Dental Disorders

The types, affects, and treatments of common dental disorders


Common dental disorders include caries, gingivitis, periodontitis, and pulpitis. Dental emergencies, such as toothache, fractured or avulsed teeth, and postextraction complications


Caries is tooth decay, commonly called cavities. The symptoms—tender, painful teeth—appear late. Diagnosis is based on inspection, probing of the enamel surface with a fine metal instrument, and dental x-rays. Treatment involves removing affected tooth structure and restoring it with various materials. Fluoride, diligent dental hygiene, sealants, and proper diet can prevent virtually all caries.



Gingivitis is inflammation of the gingivae, causing bleeding with swelling, redness, exudate, a change of normal contours, and, occasionally, discomfort. Diagnosis is based on inspection. Treatment involves professional teeth cleaning and intensified home dental hygiene. Advanced cases may require antibiotics or surgery.

Other Gingival Disorders

Hyperplasia of gingival tissues may occur without inflammation in response to various drugs, particularly phenytoin, cyclosporine, nifedipine or, less commonly, other Ca channel blockers. Hyperplasia is characterized


by diffuse, relatively avascular smooth or nodular enlargement of the gingiva, which may almost cover some teeth. The hypertrophied tissue is often excised. If possible, substitutions are made for the offending drugs. Scrupulous oral hygiene may minimize recurrence. Carcinoma can also originate in the gingiva and spread to regional lymph nodes.


Periodontitis is an infection of the periodontium—causing inflammation of the periodontal ligament, gingiva, cementum, and alveolar bone. It usually presents as a worsening of gingivitis. Symptoms are rare except with HIV or when abscesses develop, in which case pain and swelling are common. Diagnosis is based on inspection, periodontal probing, and x-rays. Treatment involves dental cleaning that extends under the gums and a vigorous home hygiene program. Advanced cases may require antibiotics and surgery.



Pulpitis is inflammation of the dental pulp resulting from untreated caries, trauma, or multiple restorations. Its principal symptom is pain. Diagnosis is based on clinical findings and is confirmed by x-ray. Treatment involves removing decay, restoring the damaged tooth, and sometimes doing root canal therapy or extracting the tooth.

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