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Sensitive things require Extra Care

ORAL HYGIENE
Its importance and its implications on General Body Health.

HYGIENE
Principles & Practice of General & Personal Cleanliness for the promotion of health and prevention of diseases.

ORAL HYGIENE
(Dental Hygiene)
Principles and Practice of Hygiene as applied to mouth i.e.
Teeth.  Gums.  Oral Mucosa.  It includes all the steps and measures that the patients and the doctor carry out for the prevention of diseases of the oral tissues and maintenance of the optimal oral and dental health.

BAD ORAL HYGIENE


A Danger to your Health
SIGNIFICANCE
1. 2. 3. 4. 5. 6. Diseases in the Oral Cavity. Affect the Chewing process. Affect the Phonation. Halitosis Bad smell from the mouth. Incidence of Mouth Cancer. Affect 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 CARIES
As a series of exacerbations (activeness) and the remissions (passiveness).

EXACERBATIONS:
o Carbohydrates + o Bacteria Cavitation Pulpitis. o Acids q pH oDemineralization

REMISSIONS:
Arrest of caries Arrest Incipient caries q Carbohydrates + q Bacteria o Remineralization. q Acids o pH qDemineralization

Bacteria of

oAcids

q Acids

Acid

Acid

AETIOLOGY & PREDISPOSING FACTORS


Dental caries depends on the presence of the three following factors: (TRIAD OF CARIES) 1. Host (Tooth & its surrounding structures). 2. Agents [Parasites] (Plaque microorganisms). 3. Medium (Environment) (Carbohydrate in diet). In Addition TIME is an important factor in development of caries. TIME

CARIES TRIAD
HOST:
a. b. c. d. e. f. g. Tooth Salivary Factors Muscular Activity Habits Group Susceptibility Age Environment

CARIES TRIAD
Host 1. Tooth:
A. Composition-a. b. c. Fluorine Calcium Tin

1 carries

B.

C.

Morphology (Susceptible sites on tooth). a. Self Cleansable areas. b. Non-Self Cleansable areas. Location and Alignment of Teeth. e.g. Last molar, Over crowding of teeth etc.

Dr. Misri Khan

B.

Morphology (Susceptible sites on tooth). a. Self Cleansable areas. b. Non-Self Cleansable areas Non-

CARIES SUSCEPTIBLE SITES ON TEETH

CARIES SUSCEPTIBLE SITES ON TEETH self cleansible and non-self cleansible areas non-

CARIES TRIAD
Host
SALIVARY FACTORS:
1.Composition: a. Phosphate, Ca, Fluoride b. Organic Substance carries 1 carries Functions of Saliva
1. 2. 3. 4. Bacterial clearance. Anti bacterial activity. Buffering action. Remineralization.

c. pHAlkalinity (normal pH of saliva is 5.67.6). pH d. Viscosity e. Flow f. Antibacterial elements g. Antibody elements.

CARIES TRIAD
Host
MUSCULAR ACTIVITY
1. 2. 3. 4.

Tongue Cheek. Lips Muscles of face

HOST HABITS
  

Poor eating habits deserts deserts snacks snackssweets. Disciplined Oral hygiene. Good eating habitsno snacks habits between meals.

CARIES TRIAD
Host
GROUP SUSCEPTIBILITY
1. 2.

Male & Female. Civilized and primitive Societies.

AGE GROUP
1. 2.

Before age of 20 years. After age of 20 years.

HOST ENVIRONMENT
1. 2. 3.

Phosphate, Content of food and water. Fluoride in water. Topical Fluoride (e.g Toothpaste).

CARIES TRIAD
2.AGENTS (PARASITES)
   

Microorganisms in the plaque---streptococcus mutants. Salivary glycoprotein. Sticky polysaccharide (Dextran). Modern diet a. Deleted protective factors e.g. Phytates. b. Added Cariogenic factors e.g. Refined carbohydrate c. Frequency of intake of sweets.

3.(MEDIUM) ENVIRONMENT

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

THEORIES OF CARIES FORMATION


1.

Acidogenic Theory: Carbohydrate + Bacteria

Fermentation

Acids Demineralization

Disintigration of organic portion Cavitation


2.

Proteolytic Theory: Carbohydrate + Bacteria Proteolysis Proteolytic enzymes destroy

organic components of tooth leave inorganic component of tooth unsupported which collapse
3.

Cavitation.

Proteolytic ProteolyticChelation Theory: Carbohydrate + Bacteria Fermentation Metabolic products of microorganisms

Chelate Ca from tooth Leave organic matrix of tooth unsupported Cavitation.

DIAGNOSIS OF DENTAL CARIES


1. 2. 3. 4.

5. 6. 7. 8. 9. 10.

Patient Complaints. The teeth are isolated & well illuminated Use of sharp explorer / probe Visual examination of the tooths surface roughness, opacification & Discoloration. Use of magnifying mirror Use of magnifying lens to give upto 5 times magnified image. Use of dental Floss / Tape. Separation of Teeth. Translumination. Special tests: thermal , electric tests & Radiographs.

Dental caries explorers [probes] Various designs

DIAGNOSIS OF DENTAL CARIES

BAD ORAL HYGIENE


A Danger to your Health
SIGNIFICANCE 1. 2. 3. 4. 5. 6. Diseases in the Oral Cavity. Affect the Chewing process. Affect the Phonation. Halitosis Bad smell from the mouth. Incidence of Mouth Cancer. Affect the General Body Health.

Oral diseases due to bad oral hygiene


1. 2. 3. 4. 5. 6. 7.

Dental caries Gingival or periodontal diseases Salivary glands diseases TMJ dysfunction syndromes Oral mucosal diseases Sinusitis Circumcoronitis etc. etc.

CONSEQUENCES OF THE DENTAL CARIES


             Hypersensitivity. Infection in the pulp.  Pulpitis.  Necrosis of the pulp. Periapical Abscess. Alveolar Abscess. Periapical Granuloma. Periapical Cyst. Osteomylitis. Osteonecrosis. Cellulitis. Maxillary Sinusitis. Ludwigs Angina. Spread of infection into Lateral & Posterior pharyngeal spaces. Spread of infection into Retropharyngeal & Mediastinum spaces

Diseases in the Oral Cavity


2.Gums or periodontal Diseases Consequences : Gingivitis (Bleeding Gums). Periodontitis (Pocket formation in gums). Loss of tooth supporting tissue (Tooth become shaky). Ultimate loss of tooth. Periodontal abscess Periapical abscess Alveolar abscess Osteomylitis Cellulitis Ludwigs Ludwig angina spread of infection in the surrounding spaces. Acute Ulcerative Necrotising Gingivitis. Bleeding Gum Bad Smell Severe Pain High fever Circumcoronitis (Gum infection around Erupting Tooth) Pregnancy 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.

AFFECT THE CHEWING PROCESS


       

Painful Teeth Painful Gums Shaky Teeth Loss of Teeth Malocclusion TMJ Pain Circumcoronitis Restricted Mouth opening

AFFECT THE PHONATION


    

Missing Teeth Painful Teeth Shaky Teeth Painful Gums TMJ Pain

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

      

Food lodgment in cavities of teeth Food lodgment in the interdental spaces Gum infection Periodontal pocket with pus discharging Sinus discharging Circumcoronitis etc. etc.

Incidence of the Mouth Cancer


Relationship between Bad Oral Habits & Bad Oral Hygiene.
   

Smoking Tobacco Chewing Pan Chewing Niswar

AFFECT GENERAL BODY HEALTH


Some serious diseases are caused or aggravated:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Stomach ulcer & Malignancy Cardiovascular (Heart) ailments:
a. b. Infective Endocarditis Septicemia/Bacteremia

Brain Disorders Lungs Infection Ear & Eye infection Tonsils Infection Allergic Asthma Joint Pains Liver & Gallbladder Infection 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 Vein
a. 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