2. Learning Objectives
• Upon completion of this presentation, participants will be able to:
➢ Define oral and dental health
➢ Identify importance of oral health
➢ Understand the effect poor oral health can have on overall health
➢ Recall the typical pattern and timing of tooth eruption
➢ Recognize and properly label oral anatomic sites.
➢ Enumerate the layers of a tooth and their basic functions
➢ List the role of nurse in promoting oral health
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3. Introduction
• Good oral health is an integral and core component of overall health
and wellbeing. Oral health enables individuals to perform
essential functions such as eating, breathing and speaking,
and encompasses psychosocial dimensions such as self-
confidence, well-being and the ability to socialize and work
without pain, discomfort and embarrassment.
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4. Definition of oral health
Oral health refers to the condition of a person’s teeth and
gums, as well as the health of the muscles and bones in
their mouth.
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5. The World Dental Federation (FDI) updated the definition of oral health
to emphasise the relationship to general health :
“Oral health is multi-faceted and includes:
✓ ability to speak, smile, smell, taste, touch,
✓ chew, swallow and convey a range of
✓ emotions through facial expressions with
✓ confidence and without pain,
✓ discomfort and disease”
Good oral health is more than just
an absence of disease
6. Dental disease
• Dental disease is one of the great preventable public health
challenges of the 21st century. Labeled a “silent epidemic”
• It is universally prevalent, but a number of subpopulations
are particularly vulnerable, including seniors, children and
adolescents, low-income people, minority groups, and people
with special health care needs
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11. Oral health across life span :
How Dental Health Affects Overall Health at Every
Age
Across the lifespan, there is a strong connection
between dental health and overall health. But the
nature of that connection — the specific challenges
and risks
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12. Periodontal treatment during pregnancy is linked to lower risk of
infant mortality, preterm birth, and low birth weight.
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Oral health across life span :
13. •Early childhood caries (cavities) and its associated pain are
linked to negative impacts on play, school, sleeping, eating, and
overall well-being.
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Oral health across life span :
14. • Older adults with fewer than 20 teeth are more likely to
experience greater overall disability and cognitive decline.
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Oral health across life span :
15. Oral systemic connection
• Oral systemic connection refers to the relationship between
oral health and overall health.
- For example, bacteria that cause abscessed teeth can spread
to the bloodstream, leading to sepsis and organ failure.
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16.
17. Diabetes
There is now a significant amount of evidence indicating a two-way
relationship between periodontal (gum) disease and diabetes
Aspiration Pneumonia
Dental plaque contains many different species of bacteria, some of
which can cause pneumonia.
Aspiration (inhalation) of oropharyngeal secretions (including dental
plaque) has been found to be associated with pneumonia.
Oral systemic Health
18. There is high quality evidence to support an association between
cardiovascular disease and oral health
There is evidence that in people with periodontal (gum) disease
there is an increase in both the prevalence and incidence of
cardiovascular disease.
Cardiovascular disease
19. What are the signs and symptoms of oral cancer?
The following list is not exhaustive but some more common
signs and symptoms include:
• A non-healing ulcer that is present in the mouth for more
than
two weeks.
• A white or red patch on the tongue, palate or on the mouth
lining
• Swellings in the mouth with no obvious cause
• Unexplained changes in speech and swallowing
Oral Cancer
21. There are certain groups of patients that will be more at risk of developing mouth
related problems due to either one or a combination of medical, cognitive or
physical disabilities.
Groups of patients who have an increased risk of poorer oral health:
▪ Dementia
▪ Frail older people
▪ Learning disabilities
▪ Palliative care
▪ Poor mobility
▪ Stroke
▪ Mental health
▪ Physical disability
High risk for people for dental health
problems
22. Returning the Mouth to the Body
As Oral health is intimately related to general health:
there are common risk factors and a bidirectional
relationship
Integration of oral health into primary health care is
critical for increasing accessibility to health care
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24. Integration of oral health into primary
health care
Many in the health-care industry hear about integrating
medical and behavioral health, but rarely do they discuss the
importance of including dental in that paradigm.
They forget that the mouth is part of the body, and to be truly
healthy, one needs a healthy mouth. After all, oral diseases
affect close to four billion people worldwide.
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25. The role of nurse in oral and dental health
• It is imperative that nurses, advanced practice
nurses, and other health care providers understand
their role in the promotion of oral systemic health,
its impact on the health, and the importance of
integrating the oral health examination into care
across the life span.
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26. Despite the availability of effective treatment and prevention
methods, only slight gains have been made, and oral health
status has declined for some populations.
It is imperative that nurses, and other health care providers
understand their role in the promotion of oral systemic health,
its impact on the health, and the importance of integrating the
oral health examination into care across the life span
The role of nurse in oral and dental health
27. The farmwork for integrating oral care
into nursing care
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28. “It is time to include oral health in routine medical care
and achieve the promise of comprehensive, whole
person care for all.”
29. Anatomy of the mouth and teeth
- Knowledge of the structures of the mouth, their locations, and
nomenclature is important in helping client to maintain good oral
health.
- The ability to recognize normal from abnormal and to
communicate that information to families and other health
professionals will aid in education and provision of care.
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30. Lips
- The lips form the entryway of the mouth.
- The following structures underlie the epithelium of the skin of
the lips:
➢ Vasculature
➢ Sweat glands
➢ Hair follicles
➢ Muscles that function to move the lips
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31. Lips, continued
• The mucous membrane of the lips is non-keratinized with many capillary
• vessels close to the surface, giving it the pinkish/red color.
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Examination of the lips is valuable
in recognizing signs of illness,
such as cyanosis, herpetic lesions,
or trauma.
32. Cheeks
• The cheeks form the sides of the mouth.
• Like the lips, the cheeks are muscles covered with skin on the
outside and mucous membranes on the inside.
• Examination of the oral mucosa is especially important in
adolescents who chew tobacco to screen for oral cancer.
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33. Gums
• The gingiva (gums) is the mucosal membrane that covers the periodontal
ligaments, the alveolar sockets, bones of the jaw, and borders the teeth at
their neck.
• The periodontal ligament is made up of bundles of connective tissue
fibers that anchor the teeth within the jaws.
• As the teeth erupt, ridges of bone called alveolar processes develop
around the teeth to provide support.
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35. Palate
•The palate is the area in the roof of the mouth that starts behind
the upper teeth and extends to the uvula.
- A normal hard palate consists of the fusion of bones in the
upper jaw and the palatine bones.
•The soft palate is mostly muscle and has an important role in
swallowing and speech.
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36. Tongue
•The tongue is composed entirely of muscle
and connective tissue and has ventral and
dorsal surfaces.
•The ventral surface (underside) is smooth.
•The dorsal surface (top) is most visible on
examination.
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The dorsal surface includes the fungiform, foliate, and circumvallate
papillae, which are associated with the sense of taste.
37. Floor of the Mouth
•Beneath the tongue is the floor of
the mouth.
The frenulum connects the floor of
the mouth to the tongue.
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A thick frenulum that limits the movement is called ankyloglossia.
In cases where breastfeeding is inhibited, a frenectomy may be
done to release the tongue.
Used with permission from Rocio B. Quinonez, DMD, MS, MPH; Associate Professor Department
of Pediatric Dentistry, School of Dentistry University of North Carolina
38. Salivary Glands
•Near the frenulum are the tiny openings of the submandibular salivary
glands. These openings are called Wharton’s ducts.
•There are 2 large salivary glands, known as the Parotid glands. These glands
empty through tiny holes called Stenson’s ducts.
•Failure of the Parotid glands to produce saliva leads to xerostomia, an
abnormal dryness of the mouth.
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39. Teeth
•There are 4 kinds
of teeth:
1. Incisors
2. Canines
3. Premolars
4. Molars
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Used with permission from the American Dental Association
40. Brief Anatomy of the oral cavity
• There are eight different types of teeth and 32 in the permanent
dentition:
• 4 central incisors
• 4 lateral incisors
• 4 canines
• 4 first premolars (first bicuspid)
• 4 second premolars (second bicuspid)
• 4 first molars
• 4 second molars
• 4 third molars 40
42. Teeth, continued
•The 4 front teeth are the central and lateral incisors. Next to the
incisors are the cuspids.
•Next to the cuspids are the 8 premolars, or bicuspids.
•The final 12 teeth are the molars.
•- The molars have pits and fissures that can harbor cariogenic
bacteria and are a common site of dental caries.
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45. Anatomy of a Tooth
•The tooth consists of a crown
and a root.
•The crown is visible above the gums.
https://www.youtube.com/watch?v=LzLfgq6M7kk
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46. Anatomy of a Tooth, continued
The hard, outer surface of the crown is the enamel.
•The enamel is mostly composed of hydroxyapatite.
Binding of fluoride to the hydroxyapatite leads to the
formation of fluoroapatite, which makes the enamel harder
and more resistant to decay.
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47. Anatomy of a Tooth, continued
•The enamel protects the dentin, a hard, thick
substance containing thousands of tubules that
surround the nerve.
•These tubules contain tiny projections of the nerve
and are sensitive to exposure to air, acid, and touch.
•The pulp is the soft core of the
tooth that contains blood vessels, connective tissue,
and the
nerve itself.
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Used with permission from the American Dental Association
