Preventing dental disease in London and its relation to tooth grinding

Let’s focus today on the three PRINCIPAL that are preventable or manageable dental diseases and next week, we will discuss other dental conditions that require treatment and may not be as predictable or preventable.

dental disease
Bruxism: neglected destructive dental condition

Of three dental diseases most common to man, two are a result of infection and one is caused by parafunction. The first two are obviously very well known:

Dental decay (caries) and Gum disease (gingivitis and periodontitis). These two conditions constitute almost all the reasons for treatment provided by most dentists to patients, both currently and historically.

The third is: Bruxism, known as night time tooth grinding. Bruxism is remarkably prevalent particularly in western society. It is probably the most neglected destructive dental condition often unrecognised both by the dental profession and patients themselves.

The first two conditions are totally preventable and the third is totally manageable.

Quite simply, dental decay and gum disease are both caused by poor oral hygiene resulting in the accumulation of plaque and tartar. Plaque contains ‘bad’ (destructive) bacteria that will eat into tooth enamel and dentine and/or cause gum inflammation and subsequently loss of jaw bone supporting the tooth roots. Left untreated, both will, of course, lead to tooth loss.

Simple, efficient and effective and continuous oral hygiene maintenance from a very early age can almost entirely prevent these conditions for life … not only resulting in a clean healthy, usually attractive mouth, with an absence of bad breath (halitosis), but a massive reduction in future invasive dental treatment.

Finally and so importantly, night-time tooth grinding (bruxism) is a very common self-damaging condition. Most often it has a strong genetic predisposing, exacerbated, commonly during periods of stress. It functions as aggressive strong sideways ‘gnashing and grinding of teeth’, during sleep. As a consequence, the enamel and subsequently the softer underlying dentine of the biting edges of the teeth chip, fracture and wear down excessively shortening the teeth. This starts at the upper and lower front, but then continues in the side and back teeth. Untreated, the result is not just loss of tooth substance but change in face shape and an unattractive, prematurely ‘aged’ smile!

The problem with this habit is that it is insidious, the individual may not even be aware they are doing it (unless brought to their attention by an observant dentist or sleeping partner). It is usually painless and relatively slowly, though persistently, progressive. So, most bruxers simply don’t take this condition seriously.

Many patients, even when made aware of it ignore dealing with the problem until it becomes very obvious and quite severe, usually in middle age, but not infrequently even in relatively early adulthood. But that time it is an extensive, difficult and expensive exercise to correct. If recognised and dealt with early, appropriately, the destructive consequences of this habit can be prevented.

The public need education of this condition, not the least because it is so common; unfortunately, so do many dentists themselves. It is simply not enough to ‘mention it’ or even prescribe a mouthguard that, in truth, 99% of patients won’t wear.

So there you are – almost all dental problems are entirely preventable, or at least more easily treatable if caught early; the earlier the better. It comes down to education … something the government via NHS dentistry seems to be woefully lacking in providing!

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