“Health” oral health problems How should we care?
Medical Doctor of the Fourth Military Medical University of the People’s Liberation Army
Professor of Tissue Engineering R&D Center of the Fourth Military Medical University of the People’s Liberation Army
In today’s society, with the improvement of living standards, food and clothing is not the goal that people pursue, and the quality of life has become The focus of people’s attention. While paying more and more attention to shape and health, the pursuit of aesthetic taste also emphasizes the details. White teeth, healthy gums, and fresh tone are the common pursuit of people in modern society. On the one hand, oral problems such as swelling and swelling of the gums can affect chewing, causing great difficulty in eating and affecting the digestion and absorption of food. On the other hand, oral problems are closely related to many systemic system diseases, which can cause cardiovascular and cerebrovascular diseases. , diabetes, respiratory diseases, Premature low birth weight, gastrointestinal infections, etc. A healthy oral environment can bring you a bright, confident smile, and can greatly reduce the incidence of diseases in other parts of the body, and protect your health.
The standard of oral health is white teeth, no dental caries; fresh breath, no bad breath; normal color of gums, no redness and bleeding, no bleeding in oral mucosa, etc. In order to have a healthy mouth, we must understand the standard of oral health. It is also necessary to understand the factors that endanger oral health and the ways in which these harmful factors harm oral health. As a result, we know how to eliminate these harmful factors.
Initiation of endangering oral health Factor – plaque
The beginning of the oral health problem is the plaque that lives in our mouth. Below, we will know the composition and structure of plaque. And the harm to oral health.
The plaque is an agglomerate of a large number of bacteria attached to the teeth, gums, etc. Unlike a single microorganism, this The bacterial aggregate on the tooth surface is a relatively independent and closed system consisting of membrane structure, bacteria, bacterial metabolites, food residues and other components. This structural feature not only helps the bacteria resist the human body’s own defense mechanism. (such as swallowing, mouthwash, saliva, etc.), and also has a certain barrier effect on external bactericidal substances. If observed under a microscope, it will be found that the internal structure of plaque is very sophisticated, it forms a network structure, various Bacteria live in this grid structure, which is equivalent to a city dominated by bacteria. There are many channel-like structures inside the plaque. These channel structures are responsible for food supply, metabolic waste discharge, and information exchange between bacteria individuals. The membrane structure on the plaque surface acts as a barrier and protection.
There are 200 to 400 kinds of bacteria in dental plaque, mostly anaerobic bacteria. Most of the bacteria in dental plaque are normal oral flora, which has no adverse effects on humans. Only a few bacteria are closely related to the occurrence and development of rickets and periodontal diseases, which are called pathogenic bacteria. These bacteria themselves and their harmful metabolites cause continuous damage to the oral tissues, which cause oral problems such as dental caries, bad breath, gingivitis and periodontitis.
Formation mechanism of common oral problems
Caries, also known as cavities, are harmful The most common disease in human oral health. The third national oral health epidemiological survey in 2005 showed that the prevalence rate of 12-year-old students was 28.9%, and the prevalence rate of middle-aged people aged 35 to 44 was 88.1%. It is 98.4%. In modern society, people pay more attention to diseases and problems such as tooth loss and toothache caused by dental caries, and they are more concerned about the influence of dental caries on the aesthetics of teeth. We can’t imagine how a woman with a good face and elegant temperament has a mouth with a broken mouth.
The main cause of dental caries is poor oral hygiene, plaque-causing bacteria in the plaque, and metabolism of oral sugars to produce a large amount of acidic substances such as lactic acid and acetic acid. Currently recognized cariogenic bacteria are Streptococcus mutans, Lactobacillus and actinomycetes. These acidic substances react with hydroxyapatite, the main component of enamel, to form soluble calcium ions, which are dissolved in the enamel. Over time, the enamel-deficient surface appears on the tooth surface, which is the initial metamorphosis. The color, shape and texture of the broken hard tissues of the teeth are further developed. The acidic substances continue to destroy the dentin, cementum and other dental tissues below the enamel, forming a cavity, which will affect the internal nerves of the teeth. It can cause pain and discomfort when stimulated by acid, sweetness, cold or heat.
The periodontal tissue is the supporting tissue of the teeth. Periodontal disease mainly exists in the form of inflammation. The infection originates from plaque bacteria in the sulcus or periodontal pocket, which is manifested as inflammation of the periodontal tissue and destruction of supporting tissues, such as gingival redness, hemorrhage, gingival atrophy, periodontal pocket. Wait. Pathogenic bacteria that are prone to periodontal tissue diseases mainly include Porphyromonas gingivalis, Actinobacillus, Clostridium nucleatum, and P. intermedia. The pathogenic bacteria destroy the periodontal tissues by secreting toxic substances such as lipopolysaccharide, protease and endotoxin, and cause local immune and inflammatory reactions in the periodontal tissues, further causing damage to the periodontal tissues. In the early stage, the main manifestation is gingivitis. At this time, the gingival capillaries are congested. When the teeth are brushed, the gums are prone to bleeding. As the disease progresses, the periodontal support tissue is inflamed, the periodontal barrier is destroyed, and the periodontal pocket is formed. Further inflammation may cause teeth. The destruction of the trough bone causes the alveolar bone to absorb, eventually causing the teeth to loosen or even fall off.
In 2005, the results of the third national oral health epidemiological survey showed that the detection rate of gingival bleeding in a 12-year-old adolescent was 57.7%, the detection rate of calculus was 59.0%; the middle age of 35 to 44 years old The detection rate of bleeding in human gums was 77.3%, the detection rate of dental calculus was 97.3%, and the detection rate of periodontal pockets was 40.9%. The detection rate of gingival bleeding in elderly people aged 65 to 74 years was 68.0%. At 88.7%, the detection rate of periodontal pockets was 52.2%. It can be seen that several indicators reflecting the health of the periodontal period are high, and the periodontal health status of the Chinese is not optimistic.
There are many reasons for bad breath, including physiological and pathological bad breath. Pathological halitosis includes non-oral mutagenicity and oral halitosis. Here, oral malodor is mainly introduced.
The smell of oral bad breath originates from the mouth and is the most common type of bad breath. More than 80% of patients with bad breath belong to this type. Periodontal disease is the main cause of odor and is a symptom associated with periodontitis, gingivitis and necrotizing ulcerative gingivitis. In addition, plaque, prosthesis and plaque residue around the orthodontic device, oral ulcers, oral infections, etc. can cause bad breath. The formation of oral halitosis is directly related to volatile sulfides in the mouth. These volatile sulfides are all produced by bacterial catabolism of sulfur-containing amino acids, mainly including sulfhydryl-containing gas complexes, 90% of which are hydrogen sulfide and methyl mercaptan. These complex gases are the source of bad breath.
Tooth allergies are abnormally sore, painful or painful in the chemical and physical stimuli of cold, heat, and probing. The obvious stimulus is caused by different degrees of wear or erosion of the enamel surface and the dentinal tube retraction leading to the exposure of the dentinal tubules, while the external stimulation acting on the dentin causes the flow of liquid in the tubules through the exposed tubules, which is transmitted to the teeth. Excitation of the pulp fibers caused by the pulp, causing soreness in the teeth, that is, dentin sensitivity. A long-term survey by the Chinese Stomatological Association showed that the prevalence of dentin sensitivity in adults aged 20 to 69 in China was 32.1%, of which the prevalence rate of urban residents was 29.7%, and the prevalence rate of rural residents was 34.8%. Among all the people surveyed, the prevalence of dentin sensitivity was highest among people aged 50 to 59.
How to develop good oral health habits
Toothpaste and mouthwash use
The bacteria in the mouth are mostly in the form of plaque, which is a film-like aggregate of a large number of bacteria attached to the oral cavity such as teeth and gums. It cannot be removed by simple cleaning methods such as mouthwash. Plaque, must support the frictional oral cleaning products of toothpaste, and use the correct brushing method to effectively remove the plaque that has formed in the mouth. Although brushing can effectively remove the plaque on the tooth surface, greatly reduce the oral cavity. The number of harmful bacteria can not control the remaining harmful bacteria in the mouth to continue to breed and multiply. After brushing for a few hours, the harmful bacteria remaining in the mouth can reattach on the cleaned tooth surface and gradually accumulate to form new plaque. Studies have shown that mouthwashes are used after brushing, 48 After living, the plaque is only about 3%, but brushing or rinsing alone, the live bacteria in the plaque is more than 20% after 48 hours. Brushing can effectively reduce the biofilm thickness during the whole oral care process. Destroy the plaque structure, use mouthwash after brushing, and the active ingredients in the mouthwash can penetrate into the plaque biofilm, thereby exerting the effect of continuously inhibiting the proliferation and proliferation of oral bacteria.
Mouth Differentiation between morning and evening
Day and evening, the oral cavity is in different states, and the needs of oral care are different. We should use special oral care products according to the different oral conditions in the morning and evening to meet different time. The need for oral care.
The oral cavity is always active during the daytime. On the one hand, there is air circulation in the mouth, which is not conducive to the breeding and reproduction of anaerobic bacteria in the mouth. On the other hand, saliva is secreted more during the day. It has a strong physical clearance effect on bacteria. The mucin and lectin contained in saliva can agglutinate bacteria suspended in saliva, and discharge into the mouth with swallowing. At the same time, saliva contains various inhibitions. Bacterial components, such as lysozyme, lactoferrin, cystin and antibacterial peptides, can strengthen the control of oral microbes. Control of oral microbes, eliminate dental problems such as dental caries, red and swollen gums, periodontal disease, bad breath and so on. The root cause is that in terms of daytime social needs, having fresh teeth and exhaling fresh air will increase our confidence in the communication process, so the main appeal of oral care during the day is whitening teeth and fresh breath.
Night, especially when people go to sleep, the mouth is in a closed and static state. If you don’t pay attention to oral hygiene, or even have the habit of brushing your teeth before going to bed, the food residue in the mouth and the anaerobic environment are especially suitable for the oral cavity. The growth and reproduction of harmful bacteria is the main reason why most people feel that the oral odor is much heavier than in the daytime. The residual food residue in the oral cavity is used by the cariogenic bacteria, and the acid production is continued. Since the oral saliva secretion is small at night, the pH in the plaque is maintained below the critical value for a long time, and the hydroxyapatite on the enamel surface is degraded. Calcium and phosphate are dissolved, and there is demineralization of the teeth and even cavities. The study found that the rate of dental plaque formation in the evening is more than three times higher than that during the day. At the same time, due to the relatively static state of the mouth at night, saliva secretion and dietary water intake are reduced, which is beneficial to repair the damaged oral tissue. The main appeal of oral care at night is antibacterial and repair.