“The mouth is a gateway to the whole body,” explains Dr. Ira Ratnayaka, Dental Surgeon and President, General Dental Practitioners Association. This week she speaks with MediScene about the importance of brushing your teeth thrice a day – once after every meal.
It’s good advice, considering recent research has revealed strong links between cardiac disease and poor oral hygiene. While tooth pain might be the only thing that could drive many of us to the dentist, regular check-ups will not only spare you the indignity of bad breath and discoloured teeth, they are essential for an early diagnosis of oral cancer, which if neglected can prove fatal. Covering the spectrum from inflammatory conditions of the mouth to carious teeth, here are some of the most common dental problems:
Cavities:
Tooth decay which results in dental caries or cavities is one of the most common of all the complaints dentists treat. Teeth combine incredible strength with equally incredible sensitivity. The tough enamel that coats the crown of your tooth is the strongest substance in the whole body, yet it too can be worn down over time. While wear and tear on the tooth due to the consumption of hard foods is known to happen, bacterial processes can take a much heavier toll.
Bacteria feeding on the debris of food stuck in the teeth multiply prolifically. But how does that lead to the development of a cavity? These bacteria liberate acids, and when they’re feeding on debris clinging to your teeth, their acids can destroy the outermost layers of the teeth. As the decay goes through the enamel, it meets a layer of dentin.
Dentin contains an incredible number of nerve endings and protects the pulp which is the innermost part of the tooth. The pulp contains nerves and the tooth’s blood supply. Its sensitivity guards the mouth. If exposed, the dentin indicates when food we’re eating is too hot or cold and might damage the tooth further along with the soft tissues of the throat and stomach. It also uses pain to let you know when the decay has gone too deep.
A doctor will need to clean up and then fill a cavity to stop the spreading decay. Such fillings can last a lifetime, but a diet of hard foods might create too much stress, adversely affecting the fillings.
The best way to prevent cavities altogether is to settle into a routine of brushing teeth thrice daily, and concentrating on the removal of any food debris out of the indentations of the teeth and the gaps between teeth, says Dr. Ratnayaka. She goes on to stress that the tradition of brushing before breakfast accomplishes little – “it is after breakfast you must brush, otherwise bits of that food will go on till dinner! If you leave even cooked food for ten hours, it will rot, so think of your teeth.”
Gum disease:
The symptoms of gum disease can cover the spectrum from embarrassing (bad breath) to painful (loss of teeth). Like any disease, it’s not wise to neglect it. Patients might experience it as a sense of enlargement in the gums or as relating to one tooth in particular, says Dr. Ratnayaka. “Food debris resulting in plaque takes a very bad toll on the lower gums,” she says, adding that “due to gravity, things settle at the lowermost levels.”
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| This is the way to brush your teeth. Pix courtesy getty images |
Gum disease and periodontal disease is essentially an infection of the membrane that supports the teeth. Periodontal diseases are often classified according to their severity.
They range from mild gingivitis where your gums may be enlarged or inflamed, to more severe periodontitis, and then to acute necrotizing ulcerative gingivitis.
The causes can occasionally be traced to a vitamin deficiency but more often than not, gum disease is due to poor oral hygiene and the build up of plaque.
Diabetes and periodontal
disease:
Other medical conditions like poorly controlled diabetes can increase an individual’s risk of gum disease, adds Dr. Ratnayaka. Diabetes adversely affects blood all over the body, resulting in unhealthy blood flow. This in turn hinders both the flow of nutrients and the removal of waste from these tissues, weakening the tissue and underlying bone and increasing one's susceptibility to infection.
Poorly controlled diabetes also means higher glucose levels in the fluids in the oral cavity – a rich feeding ground for bacteria and the generation of plaque. Smoking and excessive drinking are also both known to contribute to poor oral hygiene, and their effects are multiplied in diabetics.
Oral cancer:
Oral cancer can occur in any part of the mouth or throat. Those who chew tobacco or are addicted smokers are particularly vulnerable to it, cautions Dr. Ratnayaka. The disease claims its victims from across the board, but men over the age of 40 who use tobacco or alcohol are considered high risk. Like other forms of cancer, a family history of the disease might also make you more vulnerable.
Doctors keep an eye out for red or white patches in the mouth, a sore that won’t heal, bleeding, loose teeth, lumps in the neck and particularly sore throats that can also cause difficulty in swallowing.
“The mucus membrane of the mouth is very tender,” says Dr. Ratnayaka, stressing the sensitivity of the area. However, oral cancer has been treated successfully many a time, particularly if it is diagnosed early. “The earlier you diagnose it, the more successful your treatment can be,” she says.
But identifying a patch as a part of oral cancer is not always correct – fractured teeth have been known to cause small whitish patches as well as ulcers on the insides of the cheek or tongue. “Early treatment of such teeth can be diagnostic,” says Dr. Ratnayaka.
Oral hygiene and heart
disease:
Many of us might go through our lives without ever having known we had gum disease. Though the condition is painless, early symptoms like bleeding gums should be treated seriously. Some bacteria in the oral cavity have a preference for the platelets in the blood, says Dr. Ratnayaka, explaining that these are likely to invade the bloodstream through any open blood vessels they might find, eventually making their way down to the heart where they cause blood clots and serious cardiac disease.
According to the British Dental Health Association, people with gum disease are almost twice as likely to have coronary artery disease than those without gum disease.
Mouth ulcers:
The smallness of an ulcer is often deceptive – the extra sensitive tissues of the mouth and lips can lead to a nagging pain that makes it difficult for the sufferer to eat, drink or talk. Most ulcers will subside quickly, but a recurring ulcer should be carefully examined to rule out a more serious underlying cause.
Many things can lead to ulceration of the oral tissues including fractured teeth.
Other factors like stress, hormonal changes, food allergies and deficiencies in vitamin B12, iron and folic acid, as well as accidental biting can cause ulcers. A doctor will carefully examine you before treatment. Once again, good oral hygiene may help prevent some types of mouth ulcers, as well as circumvent complications from mouth ulcers. |
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