For decades, antibiotics have greatly benefited the medical community’s efforts to fight bacterial infections. However, we now face a new challenge with bacteria becoming resistant to this treatment modality as a consequence of widespread (and often unnecessary) use. Providers are now learning to be more prudent in appropriate prescription of these drugs. Here’s some things to know about current recommendations and guidelines:
1- In an otherwise healthy child, abscess from dental decay localized to the tooth or surrounding tissues is not an indication for use of antibiotics. The tooth however, needs to be treated as soon as possible.
2- When an acute infection that originated from tooth decay becomes systemic (ie. facial swelling, fever), oral and or intravenous antibiotics may be indicated.
3- Oral wounds at times require antibiotics. The provider needs to consider, amongst other things, the extent of damage as well as nature of contamination of wound.
4- When impact to the face has occurred, certain types of dental trauma may benefit from localized or systemic use of antibiotics to improve healing and long term prognosis of involved teeth.
5- Some gum diseases may require localized or systemic use of antibiotics . These conditions occur very rarely in children and should involve careful evaluation and a multifaceted treatment plan.
Of note, tetracycline and similar antibiotics are known to internally discolor developing teeth. Ask your child’s provider for details.
By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist
When your tooth becomes infected, it is clinically known as an abscessed tooth. The main reason for an abscessed tooth is tooth decay. An abscessed tooth can lead to serious damage including rotting of the pulp, and core of the tooth. This can even lead to pus buildup near the jawbone.
Failure to seek treatment can even cause damage to the surrounding bone and tissue.
The most common treatment for an abscessed tooth is a root canal. A root canal is a procedure where the infected tissue is cleaned, the canal is sealed, and the top of the tooth is crowned or capped.
People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth. One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.
People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.
Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.
Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint.
Teeth grinding, also called bruxism, is often viewed as a harmless, though annoying, habit. Some people develop bruxism from an inability to deal with stress or anxiety.
However, teeth grinding can literally transform your bite relationship and worse, severely damage your teeth and jaws over long periods of time.
Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin.) Bruxism can also lead to chronic jaw and facial pain, as well as headaches.
If no one has told you that you grind your teeth, here are a few clues that you may suffer from bruxism:
Your jaw is often sore, or you hear popping sounds when you open and close your mouth.
Your teeth look abnormally short or worn down.
You notice small dents in your tongue.
Bruxism is somewhat treatable. A common therapy involves use of a special appliance worn while sleeping. Less intrusive, though just as effective methods could involve biofeedback, and behavior modification, such as tongue exercises and learning how to properly align your tongue, teeth and lips.
Many people suffer from sensitive teeth: a condition in which hot and cold foods or liquids, and even sudden puffs of air can cause discomfort and pain.
Tooth sensitivity can be caused by a number of things. An unnoticed cavity or abscessed tooth can sometimes be a culprit. But over time and as you age, changes in temperature, as well as such behaviors as tooth grinding (bruxism) and overly aggressive brushing, can cause small, often microscopic cracks or fissures on the chewing surfaces of your teeth (or near the gum lines), which exposes the inner structures called dentin.
Hypersensitive teeth can cause people to change their eating habits, avoid social situations, or even avoid proper oral hygiene because the simple act of brushing or rinsing causes pain. Relief can sometimes be had by using a desensitizing toothpaste, sealants, or special fillings.
Plaque is an insidious substance: a colorless, sticky film that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.
Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.
Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.
Oral cancer is one of the most common cancers today and has one of the lowest survival rates, with thousands of new cases being reported each year. Fewer than half of all people diagnosed with oral cancer are ever cured.
Moreover, people with many forms of cancer can develop complications-some of them chronic and painful-from their cancer treatment. These include dry mouth and overly sensitive teeth, as well as accelerated tooth decay.
If oral cancer is not treated in time, it could spread to other facial and neck tissues, leading to disfigurement and pain.
Older adults over the age of 40 (especially men) are most susceptible to developing oral cancer, but people of all ages are at risk.
Oral cancer can occur anywhere in the mouth, but the tongue appears to be the most common location. Other oral structures could include the lips, gums and other soft palate tissues in the mouth.
In general, early signs of oral cancer usually occur in the form of lumps, patchy areas and lesions, or breaks, in the tissues of the mouth. In many cases, these abnormalities are not painful in the early stages, making even self-diagnosis difficult.
Here are some additional warning signs:
Hoarseness or difficulty swallowing.
Unusual bleeding or persistent sores in the mouth that won’t heal.
Lumps or growths in other nearby areas, such as the throat or neck.
If a tumor is found, surgery will generally be required to remove it. Some facial disfigurement could also result.
Prevention is the key to staving off oral cancer. One of the biggest culprits is tobacco and alcohol use. Certain kinds of foods and even overexposure to the sun have also been linked to oral cancer. Some experts believe certain oral cancer risk factors are also hereditary.
A diet rich in fruits and vegetables is one of the best defenses against oral cancer. Maintaining good oral hygiene, and regular dental checkups, are highly recommended.
Any kind of cut to your face and the delicate soft tissues inside your mouth should be addressed immediately in order to prevent further tissue damage and infection.
If a traumatic injury involves a broken facial bone such as the jaw, nose, chin or cheek, maxillofacial surgery may be required.
With jaw surgery, rubber bands, tiny wires, metal braces, screws or plates are often used to keep a fractured jaw in place following surgery. This allows the bone to heal and stay in proper alignment. Dental splints or dentures may also be required to supplement the healing process following jaw surgery.
Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.
If wisdom teeth are causing a problem and are not pulled, they can sometimes become impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: pain, inflammation, and some kinds of infections.
Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one’s ability to properly bite down, speak or eat.
Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping.
Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay.
Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable.
If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur.
Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure.
Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman’s body that promote plaque production.