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  Dental Disorders in Teeth  

The teeth can be affected by numerous disorders. This section of the web site give a run down on the more common disorders seen in teeth and oral health.

Cracked tooth syndrome

Cracked tooth syndrome refers to an incomplete fracture of a vital posterior tooth, which could extend to the pulp. It is a toothache caused by a fractured tooth without associated cavities or gum disease. It commonly involves the first and second mandibular molars and maxillary teeth of people aged between 30 and 50 years.

Cracks in teeth are usually caused by forcibly biting on hard foods and/or objects, trauma to the mouth, a history of teeth grinding or clenching (Bruxism), large fillings and periodontal diseases that weaken the teeth’s support. Complaints of tooth pain or a diffuse uncomfortable sensation on biting, chewing, or on pressure application are commonly noted, and this sensation is relieved when the pressure is withdrawn or when chewing is stopped.

Treatment depends on the degree of tooth involvement and the size of the crack or fracture. Small factures that do not involve the pulp are completely fractured off and undergo regular restorative procedures. However when larger portions are involved and the fracture extends to the pulp, the tooth should be immediately stabilized using an orthodontic stainless steel band. Care should be taken as to prevent pulpal necrosis.

Prevention of fractures is achieved thru proper cavity preparation and adequate cuspal protection. Replacement of fractured cusps is necessary to avoid progression of small fractures.

Dry socket disorder

Dry socket disorder is one of the more common complications of dental surgery, which represents a disruption of the healing process in an extraction site. It is a painful inflammation that commonly occurs in the third (3rd) molar, and more often in women than in men.

The etiology of dry socket disorders is not well understood however the theory of the disintegration of the blood clot by fibrinolysis remains widely accepted. Such theory states that fibrinolysis causes the dissolution of the blood clot and the formation of kinins, which are responsible for producing pain. Factors possibly contributing to the risk of dry socket include traumatic extraction, pre-operative infection, the use of oral contraceptives, female gender, tobacco, and the use of local anesthetics with vasoconstrictors.

Treatment is geared towards pain relief and infection prevention. The socket is flushed or irrigated to remove any debris that may have collected in it. Medicated dressings are placed in the surgical site and are changed accordingly. Pain medications are prescribed to reduce disability.

Impacted wisdom teeth

Wisdom teeth are the third molars at the very back of the mouth. They develop like any other teeth however they take so long to erupt. Any tooth can get impacted but wisdom teeth impaction is the most common. The diagnosis is made when the teeth don’t develop and function properly. Wisdom teeth oftentimes get impacted because by the time it is their turn to erupt, they have to fight for space with the other teeth that have established themselves years prior. Small jawbones predispose to teeth impaction, as well as faulty development of the alveolar bud. Impacted teeth are normally considered for removal after the risks involved have been considered carefully and the possible complications discussed with the patient.

Drug-induced tooth disorders

Disorders secondary to drug intake are classified into: 1) tooth discoloration, 2) physical damage to tooth structure, and 3) alteration in tooth sensitivity.

Extrinsic tooth discoloration may be removed by brushing or by professional cleaning. Clorhexidine, iron salts in liquid form, and a widely used anti-biotic, Amoxicillin all cause extrinsic discoloration. Intrinsic tooth discoloration, on the other hand, is permanent since the drug interferes with odontogenesis. Fluorides, although helpful in reducing caries and in strengthening enamel, is damaging to young teeth in high concentrations. It causes permanent hypomineralization of the enamel, a condition called dental fluorosis. Tetracyclines and minocyclines cause yellow discoloration of the teeth, while Ciprofloxacin, causes a greenish discoloration.

Physical damage to teeth is usually secondary to either increase in cavities, or erosions. Sugar-coated drugs and those that cause xerostomia or dry mouth (anticholinergics, amphetamine, anti-psychotics, neuroleptics, alpha receptor- and muscarinic receptor antagonists) are all implicated in increasing the dental caries. Anti-asthma drugs that are in powdered form can cause teeth erosion, as well as drugs that increase the incidence of gastric reflux (theyophylline, anti-cholinergics, calcium-channel blockers). Chemotherapeutic agents and anti-convulsants, such as phenytoin, are known to produce dento-facial and other tooth-related abnormalities.

External tooth bleaching agents, carbamide peroxide and hydrogen peroxide, are both known to increase tooth sensitivity which usually lasts up to 4 days post bleaching, however the exact mechanism by which tooth sensitivity occurs in still not well-understood.

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