The root of all oral health issues

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Highlights

Experts consider oral diseases to be among the most prevalent ailments globally, and important indicators of your overall health and well-being

We simply don’t talk about oral care enough in terms of health — it’s mostly referred to in terms of beauty. Your smile is arguably one of your most important features — and while the attention to it is paltry in comparison to skin care, or haircare — oral health and overall health are inextricably connected and need our utmost attention.

Oral health plays a vital role in one’s well-being, not just physically but psychologically as well.

– Dr Arif Kandoth, HOD Dentistry, Aster Clinics & Hospitals and Specialist Prosthodontist, Aster Clinic, JLT

Why is it important for people to seek oral healthcare? “Oral health plays a vital role in one’s well-being, not just physically but psychologically as well,” says Dr Arif Kandoth, HOD Dentistry, Aster Clinics & Hospitals and Specialist Prosthodontist, Aster Clinic, JLT. “Not maintaining good oral health can lead to dental diseases such as foul breath, decayed teeth, tooth pain, and bleeding gums. Poor oral hygiene has also been linked to heart disease. Healthy teeth are the window to a healthy body. So, it is imperative that one maintains good oral hygiene by seeking professional help and visiting one’s local dentist every six months.”

The signs to look for, says Dr Kandoth are blackening or greying teeth, bleeding gums, foul breath, deposits on teeth, sharp or dull pain and discomfort in chewing, to name a few.

Certain diseases, such as diabetes and cancer, potentially lower the body’s resistance to infection, making oral health problems worse.

– Dr Aparna Pandey, Specialist Periodontist, Thumbay Dental Hospital

Usually, the body’s natural defenses and good oral healthcare, such as daily brushing and flossing, keep bacteria under control because the mouth is the entry point to digestive and respiratory tracts. In contrast, poor oral hygiene and the inflammation associated with a severe form of gum disease (periodontitis) can increase the severity of multiple diseases. “Certain diseases, such as diabetes and cancer, potentially lower the body’s resistance to infection, making oral health problems worse,” says Dr Aparna Pandey, Specialist Periodontist, Thumbay Dental Hospital. “Furthermore, people who are on medication, including decongestants, antihistamines, painkillers, diuretics and antidepressants may experience reduced saliva flow. Now, saliva plays an important role in washing away food and neutralising acids produced by bacteria in the mouth, protecting you from pathogenic microbes that multiply and lead to infections.”

Heart problems, diabetes, respiratory disease, osteoporosis, rheumatoid arthritis, and premature birth and low birth weight in pregnant women are health conditions that can be linked to oral health.

– Dr Yasmeen Al-Bashatli, General Practitioner Dentist, Medcare Medical Centre Sharjah

Link between oral health and overall health

Studies have suggested that oral health offers clues about your overall health — or that problems in your mouth can affect the rest of your body. “Poor oral health (mainly periodontal disease) has a strong relation to many serious chronic medical conditions,” says Dr Yasmeen Al-Bashatli, General Practitioner Dentist, Medcare Medical Centre Sharjah. “Heart problems, diabetes, respiratory disease, osteoporosis, rheumatoid arthritis, and premature birth and low birth weight in pregnant women are health conditions that can be linked to oral health.”

Dr Rahi Rustham Sha, General Dentist, Thumbay Dental Hospital, says gum disease is linked to several illnesses, and is essentially the most widely known chronic inflammatory condition worldwide, but is often a silent disease. “In context, the mouth acts as a gateway for most infections; and a growing inflammation in the mouth can let bacteria enter the bloodstream to cause the exaggeration of pre-existing inflammation in other parts of your body, such as the heart,” says Dr Sha.

In context, the mouth acts as a gateway for most infections; and a growing inflammation in the mouth can let bacteria enter the bloodstream to cause the exaggeration of pre-existing inflammation in other parts of your body, such as the heart

– Dr Rahi Rustham Sha, General Dentist, Thumbay Dental Hospital

Similarly, there’s a two-way relationship between gum disease and diabetes too. “Once you check and control diabetes, there’s an associated improvement in the condition of the mouth inflammation,” explains Dr Sha. “Likewise, once the periodontal disease is treated, the need for insulin is reduced and the blood glucose readings improve.”

Dr Anvesha Gupta, Specialist Prosthodontist, JTS Medical Centre, says the mouth leads to the digestive and respiratory tracts and some of the bad bacteria that enter these tracts can cause disease.

Common dental issues

The most common dental diseases in the UAE are dental caries or decay, periodontal (gum) disease, loose teeth, and deposition of tartar and stains. These mostly occur due to lack of awareness about oral hygiene practices, and the factors that cause them, which includes smoking, consuming sugary foods and drinks. “Sugary foods are essentially the major factor contributing to dental caries, or tooth decay, which is a major oral-health problem worldwide,” says Dr Pandey. “Gum inflammation can progress to serious conditions that cause major damage to the soft tissue and the bone that supports the teeth. Moreover, foods don’t just cause gum disease and tooth decay but also lead to stains. Black tea and coffee, red juices and cola are all known to cause discoloration of teeth.”

A collaborative approach from both professionals to educate and bring awareness on maintaining good oral health will bring value to the integrated practice.

– Dr Anvesha Gupta, Specialist Prosthodontist, JTS Medical Centre

Dr Al-Bashatli cites acute gingivitis and periodontitis — gingival enlargement, redness, receding gingiva and heavy bleeding — as the most common issues.

Dr Gupta explains that current lifestyles, gum inflammation, halitosis, and cavities are the most prevalent issues, especially with the younger generation. “The symptoms are bleeding gums, bad breath, pain in the teeth, or discoloration and yellowish teeth.”

To protect your teeth at all times, says Dr Sha, one has to brush them regularly twice a day; wherein it’s important to take your time, moving the toothbrush in gentle, circular motions to remove plaque. “The toothpaste should contain fluoride in appropriate quantities as recommended for different age groups,” he says. Also, the use of dental floss and other interdental aids will help to remove plaque from in-between teeth surfaces and control inflammation of gums, called gingivitis. Thirdly, keeping the body adequately hydrated and avoiding dryness in the mouth also enhances overall health, including oral health and boosting immunity. Maintaining good levels of water consumption is an indicator of overall health — including oral health. Lastly, mindful intake of foods, which convert into acids (such as sugar) in the mouth can help in preventing enamel erosion and dental cavities.”

As far as children are concerned, says Dr Imneet Madan, a Laser Specialist Pediatric Dentist in Dubai, the most common dental concerns are cavities in-between the two teeth. “Studies have seen that about 85-87 per cent of decays in children occur in between the two teeth simply because we are not flossing regularly and children are more prone to snacking in comparison to adults,” she says. “Since eating routines in children are not as well governed as among adults, the incidents of cavities in-between the two molars or the back teeth are higher. So, one of the common things that I also see in the practice are these kinds of decays, which are then detected on the X-rays. The treatments required are then conducted.”

Studies have seen that about 85-87 per cent of decays in children occur in between the two teeth simply because we are not flossing regularly and children are more prone to snacking in comparison to adults,

– Dr Imneet Madan, a Laser Specialist Pediatric Dentist in Dubai

These kinds of decays can be well prevented through proper flossing, regular dental visits, avoiding snacking, and brushing really well. “I always inform parents that dental disease is a multi-factorial disease and the two factors that need to be under control are maintenance of good oral hygiene and dietary monitoring,” says Dr Madan. This means children need to have breakfast, lunch, dinner and two healthy snacks in between. They also need to floss and brush regularly under the supervision of the parents until the age of 10 -12 years.

Bridging the gap

Despite the scientific knowledge we now have, there remains a well-recognised gap that needs to be bridged between the medical and dental professions, and care delivery models. “Any medical doctor should inform patients about the oral symptoms that are caused by the disease they have and the importance of seeing a dentist to check these problems and treat if required,” says Dr Al-Bashatli. “All dentists should do proper oral examinations and take a detailed medical history from the patient. I also believe more medico-dental conferences need to be done to spread knowledge and awareness about the importance of this connection between both professions.”

“Currently, patients are giving least importance to their oral health due to the lack of knowledge and awareness,” adds Dr Gupta. “A collaborative approach from both professionals to educate and bring awareness on maintaining good oral health will bring value to the integrated practice.”

It is imperative that any dental disease should be curtailed in the initial stage before it progresses. “A similar dental decay on tooth surface can be treated with small filling,” says Dr Kandoth. “If it progresses, it can enter the tooth and cause sharp pain, which will require a root canal, or worse, removal of the tooth, which is 10-20 times more expensive and time consuming.”

Patients are usually nervous when thinking of their dental visit, hence building a rapport with them is imperative for dentists. “Many patients have the misconception that dental treatments are painful and scary, but it is quite the other way around,” says Dr Kandoth. “Patients are placed on comfortable, fully adjustable dental chairs, and all procedures are managed with local anaesthesia, which minimises any pain or discomfort.”

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