1.- In case of maxillofacial trauma with dental impact
Several cases may occur, going from fissure, partial or complete fracture of the tooth to its loss.
- The fissure is a more or less deep tooth crack which can cause tooth necrosis.
- The fracture may affect the root, the crown or both parts of the tooth.
- Partial or total dental luxation is the loss of the tooth. In this case, our recommendation is to recover the tooth and put in in the mouth, in milk or better in physiological serum, without letting it dry.
In these situations, it is advisable to visit your dentist as soon as possible in order to try to save the affected pieces.
2.- Diabetic patients
A lot of attention must be paid to the oral health complications associated with diabetes.
These are the most serious complications:
- Periodontal disease, with gum inflammation, bleeding (spontaneously or when brushing), gradual tooth mobility, and eventually tooth loss.
- Mouth dryness, candidiasis, soft tissue injuries, and delayed healing.
- The highest caries rates.
Visiting your dentist every 6 months is recommended for the purpose of diagnosing and treating these conditions.
3.- During pregnancy
The hormone increase during the nine months of pregnancy can have disastrous effects on the mouth.
• Inflammation, pain and bleeding may appear at the gum level. Bleeding increases because tooth brushing is painful, the woman brushes her teeth less often, dental plaque grows and the gum becomes even more inflamed.
• Hygiene at the tooth level plays an important role too; caries increases when hygiene diminishes.
- The uncomfortable feeling in the gum makes the woman brush her tooth less often.
- Nausea appears during the first months; brushing increases nausea, as a result of which tooth-brushing frequency is reduced.
- More sweets are usually eaten.
It is important for you to visit your dentist frequently during this pregnancy period in order to keep your gums healthy and your teeth clean.
Don’t be afraid if you need to treat your mouth for a problem of caries or infection. Many medicines are forbidden but others can be used with full safety.
Tobacco not only yellows teeth but also seriously affects mouth integrity and face aesthetics.
The mouth has the first contact with the hot smoke of tobacco and its harmful carcinogenic components (tars, benzopyrene and nicotine).
These aggressions provoke a defensive body reaction, creating leukoplakia plaques, hyperkeratinisation and melanin secretion. A modification of blood microcirculation, bone regeneration disorders, of the gum, and periodontal diseases with tooth loss.
It can be said that the effects of tobacco over time evolve as follows:
- In the short term: a reduction of taste, of smell, halitosis and caries
- In the medium term: appearance of stains on the teeth, periodontitis with tooth mobility and loss
- In the long term: risk of developing mouth and lip cancer
Important: a smoker has 6 or 7 times as much risk of losing the teeth as a non-smoker.
Bisphosphonates are a group of medicines used in patients with osteoporosis and some malignant tumours. There have been references to cases of osteonecrosis in the maxillae associated with the use of bisphosphonates.
The odontologist must be very careful when it comes to perform oral surgery in patients subjected to these treatments.
Some pieces of advice
Measures before starting the treatment with bisphosphonates:
- Visiting the dentist in order to diagnose and treat all the teeth which are likely to develop an infection in the mouth
Foreseeing cleanings, curettages, extractions of roots and teeth in bad condition
Measures during the period of treatment with bisphosphonates:
- Varrying out regular check-ups every 6 months
- Carefully foreseeing dental cleanings avoiding injuries
- Fitting or removing trauma dentures which cause injuries
- Avoiding extractions and implants
Measures if mouth surgery needs to be performed:
A number of preventive measures must be adopted prior to performing an odontological treatment in these patients so that the risk of maxillary osteonecrosis can be avoided
Antibiotics must be taken before and after, for at least 15 days; and the treatment with bisphosphonates must be abandoned at least 3 months before the surgery.