Dental and Periodontal Health - Looking after your pearly whites!

Tooth and gum problems are on a steep increase both in children and in adults. Between the years of 2014-2015 there was an increase of 9.8% in children under the age of 10 with dental problems [1]. Even more shockingly, 25% of adults admit to not brushing their teeth twice a day. 

Considering it’s thought that brushing only once a day increases the likelihood of developing dental problems by as much as 33%, you can see how oral hygiene needs to be reconsidered [2].

What Structures are found in the mouth?

The mouth is made up of 3 vital components these are the tongue, the gums, and the teeth. The tongue is actually a muscle, and an organ. It is the organ responsible for taste, but this is not the only role it has in the body. The tongue is made up of 8 muscles that are interwoven with one another, this allows the tongue to curl and move. Without its complex muscular movement we wouldn’t be able to talk or form sounds. The appearance of the top of the tongue (Dorsum) is textured, this is because it is covered in taste buds (Papillae) responsible for taste. There are 3 types, Filiform, Funghiform and Foliate Papillae. To be able to taste saliva is produced from the Serous glands which encapsulates the food chemicals and allows us to recognize the flavour [3].

Our gums are often neglected as very little is known about them in the general public. In scientific terms the gums are called the ‘Gingiva’. The structure is strong and sturdy so that they are able to hold our teeth in place. This structure is covered by a layer of mucosa that maintains oral hygiene. Healthy gums should be pink and well moisturized. They should be completely surround the teeth with no gaps or pain. Unhealthy gums are obvious as they are red, inflamed and often bleed [4].

Finally, our teeth have the widest knowledge and campaign base to keep them healthy. In a typical adult human mouth there are approximately 32 teeth. Each tooth is composed of about 5 layers. Working from the outside in, is the Enamel, which is made of Calcium Phosphate and serves to protect the tooth for damage or sensitivity. Next is the Dentin, which is made of living cells, hence why when enamel is destroyed our teeth become sensitive. Its role is to actively secrete mineral substances to harden teeth. Thirdly, is the pulp, this is again made of living cells which has a rich blood supply and an abundance of neural tissue. Next layer is called the cementum which is formed of connective tissue that are connected to the gum and jawbone to ‘cement’ tooth structure. Finally, is the periodontal ligament which also holds teeth in place [5].

What Diseases can affect the mouth?

Considering there are so many structures in the mouth, and we are constantly bombarding it with bacteria from the air or food it’s clear why there are a number of disease that can affect this area. Here are a few common ones.

• Gum Disease. Is an inflammation of the gums surrounding the teeth. There are two forms, Gingivits and Periodontitis. Gum disease is caused by a build up of plaque, which is the sticky white opaque substance found around the base of teeth. If this is left without removal it can develop into tartar. Gingivitis is inflammation of the gums which causes swelling, redness and pain. This is thought to be reversible with the correct treatments. Periodontitis is the inflammation of the surrounding gum of the tooth. Periodontitis is caused by the gum pulling away from the tooth and becoming infected [6].
• Halitosis. This is the scientific term for bad breath. The main cause is poor oral hygiene, gum disease and infection. It’s a reasonably common problem that is easily remedied with improved brushing, flossing and the exclusion of strong flavoured foods (onion and garlic).
• Cavities/Decay. Cavities are also known as caries, they occur when tooth decay takes hold. Caries are caused by sugar or acid laden diets or evading bacteria. This can create holes in the tooth structure damaging deeper layers of the tooth [5].

Risk factors for disease are smoking, pregnancy, menopause, diabetes, citrus fruits, acidic diets, sugar-laden diets or genetic susceptibility[6].

How to improve the health of your mouth?

Nutrition

We all know that Calcium is essential for tooth structure, but are you also aware that so is Vitamin D3 and Phosphorous? Calcium is required for tooth structure, but for this to be absorbed Vitamin D3 must also be consumed. Vitamin D3 is required for the absorption of Calcium into the blood stream and its use around the body. Phosphorous makes up the Calcium Phosphate structure in the Enamel. Calcium rich foods include dairy products, dark leafy green vegetables, tofu and nuts. Vitamin D rich foods include plant oils, especially sunflower, and oily fish. However, your best source is the sun. Phosphorous can be found in eggs, meat, and dairy products.

For the health of our gums it’s important to consider our Vitamin C intake. Majority of the gum and tooth linkages contain Collagen. An essential part of Collagen production is Vitamin C. Vitamin C rich foods include, green leafy vegetables, tomatoes, bell peppers, mango and strawberries[7].

Furthermore, there are foods and food groups to be avoided, primarily refined sugars found in soft drinks, cakes, processed foods and chocolate. Sugar is well documented food with high cariogenicity, a worrying statistic demonstrated that 15% of daily calories in 4-10 year old children is made up of refined sugar [2]. Citrus fruits and citric acid also damages the enamel of the tooth increasing its sensitivity.

Supplements

Of course Vitamin D3, Calcium, Phosphorous and Vitamin C can all be consumed in supplement form, but what other supplements can be taken?

• Sage, Garlic and Ginger. All 3 of these herbs are anti-bacterial. This plays an important role in preventing Halitosis, inflammation or Periodontitis. One 2015 study found that the application of Sage to the mouth significantly reduced bacterial colony count which is thought to have important implications in oral health [8].
• Vitamin A and Zinc, are essential nutrients for the health of mucus membranes such as those found on the gums. Taking these supplements is thought to aid gum health.
• Coenzyme Q10, is typically used in the body for energy, however it is also thought to help soft tissue health, such as that in the gums. Some evidence has been found that it prevents gaping occurring between the tooth and gum[8].
• Omega 3 fatty acids. It has been found that people who lack adequate omega 3 levels increase their risk of Periodontal disease by 1.5x. [8]

Other tips

• Visit the dentist, a minimum of twice a year.
• Brush twice daily, floss and use mouthwash regularly.
• Don’t brush straight after acidic foods as this will destroy the enamel.
• Quit or reduce your smoking.
• Chew gum containing Xylitol, it has been proven to combat unhealthy oral bacteria.