Excessive sugar in the diet can lead to general health problems such as diabetes, and to oral health problems such as dental caries and periodontal (gum) disease. Sugar is likely to be present in fizzy and sweetened drinks, and in refined carbohydrate foods such as cakes, biscuits and sweets. Too much sugar in the diet, combined with other harmful habits such as smoking, excessive alcohol consumption, and abusing teeth by opening things with them or chewing on bones, leads to oral health problems.
However, in some settings, getting enough food to eat will be a high priority for survival. If people are malnourished they are not getting a balanced diet. As a consequence of the lack of a balanced diet, people are likely to suffer from general health conditions such as scurvy and oral conditions such as bleeding gums.
Diet and oral hygiene are two closely related risk factors for the two prevalent oral health conditions of dental caries and periodontal (gum) disease, and for related infections.
Working with the local community to provide diets that are as balanced as possible in the circumstances will help both general and oral health
Cleaning the mouth frequently helps keep it healthy by removing food and plaque, which if they stay in the mouth can cause dental caries (decay) and periodontal (gum) disease. Everyone’s mouth is their own responsibility and to keep it clean does not need a dentist.
Cleaning the mouth twice a day – morning and evening – is a good routine,
With regard to cleaning instruments, in low resource communities it is important to use what is available, such as varieties of cleaning stick. Toothbrushes are also useful provided they are readily available, affordable, and are sustainable.
Cleaning agents are not essential, as mechanical cleaning, combined with water or saliva can be effective. Local cleaning agents, such as powdered charcoal or salt, need to be used with care as they are abrasive. Ideally fluoride toothpaste is best, again provided it is readily available, affordable, and is sustainable.
Working with local communities to establish cleaning routines with appropriate cleaning instruments and cleaning agents is the aim.
Drinking alcohol in moderation can be enjoyable for many people, but drinking excessively can have a harmful effect and can lead to serious health problems.
General health conditions associated with heavy alcohol drinking
- Cancers of the mouth, throat and oesophagus
- High blood pressure, Heart disease, Stroke
- Liver disease, Pancreatitis, gout, brain damage
- Anxiety, depression and poor concentration
Oral health conditions associated with heavy alcohol drinking
- Dental caries – (tooth decay) – from increased exposure to sugars and acids within the drink
- periodontal disease– increased severity of periodontal disease
- dental erosion– heavy drinking can lead to frequent vomiting and the vomit is extremely acidic, also many drinks such as beer are very acidic
- Sustaining oro-facial injuries, through violence, falls or accidents
People who use both alcohol and tobacco are at an especially high risk of cancer.
Ideally alcohol intake should be reduced, which may require support from the community
SMOKING AND CHEWING
Tobacco use is responsible for the death of one in ten adults worldwide and has been estimated to account for over 90% of cancers in the oral cavity. In low income countries smoking and chewing is more common, especially among the poor. Smoking cigarettes, pipes, cigars, and bidis, as well as using snuff, are some forms of addictive tobacco use. Chewing substances, with or without tobacco, such as areca nuts, betel quid/gutka, Qat, paan are also addictive and have similar adverse effects on oral health.
General health conditions associated with smoking and chewing
- Coronary heart disease, heart attack, stroke
- peripheral vascular disease (damaged blood vessels)
- Damage to lungs leading to conditions such as: bronchitis, emphysema, pneumonia
- Cancers – most commonly lung cancer
Oral health conditions associated with smoking and chewing
- Stained teeth and bad breath and reduced sense of taste
- Increase in severity of periodontal (gum disease)
- Delayed wound/extraction (dry socket) healing
- White and red patches (leukoplakia, smokers keratosis, submucous fibrosis, reverse smoking burn)
- Mouth cancer– oral cancers are associated with tobacco smoking especially combined with heavy alcohol intake
The risks of tobacco use greatly increase when it is used in combination with alcohol or areca nut.
Stopping tobacco use and decreasing alcohol consumption to reduce the risk of oral cancers, periodontal disease and tooth loss as well as improving general health.
FACIAL INJURIES (maxillofacial trauma)
Physical force or foreign objects can cause injuries to the face, mouth and jaw.
Facial injuries range from those that can be very minor, such as mouth ulcers caused by biting the cheek, to those that are extensive, such as jaw fractures after a road traffic accident or fight.
Across the world, up to 40% of children in the age range 6 to12 years old are affected by dental trauma due to unsafe playgrounds, unsafe schools, road accidents, or violence using protective sports and motor vehicle equipment to reduce the risk of facial injuries and providing safe physical environments.
For more extensive facial injuries initial treatment should always be to check, restore and maintain an adequate airway and arrest any haemorrhage – then refer to a specialist.
Common facial injuries include:
- fractured teeth
- knocked out (avulsed) teeth
- dislocated jaw
Occasions where facial injuries occur:
- Sports or recreational activities
- Work related tasks or unskilled home repairs and maintenance
- Motor vehicle crashes
- Fights – alcohol is a contributor to motor vehicle crashes and fights
The risk of facial injuries can be reduced by greater awareness of how to avoid physical impacts to the face, mouth and jaw.
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