On March 20 every year, the world celebrates oral health to raise awareness about the importance of caring for the mouth at every stage of life, and to draw attention to the silent but widespread oral health issues affecting millions globally. This year’s theme “A Happy Mouth is a Happy Life” speaks to the overlooked fact that oral health greatly contributes to overall health and well being, from a baby’s first set of teeth, which allows him or her to transcend from suckling breast milk to eating solid foods to maintaining a healthy smile and, of course, the ability to chew at old age. Indeed, oral health is better appreciated when we realize how often we use our mouths to eat and speak. Who can do without that? Yet, very few people understand and practice oral health.
According to the World Health Organization (WHO), oral diseases affect an estimated 3.7 billion people. Over 2.5 billion people suffer from dental caries (also known as tooth decay). It is the most common noncommunicable disease worldwide. The second most common oral disease, gingivitis (also known as periodontal or gum disease), affects more than 1 billion people globally. Oral cancer is the 13th most common cancer worldwide, with an estimated 389,846 cases and 188,438 deaths in 2022. Noma, a severe gangrenous disease of the mouth and face, mostly affecting children aged 2-6, has an annual incidence of 140,000 cases, according to 1998 estimates. Oral and dental trauma, which leads to broken teeth or edentulism (total tooth loss), affects an estimated 1 billion people; and cleft lip and palate are the most common craniofacial birth defects, with an incidence of between 1 in 1000–1500 births.
Zooming in on Nigeria, oral diseases remain one of the most neglected yet prevalent health issues. Available data from a 2012 National Oral Health Policy reveals that 6-23% of Nigerians have dental caries, and over 90% of these cases go untreated; while gingivitis affects 15-58% of the population. As of 2022, Nigeria’s dentist-to-population ratio stood at 1:53,828, a far cry from the WHO recommended 1:5,000. This explains why more than 80% of Nigerians have never visited a dentist, a crisis worsened by widespread lack of awareness about oral health, poor health infrastructure, and inadequate health funding. These oral health issues affecting Nigeria, including the University of Ibadan, have been extensively discussed in a previous article. Excessive consumption of free sugar remains the most common cause of dental caries worldwide. Other causes of poor oral health include tobacco use, alcohol consumption, poor nutrition, and poor oral hygiene practices.
Given their high prevalence, it is important to understand how dental caries and gingivitis develop. Dental caries, or tooth decay, results from the breakdown of teeth due to acids made by sugar-fermenting bacteria, most commonly Streptococcus mutans. This creates cavities, varying in colour from yellow to black, and which cause pain, inflammation around the tooth, tooth loss, infection, bad breath, and unpleasant tastes.
Gingivitis, on the other hand, is a mild form of periodontal disease caused by inflammation of the gums without tissue destruction, leading to red, swollen gums which bleed easily, tenderness and pain upon chewing food or touching, and bad breath. Just like dental caries, it is caused by sugar-fermenting acid bacteria, with risk factors such as poor oral hygiene, tobacco use, poor nutrition (especially vitamin C deficiency), and diabetes.
How to Practice Good Oral Hygiene
Practicing oral hygiene is the most effective way to maintain good oral health. Oral hygiene is the practice of keeping one’s oral cavity clean and free of disease by regularly brushing the teeth, flossing, and adopting good hygiene habits. This prevents the formation of plaques, which can lead to dental caries and gingivitis.
A toothbrush and a fluoride toothpaste can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces. When used correctly, dental flosses, a cord of thin filaments, typically made of nylon or silk – can be used to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching. Additional aids include interdental brushes, water picks, and mouthwashes. Dentists recommend brushing twice daily and replacing the toothbrush every three to four months.
Visiting the dentist at least every six months is also an effective way to practice good oral hygiene, as a professional examination better detects developing dental caries. Visiting the dentist is particularly important when dental trauma occurs or when conditions such as dental caries and gingivitis have developed. It is also important to get the expert services of a dentist to monitor dental development in children and reduce the risk of edentulism or tooth loss in the elderly.
Avoiding excessive consumption of free sugar is also an effective way to practice good oral hygiene. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids that can demineralize enamel, dentin, and cementum. The more frequently teeth are exposed to sugar, the more likely dental caries will occur. Therefore, minimizing snacking is recommended, since snacking creates a continuous supply of sugar for bacteria in the mouth. It is particularly important to enforce this hygienic practice in children who crave sweets and chocolates. Eating a healthy diet – especially one rich in vitamin C and calcium – is also an effective way to practice good oral hygiene.
In addition to oral hygiene practices, aesthetic and corrective dental procedures, such as braces, veneers, crowns and dental implants are increasingly being used to correct misaligned, damaged, or missing teeth, with the aim of improving appearance and teeth function. However, these procedures are expensive and are generally considered elective rather than urgent healthcare needs.
Healthy living really starts from a healthy oral cavity – not just because we need it to eat and speak, but because it allows us to smile confidently and laugh freely, both of which express happiness.
