The most common cause of loose and sensitive teeth is periodontal disease. Periodontal disease includes gingivitis (inflammation of the gums) and periodontitis (inflammation of the periodontium). The periodontium is the structure that surrounds the teeth and holds them in their sockets. Periodontal disease is an infection that can cause teeth to become loose and eventually lost.

Periodontal disease is most often caused by bacterial plaque that surrounds teeth. Bacterial plaque is a sticky film that continues to form around teeth. If it isn’t removed constantly, it can continually build up and form calculus (calculus is just a hardened form of bacterial plaque). There are a number of other causes of periodontal disease.

Causes of Periodontal Disease

• Smoking: smoking causes shrinkage of some blood vessels, hence the periodontium is affected by not having enough blood flow and oxygen. Smokers tend to lose teeth more than non-smokers, because of periodontal disease.
• Hormones: gum tissue are sometimes affected by hormonal changes, for example during pregnancy or menopause
• Genetics: some individuals are more prone to periodontal disease, despite proper oral hygiene practices, because of genetic factors. Early diagnosis and treatment may help to save teeth in such individuals.
• Diabetes: diabetics have a higher risk of developing infections, including periodontal disease. Healing is also slower with diabetes, making periodontal disease a greater concern with respect to oral health. Diabetes, though not the only reason, may be a cause of necrosis (tissue death due to lack of blood and oxygen).
• Poor Nutrition: a diet that is low in necessary nutrients affects the body, including the oral cavity. Periodontal disease is a distinct infection that may worsen with poor nutrition.

Treatment of Periodontal Disease

In many cases, an individual may have had long standing or severe periodontal disease, and some teeth (in other cases, all of the teeth) cannot be saved. In these cases, extractions may be the only viable option, with replacement of the missing teeth with implants, bridges or dentures. Other treatment options are available for treating periodontal disease, each option depending on individual cases/.

• Scaling and root planning: this involves professional cleaning of plaque and calculus from root surfaces and periodontal pockets. This is the most common method used to treat periodontal disease.
• Periodontal surgery: if the tissues around the teeth are determined to be unhealthy, periodontal surgery (there are more than one types) may be necessary to treat the periodontal disease. Periodontal surgery can help to improve function.
• Cosmetic methods: this can be done to improve a patient’s appearance, smile and function, if for example a lot of roots are exposed by the periodontal disease.

Each individual’s case of periodontal disease is different, so the necessary treatment may be different for each patient. An individual with a diagnosis of periodontal disease, especially long standing or advanced, can be treated by a periodontist (a dentist with specialized training in diagnosing, preventing and treating periodontal disease). You can be referred to a periodontist by a general dentist, or be treated by a general dentist. Please be pro-active in a consulting with your dentist for a comprehensive evaluation, diagnosis and treatment.

We hope this helps!

Cold sores (Fever Blisters), better known as herpes simplex virus type 1 (HSV-1), are small, irregular shaped, yellow or white ulcerations/sores located in the mouth, lips, or surrounding skin.  The sores typically start off as red, then collapse to form a yellowish ulcer.  These lesions are usually painful.

The first breakout of HSV-1 is more severe than recurrent episodes.  The initial breakout is oftentimes seen in children between 6 months and 5 years and is known as acute herpetic gingivostomatitis.

Recurrent breakouts usually appear on the lip or surrounding skin and are known as herpes labialis.  15-45% of the population has a history of herpes labialis.

What are the symptoms of Cold Sores?

The following symptoms will occur 6-24 hours before a breakout:

• Itching
• Burning
• Tingling
• Pain
• Redness of the skin

Shortly after, multiple small red lesions will appear.  The sores rupture within 2 days, crust over, and generally fully heal in 7-10 days.

If this is an initial breakout, the following symptoms may also occur:

• Sore throat
• Fever
• Muscle pain
• Headache

What causes cold sores?

The sores are caused by a DNA virus known as herpes simplex virus.  Unfortunately the virus remains in the system even when no breakout is present.  Breakouts can also be provoked by the following factors:

• Stress
• Ultraviolet light
• Pregnancy
• Trauma
• Respiratory illnesses
• Allergies
• Other diseases
• Menstruation

Is there treatment for cold sores [herpes labialis]?

Unfortunately there is no known treatment that can completely cure the disease.  However, there are several treatments that can be used to decrease or temporarily alleviate the symptoms of herpes.  These treatments include:

• Anti-viral medications such as Acyclovir
• Nonsteriodal anti-inflammatory medications (NSAIDS) such as ibuprofen, to alleviate the pain
• Over the counter topical anesthetic gels can also help to decrease pain and discomfort