Oral Health Guidelines for Chinese Residents: General Population Chapter

I. Oral health is the foundation of general health. Oral health is an important part of general health, and in 2007 the World Health Organization proposed that oral disease is a serious public health problem that requires active prevention and treatment. Oral health includes “freedom from chronic pain in the oral and maxillofacial region, oropharyngeal cancer, oral ulcers, congenital defects such as cleft lip and palate, periodontal (gum) disease, caries, loss of teeth, and other diseases and dysfunctions affecting the oral cavity.” Oral health directly or indirectly affects general health. Oral diseases such as caries and periodontal diseases destroy the hard tissues of the teeth and the supporting tissues around the teeth, which in addition to affecting the functions of mastication, speech, and aesthetics, also cause difficulties in social interaction and psychological disorders. Some microorganisms that exist in the oral cavity for a long time can cause or aggravate certain systemic diseases such as coronary heart disease, diabetes, etc., jeopardizing the health of the whole body and affecting the quality of life. The impact of systemic diseases on oral health should not be ignored, some systemic diseases may appear in the oral cavity corresponding symptoms. For example, diabetic patients with reduced resistance to infection, often accompanied by periodontitis, extraction wounds are difficult to heal. AIDS patients early oral lesions, such as oral candidiasis, hairy white spots, Kaposi’s sarcoma. Jinan Military General Hospital stomatology Bi Yingchun Second, caries and periodontal disease is jeopardizing the oral health of our residents of the two most common diseases. National oral health epidemiological survey shows that caries (commonly known as insect teeth or tooth decay) and periodontal disease (including gingivitis and periodontitis) are the two most common diseases that jeopardize the oral health of our residents, and the treatment is more complicated and costs more time and money. Changes in the color, shape and texture of the hard tissues of decayed teeth occur as a result of certain bacteria in the mouth, which gradually produce acid by fermentation using sugar in food. In the early stage of caries, there is generally no pain and discomfort, and only when the doctor examines the tooth can be found on the surface of the black spots or white spots; further development of caries can form cavities, acid, sweet, cold, hot and other stimuli will feel pain and discomfort; serious pain caused by cold and hot stimuli is very obvious; if you do not get timely treatment, and finally the destruction of the tooth into the residual root, residual crowns, and even lead to the loss of teeth, resulting in serious chewing difficulties, affecting the health. If not treated in time, the destruction of the tooth body will become stumps and crowns, and even lead to tooth loss, causing serious chewing difficulties and affecting health. Periodontal disease is a variety of diseases that occur in the supporting tissues around the teeth (dentin, alveolar bone, gums, periodontal membrane). First of all, the gums are red and swollen, and bleed easily when touched. If not treated in time, gum recession, alveolar bone resorption, periodontal pocket formation, tooth loosening and shifting, and sometimes cause periodontal pus overflow, oral odor, and finally make the teeth fall off or extracted. Therefore, periodontal disease is the main cause of tooth loss in adults. The two major oral diseases mentioned above are mainly caused by plaque. Therefore, removing plaque through self oral health care and professional oral health care is the basis for maintaining oral health. Brush your teeth in the morning and evening, and rinse your mouth after meals. Brushing teeth can remove plaque, soft dirt and food debris, maintain oral hygiene, and preserve the health of teeth and periodontal tissues. After hours of brushing to remove plaque, plaque can be reattached to the clean surface of the teeth, constantly forming, especially at night after sleep, saliva secretion is reduced, the oral self-cleaning effect is poor, bacteria are more likely to grow. Therefore, you should brush your teeth at least twice a day, and it is even more important to brush your teeth before going to bed at night. Brushing your teeth and using a tongue brush to clean the back of your tongue can significantly improve oral odor. Rinsing your mouth after meals can remove food debris from your mouth and keep it clean. Chewing sugar-free gum can also stimulate saliva secretion, reduce oral acidity, help breath fresh, clean teeth. Fourth, do one person a brush a mouthful of cup. In the same family, each person’s age is different, physical health is not the same, oral health is also different, and thus have different oral health care needs. According to the different conditions of each person, should choose the toothbrush and toothpaste suitable for the needs of each person. If a family shares a toothbrush and a mouthwash cup, it may cause diseases to spread to each other. Therefore, it is necessary to do a person a toothbrush and a mouth cup, each person placed separately to avoid cross-infection. Fifth, the correct choice and use of mouthwash. Water gargle can remove food debris in the mouth, but its removal power is weak and not enough to remove plaque. Some of the mouthwashes currently on the market have added certain antibacterial and anti-inflammatory substances, which have certain auxiliary control of dental plaque and maintain oral health. Such as fluoride mouthwash is a local fluoride prevention of caries, suitable for use in low-fluoride areas, fluoride areas of schools and families; Chlorhexidine mouthwash can kill saliva and adsorption to the bacteria on the tooth surface, suitable for periodontal disease patients to use; essential oil as the main active ingredient of the gargle, there is a broad-spectrum sterilizing effect, suitable for daily use. There are also mouthwash can suffer from stomatitis, lipitis when gargling, to prevent infection, promote the role of wound healing. Sixth, advocate the use of horizontal flutter brush method of brushing. Horizontal trembling brush method is an effective way to remove plaque in the gingival sulcus brushing method. Brushing is to gently rub over, master this brushing method, can help remove the plaque on each tooth surface, and at the same time can effectively remove plaque in the neck of the tooth and gingival sulcus. Specific operating principles are: ① hold the toothbrush handle, the first brush head placed in the mouth on the side of the neck of the back teeth, the brush bristles and the long axis of the teeth at an angle of about 45 °, the brush bristles pointing to the direction of the root (maxillary teeth up, mandibular teeth down), slight pressure, so that some of the brush bristles into the gingival sulcus, part of the gingival placed on the gums; ② 2 ~ 3 teeth as a group to start brushing, with a short-distance horizontal vibration of back and forth movement in the same place! Brush at least 10 times, and then turn the toothbrush toward the crown, continue to brush the lip (cheek) tongue (palate) surface of the teeth; ③ after the first part of the brush, move the toothbrush to the next group of 2 ~ 3 teeth to reposition the toothbrush, pay attention to the first part of the first part of the overlap with the area, continue to carry out the next part of the brushing; ④ brushing the tongue surface of the upper anterior teeth, brush head placed vertically on the surface of the teeth, so that the front bristles contact the gingival margins, and then brushing from top to bottom. Brush from top to bottom. When brushing the lingual surfaces of the lower front teeth, brush from the bottom up; ⑤ When brushing the occlusal surfaces, point the bristles to the occlusal surfaces and brush back and forth for a short distance with a little force. Promote the use of health care toothbrushes and pay attention to timely replacement. Health care toothbrush has the following characteristics: ① brush head is small, so that in the mouth (especially the back of the mouth) turn freely; ② brush bristles are reasonably arranged, generally 10 to 12 bundles long, 3 to 4 bundles wide, there is a certain spacing between the bundles, not only is conducive to the effective removal of plaque, but also to make the toothbrush itself easy to clean; ③ bristles softer, appropriate length of the bristles, brush bristles rounded at the top blunt, to avoid toothbrush on the teeth and gums of the damage; ④ The toothbrush handle is of moderate length and width, and has a non-slip design, making it easy to hold and comfortable to feel. After brushing, food debris and bacteria often stick between the bristles of the toothbrush, which may lead to the spread of diseases. After brushing, the toothbrush should be rinsed with water and the water on the bristles should be shaken off, and the brush head should be placed in a cup with the head upwards in a ventilated place. To prevent toothbrushes from harboring bacteria, you should generally replace your toothbrush every three months or so. If the bristles are bent or inverted, it will cause damage to the hard and soft tissues of the mouth, then it needs to be replaced immediately. Eight, advocate the choice of dental floss or interdental brush to assist in cleaning the gap between the teeth. The gap between teeth and teeth is called the neighboring gap or interdental space, interdental space is most likely to retain plaque and soft dirt. When brushing teeth, toothbrush bristles can not fully reach the gap, if the daily brushing at the same time, with the use of dental floss or interdental brush to help clean the gap, you can achieve the purpose of a thorough cleaning of the teeth. Dental floss is made of nylon, silk or polyester thread, which helps to clean the interspaces between the neighboring surfaces or the gum papillae, and is especially suitable for flat or convex surfaces. Interdental brushes have a metal wire head with soft bristles attached around it, and are suitable for patients with receding gums and exposed roots to remove plaque from the surfaces of the teeth in the gingival spaces and the root surfaces. It should be noted when using, if the gingival papilla without recession, insertion difficulties, do not force into, so as not to damage the gums. Nine, according to oral health needs to choose toothpaste, promote the use of fluoride toothpaste to prevent caries. Toothpaste is an agent to assist in brushing, which can enhance the friction of brushing, help remove food debris, soft tartar and plaque, help eliminate or reduce oral odor, and make the breath fresh. Adults only need about 1 gram (about 1 cm in length) of paste per brushing. If other active ingredients such as fluoride, antibacterial drugs, tartar control and anti-sensitivity chemicals are added to the toothpaste paste, it has the effect of preventing caries, reducing plaque, inhibiting tartar formation and resisting tooth sensitivity respectively. Fluoride toothpaste has a significant anti-caries effect, and its widespread use worldwide is one of the main reasons for the significant decrease in the incidence of caries. Brushing teeth with fluoride toothpaste is a safe and effective anti-caries measure, especially suitable for children and the elderly who have a tendency to suffer from caries. But it should be noted that: toothpaste is not medicine, can only prevent oral diseases, can not treat oral diseases, oral diseases or should be timely medical treatment. Ten, scientific use of fluorine is conducive to dental and general health. Fluorine is a trace element necessary for human health, intake of fluoride can reduce the solubility of teeth and promote the remineralization of teeth, inhibit the growth of oral microorganisms and prevent the occurrence of caries. Fluoride application can be divided into systemic application and local application. Systemic application includes: water fluoridation, salt fluoridation, milk fluoridation, fluoride tablets, fluoride drops; topical application includes: fluoride toothpaste, fluoride mouthwash, topical fluoride coating, fluoride paint, fluoride foam, fluoride gel and so on. However, excessive intake of fluorine by human body can also lead to some side effects, so the promotion and application of fluoride is suitable for the high-risk groups in low-fluoride areas, fluoride-suitable areas and areas with high incidence of caries. XI. Eat sugar scientifically and drink less carbonated beverages. Sugar is one of the main nutritional elements of human beings, is the main source of human energy, is the flavoring agent of many foods and beverages, and is also recognized as a risk factor for the occurrence of caries. Sucrose is the main cause of caries, followed by glucose and starch. If you regularly consume too much sugary sweets or drink too many carbonated drinks, it will lead to demineralization of teeth, cause caries or produce tooth sensitivity. Therefore, it is very important to promote scientific sugar consumption. The more often you eat sugar, the greater the chance of dental damage, so you should try to reduce the number of times a day to eat sugar; less carbonated beverages, rinse your mouth with water or tea after eating, and you can’t eat after brushing your teeth at night before going to bed. Smoking is harmful to oral health. Smoking is the main risk factor for oral cancer, and more than 90% of oral cancer patients are smokers. Smoking is also one of the main risk factors for periodontal disease, and smokers are 5 times more likely to suffer from periodontal disease than non-smokers. Smoking or passive smoking by pregnant women can cause oral and maxillofacial malformations in the fetus. Smokers often appear on the surface of the teeth brown plaque and tartar, triggering oral odor, affecting personal appearance and social interaction. Oral health checkups should be conducted at least once a year. Oral diseases such as caries and periodontal disease often occur slowly. Early no obvious symptoms, usually not easy to notice, until the emergence of pain and other uncomfortable symptoms may have reached the late stage of the disease, the treatment is very complex, the patient will also suffer more pain, spend more money, the treatment effect is not necessarily very satisfactory. Therefore, regular oral health checkups, at least once a year, will enable timely detection of oral diseases and early treatment. Doctors will also take appropriate preventive measures according to the needs of the situation to prevent the occurrence of oral diseases and control the development of oral diseases. Fourteen, advocate annual dental cleaning (scaling) once. Plaque, food debris, soft tartar attached to the surface of the teeth deposits, and saliva in the mineral combination, gradually calcified to form tartar. Tartar surface roughness, the gums cause adverse stimulation, but also conducive to the adhesion of new plaque, is caused by periodontal disease is a contributing factor. Self-oral care methods can only remove plaque, not tartar. Therefore, it is necessary to go to the hospital regularly to have your teeth cleaned by an oral surgeon, preferably once a year. A dental cleaning is performed by an oral surgeon using dental instruments to remove tartar and plaque deposited on the gums and subgingival areas around the gingival margin. There may be slight bleeding during the cleaning process and temporary tooth sensitivity after the cleaning, but it generally does not harm the gums or teeth, and will not result in thinning or loosening of the teeth. Regular dental cleaning can maintain strong teeth and periodontal health. Fifteen, oral discomfort, pain, bleeding gums, odor and other symptoms should be timely consultation. Oral diseases can be manifested as symptoms of pain or discomfort. Such as caries is often manifested in hot and cold stimulation discomfort, bite discomfort or pain; pulpitis will occur in severe spontaneous pain, night pain; gingivitis early in brushing or biting hard objects when bleeding gums; oral ulcers accompanied by a painful sensation triggered by the touch of the affected area; sensitive teeth in the encounter of cold, hot, acidic, sweet and other stimuli, a brief and sharp pain. Halitosis, 80% to 90% of which is caused by oral diseases, is mainly due to the production of volatile sulfur compounds by anaerobic bacteria in the mouth through rotting and digesting stagnant substances in the mouth. Occurrence of the above situation should be as soon as possible to go to a qualified oral health care institutions for consultation and treatment. Repair missing teeth in time. Teeth have the function of chewing food, assisting in pronunciation and maintaining the shape of the face. Missing teeth are prone to chewing difficulties, food impaction, to? Teeth elongation, neighboring teeth tilt, etc.. Missing front teeth will also lead to inaccurate pronunciation, facial shape changes, after the loss of all teeth, chewing is very difficult, the face is obviously old. Therefore, regardless of the number of lost teeth, should be timely denture repair. Restoration is generally carried out 2~3 months after tooth extraction. Before the restoration should treat the remaining teeth of the disease, if necessary, the alveolar bone and soft tissue repair, to ensure the quality of the restoration. Currently, there are mainly active restorations and fixed restorations (including fixed bridges and implant dentures) for the restoration of missing teeth. The specific choice of restoration method should be based on the patient’s oral conditions and subjective requirements. Choose qualified medical institutions for oral health care and treatment. For oral health care and treatment, it is necessary to choose qualified dental institutions in order to ensure good quality of care and strict infection control. The so-called qualified dental institutions refer to the dental clinics, outpatient clinics, general hospitals and dental hospitals that have been registered and obtained the Medical Institutions Practice License in accordance with the Medical Institutions Administration Regulations and the Medical Institutions Administration Regulations and Rules. In the process of oral diagnosis and treatment work, the patient’s blood, saliva contaminated instruments and other diagnostic and treatment equipment are the risk factors of cross-infection. Qualified medical institutions have a set of perfect infection control management system, measures and sterilization equipment to ensure that one person, one handpiece, one sterilization, can completely eliminate cross-infection in the treatment process. Moreover, the dentists of qualified medical institutions should have received professional education in dentistry and training in clinical medical skills, obtained the qualification of physicians and registered to practice, and have the ability to solve the patients’ pain. For oral health care and treatment, it is important to choose a qualified dental institution in order to ensure good quality of care and strict infection control. The so-called qualified dental institutions refer to dental clinics, outpatient clinics, dental departments of general hospitals, and dental hospitals that have been registered and obtained a Medical Institution Practice License in accordance with the “Regulations on the Administration of Medical Institutions” and the “Rules of the Regulations on the Administration of Medical Institutions”. In the process of oral diagnosis and treatment work, the patient’s blood, saliva contaminated instruments and other diagnostic and treatment equipment are the risk factors of cross-infection. Qualified medical institutions have a set of perfect infection control management system, measures and sterilization equipment to ensure that one person, one handpiece, one sterilization, can completely eliminate cross-infection in the treatment process. Moreover, dentists in qualified medical institutions should have received professional education in dentistry and training in clinical medical skills, be qualified and registered to practice dentistry, and have the ability to solve patients’ problems.