Problem: Tooth Decay
Who’s at risk: Anyone can get a cavity, but children and older people are the most prone. The incidence among children has been declining, thanks to community water fluoridation and the increased use of fluoride toothpastes, but “more than half of all children have caries by the second grade,” according to the U.S. Department of Health and Human Services report Healthy People 2010. Older adults are prone to cavities at the root because protective gum tissue often pulls away.
What to do: Don't give plaque a chance: Brush with a fluoride toothpaste and floss every day. Children can also benefit from sealants (plastic coatings applied to the chewing surfaces of their back teeth) as soon as their adult molars come in. Older people should be particularly vigilant: Those who have a tendency toward dry mouth should receive regular fluoride treatments from a dentist and use a fluoride-containing mouth rinse.
Problem: Gum Disease
Who’s at risk: Everyone. The National Institute of Dental and Craniofacial Research (NIDCR) estimates that half of all adults have some signs of gingivitis. Most at risk are people with poor oral hygiene; those with a systemic disease, such as diabetes, that lowers resistance to infection; and smokers. Women also have a tendency to develop gingivitis during pregnancy. Other risk factors are stress, which weakens the immune system, and genes. Some people can have gingivitis all their lives and never progress to periodontitis. It depends on a person's susceptibility to the disease.
What to do: See a dentist regularly, and tell him if your gums feel tender or bleed. Gingivitis can be reversed with regular brushing and flossing. To combat periodontitis, a dentist or periodontist may perform a deep cleaning around the teeth and below the gum lines and prescribe medication to combat the infection. If the disease has progressed to affect your gums and bone, your dentist might suggest surgery, such as a gum graft.
Who’s at risk: Anyone with a deep cavity or a cracked tooth, which can let in bacteria. An injured tooth can have a problem even if it's not visibly cracked or chipped.
What to do: If you feel pain in or around a tooth, see your dentist. He may refer you to an endodontist, who specializes in root-canal procedures. In one to three visits, the dentist will perform a root canal. He will remove the pulp, clean the pulp chamber and root canal, then fill the tooth.
Problem: Enamel Erosion
Who’s at risk: Anyone who sips lemonade, soda (even diet soda), or sports drinks all day. This is also an occupational hazard of wine professionals. A lot of times the only risk factor we can come up with is diet soda. Aggressive brushers may also be wearing away the enamel along with the plaque.
What to do: If necessary, teeth can be restored with bonding materials. But to prevent further damage, you have to change your habits. If soft drinks are the culprit, for example, switch to water. Second best is to drink sodas (or sports drinks) with a full meal or sip them through a straw, then follow with a tooth brushing, sugarless gum, or a good swish of water in the mouth. If the problem is overbrushing, a soft-bristled brush or an electric toothbrush is a start. A dentist or a hygienist can demonstrate proper, gentle brushing technique.
Who’s at risk: Those who take any of 400-plus medications, including diuretics and antidepressants. “Dry mouth becomes more prominent as women get older, in their 50s and 60s,” says Sally Cram, an American Dental Association consumer adviser and a periodontist in Washington, D.C. Hormonal and metabolic changes that come with age can also change your salivary flow. Another cause is Sjogren's syndrome, a rare disorder most common among women in their late 40s that causes a person's immune system to attack her salivary and tear glands.
What to do: Keep sugarless gum on hand; avoid caffeine, tobacco, and alcohol; and drink plenty of water. Artificial rinses or moisturizing mouth gels can help the salivary glands function. If you suspect that you have dry mouth, see your dentist or doctor. “Anyone needing additional fluids to speak or to swallow dry foods for three months or longer should be evaluated for Sjogren's,” says Jane Atkinson, D.D.S., deputy clinical director of the National Institute of Dental and Craniofacial Research (NIDCR). While there's no cure, she says, “as with lupus or rheumatoid arthritis, you can manage it.”
Problem: Temporomandibular Joint Disorder (TMJ)
Who’s at risk: About twice as many women as men are believed to have TMJ, most commonly during their childbearing years. People who are under a great deal of stress are also more prone to it, or a severe injury to the jaw may cause the condition. It's usually not chronic, though it can become so. TMJ can lead to worn-down and sensitive teeth, as well as other painful symptoms, such as a sore jaw, headaches, neck aches, and earaches.
What to do: See your dentist if you feel pain when you chew, find that your jaw has limited movement, or have radiating pain in your face, neck, or shoulders. Treatment may be as simple as relaxation exercises, cold compresses, ibuprofen, and avoiding foods that require serious chewing. To train yourself to stop clenching and grinding your teeth, the Mayo Clinic recommends “resting your tongue upward with your teeth apart and your lips closed.” To stop nighttime grinding, your dentist can fit you with a mouth guard.
Who’s at risk: Of the estimated 30,000 cases of oral cancer diagnosed each year in this country, about three-quarters are associated with tobacco use or tobacco in combination with heavy alcohol use. Most cases occur after age 40. Many people aren't screened, and detection usually occurs when the cancer is at an advanced stage. That's why the five-year survival rate is one of the lowest for all cancers.
What to do: Stop smoking, and make sure your dentist screens you every time you visit. Even people missing many or all of their teeth should see a dentist regularly to make sure their dentures fit, as chronic irritation can be a risk factor.