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What is it about ?
Teeth consist of a visible part (the crown) and a part located in the jawbone (the root). The neck is the part that is located under the gum tissue. The tooth is covered with a hard tissue: the enamel around the crown and the cement around the root. Inside the teeth is a bone-like material (dentin). The core of the tooth is made up of soft tissue (the pulp), filled with blood vessels and nerves. Together, the teeth form the dentition.
The children have 20 temporary teeth, the baby teeth. The first baby teeth appear around 6 months of age, although this can vary from child to child. The first dentition is fully developed around the age of 2.5 years. Baby teeth fall out spontaneously, most often from the age of 6 years. Then grow the 32 permanent teeth: 16 in the upper jaw and 16 in the lower jaw. This is the only time in a human’s life when they can lose a tooth and get another. A lost permanent tooth will never be replaced by a new natural tooth. We have 3 types of teeth: incisors, canines and molars.
All parts of the tooth can be affected (by dental plaque, tartar, cavities, abnormal wear).
Dental plaque, tartar and dental caries
Decay is a disease of the hard part of the tooth (hard tissue of the tooth), which is caused by germs on the surface of the tooth. It is the most common disease of the hard tissue of the tooth. The first step is the formation of dental plaque: a thin, barely visible layer that is still flexible enough to be removed with the tip of the nail. If you wait longer than 48 hours, the dental plaque will harden and form tartar, especially where it meets the gums. Tartar can only be removed by the dentist.
Dental plaque causes the following problems:
- bacteria in dental plaque convert sugars into acids, which make small (black) holes in teeth (cavities). Poor dental hygiene and reduced saliva production increase the risk of cavities. The disappearance of the shine of the tooth (the shine is linked to the enamel) is the first sign of tooth decay. Fast-growing decay is white in color, slow-growing decay is brown or black. The only way to prevent the penetration of bacteria is to remove the affected part and plug it (called a plugging).
- bacteria in dental plaque can also cause inflammation of the gum tissue. The gums are red, swollen, soft to the touch, and may bleed when you brush your teeth or when you eat. Sometimes an inflamed gum causes a bad taste in the mouth, bad breath, or pain.
- inflammation of the gums (gingivitis) can affect the jawbone. In this case, the gum breaks away from the teeth, creating a space (pocket) in which dental plaque forms again. The gum tissue can be visibly retracted, making the teeth very sensitive to heat, cold or sugary foods. The inflammation spreads deeper through the pockets and ultimately leads to destruction of the bone (periodontitis). At an advanced stage, teeth can come loose and eventually fall out. Smoking, diabetes, stress, pregnancy, certain systemic illnesses, and the use of certain medications can cause periodontitis.
- finally, tooth decay can lead to inflammation of the pulp. This phenomenon is accompanied by pain and tooth hypersensitivity. Acute infection produces intense painful burning sensation. General symptoms of infection (such as fever) may also occur. In addition, this inflammation can spread to the bone. Left untreated, it leads to an abscess with swelling of the cheek. Inflammation of the pulp can still be due to other causes, such as a leaky filling or trauma.
Abnormal tooth wear
Abnormal tooth wear is usually the result of friction, abrasion or tooth erosion, for example in people who grind their teeth, have dental abnormalities, or brush their teeth too vigorously. . This wear and tear can lead to pain in the jaw, among other things.
The term “dental erosion” denotes damage to the enamel of the teeth by acids, for example by soft drinks or because of gastric reflux. Your teeth are then sensitive while eating or drinking. Teeth turn yellowish and may shrink. Lost enamel does not come back; its loss is final.
How is the diagnosis made?
During your annual check-up, the dentist will check the health of your teeth (cavities, plaque?) And your gums (red, swollen, retracted?). He can use a special dye to see the dental plaque better.
What can you do ?
Good hygiene of the mouth and teeth is essential. Brush your teeth thoroughly twice a day, for at least 2 minutes, with fluoride toothpaste. There are special toothpastes that slow the formation of tartar. In addition to this, clean the gaps between your teeth once a day, for example with a toothpick or dental floss, to remove plaque.
You can also use a mouthwash, but be careful: it never replaces brushing! See the dentist at least once a year, and ask for an earlier appointment if you have pain or bleeding gums. Drink less or no soda at all and limit your sugar intake. Paracetamol or an anti-inflammatory can relieve dental pain.
What can your dentist do?
The dentist will give you advice on good dental hygiene and on the equipment to use. If you have a decayed tooth, it can only be repaired with a filling or a crown. It is not possible to restore the jaw bone destroyed due to periodontitis. It is therefore essential to intervene quickly to avoid losing your teeth. The dentist will remove dental plaque and tartar, both in the deep pockets and at the gum line. If the pockets are too deep or difficult to reach, a small intervention may be necessary.
In the case of an inflamed pulp, the infected and necrotic tissue is removed and replaced with filling material from the root (root filling). If you have a tooth abscess, you may need to take antibiotics first. Sometimes the tooth can no longer be saved and it has to be removed.
Treatment for dental erosion begins with good dental hygiene and healthy eating habits. If erosion is limited, fillings are usually sufficient to repair the teeth. If erosion is extensive, crowns may need to be placed on more than one tooth.
Want to know more?
- Mouth and teeth (images) – Christian Mutuality
- Tips for unparalleled oral hygiene – Christian Mutuality
- Visiting your dentist – Christian Mutuality
- Painkillers and self-medication – Federal Agency for Medicines and Health Products
- Paracetamol – CBIP – Belgian Center for Pharmacotherapeutic Information
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