dental disease
Introduction
Dental disease introduction Dental diseases, the most common are dental caries, periodontitis and oral ulcers. Oral diseases are characterized by high incidence, wide patient population, and popularization, making it the most common disease in the world. Among them, the incidence of dental disease is particularly significant. Oral health is an important part of physical health. Oral health not only reflects the quality of life, but also an important symbol of human modern civilization. It has been listed by the World Health Organization as one of the top ten standards for human health. basic knowledge Proportion of disease: according to different dental diseases, the proportion of illness is different Susceptible people: no special people Mode of infection: non-infectious Complications: gastric ulcer pneumonia heart disease stroke diabetes
Cause
Cause of dental disease
1. Infection, the invasion of bacteria and its toxins into the medullary cavity caused by any cause can cause inflammation of the pulp. The pulp tissue enters the pulp cavity in the center of the tooth through the apical foramen, and is surrounded by hard dentin and enamel. Under normal circumstances, it will not be attacked by bacteria, but when the hard tissue of the tooth is damaged due to various reasons. The bacteria can invade the infected pulp. Among them, dental caries is the most common cause of loss of hard tissue of the tooth. When the caries damage the enamel, reach the deep layer of dentin, and even pass through the dentin to reach the pulp cavity, the bacteria in the mouth will infect the pulp and cause inflammation of the pulp. . Other causes include tooth defects caused by abnormal tooth development, accidental crown fracture of the pulp, and direct damage to the pulp. In addition, in severe periodontal disease, the periodontal pocket is deep to the apex, and the bacteria can also enter the medullary cavity by the apical foramen or some small branches of the root to cause pulp inflammation.
2, poor oral hygiene, resulting in plaque, calculus and soft dirt deposited on the tooth surface near the gingival margin, thereby inducing gingivitis. If left untreated, gingivitis can gradually develop into periodontitis, which eventually leads to loosening and loss of full mouth opening. Improper brushing, using a hard toothbrush, the particles of the friction agent in the toothpaste are too thick, and the cross-brushing method of the sawing type. More common in the bending of the arch, such as the canine, premolar, because these roots are more prominent, the lip (cheek) side of the bone plate is thin, easy to cause the gums and alveolar bone retraction due to mechanical friction.
3, anatomical factors: the lip (cheek) of the tooth is misplaced, so that the alveolar bone of the lip is very thin, and even there is a fenestration or dehiseence. When subjected to trauma or orthodontic force, the bone plate is easily absorbed. And the gums retreat immediately. When there is inflammation caused by plaque in the gums, the adhesion is too narrow and the high adhesion of the lips and buccal ligaments is one of the reasons for promoting gingival recession. Others believe that the thickness of connective tissue of the gums has an important relationship. Under the condition of unfavorable factors, the thinner gums are prone to retraction.
4, periodontitis, calculus, oral ulcers, periodontal abscess, food impaction and inappropriate dentures, etc., are the cause of stimulation of periodontal atrophy, should go to the hospital for regular treatment, and carry out oral self-health knowledge Consultation; for the already depressed periodontal, can be treated surgically.
5, the body's resistance is reduced or there are systemic diseases. Such as diabetes, prone to periodontal abscess.
Prevention
Dental disease prevention
First, keep the mouth clean: there are more than 20 kinds of bacteria in the mouth. New plaques form 1 to 6 hours after the tooth surface is cleaned, causing dental disease. I should learn to brush my teeth when I was 3 years old. To brush your teeth within 3 minutes of eating, brush for 3 minutes each time and brush 3 times a day. If you have difficulty, you should rinse your mouth after meals and brush your teeth in the morning and evening. Especially brushing your teeth before going to bed is more important than brushing your teeth in the morning. Toothbrush should use a soft and flexible health care toothbrush, wash it after use, and place the toothbrush head up and dry. To develop the habit of brushing teeth in turn, when brushing the upper teeth, the bristles are brushed down the teeth. When brushing the lower teeth, the brush should be brushed from the bottom to the top. Do not violently brush back and forth. Otherwise, the gums will be retracted and the teeth will be wedged. Defect.
Second, pay attention to oral exercise: regular consumption of crude fiber food, chewing, can stimulate saliva secretion, wash away dirt, help the teeth self-cleaning, and can strengthen the periodontal tissue. To develop a habit of chewing on both sides, otherwise it will cause disuse of the gums and facial deformity. It is recommended to use a cleaned right index finger and massage it on the upper and lower gums for 2 to 3 minutes. It can enhance the blood circulation of the gums and surrounding tissues, and is beneficial to the metabolic function of periodontal tissues. Every morning, the caries are exercised, and the empty mouth is bitten (the upper and lower teeth are gently slammed) dozens to hundreds of times, about 2 to 3 minutes, the teeth can be honed first, the front jaws are extended to the front teeth, and the cusps are flanked on both sides.
Third, reasonable eating and drinking: should eat more fresh vegetables and fruits, keep the stool smooth. Do not eat fried foods such as fried greasy, tobacco and alcohol, sea bream. Life should be regular, go to bed early and get up early, and sleep 8 to 9 hours a day. Overwork should be avoided. In daily life, we often see that there are more patients with periodontal disease in the crowd. Many patients often have gums, periodontal sputum, loose teeth, etc. due to periodontal disease, and finally have to remove the teeth. Prevent the occurrence of periodontal disease.
Complication
Dental complications Complications stomach ulcer pneumonia heart disease diabetes
1, stomach ulcers:
According to a foreign study, the bacteria that cause gastric ulcer are living on plaque. The researchers investigated 242 patients with gastric ulcer and found that the pathogen was found in 210 of them. The relationship between oral hygiene and gastric ulcer can be seen.
2. Pneumonia:
Medical research has shown that every time a person breathes, a large amount of bacteria enter the lungs, causing respiratory diseases. At the same time, they live in people's mouths, although the human immune system can destroy them, but if people have some time When the immunity is low, these bacteria will sneak into the air and may cause bacterial pneumonia.
3, heart disease:
After studying more than 1,000 cases abroad, gingivitis patients have three times more heart disease than ordinary people. The reason is that some bacteria can enter the blood through the crack in the gums, which affects the liver and causes it to produce. A protein that blocks arteries, causing arterial embolism. The specific way bacteria cause heart disease is still a mystery, but scientists have discovered an oral bacterium in fatty arterial embolism; oral bacteria are more threatening to people already suffering from heart disease. Some patients with dental diseases may encounter such a situation. If they have cardiovascular disease at the same time, doctors will take antibiotics before the treatment of oral diseases, preventing a large number of microorganisms from entering the blood during oral surgery and causing bacterial endocarditis.
4, stroke:
Relevant foreign institutions conducted a follow-up survey of nearly 10,000 people between the ages of 25 and 75, and found that those with severe gingivitis had twice as many strokes as other people. Medical experts explain that because oral bacteria can cause fat embolism of the carotid artery, if this fat block is upstream to the brain, blocking a blood vessel in the gray matter, it will cause a stroke.
5. Diabetes:
When a diabetic patient is attacked by bacteria, insulin does not work effectively, and the blood sugar level is increased. A study of 168 diabetic patients abroad found that people with severe gingivitis have difficulty controlling blood sugar levels. Endocrinologists recommend that when a person with a family history of diabetes is infected, go to the hospital as soon as possible to see if you have diabetes.
Symptom
Symptoms of dental disease Common symptoms Toothache, brushing, bleeding, teeth, hot and cold pain, tooth damage, black teeth, roots, exposed teeth, yellow teeth, black teeth, atrophic gum bleeding
Dental caries:
1. Ask about the reaction to cold, hot and sour irritations, food ingestion and spontaneous pain.
2, check the hard tissue color, shape, quality changes, smashed parts, depth and type, pay attention to the adjacent face, neck or gingival covering part of the cavity, if necessary, you can take X-ray photo examination.
3, according to the degree of damage can be divided into:
1 shallow sputum: sputum is limited to enamel or cementum, generally no symptoms, no response during exploration,
2 sputum invade the shallow layer of dentin, which can be cold, hot, sour, sweet, and painful.
3 squat: smashed into the deeper layer of dentin, but did not puncture, generally have pain and pain, no spontaneous pain.
4, according to the type of lesions can be divided into
1 chronic sputum: long course of disease, smashed tissue texture is hard, dry and dyed deep,
2 acute sputum: short course of disease and rapid progress, smashed tissue texture is soft: moist and light dyeing, such as acute tooth decay in most teeth or even full mouth in a very short time, smashing the tooth surface, deep development Fast, in the neck of the teeth is often ring-shaped, also known as fierce sputum,
3 Resting : The cavity is shallow dish, the smashing development is very slow or static, and the hole often reveals a hard, smooth and colored dentin layer.
4 secondary spasm: caries that occur at the edge of the filling or restoration.
Gingivitis:
With gingivitis, the gums will be red and swollen, or there may be bleeding. If you feel that your teeth are prone to bleeding when you brush your teeth, or if your teeth are tender, you will need to see a dentist.
There are various types of gingivitis, but the most common and highest incidence is chronic simple gingivitis. This gingivitis is also called unclean gingivitis and marginal gingivitis. The so-called gingivitis is chronic Sexual phlegm.
Chronic simple gingivitis only invades the gum tissue and does not invade other periodontal tissues. This gingivitis is a chronic inflammation caused by plaque on the tooth surface near the gingival margin. The cause is clear, and it is more common in children and adolescents. The prevalence is around 70%-90%, usually before 4-5 years old. There is no gingivitis. Most of them start from the age of 5, and their morbidity and severity gradually increase with age. When puberty reaches a peak, the prevalence of gingivitis decreases slowly with age. The prevalence of gingivitis in adults is low.
Mild chronic simple gingivitis is invaded by sorghum and sputum nipples. In severe cases, it can invade the sputum and anterior teeth, especially in the anterior teeth. When you bite a fruit or brush your teeth, your gums bleed. Healthy gums use force to brush your teeth without bleeding. The normal free sputum is very thin and close to the tooth surface. When the gums are inflamed, the gingival margin is red, swollen and soft, the gingival margin becomes thick, the interdental nipple becomes obtuse, and the tooth surface is not close, and The ditch is deepened. In severe cases, the sputum may be due to tissue edema, the color of the spot disappears, the surface is bright, the rim may have erosion or granulation, and the sputum may overflow. The gingivitis is further developed. The gingival hyperplasia of capillaries is hyperplasia, hyperemia, and a large number of inflammatory cells and tissue fluids are exuded, resulting in hypertrophy of the gums, which can cover part of the crown. At this time, the gums are dark red or dark red, and the probing is extremely easy to hemorrhage. Longer course of disease can lead to the proliferation of gingival fibers and gingival hyperplasia. At this time, the color of the gums is slightly red or near normal, the texture is hard and the bleeding is less.
Pulpitis:
Pulpitis is a common dental disease. Pain is the main symptom, and even severe unbearable pain often makes the patient restless and the diet difficult to enter. As the saying goes, "Toothache is not a disease, it hurts to be really fatal" refers to this course of disease. Pulpitis is mainly caused by infection from the tooth. If the squat, wedge-shaped defect and other hard tissue diseases of the tooth can not be controlled and treated in time, it can cause pulpitis and become one of the most common and most common diseases in the oral cavity.
Clinical manifestations:
1, sputum pain, bite pain.
2. The teeth are loose and stretched.
3, the patient can clearly point out the tooth.
4, the root tip is red and swollen, the tenderness is obvious, and the migration groove becomes shallow.
5, persistent spontaneous pain, late pulsating pain (jumping pain).
6, there is fever, chills, and some body temperature rises.
7, the department is swollen lymph nodes, tenderness.
8, tooth discoloration.
9, the pulp has no vitality, is not sensitive to temperature and electrical measurements.
10, the tip of the fistula, redness, and purulent secretions.
11, the apical period of the bone bulging, there is a ping-pong feeling, tooth displacement, loose teeth, severe, facial deformation.
12, bone bulging puncture has viscous cyst fluid and cholesterol crystals.
Periodontitis:
1, early self-conscious symptoms are not obvious: patients often only have the symptoms of gingival bleeding or bad breath, similar to sputum inflammation. At the time of examination, the swelling of the gingival margin, licking nipple and attached sputum, the softness of the sputum, the dark red or the dark red color, the bleeding is easy to detect.
2. With the further spread of inflammation, the following symptoms occur:
(1) Periodontal pocket formation: Due to the expansion of inflammation, the periodontal ligament is destroyed, the alveolar bone is gradually absorbed, and the gingiva is separated from the root of the tooth, so that the sulcus is deepened to form a periodontal pocket. The depth of the periodontal pocket can be measured with a probe. X-ray examination revealed that the alveolar bone has different degrees of absorption.
(2) Periodontal empyema: There are ulcers and inflammatory granulation tissue in the periodontal pocket wall, and there are purulent secretions in the bag, so the gums can be lightly pressed and the pus can be seen. And often have bad breath.
(3) Loose teeth: Due to the destruction of periodontal tissues, especially when the alveolar bone is absorbed, the supporting teeth are insufficient, and the teeth are loose and displaced.
At this time, the patient often feels occlusal weakness, dull pain, bleeding gums and bad breath. When the body's resistance is reduced and the periodontal bag is not well drained, periodontal swelling can be formed. At this time, the gums are oval-shaped, red and swollen, and the tooth looseness increases, which is aching. The patient felt severe strenuous pain, sometimes multiple abscesses appeared at the same time, called multiple periodontal abscess. At this time, the patient may have symptoms such as elevated body temperature, general malaise, submandibular lymphadenopathy, tenderness and the like.
Periodontal atrophy:
1. The clinical crown becomes long, the root surface is exposed, the cold, the heat, the sweetness, etc., there is dentin hypersensitivity, the interdental space is increased, but there is no inflammation and periodontal pocket.
2, senile periodontal atrophy is a uniform reduction of the full mouth alveolar bone, accompanied by gingival recession without obvious local factors and inflammation, is a normal physiological phenomenon, if this phenomenon occurs in young people of disproportionate age For premature aging periodontal atrophy.
3, disuse of periodontal atrophy, X-ray examination revealed a narrow periodontal space, loose alveolar bone, enlarged bone marrow cavity, unclear hard bone plate and other lack of functional stimulation of atrophy.
4, mechanical atrophy more common in patients with lateral brushing habits, occurred in the 543|345 neck and wedge-shaped defects, other if the body compression, food impaction, etc., can cause gingivitis and periodontal pocket formation.
Periodontal abscess:
1, acute periodontal abscess: sudden onset, the side of the periodontal pocket formed a hemispherical swelling protrusion. The gums are red, edematous and have a bright surface. The early inflammation of the abscess is extensive, the tissue tension is large, the pain is more dramatic, and there may be pulsatile pain. Due to periodontal edema, the teeth have a "floating sensation", which is painful and loose. Patients with multiple periodontal abscess are often accompanied by more obvious systemic symptoms and localized lymphadenopathy. In the later stage of abscess, the percussion has a sense of fluctuation, and the pain is slightly reduced. At this time, the finger gum can have pus flowing out from the bag, or the abscess can be ruptured from the surface, the swelling subsides, and the looseness can completely disappear after healing.
2, chronic periodontal abscess: chronic periodontal abscess generally no obvious symptoms, visible gingival surface on the gingival surface, the opening can be flat, must be carefully examined to see a large opening of the needle tip; can also be a granulation tissue-like opening, light There was a little pus out during the pressure. The pain is not obvious, and sometimes there is a bite discomfort.
Examine
Dental examination
1. Outpatient oral examination.
2, blood routine examination.
3, X-ray film inspection.
4, secretions and tissue culture + drug sensitivity and other inspection methods.
5. Self-examination:
(1) There is blood on the bristles when brushing your teeth. There is blood on the food when you bite the food, indicating that there is gingivitis.
(2) Look in the mirror. If there is redness and swelling of the gums, it will bleed when touched, indicating that there is gingivitis.
(3) The teeth have different degrees of looseness, the roots are exposed or the gums are red and swollen, and there is pus, indicating that it has progressed to periodontitis.
(4) There is bad breath indicating that there may be periodontitis.
Mild bleeding of the gums is an indication of early gingivitis. At this time, brushing should not be stopped and the soft hair care toothbrush should be used to brush the teeth carefully. Generally, the bleeding of the gums can be controlled. If there is bleeding in the gums after one week, you should check with your dentist for treatment and treatment.
Diagnosis
Dental diagnosis
Self-diagnosis
A simple way to self-diagnose gingivitis is to observe the color, texture and presence of bleeding in the gums; the normal gums are pink, the texture is flexible and dense, and the surface is dotted. If the gums are dark red, the texture is soft and swollen, the surface color disappears, and it is easy to bleed when eating, brushing, and touching. At this time, the diagnosis of gingivitis can be made. In addition to the above signs, some patients have symptoms of itching, swelling and bad breath.
Medical diagnosis
Part of the teeth will have dental plaque deposits, and later the gums and teeth will gradually separate.
Differential diagnosis
1, acute pulpitis: there are typical pain symptoms (spontaneous paroxysmal pain, hot and cold pain, nocturnal pain, loose pain can not be located), the tooth can certainly be found to have dental damage or other causes of dental pulp disease . The endodontic temperature test results can help locate the affected tooth, and the determination of the affected tooth is the key to the diagnosis of acute pulpitis.
2, chronic pulpitis: generally no obvious spontaneous pain, but often have a long history of cold and heat stimulation pain and / or spontaneous pain history, also can be found to cause dental pulp disease or other causes of dental pulpitis . The tooth has an abnormal response to the temperature test, and percussion discomfort can be used as an important reference indicator.
3, simple periodontitis should pay attention to the identification of marginal gingivitis.
4, when the periodontal abscess should be identified with the alveolar abscess.
