Choroby zębów i jamy ustnej

Mostly happens in your sleep, mostly goes unnoticed, and quietly wears the teeth down over years.

When there is no room left in the jaw, the erupting tooth presses on its neighbour and the gum.

Clicking, pain or locking in the jaw. Most cases resolve without surgery.

Saliva is the mouth's natural protection. When it drops, decay, odour and sensitivity all rise together.

Inflammation of the gum flap over a partly erupted tooth. It can worsen quickly.

White patches caused by a fungus. Wipe them away and the red surface beneath shows.

Pain in your jaw does not always come from the joint. Most of the time the source is the chewing muscles themselves; when pressing on a muscle during the examination brings back the pain you recognise, that points this way.

The click from your jaw and your mouth not opening are not two separate problems; most of the time they are two stages of the same process. The time that passes in between can change the outcome.

If your mouth is stuck open and you cannot close it, the condyle may be caught in front of its socket. This is dealt with the same day; the longer you wait, the more muscle spasm makes it hard to put back.

If your teeth no longer meet as they did after a blow to your jaw, there may be a fracture. This is assessed in hospital; a delay can let the bone heal in the wrong position.

If your pain has increased rather than eased after a tooth was taken out, the clot in the socket may have been lost early. Dry socket is not an infection in the usual sense; it is not expected to clear with antibiotics alone.

A neglected tooth infection can settle inside the bone itself. Osteomyelitis is uncommon, but once it takes hold, treatment runs for weeks and has to be carried out together with a hospital.

Some medicines, and radiotherapy given to the head and neck, lower the jawbone's capacity to heal. Bare bone showing under the gum is the sign that defines this condition.

Jaw cysts grow silently. Most are noticed on a panoramic X-ray taken for another reason; up to that day they may have caused no symptoms at all.

When stomach acid reaches the mouth, it dissolves teeth chemically. The first person to notice this wear is most often the dentist; patients rarely make the link between their stomach and their teeth on their own.

Jaw pain that starts when you walk and eases when you rest may be coming from the heart rather than from a tooth. What has to be done here is to call 112 without losing time.

A grating sound from your jaw says something different from a click: the joint surface has changed. This can have a direct effect on your bite and on your treatment plan.

Pink-tinged oozing that lasts a few hours after an extraction is expected. Red blood that fills the mouth and runs despite biting on the gauze is not.

Red, map-like patches with clearly marked borders appear on the top of the tongue. These patches move to a different place within days. In most people they are harmless and need no medicine.

There are grooves on the top of the tongue whose depth varies from person to person. In most people this is simply how the tongue is built; the symptoms usually come not from the grooves themselves but from what collects inside them.

When the tiny projections on the top of the tongue are not shed and grow longer, they take on a hair-like look; the pigments that collect on them give the tongue a brown or black colour.

A tongue that becomes smooth, cracks at the corners of the mouth and recurrent mouth ulcers can be the first signs in the mouth of iron, B12 or folate deficiency. The diagnosis is made with a blood test.

A mouth ulcer is a painful sore on the soft lining of the mouth, whitish in the middle with a red edge. It is not contagious; the real question is why it keeps coming back.

This is a long-standing inflammatory condition that produces lacy white lines, red areas or sores on the lining of the mouth. It is not contagious and it calls for regular monitoring.

A white area in the mouth that does not rub off and cannot be explained by any other known condition is called leukoplakia. It is not cancer in itself; it is a change that needs to be monitored.

In the early stage it is most often not pain but a sore that does not heal or a change in colour that gives the first sign. The diagnosis is not made by looking but by tissue examination, and treatment is carried out outside dentistry.

Redness, cracking and crusting at the corners of the lips most often comes not from dryness but from saliva pooling in the corner and the microbes that multiply there.

A cold sore appears when the herpes virus, which stays in a nerve ganglion after the first encounter, becomes active again from time to time, and in most people it comes back in the same place.

This picture in a child, with a fever and widespread sores inside the mouth, is the first encounter with the herpes virus. It is often mistaken for teething; the thing to keep an eye on is fluid intake.

The soft, see-through bubble that appears inside the lip or under the tongue most often forms when saliva leaks from a damaged salivary duct and collects in the tissue.

Redness where a denture sits often causes no pain, which is why it goes unnoticed. It usually comes from wearing the denture overnight as well and from never cleaning its surface with a brush.

A band under the tongue that is short, or that sits close to the tip, does not always cause trouble. The decision is not based on how it looks, but on whether feeding, speech and tongue movement are genuinely affected.

The burning in your tongue and lips carries on, but the examination shows no sore or patch that explains it. When nothing else can be found to account for the burning, this picture is called burning mouth syndrome.

A lip, a tongue or a throat swelling up within minutes may be angioedema. This is not treated in dentistry; because it can narrow the airway, it is assessed in an emergency department.

Years of sun can leave the lower lip lastingly dry and flaky, with its border blurred. This change is not cancer in itself, but it is regarded as precancerous and needs monitoring.

Acid produced by bacteria dissolving the enamel. Caught early, it may not even need a filling.

A short, sharp jolt from cold or sweet. Usually not a disease in itself but a warning.

Infection collecting at the root tip or in the gum. This is not something to wait out.

Inflammation of the tooth's living tissue. It has a reversible and an irreversible form, and the length of the pain separates them.

Pain from a crack that an X-ray cannot see. The hardest part is the diagnosis.

Loss of enamel to acid directly, without bacteria. It advances by a different mechanism from decay.

Inflammation returning years later in a root-treated tooth. In most cases the tooth can still be saved.

A blow to a tooth does not stop at the break you can see; the ligament holding the tooth in place, the root and the nerve tissue inside it can all be damaged as well. When an adult tooth is knocked out, the first few minutes decide the outcome.

A dull tightness that wraps around both sides of your head like a band. It does not throb and it does not get noticeably worse with movement, but it often overlaps with teeth clenching and tension in the chewing muscles.

Recurring attacks, most often one-sided and throbbing. When the pain spreads to the temple and the upper jaw it can be taken for toothache, and telling the two apart protects a healthy tooth.

One-sided attacks that settle behind the eye and in the upper jaw and build up within minutes. A red eye and a blocked nose come with them, and they are often taken for toothache.

Pain that starts at the back of the neck and spreads to the temple, the forehead and behind the eye on the same side. It is set off by neck movement or by staying in one position for a long time.

An inflammatory disease of the blood vessels that can affect the artery at the temple. Over the age of fifty, the jaw tiring while you chew can be its first sign, and if things are left late the loss of sight can be permanent.

Tooth and face pain that carries on even though the examination and the X-rays show no cause. Where the pain is felt is not always where the damage lies.

Sudden pain on one side of the face that lasts seconds and feels like an electric shock. Because it is so like toothache, healthy teeth are sometimes treated unnecessarily.

One side of the face dropping within hours. The first thing that has to be done is to rule out a stroke; that is decided in hospital and it is not left until the next day.

The chickenpox virus reactivating years later in a single nerve branch. In the first few days it feels like toothache; the rash comes later.

Involuntary contraction on one side of the face. It usually starts in the eyelid, spreads over months to the cheek and the corner of the mouth, and can carry on even during sleep.

Numbness in the lip, chin or tongue that does not go away after wisdom tooth surgery, an implant or an injection. Noticing it early changes the path that is followed.

Blood flow to the brain suddenly cut off, or a blood vessel bleeding. When a face drops suddenly, this is the first thing to be ruled out, because every minute lost is brain tissue lost.

The airway narrows and closes over and over again during sleep. The diagnosis is made with a sleep study; your dentist notices the signs and takes part at the stage where a mandibular advancement device is fitted.

Snoring that is heard without pauses in breathing and without drops in oxygen. How loud the sound is does not show how severe the picture is; what tells the two apart is a sleep study.

Breathing through the mouth instead of the nose dries the mouth out, leaves the gums open to inflammation and can affect jaw development in children. The cause usually lies in the nose.

This is one of the most common reasons a child sleeps with the mouth open. The diagnosis and any decision about surgery belong to the ear, nose and throat specialist; the dentist is often the first to notice it.

When the width of the upper jaw falls short of the lower jaw, crossbite and crowding appear. The easiest time to widen it is during the growing years.

The first stage of gum disease, and the only stage that is fully reversible.

Irreversible loss of the bone that holds the tooth, the leading cause of tooth loss in adults.

The gum pulls back and exposes the root surface, most often the result of brushing too hard.

An implant does not decay, but the tissue around it can become diseased. The bone loss is irreversible.

A gland in your neck or under your jaw swells because it is responding to an infection nearby. A tender gland that shifts under your finger most often comes from a tooth or from the gums.

This is a quickly spreading infection that takes hold of the floor of the mouth on both sides at once. The source is most often a lower back tooth, and because it can narrow the airway it is looked after in hospital.

When infection from a tooth breaks through the bone and spreads into the tissues of the face, the swelling loses its clear edge. Once it moves towards the eye or down into the neck, it is not something to wait out at home.

When the debris collecting in the pits of the tonsils hardens, it forms white, foul-smelling lumps. They are one of the causes of bad breath that come from outside the mouth, and cleaning your teeth will not clear them.

If the area under your jaw swells up as you start eating and then settles again a while later, there may be a blockage in a salivary duct. A stone blocks the route saliva takes out, not the gland itself.

An infection of a salivary gland runs its course with the gland swelling quickly and becoming painful. The dentist's job is to notice this inside the mouth and refer you on; the treatment is carried out in the ear, nose and throat department.

If your eyes are drying out along with your mouth, this may be a condition in which the immune system targets the glands that make your secretions. The diagnosis is made in rheumatology; protecting the mouth carries on in dentistry.

If there is a painless, slowly growing lump in front of your ear or under your jaw, it is not expected to go away on its own. This page does not make a diagnosis; it explains which doctor to see and why you should not wait.

Some sinus infections that stay on one side, smell unpleasant and keep coming back begin in the upper back teeth. Sinus treatment given without dealing with the tooth behind it is not expected to last.

After an upper back tooth is taken out, a passage can be left between the mouth and the sinus. Water coming down your nose as you drink is the most familiar sign; a small opening may close on its own, while a wide one is closed surgically.

A full, blocked feeling in the ear, crackling and hearing your own voice most often come from the Eustachian tube. The dentist's job is to tell this picture apart from the jaw joint and to refer you to the right specialist.