Shocking! What you Didn't Know about Holes in Your Teeth

Hello Steemians,

It's another time of the week when I bring you information and educate you all on an essential aspect of your health.

As a Dentist, I get to see a lot of patients come in to my clinic for consultation mainly from a severe tooth ache or pain and painfully, they present when the assault or tooth infection has gone beyond a normal or less invasive treatment.

WHAT ARE DENTAL CARIES?
Dental caries otherwise known as tooth holes or cavities are defined as a progressive and irreversible disease caused by microorganisms present in the mouth (oral cavity) in the presence of multifactorial factors which result to the breakdown of the calcified tissues of the teeth.

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By irreversible we mean that when a tooth is in such a condition, it cannot return to how it was initially.

The multifactorial factors that are usually present and a must for dental caries to begin and progress are as follows:

1) Bacteria: The mouth houses over a million microbes within its space. The three most important organism that must be present for cavities to be initiated are the Streptococcus mutans, the Lactobacillus acidophilus (which initiates the process) and the Actinomyces isreali (which causes the process to progress and become worse).

2) Plaque: This is a dental biofilm which gives a medium for the microbes to be dispersed and be able to carry out their act on teeth surfaces.

The microbes do this by producing acids when fermentable sugars such as sucrose, fructose and glucose (which are in almost all our diets) are ingested and acted upon by digestive enzymes within the mouth.

3) Substrate: This refers to the tooth or teeth that are usually basking in the frequency and presence of the first two factors mentioned above.

Majority of the time, the molars as well as the premolars are more liable to suffer attack than the anteriors, the central and lateral incisor, as well as the canine teeth.

4) Time: We use this term in this area of dentistry to refer to how long the teeth in question has been exposed to all the other factors that enable the possibility of caries development.

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The more all the factors are present with less good and proper oral hygiene; the faster the rate at which these tooth holes or cavities form.

SEQUELAE OF DENTAL CAVITIES
This explains how the worsening progression of tooth holes continue to cause problems such as pain, discomfort, bleeding, abscess formation (pus), cellulitis and in some cases death, once the process of tooth cavities have begun without proper oral hygiene procedures.

Proper hygiene procedures refer to proper brushing, frequent scaling and polishing and regular visits to the dentist.

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SIGNS & SYMPTOMS OF EACH.
1) Enamel/Dentine Caries: This is hardly noticed by the patients themselves except for sharp pains that occur once in a while when sugary foods and very cold drinks are taken.

What the dentist sees on examination is whitish tint on the surface of such affected teeth.

2) Pulpitis: This simply means the inflammation of the pulp tissue which is embedded within the dentine. There are two types, reversible and irreversible pulpits.

In reversible pulpitis, the patient is aware and constantly having sharp pain when he/she takes sugary foods or very cold water but the pain seizes as soon as such stimulus is taken off.

There is also presence of an obvious cavity seen during examination by the dentist.

In irreversible pulpitis, the pain the patient experiences is worse and prolonged even after the stimulus is removed and can only be relieved when pain killers are taken.

In such cases, some patients come for help at the clinic while others don't bother as long the pain is controlled by analgesic. This looks like a smart move but it's a killer route.

3) Dentoalveolar Abscess: This is as a result of continuous infection from the already irreversibly inflamed pulpitis leading to abscess or pus formation within the bony socket that bears the teeth.

On examination, there is obvious swelling which protrudes extraorally also, the affected teeth are so painful even when tapped.

These are basically the morphological presentations of dental caries sequelae.

I won't bore you with the various physiological presentations as they are quite a number as seen in the picture above but importantly ,the end result of these sequelea is sometimes instant death when one is so careless with the health. This is called Ludwig's Angina.

THE SILENT KILLER
Yes, Ludwig's Angina is the major cause of death seen in emergency cases of dental patients.

Over time these patients have overlooked the symptoms of all the aforementioned sequelae especially because they've become used to the intake of antibiotics and analgesics continuously over a long period of time.

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As I always tell patients during oral health talks, once a tooth has developed caries no matter what the patient takes, it can only be treated by the dentist.

Ludwig's angina is a serious life threatening infection that occurs at the floor of the mouth giving a characteristic brawny-like bilateral swelling just underneath the chin around the upper neck.

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The cause of death in patients who do not get quick medical intervention is usually the blockage of the airways.

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CONCLUSION
Now that we know that a simple toothache can become a cause of death when left un-attended to, it's is imperative we give utmost concern and medical attention to our oral health.

Thanks for reading. Kindly RESTEEM so many can get to see this post and learn from it. Thank you.