module menu iconManaging oral care

The structure of a tooth

Understanding the problem

Treatment options

When to refer

Scenario

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module menu icon Understanding the problem

Understanding the problem

A number of conditions can affect teeth and gums, leading to pain, discomfort and sometimes embarrassment. Some of these conditions can lead to infection and even tooth loss, which is why good oral hygiene is so important. 

Types of oral conditions:

Tooth decay Bad breath Sensitive teeth Gum disease Periodontitis

The root cause of tooth decay is plaque, which is a thin sticky film covering the surface of the teeth and gums. It contains many different types of bacteria living naturally in the mouth. These bacteria react with the food we eat and drink, forming acids, which then attack the enamel on the surface of the tooth. Over time, this acid can destroy the enamel and a cavity will form as a result. Left untreated, dental cavities can destroy a tooth and cause significant pain. The only way to stop this extended damage is to have the cavity filled by a dentist. 

Certain foods, such as garlic and raw onion, give off an odour in the breath once they’ve been ingested, but this is only temporary and will be resolved quickly. In other cases, bad breath – also known as halitosis – can be caused by something else going on in the mouth. For instance, food that is stuck between teeth can rot, causing a bad smell. When teeth are not cleaned properly, the bacteria that grow in the mouth can cause gum disease and that, in turn, can also lead to bad breath. Bad breath can also be a sign of health problems elsewhere in the body, such as sinus infections, chronic lung infections, liver or kidney disease and diabetes. 

If a mouthful of ice cream or a sip of hot tea makes a person wince, it is likely that they are suffering from sensitive teeth. Normally, teeth are not sensitive, but when enamel is worn away or gums recede, the underlying layer of dentine can become exposed. When stimuli such as hot or cold food and drink comes into contact with the exposed nerve endings inside the teeth, the result is the sudden, sharp pain associated with sensitivity. 

Gum disease, or gingivitis as it is also known, is a very common oral health condition, with up to 90 per cent of the UK adult population estimated to have it to some degree. Gum disease can be caused by the build-up of plaque on the teeth. The bacteria in the plaque irritate the gums, causing inflammation and swelling. These swollen and irritated gums bleed more easily when the teeth are brushed. Other signs of gingivitis include bad breath or a bad taste in the mouth and shrinking of the gums. Gum disease is most likely to occur if there is poor oral hygiene, but it is also more common in smokers, people with diabetes and anyone with a weakened immune system. 

Untreated gum disease can become more severe and is called periodontitis. If the bacterial plaque spreads below the gumline, the inflammation affects not only the gums but also the jawbone and the ligaments that hold the teeth in place. If it is left to progress further, periodontitis can lead to loose teeth that may even fall out. Signs of periodontitis include: 

  • Bad breath
  • A foul taste in the mouth
  • Receding gums
  • Sensitive teeth
  • Pus or painful abscesses
  • Teeth becoming loose or falling out. 

Managing oral care

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