Influence of tobacco_use_on_caries_development_ppt
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Influence of tobacco_use_on_caries_development_ppt

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Influence of tobacco_use_on_caries_development_ppt Influence of tobacco_use_on_caries_development_ppt Presentation Transcript

  • PARTHA PRATIM DAS INTERN BURDWAN DENTAL COLLEGE AND HOSPITAL
  • TOBACCO CULTIVATION
  • INFLUENCE OF TOBACCO USE ON DENTAL CARIES DEVELOPMENT UNDER THE GUIDANCE OF DR. SANJIB MITRA ASSOCIATE PROFESSOR DEPARTMENT OF ORAL AND MAXILLOFACIAL PATHOLOGY BURDWAN DENTAL COLLEGE AND HOSPITAL
  • HISTORY OF TOBACCO •Tobacco cultivation has a history of about 8000 years. • Portuguese traders introduced tobacco in India during 1600. • The entry of European colonial powers into India spurred the import of tobacco into India. (History of Tobacco by Dr. Sanjib Mitra)
  • TOBACCO PLAYS AN IMPORTANT ROLE IN INDIAN ECONOMY  Tobacco plays a significant role in the Indian economy as it contributes substantially in terms of excise revenue, export revenue and employment.  India is the world’s second largest producer of tobacco and also the second largest consumer of unmanufactured tobacco. It is a major exporter of unmanufactured tobacco. (History of Tobacco by Dr. Sanjib Mitra)
  • TYPES OF TOBACCO USED IN INDIA Smoking Chewing Cigarettes Bidi Gudhaku Chutta Chewing tobacco 30% Zarda Dhumti Bidi 54% Khaini Hookah Cigarette 16% Gutkha Paan (with tobacco) Chillum Gul Cigars (History of Tobacco by Dr. Sanjib Mitra) Mawa ,Mishri
  • DENTAL CARIES Defined as an irreversible microbial disease of the calcified tissues of the teeth characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth which often leads to cavitations. CURRENT TRENDS IN CARIES PREVALENCE Though various studies reveal decrease of caries incidence in the developed countries but the prevalence of caries has been reported to be increasing in certain less developed countries. (Shafer’s Textbook of Oral Pathology)
  • STAGES OF TOOTH DECAY (Shafer’s Textbook of Oral Pathology)
  • Quantitative and qualitative measure that accurately reflects the extent of dental caries in a population…. D- DECAYED D- DECAYED M- MISSING F- FILLED Can be DMF(T) or DMF(S) and DEF(T) or DEF(S) E- INDICATED FOR EXTRACTION F- FILLED (considered in case of pediatric patients
  • ETIOLOGY OF DENTAL CARIES Miller’s Chemicoparasitic Theory or Acidogenic Theory Caries is caused by acids produced by micro organisms in the mouth THE ROLE OF CARBOHYDRATES THE ROLE OF MICROORGANISMS  THE ROLE OF ACIDS  THE ROLE OF DENTAL PLAQUE The Proteolysis Chelation Theory(Schatz et al,1955) The Sucrose Chelation Theory(Egglers-Lura, 1967) (Shafer’s Textbook of Oral Pathology)
  • CURRENT CONCEPTS IN CARIES ETIOLOGY (Shafer’s Textbook of Oral Pathology)
  • L O C A L I Z A T I O N Type of Caries Microorganisms Human Disease Pit & Fissure S. mutans S. sanguis Lactobacillus sp. Actinomyces sp. Very significant Uncertain Very significant By chance Smooth surface S. mutans S. salivarius Very significant By chance Root surface A. B. S. S. viscosus naeslundii mutans sanguis Very significant Very significant Significant By chance Deep dentinal caries Lactobacilli sp. A. naeslundii Other filamentous rods Very significant Very significant Very significant O F M I C R O- F L O R A R E L A T E D TO CARIE S (Shafer’s Textbook of Oral Pathology)
  • INFLUENCE OF TOBACCO USE Smoking and its relation to dental caries is a subject of many opinions. From early reports and a common belief was that smoking actually helps to reduce dental caries. Schmidt, in 1951, supported this belief when he reported that increase in tobacco smoking was against caries.. The concentration of thiocyanate, a constituent of tobacco smoke and normal saliva with possible cariesinhibiting effect, was found to be higher in smoker’s saliva. (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • Thiocyanate molecule
  • TOBACCO AGGRAVATING DENTAL CARIES  The decreased buffering effect and possible lower pH of smoker’s Saliva.  The higher number of Lactobacilli and Streptococcus mutans .  In 1952, Ludwick and Massler reported that those who smoked more than 15 cigarettes a day had significantly higher number of decayed, missing, and filled teeth. • In 1990, Zitterbart confirmed association between smoking and the prevalence of dental caries in adult males. Smokers had significantly higher DMFT (Decayed, Missing, and Filled Teeth) score, untreated decayed surfaces, and missing surfaces. (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • Association between smoking and dental caries is well documented in older age groups. Among middle-age (15) or young adults (25) results are inconsistent. Non-smokers reported more frequent healthy oral health behavior than did daily smokers (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • ENVIRONMENTAL TOBACCO SMOKE OR PASSIVE SMOKE AND PEDIATRIC DENTAL CARIES  UK National Diet and Nutrition Survey (1995) suggested maternal smoking as a significant risk factor for predicting caries in preschool children  Work of Aligne and colleagues (2003) has provided strongest evidence yet of an increased risk of dental caries in the deciduous dentition of children who are 4 to 11 years of age and have been exposed to passive smoking or environmental tobacco smoke (ETS)  A recent study done in 2004 also confirmed that children residing in regularly smoking homes had significantly higher prevalence of caries compared to Non regular/nonsmoking homes . Association of Pediatric Dental Caries With Passive Smoking FREE C. Andrew Aligne, MD, MPH; Mark E. Moss, DDS, PhD; Peggy Auinger, MS; Michael Weitzman, MD
  • Nicotine has been shown to promote the growth of cariogenic Streptococcus mutans bacteria in vitro thus, mother who smoke may be more likely than nonsmokers to transmit these germs to children .  ETS smoke has immunosuppressive properties and is a known risk factor for infections of the cranial organs (e.g. otitis media); thus it is not surprising that it might be risk factor for caries development as well..  In addition ETS is associated with decreased serum vitamin C levels in children and decreased levels of vitamin C are associated with growth of cariogenic bacteria. Association of Pediatric Dental Caries With Passive Smoking FREE C. Andrew Aligne, MD, MPH; Mark E. Moss, DDS, PhD; Peggy Auinger, MS; Michael Weitzman, MD
  • cotinine COTININE A METABOLITE OF NICOTINE FOUND IN SERUM OF PAEDIATRIC PATIENTS EXPOSED TO PASSIVE SMOKE Children from 4-11 years with serum cotinine levels more than 0.2ng/ml were detected with an increased prevalence of dental caries
  • SMOKELESS TOBACCO AND DENTAL CARIES Controlling for cigarette smoking, a dose-response relationship was also shown between caries and the number of years of snuff use..  The types of sweeteners and sugars commonly found in ST are fructose, glucose, sucrose, maltose, and isomaltose.  Individuals who chew tobacco appear to have more dental caries than non-users. (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • A wad of tobacco is kept in the oral cavity for 30 minutes on average,there isin vitro evidence of stimulated growth of Streptococcus mutans and Streptococcus sanguis in the presence of smokeless tobacco extracts.  It has been also found that extracts from chewing tobacco with high sugar content increased in vitro growth of Lactobacillus casei , a bacterium implicated in root surface caries. (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • Summary of major biological effects of tobacco related to dental caries Forms of tobacco use Biological effects Tobacco smoking •Concentration of thiocynate found to be higher in smoker’s saliva may have possible caries inhibiting effect . • Decreased buffering effect and possible lower pH of saliva in smokers may indicate increased susceptibility to caries. • Higher number of lactobacilli and Streptococcus mutans in smokers may indicate caries susceptibility Environmental tobacco smoke (ETS) • Biological plausibility of causal role of ETS in caries formation in children . • Immunosuppressive properties of ETS might be a risk factor for dental caries development . • ETS may decrease serum vitamin C level, which may be associated with growth of cariogenic bacteria in children . • ETS may reduce the protective properties of saliva that can operate against caries Smokeless tobacco • High levels of fermentable sugar and sweeteners in ST can stimulate growth of cariogenic bacteria (55, 56, 59). • Extracts from chewing tobacco with high sugar content increased in vitro growth of Lactobacillus casei (59, 61). • Extracts of ST may serve as a growth substrate for Streptococcus mutans, Streptococcus salivarius and Streptococcus sanguis (64). (Influence of tobacco use in dental caries development Sajith Vellappally1, Zdeněk Fiala1, Jindra Šmejkalová1, Vimal Jacob1, Pilathadka Shriharsha2)
  • THE BASIC UNDERLYING MECHANISM BEHIND
  • ANTIGEN I/ II BINDING OF CARIOGENIC STREPTOCOCCI
  • INSPITE OF SIGNIFICANTLY HIGHER LEVELS OF IG A & J CHAINS SMOKELESS TOBACCO HAS IMPAIRED IMMUNE RESPONSES
  • Nicotine is a major component of tobacco smoke, and signals via nicotinic acetylcholine receptors (nAChR) nicotine suppresses the cytodifferentiation and mineralization of HDPCs- human dental pulp cells , possibly via nAChR. Thus inducing caries which is a demineralising process of the calcified tissues of the teeth
  • OUR ROLE TO CURB THE MENACE OF TOBACCO USE Education Legislation Regulation Enforcement Taxation Economic Alternatives Support for cessation Community Mobilization Reduction in demand and supply Tobacco cessation
  • The 5 A’s 2 A’s and an R ASK ASK ADVISE ADVISE ASSESS ASSIST ARRANGE REFER
  • AS THEY SAY “ WHEN THERE IS A WILL, THERE IS A WAY”
  • The smiling teeth reflects a healthy heart & mind
  • THANK YOU RESPECTED JUDGES FRIENDS DR. SANJIB MITRA Associate Professor Department of Oral and Maxillofacial Pathology Burdwan Dental College and Hospital PROFESSOR DR. TAMAL PATRA Principal Burdwan Dental College and Hospital INDIAN DENTAL ASSOCIATION WEST BENGAL STATE BRANCH