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Common problems of the oral cavity

Orthodontic braces

The oral cavity is an ideal place for bacterial growth by providing warmth, moisture, food supply from the residual foods on and between the teeth and a protected environment. The number of bacteria in the mouth depends upon the degree of cleanliness of the mouth. A neglected mouth can cause various types of infection in the oral cavity.

Halitosis:- It is the offensive odour of breath. It may be an early indication of either poor oral hygiene or health problem, such as gastrointestinal tract disorder. An offensive breath odour caused by inadequate oral hygiene can be alleviated with cleansing of the teeth and oral mucosa. If the origin of the halitosis is systemic, oral hygiene will not remove the odour.

Dental caries:- It is a destructive process causing decalcification of the enamel and dentin with resulting cavitation of the tooth. When the enamel barrier is breached, cavities are developed. Dental caries is a disease of the calcified structure of the tooth.
Bacillus acidophilus, a normal inhabitant of the mouth cavity acts on the carbohydrate material that has been left on the surfaces, pits and fissures of the teeth. Lactic acid is produced which dissolves the tooth structure and form cavities in the teeth. When these cavities reach the pulp, pain ensures and the pulp cavity dies. Once the decay has started there is no cure.

Dental plaque:- It is a soft thin film of food debris, mucin and dead epithelial cells that is deposited on the teeth and provides a medium for the growth of bacteria. Freshly deposited plaque is transparent unless it is stained brown by tobacco, coffee or tea. When old dental plaque is present the teeth appear dull with dinges and yellowish cast.

Calculus or tartar:- When dental plaque remains on the teeth it becomes hardened (calcified) and forms calculus or tartar. Tartar is a yellowish film of calcium phosphate, carbonate, food particles and other organic matter deposited on the teeth by saliva. Calculus must be removed by using dental instruments. Calculus is the primary cause of gum diseases and dental caries.

Bottle mouth syndrome:- Infant’s dental caries can be caused by allowing the infant to go to bed with a bottle filled with a liquid other than water.

Periodontal diseases or pyorrhea:- It is the pus formation in the sockets of the teeth. This is the common cause for loss of teeth in people over 40 years of age. It develops in four stages.
First stage: Gingivitis is an inflammation of the gums usually manifested by the primary symptom of bleeding from the gums. It is an early stage of periodontal disease. Gingivitis may result from waste products and toxins from organisms in the mouth which may cause initial injury. Then, when plaque and bacteria accumulates they form calculus which contains more micro organisms and causes further gingivitis. Those at increased risk of gingivitis include people who breathe through the mouth, diabetic people who use orthodontic devices (e.g. braces) and people who experience hormonal fluctuations (adolescents, pregnant women and those taking oral contraceptives).
Second stage (Periodontitis): Chronic gingivitis causes the inflammation to spread and destroy the underlying bone causing Periodontitis.
Third stage: Acute necrotizing ulcerative gingivitis develops which causes mobility of the teeth, purulent discharges and tissue atrophy. It may pain severely.
Fourth stage: In this stage there is destruction of the teeth supporting structure. The periodontium atrophies so that the gums appear to have receded completely away from the tooth. Without adequate supporting structures, the tooth may become very loosely attached or falls out.

Sordes:- Brown crust which are formed on the teeth and lips are called sordes. It is a collection of food, mucus and bacteria. Lack of oral hygiene, insufficient intake of fluid in illness, drying of mucus membrane in case of mouth breathing are the common causes of formation of sore and crusts on the teeth and gums.

Cheilosis:- It is the cracking or ulceration of the lips and angles of the mouth. It can occur in riboflavin deficiency. Lack of stimulation of the flow of saliva also can lead to drying of the mouth and cracking of lips.

Bleeding gums:- I can occur in vitamin C deficiency (scurvy), use of hard and stiff brush for brushing the teeth.

Glossitis:- It is an inflammation of the tongue.

Root abscess:- It is pus formation in the root of the teeth.

Cancrum oris:- It is gangrenous stomatitis.

Stomatitis:- It is the inflammation of the mucus membrane of the mouth. This can occur in the following people:§ Those who receive drugs such as anticholinergics that cause decreased salivation resulting in dry mouth.
§ Those who have poor oral hygiene.
§ Those who have an immune deficiency.
§ Those who are undergoing chemotherapy or radiotherapy for cancer.

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