Doctor’s Corner
LAST week we looked at “bad breath” and how to control it. Now we turn to another hot topic of dental and social significance — the general aspects of oral health and hygiene.
Oral health, by definition, means being free of long-term 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 as well as other diseases and disorders that affect the mouth and oral cavity.
It is estimated that the most common oral diseases in the world are dental cavities and periodontal (gum) disease — 60 to 90 percent of school children worldwide have dental cavities.
Severe gum disease, which may result in tooth loss, is found in five to 20 percent of middle-aged adults but the rate varies across geographical regions.
Oral cancer is found in one to 10 people per 100 000 population in most countries and that 40 to 50 percent of people who are HIV-positive have oral fungal, bacterial or viral infections, which often occur early in the course of HIV infection.
In this article, we will explore different ways of maintaining good oral health and also look at foods that are good and those that are bad for your dental health.
Teeth cleaning is the removal of “dirt” from teeth in order to prevent cavities, gum disease and other diseases of the teeth and mouth. This is important because conditions such as severe gum disease cause at least one-third of adult tooth loss.
Generally, dentists recommend that teeth should be cleaned professionally at least twice per year. Professional cleaning includes “scraping” the teeth, polishing and the removal of dead tissues (debridement). This is usually followed by a fluoride treatment for children and adults.
Between cleanings by a dental hygienist, good oral hygiene is essential for preventing the build-up of dirt and dead tissues which causes the problems mentioned above. This is done by carefully and frequently brushing with a toothbrush and the use of dental floss.
The use of dental floss is an important element of oral hygiene since it removes the plaque and the decaying food remaining stuck between the teeth. This food decay and plaque cause irritation to the gums, allowing the gum tissue to bleed more easily.
Flossing is recommended at least once per day, preferably before bedtime, to help prevent receding gums, gum disease and cavities between the teeth.
Mouthwash or mouth rinse improves oral hygiene. Dental chewing gums claim to improve dental health.
Cleaning the tongue as part of the daily oral hygiene is essential since it removes the white/yellow bad breath-generating coat of bacteria, decaying food particles, fungi (such as candida) and dead cells from the surface of the tongue. Tongue cleaning also removes some of the bacterial species which generate tooth decay and gum problems.
Foods that help muscles and bones also help teeth and gums. Breads and cereals are rich in vitamin B while fruits and vegetables contain vitamin C, both of which contribute to healthy gum tissue. Lean meat, fish and poultry provide magnesium and zinc for teeth.
Some foods may protect against cavities. Fluoride is a primary protector against dental cavities. Fluoride makes the surface of teeth more resistant to acids. Drinking fluoridated water is recommended by some dental professionals while others say that using toothpaste alone is enough.
Milk and cheese are also rich in calcium and phosphate, and may also encourage strengthening of teeth.
All foods increase saliva production, and saliva contains some chemicals that maintain/stabilise the pH to near 7 (neutral) in the mouth. Foods high in fibre may also help to increase the flow of saliva. Sugar-free chewing gum stimulates saliva production, and helps to clean the surface of the teeth.
Sugars are commonly associated with dental cavities. Other carbohydrates, especially cooked starches like crisps/potato chips, may also damage teeth, although to a lesser degree since starch has to be converted by enzymes in saliva first.
Sucrose (table sugar) is most commonly associated with cavities. The amount of sugar consumed at any one time is less important than how often food and drinks that contain sugar are consumed. The more frequent the sugars are consumed, the greater the time during which the tooth is exposed to low pH levels, which is detrimental to the teeth integrity.
It is important therefore to try to encourage infrequent consumption of food and drinks containing sugar so that teeth have a chance to be repaired by remineralisation and fluoride. Limiting sugar-containing foods and drinks to meal times is one way to reduce the incidence of cavities.
Sugars from fruit and fruit juices – eg glucose fructose and maltose – seem equally likely to cause cavities.
Acids contained in fruit juice, vinegar and soft drinks lower the pH level of the oral cavity which causes the enamel to demineralise. Drinking orange juice or cola throughout the day raises the risk of dental cavities tremendously.
Another factor which affects the risk of developing cavities is the stickiness of foods. Some foods or sweets may stick to the teeth and so reduce the pH in the mouth for an extended time, particularly if they are sugary.
It is important that teeth be cleaned at least twice a day, preferably with a toothbrush and fluoride toothpaste, to remove any food sticking to the teeth.
