Dental diseases

DENTAL DISEASES
Presented by Guided by
K.suspandana, Kanchan Dwivedi
M.Pharm II sem M.Pharm
Pharmaceutics Assistant Professor,
Department of Pharmaceutics,
Gokaraju Rangaraju College of pharmacy

CONTENTS
2
Introduction
Dental diseases
Periodontal diseases
Tooth decay
Mouth odor
Sensitive tooth
Oral cancer
Noma
Congenital anomalies
Oral trauma
Enamel dental erosion
Xerostomia
Oral diseases and risk factors
Dentifrices
Oral care products
Conclusion
References

INTRODUCTION
 Teeth serves the primary role of biting, tearing or grinding
of solid food, apart from the other roles like providing
cosmetic value and being defense weapon.
 The shapes and surfaces of the teeth are designed so as to
serve the above mentioned purposes.
 As the teeth serve many purposes, it is essential that proper
care is taken for their healthy maintenance and longevity,
failing which various periodontal diseases and dental
decay are the outcomes.
3

DENTAL DISEASES
 Dental diseases have a detrimental effect on quality of
life both in childhood and older age.
 The second WHO International Collaborative Study of
Oral Health Systems (ICSII) revealed that in all countries
covered by the survey, substantial numbers of children
and adults reported impaired social functioning due to
oral disease, such as avoiding laughing or smiling due to
poor perceived appearance of teeth.
6

PERIODONTAL DISEASES
 Periodontal (gum) disease begins as gingivitis (chronic
inflammation of the gums), which is very widespread and
for the majority of patients completely reversible.
 It may progress to periodontitis, a more serious condition
that destroys tooth-supporting tissues and bone.
 In about 15 percent of the population the disease can
progress further to severe periodontitis that leads rapidly to
tooth loss.
7

AETILOGY OF PERIODONTAL DISEASE
888

CAUSES OF PERIODONTAL DISEASE
Tobacco smoking and chewing reduce tissue resistance and
increase the susceptibility to periodontal diseases.
An improper brushing technique, besides resulting in
inadequate plaque removal, can also cause gingival recession.
Drugs—certain drugs such as phenytion sodium and
nifedipine can cause gingival hyperplasia.
Stress is known to predispose to ulcerative gingivitis.
Malnutrition
Endocrine disturbances
Blood disorders
9

PREVENTION
Promoting healthy nutrition and oral hygiene practices
through school health programmes.
Providing nutritionally sound school lunches, which factor
in the protective factors in milk and cheese.
Banning soft drink and snack vending machines, and the
sale of sweets and unhealthy foods inside or just outside
school premises.
 Discourage linkages between sports and soft drinks.
Promoting pre-natal good nutrition and breastfeeding for at
least six months.
Encouraging caregivers to support healthy dietary habits in
children and the elderly.
10

TOOTH DECAY
 Tooth decay (dental caries) is the most widespread chronic
disease worldwide and constitutes a major global public
health challenge.
 Tooth decay, usually referred to as “cavities,” starts in the
enamel, the outer protective layer of the tooth.
 In some people, especially older adults, the gums pull
away from the tooth and expose the tooth root. Decay can
occur here as well.
 The good news is that because of recent scientific
advancements, tooth decay sometimes can be stopped.
11

CONTINUED….
 Foods that break down into simple sugars in the mouth are
called fermentable carbohydrates.
 These include the obvious sugary foods, such as cookies,
cakes, soft drinks and candy. But they also include
pretzels, crackers, bananas, potato chips and breakfast
cereals.
 Bacteria in your mouth turn the sugars in these foods into
acids.
 These acids begin to dissolve the mineral crystals in teeth.
 The more times you eat each day, the more times your
teeth are exposed to an acid attack.
12

PREVENTION
1. Increase the resistance of the teeth
 Fluoridation of water, milk and salt;
 Fluoride supplementation in the form of tablets and lozenges; and
 Consuming a fluoride-rich diet such as tea, fish, etc.
 Use of fluoridated toothpaste and mouth wash;
2. Combat the microbial plaque
 The correct method and frequency of brushing should be
followed.
 Tongue cleaning and the use of indigenous agents such as the bark
of neem or mango should be encouraged.
 The use of coarse toothpowder and tobacco-containing dentifrices
should be avoided.
13

3.Modify the diet
 Reduce the intake and frequency of refined
carbohydrates.
 Avoid sticky foods and replace refined with unrefined
natural food.
 Increase the intake of fibrous food to stimulate salivary
flow, which is protective against caries.
 Consume caries-protective foods such as cheese, nuts,
raw vegetables, fruits, etc.
 Stimulate salivary flow with sugar free chewing gum.
Xylitol (a sugar substitute)-containing chewing gum, if
chewed between meals, produces an anticaries effect by
stimulating salivary flow.
14

MOUTH ODOR
 Mouth odor is also known as Halitosis or fetor oris. Bad
breath is a common problem that can cause significant
psychological distress.
 There are a number of potential causes and treatments
available.
 Anyone can suffer from bad breath.
 It is estimated that 1 in 4 people have bad breath on a regular
basis.
 Halitosis is the third most common reason that people seek
dental care, after tooth decay and gum disease.
 90% of bad breath comes from proteins broken down in your
mouth.
 When bad breath is caused by oral problems, it usually smells
like rotten eggs. 15

 This is caused by the breakdown of cysteine at the front of the tongue or
on the gums. It’s a sign of poor oral hygiene.
 More rarely, dental bad breath can be a fecal odor like odor from the gums
or the top of the tongue. This is caused by imbalances within the mouth or
from protein breakdown on the gum tissue or tongue.
 There are 12 types of ‘bad breath’ caused by disease in your body
 Tonsil breath
 Sinus breath
 Lung breath
 Gut breath
 Metabolic breath
 Diabetes breath
 Drug breath
 Liver breath
 Trimethylaminuria breath
 Menstrual breath
 Drug-induced bad breath
 Halitophobia
16

SENSITIVE TOOTH
 Tooth sensitivity can have a number of causes. Some of the more
common culprits are caries (tooth decay), cracked or fractured teeth,
trauma, tooth grinding or clenching, worn fillings or tooth enamel, and
gingivae (gums) that have pulled away from the tooth roots as a result
of gum disease or vigorous brushing.
 In healthy teeth, enamel protects the crowns, the part of the tooth that
you see above the gum line. The roots of healthy teeth are coated with
a thin protective layer called “cementum.”
 Under the enamel and the cementum is a more porous layer of tooth
called “dentin.” The dentin layer contains microscopic tubules or
canals that connect with the pulp of the tooth.
 The pulp is in the center of the tooth and contains the tooth’s nerve
and blood supply. When irritants such as foods or liquids come into
contact with the exposed dentinal tubules, or when excessive pressure
is applied against a cracked tooth, a pain response can be triggered.
17

PREVENTION OF TOOTH SENSITIVITY
 Good oral hygiene is your best defense against most oral health
problems, including tooth sensitivity.
 Poor daily dental hygiene allows bacteria to collect around and
between the teeth.
 If these bacteria (plaque) are not removed, they can harden into
calculus (tartar), which can build up and cause your gums to recede
around the teeth. This is called “gingival” or “gum” disease or
“recession.”
 Gum recession exposes the roots of your teeth, which, in turn,
leaves your teeth more susceptible to sensitivity.
 Clean between your teeth with floss or another interdental cleaner
daily.
 This helps remove plaque and food particles from between your
teeth and under the gumline.
 Visit your dentist regularly for professional cleanings and oral
examinations.
18

ORAL CANCER
 In India, the incidence of oral cancer is the highest in the world
and is preceded by some premalignant lesion.
 The most important of all premalignant lesions is oral submucous
fibrosis.
 Its prevalence has increased manifold in the past three decades
due to increased consumption of paan masala and gutka by
persons of all age groups, including children.
 The condition has a high malignant potential, 7.5% of the lesions
become malignant over a 10-year period and more than one
lesion may develop at different sites in the oral cavity.
 Overall, the incidence per 100,000 population is 29 for males and
14.3 for females, the average for the population being 21.65.
19

 When these data are compared with data from other parts of
the world (US 4.4, Japan 1.6, UK 2), it is evident that the
prevalence in India is much higher.
20

WHAT CAN BE DONE?
 Early detection and timely referral
 Availability of effective and appropriate specialist
care
 Integrative policies to address risk factors,
determinants and inequalities
 Disease surveillance
21

HIV/AIDS AND ORAL HEALTH
 Globally, 35 million people were estimated to live with HIV-
infection in 2013, many of whom were surviving thanks to
life-saving Highly Active Antiretroviral Therapy (HAART).
 More than half of HIV-positive people develop oral symptoms
early in the course of the disease, including fungal, bacterial
and viral infections; severe periodontitis; dry mouth; sarcoma;
and lymphoma.
 These can all cause pain and discomfort, leading to difficulty
in chewing, swallowing and tasting food, which has significant
negative impacts on quality of life.
 Dentists and other oral healthcare professionals have an
obligation to provide ethical, equitable care to all patients,
irrespective of their HIV status.
22

NOMA
 Noma is a neglected disease mainly affecting children under six
years old in Sub-Saharan Africa.
 It is characterized by rapidly progressing, severe destruction of
the soft and hard tissues of the mouth and face. Though rare, it
devastates the lives of those affected.
 If left untreated, 70 to 90 percent of affected children die.
Survivors suffer lifelong disfigurement and are often left unable
to speak or eat due to massive tissue destruction.
 Preventive efforts addressing extreme poverty, malnutrition, and
childhood diseases must be political priorities for the eradication
of noma.
23

CONGENITALANOMALIES
 Congenital anomalies of the face and mouth are frequent, with
cleft lip and/or palate (orofacial clefts – OFC) accounting for
two-thirds of the total.
 Clefts occur either alone (70 percent) or as part of a syndrome,
affecting more than 12 in 10,000 newborns worldwide.
 For example, in India alone it is estimated that approximately
100 babies with clefts are born every day and the majority of
these infants do not survive; in the USA a baby with a cleft is
born every 75 minutes.
 Specialist nursing, plastic surgery, pediatric dentistry, speech
therapy, orthodontics, genetics and psychological services are all
important for complete rehabilitation of patients with such
anomalies.
24

ORAL TRAUMA
 Oral injuries account for 5 percent of all injuries, and craniofacial
trauma is responsible for about half of the estimated total 8.5
million trauma deaths worldwide.
 They include fractures of the jaws and other facial bones, as well
as fractures, dislocations and loss of teeth. Risk factors include
traffic and bicycle accidents, falls, physical violence, contact sports
and tongue and lip piercings.
 Oral injuries have significant physical, psychosocial and economic
impacts and are a major public health problem, particularly
affecting children and young adults.
 Craniofacial injuries are often complex and occur together with
other bodily injury, requiring costly and time-consuming treatment.
 Improving road safety, and introducing helmets, facemasks and
mouth guards are important measures in reducing the frequency
and severity of oral trauma.
25

ENAMEL (DENTAL) EROSION
Dental erosion is damage to the hard covering of teeth called
enamel.
Enamel Erosion Causes
Erosion occurs when acids in certain foods and drinks
damage enamel. The most common sources of acids in the
diet are fruit, soft drinks, and fruit juices.
Enamel Erosion Prevention
Avoiding sugary drinks helps protect tooth enamel. Fruit
and reasonable amounts of 100% fruit juice are parts of a
healthy diet. As long as one brushes and flosses regularly
and has adequate saliva flow – which buffers and
neutralizes acids – fruit and fruit juice can be safely
consumed without harming teeth.
26

XEROSTOMIA
 Dry mouth is that uncomfortable feeling you get when you're
not generating enough saliva to meet your needs. When your
mouth fails to produce enough saliva, you will find yourself
with more problems than just being thirsty.
 By salivating, your mouth helps you taste and digest what
you eat and drink. Food particles get flushed from
your teeth and acid is washed away as well, which helps
prevent tooth decay (cavities).
Want to Fight Dry Mouth? Drink More Water
 It may seem obvious, but trying to sip more water frequently
throughout the day will fight off xerostomia.
27

RISK FACTORS
28
Sugar
Tobacco
Alcohol

DENTIFRICES
29
• Dentifrices are preparations meant to clean the teeth and
other parts of the oral cavity.
• They are available as tooth powders, tooth pastes, gels,
dental creams and even as dental foams.
• They are meant to enhance the personal appearance of the
teeth by maintaining the cleaner teeth, reduction of bad odor
and reduction of tooth decay and
also make the gum healthy.

GENERAL INGREDIENTS:
30
For a good performance, dentifrices are generally made up of the
ingredients listed below.
These ingredients are common for tooth powders and tooth pastes
•Abrasives
•Surface active agents
•Sweetening agents
•Flavoring agents
Tooth pastes also contain additional agents like
•Binding agents
•Water
•Humectants
•Preservatives
•Therapeutic agents

ORAL CARE PRODUCTS
31
1. TOOTH POWDER

CONCLUSION
34
A healthy and well-functioning dentition is important during all
stages of life since it supports essential human functions, such as
speaking, smiling, socializing and eating.
Teeth help to give the face its individual shape and form.
Tooth decay and periodontal disease are the most common oral
diseases, yet they are largely preventable.
Proper self- and professional oral care, combined with a healthy
lifestyle and avoiding risks, such as high sugar consumption and
smoking, make it possible to retain a functioning dentition through
life.

REFERENCES
35
The challenge of oral disease a call for global action. The Oral
Health Atlas.2015; 2nd edition; 9-105.
Nassem shah. Oral and dental diseases: Causes, prevention and
treatment strategies. NCMH Background Papers· Burden of Disease
in India.275-298.
Nelio Veiga et al. Dental Caries: A Review. Journal of Dental and
Oral Health. August 2016; Volume 2 (5); 1-3.
Sensitive tooth treatment and causes. The Journal of American
Dental Association. December 2003; Volume 134; 1084-1691.
Tackling tooth decay. The Journal of American Dental
Association. March 2013; Volume 144(3) ; 336-400.
Dental diseases and oral health. World Health Organization. 2003.

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