World oral health day: Sparkling teeth key to health

“Smiling is fun with healthy teeth & gums” - Ninad Moon

A smile is worth a lot.  In our busy daily routine,  we often forget to use this powerful tool. Smile is more beautiful when your oral health is sound too. March 20 is being observed as World Oral Health Day. The theme this year is  ‘Say Ahh, think mouth, think health’ which focuses on the oral-systemic connection. Oral cavity serves as a mirror which reflects many systemic  diseases in the  early stage itself. 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, oral health is vital to your general health and well-being.

The World Oral Health Day has been celebrated since  2008 as a decision for this was taken at the FDI annual world dental congress in Dubai in 2007.  The initial chosen date was September 12 in correspondence with  the birthday of FDI founder Charles Godon. However,  the date has been changed to March 20  due to practical reasons. Across the globe, oral disease is a significant public health challenge. Up to 90 percent  of the world’s population will suffer from oral disease in their lifetime, including caries or tooth decay and periodontal disease. 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.

ORAL-SYSTEMIC CONNECTION
For decades, physicians and dentists have  paid close attention to their own respective  fields, specialising 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 diabetes mellitus, adverse pregnancy outcomes and osteoporosis and respiratory diseases and so on. 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 the 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 hypothesise 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. 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 micro-organisms 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.
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 micro-organisms well known to be oral colonisers in a variety of infected non-oral sites. It is also possible that periodontal bacteria or 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.

Inculcate good oral habits
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 keep your mouth healthy 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. Keep your oral hygiene habits smart so that you can confidently say ‘Ahh’ and can think not only on mouth wellness but also about general health too with a positive outlook.

(Dr.  G.R. Manikandan is  senior resident in the department of periodontics at Government Dental College Alappuzha)