Oral Health

As per WHO, Oral health is a state of being free from chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the oral cavity.  

Oral health is essential to general health and quality of life. Good oral health is important to your overall well-being.

Oral health has a significant effect on general health and vice versa. It has been proved by researchers over time that an oral infection is capable of causing major health complications. Major effects of oral health on general health are:

Heart Disease

Individuals with gum disease are twice at risk of a fatal heart attack. Similarly, individuals with pre existing cardiac diseases need to be more cautious about oral hygiene.  

Diabetes

Oral infections lead to increased blood sugar levels in diabetic patients. Individuals with Diabetes are more prone to gum disease.  

Respiratory problems

Individuals with oral infections can be affected with critical respiratory diseases such as Pneumonia.

Pregnancy

One of the factors causing premature birth or underweight babies is the presence of gum disease in pregnant woman. The biological fluids that induce labour are activated by the bacteria from gum disease.

The best measure to prevent oral infections is by brushing and flossing on regular basis.

• Brushing and flossing teeth regularly
• Visiting a dentist for regular checkups
• Eating a balanced diet which includes whole grains, vegetables, fruits and dairy products

If this habit is adopted, it will help in minimizing dental problems such as tooth decay, gum diseases and bad breath.

Brushing your teeth

Brushing teeth is an integral part of the oral hygiene routine. For a healthy mouth and smile, it is imperative to:

• Brush teeth twice a day with a soft bristled toothbrush . The size and shape of the brush should fit one's mouth so that it reaches all areas easily.

• Replace the toothbrush every three or four months or sooner if the bristles are frayed

• Use a toothpaste having appropriate fluoride content (ADA specified)

Flossing

Flossing is also an important component of any oral health care routine. Flossing is recommended at least once a day to achieve optimal oral health. Brushing alone only cleans about 60% of the surface of teeth, so it is important that you also floss between teeth since the tight contacts trap food and it is difficult to clean. Flossing should be done before brushing , daily flossing helps to remove plaque from the areas between teeth where the toothbrush can't reach and it also helps to prevent gum diseases and cavities.

Tongue Cleaner

A tongue cleaner(also called a tongue scraper) is a tool used to help clean the tongue. There is not enough evidence that tongue scrapers are more effective than regular brushing of the teeth and tongue but it may help curb bad breath. Tongue scrapers are available in different shapes and sizes, and work by initiating at the back of the tongue and pulling the scraper forward. This removes plaque and odour causing bacteria. Possible causes of bad breath include unhealthy diet, dry mouth, gum disease, tobacco use or simply bad oral hygiene. Good oral hygiene and regular dentist visits are essential for a healthy mouth.

Rinsing

Mouthwashes are used for rinsing the mouth. It eliminates the bacteria or food particles from areas that are beyond the reach of a toothbrush and floss.

Mouthwashes have various uses :

• Freshens breath

• Helps to  prevent or control tooth decay

• Reduces plaque (a thin film of bacteria that forms on teeth)

• Prevents or reduces gingivitis (an early stage of gum disease)

• Reduces the tartar formation on teeth (hardened plaque)

There are basically two types of mouthwashes:

Therapeutic mouthwashes. These reduce plaque, gingivitis, cavities, and bad breath. Those mouthwashes which contain fluoride help prevent or reduce tooth decay.

Cosmetic mouthwashes. These mouthwashes help reduce bad breath and leave the mouth with a pleasant taste, but these don't deal with the causes of bad breath, kill the bacteria that cause bad breath; or help reduce plaque, gingivitis or cavities.

If a person has difficulty in brushing and flossing, a mouthwash may provide additional protection against cavities and gum disease.

Chewing Gum

Chewing sugarless gums reduce the risk of a tooth decay and also help to minimize the risk of dental caries. Chewing sugarless gum increases the flow of saliva, which washes away food and other debris, neutralizes acids produced by bacteria in the mouth and provides disease-fighting substances throughout the mouth. Increased salivary flow also carries with it more calcium and phosphate to help strengthen tooth enamel.

Don’t let chewing sugarless gum replace brushing and flossing. It’s not a substitute.

 The Food one eats and the beverages one drinks can lead to the development of tooth decay, depending upon:

• The form of food whether it is liquid, solid, sticky or slow to dissolve
• How often one eats sugary foods and beverages and how often one eats or drinks acidic foods and beverages
• The nutritional value of the food
• The combination of food one eats and the order in which one eats it
• Medical conditions such as gastrointestinal reflux and eating disorders can increase the risk of cavities and thus tooth decay

Food that may damage your teeth

1. Hard candies

Though hard candies seem tempting and harmless, eating too many of them can lead to constant exposure to sugar which can be harmful to your teeth. In addition, hard candies can increase the risk of a dental emergency such as a broken or a chipped tooth. An alternate to these hard candies are sugarless gums that carry IDA seal.  

2.Chewing ice

It is generally a misconception that ice is good for your teeth, after all, it's natural to think that ice is made of water without any sugar or any other additive, but the truth is that chewing on hard substances make teeth vulnerable to dental emergencies and it may also damage the dental enamel(white tooth portion).  

3. Excessive citrus intake

Excessive intake of acidic food can erode the tooth enamel, making the tooth more vulnerable to tooth decay. Drink plenty of plain water instead of drinking lime sodas.  

4. Frequent coffee or tea intake

Coffee or tea can be a healthy beverage choice but excessive consumption of both may stain teeth. If you are in a habit of taking coffee or tea frequently, make sure you have plenty of water to counteract the effect.  

5. Sticky foods

Many people relish sticky foods but the truth is that they have a potency to cause tooth decay as it stays on the tooth surface for a longer time, giving more time to harmful bacteria to act over it causing tooth decay. Parents should ensure that children rinse their mouth with water after consumption of sticky candies and chocolates.  

6. Potato chips

Everyone loves the nice, satisfying crunch of potato chips, unfortunately potato chips are filled with starch that gets trapped in teeth causing tooth decay. Rinse your mouth with water and floss teeth after consumption.  

7. Soft drinks

Carbonated soft drinks have dual effect on teeth as they are both acidic and sweet which increases the risk of tooth decay .Caffeinated beverages, such as colas  tend to dry one's mouth.  

8. Excessive alcohol consumption

Alcohol causes dehydration and dries your mouth. Excessive consumption of alcohol can lead to reduced salivary flow over time, further it can lead to increased risk of tooth decay and other oral infections. Try to curb the frequency of alcohol consumption and drink plenty of water to compensate for the dehydration.  

9. Sports drinks

For many sports or energy drinks, sugar is the key component. Though sports drinks are helpful for people involved in prolonged physical or strenuous activities, the sugar content in it is harmful for the teeth. Check the label before consuming any sports drink.

Food that may benefit Dental Health

1. Milk

Milk is an excellent source of calcium and Vitamin D which is essential for tooth development, especially in children.

2. Cheese

Cheese is considered as an anti-cavity food as it stimulates saliva secretion and decreases the risk of tooth decay.

3. Fruits and Vegetables

Fruits and Vegetables have a high amount of fiber and water content, which balance the sugar they contain and thus help to clean the teeth. They also stimulate salivary secretion which washes away the harmful bacteria and debris. In addition, fruits and vegetables are rich sources of Vitamin C (essential for healthy gums and healing of wounds) and Vitamin A (key ingredient required in building tooth enamel).

4 . Protein rich foods

Protein rich foods such as meat, fish, milk, eggs are the best source of phosphorus. Both Calcium and Phosphorus together have a critical role in protecting and rebuilding the tooth enamel.

5. Fluoridated water

Water, particularly fluoridated water is the best beverage for keeping your teeth healthy.

It is a known fact that tobacco can cause heart disease and a variety of cancers but, tobacco is one of the leading causes of Oral Cancer which is a major concern to one's oral health.

How does smoking affect one's oral health ?

Smoking can lead to various oral health problems such as:

• Bad breath
• Tooth staining
• Gum disease
• Inflammation of salivary gland openings on the roof of the mouth
• Increase build up of plaque and calculus
• Loss of bone within the jaw
• Increased risk of leukoplakia (white patches within the mouth; a pre-cancerous lesion)
• Delayed healing process
• Increased risk of developing oral cancer

How does smoking affect the gums and teeth ?

The tar and nicotine content in tobacco can lead to staining of teeth, it can make the teeth yellow in a very short time and heavy smoking can lead to brownish discoloration of teeth. Smoking leads to increased risk of gum disease as it reduces the blood flow in the gums and other supporting tissues of the tooth making them more likely to get inflamed. Gum disease is still the most common cause of tooth loss.

Is smoking linked with oral cancer ?

Most people are aware of the fact that smoking can lead to lung and throat cancer but most people are not aware that smoking can lead to oral cancer too.

What is smokeless tobacco ?

It includes tobacco products other than smoking such as pan with tobacco, guthka, khaini, paan masala, mawa and dry snuff.

What kind of ailments are caused by smokeless tobacco ?

• Mouth, tongue and Oral cancer
• Cancer in the esophagus (food pipe)
• Stomach cancer
• Pancreatic cancer
• Increased risk of heart diseases, stroke and heart attack
• Leukoplakia (white patches in the mouth that can become cancerous)
• Bone loss around the root of the tooth
• Receding gums
• Abrasion of teeth ( scratching and wearing down )
• Tooth loss
• Stained and discolored teeth
• Bad breath 

Video on effect of smoking

http://www.dentalhealth.org/tell-me-about/topic/sundry/smoking-and-oral-health

1. Acute toothache

A toothache is pain in or around a tooth. In most cases, toothache is caused by problems in the tooth or jaw. Seek an appointment with a dentist in case of a toothache. The steps outlined below can provide temporary relief:

• Rinse the  mouth with warm salt water and gently use dental floss to remove any food or debris that may be lodged. Do not use a sharp or pointed instrument to remove any debris as this may damage teeth or cause injury.
• A painkiller may be taken for relief till you consult the dentist.
• Try massaging the aching tooth by hand, this can ease the pain by 50 percent. Place a cold compress on the over the cheek to minimize the swelling.
• A few doctors also recommend the use of cloves and clove oil to soothe the pain.

2. Lost tooth filling

•  Immediately report to a dentist
• As a temporary measure, fill a sugarless gum in the cavity or over the counter dental cement

3. Dislodged Crown

Crowns sometimes get dislodged. This can be caused by lack of tooth cement or an improper fit of crown. If this happens, place the crown in a secure, zip- top plastic bag, then bring it to a dentist to have it cemented back in place. If there is  no discomfort and the appearance is not affected, don't try to put the crown back in place yourself.

If there is a need to put it back in the mouth, clean it well. Use a toothpick to loosen and remove any cement or debris that is stuck to the crown. A wet cotton swab can finish the cleaning. One can replace the crown temporarily using denture adhesive or temporary cement which is available in many pharmacies. Contact a dental office immediately and try to schedule a visit for the next day.

4. Lost crown

If the crown falls off, make an appointment to see a dentist as soon as possible and take the crown along. If one can't get to the dentist right away and the tooth is causing pain, use a cotton swab to apply a little clove oil to the sensitive area. If possible, slip the crown back over the tooth. Before doing so, coat the inner surface with toothpaste or denture adhesive, to help hold the crown in place. Do not use any kind of glue.

5. Dental Abscess

• Place a dry black tea-bag or a piece of potato against the sore tooth for a couple of hours or overnight. This reduces the infection and drains the pus, thus diminishes the pain and swelling.
• Swish the mouth with Hydrogen Peroxide 1.5% as a mouthwash in order to disinfect the inflamed area.
• In case of abscess discharge brush your teeth (with a baking soda/peroxide toothpaste) and repeat the disinfectant per- oxide gargle.
• One can assist the drainage by lightly pushing against the cheek near the abscess. but, only lightly. If it is pressed strongly one may push pus into the bloodstream or nearby tissues which can cause a more serious infection.
• Consult a dentist to start appropriate medication.
• An oral infection, like tooth abscess is a serious condition and can cause problems in other areas of the body, like inflammation of the heart or facial bones. Therefore, seeking medical help is essential.

6. Gum Abscess and Periodontal Abscess

 A gum abscess is the result of irritation caused by toothpicks or other objects or aggressive brushing. Due to a break in the gum surface, bacteria invades the area, causing a local infection. Initially, the area appears red, later the area becomes tender and filled with pus.

• Use salt water and clove oil to temporarily reduce the pain before seeking dental help.
• Sometimes using mouthwashes and peroxide gargles also bring temporary relief.
• Antibiotic therapy also causes relief but visit the dentist within 24 - 48 hrs.

7. Broken Dentures or Lost Dentures

• Accidents do happen, in case of broken dentures consult a dentist immediately.
• Safeguard the pieces of the broken denture and report to a dentist.
• Do not try to use any adhesive or try to repair it yourself.

In cases of decay/ extensive cavities, disease or injury, a tooth might need to be removed and this process of tooth removal is called “tooth extraction”. After the extraction, your dentist may tell you to take some precautions in order to promote healing of the extraction site. Below are the instructions that you need to follow for a fast recovery:

Anesthesia:

Before the extraction, an anesthetic agent is injected at the extraction site. It has numbness effect that can last for few hours. Therefore, you should avoid chewing because you may bite your cheek, lip or tongue. Wait for the numbness to subside and if it does not, then contact your dentist.

Bleeding:

• After the extraction, dentist puts a gauge pack at the site which is thick enough to bite. The pressure created due to gauge reduces bleeding.
• •
• Keep that gauge for 30-45 minutes after leaving the clinic.
• •
• If bleeding still persists, then apply a fresh piece of gauge pack (wet with clean water) and place it at the extraction site for another 30 minutes. Replace again, if needed.
• • You should not disturb the extraction site with your tongue as it may hamper the clot formation. Not to be done in the next 24 hours:
• •
• Don’t smoke, don’t take alcohol or any beverages or mouthwash and avoid any hot drink.
• • Don’t rinse mouth vigorously or spit forcefully.
• •
• Don’t do any strenuous exercises.
• • Don’t clean teeth next to the extraction site.

What to be done after tooth extraction:

• Drink lots of fluid and eat soft food for the first day.
• Try chewing from the opposite side of the extraction site.
• Take medication as prescribed.
• Mouthwashes should be started 24 hours after extraction. Mix a teaspoon of salt in to a cup of clean water; keep the salt water in mouth for one minute and gently push the solution around and then spit out. Repeat mouth washes 3-4 times a day and after taking food.

Signs to look out for:

• If over the next 24 hours there is any of the following symptoms consult your dentist:
• New fresh or increased bleeding.
• Pain that is not controlled by pain relieving drugs.
• Abnormal swelling.

References:

https://www.webmd.com/oral-health/guide/pulling-a-tooth-tooth-extraction#2

https://www.ada.org/~/media/ADA/Publications/Files/ADA_PatientSmart_Extraction.pdf?la=en

http://dent.zaums.ac.ir/uploads/1_296_oral%20surg.pdf

https://www.ouh.nhs.uk/patient-guide/leaflets/files/110812dentalextractions.pdf

• Brush thoroughly twice a day with a soft bristled toothbrush. 
• Eat fruits which are rich in Vitamin C.
• Eat a healthy diet and avoid snacks in between meals.
• Replace your toothbrush every three to four months or sooner if bristles are frayed
• Rinse your mouth after every meal
• Schedule dental checkups after every 6 months
• Floss daily to remove food particles that get stuck in between teeth and to remove plaque.
• Don’t brush too hard. Over brushing erodes the enamel and irritates the gums. So, brush your teeth back and forth gently.
• Avoid tobacco and alcohol consumption as they are the prime causes of oral cancer.
• Use tongue cleaner every morning to remove tongue plaque and freshen your breath.
• Avoid food and drinks which contain high sugar content to prevent tooth decay. 

Dental Caries and Periodontitis

• Indian Dental Association      - http://www.ida.org.in/
• American Dental Association - http://www.mouthhealthy.org/en/
• British Dental Health Foundation - http://www.dentalhealth.org/
• Canadian Dental Association - http://www.cda-adc.ca/
• World Health Organisation - http://www.who.int/