Preventing Oral Health Problems

Poor oral health can undermine a person's self-image, make it hard to find a job, and contribute to inattention and lackluster performance in school. It can also cause discomfort, speech problems, malnutrition, or swallowing problems. A neglected infection or untreated oral cancer can even be fatal. Different groups of people have special dental health concerns:

Children

Early-childhood caries (ECC), or baby bottle syndrome, is a distinctive pattern of tooth decay caused by allowing a child to have a bottle containing anything other than water throughout the day or night after the teeth have erupted, which happens at about 4 months of age. Here are some tips for preventing ECC:

• Between meals, your child's bottle should contain nothing but water.
• Don't put your baby to sleep with a bottle. The milk or juice that pools in the mouth will bathe teeth in sugars on which bacteria feed. (Like the fructose in juice and soda, the lactose in milk is a sugar.)
• Before the teeth erupt, get your baby accustomed to regular oral care by wiping the gums twice a day with a clean, soft, thin cloth like a handkerchief.
• After the teeth erupt, switch to a baby toothbrush moistened with water. Don't use toothpaste until your child is old enough to spit it out. Swallowing toothpaste while the teeth are developing can cause fluorosis, a condition in which the teeth look mottled or grainy from absorbing too much fluoride.
• By the time your child is a year old, he or she should be weaned from the bottle. Introduce a valveless sippy cup. Let him or her use a spill-proof cup with a valve only after mastering the big-kid version.

Women

Women have different dental concerns during various life stages:

• Teenage years. When a young woman begins to menstruate, her periods may be accompanied by mouth sores (canker sores) or swollen gums.
• Early adulthood. Women of childbearing age have an additional reason to practice good oral hygiene: Periodontal disease increases the risk of preterm birth with low birthweight.
• Pregnancy. During pregnancy, a spike in progesterone and other hormones can upset the body's normal balance and cause gingivitis, too little or too much saliva, or benign tumorlike growths on the gums called granulomas. Frequent vomiting caused by morning sickness can encourage tooth decay. The best way to prevent these problems is to practice good oral hygiene. Consult your dentist or doctor for an accurate diagnosis of any nodules or other unusual symptoms.
• Menopause and postmenopause. When women reach menopause, estrogen deficiency puts them at risk for periodontal disease. Many also report burning mouth syndrome (BMS), a disorder characterized by an unpleasant tingling sensation occasionally associated with changes in taste perception. The condition is treated with medicated creams or lozenges or with oral medications.

Men

It's perhaps not shocking to learn that men treat their mouths the way they treat their bachelor pads—with infrequent cleanings. Studies show they brush less often than women and avoid the dentist for routine services, making an appointment only when something hurts. We’re generalizing, of course. But men lose more teeth by age 72 than women do, and they're more likely to develop oral cancer. Especially if you smoke or have diabetes, you should attend to your teeth at least as well as you look after your favorite set of tools. Think of good oral hygiene as manscaping for the mouth.

Senior Adults

It seems there's almost no part of the body that doesn't shrink, slide, weaken, or wither as we age. We may become less able to chew effectively, especially if we have missing teeth or ill-fitting dentures. We may take medications that cause dry mouth, called xerostomia (from the Greek words xero, meaning dry, and stoma, meaning mouth). This problem can cause trouble swallowing, which may lead to malnutrition. In addition, having a dry mouth can allow bacteria to build up, causing bad breath, gum disease, and infection. A quarter of adults ages 65 to 74 have periodontitis, often as a result of barriers to good oral hygiene, such as arthritis and memory impairment.

Residents of Long-term Care Facilities

Residents of long-term care facilities or other group homes include not only elderly adults, but also children and adults with physical or mental disabilities. They often depend on caregivers for proper oral hygiene. Sometimes such care is difficult to administer. The resident may become agitated if he or she misunderstands the caregiver's intent. In fact, aggression among residents of long-term care facilities is most likely to be displayed while personal care is being administered, such as when a caregiver is assisting with toothbrushing. As a result, oral care may be rushed or skipped altogether. Special measures, such as the use of physical restraints or medications, may be needed to discourage combativeness and allow the caregiver to proceed with the oral hygiene regimen.

People with HIV/AIDS

People with HIV/AIDS are vulnerable to opportunistic infections of the oral cavity. A fuzzy white patch on the tongue called hairy leukoplakia is sometimes the first indication of HIV infection. In addition, people with HIV/AIDS may develop other fungal infections of the mouth, such as histoplasmosis, aspergillosis, and oral candidiasis (commonly known as thrush).