Preventive Dental Care

Comprehensive Dental Care.

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Preventive Dental Care

best dentist Queanbeyan CanberraDiseases of the oral tissues can be classified as those affecting soft tissues and those of the hard. The former include acute infectious diseases that can affect oral tissues such as Vincent’s angina (acute ulcerative gingivitis), and the more common and multi-factorial chronic condition classed as periodontal, or gum disease. Cancer of the tongue or other oral soft tissues also can occur, and there are a number of chronic conditions of relatively uncertain aetiology such as Lichen Planus, and those related to vitamin deficiency such as sore tongue.

The hard tissues in the mouth are the teeth and bones, and both can be damaged as a result of dental caries or decay. Bone can be lost from periodontal disease which can also cause loosening and eventual loss of teeth

Thus diseases in the mouth are mainly bacterial in origin although there are some conditions caused by viruses. Bacteria are ever present in our environment and indeed inside our very body. In terms of sheer numbers they are a more successful species on our planet than man himself. The bacteria normally present in the mouth and gut are termed commensals in that they do us no harm provided their numbers are kept within reasonable limits. They co-exist with us and are not considered inherently pathogenic.

It is however possible for the waste, or by-products, of many different types of bacteria, including commensals, to cause irritation of the delicate gum tissue around the necks of the teeth. The body’s response to continued irritation of this kind is inflammation which is part of the immune response and aims to combat the offending irritants. The fact is however that plaque forms very readily on our teeth as a thin mucilaginous film which attracts and holds millions of bacteria, and because these bacteria are in close contact with the tooth surface some can cause dental decay and others gum disease. The bacteria nearest the gum margin tend to cause almost continuous gum irritation unless they are adequately removed on an on-going basis, i.e. every day, and this is the purpose behind tooth brushing and flossing. Effective tooth brushing mechanically removes plaque from the surfaces of the teeth and keeps the bacterial population down to within limits which are hopefully insufficient to provoke an inflammatory response.

The risk of gum disease is ever present however, because if all plaque is not regularly and thoroughly removed then enough remains to cause an inflammatory response which tends to get gradually worse once the balance is tipped in favour of the bacteria. Periodontal, or gum disease is a chronic, slowly progressive disease, apart from the odd acute form, and it results in progressive loss of the supporting tissues, since although the body tries to combat the infection, it is subjected to constant and continuing irritation and is often therefore unable to prevent some gum damage from occurring. This is corroborated by the findings that people who have diabetes or a condition that undermines their immune system are more likely to suffer gum disease and to a more serious extent than those who are normally healthy. Smokers also often tend to have worse gum conditions because the blood flow to the gums may be restricted by constriction of small arteries resulting in less blood flow and thus a compromised capacity for repair.

When plaque is left in contact with teeth and gums over a period of time there is an inflammation of the superficial gum tissues with eventual damage that is progressive in nature. It begins with redness and slight swelling of the gingival margins, and then looseness of the gingival cuff around the neck of the teeth followed by gradual loss of periodontal fibres that leads to a pocket forming. Once periodontal disease has reached this stage it is often slightly faster in its progression because the pockets around the teeth are less easy to clean than the teeth surfaces themselves and the result is that food debris impacts here and remains in situ to harbour increasing numbers of bacterial pathogens, and also may encourage other more aggressive types as well since they are favoured by the relatively anaerobic conditions.

Loss of gum tissue is eventually superseded by loss of bone as well, and unless the whole vicious cycle is broken there follows gradual loosening of the teeth leading to their eventual loss.

All this can be prevented however, by careful thorough cleaning of all teeth surfaces each and every day so that there are insufficient bacteria present to cause gum irritation. 

Certain bacteria in plaque are responsible for dental decay by converting sugars in the mouth to acid which softens the enamel of teeth and allows other types of bacteria to penetrate the surface and destroy tooth substance. Effective regular oral hygiene therefore kills two birds with one stone by helping to prevent tooth decay and gum disease, and is thus the most important measure in helping you to keep your teeth for life. Because dental decay relies on the presence of sugar in the mouth the other important measure is to restrict the amount of sugary and starchy foods and sugary drinks you consume. Some drinks are also harmful to teeth because of their acidity which softens enamel and encourages abrasion and loss of tooth substance.

To recap then, the prime cause of oral disease of the teeth and gums is proliferation of many different types of bacteria and the essence of preventive care is to keep the numbers down to a minimum by daily effective brushing and flossing. Keeping plaque at bay is the key to keeping your teeth healthy.


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