Oral Health

Facts about dental and oral health
Dental cavities and gum disease are very common. According to the World Health Organization:

between 60 and 90 percent of school children have at least one dental cavity
nearly 100 percent of adults have at least one dental cavity
between 15 and 20 percent of adults ages 35 to 44 have severe gum disease
about 30 percent of people around the world ages 65 to 74 don’t have any natural teeth left
in most countries, out of every 100,000 people, there are between 1 and 10 cases of oral cancer
the burden of oral disease is much higher in poor or disadvantaged population groups
There are many steps you can take to keep your teeth healthy. For example, dental and oral disease can be greatly reduced by:

brushing your teeth with fluoride toothpaste at least twice a day
flossing your teeth at least once a day
decreasing your intake of sugar
eating a diet high in fruits and vegetables
avoiding tobacco products
drinking fluoridated water
seeking professional dental care
Symptoms of dental and oral problems
You shouldn’t wait until you have symptoms to visit your dentist. Going to the dentist twice a year will usually allow them to catch a problem before you even notice any symptoms.

If you experience any of the following warning signs of dental health issues, you should make an appointment to see your dentist as soon as possible:

ulcers, sores, or tender areas in the mouth that won’t heal after a week or two
bleeding or swollen gums after brushing or flossing
chronic bad breath
sudden sensitivity to hot and cold temperatures or beverages
pain or toothache
loose teeth
receding gums
pain with chewing or biting
swelling of the face and cheek
clicking of the jaw
cracked or broken teeth
frequent dry mouth
If any of these symptoms are accompanied by a high fever and facial or neck swelling, you should seek emergency medical treatment. Learn more about the warning signs of oral health issues.

Causes of dental and oral diseases
Your oral cavity collects all sorts of bacteria, viruses, and fungi. Some of them belong there, making up the normal flora of your mouth. They’re generally harmless in small quantities. But a diet high in sugar creates conditions in which acid-producing bacteria can flourish. This acid dissolves tooth enamel and causes dental cavities.

Bacteria near your gumline thrive in a sticky matrix called plaque. Plaque accumulates, hardens, and migrates down the length of your tooth if it isn’t removed regularly by brushing and flossing. This can inflame your gums and cause the condition known as gingivitis.

Increased inflammation causes your gums to begin to pull away from your teeth. This process creates pockets in which pus may eventually collect. This more advanced stage of gum disease is called periodontitis.

There are many factors that contribute to gingivitis and periodontitis, including:

smoking
poor brushing habits
frequent snacking on sugary foods and drinks
diabetes
the use of medications that reduce the amount of saliva in the mouth
family history, or genetics
certain infections, such as HIV or AIDS
hormonal changes in women
acid reflux, or heartburn
frequent vomiting, due to the acid
Diagnosing dental and oral diseases
Most dental and oral problems can be diagnosed during a dental exam. During an exam, your dentist will closely inspect your:

teeth
mouth
throat
tongue
cheeks
jaw
neck
Your dentist might tap or scrape at your teeth with various tools or instruments to assist with a diagnosis. A technician at the dentist’s office will take dental X-rays of your mouth, making sure to get an image of each of your teeth. Be sure to tell your dentist if you’re pregnant. Women who are pregnant shouldn’t have X-rays.

A tool called a probe can be used to measure your gum pockets. This small ruler can tell your dentist whether or not you have gum disease or receding gums. In a healthy mouth, the depth of the pockets between the teeth are usually between 1 and 3 millimeters (mm). Any measurement higher than that may mean you have gum disease.

If your dentist finds any abnormal lumps, lesions, or growths in your mouth, they may perform a gum biopsy. During a biopsy, a small piece of tissue is removed from the growth or lesion. The sample is then sent to a laboratory for examination under a microscope to check for cancerous cells.

If oral cancer is suspected, your dentist may also order imaging tests to see if the cancer has spread. Tests may include:

X-ray
MRI scan
CT scan
endoscopy

Types of dental and oral diseases
We use our teeth and mouths for a lot, so it’s not surprising how many things can go wrong over time, especially if you don’t take proper care of your teeth. Most dental and oral problems can be prevented with proper oral hygiene. You’ll likely experience at least one dental problem during your lifetime.

Cavities
Cavities are also called caries or tooth decay. These are areas of the tooth that have been permanently damaged and may even have holes in them. Cavities are fairly common. They occur when bacteria, food, and acid coat your teeth and form a plaque. The acid on your teeth starts to eat away at the enamel and then the underlying dentin, or connective tissue. Over time, this can lead to permanent damage.

Gum disease (gingivitis)
Gum disease, also called gingivitis, is inflammation of the gums. It’s usually the result of plaque building up on your teeth due to poor brushing and flossing habits. Gingivitis can make your gums swell and bleed when you brush or floss. Untreated gingivitis can lead to periodontitis, a more serious infection.

Periodontitis
As periodontitis progresses, the infection can spread to your jaw and bones. It can also cause an inflammatory response throughout the body.

Cracked or broken teeth
A tooth can crack or break from an injury to the mouth, chewing hard foods, or grinding the teeth at night. A cracked tooth can be very painful. You should visit your dentist right away if you’ve cracked or broken a tooth.

Sensitive teeth
If your teeth are sensitive, you might feel pain or discomfort after having cold or hot foods or beverages.

Tooth sensitivity is also referred to as “dentin hypersensitivity.” It sometimes occurs temporarily after having a root canal or a filling. It can also be the result of:

gum disease
receding gums
a cracked tooth
worn-down fillings or crowns
Some people naturally have sensitive teeth because they have thinner enamel.

Most of the time, naturally sensitive teeth can be treated with a change in your daily oral hygiene regimen. There are specific brands of toothpaste and mouthwash for people with sensitive teeth.

Shop for toothpaste and mouthwash made for people with sensitive teeth.

Oral cancer
Oral cancers include cancer of the:

gums
tongue
lips
cheek
floor of the mouth
hard and soft palate
A dentist is usually the first person to recognize oral cancer. Tobacco use, such as smoking and chewing tobacco, is the biggest risk factor for oral cancer.

According to the Oral Cancer Foundation (OCF), nearly 50,000 Americans will be diagnosed with oral cancer this year. In general, the earlier that oral cancer is diagnosed, the better the outlook.

The link between oral and general health
Oral health has risen in importance in recent years, as researchers have discovered a connection between declining oral health and underlying systemic conditions. It turns out that a healthy mouth can help you maintain a healthy body. According to the Mayo Clinic, oral bacteria and inflammation may be associated with:

heart disease
endocarditis, or inflammation of the lining of the heart
premature birth
low birth weight
Bacteria can spread from your oral cavity to your bloodstream, causing infective endocarditis. Infective endocarditis is a life-threatening infection of your heart valves. Your dentist may suggest you take antibiotics as a preventive measure before they perform any dental procedure that could dislodge bacteria in your mouth.

Treating dental and oral problems
Even if you’ve been taking good care of your teeth, you’ll still need to have a professional cleaning twice a year during a routine visit with your dentist. Your dentist will recommend other treatments if you show signs of gum disease, infections, or other problems.

Cleanings
A professional cleaning can get rid of any plaque you may have missed while brushing and flossing. It’ll also remove tartar. These cleanings are usually performed by a dental hygienist. After all the tartar is removed from your teeth, the hygienist will use a high-powered toothbrush to brush your teeth. This is followed by flossing and rinsing to wash out any debris.

A deep cleaning is also known as scaling and root planning. It removes tartar from above and below the gumline that can’t be reached during a routine cleaning.

Fluoride treatments
Following a dental cleaning, your dentist may apply a fluoride treatment to help fight off cavities. Fluoride is a naturally occurring mineral. It can help strengthen the enamel of your tooth and make them more resilient to bacteria and acid.

Antibiotics
If you show signs of a gum infection or you have a tooth abscess that has spread to other teeth or your jaw, your dentist may prescribe antibiotics to help get rid of the infection. The antibiotic may be in the form of a mouth rinse, gel, oral tablet, or capsule. Topical antibiotic gel may also be applied to the teeth or gums during surgical procedures.

Fillings, crowns, and sealants
A filling is used to repair a cavity, crack, or hole in the tooth. The dentist will first use a drill to remove the damaged area of the tooth and then fill the hole with some material, such as amalgam or composite.

A crown is used if a large portion of your tooth needs to be removed or has broken off due to an injury. There are two types of crowns: an implant crown that fits over an implant, and a regular crown that fits over a natural tooth. Both types of crowns fill in the gap where your natural tooth appeared.

Dental sealants are thin, protective coatings that are placed on the back teeth, or molars, to help prevent cavities. Your dentist may recommend a sealant for your children as soon as they get their first molars, at around age six, and again when they get their second set of molars around age 12. Sealants are easy to apply and completely painless.

Root canal
You might need a root canal if tooth decay reaches all the way inside the tooth to the nerve. During a root canal, the nerve is removed and replaced with a filling made of a biocompatible material, usually a combination of a rubber-like material called gutta-percha and adhesive cement.

Probiotics
Probiotics are mostly known for their role in digestive health, but new research has shown that the healthy bacteria may be beneficial for your teeth and gums.

Probiotics have been shown to prevent plaque and treat bad breath. They also help to prevent oral cancers and decrease inflammation from gum disease.

While large clinical trials are still needed to prove their effectiveness, results to date have been promising. You can take a probiotic supplement or eat foods high in beneficial bacteria, such as yogurt, kefir, and kimchi. Other popular probiotic foods include sauerkraut, tempeh, and miso.

Changing daily habits
Keeping your mouth healthy is a daily commitment. A dental hygienist can teach you how to properly take care of your teeth and gums on a daily basis. In addition to brushing and flossing, your daily routine can include mouthwash, oral rinses, and possibly other tools, such as a Waterpik water flosser.

Shop for a water flosser.

Surgery for dental and oral problems
Oral surgeries are usually performed to treat more serious cases of periodontal disease. Certain dental surgeries can also be done to replace or fix missing or broken teeth caused by an accident.

Flap surgery
During a flap surgery, a surgeon makes a small cut in the gum to lift up a section of the tissue. They then remove tartar and bacteria from underneath the gums. The flap is then stitched back into place around your teeth.

Bone grafting
Bone grafting is needed when gum disease causes damage to the bone surrounding the root of your tooth. The dentist replaces the damaged bone with a graft, which can be made from your own bone, a synthetic bone, or a donated bone.

Soft tissue grafts
A soft tissue graft is used to treat receding gums. A dentist will remove a small piece of tissue from your mouth or use a donor tissue and attach it to the areas of your gums that are missing.

Tooth extraction
If your dentist can’t save your tooth with a root canal or other surgery, the tooth will likely need to be extracted.

You may also need a tooth extraction if your wisdom teeth, or third molars, are impacted. Sometimes, a person’s jaw isn’t large enough to accommodate the third set of molars. One or more of the wisdom teeth will become trapped or impacted when it tries to emerge. A dentist will typically recommend that wisdom teeth be extracted if they cause pain, inflammation, or other problems.

Dental implants
Dental implants are used to replace missing teeth that are lost due to a disease or an accident. An implant is surgically placed into the jawbone. After the implant is placed, your bones will grow around it. This is called osseointegration.

Once this process is complete, your dentist will customize a new artificial tooth for you that matches your other teeth. This artificial tooth is known as a crown. The new crown is then attached to the implant. If you’re replacing more than one tooth, your dentist may customize a bridge to fit into your mouth. A dental bridge is made of two abutment crowns on either side of the gap, which then hold the artificial teeth in between in place.

What can go wrong?
Periodontal disease can eventually break down the bone that supports your teeth. This can lead to many complications. You’ll likely need dental treatment to save your teeth.

Risks and complications of untreated periodontal disease include:

tooth abscesses
other infections
migration of your teeth
pregnancy complications
exposure of the roots of your teeth
oral cancer
tooth loss
increased risk of diabetes, heart disease, cancer, and respiratory diseases
If left untreated, an infection from a tooth abscess can spread to other parts of your head or neck. It can even lead to sepsis, a life-threatening blood infection.

Keeping your teeth and gums healthy
Good oral health boils down to good general health and common sense. The best ways to prevent oral health problems are to:

brush your teeth with fluoride toothpaste at least twice a day
floss at least once a day (one of the most beneficial things you can do to prevent disease in your oral cavity)
have your teeth cleaned by a dental professional every six months
avoid tobacco products
follow a high-fiber, low-fat, low-sugar diet that includes plenty of fruits and vegetables
limit sugary snacks and drinks
Foods with hidden sugars include:

condiments such as ketchup and barbecue sauce
sliced fruit or applesauce in cans or jars that have added sugars
flavored yogurt
pasta sauce
sweetened iced tea
soda
sports drinks
juice or juice blends
granola and cereal bars
muffins
Get more tips on preventing oral health problems. Good oral health is especially important to groups such as children, pregnant women, and older adults.

What you should know about your child’s oral health
The American Academy of Pediatrics (AAP) recommends that children start seeing a dentist by their first birthday.

Children are highly susceptible to dental cavities and tooth decay, especially those who bottle feed. Cavities may be caused by too much sugar left on the teeth after bottle feeding.

To avoid baby bottle tooth decay, you should do the following:

only bottle feed during meal times
wean your child off of a bottle by the time they’re one year old
fill the bottle with water if you must give them a bottle at bedtime
begin brushing with a soft baby toothbrush once their baby teeth start to come in; you should use only water until your child learns not to swallow the toothpaste
start seeing a pediatric dentist regularly for your child
ask your child’s dentist about dental sealants
Baby bottle tooth decay is also known as early childhood caries (ECC). Go here to find out more ways you can prevent ECC.

What men need to know about oral health
According to the American Academy of Periodontology, men are less likely to take good care of their teeth and gums than women. Compared to women, men are less likely to brush twice per day, floss regularly, and seek preventive dental care.

Oral and throat cancer is more common in men. A 2008 study showed that men with a history of periodontal disease are 14 percent more likely to develop other types of cancer than men with healthy gums. It’s important that men recognize the consequences of poor oral health and take action early in life.

What women need to know about oral health
Due to changing hormones at various stages of their lives, women are at risk for several oral health issues.

When a woman first starts menstruating, she may experience mouth sores or swollen gums during her periods.

During pregnancy, increased hormones can affect the amount of saliva produced by the mouth. Frequent vomiting caused by morning sickness can result in tooth decay. You can receive dental care during pregnancy, but you should let your dentist know if you’re pregnant.

During menopause, lower amounts of estrogen can increase your risk of gum disease. Some women may also experience a condition called burning mouth syndrome (BMS) during menopause. Learn about the different dental issues that women face throughout their lives.

What people with diabetes need to know about oral health
Diabetes affects the body’s ability to fight off bacteria. This means that people with diabetes have a higher risk of having oral infections, gum disease, and periodontitis. They’re at an increased risk of an oral fungal infection called thrush.

For people with diabetes to take charge of their oral health, they’ll need to maintain control over their blood sugar levels. This is on top of brushing, flossing, and dentist’s visits. Explore the link between type 2 diabetes and oral health.

The bottom line about dental and oral health
Your oral health has an effect on more than just your teeth. Poor oral and dental health can contribute to issues with your self-esteem, speech, or nutrition. They can also affect your comfort and overall quality of life. Many dental and oral problems develop without any symptoms. Seeing a dentist regularly for a checkup and exam is the best way to catch a problem before it gets worse.

Ultimately, your long-term outcome depends on your own efforts. You can’t always prevent every cavity, but you can reduce your risk of severe gum disease and tooth loss by staying on top of your daily oral care.

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Medically reviewed by Christine Frank, DDS on May 25, 2018 — Written by The Healthline Editorial Team and Jacquelyn Cafasso