The Star Malaysia - Star2

Im­por­tance of den­tal hygiene


THE hu­man mouth teems with bac­te­ria. Dayto- day brush­ing, floss­ing and mas­ti­ca­tion can cause bac­te­ria to en­ter the blood­stream, caus­ing low- grade bac­teremia ( pres­ence of bac­te­ria in the blood).

Dr Geetha Kan­dav­ello ( pic), se­nior con­sul­tant pae­di­atric and adult con­gen­i­tal car­di­ol­o­gist at the Na­tional Heart In­sti­tute ( bet­ter known by its Ba­hasa Malaysia acro­nym IJN), ex­plains that poor den­tal and gum hygiene sig­nif­i­cantly in­creases the risk of bac­teremia.

“When there is high in­trao­ral bac­te­ria con­tent, the chances of them breach­ing the bar­rier be­tween the gums and skin to en­ter the blood­stream in­creases, caus­ing high­grade bac­teremia,” she says.

The con­di­tions of the teeth and gums are not ex­clu­sive to oral health. They can af­fect the rest of the body, in­clud­ing the heart. Dr Geetha ex­plains that those with con­gen­i­tal or valvu­lar heart con­di­tions are sus­cep­ti­ble to in­fec­tive en­do­cardi­tis, which is the in­flam­ma­tion of the en­do­cardium ( mem­brane lin­ing the in­side of heart cham­bers and the sur­face of valves).

Bac­te­ria eas­ily lodge and pro­lif­er­ate in ab­nor­mal struc­tures of the heart or valve, dam­ag­ing them.

Th­ese can be seen as veg­e­ta­tions ( col­lec­tion of clots and rot­ten tis­sues).

As the heart pumps in­fected blood to the rest of the body, bac­teremia can spread to the brain, spleen, kid­ney and liver, lead­ing to sep­tic em­boli­sa­tion, where a bac­te­ri­ain­fected em­bo­lus is dis­lodged from its orig­i­nal lo­ca­tion and causes in­fec­tion in other parts of the body – for ex­am­ple, an em­bolism in the right side of the heart can af­fect the lungs.

“In­fec­tive en­do­cardi­tis can cause sig­nif­i­cant mor­tal­ity and mor­bid­ity in pa­tients with valvu­lar and con­gen­i­tal heart dis­ease, ar­ti­fi­cial valves, con­duits and for­eign ma­te­rial.

This is more so in Malaysia, where rheumatic heart dis­ease ( ac­quired valvu­lar heart dis­ease) is still preva­lent,” says Dr Geetha.

Pros­thetic in­stru­ments, con­duits or tubes in the body pro­vide en­vi­ron­ments con­ducive for bac­te­rial growth, al­low­ing them to breed and veg­e­tate.

To avoid th­ese, Dr Geetha says it is cru­cial for chil­dren and adults and those with struc­tural heart ab­nor­mal­i­ties to be vig­i­lant when it comes to main­tain­ing good oral hygiene.

“Proper teeth and gum care is im­por­tant, in­clud­ing reg­u­lar vis­its to the den­tist from young to re­move fear and es­tab­lish a trust­ing re­la­tion­ship,” she says.

bac­te­ria, blood

For more in­for­ma­tion, con­tact IJN.

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 ??  ?? In­ad­e­quate oral health can lead to tar­tar for­ma­tion and se­vere gum swelling.
In­ad­e­quate oral health can lead to tar­tar for­ma­tion and se­vere gum swelling.
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