RESTORATIVE DENTISTRY

World Congress on dental and oral health


RESTORATIVE DENTISTRY

“Restorative dentistry” is the term dental professionals use to explain how they replace missing or damaged teeth. Fillings, crowns (“caps”), bridges and implants are common restorative options. The goal is to bring back your natural smile and prevent future oral health issues.

Why restorative dentistry procedures are important

• Filling empty spaces in the mouth helps keep teeth properly aligned
• Replacing teeth makes it easier to maintain good oral care habits to help prevent plaque build-up and the problems plaque can lead to
• Missing teeth can affect your health, appearance and self-esteem

Restorative Dentistry Treatment Options Fillings

The most common way to treat a cavity is for your dentist to remove the decay and fill the tooth with one of several different materials. These filling materials include gold, porcelain, silver amalgam (which consists of mercury mixed with silver, tin, zinc and copper), tooth-colored plastic or composite resin.

Crowns

A crown is a tooth-shaped cap that is placed over a tooth. It is used to strengthen and protect your tooth structure. Your dentist prepares the tooth, takes an impression and the crown is made in a lab by a specialist.

A crown is ideal for people
with broken teeth or cavities.

The crown is cemented into
place over the damaged tooth.

    

Bridges

A dental bridge "bridges" the gap where there are missing teeth. A bridge has a crown on each end as an anchor with an artificial tooth or teeth connecting the crowns and filling the space. A bridge can keep your other teeth from moving out of place. Once a bridge is placed, it works just like your natural teeth.

Dental Implants

Dental implants are used to replace missing teeth. An implant has 2 parts: a metal anchor and a false tooth, similar to a crown. A dental implant looks and feels like a natural tooth.

The metal anchor is
inserted into the jawbone.

After the anchor has been inserted,a false tooth is put into place.

Tips for taking care of your restorative dentistry work

• Brush your teeth thoroughly twice a day.
• Electric toothbrushes can help remove plaque from your teeth and restorative work.
• Make sure to floss around your teeth, dental implants, crowns, and bridges every day.
• Try not to chew on hard or sticky foods. These can damage your implant, bridge, or crown.
• Use an antibacterial mouthwash to help fight plaque bacteria around restorative work.

Kids Are Using Too Much Toothpaste and It's Actually a Problem

WORLD CONGRESS ON DENTAL AND ORAL HEALTH
                                             Dental 2019

Kids Are Using Too Much Toothpaste and It's Actually a Problem

By:  Korin Miller

The CDC has an important message for parents: Your kids might be using too much toothpaste, and it can actually be dangerous for their oral health.

Kids between the ages of three and six aren't supposed to use more than a pea-sized amount, per the American Dental Association (ADA). Kids under three should only use a smear the size of a grain of rice.

But according to a new CDC report, plenty of children are using way more than that.

For the new study, researchers analyzed nationally representative survey data from parents with kids between the ages of 3 and 15 that was collected between 2013 and 2016. In all, data for 5,157 kids were included in the study.

The results showed that nearly 40 percent of children between three and six are using more toothpaste than dentists recommend. In fact, about 60 percent of kids between ages 3 and 15 used a half or full toothbrush load of toothpaste when they brushed. In the 3-to-6-year-old age group, 12 percent used a smear, 49.2 percent used the correct pea-sized amount, 20.6 percent used half a toothbrush load, and 17.8 percent used a full toothbrush load of toothpaste.

"The findings suggest that children and adolescents are engaging in appropriate daily preventive dental health practices," the authors wrote. "However, implementation of recommendations is not optimal."

Toothpaste seems pretty harmless, but using too much can cause problems.

The big concern here is fluoride, the researchers said. Fluoride is a mineral that’s important for reducing tooth decay when it’s used appropriately, according to the ADA. It’s often found in toothpaste and in many public water systems.

Although fluoride is generally considered a good thing for teeth (and the ADA recommends that you brush your child’s teeth with a fluoride toothpaste), brushing with too much fluoride toothpaste can actually damage a child’s tooth enamel (the hard, outer surface of their teeth) when they swallow it, the CDC says. And younger kids inevitably do swallow the toothpaste they brush with, Danelle Fisher, M.D., vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. “Kids under the age of six don’t spit very well,” she explains.

Too much fluoride can also cause discoloration and pitting, a condition known as dental fluorosis, the CDC says. If fluoride discolors a child’s teeth, it can make them appear mottled, lacy white, or, in severe cases, brownish, Mia L. Geisinger, D.D.S., M.S., associate professor in the University of Alabama at Birmingham School of Dentistry’s Department of Periodontology, tells SELF. And the potential issues aren’t just limited to teeth: Too much fluoride can even affect a child’s bone density, Dr. Fisher says. “This is actually a really serious thing,” she adds.

It's recommended that adults also stick with pea-sized amount, but this isn’t as much of an issue for grown-ups. “It's not as concerning for adults because their teeth and bones are developed,” Jamie Alan, Ph.D., Pharm.D., an assistant professor of pharmacology and toxicology at Michigan State University, tells SELF. You can still technically consume too much fluoride and potentially have issues with your bone density as a result, but if you're brushing properly and spitting out your toothpaste adequately like most adults do, toothpaste shouldn't cause any adverse effects, Alan says.

This really only becomes an issue if your child consistently goes overboard on the toothpaste long-term.

Sure, at some point your kid probably used too much toothpaste, and that’s okay; using too much fluoride toothpaste every once in a while is probably fine. But it's an important thing to keep an eye on: “This is not about using too much toothpaste once or twice,” Mark S. Wolff, D.D.S., Ph.D., dean at the University of Pennsylvania School of Dental Medicine, tells SELF. “It’s for years.” Basically, you'll want to correct your child's habit sooner rather than later.

While too much fluoride use is a potential issue, Dr. Geisinger says you don't need to worry toomuch. Just monitor your child’s toothpaste usage, watch them brush to make sure they're doing it well, and keep the tube out of their reach when they’re not using it.

Dental Hygiene Protects More Than Teeth

WORLD CONGRESS ON DENTAL AND ORAL HEALTH

Dental Hygiene Protects More Than Teeth

by Dr. Oz and Michael Roizen, M.D.

In the film “Castaway,” Tom Hanks' character, who is stranded on an island, performs a successful tooth extraction on himself using the blade of an ice skate. This eases his pain and keeps the infection from spreading.

While you probably shouldn’t opt for do-it-yourself dental care, you may not be getting regular check-ups and cleanings. A 2013 survey found that 23-43 percent of American adults don't make needed appointments with their dentist or dental hygienist.

We think that's probably an underestimate.

And that neglect can cause trouble — not just for gums and teeth.

An infected tooth can trigger chronic sinus problems, according to the American Association of Endodontists. Maxillary sinusitis of endodontic origin happens when the root of a molar gets infected. Bacteria can spread into the sinus cavity and cause a chronic infection, triggering nasal stuffiness, pressure, and post-nasal drip.

Many doctors misdiagnose the condition. The real solution is a (painless these days) root canal.

In addition, chronic gum disease (periodontitis) is linked to Alzheimer's disease. A multinational study in the journal Science Advances looked at the brains of Alzheimer's patients and found that gum disease produces bacteria and toxins that migrate to the brain and are instrumental in creating amyloid tangles and tau proteins. Those conditions characterize Alzheimer's disease.

Gum disease is also associated with diabetes (it raises blood glucose levels), and poorly controlled diabetes makes gum disease worse.

Your best move is to brush and floss twice daily. See your dental hygienist twice a year for a cleaning and get a complete oral exam too.

For more info: https://www.newsmax.com/health/dr-oz/dental-hygiene-diabetes-alzheimers/2019/02/20/id/903549/ 

How Dental Hygiene Affects Your Overall Health

You hear a lot these days about eating right and exercising. But did you know that dental hygiene plays a role in protecting your entire body? Here are some timely tips on this topic, brought to you for Dental Hygiene Awareness Month.

Dental Hygiene and Overall Health: the Intriguing Link

Research reveals at least five ways that the condition of your teeth and gums correlates with your overall health:

1. People with poorly managed diabetes often suffer from tooth decay and gum disease. Doctors believe that the two conditions directly influence each other. For example, uncontrolled diabetes can make your body less able to fight off infection, which in turn exposes your teeth and gums to decay-causing bacteria.
2. Pregnant women who suffer from gum disease are more likely to give birth to preterm babies, according to some studies. Women who are carrying children should see their dentist as well as their regular physician.
3. People with dental health issues are at special risk for heart disease or stroke. Some experts believe that the inflammation associated with tooth decay and gum disease plays a causal role in cardiovascular problems.
4. A report in the Journal of Neurology, Neurosurgery and Psychiatry found a link between gingivitis and impaired cognitive abilities. Patients with gingivitis took longer to recall words and complete basic arithmetic problems than others.
5. Both rheumatoid arthritis and gum disease are inflammatory conditions. Some authorities believe that infection and inflammation can spread from your mouth to cause problems throughout your system.

A Healthy Mouth Equals a Healthy Body and Mind

Doctors have long known that the body works as a unified whole. Problems in one area, such as the teeth and gums, can cause trouble elsewhere. This is all the more reason to make good dental hygiene part of your comprehensive healthcare strategy. All of us should cultivate the following important habits:

• Brushing at least twice a day. Use a soft bristled toothbrush and a toothpaste approved by the ADA. Your dentist may recommend a particular brand for your use.
• Flossing at least once per day. Floss string comes in various widths and in both waxed and un-waxed versions. You can even find flavored versions.
• Eating a sensible diet. Most of us know we should limit our consumption of sugar. But a growing body of evidence indicates that simple starches are also harmful to your teeth. Lean protein, raw fruits and vegetables, reduced-fat dairy products and whole grains are the foundation of good nutrition.
• Avoiding tobacco in all forms. Not only can smoking threaten your lungs, it also has devastating effect on your teeth and gums. Your dentist can prescribe medications that will help you kick the habit.
• Limiting consumption of alcoholic beverages. Alcohol can erode the protective enamel around your teeth. It can also rob your system of important nutrients needed to keep your teeth strong.
• Seeing your dentist for regular cleanings and checkups. This is important for catching problems they become serious.
  
  By: Dr. J Benjamin Patrick

Mouth and Oropharyngeal Cancer

About mouth and oropharyngeal cancer

The medical term for the mouth is the oral cavity. Mouth cancer can start anywhere in the oral cavity. This includes the:

• lips
• inside lining of the cheeks and lips (buccal mucosa)
• front 2/3 of the tongue
• gums (gingiva)
• floor of the mouth
• roof of the mouth (hard palate) 
• area behind the wisdom teeth (retromolar trigone)

The mouth and oropharynx help us breathe, talk, eat, chew and swallow. 

The oropharynx

The medical term for the throat is the pharynx. The pharynx is divided into 3 parts.

The parts are:

• oropharynx
• nasopharynx
• laryngopharynx

The oropharynx is the part of the throat just behind the mouth. Cancer starting in this area is called oropharyngeal cancer (pronounced oar-oh-fah-rin-jee-al).

The oropharynx includes the:

• back 1/3 of the tongue 
• soft area at the back of the roof of the mouth (soft palate)
• tonsils and 2 ridges of tissue in front of and behind the tonsils (tonsillar pillars)
• back wall of the throat



Lymph nodes in your neck

Lymph nodes are small bean shaped glands that are part of the lymphatic system. 
There are major groups of lymph nodes in your neck. Cancers starting in the mouth and oropharynx can spread to these because they are close by. 
Some people with mouth or oropharyngeal cancer often have an operation to remove lymph nodes from the same side of the neck as the cancer. Rarely the surgeon might remove them on both sides. These operations are called neck dissections. 
Cancer that starts in the lymph nodes is called lymphoma. This is very different to a mouth or oropharyngeal cancer that has spread to the lymph nodes. 
• Find out about lymphoma



What throat cancer means

The term throat cancer can be confusing because people use it to mean different types of cancer. People use the term to include the:
• 3 parts of the pharynx (oropharynx, nasopharynx, laryngopharynx)
• thyroid
• voice box (larynx)
• food pipe (oesophagus)
To avoid confusion, it is important to know the exact type of cancer you have. Cancers are treated according to where they start in the body. Ask your doctor if you do not know the name of the type of throat cancer you have. 

Who gets it

Mouth and oropharyngeal cancer is more common in men than women. 1 in 75 men and 1 in 150 women will be diagnosed with mouth cancer at some point in their life. 
Most mouth and oropharyngeal cancers are diagnosed in people over 60. 

Floss/Interdental Cleaners

Introduction

Dental floss (or dental tape) and other interdental cleaners (e.g., small brushes, special wooden or plastic picks, sticks or water flossers) removes food trapped between the teeth and removes the film of bacteria that forms there before it has a chance to harden into plaque. Toothbrush bristles alone cannot clean effectively between these tight spaces.

Plaque that is not removed can harden into tartar, a hard mineral deposit that forms on teeth and can only be removed through professional cleaning by a dental professional. When this happens, brushing and cleaning between teeth become more difficult, and gum tissue can become swollen or may bleed. This condition is called gingivitis, the early stage of gum disease.

Interdental cleaning helps remove debris and interproximal dental plaque, the plaque that collects between two teeth. Dental floss and other interdental cleaners help clean these hard-to-reach tooth surfaces and reduce the likelihood of gum disease and tooth decay. Use of an interdental cleaner (like floss) is an essential part of taking care of your teeth and gums. The U.S. Department of Health and Human Services also reaffirmed flossing as “an important oral hygiene practice” in an August 2016 communication to the ADA.

Floss and Other Interdental Cleaners

Floss was once made from silk fibers twisted to form a long strand. Today, floss is usually made from nylon filaments or plastic monofilaments. The U.S Food and Drug Administration classifies dental floss as a Class I device, which means it is deemed to be low risk and subject to the least regulatory controls.  Floss may be treated with flavoring agents, such as mint, to make flossing more pleasant.  There is no difference in the effectiveness of waxed or unwaxed floss, although rare cases of contact hypersensitivity to waxed or coated floss have been reported. It’s generally not what type of floss is used, but how and when it’s used.

While floss is a flexible strand, other interdental cleaners specifically made for this purpose include dental picks, pre-threaded flossers, tiny brushes that reach between the teeth, water flossers, or wooden plaque removers.

When’s the best time to floss?
The ADA recommends brushing twice a day and cleaning between teeth with floss (or another interdental cleaner) once a day. Some people prefer to floss in the evening before bedtime so that the mouth is clean while sleeping.  Others prefer to floss after their midday meal.  Still others chose to floss first thing as a part of their morning ritual.  The bottom line is that best time to floss is the time that fits well with the individual’s schedule.

Should I brush or floss first?
Either way is acceptable as long as you do a thorough job. Some people like to floss before brushing to better ensure that any material between teeth is swept out of the mouth.  Others prefer to first clean their mouth by brushing before working with floss between their teeth.  However, those who brush their teeth and skip flossing because they think their mouth feels clean or are short on time or tired and postpone flossing for some later time are likely missing out because flossing may never happen.

Can I rinse and reuse floss?
The ADA does not recommend using a floss strand more than once. Used floss might fray, lose its effectiveness, or may deposit bacteria in the mouth. Discard after use.

Oral health

Key facts

• Oral diseases are the most common noncommunicable diseases (NCDs) and affect people throughout their lifetime, causing pain, discomfort, disfigurement and even death.
• The Global Burden of Disease Study 2016 estimated that oral diseases affected half of the world’s population (3.58 billion people) with dental caries (tooth decay) in permanent teeth being the most prevalent condition assessed.
• Severe periodontal (gum) disease, which may result in tooth loss, was estimated to be the 11th most prevalent disease globally.
• Severe tooth loss and edentulism (no natural tooth) was one of the leading ten causes of Years Lived with Disability (YLD) in some high-income countries
• In some Asian-Pacific countries, the incidence of oral cancer (cancer of the lip and oral cavity) is within the top 3 of all cancers.
• Dental treatment is costly, averaging 5% of total health expenditure and 20% of out-of-pocket health expenditure in most high-income countries.
• The oral health care demands are beyond the capacities of the health care systems in most low-and middle-income countries (LMICs).
• Oral health inequalities exist among and between different population groups around the world and through the entire life course. Social determinants have a strong impact on oral health.
• Behavioural risk factors for oral diseases are shared with other major NCDs, such as an unhealthy diet high in free sugars, tobacco use and harmful use of alcohol.
• Poor oral hygiene and inadequate exposure to fluoride have negative effects on oral health.

Oral health is a key indicator of overall health, wellbeing and quality of life. WHO defines oral health as “a state of being free from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.” 

Oral diseases and conditions

Seven oral diseases and conditions account for most of the oral disease burden. They include dental caries (tooth decay), periodontal (gum) diseases, oral cancers, oral manifestations of HIV, oro-dental trauma, cleft lip and palate, and noma. Almost all diseases and conditions are either largely preventable or can be treated in their early stages.

The Global Burden of Disease Study 2016 estimated that oral diseases affected at least 3.58 billion people worldwide, with caries of the permanent teeth being the most prevalent of all conditions assessed. Globally, it is estimated that 2.4 billion people suffer from caries of permanent teeth and 486 million children suffer from caries of primary teeth.  

In most LMICs, with increasing urbanization and changes in living conditions, the prevalence of oral diseases continues to increase notably due to inadequate exposure to fluoride and poor access to primary oral health care services. Heavy marketing of sugars, tobacco and alcohol leads to growing consumption of unhealthy products. 

Dental caries (tooth decay)

Dental caries results when microbial biofilm (plaque) formed on the tooth surface converts the free sugars contained in foods and drinks into acids that dissolve tooth enamel and dentine over time. With continued high intake of free sugars, inadequate exposure to fluoride and without regular microbial biofilm removable, tooth structures are destroyed, resulting in development of cavities and pain, impacts on oral-health-related quality of life, and, in the advanced stage, tooth loss and systemic infection.

Periodontal (gum) disease

Periodontal disease affects the tissues that both surround and support the tooth. This often presents as bleeding or swollen gums (gingivitis), pain and sometimes as bad breath. In its more severe form, loss of gum attachment to the tooth and supporting bone causes “pockets” and loosening of teeth (periodontitis). Severe periodontal disease, which may result in tooth loss, was the 11th most prevalent disease globally in 2016. The main causes of periodontal disease are poor oral hygiene and tobacco use.

Tooth loss

Dental caries and periodontal diseases are major causes of tooth loss. Severe tooth loss and edentulism (no natural teeth remaining) are widespread and particularly seen among older people. Severe tooth loss and edentulism was one of the leading ten causes of Years Lived with Disability (YLD) in some high income countries due to their aging populations.

Oral cancer

Oral cancer includes cancers of lip and all subsites of the oral cavity, and oropharynx. The age-adjusted incidence of oral cancer (cancers of the lip and oral cavity) in the world is estimated at 4 cases per 100 000 people. However, there is wide variation across the globe: from no recorded cases to around 20 cases per 100 000 people. Oral cancer is more common in men, in older people, and varies strongly by socio-economic condition.

In some Asian-Pacific countries, the incidence of oral cancer ranks among the three top cancers.Tobacco, alcohol and areca nut (betel quid) use are among the leading causes of oral cancer. In regions like North America and Europe, “high risk” human papillomavirus infections are responsible for a growing percentages of oro-pharyngeal cancers among young people.

Oral manifestations of HIV infection

Oral manifestations occur in 30–80% of people with HIV, with considerable variations depending on the situations such as affordability of standard antiretroviral therapy (ART).

Oral manifestations include fungal, bacterial or viral infections of which oral candidiasis is the most common and often the first symptom early in the course of the disease. Oral HIV lesions cause pain, discomfort, dry mouth, eating restrictions and are a constant source of opportunistic infection.

Early detection of HIV-related oral lesions can be used to diagnose HIV infection, monitor the disease’s progression, predict immune status and result in timely therapeutic intervention. The treatment and management of oral HIV lesions can considerably improve oral health, quality of life and wellbeing.

Oro-dental trauma

Oro-dental trauma is an impact injury to the teeth and/or other hard or soft tissues within and around the mouth and oral cavity. The world prevalence of traumatic dental injuries in either dentition (primary and permanent) is around 20%. Oro-dental trauma can be caused by oral factors (e.g. increased overjet); environmental factors (for example, unsafe playgrounds or schools); risk-taking behaviour; and violence. Treatment is costly and lengthy and sometimes can even lead to tooth loss, resulting in complications for facial and psychological development and quality of life.

Noma

Noma is a necrotizing disease that affects children between the ages of 2 and 6 years suffering from malnutrition, affected by infectious disease, living in extreme poverty and with weakened immune systems.

Noma is mostly prevalent in sub-Saharan Africa, but rare cases are reported in Latin America and Asia. Noma starts as a soft tissue lesion (a sore) of the gums, inside the mouth. The initial gum lesion then develops into an ulcerative, necrotizing gingivitis that progresses rapidly, destroying the soft tissues and further progressing to involve the hard tissues and skin of the face.

In 1998, WHO estimated that there were 140 000 new cases of noma annually. Without treatment, noma is fatal in 90% of cases. Where noma is detected at an early stage, its progression can be rapidly halted, through basic hygiene, antibiotics and nutritional rehabilitation. Such early detection helps to prevent suffering, disability and death. Survivors suffer from severe facial disfigurement, have difficulty speaking and eating, face social stigma, and require complex surgery and rehabilitation.

Cleft lip and palate

Clefts of the lip and palate are heterogeneous disorders that affect the lips and oral cavity and occur either alone (70%) or as part of a syndrome, affecting more than 1 in 1000 newborns worldwide. Although genetic predisposition is an important factor for congenital anomalies, other modifiable risk factors such as poor maternal nutrition, tobacco consumption, alcohol and obesity during pregnancy also play a role. In low-income settings, there is a  high mortality rate in the neonatal period.If lip and palate clefts are properly treated by surgery, complete rehabilitation is possible.

NCDs and common risk factors

Most oral diseases and conditions share modifiable risk factors (such as tobacco use, alcohol consumption and unhealthy diets high in free sugars) common to the four leading NCDs (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes).

In addition, it is reported that diabetes mellitus is linked in a reciprocal way with the development and progression of periodontitis.
Moreover, there is a causal link between high sugars consumption and diabetes, obesity and dental caries. 

Oral health inequalities

Oral health inequalities are caused by a broad range of interacting biological, socio-behavioural, psychosocial, societal and political factors that create ‘the conditions in which people are born, grow, live, work, and age’ – the so-called social determinants.

Oral diseases disproportionally affect the poor and socially-disadvantaged members of society. There is a very strong and consistent association between socioeconomic status (income, occupation and educational level) and the prevalence and severity of oral diseases. This association exists across the life course from early childhood to older age, and across populations in high, middle and low-income countries. Oral health inequalities are therefore considered as differences in oral health that are avoidable, and deemed both unfair and unjust in modern society.

Prevention

The burden of oral diseases and other NCDs can be reduced through public health interventions by addressing common risk factors.

These include:

• promoting a well-balanced diet:
• low in free sugars to prevent development of dental caries, premature tooth loss and other diet-related NCDs;
• with adequate fruit and vegetable intake, which may have a protective role in oral cancer prevention;
• reducing smoking, the use of smokeless tobacco including chewing of areca nuts, and alcohol consumption to reduce the risk of oral cancers, periodontal disease and tooth loss; and
• encouraging use of protective equipment when doing sports and travelling in motor vehicles to reduce the risk of facial injuries.

In addition to the NCDs’ common risk factors, inadequate exposure to fluoride and a number of social determinants of health should be addressed to prevent oral diseases and reduce oral health inequalities.

Dental caries can be largely prevented by maintaining a constant low level of fluoride in the oral cavity. Optimal fluoride can be obtained from different sources such as fluoridated drinking water, salt, milk and toothpaste. Twice-daily tooth brushing with fluoride-containing toothpaste (1000 to 1500 ppm) should be encouraged.²⁰ Long-term exposure to an optimal level of fluoride results in substantially lower incidence and prevalence of tooth decay across all ages.²¹

Oral health inequalities must be reduced by tacking the broader social determinants through a range of complementary downstream, midstream and integrated upstream policies such as: water fluoridation; regulation of the marketing and promotion of sugary foods to children and taxes on sugar-sweetened beverages. Moreover, promoting healthy settings such as healthy cities, healthy workplaces and health promoting schools is critical to building comprehensive supporting environments to promote oral health.