Wednesday, January 14, 2009

Dental care

Generally, dentists recommend that teeth be cleaned professionally at least twice per year. Professional cleaning includes tooth scaling, tooth polishing, and, if too much tartar has built up, debridement. This is usually followed by a fluoride treatment for children and adults.

http://en.wikipedia.org/wiki/Oral_hygiene

______________________________________


http://www.eufic.org/article/en/page/RARCHIVE/expid/review-food-dietary-habits-dental-health/




4. What factors affect the development of dental caries?

The following factors have an important impact on dental health:



The regular application of fluoride varnishes by dental practitioners is an established caries preventive measure in many countries. This practice is especially suitable for children at high risk of dental caries.


If very little plaque is present, the amount of acid formed is insignificant and decay cannot occur.


4.3. Dietary factors

Although the decline in tooth decay in many countries has been largely linked to fluoride exposure and improved dental hygiene, eating habits still affect the risk of tooth decay.

Fermentable carbohydrates
For many years the simplified message to prevent tooth decay was ‘don’t eat too much sugar and sugary foods’. Over the last few decades sugar intake in many countries has remained constant whilst caries levels have declined. This suggests that where appropriate oral hygiene is practiced (i.e. regular tooth brushing using fluoride toothpaste) the role of sugars in tooth decay is less manifest.

Advice to replace sugar with starchy foods to avoid tooth decay is of questionable value. It is now known that any food containing fermentable carbohydrates can contribute to tooth decay. This means that as well as sweets and confectionery, pasta, rice, potato crisps, fruits, and even bread can set the scene for demineralisation. For example, a study testing the acid-producing potential of various starchy foods including pasta, rice and bread, found that these foods produced the same amount of acid as a 10% sucrose (table sugar) solution. Another study found that acid formation in plaque after eating soft bread or potato chips was greater and lasted longer than after eating sucrose.

Food characteristics
The physical characteristics of a food, particularly how much it clings to the teeth also influence the tooth decay equation. Foods that adhere to the teeth increase the risk of tooth decay compared to foods that clear from the mouth quickly. For example crisps and biscuits stick to teeth for longer periods than foods such as caramels and jelly beans. This may be because caramels and jellybeans contain soluble sugars that are washed away more quickly by saliva. The longer carbohydrate-containing foods are around the teeth, the more time bacteria have to produce acid and the greater the chance of demineralisation.

Frequency of eating
There is some debate over the relative importance of the frequency of consuming carbohydrate foods and its link with dental caries. As with the relationship between diet and caries, the link appears to have been weakened with the adoption of good oral hygiene and fluoride.

Each time we nibble a food or sip a drink containing carbohydrates, any decay-causing bacteria present on the teeth start to produce acid and demineralisation commences. This continues for 20 to 30 minutes after eating or drinking, longer if food debris is locally entrapped or remains in the mouth. In between periods of eating and drinking saliva works to neutralise the acids and assist in the process of remineralisation. If food or drink is taken too frequently the tooth enamel does not have a chance to remineralise completely and caries can start to occur. This is why nibbling or sipping continuously throughout the day should be discouraged. The best advice is to limit the consumption of food and drink containing carbohydrates to no more than 6 occasions per day and ensure teeth are brushed with fluoride toothpaste twice a day.

Baby bottle caries or nursing caries is a condition in which infants’ teeth are damaged by prolonged frequent exposure to drinks containing sugars usually via a baby feeding bottle. In particular, problems arise when infants are put to sleep with a bottle of formula or juice. The flow of saliva is greatly reduced during sleep and the sweet liquid pools around the teeth for extended periods of time. This provides the perfect environment for tooth decay to develop.

Protective foods
some foods help protect against tooth decay. For example hard cheese increases the flow of saliva. Cheese also contains calcium, phosphate and casein, a milk protein, which protects against demineralisation. Finishing a meal with a piece of cheese helps counteract acids produced from carbohydrate foods eaten at the same meal. Milk also contains calcium, phosphate and casein, and the milk sugar, lactose, is less cariogenic (caries causing) than other sugars. Nevertheless caries have been found in children breastfed frequently on demand.

Toothfriendly products

Toothfriendly products are formulated using sweetening ingredients that cannot be fermented by the mouth bacteria. Intense sweeteners such as saccharin, cyclamate, acesulfame-K and aspartame, and sugar substitutes such as isomalt, sorbitol and xylitol fall into this category.
Sugar-free chewing gums use these sweeteners. Both the sweet taste and chewing stimulate salivary flow, which contributes to the prevention of caries. Such chewing gums may also contain minerals such as calcium, phosphate and fluoride to enhance the repair process. Studies have reported that chewing sugar-free gum after a meal accelerates the clearance of food debris and reduces the rate of caries development in children.
Toothfriendly products have to comply with a specific test regimen in order to get ‘safe for teeth’ approval.



5. What is tooth erosion?

Tooth erosion is the loss of dental hard tissue from the tooth surface by chemical processes, usually acid, without involving plaque bacteria. There are many acidic foods and drinks in our diet and it is possible that in a susceptible individual in certain circumstances, for example, a higher frequency of exposure to acidic foods and/or drinks, erosion may occur. This increased frequency of exposure may override the natural buffering capacity of the mouth, which varies between individuals.

It is advised to avoid frequent nibbling and sipping of acidic foods and drinks throughout the day, restricting their consumption preferably to main meals, and to clean teeth at least twice per day using fluoride toothpaste. It has been suggested that cleaning teeth immediately after consuming an acidic food or drink should be avoided as this can result in physical wear to the teeth resulting from tooth brushing in the presence of acid. Chewing sugar free chewing gum to stimulate salivary secretion following an acid challenge helps neutralize the acid effects.



7. How can we ensure dental health?

Good oral hygiene and the use of fluoride are now considered the main factors responsible for preventing tooth decay and promoting good oral health. The following advice is also important for keeping teeth caries-free.

  • Start dental care early, brush baby’s teeth with a fluoride toothpaste as soon as they appear in the mouth. Do not habitually allow infants to fall asleep while drinking from a bottle of milk, formula, juice or sweetened drink. These sweet liquids pool around the baby’s teeth for long periods of time and can lead to “baby bottle tooth decay”.
  • Brush teeth twice a day with fluoride toothpaste. And if possible, clean between the teeth with dental floss or toothpicks once a day. Do not eat after cleaning teeth at bedtime as salivary flow decreases as we sleep.
  • Visit the dentist about every 6 months for a check-up. And seek dentist's advice before using aesthetic products (e.g: teeth whiteners) that could have a deleterious effect on the teeth.
  • Do not nibble food or sip drinks continuously. Allow time between eating occasions for saliva to neutralise acids and repair the teeth.
  • People at high risk from tooth wear and erosion should take special precautions, such as:
    • decrease frequency and contact with acidic foods and drinks;
    • avoid brushing teeth immediately after consuming acidic foods, drinks, citrus fruits and juices. This allows time for remineralisation to occur.
    Fluoride mouthwashes and sugar-free chewing gum may be useful after taking acidic food or drinks as they encourage remineralisation.
  • Sugar-free chewing gum is “toothfriendly” as it helps increase saliva flow and clears food debris from the mouth.


4.1. Individual factors

Susceptibility to dental caries varies between individuals and between different teeth within one person’s mouth. The shape of the jaw and oral cavity, tooth structure and the quantity and quality of saliva are all important in determining why some teeth are simply more susceptible to decay than others. For example, some teeth may have pits, small cracks or fissures that allow bacteria and acids to infiltrate more easily. In some cases, the structure of the jaw/dentition renders teeth more difficult to clean or floss.

The quantity and quality of saliva determines the extent to which teeth remineralise. For example relatively fewer caries are generally found in the lower front part of the mouth where teeth are more exposed to saliva.

The type and number of caries-causing bacteria present in the mouth is also relevant. All bacteria can turn carbohydrates into acids but certain families of bacteria such as Streptococci and Lactobacilli are more powerful acid producers. The presence of this type of bacteria in plaque increases the risk of decay. Some people have higher levels of decay-causing bacteria than others due to neglected or inappropriate oral hygiene.

No comments:

Post a Comment