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Oral Hygiene: A Daily Practice Regimen

Oral health is the interpretation of intraoral tissues that qualifies an individual to eat, speak and socialise without any active form of disease, discomfort, or embarrassment, thus contributing to the overall well-being of an individual. HUGO et al elucidates that any form of dental decay is the most common concern for the ageing population. Oral diseases are considered the most chronic form of any public-related health problems because of their prevalence, impact on individuals and society, and the expense of treatment.

The two hypotheses behind control measures of the pandemic spread of dental caries are:

  1. Implementation of improved personal oral hygiene practice
  2. Addressing the early defects in the coronal enamel structure

Oral Health with Overall Health 

Bacteria are ubiquitous, free-living organisms consisting of one biological cell. There are 6 billion bacteria of 700 different types that live inside the mouth- the good ones keep unhealthy microbes in check, help digest food and protect against harmful food microbes, and the bad ones lead to dental-related problems of both hard and soft tissues.

Researchers suggest that the inflammation associated with a severe form of gum disease (periodontitis) and the oral bacteria can lead to life-threatening systemic health problems like 

1. Diabetes 

2. HIV/ AIDS

3. Endocarditis 

4. Cardiovascular Diseases

5. Pneumonia

6. Osteoporosis

7. Alzheimer's Disease

8. Pregnancy and birth complications 

Commonly used medications like decongestants, antihistamines, painkillers, diuretics, and anti-depressants result in decreased salivation, a condition known as Xerostomia, leading to severe oral lesions.

Herbal Oral Hygiene 

The current market is flooded with numerous over-the-counter dental hygiene products of different compositions like abrasives, preservatives, surfactants, sweeteners, or colorants which not only lead to corrosion of the surface layer but also may lead to serious health problems.

The recent trend solicits the increased demand for the use of herbal products and treatments for the benefit of individual health. Herbal products in oral care have also attracted the researcher’s interest with recognition of the old formulation (like sulfuric acid, mercuric perchloride, carbolic acid, and formaldehyde) that have potential side effects. The more recent plant-based oral care product (like peppermint extracts, clove oil, aniseed, tea tree oil, aloe vera gel, olive oil, and neem extracts) household products (like garlic oil, thymol, eucalyptol oil), well-known Miswak available as an alternative for the commercial market to enhance the antibacterial activity of toothpaste or mouth rinse. 

A traditionally known technique of oral hygiene practice is OIL PULLING, healthcare professionals and bloggers accept a traditionally practiced across the globe, offering both general and oral health benefits. Although not recommended by any of the Health Authorities, and does not replace a required dental treatment. 

The emphasis on oral hygiene has always been the cornerstone of preventive and public health dentistry. 

Protect Oral Health

The pervading message of time is to "Promote oral health with fluoride and sealant". I suggest oral care should commence as soon as the tooth eruption happens and recommends using moist gauze with fluoride toothpaste to clean the oral cavity and teeth of children below three years of age. The World Health Organisation (WHO) has included oral hygiene as an essential part of the school curriculum.

Recommendations at an individual level:

1. Parents should educate their children about brushing by age 2-3 years or even before.

2. Easy and effective oral hygiene instructions should be adopted. 

3. Brush 2wice daily for at least 2 minutes using a soft-bristle brush and fluoride toothpaste. 

4. Health authorities and professionals recommend demonstrations for the children and parents on how to detect the plaque along with the first symptom of gingivitis and dental caries.

5. Mouth rinses are only adjunct and recommended when brushing does not achieve optimal hygiene or is indicated in the case of specific pathologies or any medical or dental interventions.

Recommendations at The Community level 

1. A population strategy should reduce the plaque level of high-risk groups.

2. Non-dental educators (general practitioners, health care providers, educators, etc.) should be provided with materials and knowledge related to oral hygiene.

3. Free sample distribution drives should be organised at the community level, as they have shown effective incentives for improved oral hygiene behavior. 

4. Mass media utilisation focusing on the current trend (such as TV, Pamphlets, tweeter, social media, etc.) should be encouraged. 

5. The nursing mother should sensitise to the regime of oral hygiene maintenance for both mother and the child. 

6. Tobacco cessation centers should be located in urban and rural areas with health education programs organised to improve oral hygiene condition. 

Oral Hygiene Routine

The oral hygiene routine should be a part of your daily morning and nighttime routine with skin care.

1. Start with a swirl of a recommended mouthwash (avoid using alcohol-based mouthwash) and swishes for 10-15 seconds followed by a rinse.

2. Second in line is the dental flossing (woven floss), wrapped between the middle fingers of both hands and grab them between the pointing finger and thumb for use in between the teeth in a c-shape manner hugging the teeth from each side.

3. Thirdly, brush with a recommended fluoridated toothpaste in pea size quantity and powered toothbrush with soft bristles for 2-3 minutes in the advised brushing manner. 

4. Last but not least is to scrap the tongue with 3-4 gentle strokes followed by a good rinse with clean water. 

If you are a clenching (bruxism) patient and use a night guard, follow the routine recommended by your dentist for regular dental oral hygiene. 

Conclusion

The diligence and enthusiasm of the dental professional toward promoting good oral hygiene is an ongoing process. I suggest regular dental hygiene practice to keep your teeth decay-free and infection-free as this is pivotal for an individual's overall health and well-being. 

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Dr Pankaj Dhawan

Guest Author Center Head Manav Rachna Center for Dental Excellence

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