Dental Plaque and affects of it

What is Dental Plaque ?
Dental plaque is a soft deposit that accumulates on the teeth. Dental plaque is a bio film, usually a pale yellow in colour that develops naturally on the teeth. Like any bio film, dental plaque is formed by inhabiting bacteria trying to attach themselves to a smooth surface of the tooth. It is a general term for the diverse microbial community, predominantly bacteria, found on the tooth surface. Dental plaque starts when bacteria that are usually present in the mouth attach themselves to teeth and begin multiplying. Plaque develops naturally on teeth, and forms part of the defence systems of the enamel. The process of attachment, growth, removal and reattachment of bacteria to the tooth surface is a continuous and dynamic aspect. According to studies, the carbohydrates present in the food forms a product called Dextran by the action of the bacteria, and this helps in binding of bacteria to the surface and formation of the thin layer.

Plaque can form on teeth both above the gum line, where it is called supra gingival plaque, or below the gum line on the roots of teeth, where it is named sub gingival plaque.

Plaque – the enemy of dental health.
Dental plaque thus is the almost invisible, soft, white substance that forms a little blanket that sticks on our teeth. Plaque is most noticeable when teeth are not brushed, and even after brushing it starts growing again immediately. Plaque consists of millions of germs in a sticky mass that are constantly forming. Plaque on teeth makes them feel furry to the tongue and by converting food into acids, plaque attacks teeth and can cause tooth decay and gum disorders. The plaque which keeps the germs close to the teeth is sometimes difficult to see. If we colour this plaque, by rinsing with a special agent or by chewing a special tablet called a disclosing tablet, we can see it quite easily. If left alone long enough, plaque begins to mineralize and harden into calculus or tartar because the plaque absorbs calcium, phosphorus and other minerals from saliva.

Fluoride increases the resistance of the enamel of the teeth to attack by acid. Studies have shown that most people have very little knowledge as to what fluoride or water fluoridation is. They also do not know that fluoride is a natural constituent of water supplies, and that water fluoridation is simply the process of topping up something which is there already, but at insufficient levels.

Effects of Plaque
Millions of germs in sticky plaque feed on the sugars you eat. Distinctly different kinds of germs dominate the plaque, depending on whether the mouth is healthy, or disease is present. In a healthy mouth, where the layer of plaque on the teeth is typically thin, bacteria that need oxygen grow and thrive. They are called aerobic organisms. These are the same bacteria normally found in the mouth. Some bacteria are able to grow with or without oxygen, although they prefer oxygen because it is beneficial to their metabolism and ability to survive. They are called facultative organisms, and they are more likely to be seen where there is disease. For example, people who regularly consume a diet rich in sugar content have large numbers of bacteria in their plaque that are associated with tooth decay or cavities. The primary microbe associated with cavities is a round shaped facultative germ called Streptococcus mutans (S.Mutans). These bacterial produce tooth dissolving acid when given an abundant supply of sugar to feed on.

They use the sugars to produce acids which are our substances like vinegar or battery acid. These acids are very strong and slowly, bit by bit, they attack your teeth until holes begin to form. One the hole is formed, it gets bigger and deeper and starts to cause pain and discomfort. If your teeth get hurt when you eat, drink hot or cold drinks, it is likely that you have a hole, even if you cannot see it. Some types of plaque cause tooth decay while other types of plaque cause gum disease

Plaque can also affect the gums by causing gum disease. Bleeding gums, bad breath, tender gums or loose teeth can be a sign of gum disease. Sometimes gums can be sick without being painful. If the gum disease is not treated, the tiny little strings that keep the tooth firmly connected to the bone are damaged and the tooth becomes loose. The formation of dental plaque on your teeth is part of normal human physiology. Therefore, it is not possible to prevent saliva and bacterial in the mouth from depositing on your teeth and contributing to the build up of plaque. So you really cannot prevent dental plaque from forming on your teeth. Besides, you would not want to, because in a healthy mouth, some dental plaque is beneficial. However, if you want your teeth and gums to remain healthy or return to a state of health, the number and types of bacteria that grow in the plaque must be controlled through regular brushing and practice of oral hygiene. Regular brushing and flossing habits prevent formation and also help remove any dental plaque present.

The Removal of Dental Plaque
The daily removal of plaque is the single most important factor in preventing gingivitis as well as the prevention of tooth decay which is caused by the acid formed by the bacterial in the same plaque. The correct tooth-brushing technique and the use of dental floss are essential for the removal of plaque. To keep the teeth clean is actually a difficult task, but rewards are marvelous – no cavities and no gingivitis will develop. Halitosis or bad breath will be prevented to a great extent.

Tooth decay

Tooth decay is a preventable disease. To maintain healthy teeth, a few basic tips are recommended:

· Eat a variety of foods for a balanced diet. Choose breads, cereals and other grain products; fruits; vegetables; meat; poultry and fish; and milk, cheese and yogurt.

· Limit the number of snacks that you eat. Each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

· If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt or a piece of fruit.

· Foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, which helps wash foods from the mouth and helps lessen the effects of acids.

· Brush twice a day with a fluoride toothpaste.

· Clean between your teeth daily with floss or inter-dental cleaners.

Visit your dentist regularly. Your dentist can help prevent problems from occurring and catch those that do occur while they are easy to treat

Health Risks of Poor Oral Health

Gum disease is an inflammation of the gums, which may also affect the bone supporting the teeth. Plaque is a sticky colourless film of bacterial that constantly builds up, thickens and hardens on the teeth. If it is not removed by daily brushing and flossing, this plaque can harden into tartar and may contribute to infections in the gums.

Left untreated, gum disease can lead to the loss of teeth and an increased risk of more serious diseases, such as respiratory disease. The bacterial in plaque can travel from the mouth to the lungs, causing infection or aggravating existing lung conditions.

There is also a link between diabetes and gum disease. People with diabetes are more susceptible to gum disease and it can put them at greater risk of diabetic complications.

Studies are also examining whether pregnant women with poor oral health may be at a higher risk of delivering pre-term, low birth weight (PLBW) babies than women with good oral health. Babies who are pre-term or low birth weight have a higher risk of developmental complications, asthma, ear infections, birth abnormalities, behavioural difficulties and are at a higher risk of infant death. Even though this research is ongoing, it is still important for pregnant women to take care of their gums and teeth.

Minimising your Risk

To maintain good oral health, you are advised to take the following steps:

· Brush and floss your teeth daily. Using an antimicrobial mouth rinse can also help to reduce the bacterial in your mouth.

· Visit your dentist regularly to have your mouth examined at least every six months. See your dentist immediately if you notice any problems.

· Eat a healthy and nutritive diet.

· Do not smoke or use tobacco in any form. If you do smoke or use any other forms of tobacco, like gutka or pan masala, make sure that you visit your dentist regularly for oral examination for any cancerous lesions.

· Also try and quit tobacco use at the earliest. The Tobacco Intervention Initiative (TII) Centres will help you in this regard.

· If you are pregnant, be sure to eat healthy foods and maintain good oral health and avoid tobacco use.

· Brush your children’s teeth for them, until they are able to write their own name. They should then be able to brush their own teeth with your guidance.

Gum disease

Gum disease is caused by infection or plaque around your teeth and is a common cause of tooth loss after age 35. The first stage and most common type of gum disease is gingivitis (jin-ji-vie-tus). Gingivitis irritates the gums and causes them to bleed and swell. Gum diseases are more often seen as people age, with most people showing signs of them by their mid-30s.

Periodontitis (pear-ee-o-don-tie-tus) is a more serious type of gum disease that, if left untreated, gets worse as pockets of infection form between the teeth and gums. This causes your gums to grow away from teeth and lose supporting bone. If the teeth cannot be supported, they could fall out. This disease results from bacteria in your mouth. You may be more likely to be infected with these bacteria if:

• someone else in your family has periodontitis.
• you are a smoker.
• you have a disease like diabetes or HIV.

Normal, healthy gums

Healthy gums and bone anchor teeth firmly in place.

Periodontitis

Unremoved, plaque hardens into calculus (tartar). As plaque and calculus continue to build up, the gums begin to recede (pull away) from the teeth, and pockets form between the teeth and gums.

Advanced periodontitis

The gums recede farther, destroying more bone and the periodontal ligament. Teeth-even healthy teeth – may become loose and need to be extracted.

Removal of plaque by brushing and flossing

It is necessary to remove the plaque by brushing and flossing, failing which generation of acids and other harmful substances will continue. This eventually destroys the tooth or the gum and the bone that holds the tooth in its place. As there are minerals in the saliva, the plaque not removed from the teeth becomes calcified and hardens – 50 percent within 48 hours and rock hard after 12 days. The calcified or hardened plaque is known as tartar. It is possible to control tartar build up by using toothpastes containing sodium pyrophosphate which interferes with mineral crystallization that causes tartar build up. Tartar can be removed only through dental cleaning and, therefore, requires professional help to remove.

Plaque and tarter contain harmful bacteria that can infect your gums. When teeth continually confront plaque, you get cavities because of disintegration of the tooth cover. Plaque collects along your gum line and between your teeth and if it is not removed with daily brushing and flossing or dental cleaning, the bacterial plaque and tarter will cause your gum tissue to get swollen and red. When your gum tissue is inflamed, it also bleeds. This is called gingivitis, the first stage in a very bad disease of the gums. The presence of inflammation of gums for long periods can also allow the plaque and tartar to start destroying the underlying bone structure eventually leading to periodontal disease. This is a more severe and harder form of disease to treat.

Prevention of gingivitis and periodontitis are important to maintain a healthy mouth and body. Although regular hygiene visits are important, nothing is more important than how well a person removes the plaque on a daily basis. Brushing after meals and daily flossing is the best defence against gum disease. Use of mouth rinses or mouth washes would be helpful in maintaining better oral hygiene.

Clinical uses of Calcium Phosphate Cements.

Clinical uses of Calcium Phosphate Cements.

The unique combination of biocompatibility, osteoconductivity and mouldability make CPCs suitable for a wide range of applications. The clinical uses cover both orthopaedics and dentistry.

The use of CPCs as a bone graft substitute has already been established. Successful clinical trials were conducted in maxillofacial reconstruction and in the treatment of the distal radius fracture. In additions, attempts have been made to use CPC for calcaneal fractures, hip fractures, the augmentation of osteoporotic vertebral bodies, tibial plateau fractures, the restoration of pedicle screw fixation, the reinforcement of thoracolumbar burst fractures, and the reinforcement of cancellous bone screws.

In dentistry, pre-clinical studies demonstrate their use in procedures like furcation perforation repair, treatment of periodontal infrabony defects, root canal filling/sealing, root apexification and alveolar ridge augmentation, and as bone filler for gaps around oral implants.