Charles McGee DDS

Mouth sores can be very annoying and painful and can have many causes.

The causes can range from infections – bacterial, viral or fungal – to a loose orthodontic wire or a denture that doesn’t fit or a sharp edge from a broken tooth or filling.

But mouth sores may be symptoms of an underlying disease or problem.

So, if you’ve had any mouth sore that lasts a week or longer, it’s a good idea to get your dentist to check it out.

Here are some of the most common mouth sores:

Canker sores: These are small ulcers with a white or gray base and a red border. They appear inside the mouth and are not contagious though they often return. Problems such as poor immune systems, viruses or fatigue and stress may be involved. They usually heal on their own after a week or two.

Cold sores: Cold sores are annoying and painful. They are also known as fever blisters or Herpes simplex and are groups of fluid-filled blisters. They often erupt around the lips and sometimes under the nose or around the chin. Cold sores caused by herpes virus type 1 are very contagious and the virus stays in the body. Cold sore blisters usually heal in a week by themselves.

Candidiasis: This fungal infection (also called moniliasis or oral thrush) occurs when the yeast Candida albicans reproduce in large numbers. It is common among denture wearers and people who have dry mouth syndrome are very susceptible to it. The focus is on preventing it or controlling the conditions that caused the outbreak.

Any mouth sores that last more than a few days should be checked with your dentist.

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

You’ll give yourself the best chance of good oral health if you build a strong relationship with your dentist.

That can sometimes mean asking the right questions and helping them to assist you in the best way possible.

So you want to make sure you have a dentist who will first of all explain techniques that you should use to help prevent dental health problems. They should be willing to show you step-by-step what you need to do.

You should also choose a dentist who is willing to take time to answer your questions, especially when they are recommending a course of treatment.

If you don’t understand any part of what your dentist recommends, don’t be afraid to ask for more information.

You may want to ask if there are other options to the solution they recommend. For example:

– How do the options differ in cost?
– Which solution will last the longest?
– Do all the options solve the problem?

Ask the dentist which treatments are absolutely necessary, which are elective and Which are cosmetic.

Ask which procedures are urgently needed, and which ones are less urgent. Your dentist will help you prioritize between problems which need immediate attention and those that are less urgent.

Often, treatment can be planned over a period of time but make sure you understand any consequences of delaying treatment.

It’s naturally also important to make sure that you are given full information about fees and payment plans before treatment is scheduled.

Your saliva plays an important role in your oral health and reduced saliva flow can lead to health problems.

Reduced saliva flow can lead to a dry mouth and this is a common problem among older adults.

It can be caused by various medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Dry mouth can be associated with various problems such as a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages.

Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common.

So, if dry mouth is not treated, it can damage your teeth.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes “tooth worms” as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first “dentist”, dies. An inscription on his tomb includes the title “the greatest of those who deal with teeth, and of physicians.”

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of “silver paste,” a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade � sharp knives and razors � were useful for surgery. Following the edicts, barbers assume the monks’ surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants – these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

If you have removable plastic dentures, it’s important to look after them carefully.

You should brush them each day to remove food deposits and plaque. This also helps prevent them from becoming permanently stained.

It’s best to use a brush that is designed for cleaning dentures as it has bristles arranged to fit the shape of the denture. But a regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles as these can damage the denture.

When you are handling a denture, hold them carefully. Try standing over a folded towel or a sink of water with them in case you accidentally drop them.

It’s advisable to use a denture cleanser which has the American Dental Association seal of acceptance. However hand soap or mild dishwashing liquid are also acceptable for cleaning dentures.

Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.

A denture can lose its proper shape if it is not kept moist. So it should be placed in soaking solution or water at night � though one with metal attachments could be tarnished if placed in soaking solution.

As you age, your mouth naturally changes, which can affect the fit of the denture so, if they no longer fit properly, they should be adjusted by your dentist.

See your dentist promptly if your denture becomes loose as this can cause sores or infections.

Don’t try to adjust or repair your denture yourself as this can damage the appliance beyond repair.

When you wear a partial denture, you need to continue brushing twice a day and cleaning between your teeth daily. This will help prevent tooth decay and gum disease.

Pay special attention to cleaning the teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Your dentist or dental hygienist can demonstrate how to properly brush and clean between teeth.

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining a healthy smile.

Choosing the right dentist for your needs is one way to give you the best chance of maximizing your oral health.

If you don’t already have a dentist – or want to find one better suited to your needs – here are a few points to consider.

– Get recommendations from family, friends, neighbors or co-workers

– Ask your physician or a local pharmacist

– If you are moving to a different area, ask your current dentist for recommendations in your new location

– Contact the local or state dental society

You can also use Yellow Pages or the American Dental Association directory at www.ADA.org.

Effective dental care depends on a great relationship between the dentist and the patient so you may want to visit more than one before making your decision.

To help decide if a dentist is right for you, consider:

Is the office easy to get to from your home or job?

Are the staff helpful and friendly?

Does the office appear to be clean, tidy and well organized?

Is the appointment schedule convenient for you?

What arrangements are made for handling emergencies outside of office hours?

Does it cater for any special needs you have?

As you’ll need to work closely with your dentist in caring for your oral health, it’s worth taking time to ask questions and take notes to make sure you choose the right one for your needs.

A newly born baby usually has no teeth visible but most have begun to develop primary or baby teeth.

These generally begin to appear about six months after birth.

Over their first few years, they will develop all 20 primary teeth and will usually have them all in place by age three.

The teething process is uncomfortable for many babies and they can become sleepless and irritable. They also might lose their appetite or drool more than usual.

If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.

Sometimes when a tooth erupts, an eruption cyst may develop. The tooth will eventually rupture this as it pushes through the gums and these cysts are usually harmless and should be left alone.

If a baby has sore or tender gums when they are teething, it can help to gently rub the gum with a clean finger, a small, cool spoon or a wet gauze pad.

When this happens, your dentist or pediatrician may suggest a pacifier, teething ring or a special “numbing” salve for the gums.

When the teeth begin to erupt, you should brush them with a soft-bristled toothbrush and a little water to prevent tooth decay.

Toothpaste is not recommended until a child reaches age two. When a child begins using toothpaste, you need to supervise the brushing to make sure they don’t swallow it.

Regular dental checks should begin after your child’s first tooth appears or by their first birthday.