A dental implant is an artificial tooth root surgically implanted into your jawbone. It is a popular tooth replacement option after tooth loss or extraction.

Dental implants have resulted in successful dental restorations for over 30 years. More than 5 million dental implants are placed in the U.S. every year.

Dental Implant Structure: How They Work

The body of a dental implant consists of three pieces that serve different functions:

1. The implant (or screw) serves as the tooth’s artificial root.
2. The abutment is the connecting post between the implant screw and crown.
3. The crown is the ‘fake’ tooth that rests on top of the abutment. They match the shape and look of your natural teeth.

4 Types of Dental Implants

There are different types of dental implants available:

1. Single Tooth Implant

A single dental implant is ideal when one tooth is missing, and you want to replace it for aesthetics, comfort, and function. It requires one dental crown that connects to the implant screw.

The average cost of a single tooth implant can range from $3,000 to $4,000.

2. Implant-Supported Bridge

Implant-supported bridges are ideal for people with several missing teeth. The implant acts as an anchor for the bridge (instead of a natural tooth).

A fixed dental bridge restores function by preventing other teeth from moving. It also improves eating and speaking functions.

An implant-supported bridge costs between $5,000 and $16,000.

3. All-on-4 Dental Implants

All-on-4 implants are recommended when a patient is looking for a secure solution for many missing teeth. This solution restores your entire upper or lower jaw (or both arches).

This is a permanent restoration. However, the overdenture can be removed for cleaning and dental exams.

The average cost ranges from $15,000 to $20,000 per arch.

4. 3-on-6 Dental Implants

An alternative to an implant-retained denture is a 3-on-6 implant. It consists of three individual dental bridges attached to six dental implants.

The cost of 3-on-6 implants can range from $10,000 to $15,000 per arch.

Benefits of Dental Implants

Dental implants have their benefits. However, they can also come with disadvantages.

Here are the benefits of dental implants:

• Allows you to chew and speak normally
• Designed to look like your natural teeth, improving your self-esteem
• Reduces stress on your remaining natural teeth by offering independent support
• Preserves bone, reducing the appearance of aging
• Helps prevent loss of jaw height
• Easy to clean and care for
• With proper care, implants can last between 15 and 25 years

Here are the disadvantages of getting dental implants:

• Will not whiten like your natural teeth
• Requires an invasive surgery for placement
• They are expensive (but the long-term benefits are usually worth it)
• Bone grafting may be necessary before placement if you do not have enough natural bone remaining

Dental Implant Techniques & Materials

Dental implants come in two different forms, including:

Endosteal Implant

An endosteal implant (root form implant) is the most commonly used today. It is made with titanium, small screws, and alloplastic material, which refers to an artificial tissue graft.

Endosteal implants are surgically inserted into the jawbone. Over time, the implants bond with the natural bone.

Subperiosteal Implant

Subperiosteal implants are extremely rare. However, they are a better option for people with insufficient natural jawbones to support endosteal implants.

A subperiosteal implant is placed under the gums (on or above the jawbone). It is not surgically inserted into the jawbone.

Dental Implant Procedure: Step-By-Step

Dental implant procedures are a type of outpatient surgery. Patients can return home on the same day of surgery.

The procedure can take many months to complete due to the healing process and artificial tooth (crown) placement. Professionals who can perform a dental implant surgery include:

• Oral and maxillofacial surgeons
• Periodontists
• Prosthodontists

The procedure is separated into multiple steps, depending on the number of implants a patient needs:

1. Remove the Tooth

If the damaged tooth is still in your mouth, the dentist will extract it. This step is not necessary if your tooth is already missing.

2. Grafting and Jawbone Preparation

Patients who undergo implant surgery may have thin or soft jawbones. In this case, bone grafting will be necessary.

It improves the quantity of bone and ensures the procedure doesn’t fail. The healing process for bone grafts takes a few months before a dental implant can be placed.

3. Implant Placement

During the actual procedure, the oral surgeon exposes the bone by cutting the gums.

An oral surgeon or periodontist drills holes into the bone. Then they position the implant (a post) deep into the bone, which functions as the tooth’s root.

If a front tooth is being restored, the dentist will fill the space with a temporary removable solution while the implant heals below the gums. If it is a back tooth, they will not place anything over it.

4. Healing and Growth

Osseointegration begins after the metal implant is placed in your jawbone. This is when the supporting bone begins to bond with the implant.

This process can take several months to complete and ensures the base is sturdy enough to support an artificial tooth (dental crown).

5. Abutment Placement (Crown Preparation)

After the healing process is complete, your dentist will place an abutment on top of the implant post.

The abutment extends the implant above the soft tissue (gums). This step allows for easy placement of the dental crown.

6. Crown Placement (Artificial Tooth)

Once the implant grows into the bone and is strong enough to support chewing, your dentist will make new impressions of your mouth.

A dental technician will create a custom dental crown in a lab. The dental crown looks similar to your natural teeth and sits on the abutment (connector). It becomes the only visible part of the implant.

7. Aftercare

Pain medications and antibiotics are usually prescribed post-op. It is important to only eat soft foods and practice excellent oral care habits during the healing process.

Restrict the intake of alcohol, caffeine, and tobacco to see the best results. Regular check-ups are necessary during the first few months after the procedure. You should also keep up with regular dental exams post-surgery.

Side Effects and Complications of Dental Implant Surgery

Most implant procedures are successful. However, there is still a risk of incorrect healing.

To reduce this risk, practice good oral health care at home, including proper nutrition, brushing, and flossing.

As with any dental surgery, minor discomfort is normal. Common side effects(that aren’t threatening to the implant) include:

• Gum and face swelling
• Bruises on the skin or gums
• Minor bleeding
• Pain where the implant was placed

More serious complications that can develop after an implant is placed include:

• Damage to your surrounding teeth, gums, and/or blood vessels
• Infection at the implant site
• Prolonged bleeding
• Sinus issues and pressure (if the implant is placed in your upper jaw)
• Fractured jaw and jaw pain
• Nerve damage, which can lead to tingling in the mouth or lips

How Much Do Dental Implants Cost?

Dental implants cost between $1,000 and $4,500 per tooth.

Does Insurance Cover Dental Implants?

Some insurance plans cover dental implants, while others do not or only cover part of the procedure. For example, some dental insurance plans may cover the crown attached to the implant.

Some medical insurance plans will cover part of the surgery if the procedure is medically necessary.

A disability is any condition that affects the body or mind and limits the person’s ability to do certain activities. Disabilities can affect all areas of life, including physical and emotional health.

Some people with disabilities, however, are prone to poor health, including oral health, and often require special health care.

This article describes how physical disabilities affect oral health. It also provides ideas for promoting oral health in people with disabilities.

How Do Physical Disabilities Affect Oral Health?

People with physical disabilities are more likely to have poor oral health than the general population.²

They’re more prone to several oral health problems, including:

• Cavities
• Gum disease
• Tooth enamel defects

Why Are People with Disabilities More Prone to Poor Oral Health?

Mobility issues can create oral health care barriers for people with disabilities. They may be unable to:

• Grasp a toothbrush
• Move their hands to clean their teeth
• Get to the dental office
• Sit in a dental chair

Dental Conditions Associated with Physical Disabilities

Common physical disabilities that may lead to adverse oral health outcomes include:

Spinal Cord Injuries

Up to 500,000 people suffer from spinal cord injuries worldwide every year. Many people with a spinal cord injury are partially or completely paralyzed.

Due to limited mobility, people with a spinal cord injury can experience oral health complications. Arm weakness and impaired mobility cause poor hand function, so they rely on others to care for their teeth.

Additionally, many spinal cord injury medications cause dry mouth (xerostomia). Dry mouth increases the risk of cavities and gum disease over time.

Cerebral Palsy (CP)

Cerebral palsy (CP) is a physical disorder that affects muscle coordination and body movement.

People with CP have a higher risk of developing oral health issues due to poor oral hygiene.

These problems may include:

• Delayed eruption of permanent teeth
• Gingivitis and gum disease
• Tooth decay and cavities
• Mouth breathing, which can lead to cavities and bad breath
• Dental erosion due to gastroesophageal reflux (GERD)
• Malocclusion (misaligned teeth) from tongue thrusting
• Enamel hypoplasia (tooth enamel defects)
• Bruxism (teeth grinding)
• Increased risk of dental injuries or trauma

Muscular Dystrophy

Muscular dystrophy is a rare group of genetic diseases. It causes severe muscle weakness and difficulty breathing and swallowing.

People with advanced muscular dystrophy can’t brush or floss their teeth without help. They have a higher risk of developing oral health conditions, including:

• Cavities (dental caries)
• Tooth decay
• Gingivitis and periodontal disease

Cystic Fibrosis (CF)

Cystic fibrosis (CF) is a chronic, genetic respiratory disorder that results in poor lung function. It’s present at birth, but it’s not considered a physical disability until the child is older.

Children with CF may experience oral health problems, such as:

• Enamel defects
• Tooth decay and cavities
• Increased calculus (hardened plaque) buildup

Other Physical Disabilities

Other common disabilities that can negatively impact a person’s oral health due to limited mobility include:

Amputation

Amputation is the removal of a limb due to an illness, accident, injury, disease, or surgery. It can make it difficult to perform daily activities, such as walking or eating.

Regularly brushing your teeth may also be difficult. This increases the risk of cavity formation and other oral infections.

Back Injuries

People with back injuries may become partially or completely paralyzed. Family members or other people often take charge of their at-home oral care routine.

Some medications for back injuries can also cause dry mouth and cavities.

Multiple Sclerosis (MS)

Multiple sclerosis (MS) damages the brain and central nervous system (CNS).

Symptoms include:

• Fatigue
• Impaired coordination
• Severe pain
• Vision loss

Due to these limitations, people with MS have a higher risk of developing cavities and gum disease.

What Are Physical Disabilities?

Physical disabilities limit a person’s mobility, stamina, and physical functioning. A physical disability can be related to conditions present at birth, injuries, and chronic or progressive diseases. Mobility problems often make it difficult for people to do daily tasks on their own, such as:

• Practicing dental hygiene like teeth brushing and flossing
• Getting dressed
• Eating and preparing food
• Moving around
• Working
• Reaching for objects
• Bathing and showering

Some people have a mouth disability, which impairs mouth movements like chewing and swallowing.

How to Improve Oral Health for People with Disabilities

Many people with disabilities have limited access to oral health care. This is especially problematic because oral health is linked to overall health.

Here are some things dental professionals, other health professionals, and family members can do to help improve oral health for people with disabilities:

Make the Dental Office Accessible

To attend regular dental visits, a person must be able to get to the office. Dental offices should be accessible to people who use a wheelchair.

This includes suitable parking spaces for vehicles that transport people in wheelchairs and access to the clinic.

A wheelchair lift and tilt device can help people who can’t transfer to a dental chair from their wheelchair. The device allows dentists and dental hygienists to perform treatment in the lifted and tilted wheelchair.

Adapt At-Home Oral Care

Some people with disabilities rely on family members and caregivers to help them manage their oral health at home.

If someone you care for is having trouble cleaning their teeth, here are some ways to help:

• Get adaptive hand grips for manual toothbrushes
• Use an electric toothbrush instead (requires less movement)
• Ask their dentist for advice on tooth brushing and general oral health care

Summary

Disabilities are common, and they affect a person’s ability to perform certain activities. There are many types of disabilities, including physical, intellectual, and developmental.

People with disabilities are more likely to have oral health problems. For those with physical disabilities, this can be due to mobility restrictions. Some medications used to treat conditions that cause disabilities can cause dry mouth, a risk factor for tooth decay.

Improving access to dental treatment and accommodating oral hygiene at home are key factors in promoting oral health in people with disabilities.

General dentists are the main dental care providers to people of all ages. They provide routine checkups, examinations, and cleanings.

Their services are geared toward cleaning, restoration, and disease prevention. Depending on your mouth’s condition, they may refer you to a specialist.

The most common dental care providers are general dentists, who comprise about 80 percent of practitioners. The other 20 percent consists of:

• Endodontists
• Oral and maxillofacial surgeons
• Orthodontists
• Pediatric dentists
• Periodontists
• Prosthodontists
• Dental public health specialists
• Oral and maxillofacial pathologists

Qualifications of General Dentists

Dentistry is a “hands-on” practice. The profession requires four years of highly accredited education after completing a bachelor’s degree.

This intensive education allows general dentists to gain dexterity, skills in performing tasks with their hands, and in-depth scientific knowledge about the field. General dentists also specialize in specific types of procedures based on their individual skills and the current needs of patients.

How is a General Dentist Different From a Specialist?

Unlike specialists, who focus on one specific area of dentistry, general dentists offer a wide range of treatments and procedures. They also treat patients of all ages.

General dentists offer preventive and restorative services, such as:

• X-rays
• Teeth cleanings
• Cavity fillings
• Sealants

Dental specialists, such as endodontists, are highly skilled at performing and treating tooth pain, specifically root canals. Some patients visit a general dentist to receive a root canal, while others may see an endodontist if they require specialized root canal treatment.

What Services Do General Dentists Offer?

Many general dentists use a combination of specialized care, including oral surgery, restorative services, and basic dental care treatments. Common general dentistry treatments include:

• Dental exams and teeth cleanings
• X-rays
• Cavity fillings
• Root canal treatment
• Sleep apnea treatment
• Gingivitis treatment
• Temporomandibular joint disorder (TMD) treatment
• Oral cancer screenings
• Tooth sealants
• Fluoride treatment
• Cosmetic dentistry procedures (including teeth whitening)
• Minor oral surgeries, such as wisdom tooth removal and tooth extractions
• Some general dentists offer braces and clear aligner treatment

When Should You See A General Dentist?

You should see a general dentist at least twice a year or every six months. The time between these appointments is just long enough to see any significant changes or if something needs to be restored.

You should also see a general dentist for a cleaning and an examination every 6 months.

Other Types of General Dentistry Services

When visiting a general dentist, there are many options, whether you are going in for a routine dental exam or a minor oral surgery.

General dentists offer restorative services, preventive treatments, oral surgery, and cosmetic dentistry:

Restorative Dentistry

During routine dental exams, your dentist searches for cavities and signs of oral diseases. They will recommend an indirect or direct restoration if you have tooth decay.

Restorative dental procedures are the “bread-and-butter” of general dentistry.

Direct Restoration Materials

Direct restorations are repairs made inside the mouth (e.g., cavity fillings). These restorations are also usually placed within one office visit:

• Composite is a tooth-colored, adhesive bonding material made of acrylic resin. Composite is one of the most common restorative materials for cavity fillings, dental bonds, inlays, and veneers.
• Amalgam combines up to 54 percent mercury with silver, tin, and copper. This material is commonly used to restore teeth (premolars and molars).
• Conventional glass Ionomer (CGI) is another tooth-colored restorative material. Glass ionomer is less durable than amalgam or composite. CGI can restore front teeth, including incisors and canines.
• Resin-Modified glass Ionomers (RMGI’s) are similar to conventional glass ionomers but with more strength and added acrylic resins. RMGI is only used to restore baby teeth.

Indirect Restoration Materials

General dentists also offer indirect restoration procedures (materials made outside the mouth based on an individual’s teeth impressions). However, unlike direct restorations, indirect options require at least two dentist appointments.

The first step is to prepare the teeth by removing decay and preparing them for indirect restoration. Then an impression is made. Lastly, your dentist sends the impressions to a dental laboratory to be created.

Available Indirect Restoration Treatments

During the second visit, the restorations are fitted to the teeth, and any necessary adjustments are made. Patients currently have a few indirect restoration treatments, including:

• Dental crowns are tooth-shaped caps that fit over a tooth to restore damaged or missing teeth
• Dentures are full or partial sets of fake teeth
• Dental implants are artificial tooth roots
• Inlays and onlays are indirect fillings that replace old dental fillings
• Wisdom tooth removal is one of the most common dental surgeries used to remove third molars
• Root canals are used to remove infected or inflamed soft tissues from the internal chamber of the tooth
• Tooth extractions involve removing the tooth from its socket in the bone to prevent further damage.

Cosmetic Dentistry

Cosmetic dentistry is one of the fastest-growing sectors of dentistry.

Many patients electively seek cosmetic procedures. This is because these treatments enhance an individual’s smile, which boosts their confidence and improves their appearance.

People of all ages can safely receive cosmetic treatment from a certified dental professional.

Additionally, if you suffer from extreme anxiety about procedures, sedation dentistry is also an option to ensure the process runs smoothly. Since cosmetic treatment is becoming more popular, many general dentists in the U.S. specialize in these procedures.

Available Cosmetic Dentistry Procedures

Treatment options include veneers and professional teeth whitening:

• Porcelain veneers are shells that bond over the front edge of a tooth to improve its appearance. Veneers also change the color and shape of teeth.
• Professional teeth whitening is a safe and effective cosmetic treatment that lightens discolored teeth.

At-home teeth whitening produces nearly identical results to professional whitening. And it costs just a fraction of the price. Read our review of the best teeth whitening kits.

Summary

General dentists offer a wide range of treatments and procedures. They also treat patients of all ages.

These dentists provide a variety of services and treatments to promote oral health, including:

• Basic, preventive dental care
• Oral surgery
• Restorative treatments
• Cosmetic dentistry

You should see a general dentist regularly to maintain oral health. Ideally, you should see a general dentist twice a year or every 6 months.

Oral STDs are sexually transmitted diseases that are spread through oral sex. These diseases can affect the mouth, throat, genitals, and other body parts.

Unprotected sex and having many sexual partners can increase your risk of getting an STD, including ones transmitted via oral sex.

Bacteria, viruses, and parasites that can be spread through oral sex include:¹

• Human papillomavirus (HPV)
• Chlamydia trachomatis (chlamydia)
• Neisseria gonorrhoeae (gonorrhea)
• Herpes simplex virus
• Treponema pallidum (syphilis)
• Trichomonas vaginalis (trichomoniasis)
• Hepatovirus A and B (hepatitis)
• Human immunodeficiency virus (HIV)

STD and STI Prevention

You can reduce your risk of acquiring an STI and avoid more serious symptoms if you’re infected by:

• Using condoms, dental dams, or other barrier methods
• Avoiding or limiting certain kinds of sexual activity or your number of sexual partners
• Discussing any risks or known prior infections with your sexual partner
• Getting screened regularly for STIs
• Obtaining treatment for an STI or STD as early as possible

8 Different Types of Oral STIs

1. Human papillomavirus (HPV)

HPV is the most common STI in the world. It’s estimated that 80% of men and women will have acquired it by age 45.^{2, 3}

Most HPV infections come and go without causing trouble, being cleared by the immune system within a couple of years. However, some virus variants can produce serious symptoms, including cancer.

Symptoms

Some variants of HPV can cause warts (papillomas) to appear in areas such as:

• Your mouth and throat, which can cause respiratory and speaking difficulties
• Your anus and genitals
• Other parts of your skin

These warts aren’t cancerous but can increase your risk for skin, anal, genital, and other cancers.

Other variants of HPV, while not causing warts, are directly responsible for certain kinds of cancer. The vast majority of cervical cancers are caused by HPV. Most oropharyngeal (throat) cancers in non-smokers are also caused by HPV.

Causes

HPV can be spread through any contact with the genitals of an infected person. Oral contact with the genitals or anus of someone with HPV can cause it to enter your mouth and throat.

Cases of non-smoking-related head and neck cancers in men have risen over the past few decades. This is partly due to the prevalence of oral sex with multiple partners.^{2, 3}

Treatment

There is no specific treatment for HPV. Warts caused by HPV can be removed, though in some cases, they may come back. Like other cancers, HPV-related cancers can be treated with chemotherapy, radiation, and surgery.

Several vaccines are available for cancer-causing variants of HPV, but they don’t prevent symptoms in people who are already infected with HPV.

2. Chlamydia

Chlamydia is the most common bacterial STI. It’s more likely to affect women than men. It may not cause any symptoms initially, and in many cases the immune system can clear it out. But it can have serious complications if left untreated.^{4, 5}

Symptoms

Chlamydia often has no symptoms, leading many women not to seek treatment.⁴ But if symptoms are present, they may include:

• Genital inflammation and discharge
• Painful urination
• Vaginal bleeding
• A sore throat, if affecting the throat

Untreated chlamydia can lead to complications such as:^{4, 5}

• Infertility
• Ectopic pregnancies
• Pelvic inflammation
• Lymphatic infections
• Blindness

Causes

Chlamydia can be spread via any kind of sex, including oral sex.

Treatment

Chlamydia can be treated with antibiotics, generally taken in pill form over a course lasting several days or weeks.

3. Gonorrhea

Gonorrhea is the second most common bacterial STI after chlamydia, and it’s especially common among young adults. It becomes resistant to antibiotics quickly, making treatment more complicated over time.⁶

Symptoms

Gonorrhea is often asymptomatic in women and symptomatic in men. If contracted from oral sex, it may affect the throat and cause inflammation (or a sore throat).⁷ When other symptoms are present, they may include:

• Painful urination
• Testicular pain
• Rectal pain
• Abnormal bleeding from the uterus
• Pain during sex

Causes

Gonorrhea can be acquired through sexual contact, including oral sex. Sex workers, men who have sex with men (MSM), and people with multiple sexual partners are more likely to be infected.⁶

Treatment

Gonorrhea is treated with antibiotics. The specific antibiotics used may differ depending on whether the infection affects the throat or anal and genital areas.

Unfortunately, new strains of gonorrhea have evolved in recent years that are resistant to many antibiotics.^{6, 7} However, many effective antibiotics remain available, and gonorrhea is generally curable.⁶

You should re-test if your symptoms don’t go away after a full course of antibiotics.

4. Herpes

Herpes is a viral infection that often causes distinctive blisters, commonly known as cold sores. It can be transmitted sexually or through any contact with the blisters of an infected person.

This condition can be caused by two types of herpes simplex virus, known as HSV-1 and HSV-2.^{8, 9}

Symptoms

The cold sores caused by HSV-1 and HSV-2 can affect:

• Lips, mouth, and throat
• Genital and anal areas

It’s possible to be infected with herpes and never show any symptoms. Some people with the herpes virus experience occasional flare-ups of cold sores caused by stress and other factors.

Though rare, herpes can also cause an infection of the esophagus. It may result in difficulty or pain when swallowing and a fever.

Causes

Herpes can be spread by contact with a cold sore, including sex, touching, or kissing. It can also be spread when there are no visible sores or other symptoms.

Treatment

HSV-1 and HSV-2 both cause lifelong infections which can’t be cured. Fortunately, they’re often asymptomatic or only flare up occasionally. Antiviral medications can help manage cold sore outbreaks.

5. Syphilis

Syphilis is a bacterial disease that can have a wide range of symptoms.

Syphilis isn’t as common or as devastating as it once was, but it still requires treatment. It can co-occur with HIV or AIDS.¹⁰

Symptoms

Syphilis is sometimes referred to as “the great imitator” because its symptoms can resemble other infections. These include:

• Ulcers or lesions on the genitals or mouth
• Rashes on various parts of the body
• Fever
• Headache

These symptoms are referred to as primary and secondary syphilis because they tend to occur in the first few weeks after infection. The infection may become dormant, remaining in the body but not showing any more symptoms.

If syphilis is left untreated, many people with dormant syphilis will eventually develop tertiary syphilis, which can cause life-threatening heart, neurological, and other problems.

Causes

Syphilis can be spread through sexual contact with an infected person and from mother to child during pregnancy or childbirth.

Treatment

Syphilis can be treated with antibiotics, usually a single dose of penicillin.¹⁰

6. Trichomoniasis

Trichomoniasis, or trich, is an infection caused by a parasite called Trichomonas vaginalis (TV). Even though it may be as common as gonorrhea or chlamydia, it isn’t as commonly tested for.¹¹

Symptoms

More than half of people infected with TV don’t experience any symptoms. When symptoms are present, they may include:

• Genital itching and redness
• Genital discharge
• Pain during urination

Trichomoniasis can also affect your throat if you’ve given oral sex to someone whose genitals were infected.¹²

Causes

Any kind of sexual activity could spread trichomoniasis. Smoking also appears to be a risk factor.¹¹

Treatment

Trichomoniasis can be eliminated with antibiotics, typically metronidazole or tinidazole.^{11, 12, 13}

7. Hepatitis A and B

Hepatitis A and B are viral infections that cause liver inflammation.

Symptoms

Symptoms of hepatitis include:

• Fever
• Nausea or loss of appetite
• Abdominal pain
• Jaundice (yellowing of the skin and eyes)
• Dark urine
• Fatigue

Causes

The viruses that cause hepatitis can be spread through oral or other sexual contact, especially involving the anus. This is because the viruses are often found in fecal matter.¹⁴

Treatment

Hepatitis A and B are likely to be cleared by the body’s immune system within a few weeks. Your doctor may recommend resting and avoiding sexual activity while it takes its course.

In some cases, however, hepatitis B can become a chronic infection, resulting in complications such as liver cancer.

Medications are available to help your immune system fight a chronic hepatitis infection. A vaccine is also available for hepatitis B.

8. HIV

The human immunodeficiency virus (HIV) is a virus that affects the immune system. Without specific treatment, it can lead to acquired immunodeficiency syndrome (AIDS), which can have severe complications.

Symptoms

HIV infection may cause flu-like symptoms at the time of infection or may show no symptoms for years. Over time, however, it can weaken the immune system, leading to AIDS.

HIV and AIDS can make it easier to become ill due to other infections, allowing complications to arise that wouldn’t otherwise be present. These can include several kinds of cancer.

AIDS can cause other systemic symptoms, such as fevers, sweats, and unintended weight loss.

Causes

HIV is often transmitted through vaginal or anal sex or from mother to child during pregnancy or childbirth. It can sometimes spread through oral sex.¹

Treatment

HIV can’t be cured, but it can be treated with various antiviral medications.¹⁵

What Do Oral STDs Look Like?

Depending on the cause, an oral STD may cause a rash, sores, or discharge in or around the mouth, throat, and other parts of the body.

STI vs. STD

STI and STD are almost the same. An STI is a sexually transmitted infection that may or may not show symptoms. An STD is a sexually transmitted disease, which by definition includes symptoms.

All STDs result from STIs, but not all STIs become STDs. Some infections are asymptomatic and are only detected by incidental medical testing.

How to Test for Oral STDs

You can get tested for infections by asking your doctor or attending a clinic. There are different testing methods depending on what’s being tested for. These can include:

• A swab of a sore or affected area (for chlamydia, gonorrhea, herpes, or syphilis)
• A urine sample (may also be used for chlamydia or gonorrhea)
• A blood sample (may be used for syphilis or HIV)
• A Pap test or Pap smear (HPV)

What’s the Outlook for STIs?

Some STIs are lifelong and can’t be eliminated, while others can be definitively cured with antibiotics. However, even lifelong STIs can often be managed with the right treatment.

If you get treatment for an STI as early as possible, you’re more likely not to have recurring symptoms. Some STIs, like HPV, are extremely common and may go unnoticed.

Summary

Various infections can be spread through sexual contact, including oral sex. Using protection during sex (including oral sex), limiting your number of sexual partners, and regular screening for STIs can all help reduce your chances of contracting an infection.

STIs can generally be treated, and some can be cured. Talk to your doctor if you notice any unusual changes or symptoms affecting your mouth, throat, genitals, or other body parts.

Halitosis is an oral health problem that causes persistent bad breath. It’s different from the “morning breath” many people experience temporarily.

About 50% of adults have bad breath at some point.¹⁰ The odor typically resolves with oral health changes like brushing and using mouthwash after eating.

However, daily brushing, chewing gum, mints, and mouthwash typically won’t improve the odor halitosis causes. This condition can also indicate a more serious problem like cavities or gum disease.

If you have bad breath, try improving your dental hygiene and the foods you eat. You may have halitosis if these lifestyle changes don’t help. Schedule an appointment with your dentist to determine the root cause.

Listen In Q&A Format

Halitosis (Bad Breath): Causes, Treatment, and Prevention

NewMouth Podcast

How to Treat and Manage Halitosis

You can manage halitosis through professional treatments, home remedies, and preventing bad breath. Here’s an overview of them:

Professional Treatments

Professional treatment is the best way to manage halitosis. Below are four causes of halitosis and their treatments:

1. Periodontal Disease

Advanced gum disease can be treated by your dentist or another oral specialist, like a periodontist. Periodontal cleanings remove tartar, plaque, and bacteria above and below the gum line.

2. Poor Oral Hygiene

If poor dental care is causing halitosis, your dentist will also recommend ways to maintain good oral hygiene and reduce bad breath at home.

3. Plaque Buildup

If you have extensive plaque buildup, your dentist or periodontist may suggest an antibacterial mouthwash. You should also brush your tongue daily to remove bacteria.

4. Health Conditions

Some underlying medical conditions can cause halitosis. Diagnosis and treatment of these conditions may be the only cure for your bad breath.

For example, a doctor treating gastroesophageal reflux disease (GERD) can stop oral malodor and clear up your halitosis.

Home Remedies

You can try several home remedies to get rid of bad breath. These include:

• Practicing good dental hygiene — This includes brushing your teeth twice a day with fluoride toothpaste, brushing your tongue, flossing daily, and rinsing with mouthwash that contains zinc and chlorhexidine.⁵
• Eating parsley — Chew on parsley leaves after a meal. Parsley, which contains chlorophyll, may mask the odor of bad breath temporarily.¹
• Drinking water — Dry mouth is one of the causes of halitosis, so staying hydrated can help eliminate bad breath by combatting a dry mouth.
• Eating yogurt — The healthy bacteria in yogurt, particularly Greek yogurt, can eliminate harmful bacteria in the mouth and reduce bad breath.⁶
• Drinking milk — Milk can reduce the “garlicky” smell of breath.³
• Drinking green tea — Green tea has disinfectant and deodorizing properties that can improve bad breath.⁷
• Taking zinc — Zinc salts (commonly found in mouthwash) help fight bad breath.⁵

These remedies are not proven to work for everyone. If bad breath persists, see your dentist.

Preventing Bad Breath

You can prevent bad breath odor by following these tips:

Practice Good Oral Hygiene

This includes:

• Brushing your teeth twice daily (with fluoride) and flossing at least once daily. Dentists recommend flossing before you brush to loosen any debris between your teeth.
• Brushing your whole mouth, tongue, cheeks, and the roof of the mouth. Also, gently brush or scrape your tongue. Your tongue harbors bacteria.
• Rinsing with mouthwash after you brush and floss your teeth (before bed).
• If you have dentures, a retainer, or a mouth guard, brush it every night before placing it in your mouth.
• Quit smoking to lower your risk of gum disease and prevent dry mouth.

Eat a Healthy Diet

Eating healthy foods that stimulate saliva production is an effective way to prevent bad breath. Carrots and apples are two examples. They require intense chewing, which increases saliva content. This, in turn, can help prevent bad breath and dry mouth.

You can also chew sugarless gum or suck on hard candy to keep your saliva flowing. If you still have a dry mouth, talk to your dentist. They may give you artificial saliva.

Visit Your Dentist Regularly

Visit your dentist twice yearly for a professional teeth cleaning and dental exam. These visits are essential for preventing oral health conditions and treating any issues early.

Primary Causes of Halitosis

If nothing eliminates your bad breath, it may indicate something else happening in your body.

Mouth, Nose, and Throat Infections

Nose, sinus, and throat infections can lead to postnasal drip, causing bad breath.

When you fight a sinus infection, your body may produce more mucus. Bacteria feed on mucus, making your mouth odor worse.

Oral Health Issues

Cavities, malocclusion, and periodontal disease (advanced gum disease) can contribute to bad breath. Holes in teeth and deep pockets between the gums give bad breath-causing bacteria a place to hide.

Bacteria is challenging to remove from deep periodontal pockets. Normal toothbrushes and floss aren’t effective at removing plaque from these areas.

Instead, you must visit a general dentist or periodontist for a professional deep cleaning. This treatment helps prevent gum disease from progressing.

Dry Mouth

If you have a dry mouth, you don’t have enough saliva to maintain your dental health, potentially causing halitosis.

The following can cause dry mouth:

• Health conditions
• Medications
• Tobacco
• Alcohol
• Caffeine
• Mouth breathing

Saliva is an integral part of your dental health. Saliva contains disease-fighting substances that protect against infections and cavities. It also helps break down food and rinse out any leftover food particles.

Side Effects of Tobacco Products

Tobacco products significantly worsen bad breath. They have a strong odor that lingers in your mouth. Smokers are also more likely to develop dry mouth and gum disease than nonsmokers.

Poor Oral Hygiene

You are more vulnerable to bad breath if you don’t have good dental hygiene. Poor oral hygiene can lead to bacteria buildup, cavities, gum disease, and other infections.

Brushing your teeth twice daily and flossing daily helps remove bad breath-causing bacteria. Waterpiks can also improve oral health.

Other Chronic Conditions

Sometimes halitosis is a sign of another health problem. For example, the following conditions can contribute to chronic bad breath:

• Diabetes
• Liver disease
• Kidney disease
• Gastric reflux

Other Possible Causes of Bad Breath 

Other causes of bad breath not necessarily linked to halitosis include:

Certain Foods

Diet is a significant factor that contributes to breath and overall dental health.

The foods you eat absorb into your bloodstream, and some can leave a bad odor in your mouth. Onions and garlic, for example, can lead to bad breath.

Odor-Causing Bacteria

Odor-causing bacteria on the tongue can react with amino acids to produce volatile sulfur compounds. These sulfur compounds can be particularly smelly, causing bad breath.

Ketoacidosis

Ketoacidosis occurs in people with diabetes. When the insulin levels are very low, bodies can no longer use sugar and start relying on stored fat for energy.

When fat is broken down, ketones are made and build up. Ketones can be poisonous in large numbers and create a distinctive and unpleasant breath smell.

Other Symptoms of Bad Breath

While bad breath is the main symptom of halitosis, it can also lead to a bad taste in the mouth.

Symptoms vary depending on what is causing the halitosis:

• Poor hygiene ⁠— If you have poor dental hygiene, you might develop a toothache, indicating a cavity.
• Infection ⁠— If a recent infection is causing your bad breath, additional symptoms may include a runny nose or other flu-like symptoms.

Breath smells can also differ depending on the cause of the problem. It is best to ask someone close to check your mouth odor as it can be challenging to assess it yourself.

How Is Halitosis Diagnosed?

A general dentist will often smell the breath of someone with suspected halitosis and rate it on a six-point intensity scale.

The dentist may scrape the back of the tongue and check the scrapings for smell, as this area can typically be a source of the odor.

Several sophisticated detectors can rate the smell more accurately. They include:

• Halimeter ⁠— This picks up low levels of sulfur.
• Gas chromatography ⁠— This test assesses three sulfur compounds, which are hydrogen sulfide, methyl mercaptan, and dimethyl sulfide.
• BANA test ⁠— This measures levels of a certain enzyme created by halitosis-causing bacteria.
• Beta-galactosidase test ⁠— This test checks levels of the enzyme beta-galactosidase, which is linked to bad mouth odor.

If the dentist cannot determine the cause of the bad breath, they will refer you to a specialist.

Summary

• Halitosis is characterized by bad breath, but it’s different from morning breath, which vanishes with regular oral care.
• There are various possible causes of halitosis, and identifying its cause can help you receive the right treatment.
• Professional treatments, home remedies, and preventing bad breath will help you manage halitosis and its symptoms.
• Visit your dentist regularly to maintain oral health and prevent bad breath.

Oral cancer is the sixth most common type of cancer in the world. The disease affects 377,700 people each year.⁹ Most of the cases, however, occur in developing nations.

There are two different categories of cancer:

1. Squamous cell carcinoma — this type of cancer begins in the skin or tissues.
2. Sarcoma — this type of cancer begins in the bones, muscles, cartilage, fat, or blood vessels.

What is Oral Cancer?

Oral cancer begins with the development of abnormal carcinoma cells. Over time, growths (sores) appear in the mouth and do not disappear on their own.

In the early stages of oral cancer, the sore commonly appears as a painless white or red patch. Over time, a larger red patch or patches (ulcer) will form. The ulcer will continue to grow, thicken, and may eventually become painful.

The earlier the cancer is detected, the more effective treatment will be. The disease can be deadly if you do not receive oral cancer treatment early.

Signs of a Cancerous Lesion in the Oral Cavity

Most oral cancers are asymptomatic, so you may not notice signs early on. Lesions or patches in the oral cavity are one of the most common signs of oral cancer.

General dentists are trained to examine mouth lesions to look for abnormal characteristics that may suggest potentially cancerous lesions. These characteristics include:

• Size, shape, and color — If the lesion’s borders, colors, and architecture change over time.
• Length of time — If a lesion has been present for more than two to three weeks without any resolution, a more serious underlying condition, such as cancer, is possible.
• Lymph nodes — Cancerous lymph nodes are typically enlarged and firm to touch, with no mobility.
• Systemic symptoms — Some symptoms include unexpected weight loss, frail appearance, fatigue, and easy bruising.
• Genetics and history — If someone has a family history of oral cancer, they are more at risk of developing cancerous lesions.

Although lesions are a common sign of oral cancer, they are not always cancerous. The development of signs and symptoms depends on the type of cancer.

Risk Factors of Oral Cancer

The leading cause of oral cancer is the use of smokeless and smokable tobacco products. This includes cigarettes, chewing tobacco, cigars, and pipe smoking.

“About 54,000 new cases of oral cancer are diagnosed in the U.S. every year. 8 out of 10 patients are smokers.”¹⁰

Other less common risk factors of oral or mouth cancer include:

• Genetics or family history of oral cancer
• Alcohol use and abuse
• Excessive, long-term exposure to the sun
• Human papillomavirus (HPV)

Listen In Q&A Format

Types of Oral Cancer, Their Signs & Treatment Options

NewMouth Podcast

How is Oral Cancer Diagnosed?

11,230 Americans die of oral cancer each year. However, early detection is necessary to prevent the spread of oral cancer. Treatment will also be more effective. ¹⁰

General dentists spend the most time treating people. This means they have the experience and expertise to detect and diagnose oral cancers early on.

There are two steps in determining if someone has oral cancer:

1. Physical Exam

During a physical exam for oral cancer, a dentist, oral surgeon, or doctor examines the mouth for potential abnormalities. They usually look for white patches (leukoplakia) and mouth sores (lesions or ulcers).

2. Biopsies

Next, the practitioner takes a biopsy of the abnormal growth(s) if they find anything suspicious. A doctor uses a scalpel or laser to remove a sample of cells from the lesion and surrounding tissues. Then they send it to a laboratory for testing to determine if it is cancerous.

A biopsy and pathologic evaluation are always required to properly diagnose cancer. A cancer diagnosis is only made after a biopsy confirms the presence of invasive cells.

Biopsies are typically necessary when a lesion is not healing on its own, is raised, and has asymmetric borders. The most difficult lesions to treat are “precancerous,” which means they have atypical and dysmorphic cellular characteristics.

Types of Biopsies

There are a few different biopsies depending on where the growth or white patches are located:

• Oral brush biopsy — A diagnostic test that detects early oral cancer (precancer) by using a small brush to remove a tissue sample from the mouth.
• Needle aspiration biopsy — A fine needle removes cells, tissues, or fluid samples.
• Incisional biopsy — A surgical incision is made through the oral mucosa to remove a small portion of the lesion.
• Excisional biopsy — The entire lesion is removed during an excisional biopsy, including 2mm of normal tissue around the ulcer.
• Speculoscopy — A special blue light is used to help predict if the lesion is cancerous, precancerous, or noncancerous.

Some procedures might cause minor pain or discomfort for a few days.

Types of Oral and Oropharyngeal Cancers

There are many types of oral and oropharyngeal cancers. Here is an overview:

Oropharyngeal Cancer

Oropharyngeal cancers are squamous cell carcinomas that can develop in or on different areas of the mouth, throat, and nose. There are two types of throat or tonsil cancer:¹¹

1. HPV-associated — caused by an oral papillomavirus infection
2. Non-HPV-associated — caused by tobacco smoking and alcohol use

Oral Cancer

Oral cancer can develop in different ways. Cancer sores in the mouth (oral lesions) can appear in different areas of the oral cavity.

Unlike oropharyngeal cancer, oral cancer develops in the mouth. It can affect the lips, gums, jaw, cheeks, and tongue.⁸

The different types of oral cancer include:

• Adenocarcinoma — develops inside the salivary glands
• Sarcoma — develops from abnormalities in bone, cartilage, muscle, or other tissue
• Oral malignant melanoma — develops in the cells that produce skin pigment or color (melanocytes)
• Lymphoma —  develops in the lymph nodes but can also grow in the mouth  

Symptoms of Oral and Oropharyngeal Cancer

The following symptoms can indicate oropharyngeal cancer or other conditions. Contact a doctor immediately if you notice these symptoms:

• A chronic or persistent sore throat
• Pain or difficulty with swallowing
• Difficulty opening your mouth or moving your tongue
• Unexplained weight loss
• Voice changes that do not go away
• Chronic ear pain
• Lumps in the back of your throat or mouth.
• Lumps on your neck
• Coughing up blood
• Lesions or patches around the mouth
• Swelling in the mouth
• White spots or white and red “speckles” in the mouth

What are The Stages of Cancer?

After your doctor diagnoses you with mouth cancer, they can determine the stage of your cancer.

First, they inspect your throat using a small camera to determine if the cancer has spread beyond the mouth. Imaging, such as X-rays, CT scans, and MRI scans, may also be used.

Oral cancers can be classified as belonging to one of four stages, including:

• I — The cancerous tumor is smaller than 2 cm across and is only found in the oral cavity.
• II — The cancerous tumor is between 2 cm and 4 cm across and is only found in the oral cavity.
• III — The cancerous tumor is larger than 4 cm across and has spread to a lymph node on the same side of the tumor.
• IV — The cancerous tumor may be any size. Stage four is also when cancer spreads beyond the oral cavity to the neck or head.

How is Oral Cancer Treated?

Depending on the stage of oral cancer and the location of the tumor or lesion, you will undergo a series of treatments. This may include:

1. Surgery
2. Radiation
3. Chemotherapy

During oral cancer treatment, your dentist will work with an oral surgeon and an oncologist to coordinate your cancer treatment. The plan may include a combination of these three procedures.

First, an oral and maxillofacial surgeon removes the cancerous oral tumor. Then you will undergo radiation and chemotherapy (if necessary).

Surgical Options

There are a few surgical treatment options for oral cancer, depending on the location of the tumor, including:

• Primary tumor surgery — Tumor removal through the mouth or an incision in the neck.
• Glossectomy — Partial or total removal of your tongue.
• Mandibulectomy — Partial or total removal of the lower jaw.
• Maxillectomy — Partial or total removal of the upper jaw.
• Sentinel lymph node biopsy — Test to see if cancer has spread beyond the original oral cancer.
• Neck dissection — Removal of lymph nodes from your neck.

In some cases, you might have to get reconstructive surgery. The surgeon may take healthy bones and tissue (skin, muscle, or bone) from other areas of your body to repair the defect left behind after the tumor has been removed.

Dental implants may be used to replace damaged natural teeth.

Non-Surgical Treatments for Oral Cancer

There are non-surgical treatment options for oral cancer. However, your healthcare provider may combine these options with surgery.

These treatment options include:

• Radiation therapy — Uses radiation to kill cancer cells or keep them from growing.
• Chemotherapy — Uses chemicals and drugs that kill cancer cells.
• Immunotherapy — Biological therapy that engages your immune system to fight the disease.
• Targeted therapy — Uses drugs or other substances to target certain cancer cells without hurting normal cells.

In many cases, radiation and chemotherapy are often combined to increase the effectiveness of both treatments. This combination is usually used when someone has advanced cancer.

Common side effects of chemotherapy include hair loss, weight loss, vomiting, and nausea. However, chemo side effects can vary from person to person.

 Summary

Oral cancer begins with the development of abnormal carcinoma cells. This causes growths (sores) to appear in the mouth. They will not disappear on their own.

There are two types of mouth cancers, oral and oropharyngeal. Both cancers develop inside or around the mouth, such as the lips or throat.

Treatment for oral cancer depends on the stage of a person’s cancer. Surgical and non-surgical treatments are available.

People living with diabetes are more likely to develop serious oral health problems, including mouth infections and diseases.

34.8 million Americans (11.6 percent) have diabetes, and 97.6 million adults live with prediabetes.¹ By definition, diabetes (diabetes mellitus) is a group of serious diseases that result in high blood sugar (glucose).

What are the Types of Diabetes?

The two types of diabetes include:

• Type I Diabetes — Commonly genetic in children, adolescents, and young adults; occurs when the body doesn’t produce enough insulin
• Type II Diabetes — Often diagnosed in overweight adults and seniors; occurs when the body no longer responds to insulin

“In total, 27.9 million Americans received diabetes diagnoses in 2022.”¹

Centers for Disease Control (CDC)

​​How Can You Manage Diabetes?

You can typically keep the diseases under control with:

• A balanced diet
• Exercise
• Insulin
• Other medications that control blood sugar levels

In 2015, diabetes was the seventh leading cause of death. Heart disease is the leading cause of death, while cancer is the second.

Common Dental Conditions Associated with Untreated Diabetes

Symptoms of diabetes can impact many different parts of your body, including the oral cavity. People with diabetes are also more likely to develop serious oral conditions, including infections and pain affecting your:

• Teeth and gums
• Jaw
• Tongue
• Palate
• Cheeks
• Bottom of your mouth

These are in addition to a higher risk of experiencing general health complications.

Connection Between High Blood Sugar and Plaque Buildup

Glucose in saliva keeps your mouth wet and helps wash out harmful bacteria. However, when too much glucose is present, it encourages the growth of harmful bacteria.

Over time, food particles and bacteria produce high plaque levels, a sticky film forming on teeth. Uncontrolled diabetes and plaque buildup can lead to many serious dental complications, including the conditions below.

Gingivitis (Minor Gum Disease)

Uncontrolled diabetes commonly causes gingivitis, a mild and reversible form of gum disease. It forms due to unremoved plaque and tartar (hardened plaque) that collects above your gum line.

Symptoms of gingivitis include swollen, red, inflamed, and bleeding gums. Treatment for gingivitis includes:

• Professional teeth cleaning
• Fluoride treatment
• A prescription toothpaste or mouth rinse

Periodontal Disease (Advanced Gum Disease)

Poor blood sugar control increases the risk of developing periodontal disease (periodontitis or PD). Untreated gingivitis often leads to PD, a severe form of gum disease that causes the gums to pull away from the teeth and can lead to permanent bone loss.

Symptoms of PD include:

• Bad breath
• Changes in teeth alignment
• Tooth loss
• Bleeding gums

Additionally, advanced gum diseases can elevate blood sugar levels. This makes diabetes harder to control and increases susceptibility to fungal infection.

How Does Periodontal Disease Affect Overall Health and Diabetes Management?

Advanced gum diseases affect oral health and complicate diabetes management by raising blood sugar levels. People with periodontitis are more prone to developing type II diabetes or pregnancy (gestational) diabetes.

Treatments for PD may include scaling and root planing, flap surgery, bone or tissue grafts, or a combination of these procedures. Twenty-two percent of people with diabetes develop periodontal disease.²

Dry Mouth & Tooth Decay

High blood sugar reduces the saliva production in your mouth, which causes dry mouth and results in plaque buildup. This condition also increases your risk of tooth decay (cavities) and chronic bad breath.

If you have cavities, a dentist may recommend:

• Cavity fillings
• Dental crowns
• Dental implants or bridges
• Root canal therapy

Oral Thrush

Oral thrush is a yeast infection due to the overgrowth of Candida fungus. In addition, high levels of glucose make it easier for the fungus to grow.

Therefore, people with diabetes who don’t monitor their blood sugar carefully have a higher risk of developing yeast infections. White or red sores and patches on the gums, cheeks, palate, or tongue are common symptoms of thrush.

Treatment includes:

• Antifungals
• Antiseptics
• Dietary supplements
• Throat lozenges (cough drops)

Oral Burning

Uncontrolled blood glucose levels can also cause a burning sensation in the mouth. Oral burning symptoms include dry mouth, bitter taste, and burning that worsens throughout the day.

Treatment may include:

• Saliva Replacements
• Prescription Mouth Rinses
• Capsaicin (Pain Reliever)
• Clonazepam (Klonopin)
• Certain Antidepressants
• Nerve Pain Blocking Medications

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Effects of Diabetes on Oral Health

NewMouth Podcast

Oral Care Tips for Diabetics

For those with diabetes, maintaining your mouth health is crucial. Here are some tips to ensure oral well-being and prevent gum disease:

• Regular dental visits — schedule dentist appointments at least twice yearly for routine cleanings, x-rays, and exams.
• Early treatment of gum disease — the American Dental Association (ADA) emphasizes that treating gum disease early can help improve blood sugar control and slow disease progression.
• Home oral hygiene practices — brush teeth twice daily using fluoride toothpaste, floss regularly to remove plaque between teeth, and use mouthwash nightly to reduce plaque and bacteria further.

Summary

Uncontrolled diabetes and poor oral hygiene can lead to much more severe dental issues. However, you can prevent these complications with proper oral care habits and regular dental visits.

Therefore, diabetic people must prioritize oral health to maintain well-being and prevent further complications. Remember to schedule regular dental visits, practice good oral hygiene habits, and closely monitor your blood sugar levels for optimal health.

Gum disease, or periodontal disease, is an inflammatory condition of the gums and other tissues surrounding the teeth. These tissues, collectively known as the periodontium, encompass:¹

• Your gums (gingiva)
• The outer parts of your tooth roots (cementum)
• The bone sockets your teeth sit in (alveolar bone)
• The ligaments connecting your teeth to their sockets (periodontal ligament)

Early-stage gum disease, or gingivitis, can cause swelling and bleeding of the gums. In some cases, gingivitis progresses into periodontitis. This advanced stage affects the bone holding the teeth, leading to tooth loss and contributing to systemic disease. ^2,3

What Causes Gum Disease?

There are many contributing gum disease risk factors. The most significant factor is your mouth’s diverse array of bacteria and fungi.

The presence of some oral organisms is normal and natural and can have a protective effect against foreign bacteria. But if poor oral hygiene causes an imbalance in the oral microflora,

gum disease can occur.

The common causes of gum disease include:

• Poor oral care
• Diabetes
• Certain medications
• Poor diet
• Bacteria from shared utensils
• Smoking
• Psychological stress
• Hormonal changes (e.g., during pregnancy)
• Poor immune function
• Vitamin deficiencies

Gingivitis vs. Periodontitis

Whitney DiFoggio, RDH, BS, explains the distinction between the two stages of gum disease:

Gingivitis

Poor oral hygiene primarily causes gingivitis, which allows oral bacteria to cause inflammation of the gums. These bacteria form plaque, which hardens into tartar and causes bone loss.

“Gingivitis is the lowest stage of gum disease where the edges of the gingiva (gums) are inflamed and swollen, but everything underneath the gums, including the bone, is still intact. Gingivitis is reversible,” DiFoggio notes. She warns that if gingivitis remains untreated, it can progress into a more severe form of gum disease.

Gingivitis Symptoms

The most common gingivitis gum disease symptoms include:

• Red gums
• Swollen gums
• Itchy gums
• Tender gums
• Bleeding gums, especially during brushing or flossing
• Spitting out blood after brushing or flossing
• Bad breath (halitosis)
• Persistent bad taste in the mouth

Periodontitis

Periodontitis always starts as gingivitis, making poor oral hygiene a critical factor in its development. Tobacco smoking is another significant risk factor for advanced gum disease due to decreased blood flow to the gums.

“Once it advances to periodontitis, the condition is no longer reversible. This is because the tissues begin to pull away from the tooth, leading to the bone beneath shrinking,” DiFoggio elaborates.

“Periodontitis varies in severity, ranging from mild to intense, based on the health of the gum tissue and the degree of bone loss.” A study found that smokers had nearly double the rate of moderate to severe periodontitis when compared to nonsmokers.⁴

Periodontitis Symptoms

The symptoms of gingivitis above can also occur in periodontitis. Other symptoms of more advanced gum disease include:

• Deep spaces or pockets between your teeth and gums due to lost connective tissue (attachment loss)
• Loose teeth
• Increased tooth sensitivity due to gum recession
• Pain while chewing
• Food getting stuck between teeth
• Bite changes

How Do Gingivitis and Periodontitis Differ in Impact?

In early or mild gum disease, only your gums are inflamed. In periodontitis, the other three tissues also suffer.

While gingivitis doesn’t always lead to periodontitis, gingivitis always precedes periodontitis. Furthermore, periodontitis leads to tissue destruction, setting it apart from gingivitis.

What are Gum Disease Complications?

Untreated gum disease can cause tooth and bone loss. Uncontrolled infection can also increase your risk for other systemic diseases, including cardiovascular and lung disease.

Other complications of untreated gum disease include:

• Loose teeth
• Large ulcers (sores) in the gum tissue
• Recurrent gum abscess (collection of pus)
• Damage to the jaw bone
• Receding gums

How Common is Gum Disease?

According to the Centers for Disease Control and Prevention (CDC):⁴

• 47.2% of adults aged 30 years and older have some form of periodontal disease
• Periodontal disease increases with age; 70.1% of adults 65 years and older have it

Periodontal disease is more common in men than women (56.4% vs 38.4%), those living below the federal poverty level (65.4%), those with less than a high school education (66.9%), and current smokers (64.2%).

How to Prevent Gum Disease

To maintain healthy gums and prevent gum disease, consider the following measures:

• Regularly brush to keep oral bacteria in check
• Floss regularly to disrupt plaque before it becomes tartar
• Ensure adequate intake of vitamins and other nutrients to reduce or prevent inflammation
• Limit the intake of simple carbohydrates, which are a significant fuel source for plaque-forming bacteria
• Avoid smoking
• Maintain good overall health

Diagnosing & Treating Gum Disease

Your dentist can diagnose gum disease by examining your mouth. They may take X-rays and measure the pocket depth between your gums and teeth to determine the extent of attachment loss.

They’ll also review your medical history to see whether the following may be contributing factors:

• Any medications
• Bad habits like smoking
• Pre-existing conditions like diabetes

How to Treat Gum Disease

Good oral hygiene can generally reverse gingivitis. However, periodontitis is irreversible. In some cases, you can slow it down, and treatment can repair tissue damage.

The primary goal of treating gum disease is to remove tartar buildup to prevent bacteria from spreading and causing bone loss. The type of gum disease treatment varies depending on the severity of the disease, including non-surgical and surgical therapies.

Non-Surgical Treatments for Gum Disease

The most common non-surgical treatments for gum disease include:

1. Deep Cleaning (Scaling and Root Planing)

Deep cleaning involves removing plaque and tartar from the gums with scaling and root planing.

Scaling is scraping the tartar from above and below the gum line.

Root planing removes rough tartar spots from the tooth’s root where disease-causing bacteria gather. Deep cleaning can cause bleeding, gum swelling, and discomfort.

2. Medications

Medications treat pain and control infection. They’re also effective in combination with surgical gum disease treatments.

Common medications that treat gum disease include:

• Prescription antimicrobial mouth rinse ⁠— To control bacteria after gum surgery
• Antibiotic gel after deep cleaning ⁠— To reduce the size of periodontal pockets
• Antiseptic chip after root planing ⁠— To reduce the size of periodontal pockets
• Enzyme suppressants ⁠— To restrain the body’s enzyme response, thereby preventing the breakdown of gum tissue
• Oral antibiotics ⁠— To treat periodontal infections in the short-term

3. Laser Treatment

Laser treatment removes plaque and tartar from the gum line as an alternative to deep cleaning. Laser treatment decreases the chance of swelling, bleeding, and discomfort associated with scaling and root planing.

Surgical Treatments for Gum Disease

Gum disease surgery may be required if deep cleaning and medication can’t control the infection. It may also be necessary if gum disease is severe and deep pockets remain.

1. Flap Surgery

Flap surgery removes tartar under the gums, then sutures them back in place. This ensures the gum tissue is tight against the tooth and reduces the size of periodontal pockets. Cleaning and maintaining healthy gums are easier after this surgery.

2. Bone Grafts

Gum disease can lead to bone loss around the tooth root. A bone graft involves placing natural or synthetic bone to stimulate regrowth where the bone is lost.

3. Soft Tissue Grafts

Gum disease also destroys soft tissue. A soft tissue graft uses a synthetic mesh material or natural tissue from your mouth to cover exposed tooth roots. This process helps reduce gum recession and improves the appearance of your smile.

4. Guided Tissue Regeneration

Guided tissue regeneration is a bone grafting technique. It involves placing a mesh-like material in between the bone and connective tissue to prevent tissue from growing where the bone should be.

According to Dr. Khushbu Gopalakrishnan, one of NewMouth’s in-house dentists, “new surgical therapies are emerging for periodontitis, including LANAP, that you may want to discuss with your dentist. Don’t be disheartened by your diagnosis, and work with your dentist to maintain your natural teeth for as long as possible.”

Can Gum Disease Cause Other Health Problems?

Bacteria causing gum disease can enter the bloodstream, spreading to other body parts. Periodontitis also increases inflammatory markers in the bloodstream, a risk factor for diabetes and cardiovascular disease.

Gum disease also increases the risk of:

• Pneumonia
• Heart disease
• Stroke
• High blood pressure
• Diabetes
• Preeclampsia (a potentially dangerous pregnancy complication involving high blood pressure)
• Pre-term labor
• Low-birthweight in babies
• Infertility
• Erectile dysfunction
• Alzheimer’s disease

Tooth and bone tissue loss can result from untreated periodontal disease. It can also cause stroke, high blood pressure, and cognitive issues in older people.

How Much Does Gum Disease Treatment Cost?

The cost to treat gum disease varies depending on the severity of the disease, the geographical location of treatment, and if you have dental insurance. Depending on these factors, gum disease treatment can range from $500 to $10,000.⁵

After gum disease treatment, you may also need maintenance therapies that add to the cost. The estimated price for these procedures are:

• Regular dental screenings — Between $30 and $75
• Scaling and root planing — Between $140 and $210
• Periodontal maintenance after initial treatment — Averages $115
• Locally administered antibiotic treatment — Averages $75 per tooth

After an initial diagnosis, a dentist might refer you to a periodontist (a dentist specializing in gum disease) for further treatment and evaluation.

Summary

Oral bacteria cause gum disease, which forms a biofilm that eventually causes inflammation. Early-stage gum disease, or gingivitis, only affects the gums and may or may not progress to a more advanced disease.

Advanced gum disease, or periodontitis, affects the deeper tissues of the periodontium. It can cause tooth loss and systemic health complications.

Gingivitis is reversible, but periodontitis isn’t, although it’s treatable. Good oral hygiene and overall health, a balanced diet, and avoiding tobacco help prevent gum disease.

Sugary food can cause tooth decay and dental caries (cavities), while acidic foods and carbonated soft drinks can wear down your tooth enamel. Poor nutrition can also speed up the development of gum disease and make it more severe.

This article covers the effects of food on dental hygiene and explains how to develop good dietary habits that promote healthy teeth and gums.

Are Oral Health and Overall Health Linked?

Your everyday lifestyle, general health status, and choices can positively or negatively impact your oral health standing.

Common risk factors associated with poor oral health include:

• Heart disease — Periodontal disease is linked to higher rates of heart disease.
• Diabetes and stroke — Untreated tooth decay increases your risk for heart disease and diabetes. There is also a higher chance of a stroke occurring as you age.
• Weakened immune system — Poor dental health results in a weakened immune system, which makes you more prone to developing systemic diseases and infections.

How Does Diabetes Affect Oral Health?

Diabetes impacts all parts of your body, including the mouth. If you have high levels of glucose (sugar) in your saliva, harmful bacteria can grow faster. Over time, food particles and bacteria result in high plaque levels (a sticky film that forms on teeth).

Uncontrolled diabetes can lead to infections and pain affecting teeth, gums, and oral tissues.

Learn which oral conditions commonly impact people with uncontrolled diabetes.

How Food Affects Your Oral Health

Sugar plays a direct role in the development of cavities. This is because bacteria in plaque use sugar as energy and then release harmful acids as waste. As a result, your enamel dissolves, and cavities form.

Tooth decay progresses as you age, and the effects of sugar on the teeth are lifelong. This means that frequent consumption of sugar over a long time results in more:

• Dental plaque
• Dental erosion
• Tooth decay
• Cavities

Tooth loss and soft-tissue (gum) damage can also occur if left untreated.

What Foods Are Bad for Dental Hygiene?

For healthy teeth and gums, avoid foods that increase acid production from oral bacteria. These include:

• Sweet foods and sticky candies — Such as caramels, lollipops, and gummies.
• Starchy foods that stick to your teeth — Potato chips and soft pieces of bread can get stuck between your teeth.
• Fizzy drinks — Regular soft drinks are full of sugar, and even diet sodas contain acids that wear down tooth enamel.
• Acidic fruits — Citrus fruit like lemons and limes are high in acid, which can erode enamel and irritate mouth sores.
• Alcoholic beverages — Alcohol causes dehydration and dry mouth. Reduced saliva levels increase your risk for tooth decay and gum disease.

Studies show that there may be a way to minimize the risk of tooth decay if you limit added sugars to 5 percent of your total daily intake.¹ Natural sugars found in fruits, vegetables, grains, and dairy products are not included in this percentage.

What Foods Are Good for Dental Hygiene?

Eating healthy foods can counteract the effects of acids on tooth erosion. Additionally, getting enough essential nutrients can protect periodontal health by boosting your immune response.

Foods and drinks that are good for your oral health include:

• Still water — Drinking water keeps your saliva levels high. Fluoridated water is especially good for restoring tooth enamel.
• Fresh fruits and raw vegetables — Fiber-rich foods like fresh fruits and veggies help to clean your teeth and boost saliva production.
• Leafy greens and dairy products — Calcium-rich foods like leafy greens, cheese, and plain yogurt help rebuild healthy teeth.
• Green and black teas — The polyphenols in these teas reduce or destroy bad bacteria in your mouth.

A balanced diet includes a variety of foods from the five major food groups. Add whole grains, lean protein, beans, and legumes to the above foods.

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The Effects of Food on Dental Hygiene and Health

NewMouth Podcast

The Effects of Other Substances on Oral Health

Good dietary habits can lead to healthy teeth and gums, but other substances can affect your dental hygiene. These include:

Medications

Many prescription and over-the-counter medications can lead to uncomfortable and serious oral health conditions.

For example, antidepressants and blood pressure medications can cause dry mouth. This condition is where the salivary glands in the mouth don’t produce enough saliva.

Learn more about which medications impact your dental health.

Chemotherapy

Chemotherapy can cause a variety of oral health problems, including:

• Dry mouth
• Cavities
• Gingivitis
• Periodontal disease
• Mouth ulcers
• Oral thrush

Excessive Alcohol Use and Addiction

Long-term and excessive alcohol consumption negatively impacts your teeth and gums. This can result in serious dental conditions, including:

• Enamel erosion
• Dry mouth
• Cavities
• Bruxism (teeth grinding)
• Periodontal disease
• Mouth sores
• Oral cancer

Other minor conditions that may develop from alcohol abuse include tooth discoloration and bad breath.

Learn more about how alcohol use and addiction negatively affect your oral health.

Substance Use and Addiction

Cavities and periodontal disease are more prevalent in people who use drugs than those who don’t. This is mainly because addicts neglect regular dentist visits and have more tartar (hardened plaque) on their teeth.

Long-term use of illicit drugs like amphetamines, cocaine, and opiates can lead to similar problems as excessive alcohol consumption.

In more severe cases, meth addicts can develop “meth mouth.” This condition can result in rotten teeth, cracked teeth, permanent gum damage, and eventually, tooth loss.

Learn more about how drugs can severely damage your oral health.

Tobacco Products

Long-term tobacco and nicotine users commonly suffer from minor and serious oral health conditions. This includes:

• Bad breath
• Dry mouth
• Tooth discoloration
• Cavities
• Oral cancer
• Gum disease

Learn more about how nicotine and tobacco can negatively impact your oral health.

4 Easy Ways to Maintain Good Oral Health

To reduce the chance of developing a minor or serious oral condition, staying on top of basic oral care practices is essential:

1. Brush Your Teeth

Brushing at least twice daily is one of the most important oral care habits. It keeps the teeth and mouth healthy. Using fluoride-based toothpaste also stimulates the gums, which helps prevent gum disease and cavities.

2. Floss Regularly

Properly flossing teeth daily helps reduce the chance of cavities forming between teeth.

Flossing removes plaque and food in places where toothbrushes can’t reach. Establishing a normal routine reduces the chance of developing cavities and other oral conditions.

3. Drink Fluoridated Water

Fluoride is a natural mineral found in soil and rocks that helps prevent cavities. Over the last 70 years, small amounts of fluoride have been added to dental materials to help strengthen tooth enamel.

4. Go to the Dentist

Regular teeth cleanings and dental exams are essential for oral disease prevention. You should get your teeth professionally cleaned every six months.

Summary

The foods you eat have a major effect on dental hygiene and oral health. Sugary foods and fizzy drinks increase acid production in your mouth, which erodes tooth enamel.

Eating healthy foods and avoiding sugars can help prevent tooth decay and reduce your risk for gum disease. It’s also important to maintain proper oral hygiene habits and get regular dental checkups.

Other substances that can negatively affect your oral health include medications, alcohol, and drugs.

• A cavity may appear as a black, brown, or gray hole going into your tooth
• Cavities are holes in the teeth caused by corrosive oral bacteria that break down minerals in the tooth enamel
• Cavities that haven’t fully formed may appear as white spots
• You can prevent cavities by managing good oral hygiene and having a balanced diet

What Are Cavities?

Cavities are holes in teeth caused by tooth decay. They result from the breakdown of tooth enamel.

Tooth decay is a gradual process. Certain oral bacteria produce acids, which eat away at your enamel faster than your saliva can replenish it. Eventually, your enamel develops a permanent hole.

What Do Cavities Look Like?

A cavity may appear as a black, brown, or gray area on a tooth surface. Its appearance can vary from a tiny, dark spot to a large hole in the tooth.

 

Saliva or food may obscure a cavity from your view. Over time, however, a cavity may change color as the decay spreads deeper or wider.

In the very early stages, a developing cavity may appear white. This is generally before the enamel damage becomes severe.

When to See a Dentist for Treatment

See a dentist if you or your child has a visible cavity in one or more teeth. The earlier you seek treatment, the less extensive it will have to be.

A fluoride gel or varnish may be enough to stop a cavity that has barely begun to form. But usually, a visible cavity will need a filling.

Early Signs and Symptoms of Cavities

Besides the obvious appearance of a dark spot, patch, or hole on a tooth, you may also notice:

• Pain or sensitivity when eating something hot or cold
• Tooth sensitivity to cold air
• Persistent toothache
• Bad breath or a foul taste in your mouth

These symptoms can also be signs of other conditions, such as an infection or dentin hypersensitivity. Visit your dentist regularly to address potential oral health issues before they cause further problems.

What Causes Cavities?

Your mouth is home to many bacteria from food particles. Some form plaque, a sticky substance that coats your teeth and gums.

These bacteria feed on the sugars and starches in your food. They use them to produce acids, which break down the calcium and phosphate-based minerals in your enamel.

However, your saliva contains minerals that naturally replenish your enamel. But tooth decay occurs when the enamel breaks down faster than your saliva can restore it. This can be caused by:

• Starchy or sugary foods — Provides fuel for bacteria
• Poor oral hygiene — Allows plaque to continue to grow and spread
• Dry mouth — Less saliva means less mineral content to keep your enamel strong
• Genetics — Some people may be more susceptible to cavities due to differences in saliva pH and other factors

Tips for Cavity Prevention

Here are a few things you can do to prevent cavities and disrupt the formation of plaque:

• Ensure good oral hygiene by brushing twice daily and flossing once daily
• Use a toothpaste that contains fluoride or hydroxyapatite to remineralize enamel
• Eat sugary or starchy foods in moderation
• Include adequate levels of vitamins D and K2 in your diet (these are vital for dental health and remineralization)
• Ask your dentist to apply a fluoride gel or varnish, or dental sealant

Regular dental checkups can also help detect problems early. If necessary, your dentist can treat cavities with fillings and other procedures.