Headlines today are reporting again the known link between gum health and heart disease..recent studies have again confirmed that patients with gum inflammation are more likely to go on to have heart disease.

The recent research has accounted for factors such as lifestyle, exercise and diet and so confirms the advice we give… that regular check ups and visits to the hygienist (two or three times a year) to ensure good oral health, is of significant benefit to our patients.

Posted by Dr. Yasmin George.

Headache can be caused by:

Grinding/clenching

The headache caused by grinding or clenching the teeth is usually a ‘tension’ headache.

Grinding often happens during sleep and may last for hours, putting a lot of pressure on the muscles around the jaw, forehead, scalp, neck and shoulders. As a result, these tense muscles may cause tension headache the following day.

Whether the affected person is aware or unaware of grinding during sleep, he/she may not relate it to the tension headache. This condition may even go undetected for years.

People usually visit their doctor regarding tension headache, but are then referred to their dentist once the grinding is established as the cause of the headache.

In many cases, the connection between grinding and tension headache is pointed out by the dentist during a routine visit as there can be signs on the teeth that this is occurring.

Once the grinding is treated by your dentist, the tension headache can disappear or improve vastly. 

The bite (occlusion)

Tension headache can also be caused by the bite (occlusion).

If you lose your back teeth (molars), the stability of the bite might be compromised putting strain on the muscles around the temporomandibular joint (the jaw joint situated in front of the ear). This can later lead to joint ache and headache.

Other malocclusions (abnormal bites) can cause similar problems.

Consult your dentist for the best advice on how to restore your bite.

Other causes for teeth-related headaches

• A decayed tooth.
• An infected tooth.
• Wisdom teeth.
• A high filling or a high crown

This means the wisdom tooth can erupt partially (part of the tooth outside the gum and the rest covered with the gum) or stay completely covered with bone and gums and is then called impacted wisdom tooth.

People usually have four wisdom teeth, but some people have fewer or none. In rare cases some will have more than four.

Do I need to remove my wisdom tooth?

There are few reasons for a wisdom tooth to be removed. The most common ones are:

• Pericoronitis: It is when the socket around the wisdom tooth gets infected and inflamed. It becomes swollen, painful and can cause a bad taste.
• Decay.
• Abnormal growth of the surrounding tissue like cysts, tumours or other rare conditions.
• Pain associated with the eruption of the wisdom tooth.
• Gum disease
• Lack of space: The wisdom tooth can erupt in an unfavourable angle where teeth are crowded causing irritation to the adjacent oral tissue.

Can my dentist remove wisdom teeth?

Some wisdom teeth are easier to remove than others. The dentist decides whether the case should be treated as a normal extraction, or should be referred to a specialist in oral surgery.

Questions

Q: My teeth were straight but now they are getting crowded and uneven in the front. Are my wisdom teeth pushing the other teeth together?

A: No. This happens even if a person does not have wisdom teeth present.

Q: I had a problem with the lower wisdom tooth but my dentist took the upper wisdom tooth out. Why did he do that?

A: In some cases the upper wisdom tooth bites on the gum around the lower tooth causing it to get swollen and painful. The patient experiences the pain in the lower jaw. If the upper wisdom tooth is removed, the cause of the trauma is removed and the pain and the swelling go down.

Gum disease is also known as periodontitis. It is a very common disease that can affect you  without clear symptoms or pain. The condition may go undetected for years before a patient becomes aware of it.

How it starts:

We all have some plaque covering our teeth.

If we do not clean our teeth thoroughly, the harmless bacteria population inside the plaque changes into a harmful one that irritates the gum margin around the teeth. The immune system fights the dangerous bacteria and its products, with its own potent defensive products. The constant battle between the body and the bacteria damages the surrounding tissue that supports the tooth. The tooth then slowly loses the attachment between its surface and the surrounding bone. The bone is destroyed and the tooth becomes loose to the point were it no longer can function and has to be taken out.

The initial phase of the disease is called Gingivitis. Gingivitis is a reversible process. This means that if the plaque is removed the gum will go back to the original healthy status with no persistent damage. A big percentage of the population has gingivitis.

If the plaque is not removed, it turns into calculus (tartar). Calculus is a hard layer that is attached to the surface of the tooth and is not easily cleaned with a conventional toothbrush.

If calculus is left long enough, the minor infection or Gingivitis turns into a more severe infection: Periodontitis. Periodontitis is an irreversible process. This means that even when the infection is treated and the bacteria are removed, the damage caused by the disease cannot be fully repaired. The bone level around the affected tooth recedes and a pocket is created between the tooth and the gums.

The longer you leave the disease untreated, the more difficult it is to cure.

Regular visits to the dentist and simple oral hygiene instructions such as brushing and flossing can prevent gingivitis from turning into periodontitis.

Symptoms:

The affected gums bleed easily, swell and change colour from light pink into dark red. Gum infection often causes bad breath.

In patients suffering from gum disease, the affected teeth can be tender to the touch.

Treatment

A big part of gum disease treatment relies on the patient’s cooperation with the dentist. The treatment plan may consist of:

• Oral hygiene instructions in brushing, flossing and using interdental brushes.
• Scaling: removing the plaque and the calculus.
• Root planing: smoothing the surface of the root after scaling.

The above treatments are often carrried out by a hygienist.

• Gum surgery: is used to reach the infected area and change the gum structure to make it easier for the patient to clean between the teeth.
• Using antibacterial mouthwashes and gels.
• Treatment with antibiotics injected directly in the infected pockets.

Why do some people get gum disease more than others?

Some people get gum disease easier than others because of their genetic disposition.

Such people are prone to attracting harmful bacteria and their immune system reacts differently towards the plaque causing more damage to its own gum structure.

Smoking is another contributing factor to gum disease as nicotine impairs the body’s immune system’s ability to fight the gum disease.

Pregnancy: during pregnancy the hormone balance in a woman’s body changes affecting even the gums. The gums become swollen and bleed easily when brushed amd are far more reactive to the effects of plaque. Careful cleaning and flossing is necessary to eliminate the plaque and help the gums during the pregnancy until the hormone balance is restored again when the baby is born and after breast feeding is finished.

Grinding or clenching the teeth is also known as bruxism.

Bruxism can occur at any age, from young children with milk teeth to adults. People are usually unaware of the condition as it occurs mostly during sleep. But there are a number of visible signs of grinding:

• Flat shiny areas on the chewing surface of the tooth.
• The impression of the teeth on the side of the tongue.
• Linea Alba: a white line on the inside of the cheek along the bite line caused by chewing the insides of the cheeks.

Until today there is no clear explanation as to why we suffer from bruxism, but we know the condition is influenced by many factors, including stress.

Bruxism is a common condition that may vary in intensity and frequency. It becomes more intense and frequent with stress.

Many people can live with bruxism if it occurs in a mild form.

When do I have to do something about it?

You should seek professional help from a doctor or a dentist if:

• The grinding is wearing down your teeth: when the enamel is worn down, it makes the teeth more sensitive.
• Your teeth or the dental restorations in your teeth start to break.
• You start to lose the enamel close to the gum line.
• It causes the enamel to crack.
• You suffer from tension headaches, a stiff neck and shoulders.
• You experience tender jaw muscles in the morning.
• You have tender teeth: during the grinding phase certain teeth are exposed to pressure more than others hence the tenderness.
• The grinding is so loud during the night that your partner’s sleep is disturbed.
• You damage the inside tissue of the cheeks while grinding.

Treatment

• A bite guard : Your dentist can provide you with a custom-made bite guard. It should be worn over the upper or lower teeth and mostly during sleeping hours, but may also be worn during the day.
• Relaxation: by choosing a suitable way for you to de-stress such as: aromatherapy, massage, hypnotherapy etc.
• Medication: see your doctor for muscle relaxants