Diseased teeth encompass conditions affecting the teeth, gums, and underlying supporting bone structure. These issues compromise the function and integrity of the mouth, potentially impacting overall health. Untreated dental disease is one of the most common health problems globally. Understanding how these conditions begin, what signs they present, and how they are managed is the first step toward prevention and treatment.
Fundamental Causes of Oral Disease
The primary cause of most dental disease is the interaction between oral bacteria and dietary sugars. Specific bacteria, such as Streptococcus mutans, thrive on fermentable carbohydrates left on the tooth surface. As a byproduct of their metabolism, these bacteria produce acids, primarily lactic acid, which significantly lowers the pH level in the mouth.
This acidic environment initiates demineralization, dissolving the calcium and phosphate minerals that form the protective enamel. If acid attacks are frequent, the enamel weakens and eventually breaks down, leading to a cavity. The sticky bacterial colonies form a film known as plaque, which hardens into tartar or calculus if not removed regularly. Tartar provides a rough surface that harbors more bacteria.
Systemic factors can accelerate this destructive cycle, even with good brushing habits. Conditions causing xerostomia, or dry mouth, reduce the cleansing and neutralizing effects of saliva, which naturally buffers acids. Underlying diseases, notably diabetes, also increase susceptibility to infections and inflammation in the gums. Frequent consumption of acidic beverages and sugary snacks provides the constant fuel needed to keep the mouth in a state of decay.
Recognizing the Signs of Dental Distress
Patients often notice dental distress through changes in sensation or appearance. A common indicator is heightened sensitivity, manifesting as sharp, temporary pain when consuming hot or cold foods and drinks. This reaction occurs when the protective enamel layer has worn away, exposing the sensitive dentin underneath.
Persistent bad breath, or halitosis, signals a buildup of bacteria and decaying food particles trapped in periodontal pockets or deep decay. Other signs include gums appearing swollen, red, or tender to the touch. Gums that bleed easily during routine brushing or flossing display the earliest signs of inflammation.
A visual inspection may reveal chalky white spots on the enamel, representing initial demineralization, or dark brown and black spots indicating advanced decay. Localized, throbbing, or continuous pain, particularly when biting down, suggests the infection may have reached the tooth’s innermost nerve tissue. A noticeable change in the fit of dentures or loose teeth signals a possible progression of supporting bone loss.
Major Categories of Tooth and Gum Disease
Diseases affecting the mouth target either hard tissues or soft tissues and supporting structures. Dental caries, or cavities, are the most frequent hard tissue disease, beginning as tiny enamel defects that expand into the softer dentin. If decay continues unchecked, it reaches the pulp—the center containing nerves and blood vessels—leading to pulpitis, an inflammation that causes significant pain.
An untreated pulp infection can progress to a dental abscess, where a pocket of pus forms at the tip of the tooth root, often requiring immediate intervention. The most common soft tissue disease is gingivitis, characterized by inflamed, red, and bleeding gums caused by plaque buildup along the gumline. Gingivitis is reversible with professional cleaning and improved hygiene habits.
If gingivitis is left unmanaged, it can advance to periodontitis, an irreversible condition. Chronic inflammation causes the gums to pull away from the teeth, creating deep pockets that harbor bacteria and toxins below the gumline. The immune response to this infection breaks down the connective tissue and alveolar bone, leading to gum recession, tooth mobility, and eventual loss.
Professional Interventions and Restoration
Dental professionals employ interventions to halt disease and restore lost tooth structure or supporting tissue. For early decay, restorative treatments involve removing the decayed material and placing a filling, typically composite resin or amalgam, to seal the hole. When decay or fracture compromises a significant portion of the tooth, a dental crown (a custom-made cap) is placed over the remaining structure to restore strength, function, and shape.
For soft tissue disease, the initial treatment is a professional cleaning to remove plaque and hardened calculus from above the gumline. If periodontitis has developed, the treatment progresses to scaling and root planing, a deep-cleaning procedure that removes calculus and bacteria from the root surfaces beneath the gumline. This process smooths the root to help the gum tissue reattach and close the periodontal pockets.
When infection has invaded the pulp, endodontic procedure, or root canal therapy, is performed to save the tooth. This involves drilling, removing the infected pulp and nerve tissue, cleaning and shaping the inner canals, and then filling and sealing the space. If a tooth is too damaged, a surgical extraction is performed to remove the entire structure and prevent infection spread to the jawbone.
Strategies for Long-Term Oral Health
Effective long-term oral health relies on consistent habits that disrupt bacterial acid production and demineralization. Brushing should be performed twice daily for two minutes using a soft-bristled brush and fluoride toothpaste. Angle the bristles at 45 degrees toward the gumline to clean the tooth surface and the gum margin. Fluoride helps remineralize and strengthen the enamel, making the tooth more resistant to acid attacks.
Cleaning between the teeth once a day is equally important, as a toothbrush cannot effectively reach the proximal surfaces where plaque tends to accumulate. Using floss or an interdental cleaner in a C-shape motion around each tooth helps remove the bacteria and food debris that contribute to both decay and gum disease. The timing of this cleaning, ideally before bed, ensures the mouth is as clean as possible during the hours when saliva flow is reduced.
Dietary modification involves limiting the frequency of consuming sugary and acidic foods and beverages. Every time sugar is ingested, it triggers an acid attack, so reducing snacking limits the duration of enamel exposure. Routine professional care, including regular examinations and cleanings, allows dental professionals to detect early signs of disease and remove hardened calculus.