Oral Health Screening Online Module
Section 4: Common Oral Health Problems & Abnormalities
Objectives
Upon completion of this section, participants will be able to:
- Identify normal oral health conditions
- Identify and describe common oral health abnormalities and problems
- Distinguish normal from abnormal oral health conditions
- Describe risk factors for common oral health abnormalities and problems
Normal Oral health Conditions
Normal oral conditions include the following (see Images 1 and 2):
- Primary teeth should be white and opaque with smooth surfaces on front teeth and grooved surfaces on back teeth
- Permanent teeth should appear creamier in color and larger than primary teeth
- Lips and tongue should be soft, pink and moist
- Tissues under the lip should appear pink or brown (depending on the child’s skin color), smooth and moist
- The palate or upper groove of the mouth should be soft, pink and moist
- Skins and tissues of the face should not be bruised, swollen or tende
 |
 |
Images 1 and 2: Normal oral health conditions Photos used with permission from Connecticut Department of Health, Office of Oral Health Unit |
|
Common Abnormalities and Problems
There are many oral abnormalities and problems that can occur from infancy to adolescence. If providers detect any abnormal conditions, they should make referrals for dental care to further assess and provide treatment or intervention. Common oral abnormalities and problems are described below.
- Dental Caries are cavities or holes in teeth caused by decay and are the most common, chronic and transmissible oral infections in children and adolescents. During food consumption, cariogenic bacteria in the mouth are activated to break down simple carbohydrates and sugar-rich foods. They also produce acids that cause demineralization of teeth. Cavities are produced when the process is prolonged and exceeds teeth remineralization.
- Early Childhood Caries (ECC), also called “baby bottle tooth decay”, are dental caries seen in infants and young children and can appear any time after tooth eruption (see Images 3, 4 and 5). ECC usually affect the primary upper and lower front teeth and are caused by eating sugary and simple carbohydrate rich foods, prolonged bottle and breast feeding and transmission from caregiver to child if toothbrush or other products are shared.
Dental Caries and ECC can be characterized by:
- Dull white band along the gum line as a result of demineralization (see Image 4)
- Yellow, brown or black collar around the neck of the teeth indicative of progression to cavities (see Image 4)
- Teeth that are brownish, black stumps as a result of advanced cavities (see Image 5)
 Image 3: Advanced ECC, molar pattern |
 Image 4: Intermediate ECC, brown spots |
 Image 5: Severe advanced ECC and associated abscesses |
Photos used with permission from Connecticut Department of Health, Office of Oral Health Unit |
- Missing or excess teeth may be present in young children. These abnormalities result from hereditary syndromes and can be detected and further assessed by radiography. Delayed tooth loss or eruption may be signs of missing or excess teeth.
- Gum and tissues problems can affect infants and young children in addition to tooth infections. Bacterial, viral or fungal disease can cause swelling, redness or ulcers in the mouth. Any abnormal or atypical conditions should be referred to dentists or other health professionals.
Quiz
1. Normal oral health conditions include which of the following? (Check all that apply)
2. What are some common oral health abnormalities and problems? (Check all that apply)
3. Which of the following is associated with an increased risk for developing dental caries? (Check all that apply)
 |
 |
