PREVENTABLE DENTAL DISEASES

PREVENTABLE DENTAL DISEASES

• DENTAL CARIES (TOOTH DECAY).• GINGIVITIS (GUM DISEASES).• PERIONDONTITIS (Diseases affecting the

supporting structures of the teeth-bone, gum and periondontal ligament).

• And many others too numerous to mention.

DENTAL CARIES (TOOTH DECAY)

• DEFINITIONDESTRUCTION OF THE TOOTH SURFACE DUE TO THE ACTION OF BACTERIA ON REFINED CARBOHYDRATE.

Food + Bacteria = AcidAcid + Tooth =Caries

Commonest cause of tooth loss in children.

AETIOLOGY/CAUSES

• 1. Bacteria• 2. Refined Carbohydrate e.g.

snacks, sweets, biscuits.(frequency more likely cause than quantity)

• 3. Susceptible teeth e.g. deep pits & fissures, tight contact areas.

SIGNS AND SYMPTOMS

• Initially symptomless-incipient caries.• Frank Hole on the tooth.• Pains with cold/ warm water with dentine

exposure.• When the pulp/nerves becomes exposed:• Pains at night and with chewing.• Unstimulated pains.

TREATMENT

• Use of amalgam (Silver)fillings).• Use of composite (white)fillings• Root canal therapy• Extraction

COMPLICATIONS OF UNTREARED TOOTH DECAY

• Dental abscess• Cellulitis /Ludwigs Angina• Osteomyelitis

prevention

• Good oral hygiene habits through brushing with fluoride containing tooth paste at least twice daily. Use ‘medium tooth brush’ with upward & downward movements.

• Avoid eating in between meals.• Avoid frequent snacking, sticky food• Brush orRinse after each meal.• Fluoridated public water supply 1ppm should

be encouraged .

PERIONDONTAL DISEASES(Gingivitis and Periondotitis)-Gum disease

Definition: Disease affecting the supporting structures of the teeth: Gingiva (gums), bone, periodontal ligament/fibres.

Aetiology/Associated factors• Poor oral hygiene• Smoking• Stress

SIGNS AND SYMPTOMS OF GINGIVITIS

REDNESS OF THE GUMSSWELLING OF THE GUMS

BLEEDS EASILYLITTLE OR NO PAIN INITIALLY

WARNING SIGNS/SYMPTOMS OF PERIONDONTAL DISEASE

• BLEEDING OF THE GUMS• REDNESS OF THE GUMS• PAINS• SORENESS OF THE GUMS• POCKETING• HALITOSIS /FOUL BREATH• PUS FROM THE GUMS• TEETH MOBILITY• DRIFTING OF TEETH

MANAGEMENT OF GINGIVITIS

Scaling and polishingGood oral home care

GENERAL PRINCIPLES OF PREVENTION AND MANAGEMENT OF PERIONDONTITIS

1. SCALING AND POLISHING 2X IN A YEAR.

2. ESTABLISH EFFECTIVE ORAL HYGIENE HABITS

3.SURGERY

HALITOSISOral malodour, breath odour, mouth odour, foul breath, fege bosta, fetor oris, fetor ex ore or most commonly,

bad breath.

• Definition : Unpleasant odour coming from the mouth when breathing whether the source is from mouth or not.

• True halitosis or False halitosis ( halitophobia).• Third most frequent reason for seeking dental care following

Dental caries (tooth decay) and periodontal disease.• GENERAL AETIOLOGY/CAUSES• 85-90% originates from the mouth.• Intensity during the day depends on what is

consumed e.g. garlic, onions, meat, fish and cheese. Obesity, smoking and alcohol consumption also implicated.

HALOTOSIS (CONT)

• Halitosis ( morning breath) worse in the morning.

• May be temporary and disappear after eating, brushing, flossing or following mouth rinses.

• May also be persistent ( chronic ). 25% of population may be affected.

HALITOSIS (cont)

• MOUTH• >600 Types of bacterial in an average mouth.• Odours produced thru anaerobic break down of proteins into

individual amino acids, followed by further breakdown of certain amino acids to produce detectable foul gases e.g. the breakdown of cysteine and methionine produce hydrogen sulphide and methyl mercapatan.

• Other parts of the mouth in descending order may also contribute to foul breath: Back of the tongue, inter dental and subgingival niches, faulty dental work. Food-impaction areas, unclean dentures and abscesses.

HALITOSIS (cont)

• TONGUE• Most common location for mouth-related halitosis.• Large colonies of bacteria on posterior dorsum of the tongue where they

thrive on food deposits, dead epithelial cells, and post nasal drip. When left on the tongue, the anaerobic respiration of such bacteria can produce offensive odours.

• CLEANING THE TONGUE• Commonest reason for cleaning the tongue is to control bad breath.

Mouth deodorants only give temporary relief because they do not remove the cause of bad breath. A tongue cleaner or tongue scraper can be used to clean the tongue.

GINGIVITIS

Subgingival plaque have a foul smelling odour.

NOSE2nd Major source of bad breath. May be due to sinus infection or

foreign bodies.

TONSILSDue to small bits of calcified matter called tonsilloliths which

smells extremely foul when released and can cause foul breath.

STOMACHIn belching, reflux, or fistula between the stomach and

oesophagus

SYSTEMIC DISEASES

• Generally INFREQUENT in the general population.

• Fetor hapticus• Lower respiratory tract infections(Bronchial and lung

infections).• Renal infections and renal failure.• Carcinoma.• Trimethylaminuria (“fish odour syndrome”).• Diabetes mellitus. Metabolic dysfunction.• Individuals suffering from the above conditions often show

more diagnostic conclusive symptoms than bad breath.

HALITOSIS (CONT)DIAGNOSIS

• Self diagnosis/Home diagnosis• Professional Diagnosis.• Halimeter- Used to test for level of sulphur emissions.• Gas chromatography- Measures hydrogen sulphide, methyl mercaptan and dimethyl

sulfide. It produces visual results in graph form via computer interface.• BANA test-Measures salivary level of an enzyme indicating the levels of certain

halitosis related bacteria.• B-galactose test- salivary levels of this enzyme were found to be correlated with

halitosis.

• THE MOST RELIABLE TEST (THE GOLD STANDARD) IS THE ACTUAL SNIFFING AND SCORING OF THE LEVEL AND TYPE OF THE ODOUR CARRIED OUT BY TRAINED EXPERTS (ORGANOLEPTIC MEASUREMENTS). THE LEVEL OF THE ODOUR IS USUALLY ASSESSED ON A 6 POINT INTENSITY SCALE.

HOME CARE AND TREATMENT

• Chronic halitosis not well understood by most physicians and dentists, hence, effective treatment is not always easy to find.

• 6 strategies may be suggested:1 Gently cleaning the surface of the tongue 2x

dly. Use tongue cleaner/brush/inverted teaspoon. .

HOME CARE AND TREATMENT (cont)

• 2.Eating a healthy breakfast with rough food helps to clean the back of the tongue.

• 3.Chewing gum- to improve salivary flow.• 4.Gargling before bed time with an effective

mouth wash• 5.Maintaining good oral hygiene.• 6.Maintain water levels in the body

RECEEDING GUMS(GINGIVAL RECESSION).

• Exposure of the root surface due to shrinkage of the gums.

• Aetiology/Causes– Overaggressive brushing– Poor oral hygiene– Periodontal disease– Bruxism/Grinding of the teeth– Adult orthodontic movement of teeth.– Sensitivity of the teeth to Sodium Lauryl

Sulphate(SLS), an ingredient of most commercial toothpastes

RECEEDING GUMS (CONT.)• Signs and SymptomsSensitive teeth 2 heat/cold,aweet, sour or spicy

foods.Teeth may appear longer than normal.Exposed & visible roots.The tooth feels notched “ the gum line.Change in tooth colour because of the difference

in colour between enamel & cementumSpacing between the gumsCavities/holes below the gum line.