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A Guide to Healthy Teeth

A Guide to Common Dental Problems

How to prevent or treat the (sometimes painful) troubles that can lurk in your mouth.

By Sally Solo
Woman running water and holding a toothbrushMonica Buck

Problem: Tooth Decay


Also known as dental caries or cavities, tooth decay occurs when plaque, a sticky film of bacteria that forms when you eat sugars or starches, is allowed to linger on teeth for too long.
 
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 cavities 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,” says Bruce Pihlstrom, D.D.S., acting director of the Center for Clinical Research at the National Institute of Dental and Craniofacial Research (NIDCR).
 
 

Problem: Gum Disease


A bacterial infection caused by plaque that attacks the gums, bone, and ligaments that keep your teeth in place. The early stage is known as gingivitis, the advanced stage as periodontitis.
 
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,” says Bruce Pihlstrom, D.D.S., acting director of the Center for Clinical Research at the NIDCR. “It depends on a person's susceptibility to the disease.”
 
What to do: See a dentist regularly, and tell her 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.
 
 

 
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