Dental and Oral Conditions
Oral health is an integral part of general; health. It entails the health of the mouth (the oral cavity), the jaws, the teeth, and all the contiguous structures. Therefore, diseases, disorders, and conditions that may be diagnosed in this area of the body can be particularly diverse. Since the mouth constitutes the main gateway in the entire body, disease processes and disorders elsewhere in the entire body may also be reflected and diagnosed here. This chapter discusses the most common diseases, conditions, and disorders that health clinicians may encounter in their daily practice.
The mouth is a favorite habitat of a myriad range of disease causing and commensal microorganisms. These include nearly the entire range of aerobes and anaerobes, as well as Gram-positive and Gram-negative microbes. Commonly, sites and sources of bacterial infection in the orofacial area include:
- Carious (decayed) teeth.
- Root remnants in the jaws.
- Periodontal infection.\Pericoronal infection.
- Pre-existing pathology such as bone cysts, bone dysplasia and neoplasms.
- Trauma to tissues.
Remarkably, bacterial infections in the oral cavity may take diverse clinical courses and presentations as outlined in the subsequent sections.
DENTAL CARIES AND PULPITIS
Dental caries is a microbial infection characterized by the demineralization of the inorganic component and destruction of the organic component of the teeth. It involves progressive damage of the enamel, dentine, and cementum initiated by microbial activity on any tooth surface in the oral activity. It is also the most common cause of pupal disease, which results from bacterial invasion of dentine and eventually the pulp. The spillage of microbial toxins into the tooth pulp through the caries lesion precipitates pulpitis.
DENTAL CARIES WITHOUT PULPITIS
Clinically the tooth presents with a cavity and the patient complains of mild pain on either chewing or extremes of temperatures.
- Dental radiographs: BBW/IOPA
- Oral hygiene instructions
- Diet counseling
- Fluoride therapy, especially for high caries risk
- Analgesics: Paracetamol 1mg oral;ly 8 hourly or ibuprofen 400mg orally 8 hourly. Adjust dose according to age.
- Restorative procedures for carious teeth Either composite resin, amalgam, glass ionomer cement or compomer restoration.
DENTAL CARIES WITH PULPITIS
- Sharp severe pain especially at night.
- Extreme tenderness of the affected tooth, which may imply impending pus formation.
- The foot may be tender to percussion.
In the absence of allergy, amoxicillin 500mg orally 8 hourly and metronidazole 400 mg orally 8 hourly remain the most useful drugs.
- Depending on severity, direct or indirect pulp capping with CaOH2 may be considered for permanent teeth. Deciduous teeth where indicated would require pulpotomy and stainless steel crowns.
- Endodontic treatment with restoration of the tooth with irreversible pulpitis.Thereafter, crown prosthesis. For deciduous teeth, pulpectomy followed by restoration and drainage in the cause of dentoalveolar abscess.
- Tooth extraction for grossly carious teeth.
- Provision of dental prosthesis where necessary.