5 oral health problems, solved

Source: Best Health magazine, March/April 2015

"You need to get a gum graft," my dentist told me.This was not surprising news since I have been well aware of how much my lower gums have receded, particularly on my incisors. It has left my teeth incredibly sensitive and me rather self-conscious.

Let’s face it: We all want healthy teeth that last us a lifetime. There is nothing appealing about the thought of chompers in a glass with your name on it. Thankfully, modern dentistry has come a long way: Canadians are, in fact, keeping their pearly whites longer than ever before, largely due to the effects of fluoride, as well as better maintenance and oral hygiene.

That said, there are still common dental risks that pop up from time to time. Here’s what you need to know to prevent problems and keep your smile bright.

Gum recession

Cause: While I knew my lower gums were receding, I didn’t realize my particular cause: clenching and grinding at night. The repeated added pressure on my teeth had this negative impact on my gums. But that’s not the only thing that can cause gums to recede.

"The two principal causes are toothbrush abrasion and chronic gum disease," explains Dr. Euan Swan, manager of dental programs at the Canadian Dental Association in Ottawa. Toothbrush abrasion is common in younger patients, he says. People who scrub their teeth with hard-bristled brushes can end up having their gum tissue recede from the tooth, thereby exposing the root surface. The other type, chronic gum disease, is a result of people losing the bone that supports their teeth. As bone loss occurs, the overlying gums will recede.

Cure: If aggressive brushing is the culprit, Dr. Swan says the solution is to use a soft-bristled toothbrush and change the way you brush from a scrubbing back-and-forth motion to a shorter up-and-down motion. For chronic gum disease, see your dentist and get regular cleanings to reduce inflammation and halt the loss of supporting bone. And don’t forget to floss.

For those of us whose gums are too far gone, there is grafting. This process requires a visit to an oral surgeon, who takes tissue from the roof of your mouth and attaches it to your recessed gums. The procedure is done under local anesthetic, and both sites heal over six weeks.

Caution: Left untreated, gum recession can lead to notched teeth as you erode the root surface. Eventually, your teeth will become mobile, meaning you’ll end up losing teeth, either because they fall out or you need them removed because they are too loose.

Gingivitis

Cause: Are you spitting blood along with saliva when you brush your teeth? That’s a classic sign of gingivitis, inflamed gum tissue caused by a buildup of plaque around the teeth.

Cure: "Gingivitis is reversible," says Dr. Swan, "so if you clean the area, remove the debris and practise good oral hygiene, the gingivitis will disappear." The best place to start is with your dental hygienist, who will scale and clean your teeth to remove the calculus (also known as tartar) and then give you some instructions about proper oral hygiene. At home, you need to brush more regularly, floss and consider an antibacterial oral rinse.

Caution: "The risk of doing nothing is that you may develop chronic gum disease," warns Dr. Swan. "That results in the loss of bone support to the tooth and receding gums." Plus, inflamed red gums are neither comfortable nor attractive.

Canker sores

Cause: According to Dr. Swan, no one actually knows what causes those little sore spots that crop up on your tongue or inside your cheek. "It’s thought that trauma to the tissue or foods that maybe irritate the surface of the cheeks can contribute to them," he says.

Cure: "The good news is, although canker sores are irritating and sore, they’re going to heal in about 10 to 14 days, whatever you do," says Dr. Swan. That said, you don’t have to suffer while you wait. "There are some over-the-counter protective gels and ointments that you can try to cover them with," he says. "But during those 10 to 14 days, if you avoid foods that irritate them, like hot and spicy foods, you’ll be more comfortable."

Caution: The odd canker sore that clears up on its own is no cause for concern. But, says Dr. Swan, if you’re getting them regularly, or if a given canker sore lingers for two weeks, it’s time to see a dentist. "It may be something that needs attention," he says. "A lesion that’s there for a long time may be a precursor to oral cancer." Canker-like sores may also be a symptom of Crohn’s disease.

Bad breath

Cause: That strong morning brew, that garlicky Caesar salad, that tasty tuna sandwich ‘ all harbingers of halitosis, or bad breath. But why? It can be as simple as the foods you eat: As you digest foods like as onions, garlic and spices, they enter your bloodstream and are carried to your lungs, affecting your breath. It can also stem from poor oral hygiene, says Dr. Swan.

The same holds true for infamous "morning breath," which Dr. Swan explains is mostly caused by the decrease in saliva flow at night, which, in turn, means food particles stay in the mouth. "As a result, the oral bacteria proliferate and produce an odour," he says.

Cure: For the short term, swish twice daily with mouthwash. There’s more choice than ever, so opt for a multi-tasker, such as a product that fights bad breath and gingivitis or doubles as a tooth whitener. For longer-term relief that goes beyond dealing with your lunchtime onion rings, the best way to banish bad breath is to clean it out. That includes brushing your tongue while brushing your teeth, says Dr. Swan. "Brushing the surface of your tongue can be helpful because some people have fissures on their tongues, and food and debris can collect in the fissures and cause a smell."

Caution: If your mouth is as clean as a whistle and your bad breath persists, it’s time to see your healthcare practitioner. Some medications can lead to halitosis by drying out your mouth or causing your body to release odour-causing chemicals. As well, some diseases and metabolic disorders can cause bad breath, so don’t ignore a lingering odour.

Yellow teeth

Cause: Is your grin less than pearly white? Consider your diet. "Tea, coffee, certain foods ‘ anything that would stain your kitchen sink could stain your teeth," says Dr. Swan. But that’s not the only cause. "As we age, our teeth naturally darken and appear more yellow," he says. That’s because as we lose tooth enamel, the dentin inside the tooth becomes more visible.

Cure: With surface staining, you could limit foods known to discolour teeth or use a straw to prevent liquids from touching your teeth. Getting your teeth cleaned regularly by a professional hygienist will also help keep stains at bay. If you’re looking to brighten your smile, there are all kinds of whitening products available at the drugstore and from dentists themselves. Chat with your pharmacist or dentist to find a product that would be appropriate for you, but keep in mind that some stains can’t be removed (such as ones caused by tetracycline, a type of antibiotic), and the same goes for discolouration after a root canal. If your yellowing teeth are simply due to the aging process, you might want to consider crowns or veneers.

Caution: Some whitening products can create tooth sensitivity or irritate gum tissue, warns Dr. Swan. He suggests proceeding conservatively: Start with a good cleaning; if the results aren’t white enough, try bleaching. And remember, if you decide on crowns and veneers, they come with an end date, so be prepared to replace them down the road.

As with all oral health concerns, your best defence is always good oral hygiene coupled with regular visits to the dentist ‘ a combination that’s sure to keep you smiling.