PREVENTABLE DENTAL DISEASES

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PREVENTABLE DENTAL DISEASES
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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.

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DENTAL CARIES (TOOTH DECAY)

• DEFINITION
• DESTRUCTION OF THE TOOTH SURFACE DUE TO THE
  ACTION OF BACTERIA ON REFINED CARBOHYDRATE.
• Food Bacteria Acid
• Acid Tooth Caries
• Commonest cause of tooth loss in children.

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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.

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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.

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TREATMENT

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

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COMPLICATIONS OF UNTREARED TOOTH DECAY

• Dental abscess
• Cellulitis /Ludwigs Angina
• Osteomyelitis

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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 .

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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

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SIGNS AND SYMPTOMS OF GINGIVITIS

• REDNESS OF THE GUMS
• SWELLING OF THE GUMS
• BLEEDS EASILY
• LITTLE OR NO PAIN INITIALLY

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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

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MANAGEMENT OF GINGIVITISScaling and
polishingGood oral home care
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GENERAL PRINCIPLES OF PREVENTION AND
MANAGEMENT OF PERIONDONTITIS1. SCALING AND
POLISHING 2X IN A YEAR.2. ESTABLISH EFFECTIVE
ORAL HYGIENE HABITS3.SURGERY
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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.

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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.

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HALITOSIS (cont)

• MOUTH
• gt600 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.

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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.

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GINGIVITISSubgingival 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
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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.

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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.

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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.
  .

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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

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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

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RECEEDING GUMS (CONT.)

• Signs and Symptoms
• Sensitive 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 cementum
• Spacing between the gums
• Cavities/holes below the gum line.