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Wisdom Teeth
Wisdom teeth usually appear at the back of the mouth during late teens or early twenties. Often there is no room for them to come through the gum and they fail to emerge properly. A wisdom tooth can erupt partly through the gum, or remain trapped as an ‘impacted' wisdom tooth. Seek advice from a dentist to see if you need to have your wisdom teeth removed.
Key points to remeber about wisdom teeth;
- wisdom teeth can be very difficult to clean, and are prone to tooth decay, gum disease, and recurring infections.
- cysts and tumours can develop in tissues around impacted wisdom teeth
- if your wisdom teeth are unable to erupt, they may cause pressure and damage or crowd the neighbouring teeth
- wisdom tooth extractions are easier when you are younger.
Straightforward removal of wisdom teeth may be done in your own dentist's surgery. If your problem is more complex, your dentist may decide to refer you to an oral surgeon.
Surgical removal of wisdom teeth can cause more discomfort than routine extractions. You likely to experience some swelling, minor bleeding and difficulty in fully opening your mouth. These symptoms are temporary, and in most cases your mouth will be feeling normal a week after your surgery.
You may also experience a change of sensation or numbness of your lip and chin and your dentist will discuss with you the risk/benefit ratio of your particular surgery.
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Teeth Straightening
If you have crooked teeth or abnormal bite, your dentist may recommend orthodontic treatment to straighten your teeth. Apart from a beautiful smile, orthodontic treatment help you have a healthier mouth.
Crowded or crooked teeth are difficult to clean and maintain. This may contribute to conditions that cause tooth decay, gum disease and eventual tooth loss. These problems can be avoided by straightening the teeth through orthodontic treatment. There are different ways to straighten your teeth. The kind of orthodontic treatment you have will depend on your commitment, preference and severity of the problem.
Orthodontic treatment may be provided by your dentist or a specialist orthodontist. Depending on their orthodontic experience and severity of your problem, your dentist may refer you to a specilaist orthodontist. If you are receiving treatment by an orthodontist, you still need to keep seeing your dentist for regular check-ups.
You can read more about orthodontists and orthodontic treatment from the New Zealand Association of Orthodontists(NZAO).
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Older People
Healthy eating, effective home oral care and regular dental visits are the three essential steps to maintain healthy teeth and gums for all age groups. It is important than an older person, just like anyone else, limits the intake of sugary food and drinks, brushes twice daily, and regularly visits the dentist.
Tips to keep your mouth healthy
- Brush your teeth twice a day with fluoride toothpaste
- Clean between the teeth at least once a day with floss or inter-dental brushes
- Reduce the intake of sugary food and drinks, ideally limiting them to meal times
- Keep hydrated with water, especially if you have dry mouth, and chew sugar-free gum if possible
- If you are a denture wearer, thoroughly clean dentures daily, and soak them overnight in denture cleaner
- Visit your dentist at least once a year so any problems can be detected early and treated
- Quit smoking - it's bad for teeth and gums as well as everything else.
If in doubt about your mouth, see your dentist.
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Dry Mouth
Dry mouth or xerostomia is a condition where the mouth becomes very dry due to reduced saliva flow. It is caused by certain medical conditions and is also a side effect of some prescription drugs. People suffering from dry mouth are more susceptible to tooth decay, gum disease and bad breath. For denture wearers, the soft tissues in the mouth are more prone to irritation causing denture wearing difficult.
Common causes:
- Certain medications (antihistamines, painkillers, high blood pressure medications, diuretics, antidepressants and others)
- Radiation and chemotherapy
- Conditions such as Sjogren's sundrome and Alzheimer's disease
Your doctor may be able to change your medication to help avoid a dry mouth. if you have a dry mouth it is important to keep hydrated by drinking water throughout the day. Chewing sugar-free gum can stimulate the flow of saliva, and there are sprays and moisteners to help lubricate the mouth.
If you have a dry mouth please discuss that with your dentist to see if they can help you find a suitable solution.
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Root Decay
Receding gums, ('getting long in the tooth') causes the exposure of the root surfaces of the teeth. Root surfaces are softer and more porous than the rest of the tooth, so they absorb stains readily and are not as resistant to decay. When a decay occurs the root becomes softened and darkly stained. In severe cases the affected teeth may break off at the gums.
Common causes
- Incorrect brushing
- Gum disease
Use a soft-bristled toothbrush and avoid vigorous brushing. Brushing twice daily with fluoride toothpaste can help protect exposed root surfaces from decay. A regular dental check-up can help detect and treat root decay early.
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Sensitive Teeth
Teeth may become sensitive as the gums recede, or as a result of breakage and wear. Heavily filled teeth are prone to fracture, and fillings may break and even fall out, causing sensitivity to cold, hot, or sweet things.
Treatment for tooth sensitivity in older people may involve managing receding gums, sealing over the fractured tooth surface, or treating the decay or broken tooth or fillings. Regular dental check-ups are important to spot and treat causes of sensitive teeth such as decay, broken teeth or fillings.
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Oral Ulcers
Oral ulcers are painful areas that appear inside the motuh. They are usually red or yellowish in colour. Ulcers can be caused by trauma due to biting the cheek or tongue, poorly fitting dentures, sharp broken teeth or dental fillings. These areas heal spontaneously or when the cause of the ulcer is removed.
If an ulcer does not heal within two weeks it is important to consult with a dentist.
Common causes
- Sharp broken teeth
- Sharp broken fillings
- Broken or poorly fitting dentures
Other but less common causes of oral ulcers include viral infections, cancer, side effects of some drugs and other general diseases.
Use of topical analgesics like gels can help manage oral ulcers. Treating the cause such as replacement of old broken fillings or adjustment of poorly fititng dentures will help heal the affected areas.
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Oral Cancer
Oral cancer includes cancer of lip, tongue, cheeks and other sites in the mouth. Ulcers lasting for longer than two weeks must be screened for oral cancer. Usually oral cancer is identified by sores or lumps in the mouth that do not heal.
Common causes
- Tobacco use
- High levels of alcohol consumption
- Infectio with viruses such a HPV
Warning signs
- An ulcer or sore spot in the mouth that does not heal within two weeks
- A white or red patch in the mouth
- Difficulty eating or swallowing
- Swelling of the jaws
- A lump in the throat
- Difficulty wearing dentures
How to prevent/manage
- Quit smoking
- Reduce the intake of alcohol
- Eat a helthy balanced nutritious diet
- Regular oral examination by a dentist
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Fungal and Bacterial Infections
Oral Thrush / Candidiasis
This is a fungal infection of the mouth. This is seen as pacthes of white film that cannot be wiped away or small red dots that can be painful. It can also be a sign of Vitamin B12, folate or iron deficiency.
Common causes
- A weak immune system which can be associated with the frail older people
- Leaving dentures in the mouth for a long time without adequate cleaning
- Dry mouth
- Taking antibiotics for a long time
Eating a well balanced nutritious diet, especially important in the frail older people. Use of antifungal medications can help manage this. For denture wearers, it is important to allow the gum tissue to rest from wearing dentures.
Angular Cheilitis
This is a bacterial or fungal infection that usually appears as red inflamed sores and cracks at the corners of the mouth.
Common causes
- Poorly fitting dentures
- Dentures not being cleaned properly
- Underlying immune or nutritional deficiency
Use of anti-fungal or anti-bacterial medications can help. A check-up by a dentist to treat ill fititng dentures and allowing gum tissue to rest from wearing dentures will help prevent this. It is good to clean and soak dentures overight in a glass of water with a cleaner such as Steradent or Polident.
Denture Stomatitis
This is also a fungal or bacterial infection caused by leaving dentures in the mouth for too long. This is seen as generalised redness usually in the area covered by a denture.
Common causes
- Leaving dentures in the mouth for a along time without adequate cleaning
Use of anti-fungal or anti-bacterial medications can help. Allowing the gum tissue to rest from wearing dentures is important to prevent this. It is good to clean and soak dentures overnight in a glass of water with a cleaner such as Steradent or Polodent.
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Pregnancy
Pregnancy is a time when women have special health needs. Your teeth and gums may be affected by your pregnancy, just as other tissues in your body are. If your gums are in good health before you get pregnant and you clean your teeth well, you are less likely to have problems.
Gum Disease
Oral tissues may show an exaggerated response to bacterial plaque during pregnancy due to increased levels of oestrogen and progesterone. These hormones may affect your immune response to bacteria and favour bacterial growth. Therefore you may experience more gum problems at this time. Inflammation of the gum or gingivitis may be more noticeable between the second and eighth month of pregnancy and tends to subside after delivery. This is called pregnancy gingivitis. Symptoms may include redness, bleeding and swelling of your gums.
If you have healthy gum tissue before pregnancy, pregnancy gingivitis may be prevented with good oral hygiene. In pregnant women with poor oral hygiene, pregnancy gingivitis may progress into periodontitis, a more severe form of gum disease.
It is important to minimise the effects of pregnancy gingivitis with professional cleaning and a good home care routine. Regular dental check-ups and professional cleaning visits during pregnancy will help prevent gum problems.
Pregnancy Granuloma
Occasionally, a gum growth may occur during pregnancy called a pregnancy granuloma. Pregnancy granulomas are more common after the third month of pregnancy and are non-cancerous. A pregnancy granuloma is caused by the inflammatory response of your gums to local irritants such as bacterial plaque or calculus/tartar.
The growth usually presents as a red nodule on the gums between the teeth, which may bleed easily and occasionally become ulcerated. The lump is usually painless, however, it may become painful if it interferes with your bite or it accumulates debris. If a pregnancy granuloma forms, professional removal of plaque and calculus is required, supported by good oral hygiene. Pregnancy granulomas normally regress after delivery, however if they require removal, this can be performed by a dentist or a specialist periodontist. This procedure is usually carried out after delivery as it may recur, if removed during pregnancy.
if you experience gum problems during your pregnancy, it is important to visit your dentist. Any treatment you might need can be provided before or after delivery as required.
Dental Erosion
Morning sickness may lead to vomiting during some stages of pregnancy. Frequent vomiting during pregnancy can have an erosive effect on your teeth surface. The tooth enamel may dissolve or become softened by gastric acids. It is important to not brush teeth immediately after vomiting. It is good to wait for about 30 minutes before brushing teeth. Instead rinse immediately with water.
Pregnant women should avoid drinking soft drinks or juices to help ease nausea as acidic drinks are highly erosive. The so-called 'diet' drinks are also acidic, and if taken frequently can lead to erosion.
Dental Visits
A dental examination before you plan to become pregnant will allow identification and treatment of teeth and gum problems beforehand. Otherwise a check-up during pregnancy is advisable to help you maintain good oral health, particularly if you have any symptoms of gum disease.
If treatment is required during pregnancy, this may be best performed during the second trimester. Emergency treatment can be undertaken at any time with proper safety measures.
