Oral Maladies: Preventive Management

Introduction

Oral maladies are diseases affecting the oral cavity. The three primary oral maladies, namely dental caries, periodontitis, and noma, are recognized as significant contributors to global healthcare burdens. These conditions are preventable, that arise from mixed bacterial infections. Read the article to be aware of the global statistics affected by these oral maladies and the preventive management to be adopted.

What Is the Current Global Status of Oral Maladies?

According to the latest assessments by the World Health Organization (WHO) and the World Bank's Global Burden of Disease (Marcenes, 2013), dental caries, periodontitis, and noma rank as the primary contributors to the worldwide healthcare burden. A staggering 35 percent of the global population is affected by untreated dental caries, whether due to a lack of oral health awareness, personal ignorance, or limited access to oral surgeons, which is a relatively uncommon cause at present.

When combining the percentages of individuals suffering from periodontitis and dental caries globally (WHO assessment), untreated oral disorders account for an alarming 50 percent of the global population, which includes nearly four billion people. Medical researchers underscore the significance that when individuals with untreated oral issues are added to those with a history of dental treatment or oral diseases, the impact extends to nearly 100 percent of the global population, as per Marcenes and others in 2013.

What Are the Major Oral Maladies?

Globally, medical research and surgical studies consistently emphasize three major oral maladies: dental caries, periodontitis, and noma. These conditions hold the highest prevalence among all oral diseases, posing significant risks to both systemic health and overall life quality for individuals affected.

Ranked third in terms of morbidity and mortality among oral diseases is noma. Numerous other oral maladies include manifestations associated with acquired immunodeficiency syndrome (AIDS), oral cancers and genetic defects, as well as those resulting from orofacial trauma and accidents.

1. Dental Caries:

• Dental caries, or tooth decay, is caused by bacterial contamination, particularly microaerophilic gram-positive strains like Lactobacillus and Streptococci bacteria.

• Dentistry has evolved significantly over the last century, with restorative management and utilizing advanced materials and technology for treating cavities.

• Modern dental surgery incorporates local anesthesia, followed by surgical or conservative decay excision and dental fillings to ensure success.

• In severe cases, endodontic treatment is preferred for saving a tooth with extensive decay and pain.

• Oral awareness is required to prevent dental caries across age groups, with systematic reviews supporting the efficacy of modern dental fillings.

• Community-level oral health awareness and regular dental checkups play a crucial role in addressing the global burden of dental caries.

2. Periodontitis:

• Periodontitis is primarily caused by anaerobic infiltration of a gram-negative mixture, featuring bacteria like Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, Prevotella intermedia, Prevotella nigrescens, and Fusobacterium nucleatum species.

• This inflammatory condition arises from the overgrowth of mixed anaerobic bacterial infections colonizing teeth's subgingival crevices, potentially leading to complications such as bleeding gums, tooth mobility, and eventual tooth loss if left untreated.

• Researchers extensively explore the adverse effects of periodontitis on systemic health, uncovering bidirectional links with cardiovascular disease, preterm births, and diabetes, contributing significantly to global healthcare burdens.

• Successful treatment options include periodontal or mechanical therapy, including scaling and root planing, with or without surgery.

• Non-surgical periodontal therapy, combined with oral hygiene and plaque control measures recommended by dentists, stands as the gold standard for mild to moderate cases.

• Regular dental follow-ups and preventive checkups every quarter are essential for sustaining long-term periodontal health at the community level.

3. Noma or Cancrum Oris:

• Noma, also known as cancrum oris, is a severe oral disease marked by a significant alteration in oral microbiota, with an increase in pathogens like Prevotella and Peptostreptococcus genus.

• Individual risk factors, such as poor nutrition, poverty, and prior infections or systemic afflictions, exacerbate this condition.

• Noma manifests as destructive ulceration of the gingival mucosa, prone to extraoral spread. Left untreated, it can result in severe degradation of facial and jaw tissues.

• Consequences include destruction of midface components like lips, cheeks, oral mucosal membranes, maxilla, mandible, nose, and even the orbital floor, potentially leading to facial disfigurement.

• Systemic or lymphatic spread of infections heightens the risk of individual mortality or morbidity.

• Early disease detection, oral health awareness, and multidisciplinary management involving antibiotic or surgical measures are crucial to prevent the worsening of noma in individuals.

How to Manage Oral Maladies?

• Dental Caries: Dental caries, commonly known as cavities, are managed by removing the decayed part of the tooth and filling the cavity with appropriate materials. This process not only halts the spread of tooth decay but also restores the normal functioning of the teeth.

• Periodontal Disease: The treatment for periodontal disease involves a comprehensive approach. Professional dental cleanings are performed to eliminate plaque and tartar buildup. Scaling and root planing address deep pockets between teeth and gums. In severe cases, surgical procedures may be necessary. Antibiotics or antimicrobial mouth rinses may be prescribed to control infections associated with periodontal disease.

• Noma: Noma is addressed through a combination of antibiotics to control infection, nutritional support, and surgical procedures. The surgical intervention includes the removal of damaged tissue and facial reconstruction. Early detection is critical for effective management, and ongoing medical, dental, and psychological care plays a crucial role in supporting optimal recovery for individuals affected by noma.

How to Prevent Oral Maladies?

Adopting general measures to maintain oral hygiene will help prevent and manage oral maladies that include dental caries, diabetes, and other infections affecting the oral cavity.

• Maintain Oral Hygiene: Employ routine practices such as brushing twice daily, regular flossing, and using antiseptic mouthwash to effectively prevent and manage oral maladies, including dental caries, periodontitis, and other infections.

• Healthy Diet: Enhance oral health by consuming a well-balanced diet rich in essential vitamins and minerals while minimizing the intake of sugar and acidic foods and drinks.

• Regular Dental Checkups: Schedule periodic dental checkups to facilitate early detection and timely management of potential oral maladies, ensuring comprehensive oral health.

• Community Awareness: Create oral health awareness within the community, educating individuals about preventive measures and recognizing early signs of oral diseases.

• Seeking Professional Help: Seek prompt dental attention for early treatment and adhere to recommended plans for various conditions such as dental caries, periodontitis, and noma.

• Lifestyle Changes: Adopt a lifestyle that restricts alcohol use and avoids tobacco, promoting holistic oral health practices.

• Global Health Initiatives: Actively participate in and endorse global health initiatives aimed at addressing oral health maladies and advocating for improved worldwide access to dental care. This engagement contributes to addressing broader challenges in global oral health.

Conclusion

Oral maladies, including dental caries, periodontal disease, and noma, are preventable and treatable infections, underscoring the pivotal role of early identification by individuals. These conditions not only impact individual health but also exert a profound influence on community and global health. Community-based preventive interventions are gaining momentum, and there is increased accessibility to dental or oral care. It becomes imperative for communities and public health bodies to promote oral awareness, thus alleviating the global burden of oral maladies. Emphasizing the significance of oral hygiene, regular dental check-ups, and recognizing the impact of the oral cavity on systemic health is paramount in the context of modern lifestyles and overall well-being.