Maintaining Oral health

Dental diseases (esp. Periodontitis) is implicated as a risk factor for heart problems, complications during pregnancy, dysregulated control of diabetes, Covid-19 complications, lung and kidney problems.

Dr. Gautam Sharma
Oral Health day is observed throughout the World on 20th of March every year. In India, oral and dental health is the most ignored aspect of the health. While the dentists were again and again insisting that the public should undergo their oro-dental check-up every six months but patients only report when they have severe toothache and swelling of the face. An unhealthy mouth not only impacts general health but it can have a severe impact on people’s emotional, social, mental, and overall physical well-being. The Theme of this year’s world oral health day is- Be Proud of your Mouth for the happiness and well-being.
Deterioration of general health
The pathogenic and virulent bacteria which causes dental infections can transport and spread via blood to cause infections in the vital organs of the body. Thus dental infections can be dangerous and can invoke damage to the other parts of the body. The harmful bacteria or even their products can travel through blood stream to different organs causing direct damage or through the process of inflammation.
The commonest reason for occurrence of gum disease is infection due to bacteria which, if left untreated, may progress to periodontitis causing destruction of the supporting structures of a tooth. The human body respond to these bacteria by activating an immune response leading to inflammation which is a protective response against the harmful stimulus. But when this inflammation is excessive then it may cause damage to the normal body tissues.

World Oral Health Day

Periodontitis which is a disease of supporting tissues of teeth may lead to chronic inflammation and inturn be a risk factor in heart problems, complications during pregnancy, dysregulated control of diabetes, Covid-19 complications, lung and kidney problems.
Bleeding during toothbrushing or after biting on hard surfaces like an apple, recession of gingiva, swollen gums and loosening or mobility of teeth may be the features of periodontitis. The margins of gum are red, puffy and swollen due to the adherence of a film known as plaque on the tooth surface. The film contains a lot of bacteria in its structure and if remains uncleaned changes into a hard structure called calculus which is visible as yellowish-white deposits on the tooth. In case, these symptoms are present then the patient must immediately report to a specialist doctor known as Periodontist who is an expert in treating diseases of gums and supporting tissues of teeth.
Damage to vital organs of body
If the inflammation due to dental disease persists for long duration (called chronic inflammation), it may become a contributor for atherosclerosis which can lead to heart problems. The most common reason for chronic inflammation of the periodontal tissues is dental plaque which is present below the gingiva (sub-gingival plaque).
During pregnancy, the bacteria that cause dental disease (particularly periodontitis) may reach the placenta, then the amniotic fluids through blood stream and in-turn influence maternal fetal tissues. Females suffering from periodontitis may give birth to low birth weight (LBW) and preterm babies. Preterm babies can have various complications including cerebral palsy, impaired learning, vision and hearing difficulties, chronic health issues, psychological problems etc.
In diabetics, periodontitis results in insulin resistance, which may adversely affect the metabolic control, and, may contribute to the development of diabetic complications. Chronic inflammation promotes insulin resistance and dysregulates glycemia, thus becoming another issue in the control of blood sugar levels.
Periodontitis was also associated with higher risk of ICU admission, need for assisted ventilation and death of COVID-19 patients. A study by Dr. Marouf and co-associates conducted on 568 patients using the national electronic health records of the State of Qatar between February and July 2020, has clearly indicated that periodontitis could be a risk factor for COVID-19 complications. This study identified that the risk of COVID-19 complications was significantly higher among patients with moderate-to-severe periodontitis compared to those with milder or no periodontitis.
Pulmonary (lung) infections and kidney diseases may be a common finding in the patients suffering from the periodontitis. Chronic periodontitis has a negative effect on renal function and pulmonary health of an individual.
Hormonal influences affect the dental tissues esp. gingiva (gums) which is a part of periodontal structure. Hormonal changes increase the risk of periodontal disease. Therefore, it becomes utmost important for a dentist to recognize and treat the female patient with an appropriate therapy as females undergo regular and periodic hormonal changes.
Maintaining oral and dental health
Brushing twice daily with a soft bristle toothbrush is a basic requirement to keep good dental health. Many people brush their teeth only in the morning, but It’s mandatory to brush after the dinner. Use of dental floss can avoid interdental caries by removing the food particles present between the two teeth.
For children, start tooth brushing as soon as first milk tooth erupts in the oral cavity. A child would start tooth brushing by self if he/she sees the parent doing brushing in the morning and night, so the parents have to become a role model.
Avoid eating soft, sticky and sweet food like candies, chocolates, wafers and also carbohydrate rich food like potato chips which get stick to the teeth and cause cavities (dental caries).
Cleaning tongue while brushing is very important because it has many papilla over its surface which may accumulate bacteria, dead cells etc. and if remained uncleaned then it may cause halitosis (bad breath from the mouth). There can be other causes of bad breath from mouth but uncleaned tongue is the most common reason for it.
Never neglect bleeding gums, yellow deposits over the teeth, mobile teeth, receding gums as these symptoms may lead to severe dental problems. Visit your dentist every six months for routine dental checkup. Simple procedure like scaling can prevent the progression of gum infection to more severe periodontal infections.
(The author is the former president of Indian Dental Association (IDA) Jammu.)