Dr. Syamala Gowri

Flossing is as important as brushing on a daily basis. Taking the floss all the way down to the point where the teeth and gums meet is the appropriate way of doing it.

The primary or milk teeth begins to erupt at about 6 months of life with the complete set in place by 2.5 years of age, and the entire set is replaced by the age of 14. The benefits of some of the preventive dental measures are outlined below.

• Maternal care during pregnancy: The teeth begin to form during the second trimester of pregnancy. It is very important that the maternal diet includes sufficient amounts of calcium, potassium, and fluoride for optimal tooth mineralization. Good tooth structure has greater resistance to decay than hypomineralized teeth.
• Routine oral hygiene: For the first 6 months, though there are no teeth, after each nursing, end it with a spoonful or two of water to wash down the milk. Gradually, the gums can be just wiped with a gauze pad or soft cotton to remove any residual bacteria. The baby also gets used to this habit, and once the teeth are in, there are lesser bacteria for the decay process to begin. Once the teeth begin to erupt, the nursing habits also need to be modified to ensure the baby is not allowed to go to sleep with a bottle. This is a common practice to put the baby to sleep and should be avoided to reduce the occurrence of nursing bottle caries.
• Fluoride application: Fluoride has been shown to have significant benefits in preventing caries. Once routine dental visits begin, then the dentist will be able to tell if fluoride needs to be applied. This can happen either in the form of a gel or varnish that is applied in the dental office or as a paste that is used at home. This helps in building resistance to decay.
• Pit and fissure sealants: The tooth has a number of pits and fissures which are 8 times more vulnerable to decay than other surfaces. Deep pits are shown to harbor more bacteria and thereby greater incidence of caries. There are sealants which are thin resins that can be applied on the tooth, which can reduce bacteria accumulation and further decay.
• Space maintainers: In the event that a child has lost a tooth, either due to trauma or decay and subsequent infection, then a space maintainer should be placed within the next 3 months. This helps in maintaining the space and establishing a good bite during the transition phase and later, once the permanent teeth are in place.
• Orthodontic treatment: If there is malocclusion, then early intervention helps by reducing treatment time and getting better results as the teeth and periodontium are still very elastic and are more malleable to movement.

By doing these preventive measures early in life, the result is a child who has healthier teeth, less decay, less pain, and a happy smile all the time! If you wish to discuss about any specific problem, you can consult a dentist and ask a free question.

‘Smoking is injurious to health’, is a caption that is flashed on all cigarette packets. However, what is not told about is their adverse effects on the mouth.  The mouth with the lips, teeth, and gums are not just the first points of contact for a cigarette but also one of the majorly affected parts.

Listed below are how smoking affects the teeth and the mouth at large.

1. Bad breath (halitosis)

2. Tooth discoloration (brown to black spotting)

3. Tobacco deposits on the teeth leading to irritation of the gums

4. Increased formation of plaque and tartar on the teeth, leading to significant gum disease

5. Gum disease leads to tooth loss

6. Increased jaw bone loss

7. Lower success rate of dental implant procedures

8. Delayed healing after any oral procedure including extraction, periodontal treatment, or oral surgery

9. Increased risk of leukoplakia, white patches inside the mouth, which is a precursor to oral cancer

10. Increased risk of developing oral cancer

11. Reduces blood flow to the gums, thereby affecting healing

The tiny tobacco deposits sit on the tooth surface and with time, produce brownish stains. These are a constant source of irritation for the gums, causing gum disease. Unlike the regular plaque caused by food, this is much harder and more abrasive on the gums. This leads to damage of the periodontal tissue, which are connecting fibers between the teeth and the gums.  This leads to gradual tooth mobility and eventually loss.

Correlation:  If you are a smoker,

1. You are at risk for gum disease twice compared to a nonsmoker.

2. More cigarettes you smoke, greater the risk for gum disease.

3. More number of years you smoke, greater the risk for gum disease.

4. Poor response to regular treatment for gum disease.

Management:  The gum disease can eventually lead to tooth loss.  Therefore, the gums need to be protected at all cost to maintain oral health.  Some things to do are listed below, starting from the seemingly innocuous to the severe infections.

1. Regular cleanings at your dentist's office once in 6 months

2. Daily brushing and flossing to manage early gum disease

3. Deep cleaning below the gum line and prescription mouth rinses if there is already existing gum inflammation

4. Surgery to remove deeply seated plaque and tartar.

5. Surgery with bone graft to replace the bone lost to periodontitis.

6. Most important of all, quitting smoking.  This will produce remarkable benefits when the above are followed.

However, if the above are done with continued smoking, the effects will not last long.

Cigarette smoking is one habit, which has way too many effects on way too many working’s of the body and therefore kicking the habit is the best way to manage, not just your teeth, but your overall health.