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11th June 2018

If the ‘tooth’ be told…


Ouch! That felt very odd as I wince again! This has become an all too common sensation for me every time I eat or drink something cold. My wife says it’s because I don’t look after my teeth! Huh? Really? How is that I say?

I brush my teeth regularly twice a day and use mouthwash every day too. However, I must admit, it has been a long time since I paid a visit to my dentist or even followed my dentists’ advice to floss regularly. Oops! Looks like I’ll be making another trip to the dentist soon and I bet they’ll tell me off for not flossing.

Persuading the public to take oral health more seriously is no easy task given the costs associated with visiting a dentist. Research for ‘National Smile Month’ (14th May – 14th June) shows that a quarter of adults haven’t visited a dentist in the past 2 years. While a similar number only visit their dentist when they have a problem.

Structure of the Tooth:

The part of the tooth that can be seen above the gum line is called the crown. The protective outer layer is an extremely hard, shiny material called the enamel. Inside the enamel is the dentine layer, which is a softer, sensitive tissue and is yellow in colour.

At the centre of the tooth is the pulp, which contains blood vessels and nerves. It’s these nerve endings that send messages to the brain. Messages like whether something is hot or cold is being eaten or if there is tooth decay or damage. Teeth are surrounded by gums which lie on and cover the bones of the jaw and fit comfortably around the neck of the teeth.

Common Oral Health Conditions:
Tooth Decay -:

Toothache is often caused by decaying teeth and needs to be treated immediately before an abscess can develop. Initially the pain may be triggered by eating or drinking hot and cold foods and liquids. This discomfort may persist or become more constant. Depending on the severity, tooth decay may be treated with a filling or with root canal treatment followed by a crown

Bad Breath (Halitosis) -:

Bad breath, also called halitosis, can keep people from feeling confident in social situations and engaging in friendly conversation. In the clear majority of cases (over 60%), bad breath is caused by improper dental hygiene. This problem can be alleviated by keeping the teeth clear of bacteria and food particles. This can be achieved by brushing and flossing thoroughly, especially after meals.

Sensitive teeth -:

Sensitive teeth affect’s up to 3 in 10 people in the UK. The problem can occur at any time and can vary in intensity and duration. Normally, teeth are not sensitive, but when enamel is worn away or gums recede, the underlying layer of dentine can become exposed.

Sensitivity can be aggravated by hot, cold, sweet, or acidic food and drink, or even cold air coming into contact with the exposed nerve endings inside the teeth. This results in the sensation of a sudden sharp pain.

Gum disease (Gingivitis) -:

Gum disease is a very common condition where the gums can bleed, swell, and become sore or infected. It is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria. If the plaque is not removed from the teeth by brushing them, it builds up and causes gum irritation. This early stage of gum disease is known as gingivitis.

Most adults in the UK have gum disease to some degree and most people experience it at least once. If gingivitis isn't treated, a condition called Periodontitis can develop. This affects more tissues that support teeth and hold them in place.

Recommendations for care staff: (NICE Guidelines 2016)

Ensure care staff provide service users with daily support to meet their care needs and preferences, as set out in their personal care plan after their assessment. This should be aligned with the advice in the Delivering better oral health toolkit, including:

  • Brushing natural teeth at least twice a day with fluoride toothpaste
  • Providing daily oral care for full or partial dentures (such as brushing, removing food debris, and removing dentures overnight)
  • Using their choice of cleaning products for dentures if possible
  • Using their choice of toothbrush, either manual or electric/battery powered
  • Daily use of mouth care products prescribed by dental clinicians (for example, this may include a high fluoride toothpaste or a prescribed mouth rinse)
  • Daily use of any over-the-counter products preferred by residents if possible, such as particular mouth rinses or toothpastes; if the resident uses sugar-free gum, consider gum containing Xylitol.

Your local pharmacist will be able to provide over the counter support and advice on most of the common oral health conditions discussed earlier and will know when you should refer a service user to their dentist.

Right! Better call my dentist and make an appointment at once! I’d also better find my floss too and of course start flossing!

*All information is correct at the time of publishing

Topics: General

Hasnain Hassam

Pharmaceutical Specialist

Hasnain Hassam is a qualified pharmacist with over 23 years’ experience. He comes to QCS from a long career at The Boots Company, where he’s worked since he qualified. During his time at The Boots Company he has held several senior management roles including Area Pharmacy Manager, Healthcare Development Manager, and most recently Regional Care Services Pharmacist. Read more

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