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is relieved when the pressure is withdrawn or when chewing is
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
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.