Public enemy #1

How plaque is the number one enemy of teeth and a review of the best ways to combat it in the Middle East

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By  Stuart Qualtrough Published  August 2, 2005

|~||~||~|To beat your enemy, you first have to know all about it: how it is born and where and how it survives and expands. Plaque is the number one enemy to healthy teeth and gum; it starts within minutes after eating and, if not contained, takes the shape of a colourless and sticky film on the teeth and its roots; it is not visible at first and thrives on food remains; with time, plaque produces enough acids that can destroy not only the teeth enamel, but also tooth roots and gum. Experts in oral care tell us all about plaque and the essentials of beating our number one enemy for a healthy mouth and an attractive smile for life.

Who’s the enemy?
Local leading dentist, Dr Irshad Skhaikh explained: “Plaque is a bacteria that develops when foods containing carbohydrates such as milk, soft drinks, raisins, cakes, or candy are frequently left on the teeth; this bacteria lives in the mouth and thrives on these foods. When thriving on food remains, plaque starts producing acids that causes tooth decay and that attacks tooth roots under the gum causing the breakdown of the bone supporting the tooth. “

He added: ”The essentials therefore of fighting tooth decay is to contain the enemy at the early start of its formation and to even prevent it from being born. In this case, containing plaque and preventing plaque from forming is a basic step to creating and maintaining healthy tooth and gums.”

Dr Irshad explains that while brushing teeth is essential immediately after meals, coffee, etc, the majority of individuals tend to either not brush properly, or even miss the difficult to reach areas where food remains resides and where plaque can be born.

He said: “Brushing teeth, although not complicated, is something most of us simply do not know how to do properly so we improvise. Proper brushing techniques not only removes bacteria and plaque, but also minimises the attachment of bacteria, not preventing the formation of additional plaque .”

So how do we brush teeth
correctly?
If plaque is not regularly removed from teeth, including the areas below the gum line, it can irritate the gums, leading to gum disease. Regular brushing and cleaning between teeth is essential to help prevent gum disease. It is also important to note that people do not give it the time it needs and they always do it in a rush.

Dentists recommend that to fight plaque, you have to be patient, thorough and consistent in brushing your teeth.

Some proper tooth brushing techniques are as follows:
Tilt the bristles of the brush along the gumline at a 45-degree angle and apply firm pressure so the bristles slide under the gumline.
Vibrate the brush while you move it in short back and forth strokes and in small circular motions. Brush two or three teeth at a time, then move to the next teeth, allowing some overlap.
Switch to the outsides of the upper teeth, and then the outsides of the lower teeth. Brush the chewing surfaces of the upper teeth, then the lower teeth and end by gently brushing your tongue and the roof of your mouth. This removes germs and keeps your breath fresh

What’s going to be my weapon?
Dr Irshad explains: “You should see a toothbrush as the proper weapon for fighting plaque and therefore, individuals should be a great attention to what toothbrushes they use and how often they need to change them. It is important to brush at least twice a day, using a soft toothbrush which makes it easier to remove the plaque below the gumline, where periodontal disease starts. In order to reach difficult places, there are toothbrushes in the market that have longer bristles towards the end of the head which allows individuals to reach the backside of jaws when brushing.”

Most people do not realise that toothbrush bristles fade away after few months. While there are toothbrushes in the market that have mechanisms to indicate to users when bristles are fading away, dentists ideally recommend changing your toothbrush every 3-4 months.”

Dr Irshad summarises the dangers of overusing toothbrushes:
Brushes should be rinsed thoroughly after each use and stored upright, allowing it to dry out properly as moisture can again lead to bacteria breeding on the brush.
Bristles of any toothbrush — manual or electric — will become worn out and frayed with regular brushing.
This will mean that your chosen brush will be less effective in cleaning your teeth and will reduce the cleaning power of your toothpaste too. Beyond the inferior toothbrush performance, continuing to use an old brush can lead to serious health problems.

Dr Irshad ends saying: “You can easily beat plaque if you devote a little more time and attention to taking care of your oral health. The essential to preventing plaque from taking over your teeth is continuous and proper brushing techniques, ensuring that you take your time choosing the correct toothbrush that allows you to reach difficult places and alerts you when it is time to replacement.” ||**|||~||~||~|Starting early, staring right
How many parents in this part of the world really realise the impact of poor oral hygiene on their children and in fact, on their children’s self esteem as they move from childhood to later stages in life? Although there is no concrete data that answers this question, non-profit organisations, public sector health officials, dentists, as well as vendors of oral care products point to this direction: few parents are really aware of the outcome of poor oral hygiene habits among children, and even fewer take a preventive approach to ensure their children face less oral care problems and most importantly, teeth, as they grow older.
In a 2003 report published by the World Health Organisation, dental cavities is still a major oral health problem in most industrialised countries, affecting 60-90% of schoolchildren and the vast majority of adults.

Another survey conducted by the Ministry of Health in the UAE earlier in 2002, points that the majority of children in the UAE experience cavities in their primary dentition, more than half of 12 years old have cavities experience in their permanent dentition; by the age of 15, more than 60% experience dental decay.

LK Gupta, the regional business manager for Oral B, said: ” Our estimates suggest that brushes for children constitute only 5-7% of all brushes sold in the Middle East, whereas if every child has a toothbrushes, and maintains a consistent and appropriate use of it throughout his or her childhood by changing the toothbrush every three or four months to achieve the desired results, then the children toothbrush size of the market should be 2-3 times as much as it is today.”

Dr M. F. Talass, a leading Dubai based orthodontist in the Middle East says that the oral hygiene, compared to other health issues, does not top the agenda of parents in this part of the world. “There is of course the element of education as primary reason and I can state few of many examples. Not many women realise that the best insurance for a healthy baby is a mother who is not only, well, but also eats a nutritious diet before and during pregnancy and while breastfeeding. The baby’s teeth in fact start to develop around the sixth week of pregnancy and therefore, Calcium is essential in a pregnant women’s diet and while breastfeeding. Even fewer women know that saliva contains components that can directly attack bacteria which cause decay, and this can easily be transmitted to babies at the early stages of their teeth formation, which would eventually lead to carries at a very early stage.”

Dr Talass continues: “Primary teeth are the foundation of a healthy mouth, including the positioning of permanent teeth and the healthiness of the gum. If your baby’s primary teeth become broken or decayed and are not properly treated, problems can occur with permanent teeth, which may contribute to other health problems. The result can be costly orthodontics and other treatments.”

Babies are exposed to decay bacteria from a variety of sources, such as a caregiver blowing on food to cool it, tasting food, sharing utensils, kissing the infant on the mouth, sharing a cup, or sucking on the baby’s fingers. Frequent, long-term exposure of a child’s teeth to sugary liquids (including breast milk, formula, and milk) causes baby bottle tooth decay. The sugars in these liquids pool around the teeth and feed the bacteria in plaque.

Dr Talass advises: “Care should be taken not to expose the infant to bacterial exposure from these sources and most importantly, mothers need to ensure that their babies teeth have enough fluoride supplements in their diets. In fact, as soon as teeth appear, babies are risk for decay and need to be brushed twice daily with a soft-bristled brush.”

Doctors and health officials advise that preventive steps against dental disease among children is the best approach that parents can take to maintain good oral health. Dr Talass added: ”Parents need to ensure that good oral health habits are established early. When the child is one year old, parents should also serve as a role model for their children by practicing good oral heath habits themselves in front of their children. Children’s toothbrush should be changed before the bristles become splayed and frayed.

“Old toothbrushes are ineffective and may contain harmful bacteria that can cause infections such as gingivitis and periodontitis. Every three to four months, parents should change their children’s toothbrush.

“Because the mouth is home to millions of micro-organisms, and a toothbrush can become contaminated with bacteria, blood, saliva, oral debris and toothpaste it is recommended parents teach their children to rinse their toothbrush with tap water after brushing.”

A lifetime of good oral health can be a reality for children if parents get them on the right track early. The role of parents is to keep their children motivated by setting a good example, and to create a consistent and fun environment for tooth brushing. Soon, children will realise that tooth brushing is part of their daily routine. A message to parents: remember, starting early and starting right will endure that your child’s smile stays healthy as well as bright.||**||

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