The doctor is in — watch your mouth: Maintaining oral hygiene

Know how oral and overall health are linked and how to maintain oral hygiene

The doctor is in — watch your mouth: Maintaining oral hygiene
Severe periodontal diseases are estimated to impact approximately 14% of the global adult population, with over one billion cases worldwide.

By Dr Amrita Chawla

How does bad oral health affect the rest of the body?
Oral health and overall health are inextricably linked. Our mouth is a reflection of our overall health. This was particularly emphasised during Covid. According to data from the World Health Organization’s (WHO) Global Burden of Disease Study (2019), oral diseases affect almost 3.5 billion people globally, with caries (cavities) of permanent teeth being the most frequent condition. Another one is periodontal or gum disease which affects the tissues that surrounds and supports the tooth. The condition is characterised by bleeding or swollen gums (gingivitis), pain and occasionally bad breath. Severe periodontal diseases are estimated to impact approximately 14% of the global adult population, with over one billion cases worldwide.

There is enough evidence to imply that oral and systemic disorders interact. Most oral diseases and conditions share modifiable risk factors (such as tobacco use, alcohol intake, and an unhealthy diet high in free sugars) with the four top non-communicable diseases (cardiovascular disease, cancer, chronic respiratory disease and diabetes). Periodontal disease is primarily caused by poor dental hygiene and tobacco usage. Oral inflammation during periodontitis can contribute to the systemic inflammatory burden and have an impact on overall health. Diabetes has been found to be directly related to the development and progression of periodontal disease. There is also a link between excessive sugar consumption and diabetes, obesity, and tooth cavities. As a result, those with poor dental health put themselves at risk for a variety of health issues.

Is mere brushing twice daily enough to ensure good oral health?
Oral hygiene is an important element in maintaining one’s health. Tooth brushing at least twice a day is required to ensure regular and optimum oral hygiene maintenance in a disease-free mouth. The primary purpose of tooth brushing is to remove plaque and food particles, thereby reducing the number of bacteria in the oral cavity and as a result decreasing the inflammation of the gums. The first step of oral hygiene is ‘dry tooth brushing’ (DTB) which is done without the use of toothpaste. The primary purpose of DTB is to dislodge the bacterial accumulation on the tooth surfaces, remove plaque from the surface of the tooth, thereby lowering the number of bacteria in the oral cavity. After DTB has reduced the bacteria from the surfaces of the teeth and gums, tooth brushing with a fluoride toothpaste should follow for caries prevention. Aside from DTB, tongue cleansing with tongue-cleaning aids has been demonstrated to reduce the bacterial burden. Interdental brushing, dental floss and oral irrigators have been advised for the proximal surfaces of the teeth. To get the greatest possible oral hygiene, a combinations of methods should be used.

How often should one opt for a dental screening?
It is recommended that you have a dental check-up every six months. This would aid in the early detection of dental caries or gum disease, which can then be handled conservatively. Regular check- ups can also aid in the detection of oral cancers, as dentists are often the first to diagnose the disease in many patients.

What are the warning signs of bad oral health?
Poor oral hygiene can present in different forms, from swollen or bleeding gums to toothaches, growths in the mouth, and changes to the surface of the tongue. It is crucial to visit a dentist frequently if you want to maintain good health. The five primary oral health red flags are listed below:

I. Pain or loosening of teeth: Pain is a signal that the body sends when anything is wrong with it. Constant tooth discomfort can be caused by inflammation or cavities, which are commonly disregarded in its early stages. A tooth may become loose due to gum disease, swelling in gums, bleeding gums or due to an abscess in the tooth which is cariously exposed. Another very common reason for perceived tooth pain can be jaw pain which is due to the unconscious grinding of the teeth called bruxism. The factors behind this could be anxiety or stress. If bruxism is not taken care of, it can lead to severe tooth loss leading to extreme sensitivity of the teeth to temperatures.
II. Bleeding gums: Can occur while tooth brushing or flossing/interdental brushing. Gum diseases are a common cause of bleeding. Gum disease is often more severe in people with underlying conditions such as diabetes, which reduces the body’s resistance to infection. This puts the gums at risk for inflammation due to the bacteria that live in plaque. Other oral signs of diabetes include dry mouth, fruity smelling breath, oral fungal infections, etc.
III. Sensitivity: Sudden or severe sensitivity to hot or cold items can be a sign of cavity formation. Sensitivity can also be due to enamel wear or gum disease. Enamel wear leading to sensitivity can also be due to eating disorders like bulimia or due to an acid reflux problem.
IV. Mouth sores: It is important to keep an eye on any oral ulcers, lesions, or sensitive areas in the mouth. Any oral growths or sores that persist for a long period of time must be checked by a professional.
V. Bad breath: Halitosis is a common problem faced by people after waking up in the morning or after consuming a spice-heavy meal. It generally goes away with brushing and rinsing. However, if it becomes chronic it is mostly is due to gum disease or a tooth decay and must be evaluated by a professional.

(Dr Amrita Chawla is additional professor, AIIMS, New Delhi)

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