Sensitive things require…………… Extra Care

ORAL HYGIENEORAL HYGIENE

Its importance and its Its importance and its implications on General implications on General

Body HealthBody Health..

HYGIENE

Principles & Practice of Principles & Practice of General & Personal General & Personal

CleanlinessCleanliness

for the promotion of for the promotion of health andhealth and

prevention of diseasesprevention of diseases..

ORAL HYGIENE ORAL HYGIENE (Dental Hygiene)(Dental Hygiene)

Principles and Practice of Hygiene asPrinciples and Practice of Hygiene asapplied to mouth i.eapplied to mouth i.e..

..TeethTeeth..GumsGums

..Oral MucosaOral Mucosa

It includes all the steps and measures that the It includes all the steps and measures that the patients and the doctor carry out for the patients and the doctor carry out for the prevention of diseases of the oral tissues and prevention of diseases of the oral tissues and maintenance of the optimal oral and dental maintenance of the optimal oral and dental healthhealth..

BAD ORAL HYGIENEBAD ORAL HYGIENEA Danger to your HealthA Danger to your Health

SIGNIFICANCESIGNIFICANCE

11 . .Diseases in the Oral CavityDiseases in the Oral Cavity..

22 . .Affect the Chewing processAffect the Chewing process..

33 . .Affect the PhonationAffect the Phonation..

44 . .Halitosis – Bad smell from the mouthHalitosis – Bad smell from the mouth..

55 . .Incidence of Mouth CancerIncidence of Mouth Cancer..

66 . .Affect the General Body HealthAffect the General Body Health..

TOOTH DECAY OR CARIES

DEFINITION• Tooth caries is the localized demineralization by acids (or

dissolution of the mineralized tissue) and disintigration of the organic components of the tooth structure, resulting in cavitation.

Dental caries is characterized by the following factors;

1. Sugar dependent.

2. Infectious and microbiological disease.

3. Progressive disease process.

4. Damage to the tooth tissue is irreversible.

5. Plaque dependent.

DYNAMICS OF CARIESDYNAMICS OF CARIESAs a series of exacerbations (activeness) and the remissions

(passiveness).

EXACERBATIONS:

Carbohydrates + Bacteria Acids pH Demineralization

Cavitation Pulpitis.

REMISSIONS:

Arrest of caries

Arrest Incipient caries

Carbohydrates + Bacteria Acids pH Demineralization

Remineralization.

Bacteria of

Acids Acids

Acid Acid

AETIOLOGY & PREDISPOSING AETIOLOGY & PREDISPOSING FACTORSFACTORS

Dental caries depends on the presence of the three following factors:Dental caries depends on the presence of the three following factors:

(TRIAD OF CARIES)(TRIAD OF CARIES)

1. Host (Tooth & its surrounding structures).1. Host (Tooth & its surrounding structures).

2. Agents [Parasites] (Plaque microorganisms).2. Agents [Parasites] (Plaque microorganisms).

3. Medium (Environment) (Carbohydrate in diet).3. Medium (Environment) (Carbohydrate in diet).

In Addition TIME is an important factor in development of caries.In Addition TIME is an important factor in development of caries.

TIME

CARIES TRIAD

HOST:a. Toothb. Salivary Factorsc. Muscular Activityd. Habitse. Group Susceptibilityf. Ageg. Environment

Dr. Misri KhanDr. Misri Khan

CARIES TRIADHost

1. Tooth:A. Composition-- 1

carries

B. Morphology (Susceptible sites on tooth).

a. Self Cleansable areas.

b. Non-Self Cleansable areas.

C. Location and Alignment of Teeth.

e.g. Last molar, Over crowding of teeth etc.

a. Fluorine

b. Calcium

c. Tin

B.B. Morphology (Susceptible sites on Morphology (Susceptible sites on tooth).tooth).

a.a. Self Cleansable areas.Self Cleansable areas.b.b. Non-Self Cleansable areasNon-Self Cleansable areas

CARIES SUSCEPTIBLE SITES ON TEETH

CARIES SUSCEPTIBLE SITES ON TEETHCARIES SUSCEPTIBLE SITES ON TEETHself cleansible and non-self cleansible self cleansible and non-self cleansible

areasareas

CARIES TRIADCARIES TRIADHostHost

SALIVARY FACTORS:SALIVARY FACTORS:1.Composition:1.Composition:

a. Phosphate, Ca, Fluoride a. Phosphate, Ca, Fluoride 1 1 carriescarries

b. Organic Substanceb. Organic Substance carriescarries

c. pH—Alkalinity (normal pH of saliva is 5.6—7.6).c. pH—Alkalinity (normal pH of saliva is 5.6—7.6).

d. Viscosityd. Viscosity

e. Flowe. Flow

f. Antibacterial elementsf. Antibacterial elements

g. Antibody elements.g. Antibody elements.

1. Bacterial clearance.

2. Anti bacterial activity.

3. Buffering action.

4. Remineralization.

Functions of Saliva

CARIES TRIADCARIES TRIADHostHost

MUSCULAR ACTIVITYMUSCULAR ACTIVITY1.1. TongueTongue

2.2. Cheek.Cheek.

3.3. LipsLips

4.4. Muscles of faceMuscles of face

HOST HABITSHOST HABITS Poor eating habits –desertsPoor eating habits –deserts

—snacks—sweets.—snacks—sweets. Disciplined Oral hygiene.Disciplined Oral hygiene. Good eating habits—no Good eating habits—no

snacks between meals.snacks between meals.

CARIES TRIADCARIES TRIADHostHost

GROUP SUSCEPTIBILITYGROUP SUSCEPTIBILITY1.1. Male & Female. Male & Female. 2.2. Civilized and primitive Societies.Civilized and primitive Societies.

AGE GROUPAGE GROUP1.1. Before age of 20 years.Before age of 20 years.2.2. After age of 20 years.After age of 20 years.

HOST ENVIRONMENTHOST ENVIRONMENT1.1. Phosphate, Content of food and Phosphate, Content of food and

water.water.2.2. Fluoride in water.Fluoride in water.3.3. Topical Fluoride (e.g Toothpaste).Topical Fluoride (e.g Toothpaste).

CARIES TRIADCARIES TRIAD2. AGENTS (PARASITES) Microorganisms in the plaque---streptococcus

mutants. Salivary glycoprotein. Sticky polysaccharide (Dextran).3. (MEDIUM) ENVIRONMENT Modern diet

a. Deleted protective factors e.g. Phytates.b. Added Cariogenic factors e.g. Refined carbohydrate c. Frequency of intake of sweets.

CHARACTERISTICS OF FOODa. Hard & Fibrous Food.b. Carbohydrates in Food.c. Fluoride, Phosphate and Vitamins in Food.d. Soft and Sticky Food.

THEORIES OF CARIES THEORIES OF CARIES FORMATIONFORMATION

1.1. Acidogenic Theory:Acidogenic Theory:Carbohydrate + Bacteria Carbohydrate + Bacteria Acids Acids DemineralizationDemineralization

Disintigration of organic portionDisintigration of organic portion

CavitationCavitation

2.2. Proteolytic Theory:Proteolytic Theory:

Carbohydrate + Bacteria Carbohydrate + Bacteria Proteolytic enzymes Proteolytic enzymes destroy destroy

organic components of toothorganic components of tooth leave inorganic component of tooth unsupported leave inorganic component of tooth unsupported

which collapse which collapse Cavitation. Cavitation.

3.3. Proteolytic—Chelation Theory:Proteolytic—Chelation Theory:

Carbohydrate + BacteriaCarbohydrate + Bacteria Metabolic products of microorganisms Metabolic products of microorganisms

Chelate Ca from toothChelate Ca from toothLeave organic matrix of tooth unsupportedLeave organic matrix of tooth unsupportedCavitation. Cavitation.

Fermentation

Proteolysis

Fermentation

DIAGNOSIS OF DENTAL DIAGNOSIS OF DENTAL CARIESCARIES

1. Patient Complaints.2. The teeth are isolated & well

illuminated3. Use of sharp explorer / probe4. Visual examination of the tooth’s

surface roughness, opacification & Discoloration.

5. Use of magnifying mirror 6. Use of magnifying lens to give upto

5 times magnified image.7. Use of dental Floss / Tape.8. Separation of Teeth.9. Translumination.10. Special tests: thermal , electric

tests & Radiographs.

Dental caries explorers [probes] Various designs

DIAGNOSIS OF DENTAL DIAGNOSIS OF DENTAL CARIESCARIES

BAD ORAL HYGIENEA Danger to your Health

SIGNIFICANCE

1. Diseases in the Oral Cavity.

2. Affect the Chewing process.

3. Affect the Phonation.

4. Halitosis – Bad smell from the mouth.

5. Incidence of Mouth Cancer.

6. Affect the General Body Health.

Oral diseasesOral diseases due to due to

bad oral hygienebad oral hygiene

1. Dental caries2. Gingival or periodontal diseases3. Salivary glands diseases4. TMJ dysfunction syndromes5. Oral mucosal diseases6. Sinusitis7. Circumcoronitis etc. etc.

CONSEQUENCES OF THE DENTAL CONSEQUENCES OF THE DENTAL CARIESCARIES

Hypersensitivity. Infection in the pulp.

Pulpitis. Necrosis of the pulp.

Periapical Abscess. Alveolar Abscess. Periapical Granuloma. Periapical Cyst. Osteomylitis. Osteonecrosis. Cellulitis. Maxillary Sinusitis. Ludwig’s Angina. Spread of infection into Lateral & Posterior

pharyngeal spaces. Spread of infection into Retropharyngeal &

Mediastinum spaces

2.2. Gums or periodontal Diseases – Gums or periodontal Diseases – Consequences :Consequences :Gingivitis (Bleeding Gums).Gingivitis (Bleeding Gums).Periodontitis (Pocket formation in gums).Periodontitis (Pocket formation in gums).Loss of tooth supporting tissue (Tooth Loss of tooth supporting tissue (Tooth become shaky).become shaky).Ultimate loss of tooth.Ultimate loss of tooth.Periodontal abscessPeriodontal abscessPeriapical Periapical abscessabscessAlveolar abscess Alveolar abscess OsteomylitisOsteomylitisCellulitisCellulitisLudwig’s Ludwig’s anginaanginaspread of infection in the spread of infection in the surrounding spaces.surrounding spaces.Acute Ulcerative Necrotising Gingivitis.Acute Ulcerative Necrotising Gingivitis.–Bleeding GumBleeding Gum–Bad SmellBad Smell–Severe PainSevere Pain–High feverHigh feverCircumcoronitis (Gum infection around Circumcoronitis (Gum infection around Erupting Tooth)Erupting Tooth)Pregnancy EpulisPregnancy Epulis

Diseases in the Oral Cavity

3. Salivary Gland Disease.

Bacterial infection occur due to retrograde passage of oral bacteria into the gland substance via the Duct.

4. Temporo Mandibular Joint Diseases TMJ dysfunction Syndrome.

Due to loss of teeth Malocclusion

TMJ infection from the Teeth & Gum.

Diseases in the Oral Cavity

AFFECT THE CHEWING PROCESSAFFECT THE CHEWING PROCESS

Painful TeethPainful Teeth Painful GumsPainful Gums Shaky TeethShaky Teeth Loss of TeethLoss of Teeth MalocclusionMalocclusion TMJ PainTMJ Pain CircumcoronitisCircumcoronitis Restricted Mouth openingRestricted Mouth opening

AFFECT THE PHONATIONAFFECT THE PHONATION

Missing TeethMissing Teeth Painful TeethPainful Teeth Shaky TeethShaky Teeth Painful GumsPainful Gums TMJ PainTMJ Pain

HALITOSISHALITOSIS

Food lodgment in cavities of teethFood lodgment in cavities of teeth Food lodgment in the interdental spacesFood lodgment in the interdental spaces Gum infectionGum infection Periodontal pocket with pus dischargingPeriodontal pocket with pus discharging Sinus dischargingSinus discharging CircumcoronitisCircumcoronitis etc. etc. etc. etc.

Bad smell from the mouth is due to infection or rotten food particles in the different parts of the mouth

Incidence of the Mouth CancerIncidence of the Mouth Cancer

Relationship between Bad Oral Relationship between Bad Oral HabitsHabits

& Bad Oral Hygiene.& Bad Oral Hygiene. SmokingSmoking Tobacco ChewingTobacco Chewing Pan ChewingPan Chewing NiswarNiswar

AFFECT GENERAL BODY HEALTH

Some serious diseases are caused or aggravated:1. Stomach ulcer & Malignancy2. Cardiovascular (Heart) ailments:

a. Infective Endocarditis b. Septicemia/Bacteremia

3. Brain Disorders4. Lungs Infection5. Ear & Eye infection6. Tonsils Infection7. Allergic Asthma8. Joint Pains9. Liver & Gallbladder Infection10. Kidney Infection

STOMACH

1. Stomach Ulcer (Bad oral hygiene).

2. Stomach Malignancy (continuous irritation from Bad oral hygiene).

BRAIN DISORDERS

1. Through Nervous

2. Through Facial Veina. Cerebral Abscess

b. Subdural Empyema

c. Septic Thrombus Phlebitis of cortical vein and venous Sinuses.

LUNGS ABSCESS

Pleuro Pulmonary infection – by Anaerobes

CARDIO VASCULAR AILMENTS

• Bacteremia / Septicemia

• Infective Endocarditis

• Odonto-Cardiac Pain