1, accept the oral health information to think about whether the scientific evidence is sufficient?
The 21st century is the age of information, the age of network, the age of prevention, the age of health care for all, the age of health for all. Nowadays, all kinds of information about health, through various information channels, are constantly transmitted to your eyes and ears every moment, see and hear, and even let you personally experience and try, really dazzling you, nothing to do, or hesitate or deceived.
What is said sounds as if there is a reason, there are reasons, and even evidence. These evidences are often Zhang San used ×××, Li Si used ×××, often with the experience of individuals or examples to prove its effectiveness, however, such health information is reliable, credible? The question can only be answered by the adequacy of scientific evidence.
Today, I will first talk about the new concept of oral health. What does it mean to be healthy? What does oral health mean? What is the relationship between oral health and general health? How much does it relate to the quality of life throughout one’s life? How can one maintain one’s oral health throughout one’s life, mainly by oneself, or mainly by doctors? What methods are safe and effective and affordable? How much scientific evidence is available for these methods?
How does the scientific evidence differ from your own experience? What should I believe? What not to believe? Do I have to stick to it for a long time to see results? The purpose of self oral health care is to maintain one’s oral health. Oral health, the whole body can be healthy in order to develop your talents, achieve your life’s aspirations and goals, and enjoy the pleasures of life.
Zhuangzi “the world” in a sentence: judge the beauty of heaven and earth, analyze the reason of all things. Used in life health, can be changed to “judge the beauty of the body, analysis of the reason for life”, used in oral health, can be changed to “judge the beauty of the mouth, analysis of the reason for care”. Oral health, really beautiful, to achieve the beauty of oral health, we must know the theory of care, care of the law, care of the line, in order to have care of the fruit.
About oral health, there are several traditional misconceptions, there are also some misleading, there is more is the need for correct understanding, moderate mastery.
(1) Several misconceptions about oral health.
① “People lose teeth in old age is a natural phenomenon” This is the first misconception. The common people have a verbal phrase called “old tooth loss” is not a person old, teeth will definitely fall out? From experience, for thousands of years it seems to be so, the old man smiles, the first to see no teeth in the mouth, called “toothless old”. It is no wonder that in the poems of the great poets of the Tang and Song dynasties, there are many expressions about teeth, such as “twilight teeth”, which means old age, and in the poem “Growing old” by Bai Juyi, it is said: “Today and tomorrow, I do not realize that my teeth are old”.
Han Yu said in his poem “To Liu Shifu”, “I have many missing teeth today, and all the ten or so remaining are ugly”, and Lu You, a great poet of the Song Dynasty. Although he was a long-lived old man and lived to be 85 years old, his tooth decay and periodontal disease were very serious, and almost troubled his whole life, otherwise, he would have written more than 150 poems related to oral diseases! In one of the poems about “tooth decay”, there are these lines: “Life in heaven and earth is not a solid gold and stone. Moreover, after a long period of time, the decay will not be complete again”.
In their poems, there are many words about tooth decay and periodontal disease, such as tooth shaking, tooth sparse, tooth falling, tooth open, tooth cold, tooth root floating and so on.
At that time, due to the helplessness of oral disease, the traditional concept of “people will lose their teeth when they are old” was formed. In fact, modern science has proved that people will not lose their teeth when they are old, but also have a good mouth of real teeth. And if you do not pay attention to oral health, there are a lot of dangerous factors harmful to oral health, even if people are young, may also lose teeth, and even become young “no teeth old”, remember that during World War II, the United States draft, in the first two million recruits qualified standards, as long as there are 6 pairs of upper and lower can be on the teeth, 3 pairs of incisors, Even with this minimum condition, there were still 1/5 of the 2 million recruits, that is, 400,000 people, who could not meet this requirement.
In modern developed countries, some people do not have a tooth decay in their mouth until they are 30 years old, and in many countries, 50-80% of preschool children do not have tooth decay. More and more elderly people keep their real teeth. In recent decades, because the oral diseases, especially dental caries, have been declined significantly, as early as in 1994, during the World Health Day, the document of World Health Organization has pointed out that the prevention of caries and periodontal disease is not only theoretically possible, but also practically feasible. In other words, it is possible to do. Therefore, it is not necessary for people to lose their teeth when they are old. The key is to take care of yourself. To invest in health, we have to start from small, from me. The key is three words: oral hygiene, appropriate amount of fluoride and the development of oral health-friendly eating habits.
②”Milk teeth have to be replaced sooner or later anyway, so caries can be left untreated.” This is the second misunderstanding, the key is the parents’ awareness. Therefore, the caries rate of children’s milk teeth in China is very high, 77 out of 100 children have caries, and each child has more than 4 caries teeth on average, and there are many bad milk teeth and many missing teeth too early, which will inevitably cause the disorder of the whole oral growth and development.
First of all, if the disease of milk teeth is not treated, the condition will be aggravated gradually, because the chronic or acute pain will prevent children from eating and affect the nutritional intake, moreover, the incomplete chewing function of teeth will also affect the normal development of jaw and face. If the baby teeth play a guiding role in the eruption of permanent teeth, they must be maintained until the age of normal loss, so that the permanent teeth can erupt normally. Normal healthy milk teeth, because the chewing function can play a normal role, can promote human brain development, as well as the healthy development of jaw and facial bones and muscles, and play a role in promoting the health of the whole body, therefore. It is important to protect the milk teeth and to treat them promptly, the earlier the better, in order to lay a good foundation for a lifetime of oral health and general health.
③ “Tartar has the role of protecting teeth, and if you remove it, your teeth will be loose” is the third misconception. What is tartar? Tartar is not a normal tissue in the human body, it is a foreigner, so to speak. Tartar is a hard dirt in the mouth, just like the scale in the kettle, water rust, can also be said to be calcified plaque, there are 80-90% of the minerals mainly in the form of apatite. People with poor oral hygiene or high alkalinity of saliva tend to deposit tartar, and the more it accumulates, the thicker it becomes.
On the surface, it seems to help hold the teeth in place. This is an illusion. In fact, it can stimulate gum congestion and inflammation, causing gingivitis and even periodontitis, and can lead to gum recession and root exposure, and it is even more harmful if it is deposited under the gums, stimulating gum bleeding and pus, worsening periodontal disease, and tartar is generally very hard. It cannot be removed by brushing, and there is nothing you can do except for scaling and removal by dental professionals.
If you have never had your teeth cleaned for more than ten years or decades, it has made your gums red, inflamed, and receded, and the roots of your teeth are exposed. After the first removal, of course, you will feel the gap between your teeth, the roots of your teeth are exposed, and your gums are receding. This is a consequence of not cleaning your teeth for many years, not a consequence of scaling, which would not have happened if you had scaled your teeth in time. Therefore, it is necessary to have your teeth cleaned regularly.
This is another misconception. If your gums are bleeding, it means you have gingivitis, so of course you should go to the dentist, but you should not stop brushing your teeth, you can use a soft-bristled toothbrush to brush your teeth more carefully, remove plaque and massage your gums. Of course, if you brush your teeth with herbal toothpaste or rinse your mouth with some medicated rinse, you can recover from gingivitis as soon as possible.
(2) In addition to the above-mentioned misconceptions, there are also some misinformation.
For example, “fluoride toothpaste is a double-tough sword”, which means “both beneficial and harmful”. There is no scientific evidence for this claim, and the year before last, a newspaper reported incorrectly that a doctor’s prescription was required to buy fluoride toothpaste in one country. In order to clarify this fact, our experts personally contacted the president of the dental association of that country and contacted the International Dental Federation and the World Health Organization and confirmed that it was a false report and that it was the unanimous position of many international organizations and experts to recommend the use of fluoride toothpaste. Therefore, at that time, the National Dental Protection Group and the Chinese Dental Association jointly published information on the Internet, affirming the safety and effectiveness of using fluoride toothpaste for caries prevention. Why do the domestic and foreign professional organizations and most experts recommend the use of fluoride toothpaste as a public health measure to prevent caries?
It is because for half a century, especially in the last 30 years or so, many developed countries and some developing countries have seen a significant decline in dental caries. In addition to the fluoridation of drinking water, the second major reason is the application of fluoride toothpaste, in addition to this basic fact, that is, a large number of scientific research provides sufficient scientific evidence. Sheiham, a world-renowned professor of dental public health in the UK, after a systematic evaluation of a large body of scientific literature, concluded that the use of fluoride toothpaste is safe and effective. For example, it is not recommended for children under 3 years of age because they are too young and have poor self-control and may swallow it accidentally, which makes it unsafe for long-term use.
②Toothpaste should be used alternately, long-term use of a toothpaste has drug resistance
This statement is not sufficient scientific evidence. Generally speaking, the choice of toothpaste should be considered according to the oral health condition of a person, for children, they are most prone to caries, so toothpaste containing fluoride should be the first choice, whether it contains sodium fluoride, sodium phosphate or both. And it should be used for a long time to have the effect of caries prevention. In addition, people with poor periodontal health who often have gum bleeding and gingivitis should prefer herbal toothpaste or medicated toothpaste with gingivitis prevention effect.
However, most of the medicated toothpaste sold in the market are oral health care products, not medicine, and have no therapeutic effect. Therefore, if you have a dental disease, you should first go to the doctor to receive proper treatment and choose toothpaste under the guidance of the doctor.
There are also many oral health knowledge questions that need to be answered with scientific evidence, such as: what is the scientific principle of sugar use? Which is better, dentures or real teeth? Can rinsing replace brushing? Does flossing with a toothpick widen the gap between teeth and loosen them? Is it necessary to have a dental cleaning once every six months or once a year? Is chewing sugar-free gum really effective in preventing caries? In which period of children’s life and which teeth are most important to prevent caries? Does brushing with a toothbrush always get the teeth clean? Which is more effective: a manual toothbrush than an electric toothbrush? Does oral health depend mainly on oneself or on doctors?
These are some of the misconceptions, misinformation, and questions that need to be answered with scientific evidence. These issues are closely related to oral health.
2.What is the new concept of oral health?
”Good teeth, good appetite, eat well!” It is a kind of enjoyment and psychological satisfaction to say that a person has good teeth and good appetite, because the function of teeth is good and everything can be eaten. However, is this true at one stage of life, or is it true throughout life? Are there any risk factors or bad habits? Are there any effective health care measures to maintain this state? Does having a good mouth mean that the mouth is healthy?
The general understanding of health is that no disease is healthy, referring to a state of a person, how long it lasts, it is not said, it is not clear. Some people say that a strong body or strong resistance to disease, not easy to get sick is healthy. Others say that health is a state of doing things. Being able to do things to the best of one’s ability is health.
According to a foreign expert, health can be understood in the opposite sense, as the absence of disease and the ability to function in a way that can cope with daily activities, or in a positive sense, as the sturdiness of the body and the state of well-being. The World Health Organization charter of 1946 states that “health is a state of complete physical, mental and social well-being of a person. It is not merely the absence of disease or infirmity.” This is undoubtedly a more complete concept, but some people criticize that this concept of health is too idealistic, not easy to achieve and unrealistic.
The new contemporary understanding of the concept of oral health, the World Health Organization in 1984 also proposed that health is a response to the degree of ability of a person or a group of people. It is a positive concept that emphasizes health as a resource for society and the individual, as well as the capacity of the body (tolerance and tolerance).
In the late 70s and early 80s, the World Health Organization proposed 10 specific criteria for human health.
① energy, easy to carry the burden of daily life, heavy work without feeling nervous, tired
② optimism, positive attitude, willing to take responsibility, no matter how big or small, not fussy
③Good at rest, sleep well
④Resilient, able to adapt to various environmental changes in the outside world
⑤ Can resist general diseases such as colds and infectious diseases
(6) Appropriate weight and proportionate body. When standing, the head, shoulders and hips are in a coordinated position
(7) Bright eyes, quick reaction, no inflammation of eyelids
(8) Clean teeth, no dental caries, no pain, normal color of gums, no bleeding
⑨ hair shiny, no dandruff
⑩Muscle plumpness, skin elasticity
In 1999, WHO also proposed health standards
Physical health (5 fast)
①Eat fast
②Walk fast
③Sleep fast
④Speak quickly
⑤Fast to poop
Mental health (3 good)
①Good personality: kind-hearted
②good ability to deal with the world: self-control, adapt to change
③Good interpersonal relationship: helping people
The concept of oral health is defined by WHO in 1946 as the possession of a completely healthy dentition (32 normal teeth, no periodontal or other soft tissue disease). This leads to a state of physical, mental and social well-being, but this is clearly impractical, unrealistic and unattainable. A more realistic definition would be to have a relatively comfortable, functional dental prosthesis that allows the individual to continue to perform his or her social role. What is more realistic and easy to do is the same 5 statements mentioned above.
(1) Dental cleaning: The human mouth is a haven for microorganisms and is one of the four major bacterial reservoirs of the human body.
Disease from the mouth, in such an environment, the teeth can be kept clean?
First of all, there must be a clean oral environment.
The function of saliva is mostly protective.
First, it acts as a lubricant, covering food and hard and soft tissues of the mouth;
② protects against mechanical, thermal and chemical damage, helps to lubricate airflow, speech and swallowing.
③ is a reservoir of various ions, ions of saturated solutions to promote tooth remineralization;
④ buffering role: help neutralize the acidity of plaque (pH), reduce the time of tooth demineralization;
⑤Cleaning effect: clean food, help swallowing;
⑥Antibacterial effect: It has specific and non-specific antibacterial mechanism to help control oral microorganisms.
In addition, there are many other functions, such as maintaining the ecological balance of the oral cavity, agglutination, and helping soft tissue repair.
The oral mucosa has a barrier immune function with a physical barrier that prevents the invasion of foreign bodies and microorganisms, an immune cell barrier with phagocytosis, and an immunoglobulin barrier that causes an immune response.
These functions can help maintain a clean oral environment, which is something that people don’t usually think about.
There is also an invisible microscopic world, that is, the human mouth is a microbial paradise. In the 13th century B.C., there is a record of dental caries in the oracle bone inscriptions of Yin Market in China. The caries is the origin of the saying that there are worms in the teeth, i.e. worm teeth. No matter it is ancient Egypt, India, Greece, Rome, ancient Somalia, American Indian, or Europe, almost every human civilization has the theory of worm teeth, there are more than 3000 years of worm teeth theory, until the 17th century, a man named Levine Hook invented the world’s first microscope, he found a large number of bacteria from human tartar, saliva, at that time he called He found a large number of bacteria in human tartar and saliva, which he called “critters” at that time, saying that “there are more critters living in each person’s mouth than in the entire population of the Netherlands”.
At that time, when the theory of worm’s teeth was prevalent, the Royal Society sent dental worms to him for examination, and it was found that the so-called maggots (cavities) were nuisance cheese. When I was a child, that is, before the liberation in the southern city of Wuxi, I used to hear the wandering doctors walking around the streets shouting “catch the toothworm, catch the toothworm”. This corresponds to a painting of “catching toothworm” in Beijing Tianqiao market before the liberation, which shows that there is a saying of toothworm and tooth decay in the folklore in the north and south of China. That is to say, tooth decay is caused by dental worms. I remember when I was in the rural medical team in the 60s, a farmer showed me the so-called toothworm, which turned out to be “leek seeds”.
Of course, until the 19th century, there was a dental scientist named Miller in the United States who proposed the chemical bacteria theory of dental caries, that is, the bacteria in the mouth use fermentable carbohydrates to produce acid, and dental caries is caused by acid erosion, from then on, there is a scientific explanation for the occurrence of dental caries, which provides the scientific basis.
There are more than 300 kinds of bacteria in human mouth, besides bacteria, there are also protozoa, virus, fungus, yeast, mycoplasma, and 1ml of saliva. There are 108=1 billion bacteria, take 1 gram of dental plaque (wet weight) there are 5×1011=500 billion bacteria. Some of them are transient bacteria, and some are resident bacteria. From the first 4 hours of life until the end of life, bacteria stay with the host for life. Why? Because the human oral cavity has a complex anatomical structure and suitable environmental conditions, such as temperature, humidity, nutrition, and various oxygen tension environments, which are suitable for the growth, reproduction and settlement of various microorganisms.
In such a complex microbial environment, it is important to maintain a state of dynamic balance between the bacteria and the host for the health of the host.
In people with poor oral hygiene, there is a lot of plaque adhering to the tooth surface, it is a layer of invisible to the naked eye with a lot of bacteria adhering to the tooth surface, generally after brushing, the old plaque is removed, and the new plaque starts to form soon in a few hours, and after 8 hours, it shows a complex bacteria cluster. Plaque is the main culprit of dental caries and periodontal disease.
In addition, the food residue and soft tartar left in the teeth after each meal need to be removed in time, and the calcified plaque becomes tartar, which cannot be removed by brushing alone, and can only be removed by doctor’s cleaning. Therefore, dental cleaning requires continuous removal of plaque, soft tartar and food debris through self oral health care, and regular dental cleaning by a dentist to remove tartar. In order to keep the teeth clean.
(2) No dental caries
A good mouth has 28 or 32 teeth, each tooth has 5 surfaces, and the front teeth have 4 surfaces, so there are 128 surfaces or 148 surfaces in total. In addition to no cavity on each tooth surface, there should also be no cavity but demineralized early caries, and furthermore, there should be no risk factors that cause dental caries. For example, the number of eating sugar and sweet food should be controlled appropriately, the amount of sugar intake per person per day should be below 30 grams, the number of eating sugar and sweet food per day should be less than 3 times, and should be eaten at the same time with the main meal, avoid eating between meals, and it is better to rinse the mouth or brush the teeth after eating sugar, in order to reduce the acid production and shorten the time of acid erosion on the teeth, and also to use fluorine appropriately to keep a low fluoride environment in the mouth.
As mentioned before, fluoride was found to have anti-caries effect in the 1930s, and the United States encountered the problem of losing many teeth during World War II, therefore, the pilot of water fluoridation for caries prevention was carried out rapidly after World War II in 1945 and was successful. About 210 million people in the world drink it every day, and after more than 50 years of practical test, there is sufficient scientific evidence to prove that water fluoridation is a safe, effective, economic and feasible caries prevention measure.
In addition to water fluoridation, more than 20 countries in the world also adopt salt fluoridation for caries prevention. The social practice and research of milk fluoridation for caries prevention have been experienced for more than 20 years, and these caries prevention measures have been affirmed and recommended by the World Health Organization.
The method of fissure closure is used to prevent the occurrence of facial caries in children. The recent researches provide new scientific evidence and conclude that fissure closure is effective in preventing caries, because of this, due to the widespread use of fluoride, the change of oral hygiene and the formation of a healthy diet, together with other protective measures such as fissure closure. In many developed countries, there is a significant decrease of caries, and the number of caries-free children is increasing, and is expanding to the adult population. Therefore, it is possible to have caries-free teeth.
In the history of human public health, there are four revolutionary events: water purification, milk sterilization, immunization, and the development of the dental caries-free diet. Milk disinfection, immunization, and fluoridation of public drinking water.
Therefore, the significant decrease of tooth decay is directly related to the fluoridation of drinking water and the widespread use of fluoride toothpaste. In developed countries, fluoride toothpaste accounts for more than 90% of the market, but in some areas of our country, it only accounts for about 60%. And tooth decay in some provinces and cities, especially in some rural areas, there is a rising trend. This is a signal that if we don’t pay attention to prevention, control or reduce which risk factors exist in the living environment, it may become serious. Many people already feel that it is now expensive to have a tooth treated and a tooth set. Therefore, it is better to take care of your teeth every day, self-care, the cheapest, and the most time-saving, the least pain.
(3) No pain The first thing that comes to mind is a toothache, and the most painful and unbearable, to die and kill people is acute pulpitis, which is the common people say the nerve inflammation of the tooth. There is also a kind of pain, although uncommon, but also pain to kill people, that is, trigeminal nerve pain, in addition to these, there are a variety of tooth and mouth-related pain, such as oral mucosal ulcers, a lot of people, often constantly in a year, pain up to eat poorly, and even affect work and life, there is a joint pain, popping, with the jaw, open mouth, bite something related, There are also some chronic pains that are often present.
Such as red, swollen and bleeding gums, accompanied by mild pain and discomfort, and biting? There are also chronic traumas caused by bite, tooth allergy, pain when hot, cold, sour or sweet, bite, trauma, and now a kind of tooth allergy in adolescents, we call it dental erosion, which is now adolescents drink a lot of acidic beverages, so that the tooth surface enamel demineralized and caused by allergy, in the past, this condition is only an occupational disease of workers in the acid plant, in foreign countries, some of them are not so good. Epidemiological surveys, the early 1990s in Switzerland, 12% of young people, 10% of middle-aged people have dental erosion, of which 8% of young people, 13% of adults are more serious, the occlusal surface is severely damaged 30% and 43%. In the UK, a survey of 14-year-olds showed that 31% and 8% of the occlusal or lingual surfaces were eroded, while another survey of 4-5-year-olds showed that nearly half were affected.
In the early 90’s, there was a national survey in the UK, nearly 10% of children had dental erosion, we do not have the corresponding survey data in our country, but the number of children saying they have dental allergies has gradually increased, this is an aspect of the Western lifestyle on children, this trend is worth paying attention to.
Of course, you may ask what can be done to prevent this? One is to reduce the number of acidic beverages consumed, and the other is to keep brushing with fluoride toothpaste.
(4) Normal gum color
Normal gums are firm, pink and slightly white. When the gums are dry, the surface is not shiny. It looks like an orange peel, which we call a spot of color. They are roughly fan-shaped and are tightly attached to the teeth and alveolar bone. What does abnormal gum color look like? They are bright red or dark red because the blood vessels are enlarged and dilated, so the gums bleed easily when brushing or biting, and there may be exudate between the teeth.
Gingivitis can be prevented, and the key is to insist on removing plaque as effectively as possible every day for the rest of your life, and to use medicated toothpaste or herbal toothpaste when brushing your teeth to help eliminate inflammation.
(5) No bleeding
As mentioned above, when the gums are inflamed, they may bleed when touched due to the expansion of blood vessels, poor blood flow, and increased capillary fragility.
Gum bleeding is most commonly caused by poor oral hygiene gingivitis, but it can also be caused by vitamin C deficiency gingivitis, or gingivitis during pregnancy, or herpes and erosion of the gums caused by viral infections, or even gum lesions caused by AIDS, anemia, leukemia, thrombocytopenic purpura, and many other systemic diseases, which can also cause gum bleeding.
So in order to make the gums healthy, no bleeding phenomenon, the first thing is to pay attention to oral hygiene, adhere to the effective brushing every morning and evening, but also to eliminate the risk factors that are not conducive to oral health, such as smoking and alcohol abuse, especially smoking people, 8,9 out of 10 periodontal unhealthy. The risk of periodontal disease is 2 times greater in people who are not addicted to smoking, and 7 times higher in those who are addicted to smoking, and the periodontal pathogenic bacteria can be as high as 300% in smokers, who destroy the body’s first line of defense.
Make the white blood cell malfunction, we know that tobacco has a nicotine poison, stimulate the nerve, acting on the blood vessels so that the local blood supply is insufficient, lack of nutrition, resistance to infection, prompting the alveolar bone resorption, poor oral hygiene, tartar, plaque, resulting in loose teeth, shedding more. Therefore, smoking has a hundred harm but no benefit, the United States more than 1/6 of the deaths related to smoking. Tobacco revenue in the United States is more than 8 billion a year, the treatment of tobacco-related diseases cost 5-7 billion, and the loss of more than 18 billion dollars due to illness and absence from work. So it is important to discipline yourself to quit smoking.
① Awareness: of the dangers of tobacco
②Be determined: never touch not to try, not to welcome, not to promote smoking, and to gradually quit if you have a smoking habit
③Prepare: Ventilate the room, open doors and windows, find a downwind entrance to smoke, rinse your mouth with acidic drinks, brush your teeth or take a hot bath after smoking
④Reduce: reduce the number of cigarettes, control the number of cigarettes, reduce the number of lungs and tobacco, reduce the number of indoor smoking
⑤ Do not smoke: do not want to smoke, do not smoke in public places, do not smoke on an empty stomach, do not smoke on foot, do not smoke after physical work, do not smoke after drinking
These are all self-discipline methods to quit smoking.
3, using scientific evidence to guide self oral health care
You may not be aware that the trend of medicine in the 21st century is evidence-based medicine. What does evidence-based medicine mean? It means that doctors should use the best scientific evidence when diagnosing and treating patients, not just rely on their own clinical experience. Now, we apply the basic principles of evidence-based medicine to self oral health care, that is, to use the best scientific evidence to guide our self oral health care, so what has the evidence-based oral health care told us?
①Brushing teeth Using fluoride toothpaste and brushing twice a day in the morning and evening can prevent dental caries and control gingivitis, and there is good evidence to recommend this. However, if you don’t use fluoride toothpaste, there is no evidence that brushing twice a day can prevent caries, so there is no scientific evidence that brushing can prevent caries.
So, is it safe and effective to apply fluoride toothpaste for caries prevention? In the previous two years, the experts and professors of British evidence-based medical center made a systematic evaluation and analysis on this issue. The effect of using fluoride toothpaste to prevent the occurrence of caries in permanent teeth is certain, and it can reduce the caries by about 25%, and it is safe. Of course, it should be applied for a long time, at least 2 years and at most 9 years. A few years ago, we also conducted a 2-year clinical trial in Beijing and observed that the effect of preventing caries in milk teeth was about 21%. Of course, the research data on fluoride toothpaste for the prevention of caries in milk teeth is still small, and it is not recommended for children under 3 years old, while children under 6 years old can use it under supervision and guidance.
The conclusions about tooth brushing are.
-Brushing is still the most common means of oral cleaning
-Brushing is also a vehicle to deliver topical fluoride to the tooth surface and has been an important reason for the decline in caries in developed countries since the 1970s.
-The anti-caries effect of fluoride toothpaste is well established. But the anti-caries effect of brushing alone is not sure.
-Brushing with fluoride toothpaste has effect on both caries and periodontal disease
a. Brushing frequency: brushing twice a day is recommended for plaque removal and gum health.
There is no sufficient evidence to show that brushing has the effect of reducing the incidence of dental caries
The quality of brushing is more important than the number of times
Brushing twice a day with fluoride toothpaste has better effect than infrequent brushing
Neither brushing nor increasing the frequency of brushing has any effect on caries prevention
Although studies suggest that increasing the number of brushing is beneficial to periodontal health, no ideal number has been determined, and the recommendation of brushing twice a day is consistent with periodontal health and reduction of caries incidence.
All articles published since 1986 do not recommend a specific brushing method.
Regardless of the method used, excessive brushing force should be avoided.
c. Toothbrush design: There are many different designs on the market. Most soft bristle nylon wire toothbrushes are effective in preventing oral disease.
Sponge foam toothbrushes are less effective than traditional toothbrushes in reducing the severity of periodontitis
Electric toothbrushes: their general usefulness is not greater than that of manual toothbrushes
Some electric toothbrushes are designed to prevent or reduce the severity of gingivitis more effectively and with less gum damage than manual toothbrushes
Electric toothbrushes with vibrating/rotating action and reversing action are more effective than manual toothbrushes in controlling gingivitis
Electric toothbrushes are better for patients with special needs, such as those with limited manual dexterity, orthodontic patients, etc.
Other electric toothbrushes, such as vertical, rotary or acoustically controlled ones, have no advantages and are not recommended due to their high cost.
② Oral hygiene aids: brushing is necessary for areas that cannot be reached in general, but not everyone needs it
a. Interdental hygiene
Flossing: Brushing and flossing are better for adult gum health than just brushing.
There is no definite ideal frequency of flossing, but generally once a day is fine
Flossing is less useful as the gaps become wider
There is no significant difference between the different types of floss
No extra benefits of flossing compared to traditional methods
Flossing for children has no additional effect on gum health than just brushing
There is no recommended appropriate age for flossing
Wooden toothpicks: brushing with the aid of toothpicks had a greater effect on reducing gum bleeding than brushing alone. No harmful effects have been reported with wooden toothpicks.
Inter-adjacent brushes: are a good inter-adjacent cleaning tool when there is sufficient clearance to allow their use. However, it has not been shown to be superior to other interdental tools or to brushing alone.
b. Interdental or end-brush: Smaller brush head, compared to traditional toothbrushes, is useful in reducing gingivitis in adults, but it is recommended to be supervised by a professional because of the concentration of force and the tendency to cause trauma.
c. Gingival massage: the use of a rubber-tipped stimulator does not have any added benefit over brushing in reducing gingivitis and is rarely clinically relevant
d. Supragingival rinsing: reduction of gingivitis has been reported. The harmful effects of rinsing with water are minimal. Expert opinion is that rinsing should be avoided in individuals at risk for bacterial endocarditis.
After any oral surgery, all patients should delay rinsing for one month.
e. Subgingival rinses: Although they may have a role in improving periodontal health, they have not been evaluated.
f. Tongue brush or tongue scraper: as an adjunct to brushing, it does not help reduce gingivitis
Regarding specialized care.
(1) Scaling.
Used only on the active side of the lesion, with 4 indications: bleeding on probing, deepening of periodontal pockets, loss of periodontal attachment, suppuration
Supragingival scaling and home care are effective in maintaining the patient’s periodontal health
Scaling is recommended for patients with periodontitis, but subgingival scaling is not necessary in areas with good oral hygiene and no progression of lesions
Patients with moderate or severe periodontitis should undergo maintenance treatment once every 3-4 months, and those who have maintained periodontal health for more than a few years. Can be extended beyond 4 months
There is no evidence to support that 6 months is the ideal interval for review.
Repeated scaling can cause damage to the enamel surface, tooth hypersensitivity, gum recession, and the risk of bacteremia during scaling in patients with certain medical conditions, requiring prophylactic antibacterial medication. Choose a qualified medical unit. Prevent cross infection.
Ultrasonic and acoustic scalers: For single-rooted teeth, manual and ultrasonic scalers are equally effective. Ultrasonic scaling can produce heat, which can cause tooth hypersensitivity and pulp damage.
Conclusion: Personal oral hygiene is fundamental to oral health. Professional treatment or regular maintenance is not universally necessary.
4.The impact of oral health on the quality of life
(1) Impact on body functions
Chewing function (chewing, biting, swallowing) affects eating, nutritional balance, 25% of the elderly have chewing difficulties. Cannot chew hard food
Speech function: limited
Absence from work: pain and discomfort, absenteeism from school, absenteeism from work
Restriction of normal activities
Interference with sleep
(2) Social function.
Avoidance of emotional expression (laughing or laughter)
Avoidance of talking
Avoidance of meeting others
Others laugh at bad teeth
Restriction of daily activities
(3) Psychological functioning (unsatisfactory appearance, poor oral health, self-confidence).
Children 10%
Adults 40%
Elderly 60%
(4) Adult denture problems.
Slurred speech
Difficulty in eating
Mouth ulcers
Poor retention
(5) Effects on general health
Gastrointestinal system diseases
Diabetes
Coronary heart disease
Infant low weight
Hypertension
Cerebrovascular disease
Arthritis
Cancer
Conclusion
1, oral health has a vital, immeasurable impact on the quality of life in a person’s life, the two bright spots in life a dark spot: two bright spots one is to enable their potential to be maximized, that is, their own talent, to create the greatest production value. The other is to enjoy the greatest pleasure of life. A dark point is to overcome the lowest and most difficult stage of life, and to withstand all kinds of storms in life.
Therefore, to have health in your life is to have wealth, capital, resources and power. Health is not an end, but the basis and means.
2, self oral health care for each person’s oral health in a lifetime, persistent efforts, play a decisive role. The doctor’s treatment and help, although essential, but it is a momentary, short-lived. Everyone should be able to find the right answer to the question of whether to leave their health to themselves or to their doctors.