Oral Health Conditions

The oral health leaflet has already told you how to keep your mouth in “tip top” shape. This leaflet will look further into our oral health and specifically, some common health conditions that you may experience over your lifetime.

Tooth decay Tooth decay is the process that results in dental cavities (caries). It occurs when plaque is left to build up on teeth, leading to acids that damage the enamel covering the teeth and thus creating holes (cavities). It is important to note that commonly there may be NO SYMPTOMS alerting you to this tooth decay,

and pain/sensitivity etc may only occur once you actu-ally have developed a cavity or infected tooth. This may mean a dentist having to perform fillings, crowns or root canals....and if a cavity is left untreated, it may lead to a tooth abscess. Untreated tooth decay also destroys the inside of the tooth (pulp), which can lead to tooth loss! Some important tips for avoiding tooth decay:

Foods that cling to your teeth are the most likely to

promote tooth decay; e.g. sugars, milk, honey, rai-sins, hard candy, dry cereal and bread.

Frequent snacking may lead to more time that the

acid in food has to damage your teeth. Brushing your teeth after eating will help to remove the plaque and also make you less likely to snack throughout the day

Many people believe bottled water is better than tap

water, but remember that your tap water contains fluoride, which promotes oral health by helping to protect tooth enamel from plaque build-up.

Brush, floss and use mouth wash at least twice a

day!

Halitosis/Bad breath Halitosis, or unpleasant smelling breath, is quite common in healthy people, especially upon awakening. This is generally as a result of low salivary flow and lack of oral cleansing during sleep. This type of halitosis can be readily rectified by eating, tongue brushing and rinsing the mouth with fresh water. Having halitosis can have a major impact on a person. Because of bad breath, other people may back away or even turn their heads and this can lead to a loss of confidence and self-esteem. What are the other causes of halitosis?

Gum disease

Infections within the mouth such as:

Dental absess

Oral candidiosis (oral thrush)

Tonsilitis

Caries (dental cavities)

Dry mouth

Starvation

Odour-causing foods (e.g. garlic, onions and certain spices)

Smoking

Drugs and alcohol

Poor dental hygiene (with food particles left between the teeth, around the gums or on the tongue

Certain systemic diseases (e.g. kidney failure, diabetes, metabolic dysfunctions)

How can we manage halitosis? There is no one treatment for halitosis; however, the following general pointers will be a good start for those of

you who require a “quick fix” from your LiveLife pharmacy:

Avoid dehydration

Keep good oral hygiene, including brushing, flossing and mouth rinses.

Remember to brush your tongue!

Saline nasal sprays may help you with chronic sinusitis that may be affecting your breath.

Saliva replacement products may help those suffering from chronic dry mouth

(from medication etc) - see dry mouth section later in leaflet

Quit smoking!

Recommended products

Toothbrush

Toothpaste

Dental floss

Mouth wash—80-90% of mouth-borne halitosis is due to mouth bacteria—please don’t underestimate the importance of an antibacterial mouthwash—it is essential!

Teeth Grinding Teeth grinding (also known as bruxism) is the involuntary clenching, grinding and gnashing of the teeth. Most commonly it occurs during sleep and it is often asso-ciated with stress or anxiety. However, it is often more likely caused by an abnor-mal bite or missing/crooked teeth. So what’s the big deal? Is grinding your teeth harmful? Chronic teeth grinding may lead to many different complications such as fractur-ing, loosening, or loss of teeth. It may even wear the teeth down to stumps.

When these things happen, you may require bridges, crowns, root canals, im-plants, partial dentures and even complete dentures! So what can I do to stop grinding my teeth?

A dentist may fit a specialised mouth guard to protect the teeth

Stress management techniques, starting an exercise program or using muscle

relaxants

Avoiding or cutting back on foods/drinks with caffeine

Avoiding alcohol

Avoiding chewing on pencils, pens etc as this may cause you to be more likely

to grind your teeth

Relaxing the jaw muscles at night by holding a warm washcloth against the

cheek in front of the earlobe

Dental Sensitivity What are some causes of dental sensitivity?

Dental sensitivity occurs when the under-

lying layer of your teeth (dentin) becomes

exposed. There are many factors that may lead to this sensitivity including:

Brushing too hard

Recession of gums

Cracked teeth

Gingivitis (gum disease)

Teeth grinding

Tooth whitening products (containing baking soda and peroxide)

Plaque build up

The use of some mouthwashes (in this case, a dentist may recommend a

neutral fluoride solution)

Regular consumption of acidic foods

Recent routine dental procedures (such as cleaning and tooth restoration)

What can I do to reduce tooth sensitivity?

The worst thing you can do is stop brushing and flossing! Please keep up your

proper techniques and clean all parts of your teeth and mouth thoroughly.

Use a soft bristled toothbrush to avoid abrasion to the tooth surface and gum irri-

tation.

Use a “sensitive” toothpaste when brushing – these specialised toothpastes work

to slowly desensitise the tooth. To speed the process along you can also apply a layer of fluoridated toothpaste directly to the affected teeth before going to bed.

Be careful with your diet and avoid regular consumption of highly acidic foods

which may gradually dissolve tooth enamel.

Use fluoridated dental mouth wash.

Avoid grinding/clenching your teeth.

Avoid whitening products, as these generally contain baking soda and peroxide

which may lead to further sensitivity!

Teeth and drug use What effect do drugs have on our teeth? Many medications from the pharmacy can cause tooth and gum damage. Your pharmacist can advise you on these adverse effects; however, you may find it interesting to read about a few:

The old sedating antihistamines (such as Phenergan and Polaramine) can cause dry mouth, chewing aspi-

rin can damage tooth enamel, and medicated syrups containing sugar can increase the risk of tooth de-cay, just to name a few. (NB. The newer non-sedating antihistamines do not have this effect)

There are also significant risks associated with illegal drug use directly relating to the health of your teeth and gums:

Cannabis – causes dry mouth and may lead to an increased risk of gum problems. The smoke is also as-

sociated with oral cancer

Cocaine – when the cocaine is rubbed over the gums, it can cause ulceration of gums and the underlying

bone. The actual mixture of cocaine with saliva also creates a very acidic solution which erodes tooth enamel

Heroin – this drug can lead to craving sweet foods which can increase the risk of tooth decay. It can also

cause dry mouth and tooth grinding

Ecstasy – can cause jaw clenching, tooth grinding and dry mouth

Methamphetamine - this drug is notorious for causing severe tooth decay in only a very short period of

time. The drug itself is highly acidic and attaches to the enamel. It also causes dry mouth, tooth grind-ing and jaw clenching

Referred sinus pain Sometimes dental pain isn’t caused by any trauma in the mouth at all. Infection of what is called the “maxillary sinus” following an upper respiratory tract infection can lead to dull pain in the upper teeth. The pain tends to be increased on lying down or bending over and there is of-ten also a feeling of “fullness” on the affected side. Your pharmacist may recommend a decongestant (e.g. con-taining pseudoephedrine) to try and clear the congestion and thus relieve this pain.

Cracked and chipped teeth

Save the pieces if possible and rinse the mouth with warm water

Apply gauze to control any bleeding

Knocked out tooth Try to find the tooth

Handle only the top of the tooth and never hold it by the roots

Do not scrape, rub or remove any tissue fragments from the tooth

If the tooth is not clean, rinse it in milk

Try to replant the tooth and hold it in its usual spot or place it in the owners mouth next to the cheek (if the

person affected is conscious and able). If not, immerse in milk (not water) and seal it in plastic wrap

It is important that the tooth doesn’t dry out

Immediate dental care is crucial

Gum disease

Gum disease is usually caused by a build-up of plaque on the teeth and one of the most com-mon signs of gum disease is bleeding gums. There are 2 different type of gum disease:

Gingivitis: This type is very

early gum disease, with symptoms such as bleeding, redness and swelling of the gum.

Periodontitis: This type is a

more advanced gum disease

that may occur if gingivitis is left untreated. This disease can lead to spaces forming between the gum and tooth, leading to bacteria becoming trapped in these pockets and thus causing further inflam-mation. Symptoms of perio-

dontitis can include bleed-ing, swelling and receding gums together with bad breath, a bad taste in the mouth and loose teeth – not something you should have to suffer from with fantastic advice from your LiveLife pharmacy!

So what can you do to avoid these conditions?

Well, by cleaning the teeth very carefully every day with a soft toothbrush

and concentrating along the gum line where the gum meets the tooth, this

will keep the gum tissue healthy. Dental floss should also be used.

It is also important to note that “fad diets” that are severely lacking in cal-

cium and vitamins B and C can increase the risk of gum disease, so consider a multi-vitamin if not eating well.

Some medications can also cause a “dry mouth” as detailed earlier in this

leaflet. The less saliva you have, the more likely you are to develop gum dis-ease, as saliva helps to keep the teeth clean by controlling bacterial growth. If you believe your medication is causing this side effect, consult the pharma-cist!

But what if I might already be suffering with gum disease? Focus on brushing and flossing techniques and the use of an antibacterial mouth wash. Consult the pharmacist for further advice as to whether you will require referral to the dentist/GP.

Dry mouth Dry mouth occurs when a person does not produce enough saliva (spit) to keep their mouth feeling wet. But why is saliva so important? Well, saliva actually:

Has anti-fungal properties and helps to destroy viruses and bacteria

Neutralises the acids produced by plaque

Helps to moisten your food to help enable swallowing

Helps with the formation of particular sounds for speech

Plays a part in the ongoing process of remineralisation (rebuilding) of tooth enamel

Boosts pain, taste and food texture sensations in the mouth

What are some causes of dry mouth? There are so many things that can lead to dry-mouth. Just a few examples include:

Drugs

Dehydration

Infection of the salivary glands

Obstruction of salivary ducts

Is there anything that can relieve the symptoms? There are many things our LiveLife pharmacies can recommend to relieve the symptoms of dry mouth such as:

Sucking on sugar-free lollies or chewing sugar-free gum

Drinking water regularly throughout the day to keep the mouth feeling moist

Using a fluoride toothpaste when brushing the teeth to ensure proper protection of

enamel whilst saliva production is limited

Trying to breathe through the nose rather than the mouth as much as possible

Using a vaporiser when sleeping at night to keep “moisture” in the air

Using an over-the-counter artificial saliva substitute; e.g. Biotene

Your pharmacist may recommend changes to your medicine or referral to the GP if

they deem it necessary. Consult the pharmacist if these measures above are not working!

Mouth sores

What causes mouth sores?

Accidental biting on the mouth /cheek

Constant rubbing against sharp teeth, dentures or braces

Poor oral hygiene

Burns from eating hot food

Adverse reactions to certain medications

A weakened immune system

Stress

Hormone changes

A lack of certain vitamins in the diet, in particular vitamin B12 and folate

How can we manage them?

Avoid hot beverages and foods, spicy and salty foods, and citrus (which

may further irritate/burn the mouth)

Use pain relievers like paracetamol and ibuprofen

Gargle with an antibacterial mouth wash containing “chlorhexidine” and

warm salt water in between

Use soothing/antiseptic gels/pastes for application directly on the sore;

e.g. Bonjela, SM33 (S2—pharmacy medicine), Kenalog in Orabase (S3—pharmacist only) - NB Kenalog in Orabase is SO much more effective in treating mouth ulcers, so please consult your pharmacist for advice!

Oral thrush What is oral thrush? Thrush is caused by forms of a fungus called candida. This fungus normally lives in our mouth and is usually kept in check by the immune system. However, when the immune system becomes weak, the fungus can grow, leading to symptoms such as whitish, velvety sores in the mouth and on the tongue. Under the whitish material, there is red tissue that may bleed easily. If thrush is not treated appropriately, these sores can increase in both number and size. So what can my LiveLife pharmacy do for me if I think I am suffering with thrush?

Consult your pharmacist – the treatments available are Schedule 3 (Pharmacist Only)

products:

Daktarin Oral Gel – this gel is measured into the provided spoon and then swal-

lowed four times a day until finished (please note it is not suitable for infants due to the increased risk of choking)

Nilstat/Mycostatin Oral Drops – this is a liquid form that is held in the mouth for

as long as possible then swallowed four times a day until finished (we use this product especially in new-born babies with oral thrush)

Yoghurt and acidophilus don’t destroy the fungus, but they can help to restore the nor-

mal bacterial flora in the body. Consider the use of a probiotic supplement such as “Inner Health Plus” capsules/powder to help restore the proper balance of good and bad bacterial flora.