ABC of oral health: Dental damages, sequelae, and prevention
Ruth Holt, Graham Roberts, Crispian Scully
Teeth may be damaged by dental caries, trauma, erosion, attrition, and abrasion or lost through periodontal disease.
Accumulation of plaque and a change in the microflora may also cause gingival inflammation (gingivitis). If conditions are appropriate this may progress to damage the periodontal membrane (chronic periodontitis) and lead to tooth loss.
Most dental pain occurs as a result of caries. Initially, caries presents as a painless white spot (decalcification of the enamel, which may be reversible), followed by cavitation and the appearance of brownish discoloration. Once caries reaches the dentine, pain may result from thermal stimulation or from sweet or sour food or drink. Pain may also occur when dentine is exposed by trauma, erosion, or abrasion; this subsides within seconds of removing the stimulus and may be poorly localised, often only to within two or three teeth of the affected tooth. The tooth should be restored (filled).