Plaque & Gum Disease: Young Adults

This article, the third in the series, is written to help young adults understand dental diseases and the preventive actions they can take to minimise their experience of tooth decay and gum disease, by the proper way of controlling plaque.

What about using other mouthwashes?

There are many mouthwashes available in the supermarkets and pharmacies.  Unfortunately, it is very difficult to scientifically evaluate each one and compare one with another in any useful way.  In terms of effectiveness, it depends on what you want from a mouthwash.  Some are antibacterial, some are analgesic, some effervesce in a cleansing action, and others may be anti-inflammatory.

In many cases, it is assumed by patients that by using a mouthwash the plaque will be killed and that it assists in controlling plaque.  This is not entirely true.  The majority of the cleaning and antibacterial disruption is due only to the mechanical cleaning action of the filaments of a toothbrush used in an effective manner for sufficient time. There is no mouthwash that adequately controls plaque.

Often the manufacturer’s claims made advertising the effective antibacterial effect of their mouthwash are based on studies where the mouthwash was used in a bacterial culture dish in a laboratory where the bacteria are not covered by a protein matrix. This does not represent the true clinical situation in the mouth and hence, many mouthwashes have very limited antibacterial effect when used in the mouth. Few studies are conducted on the thick plaque as would be encountered in many patients, as the protein matrix of the plaque prevents the chemicals of the mouthwash from exerting the chemical damaging effects on the plaque bacteria.

What works as a mouthwash?

A very effective mouthwash is available containing an antibacterial agent calledChlorhexidine. This will have a very significant antibacterial effect, even in the mouth despite the presence of plaque matrix, and will slow the growth of bacterial plaque significantly.  Such mouthwashes include Savacol and Curasept.  Unfortunately, Chlorhexidine leads to staining of the teeth and tongue if it is used for around 2 weeks or more.  This disadvantage has been overcome by the manufacturers of Curasept. This mouthwash contains an anti-discolouration system allowing the mouthwash to be used for longer periods without staining.  Other side effects may include a sore mouth, burning sensation, increased formation of tartar (calculus), interference with taste and ulceration of oral soft tissues.

Listerine is a very commonly used mouthwash containing essential oils (Thymol, Eucalyptol, Menthol and Salicylate) that have some antibacterial effect and being carried in alcohol may to some degree penetrate into the plaque.  It has an effect of reducing bacterial activity and plaque mass and has some anti-inflammatory effect and antioxidant effect.   However, the effect on a mature plaque in the mouth environment is only adequate in conjunction with good tooth brushing for adequate time.

A number of other mouthwashes exist containing a number of chemicals and systems that all have differing effects and may have some benefit in different circumstances.

Plaque and gum disease

When the plaque bacteria metabolise food, chemicals are produced some of which are toxic to the oral soft tissues.  These chemicals include hydrogen sulphide, sulphur compounds, organic acids, and ammonia.  These toxic chemicals induce an inflammatory protective response in the adjacent gum tissues.  This inflammatory condition confined only to the gum tissue is referred to as gingivitis.  This may progress on to become a destructive inflammatory process that results in loss of the bone around the teeth.  This is then referred to as periodontitis (destructive gum disease). For more information on gum disease, refer to our website, Media Centre and click on Gum Disease to access several articles written for patients to provide detailed information and advice.

Wisdom teeth are frequently a problem

An additional problem many young adults face is infection around their wisdom teeth or crowding of the wisdom teeth referred to as impacted wisdom teeth.  This problem is common in young adults usually in the age range of 17-25 years.  For more information on wisdom teeth, refer to our website, Media Centre and click on Wisdom Teeth to access several articles written for patients to provide detailed information and advice.

The problems of reaching patients

The fact emergency dental treatment is still frequently necessary is proof there are a number of problems dental teams face in reaching all members of the community and providing sound, early preventive advice about dental disease.

There are still large numbers of Australians who are not aware of the underlying causes of dental decay and gum disease and appear not to have received sufficient dental preventive advice to promote the changes in oral hygiene measures and nutrition necessary to reduce their experience of dental decay or gum disease.

Dental preventive advice needs to be provided more often and more thoroughly to children and young adults at school and during later tertiary education.  Many young people appear to be unaware of the dental problems their diet will cause and the many preventive actions they can take themselves at no extra cost to them.

Failing to take easy preventive actions may result in:

• a lifetime of dental fillings
• ongoing replacement fillings due to failed restorations
• as fillings get bigger, teeth may die and become abscessed
• huge costs over a lifetime for dental treatment and re-treatment
• the experience of losing teeth later
• the reduced ability to eat the foods you enjoy
• the loss of self-esteem and confidence due to poor appearance
• the need to wear partial or even full dentures.

Nowadays many young adults are increasingly focused on their body image.  They attend gyms to take part in aerobics classes, “bootcamps”, and weight training, they use protein shakes, follow low “carb” or high protein diets, and yet we still we see dental disease because this part of their overall general health has been overlooked and has not received the priority it should in their health education.

These are the messages we need to be giving our young people in Australia to motivate change and influence our young adults to take preventive measures to avoid decay and gum disease.

The benefits of a dental hygienist

The best way to ensure the necessary standard of plaque removal is being achieved is to make an appointment with a dentist who works with a dental hygienist to arrange for a check up and then follow-up appointments with the hygienist who can teach the newest and most effective ways of achieving good cleaning of the teeth thereby preventing dental disease.

A dental hygienist is trained to:

• provide patients with clear explanations and sound cleaning techniques
• they also provide advice on nutritional changes that may help in reducing the quantity of plaque that build-up on teeth
• they are able to perform a detailed cleaning of the teeth above and below the gum margins to help to eliminate gum disease
• they can provide resin sealant on the teeth to prevent decay of the biting surface of some teeth
• they can apply high concentration fluoride gels and varnishes to teeth to repair early decay or prevent new decay.

Thank you for reading part three of our “Preventive dental information for young adults” blog. If you would like more information, or to make an appointment please contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812 or check: Dental Hygiene Therapy