Teeth, gums and the entire periodontium are a sensitive system that is particularly sensitive to external influences. In addition, there is a moist and warm environment in the mouth, in which billions of microorganisms settle. Decisive for oral health is less the amount that a healthy balance of beneficial bacteria (important for digestion or the immune system, for example) and pests, which include inflammatory agents and caries-causing bacteria such as Streptococcus mutans. If these are selectively favored due to a very carbohydrate-rich diet and insufficient oral hygiene, the enamel is more and more damaged. Thus, widespread caries, which is also called mouth rot or “holes in the tooth”.
But tooth decay is not the only and not even the most common dental disease. Therefore, she is mentioned in this ranking only in passing. Rather, we want to introduce you to 5 dental problems that dentists often diagnose and educate you about how they develop and how they can be treated.
The term aphthous refers to painful blisters on the gum line, in the oral cavity, on the insides of the lips or on the tongue. From a medical point of view, aphthae are ulcers that can be recognized on a white surface. The small blisters are often disproportionately painful for their size and may also interfere with speech and eating when they appear on the tongue. On the other hand, aphthae on areas that are less mechanically stressed (eg on the inside of the cheek) are generally less sensitive to pain but can interfere with chewing.
Small aphthae with a diameter of less than one centimeter heal themselves within one to two weeks. With larger aphthae and severe cases, however, it may take weeks or months for the immune system to conquer the pathogens.
As a rule, aphthae are treated symptomatically and locally. Surface anesthetics, such as lidocaine or benzydamine, can be applied to the painful area as a spray, gargle or ointment pain and relieve symptoms. Even home remedies such as (diluted) tea tree oil, chamomile, sage or lemon balm (as tea) can be used for rinsing and provide pain relief.
Gingivitis is an acute or chronic bacterial inflammation of the gums. Symptoms include redness and swelling, pain, and increased bleeding tendency. The causes are like caries a lack of oral hygiene and prophylaxis because like tooth rot, gingivitis is caused by bacteria that settle on and below the gum.
In order to successfully treat gingivitis, better oral hygiene must first be ensured by the patient. Daily brushing, the use of Zahnraumraumraum or flossing and possibly a mouthwash are important prerequisites to bring the oral flora back into a healthy balance.
However, often these measures are no longer sufficient, especially if the gingivitis is already advanced and the gums are already retracting. A professional dental cleaning at the dentist, in which tartar and other coverings are thoroughly removed, usually ensures a resolution of the symptoms and a significant improvement within one to two weeks. In parallel, antibacterial mouthwashes with chlorhexidine can be used. If you prefer to do without, you can also use a tea made from chamomile, sage, myrrh or witch hazel.
An abscess is an encapsulated collection of pus in the tissue, which manifests itself by a mostly painful swelling, in severe cases also accompanied by fever. Abscesses in the oral cavity are usually caused by a pulpitis or root inflammation, triggered by strong caries damage and by bacteria that colonize and multiply in periodontal pockets. Likewise, abscesses are a typical accompaniment in the development of wisdom teeth – especially when they can not break through properly, but grow against or under the neighboring tooth.
Abscesses must be treated by a dentist who first clarifies the exact cause during an examination, if necessary with an X-ray. The abscess filled with pus then has to be surgically opened and emptied. This usually happens with a local anesthetic and is therefore painless for the patient. If the abscess is open, the dentist can drain the pus and then rinse the wound to remove any remains. In severe cases, an antibiotic can be administered locally, usually in the form of a gel, which is applied directly to the affected area.
The pain is usually after the opening of the abscess because the pressure on the tissue is abruptly reduced. Nevertheless, after acute therapy, the actual cause for the development of the abscess must be treated. If it is a non-erupting (wisdom) tooth, it may need to be pulled, while with an inflamed tooth root, root canal treatment is often sufficient and the tooth can be preserved.
4. Cysts in the jaw
Jaw cysts are like abscesses encapsulated cavities in the tissue, which are usually filled with fluid. Unlike abscesses that are always filled with pus, cysts can contain both pus and blood or sebum. In addition, both differ in their delimitation from the surrounding tissue, because cysts have a visible covering layer (epithelium), while abscesses merge seamlessly into healthy tissue.
This difference is also responsible for the fact that an ectomy is usually performed on a cyst; the cyst is removed surgically. The remaining cavity is then filled up by the oral surgeon with a bone substitute material and then sutured the wound. Only in cases where cystectomy is not possible (such as with a cyst formed around the roots of a preserved tooth), the cyst is surgically opened like an abscess, allowing the fluid to escape. Thereafter, by introducing a so-called “obturator”, the cyst is kept open and the premature closure of the wound is prevented so that the bone has sufficient time to renew itself from within and close the cavity.
The term periodontitis refers to inflammations of the periodontium, which consists of the jawbone, the periodontal gland, the gums, and tethers. This system ensures that each tooth sits firmly and yet to a certain degree flexibly in the jaw and can withstand severe chewing pressure. But it is like the teeth themselves endangered by bacteria that settle in the oral cavity. If the pathogens are not controlled by good oral hygiene and regular prophylaxis, for example, gingivitis can become inflamed (gingivitis), as bacterial plaque settles on the gingival margin, destroys the retaining threads of the gums and thus increasingly separates it from the tooth.
This results in small and increasingly larger periodontal pockets, in which the gingivitis in the depth, ie in the direction of the tooth root, can spread. With the toothbrush alone, you can only partially accomplish something in this phase.
To treat periodontal disease, the dentist must remove bacterial plaque and calculus and clean the periodontal pockets. In severe cases, local therapy with an antibiotic or surgery may be required to prevent the spread of periodontitis, which, if left untreated, inevitably leads to tooth loss – even from healthy teeth that are not caries-affected.
The most important protection against periodontitis (and many other dental diseases) is good and thorough oral hygiene. The right brushing of teeth, preferably with a soft electric toothbrush, is just as crucial as the use of dental floss or interdental brushes for cleaning hard to reach interdental spaces. In addition, a dental check-up should be carried out at least once a year in order to detect and treat early periodontitis or other dental problems at an early stage.