Head of Department of Restorative Dentistry at the Obafemi Awolowo University (OAU) in Ile-Ife, Osun State, Prof. Adeyemi Olusile, tackles the question below:
I am a researcher on lifestye. I am researching into dental ailments in Nigeria and their causes. Can you help out?
-Inaolaji Ikupayida, 28 years old, Ogbomoso, Oyo State.
Dental ailments globally have remained the same throughout history. Besides, oral health problems require rudimentary treatments, which have been identified and described for thousands of years. And recently it has dawn on us that oral health is not just about the mouth but also the body. Oral health is a component of overall health, and as should not be taken in isolation from the rest of the body. Systematically, a person is not well if he has an oral problem. Let us look at nutrition as a relationship between oral hygiene and systemic health. Unhealthy habits, such as smoking, drinking and poor diet will lead to dental diseases, and consequently pain.
When you are in pain, you cannot eat and this will affect your nutrition. That is why the mouth is a mediator between the general health and systemic health. In the last decade or so, there has been an increase in the awareness of oral health; more teeth are preserved in the mouth.
To eradicate oral problems, education is important to preventing dental problems. Be educated on the health of your mouth, the health of your teeth and even before your kids teeth come out. You should see your dentist once in six month. You do not wait until you have a problem with your teeth and be sure that everything is fine. Like a relation of mine rightly said, our mouth is the gateway to the body. Poor oral health can lead to anaemia and other systemic diseases. We can diagnose them and nip them in the bud before they get out of hand.To further address the pressing oral health issues Pepsodent Triple Protection Toothpaste, a unique formulation that helps protect against cavities/tooth decay, stains and bad breath is recommended.
I will now identify the basic dental health problems in Nigeria, and their causes:
Periodontal diseases and tooth decay are said to be the most common diseases in the world, yet they are quite preventable because they are bacterial in origin; eliminate the bacteria and eliminate the diseases. Co-habiting with the teeth and the gums in every mouth are bacterial that easily exceed the number of people who live on earth – six billion. These bacteria are the culprit in tooth decay, periodontal diseases and dirty mouth or foul breath.
Periodontal disease or gum problems are wide spread and are the leading cause of tooth loss. In Nigeria, almost every teenager above 16 years has one form of periodontitis or the other. The disease include a wide range of inflammatory diseases of the tooth supporting tissues known as the periodontum. When it is limited to the gums, it is called gingivitis but when the deeper connective tissues and bones are also involved it becomes periodontitis.
Gingivitis is usually seen as swollen red and bleeding gums around the teeth, it heals with removal of the irritating dental plaque and good oral hygiene. Periodontitis when there is pocket formation can be arrested but often the lost tissues are difficult to restore. Left untreated, the disease lead to increase tooth movement, abscess or even tooth loss.
Aetiology
Direct causes: These include poor oral hygiene leading to accumulation of dental plaque and calculus, and traumatic occlusion.
Indirect factor: Malnutrition (deficiency of vitamins A and C, niacin and protein) is associated with a higher prevalence of periodontal diseases.
• Endocrine disturbances including physiological causes such as puberty, pregnancy, menopause, and pathological causes such as hyperthyroidism, hyperparathyroidism and diabetes may aggravate existing periodontal disease.
• Decreased immunity as in persons with HIV and those on immunosuppressive drugs.
• Blood disorders such as acute monocytic leukaemia and pernicious anaemia can lead to periodontal diseases.
• Malalignment of the teeth interferes with proper plaque control.
Tobacco smoking and chewing reduce tissue resistance and increase the susceptibility to periodontal diseases.
• An improper brushing technique, besides resulting in inadequate plaque removal, can also cause gingival recession.
• Drugs—certain drugs such as phenytoin sodium and nifedipine can cause gingival hyperplasia.
Distant causes. These include low socioeconomic and literacy level, difficult access to an oral health care facility, poor oral health awareness, and lack of oral health insurance. Stress is known to predispose to acute necrotizing ulcerative gingivitis.
Dental caries is the most common chronic disease on the planet. It is an infectious microbiological disease of the teeth that results in localized dissolution and destruction of the calcified tissues. It is the second most common cause of tooth loss and is found universally, irrespective of age, sex, caste, creed or geographic location. It is considered to be a disease of civilized society, related to lifestyle factors, but heredity also plays a role. In the late stages, it causes severe pain, is expensive to treat and leads to loss of precious man-hours. However, it is preventable to a certain extent.
Bad breath is often caused by a build up of bacteria in the mouth that causes inflammation and gives off noxious odours or gases that smell like sulphur- or worse.
Everybody has nasty breath at some point, like when you get out of bed in the morning.
There are no statistics on what percentage of the population has bad breath. That’s because studies usually rely on someone reporting whether or not they think they have bad breath and may not be accurate.
Several internal medical conditions also can cause your breath to go downhill fast. They include diabetes, liver disease, respiratory tract infections, and chronic bronchitis. But studies show that about 80 percent of bad breath comes from an oral source. For instance, cavities or gum disease can lead to bad breath, as can tonsils that have trapped food particles; cracked fillings, and less-than-clean dentures. One of the chief causes of bad breath, is untreated tooth decay. Even a small amount of dental decay can produce a foul odour.
Orofacial cancers are the sixth most common worldwide and they originate from the oral cavity and adjacent structures. In Nigeria, the prevalence may not be significantly more than in other parts of the world, being about 20 to 25 in 100,000. More worrisome is that orofacial cancers are not being presented until they become so massive that sugary become very difficult if not impossible. The consequent morbidity is high.
Direct causes: Tobacco, alcohol, bacterial infections such as syphilis and fungal plus viral infections; chronic irritation due to sharp teeth and faulty pros-thesis and exposure to radiation.
Indirect causes: Industrial pollution due to asbestos, lead; nutritional deficiencies such as those due to vitamins A, B complex, and iron deficiency
Distant causes: Low socioeconomic and literacy level; poor oral health awareness and poor access to oral health care facilities for prevention and early detection.
Dentofacial anomalies include hereditary, developmental and acquired malocclusion or malalignment of the teeth. Worldwide, the average prevalence of malocclusion in the 10 to 12 years’ age group is reported to be 30 percent to 35 per cent. Personally, I think this is as a result of evolutionary trend. The jaws are getting smaller and these small jaws cannot accommodate 32 teeth. The rest are semantics.
Direct causes:
•Heredity: Hereditary factors play an important role in conditions such as cleft lip and palate, facial asymmetries variations in tooth shape and size, deep bites, discre- pancies in jaw size.
• Congenital: These include cleft lip and palate, and syndromes associated with anomalies of craniofacial structures, cerebral palsy, torticollis, cleidocranial dysostosis, congenital syphilis, etc.
• Abnormal pressure habits and functional aberrations: These include abnormal suckling, thumb and finger sucking, tongue thrusting and sucking, lip and nail biting, mouth breathing, enlarged tonsils and adenoids, trauma and accidents.
• Local factors: These include abnormalities of number such as supernumerary and missing teeth, abnormalities of tooth size and shape, abnormal labial frenum causing spacing between the upper anterior teeth, premature tooth loss with drifting of the adjoining and opposite teeth, prolonged retention of the milk teeth, delayed eruption of the permanent teeth, abnormal eruptive path, dental caries, and improper dental restorations.
