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Beyond tooth decay: The Importance of good dental hygiene

We are all aware that poor dental hygiene can lead to tooth decay, gum disease and bad breath . But did you know that not brushing your teeth could also have consequences for more serious illnesses?

Here we discuss the health conditions that are the repercussions of poor dental health.

Alzheimer’s disease

Research has shown that that there is a link between gum inflammation and Alzheimer’s disease, after an intense study of approximately 20 years.

It is recommended that we should brush for 2 minutes, twice daily. However we tend to become slow as we age and gum diseases increase at the age of 70 for this very reason.

As part of the research , brain samples from 10 living patients with Alzheimer’s with 10 brain samples from people who did not have the disease, were compared.

The results showed that a bacterium – Porphyromonas gingivalis – was present in the Alzheimer’s brain samples but not in the samples from the brains of people who did not have Alzheimer’s. The interesting bit of information here is that Porphyromonas gingivalis is usually associated with chronic gum disease.

Further research suggests that there is sufficient scientific evidence to show that two of the three gum disease-causing bacteria are capable of motion (or “motile”) and have been consistently found in brain tissue.

The motile bacteria can leave the mouth and enter the brain via two main routes by using their movement capability to directly enter the brain. The motile bacteria can either crawl up the nerves that connect the brain and the roots of teeth or go by indirect entry into the brain via the blood circulation system.

If a patient has bleeding gums, the gum disease-causing bacteria will enter the blood stream every time they clean their mouth and even when they eat food.

Porphyromonas gingivalis has found a ways to get directly to the brain, where there are no immune checkpoints. From there, they spread to the brain at their will. In addition, in older individuals, the blood vessels tend to enlarge and become leaky.

“The published work confirmed P. gingivalis placed in the mouths of mice finds its way to the brain once gum disease becomes established first,” Dr. Singhrao concludes. The research has concluded that the chemicals released by the brain’s immune system in response to Porphyromonas gingivalis reaching the brain ‘inadvertently’ damage functional neurons in the area of the brain related to memory.


Gingivitis means inflammation of the gums (gingiva). It commonly occurs because of films of bacteria that accumulate on the teeth – plaque; this type is called plaque-induced gingivitis. Gingivitis is a non-destructive type of periodontal disease. If left untreated, gingivitis can progress to periodontitis, which is more serious and can eventually lead to loss of teeth.

Signs and symptoms of gingivitis

  • Bright red or purple gums
  • Gums are tender, and sometimes painful to the touch
  • Gums bleed easily when brushing teeth or flossing
  • Halitosis (bad breath)
  • Inflammation or swollen gums
  • Receding gums
  • Soft gums

Causes of gingivitis

  • The accumulation of plaque and tartar
  • Changes in hormones – which may occur during puberty, menopause, the menstrual cycle and pregnancy. The gingiva may become more sensitive, raising the risk of inflammation.
  • Diseases – such as cancer, diabetes, and HIV are linked to a higher risk of developing gingivitis.
  • Drugs – oral health may be affected by some medications, especially if saliva flow is reduced.
  • Dilantin (anticonvulsant), and some anti-angina medications may also cause abnormal growth of gum tissue.
  • Smoking – gingivitis is common is smokers compared to non-smokers.
  • Family history – experts say that people whose parent(s) has/had gingivitis, have a higher risk of developing it themselves.
Diagnosing gingivitis

A dentist or oral hygienist checks for gingivitis symptoms, such as plaque and tartar in the oral cavity.

Checking for signs of periodontitis may also be recommended; this may be done by X-ray or periodontal probing.

Treatment options for gingivitis

If the patient is diagnosed early on, and treatment is prompt and proper, gingivitis can be successfully reversed.

Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home.

Gingivitis care with a dental professional

Plaque and tartar are removed. This is known as scaling.

The dental professional explains to the patient the importance of oral hygiene, and how to effectively brush his/her teeth, as well as flossing

Periodically following-up on the patient, with further cleaning if necessary

Fixing teeth so that oral hygiene can be done effectively. Some dental problems, such as crooked teeth, badly fitted crowns or bridges, may make it harder to properly remove plaque and tartar.

What the patient can do at home

Brush your teeth at least twice a day

Bear in mind that in most cases, electric toothbrushes do a better job than we can do on our own

Floss your teeth at least once a day

Regularly rinse your mouth with an antiseptic mouthwash. Ask your dentist to recommend one.

Possible complications from gingivitis

In the vast majority of cases, if gingivitis is treated and the patient follows the dental health professional’s instructions, there are no complications. However, if the condition is left untreated, gum disease can spread and affect tissue, teeth and bones, leading to periodontitis.

Possible complications from gingivitis
  • Abscess in the gingiva
  • Abscess in the jaw bones
  • Infection in the jaw bone or gingiva
  • Periodontitis – this is a more serious condition that can lead to loss of teeth
  • Recurrent gingivitis
  • Trench mouth – ulceration of the gums caused by bacterial infection

Studies have linked gum diseases, such as periodontitis, to cardiovascular diseases, including heart attack or stroke as well as risk of lung disease.


Fluoride is found naturally in soil, water, foods, and several minerals, such as fluorapatite and fluorite.

  • Fluoride is a common, natural and abundant element
  • Fluoride can be synthesized in a laboratory
  • Tooth decay is reduced in areas with higher natural levels of fluoride in the water supply
  • Fluoride protects teeth from decay by demineralization and remineralization
  • Children need fluoride to protect their permanent teeth as they are being formed
  • People with bridges, crowns and braces might particularly benefit from fluoride
  • Excessive levels of fluoride can produce dental fluorosis
  • Skeletal fluorosis can be caused by excess fluoride; this can cause damage to bones and joints

What does fluoride do?

Fluoride protects the teeth in two ways:

  • Protection from demineralization – when bacteria in the mouth combine with sugars they produce acid. This acid can erode tooth enamel and damage our teeth. Fluoride can protect teeth from demineralization that is caused by the acid.
  • Remineralization – if there is already some damage to teeth caused by acid, fluoride accumulates in the demineralized areas and begins strengthening the enamel, a process called remineralization.

Fluoride is extremely useful in preventing cavities and making teeth stronger. However, it is much less effective if a cavity has already formed.

Fluoride also disrupts the process of tooth decay by:

  • Altering the structure of the developing enamel so that it is more resistant to acid attack. These structural changes occur as a child’s enamel develops (before he/she is seven years old).
  • Providing an environment where better quality enamel is formed, which is much more resistant to acid attack
  • Reducing the bacteria’s (bacteria in plaque) ability to produce acid, a major cause of tooth decay

Who needs fluoride?

Children need fluoride to protect their permanent teeth as they are being formed. Adults also need fluoride to protect their teeth from decay.

Several people, especially those at higher risk of tooth decay, benefit from fluoride treatment. Individuals who might benefit from fluoride treatment include those with the following:

  • Snacking habits
  • Poor dental hygiene
  • No (or little) access to a dentist
  • Diets that are high in sugars or carbohydrates
  • Bridges, crowns, braces, and other restoration procedures
  • A history of tooth decay (cavities).
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