Oral Health

Posted: June 6, 2012 in Health



Oral health means much more than just healthy teeth.

Oral health is the state of being free from chronic mouth and facial pain ,oral and throat cancer, oral sores, birth defects such as cleft lip and cleft palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the oral cavity ….WHO.

It is thus a standard of health of the oral and related tissues which enables an individual to eat, speak and socialize without active disease, disorder or embarrassment and which contributes to general well being.

Oral cavity (mouth) is part of cranio-facial complex (the oral, dental, and other craniofacial tissues that house the organs of taste, vision, hearing, and smell). Cranio-facial complex has organs whose function is to experience and interact with the world around us / to sense our environment. The craniofacial tissues are interconnected via the nervous system and help us not only  to trigger protective reflexes that make us blink, gape, and start in surprise, but also enable us to perform countless functions we take for granted, yet they represent the very essence of our humanity. We speak and taste and chew and swallow. We express our feelings through facial expressions. Smiles and scowls; we grimace and cry out in pain; we murmur endearments and kiss out our loved ones.

Any damage to the cranio- facial complex whether from disease, disorder or injury warrants social and psychological consequences that strike at our very identity. We see ourselves and others see us in terms of the face we present to the world. Diminish that image in any way and we risk the loss of self esteem and well-being.

Mouth is a mirror that reflects on general health. E.g. presence of disease, disease progression, risk factor exposure levels, oral cells and fluids are used as diagnostic tools. Many systemic disease conditions present with oral manifestations e.g. diabetes, heart disease and stroke, anemia, HIV/AIDS, adverse pregnancy outcomes etc.  Mouth also acts as a portal of entry for infections.

Health is defined as a complete (body, soul & spirit) state of physical, mental and social well-being, and not just the absence of infirmity….WHO.

It then follows that you cannot be healthy without oral health. Oral health is a critical component of general health and should not be interpreted as a separate entity. It must be included in the promotion of healthcare and in the design of community health programs.



  • Life long lifespan of your teeth. You never assume you will lose your teeth in your lifetime.
  • Preserves masticatory (eating) and speech/phonation functions thus improved quality of life.
  • Maintains Aesthetics/ smile
  • Ensures career achievement e.g. modeling, musician, police
  • Fosters self esteem and good social interaction
  • Knowledge of teeth has been used in forensic identification and age assessment.




Most negative consequences are due to improper and infrequent brushing and flossing. Include but not limited to;

  1. Plaque – soft, sticky, creamy yellow or colourless bacterial film that grows on teeth and dorsum (upper surface) of tongue. Starts forming 4-12 hrs after brushing. Habours bacteria that breakdown sugars releasing acids (lactate, pyruvate etc) that cause tooth demineralisation. Is the main cause of caries, gingivitis and harlitosis (foul smell).
  2. Calculus / Tartar – Hardened plaque. Yellow or brown deposit. Is crusty and has rough surface that harbours more bacteria. Subgingival calculus causes periodontal disease.
  3. Gingivitis – inflammation (red, swollen, tender, easily bleeds) of the gums. Early form of periodontitis. Reversible with proper dental care.
  4. Periodontitis – disease of the periodontium (supporting structures of the teeth- gum, cementum, periodontal ligaments and alveolar bone).

Signs: gingivitis and gum recession with root exposure (CAL),sensitivity,  loss of  gingival scalloping, loosening and drifting of teeth,  dull & poorly localized toothache/discomfort, abscess, foul smell.

  1. Tooth decay / Dental caries – brown/black substance left after the mineral component of tooth is dissolved by acid produced by bacteria. Presents as holes on tooth surfaces. Prevalence in kenyan children under 5yrs 50% .
  2. Oral cancer (squamous cell carcinoma)– affects 2% of general population. Painful ulcerated lesion on tongue, oral mucosa, palate, oropharynx, lips etc. risk factors include tobacco and alcohol use, Radiation, ultra violet rays exposure, viruses (HPV), genetics.

DENTAL CARE PROFESSIONALS – the wider dental team.

  • Dentists (general practitioners and specialists)
  • Community oral health officers
  • Dental hygienists
  • Dental nurses
  • Dental technologists


Safe and effective disease prevention measures exist that everyone can adopt to improve oral health and prevent diseases.

  1. Daily oral hygiene procedures. Brush twice a day and floss once a day.
  2. Adopt healthy lifestyle behaviours. Minimize general health risk factors. Quit use of tobacco (smoking, snuffing, ugoro), betel nut chewing, alcohol, khat (miraa),snacking on caryogenic diets (highly refined sugars), reduce stress levels (to prevent bruxism and teeth grinding habits), don’t open soda using teeth, prevent a child from thumb/digit sucking and tongue thrusting, warn somebody of nail biting etc.
  3. Community programs e.g. fluoridation of water, milk, toothpastes, mouth rinses , sugarless chewing gums
  4. Visit the dentist atleast once every year for check up and to benefit from intervention/treatment services e.g. restorations/fillings, root canal treatment, crowns and bridges, pits and fissure sealing, orthodontic alignment, scaling and polishing, fluoride therapy, root planning, dental implants, diagnostic services e.g. x-ray, oral cancer screening, tooth extraction and replacement of lost teeth.


  1. Start early. wipe infants and toddlers gum pads and teeth with clean moist soft piece of cloth or gauze then introduce soft tooth brush at a later age. You get more cooperation this way.
  2. Model the habits you want to see. You are the first teacher, so lead by example. Make it a family/school affair.
  3. Use marketing magic – buy them brushes of their favourite colour, decorated with their favourite pictures, that light up or play music, shark shaped flossers etc. choose a toothpaste with flavor of their taste.
  4. Rev it up. Battery powered toothbrushes intrigue children by their rotating/ oscillating bristles. It creates fun in tooth brushing by creating an element of play/game.
  5. Create a reward chart.  The child marks the days they have brushed. evaluate and reward cooperation with much praise. Find out why they skipped brushing on some days. Catch them doing it right and reward/praise  them.
  6. First things first: to make them brush after meals, hold back their favourite play, video game, or play outside till they brush. They learn that by refusing to brush they have few options.
  7. Buy them a new toothbrush, tooth paste and floss. There is always excitement to use a new item.
  8. Use educational tools. Charts, models.

What cultural practices exist in your community that affect teeth?

What is teething?

How many teeth are there in human deciduous dentition?

Have you ever heard of nursing bottle caries?

Have you encountered cases of fluorosis?


  1. Lack of access to care; limited income, lack of insurance, transportation, flexibility to take time off from work and to attend to personal or family oral health care needs.
  2. Disability
  3. Public, policy makers and providers- not prioritizing oral health.  We need to raise awareness to improve health literacy.


  1. Dietary counseling
  2. Preventive oral health programs initiated
  3. Strengthen already existing programs
  4. Incorporate oral health in primary healthcare programs
  5. Policy makers to come up with guidelines on advertisements promoting caryogenic snacks.
  6.  Increased oral healthcare financing



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