Plaque and Calculus
Did you know that Plaque is the main cause of gum disease? As patients, this has always been drilled into us to make sure we brush our teeth regularly.
What is plaque?
Plaque is that soft, white, yellowy substance that accumulates at the margins of the gums and the teeth, which is evident after a meal or at the end to the day. It contains bacteria which causes an inflammatory reaction to the gums resulting in gingivitis. If the plaque is removed, the gingivitis goes away, but if it is not, then the gingivitis can progress to periodontitis, which affects even the bony areas supporting the teeth!
The calculus (also known as TARTAR) is the calcification and hardening of plaque. If you allow the plaque to stagnate for too long without removing it, it calcifies to form a hard, lumpy layer, which cannot be removed with the toothbrush. Typically, the occurrence of calculus above the gums happens in two places:
- tongue side of the lower front teeth
- the cheek side of the upper back teeth
This is because there are salivary ducts under the tongue and on the sides of the cheek, and the calcium in the saliva hardens the plaque. However, the worst part is once calculus is formed, it has the potential to accumulate and deposit more. Some people have had it for so long, that they have thought it is part of the teeth! There are also some people who are predisposed to the formation of calculus, especially those who smoke.
The only sure way of removing calculus is by using a scaler – which is part of the scaling process, can sometimes be an uncomfortable procedure. So, clean your teeth thoroughly every day to avoid the plaque hardening to calculus!
The most common disease in the mouth is tooth decay (caries). With today’s sugary foods becoming cheaper and more accessible, it is not surprising that this problem will always be prevalent. However, the good news is that tooth decay is totally preventable and, in some cases, reversible!
Whenever our teeth get a sugar attack by eating sugary foods, the bacteria in the mouth convert it to various acids which erode the teeth. This is the beginning of tooth decay. Studies have shown that it takes 30 minutes to an hour to recover from a 1-minute sugar attack!
This information tells us that if we don’t give our teeth enough time to recover, the acids will continuously erode the teeth until holes start to form.
Many carbonated drinks will affect the teeth in a similar way. Not only because they contain lots of sugar, but also because the fizz is acidic and can cause erosion of the teeth. So that’s double trouble!
Another thing to bear in mind is FLUORIDE can help strengthen the teeth and prevent decay further. So, make sure you use fluoride toothpaste regularly!
- Avoid sugary foods (cakes, chocolates, ice cream, biscuits, crisps) as much as you can. Healthier alternatives are fruit and vegetables!
- Sugary foods should only be taken during main meal times, and avoided in between meals.
- If drinking fizzy drinks, use a straw and swallow immediately. Don’t slush it round your mouth!
- Don’t eat anything after you brush your teeth at night. Go to bed!
Alongside dental decay, the next most common oral disease is gum disease. Gum disease (or periodontal disease) is characterised by:
- Bleeding gums
- Accumulation of plaque and calculus (tartar)
- Receding gums
- Loose teeth
- Drifting teeth
- Bad breath
- Gum detachment
- Swelling of the gums
- Loss of teeth!
Again, this is preventable! Our understanding of gum disease has improved over the past 30 years and we now know that not everyone needs to lose all their teeth by 50 years old! Most gum disease can be avoided by effective and regular cleaning. Even though the dentist can help you with the cleaning every six months, you need to maintain it daily.
- Brush your teeth two times daily with a soft bristle toothbrush
- Plaque accumulates at the gum margins – concentrate on where the teeth meet the gums
- Calculus(tartar) usually accumulates on the tongue side of the lower front teeth and the cheek side of the upper back teeth – concentrate on that
- Flossing gets in between the teeth where the toothbrush can’t reach
- Tooth brushing, along with flossing and mouthwash, increases plaque removal by about 20%
- Electric toothbrushes do most of the work for you and can get too hard to reach places because of its smaller head
SMOKING and ORAL CANCER
Oral cancer constitutes about 6.5% of all cancers in Australia. More Australians die from oral cancer than cervical cancer every year. Early detection of cancer always has a better prognosis in terms of its treatment outcome. That is why during your check-up, part of our routine examination is to check for oral cancer. It is also important that you tell your dentist/doctor if you have any concerns.
Oral cancer can sometimes mimic an ulcer; appear as a red/white patch or a firm swelling. Sometimes, it can be painless and this is why people delay their examinations. If you think you have any of these symptoms, get it checked out as soon as possible*.
- persistent ulceration – unexplained ulcers that last for more than two weeks
- a persistent or growing lump or bump that shouldn’t be there
- fixation of tissues
- white patches in the mouth
- neck lumps or swellings
It is well documented that smoking has a strong link with an increased risk of oral cancer, throat cancer and lung cancer. Smoking tobacco releases over 4000 chemical compounds into the mouth and air. It is no surprise that a smoker will have a 10 – 20 times higher chance of developing cancer than a non-smoker. In the mouth, the most commonly affected areas are lips, under the tongue, the tongue itself, the cheeks and the palate.
It is also important to note that heavy smoking, high consumption of alcohol, poor oral hygiene and age are risk factors for cancer.
If you need any help in stopping smoking, contact us or stop smoking organisations such as www.stopsmoking.com.au.
*Not all white patches/lumps and bumps are cancerous in nature. Most are due to trauma or infection, but it is important to get all symptoms checked out.
As part of your preventative regime every six months when you come for your dentist appointment, you will sometimes be given a FLUORIDE TREATMENT in the form of a gel or mouth rinse. Normally, you will need to keep this in your mouth for about a minute, and then spit out. Don’t eat or drink after this treatment for about an hour to help keep the fluoride on the surface of the teeth as long as possible.
However, don’t just depend on your dentist’s fluoride treatment. Brushing your teeth regularly, twice a day, with fluoride toothpaste is also helpful to prevent decay.
Teeth can be more resistant to decay if fluoride is used on:
- The developing teeth – The ‘developing’ teeth can utilise Fluoride from the body, i.e. by using INGESTED fluoride while the teeth are still forming. However, too much fluoride increases the risk of forming MOTTLED TEETH (fluorosis).
- The existing teeth – The enamel of the existing teeth is more resistant if there is a coated fluoride-crystal surface. This fluoride-crystal surface is formed when the tooth is exposed to fluoride in the mouth, and when it is ON the tooth surface. Once it is swallowed or rinsed out, its usefulness decreases.
The longer the fluoride mouth rinse or toothpaste is on the teeth, the more effective it will be at preventing decay.
Below are the most common types of products in the market which contain fluoride:
- Fluoride Toothpaste
- Fluoride mouth rinse
- Fluoride Gels/varnishes
- Water fluoridation
- Fluoride tablets
- Fluoride in salt
*It is also important to note that teeth that are ALREADY formed DO NOT become mottled if exposed further to fluoride…it just becomes stronger! AND the body cannot utilise ingested Fluoride if the tooth is already formed.