Oral Health
What is Oral Health Problem?
Oral health signifies freedom from chronic mouth and facial pain, oral and throat cancer, oral sores, gum diseases, tooth decay, cavities and tooth loss. In most cases a toothache is an indication of a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint or spasms of the muscles used for chewing. But it is usually ignored, till it becomes unbearable and has probably developed into a more severe condition.
Symptoms of Oral Health Problems
Some indications of oral health problems in children are thumb-sucking, lip-sucking and early tooth loss.
In adults, as there are various causes of oral health problems, the symptoms differ:
1) Symptoms of oral cancer are varied. Swollen gums, difficulty in moving the jaw or tongue, sore throat, numbness in any part of the mouth are some indications.
2) Red, swollen, or tender gums, bleeding gums, bad breath, receding gums, loose or shifting teeth, are some of the symptoms of gum diseases like Gingivitis or Periodontitis. Small spaces between teeth and gums are formed. Toxins and acids produced by the bacteria in plaque break down the bone and connective tissue that hold the tooth in place.
3) Sometimes, muscles around the Temporo-Mandibular Joints (TMJ) which are used for chewing can go into spasm causing severe headaches and neck pain. The jaws and ears hurt while speaking or eating.
4) Bruxism is grinding of the teeth, which usually occurs during sleep. A dull and constant headache as well as a sore jaw would be the indications to look for.
Diagnosis of Oral Health Problems
A thorough oral examination, which includes dental X-rays, helps determine the cause of oral health problems. If you have an abscessed tooth, you will feel pain when the dentist taps on the tooth or when you chew or when you close your mouth tightly.
To check for oral cancer a visual examination for soreness or lesion in the mouth which is more than two weeks old, a lump or thickening of the cheek, white or red patch on the gums, tongue or lining of the mouth, swelling of the jaw, swollen lymph nodes in the neck, loose teeth, ulcerations, etc is carried out. A dental X-ray and an incisional-biopsy are carried out is a lesion exists.
The dentist diagnoses Gingivitis or Periodontitis when he sees signs of gum bleeding, swelling, stiffness, larger and deeper pockets between the gum and the teeth, teeth movement, over-sensitivity of teeth and redness of gums.
Stiffness of the jaw muscles, dull and constant earache and misaligned jaws while biting are the obvious signs of the TMJ syndrome.
Causes of Bad Oral Health
Cancer: Oral cancer is caused due to constant smoking, chewing tobacco or areca/betel nut. As chewing of tobacco/areca/betel is more common among the South East Asians, there is a high rate of mortality due to oral cancer in these regions. Cancer due to smoking is a major killer in the other regions of the world.
Abscess: The cause of tooth abscess is trauma to the tooth like a broken or chipped tooth. This can lead to pus formation, pain and sensitivity of tooth.
Bruxism: Some of the causes of Bruxism are sleep disorders, alcoholism, severe stress and emotional trauma.
Cavities: Tooth decay due to neglect is the cause dental cavities. Certain harmful bacteria in the mouth consume simple sugars and convert them into acid plaque. The acid causes the hard inorganic layers of the enamel and dentin to soften. The saliva then dissolves these softened layers leaving a hole or cavity in the tooth.
Bad breath: Not brushing and flossing your teeth daily is an ideal environment for bacterial growth between teeth, around the gums and on the tongue causing bad breath. Also, if you eat foods with strong odors like garlic or onions, or have habits like smoking or chewing tobacco, it can cause bad breath and irritate gum tissues. Xerostomia (dry mouth) or yeast infection can also cause bad breath.
Gingivitis/Periodontitis: There are various causes of Gingivitis and Periodontitis. Some of them are hormonal changes during pregnancy, puberty, menopause and menstruation; illnesses like cancer or HIV that interfere with the immune system; prolonged use of anticonvulsant or anti-angina drugs; bad habits like smoking, poor oral hygiene and family history of dental diseases.
TMJ: Acute trauma like a blow to the face or degenerative arthritis causes TMJ. The pain in the TM Joints is due to the mandible being pushed back towards the ears whenever the patient chews or swallows.
Types of Oral Health Problems
1) Oral cancer: This can be found in various parts like mouth, tongue, lips, throat, salivary glands, etc.
2) Abscess: An abscessed tooth is a painful infection at the root of a tooth. It is an opening in the tooth enamel which allows bacteria to infect the center of the tooth – the pulp.
3) Cavities: Dental cavities are holes in the two outer layers of a tooth, namely the enamel and the dentin. These layers protect the inner tooth tissue called the pulp, where blood vessels and nerves reside. Food particles adhere to cavities resulting in accumulation of bacterial toxins. These toxins further degenerate the tooth causing toothache.
4) Gingivitis and Periodontitis: These are two distinct stages of gum disease. Both these gum infections begin with bacterial growth in the mouth. If not treated in time, they can lead to destruction of the tissue that surrounds the tooth and loss of the tooth. Periodontitis is an advanced form of Gingivitis.
5) Temporo-Mandibular Joints (TMJ) Syndrome: This disease can cause severe pain, usually in front of one or both ears. The TMJ hinges the lower jaw (mandible) to the skull. Movement of the jaws during eating or speaking is painful.
6) Xerostomia: This refers to dryness of the mouth. Dry mouth may be a side effect of some strong medication which affects the salivary glands. It is basically due to continuously breathing through the mouth instead of the nose.
7) Bruxism: Occasional teeth grinding does not usually cause harm, but when teeth grinding occurs frequently it can lead to other complications.
Bad Breath: Medically called halitosis, it may be a sign of other health problems. Consuming strong smelling food, smoking, poor oral hygiene, neglected oral infections can cause bad breath.
Treatment of Oral Health Problems
Like other cancers, oral cancer too has to be treated with the help of surgery followed by Chemotherapy and/or Radiotherapy.
An abscess needs to be drained by doing root canal surgery or an incision in the swollen gum tissue. Then a crown is placed upon it. Antibiotics are prescribed to help fight the infection. To relieve the pain and discomfort warm salt-water rinsing and pain killers are recommended.
If bad breath is due to oral infection or gum disease then it can be treated by a dentist but if the cause is intake of strong medication for some other ailment then the specialist has to treat it.
A cavity is cleaned and then filled with gold or porcelain to restore the tooth to its original shape and size. Porcelain is preferred nowadays because the color of porcelain filling can be matched to the natural tooth color.
A cracked tooth involves root canal and then covering with a porcelain crown. To treat Bruxism, the dentist usually suggests the use of a mouth guard while sleeping. Treatment of Gingivitis or Periodontitis ranges from non-surgical therapies that control bacterial growth to restorative surgery of supportive tissues.
Treatment of TMJ usually involves oral anti-inflammatory drugs, warm compresses, eating soft and easily-chewable food and sometimes even repositioning the mandible forward with a special dental splint. This relieves pressure on the nerves and blood vessels and thus relieves pain. Alternative measures to maintain the new position include placing full-coverage crowns on all of the back teeth.
Living with Oral Health Problems
Oral health problems also cause psycho-social disorders. Discolored teeth, misaligned teeth, bad breath will adversely affect the patient’s relationships, both at professional level as well as personal. This could result in loss of self-esteem and may even cause behavioral disorders. The life expectancy of a person after treatment of oral cancer is a maximum of 5 years.
Prevention of Oral Health Problems
Preventing oral health problems is not a very difficult or impossible task. Certain simple measures can be taken to avoid problems:
Correct diet: Reducing sugar or sucrose and increasing intake of foods containing calcium, phosphorous, vitamins A, D, and C that augment strong enamel formation is essential.
Oral hygiene: Regular brushing and flossing removes the acid plaque from between teeth. Chewing self-cleaning foods like apples and celery that are crunchy can also help.
Avoid snacks: Acids attack the teeth after every meal. Hence, reducing the number of snacks and desserts will help to reduce these attacks on teeth.
Use Fluorides: Using toothpastes or gels containing oral fluorides will strengthen the enamel and dentin layers of the teeth.
Sealants and fillings: Plastic coating painted on the pits and fissures of chewing surfaces of teeth prevents cavities.
Stop using tobacco: The most important way of preventing oral cancer is cessation of smoking and chewing of tobacco and betel nut. Regular dental checkups are also a must as a preventive measure.
For Gingivitis and Periodontitis: Proper plaque control by brushing and flossing, avoiding the use of tobacco, reducing stress and resultant comfort eating, eating a diet containing antioxidants like vitamin E or vitamin C (vegetable oils, nuts, green leafy vegetables, citrus fruits, broccoli, potatoes, etc) are some of the preventive measures of Gingivitis and Periodontitis.
For Bruxism: As sleep disorders can cause Bruxism, methods like avoiding caffeine, alcohol, sugary foods like sweets and chocolates, soft drinks and colas, avoiding stress also have to be adopted for prevention.
The World Health Organization’s global Oral Health Program (ORH) has developed the new strategy of disease prevention and promotion of oral health. Greater emphasis is put on developing global policies with the help of external partners. Their focus is more on prevention of oral health problems and reduction of mortality.
