A conceptual brief review on pharmaceutical importance
of dental products
Huda Malik1, Sumaiyya Sultana2, Nuha Rasheed3*, Abdul Saleem
1Department of Pharma.D, Nizam Institute of Pharmacy, Deshmukhi (V),
Pochampally (M), Behind Mount Opera, Yadadri (Dist)-508284, Telangana, India
2Department of Pharma.D, Nizam Institute of Pharmacy, Deshmukhi (V),
Pochampally (M), Behind Mount Opera, Yadadri (Dist)-508284, Telangana, India.
3Department of Pharmaceutics, Nizam Institute of Pharmacy, Deshmukhi (V),
Pochampally (M), Behind Mount Opera, Yadadri (Dist)-508284, Telangana, India.
4Department of Pharmaceutical Analysis and
Quality Assurance, Nizam Institute
of Pharmacy, Deshmukhi (V), Pochampally (M), Behind Mount Opera, Yadadri
(Dist)-508284, Telangana, India.
Author E-mail: firstname.lastname@example.org
Dental hygiene has been considered as
important since long. In order to maintain dental hygiene, numerous dental
products are available in market. Many chemicals find use in their preparation
as well as in dentistry. Although it is well known that clean teeth keeps good
health and clean teeth cannot decay, it is not possible to clean the teeth
continuously all the years. Numerous factors contribute to dental decay and the
problem of oral hygiene arises. A large number of inorganic chemicals and their
preparations are known which find application in the practice of dental and oral
disorders. As they come in contact with the human body, they are regarded like
other drugs and pharmaceuticals.
KEY WORDS: Dentine, Cementum, Enamel, decay, dental, disorders.
Dental products include
(b) Cleaning and polishing agents.
1) DENTINE- its surrounds the pulp cavity and extends
throughout the entire portion of teeth
2) CEMENTUM –it is a layer covering the portion of tooth
lying buried in the gum and
3) ENAMEL-it is a white hard material covering the portion
of tooth projecting above the gum
Dentine having the 75% of mineral is hard and dense. Enamel
having 98% mineral, is even more dense It is hardest substance present in the
body. The organic matrix of dentine and cementum is bone like in the fully form
enamel the hydroxyapatite crystal are quite large as compared to that of bone.
Vitamins A C and D are necessary for the proper tooth formation. Vitamin A
deficiency causes hypoplastic enamel. Vitamin C deficiency affects
calcification of dentine. Vitamin D not only helps the absorption of calcium
from GIT, but also for the proper deposition of calcium and phosphorous in
tooth .others ion like mg2+, Cl- and citrate are also present in tooth like
bones. A large variety of inorganic compound are used as dental products in
dental care and treatment. Most dental products are non-prescription and over the
counter products. A pharmacist is expected to be well- versed with common
dental terms including local dental product and specialists terminologies so
that he can advice a direct the patient accordingly.[1-3]
Dental caries or tooth decay is more or less a disease of
the teeth caused by acids produced by the action of microorganisms on
carbohydrates. This disease is characterized by decalcification of tooth
accompanied by foul mouth odor. The exact cause and mechanism of dental caries
is not known with certainty. However, it is accepted that dental caries first
of all starts on the surface of the teeth. Acids produced by bacterial
metabolism of fermenting carbohydrates act on teeth, produce lesions where
bacteria’s get localized and dental caries gets produced.
To prevent dental caries and to maintain clean and healthy
teeth, it becomes necessary to use dentifrices. Primary function of dentifrice
is to clean the accessible surface of the teeth. There are substances having
known therapeutic value. Use of ammoniated toothpaste, urea ammonia containing
powders, antibiotic containing mixtures and anti-enzyme compounds has been in
use. These compounds are having their advantages and limitations.
Role of fluoride in preventing dental caries has been well
accepted. Administration f traces of fluoride having salts or their use in
topical use to the teeth have been reported to give encouraging results.
Fluoride ion is a trace material which occurs in our body.
It is generally adequately obtained from food and water. In some parts of the
world, ground water is totally lacking fluoride. In such places occurrence of
dental caries has been becoming in alarming proportions. Addition of fluoride
to the municipal water supply, known as fluoridation is able to help in
reducing the preventing dental caries. This is not true because those who
receive slow continued ingestion of fluoride may suffer from mottling of teeth,
increased density of bones, gastric disturbances, muscular weakness,
convulsions and even heart failure. Due to beneficial effects in treating
dental caries and in some types of osteoporosis, fluorides find use in dental
When a fluoride having salt or solution is taken
internally, it is readily absorbed, transported and deposited in the bone or
developing teeth and remainder gets excreted by the kidneys. The deposited
fluoride on the surface of teeth does not allow the action of acids or enzymes
in producing lesions. A small quantity of fluoride thus becomes necessary to
prevent caries. However, if more quantity of fluoride is ingested it is carried
to bones and teeth and gives rise to mottled enamel known as dental fluorosis.
It is possible to administer fluoride by two routes (i)
orally and (ii) topically. The use of fluoridation of public water supply has
been the most common and effective way of oral administration. Water supply
containing about 0.5 to 1 ppm is provided which is sufficient. Alternatively,
it can be given in drinking water or fruit juice in such a concentration to have
about 1 ppm per day. Sodium fluoride tablets or solution of sodium fluoride in
a dose of 2.2 mg per day are used. For topical application 2 percent solution
is generally used on teeth.
Besides fluorides, inorganic phosphate salts have been
found to be useful in reducing the dental caries. Phosphate ions are needed for
stronger bones as well healthy teeth. Phosphate salts both in soluble and
insoluble forms normal diets. The phosphates are normally given in deficiency.
Role of phosphates as cleaning agent is also important.
It is having not less than 98.0 percent of NaF, calculated
with reference to the dried substance.
It may be prepared by neutralizing hydrofluoric acid with
Another method involves the double decomposition of calcium
fluoride with sodium carbonate wherein insoluble calcium carbonate can be
removed by filtration.
It forms colorless, odorless crystals or as white powder.
It is soluble in water but is insoluble in alcohol. Its aqueous solutions
corrode ordinary glass bottles and hence the solution should be prepared in
distilled water and stored in dark, Pyrex bottles.
On acidification of salt solution, hydrofluoric acid is
produced. This is weak acid and is poisonous. Aqueous solution of salt yields
Sodium fluoride due to its fluoride ion is an important
agent in dental practice for retarding or preventing dental caries.
Sodium fluoride in 2 percent aqueous solution is widely
used topically; occasionally the solution is applied to the surface of dry
teeth periodically over several times in a year. Fluoride ion enters the enamel
of teeth and becomes part of enamel structure and thus becomes effective.
Approximately 2.2 mg of NaF contains 1 mg of fluoride ion
and each g of NaF is equivalent to 23.8 m mol of sodium and fluoride. Sodium
fluoride and other soluble fluorides are readily absorbed from GIT. Fluoride
also gets absorbed slowly from gums when applied as paste and incorporated into
the teeth. Fluoridised teeth have the resistant to microorganisms causing
dental caries. It also decreases microbial acid production. Sodium fluoride can
be administered as solution, tablet, oral gel or varnish for systemic use or as
mouth wash for local use in the mouth.
A modification of sodium fluoride application is the use of
acidified phosphate-sodium fluoride gels. These preparations usually contain
the equivalent of approximately 1.23 percent fluoride and 1 percent phosphoric
A 2% solution of sodium fluoride in water may be applied to
children’s teeth, after preliminary cleansing, 3 times at the interval of one
week of 3, 7, 10, and 13 years of age to correspond with the tooth eruption.
Alternatively, a paste containing75% of sodium fluoride and 25% of glycerol is
applied to the teeth, rubbed in for 1 minute and removed by a mouthwash.
Usual Dose: 2.2 mg once a day.
Application: 1.5 to 3 ppm in drinking water, topically as a
2% solution to the teeth.
When consumed in larger doses, sodium fluoride as
poisonous. High fluoride water brings about mottling of teeth, gastric
disturbances, etc. Stiller larger doses may lend to systemic toxicities
effecting central nervous, cardiovascular, musculo-skeletal and respiratory systems.
Sometimes, sodium fluoride is used as domestic insecticide. Great precaution is
to be taken to prevent children getting access to such preparations.
It is assayed by complexometric titration method using
A weighed quantity is dissolved in water. To it a small
amount of sodium chloride and alcohol is added. Now contents are heated to
boiling and drop wise excess lead nitrate is added with stirring. On cooling,
coagulated precipitate is filtered, residue washed with dilute alcohol and the
combined filtrate and washings are made to titrate with disodium edentate using
xylenol orange as indicator.
Stannous fluoride is a valuable adjunct in the prevention
of caries and is considered to be superior to sodium fluoride for two reasons
(i) simplified application; and (ii) greater effectiveness. The first advantage
is supported by the fact that a single application of 8% aqueous solution to
the tooth surface is enough for every 6 months to 1 year, while, a 2% sodium
fluoride is applied 4 times during a 10 days a period. The second advantage
derives from the fact that the stannous ion increases the anticariogenic action
of fluoride ion so that both ions contribute towards clinical effectiveness.
It is for topical use only.
Storage: It is kept in well-closed containers.
Sodium monofluorophosphate (U.S.P)
It is also known as SMFP. It corresponds to the formula
(mole mass 143.9). It is a white odorless powder. It is freely soluble in
water, yielding near neutral solution. It is also used for fluoride supplement
of diets, fluoridation of municipal water supply and in mouth washes. It is
preferred to be included in dentifrices, particularly toothpastes. It is
believed SMFP is able to induce better fluoridation of dental enamel and decreases
its demineralization, than sodium fluoride.
Tin fluoride solution is obtained from using tin fluoride
capsules by dissolving in water. A fresh solution finds use in dentistry.
It contains not less than 71.2% of stannous ions and not
less than 22.3% and not more than 25.5% of fluoride, calculated on the dried
It is a while crystalline powder having unpleasant
astringent salty taste. It is soluble in water but insoluble in alcohol and
organic solvents. Aqueous solution of stannous fluoride deteriorates rapidly on
standing because of oxidation of stannous cation to stannic form causing
turbidity. Thus, stannous fluoride solution must be freshly made.
It is used to prevent dental caries, similar to sodium
fluoride and SMFP in the form of solution, gel, mouth wash or dentifrice. It
has an unpleasant taste and may cause discoloration of teeth on over usage.
Because of instability of prepared aqueous solutions, fresh
solutions are prepared at the time of application. A freshly prepared 8 percent
solution of stannous fluoride is applied to the cleaned dry teeth. A single
application has been reported to be sufficient for six to twelve months.
for stannous ion:
250 mg of stannous fluoride is accurately weighed and then
transferred to a conical flask. To this flask, 300 ml of hot, recently boiled
hydrochloric acid is added. The flask is shaken to dissolve the stannous
Now the flask is kept so that it gets cooled to room
temperature. To this flask, 5 ml of potassium iodide is added and the contents
in the flask are titrated with 0.1N potassium iodate using starch as an
Other fluorides used in dentifrices and oral hygiene
products include aluminum fluoride ammonium fluoride, calcium fluoride and
potassium fluoride. Sodium silicofluoride is employed for fluoridation of
Is the act of smoothing the tooth surface. The purpose of
polishing is to make it difficult for plaque to accumulate on the tooth surface
area. Common practice is to use a prophy cup—a small motorized rubber cup—along
with an abrasive polishing compound.
Rubber cups as shown in Fig.1, also called prophy cups, are
used in the hand-piece. Polishing paste, prophylactic paste, usually containing
fluoride, is used with the rubber cups for polishing. Rubber cups should not be
used over the cementum area as it may remove a layer of cementum at the
cervical area. There are two popular types of prophy cups: 4 webs and 6 webs.
Bristle brushes as shown in fig.2 are used in the
prophylaxis angle with a polishing paste. The use of the brush should be
confined to the crown to avoid injury to the gingiva and cementum.
Currently, the most commonly used tool for tooth polishing
is prophy angle. It integrates a rubber cup as shown in fig.3 into a high
torque gear, which can be plugged into a low speed handpiece and drive rubber
cup to polish teeth.
Dental tape is used for polishing the proximal surfaces of
teeth that are inaccessible to other polishing instruments. It is also used
with polishing paste. Particular care should be taken to avoid injury to the
gingiva. The area should be cleaned with warm water to remove all remnants of
Air-powder polishing is used with a specially designed
handpiece. This device is called Prophy-jet. It delivers an air-powder slurry
of warm water and sodium bicarbonate for polishing. It is very effective for
the removal of extrinsic stains and soft deposits. It is contraindicated in
patients with respiratory illness, hemodialysis and hypertension
Intention of preventing cavities (dental caries), gingivitis,
and periodontal disease. People routinely clean their own teeth by brushing and
interdental cleaning, and dental hygienists can remove hardened deposits (tartar)
not removed by routine cleaning. Those with dentures and natural teeth may
supplement their cleaning with a denture cleaner.
scrubbing and flossing:
brushing and Dental floss:
Brushingand frequent brushing with a toothbrush helps to
prevent build-up of plaque bacteria on the teeth. Electric toothbrushes were
developed, and initially recommended for people with strength or dexterity
problems in their hands, but they have come into widespread general use. The
effectiveness of electric toothbrushes at reducing plaque formation and
gingivitis is superior to that of conventional manual toothbrushes.
In addition to brushing, cleaning between teeth may help to
prevent build-up of plaque bacteria on the teeth. This may be done with dental
floss or interdental brushes.
80% of cavities occur in the grooves, or pits and fissures,
of the chewing surfaces of the teeth however, there is no evidence currently
showing that normal at-home flossing reduces the risk of cavities in these
Special appliances or tools may be used to supplement
toothbrushing and interdental cleaning. These include special toothpicks, oral
irrigators, and other devices.
Teeth can be cleaned by scrubbing with a twig instead of a
toothbrush. Plant sap in the twig takes the place of toothpaste In many parts
of the world
teeth are used. In the Muslim
world the miswak or siwak is made from twigs or roots that are said to have an antiseptic
effect when used for cleaning teeth. [6-7]
teeth cleaning :-
4 Dental hygienist polishing a patient's teeth
Teeth cleaning (also known as prophylaxis, literally a
preventive treatment of a disease) is a procedure for the removal of tartar
(mineralized plaque) that may develop even with careful brushing and flossing
as shown in Fig.4, especially in areas that are difficult to reach in routine
tooth brushing. It is often done by a dental hygienist. Professional cleaning
includes tooth scaling and tooth polishing and debridement if too much tartar
has accumulated. This involves the use of various instruments or devices to
loosen and remove deposits from the teeth.
As to the frequency of cleaning, research on this matter is
inconclusive. That is, it has neither been shown that more frequent cleaning
leads to better outcomes nor that it does not. A review of the research
literature on the question concluded "The research evidence is not of
sufficient quality to reach any conclusions regarding the beneficial and
adverse effects of routine scaling and polishing for
periodontal health and regarding the effects of providing this intervention at
different time intervals" This conclusion was reaffirmed
when the 2005 review was updated in 2007. Thus, any general
recommendation for a frequency of routine cleaning (e.g. every six months,
every year) has no empirical basis. Moreover, as economists have
pointed out, private dentists (or other dental professionals) have an economic
incentive to recommend frequent cleaning, because it increases their revenues.
Most dental hygienists recommend having the teeth
professionally cleaned every six months More frequent cleaning and examination
may be necessary during treatment of dental and other oral disorders. Routine
examination of the teeth is recommended at least every year.
Information from around the globe is presented in this
bimonthly publication featuring approximately 50 abstracts from key articles in
dentistry. Dental Abstracts keeps dentists informed of developments and
advances in general dentistry and its specialties in an easy-to-read, abstract
format. Graphs, tables, and figures that have appeared in original articles are
also included. This time-saving publication covers topics such as guided tissue
regeneration, treatments for anterior single tooth implants, clinical
evaluation of dentin bonding agents, and more.[7-8]
Source articles for Dental Abstracts are selected primarily
from a list of over 120 journals covering not only world dental literature but
also related health care disciplines with practical relevance to oral health
professionals. Many factors are considered including scientific validity,
utility to the readership, international diversity, topic variety, and
timeliness. In addition to systematic reviews, randomized-controlled trials,
cohort and case-control studies, selections by the Editor-in-Chief also include
clinical guidelines, review articles, case reports, expert opinions,
editorials, dental practice management topics, and original commentaries. The
Dental Abstracts Editorial Board provides an important collaborative resource
to the editor and publisher regarding developing and assessing journal content
as well as submitting article and commentary suggestions.
Teeth cleaning is the removal of dental plaque and tartar
from teeth to prevent cavities, gingivitis, gum disease, and tooth decay.
Severe gum disease causes at least one-third of adult tooth loss.
Tooth decay is the most common global disease. Over 80% of
cavities occur inside fissures in teeth where brushing cannot reach food left
trapped after every meal or snack and saliva or fluoride have no access to
neutralise acid and remineralise demineralised teeth, unlike easy-to-clean
parts of the tooth, where fewer cavities occur.
Dental sealants, which are applied by dentists, cover and
protect fissures and grooves in the chewing surfaces of back teeth, preventing
food from becoming trapped thus halting the decaying process. An elastomer
strip has been shown to force sealant deeper inside opposing chewing surfaces
and can also force fluoride toothpaste inside chewing surfaces to aid in
remineralising demineralised teeth
Since before recorded history, a variety of oral hygiene
measures have been used for teeth cleaning. This has been verified by various
excavations done throughout the world, in which chew sticks, tree twigs, bird feathers,
animal bones and porcupine quills were recovered. Many people used different
forms of teeth cleaning tools. Indian medicine (Ayurveda) has used the neem
tree, or daatun, and its products to create teeth cleaning twigs and similar
products; a person chews one end of the neem twig until it somewhat resembles
the bristles of a toothbrush, and then uses it to brush the teeth. In the Muslim
world, the miswak, or siwak, made from a twig or root, has antiseptic
properties and has been widely used since the Islamic Golden Age. Rubbing baking
soda or chalk against the teeth was also common, however this can have negative
side effects over time.
Generally, dentists recommend that teeth be cleaned
professionally at least twice per year Professional cleaning includes tooth
scaling, tooth polishing, and, if tartar has accumulated, debridement; this is
usually followed by a fluoride treatment. However, the American Dental
Hygienists' Association (ADHA) publicly stated in 1998 that there is an absence
of evidence that scaling and polishing provides therapeutic value The Cochrane
Oral Health Group reviewed nine studies but found them to be of insufficient
quality and not enough evidence to support the claims of the benefits of
regular tooth scaling or tooth polishing. Between cleanings by a dental
hygienist, good oral hygiene is essential for preventing tartar build-up which
causes the problems mentioned above. This is done through careful, frequent
brushing with a toothbrush, combined with the use of dental floss to prevent
accumulation of plaque on the teeth.
Dentist and dental hygienist are about preventing tooth
loss and gum disease. The patient needs to be aware of the importance of
brushing and flossing their teeth daily. New parents need to be educated to
promote a healthy life and mouth for their children. At any age; a person
should be notified about how to take care of their teeth and how they will be
able to keep their teeth and not need dentures.
Plaque is a yellow sticky film that forms on the teeth and
gums and can be seen at gum margins of teeth with disclosing tablets. The
bacteria in plaque convert carbohydrates in food (such as sugar) into acid that
demineralises teeth, eventually causing cavities. Daily brushing with
toothpaste and flossing removes plaque.
Plaque can also cause inflammation of the gum (gingivitis),
making it red, tender and can easily bleed when flossing or brushing your
teeth. If this is not treated, bones around the teeth can be affected by the
various inflammatory factors, eventually leading to periodontitis. If not
treated, the loss of bone structure may cause teeth to become mobile. The
treatment is to remove plaque inside the deep pockets between the tooth surface
and the soft tissues using specialized dental equipment. If the treatment is
not successful, the gum will pull away from the teeth (receding gums) as a
result of the cessation of the inflammatory swelling.
The use of dental floss is an important element of oral
hygiene, since it removes plaque and decaying food remaining between the teeth.
This food decay and plaque cause irritation to the gums, allowing the gum
tissue to bleed more easily. Acidic foods left on the teeth can also
demineralise teeth, eventually causing cavities.
Flossing for a proper inter-dental cleaning is recommended
at least once per day, preferably before brushing so fluoride toothpaste has
better access between teeth to help remineralise teeth, prevent receding gums, gum
disease, and cavities on the surfaces between the teeth.
A dental hygienist demonstrates dental flossing.
It is recommended to use enough floss to enable easy use,
usually ten or more inches with three to four inches of taut floss to put
between teeth. Floss is then wrapped around the middle finger and/or index finger,
and supported with the thumb on each hand.
It is then held tightly to make taut, and then gently moved
up and down between each tooth. It is important to floss under visible areas by
curving the floss around each tooth instead of moving up and down on gums,
which are much more sensitive than teeth.
Bleeding gums are normal upon first usage of floss, but
will stop as gums become healthier with use.
One should use an unused section of the floss when moving
around different teeth. Removing floss from between teeth requires using the
same back-and-forth motion as flossing, but gently bringing the floss up and
out of gaps between teeth as shown in the fig.5.
An interdental brush, also called an inter proximal brush
or a proxy brush, is a small brush, typically disposable, either supplied with
a reusable angled plastic handle or an integral handle, used for cleaning
between teeth and between the wire of dental braces and the teeth. Brushes are
available in a range of widths, color coded as per ISO 16409. Interdental
brushes are classified according to ISO standard 16409:2006. The ISO brush
sizes range from 1 to 7. The ISO brush size is determined by the PHD or Passage
Hole Diameter in mm. This PHD is the minimum diameter of a hole that the
interdental brush will pass through without deforming the brush wire stemA
peer-reviewed clinical study has found that using a toothbrush and an
interdental brush more effectively removes plaque than using a toothbrush and
Some dental professionals recommend oral irrigation as a
way to clean teeth and gums Oral irrigators reach 3–4 mm under the gum line.
Oral irrigators use a pressured, directed stream of water to disrupt plaque and
Foods that help muscles and bones also help teeth and gums.
Breads and cereals are rich in vitamin B while fruits and vegetables contain
vitamin C, both of which contribute to healthy gum tissue Lean meat, fish, and
poultry provide magnesium and zinc for teeth.
Eating a balanced diet and limiting snacks can prevent
tooth decay and periodontal disease. The
Fédération Dentaire Internationale (FDI World Dental Federation) has promoted
foods such as raw vegetables, plain yogurt, cheese, or fruit as dentally
beneficial—this has been echoed by the American Dental Association (ADA).
Some foods may protect against cavities by naturally
containing fluorine, from which fluoride is derived. Fluoride is naturally
present in all water. Community water fluoridation is the addition of fluoride
to adjust the natural fluoride concentration of a community's water supply to
the level recommended for optimal dental health, approximately 1.0 ppm (parts
per million). One ppm is the equivalent of 1 mg/L, or 1 inch in 16 miles. Fluoride
is a primary protector against dental cavities. Fluoride makes the surface of
teeth more resistant to acids during the process of remineralisation. Drinking
fluoridated water is recommended by some dental professionals while others say
that using toothpaste alone is enough. Milk and cheese are also rich in calcium
and phosphate, and may also encourage remineralisation. All foods increase
saliva production, and since saliva contains buffer chemicals this helps to
stabilize the pH to near 7 (neutral) in the mouth. Foods high in fiber may also
help to increase the flow of saliva and a bolus of fibre like celery string can
force saliva into trapped food inside pits and fissures on chewing surfaces
where over 80% of cavities occur, to dilute carbohydrate like sugar, neutralise
acid and remineralise tooth like on easy to reach surfaces.[9-10]
Sugars are commonly associated with dental cavities. Other
carbohydrates, especially cooked starches, e.g. crisps/potato chips, may also
damage teeth, although to a lesser degree (and indirectly) since starch has to
be converted to sugars by salivary amylase (an enzyme in the saliva) first.
Sugars that are higher in the stickiness index, such as toffee, are likely to
cause more damage to teeth than those that are lower in the stickiness index,
such as certain forms of chocolate or most fruits.
Sucrose (table sugar) is most commonly associated with
cavities. The amount of sugar consumed at any one time is less important than
how often food and drinks that contain sugar are consumed. The more frequently
sugars are consumed, the greater the time during which the tooth is exposed to
low pH levels, at which point demineralisation occurs (below 5.5 for most
people). It is important therefore to try to encourage infrequent consumption
of food and drinks containing sugar so that teeth have a chance to be repaired
by remineralisation and fluoride. Limiting sugar-containing foods and drinks to
meal times is one way to reduce the incidence of cavities. Sugars from fruit
and fruit juices, e.g., glucose, fructose, and maltose seem equally likely to
Acids contained in fruit juice, vinegar and soft drinks
lower the pH level of the oral cavity which causes the enamel to demineralize.
Drinking drinks such as orange juice or cola throughout the day raises the risk
of dental cavities tremendously.
Another factor which affects the risk of developing
cavities is the stickiness of foods. Some foods or sweets may stick to the
teeth and so reduce the pH in the mouth for an extended time, particularly if
they are sugary. It is important that teeth be cleaned at least twice a day
preferably with a toothbrush and fluoride toothpaste, to remove any food
sticking to the teeth. Regular brushing and the use of dental floss also remove
the dental plaque coating the tooth surface.
Chewing gum assists oral irrigation between and around the
teeth, cleaning and removing particles, but for teeth in poor condition it may
damage or remove loose fillings as well. Dental chewing gums claim to improve
dental health. Sugar-free chewing gum stimulates saliva production, and helps
to clean the surface of the teeth
Smoking is one of the leading risk factors associated with
periodontal diseases It is thought that smoking impairs and alters normal
immune responses, eliciting destructive processes while inhibiting reparative
responses promoting the incidence and development of periodontal diseases
Regular vomiting, as seen in bulimia nervosa, also causes significant damage by
drinking fresh water after a caffeinated drink and also at the dentist by
surface cleaning. Mouthwash or mouth rinse with saline (salty water), fluoridated
solution or the antiseptic solution chlorhexidine gluconate can improve oral
hygiene by removing some tooth decaying materials. In particular, it may help
to remove some foods that were recently eaten. Retainers can be cleaned in
mouthwash or denture cleaning fluid. Dental braces may be recommended by a
dentist for best oral hygiene and health. Dentures, retainers, and other
appliances must be kept extremely clean. This includes regular brushing and may
include soaking them in a cleansing solution such as a denture cleaner. Oral
hygiene and systemic diseases. Several recent clinical studies suggest oral
disease and inflammation (oral bacteria & oral infections) may be a
potential risk factor for serious systemic diseases, such as Cardiovascular
Disease (Heart attack and Stroke), Bacterial Pneumonia, Low birth weight/Extreme High Birth Weight, Diabetes
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