Understanding the problem
A number of conditions can affect teeth and gums, leading to pain and discomfort. Some of these conditions can lead to infection and even tooth loss, which is why good oral hygiene is so important.
Tooth decay
The root cause of tooth decay is plaque, which is a thin sticky film that covers the surface of the teeth and gums. Plaque contains many different types of bacteria, which live naturally in the mouth.
These bacteria react with the food we eat and drink, forming acids which then attack the enamel on the surface of the teeth.
Over time, this acid can destroy the enamel and a cavity will form as a result. Left untreated, dental cavities can destroy a tooth and cause significant pain.
The only way to stop this extended damage is to have the cavity filled by a dentist.
Bad breath
Certain foods, such as garlic and raw onion, give off an odour in the breath once they’ve been ingested, but this is only temporary and resolves quickly.
In other cases, bad breath – also known as halitosis – can be caused by something else going on in the mouth. For instance, food that is stuck between teeth can rot, causing a bad smell.
When teeth are not cleaned properly, the bacteria that grow in the mouth can cause gum disease and that, in turn, can also lead to bad breath.
Bad breath can also be a sign of health problems elsewhere in the body, such as sinus infections, chronic lung infections, liver or kidney disease and diabetes.
Sensitive teeth
If a mouthful of ice cream or a sip of hot tea makes a person wince, it is likely that they are suffering from sensitive teeth.
Normally, teeth are not sensitive, but when enamel is worn away or gums recede, the underlying layer of dentine can become exposed.
When stimuli such as hot or cold food and drink come into contact with the exposed nerve endings inside the teeth, the result is the sudden, sharp pain associated with sensitivity.
Gum disease
Gum disease, or gingivitis as it is also known, is a very common oral health condition, with up to 90 per cent of the UK adult population estimated to have it – to some degree.
Gum disease can be caused by the build-up of plaque on the teeth. The bacteria in the plaque irritate the gums, causing inflammation and swelling.
These swollen and irritated gums bleed more easily when the teeth are brushed. Other signs of gingivitis include bad breath or a bad taste in the mouth and shrinking of the gums.
Gum disease is most likely to occur if there is poor oral hygiene, but it is also more common in smokers, people with diabetes and anyone with a weakened immune system.
Periodontitis
Untreated gum disease can become more severe and develop into a condition called periodontitis. If the bacterial plaque spreads below the gumline, the inflammation affects not only the gums but also the jawbone and the ligaments that hold the teeth in place.
If it is left to progress further, periodontitis can lead to loose teeth that may even fall out. Signs of periodontitis include:
- Bad breath
- A foul taste in the mouth
- Receding gums
- Sensitive teeth
- Pus or painful abscesses
- Teeth becoming loose or falling out.
When to refer
Refer to the pharmacist anyone who presents with the following symptoms:
- Toothache that persists for more than a day or two
- Pain when eating or biting on certain foods
- Swelling in the mouth
- Pus around a tooth or a foul-tasting discharge in the mouth
- Tooth pain that is worse when lying down
- Tooth pain that spreads to the jaw, ear and/or neck
- Persistent bad breath that does not improve with good oral hygiene measures.