May smile prevail

A smile is one that really worth a lot.In our busy day to day routines we often forget to use this powerful tool .Smile is more beautiful when your oral health is sound too.Every year March 20 is being observed as World Oral Health Day (WOHD). The theme of "World Oral Health Day 2017 is ‘LIVE MOUTH SMART' which  empowers people to take control of their oral health - throughout life - so they can enjoy a healthy, functional mouth from childhood into old age. Oral health means the health of the mouth. A healthy mouth allows you to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions with confidence and without pain, discomfort and disease. No matter what your age - 5, 25, 65 or 85 years - oral health is vital to your general health and well-being. The World Oral Health Day has been celebrated since the year of 2008, as a decision for this purpose was taken in 2007 at the FDI Annual World Dental Congress in Dubai.

The initial chosen date was September 12th, in correspondence to the birthday of FDI Founder Charles Godon, however the date has been changed to March 20th due to practical reasons. Across the globe, oral disease is a significant public health challenge. Up to 90% of the world's population will suffer from oral disease in their lifetime, including caries (the process which can lead to tooth decay) and periodontal disease. The incidence of tooth decay appears to be getting worse; the American Journal of Dentistry reports an increase in the prevalence of dental caries in primary and permanent teeth of children and adults since 2001. Worryingly, it is estimated that between 60% and 90% of school children worldwide have dental caries.

To help turn the tide against these statistics, activities across the globe on World Oral Health Day will draw attention to the burden of oral disease and provide information on simple, preventive steps we can all take to maintain good oral health, including: brushing teeth with fluoride-containing toothpaste at least twice daily; regular dental check-ups; and chewing sugar-free gum after eating and drinking on-the-go.3 To encourage families to look after their teeth and their oral health, FDI has launched "The Tooth Thief", an illustrated book which tells the story of Mascarpone, the famous mouse detective, who comes to the aid of the Tooth Fairy. In addition to being an entertaining mystery story, the book shares important oral health information and tips. World renowned Ivorian Manchester City footballer YayaTouré wrote the foreword to the book.

ORAL SYSTEMIC CONNECTION
Periodontal Medicine
Introduction
For decades, physicians and dentists have  paid close attention to their own respective  fields, specializing in medicine pertaining to  the body and the oral cavity, respectively. However, recent findings have strongly  suggested that oral health may be indicative  of systemic health. Currently, this gap  between allopathic medicine and dental  medicine is quickly closing, due to  significant findings supporting the  association between periodontal disease and  systemic conditions such as cardiovascular disease, type 2 diabetesmellitus, adverse  pregnancy outcomes, and osteoporosis . Periodontitis, one of the most common  diseases of humans, is an infectious condition that can result in the inflammatory  destruction of periodontal ligament and alveolar bone. In light of the extensive  microbial plaques associated with periodontal infections, the chronic nature of  these diseases, and the exuberant local and  systemic host response to microbial assault, it is reasonable to hypothesize that these infections may influence overall health and the course of some systemic diseases.

The term Periodontal Medicine, as first suggested by Offenbacher (1996), can be viewed as a broad term that defines a rapidly emerging branch of Periodontology focusing on the wealth of new data  establishing a strong relationship between  periodontal health or disease and systemic  health or disease. This means a two-way  relationship in which periodontal disease in an individual may be a powerful influence  on an individual's systemic health or disease as well as the more customarily understood  role that systemic disease may have in influencing an individual's periodontal  health or disease The possibility that  morbidity and mortality from systemic diseases may be reduced by improving periodontal health makes it imperative that this relationship be examined more closely .

Nature of periodontal disease as infectious burden to systemic health It is estimated that 104 normal or commensal microbes reside on the surfaces of teeth, prosthetic implants, dentures, dental restorations, and the mucosal epithelia lining the oral cavity, respiratory tract, gastrointestinal tract, and urinary tract. The oral cavity contains almost half the commensal bacteria in the human body-approximately six billion microbes representing 300 to 500 species .In certain conditions, some of these microorganisms may become opportunistic species that contribute to local and/or systemic infections. It is known that the oral microbial ecosystem is highly dynamic and the oral cavity faces a constant challenge of opportunistic infections and various oral complications of systemic diseases and disorders

Periodontal lesions are recognized as continually renewing reservoirs for the systemic spread of bacterial antigens, Gram-negative bacteria, cytokines, and other proinflammatory mediators In a patient with moderate-to advanced periodontitis and a relatively complete dentition, ithas been estimated that the total area of pocket epithelium in direct contact with subgingivalbiofilms is surprisingly large, being approximately 72 cm2- the size of the palm of the human hand Oral, especially periodontal, infections have been regarded as a source of focal infections for a long time. Miller originally published his 'focal infection theory' in 1891, indicating that "micro organisms or their waste products obtain entrance of parts of the body adjacent to or remote from the mouth Three different mechanisms by which oral bacteria may contribute to non-oral diseases have been described.
(1) Metastatic infection caused by translocation of bacteria;
(2) Metastatic injury related to microbial toxins; and
(3) Metastatic inflammation due to immune injury.
The focal infection concept has recently been given more attention by the dental and medical communities. This is largely due to improvements in methods of sampling, cultivation, and identification of bacteria that revealed the presence of microorganisms well known to be oral colonisers in a variety of infected non-oral sites.

It is also possible that periodontal bacteriaor their products can directly invade the periodontal tissues. This represents a distinct mechanism by which periodontal disease-associated bacteria may gain access to the systemic circulation Moreover, periodontal diseases may also exacerbate existing heart conditions. It is known that poor dental hygiene and periodontal or periapical infections may produce bacteraemias even in the absence of dental procedures Bacteremias can be provoked by mastication and oral hygiene procedures such as toothpicking, flossing and toothbrushing. The extent to which bacteremia of oral origin occurs appears to be directly related to the severity of gingival inflammation. Thus, the best means to prevent bacteremia from the oral cavity is the maintenance of periodontal health

CONCLUSION
Good oral hygiene habits, avoiding risk factors and having a regular dental check-up from early in life can help maintain optimal oral health into old age. There are many ways you can LIVE MOUTH SMART and make sure you have set yourself up for a healthy future. Make smart decisions when you adopt good oral hygiene habits from early in life and have regular dental check-ups. This helps you maintain optimal oral health into old age and ensures you live not only a longer life, but also one free from the physical pain and often emotional suffering caused by oral diseases. Safeguard your oral health, which has a positive impact on your general health and well-being, helping you live a better quality of life into old age. Avoid risk factors such as tobacco, harmful use of alcohol and unhealthy diets - especially those rich in sugar - which helps protect your oral health and prevent other conditions such as heart disease and stroke, cancer, chronic respiratory diseases and diabetes.

(Author is Junior Resident in the Department of Periodontics, Government Dental College Thiruvananthapuram).

Tobacco kills; stay safe against oral cancer

The World Oral Health Day is being observed  on Monday in the midst of the increase in the incidence of oral cancer, especially among  Malayalis. The major reason is the use of tobacco and other products like gutka and panparag due to lack of awareness of their deadly effects.  The state health department has conducted awareness camps  in tribal hamlets  as well as among migrant labourers. Oral cancer can be cured to some extent with treatment at the initial stage when symptoms appear.

Different types of blood cancer, agranulocytosis (an acute condition involving severe lowering of white blood cell count), systemic lupus erythematosus, HIV etc can be controlled if detected early.   Oral cancer and gum diseases may give rise to heart attacks, brain haemorrhage, kidney and lung diseases, diabetes, shrinking of veins and aorta and premature birth. Awareness and detection camps  against oral cancer will be held in the state in the next one year.

Dr. Simon Morrison (Author is deputy director of health services - dental)