Oral Health

Dr Sahul Lerra
What is oral health and why consider oral diseases as a serious public health threat? Oral diseases may directly affect a limited area of the human body, but their consequences and impacts affect the body as a whole. The World Health Organization (WHO) defines oral health as ‘a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.’
A healthy mouth and a healthy body go hand in hand. Conversely, poor oral health can have detrimental consequences on physical and psychological wellbeing. Oral diseases are often hidden and invisible, or they are accepted as an unavoidable consequence of life and ageing. Oral health is about more than healthy teeth and a good-looking smile. The mouth is a mirror of the body, often reflecting signs of systemic diseases. Examination of the mouth can reveal nutritional deficiencies and unhealthy habits such as tobacco or alcohol use. Oral lesions may be the first signs of HIV-infection, and changes in tooth appearance can indicate serious eating disorders. Many general conditions increase the risk of oral diseases, such as an increased risk of periodontal disease in patients with diabetes. With the global improvement in life expectancy, a life-course approach to oral health will become more important. Different ages in life have different oral health needs, and the specific problems of older people, who are often also suffering from other diseases, are becoming more prevalent. Knowledge and awareness of the close associations between oral and general health are thus important for holistic care, as is collaboration between oral and general health professionals.
Tooth decay (dental caries) is a multifactorial disease, caused by the interaction between the tooth surface, the bacterial biofilm (dental plaque) and the presence of sugars from food. Biofilm bacteria metabolize sugars and produce acids, which over time break down tooth enamel. Tooth decay is principally caused by sugar consumption and can largely be prevented by reducing sugar intake, appropriate fluoride use and promoting good oral hygiene.
Periodontal (gum) disease begins as gingivitis (chronic inflammation of the gums), which is very widespread and for the majority of patients completely reversible. It may progress to periodontitis, a more serious condition that destroys tooth-supporting tissues and bone. The disease process is still poorly understood, but it tends to progress through phases of rapid, irreversible tissue destruction.
By the age of 65 to 74 years about 30 percent of people have lost all their teeth, with periodontal disease being the main cause. Severe periodontal disease has serious consequences for those affected, including problems with chewing and speaking, which adversely affect general wellbeing and quality of life. Specific bacteria are the essential cause of periodontal disease. Other important risk factors include tobacco use, unhealthy diet, genetic factors, stress and excessive alcohol consumption. Periodontal disease may also be associated with systemic diseases such as diabetes, cardiovascular diseases, adverse pregnancy outcomes and respiratory diseases.
Healthy living and prevention –
The promotion of a generally healthy lifestyle, with low exposure to risk factors such as tobacco or alcohol use, together with good personal oral hygiene, awareness andregular check-ups, are important elements in prevention of periodontal disease. There is a strong social gradient in the prevalence of periodontal disease, which requires interventions addressing the wider determinants of health.
Early detection and management- Through regular visits to the dentist, periodontal disease can be detected at early stages and appropriate measures for disease control can be taken. More advanced cases may require specialized care.
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