In addition to care of the teeth, dentists are often at the forefront of identifying disorders that affect the mouth, although usually physicians are the ones who would treat a diagnosed disorder. Changes in the color of the mouth’s tissues sometimes signal systemic disease.
- Introduction to the Approach to the Dental Patient
- Systemic Disorders and the Mouth
- Dental Anatomy and Development
- Evaluation of the Dental Patient
- Recurrent Aphthous Stomatitis
- Oral Growths
- Toothache and Infection
- Dental Appliances
- Acute Necrotizing Ulcerative Gingivitis (ANUG)
- Other Gingival Disorders
- Overview of Temporomandibular Disorders
- Ankylosis of the Temporomandibular Joint (TMJ)
- Arthritis of the Temporomandibular Joint (TMJ)
- Mandibular Condylar Hyperplasia
- Mandibular Condylar Hypoplasia
- Internal Temporomandibular Joint Derangement
- Myofascial Pain Syndrome
Dental Disorders Sections (A-Z)
Approach to the Dental Patient
A physician should always examine the mouth and be able to recognize major oral disorders, particularly possible cancers. However, consultation with a dentist is needed to evaluate patients with nonmalignant changes as well as tooth problems. Likewise, patients with xerostomia or unexplained swelling or pain in the mouth, face, or neck require a dental consultation.
Common Dental Disorders
Caries is tooth decay, commonly called cavities. The symptoms—tender, painful teeth—appear late. Diagnosis is based on inspection, probing of the enamel surface with a fine metal instrument, and dental x-rays. Treatment involves removing affected tooth structure and restoring it with various materials. Fluoride, diligent dental hygiene, sealants, and proper diet can prevent virtually all caries.
Periodontitis is a chronic inflammatory disease of the gums resulting from an opportunistic infection of endogenous plaque biofilm. It usually manifests as a worsening of gingivitis and then, if untreated, with loosening and loss of teeth. Other symptoms are rare except in patients with HIV infection or in whom abscesses develop, in which case pain and swelling are common. Diagnosis is based on inspection, periodontal probing, and x-rays. Treatment involves dental cleaning that extends under the gums and a vigorous home hygiene program. Advanced cases may require antibiotics and surgery.
Symptoms of Dental and Oral Disorders
Bruxism is clenching or grinding of teeth. Bruxism can abrade and eventually wear down enamel and dentin in the crowns of teeth, damage metal or ceramic dental crowns, and cause teeth to become mobile. Tooth abrasion and erosion is often worse in patients who also have gastroesophageal reflux disease (GERD—see Gastroesophageal Reflux Disease (GERD)) and/or obstructive sleep apnea (see Obstructive Sleep Apnea). A bruxism triad has been described, consisting of arousal-induced tooth grinding, airway-associated sleep disorders, and sleep-related GERD.