Category Archives: Dental Care

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What is the main cause of bad breath?

The main cause of chronic bad breath is tongue bacteria in the mouth. While there are a range of oral conditions that can potentially cause bad breath (halitosis), it is a certain species of tongue bacteria that is responsible for between 80 to 90 percent of all normal cases of oral-related bad breath. The tongue bacteria in question – identified by American researchers in 2008 – go by the name of Solobacterium moorei, or S. moorei, in short.

American researchers found this bug present in 100% of their test subjects suffering from halitosis, while only 14% of those tested without bad breath were infected with S. moorei. However, it is interesting to note that all people in the latter group were experiencing periodontitis (gum disease).

So, let’s stop for a second and consider the implications of this information. The bottom line is this – no matter how thorough you are with brushing and flossing your teeth, your bad breath probably won’t go away unless you clean your tongue regularly as well.

What part of the tongue has the largest quantities of bacteria?

The part of the tongue that contains the vast majority of naturally and unnaturally occurring bacteria is located between the top dorsal and posterior dorsum of your tongue. In plain English, this area ranges from the top to the back of your tongue which is often left undisturbed by normal eating and cleaning activity.

As such, bacteria thrive within this bio-film habitat which is made up of food residue and other organic matter. As the breakdown of bacteria and organic matter occurs, odorous volatile sulfur compounds (VSCs) are produced – known otherwise as bad breath.

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Does tongue cleaning help reduce odours?

According to German researchers, cleaning your tongue reduces foul odours emanating from tongue coatings or bio-films. The results in the German study showed that tongue cleaners reduced VSC levels by 42%, tongue scrappers by 40% and toothbrushes by 33%.

The researchers also found that a combination of using all three tongue cleaning techniques yielded slightly better overall results. However, whether the subjects of the study actually cleaned the right part of the tongue (i.e. between the top dorsal & posterior dorsum) was not stated in the testing methods of the study.

References

Haraszthy, Violet & Gerber, D & Clark, B & Moses, P & Parker, C & Sreenivasan, P & Zambon, Joseph. (2015). Characterization and prevalence of Solobacterium moorei associated with oral halitosis, from https://www.researchgate.net/publication/274373091_Characterization_and_prevalence_of_Solobacterium_moorei_associated_with_oral_halitosis/citation/download

Seemann, R., Kison, A., Bizhang, M., & Zimmer, S. (2001). Effectiveness of mechanical tongue cleaning on oral levels of volatile sulfur compounds. The Journal of the American Dental Association132(9), 1263–1267. doi: 10.14219/jada.archive.2001.0369, from https://www.ncbi.nlm.nih.gov/pubmed/11665351

Wikipedia contributors. (2019, September 13). Bad breath. In Wikipedia, The Free Encyclopedia. Retrieved 07:03, October 22, 2019, from https://en.wikipedia.org/w/index.php?title=Bad_breath&oldid=915505747


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The benefits of teeth straightening for teens

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One of the main themes of Dental Health Week 2019 is the importance of maintaining your oral health. This includes keeping good oral hygiene, eating a healthy diet and visiting your dentist for regular checkups.

Malocclusion of the teeth is also an oral health issue

In addition to these key messages, there are other oral issues that need to be considered to ensure good oral health. One of these issues that may affect a developing child, teen or even adult is malocclusion. Malocclusion is an oral condition where there is a misalignment of the top and bottom rows of teeth when they meet – as the jaws close.

There are a range of malocclusion conditions including: crowded teeth, over bites, under bites, cross bites and open bites.

Malocclusion can lead to a number of oral health complications including:

  • changes in the shape and appearance of the face,
  • wear and tear from night-time teeth grinding and/or daytime clenching,
  • tooth & jaw pain,
  • stress on jaw joints, and
  • discomfort when chewing or biting.

The benefits of realignment or teeth straightening:

  1. Better appearance and a straighter, more balanced smile to increase self-esteem
  2. Easier cleaning, care and maintenance of teeth and gums
  3. Eat better and more comfortably with correct chewing and biting action
  4. Less stress, wear, tear and damage on teeth and jaw joints
  5. Avoid jaw strain and pain with correct jaw alignment
  6. Less vulnerability to bacterial infections of tooth root tips

Do you need to straighten up?

A quick look will tell you if you or your child’s teeth need teeth straightening. However, consulting with your dentist is the best way to determine if you or your child would benefit from teeth straightening. Your dentist can conduct a full diagnostic assessment and recommend an orthodontic treatment option to straighten your child’s teeth.

Teeth straightening treatment options:

  • Metal braces
  • Ceramic braces
  • Lingual (inside) braces
  • Clear aligners, such as Invisalign
  • Removable plates

Choice Dental have a range of treatment options when it comes to straightening teeth. To find out if you can benefit from straightening your teeth, book a consultation with our specialist orthodontist.

Call our helpful reception on 07 3809 3320 to book or find out more.


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Does fruit juice cause tooth decay in kids?

No. Fortunately, real 100% fruit juice doesn’t cause tooth decay – despite growing suspicion to the contrary. Some people even believe that drinking juice is as bad for your teeth as having a soft drink. However, there is clinical evidence that strongly suggests children who drink real 100% fruit juice do not experience any tooth decay as a result.

The problem is the “fake” fruit juice products out there that are starting to give real 100% fruit juice a bad name and reputation.

The research that proves it

A National Health and Nutrition Examination Survey (NHANES) in 2014 collected data from 2,290 preschool children following a dental checkup in the United States, between the years 1999 and 2004. The children were aged 2 to 5, and drank between 118ml and 177ml of fruit juice in the previous 24 hours before a checkup. Environmental factors, such as their socio-economic background, were also taken into consideration.

The results of the US study showed that there was no link between children who drank 100% fruit juice and signs of tooth decay & early childhood caries (ECC). The US researchers recommended consumption should be limited to between 118ml and 177ml, and for that guideline to taught to preschool within their general health education.

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Beware of the 100% fruit juice imitators!

The “100% fruit juice”, which the US researchers referred to, means juice made directly from fruit, as opposed to a fruit juice product. The latter are basically water with added powdered fruit concentrates, high levels of sugar, preservatives and/or other ingredients. Unfortunately, these “fruit juice” products are easily mistaken for real 100% fruit juice by consumers via misleading labelling. A variety of misnomers are used with the intention of fooling consumers into thinking that they are buying 100% fruit juice – when in fact, they are just buying water with acidic additives that actually cause tooth decay & erosion in kids.

Misnomers to watch out for include “fresh”, “pure”, “natural” and “enriched with Vitamin C”, to name a few. However, some fruit juice product labels take it one step further, blatantly claiming the product contains 100% fruit juice, when in fact it is made from concentrates.

So next time you buy 100% fruit juice, don’t forget to check the ingredients list! Better still, avoid the fake juice minefield at the supermarket, and simply make the freshest 100% fruit juice for your kids – right there in your own kitchen.

References:

1. J ADA Continuing Education: Early childhood caries and intake of 100 percent fruit juice: Data from NHANES, 1999-2004., Clemencia M. Vargas, Bruce A. Dye, Catherine R. Kolasny, Dennis W. Buckman, Timothy S. McNeel, Norman Tinanoff, Teresa A. Marshall, and Steven M. Levy., JADA December 2014 145(12): 1254-1261; doi:10.14219/jada.2014.95


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Dental Emergencies for kids 3-10 yrs

First Aid for children with minor mouth injuries

Minor mouth injuries in young children – such as small cuts and splits – are quite common because most kids just end up tripping over or running into something sooner or later! That’s when they’ll split their lip in a collision or accidently bite their tongue hard enough to induce significant bleeding – well enough to make you feel faint anyway!

However, parents shouldn’t be daunted or distracted by the sight of blood – kids do tend to bleed very easily from the tiniest of cuts. What’s more important is to look past the blood to work out where the bleeding is actually coming from – and then stopping it.

Most of the time, children experience only minor mouth injuries that can be easily treated with some basic First Aid steps – and a little recovery time.

Step 1 – Reduce or stop the bleeding

The first step and main priority of basic First Aid in this type of injury is to reduce or stop the bleeding. To do so, locate the source of the bleeding, such as an external cut, and apply gentle pressure on the wound with a clean cloth for at least 10 min if possible. Clean the injury site with cool water, apply an antiseptic and place a bandage over the cut.

If the cut is inside the mouth, on an inner lip for example, then apply pressure on it externally against your child’s teeth or gums. Don’t start probing the injury site with your finger because that may cause further bleeding.

Normal bleeding usually stops within 15 minutes – any longer means its heavy bleeding, so you should take your child straight to the Emergency Department at your nearest hospital.

Step 2 – Distract your child to keep them still

If your child can’t stay still while you are trying to stop the bleeding, take out their favourite toy or put on a Netflix cartoon for them to watch. It’s better if they don’t move at all while you’re applying pressure to the wound.

Step 3 – Reduce the swelling

Place an ice or cold gel pack over the injury site to numb and reduce any pain and/or swelling your child may be experiencing. Wrap an ice pack with a table cloth to prevent skin irritation. Giving your child an ice block treat to suck on is another novel option to help cool and numb the affected area.

Step 4 – Administer pain medication only if necessary

If your child experiences pain that doesn’t go away, it may be necessary to administer a dose of non-prescription pain medication, such as paracetamol or ibuprofen, to help relieve pain.

Step 5 – Make sure your child eats carefully

For, internal cuts to the mouth, avoid feeding your child salty and acidic foods or beverages which may cause irritation to the wound. Stick to soft, easy-to-digest plain and healthy foods to minimise discomfort while eating. After eating, make sure your child rinses with warm water to wash away food residue, and keep the mouth clean.

Step 6 – Monitor your child’s recovery

It usually takes about 3 or 4 days for a minor cut or split to heal. After that, your child should be in the all-clear. Keep a lookout for symptoms, such as persistent pain, increased redness and swelling, an abscess and/or fever – for these may indicate infection.

Don’t forget to educate your child about the reasons why the injury happened, and what safety precautions they should take to prevent or avoid a similar injury again in the future!

Go straight to the Emergency Department for major mouth injuries

Some mouth injuries need to treated as soon as possible at an Emergency Department of a hospital.

These include mouth injuries that:

  • don’t stop bleeding,
  • are very deep or punctured,
  • contain an embedded foreign object,
  • are a result of a bite or sting, or
  • involve bone injury.

Call your nearest dentist for advice if your child’s mouth injury results in a knocked out, broken or fractured tooth. Most dentists keep emergency slots open on their daily schedules to accommodate dental emergencies.

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The oral bacteria that can crawl into your brain

It might sound like a horror movie but the fact is, if you have certain species of pathogenic oral bacteria in your gums, they could be slowly making their way into your brain as you read this. These bacteria among 100s of others responsible for oral health issues, including tooth decay, cavities and periodontal disease (or gum disease).

The bacterial invaders identified so far

UK researchers have identified three bacterial species (see below) capable of entering the brain:

  • Porphyromonas gingivalis (left),
  • Treponema denticola (centre), and
  • Tannerella forsythia (right).

How do they get there?

First off, all of these bugs need to establish colonies in plaque and calculus. That’s easy for them if you fail to maintain a proper oral hygiene routine that includes brushing your teeth twice daily and visiting your dentist every 6 months.

Next, once firmly established in the periodontal tissues (below your gum line), they can infect surrounding soft tissue and bone. That’s when you start to develop periodontal pockets and gum disease. Along with these oral conditions, you may start experiencing symptoms such as bleeding gums – their first point of exit to the rest of the body.

All they have to do then is to wait until the next bleeding event – triggered by brushing your teeth or eating food – when they hitch a ride on your red blood cells along the blood stream super highway straight into your brain. And it’s a fairly easy entry for them since your brain lacks immune checkpoints.

The other way two of the mentioned bacteria can access your brain tissue is quite unique. Since they are motile (the ability to move), they can creep along the nerve fibres that connect your tooth roots to your brain.

What happens once they get there?

In short, they can settle in biofilms (similar to the plaque on your teeth) in the areas of your brain related to memory. When your immune system eventually cottons on to what is happening, it will respond and attack the bacteria.

Now that’s okay as a one off, but repeated daily exposure to these oral bacteria and their by-products, can result in neuron and nerve cell death in your brain according to UK researchers in a 2014 study. As such, the presence of oral bacteria in the brain and the associated side-effects has been linked to the development of Alzheimer’s disease.

Browns Plains Alzheimer’s disease

Stop them at the gates!

Once P. Gingivalis and company are in your system, it can be rather difficult to get them out completely. That’s why proper oral care and regular visits to a dental hygienist throughout your life are so important – to prevent these bugs from entering your body in the first place.

References:

Poole, S., Singhrao, S. K., & Crean, S. J. (2014). Emerging evidence for associations between periodontitis and the development of Alzheimer’s disease. Faculty Dental Journal, 5(1), 38-42. doi:10.1308/204268514×13859766312719

Singhrao, S. K., Harding, A., Poole, S., Kesavalu, L., & Crean, S. (2015). Porphyromonas gingivalis Periodontal Infection and Its Putative Links with Alzheimer’s Disease. Mediators of inflammation, 2015, 137357.


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Dental Insurance cover

Choosing the right dental insurance cover

It is important to take out dental insurance extras cover to avoid expensive treatment fees for unexpected dental work, such as emergency dental, wisdom tooth removal and braces. Even though the monthly fees for major dental cover may be expensive in themselves, you can save a lot more money in the long term when the need arises.

Types of dental cover

There are two basic types of dental cover to choose from:

  • General dental cover – Covers you for a range of basic preventative treatments that can safeguard your oral health, and help prevent future oral health complications, including: oral checkups and examinations; clean, scale and polish; fissure treatments; fluoride treatment; tartar/plaque removal; small fillings and dental X-rays.
  • Major dental cover – Covers you for a range of more complex dental treatments to repair, restore and treat a number of oral health conditions, including bridges; crowns; orthodontics (e.g. braces); endodontic treatment for tooth decay and gum disease; root canal therapy; full and partial dentures; and dental surgery (e.g. tooth extractions).

Dental treatment that isn’t covered by health funds

Elective dental treatment such as cosmetic dental is usually not covered by health funds. That means you won’t be able to insure for dental work you need to enhance your appearance, such as veneers, bonding, teeth straightening and teeth whitening.

However, if cosmetic dental is necessary to improve your oral health and restore oral function, then cosmetic dental insurance coverage may be applied by a health fund.

Do I need dental cover at the moment?

There’s no point in getting the highest premium dental cover, if you are a young adult with healthy teeth and gums – unless you engage in a risky sports activity. When choosing a dental cover option, you have to consider your life stage and oral health needs.

Younger adults, who are aged 20 to 40, single or partnered, and in good oral health, are best suited for general or basics dental cover. This cover option provides basic preventative treatment that can help maintain oral health, and prevent future oral health complications.

Families, and older adults aged over 40, should consider major dental cover options, especially when more expensive, complex dental treatments may be required in the near future. Despite the higher premiums, you can avoid costly dental fees in the long run.

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Find the best deal!

There are a lot of health funds out there, and each one is different. Most health funds are similar when it comes to general or basics dental cover. However, at each higher level of cover, access to more expensive dental treatment may differ between health funds.

Visit a comparison website to find a policy that best suits your dental needs and budget. You should consider the following when gathering policy information and comparing health funds:

  • Your budget and finances
  • Your life stage and oral health needs
  • Waiting periods
  • Annual limits
  • Benefit limits
  • Out-of-pocket expenses
  • Preferred providers in your local area

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How to brush your teeth effectively

The best way to maintain your oral health is to keep good oral care and hygiene habits. And the foundation of all good oral habits is brushing your teeth. Dentists recommend that you should brush your teeth for 3 min twice daily with fortified toothpaste – once in the morning when you wake up, and once in the evening before bed.

The benefits of brushing your teeth

By brushing your teeth twice a day, you can receive a number of benefits including whiter teeth, fresher breath, and the prevention of plaque, tooth decay and gum disease. You’ll also save money by avoiding potentially expensive dental treatment for oral conditions that are entirely preventable.

Do you use good tooth brushing technique?

The way you hold and brush with your toothbrush can affect your brushing effectiveness.

For best results on the front and back of your teeth, hold your toothbrush at a 45˚ angle against the gumline, and use a combination of gentle circular or back & forth motions to brush and sweep away food debris & plaque, especially along the gumline. When brushing your chewing surfaces, use a short back & forth brushing motion.

It is also important that your brush strokes are short and precise in order to avoid damaging your delicate gum tissue, and exposing your vulnerable tooth root surfaces to oral bacteria.

How to clean teeth surfaces of human mouth using brush and tooth

Are you brushing each & every tooth in your mouth thoroughly?

Don’t rush it. Take your time. Since brushing your teeth is one of those daily routines that we tend to perform automatically, you may be missing those hard-to-reach areas behind your teeth – the ones you can’t see in the mirror! Yet it’s these same areas that are often hot spots for bacterial and plaque formation.

The key to a complete clean is to methodically target the exposed tooth surfaces of every tooth in your mouth, including the gumline, and the outer, inner and chewing surfaces of your teeth. To clean between your teeth use floss or an interdental brush.

Don’t forget to brush or scrape your tongue also!

Choose the right toothbrush, keep it clean, and replace every 3 mths

A soft-bristled toothbrush used gently is the recommended way to clean and remove plaque without wearing out your protective tooth enamel. If the back of your mouth has narrow spaces that are too difficult for a normal-sized brush head to reach, then try a toothbrush with a smaller head. Don’t simply skip those areas!

Replace your toothbrush once it begins to show signs of wear, or every 3 months. Waiting 6 months is way too long. Worn and frayed brushes can harbour tens of millions of oral bacteria, including Staph, E. coli and even fecal germs, if you have a toilet in your bathroom.

Disinfect your toothbrush between brushes by soaking the head in some antiseptic mouthwash. Store your brush out of contact with other toothbrushes; otherwise your brush may get infected with someone else’s oral bacteria.

Assess your brushing effectiveness

As good as you may think that your brushing is, you can’t really tell at a glance if you’ve missed cleaning all the plaque off your teeth. That’s because plaque is barely visible at a glance, and it’s difficult to see it in the dark recesses at the back of your mouth.

Brushing, on average, only removes 40% of existing plaque. So if your next dental visit is months away, your back teeth may be slowly decaying and eroding despite brushing twice a day.

The solution? Try plaque disclosing tablets which stain tooth plaque blue or purple so you can spot and target plaque more easily, instead of brushing blindly and hoping for the best! Use a small dental mirror to check out stained plaque at the back of your teeth.


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Ensuring your child develops healthy teeth for life

Good oral care & hygiene habits and good nutrition are essential for the health, growth and development of your child’s teeth between the ages of 3 and 12. These factors also contribute to better oral health outcomes in your child’s adult life.

If your child’s teeth, gums and jaw don’t grow and develop as nature intended, your child may experience oral complications and poorer oral health outcomes later in life. So it’s important to ensure that you teach them healthy oral habits, and support their oral development at this stage of their life.

The following steps can help put your child on the right track towards normal teeth development:

  1. Keep baby teeth clean and hygienic to prevent early tooth loss

    If a child keeps their baby teeth clean and hygienic, then they can prevent plaque, tooth decay and cavities, which can lead to early loss of baby teeth.

  2. Besides chewing food, baby teeth act as “placeholders” for permanent (or adult) teeth during oral development. If one is lost too early as a result of tooth decay, the surrounding teeth can move forward or grow into the gap before the permanent tooth has a chance to emerge. When this happens, there is less space for tooth growth, which may result in a crooked tooth, overcrowding, and/or the need for orthodontic treatment, such as braces.

    Always provide low-fluoride strength toothpaste for younger children, and replace their toothbrush every 3 months.

  3. Teach healthy oral health habits and behaviour

    Promote good oral health to your child by encouraging meal time conversations about food and the links to oral health (e.g. how sweetened drinks can harm teeth). Discourage thumb and finger sucking which can push emerging teeth out of position.

    Most importantly, supervise their tooth brushing until they are 8 years old or until they are skilled and motivated enough to do so on their own. Don’t forget to join in, and make it both a fun and thorough twice-daily family routine!

  4. Provide tooth-friendly nutrition for growing teeth

    Feed your child a healthy diet that provides all the vital vitamins, minerals and other nutrients that a growing child’s body needs. Children need to grow strong, healthy teeth that can last a lifetime, as well as well-developed dental arches that can easily accommodate all 32 of them. An underdeveloped jaw may be at risk of oral complications, such as impacted wisdom teeth and over-crowding.

    Always have healthy snacks on hand, and discourage regular consumption of soft, processed, sweetened foods, as well as sweetened drinks. Children that chew a lot of fruit, vegetables, meat and nuts develop stronger jawlines, and can avoid underdeveloped dental arches.

  5. Regular dental checkups from an early age

    Regular preventative checkups (every 6 or 12 months) are important so that a dentist can treat plaque and other oral problems at an early stage – before they get worse. Early intervention can help prevent oral complications and further treatment. Your dentist can apply dental sealants for added protection. Additionally, children can learn great tips about how to keep their teeth clean and healthy from dentists.

    With regular visits, children also become more familiar with a dental environment, and develop a more positive attitude towards visiting

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Inlays & onlays – the conservative tooth restoration

If you have a tooth that is moderately decayed, chipped, cracked or fractured, a porcelain inlay or onlay may be all you need to repair and restore your affected tooth.

Inlays & onlays are ideally suited for teeth that are too decayed or damaged to receive a filling treatment, yet still have sufficient healthy tooth structure to avoid the need for a full crown treatment. This means that your dentist removes a minimum of your remaining natural tooth. As part of this conservative approach, your dentist is also limiting the use of more invasive dentistry techniques to solve your tooth’s problems.

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The benefits of inlays & onlays:

  • Tough, stable and durable – Inlays and onlays are bonded permanently to your teeth, and can last for up to 30 years.
  • Strengthens your tooth – Protects weak areas, and strengthens your remaining tooth structure by up to 75%.
  • Conservative approach – A minimally invasive tooth restoration treatment.
  • Perfectly colour-matched – You won’t be able to tell the difference between the inlay or onlay and your natural tooth.
  • Two visit treatment – At your first visit, your tooth is prepped and an impression is taken. When you return, the prosthetic is fitted, verified and then permanently bonded.
  • Customised precise fit – Inlays & onlays are made and fitted so precisely, that no harmful oral bacteria can enter between the prosthetic and your natural tooth at the time of insert.
  • Easy to clean – Since inlays & onlays are fitted so precisely, and follow the contours or your natural tooth, cleaning and maintaining oral hygiene are a breeze.
  • Longer tooth life – Your restored tooth will last much longer, and with proper oral care you can avoid further dental treatment.

At Choice Dental, we provide inlay and onlays as a conservative dental tooth restoration option – without the costs of a full crown treatment. For more information or to book a consultation, contact our friendly reception on (07) 3809 3320.


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How oral bacteria can affect the rest of your body

On 20 March 2018, World Oral Health Day focused on the theme “Healthy mouth, healthy body”. Why? Because having a healthy mouth is a crucial part of maintaining good overall health and well-being. If you have healthy teeth and gums, you can chew and digest your food well, and your body is able to absorb the maximum nutritional benefits.

The mouth-body connection is also important since poor oral health is associated with other general health disorders, such as osteoporosis, diabetes and cardiovascular disease. But one aspect of oral health that is often overlooked is the impact oral bacteria may have on the rest of your body.

Oral bacteria can invade other parts of your body

Your mouth houses a large community of about 600 bacterial species. Some are good, a lot are bad. That’s why we brush our teeth and tongue – to get rid of them. If there are too many bacterial microbes colonising your mouth then their by-products can cause tooth decay and gum disease.
But it doesn’t stop there. If your immune system has been compromised, due to age, poor nutrition, illness, disease or the side effects of medication, bacterial organisms can start invading other parts of your body.

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What parts of the body can oral bacteria affect?

  • Heart – Oral bacteria that enter the bloodstream can affect blood vessels or cause blood clots. This can increase general inflammation which can lead to a heart attack or stroke.
  • Lungs – Oral bacteria aspirated from the mouth, as you breathe in, can cause an anaerobic infection of the lungs which can lead to a higher risk of pneumonia, especially in the elderly.
  • Joints – Oral bacteria that enter the bloodstream are a contributing factor in the cause and development of rheumatoid arthritis.
  • Bones – The presence of both oral bacteria and oesteoporosis can accelerate the weakening, breakdown and loss of alveolar bone in the jaw.

The best ways to control oral bacteria

It is essential to control oral bacteria by taking good care of your teeth and gums. Brushing twice daily, flossing once a day and visiting your dentist for regular checkups are the best ways to control oral bacteria, and reduce your risk of developing other general health disorders.

References:

Brennan-Calanan, R., Genco, R., Wilding, G., Hovey, K., Trevisan, M., & Wactawski-Wende, J. (2008). Osteoporosis and Oral Infection: Independent Risk Factors for Oral Bone Loss. Journal of Dental Research, 87(4), 323-327. doi:10.1177/154405910808700403

Harvard Health Publishing. (2015, May 20). Heart disease and oral health: role of oral bacteria in heart plaque – Harvard Health. Retrieved from https://www.health.harvard.edu/press_releases/heart-disease-oral-health

Ogrendik, M. (2009). Rheumatoid arthritis is linked to oral bacteria: etiological association. Modern Rheumatology, 19(5), 453-456. doi:10.1007/s10165-009-0194-9
Terpenning, M. (2005). Geriatric Oral Health and Pneumonia Risk. Clinical Infectious Diseases, 40(12), 1807-1810. doi:10.1086/430603


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