How can one achieve oral hygiene?

Permit me a space in your weekly column to ask about oral hygiene and health. Shed some light about it and the preventive measures.

K B. N.

Thanks for your question and let me start by providing some basic information about oral health. It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.

Oral diseases and conditions

The most common oral diseases are dental cavities, periodontal (gum) disease, oral cancer, oral infectious diseases, trauma from injuries, and hereditary lesions.

1. Dental cavities: Worldwide, 60-90% of school children and nearly 100% of adults have dental cavities, often leading to pain and discomfort.

2. Periodontal disease: Severe periodontal (gum) disease, which may result in tooth loss, is found in 15-20% of middle-aged (35-44 years) adults.

3. Tooth loss: Dental cavities and periodontal disease are major causes of tooth loss. Complete loss of natural teeth is widespread and particularly affects older people.

4. Oral cancer: The prevalence of oral cancer is relatively higher in men, in older people, and among people of low education and low income. Tobacco and alcohol are major causal factors.

5. Fungal, bacterial or viral infections in HIV: Almost half (4050%) of people who are HIV-positive have oral fungal, bacterial or viral infections. These often occur early in the course of HIV infection. 6. Oro-dental trauma due to accidents, or violence. 7. Noma is a gangrenous lesion that affects young children living in extreme poverty primarily in Africa and Asia. Lesions are severe gingival disease followed by necrosis (premature death of cells in living tissue) of lips and chin.

8. Cleft lip and palate. Birth defects such as cleft lip and palate.

Common causes

Risk factors for oral diseases include an unhealthy diet, tobacco use and harmful alcohol use. These are also risk factors for the four leading chronic diseases; cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. Oral diseases are often linked to chronic diseases. Poor oral hygiene is also a risk factor for oral disease.

The prevalence of oral disease varies by geographical region, and availability and accessibility of oral health services. Social determinants in oral health are also very strong. The prevalence of oral diseases is increasing in low- and middle-income countries. And in all countries, the oral disease burden is significantly higher among poor and disadvantaged population groups.

Prevention and treatment

1. Decreasing sugar intake and maintaining a well-balanced nutritional intake to prevent tooth decay and premature tooth loss.

2. Consuming fruit and vegetables that can protect against oral cancer.

3. Stopping tobacco use and decreasing alcohol consumption to reduce the risk of oral cancers, periodontal disease and tooth loss. 4. Ensuring proper oral hygiene. 5. Using protective sports and motor vehicle equipment to reduce the risk of facial injuries.

6. Dental cavities can be prevented by maintaining a constant low level of fluoride in the oral cavity. Fluoride can be obtained from fluoridated drinking water, salt, milk and toothpaste, as well as from professionallyapplied fluoride or mouth rinse.

7. Most oral diseases and conditions require professional dental care, however, due to limited availability or inaccessibility, the use of oral health services is markedly low among older people, people living in rural areas, and people with low income and education.