Oral and Dental Health

The mouth is a cavity composed of multiple organs, which serves as the first step of food to the digestive system, as well as an optional air intake to the respiratory system and the structure responsible for the correct pronunciation of words. It has many structures contributing to the performance of a correct masticatory action^{1, 2}.

Teeth are hard organs with a very similar composition to the bones, with multiple layers of tissues such as the enamel that covers its outer surface and the cement that covers the roots, followed by the dentin that protects the pulp, which is inside the tooth and contains its nerves and blood vessels. The most frequent tooth-related diseases and conditions are the following ^1-3:

Tooth decay

• Fractures
• Pulpitis
• Pulp necrosis
• Dental abscesses
• Deficiencies in development, such as amelogenesis imperfecta.

The gums are a soft tissue that covers and protects the bone where the tooth is anchored, called alveolar bone. Together this forms a structure called periodontum, which is responsible for the stability of the teeth in the mouth. When the structures of the periodontium become sick, the most common consequence is bleeding of the gums, which if not controlled in time can progress to the bone. This will cause the loosening of the teeth and their eventual loss. Among the most frequent diseases of the periodontium are^1-4:

• Gingivitis
• Periodontitis
• Occlusal trauma
• Gingival / periodontal abscesses
• Periodontal necrosis

The tongue is composed of multiple muscles that work together to perform different actions such as contribute to the swallowing of food and articulation of words. On its surface, it is covered with taste buds, which are responsible for perceiving the taste of food. Most diseases affecting this organ are related to nutrient deficiencies and systemic conditions. Some of the tongue diseases include^1-5:

• Glossitis
• Benign migratory glossitis (geographic tongue)
• Tongue coating
• Burning mouth syndrome
• Oral candidiasis

Preventing oral diseases

The best way to maintain good oral health is to always commit to good oral hygiene habits this will eliminate any bacteria or plaque that may be the cause of damage.

Most mouth diseases have relation to dental plaque, a layer composed of proteins, cells and bacteria that adheres to the surface of the teeth. Dental plaque bacteria produce acids that damage teeth and cause tooth decay. On the other hand, and the gums suffer an irritation when in contact with dental plaque, causing inflammation known as gingivitis and later, periodontitis⁴.

Therefore, prevention of oral diseases is based on removing dental plaque, which is done mainly by brushing your teeth and avoiding its accumulation for as long as possible. Not all places are reachable by the toothbrush, though, so it is advisable to complement the brushing with the use of mouthwashes, which also prevent the accumulation of more plaque for a longer time. Flossing is quite useful for removing the plaque between the teeth, where tooth decay can grow unnoticed⁴.

The antimicrobial properties and the ability to remove plaque of natural rinses made with extracts of green tea leaves and sage have been well documented, offeringeffectness similar to that of specialized rinses, but with the advantage of being a natural alternative that does not produces bacterial resistance nor allergic reactions, being a good choice to deal with periodontal diseases and to reduce the risk of tooth decay^6-9.

Some common habits can significantly damage mouth tissues. The most frequent one is smoking due to the harmful effects of cigar smoke. However, other habits that may seem harmless can have long-term consequences on teeth and periodontal tissue, such as thumb and lip sucking, biting nails or other objects such as toothpicks, and using your teeth to open bottles and such. These habits can alter the position of the teeth and even the shape of the bone¹⁰.

Food can also have an effect on oral health. Tooth decay is caused by the acids that are produced the bacteria of the mouth from the metabolism of sugar and other carbohydrates we consume in our meals. The consumption of acidic foods and beverages further enhances this, since their effects are added to the acids of the bacteria to enhance the degradation of the enamel ¹¹.

Diet nutrients and oral health

Consuming the right amounts of each of the nutrients and elements that constitute a balanced diet is necessary for a good general health, which of course includes mouth health. Deficiencies in different nutrients can make a someone more likely to suffer from oral diseases.

Calcium: Calcium is the most abundant element in hard tissues and therefore is necessary for the teeth and bones to be resistant. Its deficiency during the development of the teeth can produce alterations on its quality, while in adulthood can predispose to the establishment of periodontal disease and tooth decay. Its main source are dairy products and the requirements for adults up to 50 years old is 1000mg per day, which then increases to 1200 mg for people over 50 years old^12-14.

Trace elements: The presence of copper, zinc, manganese, iron and other elements is important to give resistance to the tooth, especially in the most superficial layers. Copper is necessary for proper gum formation and an adequate immune response, while zinc contributes to the perception of flavours and fights bacteria and dental plaque. These elements are not required in abundance, being sufficient the amounts consumed in meals with liver, seafood, brewer's yeast, wheat germ and other foods^{15 - 17}.

Vitamins: Vitamin A is involved in the formation of the enamel and the correct function of the salivary glands, while vitamin C participates in the formation of dentin, cement and bone; these two vitamins contribute to maintenance of the gums. Vitamin D contributes to the immune response and is necessary to take advantage of the consumed calcium, vitamin E is an important antioxidant that decreases tissue deterioration, and complex B vitamins are necessary for many metabolic functions. Because of all this, vitamin deficiencies can produce a wide variety of diseases in the mouth, such as gum hyperplasia, gingivitis, malformation of the teeth structure, ulcers, increased risk of tooth decay and infections. A diet that meets vitamin needs should include sufficient amounts of dairies, vegetables, legumes, animal products and citrus fruits, as well as adequate exposure to the sun for vitamin D production ^{12-14, 18-20}.

Coenzyme Q10: CoQ10 is a vitamin-like product primarily obtain from sardine, salmon, and mackerel but can also be found in beef, vegetables, chicken, and other similar foods. It has been proven to have antioxidant effects on the skin, which inspired its study on the tissues of the mouth, where it demonstrated the capacity to diminish the consequences of oxidative stress on the periodontal tissues, as well as its positive effect in cases of chronic periodontitis^21,22.

Lysine: It is an amino acid found naturally in foods such as beans, meat, milk and other proteins. It have favourable effects on the gums, as it helps to prevent and combat gingival inflammation, and is a good medicine for those suffering from cold sores since it decreases the duration to approximately 6 days, which without treatment last up to 21 days^23-25.

There are many different elements in the mouth that can become sick, almost always as a result of plaque accumulation, in which bacteria can growth. The best way to maintain proper oral health is through prevention with good oral hygiene through different techniques, however eradication of habits and proper nutrition is also extremely important to reduce the risk of suffering diseases, both oral and in the rest of the body.

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