Oral Health Conditions
The oral health leaflet has already told you how to keep your mouth in “tip top” shape. This leaflet will look further into our oral health and specifically, some common
health conditions that you may experience over your lifetime.
Halitosis/Bad breath
Tooth decay
Halitosis, or unpleasant smelling breath, is quite common in healthy people, especially upon awakening. This is
generally as a result of low salivary flow and lack of oral cleansing during sleep. This type of halitosis can be
readily rectified by eating, tongue brushing and rinsing the mouth with fresh water. Having halitosis can have a
major impact on a person. Because of bad breath, other people may back away or even turn their heads and this
can lead to a loss of confidence and self-esteem.
Tooth decay is the
process that results
in dental cavities
(caries). It occurs
when plaque is left to
build up on teeth,
leading to acids that
damage the enamel
covering the teeth
and thus creating
holes (cavities). It is
important to note
that commonly there
may be NO SYMPTOMS alerting you to this tooth decay,
and pain/sensitivity etc may only occur once you actually have developed a cavity or infected tooth. This
may mean a dentist having to perform fillings, crowns
or root canals....and if a cavity is left untreated, it may
lead to a tooth abscess. Untreated tooth decay also
destroys the inside of the tooth (pulp), which can lead
to tooth loss!
What are the other causes of halitosis?
 Gum disease
 Infections within the mouth such as:
 Dental absess
 Oral candidiosis (oral thrush)
 Tonsilitis
 Caries (dental cavities)
 Dry mouth
 Starvation
 Odour-causing foods (e.g. garlic, onions and certain spices)
 Smoking
 Drugs and alcohol
 Poor dental hygiene (with food particles left between the teeth, around the gums or on the tongue
 Certain systemic diseases (e.g. kidney failure, diabetes, metabolic dysfunctions)
How can we manage halitosis?
There is no one treatment for halitosis; however, the following general pointers will be a good start for those of
you who require a “quick fix” from your LiveLife pharmacy:
 Avoid dehydration
 Keep good oral hygiene, including brushing, flossing and mouth rinses.
 Remember to brush your tongue!
 Saline nasal sprays may help you with chronic sinusitis that may be affecting your breath.
 Saliva replacement products may help those suffering from chronic dry mouth
(from medication etc) - see dry mouth section later in leaflet
 Quit smoking!
 Recommended products
 Toothbrush
 Toothpaste
 Dental floss
 Mouth wash—80-90% of mouth-borne halitosis is due to mouth bacteria—please don’t underestimate
the importance of an antibacterial mouthwash—it is essential!
Some important tips for avoiding tooth decay:
 Foods that cling to your teeth are the most likely to
promote tooth decay; e.g. sugars, milk, honey, raisins, hard candy, dry cereal and bread.
 Frequent snacking may lead to more time that the
acid in food has to damage your teeth. Brushing
your teeth after eating will help to remove the
plaque and also make you less likely to snack
throughout the day
 Many people believe bottled water is better than tap
water, but remember that your tap water contains
fluoride, which promotes oral health by helping to
protect tooth enamel from plaque build-up.
 Brush, floss and use mouth wash at least twice a
day!
Teeth Grinding
Teeth grinding (also known as bruxism) is the involuntary clenching, grinding and
gnashing of the teeth. Most commonly it occurs during sleep and it is often associated with stress or anxiety. However, it is often more likely caused by an abnormal bite or missing/crooked teeth.
So what’s the big deal? Is grinding your teeth harmful?
Chronic teeth grinding may lead to many different complications such as fracturing, loosening, or loss of teeth. It may even wear the teeth down to stumps.
When these things happen, you may require bridges, crowns, root canals, implants, partial dentures and even complete dentures!
Dental Sensitivity
What are some causes of dental sensitivity?
 Dental sensitivity occurs when the underlying layer of your teeth (dentin) becomes
exposed. There are many factors that may
lead to this sensitivity including:
 Brushing too hard
 Recession of gums
 Cracked teeth
 Gingivitis (gum disease)
 Teeth grinding
 Tooth whitening products (containing baking soda and peroxide)
 Plaque build up
 The use of some mouthwashes (in this case, a dentist may recommend a
neutral fluoride solution)
 Regular consumption of acidic foods
 Recent routine dental procedures (such as cleaning and tooth restoration)
So what can I do to stop grinding my teeth?
 A dentist may fit a specialised mouth guard to protect the teeth
 Stress management techniques, starting an exercise program or using muscle
relaxants
 Avoiding or cutting back on foods/drinks with caffeine
 Avoiding alcohol
 Avoiding chewing on pencils, pens etc as this may cause you to be more likely
to grind your teeth
 Relaxing the jaw muscles at night by holding a warm washcloth against the
cheek in front of the earlobe
What can I do to reduce tooth sensitivity?
 The worst thing you can do is stop brushing and flossing! Please keep up your
proper techniques and clean all parts of your teeth and mouth thoroughly.
 Use a soft bristled toothbrush to avoid abrasion to the tooth surface and gum irritation.
 Use a “sensitive” toothpaste when brushing – these specialised toothpastes work
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to slowly desensitise the tooth. To speed the process along you can also apply a
layer of fluoridated toothpaste directly to the affected teeth before going to bed.
Be careful with your diet and avoid regular consumption of highly acidic foods
which may gradually dissolve tooth enamel.
Use fluoridated dental mouth wash.
Avoid grinding/clenching your teeth.
Avoid whitening products, as these generally contain baking soda and peroxide
which may lead to further sensitivity!
Referred sinus pain
Cracked and chipped teeth
Sometimes dental pain isn’t caused by any trauma in the
mouth at all. Infection of what is called the “maxillary
sinus” following an upper respiratory tract infection can
lead to dull pain in the upper teeth. The pain tends to be
increased on lying down or bending over and there is often also a feeling of “fullness” on the affected side. Your
pharmacist may recommend a decongestant (e.g. containing pseudoephedrine) to try and clear the congestion
and thus relieve this pain.
 Save the pieces if possible and rinse the mouth with warm water
 Apply gauze to control any bleeding
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Knocked out tooth
Try to find the tooth
Handle only the top of the tooth and never hold it by the roots
Do not scrape, rub or remove any tissue fragments from the tooth
If the tooth is not clean, rinse it in milk
Try to replant the tooth and hold it in its usual spot or place it in the owners mouth next to the cheek (if the
person affected is conscious and able). If not, immerse in milk (not water) and seal it in plastic wrap
 It is important that the tooth doesn’t dry out
 Immediate dental care is crucial
Teeth and drug use
What effect do drugs have on our teeth?
Many medications from the pharmacy can cause tooth and gum damage. Your pharmacist can advise you
on these adverse effects; however, you may find it interesting to read about a few:
 The old sedating antihistamines (such as Phenergan and Polaramine) can cause dry mouth, chewing aspirin can damage tooth enamel, and medicated syrups containing sugar can increase the risk of tooth decay, just to name a few. (NB. The newer non-sedating antihistamines do not have this effect)
There are also significant risks associated with illegal drug use directly relating to the health of your teeth
and gums:
 Cannabis – causes dry mouth and may lead to an increased risk of gum problems. The smoke is also associated with oral cancer
 Cocaine – when the cocaine is rubbed over the gums, it can cause ulceration of gums and the underlying
bone. The actual mixture of cocaine with saliva also creates a very acidic solution which erodes tooth
enamel
 Heroin – this drug can lead to craving sweet foods which can increase the risk of tooth decay. It can also
cause dry mouth and tooth grinding
 Ecstasy – can cause jaw clenching, tooth grinding and dry mouth
 Methamphetamine - this drug is notorious for causing severe tooth decay in only a very short period of
time. The drug itself is highly acidic and attaches to the enamel. It also causes dry mouth, tooth grinding and jaw clenching
Gum disease
Gum disease is usually caused
by a build-up of plaque on the
teeth and one of the most common signs of gum disease is
bleeding gums.
There are 2 different type of
gum disease:
 Gingivitis: This type is very
early gum disease, with
symptoms such as bleeding,
redness and swelling of the
gum.
 Periodontitis: This type is a
more advanced gum disease
that may occur if gingivitis is
left untreated. This disease
can lead to spaces forming
between the gum and tooth,
leading to bacteria becoming
trapped in these pockets and
thus causing further inflammation. Symptoms of periodontitis can include bleeding, swelling and receding
gums together with bad
breath, a bad taste in the mouth and loose teeth – not something you should
have to suffer from with fantastic advice from your LiveLife pharmacy!
So what can you do to avoid these conditions?
 Well, by cleaning the teeth very carefully every day with a soft toothbrush
and concentrating along the gum line where the gum meets the tooth, this
will keep the gum tissue healthy. Dental floss should also be used.
 It is also important to note that “fad diets” that are severely lacking in calcium and vitamins B and C can increase the risk of gum disease, so consider a
multi-vitamin if not eating well.
 Some medications can also cause a “dry mouth” as detailed earlier in this
leaflet. The less saliva you have, the more likely you are to develop gum disease, as saliva helps to keep the teeth clean by controlling bacterial growth.
If you believe your medication is causing this side effect, consult the pharmacist!
But what if I might already be suffering with gum disease? Focus on brushing
and flossing techniques and the use of an antibacterial mouth wash. Consult
the pharmacist for further advice as to whether you will require referral to the
dentist/GP.
Dry mouth
Dry mouth occurs when a person does not produce enough saliva (spit) to keep their
mouth feeling wet.
But why is saliva so important? Well, saliva actually:
 Has anti-fungal properties and helps to destroy viruses and bacteria
 Neutralises the acids produced by plaque
 Helps to moisten your food to help enable swallowing
 Helps with the formation of particular sounds for speech
 Plays a part in the ongoing process of remineralisation (rebuilding) of tooth enamel
 Boosts pain, taste and food texture sensations in the mouth
What are some causes of dry mouth? There are so many things that can lead to drymouth. Just a few examples include:
 Drugs
 Dehydration
 Infection of the salivary glands
 Obstruction of salivary ducts
Is there anything that can relieve the symptoms? There are many things our LiveLife
pharmacies can recommend to relieve the symptoms of dry mouth such as:
 Sucking on sugar-free lollies or chewing sugar-free gum
 Drinking water regularly throughout the day to keep the mouth feeling moist
 Using a fluoride toothpaste when brushing the teeth to ensure proper protection of
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enamel whilst saliva production is limited
Trying to breathe through the nose rather than the mouth as much as possible
Using a vaporiser when sleeping at night to keep “moisture” in the air
Using an over-the-counter artificial saliva substitute; e.g. Biotene
Your pharmacist may recommend changes to your medicine or referral to the GP if
they deem it necessary. Consult the pharmacist if these measures above are not
working!
Mouth sores
What causes mouth sores?
 Accidental biting on the mouth /cheek
 Constant rubbing against sharp teeth, dentures or braces
 Poor oral hygiene
 Burns from eating hot food
 Adverse reactions to certain medications
 A weakened immune system
 Stress
 Hormone changes
 A lack of certain vitamins in the diet, in particular vitamin B12 and folate
How can we manage them?
 Avoid hot beverages and foods, spicy and salty foods, and citrus (which
may further irritate/burn the mouth)
 Use pain relievers like paracetamol and ibuprofen
 Gargle with an antibacterial mouth wash containing “chlorhexidine” and
warm salt water in between
 Use soothing/antiseptic gels/pastes for application directly on the sore;
e.g. Bonjela, SM33 (S2—pharmacy medicine), Kenalog in Orabase (S3—
pharmacist only) - NB Kenalog in Orabase is SO much more effective in
treating mouth ulcers, so please consult your pharmacist for advice!
Oral thrush
What is oral thrush?
Thrush is caused by forms of a fungus called candida. This fungus normally lives in our
mouth and is usually kept in check by the immune system. However, when the immune
system becomes weak, the fungus can grow, leading to symptoms such as whitish, velvety
sores in the mouth and on the tongue. Under the whitish material, there is red tissue that
may bleed easily. If thrush is not treated appropriately, these sores can increase in both
number and size.
So what can my LiveLife pharmacy do for me if I think I am suffering with thrush?
 Consult your pharmacist – the treatments available are Schedule 3 (Pharmacist Only)
products:
 Daktarin Oral Gel – this gel is measured into the provided spoon and then swallowed four times a day until finished (please note it is not suitable for infants due
to the increased risk of choking)
 Nilstat/Mycostatin Oral Drops – this is a liquid form that is held in the mouth for
as long as possible then swallowed four times a day until finished (we use this
product especially in new-born babies with oral thrush)
 Yoghurt and acidophilus don’t destroy the fungus, but they can help to restore the normal bacterial flora in the body. Consider the use of a probiotic supplement such as
“Inner Health Plus” capsules/powder to help restore the proper balance of good and
bad bacterial flora.