Tooth Decay is simply the degeneration of teeth by gradual loss of the hydroxyl-apatite (calcium phosphate) and organic components of teeth. Several species of bacteria that are normally resident in the mouths of probably all individuals have been implicated as major cause of tooth decay. The currently predominant germ theory of tooth decay asserts that the loss of calcium phosphate is caused by an out-of-control bacterial disease. Archaeological evidence suggests that caries has been with human beings for thousands of years and probably even predate the human species; but historical records indicate that caries infections increased tremendously in Western Europe about 250 years ago when table sugar became widely available. The increased amounts of sugar-based and other highly processed food in diets seemed to have led to higher incidences of bacterial tooth infections or to entire populations becoming more susceptible to these infections.
Inadequate oral hygiene leads to the adhesion and accumulation of bacteria on the surfaces of enamel and dentin tissues of the teeth. A biofilm is later formed by the accumulated bacteria. A biofilm is simply a living colony or layer that consists of numerous bacteria. The biofilm that forms on tooth surfaces is known as dental plaque. It is the acidic waste products of the numerous bacteria in the biofilm that dissolve the calcium phosphate and the small amount of proteins that constitutes the structure of tooth enamel and dentin, thereby causing the formation of a carious lesion on a tooth. The small-scale action of tiny amounts of bacterial acids (such as lactic acid) on tooth can be compared to the action of say, dilute hydrochloric acid, on a limestone block.
Good oral hygiene and proper nutrition reduces the number of bacteria in the mouth and helps increase bodily resistance against caries-causing bacterial infection. Good oral hygiene consists mainly of thorough and careful tooth-brushing, flossing, and tongue scraping after (ideally) every meal or consumption of sweet or acidic beverages. Regular (at least twice yearly) enamel and dentin cleaning is also advised. Proper nutrition consists of reduced consumption of processed foods that contain fermentable carbohydrates, particularly sugar-laden food and drinks.
Wisdom teeth comprise the third and final set of molars on the upper and lower jaws. If wisdom teeth come into place without any complications, a person would then have a total of 12 molars, six molars on each side of the mouth, or three molars on each half of the upper and lower jaws.
Wisdom teeth start coming out after about age 16. These teeth are the last ones to come out, hence they are associated with coming into age or maturity (and, presumably, with having gained greater wisdom). Unfortunately for most people, and for some still largely undetermined reason/s (which some theorise as being due to the change in the diet of modern humans), there isn’t enough space in the mouths of most modern humans to accommodate the wisdom teeth; so most wisdom teeth come out impacted, that is, instead of erupting straight up and out just like the other teeth, wisdom teeth usually erupt in three possible but wrong directions, or generally upwards, but at a too shallow depth.
Impacted wisdom teeth can grow at an angle towards the second molar in front of it (mesial impaction), at an angle towards the back of the mouth (distal impaction), perpendicular to the long axes of the other teeth (horizontal impaction), or straight up but not enough to come out of either the gums or the jawbone (soft tissue vertical impaction and bony vertical impaction, respectively). Impacted wisdom teeth can also be deflected towards the tongue or towards the cheeks. If some part of a wisdom tooth breaks out through the gums, the tooth is considered partially impacted. If no part of the tooth is visible, it is considered fully impacted. The most common impacted growth direction is towards the front of the jaw arches (mesial impaction).
As they continue to erupt and exert pressure on adjacent teeth, bone, or gums, impacted wisdom teeth can cause severe and throbbing pain. This pain may radiate towards the ear or may diffuse throughout the whole skull, causing earaches and headaches, respectively. Bleeding and swelling of the gums can also occur.
If left on its own, the presence of an impacted wisdom tooth can lead to a number of dental or oral-maxillofacial conditions and complications such as malocclusion of the adjacent teeth it is pushing out against (via a domino-effect type of reaction), tooth decay of the adjacent teeth and/or the wisdom tooth itself, contact pressure on the mandibular nerve (which could lead to numbness of the cheeks, lower lip, and chin), formation of an infected cyst or non-malignant tumour on the gums, infection of the jawbone (which in turn could lead to a temporomandibular joint disorder or to an infection of the mandibular nerve), and gingivitis (which in turn could lead to full-blown periodontal disease). With the high probability or the actual occurrence of these and other serious complications, it is generally advisable to have the impacted tooth extracted.
Dental Trauma refers either to an event that causes an acute dental injury or to the dental injury itself. Depending on the severity, this type of injury always involves one or more teeth. Some dental trauma injuries also involve the tooth socket, which is part of the jawbone, as well as soft issues such as the gums, lips, tongue, and cheek. Teeth can become cracked, chipped, fractured, partly dislodged, knocked out, etc. The tooth socket may become bruised or fractured. Soft tissues can be cut, lacerated, or bruised. A minor Dental Trauma can heal on its own, but severe traumas that are untreated will lead to the loss of the affected tooth/teeth and maybe even to additional oral-maxillofacial injuries and complications.
Impact-causing accidents that deliver blunt-force trauma to the mouth and facial regions are the most common causes of dental trauma. Bad falls, vehicular crashes, collisions with walls, doors, appliances, fixtures, lampposts, pet animals, etc., can all lead to dental injuries that range in severity from slight to severe. Toddlers at 2 to 3 years of age, in particular, can be prone to falls and collision types of accidents. Sports-related activities are also familiar sources of dental injuries, particularly contact sports that involve multiple strikes, throws, and intentional collisions. Physical assaults carried out by people on other people or by large aggressive animals are also common causes of usually severe dental injuries.
The two large incisors on the upper jawbone (maxillary central incisors) are the most trauma-prone teeth, and around 70% of all dental injuries involve either one or both of these two teeth. People who have misaligned teeth (particularly the overbite-type of malocclusion), periodontal disease, decayed teeth, and some other types of dental conditions are also more prone to having trauma-induced dental injures.
A damaged and/or dislodged, bleeding, sensitive, and often painful tooth is the most common and obvious symptom of dental trauma. Pain in the gums around the affected tooth is also very common. As the severity of the injury increases, additional symptoms are manifested. These can include swollen or bleeding soft tissues (tongue, lips, gums, cheeks, etc.) and painful or disfigured (and probably fractured) jawbones or cheek bones.
Teeth, especially the primary (or “milk”) teeth of young children, can become discolored due to a dental trauma. A slight damage to the dental pulp can result in a yellowish or brownish discoloration, while a pinkish tint could indicate bleeding into the dentin. A dark or black-coloured discoloration usually signifies dental pulp necrosis, in which case the tooth has to be either endodontically treated or extracted.
If you have suffered a dental trauma and are in pain please could you call the practice and arrange to see a dentist as soon as possible. If you have an out of hours emergency please contact the Emergency Dental Service.
Tooth decay is a common issue faced by young children throughout the world. If this problem is left untreated, it doesn’t only cause severe pain but it also accompanies oral infections and eating problems. But the good side of the picture is that tooth decay and other dental health problems can be prevented if parents take the right steps on time. Experts believe that helpful dental health measures including dental sealants as well as the use of fluoride can play an important role in eliminating tooth decay in younger children.