careful that your child does not accidentally bite or scratch the numb cheek. The numbness generally lasts one to two hours.
Give acetaminophen (Tylenol) for any discomfort or pain.
Gentle brushing and gentle rinsing with warm salt water (1tsp dissolved in an 8oz glass of water) can begin the morning following extraction. A clean mouth will heal more quickly. Continue the rinsing for several days and longer if there is a problem keeping the area clean.
Please call our office if you have any questions or concerns.
Other concerns that parents may want to keep a look out for are:
a. Amelogenesis or Dentinogenesis Imperfecta where there are defects in tooth formation; this is usually hereditary. The affected teeth usually appear discolored and weak.
b. Congenitally missing teeth. In some children, some of the permanent teeth may fail to develop. When this happens, the primary tooth preceding the missing permanent tooth fails to fall out.
c. Teeth misalignment: To some extent, this can be prevented by:
- Early interceptive orthodontic treatment with functional appliance;
- Regular visits to the dentist to extract over retained primary teeth to avoid cross bite in adult teeth;
- Prevention of early loss of primary teeth;
- Correcting bad habits, for instance stopping the use of pacifier after age 3